2021 Vol. 34, No. 2

2021, 34(2): 0-0.
2021, 34(2): 1-2.
Original Article
Effects of Outdoor Temperature on Blood Pressure in a Prospective Cohort of Northwest China
ZHENG Shan, WANG Min Zhen, CHENG Zhi Yuan, KANG Feng, NIE Yong Hong, MI Xiu Ying, LI Hai Yan, JIN Lan, ZHANG Ya Wei, BAI Ya Na
2021, 34(2): 89-100. doi: 10.3967/bes2021.014
  Objective  The relationship between outdoor temperature and blood pressure (BP) has been inconclusive. We analyzed data from a prospective cohort study in northwestern China to investigate the effect of outdoor temperature on BP and effect modification by season.  Methods  A total of 32,710 individuals who participated in both the baseline survey and the first follow-up in 2011–2015 were included in the study. A linear mixed-effect model and generalized additive mixed model (GAMM) were applied to estimate the association between outdoor temperature and BP after adjusting for confounding variables.  Results  The mean differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between summer and winter were 3.5 mmHg and 2.75 mmHg, respectively. After adjusting for individual characteristics, meteorological factors and air pollutants, a significant increase in SBP and DBP was observed for lag 06 day and lag 04 day, a 0.28 mmHg (95% CI: 0.27–0.30) per 1 °C decrease in average temperature for SBP and a 0.16 mmHg (95% CI: 0.15–0.17) per 1 °C decrease in average temperature for DBP, respectively. The effects of the average temperature on both SBP and DBP were stronger in summer than in other seasons. The effects of the average temperature on BP were also greater if individuals were older, male, overweight or obese, a smoker or drinker, or had cardiovascular diseases (CVDs), hypertension, and diabetes.  Conclusions  This study demonstrated a significant negative association between outdoor temperature and BP in a high-altitude environment of northwest China. Moreover, BP showed a significant seasonal variation. The association between BP and temperature differed by season and individuals’ demographic characteristics (age, gender, BMI), unhealthy behaviors (smoking and alcohol consumption), and chronic disease status (CVDs, hypertension, and diabetes).
The Association of Socioeconomic Status with the Burden of Cataract-related Blindness and the Effect of Ultraviolet Radiation Exposure: An Ecological Study
DENG Yan, YANG Dan, YU Jia Ming, XU Jing Xian, HUA Hui, CHEN Ren Tong, WANG Nan, OU Feng Rong, LIU Ru Xi, WU Bo, LIU Yang
2021, 34(2): 101-109. doi: 10.3967/bes2021.015
  Objective  To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability (YLD) rates and to determine whether ultraviolet radiation (UVR) levels modify the effect of socioeconomic status on this health burden.  Methods  National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease (GBD) study 2017. The human development index (HDI) from the Human Development Report was used as a measure of socioeconomic status. Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument (OMI) dataset of the National Aeronautics and Space Administration (NASA).   Results  Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95% confidence interval (CI): 60%–93%, P < 0.001] than countries with a low HDI; for high-HDI countries, the proportion was 76% (95% CI: 53%–88%, P < 0.001), and for medium-HDI countries, the proportion was 48% (95% CI: 15%–68%, P = 0.010; P for trend < 0.001). The interaction analysis showed that UVR exposure played an interactive role in the association between socioeconomic status and cataract blindness burden (P value for interaction = 0.047).   Conclusion  Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.
Effects of Toluene on the Development of the Inner Ear and Lateral Line Sensory System of Zebrafish
LI Xu Dong, TU Hong Wei, HU Ke Qi, LIU Yun Gang, MAO Li Na, WANG Feng Yan, QU Hong Ying, CHEN Qing
2021, 34(2): 110-118. doi: 10.3967/bes2021.016
  Objective  The aim of this study was to explore the ototoxicity of toluene in the early development of zebrafish embryos/larvae.  Methods  Zebrafish were utilized to explore the ototoxicity of toluene. Locomotion analysis, immunofluorescence, and qPCR were used to understand the phenotypes and molecular mechanisms of toluene ototoxicity.  Results  The results demonstrated that at 2 mmol/L, toluene induced zebrafish larvae death at 120 hours post fertilization (hpf) at a rate of 25.79% and inhibited the rate of hatching at 72 hpf. Furthermore, toluene exposure inhibited the distance travelled and average swimming velocity of zebrafish larvae while increasing the frequency of movements. As shown by fluorescence staining of hair cells, toluene inhibited the formation of lateral line neuromasts and middle line 1 (Ml1) neuromasts in 3 days post fertilization larvae in a concentration-dependent manner. Toluene altered the expression level of genes involved in ear development/function in zebrafish, among which the mRNA levels of cd164l2, tekt3, and pcsk5a were upregulated, while the level of otofb was downregulated, according to the qPCR results.  Conclusion  This study indicated that toluene may affect the development of both the inner ear and lateral line systems in zebrafish, while the lateral line system may be more sensitive to toluene than the inner ear.
Untreated Prior Pulmonary Tuberculosis Adversely Affects Pregnancy Outcomes in Infertile Women Undergoing in vitro Fertilization and Embryo Transfer: A Large Retrospective Cohort Study
GAI Xiao Yan, CHI Hong Bin, ZENG Lin, CAO Wen Li, CHEN Li Xue, ZHANG Chen, LU Ming, NING Lan Ding, CHANG Chun, ZHANG Wei Xia, LIU Ping, LI Rong, SUN Yong Chang, QIAO Jie
2021, 34(2): 130-138. doi: 10.3967/bes2021.019
  Objective  Prior pulmonary tuberculosis (PTB) on chest X-ray (CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer (IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.  Method  We conducted a retrospective cohort study of 14,254 infertile patients who had received IVF-ET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth, clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.  Results  The untreated PTB group had significantly lower clinical pregnancy (31.7% vs. 38.1%) and live birth (23.8% vs. 30.6%) rates than the non-PTB group (both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio (OR), 0.80; 95% confidence interval (CI), 0.66–0.98; P = 0.028] in all patients and for increased miscarriage (OR, 4.19; 95% CI, 1.69–10.39; P = 0.002) and decreased live birth (OR, 0.45; 95% CI, 0.24–0.83; P = 0.011) rates in patients with unexplained infertility.  Conclusions  Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.
Ezrin Promotes the Proliferation, Migration, and Invasion of Ovarian Cancer Cells
LI Mo Juan, XIONG Dan, HUANG Hao, WEN Zhong Yong
2021, 34(2): 139-151. doi: 10.3967/bes2021.020
  Objective  The underlying mechanism of Ezrin in ovarian cancer (OVCA) is far from being understood. Therefore, this study aimed to assess the role of Ezrin in OVCA cells (SKOV3 and CaOV3) and investigate the associated molecular mechanisms.  Methods  We performed Western blotting, reverse transcription-quantitative polymerase chain reaction, MTT, cell colony, cell wound healing, transwell migration and invasion, RhoA and Rac active pull down assays, and confocal immunofluorescence experiments to evaluate the functions and molecular mechanisms of Ezrin overexpression or knockdown in the proliferation and metastasis of OVCA cells.  Results  The ectopic expression of Ezrin significantly increased cell proliferation, invasiveness, and epithelial–mesenchymal transition (EMT) in OVCA cells. By contrast, the knockdown of endogenous Ezrin prevented OVCA cell proliferation, invasiveness, and EMT. Lastly, we observed that Ezrin can positively regulate the active forms of RhoA rather than Rac-1 in OVCA cells, thereby promoting robust stress fiber formation.  Conclusion  Our results indicated that Ezrin regulates OVCA cell proliferation and invasiveness by modulating EMT and induces actin stress fiber formation by regulating Rho-GTPase activity, which provides novel insights into the treatment of the OVCA.
Assessment of Prognostic Factors of Racial Disparities in Testicular Germ Cell Tumor Survival in the United States (1992–2015)
WU Jing, JI Yi Bing, TANG Bi Wei, BROWN Matthew, WANG Bao Hua, DU Chen Lei, DU Jian Shu, WANG Xue Mei, CAI Li Jun, WU Guo Yi, ZHOU Yan
2021, 34(2): 152-162. doi: 10.3967/bes2021.021
  Objective  Testicular germ cell tumors (TGCT) are the most common cancer among men aged 15 to 39 years. Previous studies have considered factors related to TGCT survival rate and race/ethnicity, but histological type of the diagnosed cancer has not yet been thoroughly assessed.  Methods  The data came from 42,854 eligible patients from 1992 to 2015 in the Surveillance Epidemiology and End Results 18. Frequencies and column percent by seminoma and nonseminoma subtypes were determined for each covariates. We used Cox proportional hazard regression to assess the impact of multiple factors on post-diagnostic mortality of TGCT.  Results  Black males were diagnosed at a later stage, more commonly with local or distant metastases. The incidence of TGCT in black non-seminoma tumors increased most significantly. The difference in survival rates between different ethnic and histological subtypes, overall survival (OS) in patients with non-seminoma was significantly worse than in patients with seminoma. The most important quantitative predictor of death was the stage at the time of diagnosis, and older diagnostic age is also important factor affecting mortality.  Conclusion  Histological type of testicular germ cell tumor is an important factor in determining the prognosis of testicular cancer in males of different ethnic groups.
Correlation of An Ultrasonic Scoring System and Intraoperative Blood Loss in Placenta Accreta Spectrum Disorders: A Retrospective Cohort Study
CHEN Lian, SHI Hui Feng, JIANG Hai, SHI Xiao Ming, WANG Yuan Yuan, ZHANG Ai Qing, CHONG Yi Wen, ZHAO Yang Yu
2021, 34(2): 163-169. doi: 10.3967/bes2021.022
  Objective  This study aims to investigate the correlation of an ultrasonic scoring system with intraoperative blood loss (IBL) in placenta accreta spectrum (PAS) disorders.  Methods  A retrospective cohort study was conducted between January 2015 and November 2019. Clinical data for patients with PAS have been obtained from medical records. Generalized additive models were used to explore the nonlinear relationships between ultrasonic scores and IBL. Logistic regressions were used to determine the differences in the risk of IBL ≥ 1,500 mL among groups with different ultrasonic scores.  Results  A total of 332 patients participated in the analysis. Generalized additive models showed a significant positive correlation between score and blood loss. The amount of IBL was increased due to the rise in the ultrasonic score. All cases were divided into three groups according to the scores (low score group: ≤ 6 points, n = 147; median score group: 7−9 points, n = 126; and high score group: ≥ 10 points, n = 59). Compared with the low score group, the high score group showed a higher risk of IBL ≥ 1,500 mL [odds ratio, 15.09; 95% confidence interval (3.85, 59.19); P ≤ 0.001] after a multivariable adjustment.  Conclusions  The risk of blood loss equal to or greater than 1,500 mL increases further when ultrasonic score greater than or equal to 10 points, the preparation for transfusion and referral mechanism should be considered.
Letter to the Editor
Stimulated Ag Nanoparticles by Pulsed Laser Ablation for Breast Cancer Treatment
WAN MOHD SHUKRI Wan Norsyuhada, BAKHTIAR Hazri, ISLAM Shumaila, BIDIN Noriah, BABA Sayang, HAMDAN Salehhuddin, CHE ABDULLAH Mohd Azahar
2021, 34(2): 119-123. doi: 10.3967/bes2021.017
Astragaloside IV Improves Angiogenesis and Promotes Wound Healing in Diabetic Rats via the Activation of the SUMOylation Pathway
WANG Bao Shen, MA Xiao Fang, ZHANG Chun Yan, LI Yan Xia, LIU Xiao Zhi, HU Chang Qing
2021, 34(2): 124-129. doi: 10.3967/bes2021.018
Polycystic Ovary Syndrome is not Associated with Offspring Birth Weight: A Mendelian Randomization Study
WU Peng Fei, LI Rui Zhuo, ZHANG Wan, SU Zhong Zhen, LIN Yu Hong
2021, 34(2): 170-174. doi: 10.3967/bes2021.023