Objective To investigate the correlation and lag effect between atmospheric particulate matter and the risk of hospitalization for chronic kidney disease(CKD).Methods The daily hospitalization data for CKD in 9 hospitals in Urumqi from Jan.1,2019,to Dec.31,2020,and the air pollution and meteorological data during the same period were collected.The relationship between PM2.5 and PM10 concentrations and CKD incidence was analyzed after controlling for long-term trends,meteorological factors,and potential confounding factors such as the"day of the week effect"by using the generalized additive model(GAM).The effects of single-day lag of 0-7 d(lag0-lag7)and cumulative lag of 0-7 d(lag01-lag07)were analyzed,and subgroup analyses were conducted for gender,age,and season.On the basis of the single pollutant model,other pollutants were included(at most 2 pollutants were included at a time),and a double pollutant model was constructed to evaluate the stability of the model.Results For every 10 μg/m3 increase in PM2.5 concentration,the highest risk of CKD hospitalization occured when lagged alone at lag2(relative risk[RR]=1.014,95％confidence interval[CI]1.006-1.023)and lagged cumulatively at lag04(RR=1.018,95％CI 1.007-1.029).For every 10 μg/m3 increase in PM10 concentration,the risk of CKD hospitalization was highest when lagged alone at lag0 and lagged cumulatively at lag07(RR=1.012,95％CI 1.007-1.017;RR=1.024,95％CI 1.016-1.032).In gender stratification,for every 10 μg/m3 increase in PM2.5 concentration,the cumulative lag at lag04 indicated that males had the highest risk of CKD hospitalization(RR=1.023,95％CI 1.008-1.038);for every 10 μg/m3 increase in PM10 concentration,the highest risk of CKD hospitalization was observed in males when lagged alone at lag0(RR=1.013,95％CI 1.006-1.020),and in females when lagged alone at lag1(RR=1.013,95％CI 1.006-1.020).In age stratification,for every 10 μg/m3 increase in PM2.5 concentration,the risk of CKD hospitalization was highest in people 65 years old with single-day lag at lag3 and cumulative lag at lag04(RR=1.016,95％CI 1.007-1.026;RR=1.022,95％CI 1.010-1.035);for every 10 μg/m3 increase in PM10 concentration,the cumulative lag at lag07 indicated that individuals aged＜65 years old and ≥65 years old had the highest risk of CKD hospitalization(RR=1.027,95％CI 1.017-1.037;RR=1.015,95％CI 1.001-1.028).In seasonal stratification,for every 10 μg/m3 increase in PM2.5 concentration during the cold season,the risk of CKD hospitalization was highest when lagged alone at lag3 and lagged cumulatively at lag07(RR=1.020,95％CI 1.011-1.029;RR=1.025,95％CI 1.011-1.038).For every 10 μg/m3 increase in PM10 concentration during the cold season,the risk of CKD hospitalization was highest when lagged alone at lag2(RR=1.013,95％CI 1.007-1.019).For every 10 μg/m3 increase in PM10 concentration during the warm season,the risk of CKD hospitalization was highest when lagged alone at lag7(RR=1.015,95％CI 1.006-1.024).In the dual pollutant model,the effects of PM2.5 adjusting PM10,SO2,O3 and CO,and PM10 adjusting NO2,SO2,O3,and CO on the risk of CKD hospitalization were still significant(P＜0.05).Conclusion The increase in atmospheric particulate matter concentrations of PM2.5 and PM10 can lead to an increased risk of CKD,and there is a lag effect.Men,people under the age of 65 years old,and those in cold seasons(heating periods)are more sensitive to exposure to PM2.5 and PM10.

Objective:To investigate the radiation field distribution characteristics in a 9 MeV electron FLASH (e-FLASH) linear accelerator treatment room.Methods:The Geant4 Monte Carlo program was employed for physical simulating of the radiation field distribution inside and outside the treatment room under a single-beam delivery condition with a total dose of 50 Gy at the reference point and a dose rate of 250 Gy/s. High-sensitivity radiation detectors (AT1123) were used to validate the measurements at key points.Results:The dose rate at the reference point was approximately 9×10 11 μSv/h. Due to the scattering and shielding effects, the deviation of the attenuation rate from the inverse-square law was observed and the isodose lines exhibited spatial drift. Measured dose rates at key points showed good agreement with the simulation result, with a maximum deviation within 30%. Conclusions:The complex radiation field distribution can be effectively simulated using Geant4 in an e-FLASH treatment room. This indicated the Geant4 is not only applicable for the shielding calculations in e-FLASH radiotherapy facilities, but also for the design optimization through, reduction of trial-and-error iterations and engineering costs.

Objective:To investigate the radiation field distribution characteristics in a 9 MeV electron FLASH (e-FLASH) linear accelerator treatment room.Methods:The Geant4 Monte Carlo program was employed for physical simulating of the radiation field distribution inside and outside the treatment room under a single-beam delivery condition with a total dose of 50 Gy at the reference point and a dose rate of 250 Gy/s. High-sensitivity radiation detectors (AT1123) were used to validate the measurements at key points.Results:The dose rate at the reference point was approximately 9×10 11 μSv/h. Due to the scattering and shielding effects, the deviation of the attenuation rate from the inverse-square law was observed and the isodose lines exhibited spatial drift. Measured dose rates at key points showed good agreement with the simulation result, with a maximum deviation within 30%. Conclusions:The complex radiation field distribution can be effectively simulated using Geant4 in an e-FLASH treatment room. This indicated the Geant4 is not only applicable for the shielding calculations in e-FLASH radiotherapy facilities, but also for the design optimization through, reduction of trial-and-error iterations and engineering costs.

Objective:To measure the beam stability of the electron FLASH radiotherapy accelerator developed by the Institute of Applied Electronics of Chinese Academy of Engineering Physics and to evaluate the performance of scintillator, fast current sensor (FCT) and graphite under the electron FLASH beam.Methods:Each continuous beam exit deviation and each pulse deviation at the electron FLASH radiotherapy accelerator in the same working state were measured. The correlation among three monitors and the measured dose of the accelerator at different electron beam energy (controlled by changing the charging voltage) and different beam pulse numbers were compared, which were validated by a Monte Carlo simulation procedure.Results:At the first high pressure, the first 10 scintillators and FCT signals were relatively large, approximately 2% deviation compared with the average value of 400 pulses. Among 40 beam outflows, the deviation between each pulse was within ±5%. In the accelerator steady state, each beam outflow deviation was within ±1%. Both simulated and measured values showed that the monitor could not be used for dose monitoring at different electron beam energy. However, when the energy was the same, only the number of beam pulses was changed, and linear relationship was observed between the number of the three monitors and the dose measured by the film (all R 2 > 0.999). Conclusions:The beam deviation of each beam outflow of this electron FLASH accelerator is within ±1%. Under the stability of the accelerator beam, the scintillator, FCT and graphite can meet the dose monitoring of the target area, which can provide reference for dose monitoring for subsequent biological experiments.

Objective To investigate the effect of diurnal temperature difference on hospitalization volume of patients with cardiovascular and cerebrovascular diseases in Urumqi City. Methods The daily hospitalization data for cardiovascular and cerebrovascular diseases in Urumqi City from 2019-2021, and meteorological and pollutant data for the same period were collected. The relationship between diurnal temperature range and hospitalizations for cardiovascular and cerebrovascular diseases was analyzed using a distribution lag non-linear model (DLNM), controlling for the long-term trends, the day-of-week effects and other factors. Results The greater the diurnal temperature range, the longer the lag time, and the higher the risk of hospitalization for cardiovascular and cerebrovascular diseases. The lag effect increased significantly when the maximum diurnal temperature range reached 21.0°C. The risk effect appeared on the day of exposure and lasted until day 20, with a maximum RR of 1.266 (95% CI: 1.129-1.421) at a lag of 13 days. At very high diurnal temperature range, the risk of hospitalization for cardiovascular and cerebrovascular diseases was higher in the cold season than that in the warm season. Results after stratified analysis by sex and age showed that men and people aged ≥65 years were more susceptible to diurnal temperature range. Conclusion Extremely high diurnal temperature range is a potential trigger for hospitalization for cardiovascular and cerebrovascular diseases in Urumqi. Men and people aged ≥65 years are more vulnerable to the impact of diurnal temperature range. In the cold season, more attention should be paid to protecting vulnerable people from the impact of the extremely high diurnal temperature difference.

Objective Sialic acid and its derivatives in mammalian cells mainly include N-acetylneuraminic acid (Neu5Ac), N-glycolylneuraminic acid (Neu5Gc) and deaminoneuraminic acid (KDN), among which Neu5Ac can be catalyzed by cytidine monophospho-N-acetylneuraminic acid hydroxylase (CMAH) for the synthesis of Neu5Gc. In this study, the transcriptional level of CMAH in different tissues of BALB/c mice were determined by relative fluorescence quantitative PCR, to provide a reference for further analysis of Neu5Gc levels in different tissues. Methods The mRNA sequence of CMAH was searched in the NCBI database and specific primers were designed. The mouse β-actin was selected as an internal control, and the transcriptional levels of CMAH in 9 different organ tissues of BALB/c mice were detected by relative fluorescence quantitative PCR using SYBR Green dye. Results Among the 9 mouse organs, the transcriptional level of CMAH in the liver tissue was the highest, which was 2. 46 times higher of that in the spleen, 3. 17 times of the kidney, 5. 14 times of the trachea, 11. 70 times of the lung, 21. 12 times of the myocardium, 31. 37 times of the skeletal muscles, 66. 90 times of the small intestine and 1056. 99 times of the brain tissue, respectively. Conclusions CMAH is transcribed in many organ tissues of mice, and its transcriptional levels vary in a quite wide range.

Objective To verify the reliability of our previously established reverse-transcription loop-mediated isother-mal amplification ( RT-LAMP) method for the detection of sentinel lymph nodes metastasis in breast cancer patients .Meth-ods Sentinel lymph nodes of breast cancer patients were analyzed by RT-LAMP and FDA-approved GeneSearch methods respectively, and the consistency of the two methods was assessed with a kappa concordance test.Results One hundred and thirty-four cases of sentinel lymph node samples were collected from seven hospitals in Beijing .Using the GeneSearch assay as the gold standard, the sensitivity, specificity and consistentcy of RT-LAMP were 96.2%(25/26),96.3%(104/108) and 96.3%(129/134), respectively.Statistical analysis showed that the two methods were consistent (Kappa=0.8857, P<0.001).Conclusion RT-LAMP is highly consistent with GeneSearch ,efficient,simple and inexpensive, promising a good prospect of application to intra-operative detection of sentinel lymph nodes metastasis for breast cancer patients.

Objective:The study aimed to validate the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and Stan-ford Online Calculator (SOC) prediction of non-sentinel lymph node (NSLN) metastasis in Chinese patients with sentinel lymph node (SLN)-positive breast cancers. Methods:The MSKCC nomogram and SOC were used to calculate the probability of NSLN metastasis in 120 breast cancer patients who were positive for SLNs. The area under the receiver operating characteristic curves (AUC) for each model was evaluated. Patients with 10%and 90%probabilities of NSLN metastasis were separately examined. Results:The MSKCC and SOC predicted the likelihood of NSLN metastasis in a consecutive group of 120 patients with AUCs of 0.688 and 0.734, respective-ly. At the lowest probability cutoff value of 10%, the false-negative rates of MSKCC and SOC were both 4.4%, and the negative predic-tive values were 75.0%and 90.0%, respectively. When the highest probability cutoff value of 90%was used, the false-positive rates were 0.0%and 6.7%, and the positive predictive values were 100.0%and 68.8%, respectively. Conclusion:Results of the MSKCC no-mogram and SOC were inferior to those of previous studies on predicting NSLN metastasis in Chinese patients with breast cancers. The prediction ability of SOC was slightly superior to that of the MSKCC nomogram.

BACKGROUNDThis multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging (MRI) prior to breast-conserving surgery for breast cancer.

METHODSThe research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012. The participants were allocated to a breast-conserving surgery group (breast-conserving group) or a total mastectomy group (total mastectomy group). Enhanced MRI was used to measure breast volume, longest diameter of tumor and tumor volume. The correlations between these measurements and those derived from histopathologic findings were assessed. The relationships between the success rate of breast-conserving surgery and MRI- and pathology-based measurement results were statistically analyzed in the breast-conserving group.

RESULTSThe study included 461 cases in the total mastectomy group and 195 in the breast-conserving group. Allocation to these groups was based on clinical indications and patient preferences. The cut-off for concurrence between MRI- and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm. In the total mastectomy group, the confidence interval for 95% concurrence of these measurements was 35.41%-44.63%. Correlation coefficients for MRI and histopathology-based measurements of breast volume, tumor volume and tumor volume/breast volume ratio were r = 0.861, 0.569, and 0.600, respectively (all P < 0.001). In the breast-conserving group, with 0.30 cm taken as the cut-off for concurrence, the 95% confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98%-44.01%. The subjective and objective success rates for breast-conserving surgery were 100% and 88.54%, respectively.

CONCLUSIONSThere were significant correlations between dynamic enhanced MRI- and histopathology-based measurements of the longest diameter of breast lesions, breast and tumor volumes, and breast volume/tumor volume ratios. Preoperative MRI examination improves the success rate of breast-conserving surgery.

Objective Through the community health management of hypertension , to determine the input and output , change the knowledge , attitude, practice ( KAP) of hypertension patients and put forward the reasonable suggestions of antihypertensive treatment in order to reduce hypertensive patients 'medical expenses . Methods By random cluster sampling method , we selected 809 hypertension patients , over 18 years old, from two communities in Urumqi .414 patients were in the management group and 395 patients were in the control group.The health management the cost benefit was analyzed by the change of patient 's KAP, medical expenses and so on.Results For the knowledge and behavior changes , 17.94% patients in the management group and 3.04%patients in the control knew the classification of blood pressure (Z=-5.688,P=0.000).The master of normal range of blood pressure (Z=-11.927,P=0.000), knowledge of obesity (χ2 =15.608,P=0.000) and knowledge of risk factors (χ2 =-17.677,P=0.000) between groups had significant differences (P<0.01).The total drug expenses of the management group and the control group were (1 583.88 ±981.24) and (1 923.90 ±1 523.81) yuan, respectively;the total hospitalization expenses of the management group and the control group were (10 725.77 ±11 688.26) and (15 327.03 ±10 280.42) yuan, respectively, the differences were significant (t=2.14,2.75, respectively;P<0.05).The costs of patients taking the drug and other costs in the management group were lower than the control group , the differences were significant ( P <0.01 ). Conclusions Hypertension health management can obtain a good cost benefit , reduce hypertension sickness cost, and improve quality of life .