Background/Aims: Published studies indicated that the MTHFR gene polymorphisms C677T and A1298C are associated with congenital heart disease (CHD) risk in children, but obtained inconsistent results. Our study aims to reach a more accurate association between these two polymorphisms and CHD risk. Methods: Eligible studies were obtained by screening the PubMed, Embase, China National Knowledge Infrastructure, Wan Fang and VIP databases based on designed searching strategy. The odds ratio (OR) and 95% confidence interval (CI) were calculated. Moreover, a trial sequential analysis was introduced to confirm the positive results and an RNA secondary structure analysis was also applied to discover the potential molecular mechanism. Results: Based on thirty-two published articles, involving 6988 congenital heart disease subjects and 7579 healthy controls, the pooled results from the C677T polymorphism in the fetal population showed increased risks in allelic model (OR=1.32, 95%CI=1.14-1.53), recessive model (OR=1.69, 95%CI=1.25-2.30), dominant model (OR=1.35, 95%CI=1.11-1.64), heterozygote model (OR=1.20, 95%CI=1.01-1.41) and homozygote model (OR=1.75, 95%CI=1.31-2.33). An increased risk was only detected in the A1298C polymorphism in the overall fetal popalation in a recessive model (OR=1.42, 95%CI=1.10-1.84). In the subgroup stratified by region, sample size, genotyping method and source of controls, the increased risks were widely observed in both the C677T and A1298C polymorphisms with CHD risk. Furthermore, trial sequential analysis confirmed our positive results, and the RNA secondary structure analysis detected the changes in the RNA secondary structure caused by the mutant 677T allele and 1298C allele. Conclusion: In summary, we found that the MTHFR C677T polymorphism is associated with a significant increased risk in congenital heart disease in the fetal population. Moreover, an increased risk in the CC genotype of MTHFR A1298C polymorphism was observed, but the protective role of the 1298C allele needs further study.

ADIPOQ gene polymorphisms have been indicated to be associated with hypertension; however, published studies have reported inconsistent results. Eligible studies were retrieved by searching the PubMed, Embase and China National Knowledge Infrastructure databases. The case group consisted of patients with hypertension, and the control group consisted of subjects with normal blood pressure. Based on eleven published articles, involving 4837 cases and 5618 controls, the pooled results from rs2241766 polymorphism showed increased risk in the allelic model (G VS T: OR = 1.16, 95%CI = 1.06–1.27), recessive model (GG VS GT + TT: OR = 1.34, 95%CI = 1.10–1.63), dominant model (GG + GT VS TT: OR = 1.15, 95%CI = 1.02–1.30) and homozygote model (GG VS TT: OR = 1.38, 95%CI = 1.21–1.69). In addition, rs266729 polymorphism showed increased risk for hypertension in the recessive model (GG VS GC + CC: OR = 1.43, 95%CI = 1.02–2.01). In the Caucasian subgroup, rs1501299 polymorphism showed decreased risk of hypertension in the allelic model (T VS G: OR = 0.75, 95%CI = 0.58–0.97), dominant model (TT + TG VS GG: OR = 0.83, 95%CI = 0.71–0.98) and heterozygote model (TG VS GG: OR = 0.82, 95%CI = 0.68–0.99). The rs2241766 polymorphism was associated with a significant increase in hypertension risk based on our analysis. Moreover, an increased risk of rs266729 in hypertension patients was also detected. Our meta-analysis suggests that the rs1501299 polymorphism may play a protective role in hypertension in Caucasian subgroup; however, this finding requires further study.

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The composite layered structures including paper corrugation, paper honeycomb and expandable polyethylene are innovative structures of cushioning energy absorption, and the compression and impact resistances of the expandable polyethylene can be enhanced by laminating the corrugated paperboard or honeycomb paperboard. This article evaluated the compression performance and cushioning energy absorption of the composite layered structures by the static compression and drop impact compression tests. On one hand, the static compression properties showed that the total energy absorption, energy absorption per unit volume and stroke efficiency of the composite layered structures were all higher than those of expandable polyethylene. The specific energy absorption was enhanced with the increase in compression strain but almost not affected by the compression rate. The specific energy absorption of the composite layered structures including the expandable polyethylene and honeycomb paperboard was greater than those of the expandable polyethylene and corrugated paperboard. The energy absorption efficiency of the composite layered structures including the expandable polyethylene and corrugated paperboard was large for the low compression stress level, yet that of the composite layered structures including the expandable polyethylene and honeycomb paperboard was large for the high compression stress level. On the other hand, the dynamic compression characteristics showed that the peak stress, energy absorption per unit area, energy absorption per unit volume and specific energy absorption of the composite layered structures embodying paper sandwich cores and expandable polyethylene had linear increasing trends with the increase of drop shock energy. At the same drop impact condition, the composite layered structures including the honeycomb paperboard and expandable polyethylene had better cushioning energy absorption, the peak stress decreased by 23.6% on average, the energy absorption efficiency raised by 8.85% on average and the specific energy absorption increased by 18.1% on average than those including the corrugated paperboard and expandable polyethylene. Therefore, the corrugated paperboard and honeycomb paperboard can helpfully improve the cushioning energy absorption of the expandable polyethylene, and the composite layered structures embodying the expandable polyethylene, corrugated paperboard and honeycomb paperboard may hold excellent packaging protection.

In view of cushioning energy absorption of paper composite sandwich structures with sinusoidal corrugation and hexagonal honeycomb cores, the static yield strength and compression deformation were firstly analyzed by experiments, then the unit volume energy absorption, unit area energy absorption, and specific energy absorption were evaluated. Further, the influences of static compression rate, corrugation types, and honeycomb thickness on the cushioning energy absorption were respectively studied. The experimental observations show that the paper composite sandwich structures are crushed layer by layer due to the difference in the yield strength of sandwiches, and the honeycomb core is crushed after the collapsing of corrugation core. The three evaluation indices of cushioning energy absorption have similar change rule with the compression rate, corrugation types, and honeycomb thickness. The influence of static compression rate on the yield strength and cushioning energy absorption of the paper composite sandwich structure is not obvious. The composite sandwich structures consisting of paper corrugation sandwich with large inertia moment and honeycomb sandwich with large thickness have more excellent cushioning energy absorption, the B-corrugation can increase the unit volume energy absorption of paper composite sandwich structures by up to 18% than C-corrugation, and the 3-honeycomb can increase the unit volume energy absorption of paper composite sandwich structures by up to 32% than 2-honeycomb.