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The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.
The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.
Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.
Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
The jungles of Linyun and Longlin Autonomous Prefecture, located in the heart of the southwestern Guangxi Zhuang Autonomous Region of China, are home to the oldest tea trees (Camellia sinensis) in the world. In the absence of regular annual rings, radiocarbon (14C) dating is one of the most powerful tools that can assist in the determination of the ages and growth rates of these plants. In this work, cores were extracted from large ancient tea trees in a central Longlin rain forest; extraction of carbon was performed with an automated sample preparation system. The 14C levels in the tree cores were measured using accelerator mass spectrometry (AMS) at the University of Tsukuba. These measurements indicated that contrary to conventional views, the ages of trees in these forests range up to ~700 years, and the growth rate of this species is notably slow, exhibiting a long-term radial growth rate of 0.039±0.006 cm/yr. It was demonstrated that 14C analyses provide accurate determination of ages and growth rates for subtropical wild tea trees.
The dipeptide dl-methionyl-dl-methionine (Met-Met) has extremely low water solubility and better absorption than other methionine sources (such as dl-methionine and l-methionine) available in the market. Therefore, six diets (D1, D2, D3, D4, D5 and D6) containing 0, 0·07, 0·15, 0·21, 0·28 and 0·38 % Met-Met were formulated to investigate the effects of Met-Met in juvenile Nile tilapia, Oreochromis niloticus (17 g initial body weight). The results indicated that percentage weight gain and specific growth rate of fish fed with D2 and D3 diets were higher than those fed with D1, D4–D6 diets. The levels of total essential amino acid in whole body of fish fed with D3 and D4 diets were significantly higher than those fed the D1 diet. Superoxide dismutase activity and malondialdehyde content have no significant difference in fish fed the diet with or without Met-Met supplementation. Majority of reads derived from the fish intestine belonged to members of Fusobacteria, followed by Bacteroidetes and Proteobacteria. Diversity of intestinal microbiota and total antioxidant capacity in fish fed with D3 diet was significantly higher than that of other groups. Based on the growth results, the authors conclude that the optimal level of Met is 0·61 % Met with the addition of 0·15 % Met-Met for grower-phase O. niloticus.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
Kaolinite can be used for many applications, including the underground storage of gases. Density functional theory was employed to investigate the adsorption of hydrogen molecules on the kaolinite (001) surface. The coverage dependence of the adsorption sites and energetics was studied systematically for a wide range of coverage, Θ (from 1/16 to 1 monolayer). The three-fold hollow site is the most stable, followed by the bridge, top-z and top sites. The adsorption energy of H2 decreased with increasing coverage, thus indicating the lower stability of surface adsorption due to the repulsion of neighbouring H2 molecules. The coverage has obvious effects on hydrogen adsorption. Other properties of the H2/kaolinite (001) system, including the lattice relaxation and changes of electronic density of states, were also studied and are discussed in detail.
To investigate the effects of heat stress on broiler metabolism, we assigned 144 broilers to normal control (NC), heat stress (HS) or pair-fed (PF) groups and then monitored the effects using growth performance, carcass characteristics, biochemical assays and GC-MS-based metabolomics. The up-regulation of cloacal temperature confirmed that our experiment was successful in inducing chronic heat stress. The average daily gain and average daily feed intake of the HS group were significantly lower than those of the NC group, by 28·76 and 18·42 %, respectively (P<0·001), whereas the feed:gain ratio was significantly higher, by 14·49 % (P=0·003), and heat stress also increased leg proportion (P=0·027) and intramuscular fat proportion (P<0·001) and decreased breast proportion (P=0·009). When comparing the HS and NC groups and HS and PF groups, our metabolomics approach identified seventy-eight and thirty-four metabolites, respectively, with significantly different levels (variable importance in the projection values >1 and P<0·05). The greater feed:gain ratio of the HS group was significantly positively correlated with the leg, abdominal fat, subcutaneous fat and intramuscular fat proportions and levels of some free amino acids (proline, l-cysteine, methionine and threonine) but was negatively correlated with breast proportion and levels of some NEFA (stearic acid, arachidonic acid, palmitic acid and oleic acid). These findings indicated that the heat-stressed broilers were in negative energy balance and unable to effectively mobilise fat, thereby resulting in protein decomposition, which subsequently affected growth performance and carcass characteristics.
In the light curves of some solar-type stars, both rotational modulation (caused by corotating bright or dark magnetic features) and flare phenomena can be seen simultaneously. Based on these light curve observations, the relation between stellar magnetic feature activity (reflected by the rotational modulation component of the light curves) and flare activity can be investigated. Here, we analyze the light curve data of a flare-abundant solar-type star, KIC 6034120, observed with Kepler space telescope, and describe magnetic feature activity property by fluctuation range of light curves and flare activity property by time occupation ratio of flares. Distinct phase difference between long-term magnetic feature activity and flare activity is found for this star, which indicates that the source regions of stellar flares (e.g., starspots) on this star do not dominate the rotational modulation of light curves, yet they might be related to a same stellar dynamo process.
Magnetic activity information is concealed in the shape of stellar light curves owing to the process of rotational modulation. We developed approaches to extract magnetic activity characteristics from stellar light curves, and applied the method to a solar-type star observed with Kepler space telescope and also to the Sun for comparison. The result reveals distinct magnetic activity discrepancies between the solar-type star and the Sun. (1) The light-curve periodicity of the solar-type star is generally stronger than that of the Sun. (2) For the solar-type star, when the range of light-curve fluctuation is larger, the periodicity is also higher; while for the Sun, only during the solar minima with minimal range of fluctuation, the light curves show some periodicity. We propose that on the solar-type star, it is the large-scale magnetic field that leads to the light curves with both high periodicity and large range of fluctuation.
According to the Institute of International Education, China has become a major receiving country of international students, like the United States, United Kingdom, Australia, and Canada. The rapid development of international education in China evidences a major progress in the infrastructure of Chinese higher education. While internationalization creates unprecedented opportunities for the knowledge economy in China, it simultaneously poses unparalleled challenges for Chinese higher education (An & Chiang, 2015) and one of these challenges is the medium of instruction (MOI). While English has been widely taught in China since 1978 (McArthur, 2005), it was not until the turn of the century that English was endorsed as the medium of instruction for the so-called Chinese-English bilingual education.
We analyzed birth order differences in means and variances of height and body mass index (BMI) in monozygotic (MZ) and dizygotic (DZ) twins from infancy to old age. The data were derived from the international CODATwins database. The total number of height and BMI measures from 0.5 to 79.5 years of age was 397,466. As expected, first-born twins had greater birth weight than second-born twins. With respect to height, first-born twins were slightly taller than second-born twins in childhood. After adjusting the results for birth weight, the birth order differences decreased and were no longer statistically significant. First-born twins had greater BMI than the second-born twins over childhood and adolescence. After adjusting the results for birth weight, birth order was still associated with BMI until 12 years of age. No interaction effect between birth order and zygosity was found. Only limited evidence was found that birth order influenced variances of height or BMI. The results were similar among boys and girls and also in MZ and DZ twins. Overall, the differences in height and BMI between first- and second-born twins were modest even in early childhood, while adjustment for birth weight reduced the birth order differences but did not remove them for BMI.
A large schizophrenia genome-wide association study (GWAS) and a
subsequent extensive replication study of individuals of European
ancestry identified eight new loci with genome-wide significance and
suggested that the MIR137-mediated pathway plays a role
in the predisposition for schizophrenia.
To validate the above findings in a Han Chinese population.
We analysed the single nucleotide polymorphisms (SNPs) in the newly
identified schizophrenia candidate loci and predicted
MIR137 target genes based on our published Han
Chinese populations (BIOX) GWAS data. We then analysed 18 SNPs from the
candidate regions in an independent cohort that consisted of 3585
patients with schizophrenia and 5496 controls of Han Chinese
We replicated the associations of five markers
(P<0.05), including three that were located in the
predicted MIR137 target genes. Two loci
(ITIH3/4: rs2239547, P
=1.17×10–10 and CALN1: rs2944829,
P=9.97×10–9) exhibited genome-wide
significance in the Han Chinese population.
The ITIH3/4 locus has been reported to be of genome-wide
significance in the European population. The successful replication of
this finding in a different ethnic group provides stronger evidence for
the association between schizophrenia and ITIH3/4. We
detected the first genome-wide significant association of schizophrenia
with CALN1, which is a predicted target of
MIR137, and thus provide new evidence for the
associations between MIR137 targets and
To evaluate vitamin D deficiency prevalence and risk factors among pregnant Chinese women.
A descriptive cross-sectional analysis.
China National Nutrition and Health Survey (CNNHS) 2010–2013.
A total of 1985 healthy pregnant women participated. Possible predictors of vitamin D deficiency were evaluated via multiple logistic regression analyses.
The median serum 25-hydroxyvitamin D level was 15·5 (interquartile range 11·9–20·0, range 3·0–51·5) ng/ml, with 74·9 (95 % CI 73·0, 76·7) % of participants being vitamin D deficient (25-hydroxyvitamin D <20 ng/ml). According to the multivariate logistic regression analyses, vitamin D deficiency was positively correlated with Hui ethnicity (P=0·016), lack of vitamin D supplement use (P=0·021) and low ambient UVB level (P<0·001). In the autumn months, vitamin D deficiency was related to Hui ethnicity (P=0·012) and low ambient UVB level (P<0·001). In the winter months, vitamin D deficiency was correlated with younger age (P=0·050), later gestational age (P=0·035), higher pre-pregnancy BMI (P=0·019), low ambient UVB level (P<0·001) and lack of vitamin D supplement use (P=0·007).
Vitamin D deficiency is prevalent among pregnant Chinese women. Residing in areas with low ambient UVB levels increases the risk of vitamin D deficiency, especially for women experiencing advanced stages of gestation, for younger pregnant women and for women of Hui ethnicity; therefore, vitamin D supplementation and sensible sun exposure should be encouraged, especially in the winter months. Further studies must determine optimal vitamin D intake and sun exposure levels for maintaining sufficient vitamin D levels in pregnant Chinese women.
A trend toward greater body size in dizygotic (DZ) than in monozygotic (MZ) twins has been suggested by some but not all studies, and this difference may also vary by age. We analyzed zygosity differences in mean values and variances of height and body mass index (BMI) among male and female twins from infancy to old age. Data were derived from an international database of 54 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins), and included 842,951 height and BMI measurements from twins aged 1 to 102 years. The results showed that DZ twins were consistently taller than MZ twins, with differences of up to 2.0 cm in childhood and adolescence and up to 0.9 cm in adulthood. Similarly, a greater mean BMI of up to 0.3 kg/m2 in childhood and adolescence and up to 0.2 kg/m2 in adulthood was observed in DZ twins, although the pattern was less consistent. DZ twins presented up to 1.7% greater height and 1.9% greater BMI than MZ twins; these percentage differences were largest in middle and late childhood and decreased with age in both sexes. The variance of height was similar in MZ and DZ twins at most ages. In contrast, the variance of BMI was significantly higher in DZ than in MZ twins, particularly in childhood. In conclusion, DZ twins were generally taller and had greater BMI than MZ twins, but the differences decreased with age in both sexes.
For over 100 years, the genetics of human anthropometric traits has attracted scientific interest. In particular, height and body mass index (BMI, calculated as kg/m2) have been under intensive genetic research. However, it is still largely unknown whether and how heritability estimates vary between human populations. Opportunities to address this question have increased recently because of the establishment of many new twin cohorts and the increasing accumulation of data in established twin cohorts. We started a new research project to analyze systematically (1) the variation of heritability estimates of height, BMI and their trajectories over the life course between birth cohorts, ethnicities and countries, and (2) to study the effects of birth-related factors, education and smoking on these anthropometric traits and whether these effects vary between twin cohorts. We identified 67 twin projects, including both monozygotic (MZ) and dizygotic (DZ) twins, using various sources. We asked for individual level data on height and weight including repeated measurements, birth related traits, background variables, education and smoking. By the end of 2014, 48 projects participated. Together, we have 893,458 height and weight measures (52% females) from 434,723 twin individuals, including 201,192 complete twin pairs (40% monozygotic, 40% same-sex dizygotic and 20% opposite-sex dizygotic) representing 22 countries. This project demonstrates that large-scale international twin studies are feasible and can promote the use of existing data for novel research purposes.
The aim of the present study was to investigate the prevalence of hyperhomocysteinaemia (HHCY; total plasma homocysteine (tHcy) concentration >15 μmol/l) and its major determinants in healthy Chinese northerners. A descriptive and cross-sectional study was conducted in Shaanxi Province, China. The study sample included 2645 participants (1042 men and 1603 women) aged >20 years. Demographic characteristics and lifestyle factors were assessed via questionnaire interviews and physical examination. Plasma levels of homocysteine and folate and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism were determined according to standard methods. The prevalence of HHCY was 67·7 % (81·4 % in men and 58·8 % in women). The geometric mean of tHcy concentration was 19·1 μmol/l. The OR of HHCY were 0·44 (95 % CI 0·34, 0·57) for women v. men; 1·95 (95 % CI 1·41, 2·70), 1·41 (95 % CI 1·05, 1·88) and 0·76 (95 % CI 0·64, 0·89) for participants with smoking and alcohol drinking cessation and improved physical activity levels, respectively; 0·25 (95 % CI 0·17, 0·38), 0·33 (95 % CI 0·22, 0·49) and 0·56 (95 % CI 0·36, 0·88) for participants with an education level of elementary school, secondary school and university v. illiterate, respectively; 1·41 (95 % CI 1·13, 1·75) and 3·05 (95 % CI 2·35, 3·97) for participants with CT and TT v. CC genotype at MTHFR 677C → T polymorphism, respectively. These results demonstrate that the prevalence of HHCY is considerably high in Chinese northerners, especially in TT subjects, suggesting that implementation of tHcy-lowering strategies, such as lifestyle changes, is necessary.
It is well established that estrogen and progesterone are critical endogenous hormones that are essential for implantation and pregnancy in females. However, the distribution of estrogen receptor α (ERα) and progesterone receptor (PR) in female reproductive tracts is elusive. Herein, we report that after serial treatments with pregnant mare's serum gonadotrophin (PMSG) with or without anti-PMSG (AP), mice could regulate the distribution of ERα and PR in the murine ovary, oviduct and uterus and the level of estradiol in serum. ERα and PR regulation by PMSG and anti-PMSG was estrous cycle-dependent and critical for promoting the embryo-implantation period. Furthermore, our results suggested that AP-42 h treatment is more effective than the other treatments. In contrast, other treatment groups also affected the distribution of ERα and PR in mouse reproductive tracts. Thus, we found that anti-PMSG has the potential to restore the distribution of ERα and PR, which could effectively reduce the negative impact of residual estrogen caused by the normal superovulation effect of PMSG in mice.
There is a limited understanding about the ecological mechanisms that enable certain plant species to become successful invaders of natural areas. This study was conducted to determine the soil and landscape characteristics that correlate with invasion of Chinese privet (CHP), and to develop a model to predict the probability of CHP invasion in Piedmont forests. A landscape ecosystem classification (LEC) system—based on the percentage of clay in the B horizon, depth to maximum clay (cm), exposure, terrain shape, and aspect (degrees)—was used to determine the soil moisture characteristics of invaded and uninvaded plots. Additional measurements included the cover classes of CHP and other species, litter depth (cm), slope (degrees), overstory basal area (m2 ha−1), and soil chemical properties. CHP invasion was negatively correlated with overstory basal area and slope and positively with litter depth and pH. A stepwise logistic regression model containing these four variables was highly sensitive, with an overall accuracy of 78%. Given the accuracy of this model, we propose that it can be used to calculate the probability of invasion in a given area, provided that some basic, readily obtainable site characteristics are known.
Systemic Fe overload can contribute to abnormal glucose metabolism and the onset of type 2 diabetes (T2D). Although hepcidin is the master regulator of systemic Fe homeostasis, few studies have systematically evaluated the associations of serum hepcidin concentrations with Fe metabolism parameters and risks for the development of T2D. In this regard, whether hepcidin concentrations are associated with T2D remains controversial. We measured serum hepcidin and ferritin concentrations in a case–control study of 1259 Han Chinese participants to evaluate the possible associations of serum hepcidin concentrations with Fe metabolism parameters and risks of T2D. Individuals with diabetes (n 555) and control participants (n 704) were recruited and serum hepcidin and ferritin concentrations were quantified. Additionally, selected biochemical and anthropometric variables were determined. A logistic regression analysis was performed to evaluate the association of serum hepcidin and ferritin concentrations with T2D. A linear regression analysis was used to test for associations between serum hepcidin and ferritin concentrations and a number of clinical, demographic and diabetes-associated variables. We found that serum hepcidin concentrations correlated with Hb and serum ferritin concentrations. No differences in hepcidin concentrations were found between the group with diabetes and the control group. Hepcidin concentrations were not significantly correlated with T2D risk factors. We also found that serum ferritin concentrations were elevated in individuals with diabetes and were positively correlated with both Hb concentrations and T2D risk factors. The present findings suggest that serum ferritin concentrations correlate with T2D risk factors, while serum hepcidin concentrations are positively associated with Hb and serum ferritin concentrations, but do not correlate with T2D.