Objective To investigate the correlation between the concentration of air pollutants (PM₁₀, SO₂, NO₂) and the number of outpatient and emergency visits for pediatric respiratory diseases in a general hospital in Shanghai. Methods Data including pediatric respiratory disease outpatient and emergency visits in a hospital in Pudong New Area of Shanghai from May 1, 2013 to March 20, 2022 were collected. Daily concentration of air pollutants including PM₁₀, SO₂ and NO₂ and meteorological data in Pudong New Area during the same period were collected. A case-crossover study with distributed lag non-linear model was conducted to explore the correlation between air pollutants (PM₁₀, SO₂, NO₂) and the number of outpatient and emergency visits for pediatric respiratory diseases. Results The concentrations of PM₁₀, SO₂ and NO₂ were positively with the number of outpatient and emergency visits for pediatric respiratory diseases. The strongest cumulative effect was observed on six days lag (Lag0-5) for PM₁₀. For a 10 μg/m³ increase of the concentrations of PM₁₀, the corresponding increase of cumulative pediatric respiratory disease outpatients was 1.10% (95%CI:0.97%, 1.23%) in Lag0-5. The strongest cumulative effect was observed on eight days lag (Lag0-7) for SO₂ and NO₂. For a 10 μg /m³ increase of the concentrations of SO₂ and NO₂, the corresponding increase of cumulative pediatric respiratory disease outpatients was 5.64% (95%CI:5.16%, 6.13%) and 5.41% (95%CI:5.15%, 5.66%) in Lag 0-7, respectively. The association of PM₁₀ and SO₂ with the number of pediatric respiratory disease visits in males was significantly stronger than that in females. The impact of PM₁₀ on the number of pediatric respiratory disease visits in children aged 0-6 was higher than that in children aged 7-14, while the impact of SO₂ and NO₂ on the number of pediatric respiratory disease visits in children aged 7-14 was higher than that in children aged 0-6. Conclusion The concentration of ambient PM₁₀, SO₂, and NO₂ is positively correlated with outpatient and emergency visits for pediatric respiratory diseases, with obvious lag and cumulative effect. Boys and children aged 0-6 are more susceptible to the hazard of air pollution.

Objective: To investigate the effects of interleukin ( IL) -10 on the proliferation of HaCaT cells and CaCl2 induced expression of differentiation markers and its possible molecular mechanisms． Methods: HaCaT cells were treated with various concentrations of IL-10 (0，3，10，30 ng / ml) for different time (0，24，48，72 h) ，cell proliferation was measured using MTS，and cell cycle was determined by flow cytometry．HaCaT cells were pretreated with IL-10 (final concentration 10 ng / ml) for 1 h，then incubated with or without CaCl2 (final concentration 1. 2 mmol / L) for 24，48，72 h ，Western blot was performed to detect the effect of IL-10 on the expression of HaCaT keratinocyte differentiation markers．After pretreatment of HaCaT cells with PD98059，an inhibitor of mitogen-activated kinase-ERK1 /2，and LY294002，an inhibitor of phosphatidylinositol kinase-serine / threonine kinase (PI3K-AKT) ，the total RNA and proteins were extracted separately，real time quantitative polymerase chain reaction (RT-qPCR) and Western blot were used to examine the influence of IL-10 on the expression of differentiation markers (Keratin1，Keratin5，Involucrin) . Results : MTS results revealed that IL-10 (30 ng / ml and lower doses) did not alter the proliferation of HaCaT cells in 72 h．Flow cytometry analysis demonstrated that IL-10 had no significant influence on cell cycle progression．The results of Western blot showed that IL-10 upregulated the expression of differentiation markers Involucrin，while there was no significant effect on Keratin1 and Keratin5 ．Mechanism research analysis demonstrated that IL-10 could activate ERK1 /2 and AKT ，increase their phosphorylation levels ; RT-qPCR and Western blot results showed that PD98059 and LY294002 partially blocked IL-10 induced Involucrin expression． Conclusion At a particular concentration range，IL-10 has little effect on HaCaT proliferation ，but it partially upregulates the expression of differentiation marker Involucrin via the MAPKs-ERK1 /2 and PI3K-AKT pathways.

Objective To investigate the modification effect of atmospheric temperature on outpatient visits caused by O₃ in Linzhi City. Methods The daily outpatient data, the daily O₃ concentration and daily meteorological data (including daily average temperature, average relative humidity, etc.) in Linzhi City from 2018 to 2019 were collected. The distributed lag non-liner-model (DLNM) was used to quantitatively evaluate the impact of O₃ in different temperature layers on the risk of outpatient visits. Results At low temperature layers, the cumulative relative risk (CRR) of total outpatient visits and non-injury outpatient visits increased by 53.8%（4.2% -126.9%) and 59.1%（5.8% -139.2%）for every 10 μg/m³ increase of O₃ concentration, respectively. The subgroup analysis showed that for every 10 μg/m³ increase of O₃ concentration at low temperature, the CRR of patients with circulatory diseases, men, women, and people being <14 years old and 14-65 years old increased by 152.1% (15.1% - 451.9%), 58.3% (2.1%-145.5%), 49.2% (3.0% -116.1%), 39.6% (2.5% - 90.3%), and 61% (0.8%-157.1%), respectively. Conclusion The average temperature may have a modifying effect on the outpatient visits caused by O₃ in Linzhi City. In general, the cumulative risk increases as the temperature decreases.

Objective To examine the epidemiological characteristics and trends of the active pre-hospital transportation of 6 338 newborns. Methods Newborns who were actively transported from other hospitals to the neonatal transportation center of Xuzhou children’s hospital from January 2014 to December 2018 were enrolled in the present study. The demographic information, clinical characteristics and transport data of the newborns were retrospectively analyzed. The epidemiological trends of the neonatal transfers in different years were analyzed. Results A total of 6 338 cases were included in the study, including 4,093 boys and 2,245 girls. The proportion of girls increased year by year (P<0.05). The average gestational age was 36.62 weeks, with no significant difference between years (P>0.05). The proportion of transferred neonates within 24 hours showed a downward trend (P<0.05). The proportion of premature infants, extremely low birth weight infants, invasive respiratory support infants and critical cases increased yearly (P<0.05). The number of surgical transfer cases in 2017 and 2018 increased compared with the previous years (P<0.05). The top three diseases were neonatal aspiration pneumonia, neonatal respiratory distress syndrome and neonatal asphyxia. There were no differences in the levels of the referral hospitals, transportation time and distance (P>0.05). In the past five years, there were only two deaths in the transfers (0.32‰). The overall rate of successful transfers was 99.08%. Conclusion The proportion of extremely low birth weight neonates, critical cases, invasive respiratory support cases, and surgical disease cases transported from 2014 to 2018 increased year by year. It is necessary to strengthen training of the relevant medical personnel to improve their techniques and skills according to the epidemic trends of neonatal pre-hospital transfer.

Objective To understand the application effect of community chronic disease health management in elderly patients with diabetes, and to provide health management basis for the prevention and treatment of elderly patients with diabetes in community. Methods A total of 200 community type 2 diabetes patients were selected from July 2019 to December 2019, and were divided into two groups with 100 patients in each group by randomized control method. The control group was managed by conventional way, and the observation group was managed by community chronic disease health management. The two groups agreed to follow up patients monthly. Life behavior factors and clinical metabolic indicators of patients were obtained and recorded, and the effects of the two groups were evaluated after a 6-month cycle. Results After intervention, the levels of serum FPG, 2hPG and HbA1c in the two groups were significantly lower than those before treatment (P<0.05). The serum levels of FPG, 2hPG and HbA1c in observation group were significantly lower than those in control group (P<0.05). After intervention, diet control, movement dependence, foot care, test compliance score and SDSCA total score in both groups were significantly increased compared with those before treatment (P<0.05). The observation group was significantly higher than the control group (P<0.05). After intervention, the scores of physiological, psychological, environmental and social relationship in the two groups were significantly lower than those before treatment (P<0.05). The observation group was significantly lower than the control group (P<0.05) . Conclusion Community chronic disease health management has a good effect on elderly diabetes patients in community, which is worth long-term implementation and promotion in social health centers.

AIM: To explore the levels of interleukin-8, interleukin-8 receptor 1, 2(CXCR1, CXCR2)in aqueous humor of polypoid choroidal vasculopathy(PCV)and their clinical significance.

METHODS: Totally 67 patients with PCV in our hospital were selected as PCV group, and another 50 patients with cataract were selected as control group, fluorescence quantitative PCR(QPCR)was used to detect the expression of IL-8, CXCR1 and CXCR2 mRNAs in aqueous humor of two groups, the best corrected visual acuity(BCVA)of all subjects were measured by the international standard visual acuity chart, optical coherence tomography(OCT)was used to detect foveal retinal thickness(CMT), the receiver operating characteristic curve(ROC)was created to analyze the predictive values of IL-8, CXCR1 and CXCR2 in the occurrence of PCV. Multivariate Logistic regression analysis was used to assess the risk factors for PCV.

RESULTS: Compared with the control group, the expression of IL-8, CXCR1 and CXCR2 mRNA increased in group PCV. BCVA in PCV group decreased and CMT increased(P<0.05). IL-8, CXCR1 and CXCR2 were significantly positively correlated with BCVA(r=0.438, 0.346, 0.385, all P<0.05), IL-8, CXCR1 and CXCR2 were positively correlated with CMT(r=0.378, 0.606, 0.357, all P<0.05). Logistic multivariate regression analysis showed that IL-8, CXCR1, CXCR2, BCVA and CMT were the risk factors of PCV. The AUC of IL-8, CXCR1 and CXCR2 for PCV diagnosis was 0.882, 0.860 and 0.812.

CONCLUSION: The expression of IL-8, CXCR1 and CXCR2 in PCV aqueous humor were all increased, which was not only related to BCVA and CMT in patients, but also related to the occurrence of PCV, and it may become a potential predictor of PCV.

Objective To investigate the clinical characteristics of nontraumatic spinal cord injury, including the demographic characteristics,etiology and neurological function. Methods 44 patients with nontraumatic spinal cord injury in the past 4 years were reviewed. Results There were 27 males (61.3%) and 17 females (38.7%) with mean age of 39.85 years (3.5~78). They were followed up for mean of 13.3 (3~23) months. Myelitis (36%) and spinal tumor (including primary and metastatic tumor, 18.1%) were the most common causes, followed by intraspinal tumor (15.9%), vascular disease (13.6%), nontraumatic acute disc herination (6.8%), spinal cord ischemia after non-spinal surgery (4.5%) and hepatic myelopathy (4.5%). Neurological function at the initial admission included tetraplegia in 9 patients, paraplegia in 30 patients, conus medullaris syndrome in 2 patients and cauda equina syndrome in 2 patients. Neurological function of ASIA at the initial admission included A in 14 cases, B in 6, C in 13 and D in 11. 34% patients improved at least one ASIA grade when evaluated at final follow up. Conclusion Nontraumatic etiologies contribute to a significant proportion for spinal cord injury. Patients with nontraumatic spinal cord injury present the clinical characteristics different from traumatic spinal cord injury cases.