Objective This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease (CKD) in Shanghai community residents.Methods We used data from a cohort study of community residents who participated in three examinations in 2008, 2009, and 2013, respectively. Fasting plasma glucose (FPG) level, blood pressure (BP), and lipid levels were determined in 2,109 participants at all three visits, and CKD was evaluated between the second and the third visits. Visit-to-visit variabilities in metabolic factors were described by coefficients of variation (CV) at three visits. A variability score was calculated by adding the numbers of metabolic factors with a high variability defined as the highest quartile of CV. CKD was defined as the estimated glomerular filtration rate < 60 mL/min per 1.73 m2 or urinary albumin-to-creatinine ratio ≥ 30 mg/g.Results A total of 200 (9.5%) participants had CKD at the third visit. Compared with the lowest quartile of CV, the highest quartile was associated with a 70% increased risk of CKD for FPG [odds ratio, OR = 1.70; 95% confidence interval (CI) 1.06–2.72], 62% for systolic BP (OR = 1.62, 95% CI 1.04–2.50), and 85% for low-density lipoprotein cholesterol (OR = 1.85, 95% CI 1.23–2.80). Furthermore, the risk of CKD increased significantly with an increasing variability score. Compared with participants with score 0, participants with scores of 1, 2, and 3 were associated with 58% (OR = 1.58, 95% CI 1.08–2.32), 121% (OR = 2.21, 95% CI 1.40–3.49), and 548% (OR = 6.48, 95% CI 3.18–13.21) higher risks of CKD, respectively.Conclusion The visit-to-visit variabilities in metabolic factors were significantly associated with the risks of CKD in Shanghai community residents.
Objective This study aimed to evaluate the epidemiological, clinical and mycological characteristics of invasive candidiasis (IC) in China. Methods A ten-year retrospective study including 183 IC episodes was conducted in a tertiary hospital in Beijing, China. Results The overall incidence of IC from 2010–2019 was 0.261 episodes per 1,000 discharges. Candidemia (71.0%) was the major infective pattern; 70.3% of the patients tested positive for Candida spp. colonization before IC and the median time to develop an invasive infection after colonization was 13.5 days (interquartile range: 4.5–37.0 days). Candida albicans (45.8%) was the most prevalent species, followed by Candida parapsilosis (19.5%), Candida glabrata (14.2%) and Candida tropicalis (13.7%). C. non-albicans IC was more common in patients with severe anemia (P = 0.018), long-term hospitalization (P = 0.015), hematologic malignancies (P = 0.002), continuous administration of broad-spectrum antibiotics (P < 0.001) and mechanical ventilation (P = 0.012). In vitro resistance testing showed that 11.0% of the Candida isolates were resistant/non-wild type (non-WT) to fluconazole, followed by voriconazole (9.6%), micafungin (3.8%), and caspofungin (2.9%). Fluconazole was the most commonly used drug to initiate antifungal therapy both before and after the proven diagnosis (52.6% and 54.6%, respectively). The 30-day and 90-day all-cause mortality rates were 24.5% and 32.7%, respectively. Conclusion The incidence of IC has declined in the recent five years. C. non-albicans contributed to more than half of the IC cases. Fluconazole can be used as first-line therapy if resistant strains are not prevalent. Prospective, multi-center surveillance of the clinical and mycological characteristics of IC is required.
Objective The expression patterns of ribosomal large subunit protein 23a (RPL23a) in mouse testes and GC-1 cells were analyzed to investigate the potential relationship between RPL23a expression and spermatogonia apoptosis upon exposure to X-ray. Methods Male mice and GC-1 cells were irradiated with X-ray, terminal dUTP nick end-labelling (TUNEL) was performed to detect apoptotic spermatogonia in vivo. Apoptotic rate and cell cycle phase of GC-1 cells were analyzed with flow cytometry. Protein interactions were detected by Immunoprecipitation and protein localization as studied by immunofluorescence. Immunoblotting and real-time PCR were applied to analyze to protein and gene expression. Results Ionizing radiation (IR) increased spermatogonia apoptosis, the expression of RPL11, MDM2 and p53, and decreased RPL23a expression in mice spermatogonia in vivo and in vitro. RPL23a knockdown weakened the interaction between RPL23a and RPL11, leading to p53 accumulation. Moreover, knockdown and IR decreased RPL23a that induces spermatogonia apoptosis via RPL23a-RPL11-MDM2-p53 pathway in GC-1 cells. Conclusion These results suggested that IR reduced RPL23a expression, leading to weakened the RPL23a-RPL11 interactions, which may have activated p53, resulting in spermatogonia apoptosis. These results provide insights into environmental and clinical risks of radiotherapy following exposure to IR in male fertility. The graphical abstract was available in the web of www.besjournal.com.
Objective The study aims to predict 10-year cardiovascular disease (CVD) risk and explore its association with sleep duration among Chinese urban adults.Methods We analyzed part of the baseline data of a cohort that recruited adults for health screening by cluster sampling. The simplified Pittsburgh Sleep Quality Index (PSQI) and Framingham 10-year risk score (FRS) were used to measure sleep duration and CVD risk. Demographic characteristics, personal history of chronic diseases, lifestyle factors were collected using a questionnaire. Height, weight, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were also measured. Multiple logistic regression models were performed to explore the association of sleep duration with the predicted CVD risk.Results We included 31, 135 participants (median age 44 years, 53.02% males) free of CVD, cerebral stroke, and not taking lipid-lowering agents. Overall, 14.05%, and 25.55% of participants were at medium and high predicted CVD risk, respectively. Short sleep was independently associated with increased odds of medium to high risk of predicted 10-year CVD among males (OR = 1.10; 95% CI: 1.01–1.19) and increased odds of medium to high and high risk of predicted 10-year CVD among females (OR = 1.23; 95% CI: 1.08–1.40; OR = 1.27; 95% CI: 1.11–1.44). In contrast, long sleep had no association with cardiovascular risk.Conclusion A substantial number of adults free of CVD were at high 10-year CVD risk. Short sleep was associated with increased odds of predicted CVD risk.
Thalassemia is a group of genetically heterogeneous diseases characterized by hemolytic anemia. To investigate molecular characteristics of α- and β-thalassemia among young individuals of marriageable age in Guangdong Province, 24,788 subjects with suspected thalassemia were genetically tested for α- and β-thalassemia by Gap-PCR and reverse dot blot during 2018–2019. For suspected rare thalassemia cases, DNA sequencing was performed to identify rare and unknown thalassemia gene mutations. A total of 14,346 thalassemia carriers were detected, including 7,556 cases of α-thalassemia with 25 genotypes and 8 α-gene mutations identified, 5,860 cases of β-thalassemia with 18 genotypes and 18 β-gene mutations identified, and 930 cases of compound α/β-thalassemia. Among them, the frequency of --SEA deletion was the highest in α-thalassemia (66.01%), followed by -α3.7 (17.98%) and -α4.2 (8.22%), and the frequency of CD41-42 (-TCTT) mutation was the highest in β-thalassemia (38.38%), followed by IVS-II-654 (C > T) (25.67%), -28 (A > G) (15.76%), and CD17 (10.01%). In addition, 5 rare mutations (--THAI and HKαα, CD113, -90, and CD56) were found in the study population. Our results revealed molecular epidemiological background of α- and β-thalassemia in Guangdong Province, which can support optimization of thalassemia prevention and control strategies. We demonstrated that thalassemia is heterogeneous with significant geographical differences and population specificity.