Search

Objectives: Early in the outbreak, to predict the final size of the COVID-19 outbreak in Dalian, Liaoning province, China, the finding can be used to provide a scientific reference for timely adjustment of prevention and control strategies., Methods: Data from COVID-19 patients were collected from August 26 to September 14 2022. Early in the outbreak, a Susceptible-Exposed-Infectious-Quarantine-Recovered (SEIQR) dynamics model with an epidemic amplifier effect, based on the basic model, was developed to fit the data and predict the final size of the COVID-19 outbreak in Dalian, Liaoning province, China. The mean absolute relative error(MARE), root mean squared error(RMSE) and mean absolute error(MAE) were used to assess the predictive capacity of the model., Results: From 26 August to 14 September 2022, 1132 confirmed cases and infected asymptomatic cases of COVID-19 (558 males and 574 females) were reported in Dalian. There were two epidemic amplifiers in this outbreak, namely, T Market and H Hotel. The outbreak size predicted by the combined application of the SEIQR model with these two amplifiers is 1168.34 cases, and MARE, RMSE and MAE compared to the actual value from September 1 to 14 is 1.894%, 21.473 and 17.492 respectively According to the fitting results of the basic SEIQR model, if there was no epidemic amplifier in this outbreak, the final outbreak size was 349.96 cases, which means that the T Market and H Hotel increased 822 infections through amplification., Conclusions: Early in the outbreak, it was effective and reliable to use the SEIQR transmission dynamics model with the amplifier effect to predict the final size of the COVID-19 outbreak in Dalian, Liaoning province, China, and the result can provide a theoretical basis for the early closing of the COVID-19 epidemic amplifier sites. Furthermore, the epidemic amplifier effect added to the model can solve the homogeneous mixing hypothesis problem that does not match the actual spread of infectious diseases but commonly used by researchers in the construction process of the dynamic model., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 An et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Influenza A (H7N9) has caused multiple disease waves with evidence of strain diversification. Optimal influenza A (H7N9) prime-boost vaccine strategies are unknown., Methods: We recruited participants who had received monovalent inactivated A/Shanghai/2/2013 (H7N9) vaccine (MIV) approximately 5 years earlier, as follows: MIV with MF59 (MF59 × 2 group), MIV with AS03 (AS03 × 2 group), unadjuvanted MIV (No Adj group), MIV with MF59 or AS03 followed by unadjuvanted MIV (Adjx1 group), and A/H7-naive (unprimed group). Participants were randomized to receive 1 dose of AS03-adjuvanted or unadjuvanted A/Hong Kong/125/2017 (H7N9) MIV and were followed for safety and immunogenicity using hemagglutination inhibition (HAI) and neutralizing antibody assays., Results: We enrolled 304 participants: 153 received the adjuvanted boost and 151 received the unadjuvanted boost. At 21 days postvaccination, the proportion of participants with HAI antibody titers against the boosting vaccine strain of ≥40 in the adjuvanted and unadjuvanted arms, respectively, were 88% and 49% in MF59 × 2 group, 89% and 75% in AS03 × 2 group, 59% and 20% in No Adj group, 94% and 55% in Adjx1group, and 9% and 11% in unprimed group., Conclusions: Serologic responses to a heterologous A(H7N9) MIV boost were highest in participants primed and boosted with adjuvant-containing regimens., Clinical Trials Registration: NCT03738241., Competing Interests: Potential conflicts of interest . I. Y.’s institution received funding to conduct clinical research unrelated to this manuscript from Moderna and Pfizer; and I. Y. consults for Merck and Sanofi-Pasteur. P. W. has received research funding unrelated to this manuscript from Pfizer and Sanofi; and has consulted for Pfizer. C. B. C. serves as a consultant to Pfizer, Moderna, GSK, and Vir. K. M. E. serves as consultant to Bionet and IBM; and member of the Data Safety and Monitoring Boards for Sanofi, X-4 Pharma, Seqirus, Moderna, Pfizer, Merck, and Roche. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

China currently has the largest population of overweight and obese individuals globally. Bariatric surgery is by far the most effective approach to address obesity and associated metabolic conditions. To manage the significant growth of obesity, China's bariatric and metabolic surgery has assumed a pivotal role. Despite a delayed start compared to other nations, China has made significant progress in bariatric metabolic surgery over the past two decades. Presently, the annual number of surgeries ranks ahead worldwide. However, the proportion of eligible obese patients undergoing bariatric surgery in China remains lower than global averages. Looking ahead, China's bariatric metabolic surgery field offers ample room for growth and improvement. This paper aims to highlight the achievements in bariatric and metabolic surgery within China while also addressing challenges, such as the high proportion of laparoscopic sleeve gastrectomy, adherence to operation standards and guidelines, postoperative management and loss of follow-up, and quality control of database. By analyzing the current landscape and challenges, it is anticipated that China's bariatric metabolic surgery will continue to make remarkable progress in the future, bolstered by the collective dedication of the medical community.

Health damage including chronic disease caused by air pollution have attracted increasing attention. With the acceleration of industrialization and urbanization, the emission of air pollutants has increased, and its association with chronic diseases has become a research trending topic. Cardiovascular disease, cancer, diabetes, and chronic respiratory disease are the major chronic diseases, causing about 86.6% of the total deaths in China. The prevention and control of chronic diseases, especially the etiologic prevention, is a major public health issue related to national health. This article summarizes the recent progress in research of association of indoor and outdoor air pollution with all-cause mortality, the deaths and disease burden of four major chronic diseases, i.e. cardiovascular disease, cancer, diabetes, and chronic respiratory disease, and puts forward suggestions for the reduction of the burden caused by chronic diseases due to air pollution to provide a theoretical foundation to revise air quality standards in China.

Tiankeng acts as a refugium for biodiversity amid a changing global climate, and a previous study has shown that some ancient ( Alsophila spinulosa ) and unique plants (cool-adapted plants) are present in Tiankeng. However, there are few reports on Ascomycota from the Tiankeng karst region. In this research, the species diversity of Cordyceps -like fungi in Monkey-Ear Tiankeng was investigated. Seven species in the genera Akanthomyces , Beauveria , Cordyceps , and Samsoniella were identified based on internal transcribed spacer sequences and morphological characteristics. Eight new species in the genera Akanthomyces , Cordyceps , and Samsoniella were established and described according to a multilocus phylogenetic analysis and morphological characteristics. Our results revealed that Cordyceps -like fungi were abundant in Monkey-Ear Tiankeng, providing new insights into the diversity of Ascomycota in this special eco-environment. IMPORTANCE Karst Tiankeng has a special eco-environment and acts as a refugium for biodiversity. However, there are few reports on Ascomycota from the Tiankeng karst region. In this research, seven known species and eight new species in the genera Akanthomyces , Beauveria , Cordyceps , and Samsoniella were reported. The results showed that Cordyceps -like fungi are abundant in Monkey-Ear Tiankeng. Interestingly, the month of the sampling was November, which is not an active period of growth and reproduction for Cordyceps -like fungi. These results revealed that unconventional time sampling should not be ignored, especially for a special eco-environment, and provided new insights into the diversity of Ascomycota in this special eco-environment.

Keratinophyton is a genus of well-known keratinophilic fungi found in various terrestrial habitats. During a survey of keratinolytic fungi in China, a total of 12 isolates of Keratinophyton species, representing eight taxa, were obtained from the soil. Two of these isolates were described as new species based on their morphological characteristics and molecular analyses of the internal transcribed spacer region and the rRNA gene of the nuclear large subunit. Descriptions and illustrations of these two novel species, which are named Keratinophyton chongqingense sp. nov. and Keratinophyton sichuanense sp. nov., are provided herein.

With the rapid development of urbanization, ozone (O 3 ) pollution is an ongoing occurrence in the Pearl River Delta (PRD) region in China. The effective control of O 3 pollution is a great challenge owing to the nonlinear relationship between O 3 and precursor emissions and the effect of meteorological conditions. Based on the regional air quality model CAMx-OSAT (ozone source apportionment technology), O 3 formation regimes were determined, and inter-city transportation across PRD was quantified under different transmission channels. The results showed that spatial differences were observed for the O 3 formation regimes under different transmission channels. The VOCs-sensitive regime was mainly located in the central areas of the PRD region, and the NO x -sensitive regime was distributed in the suburban areas of the PRD regions under calm wind conditions. When the northeast wind was prevailing, the polluted air mass of the urban agglomeration was transmitted southwesterly downward, resulting in the downwind areas being transformed to VOCs-sensitive; the upwind areas were still NO x -sensitive. Under the southeast wind, the VOCs-sensitive regime had a banding distribution along the southeast-northwest direction, and the remaining areas were NO x -sensitive. With the influence of transmission channels, downwind cities were significantly affected by the transmission of upwind urban agglomerations (41%-87%), whereas the local formation was the main contributor under the calm wind conditions (60%-87%). To explore the relationship between O 3 and precursor emissions, a series of sensitivity tests were designed. The results showed that maximized areas (20%-36%) with reductions in O 3 can be achieved by reducing VOCs and NO x in the corresponding sensitive regimes, and the maximized level with the reduction in O 3 can be fulfilled by reducing VOCs in the VOCs-sensitive regime. For the typical city Jiangmen, the area that met the standard increased the most under the calm wind (11%) and southeast wind (8%) conditions when VOCs and NO x were reduced in the corresponding sensitive regimes. Additionally, under northeast wind conditions, reducing VOCs in the VOCs-sensitive regime can more effectively control O 3 , as the area up to the standard increased by 140%.

An investigation of members of the soil keratinophilic fungi community in China resulted in the identification of one new monotypic genus, Zongqia , and 10 new species, 2 of which are affiliated with Solomyces , 1 with the new genus Zongqia , 4 with Pseudogymnoascus , and 3 with Scedosporium . These novel taxa form an independent lineage distinct from other species, based on morphological and multilocus phylogenetic analyses. Descriptions, illustrations, and notes are provided for each taxon. These new taxa of the soil keratinophilic fungi add to the increasing number of fungi known from China, and it is now evident that numerous novel taxa are waiting to be described. IMPORTANCE Keratinophilic fungi are a group that can degrade and utilize keratin-rich material. It is also because of this ability that many taxa can cause infections in animals or humans but remain poorly studied. In this study, we reported a novel genus and 10 novel species, 7 novel species belonging to the order Thelebolales and 3 to the genus Scedosporium , based on multilocus phylogenetic analyses combined with morphological characteristics. Our study significantly updates the taxonomy of Thelebolales and Scedosporium and enhances our understanding of this group of the keratin-degrading fungal community. The findings also encourage future studies on the artificially constructed keratin-degrading microbial consortia.

Dendrobium officinale Kimura et Migo (D. officinale) is used as herbal medicine and new food resource in China, which is nontoxic and harmless, and can be used as common food. Polysaccharide as one of the main bioactive components in D. officinale, mainly composed of glucose and mannose (Manp: Glcp = 2.01:1.00-8.82:1.00), along with galactose, xylose, arabinose, and rhamnose in different molar ratios and types of glycosidic bonds. Polysaccharides of D. officinale exhibit a variety of biological effects, including immunomodulatory, anti-tumor, gastro-protective, hypoglycemic, anti-inflammatory, hepatoprotective, and vasodilating effects. This paper presents the extraction, purification, structural characteristics, bioactivities, structure-activity relationships and analyzes gaps in the current research on D. officinale polysaccharides. In addition, based on in vitro and in vivo experiments, the possible mechanisms of bioactivities of D. officinale polysaccharides were summarized. We hope that this work may provide helpful references and promising directions for further study and development of D. officinale polysaccharides., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Simplicillium species are commonly found from soil, seawater, rock surface, decayed wood, air and as symbiotic, endophytic, entomopathogenic and mycoparasitic fungi. Minority insect-associated species was reported. Simplicillium coccinellidae, S. hymenopterorum, S. neolepidopterorum and S. scarabaeoidea were introduced as the newly insect-associated species. The phylogenetic analyses of two combined datasets (LSU + RPB1 + TEF and SSU + ITS + LSU) revealed that S. coccinellidae and S. hymenopterorum were both nested in an independent clade. S. neolepidopterorum and S. scarabaeoidea have a close relationship with S. formicidae and S. lepidopterorum, respectively. S. neolepidopterorum can be easily distinguished from S. formicidae by ellipsoidal to cylindrical, solitary conidia which occasionally gather in short imbricate chains. S. scarabaeoidea could be easily distinguished from S. lepodopterorum by having longer phialides and larger conidia. Based on the morphological and phylogenetic conclusion, we determine the four newly generated isolates as new species of Simplicillium and a new combination is proposed in the genus Leptobacillium., (© 2021. The Author(s).)

Background: The number of human influenza A (H7N9) infections has escalated since 2013 with high resultant mortality. We conducted a phase II, randomized, partially-blinded trial to evaluate the safety and immunogenicity of an MF59-adjuvanted inactivated, split virion, H7N9 influenza vaccine (H7N9 IIV) administered at various dose levels and schedules in older adults., Methods: 479 adults ≥ 65 years of age in stable health were randomized to one of six groups to receive either 3.75, 7.5 or 15 µg of influenza A/Shanghai/02/2013 (H7N9) IIV adjuvanted with MF59 given as a 3-dose series either on days 1, 28 and 168 or on days 1, 57 and 168. Immunogenicity was assessed using both hemagglutination inhibition (HAI) and microneutralization (MN) assays prior to and 28 days following each dose. Safety was assessed through 1 year following the last dose., Results: Subjects in all groups had only modest immune responses, with the HAI GMT < 20 after the second vaccine dose and <29 after the third vaccine dose. HAI titers ≥ 40 were seen in <37% of subjects after the second dose and <49% after the third dose. There were no significant differences seen between the two dose schedules. MN titers followed similar patterns, although the titers were approximately two-fold higher than the HAI titers. Logistic regression modeling demonstrated no statistically significant associations between the immune responses and age, sex or body mass index whereas recent prior receipt of seasonal influenza vaccine significantly reduced the HAI response [OR 0.13 (95% CI 0.05, 0.33); p < 0.001]. Overall, the vaccine was well tolerated. Two mild potentially immune mediated adverse events occurred, lichen planus and guttate psoriasis., Conclusions: MF59-adjuvanted H7N9 IIV was only modestly immunogenic in the older adult population following three doses. There were no significant differences in antibody responses noted among the various antigen doses or the two dose schedules., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [PLW, LAJ, KE, DIB, MJM, HES, RER, HH, SEF, KS have no conflicts of interest. WHC has consulted for Sequirus, FluGen and Pharmaron on influenza related projects.]., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background It was uncertain if direct endovascular thrombectomy (ET) was superior to bridging thrombolysis (BT) for patients with acute ischemic stroke caused by large-vessel occlusions. We aimed to examine real-world clinical outcomes of ET using nationwide registry data in China and to compare the efficacy and safety between BT and direct ET. Methods and Results Patients treated with ET from a nationwide registry study in China were included. Rapid neurological improvement, intracranial hemorrhage, and in-hospital mortality were compared between the 2 groups using multivariate logistic models and propensity-score matching analyses. A total of 7674 patients from 592 stroke centers were included. The median onset-to-puncture time, onset-to-door time, and door to puncture time were 290, 170, and 99 minutes, respectively. A total of 2069 (27.0%) patients received BT treatment. Patients in the BT group had a significantly shorter onset-to-puncture time (235 versus 323 minutes; P <0.001) and onset-to-door time (90 versus 222 minutes; P <0.001) compared with the direct ET group. The prior use of intravenous thrombolysis was associated with a higher rate of rapid neurological improvement (adjusted odds ratio [OR], 0.83; 95% CI, 0.71-0.96) and higher risk of intracranial hemorrhage (adjusted OR, 1.46; 95% CI, 1.18-1.80) in multivariate analyses and propensity-score matching analyses. Conclusions This study reflects the current application of ET in China. More patients received direct ET than BT. Our results suggested that favorable short-term outcomes could be achieved with BT compared with direct ET. Higher risk of intracranial hemorrhage was observed in the BT group.

Objective: To investigate the application of treatment modalities for patients with osteonecrosis of the femoral head (ONFH) in mainland China., Methods: This cross-sectional study was based on the online application of China Osteonecrosis of the Femoral Head Database (CONFHD). Between July 2016 to December 2018, the CONFHD program planned to recruit ONFH patients from 12 administrative areas across mainland China. Real-world medical records of treatment regimens for these patients, including surgeries and prescriptions, were approved to upload to the CONFHD application for further analysis. The surgeries performed on these patients were classified into total hip arthroplasty and hip-preserving procedures, and the latter was further classified into core decompression, bone grafting, and tantalum rod implantation. Prescription medications were classified into chemical medicine and Chinese herbal medicine (CHM); chemical medicine was further classified according to their chemical compounds, and CHM was classified according to therapeutic functions based on traditional Chinese medicine theory. Descriptive analysis was performed to summarize the application of different treatment regimens on the overall sample., Results: A total of 1491 patients (2381 hips) who fulfilled the protocol criteria were included. There were 1039 males and 452 females with a mean age of 47.29 ± 12.69 years. The causes of ONFH were alcoholism in 642 patients (43%), corticosteroid in 439 patients (29%), trauma in 239 patients (16%), and idiopathic ONFH in 171 patients (11%). Operative treatments (including total hip arthroplasty and hip-preserving procedures) were performed on 49% of patients (43% of hips), chemical medicine therapy (including bisphosphonate, statins, and prostacyclin) was given to 37% of patients (37% of hips), and CHM was administrated to 72% of patients (75% of hips). The aforementioned interventions were not always used alone, since 47% of patients (52% of hips) received combined regimens with multiple interventions. Among hips treated by surgery, all hips with ARCO stage IV ONFH received THA (305 hips), and THA was also performed on 63 hips with stage II ONFH. Over half of hips with stage I (81%), II (91%), and III (92%) ONFH had received pharmacological treatments. Prostacyclin and bisphosphonate were the top two most prescribed medicines used alone. CHM therapies with multiple CHM functions were more commonly prescribed., Conclusion: Current treatment modalities for ONFH patients in mainland China include operative treatment, chemical medicine, and CHM. Combined regimens with different treatment modalities are common in real-world clinical practices., (© 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.)

Objective: The purpose of the present study was to evaluate the present situation and risk factors for the misdiagnosis of osteonecrosis of femoral head (ONFH), providing the basis for accurate diagnosis of ONFH., Methods: For this retrospective study, 1471 patients with ONFH were selected from the China Osteonecrosis of Femoral Head Database (CONFHD). These patients had been recruited between July 2016 and December 2018. According to whether or not they were misdiagnosed, the patients were divided into two groups, with 1168 cases (22-84 years old) included in the diagnosis group and 303 cases (21-80 years old) in the misdiagnosis group. Misdiagnosis was measured using the following criteria: (i) the patient had the same symptoms and signs, and the second diagnosis was not consistent with the initial diagnosis within 6 months; and (ii) the patient was admitted to a hospital participating in CONFHD and the previous diagnosis was inconsistent with the diagnosis given by the expert group. Comparisons of age, visual analogue scale for pain, and body mass index between the two groups were performed using a t-test. Gender, causes of ONFH, primary diseases requiring corticosteroids, methods of corticosteroid use, corticosteroid species, type of trauma, onset side of the disease, pain side, whether symptoms are hidden, and type of imaging examination at the initial visit were compared using the χ 2 -test. Years of alcohol consumption, weekly alcohol consumption, and physician title at the initial visit were compared using a Mann-Whitney U-test. Furthermore, the statistically significant factors were evaluated using multiple regression analysis to investigate the risk factors of misdiagnosis., Results: A total of 303 patients (20.6%) were misdiagnosed: 118 cases were misdiagnosed as lumbar disc herniation, 86 cases as hip synovitis, 48 cases as hip osteoarthritis, 32 cases as rheumatoid arthritis, 11 cases as piriformis syndrome, 5 cases as sciatica, and 3 cases as soft-tissue injury. Whether symptoms are hidden (P = 0.038, odds ratio [OR] = 1.546, 95% confidence interval [CI] = 1.025-2.332), physician title at the initial visit (P < 0.001, OR = 3.324, 95% CI = 1.850-5.972), X-ray examination (P < 0.001, OR = 4.742, 95% CI = 3.159-7.118), corticosteroids (P < 0.001, OR = 0.295, 95% CI = 0.163-0.534), alcohol (P < 0.001, OR = 0.305, 95% CI = 0.171-0.546), and magnetic resonance imaging (MRI) examination (P = 0.042, OR = 0.649, 95% CI = 0.427-0.985) were each found to be associated with misdiagnosis., Conclusion: Osteonecrosis of the femoral head is easily misdiagnosed as lumbar disc herniation, hip synovitis, hip osteoarthritis, and rheumatoid arthritis. Patient history of corticosteroid use or alcohol abuse and MRI examination at the initial diagnosis may be protective factors for misdiagnosis. Hidden symptoms, physician title at the initial visit (as attending doctor or resident doctor), and only X-ray examination at the initial diagnosis may be risk factors for misdiagnosis., (© 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.)

Objective: To investigate the relationship between urinary polycyclic aromatic hydrocarbons(PAHs) metabolites and pulmonary function in community population. Methods: A total of 4 812 participants were recruited from two communities in Wuhan city from April to May 2011 and two communities in Zhuhai city in May 2012. Information of demographic characteristics and life style was collected by semi-structural questionnaire. Physical examination was performed and pulmonary function was measured. Morning urine was also collected. The concentration of 12 urinary PAHs metabolites was tested and classified into four types by chemical structure, including hydroxynaphthalene, hydroxyfluorene, hydroxyphenanthrene and hydroxypyrene. The level of pulmonary function in different group of urinary PAHs metabolites was compared by using covariance analysis. The association of the urinary PAHs metabolites and pulmonary function was analyzed by using generalized linear model, and the interaction of different population characteristics and life style on the association was analyzed. Results: The age of participants was(51.99±13.64) years old, and 67.66% ( n =2 565) of the population were women. The M ( P (25), P (75)) of concentration of total urinary PAHs metabolites was 5.72 (3.91,8.72) μg/mmol Cr. After controlling for variables including age, gender, city, Waist-to-Hip Ratio, smoking status, drinking situation, physical activity, cooking meals at home or not, kitchen ventilation and exposure to dust as confounding factors, generalized linear model showed that each 1-unit increase in log-transformed levels of hydroxynaphthalene, hydroxyfluorene, hydroxyphenanthrene, hydroxypyrene and total PAHs was associated with 26.83 (95% CI : -48.18, -5.48) , 21.86 (95% CI : -40.49, -3.23), 26.18(95% CI : -48.27, -4.09), 34.95 (95% CI : -55.95, -13.94), and 35.23 (95% CI : -58.93, -11.54) ml reduction of FVC and 29.36 (95% CI : -47.23, -11.48), 20.79 (95% CI : -36.39, -5.19), 22.65 (95% CI : -41.15, -4.15), 31.44(95% CI : -49.03, -13.85), and 33.20 (95% CI : -53.04, -13.36) ml reduction of FEV(1) respectively (all P values<0.05). Compared to non-alcohol users and participants with home cooking, the association was more evident in alcohol users and participants without home cooking( P for interaction<0.05). Conclusion: The exposure to PAHs was associated with decreased pulmonary function, and the association was more evident in alcohol users and participants without home cooking.

BACKGROUND TaohongSiwu decoction (THSWT), a traditional herbal formula, has been used to treat cardiovascular and cerebrovascular diseases such as essential hypertension (EH) in China. However, the pharmacological mechanism is not clear. To investigate the mechanisms of THSWT in the treatment of EH, we performed compounds, targets prediction and network analysis using a network pharmacology method. MATERIAL AND METHODS We selected chemical constituents and targets of THSWT according to TCMSP and UniProtKB databases and collected therapeutic targets on EH from Online Mendelian Inheritance in Man (OMIM), Drugbank and DisGeNET databases. The protein-protein interaction (PPI) was analyzed by using String database. Then network was constructed by using Cytoscape&#95;v3.7.1, and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment was performed by using Database for Annotation, Visualization and Integrated Discovery (DAVID) software. RESULTS The results of our network pharmacology research showed that the THSWT, composed of 6 Chinese herbs, contained 15 compounds, and 23 genes regulated the main signaling pathways related to EH. Moreover, the PPI network based on targets of THSWT on EH revealed the interaction relationship between targets. These core compounds were 6 of the 15 disease-related compounds in the network, kaempferol, quercetin, luteolin, Myricanone, beta-sitosterol, baicalein, and the core genes contained ADRB2, CALM1, HMOX1, JUN, PPARG, and VEGFA, which were regulated by more than 3 compounds and significantly associated with Calcium signaling pathway, cGMP-PKG signaling pathway, cAMP signaling pathway, PI3K-Akt signaling pathway, Rap1 signaling pathway, and Ras signaling pathway. CONCLUSIONS This network pharmacological study can reveal potential mechanisms of multi-target and multi-component THSWT in the treatment of EH, provide a scientific basis for studying the mechanism.

Background: Lung transplantation (LT) has been demonstrated as the only effective therapy for patients with end-stage lung diseases. Increasing listed lung transplant candidates and expanding volumes of lung transplant centers across China require well-organized programs and registry data collection based on the large population. This study aimed to summarize and analyze the data of LT development in China., Methods: We retrospectively collected and analyzed data from the China Lung Transplantation Registry (CLuTR). Key data were reported from the registry with transplant types, indications, donor and recipient characteristics, outcomes and survival. The survival <30 days, 1-year and 3-year survival rates were estimated with risk factors identified., Results: CLuTR contained data from 1053 lung transplants performed through January 1st, 2015 to December 31st, 2018 reported by 18 registered transplant centers. The largest category of diagnosis before transplantation was idiopathic interstitial pneumonitis. The total <30 days, 1-year and 3-year survival rates in CLuTR were 81.45%, 70.11%, and 61.16% with discrepancy by indications. Large proportion of recipients who were more than 60 years old required higher standard of care. Infection-related complications resulted in more death events in the early post-surgery periods. New York Heart Association grading at listing, extra-corporeal membrane oxygenation usage peri-transplantation, allograft dysfunction (primary graft dysfunction >Grade 0), renal insufficiency (estimated glomerular filtration rate <60 mL·min·1.73 m), were independently associated with a higher risk for 3-year mortality in the entire cohort., Conclusions: Facing more end-stage of lung diseases and comorbidities, this study analyzed the outcomes and survival of LT recipients in China. Further prospectively stratified analyses with longer follow-up will be needed.

Objective: To investigate the incidence of venous thromboembolism (VTE) in lung transplant (LT) recipients. Methods: The clinical data on 124 consecutive patients who underwent lung transplant at Lung Transplantation Center of China-Japan Friendship Hospital from March 2017 to September 2018 were retrospectively collected. Deep venous thrombosis (DVT) was ascertained by vascular ultrasound. Pulmonary embolism (PE) was diagnosed by either chest computed tomography pulmonary angiogram or ventilation/perfusion scan. The risk factors in those patients with postoperative VTE were studied. Results: A total of 124 lung transplant recipients including 78 single lung transplant recipients (62.9%) and 46 bilateral lung transplant recipients(37.1%) were enrolled. Preoperative and postoperative prophylactic anticoagulant was used in 52 patients(52/124, 41.9%) and 69 patients(69/124, 55.6%) respectively. Thirty-two patients developed postoperative VTE among 124 consecutive patients. The overall incidence rate of VTE among 124 LT recipients was 25.8%. The median time to VTE episode following lung transplant was 22.5 days (range 4-295 days). The percentage of DVT in VTE was 93.8%(30/32), involving 1-8 (2.83±1.86) veins. And 60.0% of DVT was from lower extremities and 56.7% located in upper extremities ( P> 0.05). Four patients (4/32,12.5%) had PE episodes, and half of them suffered from only PE without DVT. The use of extracorporeal membrane oxygenation (ECMO) in 32 patients with VTE was 90.6% (29/32), which was significantly higher than that without VTE (64/92,69.6%, P= 0.033). However, there was no difference in the use of peripherally inserted central catheter (PICC) between two groups (96.9% vs 81.5%, P= 0.067). Resolution of VTE was successfully accomplished by anticoagulant therapy with long-term use of low molecular weight heparin in 30 patients (93.7%) and followed by oral warfarin in 2 patients (6.3%). Three months follow-up data after anticoagulant therapy showed that total and partial vascular recanalization rate was 65.6%(21/32) and 34.4%(11/32), respectively. Despite anticoagulation-related bleeding complications in three patients, no serious consequences occurred. Conclusions: VTE was frequent in LT recipients. It was speculated that ECMO utilization may be a major risk factor for high incidence of VTE in LT recipients. Aggressive VTE screening/treatment protocols were suggested to be implemented in LT recipients.

The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.

Background: To systematically evaluate efficacy of traditional Chinese medicine (TCM) in treating chronic gastritis (CG)., Methods: Data sources from PubMed, Embase, Springer Link, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Chinese Biomedicine Database, and Wan-fang database were searched up to July 5, 2018. Review Manager software version 5.3, the Cochrane Collaboration's risk of bias tool, and the Grading of Recommendations Assessment, Development, and Evaluation profiler software were conducted for this meta-analysis., Results: Sixteen studies involving 1673 participants (906 vs 767) were included in this study. Pooled data showed significant statistical differences between TCM groups and current routine pharmacotherapy (RP) groups in overall clinical efficacy (odds ratio [OR] 4.65; 95% confidence interval [CI] 3.29, 6.56; P < .00001), efficacy under endoscopy (OR 2.46; 95% CI 1.12, 5.43; P = .03), stomach distension (mean difference [MD] -0.37; 95% CI -0.56, -0.19; P < .0001), stomachache (standardized MD [SMD] -0.80; 95% CI -1.45, -0.14; P = .02), and belching (SMD -2.00; 95% CI -3.80, -0.20; P = .03). However, acid regurgitation (SMD -0.71; 95% CI -1.69, 0.28; P = .16) and anorexia (SMD -0.75; 95% CI -2.30, 0.80; P = .35) showed no significant statistical differences between 2 groups. In addition, incidence of adverse reactions of TCM groups was lower than that of RP groups., Conclusion: Evidence from this meta-analysis suggests that TCM could be more efficacious than current RP in treating CG. But further standardized research of rigorous design should be needed to further validate its efficacy.

Objective: To explore serum levels of measles and rubella IgG antibodies among mothers and infants. Methods: According to the inclusion and exclusion criteria, we selected 319 puerperae and their infants in maternal hospitals of Songjiang district November 2016 to February 2017, venous blood were collected and serum measles and rubella IgG antibodies were measured using ELISA. To study the correlation between the level of measles and rubella antibodies in infants and mothers' by using the Spearman's correlation analysis. Results: The age at delivery was (29.71±4.25) years old; and the gestational age at delivery was (39.06±1.30) weeks. The positive rate and protection rate of measles antibody in puerperae were 82.5% (243/319) and 43.3% (135/319), the GMC [ M ( QR )] was 655.74 (251.21-1 299.02) mIU/ml. The positive rate of rubella antibody in puerperae was 61.1% (195/319), the GMC [ M ( QR )] was 31.34 (11.65-73.61) IU/ml. The positive rate and protection rate of measles antibody in infants were 84.1% (270/321) and 46.1% (148/321), the GMC [ M ( QR )] was 665.07 (279.63-1 544.07) mIU/ml. The positive rate of rubella antibody in infants was 69.5% (223/321), the GMC [ M ( QR )] was 40.30 (16.12-98.48) IU/ml. There was statistical difference in measles ( Z= -14.64, P< 0.001) and rubella ( Z= -8.66, P< 0.001) antibody levels between mothers and infants. There was positive correlation in measles ( r= 0.76, P< 0.001) and rubella ( r= 0.86, P< 0.001) antibody level between mothers and infants. Conclusion: The maternal antibody of measles and rubella had a concentration effect. The level of measles and rubella antibodies in the infants was higher than that in the mothers' and increased with the increase of the level of measles and rubella antibodies in the mothers.

Objective: To investigate the application and effectiveness evaluation of the standard of GBZ/T 229.1-2010 in practice, and to explore the applicability, aiming to provide technical evidence for the revision of GBZ/T 229.1-2010. Methods: There were 2 questionnaire surveys carried out in the study, including general survey and specific survey. Databases were established and data were input with Excel 2010 and Epidata version 3.1 software. SPSS version 19.0 software was used for data cleaning and statistical analysis. Results: The general survey received 100 questionnaires, with 43 from facilities and 57 from professional expertise. There were 59 questionnaires from occupational health technical service organizations held by government, and 11 from colleges and universities. The leading three jobs using GBZ/T 229.1-2010 were the occupational hazards evaluation for constructive project (69.0%) , lecturing/training (55.0%) , occupational hazards monitoring (50.0%) , respectively. The high frequency used contents of GBZ/T 229.1-2010 were the fourth part "classification" (67.0%) , the fifth part "the principles of classification management" (59.0%) , annex A "the correct use instructions" (52.0%) , respectively. In the results of feasibility, scores of the fourth part "classification" , the fifth part "the principles of classification management" , annex A "the correct use instructions" were 3.07, 3.03, 3.23, respectively. The parts needed to be modified as priories were the fourth part "classification" (22.0%) , the fifth part "the principles of classification management" (13.0%) , annex A "the correct use instructions" (12.0%) . The specific survey received 15 questionnaires, with 12 from the employers and 3 from occupational health technical service organizations. The awareness rate of GBZ/T 229.1-2010 among occupational health professionals was 83.3%. Classification results in the employers were used for guidance on improvement measures (66.7%) , health surveillance and monitoring (58.3%) , certification for occupational health and safety management system (33.3%) , occupational disease diagnosis (33.3%) , and personal protective equipment issued (33.3%) , etc. In the results of feasibility, scores of the content of free SiO(2), occupational exposure ratio, physical labor intensity level, classification of industrial dust, principles of classification management, annex A "the correct use instructions" were 5.00, 4.33, 5.00, 5.00, 3.67, 3.67, respectively. Conclusion: GBZ/T 229.1-2010 indicates that the standard is feasible and practical. But there are still some problems, such as classification of different kinds of industrial dusts at workplace, and the interaction of occupational exposure to industrial dusts and other hazards at workplace, etc.

Objective: To explore the influence of heat shock protein 70 (HSP70) gene genetic susceptibility of coal worker's pneumoconiosis among the han nationality in xinjiang. Methods: 156 coal worker's pneumoconiosis patients and 96 mine workers were randomly selected from the han coal worker's pneumoconiosis patients and attend the health check retirement mine workers from March to December, 2014 in Xinjiang Uygur Autonomous Region of Occupational Disease Hospital. Using TaqMan genotyping methods to detect HSP70 genotype distribution in the two groups. Results: The HSP70-1+190 loci GC genotype occurrence frequencies of coal worker's pneumoconiosis was significantly higher than the control group (χ 2 =6.75, P <0.05) , the risk of coal worker's pneumoconiosis armed with HSP70-1+190 GC genotype individual was 2.21 times of CC genotype individual (95% CI : 1.03~4.75) , and HSP70-2+1267 and HSP70-hom+2437 loci polymorphism were no significant difference between the two groups (HSP70-2+1267: χ 2 =3.30, P =0.19; HSP70-hom+2437: χ 2 =0.12, P =0.94) . Conclusion: HSP70-1+190 GC genotypes may be a susceptible genotype, the genotype individual may be more likely to suffer from coal worker's pneumoconiosis.

Objective: To explore the association between DNA damage-related genetic variants and lung cancer susceptibility in a Han Chinese population., Methods: This case-control study enrolled patients from the Cancer Hospital of Jiangsu Province and Jiangsu Province Hospital from 2003 to 2009. Controls were randomly selected from individuals who visited the same hospital or a community-based health examination program during the same time period. A 5 ml venous blood sample was obtained from each participant and epidemiological information was collected on a standard questionnaire. Illumina Infinium(®) BeadChip was used for genotyping of 35 DNA damage-related single nucleotide variations (SNVs), which were identified in our previous study. Multivariate and binary logistic regressions were used to calculate the OR and 95%CI for lung cancer risk. HaploReg V4.1 and Regulome DB were used to understand functional annotation on important SNV., Results: The distributions of age (61.06±10.15) vs. (61.32±11.07) years; t=-0.72, P=0.473) and sex (χ(2)=1.81, P=0.179) were similar between cases and controls. However, the case group had a higher frequency of smokers (61.08% vs. 48.54%; χ(2)=50.04, P<0.001) and heavy smokers (42.28% vs. 24.07%; χ(2)=122.32, P<0.001). Among the 34 SNVs that passed quality control, two SNVs were significantly associated with lung cancer risk after adjustments for age, sex and cumulative smoking dose: rs9267576 C>A (CA genotype/CC genotype, OR=1.56, 95% CI: 1.01-2.40) and rs3130683 A>G (AG genotype/AA genotype, OR=1.87, 95%CI: 1.13-3.09). After step-wise logistic regression analysis, only the rs3130683 SNV was retained in the model, indicating that the association between rs9267576 and lung cancer may be due to the effect of rs3130683. Functional annotation indicated that rs3130683 was located in the promoter and enhancer regions, and was an expression quantitative trait loci of HLA. The Cancer Genome Atlas indicated that expression of HLA-C, DQB1, DRB1 and DRB5 in lung cancer tissue was significantly lower than in paired normal tumor-adjacent tissue, with down-regulation of the four respective genes in 81.3%, 88.8%, 90.7% and 90.7% of lung cancer tissues (P-values were 6.68×10(-15), 2.21×10(-13), 2.20×10(-16), 2.58×10(-13), respectively)., Conclusions: The SNV rs3130683 (A>G) was associated with the risk of lung cancer in a Han Chinese population. This SNV may affect the risk of lung cancer by regulating HLA expression.

Background: This study aimed to establish an effective prognostic nomogram with or without plasma Epstein-Barr virus DNA (EBV DNA) for nondisseminated nasopharyngeal carcinoma (NPC)., Methods: The nomogram was based on a retrospective study of 4630 patients who underwent radiotherapy with or without chemotherapy at Sun Yat-sen University Cancer Center from 2007 to 2009. The predictive accuracy and discriminative ability of the nomogram were determined by a concordance index (C-index) and calibration curve and were compared with EBV DNA and the current staging system. The results were validated using bootstrap resampling and a prospective cohort study on 1819 patients consecutively enrolled from 2011 to 2012 at the same institution. All statistical tests were two-sided., Results: Independent factors derived from multivariable analysis of the primary cohort to predict recurrence were age, sex, body mass index (BMI), T stage, N stage, plasma EBV DNA, pretreatment high sensitivity C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), and hemoglobin level (HGB), which were all assembled into the nomogram with (nomogram B) or without EBV DNA (nomogram A). The calibration curve for the probability of recurrence showed that the nomogram-based predictions were in good agreement with actual observations. The C-index of nomogram B for predicting recurrence was 0.728 (P < .001), which was statistically higher than the C-index values for nomogram A (0.690), EBV DNA (0.680), and the current staging system (0.609). The C-index of nomogram B (0.730) and nomogram A (0.681) remained higher for predicting recurrence among patients treated with intensity-modulated radiotherapy (P < .001). The results were confirmed in the validation cohort., Conclusions: The proposed nomogram with or without plasma EBV DNA resulted in more accurate prognostic prediction for NPC patients., (© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

Purpose: A few prospective studies demonstrated that bilirubin levels were inversely associated with the risk of lung cancer. However, the retrospective study about the relationship between bilirubin levels and lung cancer in China was not available. So, we want to know whether there has a difference in serum bilirubin concentrations between normal people and lung cancer patients., Materials and Methods: Using a case-control study, we investigated the bilirubin levels in 317 patients with lung cancer and 317 age-, sex-matched controls from Zhejiang Cancer Hospital. Furthermore, we analyzed the associations between serum bilirubin expressions and baseline clinical features of lung cancer patients using a Wilcoxon rank sum test., Results: Bilirubin levels, including total bilirubin, direct bilirubin, and indirect bilirubin, were significantly lower in human lung cancer serum relative to normal control (P < 0.001), and the older (> 50 years) had higher bilirubin levels compared with the younger (27-50 years) in lung cancer group. Besides, the duration of smoking was negatively related to bilirubin levels, but they did not reach statistical significance except for indirect bilirubin (P = 0.041). However, there was no difference in bilirubin levels between small cell lung cancer (SCLC) and non-SCLC (NSCLC), and we did not find that the bilirubin levels were correlated with sex, drinking status in patients of lung cancer., Conclusion: Serum total bilirubin, indirect bilirubin, and direct bilirubin levels of the patients with lung cancer were all significantly lower than those of control group (P < 0.001). Lower levels of bilirubin may be a risk factor for lung cancer, and it could serve as a potential screening biomarker for lung cancer. Large-scale investigations and additional improvements are urgently needed to demonstrate the mechanism and molecular pathway in order to achieve the clinical utility in the future.

Purpose: To evaluate the effects of combining the assessment of circulating high-sensitivity C-reactive protein (hs-CRP) with that of Epstein-Barr virus DNA (EBV DNA) in the pretherapy prognostication of nasopharyngeal carcinoma (NPC)., Patients and Methods: Three independent cohorts of NPC patients (training set of n=3113, internal validation set of n=1556, and prospective validation set of n=1668) were studied. Determinants of disease-free survival, distant metastasis-free survival, and overall survival were assessed by multivariate analysis. Hazard ratios and survival probabilities of the patient groups, segregated by clinical stage (T1-2N0-1M0, T3-4N0-1M0, T1-2N2-3M0, and T3-4N2-3M0) and EBV DNA load (low or high) alone, and also according to hs-CRP level (low or high), were compared., Results: Elevated hs-CRP and EBV DNA levels were significantly correlated with poor disease-free survival, distant metastasis-free survival, and overall survival in both the training and validation sets. Associations were similar and remained significant after excluding patients with cardiovascular disease, diabetes, and chronic hepatitis B. Patients with advanced-stage disease were segregated by high EBV DNA levels and high hs-CRP level into a poorest-risk group, and participants with either high EBV DNA but low hs-CRP level or high hs-CRP but low EBV DNA values had poorer survival compared with the bottom values for both biomarkers. These findings demonstrate a significant improvement in the prognostic ability of conventional advanced NPC staging., Conclusion: Baseline plasma EBV DNA and serum hs-CRP levels were significantly correlated with survival in NPC patients. The combined interpretation of EBV DNA with hs-CRP levels led to refinement of the risks for the patient subsets, with improved risk discrimination in patients with advanced-stage disease., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Esophageal carcinoma is one of the world's deadliest cancers. Esophageal squamous cell carcinoma (ESCC) is more frequent than adenocarcenoma (AC) in China. Platinum-based chemotherapy with surgical resection is a common treatment approach for ESCC; however, the treatment response is uncertain. Evidence suggests polymorphisms in genes encoding excision repair cross-complementing group 1 (ERCC1), a protein involved in nuclear excision repair (NER), may help predict response to cisplatin and other platinum-based chemotherapeutics. Multiple ERCC1 single nucleotide polymorphisms (SNPs) have been associated with platinum chemotherapy response. Two common SNPs occur at the C8092A and C118T loci. Our study aimed to determine if 1) an association exists between ERCC1 tumor expression and patient survival, 2) whether adjuvant therapy influence on survival is related to histological ERCC1 presence in tumor cell nuclei, and 3) whether other clinicopathological characteristics in a cohort of patients following surgery for various stages of ESCC are associated with tumor ERCC1 expression. One hundred eight patients were included in the study, and tumor biopsy was collected for genotyping and immunohistochemical analysis of ERCC1. Sixty-seven patients (62%) received no adjuvant therapy, and the rest had either platinum-based chemotherapy (28.5%), radiotherapy (6.5%) or both treatments (2.8%). Log-rank analysis revealed no significant connection between tumor ERCC1 expression (P = 0.12) or adjuvant therapy (P = 0.56) on patient survival. Also, non-parametric Mann-Whitney analysis showed no significant link between tumor size or nodus tumor formation and ERCC1 presence in patients in the study. Interestingly, C8092A SNP showed significant association with patient survival (P = 0.01), with patients homozygous for the mutant allele showing the most significantly reduced survival (P = 0.04) compared to those homozygous for the dominant allele (CC). Our results provide novel insight into the genotypic variation of patients from Quanzhou, Fujian province China.

The uncontrolled release of volatile organic compounds (VOCs) from wastewater treatment plants (WWTPs) and the adverse health effects on the public have been of increasing concern. In this study, a lab-scale bioreactor was prepared to analyze the mass distribution of three aromatic (benzene, toluene, and xylenes) and four chlorinated VOCs (chloroform, carbon tetrachloride, trichloroethylene, and tetrachloroethylene) among the air, water and sludge phases in wastewater treatment processes. The VOC distribution through a full-scale WWTP in northern China was further investigated with respect to the effects of seasonal temperature variations and treatment technologies, followed by the cancer risk assessment using a steady-state Gaussian plume model (Industrial Source Complex) to simulate the atmospheric behaviors of the VOCs emitted from the WWTP. It was found that three aromatic hydrocarbons, notably benzene, were more readily released from the wastewater into the atmosphere, whereas the chlorinated compounds except chloroform were mainly present in the water phase through the treatment processes. The primary clarifier was the technology releasing high levels of VOCs into the atmosphere from the wastewater. The extents of volatilization or biodegradation, two important mechanisms to remove VOCs from wastewater, appeared to be determined by the physicochemical characteristics of the compounds, as the influence of treatment technologies (e.g., aeration) and seasonal temperature variations was rather limited. More importantly, the people living in the areas even more than 4 km away from the WWTP were still potentially exposed to cancer risks exceeding the regulatory threshold limit. The findings described the complex nature of VOC emissions from WWTPs and quantitatively indicated that the associated health impacts on the public near the WWTPs could be severely underestimated, whereas their treatment efficiencies by wastewater treatment technologies were overestimated. Instead of fully controlling the VOC release from WWTPs, the identification and abatement of important VOC species with regard to the atmospheric emission and health concerns is one possible alternative approach to effectively minimize the environmental and public health impacts by VOCs released from this particular source.

Recent population-based genome wide association studies have revealed potential susceptibility loci of lung cancer at the region of chromosome 15q25.1 containing nicotinic acetylcholine receptor genes. The loci increasing lung cancer risk has been widely identified in Caucasians, but whether this association also exists in Asians and whether this association is a direct role or mediated via tobacco smoking indirectly has not been fully established. We conducted a case-control study comprising of 210 histologically confirmed lung cancer cases and 200 healthy controls to examine rs1051730 genotyping, a single nucleotide polymorphism receiving much attention recently, and its influence on lung cancer risk as well as nicotine dependence in a Chinese Han population. Our results showed that the heterozygous C/T genotype and minor allele T conferred a significant higher risk of lung cancer than the CC homozygotes and allele C (adjusted OR=2.25, 95% CI=1.04-4.89, P=0.040 and OR=2.18, 95% CI=1.02-4.67, P=0.045 respectively). However, no association between the smoking habit and the CHRNA3 rs1051730 polymorphism was observed in this study. The results suggested that the rs1051730 polymorphism may modify susceptibility to lung cancer via a smoking-independent manner among Chinese Han population. Additional studies in vitro and in vivo are warranted to further elucidate the impact of rs1051730 on lung cancer susceptibility.

Identifying and clarifying how stream fish assemblage patterns vary spatially and temporally are basic measures for the conservation and management of fish species. Based on data collected from 24 wadeable reaches within the Qiupu Headwaters National Wetland Park between May and October 2012, we examined the spatial and temporal patterns of the assemblage structures and diversities, collecting a total of 29 fish species belonging to four orders and ten families. The results of our survey showed influences of local habitat and tributary spatial position variables on fish assemblages. Fish diversity showed significant variations across stream-orders and seasons, which were higher in the second-order streams than in first-order streams and higher in October than in May. Habitat factors such as substrate coarseness and heterogeneity, water temperature and water depth, as well as tributary position factor-link, showed significant effects on fish diversity. Fish assemblages fitted the nested pattern that upstream assemblages presented as a nested subset of downstream assemblages. Fish assemblage structures did not vary significantly across seasons but did across stream-orders; fish assemblages between first- and second-order streams showed significant differences despite some overlap. These spatial differences mainly resulted from spatial variations of the relative abundance of Cobitis rarus, Ctenogobius sp., Zacco platypus, Phoxinus oxycephalus, Rhodeus ocellatus and Vanmanenia stenosoma, among which P. oxycephalus had higher abundance in first-order than in second-order streams but the other five species were more abundant in second-order streams. Fish assemblage structures were significantly related to substrate heterogeneity, water depth, stream order, link and C-link.

Objective: To investigate the characteristics and changing trend of occupational hazards in the working environment of a foundry plant from 1987 to 2010., Methods: The foundry plant of a large-scale automobile company in Hubei Province, China was chosen as the study site. The data on occupational hazards in the working environment of the foundry plant in the past years were collected, and additional measurements were performed. The means and geometric means of the concentrations of occupational hazards were calculated. The characteristics and changing trend of occupational hazards from 1987 to 2010 were presented., Results: There were dust, chemical, and physical occupational hazards in the working environment of the foundry plant, with silica dust, noise, and heat stress as the main ones. Dust, mainly silica dust, is found in all aspects of foundry. The mean concentration of silica dust was high (3.2∼8.2 mg/m(3)), exceeding the national occupational exposure limit (1 mg/m(3)). The mean concentrations of silica dust varied across different types of work, with higher levels in cast shakeout and finishing, overhead crane operation, and sand preparation. The mean concentration of respirable dust in the foundry plant was low (0.38 mg/m(3)), not exceeding the national occupational exposure limit (0.7 mg/m(3)). There were high concentrations of grinding wheel dust (10.6 mg/m(3)) and welding fume (5.7 mg/m(3)) in cast shakeout and finishing, exceeding the national occupational exposure limit (8 and 4 mg/m(3)). Coal dust was mainly found in melting as well as cast shakeout and finishing, with higher concentration in the former (4.7 mg/m(3). The main chemical occupational hazard in the environment of the foundry plant was formaldehyde (1.23 mg/m(3)), exceeding the national occupational exposure limit (0.5 mg/m(3)). The concentrations of ammonia, phenol, metal fume, sulfur dioxide, hydrogen sulfide, and phosphine in the foundry plant were low. The mean concentration of polycyclic aromatic hydrocarbons was 0.1405 µg/m(3), with a higher level in pouring. The main physical occupational hazards in the working environment of the foundry plant were noise and heat stress. Noise, mainly steady noise, was distributed in all workshops of the foundry plant, with a mean intensity of 85.1 db (A). Noise levels varied across different types of work, higher in cast shakeout and finishing (89.3 db (A)) and moulding (85.4 db (A)). Heat stress mainly existed in overhead crane operation (35.1°C), pouring (33.3°C), and melting (32.8°C)., Conclusion: Dust, chemical, and physical occupational hazards co-existed in the working environment of the foundry plant. High concentration of dust was widely distributed in many workshops and across many types of work, but the dust concentration showed a downward trend. Chemical occupational hazards included ammonia, phenol, hydrogen sulfide, and metal fume, most at low concentrations. High-intensity noise was widely distributed in all working positions of foundry process and mainly from equipment operation, collision between parts, and gas injection. High-intensity heat stress mainly existed in overhead crane operation, pouring, and melting.

With the growing concern regarding emission of volatile organic compounds (VOCs) from wastewater treatment plants (WWTPs), the relationship between the VOC emission rates and the associated public health risks has been rarely discussed. The objective of this study was to examine and compare the VOC emission rates and cancer and non-cancer risks by inhalation intake, using a municipal WWTP in China as an example, with respect to the effects of treatment technologies, VOC species, and seasonal variation. Given the treatment technology considered, the emission rates of VOCs in this study were estimated by means of mass balance or calculated on the molecular level. From the viewpoints of both emission rates and cancer and non-cancer risks, sedimentation was the treatment technology with the highest health risks to the workers. Slightly lower VOC emission rates and health risks than those for sedimentation were observed in anaerobic treatment. Although the aeration significantly enhanced the VOC emission rates in the aerobic treatment process, the associated health risks were limited due to the low VOC concentrations in the gas phase, which were likely attributed to the strong mixing and dilution with fresh air by aeration. Amongst the VOCs investigated, benzene was the VOC with both a relatively high emission rate and health risk, while trichloroethylene possessed a high emission rate but the lowest health risk. Without strong interfacial aeration and turbulence between the water and atmosphere, the effects of treatment technology and seasonal variation on the health risks might be connected to the VOC emission rates, while the effect of VOC species depended considerably on the respective cancer slope factors and reference concentrations; the employment of aeration provided a different conclusion in which the emission rates were enhanced without a significant increase in the related cancer risks. These findings can provide insight into future health risk management and reduction strategies for workers in WWTPs.

Objective: To develop two new respirator fit test panels using data from anthropometric survey of Chinese adult workers: bivariate panel and principal component analysis (PCA) panel for meeting the requirements of respirator fit design and testing and evaluate the applicability of the two different fit test panels for current Chinese workers., Methods: An anthropometric database based upon anthropometric data of current Chinese workers was used for panel design. The bivariate panel was based upon the bivariate distribution of the face length and face width measurements, and the PCA panel was developed using principal components analysis of 10 stable facial dimensions (minimum frontal breadth, face width, bigonial breadth, face length, interpupillary distance, head breadth, nose protrusion, nose breadth, nasal root breadth, subnasale-sellion length). The distribution of Chinese workers across the panels was used to analyze the panels' applicability for Chinese workers., Results: The bivariate panel and PCA panel developed in this study consisted of 10 cells and 8 cells respectively, covered 96.9% (male 95.4%, female 98.4%) and 96.5% (male 95.1%, female 98.1%) of the current Chinese workers, respectively. The distribution of workers across both panels was uniform. Each cell contained 4.6% - 21.7% of the population in the bivariate panel and 10.4% - 14.6% of the population in the PCA panel. The LANL full-face piece respirator fit test panel covered only 70.9% of the Chinese workers, It was thought to be no longer adequate for the Chinese adult workers., Conclusion: New respirator fit test panels based on updated anthropometric database and distributions specific to Chinese workers may be more beneficial for applications in China.

Objective: To understand the major causes of death in automobile foundry workers and investigate casting manipulations hazards to health., Methods: A cohort study of 3529 foundry workers registered in one big automobile factory in Shiyan city of China was performed. Standardized mortality ratios (SMRs) were calculated for the main causes of death by using Chinese national mortality rates as reference., Results: The cohort mortality was traced from 1980 to the end of 2005 with an accumulation of 84 999 person-years, revealed 265 deaths. The results of this study showed that the standardized mortality ratio for all subjects was 0.96 (95% CI: 0.85 approximately 1.08), which was very close to that expected on the basis of the China national mortality rates. The SMR increased with age, the SMR became greater than 1 in all groups of age 50 and higher. The results showed that malignant neoplasm (3.43%), accidents (1.16%), cerebro-vascular diseases (1.08%), cardio-vascular diseases (0.79%) were the first four illnesses that threatened workers' life span. Statistically significant mortality of malignant neoplasm (SMR = 7.87), accidents (SMR = 2.70), cardio-vascular diseases (SMR = 2.68) and digestive diseases (SMR = 2.79) were found in the foundry workers. The relative risk of malignant neoplasm for first line workers to assistant workers was 1.99 (P < 0.05)., Conclusion: The occupational hazards in foundry factory have harmful impact on the workers' health and life span.

Objective: To evaluate efficacy of sputum imaging cytometry in early diagnosis on lung cancer among tin miners exposed to dust and analyze possible risk factors related to lung cancer among tin miners., Methods: From a cohort of tin miners in Guangxi Province, a total of 345 male tin miners higher than 45 years old and with high exposure to crystalline silica dust were randomly selected as the objects. Imaging cytometry was used to implement the sputum analysis for the screening on lung cancer according to the experience diagnostic standard. All objects were then followed up to the end of 2006. Clinical diagnosis of lung cancer was used as the golden standard to evaluate the efficacy of screening., Results: From 1998 to 2006, 11 new cases were diagnosed as clinical lung cancer. Except of age and exposure to occupational hazards, smoking status (P = 0.0384) and mean smoking dose (P = 0.0078) were significantly associated with lung cancer, and the adjusted odds ratio of high level to the low was 18.21 (2.15 approximately 154.39). The sensitivity, specificity and Youden's index of the sputum imaging cytometry for the experience diagnosis were 27.3%, 83.9% and 11.2% respectively. According to the ROC curve analysis, area under ROC Curve (AUC) of C2.5 (the percentage when the DNA index ranged from 1.25 to 2.50) was 0.647 (0.525 approximately 0.768), with the optimal operating point (OOP) of 1.70%. Sensitivity, specificity, agreement rate, positive predictive value, negative predictive value and Youden's index for predicting lung cancers in high-exposure tin miners were found to be 72.7%, 62.3%, 62.6%, 6.0%, 98.6% and 35.0% respectively., Conclusion: Smoking is confirmed as an important risk factor of lung cancer in tin miners. The diagnostic efficiency can be improved if the diagnostic point of C2.5 is adjusted to 1.70%.

Objective: To investigate the effects of Apo A1 and B gene polymorphism on avascular necrosis of the femoral head (ANFH) in north Chinese Han population., Methods: Polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) technique was used in samples of 143 cases with documented ANFH and 92 healthy control matched by age and sex individuals selected from north Chinese Han nationality. The studied loci include promoter region (-75bp) and the intron 1 (+83 bp) of Apo A1 gene, Eco RI,Xba I of Apo B gene; polymerase chain reaction was used to study 3'-VNTR of Apo B gene., Results: At -75 bp in promoter, the frequency of A/A genotype in ANFH group was significantly higher than that in control group (P < 0.01), while the frequency of G/A genotype in ANFH group was significantly lower than that in control group (P < 0.01). No difference was found in the frequency of genotype at +83bp in intron 1 of Apo A1 gene, Eco RI, Xba I and 3'-VNTR loci of Apo B gene., Conclusion: Apolipoprotein A1 gene A/A substitution at position -75 in promotor is associated with ANFH, the mutation may be one of the sensitive genes of ANFH, first reported inside and abroad. But no evident relationship was found between gene polymorphism of +75 bp loci of Apo A1 gene, Eco RI loci of Apo B gene, Xba I loci of Apo B gene or 3'-VNTR of Apo B gene and ANFH.

Objective: To investigate the main diseases jeopardizing the health of the iron miners and to explore the relationship between dust exposure and malignancies as well as other diseases., Methods: A retrospective study with a cohort of 7,469 workers employed between January 1, 1972 and December 31, 1974 in Daye Iron Ore Mine Co. in Hubei Province was conducted. Standardized mortality ratio (SMR) was calculated for the main causes of death using Chinese national mortality rates for reference., Results: All subjects were followed up through December 31, 2003 with an accumulation of 199, 108.0 person years. A total of 1,752 workers died. The cumulative mortality was 23.5%. The cancers, cerebrovascular diseases, non-malignant respiratory diseases and cardiovascular diseases were main diseases that threatened workers' life span. The SMR for all subjects was a little higher than expected based on the Chinese national mortality rates. The diseases causing the significantly higher death rate were the nasopharynx cancer, liver cancer, lung cancer, pneumoconiosis and accident with SMR 1.84, 1.51, 1.83, 14.94 and 1.25 respectively. Increased mortality was observed among dust-exposed workers in the cohort. The cumulative mortality from all causes such as stomach cancer, lung cancer, nonmalignant respiratory diseases, cardiovascular diseases and accident in dust exposed workers were significantly increased compared with those in non-exposure workers with RR 1.35, 1.83, 1.61, 2.27, 1.34 and 1.69 respectively., Conclusion: The risk factors especially dust exposure affect the health and lifespan of the iron mine workers.

Tetrodotoxication was observed in six patients who ate gastropods from the South China Sea near Pratas Island. The pathogenic gastropod was Nassauris glans, which had not been previously mentioned in human tetrodotoxication. An extremely high level of tetrodotoxin was found in the causative gastropods, and a variety of clinical signs were observed in the survivors. The postmortem autopsy of two patients showed severe distension and hypersecretion of the alimentary tract, suggestive of a cholinergic crisis as the cause of their early death. A recognition of education regarding the risk of tetrodotoxication by N. glans in the study area is important to prevent further tragedy. A retrospective review of the tetrodotoxication in this region may aid in understanding the changes and route of tetrodotoxication in marine products, and provide valuable information for preventive measures.

Objective: To study the cost of the hypertensive outpatients., Methods: The study randomly selected 460 insured patients with hypertension and investigated their cost on each case in the out-patient department through 2002, based on the electronic system of medical insurance., Results: As a whole, the distribution of hypertensive outpatient expenditure takes on the positively skewed, with the median of 1 567.9 Yuan RMB. With the increase of age, the average expenses in each age group increased accordingly. In the study, the average number of outpatient attendances per patient was 19.5, the average expenses per visit was 115.4 Yuan RMB. In age groups 40 - 49 and 50 - 59, expenses of outpatient in male and female groups are obviously different in 2002 (Wilcoxon W(40 - 49) = 36, P(40 - 49) = 0.037; Wilcoxon W(50 - 59) = 374, P(50 - 59) = 0.023), as well as the number of out-patients (Wilcoxon W(40 - 49) = 52.5, P(40 - 49) = 0.007; Wilcoxon W(50 - 59) = 379, P(50 - 59) = 0.028). When considering the factors of gender and age at one time, the outpatient expenditures in the male group were significantly different between the different age groups (chi(2) = 22.3, P < 0.001), as well as the number of outpatients (chi(2) = 25.4, P < 0.001). In addition, the expenditure of drugs, which took a large proportion of the total expenditure of hypertensive outpatients (about 83.6 percent), was divided into three parts according to the degree of correlation with hypertension: direct expenses related to the with disease, the indirect expenses and the irrespective. The proportions of each part were 19.9 percent, 32.3 percent and 47.8 percent respectively., Conclusion: When economic evaluation of community prevention is carried out, the cost and cost-benefit analysis based on the analysis of outpatient expenditure and the proportion of expenses on hypertension should be taken into account. Additionally, to provide appropriate mode of medicare, to impact the behaviors and expenditure of patients, and to provide low-cost but good effective drug are also essential and important factors.

We evaluated the eye blink rate (EBR) in healthy Chinese adults and Parkinson's disease (PD) patients. In healthy subjects, the EBR declined with age, was lower in women than men younger than 50 years of age, and did not differ from male PD patients older than 60 years or female PD patients older than 50 years. Accordingly, EBR is not a good indicator for bradykinesia in Chinese individual older than 50 years that is prevalent for PD onset also.

This study assessed the pharmacokinetics, safety and efficacy of intravenous enoxaparin in patients undergoing percutaneous coronary intervention (PCI). Sixty consecutive patients [(age, 62 11 years; female, 16%; diabetes, 18%; hypertension, 53%; prior myocardial infarction (MI), 43%] undergoing PCI (stable angina, 89%; stent, 92%; two-vessel disease, 23%; B2/C lesions, 45%) were administered intravenous enoxaparin 1 mg/kg for procedural anticoagulation. Blood samples for anti-Xa level and activated partial thromboplastin time (aPTT) were assayed from the first 20 patients before and after enoxaparin administration at the following intervals: 5, 30, 60, 90, 120, 150, 180, 210, 240, 360 and 480 minutes. Activated clotting time was assessed 5 minutes after enoxaparin administration. Bleeding complications were classified according to Thrombolysis In Myocardial Infarction (TIMI) criteria. All patients were monitored for adverse clinical events at clinic visit 4 8 weeks after hospital discharge. No TIMI major or minor bleedings occurred during hospitalization for the PCI (median stay post-PCI = 1 day). One patient (2%) developed a non-Q wave MI after the PCI and before hospital discharge. There was no death or urgent revascularization up to clinical follow-up. The peak anti-Xa level was 1.30 0.18 IU/ml (range, 1.03 1.69 IU/ml). The minimum anti-Xa level was 0.55 IU/ml 4 hours after enoxaparin. Thus, the use of intravenous enoxaparin in patients undergoing PCI is associated with a low incidence of ischemic and bleeding complications. A stable therapeutic anticoagulant effect is provided without the need for monitoring within 4 hours of enoxaparin administration.

Aims: To test the usefulness of upper gastrointestinal investigations and quality of life assessment in Chinese patients with non-cardiac chest pain., Methods: Seventy-eight consecutive patients with non-cardiac chest pain underwent upper endoscopy. Eight patients had upper gastrointestinal pathology (10%). The remaining 70 patients received acid perfusion test, oesophageal manometry and 24-h ambulatory oesophageal pH (n=65)/manometry (n=61), and the results were compared with those of healthy controls (n=20). Symptoms and quality of life (SF-36) were assessed by standard validated questionnaire., Results: Significant acid reflux symptoms were present in five (5/70, 7%) patients. Abnormal 24-h oesophageal pH, indicating gastro-oesophageal reflux, was found in 19 (19/65, 29%) patients. The percentage of simultaneous contractions was higher and the percentage peristalsis was lower in patients with non-cardiac chest pain when compared with normal subjects by 24-h ambulatory manometry. Patients with non-cardiac chest pain had a lower SF-36 score when compared to controls., Conclusions: Typical acid reflux symptoms are uncommon in Chinese patients with non-cardiac chest pain, but abnormal 24-h pH results, indicating gastro-oesophageal reflux, were found in 29% of patients. Ineffective contractions were more frequently found in patients with non-cardiac chest pain by 24-h ambulatory manometry, which may have a bearing on the impaired quality of life in such patients. Upper gastrointestinal investigations are useful for the evaluation of Chinese patients with non-cardiac chest pain.

According to large-scale studies, oral contraceptive users become pregnant at rates that exceed ideal use failure rates. It is thought that a major cause is missed pills, but current research on consistent contraceptive pill taking is characterized by inadequate measures and a failure to investigate women's thinking about their own patterns of use. The purpose of this study was to gain some understanding about women's interpretations of consistency in their own pill taking through combining qualitative with quantitative data. The study was conducted in China, where contraception is free and widely available. Five urban and five rural oral contraceptive users were followed for up to three pill-taking cycles during 1996 for a total of 759 person-days. Consistency of pill taking was measured with electronic data obtained from a new blister package made by Anderson Clinical Technologies (Elmhurst, IL). Data from these devices were reviewed and interpreted by the study participants during in-depth private interviews. The users' reasons for missing pills included disruptions in their daily routines, their husband's absence, spotting, and trouble implementing the family planning program's instructions to take one pill per day for 22 days and start the next cycle on the fifth day of menses. One user gave these reasons for two cycles but denied missing numerous pills in her third cycle. Data from a series of four questionnaires showed that most demographic, psychosocial, and service system characteristics were not related to missed pills. However, results suggested that the daily routines of rural living may make consistent use more likely and that instructions for taking the pill may be associated with prolonged pill-free intervals and skipping pills during episodes of spotting. Three of the 10 women were at increased risk of pregnancy during the study period because of their pill-taking pattern. We concluded that the combination of qualitative with quantitative data enhances understanding of contraceptive use. Women themselves offer plausible reasons for their use behaviors. Listening to women could be useful in improving programs.

Background and Purpose: Chinese have been reported to have an extremely low prevalence rate of carotid and vertebral artery disease in comparison with whites. Previous studies, however, have been limited to general hospital stroke admission or postmortem series and were prone to selection bias. Extracranial cerebrovascular disease (ECCVD) is associated with coronary artery disease (CAD) in whites. Data associating ECCVD with CAD in Chinese patients are not available., Methods: We studied 153 consecutive Chinese patients with angiographically documented CAD. Duplex ultrasonography was performed to identify any underlying extracranial carotid and vertebral artery disease. Patient demographics; vascular risk factors; history of myocardial infarction, transient ischemic attack (TIA) or stroke; concomitant peripheral vascular disease (PVD); degree of left ventricular dysfunction; and extent and severity of CAD were also noted and analyzed., Results: Significant (> or = 50%) stenosis of one or more of the extracranial cerebral arteries was found in 32 patients (21%). The internal and external carotid arteries were involved in 17 of 153 patients (11%) and 19 of 153 patients (12%), respectively. The vertebral artery was involved in 9 of 153 patients (6%) and the common carotid artery in 3 of 153 (2%). Diabetes mellitus, hypertension, a history of TIA or stroke, and PVD were significantly associated with the presence of ECCVD., Conclusions: Significant ECCVD is not uncommon in Chinese patients with CAD, and the prevalence is comparable with that reported in white populations. Patients with a history of diabetes, hypertension, TIA, stroke, and PVD are more likely to have concomitant ECCVD.