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Huang Z, Shen M, Luo D, Huang X, Shu Z, Lu Y, Quan J, Duan Y, Xiao Y, Xiao S, He M, Zhang Y, Fan G, Wu T, Yuan H, Chen X. Cohort Profile: The Hunan Cohort of residents exposed to heavy metals. Int J Epidemiol 2024; 54:dyae148. [PMID: 39690522 DOI: 10.1093/ije/dyae148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 11/28/2024] [Indexed: 12/19/2024] Open
Affiliation(s)
- Zhijun Huang
- Center for Clinical Pharmacology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Furong Laboratory, Changsha, Hunan, China
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Minxue Shen
- Furong Laboratory, Changsha, Hunan, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dan Luo
- Furong Laboratory, Changsha, Hunan, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Xiaoyan Huang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhihao Shu
- Center for Clinical Pharmacology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yao Lu
- Center for Clinical Pharmacology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Furong Laboratory, Changsha, Hunan, China
| | - Jingjing Quan
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanying Duan
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yi Xiao
- Furong Laboratory, Changsha, Hunan, China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Meian He
- Department of Environmental and Occupational Health, Tongji School of Public Health, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yirui Zhang
- Hunan Prevention and Treatment Center for Occupational Disease, Changsha, Hunan, China
| | - Guangqin Fan
- Department of Occupational Health and Toxicology, School of Public Health, Nanchang University, Nanchang, Jiangxi, China
| | - Tangchun Wu
- Department of Environmental and Occupational Health, Tongji School of Public Health, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hong Yuan
- Center for Clinical Pharmacology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Furong Laboratory, Changsha, Hunan, China
| | - Xiang Chen
- Furong Laboratory, Changsha, Hunan, China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Liu ST, Xia XY, Song ZC, Hu JJ, Zhao W. Needs for discharge planning and facilitators-barriers to implementing discharge plans for patients with SLE: A qualitative study. Lupus 2024; 33:1466-1475. [PMID: 39305474 DOI: 10.1177/09612033241286991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2024]
Abstract
OBJECTIVE To investigate the needs of patients with SLE in terms of discharge planning, to outline the practical perspectives of clinical healthcare professionals regarding the enablers and impediments to SLE patients' discharge planning, and to establish a basis for the creation of SLE discharge plans for subsequently diagnosed patients. METHODS Descriptive qualitative research methodology was used in this study, with the researcher herself as the research instrument. Healthcare professionals formally employed in the rheumatology and immunology department, as well as SLE patients admitted to a tertiary-level hospital in Anhui Province between August and December 2023, were chosen for the study using a purposeful sample technique. In-person, semi-structured in-depth interviews were carried out, and used thematic analysis to analyze the interview data and distil themes. RESULT A total of 17 patients and 13 healthcare professionals were interviewed. Five themes and sixteen sub-themes in all were extracted: ①the needs of SLE patients for discharge planning; ②the present state of discharge planning implementation; ③factors conducive to the implementation of discharge planning; ④factors hindering the implementation of discharge planning; ⑤recommendations for implementing of discharge planning. CONCLUSION Planning for the discharge of SLE patients is essential, and in order to support patients' successful discharge, management should strengthen training, thoroughly evaluate the needs of SLE patients, and create customized discharge plans.
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Affiliation(s)
- Shu-Ting Liu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Xue-Ying Xia
- School of Nursing, Anhui Medical University, Hefei, China
| | - Zi-Cheng Song
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jia-Jia Hu
- Blood Purification Center, The Second People's Hospital of Hefei, Hefei, China
| | - Wei Zhao
- School of Nursing, Anhui Medical University, Hefei, China
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Wen J, Zhang J, Zhang H, Zhang N, Lei R, Deng Y, Cheng Q, Li H, Luo P. Large-scale genome-wide association studies reveal the genetic causal etiology between air pollutants and autoimmune diseases. J Transl Med 2024; 22:392. [PMID: 38685026 PMCID: PMC11057084 DOI: 10.1186/s12967-024-04928-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/23/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Epidemiological evidence links a close correlation between long-term exposure to air pollutants and autoimmune diseases, while the causality remained unknown. METHODS Two-sample Mendelian randomization (TSMR) was used to investigate the role of PM10, PM2.5, NO2, and NOX (N = 423,796-456,380) in 15 autoimmune diseases (N = 14,890-314,995) using data from large European GWASs including UKB, FINNGEN, IMSGC, and IPSCSG. Multivariable Mendelian randomization (MVMR) was conducted to investigate the direct effect of each air pollutant and the mediating role of common factors, including body mass index (BMI), alcohol consumption, smoking status, and household income. Transcriptome-wide association studies (TWAS), two-step MR, and colocalization analyses were performed to explore underlying mechanisms between air pollution and autoimmune diseases. RESULTS In TSMR, after correction of multiple testing, hypothyroidism was causally associated with higher exposure to NO2 [odds ratio (OR): 1.37, p = 9.08 × 10-4] and NOX [OR: 1.34, p = 2.86 × 10-3], ulcerative colitis (UC) was causally associated with higher exposure to NOX [OR: 2.24, p = 1.23 × 10-2] and PM2.5 [OR: 2.60, p = 5.96 × 10-3], rheumatoid arthritis was causally associated with higher exposure to NOX [OR: 1.72, p = 1.50 × 10-2], systemic lupus erythematosus was causally associated with higher exposure to NOX [OR: 4.92, p = 6.89 × 10-3], celiac disease was causally associated with lower exposure to NOX [OR: 0.14, p = 6.74 × 10-4] and PM2.5 [OR: 0.17, p = 3.18 × 10-3]. The risky effects of PM2.5 on UC remained significant in MVMR analyses after adjusting for other air pollutants. MVMR revealed several common mediators between air pollutants and autoimmune diseases. Transcriptional analysis identified specific gene transcripts and pathways interconnecting air pollutants and autoimmune diseases. Two-step MR revealed that POR, HSPA1B, and BRD2 might mediate from air pollutants to autoimmune diseases. POR pQTL (rs59882870, PPH4=1.00) strongly colocalized with autoimmune diseases. CONCLUSION This research underscores the necessity of rigorous air pollutant surveillance within public health studies to curb the prevalence of autoimmune diseases.
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Affiliation(s)
- Jie Wen
- The Animal Laboratory Center, Hunan Cancer Hospital, and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jingwei Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hao Zhang
- Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Nan Zhang
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Ruoyan Lei
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Yujia Deng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- First Clinical Department, Changsha Medical University, Changsha, China
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - He Li
- The Animal Laboratory Center, Hunan Cancer Hospital, and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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Hu H, Yang X, Chen Q, Huang X, Cao X, Zhang X, Xu Y. Causal association between air pollution and autoimmune diseases: a two-sample Mendelian randomization study. Front Public Health 2024; 12:1333811. [PMID: 38605869 PMCID: PMC11007215 DOI: 10.3389/fpubh.2024.1333811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
Background In recent years, an increasing number of observational studies have reported the impact of air pollution on autoimmune diseases (ADs). However, no Mendelian randomization (MR) studies have been conducted to investigate the causal relationships. To enhance our understanding of causality, we examined the causal relationships between particulate matter (PM) and nitrogen oxides (NOx) and ADs. Methods We utilized genome-wide association study (GWAS) data on PM and NOx from the UK Biobank in European and East Asian populations. We also extracted integrated GWAS data from the Finnish consortium and the Japanese Biobank for two-sample MR analysis. We employed inverse variance weighted (IVW) analysis to assess the causal relationship between PM and NOx exposure and ADs. Additionally, we conducted supplementary analyses using four methods, including IVW (fixed effects), weighted median, weighted mode, and simple mode, to further investigate this relationship. Results In the European population, the results of MR analysis suggested a statistically significant association between PM2.5 and psoriasis only (OR = 3.86; 95% CI: 1.89-7.88; PIVW < 0.00625), while a potential association exists between PM2.5-10 and vitiligo (OR = 7.42; 95% CI: 1.02-53.94; PIVW < 0.05), as well as between PM2.5 and systemic lupus erythematosus (OR = 68.17; 95% CI: 2.17-2.1e+03; PIVW < 0.05). In East Asian populations, no causal relationship was found between air pollutants and the risk of systemic lupus erythematosus and rheumatoid arthritis (PIVW > 0.025). There was no pleiotropy in the results. Conclusion Our results suggest a causal association between PM2.5 and psoriasis in European populations. With the help of air pollution prevention and control, the harmful progression of psoriasis may be slowed.
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Affiliation(s)
- Haiping Hu
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xinxin Yang
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Qingquan Chen
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xinfeng Huang
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiangyu Cao
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoyang Zhang
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Youqiong Xu
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
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Chen P, Chen Z, Xiao Y, Chen X, Li J, Tang Y, Shen M. Characteristics and economic burden of hospitalized patients with herpes zoster in China, before vaccination. Hum Vaccin Immunother 2023; 19:2268990. [PMID: 37899682 PMCID: PMC10760360 DOI: 10.1080/21645515.2023.2268990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/06/2023] [Indexed: 10/31/2023] Open
Abstract
Herpes zoster (HZ) brings a significant economic burden. The HZ vaccine was introduced in China for the first time in 2020, and there is a lack of up-to-date information on the hospitalization costs and characteristics prior to vaccination. This study aimed to describe the characteristics and economic burden of HZ inpatients in Hunan Province, China, and analyze the factors influencing the length of stay (LOS) and costs. This was a retrospective study and we extracted information from the Chinese National Health Statistics Network Reporting System on HZ inpatients in Hunan Province, China from 2017 to 2019. Spatial join tools and Global or Local Moran's Index were used for the geographic analysis of hospitalized HZ incidence. Multivariate linear regression models were used to analyze the factors influencing LOS and costs. There were 44,311 HZ inpatients included in this study, incurring a total of $31,857,734 medical costs. These patients had a median LOS of 8 days and a median expenditure of $573.47. Older age, more comorbidities, and the presence of complications with nervous system involved were all significantly associated with longer LOS and higher costs. HZ infection resulted in a large direct medical cost and heavy disease burden, especially in patients with advanced age or underlying medical conditions. The HZ vaccine has the potential to effectively reduce the disease burden and should be widely popularized especially among high-risk groups.
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Affiliation(s)
- Peng Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zheng Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Tang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Deng X, Zou B, Li S, Wu J, Yao C, Shen M, Chen J, Li S. Disease specific air quality health index (AQHI) for spatiotemporal health risk assessment of multi-air pollutants. ENVIRONMENTAL RESEARCH 2023; 231:115943. [PMID: 37084946 DOI: 10.1016/j.envres.2023.115943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/02/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
While significant reductions in certain air pollutant concentrations did not induce obvious mitigations of health risks, a shift from air quality management to health risk prevention and control might be necessary to protect public health. This study thus constructed an Air Quality Health Index (AQHI) for respiratory (Res-AQHI), cardiovascular (Car-AQHI), and allergic (Aller-AQHI) risk groups using mixed exposure under multi-air pollutants and portrayed their distribution and variation at multiple spatiotemporal scales using spatial analysis in GIS with the medical big data and air pollution remote sensing data by taking Hunan Province in China as a case. Results showed that the AQHIs constructed for specific health-risk groups could better express their risks than common AQHI and AQI. Moreover, based on the spatiotemporal association of health and environmental information, the allergic risk group in Hunan provided the highest health risk mainly affected by O3. The following cardiovascular and respiratory risk groups can be significantly attributed to NO2. Moreover, the spatiotemporal heterogeneity of AQHIs within regions was also evident. On the annual scale, the population in the air health risk hotspots for respiratory and cardiovascular risk decreased, while allergic risks increased. Meanwhile, on seasonal scale, the hotspots for respiratory and cardiovascular risks expanded significantly in winter while completely disappearing for allergic risk. These findings suggest that disease specific AQHIs effectively disclose the health effects of multi-air pollutants and their subsequently varied spatiotemporal distribution patterns.
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Affiliation(s)
- Xun Deng
- School of Geosciences and Info-Physics, Central South University, Changsha, 410000, China
| | - Bin Zou
- School of Geosciences and Info-Physics, Central South University, Changsha, 410000, China.
| | - Shenxin Li
- School of Geosciences and Info-Physics, Central South University, Changsha, 410000, China
| | - Jian Wu
- Changsha Environmental Monitoring Center of Hunan Province, Changsha, 410000, China
| | - Chenjiao Yao
- Department of General Medicine, The 3rd Xiangya Hospital, Central South University, Changsha, 410000, China
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410000, China; Furong Laboratory, Changsha, 410000, China; Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410000, China
| | - Jun Chen
- Changsha Environmental Monitoring Center of Hunan Province, Changsha, 410000, China
| | - Sha Li
- School of Geosciences and Info-Physics, Central South University, Changsha, 410000, China
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