Genomic analysis reveals deep population divergence in the water snake Trimerodytes percarinatus (Serpentes, Natricidae)

Although several phylogeographic studies of Asian snakes have been conducted, most have focused on pitvipers, with non-venomous snakes, such as colubrids or natricids, remaining poorly studied. The Chinese keelback water snake (Trimerodytes percarinatus Boulenger) is a widespread, semiaquatic, non-venomous species occurring in China and southeastern Asia. Based on mitochondrial DNA (mtDNA) and single nucleotide polymorphism (SNP) data, we explored the population genetic structure, genetic diversity, and evolutionary history of this species. MtDNA-based phylogenetic analysis showed that T. percarinatus was composed of five highly supported and geographically structured lineages. SNP-based phylogenetic analysis, principal component analysis, and population structure analysis consistently revealed four distinct, geographically non-overlapping lineages, which was different from the mtDNA-based analysis in topology. Estimation of divergence dates and ancestral area of origin suggest that T. percarinatus originated ~12.68 million years ago (95% highest posterior density: 10.36-15.96 Mya) in a region covering southwestern China and Vietnam. Intraspecific divergence may have been triggered by the Qinghai-Xizang Plateau uplift. Population demographics and ecological niche modeling indicated that the effective population size fluctuated during 0.5 Mya and 0.002 Mya. Based on the data collected here, we also comment on the intraspecific taxonomy of T. percarinatus and question the validity of the subspecies T. p. suriki.

Liquid crystal monomers (LCMs) in indoor residential dust from Beijing, China: occurrence and human exposure

Liquid crystal monomers (LCMs) are widely used in electronic devices and emerging as an environmental pollutant, while their occurrence in indoor environments is still less studied. In this study, 32 out of 37 target LCMs were detected in indoor residential dust samples (n = 112) from Beijing, China. Concentrations of Σ32LCMs ranged from 17.8 to 197 ng/g, with a median value of 54.7 ng/g. Fluorinated biphenyls and analogs (FBAs) and cyanobiphenyls and analogs (CBAs), with median concentrations of 22.8 and 15.9 ng/g, respectively, were the main kinds of LCMs. Although 32 LCMs can be detected, four monomers with the highest contamination levels contributed to almost 70% of the total LCMs. Spearman correlation analysis found significant correlations among some monomers, which indicated that they might share similar sources in the residential environment. Estimated daily intakes (EDIs) of LCMs via indoor dust for Beijing residents were calculated, and the results showed that dust ingestion and dermal contact were both main intake pathways to LCMs, and younger people may face higher exposure to LCMs. A comparison to the results of China's total diet study showed that EDIs of LCMs via food consumption might be higher than that via dust intake, while health risks caused by exposure of LCMs for the general population, both through food and dust, were insignificant at present.

[Gastrointestinal tumors with SWI/SNF complex deficiency: a clinicopathological analysis of 36 cases]

Objective: To investigate the clinicopathological characteristics of gastrointestinal tumors with SWI/SNF complex deficiency and to perform a prognostic analysis of the patients. Methods: Gastrointestinal tumor cases with SWI/SNF complex deficiency expression diagnosed at the Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China from August 2021 to May 2023 were collected. Hematoxylin and eosin (HE) stained slides were reviewed, and immunohistochemical results were analyzed. Clinical and pathological information was recorded, and relevant literature was reviewed. Results: A total of 36 cases of gastrointestinal tumor with loss of SWI/SNF complex expression were identified, including 28 males (77.8%) and 8 females (22.2%). The average age at diagnosis was 70 years (range 48-85 years). Clinical staging showed 3 cases in stage Ⅰ (8.3%), 12 cases in stage Ⅱ (33.3%), 19 cases in stage Ⅲ (52.8%), and 2 cases in stage Ⅳ (5.6%). Complete or partial loss of ARID1A expression was observed in 20 cases (55.6%); complete or partial loss of SMARCA2 expression was observed in 24 cases (66.7%). SMARCA4 exhibited complete loss of expression in 4 cases (11.1%). Eleven cases (30.6%) showed concurrent complete or partial losses of both ARID1A and SMARCA2 expression. Twelve cases (33.3%) had mismatch repair protein deficiency, all of which were characterized by MLH1/PMS2 absence. Mismatch repair protein deficiency was associated with loss of ARID1A expression (P<0.01). Patients with mismatch repair protein deficiency were also associated with earlier clinical stage and a lower risk of lymph node metastasis compared to the ones with intact mismatch repair proteins (P<0.05). Conclusions: SWI/SNF complex deficiency in gastrointestinal tumors is associated with dedifferentiation and often accompanied by mismatch repair protein deficiency. Compared to the cases with intact mismatch repair proteins, the cases with defective mismatch repair protein have an earlier clinical stage and a lower risk of lymph node metastasis.

[Clinical, endoscopic, and pathological analyses of 14 cases of gastric adenocarcinoma of the fundic gland type]

Objective: Gastric adenocarcinoma of the fundic gland type (GA-FG) is rare and often occurs in patients who are not infected with Helicobacter pylori. The current study analyzed and summarized the clinical, endoscopic, and pathological features of GA-FG, in an effort to improve its diagnosis. Methods: Patients who were diagnosed with GA-FG and treated with endoscopic submucosal dissection (ESD) resection at the Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University from January 1st 2020 to October 1st 2022 were included in the study. Their clinical manifestations, endoscopic features, pathological immunohistochemistry, and other characteristics were analyzed. Results: A total of 14 patients with GA-FG were included in the study, 5 males and 9 females, with a mean age of 59 years. Most had no substantial clinical manifestations. Twelve patients were H. pylori-negative, all patients underwent ESD resection, and all patients survived during the follow-up period of 13±9 months. Eleven patients had postoperative endoscopic follow-up records, and no recurrence was detected. Fifteen lesions were detected (2 were present in 1 patient). Twelve were located in the upper 1/3 of the stomach, 10 were ≤ 1 cm in diameter, 12 had a morphology of type 0-Ⅱa, 8 had visible discoloration changes, and 12 had visible vasodilation on the surface. Magnified endoscopy and narrow-band imaging indicated that 12 of the lesions had enlarged marginal crypt epithelium, without any obvious microvascular pattern abnormalities and no obvious borderline. After resection the pathological specimens were all without vascular infiltration, and there was no atrophy of the mucosa at the edge of the lesion. In immunohistochemistry analyses MUC-2 was negative in all cases. MUC5AC was negative in 11 cases, MUC-6 was positive in all cases, and Ki-67 was ≤ 5% in 12 cases. Conclusions: GA-FG is a newly identified type of gastric cancer with low malignancy and a good prognosis. Characteristic discoloration and surface dilated vessels are often evident endoscopically. Enlarged marginal crypt epithelium and no visible boundary lines are often apparent in magnification endoscopy and narrow band imaging.

Genomic evidence sheds new light on phylogeny of Rhabdophis nuchalis (sensu lato) complex (Serpentes: Natricidae)

Stable taxonomy and robust phylogeny are essential for the evolution and conservation of organisms. The Rhabdophis nuchalis (sensu lato) complex presently contains three species (R. nuchalis, R. chiwen, R. pentasupralabialis). Although several studies have explored the diversity and phylogeography of this group, certain issues related to systematics and taxonomy remain unresolved. Here, based on genome-wide data, including single nucleotide polymorphisms (SNPs) generated from ddRAD-seq and mitochondrial DNA (mtDNA), we re-evaluated the phylogenetic relationships and cryptic diversity of this species group. Our results are generally consistent with previous studies but provide some new insights. Phylogenetic relationship reconstruction based on SNPs and mtDNA revealed that three species in the R. nuchalis (sensu lato) complex did not form a monophyly but each species is well supported as monophyletic lineage in SNP-based analyses. Population structure analyses showed genetic admixture between several species pairs. Additionally, the population in eastern Yunnan, China, was identified as a potential cryptic species and thus described as a new species based on morphological data. From our results and previous studies, we redefined the distribution boundary for each species in the R. nuchalis (sensu lato) species complex.

Long-Term Results of Induction Chemotherapy for Esophageal Squamous Cell Carcinoma Receiving Concurrent Chemoradiotherapy

PURPOSE/OBJECTIVE(S)

This study aimed to investigate the long-term clinical outcomes and toxicities of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) versus CCRT alone in patients with esophageal squamous cell carcinoma (ESCC).

MATERIALS/METHODS

Between 2008 and 2022, 271 ESCC patients who received definitive CCRT (IC followed by CCRT, n = 72; CCRT alone, n = 199) were enrolled. Radiotherapy technique included intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT). Through a propensity score matched (PSM) method, 71 patients receiving IC and CCRT were matched 1:1 to patients who received CCRT alone, according to age, gender, performance status, tumor length, and pre-treatment TN stage. The Kaplan-Meier method and Cox proportional hazards model were applied to analyze survival and prognosis.

RESULTS

The IC + CCRT group had no improvement in 5-year overall survival (OS) rate (39.0% vs 29.3%, p = 0.360), recurrence-free survival (RFS) rate (39.0% vs 26.9%, p = 0.142), and distant metastasis-free survival (DMFS) rate (33.6% vs 27.2%, p = 0.515) compared with the CCRT group. The overall clinical response rate was 45.1% after IC in the IC + CCRT group. The IC responders (CR + PR + SD) group showed more favorable 5-year OS (41.7% vs. 14.3% vs. 29.3%, p < 0.001), RFS (41.7% vs. 14.3% vs. 26.9%, p < 0.001) and DMFS (37.3% vs. 0% vs. 27.2%, p < 0.001) compared with the IC non-responders (PD) group and the CCRT group. Besides, the 5-year OS rate (65.6% vs. 17.6% vs. 29.3%, p < 0.001), RFS rate (65.6% vs. 17.6% vs. 26.9%, p < 0.001), and DMFS rate (62.5% vs. 10.3% vs. 27.2%, p < 0.001) of the IC good responders (CR + PR) were significantly higher than that of the IC poor responders (SD + PD) and CCRT group. Multivariate analysis revealed that total radiotherapy time (≥ 49 days) and AJCC stage (Ⅲ/Ⅳ) were independent predictive factors of OS, RFS and DMFS. Besides, age was an independent predictive factor of DMFS. No significant difference was observed in the rates of grades 3-4 toxicities between both groups.

CONCLUSION

Our results showed the addition of IC to CCRT was not superior to CCRT in unselected ESCC patients, while IC responders could benefit from this regime without increase in toxicities.

Concentrations, Profiles, and Health Risks of Organic Ultraviolet Filters in Eight Food Categories Determined through the Sixth Chinese Total Diet Study

Ultraviolet (UV) filters are emerging contaminants that have been found in high concentrations in human tissues. Food intake is generally considered to be the primary route of human exposure to contaminants. In this study, 184 composite food samples, prepared from 4268 individual samples in eight categories collected from 23 Chinese provinces for the sixth Chinese total diet study, were analyzed. The total and median UV filter concentrations in food samples were 1.5-68.3 and 7.9 ng/g wet weight, respectively. The highest median concentrations were found in decreasing order in meat, cereals, and legumes. In total, 15 UV filters were analyzed. 2-Ethylhexyl salicylate, homosalate, and 2-ethylhexyl-4-methoxycinnamate were dominant and made median contributions of 34.1%, 22.6%, and 14.5%, respectively, and 2-(2H-benzotriazol-2-yl)-4,6-di-tert-pentylphenol contributed the median of 0.03%, of the total UV filter concentrations. The estimated total daily UV filter intake in animal-origin foods and total UV filter concentration in human milk from the same province were significantly correlated (r = 0.44, p < 0.05). Predicted absorption, distribution, metabolism, and elimination properties led to 10 UV filters being prioritized as most likely to be retained in human tissues. The prioritization results and toxicity assessments indicated that octocrylene and 2-ethylhexyl-4-methoxycinnamate have stronger effects in vivo and therefore require more attention than others.

A Nationwide Survey and Risk Assessment of Ethyl Carbamate Exposure Due to Daily Intake of Alcoholic Beverages in the Chinese General Population

Ethyl carbamate (EC) is carcinogenic, and, in China, oral intake of EC mainly occurs as a result of the consumption of alcoholic beverages. To obtain the latest EC intake and risk analysis results for the general population in China, the China National Center for Food Safety Risk Assessment (CFSA) conducted the sixth total diet study (TDS) as a platform to analyze EC contents and exposure due to the intake of alcoholic beverages. A total of 100 sites in 24 provinces were involved in the collection and preparation of alcohol mixture samples for the sixth TDS. There were 261 different types of alcohol collected across the country, based on local dietary menus and consumption survey results. Ultimately, each province prepared a mixed sample by mixing their respective samples according to the percentage of local consumption. The EC levels of these twenty-four mixed samples were determined using our well-validated gas chromatography-mass spectrometry (GC-MS) method. The values ranged from 1.0 μg/kg to 33.8 μg/kg, with 10.1 μg/kg being the mean. China's EC daily intake ranged from 0.001 ng/kg bw/d to 24.56 ng/kg bw/d, with a mean of 3.23 ng/kg bw/d. According to the margin of exposure (MOE), virtually safe dose (VSD), and T25 risk assessments of the carcinogenicity of EC, the mean lifetime cancer risk for the Chinese population was 9.8 × 104, 1.5 × 10-7, and 8.6 × 10-8, respectively. These data show that the carcinogenicity of EC in the general Chinese population due to alcoholic intake is essentially minimal.

Molecular phylogeny reveals cryptic diversity in Sibynophis from China (Serpentes: Sibynophiidae)

The elucidation of species diversity and distribution is critical within the fields of evolution, genetics, and conservation. The genus Sibynophis contains rare snakes that have historically received little attention. In this study, we conducted comprehensive sampling and use both mitochondrial and nuclear genetic markers to explore Sibynophis species diversity within China. Our findings revealed that S. c. miyiensis should be considered synonymous with S. c. grahami, and S. c. grahami should be gave a specific rank as S. grahami. In addition, we discovered S. triangularis was new to China and Myanmar. Based on the specimens and molecular phylogeny results, we redefined the species distribution boundaries of each Chinese species.

Chronic Health Risk for Chinese Adults and Breastfed Infants on Dietary Exposure to Chlorothalonil and Its Main Metabolite

This study presents the first nationwide study on the chronic health risks of chlorothalonil and its metabolite (4-OH-chlorothalonil) for Chinese adults and breastfed infants via dietary intake. The determination of chlorothalonil and 4-OH-chlorothalonil in dietary samples was accomplished by cold-induced liquid-liquid extraction using liquid chromatography─high-resolution mass spectrometry. Chlorothalonil and 4-OH-chlorothalonil were detected in 43.1 and 46.1% of total dietary samples, respectively, while only 4-OH-chlorothalonil was detected in 100% of breast milk samples. Chlorothalonil and 4-OH-chlorothalonil residues in dietary samples of Northwest China and Shandong regions were higher in comparison to those of other regions. No correlation between 4-OH-chlorothalonil residues in breast milk and adult daily dietary intake to total chlorothalonil indicates the presence of other exposure routes besides dietary exposure. Furthermore, a residue analysis of 4-OH-chlorothalonil in breast milk between urban and rural areas in all sampling locales showed no statistical difference (p > 0.05). The findings of this study reveal that the chronic health risks caused by dietary exposure to chlorothalonil and 4-OH-chlorothalonil are low for Chinese adults and breastfed infants.

A Comparison of Clinical Characteristics of Infections with SARS-CoV-2 Omicron Subvariants BF.7.14 and BA.5.2.48 - China, October-December 2022

What is already known about this topic?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to evolve, the clinical manifestations resulting from different SARS-CoV-2 variants may demonstrate significant variation.

What is added by this report?

We conducted a comparative analysis of the clinical features associated with SARS-CoV-2 Omicron subvariants BF.7.14 and BA.5.2.48 infections. The results of our study indicate that there are no substantial differences in clinical manifestations, duration of illness, healthcare-seeking behaviors, or treatment between these two subvariants.

What are the implications for public health practice?

Timely identification of alterations in the clinical spectrum is crucial for researchers and healthcare practitioners in order to enhance their comprehension of clinical manifestations, as well as the progression of SARS-CoV-2. Furthermore, this information is beneficial for policymakers in the process of revising and implementing appropriate countermeasures.

Comprehensive evaluation of perchlorate dietary exposure and health risks for Chinese adult males and breastfed infants

Perchlorate is an environmental contaminant that has both natural and anthropogenic sources. Widespread contamination of various foods with perchlorate can be caused by water, soil, and fertilizer. Because of concerns about the health effects of perchlorate, attention has focused on its occurrence in food and potential human exposure. In this study, the dietary exposures of Chinese adult males and breastfed infants to perchlorate were evaluated using data from the sixth China Total Diet Study and the third National Breast Milk Monitoring Program conducted between 2016 and 2019. In the sixth China Total Diet Study, perchlorate was detected in 94.8 % of composite dietary samples (n = 288) from 24 provinces in China, while for the third National Breast Milk Monitoring, perchlorate was found in 100 % of pooled breast milk samples (n = 100) collected from 100 cities/counties in China. Vegetables were found to be the main source of dietary exposure for Chinese adult males. Furthermore, the concentrations in breast milk between urban (n = 34, mean: 38.6 μg/L) and rural (n = 66, mean: 59.0 μg/L) regions from 100 cities/counties in China were not significantly different. On average, the estimated daily intake of Chinese adult males (18-45 years) to perchlorate was 0.449 μg/kg bw/day, while that for breastfed infants (0-24 months) was 3.21-5.43 μg/kg bw/day. The exposure to perchlorate in breastfed infants was almost 10-fold greater than that of Chinese adult males.

Dietary Intake of Multiple Nutrient Elements and Associated Health Effects in the Chinese General Population from a Total Diet Study

Nutrient elements are essential for human health. The intake of nutrient elements (Na, K, Ca, Mg, P, Mn, Fe, Zn, Cu, Se, Mo, and Cr) in the general Chinese population was comprehensively evaluated via a recent total diet study (2016-2019), covering more than two-thirds of the total population. The contents of nutrient elements in 288 composite dietary samples were determined by ICP-MS. The dietary sources, regional distribution, the relationship with the earth's crust, dietary intake, and health effects were discussed. Plant foods were the main source of both macro-elements and trace elements, accounting for 68-96% of total intake. Trace elements in food were compatible with their abundance in the earth's crust. Na intake reduced by 1/4 over the last decade but was still high. The average intake of Ca, Mg, Zn, and Se did not reach the health guidance values, while the average intake of K, P, Mn, Fe, Cu, Mo, and Cr fell within a reasonable range. No element exceeded the UL. However, an imbalance was identified in the dietary Na/K ratio and Ca/P ratio. This paper provides a most recent and national-representative assessment of nutrient element intake, indicating the significance of salt reduction and dietary structure optimization for the population.

Monosodium Glutamate Intake and Risk Assessment in China Nationwide, and a Comparative Analysis Worldwide

The sixth Total Diet Study (TDS) of China included a countrywide study to assess the health effects of MSG (monosodium glutamate). MSG detection, consumption analysis, and risk assessment were conducted on 168 samples from seven food categories of the most typical Chinese daily diet. The highest value of MSG in the daily diet of the Chinese population was 8.63 g/kg. An MSG intake of 17.63 mg/kg bw/d for the general population of China was obtained from content measurements combined with food consumption, while the data from the apparent consumption survey alone gave 40.20 mg/kg bw/d. The apparent consumption did not consider the loss of MSG during food cooking, resulting in an overestimate. To offer a global perspective, MSG content, food category contributions, and ingestion levels across nations were summarized and thoroughly investigated. A realistic, logical, and precise risk assessment protocol for MSG daily intake was developed in this article.

Genomic Analysis and Antimicrobial Resistance of Campylobacter jejuni Isolated from Diarrheal Patients - Beijing Municipality, China, 2019-2021

Introduction

Campylobacter jejuni (C. jejuni) is the leading cause of human bacterial gastroenteritis worldwide and has a major impact on global public health. The objective of the present study was to conduct whole genome sequencing (WGS) to determine the genetic diversity, virulence factors, and determinants of antimicrobial resistance of C. jejuni during a 3-year surveillance period in Beijing, China.

Methods

A total of 184 clinical isolates were obtained from sentinel hospital surveillance between 2019 and 2021. Antimicrobial susceptibility testing was conducted using the agar dilution method. WGS was employed to characterize the 184 C. jejuni strains.

Results

Multilocus sequence typing analysis revealed high genetic diversity among the 184 C. jejuni strains, identifying 71 sequence types (STs) and 19 clonal complexes (CCs). The most prevalent ST was ST760 (6.5%), and the most common CC was CC21 (24.5%), consisting of 11 STs. High resistance rates were observed for ciprofloxacin (76.6%), nalidixic acid (76.1%), and tetracycline (71.2%). A total of 77 C. jejuni isolates (41.8%) exhibited multidrug resistance with 43 resistance patterns. Virulome analysis disclosed the differential distribution of virulence factors related to adherence, colonization, chemotaxis, as well as lipo-oligosaccharide and capsular polysaccharide biosynthesis. Resistome analysis demonstrated widespread resistance to quinolones and tetracycline, but low rates of macrolides resistance. The phylogeny, based on whole genome single nucleotide polymorphisms, indicated a high degree of clonality and grouped the C. jejuni strains into six clades. Closely related isolates that were part of a genetic cluster mostly shared a homogenous clonal complex.

Conclusions

The present study emphasizes the rising resistance to quinolones and tetracycline, as well as the virulence potential and diverse genotypes identified among C. jejuni strains isolated from diarrheal patients in Beijing.

Polychlorinated dibenzo-p-dioxins and dibenzofurans and dioxin-like polychlorinated biphenyls in human milk from national human breast milk monitoring in 2016-2019 in China

Human breast milk monitoring programs were recommended to be carried out to assess human body burden to persistent organic pollutants and their temporal trends. Thus, we conducted a national survey during the period of 2016-2019 to determine PCDD/Fs and dl-PCBs in human breast milk from China. The total TEQ amounts in the upper bound (UB) was in the range of 1.97 to 15.1 pg TEQ g^-1 fat with a geometric mean (GM) of 4.50 pg TEQ g^-1 fat. 2,3,4,7,8-PeCDF, 1,2,3,7,8-PeCDD, and PCB-126 were more predominant contributors with the percentage contribution of 34.2 %, 17.9 %, and 17.4 %, respectively. By comparison with our previous monitoring results, the total TEQ in breast milk sample of the present study is statistically lower than that in 2011 with a reduction of 16.9 % in the average (p < 0.05), and comparable to that in 2007. The estimated GM of dietary intake of total TEQ for the breastfed was 25.4 pg TEQ kg^-1 body weight day^-1 that was higher than that of the adult. It is therefore worthy to make more efforts to reduce amounts of PCDD/Fs and dl-PCBs in breast milk and to continue monitoring to further observe if the amount of these chemicals continue to decrease.

Penetration of Perfluorooctanesulfonate Isomers and Their Alternatives from Maternal Blood to Milk and Its Associations with Chemical Properties and Milk Primary Components

Perfluorooctanesulfonate (PFOS) and its alternatives, including chlorinated polyfluorinated ether sulfonates (Cl-PFESAs), are mainly detected per- and polyfluoroalkyl substances (PFAS) in human samples such as milk. However, the mechanism of their blood to milk transfer was not well studied. Here, 145 paired maternal serum and human milk samples were analyzed for six PFOS isomers and Cl-PFESAs to evaluate the transfer efficiency from maternal serum to human milk (TE_HM/MS). Besides physicochemical properties, this study for the first time evaluated the influencing effects of the primary components in human milk (carbohydrate, lipid, and protein) on TE_HM/MS of PFAS. No significant association was observed between TE_HM/MS and the albumin binding affinity of the compounds (p = 0.601), but TE_HM/MS was significantly negatively correlated with the logarithmic octanol-water partition coefficients (r² = 0.853, p = 0.001), the logarithmic membrane-water partition coefficients (r² = 0.679, p = 0.012), and the carbohydrate contents in human milk. The effect of carbohydrate was further confirmed using in vitro tests. The negative associations between TE_HM/MS and hydrophobicity, membrane passive permeability, and the carbohydrate content in human milk consistently indicated that passive diffusion through the paracellular route might be the main transfer pathway for PFOS and Cl-PFESAs from blood to milk in humans.

Legacy and novel brominated flame retardants in animal-derived foods from China Total Diet Study (CTDS): Temporal trends, evidence of substitution, and dietary exposure assessment

Based on the 6th China Total Diet Study (CTDS) conducted in 2016-2019, the occurrence of both legacy and novel brominated flame retardants (BFRs) was measured in animal-derived foods collected across China. Most BFRs could be frequently detected in food samples, indicating their ubiquity in the environment. Decabromodiphenyl ethane (DBDPE), a typical novel BFR, presented the highest contamination level, whereas legacy BFRs, including decabrominated diphenyl ether (BDE-209), tetrabromobisphenol A (TBBPA), and hexabromocyclododecane (HBCDD), still presented high detection frequencies and relatively abundant proportions in total BFRs. Compared with previous CTDSs conducted from 2007 to 2011, the levels and estimated dietary intakes (EDIs) of most BFRs showed a significant downtrend, which suggested that flame retardant consumption in China has transferred from legacy BFRs to novel BFRs (mainly DBDPE) and from BFRs to other kinds of flame retardants. Based on probabilistic estimation, the median EDIs of mainly used BFRs for the Chinese population ranged from 41.0 to 1.67 × 10³ pg/kg bw/day, and meat consumption was the primary source in dietary BFR intake. By conducting the margin of exposure (MOE) approach or comparing with the reference dose (RfD), it can be concluded that daily dietary intakes of BFRs were still unable to cause significant health risks to the general population in China.

Occurrences of legacy and emerging per- and polyfluoroalkyl substances in human milk in China: Results of the third National Human Milk Survey (2017-2020)

Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants widely contaminated and exposed in humans. China is a major manufacturer and consumer of these chemicals. To characterize the occurrences, geographical variations, temporal trends, and exposure risks of legacy and emerging PFAS in perinatal women and their children in China, 30 PFAS were measured in 100 pooled human milk samples consisting of 3531 individual samples collected from 100 sites in 24 provinces during the 2017-2020 National Human Milk Survey. Linear-perfluorooctanoic acid (L-PFOA, 151 pg/mL) and linear-perfluorooctane sulfonate (L-PFOS, 57.0 pg/mL) were the predominant PFAS in human milk, followed by 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA, 25.9 pg/mL). The geographic variation trend of PFOA was different from PFOS and Cl-PFESA, and a special geographic trend of perfluoropentanesulfonate (PFPeS) was observed. Comparison of National Human Milk surveys from different periods showed a sharp decrease of PFAS exposure in old industrial areas including Shanghai and Liaoning, but higher PFAS exposure observed in Shandong and Hubei indicated a possible domestic shift of PFAS manufacture to these areas. Worldwide comparison of PFAS in human milk indicated high PFOA exposure in China. Risk assessments for mothers and breastfeeding infants showed that PFAS exposure is of concern in China.

Human dietary exposure to bisphenol-diglycidyl ethers in China: Comprehensive assessment through a total diet study

Despite the widespread use of bisphenol A diglycidyl ether (BADGE) and bisphenol F diglycidyl ether (BFDGE) in various consumer products as protective plasticizer, studies on human dietary exposure to these compounds are scare. In this study, nine bisphenol diglycidyl ethers (BDGEs) including BADGE, BFDGE, and seven of their derivatives were determined in the Chinese adult population based on composite dietary samples collected from the sixth (2016-2019) China total diet study (TDS). Contamination level of nine BDGEs was determined in 288 composite dietary samples from 24 provinces in China. BADGE·2H₂O and BADGE are the most frequently detected and BADGE·2H₂O presented the highest mean concentration (2.402 μg/kg). The most contaminated food composite is meats, with a mean ∑₉BDGEs of 8.203 μg/kg, followed by aquatic products (4.255 μg/kg), eggs (4.045 μg/kg), and dairy products (3.256 μg/kg). The estimated daily intake (EDI) of ∑₉BDGEs based on the mean and 95th percentile concentrations are 121.27 ng/kg bw/day and 249.71 ng/kg bw/day. Meats, eggs, and aquatic products are the main source of dietary exposure. Notably, beverages and water, alcohols were the main contributors of dietary exposure to BADGE and BADGE·2H₂O, followed by animal-derived foods. Dietary exposure assessment demonstrated that human dietary BDGEs do not pose risks to general population based on the mean and 95th percentile hazard index with < 1. This is the first comprehensive national dietary exposure assessment of BDGEs in Chinese general population.

Concentrations, Compound Profiles, and Possible Sources of Organic UV Filters in Human Milk in China

Ultraviolet (UV) filters are of great concern due to their wide occurrence, bioaccumulation, and toxicity. Little is known about human exposure to UV filters. A total of 3467 individual human milk samples from 24 Chinese provinces were collected during 2017-2019. The concentrations of 12 UV filters in 100 pooled milk samples were determined. The total UV filter concentration was 78-846 (mean 235 ± 120) ng/g lipid weight. The highest and lowest total mean concentrations were for samples from Qinghai and Sichuan provinces, respectively. A significant positive correlation was found between UV radiation levels and UV concentrations in the samples. The dominant UV filters were 2-(2-hydroxy-5-methylphenyl) benzotriazole (UV-P) and ethylhexyl methoxycinnamate (EHMC), which contributed means of 32 and 22%, respectively, to the total concentrations. Plastic products and sunscreens were probably the sources of UV-P and EHMC in the human milk from China, respectively. The mean 2-(3,5-di-tert-amyl-2-hydroxyphenyl) benzotriazole (UV-328) concentration was 2.6 ± 2.6 ng/g lipid weight. The UV filter profiles were similar to profiles for samples from Japan, the Philippines, and Switzerland but not for samples from Korea and Vietnam. The estimated daily UV filter intake for breastfed infants was below the corresponding reference dose. This was the first large-scale study of UV filters in human milk and will help assess the risks posed.

Genomic characteristics of SARS-CoV-2 in Beijing, China, 2021

At present, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread worldwide, which has emerged multiple variants and brought a threat to global public health. To analyze the genomic characteristics and variations of SARS-CoV-2 imported into Beijing, we collected the respiratory tract specimens of 112 cases of coronavirus disease 2019 (COVID-19) from January to September 2021 in Beijing, China, including 40 local cases and 72 imported cases. The whole-genome sequences of the viruses were sequenced by the next-generation sequencing method. Variant markers and phylogenic features of SARS-CoV-2 were analyzed. Our results showed that in all 112 sequences, the mutations were concentrated in spike protein. D614G was found in all sequences, and mutations including L452R, T478K, P681R/H, and D950N in some cases. Furthermore, 112 sequences belonged to 23 lineages by phylogenetic analysis. B.1.1.7 (Alpha) and B.1.617.2 (Delta) lineages were dominant. Our study drew a variation image of SARS-CoV-2 and could help evaluate the potential risk of COVID-19 for pandemic preparedness and response.

Vibrio parahaemolyticus O10:K4: An Emergent Serotype with Pandemic Virulence Traits as Predominant Clone Detected by Whole-Genome Sequence Analysis - Beijing Municipality, China, 2021

Introduction

Vibrio parahaemolyticus (V. parahaemolyticus) is a common foodborne pathogen which causes gastroenteritis in humans, especially the O3:K6 pandemic clone which is still a prominent serotype in Beijing, China. In this study, we observed a novel serotype O10:K4 isolated from clinical diarrhea cases, which became the most prevalent clone in 2021.

Methods

73 clinical isolates were collected through sentinel hospitals' surveillance in 2021. Serum agglutination testing and antimicrobial susceptibility testing were conducted. Whole genome sequencing was applied to characterize 73 V. parahaemolyticus strains and complete phylogenetic analysis.

Results

Seven serotypes were identified among 73 strains. O10:K4 was the most common serotype (83.6%), followed by O2:KUT, O4:KUT, and O1:KUT. Multilocus sequence typing divided the 73 isolates into 10 sequence types (STs) with ST3 as the most prevalent, which covered all O10:K4 strains. Most isolates were sensitive to common antimicrobial agents apart from colistin. All the O10:K4 isolates were positive for the thermostable direct hemolysin gene, toxRS/new, andorf8, and negative for the TDH-related hemolysin gene. The whole genome sequencing-single nucleotide polymorphism phylogenetic analysis revealed O10:K4 strains formed a main genetic lineage, which was genetically distinct from other serotypes. We also demonstrated the presence of two type III secretion system genes (T3SS1 and T3SS2) and β lactamase resistance gene blaCARB-22 in all O10:K4 strains.

Conclusions

The study confirmed the emergence of V. parahaemolyticus O10:K4 possessing virulence factors similar to the O3:K6 pandemic clone, which may have enabled them to become prevalent in Beijing, China.

[Etiological and epidemiological characteristics of Vibrio cholerae in Beijing, 2015-2021]

Objective: To analyze the etiological and epidemiological characteristics of Vibrio cholerae in Beijing during 2015-2021 and provide evidence for the prevention and control of cholera. Methods: The V. cholerae strains isolated in Beijing during 2015-2021 were analyzed by serotyping and virulence genes detection. Pulsed field gel electrophoresis (PFGE) was performed for the molecular typing of the strains. Based on the collected epidemiological and clinical data of cholera cases,the epidemiological characteristics of cholera were analyzed by descriptive epidemiology method. Results: A total of 76 Vibrio cholerae O1 strains were isolated in Beijing during 2015-2021, including 61 strains from human, 10 strains from environment and 5 strains from seafood. The 76 strains consisted of 68 Ogawa strains and 8 Inaba strains. Six Ogawa strains isolated from sporadic cases carried ctxAB. After NotⅠ digestion, 76 strains were divided into 33 PFGE patterns. From 2015 to 2021, a total of 38 cholera epidemics were reported in Beijing, most of them were sporadic ones, accounting for 92.11% (35/38). A total of 45 cases were reported, and the cases occurred during June-September accounted for 97.78% (44/45). Cholera cases occurred in 9 districts of Beijing, and the cases reported in Chaoyang district accounted for 42.22% (19/45) and in Changping district accounted for 31.11% (14/45). The age of the cholera cases ranged from 19 to 63 years. Except for one case with unknown clinical symptoms, 44 cases had diarrhea symptoms with 84.09% (37/44) of the cases reporting diarrhea (3-9 times/day), followed by yellow watery stool (95.45%, 42/44), abdominal pain (68.18%, 30/44), nausea and vomiting (40.91%, 18/44) and fever (36.36%, 16/44). Conclusion: Vibrio cholerae strains isolated in Beijing during 2015-2021 were mainly O1 serotype Ogawa,most of which were non-toxigenic. The PFGE of the strains varied. Cholera epidemics occurred in 9 districts of Beijing, but most were sporadic ones with incidence peak during June-September.

Comprehensive Evaluation of Dietary Exposure and Health Risk of Polychlorinated Naphthalenes

Intake from food is considered an important route of human exposure to polychlorinated naphthalenes. To our knowledge, several studies have quantified dietary exposure but only in European countries and measuring only a few of the 75 congeners. In addition, the influence of source diversity on human exposure has seldom been assessed. We analyzed 192 composite food samples composed of 17,280 subsamples from 24 provinces in China to measure the concentrations of polychlorinated naphthalenes and estimate their daily intake and potential health risks on a national scale. The estimated cancer risk was in the range of 6.8 × 10^-8 to 4.6 × 10^-7. We compared our findings for 75 congeners with reports in the literature that quantified only 12 congeners. We estimate that these 12 congeners contribute only approximately 4% to the total mass daily intake of polychlorinated naphthalenes and 70% to the total toxic equivalent quantity, indicating underestimation of dietary exposure. The contributions of combustion-associated congeners to the total concentrations of polychlorinated naphthalenes were in the range of 31-52%, suggesting that the ongoing unintentional release of these compounds from industrial thermal processes is an important factor in polychlorinated naphthalene contamination and human exposure in China.

Occurrence of Phenylpyrazole and Diamide Insecticides in Lactating Women and Their Health Risks for Infants

To investigate the exposure of infants to phenylpyrazole and diamide insecticides during lactation, we collected 3467 breast milk samples of lactating women from 100 cities of 24 provinces in China and prepared 100 pooled samples together city-by-city. Among phenylpyrazole insecticides, fipronil and its metabolites (63-100%) were widely detected in breast milk, with total detection concentrations ranging from 178 to 2947 ng/L (median: 921 ng/L). Among diamide insecticides, chlorantraniliprole and flubendiamide were detected in breast milk, but their detection frequencies (20-85%) and concentration levels (nondetected to 89.9 ng/L) were far lower than those of total fipronils. The average estimated daily intake of infants exposed to total fipronils through breast milk is 209 ng/kg-bw/day by upper-bound scenario evaluation, which is higher than the acceptable daily intake (200 ng/kg-bw/day). This study indicates that infants have far higher exposure levels to fipronil than adults, while exposure levels to other types of phenylpyrazoles and diamide insecticides are low.

[The value of OLGA staging system in risk assessment of gastric precancerous states and precancerous lesions]

Objective: To investigate the role of operative link on gastritis assessment (OLGA) staging system in risk assessment of gastric precancerous states and precancerous lesions. Methods: A total of 682 patients undergoing gastroscopy from January to July 2016 at the First Hospital of Jiaxing were enrolled. According to the results of gastroscopy and pathology, patients were divided into five groups by OLGA staging system, respectively. The differences of atrophic progression/reversion rate, detection rates of intraepithelial neoplasia and gastric cancer among different OLGA groups during 5-year follow-up were compared. Results: A total of 437 patients completed endoscopic follow-up, including 207 cases in Stage-0, 158 cases in Stage-Ⅰ, 47 cases in Stage-Ⅱ, 18 cases in Stage-Ⅲ and 7 cases in Stage-Ⅳ. There were 24 cases of atrophy progression, 78 cases of atrophy reversion, 5 cases of intraepithelial neoplasia and 2 cases of gastric cancer. The atrophy progression rate correlated with the rising OLGA stages(χ²=19.14, P<0.001);The rate of atrophy reversion in high-risk group was significantly lower than that in low-risk group(χ²=4.96, P=0.026); The detection rate of intraepithelial neoplasia and gastric cancer in high-risk group was significantly higher than that in low-risk group(χ²=29.63, 11.60, both P<0.05). Conclusions: Histological OLGA staging system is helpful to realize the risk stratification assessment of gastric precancerous states and precancerous lesions. It has practical significance to formulate individualized endoscopic/histological follow-up plan for OLGA high-risk group.

[Differential diagnosis between pulmonary artery sarcoma and central chronic pulmonary thromboembolism:a preliminary study on CT signs]

Objective: To improve the diagnostic accuracy of pulmonary artery sarcoma, and to distinguish it from central chronic pulmonary thromboembolism using CT scans. Methods: In this retrospective study, two groups of pulmonary artery sarcoma (PAS group) and central chronic pulmonary thromboembolism (central CPTE group) confirmed by pathology at our hospital between August 2009 and July 2019 were enrolled, clinical features and pre-operative CT pulmonary artery manifestation were collected, and the key points of differential diagnosis were summarized. Results: The study was composed of 13 cases in the PAS group including 10 males (76.9%), with an average age of (45.4±15.5) years. There were 19 patients in the central CPTE group including 14 males (73.7%), with an average age of (38.6±14.1) years. There were no significant differences in gender and age between the two groups. Deep venous thrombosis in the lower extremities was significantly higher in the central CPTE group than in the PAS group (7/19 vs. 0/13, P=0.025), and the N-terminal pro-brain natriuretic peptide value was higher in the central CPTE group than in the PAS group [674.50(261.70-1 977.70) vs. 66.00(28.10-505.50),P=0.001]. In CT pulmonary angiography, the involvement of the main pulmonary artery, and the proximal lesion showing an acute angle to the pulmonary artery wall were more common in the PAS group [11(84.6%) vs. 5(26.3%), P=0.003; 11(84.6%) vs. 2(10.5%), P<0.001, respectively]. The swelling index of the main pulmonary and the left/right main pulmonary arteries in the PAS group were significantly higher, as well as the dilatation in the lobar and segmental pulmonary arteries [1.19±0.17 vs. 0.99±0.19,P=0.006, 10(76.9%) vs. 2(10.5%), P<0.001, respectively]. The right ventricular transverse diameter/left ventricular transverse diameter (RVd/LVd) and pulmonary artery diameter/ascending aortic diameter ratio (Pad/Aod) were significantly lower in PAS group than those in the central CPTE group (0.97±0.19 vs. 1.23±0.35,P=0.020; 0.98±0.25 vs. 1.15±0.20,P=0.039). Conclusions: In CT pulmonary angiography, filling defects involving the main pulmonary artery and showing expansive growth were highly suggestive of pulmonary artery sarcoma. The history of deep venous thrombosis of the lower extremities was helpful for the diagnosis of chronic pulmonary embolism.

Generic Enrichment of Organic Contaminants in Human Biomonitoring: Application in Monitoring Early Life Exposures to Fipronil via Breast Milk

In human biomonitoring, a high-throughput extraction and enrichment method for multiple types of organic contaminants at the part-per-trillion level is critical yet challenging, especially in the limited sample volume. When large-scale sample analysis is involved, low cost is often what we should consider. We describe a generic and straightforward cold-induced liquid-liquid extraction (CI-LLE) strategy to meet this need. Current methods for extracting and enriching organic contaminants from biological samples often require multistep sample processing, including specially tailoring the extraction solvent or adsorbents. This method uses cold-induced phase separation to achieve the extraction and enrichment of studied organic contaminants by adjusting the proportion of acetonitrile/water mixture, so as to integrate the extraction and enrichment in one step without additional reagents and adsorbents. In this study, fipronil insecticide was used as a representative compound to determine the key parameters of CI-LLE. The optimized CI-LLE procedure allowed simultaneous extraction and enrichment of studied organic contaminants, providing excellent enrichment factors (especially for lipophilic organic contaminants). CI-LLE was further applied in monitoring early life exposures of fipronil in 109 breast milk samples. This study provided baseline data on fipronil levels in breast milk samples from China. For infants, exposure to fipronil is of concern. In summary, CI-LLE provides a feasible solution for a generic, efficient, and low-cost preparation of biological samples and promotes high-throughput batch analysis of organic contaminants for large-scale human biomonitoring.

[Fibrinogen gamma-chain mutation, p.Ile171His, leads to hereditary hypofibrinogenemia]

Objective: To explore the clinical phenotype and genotype of a family with hereditary hypofibrinogenemia. Methods: Activated partial thrombin time (APTT), prothrombin time (PT),thrombin time (TT) and thrombelastogram (TEG) were tested in all family members. Fibrinogen activity and antigen were detected by Clauss method and immunoturbidimetric method respectively. All exons and flanking sequences of fibrinogen FGA,FGB,FGG genes were analyzed by PCR, and the products were subjected to Sanger sequencing. Results: The proband represented prolonged PT and TT, low Fg activity and antigen, elevated K value and decreased Angle value in TEG. Other family members reported similar changes including proband's father,daughter and son, and his elder brother and his niece. Exon 5 c.510_512 of FGG gene in the proband revealed a minor deletion mutation. Conclusion: The novel heterozygous missense mutation of exon 5 c.510_512del (Gln170_Ile171 del ins His) of FGG gene is the molecular mechanism that leads to hereditary hypofibrinogenemia in this family.

Exposure to Bisphenolic Analogues in the Sixth Total Diet Study — China, 2016–2019

What is already known about this topic?

Bisphenol A (BPA) and other bisphenolic compounds (BPs) are proved to pose potential endocrine disrupting properties. The primary source of BP exposure is the diet. European Food Safety Authority (EFSA) established a temporary tolerable daily intake (t-TDI) of BPA 4 μg/kg body weight per day.

What is added by this report?

BPs were detected in composite food samples from the Sixth China Total Diet Study (TDS) at percentages of 27.1%–78.5%. The estimated dietary exposure of BPA and bisphenol S (BPS) for an average adult were 18.1 ng/kg body weight per day and 22.2 ng/kg body weight per day, respectively. The main dietary contributors for BPs were cereals, water and beverage, meat as well as vegetables.

What are the implications for public health practices?

BP dietary intake poses low risks on the Chinese general population based on the t-TDI set by EFSA. BPS presented a higher exposure level than BPA, which highlights the need to strengthen the surveillance of BP alternatives in foodstuffs.

Extensively Drug-Resistant (XDR) <i>Salmonella</i> Typhi Outbreak by Waterborne Infection — Beijing Municipality, China, January–February 2022

What is already known about this topic?

Typhoid fever remains a major public health problem in developing countries. Waterborne typhoid fever affects an estimated 27 million people worldwide each year. Decades of indiscriminate antibiotic usage has driven the emergence and spread of multidrug-resistant (MDR) and even extensively drug-resistant (XDR) Salmonella Typhi (S. Typhi) strains.

What is added by this report?

By combining the epidemiological investigations, bacterial isolation from patients and household water, whole genome sequencing and drug resistance analysis, we identified a waterborne typhoid fever outbreak caused by XDR S. Typhi in Beijing municipality. This was the first report of the XDR S. Typhi triggered outbreak in Beijing, which was also rare in China.

What are the implications for public health practice?

This report highlights the importance of ensuring access to affordable and safe drinking water, improved sanitation, and waste management systems for resource-constrained urban populations. Typhoid fever caused by XDR S. Typhi is still a severe public health threat.

Exposure to Polybrominated Diphenyl Ethers in the Sixth Total Diet Study — China, 2016–2019

What is already known about this topic?

What is added by this report?

What are the implications for public health practice?

Exposure to Fipronil Insecticide in the Sixth Total Diet Study — China, 2016–2019

What is already known about this topic?

What is added by this report?

What are the implications for public health practice?

Exposure to Acrylamide in the Sixth Total Diet Study — China, 2016–2019

What is already known about this topic?

Acrylamide (AA) is toxic and potentially carcinogenic and could be formed during the cooking process. It is understood that almost all foods cooked at high temperature contain AA, especially fried foods. The exposure of AA in food threatens human health.

What is added by this report?

In the Sixth China Total Diet Study (TDS), AA was detected in 73.3% samples of the 12 food categories with the concentrations ranging from undetected to 176.90 μg/kg. The average dietary intake of AA was 0.175 µg/kg body weight per day and a significant decrease (45.1%) was observed compared with the Fifth China TDS. Among the 12 food categories, vegetables (59.0%), cereals (18.9%), and potatoes (10.1%) were the main contributors to AA exposure at 88.0%.

What are the implications for public health practice?

This study highlighted the need to continuously monitor dietary acrylamide exposure in China, including changing food processing methods and making reasonable selection of foodstuffs in the daily diet.

Exposure to Chlorinated Paraffins in the Sixth Total Diet Study <i> —</i> China, 2016‒2019

What is already known about this topic?

Short-chain chlorinated paraffins (SCCPs) are persistent organic pollutants that are toxic to organisms. Medium-chain chlorinated paraffins (MCCPs) have similar properties. Chlorinated paraffins (CPs) may be biomagnified through the food chain, thereby threatening human health.

What is added by this report?

The concentrations of SCCP and MCCP in each food sample were 5–265 and 4–306 ng/g, respectively. The estimated dietary exposure to CPs was relatively lower than the threshold set in the current guidelines.

What are the implications for public health practice?

The production and use of SCCP and MCCP have not been prohibited in China yet. Further studies are needed to assess the health risks through dietary exposure to CPs.

Dietary exposure to fumonisins and ochratoxins in the Chinese general population during 2007-2020: Results from three consecutive total diet studies

As widespread contaminants, fumonisins (FBs) and ochratoxins (OTs) in food may cause public health threat. In this study, the dietary exposures to FBs and OTs in the Chinese general population were investigated by means of a total diet study (TDS) approach. A total of 672 composite dietary samples were analyzed by liquid chromatography tandem mass spectrometry (LC-MS/MS) in three consecutive China total diet studies from 2007 to 2020. Combining with the national consumption data, estimated dietary exposure to FBs and OTs were assessed and compared with health-based guidance values (HBGVs). The estimated daily intakes (EDIs) of FBs were 55-237 ng/kg bw/day at the upper bound accounting 2.77%-17.4% of provisional maximum tolerable daily intake (PMTDI). Cereals were the greatest contributor to fumonisin exposure. For ochratoxin A (OTA), the EDIs were 0.65-5.72 ng/kg bw/day at the upper bound accounting 4.67%-40.8% of provisional tolerable weekly intake (PTWI). Although the estimated exposures were well below their respective HBGVs in general, they were found to exceed HBGVs in sporadic regions. Moreover, there was a remarkable increase in the dietary exposure to fumonisin B3 (FB3) and ochratoxin B (OTB) over the last decade that is worth further attention.

Occurrence and Dietary Intake of Organophosphate Esters via Animal-Origin Food Consumption in China: Results of a Chinese Total Diet Study

Although diet is regarded as a major exposure source of organophosphate esters (OPEs), the dietary survey of OPEs in China has been limited. Based on the sixth Chinese Total Diet Study (TDS) conducted during 2016-2019 in 24 of 34 provinces in China, 14 OPEs were detected in 96 food composites from four animal-origin food categories. Twelve OPEs were detected in more than 80% of the samples and 2-ethylhexyl diphenyl phosphate (EHDPP) presented the highest median concentration (1.63 ng/g wet weight (ww)). The most contaminated food composite was meat, with a median ∑₁₄OPEs of 13.6 ng/g ww, followed by aquatic food (11.5 ng/g ww), egg (7.63 ng/g ww), and milk (3.51 ng/g ww). The contribution of the meat group was close to or even greater than 50% in the estimated dietary intake (EDI) of OPEs. The average (range) EDI of the ∑₁₄OPEs via animal food consumption for a Chinese "standard man" was 34.4 (6.18-73.3) ng/kg bodyweight (bw)/day. The geographical distribution showed higher EDI in southern coastal provinces compared to the northern inland provinces. Nevertheless, the highest EDI of ∑₁₄OPEs from animal food was still more than 10 times lower than the reference dose. This is the first national survey of OPEs in foods from China.

[Effect of spinopelvic sagittal parameters and facet joint angle on degenerative lumbar spondylolisthesis]

OBJECTIVE

To investigate the effect and correlation of spinopelvic sagittal parameters and facet joint angle on degenerative lumbar spondylolisthesis.

METHODS

From July 2016 to September 2019, a total of 120 patients with L₄-L₅ single segment degenerative spondylolisthesis were selected as observation objects (spondylolisthesis group), and 120 patients with L₄-L₅ single-segment degenerative spinal stenosis matched by gender and age were selected as the control group. The following parameters were measured by imaging data:pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), sagittal vertical axis (SVA), L₄-L₅ cephalic facet joint angle, caudal facet joint angle and facet asymmetry.The differences of parameters between the two groups were compared and the meaningful parameters were analyzed by Logistic regression. The correlations between facet joint direction and spinopelvic parameters in patients with degenerative lumbar spondylolisthesis were analyzed.

RESULTS

There were significant differences in PI, PT, LL, SVA, cephalic facet angle and caudal facet angle between two groups (P<0.05). Logistic regression analysis showed that PI, PT and cephalic facet joint angle were the risk factors for lumbar spondylolisthesis (P<0.05). The sagittal of the cephalic facet joint in spondylolisthesis group was significantly correlated with PI and PT(P<0.05).

CONCLUSION

High PI, PT and sagittal of cephalic facet joint are the risk factors for lumbar spondylolisthesis, and the sagittal degree of facet joints is closely related to high PI and PT.

[A multicenter randomized controlled study of bismuth-containing quadruple therapy followed by Jing-Hua-Wei-Kang in the treatment of patients newly diagnosed with Helicobacter pylori infection and dyspepsia]

Objective: To investigate the Helicobacter pylori (H. pylori) eradication rate and improvement of dyspepsia in patients who were newly diagnosed with H. pylori infection and dyspepsia and treated by bismuth-containing quadruple therapy followed by Jing-Hua-Wei-Kang(JHWK). Methods: Patients who were newly diagnosed with dyspepsia and H. pylori infection and treated in 16 medical centers in China between December 1, 2017 and September 30, 2019 were randomly divided into two groups. The experimental group received bismuth-containing quadruple therapy (esomeprazole+amoxicillin+furazolidone+colloidal bismuth pectin capsule, 14 days), followed by JHWK (30 days), and the course of treatment was 44 days in total. In the control group, the administration regimen was bismuth-containing quadruple therapy (esomeprazole+amoxicillin+furazolidone+colloidal bismuth pectin capsule, 14 days). The main outcome measure was H. pylori eradication rate, while the secondary outcome measures were dyspepsia symptom changes and adverse events during the treatment and the 1st month after treatment. Results: A total of 1 054 patients were included in the study. There were 522 cases enrolled in the experimental group, including 224(42.91%) men and 298(57.09%) women, and the age was 53(26, 73) years old; 532 cases enrolled in the control group, including 221(41.54%) men and 311(58.46%) women, and the age was 46(22, 71) years old. Based on PP analysis, it was found that the H. pylori eradication rate in the experimental group was significantly higher than those in the control group (93.85% vs 87.88%, P=0.001). In the group of all enrolled patients, the symptom dyspepsia after H. pylori eradication was significantly improved compared with that before treatment [4(4, 7) vs 15(10, 22), P<0.001], so was the superior and middle abdominal pain [1(1, 4) vs 4(1, 8), P<0.001], the postprandial fullness [1(1, 4) vs 4(4, 9), P<0.001], the early satiety [1(1, 1) vs 4(1, 4), P<0.001], and the heartburn [1(1, 1) vs 1(1, 4), P<0.001]. The symptom dyspepsia after treatment was significantly improved compared with that before treatment in the experimental, the control groups, the successful and the unsuccessful H. pylori eradication groups. The superior and middle abdominal pain after treatment was signifcantly improved than that before treatment [1(1, 2) vs 1(1, 4), P<0.001], so were the postprandial fullness [1(1, 3) vs 1(1, 4), P=0.002] and the dyspepsia[4(4, 7) VS 7(4, 10), P<0.001]. There was no statistically significant difference in the incidence of adverse events between the experimental group and the control group (1.34% vs 0.38%, P=0.09). Conclusions: Compared with bismuth-containing quadruple therapy, bismuth-containing quadruple therapy followed by JHWK significantly improves the H. pylori eradication rate without increasing the incidence of adverse events. H. pylori eradication therapy can improve symptoms of patients with H. pylori infection and dyspepsia.