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

As an important complementary form of decoction pieces of traditional Chinese medicine（TCM）， TCM dispensing granules has the advantages of being free of decoction， easy to take， easy to carry and easy to be dispensed， which greatly improves the capacity of emergency services of TCM and is more in line with the needs of modern society. With the end of the pilot project of TCM dispensing granules， the market has been fully liberalized， the competition has been intensified， and it is in the transition period of switching between the new standard and the old one， and there are some problems such as the shortage of varieties， the change of specifications and the difference of quality， and the production enterprises are facing new opportunities and challenges. Based on this， the authors intend to systematically sort out the policies and regulations， enterprise layout and standard formulation since the pilot of TCM dispensing granules. In view of the problems in the post-pilot stage and from the perspective of survival and development of enterprises， it is suggested that enterprises should establish a quality control system for the whole industry chain of TCM dispensing granules to reduce process costs and increase enterprise competitiveness， further increase the investment in scientific research， overcome the key technical problems of difficult varieties， actively and orderly promote the research of national standards， in order to ensure the integrity of clinical formula varieties， and establish and improve the efficacy evaluation mechanism of TCM dispensing granules， build a consistency evaluation system between TCM dispensing granules and decoction pieces. Government departments should strengthen the guidance， fully mobilize the enthusiasm of scientific research institutions， enterprises and hospitals， and explore the establishment of "government-industry-study-research-application" mode to promote the development of TCM dispensing granule industry.

Objective:To describe the prevalence of heart failure in China and to explore the prospective association between smoking behavior and the risk of incident heart failure.Methods:The subjects were from the China Kadoorie Biobank (CKB) and the baseline survey was conducted from June 2004 to July 2008. A total of 487 197 subjects were included in this study, after excluding those with missing BMI information, lost follow-up immediately after baseline investigation, and self-reported coronary heart disease, stroke, or malignant tumor at baseline. This study included data from baseline and follow-up until December 31, 2016. Cox proportional hazards regression models were used to estimate the association between smoking behavior and the risk of heart failure.Results:The median follow-up time was 10.15 years, during which a total of 4 208 new cases of heart failure occurred, with a crude incidence rate of 0.87/1 000 person-years and a cumulative incidence rate of 0.86%. The higher the age at baseline, the higher the incidence of heart failure. The incidence of heart failure in high age group, rural area and male was higher than that in low age group, urban area and female population respectively. Compared with non-smokers, there was no significant difference in the risk of heart failure in occasional smokers ( HR=1.05; 95% CI: 0.91-1.22), while former smokers ( HR=1.48; 95% CI:1.31-1.67) and current smokers ( HR=1.34;95% CI:1.22-1.49) increased risk. Former smokers ( HR=1.33;95% CI:1.21-1.46) and current smokers ( HR=1.46; 95% CI:1.31-1.64) had higher risk of heart failure than non-smokers or occasional smokers. No dose-response relationship was observed between the number of cigarettes smoked per day and the risk of heart failure in current and former smokers (for trend P=0.347 and 0.066). Compared with non-smokers or occasional smokers, the hazard ratios of <5, 5-, 10- and ≥20 years since quit smoking were 1.61 (95% CI: 1.36-1.92), 1.55 (95% CI: 1.27-1.90), 1.24 (95% CI: 1.02-1.51) and 1.35 (95% CI: 1.08-1.68), respectively (for trend P=0.091). The hazard ratios of quitting smoking due to disease and other reasons were 1.62 (95% CI:1.41-1.86) and 1.23 (95% CI: 1.04-1.45). Healthy smoking behaviors had a significant protective effect on heart failure compared with non-healthy smoking behaviors ( HR=0.75, 95% CI:0.69-0.81). Area and family history of coronary heart disease, and the smoking behaviors interacted with the risk of heart failure (for all interactions were P<0.05). Conclusions:The incidence of heart failure in China is higher in males than females, higher in rural areas than in urban areas, and increases with age. Both former smokers and current smokers had a higher risk of heart failure than nonsmokers or occasional smokers, regardless of the frequency, amount, duration, and reason for quitting. Smoking is an important risk factor for heart failure and comprehensive anti-smoking measures should be maintained.

Objective:To explore the mediating effect of physical activity on association between sedentary leisure-time and obesity indexes among hypertensive individuals.Methods:After excluding of those with a prior history of heart disease, stroke and cancer, a total of 20 178 hypertensive participants in the China Kadooire Biobank (CKB) study from Wuzhong district of Suzhou city were included. Mediating effect analysis was used to analyze the mediating effect of physical activity (PA) on correlation between sedentary leisure-time and body fat percentage (BFP), waist circumference (WC) and body mass index (BMI).Results:After adjusted for age, gender, smoking status, alcohol consumption, education levels, intake frequencies of meat and intake frequencies of fresh fruit, sedentary leisure-time (SLT) was negatively correlated with PA ( β=-0.246, P<0.001), but positively associated with BFP ( β=0.061, P<0.001), WC ( β=0.087, P<0.001) and BMI ( β=0.071, P<0.001). After including the mediator variable PA, the direct effect of SLT on obesity index was still significant. PA was negatively correlated with BFP, WC and BMI ( β=-0.052, -0.083 and -0.028, respectively, P<0.001). Analysis of mediating effect indicated that the association of SLT with BFP, WC and BMI were partly mediated by PA, the proportion of mediating effect was 20.820%, 23.421% and 9.915%. Stratified by gender, PA had mediating effect on SLT and all obesity indexes in women, while only on SLT and BFP and WC in men. Conclusions:There is a significant mediating effect of PA on correlation between SLT and obesity indexes among hypertensive individuals. Hypertensive patients should increase the level of physical activity and reduce sedentary behavior to achieve a profounder healthy effect.

Objective:To evaluate the association betweew family history of diabetes and incident diabetes of adults.Methods:A total of 49 266 participants in the China Kadoorie Biobank (CKB) study from Wuzhong district of Suzhou city were included in the analysis, after the exclusion of those with heart disease, stroke, cancer and diabetes at baseline survey. The person-year of follow-up was calculated from the date on completion of baseline survey to the date on any firstly-occurred event, i.e., diabetes incidence, death, loss of follow-up, or December 31, 2013. Cox regression model was used to estimate the hazards ratios of the association between family history of diabetes and incident diabetes.Results:During 348 677 person-years of the follow-up (median 7.08 years), a total of 423 men and 791 women were diagnosed as having diabetes. Compared to those without diabetic family history, participants with family history of diabetes showed a higher risk of diabetes, with a HR (95% CI) of 1.90 (1.57-2.29), and the risk increased with the number of relatives suffering from diabetes ( P for trend<0.05). The family history of maternal type, sibling type, and sibling and parental type had a statistically significant association with the risk of diabetes. The adjusted HR (95% CI) was 2.03 (1.45-2.77), 2.07 (1.56-2.68) and 2.39 (1.14-4.34), respectively. Modification effects of tobacco smoking, alcohol drinking, body mass index and physical activity on the association between diabetic family history and risk of diabetes were not observed in the study ( P for interaction>0.05). Conclusions:Diabetic family history is associated with the increased incident diabetes, and the risk increased with the number of relatives suffering from diabetes.

Objective:To evaluate the association betweew family history of diabetes and incident diabetes of adults.Methods:A total of 49 266 participants in the China Kadoorie Biobank (CKB) study from Wuzhong district of Suzhou city were included in the analysis, after the exclusion of those with heart disease, stroke, cancer and diabetes at baseline survey. The person-year of follow-up was calculated from the date on completion of baseline survey to the date on any firstly-occurred event, i.e., diabetes incidence, death, loss of follow-up, or December 31, 2013. Cox regression model was used to estimate the hazards ratios of the association between family history of diabetes and incident diabetes.Results:During 348 677 person-years of the follow-up (median 7.08 years), a total of 423 men and 791 women were diagnosed as having diabetes. Compared to those without diabetic family history, participants with family history of diabetes showed a higher risk of diabetes, with a HR (95% CI) of 1.90 (1.57-2.29), and the risk increased with the number of relatives suffering from diabetes ( P for trend<0.05). The family history of maternal type, sibling type, and sibling and parental type had a statistically significant association with the risk of diabetes. The adjusted HR (95% CI) was 2.03 (1.45-2.77), 2.07 (1.56-2.68) and 2.39 (1.14-4.34), respectively. Modification effects of tobacco smoking, alcohol drinking, body mass index and physical activity on the association between diabetic family history and risk of diabetes were not observed in the study ( P for interaction>0.05). Conclusions:Diabetic family history is associated with the increased incident diabetes, and the risk increased with the number of relatives suffering from diabetes.

Objective: To assess the association of BMI and waist circumference (WC) with metabolic risk factors, and confirm the appropriate cut-off points of BMI and WC among Chinese adults. Methods: After excluding participants with missing or extreme measurement values, as well as individuals with self-reported histories of cancer, a total of 501 201 adults in baseline and 19 201 adults in the second re-survey from the China Kadoorie Biobank were included. The associations of BMI and WC with metabolic risk factors were estimated. Receiver operating characteristic (ROC) analyses were conducted to assess the appropriate cut-off values of BMI and WC to predict the risk of hypertension, diabetes, dyslipidemia and clustering of risk factors. Results: The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all presented ascending trends with the increasing levels of BMI or WC. Defined as the points on the ROC curve where Youden’s index reached the highest, the appropriate overweight cut-off points of BMI were around 24.0 kg/m² both in men and women, and the points of WC were around 85 cm in men and 80 to 85 cm in women. With specificity 90% for identification of risk factors, the appropriate obese cut-off points of BMI were around 28.0 kg/m² both in men and women, with the range of 27.0 to 28.9 kg/m². Conclusions The cut-off points for overweight and obesity recommended by Coorperative Meta-analysis Group of China Obesity Task Force was verified in the large sample survey conducted more recently. The cut-off points of BMI were 24.0 and 28.0 kg/m² for overweight and obesity, and the cut-off point of WC was 85 cm in men and 80 to 85 cm in women for central obesity.

Objective To explore the relationship between sleep status and the risk of diabetes in adults.Methods The baseline data of 53 260 subjects who were aged 30-79 years and had been enrolled into China Kadoorie Biobank (CKB) study from Suzhou,Jiangsu province were analyzed.Multiple logistic regression models were used to investigate the association between sleep status and diabetes after adjusting for potential confounders.Results Among 53 260 subjects,5.3％ had diabetes.The proportions of difficultly falling asleep,early morning arousal and snoring frequently was 7.2％,10.0％ and 29.5％,respectively.There were 22.6％ of subjects reporting sleep duration ≤6 hours.After controlling for possible confounders,the subjects with difficulty falling sleep (OR=1.63 for male,95％ CI:1.30-2.05;OR=1.48 for female,95％ CI:1.27-1.73),early morning arousal (OR=1.37 for male,95％CI:1.12-1.68;OR=1.31 for female,95％CI:1.14-1.51) or snoring frequently (OR=1.16 for male,95％CI:1.00-1.34;OR=1.39 for female,95％CI:1.23-1.57) had a higher risk of diabetes.Using hypnotics regularly was associated with the risk of diabetes in females (OR=1.42,95％CI:1.06-1.92).Compared with 8 hours sleep duration daily,shorter sleep duration (≤ 6 hours) was associated with risk of diabetes in both males (OR=1.37,95％CI:1.17-1.60) and females (OR=1.24,95％ CI:1.08-1.41).No statistical significant association was found between longer sleep duration (≥9 hours) and the risk of diabetes.Conclusion Sleep problems,including difficulty falling asleep,early morning arousal,snoring frequently and shorter sleep duration,were associated with the risk of diabetes,but no statistical significant association was observed between longer sleep duration and the risk of diabetes.

Objective To discuss the effect of in vitro fertilization ( IVF) and mouse sperm cryopreservation , to establish a simple and economic frozen system for the genetically engineering mice preservation .Methods Sperm from genetically engineering mice were cryopreserved , IVF was performed using post-thawed sperm, then embryo transfer, to compare the effects of cryopreservation medium、age of male mice and sperm preincubation medium .Results Using CPA as sperm cryopreservation medium , when PM was used thawed-sperm preincubation in IVF , the fertility rates were from 82.49%to 91.43%, when HTF was used thawed-sperm preincubation in IVF , the fertility rates were from14.46%to 27.38%, there was a signification difference between PM and HTF sperm preincubation medium;10 to 35 weeks male genetically engineering mice sperm were succeed cryopreservation , and positive mice were procreated after 2-cell embryos were transferred;R18S3、CPM and CPA was used to freeze sperm , the fertility rates were 75.85%、88.89%to 94.27%, positive mice were procreated after 2-cell embryos were transferred;2-cell embryos after IVF were freezed , then thawed and positive mice were procreated after 2-cell embryos were transferred .Conclusion Using CPA as sperm cryopreservation medium , when PM was used thawed-sperm preincubation in IVF , genetically engineering mice sperm were succeed cryopreservation .

Objective To investigate technique and indications of proximal femoral autograft for pelvic reconstruction after tumor resection.Methods Between October 2006 and May 2011,5 patients with primary malignant pelvic tumor underwent tumor resection,pelvic reconstruction by proximal femoral autograft,and hip reconstruction by tumor prosthesis.There were 3 males and 2 females,aged from 19 to 55years (average,30.6 years).There were 3 cases of chondrosarcoma and 2 cases of primitive neuroectodermal tumor (PNET).The tumor involved zone Ⅰ and zone Ⅱ in 3 cases,and zone Ⅱ and zone Ⅲ in other 2cases.All 5 patients were followed up,and complications,MSTS (Musculoskeletal Tumour Society) score and prognosis were recorded.Results At final follow-up,one patient died of pulmonary metastasis,one patient survived with local recurrence,and other 3 patients survived without recurrence.The complications consisted of local recurrence,prosthesis loosening,nonunion,infection,and sciatic nerve palsy.One patient underwent revision surgery for prosthesis loosening 26 months after the initial operation.One patient underwent amputation for local recurrence 6 months after the initial operation.The average MSTS score was 19.2.Conclusion Proximal femoral autograft is an effective method for pelvic reconstruction after tumor resection,which can be used for defect in zone Ⅱ and zone Ⅲ,as well as in zone Ⅰ and zone Ⅱ.However,the method has a high rate of complications.The short-term result is similar to that of pelvic prosthesis,while the long-term result needs further observation.