BACKGROUND: Congenital heart disease (CHD) is one of the most common congenital malformations in humans. Inconsistent results emerged in the existed studies on associations between air pollution and congenital heart disease. The purpose of this study was to evaluate the association of gestational exposure to air pollutants with congenital heart disease, and to explore the critical exposure windows for congenital heart disease. METHODS: The nested case-control study collected birth records and the following health data in Tianjin Women and Children's Health Center, China. All of the cases of congenital heart disease from 2013 to 2015 were selected matching five healthy controls for each case. Inverse distance weighting was used to estimate individual exposure based on daily air pollution data. Furthermore, the conditional logistic regression with distributed lag non-linear model was performed to identify the association between gestational exposure to air pollution and congenital heart disease. RESULTS: A total of 8,748 mother-infant pairs were entered into the analysis, of which 1,458 infants suffered from congenital heart disease. For each 10 µg/m³ increase of gestational exposure to PM_2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001-1.016) to 1.013 (1.001-1.024) during the 1^st-2^nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O₃ exposure during the 1^st week and SO₂ exposure during 6^th-7^th weeks in the first trimester, while no significant findings for other air pollutants. CONCLUSIONS This study highlighted that gestational exposure to PM_2.5, O₃, and SO₂ had lag effects on congenital heart disease. Our results support potential benefits for pregnancy women to the mitigation of air pollution exposure in the early stage, especially when a critical exposure time window of air pollutants may precede heart development.
Infant ; Pregnancy ; Child ; Humans ; Female ; Air Pollutants/analysis* ; Case-Control Studies ; Prenatal Exposure Delayed Effects/epidemiology* ; Heart Defects, Congenital/etiology* ; China/epidemiology* ; Particulate Matter/adverse effects* ; Maternal Exposure/adverse effects*

Objective:To develop a multifunctional cervical muscle protective plaster and explore its effect on pilots with neck muscle injury.Methods:The multifunctional cervical muscle protective plaster combined the flame-retardant function of an independently developed seaweed fiber，the far-infrared and ultrasonic effects of Bian-stone，and the elastic effect of sports taping. From October 2019 to November 2020，a total of 80 pilots with nonspecific chronic neck pain（NCNP）were selected and randomly divided into observation group（ n=40）and control group（ n=40），according to random number table method. The observation group was treated with the cervical muscle protective plaster，while the control group was treated with Huoxue Zhitong Gao（blood-activating and analgesic plaster）. At the time points of six hours and three days after treatment，the visual analogue scale（VAS）scores，neck disability index（NDI）scores，and joint mobility of the two groups were compared，respectively. Results:At the two time points of six hours and three days after treatment，the VAS and NDI scores in both groups decreased compared with those before treatment，with statistically significant differences（ P<0.05）；and the scores in the observation group decreased greater than those in the control group，and the differences were statistically significant（ P < 0.05）. After three days of treatment，the VAS score and NDI score decreased more significantly than those of six hours after treatment. After three days of treatment，the joint mobilities of the two groups were improved compared with those before treatment，but there was no significant difference between the two groups（ P > 0.05）. Conclusion:The multifunctional cervical muscle protective plaster is effective in treating neck muscle injury in pilots，and it helps to facilitate the healing and caring of neck discomfort and pain.

Objective:To develop a multifunctional cervical muscle protective plaster and explore its effect on pilots with neck muscle injury.Methods:The multifunctional cervical muscle protective plaster combined the flame-retardant function of an independently developed seaweed fiber，the far-infrared and ultrasonic effects of Bian-stone，and the elastic effect of sports taping. From October 2019 to November 2020，a total of 80 pilots with nonspecific chronic neck pain（NCNP）were selected and randomly divided into observation group（ n=40）and control group（ n=40），according to random number table method. The observation group was treated with the cervical muscle protective plaster，while the control group was treated with Huoxue Zhitong Gao（blood-activating and analgesic plaster）. At the time points of six hours and three days after treatment，the visual analogue scale（VAS）scores，neck disability index（NDI）scores，and joint mobility of the two groups were compared，respectively. Results:At the two time points of six hours and three days after treatment，the VAS and NDI scores in both groups decreased compared with those before treatment，with statistically significant differences（ P<0.05）；and the scores in the observation group decreased greater than those in the control group，and the differences were statistically significant（ P < 0.05）. After three days of treatment，the VAS score and NDI score decreased more significantly than those of six hours after treatment. After three days of treatment，the joint mobilities of the two groups were improved compared with those before treatment，but there was no significant difference between the two groups（ P > 0.05）. Conclusion:The multifunctional cervical muscle protective plaster is effective in treating neck muscle injury in pilots，and it helps to facilitate the healing and caring of neck discomfort and pain.

Objective To analyze clinical and radiological characteristics of intracranial hemorrhage in hematological diseases to improve the recognition of them. Methods Thirty-one clinical data of intracranial hemorrhage cases with hematological diseases were reviewed. The basic diseases, clinical and radiological manifestations, and risk factors of mortality were analyzed. Results Intracranial hemorrhage usually occurred in patients with acute myeloid leukemia (AML) or idiopathic thrombocytopenic purpura (ITP),and 13 and 6 cases, respectively, in this group. Most patients presented with headache, restlessness, nausea,vomiting, conscious disturbance and no localization sign by physical examination. CT or MRI images often revealed focus of errlysis. Compared with CT scan, a higher detection rate of ICH could be realized by MRI scan. The total mortality in this group of ICH patients was 71% (22/31). Fever, white blood cell ＞5×109/L,platelet ＜50×109/L, hyperimmunoglobulinemia and disturbance of blood coagulation were risk factors for ICH of this group of patients. The mortality was higher in patients with no less than 2 risk factors[86.4 % (19/22)vs 33.3 % (3/9)] (x2 = 8.718, P = 0.003). Conclusion ICH is a serious complication for hematological patients. MRI scan is good at improving the diagnosis of ICH. It is of high risk of death in patients with no less than 2 risk factors such as fever, white blood cell higher than 5×109/L, platelet less than 50×109/L,hyperimmunoglobulinemia and disturbance of blood coagulation.

Objective To survey birth defects of neonates conceived by using various types of in vitro fertilization and embryo transfer (IVF-ET) between 1998 and 2007 in Shanghai. Methods From 1998 to 2007, 8507 neonates from 6551 pregnancies conceived through assistant reproductive technology (ART) from 7 reproductive medicine center in Shanghai were enrolled in this retrospective study, including Shanghai Ji-Ai Genetics and IVF Institute, Shanghai Jiaotong University School of Medicine affiliated Renji Hospital,Buijin Hospital, China Welfare Institute International Maternal and Infant Health Hospital, Shanghai First Maternity and Infant Health Hospital, Shanghai the Ninth People's Hospital and the Second Military Medical University affiliated Changhal Hospital. The clinical data about the type and incidence of birth defect were analyzed. Meanwhile, the factors associated with birth defect were investigated, such as various ART,gender, mother age, numbers of gestational sac, the source and quality of sperm. Results The birth defect rate was 1.08% (92/8507) and the most remarkable malformation occurred in circulation system [34% (31/92)]. The rates of major congenital malformations were 1.21% (34/2799) in fresh conventional IVF-ET, 1.07% (20/1871) in IVF-frozen-thawed embryo transfer(IVF-FET), 1.04% (23/2212) in fresh intracyto plasmic sperm injection (ICSI)-ET and 0.92% (15/1625) in ICSI-FET, which did not show statistical difference (P>0.05). There was also no significantly different incidence of malformations between 1.12% (49/4371) in male neonates and 1.02% (42/4136) in female neonates (P >0.05).However, the occurrence of congenital malformation is positively related with maternal age, the rates were 0.84% (41/4884) in mother's age less than 30 years and 1.77% (16/902) in mother' age more than 35 years, which reached statistical difference (P < 0.05). It also showed remarkable different incidence among 0.53% (25/4679) in singletons, 1.59% (57/3576) in twins and 3.97% (10/252) in triplets (P< 0.05). No remarkable difference of malformation rate among sperm sources used in fertilization were observed, including 1.09% (81/7419)in ejaculated sperm, 1.21% (7/579)in percutaneous epididymal aspiration (PESA) and 0. 79% (4/509) in donor sperm (P>0.05). Conclusions The overall incidence of birth defect in neonates from ART is similar to those conceived naturally and is not associated with different types of IVF-ET, embryo cryopreservation, sperm sources. However, maternal age and multiple pregnancies coder the higher possibility of birth defect.

Objective To study the characteristics of EEG after tramsient ischemic attack and to offer reference for screening procedure of aircrew and astronaut selection. Method The dominant frequency uncertainty of alpha band EEG in 12 pilots(males; age 30±5) with transient ischemic episodes in middle cerebral artery(MCA) territories and in 20 normal healthy pilots was analyzed with frequency-fluctuation analysis. Result The dominant probability of the main frequency coinciding with sites affected by transient ischaemic attack(TIA) in patient pilots was higher than that in healthy pilots (P<0.01),and the dominant probability ratio logarithmic index I≥0 in all patient pilots with normal EEG, but I<0 in all healthy pilots. It was also found that not only I≥0, but the second component shifted to lower frequency(8 Hz) in patients with slight focal EEG alterations,i.e. slowing of frequency. The relative entropy values (percentage) were decreased significantly in pilots with TIA as compared with healthy pilots (P＜0.05). Conclusion The dominant frequency uncertainty analysis of alpha band showed clear superiority of computerized evaluation over routine visual assessment for the diagnosis of minor cerebral ischemia. It offers not only a possibility of studying pathophysiological functional parameter, but also the reference for screening procedure in aircrew and astronaut selection.