Association between temperature and mortality: a multi-city time series study in Sichuan Basin, southwest China

BACKGROUND@#There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden.@*METHODS@#Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status.@*RESULTS@#A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status.@*CONCLUSIONS@#Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.

Verification of accuracy of warfarin stable dose prediction models in Shandong population / 中华医学遗传学杂志

OBJECTIVE@#To compare the accuracy of five warfarin-dosing algorithms and warfarin stable dose model (2.5 mg/day) for Shandong population.@*METHODS@#One hundred and twenty five patients who achieved stable warfarin dose were enrolled. Clinical and genetic data were used to evaluate the value of each algorithm by calculating the percentage of patients whose predicted warfarin dose was within 20% of the actual stable therapeutic dose and mean absolute error (MAE).@*RESULTS@#The frequency of patients with CYP2C9*1/*1, CYP2C9*1/*3 and CYP2C9*1/*2 genotype was 92.00%, 7.20%, 0.80%, respectively. That of VKORC1-1639 AA, AG and GG genotype was 82.40%, 15.20%, 2.40%, respectively. CYP4F2*1/*1, *1/*3, *3/*3 genotype was 50.40%, 39.20%, 10.40%, respectively. With the same genotypes for other loci, patients who carried at least one VKORC1-16398G mutant allele had increased warfarin stable daily dose compared with VKORC1-1639AA. Compared with CYP4F2*1/*1, those carrying at least one CYP4F2*3 mutant allele had warfarin stable daily dose increased by 5.9%-13.00%. The percentage of ideal prediction calculated from IWPC model (59.20%), Huang model (57.60%) and Ohno model (52.80%) were higher than others. The MAE were 0.35 (95%CI: 0.11-0.49), 0.15 (95%CI: 0.10-0.32), 0.39 (95%CI: 0.12-0.51), respectively.@*CONCLUSION@#The polymorphisms of CYP2C9, VKORC1 and CYP4F2 genes can influence the stable dose of warfarin in Shandong population. IWPC algorithm is suitable for guiding the use of warfarin in this population.

Association between gaseous pollutants and emergency ambulance dispatches for asthma in Chengdu, China: a time-stratified case-crossover study

OBJECTIVES@#The association between concentrations of sulfur dioxide (SO), nitrogen dioxide (NO), carbon monoxide (CO), ozone (O), and emergency ambulance dispatches (EADs) for asthma was explored in the central Sichuan Basin of southwestern China for the first time.@*METHODS@#EADs for asthma were collected from the Chengdu First-Aid Command Center. Pollutant concentrations were collected from 24 municipal environmental monitoring centers and including SO, NO, CO, daily 8-h mean concentrations of O (O-8 h), and particulate matter less than 2.5 μm in aerodynamic diameter (PM). The climatic data were collected from the Chengdu Municipal Meteorological Bureau. All data were collected from years spanning 2013-2017. A time-stratified case-crossover design was used to analyze the data.@*RESULTS@#After controlling for temperature, relative humidity, and atmospheric pressure, IQR increases in SO (13 μg/m), NO (17 μg/m), and CO (498 μg/m) were associated with 18.8%, 11.5%, and 3.1% increases in EADs for asthma, respectively. The associations were strongest for EADs and SO, NO, and CO levels with 3-, 5-, and 1-day lags, respectively.@*CONCLUSIONS@#This study provides additional data to the limited body of literature for potential health risks arising from ambient gaseous pollutants. The results of the study suggest that increased concentrations of SO, NO, and CO were positively associated with emergency ambulance dispatches for asthma in Chengdu, China. Further studies are needed to investigate the effects of individual air pollutants on asthma.

Monitoring on main hygiene indicators before and after clean operating rooms are used / 中国感染控制杂志

Objective To compare the main hygiene indicators before and after clean operating rooms are used,evaluate the influencing factors,and find out the improvement measures.Methods In 2015,some cleaning operating rooms in Chengdu were detected,according to different service years and maintenance status,operating rooms were divided into newly-built group,replacement group,and non-replacement group,change in qualified rate of three groups of clean operating room indicators were analyzed.Results A total of 111 cleaning operating rooms were detected,including 56 newly-built operating rooms,and 55 operating rooms (24 in replacement group,31 in non-replacement group) which have been used for more than 1 years.The qualified rate of air cleanliness in newlybuilt group,replacement group,and non-replacement group were 98.21％,100.00％,and 74.19％ respectively,difference among three groups was significantly(P＜0.001),the qualified rate of air cleanliness in newly-built group and replacement group were both higher than non-replacement group,while newly-built group and replacement group was not significantly different (P =1.000);difference in bacterial concentration,static pressure difference,and ventilation frequency of air in operating rooms of three groups were all not statistically significant(all P＞0.05).Conclusion After clean operating room have been used for one year,air cleanliness declined,there was no significant change in static pressure difference and air exchange frequency,which indicates that when concentration of airborne bacteria is qualified,risk of infection due to unqualified air cleanliness still needs to be paid attention,the replacement of high efficiency particulate air filter in clean operating rooms can significantly improve the cleanliness of operating rooms.

Relationship between Quantity of Alcohol Intake and Blood Pressure / 中国慢性病预防与控制

Objective To explore the association between the daily intake of alcohol and blood pressure in Chinese.Methods With the baseline data of the Qingdao Port Health Study,all subjects aged 18 to 54 yrs including all in-service and retired employees in Qingdao port were selected and divided into seven groups according to their daily intake of alcohol: groups of 0,0～,5～,10～,20～,40～ and 60～g alcohol/d,also stratified by ages.The amount of alcohol intake was assessed by a questionnaire.The cross-sectional association between blood pressure and intakes of alcohol was analyzed with general linear model and Logistic regression.Results In the groups of 25～34,35～44,45～54 yrs old both before and after adjustment,systolic and diastolic blood pressure were linearly increased with the amount of alcohol intake from the 0 g/d group to 60～g/d group.In the group of 18～24 yrs old,there was no obvious relationship between BP and alcohol intake.Logistic regression model showed that odds ratios in the groups of 0～g/d,5～g/d,10～g/d,20～g/d,40～g/d and 60～g/d versus the abstainers was 1.05,1.14,1.08,1.24,1.30 and 2.02,respectively,and the prevalence of hypertension in the 20～g/d group was significantly higher than that in the 0 g/d group and groups of low or moderate alcohol intake.Conclusion An increasing and linear relationship between alcohol consumption and blood pressure was established,and alcohol intake ≥20 g /d is an independent risk factor for hypertension.