Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO₂, NO₂, CO, PM_2.5, PM₁₀, and maximum 8 h O₃ concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM_2.5, NO₂, SO₂, and O₃ were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM_2.5, NO₂, SO₂ and O₃ were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.

T2DM+LIRA group and T2DM+LIRA+UC-MSCs group (P<0. 05). The ratio of insulin positive area in pancreas tissue was obviously rised, while the ratio of glucagon positive area in pancreas tissue was clearly descended in T2DM+LIRA+UC-MSCs group. And the same difference in valuating islet cells apoptosis by TUNEL could be observed ( P<0. 05). The expression of NF-κB and TLR4 protein in pancreas tissue of T2DM+LIRA+UC-MSCs group were the least amongthefourgroups[(0.75±0.10)vs(0.60±0.08),(0.47±0.08),(0.31±0.04),P<0.05]and[(1.24± 0. 12) vs (0. 93 ± 0. 10), (0. 95 ± 0. 09), (0. 74 ± 0. 07), P<0. 05 ]. Conclusion The combined treatment of liraglutide with umbilical cord mesenchymal stem cells is superior over a single treatment of liraglutide or umbilical cord mesenchymal stem cells in improving the islet function in type 2 diabetes mellitus models, which may be related to the down modulating the TLR4/NF-κB inflammatory signaling pathway.

Objective To investigate the effect of liraglutide combined with bone marrow mesenchymal stem cells (BM-MSCs) on glucose metabolism in experimental type 1 diabetic (T1DM) rats.Methods T1 DM rats were established by injecting 60 mg/kg streptozotocin.According to random number table,they were divided into T1DM group (n =10),BM-MSCs group (n =10),LIRA group (n =10),and LIRA+BM-MSCs group (n =10),and were treated for 8 weeks respectively.Random blood glucose,24 h urine volume and protein excretion were tested.Serum concentrations of insulin,C-peptide,glucagon,gastrin,cholecystokinin,and glucagon-like peptid 1 (GLP-1) were assayed by ELISA.Expressions of insulin and glucagon in pancreas were measured by immunohistochemistry.Results After 8 weeks,the levels of random blood glucose,HbA1C,24 h urine volume and 24 h urinary protein excretion in group 4 were significantly decreased compared to the other three groups (P＜0.05).Compared to T1DM group and BM-MSCs group,the levels of insulin,C-peptide,gastrin,cholecystokinin and GLP-1 in LIRA+BM-MSCs group were significantly increased,while glucagon was decreased (P＜0.05).Compared to group LIRA,the levels of insulin,C-peptide,gastrin,and cholecystokinin in LIRA + BM-MSCs group were increased (P ＜ 0.05),there was no significantly difference in glucagon or GLP-1 (P＞0.05).The analysis revealed that the level of insulin was positively correlated with gastrin (r =0.544,P＜0.01),cholecystokinin (r =0.710,P＜0.01) and GLP-1 (r =0.669,P＜ 0.01),but was negatively correlated with glucagon (r =-0.506,P＜0.01);the level of glucagon was negatively correlated with gastrin (r =-0.364,P＜0.05),cholecystokinin (r =-0.433,P＜0.01) and GLP-1 (r =-0.591,P＜ 0.01).Compared to the other three groups respectively,immunohistochemistry displayed that the positive area of insulin in pancreas was significantly increased in LIRA + BM-MSCs group,while that of glucagon was decreased (P＜ 0.05).Conclusions By means of regulating gastrointestinal hormones efficiently,combination of liraglutide withBM-MSCs may improve glucose metabolism more efficaciously than treatment with a single agent in T1DM rats.

Objective To evaluate the efficacy and safety of human glucagon-like peptide-1 analogue liraglutide in newly diagnosed type 2 diabetes mellitus (T2DM) with glycosylated hemoglobin A1c (HbA1c) ＞ 9％.Methods This was an open-labelled,randomized,parallel-group,treat-to-target trial.Newly diagnosed T2DM patients with HbA1c ＞ 9％ were enrolled.These patients were treated with metformin with repaglinide and randomized to receive once-daily liraglutide (LIRA,n =25) or the insulin glargine (IGla,n =24) at bedtime.Efficacy and safety were assessed and compared after 18-month treatment.Results (1) Compared with the baseline,patients with LIRA had significantly reduced mean body weight,BMI and waist circumference (P ＜ 0.01),whereas,the above indexes were increased (P ＜ 0.01) in patients treated with IGla.(2) After 18 months of treatment,fasting plasma glucose (FPG),2-hour plasma glucose after a 75g oral glucose load(2hPG) and HbA1c were significantly improved in all patients (P ＜ 0.01),with 2hPG,mean blood glucose (MBG),the largest amplitude of glycemic excursions (LAGE),mean amplitude of glycemic excursions (MAGE) were significantly lower in LIRA group than in IGla group (all P ＜ 0.05).(3) HOMA-IR decreased in both groups (P ＜ 0.05).However,△I30/△G30,AUCCP180 and Matsuda index were only significantly increased in patients treated with LIRA (respectively,4.88 ± 1.55 vs 7.60 ± 1.91,9.23 ± 2.66 vs 13.18 ± 2.72,39.28 ± 20.35 vs 54.64 ± 23.34,all P ＜ 0.01),while HOMA-IR reduced(4.41 ± 1.58 vs 3.52 ± 1.44,P ＜0.05).But in IGla group only HOMAIR was reduced (4.92 ± 1.84 vs 4.57 ± 1.80,P ＜0.05).The index of △I30/△G30,AUCCP180 and Matsuda index in LIRA group are higher than those of indexes in IGla group(respectively,7.60 ± 1.91 vs 4.18 ± 1.00,13.18 ± 2.72 vs 10.53 ± 2.68,54.64 ± 23.34 vs 41.65 ± 17.84,all P ＜ 0.05),while HOMA-IR is lower (3.52 ± 1.44 vs 4.57 ± 1.80,P ＜ 0.05).(4) The rate of HbA1 c ≤ 6.5 ％ and the dosages of oral anti-diabetic drugs in LIRA group were significantly better than that in IGla group.(5) No significant differences were observed in hypoglycemic episodes and adverse events between two groups.Conclusion It seems that liraglutide is superior to insulin glargine in newly diagnosed T2DM patients with HbA1c ＞ 9％ in improving beta-cell function,insulin sensitivity and glucose homeostasis.

OBJECTIVE: To investigate the prevalence and related factors of emotional problems of newly identified patients with HIV/AIDS in Changsha, Hunan Province, and to provide scientific evidence for the mental health intervention in this special population. METHODS: A total of 370 patients with HIV/AIDS who were newly identified by the Center for Disease Prevention and Control in Changsha City from March 1, 2013 to February 28, 2014 were investigated. Self-designed questionnaire, Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), HIV/AIDS Stress Scale and Social Support Rating Scale (SSRS) were performed to assess the prevalence of depression, the anxiety symptoms, the HIV related stress and the status of social support. RESULTS: The prevalence of depression and anxiety were 40.3% (PHQ-9 ≥ 10 points) and 30.5% (GAD-7 ≥ 10 points), respectively. Severe depressive symptoms (PHQ-9≥20 points) and severe anxiety (GAD-7 ≥ 15 points) accounted for 8.1% and 14.3%, respectively. Hierarchical regression analysis showed that the status of employment (b=-3.407, P<0.001; b=-2.799, P=0.001), the sexual orientation (b=1.903, P=0.008; b=1.314, P=0.034), the resident status (b=-1.995, P=0.012; b=-2.167, P=0.002), the emergence of HIV-related symptoms(b=4.578, P<0.001; b=3.652, P<0.001) and the HIV related stress (b=0.081, P<0.001; b=0.090, P<0.001) were the predictors for both depressive and anxious emotional problems whereas the social support (b=-0.046, P=0.044) was the predictor for depressive emotional problems. Both anxiety (ΔR2=54.7%, P<0.001) and depression (ΔR2=55.8%, P<0.001) were strong predictors for patients with HIV/AIDS. CONCLUSION Depression and anxiety are prevalent among the newly identified patients with HIV/ AIDS. Psychosocial support and basic mental health services should be integrated into the current HIV/AIDS care system.
Acquired Immunodeficiency Syndrome ; psychology ; Anxiety ; epidemiology ; Depression ; epidemiology ; HIV Infections ; psychology ; Humans ; Mental Health ; Prevalence ; Regression Analysis ; Social Support ; Surveys and Questionnaires

Objective To investigate the relationship between the expression of regulated-upon activation normal T expressed and secreted(RANTES)and microvascular density(MVD)in hepatocarcinoma(PHC)tissues,and explore its clinical significance. Methods The samples of PHC tissues and adjacent tissues in 47 patients were collected.The expression of RANTES in tissues was detected by immunohistochemistry,and MVD was calculated.The relationship among the expression of RANTES,MVD and clinicopathological features was analysed. Results The positive expression rate and expression score of RANTES in PHC tissues were significantly higher than those in adjacent tissues(55.32% vs 19.15%,P<0.01;1.89±1.77 vs 0.77±1.29,P<0.01).MVD in PHC tissues was significantly higher than that in adjacent tissues(67.30±13.68 vs 37.20±10.58,P<0.01).MVD of PHC tissues in patients with metastasis was significantly higher than that in patients without metastasis[(73.50±13.77)/HP vs (64.10±12.68)/HP,P<0.05],while there were no correlations among MVD,expression of RANTES and the other clinicopathological features of PHC.MVD was positively correlated with the expression score of RANTES in PHC tissues(r=0.386,P<0.05). Conclusion RANTES might be closely related to the angiogenesis in PHC.

Objective To observe the effect of soy isoflavones on incretion of female rats. Methods 42 fe-male rots of 12 weeks old were divided into 3 groups at random. Low dose group were perfused with 40mg · kg-1·d-1 into stomach per day;high dose group were perfused with 80mg·kg-1·d-1 into stomach per day;control group were perfused with physiological saline into stomach. After 14 days,collected blood via jugular vein and tested 4 inde-xes-FSH, LH,E2 and P with chemoluminescence method. Results In 3 groups of soy isoflavones low doee group,soy isoflavones high dose group and control group,FSH were (0.13±0.021) mIu/ml, (0.12±0.018) mIu/ml, (0.15 ±0.024) mIu/ml respectively; LH were (0.17±0.032) mIu/ml, (0.15±0.043) mIu/ml, (0.18±0.047) mIu/ml respectively, which has no obvious differences (P > 0.05) ; E2 were (0.09±0.03) nmol/L, (0.03±0.03) nmol/L, (0.12±0.04) nmol/L respectively; P were (1.43±0.27) ng/ml, (2.82±0.37) ng/ml, (0.67±0.56) ng/ml re-spectivdy. Compare those 3 groups, E2 activeness of soy isoflavones group decreased obviously; but P activeness of soy isoflavones group increased obviously. Conclusion Soy isoflavones has no obvious effect on hypophysis hormone of rat, but the soy isoflavones of different dosages may measure the secretion of female rat ovary hormones by estrogen ac-tivity and antiestrogen activity.

Objective Amniotic membrane as the carrier to culture the vascular endothelial cells was investigated in this study in order to explore whether the corneal endothelial cells superseded by the vascular endothelial cells is feasible on the account of directing a kind of the original method to handle the bullous keratopathy.Methods The vascular endothelial cells adhering to the sphagitides lumen of the experimental rabbits were digested and gained by means of the perfusion method with 0.25%tripsin plus 0.02%EDTA.Fresh amniotic membrane without the amniotic epithelial cells was cut into the square tissue about 1.5 cm?1.5 cm and spread evenly in the 24-well culture dish.Primary cultured cells were subcultured on the amniotic membrane.We would not transplant the vascular endothelial cells feeding on the amniotic membrane until cells is full of the whole amniotic membrane surface.One to two months after the operation,the change of corneal diaphaneity was observed.Results About 12 days since the cell transplantation was performed,the corneal transparency alteration between the experimental groups and the control one is different.The corneal buttons in the experimental group show the severe edema and opacity,and the anterior chamber couldn't be seen unclearly.But,10 days after the operation,the corneal oedema which begins to extenuate was judged through the indicatrix that the corneal edema in the experimental group has been recovering slowly,among which the anterior chamber tissue of 7 animals was visible through the implant.The corneal edema in the control groups intensified evidently,even,the part of these appeared the ulcerous necrosis as result of the corneal severely edema.There is the existence of difference between two groups(P

Objective To study the clinicopathological significance of the expression of glutameta decarboxylase 65(GDA65) and protein kinase C(PKC) in the central cancer tissues, cancer edge tissues, paracancerous liver tissue and non-cancer liver tissues. Methods The expression of GDA65 and PKC were detected by immunohistochemical method in 10% neutral formalin- fixed and routinely paraffin-embedded sections in 37 hepatic cancer specimen. Results The positive rate and the score of GDA65 and PKC in the cancer tissues were significantly higher than that in the paracancer tissues or non-cancer liver tissues, but the PKC expression was no difference between the central cancer tissues and the cancer edge tissues . The expression of GDA 65 was related to the pathological types, differentiated degrees, liver cirrhosis or metastasis of hepatocarcinomas. No correlation was found between the expression of PKC and the clinicopathological features of hepatocarcinomas. Conclusions The expression of GDA65 and PKC might be closely related to the carcinogenesis of hepatocarcinoma, they might be important biological markers of hepatocarcinoma.

Objective To study the effect of expression of myoglobin which mediated by adenovirus,on ATP value of liver and the protective effect on liver ischemia reperfusion injury.Methods Adenovirus carrying CMV promoter sequences linked to the human myoglobin gene(AdCMVMyo) were transfected into rats liver. Then myoglobin, hepatic ATP levels and liver function were evaluated. Results Myoglobin expression was verified in rat livers after AdCMVMyo transfection. The ATP levels in rat livers 72 hours after AdCMVMyo transfection were significantly higher than that in control group(P