ABSTRACT
Background: Traumatic spinal cord injuries (TSCIs) are worldwide public health problems that are difficult to cure and impose a substantial economic burden on society. There has been a lack of extensive multicenter review of TSCI epidemiology in northwest China during the Corona Virus Disease 2019 (COVID-19) pandemic. Method: A multicenter retrospective study of 14 selected hospitals in two provinces in northwest China was conducted on patients admitted for TSCI between 2017 and 2020. Variables assessed included patient demographics, etiology, segmental distribution, treatment, waiting time for treatment, and outcomes. Results: The number of patients with TSCI showed an increasing trend from 2017 to 2019, while there were 12.8% fewer patients in 2020 than in 2019. The male-to-female ratio was 3.67:1, and the mean age was 48 ± 14.9â years. The primary cause of TSCI was high falls (38.8%), slip falls/low falls (27.7%), traffic accidents (23.9%), sports (2.6%), and other factors (7.0%). The segmental distribution showed a bimodal pattern, peak segments were C6 and L1 vertebra, L1 (14.7%), T12 (8.2%), and C6 (8.2%) were the most frequently injured segments. In terms of severity, incomplete injury (72.8%) occurred more often than complete injury (27.2%). The American Spinal Injury Association impairment scale of most patients did not convert before and after treatment in the operational group (71.6%) or the conservative group (80.6%). A total of 975 patients (37.2%) from urban and 1,646 patients (62.8%) from rural areas were included; almost all urban residents could rush to get treatment after being injured immediately (<1â h), whereas most rural patients get the treatment needed 4-7â h after injury. The rough annual incidence from 2017 to 2020 is 112.4, 143.4, 152.2, and 132.6 per million people, calculated by the coverage rate of the population of the sampling hospital. Conclusion: The incidence of TSCI in northwest China is high and on the rise. However, due to pandemic policy reasons, the incidence of urban residents decreased in 2020. The promotion of online work may be an effective primary prevention measure for traumatic diseases. Also, because of the further distance from the good conditional hospital, rural patients need to spend more time there, and the timely treatment of patients from remote areas should be paid attention to.
ABSTRACT
In recent years, air pollution has become a serious threat, causing adverse health effects and millions of premature deaths in China. This study examines the spatial-temporal characteristics of ambient air quality in five provinces (Shaanxi (SN), Xinjiang (XJ), Gansu (GS), Ningxia (NX), and Qinghai (QH)) of northwest China (NWC) from January 2015 to December 2018. For this purpose, surface-level aerosol pollutants, including particulate matter (PMx, x = 2.5 and 10) and gaseous pollutants (sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O-3)) were obtained from China National Environmental Monitoring Center (CNEMC). The results showed that fine particulate matter (PM2.5), coarse particulate matter (PM10), SO2, NO2, and CO decreased by 28.2%, 32.7%, 41.9%, 6.2%, and 27.3%, respectively, while O-3 increased by 3.96% in NWC during 2018 as compared with 2015. The particulate matter (PM2.5 and PM10) levels exceeded the Chinese Ambient Air Quality Standards (CAAQS) Grade II standards as well as the WHO recommended Air Quality Guidelines, while SO2 and NO2 complied with the CAAQS Grade II standards in NWC. In addition, the average air quality index (AQI), calculated from ground-based data, improved by 21.3%, the proportion of air quality Class I (0-50) improved by 114.1%, and the number of pollution days decreased by 61.8% in NWC. All the pollutants' (except ozone) AQI and PM2.5/PM10 ratios showed the highest pollution levels in winter and lowest in summer. AQI was strongly positively correlated with PM2.5, PM10, SO2, NO2, and CO, while negatively correlated with O-3. PM10 was the primary pollutant, followed by O-3, PM2.5, NO2, CO, and SO2, with different spatial and temporal variations. The proportion of days with PM2.5, PM10, SO2, and CO as the primary pollutants decreased but increased for NO2 and O-3. This study provides useful information and a valuable reference for future research on air quality in northwest China.