Objective:To evaluate the effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor (CGRP-mAbs) on migraine.Methods:Database of PubMed, Embase, Cochrane, CNKI, Wangfang digital journals were searched for randomized controlled trials (RCTs) of CGRP-mAbs in treatment of migraine. Quality of enrolled literature was assessed by the software of Review Manager 5.3 and software of StataMP14 was employed to conduct meta analysis.Results:A total of 13 RCTs were included, including 6 218 adult migraine patients (experimental group: 2 679 patients, placebo group: 3 539 patients). Meta analysis suggested that CGRP-mAbs for preventive treatment of migraine significantly reduced the monthly migraine days from baseline (standardized mean difference (SMD)=-0.35, 95% CI-0.4--0.3) and monthly acute migraine-specific medication consumption from baseline (SMD=-0.38, 95% CI-0.43--0.32), as compared with placebo group. CGRP-mAbs for preventive treatment of migraine significantly increased the ≥50% reduction from baseline in migraine days per month ( RR=1.65, 95% CI 1.54-1.76). The adverse events were similar between the CGRP-mAbs group and placebo group ( RR=1.06, 95% CI 1.01-1.10). Conclusion:CGRP-mAbs are effective and safe for preventive treatment of migraine.

Objective To analyze the factors related to the household abundance of rodents in rodent-borne disease foci in the western part of Yunnan province.Methods From July 2011 to October 2012,800 households (20 households in 1 village) were randomly selected in 40 natural villages of 10 counties in western Yunnan where rodent borne disease was endemic to conduct a study on relationship between rodent abundance and environmental factors.Five cages were placed in each household for 3 consecutive nights to capture rodents.The rodent species were identified based on their morphological characteristics.The data on potential factors related to rodent abundance were collected through questionnaires and field observation.A dataset was established by using EpiData software and the analysis was performed with hurdle regression model under R software.Results A total of 421 rodents were captured in 800 households,belonging to 9 species,6 genera,2 families,2 orders.Rattus tanezumi was the predominant species (66.03％).The final hurdle regression model showed that the probability of capturing rodents in the households where family member had high education level and the garbage was placed outside declined by 50％-68％ ; The probability of capturing rodents in the households of Dai and Yi ethnic groups increased by 2.16-2.87 times; The probability of capturing rodents in the households where rodents were observed or vegetables grown near houses increased by 1.54-1.59 times; In the households where many rodents were believed to exist,the probability of capturing rodents and the number of rodents captured increased by 1.59 and 1.84 times respectively.The number of rodents captured in the houses with cement or tile floor increased by 3.62 times.Conclusion The household abundance of rodents in the area in western Yunnan,where the rodent-borne disease survey was conducted,seemed to be closely related to the social economy status,human intervention and ecological environment.To control the abundance of rodents effectively,it is necessary to take these factors into consideration.

Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years. In these patients, first time operations were ascending aorta replacement procedure in 3 patients, ascending aorta combined with partial aortic arch replacement in 4 patients, aortic root replacement (Bentall) associated with Marfan syndrome in 3 patients, aortic valve combined with ascending aorta replacement (Wheat) in 1 patient, ascending aorta combined with Sun′s procedure in 1 patient, Wheat combined with Sun′s procedure in 1 patient, Bentall combined with Sun′s procedure in 1 patient. The interval between two operations averaged 0.3 to 10.0 years with a mean of (4.8±3.1) years. The reasons for reoperations included part anastomotic split, aortic valve insufficiency, false aneurysm formation, enlargement of remant aortal and false cavity. The selection of reoperation included anastomotic repair, aortic valve replacement, total arch replacement and Sun′s procedure. Results: Of the 14 patients, the cardiopulmonary bypass times were 107 to 409 minutes with a mean of (204±51) minutes, cross clamp times were 60 to 212 minutes with a mean of (108±35) minutes, selective cerebral perfusion times were 16 to 38 minutes with a mean of (21±11) minutes. All patients survived from the operation, one patient died from severe pulmonary infection 50 days after operation. Three patients had postoperative complications, including acute renal failure of 2 patients and pulmonary infection of 1 patient, and these patients were recovered after treatment. Thirteen patients were finally recovered from hospital. The patients were followed up for 16 to 45 months, and no aortic rupture, paraplegia and death were observed in the follow-up. Conclusions Patients for residual aortic dissection after initial operations on Stanford type A aortic dissection should be attached great importance and always need emergency surgery, but the technique is demanding and risk is great for surgeons and patients, which need enough specification and accurate on aortic operation. More importantly, the Sun′s procedure also should be performed on the treatment of residual aortic dissection or distal arch expansion, and obtains the short- and long-term results in the future.

Background Kunming is a plateau city with sufficient sunshine, high ultraviolet intensity, and strong radiation. In recent years, ozone (O₃) pollution has gradually become the primary problem of air pollution in the city. Objective To evaluate the health effects of atmospheric O₃ exposure on non-accidental deaths in Kunming. Methods The data of meteorological variables (average temperature, average relative humidity, average air pressure, and average wind speed), air pollutants (PM_2.5, PM₁₀, SO₂, CO, and O₃) and non-accidental deaths (NAD) of residents were collected in Kunming from 2017 to 2019. A generalized additive model was adopted to conduct time-series analyses on the current-day (lag0), single-day (lag1-lag3), and cumulative lag (lag01-lag03) effects of O₃ on NAD; furthermore, hierarchical analyses by gender, age, and season (warm and cold) were conducted. Results The average concentration of O₃-8h from 2017 to 2019 was (84.3±32.3) μg·m⁻³. For every 10 μg·m⁻³ increase in O₃-8h concentration, the NAD risks of lag0, lag01, and lag02 of total population increased by 0.70% (95%CI: 0.11%-1.29%) 0.79% (95%CI: 0.14%-1.44%), and 0.75% (95%CI: 0.08%-1.43%), respectively; for women, the NAD risks of lag2 and lag02 increased by 0.80% (95%CI: 0.08%-1.53%) and 1.05% (95%CI: 0.09%-2.03%) respectively; for the residents over the age of 65, the associated NAD risks of lag0, lag01, and lag02 increased by 0.82% (95%CI: 0.16%-1.48%), 0.93% (95%CI: 0.20%-1.67%), and 0.96% (95%CI: 0.20%-1.73%), respectively; in the warm season, the NAD risks of lag0, lag01, and lag02 increased by 0.91% (95%CI: 0.12%-1.70%), 0.98% (95%CI: 0.12%-1.86%), and 1.00% (95%CI: 0.07%-1.93%), respectively; After introducing PM_2.5, PM₁₀, SO₂, NO₂, and CO to the model, the effects of O₃ exposure level on resident’s NAD was not statistically significant. Conclusion An increase of O₃ exposure level associates with an increase of NAD risk in residents, and there is a lag effect. Residents over the age of 65, women, and all residents in warm season may be more sensitive to O₃ exposure.

Objective:To analyze the epidemic situation and influencing factors of plague in Dehong Dai and Jingpo Autonomous prefectures (Dehong) from 1950 to 2019, for the improvement of strategies on prevention and control of the disease.Methods:The epidemic situation and surveillance data of animal and human plague in Dehong prefecture from 1950 to 2019 were collected and analyzed by descriptive epidemiological methods. Multiple linear regression equations were established by SPSS 20.0 software to analyze the relationship between plague among animals and rat density and flea index, as well as the relationship between human plague and plague among animals.Results:In Dehong prefecture, plague experienced a phenomenon of epidemic-resting-epidemic-resting cycle, between 1950 and 2019. During this period, 614 epidemic spots were identified in 36 townships of five counties/cities,. Human plague had been prevalent for 15 years, with 1 153 human cases and 379 deaths involved. Between 1982 and 2019, 261 319 rodents were captured, of which Rattus flavipectus accounted for 70.95%(185 421/261 319). A total of 70 124 fleas were seized with 76.65%(53 752/70 124), xenopsylla cheopis as fleas. The index of fleas and free fleas were 0.57 and 0.22 respectively. A total of 1 577 strains of Yersinia pestis were isolated from 285 091 animal specimens and 418 strains of Yersinia pestis were isolated from 60 119 groups of fleas, with 255 F1 antibody positive samples were detected from 64 157 sera samples. Neither Yersinia pestis nor the outbreak of plague had been noticed since 2008. Correlations between both animal plagues and rat density, as well as human plague and animals plague were noticed from the regression analysis. Conclusions:The epidemics of plague were with long-term and stable nature, in Dehong prefecture. Affected by many factors, plague seemed in a resting period currently. However, we should be reminded that the fact that outbreak of plague may revive at some uncertaint point. Hence in order to prevent human plague, strategies as careful surveillance programs on animals, need to be strenthened.