Objective:To identify the threshold of a health warning system based on the association of apparent temperature and years of life lost (YLL).Methods:Daily mortality records and meteorological data were collected from 364 Chinese counties for 2006-2017. Distributed lag nonlinear model and multivariate Meta-analyses were applied to estimate the association between the apparent temperature and YLL rate. A regression tree model was employed to estimate the warning thresholds of the apparent temperature. Stratified analyses were further conducted by age and cause of death.Results:The daily YLL rate was 23.6/10 5. The mean daily apparent temperature was 15.7 ℃. U-shaped nonlinear associations were observed between apparent temperature and YLL rate. The actual temperature-caused YLL rate for the elderly was higher than the young population. The daily excess deaths rate increased with the higher effect levels. Conclusions:Regression tree model was employed to define the warning threshold for meteorological health risk. The present study provides theoretical support for the weather-related health warning system.

Objective:To explore the prevalence and risk factors of exit-site infection (ESI) in elderly peritoneal dialysis (PD) patients.Methods:The status of exit-site was evaluated in elderly PD patients (≥60 years) who had catheter insertion in our center between January 1, 2009 and December 31, 2013, with follow-up for 1 year or withdrawing from peritoneal dialysis in this period. The patients were divided into ESI and non-ESI group. The data was collected including demographics, clinical features, and nursing care methods of the exit-site.Results:A total of 247 patients were recruited in this study, aged (68.6±6.2) years, among whom there were 132 male (53.4%) and 119 diabetes (48.2%). Median follow-up time was 12.0 months. Thirty-two patients had 34 episodes of ESI with a rate of 82.5 patient-months per episode (0.15 episodes per year). Coagulase-negative Staphylococcus was the main pathogen, accounting for 35.3% of the ESI. No bacterial growth was found in 8.8%. The exit-site nursing care status included that poor compliance of exit-site care 23.5%, poor catheter immobilization 62.3%, history of catheter-pulling injury 9.7%, mechanical stress on exit-site 5.3%, improper frequency of nursing care 29.6%, mupirocin usage 13.8%, patients taking exit-site care 26.7%, exit-site caregiver instability 16.6%. There were no differences in demographic (such as age, gender, primary disease, etc) and laboratory data (hemoglobin, serum albumin, blood potassium, etc) between the ESI and non-ESI groups. Poor compliance with exit-site care ( HR=2.352, 95% CI 1.008-5.488, P=0.048), poor catheter immobilization ( HR=3.074, 95% CI 1.046-9.035, P=0.041) and exit-site caregiver instability ( HR=2.423, 95% CI 1.004-5.845, P=0.049) were significantly correlated with increased risk of ESI. Conclusions:The prevalence of ESI in elderly PD patients was 0.15 episodes per year. Educating PD patients to improve the compliance with exit-site care, maintain catheter immobilization and do exit-site care by a stable and trained caregiver may reduce ESI events in elderly PD patients.

Objective To explore the efficacy of early aggressive debridement with implant retention, primary wound clo-sure, closed suction drain without irrigation and antibiotic therapy for the treatment of delayed deep infection after spinal fixation. Methods 4057 patients were underwent dorsal spinal fixation from January 2010 to June 2014. Among them, 42 cases of de-layed deep infection after operation were included in the study. There were 25 males and 17 females, with an average age of 68.6± 8.1 years (ranged from 53 to 83 years). The diagnosis of delayed deep infection was based on the time of onset, clinical symptoms and signs, imaging and laboratory findings. Surgical debridement was performed immediately after diagnosis of infection. In addi-tion, devitalized and necrotic tissue and biofilms which adhered to the surface of the implant were removed meticulously and thor-oughly. Primary wound closure was performed in each patient, and closed suction drains were maintained for about 7-10 d without irrigation. Routine sensitive antimicrobial drugs was applied for 3 months after operation. Results 42 cases were all followed up for 24 to 72 months with an average of 46 months. Among the 42 infected patients, 3 patients were underwent posterior cervical spine surgery and 39 patients were underwent posterior lumbar spine surgery. There were 13 cases of staphylococcus aureus infec-tion, 7 cases of escherichia coli infection, 3 cases of ESBL escherichia coli infection, 3 cases of enterobacter cloacae infection, 2 cases of MRSA, 2 cases of acinetobacter baumannii infection, 2 cases of klebsiella pneumoniae infection, 1 case in enterococcus faecium and pseudomonas aeruginosa and staphylococcus haemolyticus, respectively. There were still 7 patients with negative bacterial culture. 41 cases retained their implant, whereas 1 staphylococcus aureus infection patient had the implants removed be-cause of loosening during debridement. Nevertheless, primary wound healing was found in all patients, and stitches were removed 2 to 3 weeks after debridement. Infections were effectively controlled with no recurrence of infection during the follow-up. The av-erage erythrocyte sedimentation rate was (65.76±20.08) mm/h preoperative, (41.43±14.65) mm/h 1 month postoperative, (10.81±2.72) mm/h 6 months postoperative, and (8.10±5.46) mm/h 12 months postoperative, respectively, the differences were statistically significant. The average C reactive protein was (40.55±16.91) mg/L preoperative, (6.50±2.46) mg/L 1 month postoperative, (4.31± 1.26) mg/L 6 months postoperative, and (3.83±1.50) mg/L 12 months postoperative, respectively, the differences were statistically significant. The average procalcitonin was (0.47±0.28) ng/ml preoperative, (0.08±0.06) ng/ml 1 month postoperative, (0.06±0.03) ng/ml 6 months postoperative, and (0.05±0.00) ng/ml 12 months postoperative, respectively, and the differences were statistically significant. Conclusion A timely diagnosis, aggressive and meticulous debridement, high vacuum closed-suction drain, routine and adequate use of antibacterial agents are keys to successfully resolving infection and maintaining implant retention in the treat-ment of delayed deep infection after spinal fixation.

Objective:To find the best synthesis method of 6-benzyl-1-[ ( benzyloxy ) methyl ]-3-hydro-xy-5-(hydroxymethyl)pyrimidine-2,4(1H,3H)-dione e for observing the change of its biological activity after N-3 hydroxylation .Methods:After trying some N-hydroxylation methods , the target compound was successfully synthesized via one-pot oxidizing process by sodium hydride ( NaH) and 3-chloroperbenzoic acid( m-CPBA);the anti-HIV reverse transcriptase ( RT) activity and integrase ( IN) activity of the tar-get compound was assayed via enzyme-linked immunesorbent assay ( ELISA) and phosphorylation of DNA package method .Results:The target compound could be obtained through the improved m-CPBA oxida-tive method by only one step , and the yield of the reaction could reach 60%-70%.And the structure of this compound was identified by 1 H NMR, 13 C NMR and MS;The activity result showed it added the an-ti-HIV IN activity after N-3 hydroxylation as well as retained the anti-HIV RT activity.Conclusion:The improved m-CPBA oxidative method is a convenient and efficient way to prepare the compound 6-benzyl-1-[(benzyloxy)methyl]-3-hydroxy-5-(hydroxymethyl)pyrimidine-2,4(1H,3H)-dione e which has both anti-HIV RT and IN activity .

Objective To investigate the clinical features of ischemic stroke in patients with nasopharyngeal carcinoma.Methods The clinical data of the nasopharyngeal carcinoma patients with ischemic stroke treated at the First Affiliated Hospital of Guangxi Medical University between January 2006 and December 2013 were collected.Results Among 3 822 patients with nasopharyngeal carcinoma l0 patients suffered from acute ischemic stroke.The 10 patients were males and their age ranged from 39 to 70 years old,with an average age of 51 years.All of the patients were found with squamous cell carcinoma,with metastasis in 7 of them.Among the 10 patients,only 3 patients had with traditional risk factors for ischemic stroke,but no traditional risk factor was found in other 7 patients;2 patients showed single lesion in brain and 8 patients with two or more lesions due to the blockage of multiple cerebral arteries;7 patients showed an elevated plasma D-dimer level.Conclusion It is suggested that the acute ischemic stroke occurring in the patients with nasopharyngeal carcinoma commonly lacks traditional risk factors,with elevated plasma D-dimer levels and multiple lesions due to involvement of several cerebral arteries.

Colostrum provides essential nutrients and immunologically active factors that are beneficial to newborns. Our previous work demonstrated that milk contains large amounts of miRNA that is largely stored in milk-derived microvesicles (MVs). In the present study, we found that the MVs from colostrum contain significantly higher levels of several immune-related miRNAs. We hypothesized that the colostrum MVs may transfer the immune-related miRNAs into cells, which contribute to its immune modulatory feature. We isolated colostrum MVs by ultracentrifugation and demonstrated several immune modulation features associated with miRNAs. We also provide evidence that the physical structure of milk-derived MVs is essential for transfer miRNAs and following immune modulation effect. Moreover, we found that colostrum powder-derived MVs also contains higher levels of immune-related miRNAs that display similar immune modulation effects. Taken together, these results show that MV-containing immunerelated miRNAs may be a novel mechanism by which colostrum modulates body immune response.
Animals ; Cattle ; Cell Movement ; Cell Proliferation ; Colostrum ; metabolism ; Cytokines ; metabolism ; Female ; Liposomes ; chemistry ; isolation & purification ; metabolism ; Macrophages ; immunology ; metabolism ; Mice ; MicroRNAs ; immunology ; metabolism ; Milk ; immunology ; metabolism ; Phagocytosis ; Pregnancy ; Ultracentrifugation