Background In 2021, chronic obstructive pulmonary disease (COPD) emerged as the forth leading cause of death in the world. However, the impact of air pollutants on COPD is still inconsistent across current studies. Objective To analyze the relationship between ambient sulfur dioxide (SO₂) exposure and hospital admissions for COPD in Lanzhou, and to examine the modified effects of SO₂ across different genders, age groups, and seasons. Methods A total of 20718 hospital admission records for COPD were collected from Lanzhou between 2016 and 2020, alongside synchronized data on SO₂ concentration and meteorological variables. A generalized additive model integrated with a distributed lag nonlinear model was used to assess the relationship and the lag effects between SO₂ exposure and COPD admissions. Potential confounders, including meteorological factors, day-of-the-week effect, and holidays, were controlled for, with a maximum lag period set at 7 d. Two-pollutant models and sensitivity analyses were conducted to ensure robustness. Results are expressed as relative risks (RR) with 95% confidence intervals (95%CI). Results During the study period, the average daily number of COPD admissions was 11.34±7.03. The average mass concentration of SO₂ was (23.72±12.35) μg·m⁻³. SO₂ exposure was positively correlated with COPD admissions; specifically, each 10 μg·m⁻³ increase in SO₂ concentration was associated with an RR of 1.440 (95%CI: 1.317, 1.573). Stratified analyses found that at a cumulative lag of 7 d, the RRs were higher among females, individuals aged ≥65 years, and during the cold season. Conversely, no significant increase in COPD admission risk related to SO₂ was observed during the warm season. For every 10 μg·m⁻³ increase in SO₂ concentration, the RR was 1.483 (95%CI: 1.311, 1.678) for females, 1.441 (95%CI: 1.311, 1.583) for those aged > 65 years， and 1.595 (95%CI: 1.313, 1.937) during the cold season. Conclusion Short-term exposure to ambient SO₂ exposure in Lanzhou is associated with an increased risk of COPD admission. The association is more pronounced among females, the elderly (aged> 65 years) and during the cold season.

BACKGROUND: Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association. METHODS: This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results. RESULTS: During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week ( Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD ( Ptrend = 0.011) and MCEs ( Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD ( Pinteraction = 0.037). CONCLUSIONS Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.
Humans ; Male ; Female ; Prospective Studies ; Middle Aged ; Aged ; Vascular Diseases/etiology* ; Risk Factors ; China/epidemiology* ; Adult ; Proportional Hazards Models ; Cerebrovascular Disorders/epidemiology* ; East Asian People

Objective:To understand the infection status and characteristics of 2019-nCoV infection in different areas in China after the adjustment of the national prevention and control strategy of 2019-nCoV infection.Methods:The online questionnaire survey was conducted among staff and students of 39 public health schools in 23 provinces (municipalities) in China from 12: 00 on December 20 to 9: 00 on December 23, 2022. The infection rates in staff and students in all the provinces were estimated. The risk factors, demographic and clinical characteristics of 2019-nCoV infections were explored.Results:A total of 28 901 valid questionnaires were obtained (26 355 from students and 2 546 from staff) with a qualified rate of 94.3%. The infection rates varied greatly among provinces and cities; the infection rates in students and staff in Beijing reached 78.55% and 76.40%, respectively. Infection rates in students and staff in Tianjin and Hebei also exceeded 65.00%, and 96.76% of infections occurred on and after December 1, 2022. Students had lower risk for the infection compared with staff ( OR=0.72, 95% CI: 0.60-0.86). Compared with age group ≤20 years, the OR of age groups 21-30, 31-40, 41-50, 51-60 and > 60 years were 1.22 (95% CI: 1.14-1.30), 1.54 (95% CI: 1.30-1.84), 1.25 (95% CI: 0.99-1.58), 1.29 (95% CI: 0.94-1.78) and 1.19 (95% CI: 0.51-2.80), respectively. The longer the period after the last vaccination, the higher the risk for the infection. Compared with those who received the last vaccination in the past 3 months, the OR of those who received the last vaccination in the past 4-6 months, 7-9 months, 10-12 months, 13-15 months and ≥16 months were 1.56 (95% CI: 1.34-1.82), 1.59 (95% CI: 1.36-1.86), 1.67 (95% CI: 1.45-1.93), 1.86 (95% CI:1.58-2.19) and 2.46 (95% CI: 2.09-2.90), respectively. Compared with those living alone, the OR of those living with 1-2, 3-4 and ≥5 roommates were 17.55 (95% CI: 15.91-19.39), 20.22 (95% CI: 18.25-22.43) and 11.78 (95% CI: 10.40-13.36), respectively. Only 5.94% of the staff and 7.19% of the students reported asymptomatic infections. Among those with symptoms, 88.18% of students and 85.65% of staff reported symptom of fever. Conclusions:The transmission dynamics of 2019-nCoV infection varied significantly across the country. The speed of transmission of 2019-nCoV and clinical severity of the infection were far beyond our knowledge. Organized epidemiological survey should be regularly carried out to provide reliable data support for more accurate prediction of the epidemic and medical resource allocation.

Bacillus spp. are probiotics and can secrete a variety of natural antimicrobiol active substances, of which lipopeptides are an important class. Up to now, about 90 lipopeptides have been identified, and most of them are cyclic lipopeptides. surfactin, iturin, fengycin, bacillomycin and polymyxins are widely studied, and the first three have huge potential for application due to their properties of surfactants and anti-fungal, anti-bacterial, anti-viral, anti-tumor and anti-inflammatory functions. In this paper, the research progress in the structure, function, synthesis regulation, separation, purification and production of surfactin, iturin and fengycin was reviewed. Synthetic biology is a vital means to increase the yield of lipopeptides, and in the future, lipopeptides can be used in crop cultivation, animal farming, food, medicine and petroleum industries as well as environmental protection. Future research should be strengthened on the discovery of new lipopeptides, synthesis of high-activity lipopeptides, economical production of lipopeptides on a large scale and their safety evaluation.
Anti-Bacterial Agents ; Anti-Infective Agents/pharmacology* ; Bacillus ; Bacillus subtilis ; Lipopeptides/pharmacology* ; Peptides, Cyclic/pharmacology*

Surgical robots, as a new means for surgeons, have been gradually applied in orthopedics. Initially, the development of orthopedic robots was stagnant for a long time because of limited techniques available, clumsy equipment, high costs, and low market demands. The recent decade has witnessed rapid growth of artificial intelligence in all walks of life, increasing investment in research and development, reducing manufacture costs and expanding demands for precise and individualized medical treatment so that a wide variety of novel and ingenious robotic systems have been proposed, prototyped, and commercialized in most of the major procedures in orthopedic surgery, including knee and hip replacements, cruciate ligaments surgery, spine surgery, corrective osteotomy, bone tumor surgery, and trauma surgery. This review depicts the history of development and future prospects in application of surgical robots in the field of orthopedics.

Objective:To explore the consistency of peripheral whole blood and venous serum procalcitonin (PCT) levels, and the value of peripheral whole blood PCT in evaluating pediatric bacterial infection.Methods:This multicenter cross-sectional parallel control study was conducted in 11 children′s hospital. All the 1 898 patients older than 28 days admitted to these hospitals from March 2018 to February 2019 had their peripheral whole blood and venous serum PCT detected simultaneously with unified equipment, reagent and method. According to the venous serum PCT level, the patients were stratified to subgroups. Analysis of variance and chi-square test were used to compare the demographic characteristics among groups. And the correlation between the peripheral blood and venous serum PCT level was investigated by quantitative Pearson correlation analysis.The PCT resultes were also converted into ranked data to further test the consistency between the two sampling methods by Spearman′s rank correlation test. Furthermore, the ranked data were converted into binary data to evaluate the consistency and investigate the best cut-off of peripheral blood PCT level in predicting bacterial infection.Results:A total of 1 898 valid samples were included (1 098 males, 800 females),age 27.4(12.2,56.7) months. There was a good correlation between PCT values of peripheral whole blood and venous serum ( r=0.97 , P<0.01). The linear regression equation was PCT?venous serum=0.135+0.929×PCT peripheral whole blood. However, when stratified to 5 levels, PCT results showed diverse and unsatisfied consistency between the two sampling methods ( r=0.51-0.92, all P<0.01). But after PCT was converted to ordinal categorical variables, the stratified analysis showed that the coincidence rate of the measured values by the two sampling methods in each boundary area was 84.9%-97.1%. The dichotomous variables also showed a good consistency (coincidence rate 96.8%-99.3%, Youden index 0.82-0.89). According to the severity of disease, the serum PCT value was classified into 4 intervals（<0.5、0.5-<2.0、2.0-<10.0、≥10.0 μg/L）, and the peripheral blood PCT value also showed a good predictive value (AUC value was 0.991 2-0.997 9). The optimal cut points of peripheral whole blood PCT value 0.5、1.0、2.0、10.0 μg/L corresponding to venous serum PCT values were 0.395, 0.595, 1.175 and 3.545 μg/L, respectively. Conclusions:There is a good correlation between peripheral whole blood PCT value and the venous serum PCT value, which means that the peripheral whole blood PCT could facilitate the identification of infection and clinical severity. Besides, the sampling of peripheral whole blood is simple and easy to repeat.

Objectives:The COVID-19 epidemic has swept all over the world. Estimates of its case fatality rate were influenced by the existing confirmed cases and the time distribution of onset to death, and the conclusions were still unclear. This study was aimed to estimate the age-specific case fatality rate of COVID-19.Methods:Data on COVID-19 epidemic were collected from the National Health Commission and China CDC. The Gamma distribution was used to fit the time from onset to death. The Markov Chain Monte Carlo simulation was used to estimate age-specific case fatality rate.Results:The median time from onset to death of COVID-19 was M=13.77 ( P25- P75: 9.03-21.02) d. The overall case fatality rate of COVID-19 was 4.1 % (95 %CI: 3.7 %-4.4 %) and the age-specific case fatality rate were 0.1 %, 0.4 %, 0.4 %, 0.4 %,0.8 %, 2.3 %, 6.4 %, 14.0 and 25.8 % for 0-, 10-, 20-, 30-, 40-, 50-, 60-, 70- and ≥80 years group, respectively. Conclusions:The Markov Chain Monte Carlo simulation method adjusting censored is suitable for case fatality rate estimation during the epidemic of a new infectious disease. Early identification of the COVID-19 case fatality rate is helpful to the prevention and control of the epidemic.

Objective: To examine the association between the frequencies of bowel movement (BMF) and the risk of colorectal cancer (CRC). Methods: In this study, 510 134 participants from the China Kadoorie Biobank (CKB) were included, after excluding those who reported as having been diagnosed with cancer at the baseline survey. The baseline survey was conducted from June 2004 to July 2008. The present study included data from baseline and follow-up until December 31, 2016. We used the Cox proportional hazards regression models to estimate the HR and the 95%CI of incident CRC with BMF. Results: During an average follow-up period of 9.9 years, 3 056 participants were documented as having developed colorectal cancer. In the site-specific analysis, 1 548 colon cancer and 1 475 rectal cancer were included. Compared with participants who had bowel movements on the daily base, the multivariable-adjusted HR (95%CI) for those who had more than once of BMF were 1.24 (1.12-1.39) for CRC, 1.12 (0.95-1.31) for colon cancer, and 1.37 (1.18-1.59) for rectal cancer. We further examined the association between BMF and CRC, according to the stages of follow-up, the corresponding HR (95%CI) for CRC, colon and rectal cancer were 1.59 (1.36-1.86), 1.43 (1.14- 1.80), and 1.76 (1.41-2.19) for the first five years, while such associations became statistically insignificant in the subsequent follow-up (P for all interactions were <0.05), as time went on. As for CRC, colon or rectal cancers among participants who had lower bowel movements, the risks were not significantly different from those who had bowel movements everyday. Conclusions Participants who had BMF more than once a day, appeared an increased risk of CRC in the subsequent five years. Since abnormal increase of bowel movements is easily recognizable, programs should be set up on health self- management and early screening for CRC.

Objective To investigate the clinical manifestations, genetic basis and related literatures of Boucher-Neuh(a)user syndrome(BNS), hoping to help physicians recognize this rare disease. Methods A 25-year-old BNS patient was reported.The clinical manifestations and the laboratory data including fundus examination, blood testing, brain MRI and genetic data were summarized.The related literatures were also reviewed.Results The patient presented with tremors, ataxia, secondary sexual characteristics dysplasia,epilepsy, and then got worse progressively.Brain MRI showed severe cerebellar atrophy.Two mutations of PNPLA6 gene were found: one is the heterozygous mutation c.1811C >T (p.A604V),which has not been reported;another is c.2990C>T(p.S997L),which has been reported as a pathogenic mutation related to BNS.Conclusion PNPLA6-related BNS may be considered for adolescent patients with tremor and ataxia,secondary sexual characteristics dysplasia and epilepsy.

Objective To investigate the correlation between serum biochemical parameters and Parkinson's disease (PD) risk in the elderly.Methods The 277 inpatients with PD as PD group in Jiangsu Province Hospital from January 2009 to December 2013 were selected,at the same time,the 277 age and gender-matched healthy persons were enrolled as control group.The levels of total cholesterol (TG),total bilirubin (TB),uric acid (UA),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were detected and compared between the two groups.Results The levels of TG,UA,TB,HDL-C and LDL-C were significantly lower in PD group than in control group [(4.35±1.13) mmol/L vs.(4.95±0.98) mmol/L,t=6.63;(278.00± 101.89)μmol/L vs.(380.90 ± 108.28) μmol/L,t =12.44;(13.02 ± 7.56) μmol/L vs.(17.39 ± 7.30)μmol/L,t=7.09;(1.26±0.37) mmol/L vs.(1.34±0.28) mmol/L,t=3.38;(2.59±0.79) mmol/L vs.(3.17±0.91) mmol/L,t=7.42,all P＜0.05].Logistic multiple regression analysis showed that the decreased levels of TB,UA and LDL-C were independently associated with prevalence risk of PD (OR=0.940,0.991 and 0.219,all P＜0.001).The combined score of TB,UA and LDL-C was constructed by using the linear weighted method.ROC curve was drawn to select the higher diagnostic validity index among TB,UA,LDL-C and combined score.The area under the ROC curve for TB,UA,LDL-C and combined score was 0.713,0.765,0.682 and 0.809 (all P＜0.001),and the value of combined score was the highest.Conclusions The decreased levels of TB,UA and LDL-C are independently associated with PD.They possess certain clinical value in evaluating the prevalence risk of PD.