OBJECTIVETo explore acute effects of SO(2) and NO(2) on mortality in the six cities of China.

METHODSSurveillance data on daily air quality, meteorology and the cause of death were collected from January 1, 2007 to December 31, 2009 in Beijing, Tianjin, Xi'an, Shanghai, Guangzhou and Wuhan. Generalized additive model was used to explore the relationship between the daily average concentration of SO(2) and NO(2) and daily mortality, after adjusting the effects of long-term and seasonal trend and weather conditions.

RESULTSIn Beijing, Tianjin, Xi'an, Shanghai, Guangzhou and Wuhan, the daily average concentration of SO(2) and NO(2) were in the range of 39.8-59.5 µg/m(3) and 41.4-60.1 µg/m(3) respectively; the daily mortality for non-accidental were 174.5, 101.4, 27.7, 108.4, 50.6, 17.8, cardiovascular were 86.9, 53.3, 12.8, 34.8, 16.3, 8.1 and respiratory were 18.3, 8.6, 2.6, 18.6, 9.0, 1.8 respectively. The daily average concentration of SO(2) were negatively correlated with daily average temperature in Beijing, Tianjin, Xi'an and Wuhan (the correlation coefficients were -0.66, -0.73, -0.67 and -0.39 respectively, P<0.05). The daily average concentration of SO(2) were negativeiy correlated with relative humidity in Tianjin, Shanghai and Wuhan (the correlation coefficients were -0.26, -0.46 and -0.28 respectively, P<0.05). The daily average concentration of NO(2) were negative correlated with daily average temperature in Beijing, Tianjin, Xi'an and Wuhan (the correlation coefficients were -0.27, -0.49, -0.45 and -0.38 respectively, P<0.05). When the day concentration of SO(2) increased every 10 µg/m(3), the non-accidental mortality in Tianjin and Wuhan raised 0.44%(95%CI: 0.11%-0.78%) and 0.96%(95%CI: 0.22%-1.72%) respectively. When the 1 day-lag concentration of SO(2) increased every 10 µg/m(3), the non-accidental mortality in Shanghai, Guangzhou and Wuhan raised 0.28% (95% CI: 0.02%-0.54% ), 0.41% (95% CI: 0.04%-0.79% ) and 1.14% (95% CI: 0.44%-1.84%) respectively. When the day and 1 day-lag concentration of SO(2) increased every 10 µg/m(3), the non-accidental mortality and the cardiovascular mortality at the six cities scale raised 0.40% (95% CI: 0.13%-0.67%) and 0.48% (95% CI: 0.11%-0.85%) respectively. When the day concentration of NO2 increased every 10 µg/m(3), the non-accidental mortality in Beijing, Tianjin, Shanghai, Guangzhou and Wuhan raised 0.60% (95% CI: 0.26%-0.95%), 0.96% (95% CI: 0.29%-1.64%), 0.43% (95% CI: 0.09%-0.78%), 1.17%(95%CI: 0.69%-1.66%) and 1.23%(95%CI: 0.19%-2.28%) respectively; the cardiovascular mortality in Beijing, Tianjin, Xi'an, Guangzhou and Wuhan raised 0.83% (95% CI: 0.34%-1.32%), 1.09% (95% CI: 0.25%-1.94%), 1.98% (95% CI: 0.00%-4.01%), 1.52% (95% CI: 0.70%-2.36%) and 2.04% (95% CI: 0.54%-3.56%) respectively. When the 1 day-lag concentration of NO(2) increased every 10 µg/m(3), the non-accidental mortality in Guangzhou and Wuhan raised 0.97% (95% CI: 0.49%-1.46%) and 1.67% (95% CI: 0.66%-2.70%)respectively; the cardiovascular mortality in Guangzhou and Wuhan raised 1.06% (95% CI: 0.24%-1.89%)and 2.42% (95% CI: 0.97%-3.89%) respectively. When the day and 1 day-lag concentration of NO(2) increased every 10 µg/m(3), the non-accidental mortality and the cardiovascular mortality at the six cities scale raised 0.81% (95% CI: 0.35%-1.28%), 1.03% (95% CI: 0.40%-1.66%) respectively.

CONCLUSIONExposure to SO(2) and NO(2) was significantly associated with daily non-accidental morality and cardiovascular morality at the multi-city scale in China.

Air Pollution ; adverse effects ; China ; Cities ; Humans ; Mortality ; Nitric Oxide ; adverse effects ; Particulate Matter ; Sulfur Dioxide ; adverse effects ; Temperature ; Weather

OBJECTIVE: To raise clinical awareness of carcinoembryonic antigen(CEA) increased as initial manifestation of medullary thyroid cancer(MTC) and explore the diagnosis and treatment. METHOD: Clinical data of 2 cases CEA increased as the initial presentation of MTC were retrospectively analyzed and clinical manifestations of the disease, diagnosis, treatment were also discussed by literature reviewing. RESULT: Two patients received thyroid ipsilateral lobe total resection, MTC was confirmed by intraoperative frozen pathology, re-total resection of the contralateral lobe and bilateral VI lymph node dissection were performed. Lymph nodes had no metastasis confirmed by pathological frozen examination. CEA returned to normal within 2 months after surgery. No tumor recurrence and metastasis were found after follow-up for 3 to 24 months. CONCLUSION CEA increased as the initial presentation MTC was rare and clinical identification of CEA increased disease should be taken into account the MTC as possible. Total thyroidectomy and bilateral VI lymph node dissection was the main surgical treatment for it.
Adult ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Neuroendocrine ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; metabolism ; pathology

OBJECTIVE: To evaluate the long-term efficacy of submandibular gland transfer for prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma. METHOD: Sixty-five cases of nasopharyngeal carcinoma patients were randomly divided into study group of 32 patients and control group of 33 patents. The submandibular gland was transferred to submental region on 32 cases with nasopharyngeal carcinoma before receiving conventional radiotherapy and a block was used to cover the submental region. Before radiotherapy, two groups of submandibular gland function was detected by imaging of the submandibular gland. At 60 months after radiotherapy, submandibular gland function was detected by 99mTc radionuclide scanning, the questionnaire about the degree of xerostomia was investigated respectively. Five-year survival rate was counted. RESULT: After following up for 60 months, submandibular gland uptake and secretion function in the study group was significantly higher than that in the control group, there was significant difference between the two groups (P < 0.01) respectively. The incidence of moderate or severe xerostomia in the study group was significantly lower than that in the control group (15.4% vs 76.9%, P < 0.01). Five-year survival rate of the study group and control group was 81.3% and 78.8% respectively, there was no significant difference between the two groups (P > 0.05). CONCLUSION The long-term efficacy of submandibular gland transfer for prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma was well. It could improve the quality of life in nasopharyngeal carcinoma patients after radiotherapy, and did not affect the long-term efficacy of nasopharyngeal carcinoma.
Adult ; Carcinoma ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Prospective Studies ; Radiotherapy ; adverse effects ; Submandibular Gland ; surgery ; Xerostomia ; etiology ; prevention & control

Objective: To evaluate the association between atmospheric inhalable particulate matter (PM₁₀) concentration and cardiovascular diseases burden in Tianjin. Methods: The data on daily mean concentrations of main pollutants (PM₁₀, nitrogen dioxide(NO₂) and sulfur dioxide(SO₂)), meteorological factors (temperature and relative humidity) and population death monitoring data in Tianjin, from January 1, 2001 to December 31, 2010, were collected and analyzed in this study. The death counts and years of life lost were simultaneously used as the indicators of disease burden. The generalized additive model was used to assess the associations between PM₁₀ and daily death counts and years of life lost due to cardiovascular system diseases in Tianjin by adjusting the confounding factors such as long-term trend, seasons, meteorological factors and other factors related to the long-term variability. Results: The daily average concentration of PM₁₀ was 117.6 μg/m³ in Tianjin during 2001 to 2011. The daily average number of deaths of cardiovascular system diseases, cerebrovascular diseases and ischemic heart diseases in Tianjin were 38.4, 14.8 and 17.2 people respectively, and the daily average years of life lost were 776.8, 306.5 and 326.1 person years respectively. The effects of PM₁₀ on the daily death counts of the three diseases categories were statistically significant (all P<0.01) in Tianjin and the maximum effect occurs at the moment when PM₁0 was at moving average concentration of today and lagged 1-day (Lag01). The effects of decreasing order were ischemic heart diseases, cardiovascular system diseases and cerebrovascular diseases, excess risks were 0.53% (95% CI 0.35%-0.71%), 0.40% (95%CI 0.28%-0.53%) and 0.38% (95%CI 0.19%-0.56%). The effects of atmospheric PM₁₀ on the years of life lost of the three diseases were also statistically significant on the different lag days (all P<0.01) in Tianjin and the maximum effect of PM₁₀ appeared in Lag01. The effects from the largest to the lowest were 2.86 (95%CI 1.79-3.93) person years for cardiovascular system diseases, 1.59 (95%CI 0.95-2.23) person years for ischemic heart diseases and 1.07 (95%CI 0.43-1.71) person years for cerebrovascular diseases, respectively. In multi-pollutant models, after controlling SO₂, the effect of PM₁₀ on the daily life loss of above 3 kinds of diseases was higher than that of single pollutant model. In contrast, after controlling SO₂ or SO₂ with NO₂, the effect was lower. After controlling NO₂, the effect of PM₁₀ on the daily life loss of cerebrovascular disease was no longer statistically significant (P>0.05). Conclusions Exposure to atmospheric PM₁₀ can significantly increase the cardiovascular diseases burden in Tianjin, especially for ischemic heart diseases. These results suggested that particular attention should be paid to reduce the exposure to atmospheric inhalable particulate matter for patients with ischemic heart diseases.

Air Pollution ; adverse effects ; Biomedical Research ; trends ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; epidemiology

Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16％.The most common underlying disease were coronary disease (43.27％),hypertension (17.73％),cardiomyopathy (16.07％) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81％ (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3％ and 32.27％,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64％ and 46.89％,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64％ vs.49.93％),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43％ vs.37.45％) and emergency department mortality(1.58％ vs.4.09％).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6％ vs.33.2％),cardiovascular disease mortality (20.2％ vs.26.0％),aggravated heart failure mortality (22.4％ vs.28.8％) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51％ vs.28.17％,1.41％ vs.9.58％),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.

Objective: To explore the clinical application value of enhanced recovery after surgery (ERAS) in the laparoscopic surgery for cholecystolithiasis comorbid with choledocholithiasis. Methods: The prospective study was conducted. The clinicopathological data of 52 patients with cholecystolithiasis comorbid with choledocholithiasis who were admitted to the Third Affiliated Hospital of Zunyi Medical University from September 2016 to September 2018 were collected. Patients were divided into 2 groups by random number table: patients in observation group received laparoscopic cholecystectomy + choledocholithotomy + choledochoscopic exploration + T-tube drainage (or primary suture of common bile duct) and perioperative management guided by the concept of enhanced recovery after surgery (ERAS), and patients in control group received traditional perioperative management. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) postoperative complications; (4) postoperative pain scores; (5) changes in hepatic function and blood routine during perioperative period. Follow-up using outpatient examination and telephone interview was performed to detect complications during the postoperative 6 months up to March 2019. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the paired t test or repeated ANOVA. Count data were described as absolute numbers and percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results: Fifty-two patients were screened for eligibility, including 20 males and 32 females, aged 25-68 years, with an average age of 53 years. There were 30 patients in the observation group and 22 in the control group. (1) Surgical situations: the operation time and volume of intraoperative blood loss were (133±19)minutes and (47±21)mL in the observation group, and (136±22)minutes and (49±23)mL in the control group, respectively, showing no significant difference between the two groups (t=-0.386, -0.211, P>0.05). (2) Postoperative situations: time to out-of-bed activity, time to initial food intake, time to first anal flatus, duration of postoperative hospital stay, and hospital expenses were (18±4)hours, (19±5)hours, (28±2)hours, (4.0±1.0)days, and (1.82±0.22)×10⁴ yuan in the observation group, and (29±7)hours, (46±9)hours, (37±4)hours, (6.6±1.6)days, and (2.25±0.29)×10⁴ yuan in the control group, respectively, showing significant differences between the two groups (t=-7.054, -14.169, -9.426, -6.582, -5.809, P<0.05). (3) Postoperative complications: 1 of 30 patients in the observation group had postoperative biliary leakage, with a postoperative complication rate of 3.3%, and was cured after symptomatic support treatment. Six of 22 patients in the control group had postoperative complication, with a postoperative complication rate of 27.3%, including 2 of biliary leakage, 1 of hemorrhage, 1 of abdominal infection, 1 of pulmonary infection, 1 of urinary infection, and they were cured after symptomatic support treatment. There was a significant difference between the two groups (χ²=4.358, P<0.05). (4) Postoperative pain scores: from postoperative 6 hours to 48 hours, the postoperative pain score changed from 2.4±0.7 to 1.9±0.9 in the observation group, and from 4.1±0.7 to 2.9±0.9 in the control group, respectively, showing a significant difference in the changing trend between the two groups (F=78.053, P<0.05). (5) Changes in hepatic function and blood routine during perioperative period: from preoperation to postoperative 3 days, levels of alamine aminotransferase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT), total bilirubin (TBil), and count of white blood cells in the observation group changed from (77±20)U/L to (53±12)U/L, from (85±22)U/L to (61±17)U/L, from (166±39)U/L to (55±24)U/L, from (40±13)μmol/L to (29±12)μmol/L, from (7.0±2.0)×10⁹/L to (6.8±1.9)×10⁹/L, and changed from (79±23)U/L to (62±14)U/L, from (88±24)U/L to (64±17)U/L, from (179±34)U/L to (74±29)U/L, from (45±13)μmol/L to (35±12)μmol/L, from (7.9±2.4)×10⁹/L to (7.5±1.9)×10⁹/L in the control group, respectively. The levels of ALT, AST, GGT, TBiL, and count of WBC showed increasing at postoperative 1 day, and decreasing at postoperative 3 days. There was no significant difference in the changing trend between the two groups (F=0.058, 0.471, 3.021, 1.593, 2.172, P>0.05). Conclusion ERAS is safe and effective in the laparoscopic surgery for choledocholithiasis comorbid with cholecystolithiasis.

In previous studies, we found that truncated rotavirus VP4* (aa 26-476) could be expressed in soluble form in Escherichia coli and confer high protection against rotavirus in the mouse mode. In this study, we further improved the immunogenicity of VP4* by polymerization. The purified VP4* was polymerized through incubation at 37 ℃ for 24 h, and then the homogeneity of the particles was analyzed by HPLC, TEM and AUC, while the thermal stability and antigenicity was analyzed by DSC and ELISA, respectively. Finally, the immunogenicity and protective efficacy of the polymers analyzed by a mouse maternal antibody model. The results showed that VP4* aggregated into homogeneous polymers, with high thermostability and neutralizing antibody binding activity. In addition, VP4* polymers (endotoxin <20 EU/dose) stimulated higher neutralizing antibodies and confer higher protection against rotavirus-induced diarrhoea compared with the VP4* trimers when immunized with aluminium adjuvant. In summary, the study in VP4* polymers provides a new strategy for the development of recombinant rotavirus vaccines.
Animals ; Antibodies, Viral ; Antigens, Viral ; Capsid ; Capsid Proteins ; Mice ; Polymerization ; Rotavirus ; Rotavirus Infections