Can environmental policies improve marine ecological efficiency? Examining China's Ecological Civilization Pilot Zones.

Terrestrial ecosystems can benefit from environmental protection policies; however, their impact on marine ecological efficiency deserves further exploration. This study uses China's Ecological Civilization Pilot Zone (ECZ) policy as an example of a quasi-natural experimental study, with data from 11 coastal provinces in China from 2006 to 2019 as the initial sample. First, a Super-SBM model considers undesired outputs to measure marine eco-efficiency, while a synthetic control method (SCM) investigates the effect of environmental regulations on marine eco-efficiency. The results show that ECZ policies can promote marine eco-efficiency and the effect mechanisms of these policies are discussed from national and regional perspectives. This study contributes to the current literature by theoretically evaluating the impact of ECZ policies on the marine environment in coastal areas, enriching the mechanism of integrated environmental policies on marine ecological protection, and providing references for formulating and implementing environmental policies.

A Nomogram Prediction Model Based on Tissue Window for the Prognosis of Patients with Acute Ischemic Stroke Undergoing Thrombectomy.

OBJECTIVE: Thrombectomy greatly improves the clinical prognosis of patients with acute ischemic stroke (AIS). The aim of this study is to develop a nomogram model that can predict the prognosis of patients with acute ischemic stroke undergoing thrombectomy. METHODS: We retrospectively collected information of patients with acute ischemic stroke who were admitted to the stroke Green Channel of the First Affiliated Hospital of Soochow University from September 2018 to May 2022. The main outcome was defined as a three-month unfavorable outcome (modified Rankin Scale 3-6). Based on the results of multivariate regression analysis, a nomogram was established. We tested the accuracy and discrimination of our nomogram by calculating the consistency index (C-index) and plotting the calibration curve. RESULTS: National Institutes of Health Stroke Scale (NIHSS) score (OR, 1.418; 95% CI, 1.177-1.707; P＜0.001), low density lipoprotein cholesterol (LDL-C) (OR, 2.705; 95% CI, 1.203-6.080; P = 0.016), Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (OR, 0.633; 95% CI, 0.421-0.952; P = 0.028), infarct core volume (OR, 1.115; 95% CI, 1.043-1.192; P = 0.001) and ischemic penumbra volume (OR, 1.028; 95% CI, 1.006-1.050; P = 0.012) were independent risk factors for poor clinical prognosis of AIS patients treated with thrombectomy. The C-index of our nomogram was 0.967 and the calibration plot revealed a generally fit in predicting three-month unfavorable outcomes. Based on this nomogram, we stratified the risk of thrombectomy population. We found that low-risk population is less than or equal to 65 points, and patients of more than 65 points tend to have a poor clinical prognosis. CONCLUSION: The nomogram, composed of NIHSS, LDL-C, ASPECTS, infarct core volume and ischemic penumbra volume, may predict the clinical prognosis of cerebral infarction patients treated with thrombectomy.

[Effect of Diurnal Temperature Range on the Number of Residents Hospitalized Due to Stroke in Lanzhou].

Objective To analyze the relationship between diurnal temperature range (DTR) and the hospitalization of stroke in Lanzhou,so as to provide a scientific basis for probing into the mechanism of temperature changes in inducing stroke and formulating comprehensive prevention and control measures for stroke by relevant departments.Methods The information of the patients hospitalized due to stroke in Lanzhou during January 2014 to December 2019 and the air pollutants (PM10,SO2,and NO2) and meteorological data in the same period were collected for statistical analysis.Spearman rank correlation analysis was performed to analyze the correlations between air pollutants and meteorological factors.The distributed lag nonlinear model was adopted to fit the relationship between DTR and the number of stroke inpatients,and three-dimensional diagrams and the correlation diagrams of DTR against stroke risk were established.The stratified analysis was performed according to gender and age (< 65 years and ≥65 years).Results From 2014 to 2019,a total of 92 812 stroke patients were hospitalized in Lanzhou,with a male-to-female ratio of 1.35:1.There was a nonlinear relationship between DTR and the number of stroke inpatients in Lanzhou,which presented a lag effect.The low DTR at 4.5 ℃ had the largest RR value of 1.25 (95%CI=1.16-1.35) for stroke inpatients at a cumulative lag of 18 d.The effect of high DTR (18.5 ℃) on the hospitalization of stroke patients peaked at a cumulative lag of 21 d,with an RR value of 1.09 (95%CI=1.01-1.18).The stratified analysis results suggested that low levels of DTR had greater effects on the hospitalization of male stroke patients and stroke patients <65 years.Conclusions Short-term exposure to different levels of DTR had an impact on the number of stroke inpatients,and low levels of DTR had a slightly greater impact on stroke inpatients than high levels of DTR.Importance should be attached to the protection of males and people aged <65 years at low levels of DTR.

Characteristics of symptomatic plaque on high-resolution magnetic resonance imaging and its relationship with the occurrence and recurrence of ischemic stroke.

BACKGROUND: Atherosclerosis is the most common cause of ischemia stroke. Computed tomographic angiography (CTA) and digital subtraction angiography (DSA) are used to evaluate the degree of lumen stenosis. However, these examinations are invasive and can only reveal mild to moderate stenosis. High-resolution magnetic resonance imaging (HRMRI) seems a more intuitive way to show the pathological changes of vascular wall. Hence, we conducted a systematic retrospective study to determine the characteristics of symptomatic plaques in patients with intracranial atherosclerosis on HRMRI and their association with the occurrence and recurrence of ischemic stroke events. METHODS: The PubMed database was searched for relevant studies reported from January 31, 2010, to October 31, 2020. RESULTS: We selected 14 clinical outcome studies. We found that plaque enhancement and positive remodeling on HRMRI indicate symptomatic plaques. Besides, intraplaque hemorrhage and positive remodeling index are closely related to the occurrence of stroke. However, it is still controversial whether the initial enhancement of plaque and the occurrence and recurrence of stroke are related. There is also no significant correlation between vascular stenosis and symptomatic plaque or the occurrence and recurrence of ischemic stroke. CONCLUSION: High-resolution magnetic resonance imaging can be used as an assessment tool to predict the risk of stroke onset and recurrence in patients with atherosclerosis, but further research is also needed.

[Clinical observation on warming-promotion acupuncture for lumbar muscle strain].

OBJECTIVE: To observe the theraputic effect of warming-promotion acupuncture for lumbar muscle strain. METHODS: Sixty-four cases were randomly divided into a warming-promotion acupuncture group(group A) and a routine acupuncture group (group B), 32 cases in each group. The group A was treated with acupuncture at Shenshu (BL 23) and Guanyuanshu (BL 26) with warming-promotion acupuncture method, (Guanyuanshu (BL 26), Yaoyangguan (GV 3), Weizhong (BL 40) with twirling uniform reinforcing-reducing method. The group B was treated with acupuncture at same acupoints only with twirling uniform reinforcing-reducing method. After four-session treatment, the theraputic effect of two groups was compared. RESULTS: The cured and markedly effective rate of 65.6% (21/32) in the group A, which was superior to that of 40.6% (13/32)in the group B (P < 0.05). CONCLUSION: The efficiency on lumbar muscle strain treated with warming-promotion acupuncture is superior to that with routine acupuncture, means a suitable manipulation can enhance the therapeutic effect.

[Observation on therapeutic effect of acupuncture at point "Xiajiquan" on muscular strength of finger after apoplexy].

OBJECTIVE: To approach to the best therapy for recovery of fingers function after apoplexy. METHODS; One hundred and twenty-three cases were randomly divided into an observation group of 63 cases and a control group of 60 cases. The control group were treated by acupuncture at Quchi (LI 11), Shousanli ( LI 10), Waiguan (TE 5), etc., and the observation group by acupuncture at point "Xiajiquan" besides the acupoints for the control group. After treatment of 10 sessions, the therapeutic effects were assessed. RESULTS: The cured and markedly effective rate was 74.6% in the observation group and 40.0% in the control group, the observation group being significantly better than the control group (P < 0.05). CONCLUSION: Point "Xiajiquan" has a better therapeutic effect on derivation of finger muscular strength.