Objective To assess the relationship between acute exposure to gaseous air pollutants (SO2, NO2) and daily mortality in Shanghai. Methods Semi-parametric generalized additive model was used to analyze the relationship between SO2/NO2 concentrations and daily death numbers from January 1, 2001 to December 31, 2004 in the urban area of Shanghai after adjustment for the long-term trend of death, weather conditions, and "days of the week" effect. Results An increase of 10 ?g/m3 of SO2 could increase the total mortality, cardiovascular disease mortality and respiratory disease mortality by 1.25%(95%CI: 0.85%-1.65%), 1.45%(95%CI: 0.86%-2.04%) and 1.71%(95%CI: 0.72%-2.71%) respectively; as for an increase of 10 ?g/m3 of NO2, the mortalities could be increased by 1.04%(95%CI: 0.72%-1.35%), 1.05%(95%CI: 0.59%-1.51%) and 1.43%(95%CI: 0.65%-2.21%) respectively. Conclusion The air SO2, NO2 of present levels in Shanghai have an adverse effect on the daily mortality of residents.

ObjectiveTo objectively evaluate the clinical efficacy of three-step acupuncture-cupping therapy for cervicogenic headache.MethodSixty patients were randomly allocated to treatment and control groups. The treatment group received three-step acupuncture-cupping therapy and the control group, conventional acupuncture based on “Acupuncture Therapeutics”. Both groups were treated for three courses (10 days as acourse with two days of rest between two courses) and then the clinical therapeutic effects were evaluated. The evaluation included the overall therapeutic effect on the symptoms, the VASscore and the follow-up recurrence rate at six months after treatment.ResultThe total efficacy rate was 96.7% in the treatment group and 83.3% in the control group; there was a statistically significant difference between the two groups (P<0.01). A follow-up of six months after treatment in the two groups showed that the recurrence rate was 16.7% in the treatment group and 46.7% in the control group;there was a statistically significant difference between the two groups (P<0.05).ConclusionThree-step acupuncture-cupping therapy has a definite effect on cervicogenic headache. Its immediate and long-term effects are superior to those of conventional acupuncture. The recurrence rate in six months is lower in this therapy than in conventionalacupuncture.

Objective To investigate the effect of leg cycle ergometer on walking ability of stroke patients with hemiplegia at convalescent period.Methods Seventy patients with hemiplegia after stroke for 3 to 6 months with a certain walking capability were randomly divided into the treatment group and control group with 35 cases in each group.The control group was treated with routine rehabilitation training;the treatment group was added with leg cycle ergometer training.All patients in the two groups were assessed with simplified Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS),ambulation capacity(walking time in 10 meters and walking distance in 6 minutes and Holden's functional ambulance classification),changes of spasticity,and the ability of daily living(ADL)at the time of begin and 6 weeks later.Results The motor function of lower extremity,balance performance,walking capability and ADL of the patients in two groups improved(P<0.05)after 6 weeks' treatment,but the therapeutic effect of the treatment group was better than the control group(P<0.05).Conclusion The application of leg cycle ergometer combined with routine rehabilitation training can distinctly improve the motor function of lower extremity,balance performance,walking ability and ADL for patients after stroke.

Objective To detect the expression of osteopontin (OPN) in the pancreatic tissues of chronic pancreatitis (CP) rats,and analyze the relationship between the expression of OPN and pancreatic fibrosis.Methods A total of 20 male Wistar rats were randomly divided into control group and CP model group.Control group was treated by tail vein injection of absolute ethanol and glycerol,and CP model group received a single tail vein injection of dibutyltin dichloride (DBTC) to construct CP model.Six weeks after the procedure,the rats were sacrificed to obtain pancreatic tissue,and pathological examinations were routinely performed.Sirius-red staining was used to assess the degree of pancreatic fibrosis.The expression of OPN,α-SMA and Col I in the pancreas of CP rats was detected by immunohistochemistry and Western blot,and the relationship between the expression of OPN and the degree of fibrosis was analyzed.Results In CP model group,3 rats died.In the 7 rats which survived,light microscopic examination observed great proliferation of fibrous tissue in pancreatic interlobular space,vacuolization and necrosis of acinous cells,the infiltration of inflammatory cells in the pancreatic interlobular space and dilation of pancreatic duct.Results of Sirius-red staining showed that a large number of fresh red stripe and reticular collagen fibers were deposited in the interlobular space of the pancreatic tissues in the CP group,whereas there were only a few fiber deposited around the blood vessels and the pancreatic duct in the control group and the stained area in CP group (51 ± 11)％ was significantly larger than that of control group (9 ± 4)％ and the difference was statistically significant (P ＜ 0.01).The results of immunohistochemistry showed that the expression of OPN in CP group was strong positive in 3 rats and positive in 4 rats,which in control group was weak positive in 3 rats and negative in 7 rats.OPN expression in CP group was significantly higher than that in control group (Z =-5.170,P ＜ 0.01),and the expression of OPN was positively correlated with the Sirius-Red staining area (r =0.790,P ＜ 0.01).Western-blot results showed that the expression of OPN,α-SMA and Col I in CP group was significantly higher than that in control group (0.70 ±0.22 vs 0.24 ±0.11,0.71 ± 0.10 vs 0.06 ± 0.01,2.83 ± 1.42 vs 0.39 ± 0.07),and the differences were statistically significant (all P ＜ 0.05).Conclusions A single tail vein injection of DBTC can be used to successfully establish CP rat model.The expression of OPN is significantly increased in the CP group and is positively correlated with pancreatic fibrosis.

Objective To explore the disease cognition and demand of health education in outpatients with foodborne diarrhea so as to provide a basis for prevention and health education of foodborne diarrhea. Methods A total of 342 patients with foodborne diarrhea were selected by convenience sampling from 1st April 2016 to 1st October 2016. They were investigated with the self-designed disease cognition scale for patients with foodborne diarrhea and the demand of health education scale. Results When foodborne diarrhea occurred, treatment behavior patients preferred was without treatment (41.81%). Before the hospital visit,most of them used antidiarrheal agent (47.37%) and antibiotics (31.87%). During diarrhea,fasting was in the majority (69.88%). The influencing factors of knowledge condition in patients with foodborne diarrhea were ages, degrees of education,frequency of diarrhea in the last six months (P< 0.01). The high demand of patients with foodborne diarrhea on knowledge was the prevention of foodborne diarrhea (89.47%),treatment methods of diarrhea (88.30%),diet management (82.75%). The low demand on knowledge was the cause (35.96%) and clinical manifestation (31.58%) of foodborne diarrhea. Conclusions The disease cognition of outpatients with foodborne diarrhea is low. They are with high demand on prevention and treatment of foodborne diarrhea. Medical staff should provide targeted health education according to ages,degrees of education,actual demand and so as to prevent foodborne diarrhea.

Objective To explore the application effect of Orem self -care theory on incision infection in the elderly patients in the orthopedics department .Methods One hundred and twenty elderly patients with operation in the orthopedics department were randomly divided into the observation group and the control group , each with 60 cases.The control group received the routine nursing , and the observation group received the self-care with the help of Orem self-care theory including three systems on the basis of routine nursing .The incidence rate of incision infection and the satisfaction of nursing were compared between the two groups .The obtained datas were analyzed by the statistical software SPSS 16.0, the satisfaction of patients was compared with t test, the incidence rate of incision infection was compared with χ2 test, and a P-value less than 0.05 was considered statistically significant .Results The score of patients ’ satisfaction was (84.23 ±5.52) in the control group, and (97.98 ±6.01) in the observation group, and the difference was statistically significant (t=4.980, P<0.05).The cases of incision infection were three cases in the control group , and no incision infection was found in the observation group, and the difference was statistically significant (χ2 =12.412, P <0.05). Conclusions Orem self-care theory can help the elderly patients with incision infection get better result of operation in the orthopedics department .

Objective:To summarize the clinical characteristics and treatment outcome of neonates with laryngopharyngeal congenital structural abnormalities in intensive care unit.Methods:The clinical data of neonates with congenital laryngopharyngeal structural abnormalities in the Neonatal Intensive Care Unit of the National Center of Beijing Children′s Hospital, Capital Medical University from January 2017 to December 2018 were retrospectively analyzed.The general data, birth status, disease types and clinical characteristics of abnormal laryngeal structure, complications, treatment and follow-up of some children with special diseases were summarized.These neonates were divided into the operation group and the conservative treatment group according to treatment methods, and then the outcomes of the two groups were compared.Results:A total of 133 cases of neonates with laryngopharyngeal congenital structural abnormalities were enrolled, including 73 cases(54.88%) with laryngomalacia, and 60 cases(45.12%) with special structural abnormalities.Of 60 cases with special structural abnormalities, 26 cases (19.54%) had pharynx and larynx cysts, 18 cases (13.53%) had vocal cord paralysis, 4 cases (3.00%) had laryngeal cleft, 2 cases (1.50%) had subglottic hemangioma, 3 cases (2.25%) had Pireer Robin, 1 case (0.75%) had laryngeal poof, 5 cases (3.75%) had pharynx softening, 1 case (0.75%) had subglottic stenosis.Nine patients had special structural abnormalities and laryngomalacia simultaneously.Fiber nasopharyngoscope and enhanced CT were main auxiliary examinations.Twenty-two(16.5%) cases received surgical treatment.Conclusions:Early diagnosis is needed for the neonates and abnormal laryngeal structure.The best treatment scheme should be evaluated according to the condition of the newborn.For some acute cases, early operation and multidisciplinary comprehensive treatment are warranted.

Objective:To investigate the efficacy of venetoclax-based combined regimen in treatment of adult patients with acute myeloid leukemia (AML).Methods:The data of 50 adult AML (non-acute promyelocytic leukemia) who received venetoclax-based combined regimen in the First Affiliated Hospital of Xiamen University, Dongguan People's Hospital, the First Hospital of Longyan City, Jieyang People's Hospital from December 2018 to May 2021 were retrospectively analyzed. Different doses venetoclax combined with demethylation drugs or low-dose chemotherapy regimen were used to analyze the therapeutic efficacy. The related factors influencing efficacy were analyzed by using logistic regression.Results:The composite complete remission (CR) rate of 50 AML patients was 62.0% (31/50), the overall response rate (ORR) was 76.0% (38/50); 28 patients achieved effectiveness [CR and partial remission (PR)] after the first cycle and could achieve effectiveness by 3 courses of treatment at the latest. Among 50 patients, 28 cases were newly diagnosed AML, the composite CR rate was 60.8% (17/28), ORR was 78.6% (22/28); 22 cases were recurrent and relapsed, the composite CR rate was 63.6% (14/22), ORR was 72.7% (16/22); and there was no statistically significant difference of ORR between the both groups ( χ2 = 0.23, P = 0.743). Logistic regression multivariate analysis showed age was the only independent influencing factor for the treatment effectiveness ( OR = 8.451, 95% CI 1.306-54.697, P = 0.025). The median duration time of patients receiving venetoclax treatment regimen was 4.5 months (1.1-15.0 months); 16 cases who had treatment effectiveness finally relapsed, the median time of maintaining effectiveness was 5 months (1.1-11.0 months). Additionally, the common treatment-related adverse reactions included bone marrow suppression after treatment, followed by some gastrointestinal reactions like nausea, vomiting and stomachache. In addition, no patient stopped medication for more than 1 week due to bone marrow suppression related complications. Conclusion:Venetoclax-based combined regimen shows a good short-term efficacy in treatment of AML. It is also effective and tolerable for elderly patients receiving reduced dose therapy.

【Objective】 To evaluate the efficacy and safety of plasma-derived human coagulation factor Ⅷ (FⅧ) in the treatment of patients with hemophilia A. 【Methods】 A multi-center and open, SAT(single-arm trials) clinical study was conducted. A total of 54 subjects with hemophilia A were enrolled in 5 research centers. FⅧ was injected according to the subjects' weight, severity of disease and other factors, and the transfusion efficiency of FⅧ activity at 10 min after the first infusion of the first bleeding event was taken as the main efficacy indexes. The improvement scores of bleeding symptoms and signs within 24 h after the first infusion of the first bleeding event were the secondary efficacy indexes. The pathogenic microbial indexes and FⅧ inhibitors were detected on 90(th) and 180(th) day after treatment. 【Results】 The transfusion efficiency of FⅧ activity of 54 subjects at 10 min after the first infusion was 171.9% on average, with median of 169.5%, both higher than the target value of 100%. Within 24 h after the first infusion, the improvement of bleeding symptoms and signs of the subjects were scored, among which 19 cases (35.2%) were "obvious", 35 cases (64.8%) were "good", and the total clinical effective rate reached 100%. Five subjects (9.3%) had six drug-related adverse events. On 90(th) and 180(th) day after treatment, hepatitis B surface antigen, hepatitis C antibody, HIV antibody, treponema pallidum antibody and FⅧ inhibitors were detected, and no negative to positive cases were found. 【Conclusion】 After infusion, the FⅧ preparation can significantly improve the FⅧ activity level in hemophilia A patients in a short period of time, which has high infusion efficiency and can achieve better treatment efficacy, and can also effectively control and relieve bleeding symptoms and signs, with good overall safety.