A growing body of evidence has investigated the association between maternal exposure to PM2.5 (particulate matter with aerodynamic diameter 2.5 μm) during pregnancy and adverse pregnancy outcomes. However, the results of those studies are not consistent. To synthetically quantify the relationship between maternal exposure to PM2.5 during pregnancy and pregnancy outcomes (the change in birth weight, low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), and stillbirth), a meta-analysis of 25 published observational epidemiological studies that met our selection criteria was conducted. Results suggested a 10 μg/m(3) increase in PM2.5 was positively associated with LBW (odds ratio (OR) = 1.05; 95 % confidence interval (CI), 1.02-1.07), PTB (OR = 1.10; 95 % CI, 1.03-1.18), and SGA (OR = 1.15; 95 % CI, 1.10-1.20) based on entire pregnancy exposure, and pooled estimate of decrease in birth weight was 14.58 g (95 % CI, 9.86-19.31); however, there was no evidence of a statistically significant effect of per 10 μg/m(3) increase in PM2.5 exposure on the risk of stillbirth (OR = 1.18; 95 % CI, 0.69-2.04). With respect to three different gestation periods, no significant risks were found in PTB, stillbirth, and the first trimester on the change of birth weight with a 10 μg/m(3) increase in PM2.5. In this study, a comprehensive quantitative analysis of the results show that PM2.5 can increase the risk of LBW, PTB, and SGA; pregnant women need to take effective measures to reduce PM2.5 exposure.

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A growing number of studies have associated short-term exposure to ambient particulate matter air pollution (PM) and risk of specific cardiovascular events, just as myocardial infarction (MI). However, the results of the recent studies were inconsistent; therefore, a systematic review and meta-analysis was performed. To synthetically quantify the association between short-term exposure to PM and risk of MI, a meta-analysis was conducted to combine the estimates of effect for a relationship between short-term exposure to PM10, PM2.5 (particulate matter ≤ 10 μm, 2.5 μm in diameter) and risk of MI. Electronic database searches for all relevant published studies were updated in January 2015. And, a random-effects model was performed to estimate pooled relative risk (RR) and 95 % confidence intervals (95 % CI). Thirty-one published observational epidemiological studies were identified. Risk of MI was significantly associated with per 10 μg/m(3) increment in PM10 (OR = 1.005; 95 % CI 1.001-1.008) and PM2.5 (OR = 1.022; 95 % CI 1.015-1.030). The risk of PM2.5 exposure was relatively greater than PM10. In the subgroup analysis by study design, location, quality score, and lag exposure, the results were basically consistent with the former overall results in PM2.5 but slightly changed in PM10. Short-term exposure to particulate matter (PM2.5, PM10) was a risk factor for MI, and the results further confirmed the discovery in the previous meta-analysis.

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High expression of cancer stem cell (CSC) markers is related to poor prognosis of patients with hepatocellular carcinoma (HCC). However, the expression of these markers in patient-derived xenograft (PDX) models and the relationship of the expression levels of these markers between HCC patients and their PDX models at subsequent low passages are unclear. To investigate the prognostic impact of putative CSC markers in patients with HCC and in related PDX models, the expression of CD133, CD90, CD44, ALDH1, CK7, CK19, OCT4, SOX2, vimentin, nestin, CD13 and EpCam were assessed by quantitative reverse transcription-PCR (qRT-PCR) and then were validated using immunohistochemistry in tumor or peritumoral tissues from patients and tumor tissues from PDX models. Cumulative survival analysis of the patients and animals was conducted using the Kaplan-Meier method and the log-rank test. Only the expression levels of CD133 and CD44 were higher in tumor tissues than in the peritumoral tissues of HCC patients by qRT-PCR. High consistency of the prognostic value of the expression of CD133/CD44 was observed in HCC patients and the PDX models. High expression levels of CD133 and CD44 were positively related to the poor prognosis of HCC patients and to that in the PDX models. PDX HCC models in the present study have been suggested to be predictive of disease outcome, which could shed light on personalized medicine and the mechanisms of CSC marker expression on prognosis.

BackgroundAdjunctive corticosteroids therapy is an attractive option for community-acquired pneumonia (CAP) treatment. However, the effectiveness of adjunctive corticosteroids on mortality of CAP remains inconsistent, especially in severe CAP. We performed a meta-analysis to evaluate the efficacy and safety of adjunctive corticosteroids in severe CAP patients.MethodsThree databases of PubMed, EMBASE and Cochrane Library were searched for related studies published in English up to December, 2015. Randomized controlled trials (RCTs) of corticosteroids in hospitalized adults with severe CAP were included. Meta-analysis was performed by a random-effect model with STATA 11.0 software. We estimated the summary risk ratios (RRs) or effect size (ES) with its corresponding 95% confidence interval (95%CI) to assess the outcomes.ResultsWe included 8 RCTs enrolling 528 severe CAP patients. Adjunctive corticosteroids significantly reduced all-cause mortality (RR = 0.46, 95%CI: 0.28 to 0.77, p = 0.003), risk of adult respiratory distress syndrome (ARDS) (RR = 0.23, 95%CI: 0.07 to 0.80, p = 0.02) and need for mechanical ventilation (RR = 0.50, 95%CI: 0.27 to 0.92, p = 0.026). Adjunctive corticosteroids did not increase frequency of hyperglycemia requiring treatment (RR = 1.03, 95%CI: 0.61 to 1.72, p = 0.91) or gastrointestinal hemorrhage (RR = 0.66, 95%CI: 0.19 to 2.31, p = 0.52). In subgroup analysis by duration of corticosteroids, we found that prolonged corticosteroids therapy significantly reduced all-cause mortality (RR = 0.41, 95%CI: 0.20 to 0.83, p = 0.01) and length of hospital stay (−4.76 days, 95% CI:-8.13 to -1.40, p = 0.006).ConclusionsResults from this meta-analysis suggested that adjunctive corticosteroids therapy was safe and beneficial for severe CAP. In addition, prolonged corticosteroids therapy was more effective. These results should be confirmed by adequately powered studies in the future.

Accumulating evidence has shown the effects of air pollution on respiratory disease and lung cancer mortality, but the evidence is still inconclusive to date. We conducted a time-series analysis, which included 10388 subjects, to assess the short-term effects of air pollution on respiratory disease and lung cancer mortality in Hefei, China, from 2009 to 2015. The mean concentrations of pollutants (PM 10 , NO 2 and SO 2 ) were 106.35, 30.40, and 20.66 μg/m 3 , respectively, during the study period. An increase of 10 μg/m 3 in SO 2 , NO 2 , and PM 10 was associated with 7.69% (95%CI: 3.41%-12.15%), 4.38% (95%CI: 1.33%-7.53%), and 1.55% (95%CI: 0.80%-2.30%) increase of respiratory diseases mortality, respectively. In contrast, lung cancer mortality was only significantly associated with SO 2 level. Subgroup analyses showed that female in respiratory disease patients were more sensitive to air pollution than male. Studies about seasonality of pollutants on respiratory and lung cancer mortality were inconsistent. Further analyses with multiple-pollutant model showed that the effects of pollutants were generally decreased after the other pollutants were adjusted, except the effects of SO 2 on lung cancer. These findings demonstrated that air pollution could evidently increase the respiratory disease and lung cancer mortality.

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