BACKGROUND: Previous evidence showed that ambient air pollution and cardiovascular mortality are related. However, there is a lack of evidence towards the modification effect of long-term lifestyle on the association between short-term ambient air pollution and death from cardiovascular events. METHOD: A total of 14,609 death from major adverse cardiovascular events (MACE) were identified among the China Kadoorie Biobank participants from 2013 to 2018. Ambient air pollution exposure including particulate matter 2.5 (PM_2.5), SO₂, NO₂, CO, and O₃ from the same period were obtained from space-time model reconstructions based on remote sensing data. Case-crossover design and conditional logistic regression was applied to estimate the effect of short-term exposure to air pollutants on MACE mortality. RESULTS: We found MACE mortality was significantly associated with PM_2.5 (relative percent increase 2.91% per 10 µg/m³ increase, 95% CI 1.32-4.53), NO₂ (5.37% per 10 µg/m³ increase, 95% CI 1.56-9.33), SO₂ (6.82% per 10 µg/m³ increase, 95% CI 2.99-10.80), and CO (2.24% per 0.1 mg/m³ increase, 95% CI 1.02-3.48). Stratified analyses indicated that drinking was associated with elevated risk of MACE mortality with NO₂ and SO₂ exposure; physical inactivity was associated with higher risk of death from MACE when exposed to PM_2.5; and people who had balanced diet had lower risk of MACE mortality when exposed to CO and NO₂. CONCLUSIONS The study results showed that short-term exposure to ambient PM_2.5, NO₂, SO₂, and CO would aggravate the risk of cardiovascular mortality, yet healthy lifestyle conduct might mitigate such negative impact to some extent.
Humans ; Cardiovascular Diseases/epidemiology* ; China/epidemiology* ; Male ; Female ; Air Pollution/adverse effects* ; Middle Aged ; Air Pollutants/analysis* ; Particulate Matter/analysis* ; Environmental Exposure/adverse effects* ; Life Style ; Aged ; Adult ; Risk Factors ; Cross-Over Studies ; East Asian People

Objective:To construct a diabetic foot classification prediction model based on radiomics features of fundus photographs.Methods:A total of 2 035 fundus photographs of patients with type 2 diabetes diagnosed at Nanfang Hospital between December 2011 and December 2018 were retrospectively collected [282 photographs from patients with diabetic foot(DF), and 1 753 from patients with diabetes mellitus(DM)]. All fundus photographs were randomly divided into a training set(1 424 photos) and a test set(611 photos) using a computer generated random number at 7∶3. After pre-processing the fundus photographs, a total of 4 128 texture features based on the gray matrix were extracted by the Radiomic toolkit, and 11 339 other features were extracted using the ToolboxDESC toolkit. The LASSO algorithm was used to select the 30 features most relevant to DF, and then the Bootstrap + 0.632 self-sampling method was used to further select the 7 best combinations. Logistic regression analysis was used to obtain the regression coefficients and establish the final diabetic foot classification prediction model. ROC curve was drawn, and AUC, sensitivity, specificity, and accuracy of the training and test sets were calculated to verify its prediction performance. Results:We screened 7 fundus radiomics markers for diabetic foot patients, and based on this established a DF/DM classification prediction model. The AUC, sensitivity, specificity, and accuracy of the model were 0.958 6, 0.984 0, 0.920 0, and 0.928 0 in the training set, and 0.927 1, 0.988 9, 0.881 0, and 0.896 9 in the test set, respectively.Conclusion:In this study, seven DF fundus markers were screened using radiomics technology. Based on this, a highly accurate and easy-to-use DF/DM classification model was constructed. This technology has the potential to increase the efficiency of DF screening programs.

Objective To analyze risk factors for diabetic kidney disease (DKD) in inpatients with type 2 diabetes.Methods A total of 930 inpatients with type 2 diabetes were enrolled in the study and grouped according to different levels of estimated glomerular filtration rate (eGFR),albuminuria,and diabetic retinopathy.Logistic regression analysis was adopted to explore the risk factors for DKD in inpatients with type 2 diabetes.Results (1) The prevalence of albuminuria in patients with type 2 diabetes mellitus was increased with declining eGFR (P ＜ 0.05).(2) The prevalences of DKD and non-diabetic renal disease (NDRD) in patients with type 2 diabetes mellitus were 22.26％ and 8.92％,respectively.Compared with patients with NDRD,patients with DKD had longer diabetic duration,higher levels of systolic blood pressure,serum creatinine,and urinary albumin excretion,and lower levels of hemoglobin[(125.40 ± 21.95 vs 138.18 ± 19.67) g/L],serum albumin[(37.45 ± 5.54 vs 40.55 ± 3.55) g/L],and eGFR[(89.66 (59.10-108.25) vs 103.15 (85.39-114.88) ml · min-1 · (1.73 m2)-1,all P＜0.05].(3) Logistic regression analysis showed that age,diabetic duration,systolic blood pressure,serum uric acid,diabetic retinopathy,and hypertension are the independent risk factors for diabetic kidney disease in inpatients with type 2 diabetes,while serum albumin was the protective factor (all P＜0.01).Conclusions A variety of clinic risk factors were associated with DKD.Better control of blood pressure,serum uric acid,and hypoalbuminemia should be performed to delay the progress of DKD.

Objective To investigate the efficacy of ambroxol combined with penehyclidine hydrochloride for prevention of pulmonary complications after surgery due to acute abdomen in pediatric patients with upper respiratory tract infection.Methods Fifty pediatric patients with acute abdomen complicated with respiratory infection,of ASA physical status Ⅰ or Ⅱ,aged 6 months-5 yr,were randomly divided into test group (group A) and control group (group B),with 25 cases in each group.Immediately after admission to the operating room,ambroxol 1 mg/kg and penehyclidine hydrochloride 0.02 mg/kg were injected intravenously in group A,and atropine 0.02 mg/kg was given in group B.Extubation time and development of laryngospasm,bronchospasm and hypoxemia were recorded.The patients were followed up for 72 h after surgery and the development of postoperative pulmonary complications was recorded.Results Compared with group B,the incidence of hypoxemia and pulmonary complications was significantly decreased,and extubation time was shortened in group A.Conclusion Ambroxol combined with penehyclidine hydrochloride can prevent pulmonary complications after surgery due to acute abdomen and is helpful for prognosis in pediatric patients with upper respiratory tract infection.

8 cases of adrenal tumors were subjected to laparoscopy from October 2000 to June 2001.Success was achieved in 7 cases, one patient was convevted to open surgery because of bleeding. Recovery was uneventful in all without complication. The indications and technique of operation as well as complications were discussed.

Objective It would make a reconstructed ear more naturally when deep temporal fascia, which is much thinner, cover the MEDPOR ear framework instead of superficial temporal fascia. However, without an axial vascular supply, should skingraft be taken on the islanded deep temporal fascia flap? Perhaps this fascia flap could get a new blood supply from the underlying superficial temporal fascia through the porous framework after a period of time. This study was to test its possibility. Methods A piece of 30?15?2mm MEDPOR material was inserted between superficial and deep fascia on the back of a rabbit. In control group, skin graft on the deep surface of deep fascia was operated at once; in experiment group, the incision was sutured and the skin graft was operated 3 weeks later in the same incision. Results Skin grafts were taken in all the 6 rabbits in the experiment group. 80%～100% of necrosis occurred in all the 6 rabbits of control group. Conclusion Without an axial vascular supply, skin graft can not survive on the islanded deep fascia flap. This fascia flap can get a new blood supply from the underlying superficial fascia through the porous MEDPOR material, through which small vessels grow between the two fascia after 3 weeks.