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Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO2, NO2, CO, PM2.5, PM10, and maximum 8 h O3 concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM2.5, NO2, SO2, and O3 were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM2.5, NO2, SO2 and O3 were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.
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Objective To analyze the epidemiological characteristics of temporal-spatial distribution on varicella in Guangxi Zhuang Autonomous Region (Guangxi) during 2014 to 2016.Methods Incidence data on varicella was collected from the National Notifiable Infectious Disease Reporting Information System (NNIDRIS) of the Center for Disease Control and Prevention (CDC)while geographic information data was from the national CDC.ArcGIS 10.2 software was used to analyze global and local spatial auto correlation on spatial clusters.SaTScan v9.1.1 was used to conduct temporal-spatial scan for exploring the areas of temporal-spatial clusters.Results The overall incidence rates of varicella during 2014 to 2016 were 32.48/100 000,43.56/100 000 and 61.56/100 000 respectively.Incidence of varicella showed a positive spatial auto correlation at the county level (the value of Moran's I was between 0.24 to 0.35,P＜0.01),with consistent high morbidity.High-high cluster areas were seen and mainly concentrated in the north-western areas of Guangxi.Result from the temporal-spatial scan showed that temporal cluster of varicella occurred mainly between October and next January while the type I cluster area was mainly distributed in all of the counties in Hechi city and most counties of Baise city,with most counties being covered in the north-western areas of Guangxi,during 2014-2016.When comparing to data from the last two years,two type Ⅱ cluster areas with larger scales were formed in the north-eastern area of Guanyang county and Haicheng county of southem area in Guangxi,in 2016.Conclusions Incidence on Varicella seemed on the rise,and the distribution of cases showed clustered features,both on time and space.Strategies regarding control and prevention on Varicella should focus on high-high clustered areas,namely north-western areas of the province,including surrounding areas during the high onset season.
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Objective To analyze the influencing factors on condom use among 35-yearsor-older female sex workers (OFSWs) in Qingdao by using the three-level logistic model.Methods From March to June 2014,OFSWs were recruited in Qingdao,using respondent-driven sampling.Related information on OFSWs and their recent five sexual partners (not including husband) were obtained by conducting a questionnaire survey on OFSWs.A Three-level logistic regression model was conducted to analyze the influencing factors of condom use between OFSWs and their sexual partners.Results A total of 420 OFSWs participated the survey as well as information on 2 100 sexual partners.Results from the empty model showed that the use of condoms among OFSWs having an aggregation that related to the levels of working sites and their own behaviors.Results from the three-levels of logistic model analysis showed that,OFSWs that having had junior middle school education (OR=1.450,95％CI:1.054-1.994)/high school education or above (OR=2.264,95％ CI:1.215-4.222),knowing the function of condom use (OR=2.004,95％ CI:1.273-3.154) would have higher rates of condom use.OFSWs with higher score of attitude on condom use (OR=0.796,95％CI:0.745-0.849),having had syphilis infections in the past (OR=0.657,95％ CI:0.478-0.902) would have lower rate of condom use.For the sexual partners,the rate of condom use among OFSWs' regular partners were higher than that of OFSWs' boyfriends (OR=15.291,95％CI:8.441-27.700;OR=29.032,95％ CI:15.413-54.682).Conclusion Condom use of OFSWs was affected by behaviors of both OFSWs themselves and their sexual partners.Prevention and control programs should focus on OFSWs and their sexual partners at the same time.The key intervention contents should include target populations as:OFSWs with low level of education,having had infections of syphilis,those who do not use condoms with their trusted partners.
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Objective To analyze the epidemiological characteristics of temporal-spatial distribution on varicella in Guangxi Zhuang Autonomous Region (Guangxi) during 2014 to 2016.Methods Incidence data on varicella was collected from the National Notifiable Infectious Disease Reporting Information System (NNIDRIS) of the Center for Disease Control and Prevention (CDC)while geographic information data was from the national CDC.ArcGIS 10.2 software was used to analyze global and local spatial auto correlation on spatial clusters.SaTScan v9.1.1 was used to conduct temporal-spatial scan for exploring the areas of temporal-spatial clusters.Results The overall incidence rates of varicella during 2014 to 2016 were 32.48/100 000,43.56/100 000 and 61.56/100 000 respectively.Incidence of varicella showed a positive spatial auto correlation at the county level (the value of Moran's I was between 0.24 to 0.35,P＜0.01),with consistent high morbidity.High-high cluster areas were seen and mainly concentrated in the north-western areas of Guangxi.Result from the temporal-spatial scan showed that temporal cluster of varicella occurred mainly between October and next January while the type I cluster area was mainly distributed in all of the counties in Hechi city and most counties of Baise city,with most counties being covered in the north-western areas of Guangxi,during 2014-2016.When comparing to data from the last two years,two type Ⅱ cluster areas with larger scales were formed in the north-eastern area of Guanyang county and Haicheng county of southem area in Guangxi,in 2016.Conclusions Incidence on Varicella seemed on the rise,and the distribution of cases showed clustered features,both on time and space.Strategies regarding control and prevention on Varicella should focus on high-high clustered areas,namely north-western areas of the province,including surrounding areas during the high onset season.
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Objective To analyze the influencing factors on condom use among 35-yearsor-older female sex workers (OFSWs) in Qingdao by using the three-level logistic model.Methods From March to June 2014,OFSWs were recruited in Qingdao,using respondent-driven sampling.Related information on OFSWs and their recent five sexual partners (not including husband) were obtained by conducting a questionnaire survey on OFSWs.A Three-level logistic regression model was conducted to analyze the influencing factors of condom use between OFSWs and their sexual partners.Results A total of 420 OFSWs participated the survey as well as information on 2 100 sexual partners.Results from the empty model showed that the use of condoms among OFSWs having an aggregation that related to the levels of working sites and their own behaviors.Results from the three-levels of logistic model analysis showed that,OFSWs that having had junior middle school education (OR=1.450,95％CI:1.054-1.994)/high school education or above (OR=2.264,95％ CI:1.215-4.222),knowing the function of condom use (OR=2.004,95％ CI:1.273-3.154) would have higher rates of condom use.OFSWs with higher score of attitude on condom use (OR=0.796,95％CI:0.745-0.849),having had syphilis infections in the past (OR=0.657,95％ CI:0.478-0.902) would have lower rate of condom use.For the sexual partners,the rate of condom use among OFSWs' regular partners were higher than that of OFSWs' boyfriends (OR=15.291,95％CI:8.441-27.700;OR=29.032,95％ CI:15.413-54.682).Conclusion Condom use of OFSWs was affected by behaviors of both OFSWs themselves and their sexual partners.Prevention and control programs should focus on OFSWs and their sexual partners at the same time.The key intervention contents should include target populations as:OFSWs with low level of education,having had infections of syphilis,those who do not use condoms with their trusted partners.
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Objective To understand the influence of floods on bacillary dysentery in Liaoning province.Methods The monthly surveillance data of bacillary dysentery,floods,meteorological and demographic data in Liaoning from 2004 to 2010 were collected.Panel Poisson regression analysis was conducted to evaluate the influence of floods on the incidence of bacillary dysentery in Liaoning.Results The mean monthly morbidity of bacillary dysentery was 2.17 per 100 000 during the study period,the bacillary dysentery cases mainly occurred in during July-September.Spearman correlation analysis showed that no lagged effect was detected in the influence of floods on the incidence of bacillary dysentery.After adjusting the influence of meteorological factors,panel data analysis showed that the influence of floods on the incidence of bacillary dysentery existed and the incidence rate ratio was 1.439 4 (95％CI:1.408 1-1.471 4).Conclusion Floods could significantly increase the risk of bacillary dysentery for population in Liaoning.
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Objective To understand the influence of floods on bacillary dysentery in Liaoning province.Methods The monthly surveillance data of bacillary dysentery,floods,meteorological and demographic data in Liaoning from 2004 to 2010 were collected.Panel Poisson regression analysis was conducted to evaluate the influence of floods on the incidence of bacillary dysentery in Liaoning.Results The mean monthly morbidity of bacillary dysentery was 2.17 per 100 000 during the study period,the bacillary dysentery cases mainly occurred in during July-September.Spearman correlation analysis showed that no lagged effect was detected in the influence of floods on the incidence of bacillary dysentery.After adjusting the influence of meteorological factors,panel data analysis showed that the influence of floods on the incidence of bacillary dysentery existed and the incidence rate ratio was 1.439 4 (95％CI:1.408 1-1.471 4).Conclusion Floods could significantly increase the risk of bacillary dysentery for population in Liaoning.
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[Objective] To observe the effect of Zhuyun Decoction on immune sterility rats.[Method] Set up groups of normal saline,model,Zhuyun Decoction and prednisone,make models of every group by injecting subcutaneously suspension of sperm and Fu's adjuvant,etc.into female SD rats along the groin,NS into normal saline group.After 4 weeks,the groups of normal saline and model take NS,Zhuyun Decoction for Zhuyun Decoction group,prednisone for prednisone group.After 2 weeks,they are closed together with male ones.Before the first immune and 1 week after strengthened immune,take blood and measure AsAb with ELISA method,measure the immune integral of IgG and IgA in uterus tunica intima with SABC method;meanwhile,compare the pregnant rats and average nidation points in all groups.[Result] In the Zhuyun Decoction group,the pregnant rats and nidation points are much more that other groups;Zhuyun Decoction can reduce IgG and IgA integral in uterus tunica intima.[Conslusion] Zhuyun Decoction has definite effect on immune sterility rats,whose mechanism may be related with regulation of IgG and IgA integral in uterus tunica intima.
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Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered. Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7%) while in the later, 4 (80%) died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Abdome , Síndromes Compartimentais , Diagnóstico , Cirurgia Geral , Descompressão Cirúrgica , Insuficiência de Múltiplos Órgãos , Diagnóstico , Cirurgia Geral , Pancreatite Necrosante Aguda , Diagnóstico , Cirurgia GeralRESUMO
Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered. Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7%) while in the later, 4 (80%) died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.