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Objectives To describe the hospitalization spending for cancers in Hunan Province, China, and to investigate the hospitalization cost across diverse cancer classifications. Methods We conducted a retrospective study based on the hospitalization admission data from 2017 to 2019 in Hunan Province. We retrieved information on age, sex, diagnosis, number of comorbidities, level of hospitalization, hospital location, hospital costs, length of stay, and type of payer for eligible participants. Factors for cost (log-transformed) were investigated through multiple linear regression. Results A total of 872,309 records of cancer were hospitalized in Hunan Province during 2017–2019, with a total cost of US$2490.36 million, and 64.10% of the cost was covered by medical insurance. The top five cancers in terms of cost were lung (300.32 million), colorectum ($234.56 million), liver ($126.46 million), lip, oral cavity & pharynx ($102.29 million), and stomach ($98.98 million) cancers in men, were breast ($176.03 million), colorectum ($156.15 million), cervix ($112.68 million), lung ($112.21 million), and thyroid ($56.75 million) cancers in women, respectively. Site of cancer, sex, age, year of hospitalization, number of comorbidities, length of stay, hospital level, and hospital location were significantly associated with the per-capita log-transformed cost. Conclusion The economic burden of cancer was heavy in Hunan, and lung, colorectal, breast, liver, and stomach cancers accounted for half of the total cost. Site of cancer, sex, age, comorbidity, level, and location of hospital were factors for the per-capita cost.

It remains an enigma whether gestational hypertension (GH) and pre-eclampsia (PE) are distinct entities or different spectrum of the same disease. We aimed to compare the risk factors and outcomes between GH and PE. A total of 7,633 pregnant women recruited between 12 and 20 weeks of gestation in the Ottawa and Kingston Birth Cohort from 2002 to 2009 were included in the analysis. Cox proportional hazards model was used to identify and compare the risk factors for GH and PE by treating gestational age at delivery as the survival time. Logistic regression model was used to compare outcome. Subgroup analysis was performed for early- and late-onset PE. GH and PE shared most risk factors including overweight and obesity, nulliparity, PE history, type 1 and 2 diabetes, and twin birth. Effect size of PE history (RR = 14.1 for GH vs. RR = 6.4 for PE) and twin birth (RR = 4.8 for GH vs. RR = 10.3 for PE) showed substantial difference. Risk factors modified gestational age at delivery in patients with GH and PE in similar pattern. Subgroup analysis showed that early- and late-onset PE shared some risk factors with different effect sizes, whereas folic acid supplementation showed protective effect for early-onset PE only. PE was strongly associated with several adverse outcomes including cesarean section, placental abruption, small for gestational age, preterm birth, and 5 min Apgar score < 7, whereas GH was associated with increased risk of preterm birth only. GH and PE shared common risk factors. Differences in effect sizes of risk factors and outcomes indicate that the conditions may have different pathophysiology and mechanism.

Atopic dermatitis (AD) is a prevalent, burdensome, and psychologically important pediatric concern. Probiotics have been suggested as a treatment for AD. Some reports have explored this topic; however, the utility of probiotics for AD remains to be firmly established. To assess the effects of probiotics on AD in children, the PubMed/Medline, Cochrane Library Scopus, and OVID databases were searched for reports published in the English language. Thirteen studies were identified. Significantly higher SCORAD values favoring probiotics over controls were observed (mean difference [MD], -3.07; 95% confidence interval [CI], -6.12 to -0.03; < 0.001). The reported efficacy of probiotics in children < 1 year old was -1.03 (95%CI, -7.05 to 4.99) and that in children 1-18 years old was -4.50 (95%CI, -7.45 to -1.54; < 0.001). Subgroup analyses showed that in Europe, SCORAD revealed no effect of probiotics, whereas significantly lower SCORAD values were reported in Asia (MD, -5.39; 95%CI, -8.91 to -1.87). GG (MD, 3.29; 95%CI, -0.30 to 6.88; = 0.07) and (MD, -0.70; 95%CI, -2.30 to 0.90; = 0.39) showed no significant effect on SCORAD values in children with AD. However, (MD, -11.42; 95%CI, -13.81 to -9.04), (MD, -7.21; 95%CI, -9.63 to -4.78), and a mixture of different strains (MD, -3.52; 95%CI, -5.61 to -1.44) showed significant effects on SCORAD values in children with AD. Our meta-analysis indicated that the research to date has not robustly shown that probiotics are beneficial for children with AD. However, caution is needed when generalizing our results, as the populations evaluated were heterogeneous. Randomized controlled trials with larger samples and greater power are necessary to identify the species, dose, and treatment duration of probiotics that are most efficacious for treating AD in children.

A growing body of evidence indicates that microcystins (MCs) exposure may cause metabolic diseases. However, studies exploring the effects of MCs exposure on the risk of metabolic syndrome (MetS) in humans are currently lacking, and the underlying mechanisms remain unclear. Here, we conducted a cross-sectional study in central China to explore the effect of serum MCs on MetS, and assessed the mediation effects of the inflammation biomarker, white blood cell (WBC) level, in this relationship. The relationships among MCs and WBC level and risk of MetS were assessed using binary logistic and linear regression. Mediation analysis was used to explore possible mechanisms underlying those associations by employing R software (version 4.3.1). Compared to the lowest quartile of MCs, the highest quartile had an increased risk of MetS (odds ratio [OR] = 2.10, 95% confidence interval [CI]: 1.19, 3.70), with a dose–response relationship (p for trend < 0.05). WBCs mediated 11.14% of the association between serum MCs and triglyceride (TG) levels, but did not mediate the association of MCs exposure with MetS. This study firstly reveals that MCs exposure is an independent risk factor for MetS in a dose–response manner, and suggests that WBC level could partially mediate the association of MCs exposure with TG levels.

To evaluate the epidemiology and disease burden of androgenetic alopecia (AGA) in college freshmen in China. This population-based cross-sectional survey was carried out among 9227 freshmen of two comprehensive universities in two cities of China (Changsha and Xiamen) from September 2018 to October 2018. Questionnaires covering basic issues, surrounding demographic information, history of diseases, living habits, comorbidities, etc. were completed online in a self-reported manner Dermatological examination was performed by certified dermatologists. The disease burden of AGA, which includes health-related quality of life, symptoms of anxiety, symptoms of depression and quality of sleep, was measured by EQ-5D-3L, PHQ-2, GAD-2 and PSQI, respectively. The prevalence of AGA in college freshmen in China was 5.3/1000. Male was significantly associated with higher prevalence of AGA (7.9/1000, P<0.01) while female with lower risk of AGA (OR = 0.29, P = 0.002). There was no significant association between BMI and AGA, nor predilection of AGA in the Han nationality or the other ethnic minorities. Annual household income or parental highest educational level exerted no significant influence on the prevalence of AGA. Rosacea (OR = 3.22, P = 0.019) was significantly associated with higher prevalence of AGA while acne seemed not to be related to AGA. The scores of EQ-5D, GAD-2, PHQ-2 and PSQI were not significantly different between students with and without AGA. The onset of AGA in Chinese college freshmen differ between genders and was significantly associated with rosacea.

Increasing evidence from experimental research suggests that exposure to microcystins (MCs) may induce lipid metabolism disorder. However, population-based epidemiological studies of the association between MCs exposure and the risk of dyslipidemia are lacking. Therefore, we conducted a population-based cross-sectional study involving 720 participants in Hunan Province, China, and evaluated the effects of MCs on blood lipids. After adjusting the lipid related metals, we used binary logistic regression and multiple linear regression models to examine the associations among serum MCs concentration, the risk of dyslipidemia and blood lipids (triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)). Moreover, the additive model was used to explore the interaction effects on dyslipidemia between MCs and metals. Compared to the lowest quartile of MCs exposure, the risk of dyslipidemia [odds ratios (OR) = 2.27, 95% confidence interval (CI): 1.46, 3.53] and hyperTG (OR = 3.01, 95% CI: 1.79, 5.05) in the highest quartile was significantly increased, and showed dose–response relationships. MCs were positively associated with TG level (percent change, 9.43%; 95% CI: 3.53%, 15.67%) and negatively associated with HDL-C level (percent change, −3.53%; 95% CI: −5.70%, −2.10%). In addition, an additive antagonistic effect of MCs and Zn on dyslipidemia was also reported [relative excess risk due to interaction (RERI) = −1.81 (95% CI: −3.56, −0.05)], and the attributable proportion of the reduced risk of dyslipidemia due to the antagonism of these two exposures was 83% (95% CI: −1.66, −0.005). Our study first indicated that MCs exposure is an independent risk factor for dyslipidemia in a dose–response manner.

Few studies on nutrition and food safety education intervention for students in remote areas of China were reported. The study aimed to assess the questionnaire used to measure the knowledge, attitude and behavior with respect to nutrition and food safety, and to evaluate the effectiveness of a quasi-experimental nutrition and food safety education intervention among primary school students in poverty-stricken counties of west China. Twelve primary schools in west China were randomly selected from Zhen'an of Shaanxi province and Huize of Yunnan province. Six geographically dispersed schools were assigned to the intervention group in a nonrandom way. Knowledge, attitude and behavior questionnaire was developed, assessed, and used for outcome measurement. Students were investigated at baseline and the end of the study respectively without follow-up. Students in intervention group received targeted nutrition and food safety lectures 0.5 hour per week for two semesters. Item response theory was applied for assessment of questionnaire, and a two-level difference-in-differences model was applied to assess the effectiveness of the intervention. The Cronbach's alpha of the original questionnaire was 0.84. According to item response model, 22 knowledge items, 6 attitude items and 8 behavior items showed adequate discrimination parameter and were retained. 378 and 478 valid questionnaires were collected at baseline and the end point. Differences of demographic characteristics were statistically insignificant between the two groups. Two-level difference-in-differences models showed that health education improved 2.92 (95% CI: 2.06-3.78) and 2.92 (95% CI: 1.37-4.47) in knowledge and behavior scores respectively, but had no effect on attitude. The questionnaire met the psychometric standards and showed good internal consistence and discrimination power. The nutrition and food safety education was effective in improving the knowledge and behavior of primary school students in the two poverty-stricken counties of China.

Background Antenatal depression, especially moderate-to-severe depression, is associated with adverse maternal and infant health outcomes and is affected by multiple psychosocial factors. However, the cumulative effects of psychosocial determinants and trajectories of antenatal depression are underappreciated. This study aimed to investigate the cumulative effects of various psychosocial determinants on antenatal moderate-to-severe depressive symptoms (MSD) based on the polysocial risk score (PsRS), to identify trajectories of MSD based on group-based trajectory modeling (GBTM), and to explore the association between the PsRS and diverse trajectories. Methods A retrospective cohort study was conducted among 21,336 pregnant women in Shenzhen, China, from 2020 to 2023. Antenatal depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9) across three pregnancy trimesters. The PsRS was selected and calculated by counting established social determinants from four social risk domains, including socioeconomic status, lifestyle behaviors, psychosocial factors, and living conditions. GBTM was employed to identify distinct trajectories of depressive symptoms. Multinomial logistic regression investigated the relationship between PsRS and diverse trajectories. Results Of women, 9.1% experienced at least one episode of MSD across three pregnancy trimesters. An intermediate PsRS and a high PsRS were associated with higher risks of MSD during pregnancy, with the adjusted hazard ratios being 1.99 (95% CI, 1.71–2.31) and 4.44 (95% CI, 3.81–5.17), respectively, compared with those with a low PsRS. GBTM identified five distinct trajectories of antenatal depressive symptoms: persistent MSD, resolving MSD, chronic mild, resolving mild, and no depressive symptoms. Above all trajectories, persistent MSD demonstrated the highest PSRS scores and risk gradients. Conclusions This study provides a practical basis for integrating early polysocial risk screening into routine prenatal care, enabling the timely identification and targeted support of high-risk pregnant women. These findings underscore the need for incorporating comprehensive social risk assessment into maternal health policies and intervention programs to improve mental health outcomes across pregnancy.

The study aims to examine the blood pressure (BP) trajectory during pregnancy and its association with pre-gravid BP level. In a pre-conception cohort study, newly-married women in Liuyang, China underwent pre-gravid measurements and were followed throughout the pregnancy. BP was measured at pre-conception and again throughout pregnancy. The functional principal component analysis was used to examine the trajectory of BP changes during pregnancy. A total of 1282 women with a singleton pregnancy who had both pre-conception and gestational BP measurements performed were included in the final analysis. The results showed that BP decreased significantly in early pregnancy and increased thereafter, without BP drop around 20 weeks of gestation. Pre-gravid BP level was inversely associated with the BP drop in early pregnancy, such that women with higher pre-gravid BP had greater BP drop at the beginning, while women with the lowest pre-gravid BP level demonstrated no obvious BP drop throughout the entire pregnancy.

Background Exosomes are a promising tool in disease detection because they are noninvasive, cost-effective, sensitive and stable in body fluids. MicroRNAs (miRNAs) are the main exosomal component and participate in tumor development. However, the exosomal miRNA profile among Asian melanoma patients remains unclear. Methods Exosomal miRNAs from the plasma of melanoma patients (n = 20) and healthy individuals (n = 20) were isolated and subjected to small RNA sequencing. Real-time PCR was performed to identify the differential miRNAs and to determine the diagnostic efficiency. Proliferation, scratch and Transwell assays were performed to detect the biological behavior of melanoma cells. Results Exosomal miRNA profiling revealed decreased miR-1180-3p expression as a potential diagnostic marker of melanoma. The validation group of melanoma patients (n = 28) and controls (n = 28) confirmed the diagnostic efficiency of miR-1180-3p. The level of miR-1180-3p in melanoma cells was lower than that in melanocytes. Accordingly, the level of miR-1180-3p was negatively associated with the proliferation, migration and invasion of melanoma cells. Functional analysis and target gene prediction found that ST3GAL4 was a potential target and highly expressed in melanoma tissues and was negatively regulated by miR-1180-3p. Knockdown of ST3GAL4 hindered the malignant phenotype of melanoma cells. Conclusions This study indicates that reduced exosomal miR-1180-3p in melanoma patient plasma is a promising diagnostic marker and provides novel insight into melanoma development.