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Background Exposure to ambient nitrogen dioxide (NO2) could increase the risks of small for gestational age (SGA) and large for gestational age (LGA). Nevertheless, previous published studies usually use a time period over relatively long durations as the exposure window, such as trimester-specific or gestational months, to identify adverse pregnancy outcomes related susceptible exposure windows for ambient air pollution. At present, no study has explored associations of weekly-specific ambient air NO2 exposure around pregnancy with SGA and LGA. Objective To evaluate the associations of exposure to ambient NO2 over the preconception and entire pregnancy period with risks of SGA and LGA, as well as to explore critical windows of NO2 exposure by refining exposure period to specific weeks. Methods Based on a birth cohort established by the project Environmental and LifEstyle FActors iN metabolic health throughout life-course Trajectories (ELEFANT) situated in Tianjin, 10 916 singleton pregnant women whose dates of the last menstrual period and delivery were both between June 2014 and June 2016, and whose gestational age were within 24-42 completed gestational weeks were included in this study. Each pregnant woman's exposures to ambient NO2 throughout 12 weeks before pregnancy and pregnancy period were matched with daily average NO2 concentrations obtained from the Chinese air quality reanalysis datasets (CAQRA). Distributed lag models incorporated in Cox proportional hazard regression models were applied to explore the associations of maternal exposure to weekly ambient NO2 throughout 12 weeks before pregnancy and pregnancy period with risks of SGA and LGA after controlling for potential confounders including maternal age, ethnicity, educational level, occupation, body mass index before pregnancy, residence, times of gravidity and parity, smoking, alcohol consumption, husband smoking, and season of conception. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated per 3 μg·m−3 increase in ambient NO2 concentrations. Results The average levels of maternal exposure to NO2 over the preconception, first trimester, second trimester, third trimester, and entire pregnancy periods were (39.6±10.8), (42.7±10.5), (44.8±12.7), (37.7±11.1), and (41.6±4.8) μg·m−3, respectively. For a 3 μg·m−3 increase in NO2 over the first trimester, the risk of SGA increased by 19.0% (95%CI: 8.0%-32.0%). For a 3 μg·m−3 increase in NO2 over the preconception, first trimester, and entire pregnancy, the associated risks of LGA increased by 7.0% (95%CI: 1.0%-13.0%), 37.0% (95%CI: 29.0%-46.0%) and 19.0% (95%CI: 9.0%-31.0%), respectively. For SGA, the susceptible exposure windows for NO2 were observed during the 7th to 12th preconceptional weeks and the 6th to 12th gestational weeks, with the strongest association found at the 12th preconceptional week, when the risk of SGA increased by 6.0% (95%CI:3.2%-8.9%) for a 3 μg·m−3 increase in NO2. For LGA, the susceptible exposure windows for NO2 were observed during the 1st to 12th preconceptional weeks and the 1st to 6th gestational weeks, with the strongest association found at the 12th preconceptional week, when the risk of LGA increased by 6.1% (95%CI: 4.5%-7.8%) for a 3 μg·m−3 increase in NO2. Conclusion Exposure to ambient NO2 is associated with increased risks of both SGA and LGA, and the most susceptible weekly exposure windows are nested within the 12 weeks before pregnancy and early pregnancy.
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Since the outbreak of COVID-19, several prevention and control measures have been successively promulgated in Wuhan. To name a few, setup of designated hospitals for severe COVID-19 patients is key to enforcing the policy of pooling patients, experts, resources and standardizing treatment. These efforts contribute decisively to improving the cure rate and reducing the mortality of COVID-19. As one of the designated hospitals composed of multiple medical teams, Wuhan Union Hospital put in place a joint working mode for treating severe COVID-19 patients, and found solutions to the main problems and difficulties in management. Its experiences provide references for the operation of joint medical institutions in emergency.
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Objectives@#To investigate the effect of short-term exposure to ambient NO2 has influence on lung function and fractional exhaled nitric oxide (FeNO) in chronic obstructive pulmonary disease (COPD) patients.@*Methods@#A panel of doctor-diagnosed stable COPD patients (n=33) were recruited and repeatedly measured for lung function and FeNO from December 2013 to October 2014. The patients who lived in Beijing for more than one year and aged between 60 and 85 years old were included in the study. We excluded patients with asthma, bronchial tensor, lung cancer and other respiratory disorders other than chronic obstructive pulmonary disease and occupational exposure and chest trauma surgery patients. Because the frequency of each subject visiting to the hospital was different, a total of 170 times of lung function measurements and 215 times of FeNO measurements were conducted. At the same time, the atmospheric NO2 data of Beijing environmental monitoring station near the residence of each patient during the study period were collected from 1 day to 7 days lag before the measurement. Effects of short-term NO2 exposure on lung function and FeNO in COPD patients were estimated by linear mixed-effects models.@*Results@#The subjects' forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and exhaled NO of subjects were (3.26±0.83) L, (1.66±0.61) L, (4.13±1.77) L/s, and (48.99±14.30) μg/m3, respectively. The concentration of NO2 was (70.3±34.2) μg/m3 and the interquartile range (IQR) was 39.0 μg/m3. Short-term exposure to NO2 resulted in a significant decrease in FVC among COPD patients' which was most obvious in 2 days lag. Every quartile range increased in NO2 (39 μg/m3, 2 day) would cause a 1.84% (95%CI: -3.20%- -0.48%) reduction in FVC. The effects of exposure to higher concentration of NO2 (≥58.0 μg/m3) on FVC estimate was -2.32% (95%CI: -4.15%- -0.48%)(P=0.02). No significant relevance of FeNO and NO2 was observed in this study.@*Conclusions@#Short term exposure to ambient NO2 may bring down pulmonary function in COPD patients.
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Objective To study the clinical efficacy and adverse reactions of different blue-light and expo-sure patterns for the treatment of neonatal hyperbilirubinemia.Methods 127 neonates with hyperbilirubinemia were divided into cold-light illuminator blue-light irradiation group (group A, n=32), cold-light illuminator blue-light group intermittent irradiation group (group B, n=32), traditional blue-light irradiation group (group C, n=31) and traditional blue-light intermittent irradiation group (group D, n=32).The treatment course of the four groups was all 72 hours.The level of serum total bilirubin ( TBIL) , direct bilirubin ( DBIL) and auditory brainstem response before and after treatment in the four groups were respectively observed and compared.The adverse reactions associated with treatment were recorded and compared among the four groups.After 9 months of follow-up, the audi-tory brainstem response ( ABR) was respectively tested at 3 days, 3 months and 9 months after the treatment.Results The level of TBIL in the four groups after treatment were significantly decreased compared with that before treatment (p0.05).The ABR in the four groups returned to the nor-mal after 9 months of treatment.Conclusion The therapy of the cold-light illuminator blue-light irradiation has significant clinical efficacy in the treatment of neonatal hyperbilirubinemia.It can effectively reduce the hearing im-pairment of neonates, and the incidence of adverse reaction and total effective rates are equivalent in therapeutic pat-terns of intermittent irradiation and continuous irradiation.
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Hierarchical medical system is a high priority in China ’s health reform,bearing significant impacts on remolding of its healthcare system,in which tertiary public hospitals must redefine its role.Five strategies have been proposed as follows:the first is internal management;The second is high-tech;Third is paring assistance;Fourth is telemedicine;Fifth is better medical conditions.
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The paper presented the theoretic basis for the comprehensive hospital evaluation system, and initiated the indicator system for hospital comprehensive evaluation results with both Delphi method and the balance scorecard. Two rounds of experts consultation have decided to evaluate hospital comprehensive strengths from such aspects as hospital resources deployment, business process, financial standing, customers, customers, public welfare and development potential of the hospital. Under these grade-1 indicators are 13 grade-2 ones and 83 grade-3 ones. The importance, operability and sensitivity of these indicators are accepted by experts unanimously.
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Objective To investigate the effects of carbachol on intestinal inflammation and mucosal blood flow after gut ischemia-repedusion(I/R) in rat. Method A jejunal sac was formed in Wistar rats. The superior mesenteric artery (SMA) was occluded for 45 mi-nutes followed by 240 minutes of reperfusion. Animals were random divided into three groups: sham operation, L/R + saline injection (I/R + NS) and I/R + carbachol injection (0.1mg/kg, I/R + Ca). Immediately after occluded of SAM blood flow, either 0.1mg/kg of carba-chol or same account of 0.9% saline was injected into the jejunal sac. The pathological injury was observed with HE staining. The activity of DAO and content of TNF-α in intestinal mucosa tissue were determined. Mucosal blood flow was measured by laser Doppler. All measure-ments were done at 0 min, 30 min, 60 min, 120 min, and 240 min after reperfusion. Result In I/R group the activity of DAO in intestinal mucosa and mucosal blood flow deceased, meanwhile the content of TNF-α gut tissue was dramatically increased than those in sham operation (P<0.01). Severe pathological changes were observed in intestinal mucosa. After injection of carbachol, the activity of DAO and mucosal blood flow increased (P<0.01), but the content of TNF-α in intestinal mucosa were dramatically decreased (P<0.01), compared with those in I/R group. Conclusion Administration of carbachol protects intestinal ischemia-reperfusion injury by attenuating intestinal mucosa inflammation and increasing gut mueosal blood flow.
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Objective To estimate the effect of ambient air pollution on cardiovascular related blood indicators in occupational,highly-exposed population in Beijing. Methods The blood samples were collected for twice from 14 taxi drivers in spring(15-16 April) and autumn(17 September) of 2008,respectively. The air pollution index before the sampling days was also collected for three months in each season. Results Ambient air quality was better in autumn than spring of 2008. The level of plasma viscosity was lower and levels of low-/high-density lipoproteins were higher in autumn compared with those of taxi drivers in spring. Conclusion Air pollution is positively associated with plasma viscosity and negatively associated with low-/high-density lipoproteins in occupational,highly-exposed individuals.
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Objective:To study short-term effects of PM10(particulate matter of aerodynamic diameter
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Objective To compare the results of three different types of fine particulate matter laser light scattering aerosol monitors and to explore the influencing factors.Methods Three types of Aerosol Monitor A, B, and C were used to monitor the mass concentration of indoor PM2.5 at the same time and place and the membrane weighing method was used at the same time.In order to explore the possible impacts of temperature and humidity indoor on the results of monitoring, a simultaneous monitoring on the temperature and humidity indoor was conducted.The sampling continued 2 days and with 23 hours per day.Results The results of PM2.5 monitored by the three types of aerosol monitors had a good consistency(r were 0.965, 0.988, and 0.984 respectively), but there was significant difference among them(P