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Landfills receive about 350 million tons of municipal solid wastes (MSWs) per year globally, including antibiotics and other coselecting agents that impact antimicrobial resistance (AMR). However, little is known about AMR in landfills, especially as a function of landfill ages. Here we quantified antibiotics, heavy metals, and AMR genes (ARGs) in refuse and leachates from landfills of different age (<3, 10, and >20 years). Antibiotics levels were consistently lower in refuse and leachates from older landfills, whereas ARG levels in leachates significantly increased with landfill age (One-way ANOVA, F = 10.8, P < 0.01). Heavy metals whose contents increased as landfills age (one-way ANOVA, F = 12.3, P < 0.01) were significantly correlated with elevated levels of ARGs (Mantel test, R = 0.66, P < 0.01) in leachates, which implies greater AMR exposure risks around older landfills. To further explain ARGs distributional mechanisms with age, microbial communities, mobile genetic elements (MGEs) and environmental factors were contrasted between refuse and leachate samples. Microbial communities in the refuse were closely correlated with ARG contents (Procrustes test; M2 = 0.37, R = 0.86, P < 0.001), whereas ARG in leachates were more associated with MGEs.

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OBJECTIVE: To master the epidemic situation and control effect of schistosomiasis in Yugan County, Jiangxi Province. METHODS: The data of the schistosomiasis prevalence in human and cattle as well as Oncomelania hupensis snail status were collected and the change trends were analyzed in Yugan County from 2008 to 2012. RESULTS: The schistosome infection rates of residents in Yugan County have declined every year since 2008, and currently, the prevalence of schistosomiasis was at a low level. No acute schistosomiasis case was found during the past 5 years. In 2012, the infection rate of bovine was above 1% in 88 endemic villages, and the area with schistosome infected snails was 10 hm2. CONCLUSION: In order to achieve the goal of schistosomiasis transmission control in the whole county in 2015, the comprehensive control measures based on infection source control should be strengthened.

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OBJECTIVE: Submandibular gland obstruction caused by foreign body is relatively uncommon. We discuss the diagnosis and management of foreign body-induced submandibular sialadenitis by an illustrative case report and review of the literature. STUDY DESIGN: We report a case of a patient who suffered from obstructive submandibular sialadenitis caused by an intraglandular fish bone, indicating the benefits of sialoendoscopy in diagnosis and treatment of such diseases. A search of the Medline database (from 1967 to February 2011) for foreign body-caused submandibular sialadenitis was performed. RESULTS: The clinical outcome was satisfactory during a 14 months' follow-up, with no evidence of recurrence. Literature review showed that obstructive submandibular sialadenitis originating from a foreign body is relatively rare, and successful removal of an intraglandular foreign body with gland preservation had never been reported before. CONCLUSIONS: Sialoendoscopy can be served as an organ-preserving approach for diagnosis and treatment of foreign body-induced obstructive salivary diseases.

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BACKGROUND: Seventeen million births occur in China each year. Neonatal mortality is the leading cause of under 5-year-old child deaths, and intrapartum-related injury accounts for much of mental retardation in young children. The Chinese Ministry of Health sought to improve infant and child survival through a nationwide initiative to have at least one person trained in neonatal resuscitation at every birth. The aim of the current study was to evaluate the impact of China Neonatal Resuscitation Program (NRP) on policy and infrastructure changes and its effectiveness in decreasing the incidence of mortality among newborn infants. METHODS: The Chinese NRP incorporated policy change, professional education, and creation of a sustainable health system infrastructure for resuscitation. Multidisciplinary teams from all 31 provinces and municipal states disseminated NRP in a train-the-trainer cascade. The intervention targeted 20 provinces with high neonatal mortality and programs to reduce maternal mortality. Program evaluation data came from 322 representative hospitals in those provinces. RESULTS: Changes in policy permitted midwives to initiate resuscitation and required resuscitation training for licensure. From 2004 through 2009 more than 110,659 professionals received NRP training in the 20 target provinces, with 94% of delivery facilities and 99% of counties reached. Intrapartum-related deaths in the delivery room decreased from 7.5 to 3.4 per 10,000 from 2003 to 2008, and the incidence of Apgar ≤ 7 at 1 minute decreased from 6.3% to 2.9%. CONCLUSIONS: The Chinese NRP achieved policy changes promoting resuscitation, trained large numbers of professionals, and contributed to reduction in delivery room mortality. Improved adherence to the resuscitation algorithm, extension of training to the township level, and coverage of births now occurring outside health facilities can further increase the number of lives saved.

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OBJECTIVE: To detect the change of nerve growth factor (NGF) level in human amniotic fluid during gestation, and to explore the relationship between this change and fetal ventriculomegaly (VM). METHODS: The studied subjects (collected from 2004 to 2007) were divided into four groups, including the second-trimester pregnancy group (n=113), third-trimester pregnancy group (n=110), fetal cerebral VM group (n=12), and healthy control group (n=12) which matched with the VM group in gestational weeks. The amniotic fluid specimens were obtained during amniocentesis or cesarean section. The NGF levels in amniotic fluid were detected with enzyme-linked immunosorbent assay. RESULTS: A significantly negative correlation was found between gestational age and the NGF level in amniotic fluid (r=−0.6149, P<0.0001). The NGF level in patients with fetal VM was significantly lower than that in healthy controls (33.95±29.24 pg/mL vs. 64.73±16.21 pg/mL, P=0.024). CONCLUSION: NGF levels in amniotic fluid may be a sensitive marker for fetal VM.

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OBJECTIVE: To determine clinical characteristics and perinatal outcomes of non-overweight/obese (pre-pregnancy body mass index BMI < 24 kg/m(2)) pregnant women with polycystic ovary syndrome (PCOS). METHODS: The screening of PCOS was performed when they were at first prenatal visit in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from May, 2008 to July, 2010.61 PCOS women of pregnancy women with BMI < 24 kg/m(2) were considered as the study subjects, and 122 pregnant women without PCOS matched by age and pre-pregnancy body mass index (BMI) were selected as the control ones. Patients with history of pre-pregnancy diabetes, hypertension, cardiovascular disease, renal diseases and multiple pregnancies were excluded from the study. We followed pregnancy outcomes of two groups until delivery. RESULTS: Significantly higher total cholesterol, triglycerides concentrations and low-density lipoprotein cholesterol concentrations were found in the PCOS group than in the controls. PCOS women with BMI < 24 kg/m(2) had significantly higher rates of GDM (27.9% (17/61)) and pre-eclampsia (13.1% (8/61)) compared with the controls (15.6% (19/122), 1.6% (2/122)), P < 0.05, < 0.01, respectively. No statistical significance was found in prevalence of pregnancy-induced hypertension, polyhydramnios, oligohydramnios, macrosomia, premature rupture of membranes, placental abruption, macrosomia, fetal death and neonatal congenital abnormality between the two groups (all P > 0.05). CONCLUSIONS: It is at increased risk of GDM and pre-eclampsia in non-overweight/obese PCOS women, this risk seemed to be due to PCOS itself rather than obesity.

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OBJECTIVE: To investigate the perinatal outcomes of twin-twin transfusion syndrome (TTTS) and the management. METHODS: During Nov 1, 2002 to Sep 30, 2005, 24 cases of TTTS in Beijing Obstetrics and Gynecology Hospital were analyzed. The outcomes of them were compared with the pregnancy without TTTS in all twins and in monozygotic twins. The outcomes of the blood-supplying fetus and the blood-recepter were compared. RESULTS: 6.8% cases had TTTS in all twins. The group of TTTS had more maternal, fetal and neonatal complications than twins pregnancy without TTTS: polyhydramnios [37.5% (9/24) vs 2.1% (7/328), P < 0.01], gestational hypertension [20.8% (5/24) vs 7.0% (23/328), P = 0.043], premature labor [66.7% (16/24) vs 36.3% (119/328), P = 0.003], perinatal dead fetus in uterus [18.8% (6/32) vs 1.1% (7/640), P < 0.01], neonatal asphyxia [73.1% (19/26) vs 3.0% (19/632), P < 0.01], the proportion of NICU [88.5% (23/26) vs 23.4% (148/632), P < 0.01], neonatal death [15.4% (4/26) vs 1.7% (11/632), P = 0.002] and the rate of perinatal mortality [31.2% (0/32) vs 2.8% (18/632)]. Compared with the monozygotic twins without TTTS, in TTTS group there were more complications of the mother, the fetus and the neonates: gestational hypertension [20.8% (5/24) vs 9.9% (14/142), P = 0.224], premature labor [66.7% (16/24) vs 49.3% (70/142), P = 0.115], perinatal dead fetus in uterus [18.8% (6/32) vs 0.7% (2/282), P < 0.01], neonatal asphyxia [73.1% (19/26) vs 3.9% (11/280), P < 0.01], the proportion of NICU [88.5% (23/26) vs 29.3% (82/280), P < 0.01], neonatal death [15.4% (4/26) vs 2.1% (6/280), P = 0.006] and the rate of perinatal mortality [31.3% (10/32) vs 3.2% (8/282)]. The perinatal outcomes were better in those cases that the grades of TTTS were below 3 in the first diagnosis. CONCLUSIONS: We should try to diagnose and treat TTTS as early as possible because the outcome is poor.

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Hypoxic-ischemic encephalopathy (HIE) is a common cause of neonatal encephalopathy and is one of the most important causes of neonatal death and disabilities, especially those infants with moderate to severe encephalopathy. However, the pathogenesis of HIE still remains unclear. The purpose of this study was to explore the dynamic changes in plasma neuropeptide Y (NPY) and neurotensin (NT) as well as their role in regulating cerebral hemodynamics in HIE patients. The plasma levels of NPY and NT in the umbilical artery and peripheral blood on the first, third, and seventh days after birth in 40 term infants with HIE and 40 healthy controls were measured using radioimmunoassay. On the first day of life, the blood samples were collected immediately when ultrasound examinations were finished. The ultrasound transducer was placed on the temporal fontanelle to detect the hemodynamic parameters of the middle cerebral artery, including peak systolic flow velocity, end-diastolic flow velocity, time-average mean velocity, pulsatility index, and resistance index (RI) in both groups were measured by pulse Doppler ultrasound in the first day after birth. The relationship between RI and NPY or NT was analyzed by linear regression analysis. NPY levels in umbilical blood ([mean +/- standard deviation] 615.5 +/- 130.7 ng/L) and first-day peripheral blood (355.9 +/- 57.4 ng/L) in neonates with HIE were significantly higher than those in normal newborns' blood (199.1 +/- 63.2 and 214.4 +/- 58.0 ng/L, respectively; P < 0.01). NPY levels in HIE neonates then declined to control levels on the third day after birth ( P > 0.05). However, the levels of plasma NT in umbilical blood and peripheral blood were much higher in the HIE group than those in normal newborns during the first week ( P < 0.01). The results of Doppler ultrasound examinations showed that cerebral blood flow velocity significantly decreased, whereas RI increased markedly in HIE patients compared with healthy controls ( P < 0.01). Linear regression analysis revealed that the RI was positively correlated with NPY levels ( R = 0.614; P < 0.01) and negatively correlated with NT levels ( R = -0.579; P < 0.01). The results of this study showed that there was a significant increase in plasma NPY and NT levels in HIE patients and this was strongly related to the severity of HIE, and the hemodynamic parameter RI was significantly correlated with NPY and NT. Therefore, we believe that the dynamic changes in plasma NPY or NT levels participate in the mechanisms of HIE by regulating cerebral hemodynamic changes after neonatal asphyxia occurs.

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This article investigates the value of early diagnosis and prognostic evaluation of Doppler ultrasound for neonatal hypoxic-ischemic encephalopathy (HIE). Study population included 40 term neonates with HIE and 30 healthy controls. Color Doppler ultrasound was performed at the bedside within 24 h after birth. The transducer was placed on the temporal fontanelle to detect the hemodynamic parameters of bilateral middle cerebral arteries. The results showed that infants with HIE had significant cerebral hemodynamic disturbance. The cerebral blood flow velocity decreased or increased markedly as resistive index (RI) decreased or increased markedly, which usually suggested the diagnosis of HIE, RI < 0.50 or RI > 0.90 usually occurred in severe patients, while RI > 1.0 would be associated with later brain death. So we believe that using Pulsed Doppler ultrasound to monitor the changes of cerebral hemodynamics can be used for the early diagnosis of HIE and help us to distinguish the grades of HIE.

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OBJECTIVE: To explore the effects of mild hypothermia on expression of N-methyl-D-aspartate receptor-1 (NMDAR1) in hippocampus neurons after cardiopulmonary resuscitation (CPR) in rats. METHODS: Twenty-four male SD rats were randomly divided into normal control group, normal temperature group, and mild hypothermia group, with 8 rats in each group. The cerebral edema model after CPR was replicated by the sealed bottle method in rats in both normal temperature group and mild hypothermia group. The rats in the mild hypothermia group were treated with mild hypothermia after the model was established. The change in expression of NMDAR1 in hippocampus neurons in rat was determined with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR), and pathologic changes in brain tissue were observed in both groups. RESULTS: The cerebral edema was ameliorated, NMDAR1 mRNA and protein in cerebral hippocampus neurons were significantly lower in hypothermia group than control group with significant difference (NMDAR1 mRNA: 80.48+/-0.03 vs. 80.64+/-0.18, P<0.05 ). CONCLUSION: Mild hypothermia can down regulate the expression of NMDAR1 mRNA and protein level, lower positive ion concentration and thus decrease cerebral edema, so mild hypothermia can serve as a treatment measure for cerebral edema after CPR.

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OBJECTIVE: To investigate the clinical significance and safety of liquid-based cytology (thinprep cytologic test, TCT) in pregnant women and cytological characteristics of the smears during pregnancy. METHODS: TCT were performed in 1951 pregnant women (group A), 3752 gynecological out-patients (group B) and 5069 routine screening women (group C). The age of the women was ranged from 20 to 39 years. The cytological preparations were analyzed using TCT method following the Bathesda system (TBS) standard. RESULTS: (1) The incidence of abnormal epithelial patterns in groups A, B and C was 23.58% (460/1951), 19.22% (721/3752) and 13.40% (679/5069) respectively (P < 0.01). (2) The incidence of infection in three groups was 19.02% (371/1951), 10.66% (400/3752) and 9.23% (468/5069) respectively (P < 0.05). (3) The incidence of cervical intraepithelial neoplasia (CIN) in three groups was 1.13%, 1.87% and 0.77% respectively. No significant difference was found between pregnant group (A) and non-pregnant group (B + C, P > 0.05). CONCLUSIONS: TCT smear screening is necessary, safe and acceptable for routine prenatal tests. There is no difference in the cervical squamous intraepithelial lesions between pregnant and non-pregnant women.

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OBJECTIVES: To provide a new, reliable noninvasive method for fetal sex determination. METHODS: Fetal sex was detected in 32 early pregnant women by identifying the amelogenin gene in maternal plasma using nested PCR analysis. First, the 122/128 bp of X-Y homologous region containing 6 bp deletions in the intron 3 of amelogenin gene in X chromosome was amplified, and then the nested PCR was carried out, whose 3' end of the upstream primer is just located in the deletion region. The fetus was male or female, depending on whether it had the 89-bp nested PCR product or not. RESULTS: The 89 bp of nested PCR product was detected in 19 plasma samples obtained from pregnant women, deducing they bear the male fetus and the remaining pregnant women bear female. When compared with the birth outcome, two samples were pseudo-positive. The coincidence was 93.8%. This method had high sensitivity that even trace amount of target fetal DNA (10 pg) could be detected. CONCLUSIONS: This conventional nested PCR analysis of amelogenin gene promises to be a reliable method for noninvasive fetal sex determination at early pregnancy using maternal plasma DNA.

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PURPOSE: Bladder carcinoma is the most common urological malignancy in China. Gene mutation may be one of causes of carcinogenesis in the cancer. We therefore investigated the mRNA expression of RTKN gene in clinic malignant bladder carcinoma and explored the relationship between the novel gene and the cancer. METHODS: Total RNA was extracted from 33 surgically resected specimens of bladder carcinoma and 19 specimens of tumor-free bladder tissues. After the optimal reverse-transcription polymerase chain reaction condition was established, the mRNA expression levels of the RTKN gene in the lesions and tumor-free bladder tissues were examined semiquantitatively, and the relationships between expression levels of RTKN and clinical pathological features were analyzed. RESULTS: The expression of RTKN gene mRNA in 33 human bladder carcinoma tissues was significantly higher than that in 19 human tumor-free bladder tissues (0.937+/-0.103 vs. 0.350+/-0.082). The average ratio of RTKN expression in neoplasms to that in tumor-free bladder tissues was 0.350+/-0.164. Based on this ratio the 33 patients were divided into three groups: a down-regulated expression group (n=2), an up-regulated expression group (n=22), and an unchanged group (n=9). Although the chi(2) test demonstrated a statistically nonsignificant differences in RTKN expression between tumor stages Ta, T(1), and T(2) overall in the 33 human bladder carcinoma, the t test showed that there were statistically significant differences between solitary and multiple tumors, between the paired group aged younger or older than 70 years in 27 de novo bladder carcinoma patients, and between the groups with tumor larger or smaller than 2.25 cm(3). CONCLUSIONS: These results suggest that the RTKN gene is involved in bladder carcinogenesis and progression in bladder carcinoma, indicating that RTKN gene could be a molecular target in cancer therapy.

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BACKGROUND: Studies showed that propentofylline enhances the action of adenosine and protects hippocampal neuronal damage against transient global cerebral ischaemia. Our study was to investigate the effect of propentofylline on hypoxic-ischaemic brain damage in neonatal rat. METHODS: Seven-day-old Wistar rats were subjected to unilateral common carotid artery ligation and hypoxia in oxygen 8 kPa for two hours at 37 degrees C. Propentofylline (10 mg/kg) was administered intraperitoneally one hour after hypoxia-ischaemia (treated group). Control group rats were received an equivalent volume of saline. The effects of propentofylline were assessed by observing the body mass gain, behavioural alteration and neurohistological changes. The rats were sacrificed at 72 hours after hypoxia-ischaemia, and the brain sections were examined after haematoxylin and eosin staining. RESULTS: The propentofylline-treated rats had better body mass gain and better behavioural response than the paired saline-controls did. In the control group, the rats either lost body mass or had little mass gain after the insult, their average body mass gain was 97.3% at 24 h, 100.3% at 48 h, and 114.1% at 72 h of recovery. In propentofylline-treated group, there was a significant improvement of body mass gain at 24 h (100.2%, P < 0.05) and 48 h (110.3%, P < 0.01) of recovery; the percentage of rats that performed well on behavioural test was significantly higher from 48 h to 72 h of recovery (P < 0.05); the incidence of severe brain damage to the cerebral cortex and dentate gyrus was significantly reduced in propentofylline-treated rats (cortex, 93% - 70.8%, P < 0.01; dentate gyrus 95% - 66.7%, P < 0.01) as compared with control rats. CONCLUSIONS: Administration of propentofylline 1 hour after hypoxia-ischaemia significantly attenuates brain damage in both the cerebral cortex and dentate gyrus, and also improves the body mass gain as well as behavioural disturbance in 7-day-old rats.

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