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Background: Initiating ivabradine in acute heart failure (HF) is still controversial. Hypothesis: Ivabradine might be effective to be added in acute but hemodynamically stable HF. Methods: A retrospective cohort of hemodynamically stable acute HF patients was enrolled from January 2018 to January 2020 and followed until July 2020. The primary endpoints were all‐cause mortality and rehospitalization for HF. Secondary endpoints included heart rate (HR), cardiac function measured by New York Heart Association (NYHA) class, and left ventricular ejection fraction (LVEF) and adverse events, which were compared between patients with or without ivabradine. Results: A total of 126 patients were enrolled (50 males, median age 54 years, 81% with decompensated HF, median follow‐up of 9 months). In patients treated with ivabradine, although baseline HRs were higher than the reference group (96 vs. 80 bpm), they were comparable after 3 months; more patients tolerated high doses of β‐blockers (27% vs. 7.9%), improved to NYHA class I function (55.6% vs. 23.8%) and exhibited normal LVEFs (37.8% vs. 14.3%) than the reference group (all p <.05). Ivabradine was associated with a significant reduction of rehospitalization for HF than the reference group (25.4% vs.61.9%), with longer event‐free survival times (hazard ratio: 0.45, 95% confidence interval [CI]: 0.25–0.79), and was related with primary endpoints negatively (hazard ratio 0.51, 95% CI: 0.28–0.91) (all p <.05). Conclusion: In patients with acute but hemodynamically stable HF, ivabradine may significantly reduce HR, improve cardiac function, and reduce HF rehospitalization. [ABSTRACT FROM AUTHOR]

Due to the large annual production of construction waste in China, the rapid changes in construction waste materials, and the need to quickly obtain high-precision 3D change information for construction waste, we have used a rapid monitoring method for construction waste accumulations, which uses unmanned aerial vehicle (UAV) photogrammetry to obtain a digital surface model (DSM) and a digital orthophoto map (DOM) of two study areas located in Pingdingshan City, China. Then, we built 3D models of waste accumulations in 2019 and 2020 for the two study areas. We also proposed a 3D change detection model combined with self-adaptive roughness quantification and supervised classification based on the elevation threshold to extract construction waste accumulations, and the extraction accuracies in 2019 and 2020 were 84.9 and 85.6%, respectively. Also, we used the adaptive threshold method and the discrete integral method to calculate the changes in areas and volumes of the accumulations. The calculation accuracy of the volume of construction waste reached 88%. This study provides a method for quickly obtaining 3D change information for construction waste accumulations. [ABSTRACT FROM AUTHOR]

Aims: This follow‐up study aimed to examine the 8‐year efficacy and safety of subthalamic nucleus (STN) deep brain stimulation (DBS) for patients with Parkinson's disease (PD) in southern China. Methods: The follow‐up data of 10 patients with PD undergoing STN‐DBS were analyzed. Motor symptoms were assessed before and 1, 3, 5, and 8 years after the surgery with stimulation‐on in both off‐medication (off‐med) and on‐medication (on‐med) status using the Unified Parkinson's disease Rating Scale Part III. The quality of life was assessed using the 39‐item Parkinson's Disease Questionnaire. The sleep, cognition, and emotion were evaluated using a series of nonmotor scales. Levodopa equivalent daily dose (LEDD) and stimulation parameters were recorded at each follow‐up. Results: The motor symptoms were improved by 50.9%, 37.7%, 36.7%, and 37.3% in 1, 3, 5, and 8 years, respectively, in the off‐med / stimulation‐on status compared with the baseline. The quality of life improved by 39.7% and 56.1% in 1 and 3 years, respectively, but declined to the preoperative level thereafter. The sleep, cognition, and emotion were mostly unchanged. LEDD reduced from 708.1 ± 172.5 mg to 330 ± 207.8 mg in 8 years. The stimulation parameters, including amplitude, pulse width, and frequency, were 2.77 ± 0.49 V, 71.3 ± 12.8 μs, and 121.5 ± 21 Hz, respectively, in 8 years. Conclusion: Long‐term therapeutic efficacy of STN‐DBS could be achieved even with relatively low stimulation intensity and medication dosage for PD patients in southern China. Motor improvement and medication reduction were maintained through the 8‐year follow‐up, but improvement in quality of life lasted for only 3 years. No definite changes was found in nonmotor symptoms after STN‐DBS. [ABSTRACT FROM AUTHOR]

The existing database of the loading response of offshore pile foundations needs to be enriched, so that safety and economic considerations can be optimally balanced in design. This paper details a programme of field tests on an open-ended steel pile. The pile with a diameter of 2 m was driven to a depth of 72.8 m in a stratified soil site and then subjected to monotonic compressive, tensile and lateral loadings. Resting periods were allowed before each test to enable strength recovery, and a period of about one month was found to be sufficient (i.e., the axial bearing capacity increases from about 10 MN to 25 MN). The test results were interpreted in terms of the internal forces and displacements/deformations of the pile, and the more detailed pile-soil interactions (i.e., qs-s and p-y curves). It is found that, for cohesive soils, the unit shaft resistance qs remains constant through each soil layer regardless of the almost linearly varying undrained shear strength su obtained from CPTu tests, and the soil layer with overall higher su does not guarantee greater qs owing to different proportions of silty and clayey components. Upon reaching the ultimate uplift load, the shaft resistance within the cohesive soils shows a clear softening response. Extensive comparisons were made between these results and the predictions from existing design methods wherever applicable to discuss the accuracy of each. [ABSTRACT FROM AUTHOR]

Past changes in the distribution of tree species are critical to predict future vegetation dynamics under changing climate conditions. In this study, pollen-based reconstruction with 60 pollen records from mid-latitude region was performed in China. Betula emerged after the Last Glacial Maximum (LGM), when the climate ameliorated gradually. The distribution range was small but increased significantly during the early Holocene. However, when the climate was wet and warm during the mid-Holocene, the distribution range did not continue to expand. The relationships between the percentages of Betula pollen and the strength of the East Asian summer monsoon (EASM) or its variability were positively correlated, while those of Betula and Pinus had opposite trends in the study region. Besides, the post-glacial distribution dynamics of Betula platyphylla and Betula dahurica were influenced by climate change which were simulated by species distribution models (SDMs). We conclude that birch distribution in mid-latitudinal northern China was mainly driven by the EASM or its variability, especially during the LGM and early Holocene when the climate was unstable, while the replacement by Pinus and Quercus occurred during the mid-Holocene when the climate remained stable. The future unstable climate may benefit birch development. [ABSTRACT FROM AUTHOR]

Background. Hip fracture is one of the major risk factors of global mortality and disability. The aim of this study was to map the pattern of intertrochanteric femoral fractures in China, providing a pilot national dataset and basis for medical policy proposals. Methods. A multistage probability sampling strategy was applied in the national baseline survey. Thirty provinces in mainland China were included in this survey. A standardized questionnaire survey was conducted to collect information about basic characteristics such as age, working seniority, hospital level, and residence, with two other parts including perioperative and postoperative treatment parameters. Odds ratios and 95% confidence interval were used to determine essential statistical differences. The proportion of the options in each region was compared using the chi-square (χ2) test. The histogram and choropleth map of the monthly number of admissions were created using Excel 2016 to show the distribution characteristics. Results. In total, 1065 valid responses were included, representing a 96.7% survey capture rate. Perioperative treatment and postoperative care distinctly varied across regions and hospital levels. The monthly number of admissions was relatively lower in the Northern region, with higher proportion of hospitalizations to secondary hospitals compared with the Eastern region. The patients in the Eastern region or tertiary hospitals had shorter preoperative waiting time and hospitalization period. Conclusions. We found apparent geographic variations in intertrochanteric femoral fractures in this study, and the data can be used for drafting national healthcare plans and medical policies. [ABSTRACT FROM AUTHOR]

Backgrounds. Previous studies have reported a relationship between serum total bilirubin (STB) and coronary artery disease (CAD). However, the relationship between STB and prognosis of patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) remains inconclusive. The present study aimed to evaluate the relationship between STB level and prognosis of PCI in patients with ACS. Methods. In total, 2850 ACS patients who underwent PCI at the Affiliated Zhongda Hospital of Southeast University from June 2009 to Jan 2017 were included in the study. Twenty-four-hour STB, 30-day, and 1-year postoperative major adverse cardiovascular events (MACE) were recorded. Subjects were assigned to one of three groups based on STB: Group A (STB ≤ 9.6 μmol/L), Group B (9.7 μmol/L < STB ≤ 15.4 μmol/L), and Group C (STB ≥ 15.5 μmol/L). COX survival analysis was subsequently used to investigate the relationship between the incidence of MACE and STB in the three groups. Results. A total of 2770 subjects were successfully followed up; within 1 year after PCI, 115 (4.15%) subjects died and 191 (6.90%) subjects experienced MACE. One-year follow-up results showed that the incidence of MACE decreased significantly as STB increased; the risk of Group A was 2.002 times that of Group C (95% CI: 1.342-2.986). Cardiac mortality also decreased with increasing STB; the risk of Group A was 3.403 times that of Group C (95% CI: 1.319-8.785). Conclusion. Lower mortality and MACE incidence rates were found in patients with higher STB within 1 year. Therefore, STB is highly recommended as an independent long-term prognosis predictor of PCI in patients with ACS. [ABSTRACT FROM AUTHOR]

Objectives: Adiposity, defined by higher cardiometabolic index (CMI), lipid accumulation product (LAP), and body adiposity index (BAI), has conferred increased metabolic risk. However, the incremental utility of CMI, LAP, and BAI in association with prevalent hypertension has not been well described in a population-based setting. We hypothesized that CMI, LAP, and BAI would provide important insight into hypertension risk.Methods: Blood pressure (BP), fasting lipid profiles, and anthropometric parameters were recorded in a cross-sectional study of 11,400 participants (mean age, 54 years; 53% women) from China. Logistic regression models were used to assess associations of CMI, LAP, and BAI with prevalent hypertension. BAI was evaluated according to hip (cm)/[height (m)1.5]-18; LAP was calculated separately for men [(WC-65) × TG] and women [(WC-58) × TG]; and CMI was defined by TG/HDL-C × waist-to-height ratio.Results: CMI, LAP, and BAI were independently correlated with higher SBP and DBP, with nonstandardized (B) coefficients ranging from 1.827 to 4.590 mmHg and 1.475 to 2.210 mmHg (all P < 0.001). After adjustment for hypertension risk factors and potential confounders, CMI, LAP, and BAI, modeled as continuous measures, carried hypertension odds (95% CI) of 1.356 (1.259-1.459), 1.631 (1.501-1.771), and 1.555 (1.454-1.662) in women, respectively, per SD increment. In men, each SD increase in CMI, LAP, and BAI experienced a 31%, 65%, and 53% higher hypertension risk, respectively. Moreover, among women, the odds ratio (95% CI) for hypertension were 2.318 (1.956-2.745), 3.548 (2.985-4.217), and 3.004 (2.537-3.557) in the 4th quartile vs the first quartile of CMI, LAP, and BAI, respectively. For men, the corresponding figures were 2.200 (1.838-2.635), 3.892 (3.238-4.677), and 3.288 (2.754-3.927), respectively.Conclusion: Measurements of CMI, LAP, and BAI provide a more complete understanding of hypertension risk related to variation in body fat distribution and pinpoint hypertensive participants in great risk of cardiovascular disease in the future. [ABSTRACT FROM AUTHOR]

Background: In China, the incidence of Inflammatory bowel disease (IBD) has shown a significant growth trend. Analysis of the epidemiology, clinical manifestations, diagnostic means, and treatment of IBD will further improve the clinician's understanding of IBD, improve knowledge and further enable early diagnosis and standardized therapeutic management. The purpose of this study was to analyze the clinical characteristics of IBD inpatients in General Hospital of NingXia Medical University over a 12-year period to identify trends in clinical and epidemiological features, clinical manifestations, and treatment programs.Methods: By excluding188 patients with incomplete information or incompatible with the 2012 Guidlines cases, we retrospectively analyzed the case records of 567 inpatients with a diagnosis of IBD admitted to the General Hospital of NingXia Medical University between January 2002 and December 2014. The clinical epidemiological features, clinical manifestations, diagnostic methods, and therapeutic status were analyzed.Results: Over the study period, IBD hospitalization rates in 2002 and 2014 groups was 1.96 % and 4.05 %, increased 2.07 times. Of 567 cases of IBD, 483 (85.19 %) cases were categorized as ulcerative colitis (UC) and 84 as Crohn's disease (CD) (14.81 %). Total male cases were 321 (56.61 %). Mean age of cases was 49.06 ± 14.92 years for UC and 44.84 ± 14.67 years for CD. The majority of UC was located in the colon, with a moderate level of disease activity. A combination of clinical manifestations and colonoscopy was mostly used to make a diagnosis; relatively the rate of pathological diagnosis was low, with a small proportion of patient's diagnosed based on radiology. Treatment with SASP/5ASA and steroids was applied to the majority of inpatients and 47.83 % were treated with antibiotics; in contrast, only 1.86 % cases were treated with immunosuppressive therapy.Conclusions: An increasing trend of admissions for IBD can be observed in our study; there are some differences in clinical features and treatment compared with Western countries, and further research into this is required. [ABSTRACT FROM AUTHOR]

Fine flow and heat transfer characteristics are critical to nuclear reactor safety. However, a comprehensive CFD calculation of the entire reactor core requires substantial computing resources, restricting the research domain's scope. To address this issue, we propose a Distributed Parallel (DP) computing scheme, tailored specifically for reactor cores using plate-type fuel assemblies. This study focuses on the thermal-hydraulic calculation of the large domain of a reactor core utilizing plate-type fuel assembly, based on the Computational Fluid Dynamics (CFD) method. This innovative solution enables the completion of extensive domain CFD calculations using modestly equipped personal workstations (8 cores, 128G RAM), which traditionally would require supercomputing platforms. To verify the distributed-parallel computing technique, it is successfully applied to all standard, full-length fuel assemblies in the China Advanced Research Reactor (CARR). In the result analysis, it was observed that detailed results could be obtained with reduced computational resources, demonstrating a significant breakthrough for CFD engineering analysis. [ABSTRACT FROM AUTHOR]

• Traditional preventive measures lack quantifiable evaluation criteria. • We surveyed valve health diagnosis and assessment techniques and research. • We statistically sorted the common failure modes and causes of key valves. • We explored strategies for intelligent maintenance of gas pipeline valves. Valves, susceptible to malfunctions in natural gas transmission control, play a critical role and require vigilant maintenance within pipeline companies. Despite traditional preventive measures, involving routine inspections and repairs, intermittent valve failures persist. These failures are often attributed to a maintenance approach that primarily emphasizes functional testing, lacking quantifiable evaluation criteria or methodologies to assess valve conditions. Furthermore, the industry lacks efficient tools for fault diagnosis and informed predictive maintenance decision-making. In response, this study delves into an exploration of current valve fault diagnosis techniques and relevant research. We comprehensively examine conventional maintenance methods, performance testing parameters, and strategies applied across diverse sectors. Our analysis extends to encompass leading valve diagnostic equipment, its global utilization, and recent advancements in data-driven and model-based fault diagnostics, as well as reliability assessment within the valve domain. Through these investigations, our research aims to pave the way for the advancement of intelligent maintenance for pipeline valves. We summarize common failure modes and causes of key valves in natural gas pipelines, analyze the available performance signals of the valves, and envision strategies and frameworks for intelligent maintenance of natural gas pipeline valve systems. These contribute to the development of cutting-edge valve fault diagnosis and prognostic maintenance techniques, ultimately enhancing the industry's proactive ability to address valve-related challenges. [ABSTRACT FROM AUTHOR]

Objective To ascertain whether sleep abnormalities including daytime sleepiness, snoring, apnea, sleep disruption and sleep duration abnormity are significantly associated with hyperhomocysteinemia (Hhcy). Methods A total of 5992 participants were involved in the cross-sectional study. Sleep abnormalities were evaluated by a structured questionnaire. Hhcy was defined as plasma levels of homocysteine ≥ 15 μm/L. Results After adjustment for age, gender, education, current smoking status and current drinking status, daytime sleepiness (OR, 1.597; 95%CI, 1.210–2.110, P = 0.001), sleep duration < 6 h (OR, 1.273; 95%CI, 1.063–1.524, P = 0.009) and sleep duration > 8 h (OR, 1.205; 95%CI, 1.065–1.364, P = 0.003) were significantly associated with Hhcy. While snoring (OR, 1.065; 95%CI, 0.950–1.195, P = 0.279), apnea (OR, 1.170; 95%CI, 0.924–1.482, P = 0.193), and sleep disruption (OR, 1.065; 95%CI, 0.852–1.331, P = 0.580) were not. After further adjustment for body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, total cholesterol, physical activity, diabetes, coronary heart disease, stroke, depression, glomerular filtration rate, hypertension and hyperuricemia, still the increased OR could be found in the daytime sleepiness group (OR, 1.569; 95%CI, 1.145–2.150, P = 0.005). However, sleep duration < 6 h (OR, 1.067; 95%CI, 0.788–1.445, P = 0.676) and sleep duration > 8 h groups (OR, 1.080; 95%CI, 0.883–1.320, P = 0.453) were no longer significantly associated with Hhcy. Conclusions Daytime sleepiness, but not sleep duration abnormity, snoring, apnea and sleep disruption was an independent risk factor for Hhcy. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to identify potential risk factors for family transmission and to provide precautionary guidelines for the general public during novel Coronavirus disease 2019 (COVID-19) waves., Methods: A retrospective cohort study with numerous COVID-19 patients recruited was conducted in Shanghai. Epidemiological data including transmission details, demographics, vaccination status, symptoms, comorbidities, antigen test, living environment, residential ventilation, disinfection and medical treatment of each participant were collected and risk factors for family transmission were determined., Results: A total of 2,334 COVID-19 patients participated. Compared with non-cohabitation infected patients, cohabitated ones were younger ( p  = 0.019), more commonly unvaccinated ( p  = 0.048) or exposed to infections ( p  < 0.001), and had higher rates of symptoms ( p  = 0.003) or shared living room ( p  < 0.001). Risk factors analysis showed that the 2019-nCov antigen positive (OR = 1.86, 95%CI 1.40-2.48, p  < 0.001), symptoms development (OR = 1.86, 95%CI 1.34-2.58, p  < 0.001), direct contact exposure (OR = 1.47, 95%CI 1.09-1.96, p  = 0.010) were independent risk factors for the cohabitant transmission of COVID-19, and a separate room with a separate toilet could reduce the risk of family transmission (OR = 0.62, 95%CI 0.41-0.92, p  = 0.018)., Conclusion: Patients showing negative 2019-nCov antigen tests, being asymptomatic, living in a separate room with a separate toilet, or actively avoiding direct contact with cohabitants were at low risk of family transmission, and the study recommended that avoiding direct contact and residential disinfection could reduce the risk of all cohabitants within the same house being infected with COVID-19., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Liu, Chai, Wu, Zhang, Wang, Yang, Shi, Wang, Zhang, Chen, Fan, Wen, Yang, Li, Liu, Zheng, Jiang, Qian, Tao, Qian, Wang, Chen, Xu and Wang.)

Objectives: By retrospective study of the epidemiological characteristics of sports-related sudden death (SrSD), the risk factors associated with SrSD were analyzed and explored to provide a scientific basis for comprehensive prevention and treatment of SrSD., Methods: The personal information (sex, age, occupation, etc.), case information (time, place, type of sports, relative time between SrSD occurrence and exercise, etc.), death related information (sign or prodrome, medical history and surgical history, etc.), rescue situation (witnesses, on-site assistance, the availability of paramedics, etc.) of 374 SrSD cases in Guangdong Province from 2017 to 2021 were collected. Statistical analysis was conducted aiming at the key factors., Results: In the 374 cases, there were significantly more males than females (19.78:1); the number of people aged between >39 and 59 was the largest (151, 40.37%); non-manual workers (68.98%) were more than manual workers; the top three sports with the highest number cases were basketball (34.49%), running (19.52%) and badminton (12.03%); from 3 pm to 9 pm (63.10%) was the time period with the highest incidence of events; sudden death mainly occurred during exercise (75.27%) and within 1 h after exercise (20.05%); the on-site rescue rate was very low (6.15%); the rate of autopsies was extremely low (1.07%); sudden cardiac death was the most common cause (67.11%)., Conclusions: SrSD is most common in males aged >39 to 59 years old, mostly in non-manual workers, and usually occurs in basketball and running. Sudden death is more likely to occur during exercise and within 1 h after exercise. Therefore, the above potential risk factors should be focused on and studied in daily comprehensive prevention and treatment to provide scientific basis for accurate prevention and first aid of such sudden death.

Chronically SHIV SF162P3N -infected cynomolgus monkeys were used to determine the effects of the antibody-mediated acute CD4 + T cell depletion on viral load as well as on the immunological factors associated with disease progression. Compared with the control animals, CD4 + T cell-depleted animals with SHIV infection showed (i) little alteration in plasma viral load over the period of 22 weeks after the depletion; (ii) increased CD4 + T cell proliferation and turnover of macrophages at the early phase of the depletion, but subsequent decline to the basal levels; and (iii) little impact on the expression of the inflammatory cytokines and CC chemokines associated with disease progression. These findings indicate that the antibody-mediated acute CD4 + T cell depletion had minimal impact on plasma viral load and disease progression in chronically SHIV SF162P3N -infected cynomolgus monkeys. Future investigations are necessary to identify the key factor(s) related to the immune activation and macrophage infection during the CD4 deletion in chronic viral infection., (Copyright © 2021 Elsevier Inc. All rights reserved.)

BACKGROUND Robotic pancreaticoduodenectomy (RPD) is a novel type of minimally invasive surgery to treat tumors located at the head of the pancreas. This study aimed to construct a novel prediction model for predicting selection preference for RPD in a Chinese single medical center population. MATERIAL AND METHODS The clinical data from 451 pancreatic ductal adenocarcinoma patients were collected and analyzed from January 2013 to December 2016. Twenty-three items affecting clinical strategies were optimized by LASSO (least absolute shrinkage and selection operator) regression analysis and then were incorporated in multivariable logistic regression analysis. C-index was used for evaluating the discriminative ability. Decision curve was applied to determine clinical application of this model and the calibration of this nomogram was evaluated by calibration plot. The model was internally validated through bootstrapping validation. RESULTS Clinicopathological factors included in the model were age, history of diabetes mellitus, history of hypertension, history of heart, brain and kidney disease, history of abdominal surgery, symptoms (jaundice, accidental discovery and weight loss), anemia, elevated carcinoembryonic antigen (CEA), smoking, alcohol intake, American Society of Anesthesiologists (ASA) scores, vascular invasion, overweight, preoperative lymph node metastasis and tumor size >3.5 cm. A C-index of 0.831 indicated good discrimination and calibration of this model. Interval validation generated an acceptable C-index of 0.787. When surgical approach was determined at the threshold of preference possibility less than 63%, decision curve analysis indicated that this model had good clinical application value in this range. CONCLUSIONS This new nomogram could be conveniently used to predict the selection preference of robotic surgery for patients with pancreatic head cancer.

Background: Recently, a novel 4-tiered classification of left ventricular hypertrophy (LVH) based on ventricular dilatation (indexed LV end-diastolic volume [EDV]) and concentricity (mass/EDV 0.67 ) has improved all-cause and cardiovascular mortality risk stratification. However, their possible association with ischemic stroke has not been extensively evaluated in the general population., Methods: We evaluated a cross-sectional study of 11,037 subjects from the general population of China in whom echocardiographic and ischemic stroke data were available to subdivide patients with LVH into four geometric patterns: indeterminate, dilated, thick and both thick and dilated hypertrophy., Results: Compared with normal LV geometry, indeterminate and thick hypertrophy showed a higher prevalence of ischemic stroke (p < .05). Ischemic stroke was significantly greater in participants with indeterminate (adjusted odd ratio [OR]:1.635, 95% confidence interval [CI]: 1.115-2.398) and thick (2.143 [1.329-3.456]) hypertrophy but not significantly in those with dilated (1.251 [0.803-1.950]) and both thick and dilated hypertrophy (0.926 [0.435-1.971]) compared with normal geometry in multivariable analysis., Conclusions: Indeterminate and thick hypertrophy were significantly associated with the presence of ischemic stroke in the general Chinese population. The new 4-tiered categorization of LVH can permit a better understanding of which subjects are at high enough risk for ischemic stroke to warrant early targeted therapy. Key messages This was the first study to investigate whether a 4-tiered classification of LVH defines subgroups in the general population that are at variable risks of ischemic stroke. We identified that thick hypertrophy carried the greatest odd for ischemic stroke, independently of traditional risk factors, followed by indeterminate hypertrophy. The new 4-tiered categorization of LVH emerged as a valuable operational approach, a potential alternative to LVM, to refine ischemic stroke stratification in general population.

Adiposity phenotypes, estimated by higher body adiposity index (BAI), lipid accumulation product (LAP), and cardiometabolic index (CMI), has conferred increased metabolic risk. The relative contribution of BAI, LAP, and CMI in hyperuricemia, however, is unknown. We hypothesized that these obesity indicators would refine identification of hyperuricemia. Information on serum uric acid (SUA), fasting lipid profiles, and body adiposity measures (BAI, LAP, and CMI) were recorded in a cross-sectional population-based sample of 11,102 participants (≥ 35 years old) from China. BAI, LAP, and CMI were strong independent predictors of SUA in both sexes after correction for potential confounders. In multivariable models, odds ratio (OR) for hyperuricemia for 1 SD increment in BAI, LAP, and CMI were 1.361 (95% CI, 1.224-1.513), 1.393 (95% CI, 1.273-1.525), and 1.332 (95% CI, 1.224-1.448) in females, respectively. For males, these adiposity indices corresponded to an increased hyperuricemia risk of 14, 47, and 33%, respectively. Additionally, compared to the bottom category, females with the top quartile of BAI, LAP, and CMI showed higher adjusted odds of having hyperuricemia, with ORs of 2.064, 7.500, and 4.944, respectively. ORs for hyperuricemia were statistically significant in the fourth quartile of BAI (1.622 [1.258-2.091]), LAP (5.549 [3.907-7.880]), and CMI (3.878 [2.830-5.313]) of male subgroup. Accumulation of ectopic adiposity in general (quantified by increased BAI), and of visceral adipose tissue in particular (reflected by elevated LAP and CMI), provided important insight regarding hyperuricemia risk and might potentially shed further light on our understanding of the metabolic sequelae of obesity.

Background: Subthalamic nucleus deep brain stimulation (STN DBS) is effective against advanced Parkinson's disease (PD), allowing dramatic improvement of Parkinsonism, in addition to a significant reduction in medication. Here we aimed to investigate the long-term effect of STN DBS in Chinese PD patients, which has not been thoroughly studied in China., Methods: Ten PD patients were assessed before DBS and followed up 1, 3, and 5 years later using Unified Parkinson's Disease Rating Scale Part III (UPDRS III), Parkinson's Disease Questionnatire-39, Parkinson's Disease Sleep Scale-Chinese Version, Mini-mental State Examination, Montreal Cognitive Assessment, Hamilton Anxiety Scale and Hamilton Depression Scale. Stimulation parameters and drug dosages were recorded at each follow-up. Data were analyzed using the ANOVA for repeated measures., Results: In the "off" state (off medication), DBS improved UPDRS III scores by 35.87% in 5 years, compared with preoperative baseline (P < 0.001). In the "on" state (on medication), motor scores at 5 years were similar to the results of preoperative levodopa challenge test. The quality of life is improved by 58.18% (P < 0.001) from baseline to 3 years and gradually declined afterward. Sleep, cognition, and emotion were mostly unchanged. Levodopa equivalent daily dose was reduced from 660.4 ± 210.1 mg at baseline to 310.6 ± 158.4 mg at 5 years (by 52.96%, P < 0.001). The average pulse width, frequency and amplitude at 5 years were 75.0 ± 18.21 μs, 138.5 ± 19.34 Hz, and 2.68 ± 0.43 V, respectively., Conclusions: STN DBS is an effective intervention for PD, although associated with a slightly diminished efficacy after 5 years. Compared with other studies, patients in our study required lower voltage and medication for satisfactory symptom control.

This article presents an overview of occupational benzene exposures in China based on data published in Chinese medical journals. The data were derived from 384 reports of benzene poisoning or industrial hygiene surveys published in Chinese medical journals between 1960 and 2003. The following information was extracted whenever available: industry, occupation, task, date, benzene levels, sampling location, workplace descriptions and, for case reports, medical diagnosis. Each paper provided one or more sets of benzene data, each set representing a sampling location or job title with one to several measurements including, mainly, breathing zone area concentration measurements, and much less frequently personal monitoring. Two criteria based on data quality were applied to select suitable data for analyses. The selected exposure data were analyzed by industry and time period. Nine hundred five sets of benzene measurements from 72 industries were reported in the 384 papers selected for this review, and 621 sets (68.6%) presented average benzene concentrations, which covered 55 industries. The distribution of the reported average benzene exposures was skewed with a median of 51.5 mg/m3. The average benzene concentrations were below 100 mg/m3 for 406 (65%) of the 621 reported average concentrations. The medians of the reported averages in mg/m3 for the five industries with the highest exposures were: 124.8 for leather products, 98.7 for electronic devices, 75.4 for machinery, 50.4 for shoes, and 50.3 for office supplies and sports equipment manufacturing. These data describe the concentrations and changing patterns of occupational benzene exposure by industry and time period in China.

Objectives: To discuss the experience of diagnosis and treatment of VIPoma by summarizing clinical information of 31 patients with VIPoma in China., Methods: To analyze clinical manifestations, laboratory examinations, imaging features, operation, pathologic findings, and follow-up survey of 31 patients, among them 1 case was from our hospital and the other 30 cases were reported in Chinese literature from 1977 to 2002., Results: Periodical backache, skin rash, and polyps of colon were never reported previously, all of which except polyps disappeared after operation. Partial resection of superior mesenteric vein was also never reported. The mean serum value of VIP which had been very high before operation, decreased markedly after the operation (963.2 pg/ml Versus 131.9 pg/ml),the immunohistochemical expression of many kinds of digestive hormone including VIP presented positive. Hepatic involvement was 29.0%,nodal metastasis was 9.7%., Conclusions: VIPoma is rare. Typical symptoms and the serum value of VIP are keys to diagnosis before operation, Surgical resection is the most effective means for cure. surgical debulking of the tumor, somatostatin analogues can be used for good palliation.