Objective To investigate the levels of IL-18,Th1(IL-2,TNF-?) and Th2(IL-4,IL-10) in patients with lung cancer and their relation to clinical pathological stages.Methods Totally 109 lung cancer patients were of 45 squamous cancer,40 adenocarcinoma,18 small cell lung cancer and 6 large cell carcinoma.Serum levels of IL-18,TNF-?,IL-2,IL-4 and IL-10 were determined by using an ELISA assay in 109 lung cancer patients and in 30 normal people.Results The levels of IL-18,TNF-? and IL-2 were significantly lower and the levels of IL-4 and IL-10 were significantly higher in lung cancer patients than in controls(P

Background Nitrosamines (NAms) are highly carcinogenic and frequently detected in drinking water systems in China, indicating potential human health risk through drinking water. Objective To analyze the distribution of NAms in drinking water in Shanghai and to evaluate relevant human health risk. Methods A total of 94 samples of source water and 120 samples of finished water were collected in February (dry period) and August (wet period) of 2021 from 30 drinking water plants in Shanghai, and eight NAms were quantitatively analyzed by gas chromatography tandem mass spectrometry after solid phase extraction. Cancer risks for different age groups caused by NAms exposure through water were evaluated using Monte Carlo probabilistic method and carcinogens risk assessment model recommended by the United States Environmental Protection Agency. Results The concentrations of total NAms in source and finished water were 12.56-65.86 ng·L⁻¹ and 8.52-57.38 ng·L⁻¹, respectively. The average concentration of total NAms was higher in source water (33.50 ng·L⁻¹) than in finished water (22.07 ng·L⁻¹, P<0.05) during dry season, and lower in source water (16.90 ng·L⁻¹) than in finished water (21.02 ng·L⁻¹, P<0.05) during wet season. The average concentration of total NAms in source water during dry season was twice of that during wet season. The positive rate of N-nitrosodimethylamine (NDMA) was the highest (100%) among the eight NAms. The cancer risk of exposure to NAms in finished water in Shanghai was mainly from the ingestion route, which was mostly caused by NDMA. The cancer risk from exposure to NAms in water for children (median=4.32×10⁻⁵) was slightly higher than that for adults (median=3.34×10⁻⁵) and adolescents (median=2.27×10⁻⁵). The cancer risks of exposure to NAms in water for people of different ages were mainly (80% - 95%) at an acceptable level (1×10⁻⁶ - 1×10⁻⁴). Conclusion NAms contamination is positive in Shanghai’s drinking water and NDMA is the main contaminant. The removal of NAms in water by current water treatment process is season-dependent. The cancer risk of children exposed to NAms in water was slightly higher than that of adults and adolescents, but all at acceptable levels.

Objective To investigate the clinical outcomes of cranioplasty with polyether ether ketone(PEEK)or titanium after large craniectomy in patients.Methods Clinical data of 150 patients undergoing skull repair due to large frontotemporal skull defect in our hospital from April 2018 to June 2022 were retrospectively analyzed,and they were divided into titanium mesh group and PEEK group according to different repair materials.The conditions of surgical site infection,bleeding,subcutaneous effusion,seizure,implant rupture or exposure in the two groups were compared.Results In the PEEK group,96.3％of patients needed to implant the repair material under the temporal muscle,which was significantly higher than that in the titanium mesh group(78.1％)(P＜0.05).There were no significant differences in postoperative complications including infection,bleeding,seizure,implant rupture or leakage between the two groups(P＞0.05).However,the incidence of postoperative subcutaneous effusion in PEEK group was higher than that in titanium mesh group(14.8％VS4.2％,P＜0.05),and the difference was statistically significant.Conclusion Both titanium and PEEK can be used in cranioplasty for patients with large frontotemporal cranial defects.Subcutaneous effusion is common in patients underwent cranioplasty with PEEK postoperatively,which needs to be paid more attention.

Objective:To investigate the independent risk factors for postoperative severe pulmonary infection (SPI) in patients with severe traumatic brain injury (sTBI) and evaluate their predictive value.Methods:A retrospective cohort study was conducted to analyze the clinical data of 163 sTBI patients admitted to Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from April 2021 and March 2023, including 101 males and 62 females, aged 20-80 years [53.0(46.0, 59.0)years]. The surgical procedures involved decompressive craniectomy, subdural hematoma removal, epidural hematoma removal, and intracranial hematoma removal. The patients were divided into SPI group ( n=62) and non-SPI group ( n=101) according to whether they had SPI postoperatively. The following data of the two groups were collected, including gender, age, preoperative Glasgow coma scale (GCS), elevated blood glucose, abnormal liver function, abnormal renal function, hemoglobin level, anemia, albumin level, hypoproteinemia, white blood cell count, neutrophil count, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI) and serum lactate dehydrogenase (LDH) level. All the hematological tests were performed on venous blood samples collected preoperatively before anti-inflammatory treatment. Independent risk factors for predicting the postoperative occurrence of SPI in sTBI patients were identified through univariate analysis and multivariable stepwise regression analysis. The predictive value of separate indicator or indicators combined was assessed by calculating the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results:Univariate analysis demonstrated that preoperative GCS, albumin level, lymphocyte count, NLR, PNI and serum LDH level in both groups were significantly correlated with the postoperative occurrence of SPI ( P<0.05), while gender, age, elevated blood glucose, abnormal liver function, abnormal renal function, hemoglobin level, anemia, hypoproteinemia, white blood cell count, neutrophil count, platelet count, dNLR and PLR were not correlated with the postoperative occurrence of SPI in sTBI patients ( P>0.05). Multivariable stepwise regression analysis revealed that low lymphocyte count (95% CI -0.337, -0.013, P<0.05), high NLR (95% CI -0.023, -0.005, P<0.01), low PNI (95% CI 0.007, 0.026, P<0.01), and high serum LDH (95% CI -0.002, -0.001, P<0.01) were independent risk factors for SPI in sTBI patients ( P<0.05). ROC curve analysis indicated that low lymphocyte count, high NLR, low PNI and high serum LDH level could predict SPI in sTBI patients postoperatively, with the combination of PNI and serum LDH showing the highest predictive ability (AUC=0.78, 95% CI 0.70, 0.85). Conclusion:Low lymphocyte count, high NLR, low PNI, and high serum LDH level are independent risk factors for postoperative SPI in patients with sTBI, and the combination of PNI and serum LDH possesses a high predictive value for postoperative SPI in sTBI patients.

Background Nitrosamines, especially N-nitrosodimethylamine (NDMA), are highly carcinogenic and frequently detected in drinking water systems in China, indicating potential human health risk through drinking water. Objective This study aims to analyze the distribution of NDMA in urban drinking water around China and to evaluate relevant human health risk, thus providing recommendations for drinking water safety standards. Methods The database of China National Knowledge Infrastructure was searched using nitrosamines and drinking water as key words in Chinese, and PubMed was searched usingN-nitrosodimethylamine or nitrosodimethylamine or NDMA, drinking water, and China as key words in English for relevant literature published from January 1, 2000 to March 1, 2021. Eligible data were extracted to statistically analyze the spatiotemporal exposure levels of NDMA in raw and finished water serving Chinese cities. According to the health risk assessment model for carcinogens recommended by the United States Environmental Protection Agency (US EPA), the cancer risk via drinking water of NDMA in finished water was evaluated for different age groups and different regions. Results A total of 102 studies were retrieved, 21 of which met the inclusion criteria and were finally included. The NDMA concentrations in 347 raw water samples and 276 finished water samples were extracted and studied, with positive rates of 82.4% and 67.0%, levels of not detected (ND)-141 and ND-67.1 ng·L⁻¹, and the 95th quantiles of 51.4 and 32.1 ng·L⁻¹, respectively. The level of NDMA in raw water was higher than that in finished water in cities of East and North China (P<0.05). East China had the highest average concentrations of NDMA in raw and finished water (21.4 and 9.0 ng·L⁻¹ respectively). In East China, the average concentrations of NDMA in raw and finished water from 2018 to 2019 (5.9 and 6.1 ng·L⁻¹ respectively) were significantly lower than those from 2015 to 2017 (28.7 and 16.5 ng·L⁻¹ respectively) (P<0.05). The average concentration of NDMA in rivers, lakes, ponds, and streams as drinking water sources (20.8 ng·L⁻¹) was significantly higher than that in groundwater sources (8.0 ng·L⁻¹) and in reservoir sources (6.5 ng·L⁻¹) (P<0.05). The average concentration of NDMA in finished water with pre-chlorination (9.4 ng·L⁻¹) was higher than that without (6.0 ng·L⁻¹) (P<0.05). The cancer risk of NDMA through drinking water for children over 1 year old in China decreased with older age, and the risk of infants aged 1~<2 years (2.52×10⁻⁴) was 23 times higher than that of adults (1.09×10⁻⁵) (P<0.05). Conclusion Raw water pollution is the main source of NDMA in urban drinking water in China, and current water treatment technology can partially remove NDMA. The NDMA level in finished water of East China shows a downward trend in recent two years. The carcinogenic risk of NDMA via drinking water for children is higher than that for adults, and their health risk management needs to be strengthened. The study findings recommend 35 ng·L⁻¹ as the limit of NDMA water quality safety standard in China.

Objective:To establish the biology reference interval (RI) of peripheral blood procalcitonin (PCT) for children between 3 days and 6 years old in China.Methods:Totally 3 353 reference individuals with apparent health or no specific diseases were recruited in 18 hospitals throughout the country during October 2020 to May 2021. Reference individuals were divided into four groups: 3-28 days, 29 days - 1 year, 1-3 years and 4-6 years. Vein blood or capillary blood were collected by percutaneous puncture from every reference individual. The PCT level in serum and the capillary whole blood were assayed by Roche Cobas e601 and Norman NRM411-S7 immunoanalyzer. Outliers were deleted and 95th percentiles of every group were provided as RIs. Man-Whitney U test or Kruskal-Wallis test were used performed to assess the difference among different gender, age or method groups. Results:The difference of PCT distribution between male and female is not statistically significant, but the difference between serum and capillary whole blood is statistically significant. The differences between age groups are significant too. For Roche e601, serum PCT RI of 3-28 days group is <0.23 μg/L, 29 days - 6 years are <0.11 μg/L. For NRM411, Serum PCT RI of 3-28 days group is <0.21 μg/L, 29 days - 1 year: <0.09 μg/L, 1 - 6 years: <0.10 μg/L. For whole blood PCT, RI of 3-28 days group is <0.26 μg/L, 29 days - 6 years is <0.15 μg/L.Conclusions:Serum and capillary whole blood PCT have different RIs, however, capillary whole blood PCT testing is valuable in pediatric application. Children in 3-28 days show higher PCT levels than other age group. To establish the RIs and understand the differences among different groups are essential for the interpretation and clinical application of peripheral blood PCT testing results.