DALY of diseases caused by air pollution in Ulaanbaatar city 2008-2017 / Монголын Анагаах Ухаан

Background@#Air pollution has been increasing intensively during last decade in big cities of Mongolia especially in Ulaanbaatar due to urbanization, poor urban plan, migration from rural areas to urban areas, poverty, unemployment, economic crises, exercise with unclean technology mainly coal for heating and cooking, raise of number of motor vehicle and other air pollution sources; as result of this phenomena population health has been worsening. The Global burden of disease concept, first published in 1996, constituted the most comprehensive and consistent set of estimates of mortality and morbidity and WHO now regularly develops GBD estimates at regional and global level. The goal of this study is to define DALY of air pollution related diseases in Ulaanbaatar. @*Materials and Methods@#This is retrospective study which used air pollution and mortality secondary data 2008-2017. The DALY extends the concept of potential years of life lost due to premature death (YLL) to include equivalent years of ‘healthy’ life lost by virtue of being in states other than good health. DALYs for a disease or health condition are calculated as the sum of the years of life lost due to premature mortality (YLL) in the population and the equivalent ‘healthy’ years lost due to disability (YLD) for incident cases of the health condition. We used WHO recommended estimation methodology and selected 2 disease category of mortality of each RSD (pneumonia, COPD) and CVD (ischemic heart disease, cerebrovascular disease).@*Results@#According to the age group, most of children 0-4 due to RSD and most of adults were died due to CVD. In general, hospitalization is increasing year by year and differing by season. Significant associations were found for all air pollutants such as PM10, PM2.5, CO, SO₂, and O₃ had a statistically significant association with cold season’s mortality of RSD and CVD. The most common mortality cases were ischemic heart disease, cerebrovascular disease, pneumonia and COPD. In Ulaanbaatar in 2008-2017, 2205 people were died due to RSD and CVD. Hospital admission and mortality has an increasing trend. @*Conclusion@#Residents of Ulaanbaatar were lost in total 249854 years due to pneumonia, COPD, ischemic heart disease, and cerebrovascular disease during 2008-2017. The most vulnerable group of people on air pollution was children and elders of Ulaanbaatar city.

Vitamina D y enfermedades respiratorias pediátricas / Vitamin D and pediatrics respiratory diseases

Resumen: El mejor entendimiento sobre la actividad global de la vitamina D, ha llevado a una intensa búsque da de sus implicancias en enfermedades no esqueléticas. En este artículo se presenta una revisión actualizada de la relación entre la vitamina D y la patología respiratoria pediátrica. Se realizó una búsqueda bibliográfica en PUBMED utilizando términos libres y MESH: vitamina D, enfermedades del sistema respiratorio, asma, bronquiolitis. Se seleccionó estudios en humanos menores de 18 años y animales, publicados en inglés y español hasta el 2017. Se encontraron 507 artículos, de los cuales se incluyeron 43. Evidencia indirecta apunta hacia un rol de la vitamina D y la maduración pulmonar fetal. En relación a la patología pulmonar pediátrica, los estudios son escasos y poco concluyentes. Nuevos meta - análisis, con evaluación individualizada de los participantes, muestran un importante rol protector de la suplementación en la prevención de exacerbaciones asmáticas severas e infecciones virales agudas. En bronquiolitis los resultados son contradictorios, sin relación clara entre niveles plasmáticos y severidad. No existe suficiente evidencia que evalué los beneficios en fibrosis quística y tuberculosis. Recientemente se ha propuesto una relación directa entre la severidad de los trastornos respiratorios del sueño y los niveles plasmáticos de vitamina D, aunque se desconoce los mecanismos exactos involucrados a esta asociación. La información actual permite suponer que la suplementación de vitamina D puede representar una estrategia costo - efectiva en la reducción de importantes causas de morbimortalidad infantil.

Abstract: The better understanding of the global activity of vitamin D has led to an intense search for its involvement in non-skeletal diseases. This article presents an updated review of the relationship between vitamin D and pediatric respiratory pathology. A literature search was performed in PUBMED using free terms and MESH terms: vitamin D, asthma, respiratory system diseases, and bronchiolitis. Stu dies in human patients younger than 18 years and animals, published in English and Spanish until 2017 were included. 507 articles were found, of which 43 were included. Indirect evidence suggests a role of vitamin D and fetal lung maturation. In relation to pediatric pulmonary pathology, studies are scarce and inconclusive. Recent meta-analyses performed with individualized evaluation of the participants shows an important protective role of vitamin D supplementation in the prevention of severe asthma exacerbations and acute viral infections. In bronchiolitis, the results are contradictory, with no clear relationship between plasma levels and severity. There is not enough evidence to assess the benefits of vitamin D supplementation in cystic fibrosis and tuberculosis. A direct relationship between the severity of sleep-related breathing disorders and vitamin D plasma levels has recently been proposed, although the exact mechanisms involved in this association are unknown. Current information suggests that vitamin D supplementation may represent a cost-effective strategy in redu cing important causes of infant morbidity and mortality.

Systematic Evaluation of the Effectiveness of Corbrin Capsules for Respiratory System Disease / 中国药房

OBJECTIVE:To evaluate the effectiveness of Corbrin capsules for respiratory systemdisease systematically,in or-der to provide evidence-based reference for clinical use. METHODS:Retrieved from CJFD,China Dissertation Database,Wanfang database,VIP,Cochrane Library,Medline and PubMed,randomized controlled trials(RCTs)about conventional treatment plan(trial group)vs. single treatment plan(control group)in the treatment of respiratory system disease. The quality of included studies were evaluated after extracting data and modifying according to Jadad scale and Cochrane bias risk assessment scale. Meta-analysis was performed by using RevMan 5.2 statistical software. RESULTS:A total of 17 RCTs were included,involving 1801 patients. The re-sults of Meta-analysis showed that response rate [RD=0.15,95%CI(0.10,0.19),P<0.001],FEV1[MD=0.21,95%CI(0.14,0.28), P<0.001],FVC [MD=0.26,95%CI(0.05,0.47),P<0.001] and FEV1/FEV [MD=5.60,95%CI(3.42,7.78),P<0.001] of trial group were significantly higher than those of control group,with statistical significance. CONCLUSIONS:Corbrin capsules have good therapeutic efficacy for respiratory system disease and effectively improve lung related indicators.

Therapeutic effect of Qingzao Runfei Huazhuo Xingxue decoction on PM2.5-induced respiratory disease in ;mice / 中华危重病急救医学

Objective To study the influence of Qingzao Runfei Huazhuo Xingxue decoction on pulmonary tissue and lung function in mouse model of lung injury induced by PM2.5, and to provide an idea of clinical prevention and treatment of respiratory diseases induced by PM2.5. Methods Totally 30 clean level male ICR mice were randomly divided into three groups: normal control group, model group and Qingzao Runfei Huazhuo Xingxue decoction intervention group, with 10 mice in each group. Model of PM2.5-induced respiratory disease in mice was reproduced by instilling nasal cavity drip PM2.5 suspension 40 mg/kg once a day for 6 weeks. In the treatment group, the mice were fed with the Qingzao Runfei Huazhuo Xingxue decoction twice a day from the 4th week of instilling PM2.5 suspension until the end of experiment. In the normal control group, the mice were fed as usual. At the end of the experiment, the total protein content in bronchoalveolar lavage fluid (BALF), and lung wet/dry weight (W/D) ratio was determined. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes in lung tissue under light microscope. The inflammatory mediators levels in lung tissue were determined by antibody-sandwich enzyme linked immunosorbent assay (ELISA). Results Respiratory system damage model was successfully reproduced by dripping of PM2.5 suspension in nasal cavity. Compared with normal control group, inflammatory changes and inflammatory cell infiltration in model group were significant, and lung W/D ratio (4.71±0.33 vs. 3.13±0.12), total protein content in BALF (mg/L: 363.98±18.24 vs. 82.13±12.78), tumor necrosis factor-α [TNF-α (ng/L): 185.72±0.23 vs. 31.03±0.16], interleukin-8 [IL-8 (ng/L): 531.85±37.83 vs. 72.64±16.72], and leukotriene B4 [LTB4 (ng/L): 931.74±48.64 vs. 483.81±41.74] in lung tissue were significantly increased (all P < 0.05). Compared with the model group, the inflammatory changes of lung tissue in Qingzao Runfei Huazhuo Xingxue decoction intervention group were significantly reduced, lung W/D ratio (3.92±0.41 vs. 4.71±0.33), total protein content in BALF (mg/L: 213.21±19.62 vs. 363.98±18.24), TNF-α (ng/L: 124.15±0.27 vs. 185.72±0.23), IL-8 (ng/L: 238.42±35.82 vs. 531.85±37.83) and LTB4 (ng/L: 582.85±31.00 vs. 931.74±48.64) levels in lung tissue in Qingzao Runfei Huazhuo Xingxue decoction intervention group were significantly decreased (all P < 0.05). Conclusion Qingzao Runfei Huazhuo Xingxue decoction can improve PM2.5-induced damage and pathological inflammatory changes in lung tissue, which provided some new ideas for the treatment of PM2.5-induced respiratory diseases.

Health impact assessment of ambient air pm2.5 and pm10 of Ulaanbaatar city / Монголын Анагаах Ухаан

Air pollution is an increasingly serious problem in Mongolia, especially in the capital city of Ulaanbaatar, Darkhan and several other urban areas.The goal:The goal of this study is to determine the relationships between air pollutants (PM10, PM2.5, NO2 and SO2) and meteorological parameters (average temperature, humidity, and wind speed) and respiratory and cardiovascular morbidity and mortality of all secondary level and tertiary level hospitals of Ulaanbaatar and 8 primary level hospitals. This is a cross sectional study using secondary air quality and hospital morbidity and mortality data.Material and Methods:Sampling unit is a total number morbidity of respiratory and cardiovascular diseases at the selected study hospitals, number of mortality of the selected II and III level hospitals. Data were collected during 1 year and 5 days or 370 days from 1 June 2008 to 5 of June 2009. Hospital morbidity and mortality admission data were obtained from each hospitals statistic department. Daily data of FGPs were collected manually by data collectors in accordance with scheduled date. Emergency data was also been obtained from the City emergency center.Results:The daily concentrations of PM10, PM2.5, SO2 and NO2 had exceeded the MNAAQS mainly in the winter months from November to February. The correlation mainly between respiratory and cardiovascular disease case admissions with meteorological parameters is because the cold winter conditions in Ulaanbaatar result in the accumulation of pollutants in the atmosphere. Thus, population exposure to air pollution is increase significantly during winter months. Based on recent study result, during winter 1 out of 2 diseases admission case of respiratory system disease caused due to average temperature, relative humidity, NO2, and PM10 and cardiovascular disease also caused due to relative humidity, NO2, and PM10 level. So thus, not only fuel based pollutants but also vehicle related pollutants and meteorological conditions also causing onset of cardiovascular and respiratory system disease. Children under 15 years old are more likely get admitted to the hospital due to respiratory system disease cases whereas cardiovascular disease admission more registered among older age group of people. In addition, residents of ger area are more visited to the FGPs than the residents of apartment area.Conclusions:1. The correlation mainly between respiratory and cardiovascular disease case admissions with meteorological parameters is because the cold winter conditions in Ulaanbaatar result in the accumulation of pollutants in the atmosphere.2. Population exposure to air pollution is increase significantly during winter months.3. During winter 1 out of 2 diseases of respiratory system disease caused due to average temperature, relative humidity, NO2, and PM10 and cardiovascular disease also caused due to relative humidity, NO2, and PM10 level.

The Study of Respiratory System Disease Morbidity and Mortality of Ulaanbaatar City Population / Монголын Анагаах Ухаан

This survey had conducted for determining respiratory system disease and mortality trend of Ulaanbaatar city population and for developing evidence based recommendations. In accordance with the methodology we had done meta-analysis and statistical analysis on data 2004-2008. For the data analysis we used SPSS and parametric and non-parametric tests were used for determining disease changes and differences of seasonal, age and gender. In recent 5 years, in Ulaanbaatar, respiratory system disease cases are continuously leading 5 leading causes of disease. In 2008, respiratory system disease cases were 865.0 per 10000 populations and it is compare to 2004 increased by 10-30 percent. Children and women are more tend to attend to hospitals due to diseases cases. The survey also revealed that incidence of pneumonia (116.7-145.8 per 10000 populations) was the most visited case from other ICD10 causes of diseases.The mean age of mortality of respiratory system disease was 36.6±31.8 and the oldest age was 101 and the youngest was under 1 year old during 2004-2008 in Ulaanbaatar. During spring season, acute respiratory system disease, chronic bronchitis pneumonia and others respiratory system disease cases were more admitted from the respiratory system disease. Whereas, during autumn season, emphysema, during winter season bronchitis were the leading causes of respiratory system disease admission (x2=33.779, p=0.013).CONCLUSION: The statistics, 2004-2008 in Ulaanbaatar, were showing respiratory system disease trend constantly and continuously increasing. Age, gender and seasonal characteristics were signifi cantly correlated with the respiratory system disease. During these 5 years, 932 deaths were recorded and mean age of dying was 36.6±31.8.