OBJECTIVE To explore the mechanism by which Qingre antai decoction improves pregnancy outcomes of threatened abortion rats with blood heat syndrome. METHODS The pregnant rats were randomly divided into normal group， model group， dydrogesterone group （0.002 g/kg）， and Qingre antai decoction group （44.1 g/kg）， with 13 rats in each group. Except for normal group， other groups were given warming-yang Chinese medicine and corresponding drugs intragastrically， once a day， for 12 consecutive days. On the 13th day of pregnancy， a single intragastric administration of mifepristone （5 mg/kg） was performed to establish a model of threatened abortion with blood heat syndrome. On the 14th day of pregnancy， the abortion rate and uterine coefficient were calculated； the pathological morphology of pregnant uterine was observed； the serum levels of 3，5，3′-triiodothyronine （T3）， thyroid hormone （T4）， thyroid stimulating hormone （TSH）， as well as the levels of vascular endothelial growth factor （VEGF） and nitric oxide （NO） in the pregnant uterus were all determined； the expressions of mRNA and protein related to Janus kinase 2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （AKT） pathways were detected. RESULTS Compared with normal group， the model group exhibited endometrial tissue damage， a reduced number of decidual cells， and a significant presence of blood stasis within the uterus； abortion rate， the serum levels of T3， T4 and TSH， the mRNA expressions of JAK2， STAT3 and suppressor of cytokine signaling 3 （SOCS3） as well as protein expressions of p-JAK2， p-STAT3 and SOCS3 in the pregnant uterus were increased significantly （ P ＜0.05）； uterine coefficient， the levels of VEGF and NO in pregnant uterus， mRNA expressions of VEGFR2， PI3K， AKT and endothelial nitric oxide synthase（eNOS）， protein expressions of VEGFR2， PI3K and eNOS as well as phosphorylation level of AKT in the pregnant uterus were significantly reduced （ P ＜0.05）. Compared with model group， the endometrial tissue damage and congestion in the Qingre antai decoction group were significantly improved， and the levels of the aforementioned quantitative indicators were significantly reversed （ P ＜0.05）. CONCLUSIONS Qingre antai decoction can improve the pregnancy outcomes in rats with threatened abortion of blood heat syndrome， the mechanism of which may be associated with inhibiting JAK2/STAT3 pathway and activating PI3K/AKT pathway.

Objective:To investigate the relevant situation of the emergency departments (ED) of general hospitals at all levels in Zhejiang Province participating in the prevention and control of Corona Virus Disease 2019 (COVID-19), and to provide a reference for further improving the capacity of emergency services.Methods:A multi-center cross-sectional investigation study was jointly initiated by the Zhejiang Provincial Emergency Medicine Quality Control Center, the Emergency Medicine Branch of Zhejiang Medical Association, and the Emergency Physicians Branch of Zhejiang Medical Doctors Association. Before investigation, experts were organized to develop a special questionnaire. Then the ED of general people's hospitals or Chinese Medicine hospitals at the county/district-level or above were included and their participations in the prevention and control of COVID-19 epidemic between March 9, 2020 and March 15, 2020 were investigated. The collected information included: basic information of the hospitals; participation of ED in fever clinics; the number of COVID-19 patients admitted to ED; the situation of ED support to the anti-epidemic front-line; and the epidemic prevention facilities of ED, and the early supply of medical protective equipments.Results:A total of 181 hospitals from 11 prefectures and cities across the province were finally included, including 52 (28.7%) Grade-A tertiary hospitals, 45 (24.9%) Grade-B tertiary hospitals, 64(35.4%) Grade-A secondary hospitals, and 20 (11.0%) Grade-B secondary or lower hospitals. Among them, 93 (51.4%) were COVID-19 designated hospitals, and 49 (27.1%) had the ability to detect COVID-19 nucleic acid; 177 (97.8%) set up independent fever clinics and 33 (18.6%) were managed by ED alone or mainly. The medical staffs of 65 (36.7%) fever clinics were all or mainly from ED. A total of 213 cases of COVID-19 were received/treated in 40.3% ED, accounting for 17.3% of the total number of cases in Zhejiang Province. A total of 3 848 doctors and nurses supported the front-line of epidemic prevention, of them, 253 supported Hubei Province (accounting for 12.5% ??of the total number). There were 68.5% and 76.8% ED having spare separate clinic and ordinary rescue single room to deal with the COVID-19. In addition, at the early days of anti-epidemic, more than 50% ED were in short supply or even had no medical protective equipment.Conclusions:The ED of Zhejiang Province plays an important role and has made a great contribution to the prevention and control of the COVID-19 epidemic. It is necessary to improve the conditions of ED to effectively respond to the prevention and control of daily infectious diseases.

"Air pollution and population health" is one of the most important environmental and public health issues. Economic development, urbanization, energy consumption, transportation/motorization, and rapid population growth are major driving forces of air pollution in large cities, especially in megacities. Air pollution levels in developed countries have been decreasing dramatically in recent decades. However, in developing countries and in countries in transition, air pollution levels are still at relatively high levels, though the levels have been gradually decreasing or have remained stable during rapid economic development. In recent years, several hundred epidemiological studies have emerged showing adverse health effects associated with short-term and long-term exposure to air pollutants. Time-series studies conducted in Asian cities also showed similar health effects on mortality associated with exposure to particulate matter (PM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)) and ozone (O(3)) to those explored in Europe and North America. The World Health Organization (WHO) published the "WHO Air Quality Guidelines (AQGs), Global Update" in 2006. These updated AQGs provide much stricter guidelines for PM, NO(2), SO(2) and O(3). Considering that current air pollution levels are much higher than the WHO-recommended AQGs, interim targets for these four air pollutants are also recommended for member states, especially for developing countries in setting their country-specific air quality standards. In conclusion, ambient air pollution is a health hazard. It is more important in Asian developing countries within the context of pollution level and population density. Improving air quality has substantial, measurable and important public health benefits.

Objective To get comprehensive and quantitative evaluation of the impact of ambient air pollution on human health. Methods The approach recommended in this paper is a quantitative estimate on the health impact from exposure to air pollutants based on the internationally accepted quantitative risk assessment framework and the per unit increase in mortality or morbidity due to per unit increase of air pollutants levels. Results A schematic diagram of health-based risk assessment on air pollutants is presented. Calculation for excess deaths and excess disease cases is also provided. Conclusion This approach could be used for comparing the health effects associated with exposure to air pollutants of various Chinese cities in different time periods and is also useful in the priority setting of air pollution intervention and improvement measures and health-based cost benefit analysis.

Objective To get the quantitative result of the impact of air sulfur dioxide on human health in the urban districts of Shanghai. Methods The approach recommended in this paper is based on the internationally accepted quantitative risk assessment framework and the unit increase in mortality or morbidity per unit increase of air pollutant level. Results In 1990,1998,the air sulfur dioxide caused 450～2 400,30～170 attributable deaths,accounting also for 54 600,4000 of chronic bronchitis,515 800,32 200 of outpatient visits of internal medicine,157 000～7 000 of outpatient visits of paediatrics medicine, 101 900～334 600, 6 600～23 200 of emergency room visits,23.3%,1.6% increase of cough,53.3%,3.6% increase of out of breath. Conclusion The impact of air sulfur dioxide in the urban districts of Shanghai on public health is considerable,although there is a decline trend.

Objective To assess the association of air pollution with daily mortality among residents of Zhabei district in Shanghai. Methods Case,crossover analysis and conditional Logistic regression model were used to analyze the association of air pollution with daily mortality of residents in Zhabei district of Shanghai from June 2000 to December 2002. Results Using a symmetric bi,directional control sampling approach, the results obtained from a conditional logistic regression model with four reference periods after controlling for weather conditions showed that the OR of non,accidental mortality associated with each 10 ?g/m3 increment of PM10, SO2 and NO2 over a 48,hr moving average were 1.007(95%CI 1.003-1.011),1.011(95%CI 1.001-1.021),1.010(95%CI 1.000-1.020)respectively. Similar associations were observed between mortality of cardiovascular diseases and PM10, mortality of respiratory diseases and NO2. Also, PM10 was associated with mortality in a sensitivity analysis. Conclusion The acute effect of air pollution on mortality of the general population was established in Zhabei district of Shanghai.

Objective To analyze the epidemiological data on air particulate matter and adverse health outcomes in China, and to estimate the exposure_response relationships. Methods An electronic search of relevant literature was conducted to determine the exposure_response relationship for each health outcome associated with exposure to air particulate matter, and the approach of Meta_analysis was used when there were several studies describing the same health endpoint. Results For each health outcome from morbidity to mortality changes, the relative risks were estimated when the concentration of air particulate matter increased some certain units. Conclusion The exposure_response relationships described here might be further applied to health risk assessment of air particulate matter in China.