BACKGROUND: Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients. METHODS: Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes. RESULTS: Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53-3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32-2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24-1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs, except for invasive mechanical ventilation in the subgroup with CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality. CONCLUSION: Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients. CLINICAL TRIAL REGISTRATION Chinese Clinical Trail Registry, No. ChiCTR2100044625.
Humans ; Blood Pressure ; Pulmonary Disease, Chronic Obstructive/therapy* ; Cohort Studies ; Respiration, Artificial ; Inpatients ; Hospital Mortality

Humans ; Noninvasive Ventilation ; Cannula ; Airway Extubation ; Retrospective Studies ; Pulmonary Disease, Chronic Obstructive/therapy* ; Hypercapnia/therapy* ; Oxygen Inhalation Therapy ; Respiratory Insufficiency/therapy*

Objective:To understand the non-uranium miners′ awareness of radon and health risks in China and analyze the relevant influencing factors, in order to provide research basis for radiological protection institutions and employers to carry out radon health education.Methods:Male miners in 32 typical non-uranium mines from 11 provinces were selected by using cluster random sampling method from June 2020 to December 2021. The awareness of radon and health risks was investigated, and the influencing factors were analyzed by binary logistic regression model.Results:A total of 1 184 non-uranium miners were investigated, and the radon awareness rate of them was 19.17%. 36.56% of the non-uranium miners heard about radon knew the radon health risks accurately, and 18.06% could identify the measures to reduce radon concentration correctly. Univariate analysis showed that the radon awareness rate of non-uranium miners varied with different education levels, labor relations, post categories, and regions ( χ2=55.92, 21.89, 64.31, 11.26, P<0.05 ). The result of logistic regression analysis showed that a bachelor degree or above, regular employee, administrative personnel and technical personnel were influencing factors of the radon awareness level ( χ2=12.81, 6.58, 5.66, 21.44, P<0.05 ). There was no statistically significant difference of radon awareness rate in different ages, working years, regions, and smoke groups ( P>0.05 ). Conclusions:The awareness level of radon and health risks of non-uranium miners was relatively low in China. Radiological protection institutions and employers should strengthen education and training of radon related knowledge in non-uranium miners through mass media, on-duty training, contract notification and workplace publicity board notification, so as to improve their personal protection consciousness.

Objective:To investigate and analyze the eye lens dose to interventional radiology workers in China from 2019 to 2021.Methods:The monitoring data on eye lens dose to interventional radiology workers from 31 province-level units during 2019-2021 were collected through the National Radiological Health Information Platform. The eye lens dose evaluation indicator was Hp(3), with each monitoring period of no more than 3 months. Kusall-Wallis H test was used for the comparison of multiple groups and pairwise. Results:A total of 6 643 interventional radiology workers were investigated from 2019 to 2021. The average annual eye lens dose was 1.03 mSv, with the median of 0.17 mSv and the maximum of 94.88 mSv. The annual eye lens dose to 59 workers exceeded 20 mSv. It was also found that the annual eye lens dose to the doctors in 2019 and 2020 was slightly higher than that to nurses (rank mean difference=118.29, 129.71, P<0.01), and the lens dose to interventional radiology workers who performed cardiac interventions in 2019 was higher than that to workers who performed peripheral vascular interventions (rank mean difference=46.52, P<0.05). Conclusions:The lens dose to interventional radiology workers is lower than the limits given in Chinese national standard currently in effect, but exceed the latest internationally recommended limit for a few ones. In order to protect the occupational health of interventional radiology workers, the monitoring of lens dose should be strengthened.

To explore the pharmacogenomic markers that affect the platinum-based chemotherapy response in non-small-cell lung carcinoma (NSCLC), we performed a two-cohort of genome-wide association studies (GWAS), including 34 for WES-based and 433 for microarray-based analyses, as well as two independent validation cohorts. After integrating the results of two studies, the genetic variations related to the platinum-based chemotherapy response were further determined by fine-mapping in 838 samples, and their potential functional impact were investigated by eQTL analysis and in vitro cell experiments. We found that a total of 68 variations were significant at P < 1 × 10^-3 in cohort 1 discovery stage, of which 3 SNPs were verified in 262 independent samples. A total of 541 SNPs were significant at P < 1 × 10^-4 in cohort 2 discovery stage, of which 8 SNPs were verified in 347 independent samples. Comparing the validated SNPs in two GWAS, ADCY1 gene was verified in both independent studies. The results of fine-mapping showed that the G allele carriers of ADCY1 rs2280496 and C allele carriers of rs189178649 were more likely to be resistant to platinum-based chemotherapy. In conclusion, our study found that rs2280496 and rs189178649 in ADCY1 gene were associated the sensitivity of platinum-based chemotherapy in NSCLC patients.

Abstract As part of the human environment, ionizing radiation can produce adverse tissue reactions known as determinist- ic effects at sufficiently high exposure levels, and cause stochastic effects (cancer and genetic diseases), where single cells with mutations can trigger somatic or genetic effects, even at low exposure levels. Given the unfavorable health effects of ra- diation, a comprehensive technical report is warranted to address the measurement and control of radiation exposure levels. The Assessment of Prospective Cancer Risks from Occupational Exposure to Ionizing Radiation published by the Internation- al Atomic Energy Agency fills this gap. This paper outlines the methodology of prospective cancer risk assessment for work- ers occupationally exposed to radiation, which provides a flexible framework based on radiobiology, risk modeling, and epi- demiological data and a new tool for managing occupational radiation exposure and assessing potential risks from occupa- tional radiation exposure.

Objective:To analyze the dose range distribution of abnormal result, the distribution of occupational categories, the incidence of abnormal result of different occupational categories, the causes of abnormal result and the factors influencing abnormal values, on the basis of investigated abnormal result of individual monitoring for occupationally external exposure, in order to provide the scientific basis for the formulation of the relevant regulations and standards and the hospital radiation protection management.Methods:The abnormal result of 389 radiation workers in medical institutions receiving annual individual doses each exceeding 1.25 mSv, reported in 2017 in 19 provinces, were collected and analyzed.Results:Dose distribution range of abnormal result were mainly between 1.25 and 5 mSv; diagnostic radiology workers accounted for the highest fraction, 59.64% of the totals; and interventional radiology workers had the highest incidence, 4.17‰ of abnormal result. The abnormal result was mainly caused by improper wearing or operating personal dosimeters; the abnormal values in the eastern regions were higher than those in other regions, with a median of 6.41 mSv; the abnormal values in the cause-unknown group was higher than those in other groups, with a median of 10.32 mSv.Conclusions:The publicity and training of radiation protection knowledge should be further strengthened to improve the protection awareness of radiation workers. The occupational exposure of interventional radiology workers should receive special attention.

Objective:To analyze distributions of dose range, occupational category, and causes of abnormal dose values from individual dose monitoring of radiation workers and to provide recommendations for improving the quality of individual monitoring data and occupational health management in medical institutions.Methods:The data of individual dose monitoring result exceeding 1.25 mSv in a single monitoring cycle, collected by Occupational Health System for Radiology Facilities’ on National Radiological Health Information Platform, was analyzed.Results:A total of 1 113 abnormal dose values were detected in 31 provinces in 2020, with an abnormal rate of 2.48‰, of which workers of diagnostic radiology and interventional radiology accounted for 68.01% and 18.78%, respectively. The dose distribution of abnormal dose values was mainly between 1.25 and 5 mSv. The abnormal dose values were mainly caused by improperly wearing or using personal dosimeters, accounting for 63.88%. Workers for whom the dose values was abnormal due to increased workload accounted for 12.32%, with an average annual individual dose of 5.14 mSv. There was no statistically significant difference in annual individual dose among radiation workers between different occupational groups( P>0.05). Conclusions:Education and training on radiation protection for radiation workers should be strengthened, and a specific and feasible system for radiation protection management, as well as a reward and punishment system, should be established in order to reduce the occurance of the improper wearing of personal dosimeters. Great attention should be paid to occupational exposure of workers in diagnostic radiology and interventional radiology, and a work shift system should be conducted to reduce individual dose levels. It is recommended that standard verification procedures for abnormal dose values from individual dose monitoring should be developed to improve the quality of individual monitoring data.

Objective:To investigate the allocation of radiation protection equipment and status of radiological protection management for radiation workers in hospitals nationwide.Methods:A descriptive analysis was conducted of the data reported from the investigated hospitals based the data for 2019 available from the National Radiological Health Information Platform.Results:A total of 3 806 hospitals were investigated in 2019, including 609 tertiary hospitals, 1 421 secondary hospitals, 1 776 primary and ungraded hospitals. Large differences had been shown in the number of radiation workers in different grade hospitals. The average number of radiation workers were found to be, respectively, 99 in tertiary hospitals, 19 in secondary hospitals, 2 in primary and/or ungraded hospitals. Interventional radiology and nuclear medicine workers were equipped seperately with 0.40 and 0.43 pieces of lead apron, 0.27 and 0.31 lead caps, 0.38 and 0.45 lead rubber neck sleeves, 0.18 and 0.08 pairs of lead rubber gloves and 0.31 and 0.22 pairs of lead glasses. No personal alarming dosimeter was available in 15.25% hospitals where radiotherapy was performed, nor radiation surveillance meter in 27.90% such hospitals. In the hospitals considered, 88.13% workers were granted the Radiation Worker Cetificate and 83.69% received the on-the-job radiation protection training. The number of monitored workers accounted for 99.20%, of which 0.40% received the personal annual dose Hp(10)≥20 mSv. The occupational health surveillance files that had been completed reached 98.05% of the total and the on-the-job radiation workers who had passed the occupational health examination made up to 96.00%. It was advised that, of 76 627 radiation workers who received the 2019 health examination, 0.88% should get out of radiation work for the being time and 0.11% should not continue for this work. Conclusions:The considerably large proportion of radiation workers in China have received individual dose monitoring and occupational health examination. Radiological diagnosis and therapy departments should enlarge the allocation of radiation monitoring and personal protection equipment for radiaton workers in their hospitals.

Objective To explore the effects of high background radiation on the expressions of miR-16, miR-106b, miR-449a, miR-34a and let-7g in peripheral blood plasma of the residents .Methods Totally 110 healthy female long-term local residents aged over 50 years were randomly selected from the high background radiation area and the control area , while their age, body mass index(BMI) and other indicators were surveyed .The relative expression levels of miRNAs in peripheral blood plasma of these women were quantitatively detected by real-time fluorescence quantitative PCR ( RT-PCR) .Then t-test was used to analyze the cumulative dose , age and BMI between the high background and control group .Mann-Whitney U-test was used for statistical analysis of miRNA expression levels between two groups , and the multiple regression analysis was used finally .Results Compared with the control group , the cumulative dose of individuals in the high background group was about four times higher (t=42.803, P<0.05), and the levels of miR-16 and miR-106b in plasma of high background group were down-regulated, while the level of miR-449a was up-regulated ( Z =4.180, 2.422, 2.794, P <0.05 ).After controlling of confounding factors such as age and BMI , the expression levels of miR-16 and miR-106b were negatively correlated with the cumulative dose of individuals (P<0.05).On the contrary, no significant correlation was observed between the levels of miR-449a, miR-34a, let-7g and the individual cumulative dose (P>0.05).Conclusions miR-16 and miR-106b may serve as biomarkers for the early stage of low dose radiation health effects .