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Objective To assess the acute effects of daily mean temperature,cold spells,and heat waves on stroke mortality in 12 counties across Hubei province,China.Methods Data related to daily mortality from stroke and meteorology in 12 counties across Hubei province during 2009-2012,were gathered.Distributed lag nonlinear model (DLNM) was first used,to estimate the county-specific associations between daily mean temperature,cold spells,heat waves and stroke mortality.Multivariate Meta-analysis was then applied to pool the community-specific relationships between temperature and stroke mortality (exposure-response relationship) as well as both cold-and-heatassociated risks on mortality at different lag days (lag-response relationship).Results During 2009-2012,a total population of 6.7 million was included in this study with 42 739 persons died of stroke.An average of 2.7 (from 0.5 to 6.0) stroke deaths occurred daily in each county,with annual average mean temperature as 16.6 ℃ (from 14.7 ℃ to 17.4 ℃)during the study period.An inverse J-shaped association between temperature and stroke mortality was observed at the provincial level.Pooled mortality effect of cold spells showed a 2-3-day delay and lasted about 10 days,while effect of heat waves appeared acute but attenuated within a few days.The mortality risks on cold-spell days ranged from 0.968 to 1.523 in 12 counties at lag 3-14,with pooled effect as 1.180 (95％ CI:1.043-1.336).The pooled mortality risk (ranged from 0.675 to 2.066) on heat-wave days at lag 0-2 was 1.114 (95％CI:1.012-1.227).Conclusions An inverse J-shaped association between temperature and stroke mortality was observed in Hubei province,China.Both cold spells and heat waves were associated with increased stroke mortality,while different lag patterns were observed in the mortality effects of heat waves and cold spells.
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Objective To assess the acute effects of daily mean temperature,cold spells,and heat waves on stroke mortality in 12 counties across Hubei province,China.Methods Data related to daily mortality from stroke and meteorology in 12 counties across Hubei province during 2009-2012,were gathered.Distributed lag nonlinear model (DLNM) was first used,to estimate the county-specific associations between daily mean temperature,cold spells,heat waves and stroke mortality.Multivariate Meta-analysis was then applied to pool the community-specific relationships between temperature and stroke mortality (exposure-response relationship) as well as both cold-and-heatassociated risks on mortality at different lag days (lag-response relationship).Results During 2009-2012,a total population of 6.7 million was included in this study with 42 739 persons died of stroke.An average of 2.7 (from 0.5 to 6.0) stroke deaths occurred daily in each county,with annual average mean temperature as 16.6 ℃ (from 14.7 ℃ to 17.4 ℃)during the study period.An inverse J-shaped association between temperature and stroke mortality was observed at the provincial level.Pooled mortality effect of cold spells showed a 2-3-day delay and lasted about 10 days,while effect of heat waves appeared acute but attenuated within a few days.The mortality risks on cold-spell days ranged from 0.968 to 1.523 in 12 counties at lag 3-14,with pooled effect as 1.180 (95％ CI:1.043-1.336).The pooled mortality risk (ranged from 0.675 to 2.066) on heat-wave days at lag 0-2 was 1.114 (95％CI:1.012-1.227).Conclusions An inverse J-shaped association between temperature and stroke mortality was observed in Hubei province,China.Both cold spells and heat waves were associated with increased stroke mortality,while different lag patterns were observed in the mortality effects of heat waves and cold spells.
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Objective To explore the morphologic features of the biceps reflection pulley through the comparative study of the thin sec -tional anatomy based on the Chinese Visible Human ( CVH) and MRI sectional anatomy of the biceps reflection pulley ,and to provide ima-ging anatomic data for the diagnosis of lesions .Methods The thin slices of sagittal oblique plane and coronal oblique plane by visualization -al reconstruction based on 5 data set of the Chinese visible human ( CVH) were compared with the corresponding MR images from 20 shoulder joints of the normal volunteer individuals with routine MRI ,5 shoulders without abnormalities with MR arthrography .The detailed sectional a-natomy structure of the the biceps reflection pulley was marked from the CVH ,routine MRI and MR arthrography one by one with Photoshop CS2 software.Results The main three components of the biceps reflection pulley including the coracohumeral ligament (CHL),the superior glenohumeral ligament ( SGHL) ,and the long head of the biceps tendon ( LBT) were markedly displayed on the CVH and MRI .The CHL was markedly displayed on the sagittal oblique , using plain MRI .The SGHL was markedly displayed on the CVH , especially in the transverse plane.The LBT was markedly displayed on the CVH ,especially in the coronal oblique plane parallel to the LBT .The biceps reflection pulley was markedly displayed on the sagittal oblique plane with CVH and MR arthrography .The SGHL was perpendicular to the CHL , with T-shaped link anterior to the LBT on the sagittal oblique plane .Conclusion It is complementary for MRI and CVH displaying the components of the biceps reflection pulley .The sagittal oblique plane is the best position for displaying the components and adjacent structures of the bi -ceps reflection pulley ,which provide helpful position mark for the diagnosis of the lesions in the rotator interval .
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Objective To evaluate the diagnosis of frozen shoulder with the coracohumeral ligament on the coronal oblique plane with MRI.Methods There were 60 patients(120 shoulder joints)in control group,with 30 males and 30 females,the mean age was 50.5 years old.There were 72 shoulder joints in 72 patients of frozen shoulder group(50 femles and 22 males with a mean age of 53.5 years)with clini-cal evidence and MR imaging evidence of frozen shoulder.These were prospectively analyzed to identify the CHL visualization rate and meas-ure the maximum thickness of the CHL.Results The CHL visualization rate on the coronal oblique plane in the control group was 86.7%(104 /120),and the frozen shoulder group was 87.5%(63 /72),the difference was not significant(P >0.05).The CHL visualization rate on the axial view in the frozen shoulder group was 19.4%(14 /72)and the control group was 24.2%(29 /120),the difference was not signifi-cant(P >0.05).The CHL thickness on the coronal oblique plane (n =63)in the patients with frozen shoulder was (4.37 ±1.71)mm, which was significantly greater than (2.84 ±0.79)mm ofpatients in the control group(n =104),the difference was significant(P <0.001). The CHL thickness on the axial plane(n =14)in the patients with frozen shoulder was (3.93 ±1.49)mm,which was significantly greater than (2.29 ±0.65)mm of patients in the control group(n =29),the difference was significant(P <0.001).Conclusion A thickened CHL is highly suggestive of frozen shoulder,which is 4.37 mm on the coronal oblique plane.
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Objective To investigate the imaging characteristics and diagnostic value of tri-phase dynamic enhancement scan with CT for acute renal infarction. Methods The image features of CT plain scan and tri-phase dynamic enhancement scan of 10 patients (19 sides) with acute renal infarction were retrospectively analyzed, and the CTA expression of 6 patients were observed. Results Fourteen acute renal infarction lesions of 10 cases were diagnosed. The CT scan showed there were 4 cases with enlargement of kidney, and the other 6 cases were of no abnormality. The tri-phase enhancement CT scan showed there were 6 cases of unilateral renal infarction and 4 cases of bilateral renal infarction, which totally involving 14 sides. The acute renal infarction lesions lacked of high density region in the corticomedullary in cortical phase, and there were wedge-shaped hypodense area, even low density of full kidney in parenchymal phase and pyelographic phase. The a-cute renal infarction lesions were revealed better in parenchymal phase and pyelographic phase than in cortical phase. Six cases of CTA re-vealed the responsible vessels of renal infarction lesions and the other vascular diseases. Conclusion CT tri-phase dynamic enhancement scan has important value in the diagnosis of acute renal infarction, and CTA can identify the responsible vessels of renal infarction lesions.
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Objective To investigate the correlation between minimum apparent diffusion coefficient ( ADC) values and consistency of intracranial meningiomas of different parts and nature, providing radiographic evidence of selection for surgical approach. Methods The routine MRI, diffusion-weighted imaging imaging (DWI), ADC maps and ADC value of 23 patients (25 cases) who were confirmed as men-ingiomas through surgery and pathology were retrospectively analyzed and compared with the surgical findings and pathology results. Results ADC values in meningiomas with a hard consistency were significantly lower than those with a soft consistency. Meningiomas with low mini-mum ADC were considered to have a hard consistency. Conclusion The consistency of meningiomas is an important factor in developing the strategy of surgical resection and predicting the degree of removal. The minimum ADC value might have clinical use as a predictor of menin-gioma consistency.
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<p><b>OBJECTIVE</b>To assess the association between heat wave and stroke mortality in Jiang'an District of Wuhan, China during 2003 to 2010.</p><p><b>METHODS</b>Daily data of stroke mortality, meteorological factor and ambient pollution were collected from June to September during 2003 to 2010 in Jiang'an District of Wuhan.Quasi-Poisson regression in generalized additive model was applied to evaluate the impact of heat wave on stroke mortality on different lag days.</p><p><b>RESULTS</b>During the study period, a total of 38 heat wave events and 191 heat wave days were registered. The total stroke death was 2 455 (1 182 women and 1 998 people aged 65 years old and over). Quasi-Poisson regression in generalized additive model showed that after controlling for long-term trend and seasonal trend, weekday, holiday, and relative humidity, heat wave was associated with stroke mortality on current day with relative risk of 1.15 (95%CI 1.01-1.30). Heat wave was not significantly associated with stroke mortality on current day among men (RR= 0.98, 95%CI 0.82-1.18, P=0.848) and people aged below 65 years old (RR=0.90, 95%CI 0.67-1.22, P=0.500), but relative risk increased to 1.34 (95%CI 1.12-1.62, P=0.002) and 1.20 (95%CI 1.04-1.39, P=0.002) for women and elderly (≥65 years old) people, respectively. When ambient pollutants (PM(10), sulfur dioxide and nitrogen dioxide) were involved into the models, the impacts of heat wave on stroke mortality almost remained unchanged. Lagged effects were found in the association between heat wave and stroke mortality, relative risks reached the highest on lag of 2 days and the effects of heat wave usually lasted for 3 to 5 days. Moreover, lagged patterns of the effects of heat wave on stroke mortality were different between female and male and people of different age groups.significantly increased relative risks were found on current day in the elderly (≥65 years old) people and women, while significant associations occurred on lag of 2 days for men and people aged below 65 years old.</p><p><b>CONCLUSIONS</b>Heat wave increased the risk of stroke mortality in Jiang'an District of Wuhan. The effect of heat wave lasted for several days and lagged patterns of the effects of heat wave on stroke mortality were different between females and males and people of different age groups.</p>
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Aged , Female , Humans , Male , Air Pollution , China , Hot Temperature , Stroke , MortalityABSTRACT
<p><b>OBJECTIVE</b>Using time-series analyses to determine the association between ambient air pollution and stroke mortality in Jiang'an District of Wuhan, China from 2003 to 2010.</p><p><b>METHODS</b>Data on daily stroke mortality for the period 2003 January 1 to 2010 December 31 was obtained from Jiang'an District Center for Disease Control and Prevention, Wuhan and data on relevant air pollution and meteorological factors from the local municipal environmental monitoring center and meteorology bureau of Wuhan, respectively. Application of a time-series analysis in generalized additive model was applied to evaluate the association between air pollution and stroke mortality.</p><p><b>RESULTS</b>Annual average concentrations of PM10, SO(2) and NO(2) during the study period were (115.0 ± 60.0), (50.2 ± 33.7), and (57.6 ± 25.3) µg/m³ respectively. The total stroke death was 9 204, including 4 495 women, and 7 628 people aged over 65-years old. In single-pollutant model, a 10 µg/m³ increase in previous day (lag 1 d) ambient pollutants was associated with 0.67% (95% CI: 0.25%-1.10%) excess risk in stroke mortality for PM10, 0.87% (95% CI: 0.13%-1.63%) excess risk for SO(2) and 2.07% (95% CI: 1.08%-3.07%) excess risk for NO(2), respectively. When co-pollutants were involved into the models, only NO(2) remained strongly associated with stroke mortality (β = 2.07, 95% CI: 1.08-3.07, P < 0.001). A 10 µg/m³, increase of NO(2) in lag 1 d was associated with 1.77% (95% CI: 0.54%-3.01%), 2.27% (95% CI: 0.98%-3.57%) and 2.00% (95% CI: 0.59%-3.43%) excess risk in stroke mortality, respectively, after adjusting for PM10, SO(2)th PM10 and SO(2) e-specific and gender-specific analyses showed that the association between ambient air pollution and stroke mortality was stronger in the elderly (≥ 65 years old) people and women. A 10 µg/m, increase of PM10, SO(2) NO(2) in lag 1 d was associated with excess stroke mortality of 0.97% (95% CI: 0.37%-1.57%), 1.73% (95% CI: 0.69%-2.78%) and 2.98% (95% CI: 1.59%-4.39%) for women, respectively and 0.94% (95% CI: 0.47%-1.42%), 1.06% (95% CI: 0.23%-1.90%) and 2.50% (95% CI: 1.40%-3.62%) for the elderly people (> 65 years old), respectively.</p><p><b>CONCLUSION</b>PM10 and gaseous pollutants (SO(2), NO(2)) were significant risk factors for acute stroke death, and people aged over 65-years old and women were more susceptible to the effect of ambient pollutants on stroke mortality.</p>
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Aged , Female , Humans , Air Pollutants , Air Pollution , China , Environmental Monitoring , Models, Theoretical , Mortality , Nitrogen Dioxide , Particulate Matter , Risk , Risk Factors , Stroke , Sulfur DioxideABSTRACT
The effect of ambient particulate matters on human health is of great concern. Numerous epidemiological studies have revealed that particulate matters were associated with increased population mortality. Moreover, many studies found that season and temperature might modify the effect of particles on mortality. This paper summarized the potential effect modification of season and temperature and the possible mechanism, so as to provide certain evidence and reference for the future relevant studies.
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Humans , Air Pollutants , Epidemiologic Studies , Particulate Matter , Seasons , TemperatureABSTRACT
<p><b>OBJECTIVE</b>To evaluate the acute effects of indoor and outdoor particulate matter on lung function and respiratory symptoms of college students in winter.</p><p><b>METHODS</b>A panel of 37 college students aged 19-21 in Wuhan were included and the investigation was carried out from 12/23/2009 to 01/05/2010. Daily morning/evening forced expiratory volume in one second (FEV1) and respiratory symptoms (cough, phlegm and runny) were measured and reported by subjects, respectively. Meanwhile, daily data of indoors and outdoors PM10, PM2.5, temperature, and relative humidity were collected. Generalized Estimating Equations (GEEs) were used to estimate the association between particulate matters exposure and respiratory symptoms and FEV1).</p><p><b>RESULTS</b>Average daily concentrations of indoor, outdoor PM2.5 during the study period were (110.6 ± 42.3), (143.5 ± 51.2) µg/m³, (148.2 ± 43.2) and (239.1 ± 71.3) µg/m³ for indoor, outdoor PM10, respectively. Outdoor exposure to PM2.5 on lag 0 had little effect on evening FEV1). However, researchers observed a significant lagging effect (lag 1 d) and accumulative effect (lag 0-1 d and lag 0-2 d). A rise in the PM2.5 concentration of 10 µg/m³ resulted in the change of evening FEV1) of -0.28% (95% CI: -0.52%, -0.03%), -0.45% (95% CI: -0.81%, -0.08%) and -0.63% (95% CI: -1.15%, -0.11%), respectively. For respiratory symptoms of coughing up phlegm, 10 mg/m³ increase of indoor/outdoor PM2.5 concentration were associated with odds ratio of 1.18 (95% CI: 1.02-1.36) and 1.08 (95% CI: 0.97-1.19), respectively. Moreover, risk of coughing up phlegm increased with lagging time, and accumulative time of indoor and outdoor PM2.5 and PM10.</p><p><b>CONCLUSION</b>Our study suggested that short-term exposure to particulate matters in winter was significantly associated with acute changes of respiratory symptoms and FEV1) of college students in Wuhan. Moreover, the effects of particulate matters tended to be larger as the increase of lagged and accumulative days.</p>
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Humans , Air Pollutants , Cough , Forced Expiratory Volume , Humidity , Mucus , Particulate Matter , Respiratory Tract Diseases , Seasons , Students , TemperatureABSTRACT
Objective To analyze the therapeutic effect of three-dimensional conformal involvedfield radiotherapy (3D-CRT)combined with chemotherapy on limited disease stage small cell lung cancer (LD-SCLC).Methods The clinical data of 85 patients of LD-SCLC treated with 3D-CRT at the dose of 2 Gy/fraction,5 fractions per week for 5 - 7 weeks,with the median dose of 50 Gy ( 46 - 66 Gy),combined with 4 -8 cycles chemotherapy,64 males and 21 females,aged 29 -76,were collected and analyzed.Results The complete remission rate,partial remission rate,stability rate,and total effective rate were 36.5％,52.9％,10.6％,and 89.4％,respectively.The median survival time was 18 months,with the 1-,2-,and 3-year overall survival rates of 65.9％,33.8％,and 15.9％,respectively.The local recurrence rate,distant metastasis rate,and local recurrence + distant metastasis rate were 15.2％ (9/85),49.2％ (29/85),and 35.6％ (21/85),respectively.Body weight,response to therapy,cycles for chemotherapy,and concurrent chemo-radiotherapy were all independent prognostic factors for LD-SCLC.Cox muhivariable regression was used to analyze the prognostic factors.Conclusions Involved-field radiotherapy is effective for LD-SCLC.Distance metastasis is the main cause of treatment failure.