Objective To research the relationship between high temperature and population death in cardio-cerebrovascular diseases in Shijiazhuang.Methods The time series of maximum daily temperature and daily death number of cardio-cerebrovascular diseases were described,and the relationship between daily maximum temperature and daily mortality of cardio-cerebrovascular diseases in summer was analyzed.The impact of daily highest temperature in summer from 2009 to 2011 on daily death of cardio-cerebrovascular diseases was analyzed.Results In summer,the highest temperature which could reach to 41.7℃ emerged mostly in July and August,and when the highest temperaiure was higher than 34℃,cardio-cerebrovascular diseases death increased obviously as the temperature increasing.The relative humidity was more than 70％ in most time of the year round.The excessive death in hot days accounted for 10.9％ in which the old people occupied the majority.Conclusion The extreme high temperature may obviously increase the cardio-cerebrovascular death in Shijiazhuang.

Objective To compare the efficacy, toxicity and later period complications of Cf-252 neutron intracavitary brachytherapy(IBT) combined with external-beam radiotherapy (EBRT) with those of EBRT alone in patients with esophageal carcinoma. Methods Eighty-six patients were randomized into 252Cf neutron IBT and EBRT group (intracavitary group: 43 patients) and EBRT alone group (external group:43 patients). The external group was treated with three-dimensional conformal radiotherapy(3DCRT) or conventional radiotherapy of 70 Gy in 7.0 weeks using Elekta Precise medical linear accelerator. The EBRT in intraeavitary group was as same as external group, except the total dose was decreased to 60 Gy in 6.5 weeks. For IBT, the applicator with special water bursa was settled to the esophageal lesion through the mouth. The dose calculation point was 10 mm far away from the source and 1-2 em cranial-caudally from the tumor margin. 252Cf braehytherapy was delivered 3-4 fractions at 4 Gy per fraction per week. In intracavitary group, EBRT was begun on the second day of IBT. EBRT and IBT were not given on the same day. Results After the treatment,the esophageal stricture was relieved earlier in intracavitary group than external group.Six patients in intracavitary group who had drinking obstruction symptom could eat liquid food after esophageal balloon dilation, one fraction of 252 Cf neutron IBT and 5-6 days of EBRT, and could eat semiliquid food two weeks after. In the third month, the complete response rate, partial response rate and no response rate were 33%, 67% and 0% in i ntracavitary group and 19% ,76% and 5% in external group, respectively. The overall response rates of the two groups were 100% and 95% ( χ2 = 4.32, P ＜ 0.05 ). The 1 -year local control rates were 84% and 70% (χ2 =4.57 ,P ＜0.05). The 1-year survival rates were 81% and 61% (χ2 =4.17,P ＜0.05 ). The rates of acute esophageal toxicity was 61% and 51% ( χ2 = 1.75,P ＞ 0.05 ). The acute radiation esophagitis was slightly higher in "BZ ]intracavitary group than that in external group, but the difference was insignificant. The late esophageal-cardiac stricture had no significant difference between the two groups. Conclusions 252 Cf-252 neutron IBT plus EBRT, without increasing the toxicity,are better than EBRT alone.

Objective:To investigate the incidence and prothrombotic risk factors of postoperative venous thromboembolism(VTE) in Cushing′s disease and to further develop an assessment model to identify those at high risk of postoperative VTE events.Methods:A retrospective study was performed in 82 patients who were admitted to Huashan Hospital, Fudan University during January 2019 and January 2020 and diagnosed with Cushing′s disease. These patients underwent the evaluation about their clinical, hormonal, and coagulation parameters, as well as ultrasonography and pulmonary angio-CT when necessary. The least absolute shrinkage and selection operator(LASSO) regression analysis was used to screen independent risk factors, and a nomogram model for postsurgical VTE risk assessment in Cushing′s disease was initially established, and Bootstrap method was used for internal verification. Finally, the predictive model was evaluated for calibration and clinical applicability in the study cohort.Results:Nineteen patients(23.17%) developed VTE events, with 14 cases occurring after endoscopic transsphenoidal surgery. Compared to patients without VTE, those in the VTE group were older( P<0.001), had longer postoperative bed rest, higher rates of current infection, higher HbA 1C levels, and more severe glucose tolerance impairment(all P<0.05). Through LASSO regression analysis, two independent risk factors for postoperative VTE were identified: Age and current infection. Then a VTE risk assessment nomogram model was established to predict the patients at high risk of VTE. In the nomogram model for VTE risk assessment, the area under the receiver operating characteristic curve was 0.868(95% CI 0.787-0.949), with the calibration curve closely aligning with the ideal diagonal line and the clinical decision curve exceeding the two extreme curves. Conclusions:Advanced perioperative assessment needs to be taken to screen those with high VTE risks in patients diagnosed with Cushing′s disease. Additionally, during the perioperative period, patients with Cushing′s disease should undergo mandatory physical activity or prophylactic anticoagulant therapy.