The theoretical basis of premature aging originates from The Yellow Emperor's Inner Classic. The etiology of premature aging is complex， and the disease mechanism is based on deficiency. The treatment for premature aging is based on tonicity. The essence-Qi-spirit theory of Qiluo doctrine summarizes that "essence is the origin of life， Qi is the driving force of life， and spirit is the embodiment of life"， which is the law of life. The theory puts forward the core disease mechanism of aging， which states that "deficiency of kidney essence is the root of aging， deficiency of primordial Qi is the key to aging， impairment of soma and spirit is the manifestation of aging". The theory also proposes the treatment of "tonifying kidney and supplementing essence， harmonizing Yin and Yang， warming and supporting primordial Qi， and nourishing soma and spirit" and the representative anti-aging drugs. The article unfolds from the perspective of the concepts of natural life span， premature senility before fifty， decline， and aging and also explains the origins and connotations of premature aging. The article explains the disease mechanism of premature aging under the guidance of the essence-Qi-spirit theory of Qiluo doctrine， which is "early deprivation of kidney essence， deficiency of primordial Qi， accumulation of deficiencies into impairment， and decline and impairment of soma and spirit"， summarizes the progress of modern medical research on the treatment of premature aging and representative drugs， and finds that Bazi Bushen capsules have a precise therapeutic effect on the overall premature aging， systematic functional decline， and related diseases. The study provides theoretical basis and new ideas to solve the problems of premature aging and geriatric diseases.

Objective To compare the dosimetric differences in the heart and its substructures between two hybrid plans for hypofractionated whole-breast radiotherapy after breast-conserving surgery in patients with early-stage left-sided breast cancer. Methods A total of 46 patients with early-stage left-sided breast cancer who underwent hypofractionated whole-breast radiotherapy were randomly selected. Two hybrid radiotherapy plans were used, including hybrid intensity-modulated radiotherapy (H_IMRT) and hybrid volumetric-modulated arc therapy (H_VMAT). The heart and its substructures were contoured, including left anterior descending (LAD), left ventricle (LV), right coronary artery (RCA), and right ventricle (RV). The heart and substructure doses, as well as monitor units, were compared between H_IMRT and H_VMAT. Results Both hybrid plans met the clinical requirements. H_IMRT significantly outperformed H_VMAT for the heart (V₁₀, V₃₀, and D_mean), LAD (V₃₀, V₄₀, D_max and D_mean), LV (V₁₀, V₂₀ and D_mean), RCA (D_max, D_mean), and RV (V₅, V₁₀, D_mean) (P < 0.001). Additionally, H_IMRT was significantly superior to H_VMAT for heart V₅, LAD V₂₀, and RV V₂₀ (P = 0.005, 0.035 and 0.037). For LAD (V₁₅, V₄₀) and LV (V₅, V₂₅), H_IMRT was slightly better than H_VMAT, and the difference was not statistically significant. Conclusion Both H_IMRT and H_VMAT hybrid radiotherapy plans are suitable for hypofractionated whole-breast radiotherapy after breast-conserving surgery in patients with early-stage left-sided breast cancer. H_IMRT is slightly better than H_VMAT in dose sparing for the heart and its substructures.

Objective To explore the optimal radiotherapy method by comparing the dosimetric differences of target and organs at risk of four radiotherapy plans for left sided breast cancerafter breast-conserving surgery. Methods Twenty-three patients with left breast cancer were randomly selected and given PTV 25 fractions, 50 Gy prescription dose.TheHybrid_IMRT, rj_IMRT, VMAT and t_VMAT plans were designed for each patients. Dosimetric differences were compared, including dose volume histograms of target and OARs, target homogeneity indexes (HI), conformal indexes (CI) and the machine MUs. Results Target Dosimetric comparison, HI: t_VMAT plan target has highest HI and had significant difference (P ≤ 0.001); The target CI of VMAT plans were 0.967 ± 0.016, had significant difference compared with the other 3 plans (P < 0.05). The CI of rj_ IMRT were 0.942 ± 0.018 better than that of IMRT and t_VMATs. Dosimetric comparison of OARs, left_lung mean dose (MLD_L): rj_IMRT were （8.76 ± 1.52） Gy which were best of 4 plans, and had statistical significance (P < 0.05). Heart mean dose: rj_IMRT were （4.68 ± 0.87） Gy were better than that of VMAT (P < 0.05). Conclusion All of these four plans could be applied in clinical treatments, while the limitations of treatment equipment, patients’ physical conditions and some other factors should be considered before selecting an appropriate one.

OBJECTIVE: To comprehend the status of knowledge-attitude-practice( KAP) and its effect on blood lead in workers exposed to lead.METHODS: Three hundred and fifty-one first-line lead exposed workers in the smelting industry were chosen as study subjects by cluster sampling method.Blood lead levels in peripheral venous blood were detected.Questionnaire survey was conducted by self-compiled Questionnaire of Knowledge-attitude-practice on Occupational Health in Lead Workers.RESULTS: Among the study subjects,145 workers had abnormal blood lead level( ≥600 μg/L),the abnormal rate was 41.3%.The correct scoring rate in occupational knowledge,attitude,and practice were 25.1%,45.3% and 15.7%,respectively.Multivariate logistic regression analysis results showed that the four risk factors of high blood lead level were wearing no personal protective equipment,not bathing and changing clothes before returning home,not gargling and washing hands before meals,smoking and eating in workplace.CONCLUSION: Poor occupational behaviors can increase the risk of high blood lead level in lead exposed workers.

OBJECTIVE: To explore the relationship between metabolic syndrome( MS) and occupational stress among workers in high altitude area. METHODS: A cross-sectional study was conducted in 940 workers as research subjects who were engaged in petroleum smelting,thermal power generation and financial management et al. in high altitude area. A questionnaire survey was conducted using the Occupational Stress Inventory-Revised for occupational stress, The occupational health examination was performed to measure waist circumference,blood pressure,blood sugar and blood lipids. RESULTS: The abnormal rates in obesity,triglycerides,high-density lipoprotein,blood pressure and fasting blood glucose were 28. 3%,16. 3%,14. 3%,13. 3% and 6. 5%, respectively. The detection rate of MS was 5. 0%( 47/940). The multivariate logistic regression analysis showed that the risk of elevated MS decreased with the increased of occupational stress level( P < 0. 05),and the risk of elevated MS increased with the increased of occupational stress reaction severity( P < 0. 05),after adjusting the confounding factors of gender and labor nature. CONCLUSION: The higher occupational stress reaction of the workers in high altitude area,the higher the risk of MS.

OBJECTIVETo evaluated the manganese (Mn), cobalt (Co) and molybdenum (Mo) levels in blood and urine among general population in China, and thereby to analyze their prevalent features.

METHODSFrom 2009 to 2010, a total of 18 120 subjects of general population aged 6-60 years were recruited from 24 districts in 8 provinces in eastern, central and western China mainland, by cluster random sampling method. The information about their living environment and health status were collected by questionnaire, and their blood and urine samples were also collected.Inductive coupled plasma mass spectrometry (ICP-MS) was applied to test the Mn, Co and Mo levels of blood and urine samples, and the Mn, Co, Mo distribution in blood and urine among groups of population in different ages and genders were then analyzed.

RESULTSAmong general population in China, the geometric mean (GM) of Mn concentration in blood was 8.98 µg/L. The Mn concentration in blood among males and females were separately 8.14 µg/L and 9.88 µg/L (Z = -18.84, P < 0.01). The GM of Mn concentration in urine was 0.63 µg/L. The Mn concentration in urine among males and females were separately 0.62 µg/L and 0.63 µg/L (Z = -0.67, P > 0.05). The geometric mean (GM) of Co concentration in blood was 0.194 µg/L. The Co concentration in blood among males and females were separately 0.166 µg/L and 0.225 µg/L (Z = -23.04, P < 0.01). The GM of Co concentration in urine was 0.282 µg/L. The Co concentration in urine among males and females were separately 0.260 µg/L and 0.307 µg/L (Z = -7.35, P < 0.01). The GM of Mo concentration in blood was 0.25 µg/L. The Mo concentration in blood among male and female group were separately 0.27 µg/L and 0.23 µg/L (Z = -5.03, P < 0.01). The GM of Mo concentration in urine was 27.7 µg/L. The Mo concentration in urine among males and females were 29.8 µg/L and 25.6 µg/L (Z = -6.31, P < 0.01), respectively.

CONCLUSIONThe Mn, Co and Mo levels in blood and urine varied by gender and area among general population in China, the study provided basic data evidence for the following Mn, Co and Mo biological monitoring studies in near future.

Adolescent ; Adult ; Child ; China ; epidemiology ; Cobalt ; Environmental Exposure ; Environmental Monitoring ; Female ; Humans ; Male ; Manganese ; Middle Aged ; Molybdenum

OBJECTIVETo investigate the level of zinc (Zn) and copper (Cu) in whole blood among general population from 8 provinces in China, and to analyze the characteristics of distribution among different regions.

METHODSThis cross-sectional study was performed in 8 provinces from eastern, middle and western China between 2009 and 2010, including 13 110 subjects from 24 regions, and the blood and urine samples were collected. The ICP-MS was applied to test the content of ICP-MS in blood samples, and the results were used to analyze the characteristics of contents and distributions of Zn and Cu among population from different ages, genders and regions groups.

RESULTSTotally, the mean (95%CI) contents of Cu and Zn in blood were 795 (791-799)µg/L and 3 996(3 976-4 015) µg/L, respectively. The characteristics of distribution of Cu content were as followed, the content of males were lower than it of females (male:767 µg/L; female: 822 µg/L, t = -13.302, P < 0.01). The contents of blood Cu in groups of people aging 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were separately 860(853-868), 758(748-769), 734(728-734), 782(774-790), 811(795-827) and 820(815-826) µg/L. The differences showed statistical significance (F = 78.77, P < 0.01). The blood Cu content of people in eastern China (800µg/L) were also significantly higher than it in middle (774 µg/L)and western China (782 µg/L) (F = 10.94, P < 0.01). Distribution of blood Zn content showed characteristics as follows: the Zn content was higher in males than in females (male 4 085 µg/L and female 3 908 µg/L, t = 8.78, P < 0.01). The contents of blood Zn in groups of people aging 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were separately 3 306 (3 261-3 350), 3 888 (3 839-3 937), 3 948 (3 902-3 994), 4 272(4 228-4 315), 4 231(4 180-4 281) and 4 250 (4 205-4 294)µg/L, which showed significant statistical differences (F = 233.68, P < 0.01). The blood Zn content of people in eastern China (3 938 µg/L) were significantly lower than it in middle (4 237 µg/L)and western China (4 105 µg/L) (F = 53.16, P < 0.01). In addition, the study also compared the relation between content of Cu and Zn and the frequency of eating seafood. The results found that the frequency of eating seafood could influence the content of Cu and Zn (Cu: F = 13.54, P < 0.01; Zn: F = 200.20, P < 0.01).

CONCLUSIONThe contents and distributions of Cu and Zn in blood differs among people from different groups in ages, genders and regions. The baseline data of this study provided reliable scientific evidence for further research.

Adolescent ; Adult ; Child ; China ; epidemiology ; Copper ; blood ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Zinc ; blood

OBJECTIVETo assess the levels of polycyclic aromatic hydrocarbons monohydroxy metabolites in urine of general population in China among 8 provinces, provide the baseline of the metabolites in the general population.

METHODSFrom 2009 to 2010, 18 120 subjects of general population aged 6-60 years old were recruited from 24 areas among 8 provinces in east, west and central areas of China mainland by cluster random sampling. The information of the living environment and health condition were collected by questionnaire and spot urine samples were collected, 4 680 urine samples were analysed by high performance liquid chromatography with tandem mass spectrometry, and monohydroxy metabolites distribution in urine among groups of gender and ages were analysed.

RESULTSGeometric means (GM) of 2-naphthol, 1-naphthol, 3-phenanthrol and 1-hydroxypyrene concentration in urine (95%CI) were 1.85 (1.75-1.95), 1.55 (1.50-1.61), 0.57 (0.54-0.59) and 0.82 (0.78-0.85) µg/L, respectively;and median are 2.44, <0.50, 0.72 and 0.90 µg/L, respectively. The concentration between male and female were significantly different (P < 0.01), and the concentration among the groups of population were significantly different (P < 0.01), the GM of 2-naphthol among the groups of population aged 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were 1.60, 1.56, 1.69, 2.23, 1.91 and 1.86 µg/L (χ(2) = 17.90, P < 0.01), the GM of 1-naphthol in the groups were 1.30, 1.16, 1.53, 1.68, 1.80 and 1.52 µg/L (χ(2) = 76.22, P < 0.01), the GM of 3-phenanthrol in the groups were 0.78, 0.76, 0.55, 0.42, 0.50 and 0.99 µg/L (χ(2) = 66.48, P < 0.01), the GM of 1-hydroxypyrene in the groups were 0.77,0.64, 1.00, 0.84, 0.84 and 0.57 µg/L (χ(2) = 51.48, P < 0.01), respectively.

CONCLUSIONThe distribution of monohydroxy metabolites levels in urine of general population were different, it provided a basic data for the further study of polycyclic aromatic hydrocarbons biomonitoring in the population.

Adolescent ; Adult ; Child ; China ; epidemiology ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Humans ; Male ; Middle Aged ; Naphthols ; urine ; Polycyclic Aromatic Hydrocarbons ; urine ; Pyrenes ; urine ; Sentinel Surveillance ; Young Adult

OBJECTIVETo evaluated the levels of arsenic (As) in blood and urine among general population in China and analyze its influencing factors.

METHODSA total of 18 120 subjects from general population aged 6-60 years were recruited from 24 districts in 8 provinces in eastern, central and western China mainland from 2009 to 2010, by cluster random sampling method. Blood samples and urine samples were collected, the information of the life-style was collected by questionnaire.Inductive coupled plasma mass spectrometry was applied to test the As level in the samples, and the distribution of As in blood and urine for different ages, genders, areas and life habits were then analyzed.

RESULTSThe geometric mean (GM) of blood As concentration among general population was 2.33 µg/L;the GM of blood As in male (2.35 µg/L) was higher than and female (2.30 µg/L) (Z = -1.42, P < 0.05); from eastern, central to western China, the blood As level were 2.94, 1.30 and 0.98 µg/L (χ(2) = 643.22, P < 0.05) , respectively; the GM in smokers (2.84 µg/L) was higher than non-smokers (2.27) (Z = -6.28, P < 0.05) ;the seafood consumer had a higher blood As level (2.59 µg/L) than people not consuming seafood (1.47 µg/L) (Z = -23.68, P < 0.05). The urine As level of the whole population was 13.72 µg/L;while its GM in male (14.10 µg/L) was higher than female (13.33 µg/L) (Z = -3.94, P < 0.05); the values from eastern, central to western China were 14.14, 16.02 and 9.57 µg/L (χ(2) = 353.89, P < 0.05), respectively;the level in smokers (16.06 µg/L) was higher than nonsmokers (13.70 µg/L) (Z = -2.63, P < 0.05); the level in seafood consumers (14.82 µg/L) was higher than people not consuming seafood (10.99 µg/L) (Z = -3.20, P < 0.05). The blood As level had a positive correlation with urine As level (correlation coefficient:0.285, P < 0.05).

CONCLUSIONThe As level in blood and urine varied by gender and area among general population in China, and related to life-styles. There was a positive correlation between As level in blood and that in urine.

Adolescent ; Adult ; Arsenic ; blood ; urine ; Child ; China ; epidemiology ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Humans ; Male ; Middle Aged ; Sentinel Surveillance ; Young Adult

OBJECTIVETo evaluate the levels of lead (Pb) and cadmium (Cd) in blood and urine among general population in China, and thereby analyze their prevalent features.

METHODSA total of 18 120 subjects from general population aged 6-60 years were recruited from 24 districts in 8 provinces in eastern, central and western China mainland from 2009 to 2010, by cluster random sampling method. The blood samples and urine samples of these people were collected. The questionnaire survey was used to collect the information of the living environment and health conditions.Inductive coupled plasma mass spectrometry was applied to test the Pb and Cd levels in the samples, and the distribution of Pb and Cd in blood and urine for different ages, genders, areas and life habits were then analyzed.

RESULTSAmong the general population in China, the geometric mean (GM) of blood Pb concentration was 34.9 µg/L; the GM of blood Pb in male and female groups were 40.1 and 30.4 µg/L (Z = -28.05, P < 0.05), respectively; the GM from eastern, central and western China were 31.2, 38.8 and 58.9 µg/L (χ(2) = 1 483.33, P < 0.05) , respectively. The GM of urine Pb of the whole population was 1.05 µg/L;while the GM in male and female groups were 1.06 µg/L and 1.05 µg/L (Z = -0.73, P > 0.05) , respectively;the values from eastern, central and western China were 0.76, 2.85 and 3.22 µg/L (χ(2) = 1 982.11, P < 0.05), respectively. The GM of blood Cd concentration among general population was 0.49 µg/L; and the values in male and female group were 0.60 and 0.41 µg/L (Z = -11.79, P < 0.05) , respectively; the GM from eastern, central and western China were 0.45, 0.65 and 0.67 µg/L (χ(2) = 69.87, P < 0.05), respectively; the GM of urine Cd concentration of the whole population was 0.28 µg/L, while the GM in male and female groups were 0.29 and 0.28 µg/L (Z = -3.86, P < 0.05), respectively; the values from eastern, central and western China were 0.29,0.42 and 0.18 µg/L (χ(2) = 402.76, P < 0.05), respectively. the Spearman's rank correlation coefficient for Cd in blood and Cd in urine was 0.22, for Pb in blood and Pb in urine was 0.21. Both the correlations were statistic significant (P < 0.05).

CONCLUSIONThe Pb and Cd levels in blood and urine were relatively higher among general population in China varying by gender and area. There were positive correlations between Pb and Cd levels in blood and those in urine.

Adolescent ; Adult ; Cadmium ; blood ; urine ; Child ; China ; epidemiology ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Humans ; Lead ; blood ; urine ; Male ; Middle Aged ; Sentinel Surveillance ; Young Adult