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Objective. To explore the effects of epidural anesthesia and general anesthesia on perioperative cognitive function and deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA). Methods. Total of 68 patients undergoing TKA in our hospital from September 2019 to March 2021 were selected and divided into the control group under general anesthesia and the observation group under epidural anesthesia according to the different anesthesia methods, 34 patients in each group. TKA was selected in both groups and performed by the same group of physicians, anesthesiologists, and nursing staff. The mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation (SpO2) were observed immediately before anesthesia (T1), 30 min after anesthesia (T2), after surgery (T3), and 1 d after surgery (T4). The changes of platelet (PLC), fibrinogen (Fbg), prothrombin time (PT), activated partial thrombin time (APTT), and other coagulation indicators were recorded. The Montreal Cognitive Assessment (MoCA) scores before surgery and 1 d and 3 d after surgery were observed. The blood samples of the two groups were collected before surgery and 1 d and 3 d after surgery, and the levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in the peripheral blood of the two groups were measured by ELISA. The number of postoperative mental disorders and DVT in the two groups was calculated. Results. The MAP and HR of T4 were lower than those of T1, T2, and T3. The MAP of T2, T3, and T4 in the observation group was lower than that in the control group (P < 0.05), and the SpO2 of T1–T4 in the two groups did not change significantly, and there was no significant difference between the two groups (P > 0.05). Compared with T1, there was no significant difference in PLC, Fbg, and PT in the observation group T4 (P > 0.05), and APTT was lower than T1 (P < 0.05). The PLC, PT, and APTT of T4 in the control group were all lower than those of T1 (P < 0.05), and there was no significant difference between Fbg and T1 (P > 0.05). The PLC, Fbg, and PT of T4 in the observation group were higher than those in the control group, while APTT was lower than that in the control group (P < 0.05). The MoCA scores of patients in both groups on the 1st and 3rd day after operation were lower than those before operation, and the observation group was higher than that in the control group (P < 0.05). The BDNF and NGF of patients in both groups were lower than those before operation on the 1st day after operation, and the BDNF and NGF in the observation group were higher than those in the control group on the 1st and 3rd day after operation (P < 0.05). The mental disorder (2.94%) and DVT incidence (2.94%) in the observation group were lower than those in the control group (29.41%, 26.47%) (P < 0.05). Conclusion. Epidural anesthesia for patients with TKA can obtain better clinical effects, maintain stable hemodynamic and coagulation states, reduce stress response of patients at the same time, and reduce perioperative cognitive dysfunction and the incidence of DVT in patients. [ABSTRACT FROM AUTHOR]

The allowable safety factors of slope stability for rockfill dams in Chinese design codes are defined irrespective of dam heights and are mainly based on the engineering experiences with respect to the rockfill dams which are lower than 200 m. It is well known that safety margins for different structures are not comparable when safety factors are taken as the measure of safety margin. Thus whether the current allowable safety factors are applicable to the rockfill dams with heights of over 200 m has been controversial in the engineering and academic field. Reliability is well known as a unified measure of safety margin for different structures. Therefore, the slope safety margins of rockfill dams with different heights can be compared in terms of slope reliability indices derived from probabilistic methods. Based on the statistical analysis of nonlinear shear strength parameters of rockfills from 14 Chinese dams, the slope reliabilities of fictitious rockfill dams of different heights designed with equal allowable safety factor are calculated and compared in this paper. It is shown that the slope failure risk of higher dams is larger than that of lower dams if the dams are designed with equal allowable safety factor rather than equal reliability. Therefore, from the perspective of maintaining consistent slope reliability levels among rockfill dams with different heights, the allowable safety factors should be prescribed in terms of dam height, i.e. the allowable safety factor for higher dams should be larger than that for lower dams. • Slope stability analysis of high rockfill dams using fixed allowable safety factor may induce misleading assessment. • Safety margins for rockfill dams designed with fixed allowable safety factor are not identical in terms of reliability. • The allowable safety factors should be prescribed in terms of dam height. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness among diabetics. We aimed to explore whether long-term exposure to residential greenness was beneficial to DR. We used data from a large-scale, cross-sectional screening survey conducted in 129 cities of 27 provincial regions of China from 2018 to 2021 among patients with diabetes. We measured residential greenness exposure as the 3-year average of annual maximum Normalized Difference Vegetation Index (NDVI) at a spatial resolution of 250 m. DR was assessed by ophthalmologists based on fundus photographs. The primary outcome was DR, and secondary outcome included DR severity status (i.e., nonproliferative and proliferative), hallmarks of retinal lesions and macular oedema. A total of 484,380 adult participants with diabetes were included in the current analysis, and 15.7% of them were diagnosed with DR. NDVI was inversely and linearly associated with DR prevalence, and an increment of 0.1 NDVI was associated with a 10% (9%–10%) decrease in DR prevalence. Significant and inverse associations were further found for nonproliferative and proliferative DR, hallmarks of lesions and macular oedema. The association between greenness and DR was stronger among participants who were older, obese, lived in the south, had longer duration of diabetes or did not take antidiabetic medications. This large-scale nationwide study provides the first-hand epidemiological evidence on the associations of residential greenness with DR. Our findings highlight the importance of residential greenness in alleviating DR risk especially in an era of aging and urbanization. • The first to examine the relationship between greenness and diabetic retinopathy (DR). • Greenness exposure was almost linearly associated with decreased odds of DR. • Greenness was inversely associated with nonproliferative and proliferative DR. • Greenness was inversely associated with hallmarks of DR and macular oedema. [ABSTRACT FROM AUTHOR]

Based on Doppler radar observation and reanalysis data, the statistical characteristics of mesovortices (MVs) during the first rainy season (April–June) in Guangdong, South China, from 2017 to 2019 are studied, including their spatiotemporal distributions, structural features and favorable environmental conditions. The results show that the MVs usually exhibit short lifetimes; about 70% last for less than 30 min. The intensity and horizontal scale of the MVs are proportional to their lifetime. Long-lived MVs have larger horizontal scales and stronger intensities than short-lived ones. The MVs are mainly observed over the Pearl River Delta region, followed by western Guangdong Province, but relatively fewer in both eastern and northern Guangdong Province. The uneven spatial distribution of the MVs is closely related to the differences in the topographical features and the environment conditions over South China. MVs are prone to form over flat regions. The Pearl River Delta and eastern Guangdong regions are relatively flat compared to the more mountainous western and northern Guangdong regions. Moreover, the monsoonal south-westerlies, water vapor flux, atmospheric instability and vertical wind shear over southwest Guangdong are significantly larger than those in other regions and are favorable for the formation of MVs. The occurrence frequencies of MVs in central and southern parts of Guangdong display similar diurnal variations, reaching the peak during the late afternoon and early evening while dropping to the minimum overnight. However, the situation is opposite in northern Guangdong, with the peak overnight and the minimum during the late afternoon and early evening. The regional differences in diurnal variation are likely related to the moving direction of mesoscale convective systems (MCSs) in Guangdong. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the prevalence and characteristics of imipenem-resistant Acinetobacter baumanni isolated from surgical wards in a university hospital, China. A total of 143 non-duplicate A. baumannii were isolated from 517 inpatients in surgery intensive care units (ICUs), burn wards, and general surgery wards. Of these, 102 isolates of A. baumannii (71.3%) were resistant to imipenem. Among imipenem-resistant isolates, all isolates were resistant to almost all antimicrobial agents except polymyxin E, all isolates were positive for blaOXA-23 and bla OXA-51 in addition to IS Aba1, 52 (51%) were positive for blaOXA-58 , 8 (7.8%) contained blaVIM-2 , which co-harbored with blaOXA-58 . Molecular typing revealed the presence of three clones among imipenem-resistant isolates. This study confirmed that A. baumannii strains harboring OXA or VIM type β-lactamases are widely distributed throughout the surgery wards. The data demonstrate that there was a high prevalence of imipenem-resistant A. baumannii infection in the region. [ABSTRACT FROM AUTHOR]

The banking industry plays an essential role in China's economic growth, and the assessment of bank efficiency has attracted increasing interest in the past two decades. Given that the data envelopment analysis cross-efficiency method can provide a more reliable reference set, a large number of studies targeting performance evaluation and its applications adopt this method. Few studies, however, address the issue of the non-uniqueness of weights in cross-efficiency evaluation. Whereas, this paper proposes a cross-efficiency interval considering all weighting schemes along with a VIKOR aggregate model to gauge the universal productive efficiency of 16 major Chinese commercial banks of China and rank them for the period of 2007–14. Specifically, we use the cross-efficiency interval to generate the global performance of each bank based on internal and external assessment while using VIKOR to compare the solution with the attitude index which ranks all of the banks. The results indicate that the cross-efficiency interval can provide more information than the traditional DEA model, that the banking system efficiency of China has been improved during the study period, especially for SOBs; that JSBs are more efficient compared with SOBs; and the efficiency gap narrowed during the study period. [ABSTRACT FROM AUTHOR]

Purpose. To investigate the ocular features of children with congenital cataract in a tertiary referral eye center in East China. Methods. We retrospectively reviewed the clinical data of congenital cataract children who underwent cataract surgery between April 2009 and April 2014 at the Eye and ENT Hospital of Fudan University and identified factors associated with the axial length (AXL) and corneal curvature (K value). Results. We included 493 children, 210 with unilateral and 283 with bilateral cataract. The mean AXL was 22.03 ± 1.97 mm and the mean K value was 43.61 ± 1.86 D. Age showed a linear correlation with AXL in unilateral cataract eyes and a logarithmic correlation with AXL in bilateral cataract eyes (both P<0.001). AXL was longer and the K value was smaller (both P<0.01) in boys than in girls after adjusting for age and cataract laterality. AXL was longer in unilateral cataract eyes than in bilateral cataract eyes after adjusting for age and gender (P=0.004). In children with unilateral cataract, AXL was significantly longer in the affected eye than in the contralateral eye (P<0.001). Conclusion. Age, gender, and cataract laterality together contribute to the development of ocular features of congenital cataract children, especially for AXL. [ABSTRACT FROM AUTHOR]

Using a sample of angel investments in China from 1994 to 2013, we examine effects of government policies that are favorable to start-ups on angel investment. Our findings show that positive effects of these policies on the amounts of angel investments are more significant in provinces with higher economic growth than those in provinces with lower economic growth. Policies that promote entrepreneurship affect the returns from high-amount angel investments more than those from low-amount ones. These findings indicate that such policies help to shape the new venture market in China and guide angel investors in making more efficient investments. [ABSTRACT FROM AUTHOR]

Background: Long-term glycemic variation in diabetes patients may have contributed to cancer incidence.Aim: In this study we aimed at the association between annual glycemic variation and the risk of cancer in Chinese patients with type 2 diabetes mellitus (T2DM).Methods: Subjects of this study were from an established population-based cohort of T2DM patients in Minhang District of Shanghai, China. Incident cancer were obtained from the Shanghai Cancer Registry. Glycemic variation was evaluated using the annual fasting glucose coefficient of variation (FG-CV), which was used as a time-dependent variable in a Cox regression model to estimate the associations with the cancer risk. Restricted cubic splines were used to explore potential non-linear associations.Results: A total of 2,140 incident cancers (1100 men and 1040 women) were identified from the 46,202 diabetes patients during 12-year follow-up. The annual FG-CV remained significantly associated with an increased risk of cancer, even after adjusting for the annual mean FG level. A significant non-linear association was found in male T2DM patients, and a significant linear association in female patients.Conclusions: The positive association of the annual FG-CV with the risk of cancer in T2DM patients indicate the importance to stabilize the FG level. [ABSTRACT FROM AUTHOR]

Background: Little is known about the long-term shifts in distributions of three abdominal-obesity-related indicators, waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) among Chinese adults. Traditional mean regression models used in the previous analyses were limited in their ability to capture cross-distribution among effects. The current study aims to describe the shift in distribution of WC, WHpR, and WHtR over a period of 18 years (1993-2011) in China, and to reveal quantile-specific associations of the three indicators with key covariates.Methods: Longitudinal data from seven waves of the China Health and Nutrition Surveys (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009 and 2011 were analyzed. The LMS method was used to illustrate the gender-specific quantile curves of WC, WHtR and WHpR over age. Separate gender-stratified longitudinal quantile regressions were employed to investigate the effect of important factors on the trends of the three indicators.Results: A total of 11,923 participants aged 18-65 years with 49,507 observations were included in the analysis. The density curves of WC, WHtR and WHpR shifted to right and became wider. The three outcomes all increased with age and increased more at upper percentiles. From the multivariate quantile regression, physical activity was negatively associated in both genders; smoking only had a negative effect on male indicators. Education and drinking behavior both had opposite effects on the three indicators between men and women. Marital status and income were positively associated with the shifts in WC, WHtR and WHpR in male and female WC, while urbanicity index had a positive effect on three outcomes in men but inconsistent effect among female outcomes.Conclusions: The abdominal-obesity related indicators of the Chinese adults experienced rapid growth according to our population-based, age- and gender-specific analyses. Over the 18-year study period, major increases in WC, WHtR and WHpR were observed among Chinese adults. Specifically, these increases were greater at upper percentiles and in men. Age, physical activity, energy intake, drinking, smoking, education, income and urbanicity index were associated with elevated abdominal obesity indicators, and the effects differed among percentiles and between genders. [ABSTRACT FROM AUTHOR]

Background: Although palliative care has been accepted throughout the cancer trajectory, accurate survival prediction for advanced cancer patients is still a challenge. The aim of this study is to identify pre-palliative care predictors and develop a prognostic nomogram for overall survival (OS) in mixed advanced cancer patients. Methods: A total of 378 consecutive advanced cancer patients were retrospectively recruited from July 2013 to October 2015 in one palliative care unit in China. Twenty-three clinical and laboratory characters were collected for analysis. Prognostic factors were identified to construct a nomogram in a training cohort (n = 247) and validated in a testing cohort (n = 131) from the setting. Results: The median survival time was 48.0 (95% CI: 38.1–57.9) days for the training cohort and 52.0 (95% CI: 34.6–69.3) days for the validation cohort. Among pre-palliative care factors, sex, age, tumor stage, Karnofsky performance status, neutrophil count, hemoglobin, lactate dehydrogenase, albumin, uric acid, and cystatin-C were identified as independent prognostic factors for OS. Based on the 10 factors, an easily obtained nomogram predicting 90-day probability of mortality was developed. The predictive nomogram had good discrimination and calibration, with a high C-index of 0.76 (95% CI: 0.73–0.80) in the development set. The strong discriminative ability was externally conformed in the validation cohort with a C-index of 0.75. Conclusions: A validated prognostic nomogram has been developed to quantify the risk of mortality for advanced cancer patients undergoing palliative care. This tool may be useful in optimizing therapeutic approaches and preparing for clinical courses individually. [ABSTRACT FROM AUTHOR]