BACKGROUND: Ambient fine particle (PM METHODS: A time-stratified case-crossover design was used to analyze YLL from respiratory diseases in the elderly related to ambient PM RESULTS: Each 10 μg/m CONCLUSIONS Birth season which reflects the early-life PM
Aged ; Aged, 80 and over ; Air Pollutants/analysis* ; Cause of Death ; China/epidemiology* ; Cross-Over Studies ; Environmental Exposure/analysis* ; Humans ; Life Expectancy ; Particulate Matter/analysis* ; Respiration Disorders/mortality* ; Seasons

Objective:To evaluate the safety and clinical efficacy of transplanting a muscle flap to treat the postoperative refractory empyema with a bronchopleural fistula.Methods:From July 2015 to December 2019, the clinical data of 15 patients who suffered from postoperative refractory empyema with bronchopleural fistula was retrospectively summarized. There were 13 males and two females with a mean age of 61.7 years. Ten cases had previous posterolateral thoracotomy and four cases underwent minimally invasive surgery. After conservative and endoscopic therapy, a pedicled latissimus dorsi muscle flap, a pectoralis major muscle flap, or a free vastus lateralis myocutaneous flap was harvested from the ipsilateral local thorax or thigh and was transferred to cover the intrathoracic cavity.Results:There was no perioperative death. During a mean follow-up of 14.8 months, one patient was dead, one suffered from a recurrence of refractory empyema, and l3 patients had an uneventful course with no recurrence of refractory empyema and bronchopleural fistula. Postoperative chest computed tomography or magnetic resonance imaging showed the empyema cavity was satisfactorily covered with a pedicle or free muscle flap.Conclusions:Muscle flap transplantation is an effective alternative for treating the postoperative refractory empyema with bronchopleural fistula, which can achieve promising short-medium-term results.

Objective:To evaluate the safety and clinical efficacy of transplanting a muscle flap to treat the postoperative refractory empyema with a bronchopleural fistula.Methods:From July 2015 to December 2019, the clinical data of 15 patients who suffered from postoperative refractory empyema with bronchopleural fistula was retrospectively summarized. There were 13 males and two females with a mean age of 61.7 years. Ten cases had previous posterolateral thoracotomy and four cases underwent minimally invasive surgery. After conservative and endoscopic therapy, a pedicled latissimus dorsi muscle flap, a pectoralis major muscle flap, or a free vastus lateralis myocutaneous flap was harvested from the ipsilateral local thorax or thigh and was transferred to cover the intrathoracic cavity.Results:There was no perioperative death. During a mean follow-up of 14.8 months, one patient was dead, one suffered from a recurrence of refractory empyema, and l3 patients had an uneventful course with no recurrence of refractory empyema and bronchopleural fistula. Postoperative chest computed tomography or magnetic resonance imaging showed the empyema cavity was satisfactorily covered with a pedicle or free muscle flap.Conclusions:Muscle flap transplantation is an effective alternative for treating the postoperative refractory empyema with bronchopleural fistula, which can achieve promising short-medium-term results.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

OBJECTIVE: To report on a case with homozygous deletion of large β gene cluster and its clinical characteristics. METHODS: A total of 71 001 peripheral blood samples were subjected to capillary electrophoresis and conventional testing for common thalassemia mutations. The genotypes of suspected β gene cluster deletions were analyzed by Gap-PCR and multiplex ligation-dependent probe amplification (MLPA). Their hematological characteristics were compared by statistical analysis R software. RESULTS: Eighty-nine cases were detected with Chinese CONCLUSION The carrier rate for large fragment deletions of β gene cluster in Huizhou region is rather high, for which the value of HbF is significantly increased. Attention should be paid to screening and diagnosis of rare genotype to prevent missed diagnosis and/or misdiagnosis.
Gene Deletion ; Homozygote ; Humans ; Multigene Family/genetics* ; Phenotype ; beta-Thalassemia/genetics*

Objective To investigate the in vivo radioprotective effect of adenosine triphosphate (ATP) on radiation damage induced by high dose γ-ray ionizing radiation(IR) in mice.Methods Specific pathogen-free C57BL/6 female mice were randomly divided into IR group and IR+ATP group by body weight,with 10 mice in each group.All the mice were treated with a 8 Gy one-time and high-dose whole body γ-ray irradiation.Within 6 h after irradiation,mice were injected intramuscular injection of 150 pl sodium chloride solution (9 g/L) for IR group,and 150 μl ATP solution (6 mg/kg) for IR+ATP group,respectively.The drug was administered once a day until the death of the animal.The mean survival days,survival rate,body weight and major organ coefficients in both groups were measured.Results The average survival days of mice in IR group and IR +ATP group were 6.5 d and 9.6 d,respectively.The survival rate of the mice in IR+ATP group was higher than that in IR group (P＜0.01).The body weight values of the mice in IR+ATP group was higher than that in IR group on the after the 4th day post-irradiation,and the differences were statistically significant (all P＜0.05).Except for heart and stomach,the organ coefficients of liver,spleen,lung,and kidney in IR +ATP mice were higher than those in IR group,and the differences were statistically significant (all P＜0.05).Conclusion ATP has certain radiation protection effect,and it can reduce the radiation damage of mice induced by high-dose (8 Gy) γ-ray IR so as to increase the survival rate.

OBJECTIVETo explore hematological and molecular characteristics of Hemoglobin Q-Thailand in Huizhou area of Guangdong Province.

METHODSA total of 34 977 samples were screened by capillary and agarose gel electrophoresis. Samples suspected with HbQ strips were subjected to blood cell count and DNA sequencing. Twenty three common mutations associated with α- and β-thalassemia were identified by liquid phase chip and diversion hybridization technique.

RESULTSThe carrier rate of Hb Q-Thailand in Huizhou area was 0.13%. Pedigree analysis indicated that the Hb Q-Thailand allele is linked with a leftward single a-globin gene deletion (-α). Hematological index (HGB, MCV, MCH, HbA, HbA, HbQ) of 45 heterozygous carriers of Hb Q-Thailand were (130.25±17.37) g/L, (79.81±4.97) fl, (26.38±1.48) pg, (71.37±5.07)%, (1.65±0.45)%, (26.87±4.95)%, respectively. A statistical difference was also found in their hematological index of HbA and HbA compared with 408 heterozygous carriers of -α mutation (P<0.05).

CONCLUSIONHb Q-Thailand has a high detection rate in Huizhou area. The allele is mainly in a heterozygous status and linked with -α. The Hb Q strip can be detected by hemoglobin electrophoresis. When combined with other types of thalassemia, the heterozygotes will show unique hematological parameters.

Objective To explore the effect of carbon monoxide (CO) and ozone (O3) in the air on the myocardial infarction mortality in Ningbo,Zhejiang province,from 2011 to 2015.Methods The data of daily air quality surveillance and the causes of deaths in Ningbo from January 1,2011 to December 31,2015 were collected and the time series study using a generalized additive model was conducted to evaluate the relationship between the mortality of myocardial infarction and the air pollutants after adjustment for the long-term trend of death,weather conditions,"days of the week" and other confounding factors.Results The daily average concentrations of CO and O3 in Ningbo during 2011-2015 were 0.90 (0.02-3.31) mg/m3 and 82.78 (4-236) μg/m3,respectively.A total of 5 388 myocardial infarction deaths occurred,with a daily average of 3 deaths.In single-pollutant model,an increase of 0.1 mg/m3 in average concentration of CO could increase the risk of myocardial infarction mortality by 1.06％ (95％ CI:0.29％-1.93％) in general population,and by 1.26％ (95％ CI:0.28％-2.24％) in aged people aged ≥65 years in lagged 6 days,but the influence was not significant in people aged ＜65 years.The influence had no significant difference in males,but it increased the risk of myocardial infarction mortality by 1.77％ in females (95％ CI:0.44％-3.13％).In multipollutant model,CO did remain robust after adjusting for other co-pollutants.Whereas the effect of O3 had no significant influence.Conclusion These findings suggested that the increased risk of daily myocardial infarction mortality was associated with the increase of CO concentration,but no such association was found for O3 in Ningbo.

Clinically rare with an acute or subacute onset,Hashimoto's encephalopathy (HE) is characterized as autoimmune encephalopathy with elevated anti-thyroid autoantibodies.If timely diagnosed and treated,its prognosis is often fair.Four HE cases admitted from January 2012 to June 2014 were analyzed with a literature review.HE 4 cases had a significantly higher level of thyroperoxidase (TPO) while the lowest increase over four folds.There were cognitive decline,memory loss and even coma.And 50％ had abnormal electroencephalogram (EEG) consistent with radiographic lesions.In short,EEG may aid an early diagnosis of HE.

Objective To observe the epidemic trends of Keshan disease (KD) from 1967 to 2012 in Chuxiong City,in order to provide a scientific basis for prevention and control of the disease.Methods The data below was collected and analyzed with epidemiological method.KD cases reported through registration and the death case reported were collected in Chuxiong City from 1960 to 2012,also the reported monitoring results of KD and the adult KD screening results of dilated cardiac patients and mountain patients in 2012 were collected,then epidemic trends of KD was analysed comprehensively.Results There were 1 569 cases of KD registered from 1967 to 2012.There were 566 death cases of KD.The total prevalence rate of KD was 7.7％ (226/2 953) by monitoring children KD at the diseased areas of KD and the potential KD patients accounted for 97.3％ (220/226) from 1990 to 1994.The total prevalence rate of KD was 0.6％ (44/7 174) by surveillance at KD diseased areas from 2005-2012 and the potential KD patients accounted for 70.5％ (31/44),there were 7 children cases of KD under 15 years who accounted for 15.9％ from 2005 to 2012.Totally 313 551 children were given sodium selenium for supplying selenium from 1976 to 2008.Totally 151 cases of KD were found by screening from the patients with dilated cardiac patients since 1988 and they were all chronic KD patients.There were 112 cases of KD in 2012 and there were 6 children cases of KD under 15 years,which accounted for 5.4％.Chuxiong City Keshan disease epidemic presented from subacute Keshan disease to Keshan disease,to latent Keshan disease a slow transition;age from children (＜6 years) to children (＜15 years) to adult-oriented features.Conclusions The incidence and prevalence rate of KD has reached the basic control standards,but children KD is coexisting with adults KD.The pathogenic factors have not been eliminated,disease monitoring and health promotion should be carried out.