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Chinese visceral adiposity index (CVAI) is a novel indicator of visceral obesity, but little is known about the association between CVAI and risk of hypertension. This study aimed to investigate the association of CVAI and its 6-year change with hypertension risk and compare the ability of CVAI and other obesity indices to predict hypertension based on the Rural Chinese Cohort Study. Study participants were randomly recruited by a cluster sampling procedure, and 10,304 participants ≥18 years were included. Modified Poisson regression was used to derive adjusted relative risks (RRs) and 95% confidence intervals (CIs). We identified 2,072 hypertension cases during a median of 6.03 years of follow-up. The RRs (95% CIs) for the highest versus lowest CVAI quartile were 1.29 (1.05-1.59) for men and 1.53 (1.22-1.91) for women. Per-standard deviation (SD) increase in CVAI associated with hypertension for both men (RR 1.09, 95% CI 1.02-1.16) and women (1.14, 1.06-1.22). Also, the area under the receiver operating characteristic curve value for hypertension was higher for CVAI than the four other obesity indices for both sexes (all P < 0.05). Finally, per-SD increase in CVAI change associated with hypertension for both men (RR 1.26, 95% CI 1.16-1.36) and women (1.23, 1.15-1.30). Similar results were observed in sensitivity analyses. CVAI and its 6-year change are positively associated with hypertension risk. CVAI has better performance in predicting hypertension than other visceral obesity indices for both sexes. The current findings suggest CVAI as a reliable and applicable predictor of hypertension in rural Chinese adults.
A recently developed pneumonia caused by SARS-CoV-2 has quickly spread across the world. Unfortunately, a simplified risk score that could easily be used in primary care or general practice settings has not been developed. The objective of this study is to identify a simplified risk score that could easily be used to quickly triage severe COVID-19 patients. All severe and critical adult patients with laboratory-confirmed COVID-19 on the West campus of Union Hospital, Wuhan, China, from 28 January 2020 to 29 February 2020 were included in this study. Clinical data and laboratory results were obtained. CURB-65 pneumonia score was calculated. Univariate logistic regressions were applied to explore risk factors associated with in-hospital death. We used the receiver operating characteristic curve and multivariate COX-PH model to analyse risk factors for in-hospital death. A total of 74 patients (31 died, 43 survived) were finally included in the study. We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (area under curve 0.81, 95% confidence interval (CI) 0.71–0.91). CURB-65 ⩾ 2 may serve as a cut-off value for prediction of in-hospital death in severe patients with COVID-19 (sensitivity 68%, specificity 81%, F1 score 0.7). CURB-65 (hazard ratio (HR) 1.61; 95% CI 1.05–2.46), LDH (HR 1.003; 95% CI 1.001–1.004) and albumin (HR 0.9; 95% CI 0.81–1) were risk factors for in-hospital death in severe patients with COVID-19. Our study indicates CURB-65 may serve as a useful prognostic marker in COVID-19 patients, which could be used to quickly triage severe patients in primary care or general practice settings.
Witherite originates from the biochemical sedimentation of barium in sea water. Due to the complexity of the metallogenic environment, witherite appears in many morphologies. However, the relationship between its diverse morphologies and its mineralisation environment is not well understood. In this paper, Ca2+, a common substitute for Ba2+, and mixed protein (egg white) were used to simulate the inorganic and organic environments of witherite mineralisation, respectively. Comparison of samples prepared under different conditions showed that Ca2+ and egg white have relatively independent regulatory effects on the mineralisation of witherite particles. Egg white primarily limits the growth of the nanocrystals, while Ca2+ directs their non-isodiametric growth. Results shows that Ca2+ is distributed along a gradient in nanocrystalline witherite particles, with the Ca2+ content being proportional to the diameter of the nanocrystals. The results of this study shed light on the different roles of organic matter and inorganic ions in the formation of witherite and offer insight into the genesis of its various morphologies.
This study aimed to gain insight into how adipose tissue of Tibetan sheep regulates energy homoeostasis to cope with low energy intake under the harsh environment of the Qinghai-Tibetan Plateau (QTP). We compared Tibetan and Small-tailed Han sheep (n 24 of each breed), all wethers and 1·5 years of age, which were each divided randomly into four groups and offered diets of different digestible energy (DE) densities: 8·21, 9·33, 10·45 and 11·57 MJ DE/kg DM. When the sheep lost body mass and were assumed to be in negative energy balance: (1) adipocyte diameter in subcutaneous adipose tissue was smaller and decreased to a greater extent in Tibetan than in Small-tailed Han sheep, but the opposite occurred in the visceral adipose tissue; (2) Tibetan sheep showed higher insulin receptor mRNA expression and lower concentrations of catabolic hormones than Small-tailed Han sheep and (3) Tibetan sheep had lower capacity for glucose and fatty acid uptake than Small-tailed Han sheep. Moreover, Tibetan sheep had lower AMPKα mRNA expression but higher mammalian target of rapamycin mRNA expression in the adipocytes than Small-tailed Han sheep. We concluded that Tibetan sheep had lower catabolism but higher anabolism in adipose tissue and reduced the capacity for glucose and fatty acid uptake to a greater extent than Small-tailed Han sheep to maintain energy homoeostasis when in negative energy balance. These responses provide Tibetan sheep with a high ability to cope with low energy intake and with the harsh environment of the QTP.
Cognitive dysfunction is a major component of schizophrenia, with deficits in executive function particularly pertinent to successful daily living and outcome.The objective of this study was to explore the long-time efficacy of Olanzapine in the treatment of cognitive control in schizophrenia.
36 cases of patients maintained treated with Olanzapine and 30 cases of patients treated with chlorpromazine were included in the 6 months follow-up study. Cognitive control was tested with Wisconsin card sorting test (WCST) and Trail Making.
At the time of 6 months，all the scores of total trial, sorts, perseverative errors and random errors on WCST and all target of Trail Making Test were significantly decreased in the two groups of patients (P<0.05 or P<0.01)；but the decreased rate of perseverative errors on WCST of Olanzapine group were significantly higher than that of chlopromazine group(P<0.01).
Olanzapine have a good efficacy in the long-time treatment of cognitive control in schizophrenia.
Most previous researches indicated that impaired inhibition to emotional stimuli could be one of the important cognitive characteristics of depression individuals. The antisaccade tasks which composed of prosaccade task (PS) and antisaccade task (AS) were often used to investigate response inhibition.
This study aimed to investigate the volition inhibition toward emotional stimuli in depressed mood undergraduates (DM).
Subjects were grouped as 21 DM and 25 non-depressed undergraduates (ND) on the Beck Depression Inventory and Self-rating Depression Scale. The antisaccade tasks were conducted to examine the inhibition abilities by varying the arousal level of volition (low and high) of the tasks, with happy, neutral and sad facial expressions as stimuli.
The results showed that at the low volition level in the AS condition, the correct saccade latency in the DM were significant slower than the ND; The DM had reliable higher direction error rates in response to emotional facial expressions, especially for sad expressions. However, all of the differences disappeared in the high volition level antisaccade tasks. The amplitude errors data were not influenced by emotional facial expressions, and there were no group differences across tasks.
These results indicated the DM showed slower speed of cognitive processing and impaired inhibition abilities toward emotional faces than the ND, particularly for sad faces, but these abilities will be repaired in the high arousal level of volition, which enlighten us that training the DM's volition level of inhibition could prove to be an effective strategy to alleviate depression.
To evaluate the efficacy and safety of venlafaxine HCL sustained release capsules in treatment of depression in adolescents.
A randomized，double blind and double dummy clinical trial enrolled 60 adolescents patients with depression, who were randomized 1:1 to administer venlafaxine HCL sustained release capsules 150 mg or fluoxetine 20 mg daily for 8 weeks．The efficacy of both treatment groups was evaluated based on the Hamilton Depression Scale and Clinical General Impression Scale pre- and post-treatment.
The scores of Hamilton Depression Scale at the end of therapy were significantly reduced compared with the baseline in both groups(P<0.01).The efficacy rate of venlafaxine HCL sustained release capsules versus fluoxetine treatment was 70.0％ and 65.5％, respectively;the P value showed no statistical difference(P>0.05).The common adverse reactions included dry mouth，insomnia，dizziness，and loss of appetite.
Venlafaxine HCL sustained release capsules is efective and safe agent for adolescents with major depression.
Current available antidepressants exhibit low remission rate with a long response lag time. Growing evidence has demonstrated acute sub-anesthetic dose of ketamine exerts rapid, robust, and lasting antidepressant effects. However, a long term use of ketamine tends to elicit its adverse reactions. The present study aimed to investigate the antidepressant-like effects of intermittent and consecutive administrations of ketamine on chronic unpredictable mild stress (CUMS) rats, and to determine whether ketamine can redeem the time lag for treatment response of classic antidepressants. The behavioral responses were assessed by the sucrose preference test, forced swimming test, and open field test. In the first stage of experiments, all the four treatment regimens of ketamine (10 mg/kg ip, once daily for 3 or 7 consecutive days, or once every 7 or 3 days, in a total 21 days) showed robust antidepressant-like effects, with no significant influence on locomotor activity and stereotype behavior in the CUMS rats. The intermittent administration regimens produced longer antidepressant-like effects than the consecutive administration regimens and the administration every 7 days presented similar antidepressant-like effects with less administration times compared with the administration every 3 days. In the second stage of experiments, the combination of ketamine (10 mg/kg ip, once every 7 days) and citalopram (20 mg/kg po, once daily) for 21 days caused more rapid and sustained antidepressant-like effects than citalopram administered alone. In summary, repeated sub-anesthestic doses of ketamine can redeem the time lag for the antidepressant-like effects of citalopram, suggesting the combination of ketamine and classic antidepressants is a promising regimen for depression with quick onset time and stable and lasting effects.
Wireless power transfer (WPT) has attracted attention from academia and industry in recent years. WPT has natural electrical isolation between primary and secondary side, which ensures safe charging in an underwater environment. This breakthrough technology greatly facilitates the deep-sea power transmission. However, at the current stage the transferred power and energy efficiency level are not up to that of the WPT system in the air. The major concerns include the attenuation is seawater, extreme temperature and pressure conditions, disturbance of ocean currents, and bio-security. Three questions are answered in this paper: first, the expressions of eddy current loss and attenuation of electromagnetic wave in seawater are unified, and the influence of seawater as transmission medium on the WPT system is discussed. Second, the evolution of electromagnetic coupling structure suitable for underwater applications is studied. Third, the loss and heating effects of an underwater WPT system and the corresponding bio-fouling phenomenon are investigated. The questions above were addressed through analysis of electrical properties, coupler structures, and bio-fouling effects of the underwater WPT system. This paper will facilitate the study and research on underwater WPT applications.
To improve the corrosion resistance and to increase the hardness of copper substrate in marine environment, the Cu-Ni/Ni-P composite coatings were prepared on the copper substrate using the galvanostatic electrolytic deposition method. The deposition current densities were explored to find the optimized deposition conditions for forming the composite coatings. Corrosion resistance properties were analyzed using the polarization curves and electrochemical impedance spectroscopy (EIS). Considering the corrosion resistance and hardness, the −20 mA/cm2 was selected to deposit Cu-Ni coatings on copper substrate and the −30 mA/cm2 was selected to deposit Ni-P coating on the Cu-Ni layer. The Cu-Ni/Ni-P composite coatings not only exhibited superior corrosion resistance compared to single Cu-Ni coating in 3.5 wt.% NaCl solution, but also showed much better mechanical properties than single Cu-Ni coating.
This study develops a Yb:KGW dual-crystal based regenerative amplifier. The thermal lensing and gain-narrowing effects are compensated by the dual-crystal configuration. Sub-nanojoule pulses are amplified to 1.5 mJ with 9 nm spectral bandwidth and 1 kHz repetition rate using chirped pulse amplification technology. Consequently, 1.2 mJ pulses with a pulse duration of 227 fs are obtained after compression. Thanks to the cavity design, the output laser was a near diffraction limited beam with M2 around 1.1. The amplifier has the potential to boost energy above 2 mJ after compression and act as a front end for a future kilohertz terawatt-class diode-pumped Yb:KGW laser system.
To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women.
A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range.
Pregnant women (n 1910) in 2017.
After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM (P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively.
Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.
The nutritional intake of Tibetan sheep on the harsh Qinghai–Tibetan Plateau is often under maintenance requirements, especially during the long, cold winter. However, they have adapted well and even thrive under these conditions. The aim of the present study was to gain insight into how the rumen epithelium of Tibetan sheep has adapted to the consumption of low-energy-level diets. For this purpose, we compared Tibetan and small-tailed Han sheep (n 24 of each breed, all wethers and 1·5 years of age), which were divided randomly into one of four groups and offered ad libitum diets of different digestible energy (DE) densities: 8·21, 9·33, 10·45 and 11·57 MJ DE/kg DM. The Tibetan sheep had higher rumen concentrations of total SCFA, acetate, butyrate and iso-acids but lower concentrations of propionate than small-tailed Han sheep. The Tibetan sheep had higher absorption capability of SCFA due to the greater absorption surface area and higher mRNA expression of the SCFA absorption relative genes than small-tailed Han sheep. For the metabolism of SCFA in the rumen epithelium, the small-tailed Han sheep showed higher utilisation of the ketogenesis pathway than Tibetan sheep; however, Tibetan sheep had greater regulation capacity in SCFA metabolism pathways. These differences between breeds allowed the Tibetan sheep to have greater capability of absorbing SCFA and better capacity to regulate the metabolism of SCFA, which would allow them to cope with low energy intake better than small-tailed Han sheep.
Metabolically healthy obesity refers to a subset of obese people with a normal metabolic profile. We aimed to explore the association between metabolically healthy and obesity status and risk of hypertension among Chinese adults from The Rural Chinese Cohort Study. This prospective cohort study enrolled 9137 Chinese adults without hypertension, type 2 diabetes or treatment for lipid abnormality at baseline (2007–2008) and followed up during 2013–2014. Modified Poisson regression models were used to examine the risk of hypertension by different metabolically healthy and obesity status, estimating relative risks (RR) and 95 % CI. During 6 years of follow-up, we identified 1734 new hypertension cases (721 men). After adjusting for age, sex, smoking and other confounding factors, risk of hypertension was increased with metabolically healthy general obesity (MHGO) defined by BMI (RR 1·75, 95 % CI 1·02, 3·00) and metabolically healthy abdominal obesity (MHAO) defined by waist circumference (RR 1·51, 95 % CI 1·12, 2·04) as compared with metabolically healthy non-obesity. The associations between metabolically healthy and obesity status and hypertension outcome were consistent after stratifying by sex, age, smoking, alcohol drinking and physical activity. Both MHGO and MHAO were associated with increased risk of hypertension. Obesity control programmes should be implemented to prevent or delay the development of hypertension in rural China.
To investigate the hypothesis that folic acid supplementation and dietary folate intake before conception and during pregnancy reduce the risk of small for gestational age (SGA) and to examine the joint effect of folic acid supplementation and dietary folate intake on the risk of SGA.
Participants were interviewed by trained study interviewers using a standardized and structured questionnaire. Information on birth outcomes and maternal complications was abstracted from medical records and dietary information was collected via a semi-quantitative FFQ before conception and during pregnancy.
A birth cohort data analysis using the 2010–2012 Gansu Provincial Maternity and Child Care Hospital.
Women (n 8758) and their children enrolled in the study.
Folic acid supplementation was associated with a reduced risk of SGA (OR = 0·72, 95 % CI 0·60, 0·86), with the reduced risk seen mainly for SGA at ≥37 weeks of gestational age (OR = 0·70, 95 % CI 0·58, 0·85) and nulliparous SGA (OR = 0·67, 95 % CI 0·54, 0·84). There was no significant association between dietary folate intake and SGA risk.
Our study suggested that folic acid supplementation was associated with a reduced risk of SGA and the risk varied by preterm status and parity.
Echinococcus granulosus sensu stricto (s.s.), Echinococcus multilocularis and Echinococcus canadensis are the common causes of human echinococcosis in China. An accurate species identification tool for human echinococcosis is needed as the treatments and prognosis are different among species. The present work demonstrates a method for the simultaneous detection of these three Echinococcus species based on multiplex polymerase chain reaction (mPCR). Specific primers of this mPCR were designed based on the mitochondrial genes and determined by extensive tests. The method can successfully detect either separated or mixed target species, and generate expected amplicons of distinct size for each species. Sensitivity of the method was tested by serially diluted DNA, showing a detection threshold as less as 0.32 pg for both E. granulosus s.s. and E. canadensis, and 1.6 pg for E. multilocularis. Specificity assessed against 18 other parasites was found to be 100% except weakly cross-react with E. shiquicus. The assay was additionally applied to 69 echinococcosis patients and 38 healthy persons, confirming the high reliability of the method. Thus, the mPCR described here has high application potential for clinical identification purposes, and can further provide a useful tool for evaluation of serology and imaging method.
Computerized cognitive remediation therapy (CCRT) is generally effective for the cognitive deficits of schizophrenia. However, there is much uncertainty about what factors mediate or moderate effectiveness and are therefore important to personalize treatment and boost its effects.
In total, 311 Chinese inpatients with Diagnostic and Statistical Manual of Mental Disorders-IV schizophrenia were randomized to receive CCRT or Active control for 12 weeks with four to five sessions per week. All participants were assessed at baseline, post-treatment and 3-month follow-up. The outcomes were cognition, clinical symptoms and functional outcomes.
There was a significant benefit in the MATRICS Consensus Cognitive Battery (MCCB) total score for CCRT (F1,258 = 5.62; p = 0.02; effect size was 0.27, 95% confidence interval 0.04–0.49). There were no specific moderators of CCRT improvements. However, across both groups, Wisconsin Card Sort Test improvement mediated a positive effect on functional capacity and Digit Span benefit mediated decreases in positive symptoms. In exploratory analyses younger and older participants showed cognitive improvements but on different tests (younger on Symbol Coding Test, while older on the Spatial Span Test). Only the older age group showed MSCEIT benefits at post-treatment. In addition, cognition at baseline negatively correlated with cognitive improvement and those whose MCCB baseline total score was around 31 seem to derive the most benefit.
CCRT can improve the cognitive function of patients with schizophrenia. Changes in cognitive outcomes also contributed to improvements in functional outcomes either directly or solely in the context of CCRT. Age and the basic cognitive level of the participants seem to affect the cognitive benefits from CCRT.
Estimating the feed intake of grazing herbivores is critical for determining their nutrition, overall productivity and utilization of grassland resources. A 17-day indoor feeding experiment was conducted to evaluate the potential use of Medicago sativa as a natural supplement for estimating the total feed intake of sheep. A total of 16 sheep were randomly assigned to four diets (four sheep per diet) containing a known amount of M. sativa together with up to seven forages common to typical steppes. The diets were: diet 1, M. sativa + Leymus chinensis + Puccinellia distans; diet 2, species in diet 1 + Phragmites australis; diet 3, species in diet 2 + Chenopodium album + Elymus sibiricus; and diet 4, species in diet 3 + Artemisia scoparia + Artemisia tanacetifolia. After faecal marker concentrations were corrected by individual sheep recovery, treatment mean recovery or overall recovery, the proportions of M. sativa and other dietary forages were estimated from a combination of alkanes and long-chain alcohols using a least-square procedure. Total intake was the ratio of the known intake of M. sativa to its estimated dietary proportion. Each dietary component intake was obtained using total intake and the corresponding dietary proportions. The estimated values were compared with actual values to assess the estimation accuracy. The results showed that M. sativa exhibited a distinguishable marker pattern in comparison to the other dietary forage species. The accuracy of the dietary composition estimates was significantly (P < 0.001) affected by both diet diversity and the faecal recovery method. The proportion of M. sativa and total intake across all diets could be accurately estimated using the individual sheep or the treatment mean recovery methods. The largest differences between the estimated and observed total intake were 2.6 g and 19.2 g, respectively, representing only 0.4% and 2.6% of the total intake. However, they were significantly (P < 0.05) biased for most diets when using the overall recovery method. Due to the difficulty in obtaining individual sheep recovery under field conditions, treatment mean recovery is recommended. This study suggests that M. sativa, a natural roughage instead of a labelled concentrate, can be utilized as a dietary supplement to accurately estimate the total feed intake of sheep indoors and further indicates that it has potential to be used in steppe grassland of northern China, where the marker patterns of M. sativa differ markedly from commonly occurring plant species.
Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
The third generation of the BeiDou navigation satellite system (BDS-3) is a global navigation system, and is expected to be in full operation by 2020. High-precision orbits are a precondition for BDS-3 to provide a highly accurate service, which needs a global tracking and monitoring capability for the operational satellites. However, it is difficult for BDS to construct global ground monitoring stations. Fortunately, Ka-band Inter-Satellite Link (ISL) antennae fitted to the BDS-3 satellites can be used to extend the visible arc of the Medium Earth Orbit (MEO) satellites and to enhance the ground stations for orbit determination. This paper analyses the ISL-enhanced orbit determination for eight BDS-3 satellites, using the data from ten Chinese domestic stations and 13 international Global Navigation Satellite System (GNSS) Monitoring and Assessment System (iGMAS) overseas stations. The results show that the Three-Dimensional (3D) position Root Mean Square (RMS) error of the Overlapping Orbit Differences (OODs) is approximately 1 m when only ten regional stations are used. When the ISL measurements are added, the 3D position RMS error is decreased to 0·5 m, and the accuracy of the 24-hour orbit prediction can also be improved from 2 m to 0·7 m, which is even better than that of the orbits determined using globally distributed stations. It can be expected that with the subsequent launch of BDS-3 satellites and the increasing number of ISLs, the advantage of the ISL enhanced orbit determination will become more significant.