Temporal variations and trends prediction of water quality during 2010-2019 in the middle Yangtze River, China.

Water quality plays an important role in river habitats. This study revealed the annual and seasonal variations and trend prediction of water quality in the middle Yangtze River after the third impoundment stage of the Three Gorges Reservoir. Multivariate statistical methods including principal component analysis/factor analysis (PCA/FA), Mann-Kendall (M-K) tests, discriminant analysis (DA), rescaled range (R/S) analysis, and the Canadian Council of Ministers of the Environment Water Quality Index (CCME-WQI) were used. Herein, eight water quality constituents including pH, electrical conductivity (EC), chloride (Cl), dissolved oxygen (DO), ammonia nitrogen (NH3N), total phosphorus (TP), water temperature (T), and permanganate index (CODmn) were monthly monitored in the Jiujiang hydrological transaction during 2010-2019. The information of eight water quality constituents, related to salinity, nutrient status, and oxidation reactions efficiency, was extracted. Water quality status remained as fair-good during 2010-2019 based on the results of CCME-WQI, with the seasonal significance ranked as T > DO > Cl > pH > EC > TP > NH3N > CODmn. In the future decade, annual average T was predicted to continue to increase although it might decrease in the wet season. EC was predicted to continue increasing annually especially in the wet season while Cl might decrease. NH3N and TP might maintain a significant decreasing trend in the future wet and dry seasons. DO maintained significantly increasing especially in the future dry seasons, whereas CODmn will continue to decrease annually and seasonally. The continued alkalization trend of waterbody was predicted, which is more significant in the wet season. The results provide helpful references for the ecological protection of the middle Yangtze River.

The effects of magnesium sulfate therapy after severe diffuse axonal injury.

PURPOSE: To evaluate the clinical effects of magnesium sulfate in the treatment of diffuse axonal injury (DAI). PATIENTS AND METHODS: This study was a randomized, double-blind, placebo-controlled trial conducted in the First Affiliated Hospital of Sun Yat-sen University, Guangzhou and Zhuhai People's Hospital, Zhuhai, two trauma center hospitals. A total of 128 patients suffered from DAI, with initial Glasgow coma scale (GCS) scores of 3-8. They were randomly divided into two groups: magnesium sulfate treatment (MST) group (n=64) and control group (n=64). The MST group received 250 µmol/kg magnesium sulfate intravenously 20 minutes after admission, followed by 750 µmol/kg magnesium sulfate intravenously daily for 5 days. The control group received standard management without MST. GCS scores and serum neuron-specific enolase values were measured and recorded at admission, and on days 3 and 7 after injury. Outcomes were determined by Glasgow outcome scale scores at discharge and at 3 months' follow-up, respectively. RESULTS: After the 7-day treatment, patients in the MST group, compared with those in the control group, had a lower serum neuron-specific enolase level (25.40±6.66 vs 29.58±7.32, respectively, P=0.001) and higher GCS score (8.23±2.72 vs 7.05±2.64, respectively, P=0.016). Although the length of stay and mortality did not differ between the groups in the intensive care unit, Glasgow outcome scale score was significantly lower in the MST group at discharge (3.30±1.35 vs 3.90±1.10, P=0.004) and 3 months after discharge (2.95±1.48 vs 3.66±1.44, P=0.009). CONCLUSION: Early treatment with magnesium sulfate resulted in a significant improvement in DAI outcome. Further studies are needed to confirm the clinical significance of treatment of DAI patients with magnesium sulfate.

Soluble receptor for advanced glycation end products in critically ill patients and its associations with other clinical markers and 28-day mortality.

PURPOSE: To investigate the possible associations between serum levels of soluble receptor for advanced glycation end products (sRAGE) and specific clinical markers and prognosis in critically ill patients diagnosed with stress hyperglycemia. PATIENTS AND METHODS: A total of 70 critically ill patients and 25 normal controls were recruited for this study. Serum levels of sRAGE and advanced glycation end products (AGEs) were determined using enzyme-linked immunosorbent assay. Additional data on other clinical markers were obtained from patient records in the intensive care unit. Comparisons of sRAGE and AGEs levels between groups were assessed by t-test. The relationships between sRAGE and other clinical markers were assessed by Pearson's correlation analyses and multiple linear regression analyses. Risk factors for prognosis, such as 28-day mortality were analyzed using logistic regression analysis. RESULTS: Serum sRAGE and AGEs levels were significantly higher in critically ill patients, compared to normal controls (P<0.05). The increase in serum sRAGE levels was significantly correlated with AGEs levels, interleukin-6 levels, and the sequential organ failure assessment score (P<0.01). Using multiple linear regression analysis, the association between AGEs and sRAGE remained significant after adjustment of other clinical factors. However, there were no significant correlations between sRAGE levels and patient outcome in these critically ill patients. CONCLUSION: Serum sRAGE levels were significantly elevated in critically ill patients and positively correlated with higher AGEs levels, but sRAGE levels were not associated with increased mortality, suggesting sRAGE levels are not a predictor of prognosis in critically ill patients.

[Impact of metabolic syndrome on cardio-cerebral vascular events in pre-hypertensive population].

OBJECTIVE: This study investigated the impact of metabolic syndrome on the development of cardio-cerebral vascular (CVD) events in a pre-hypertensive population. METHODS: The data used in this prospective study was derived from the Kailuan study cohort (n = 101 510). Prehypertension was diagnosed in 29 968 (mean age: 50 ± 9 years and 23 744 males) individuals by the JNC VII criteria and these subjects were further classified into metabolic syndrome positive (MS+, n = 3447) and MS negative (MS-, n = 26 521) groups according to the modified 2004 Chinese Diabetes Society criteria. Subjects were followed up for 38 - 53 (mean 47 ± 5) months and first-ever CVD events were recorded. Baseline anthropometric and laboratory features were obtained by physical examination from June 2006 to October 2007 and the last follow-up day was December 31, 2010. Multivariable Cox proportional hazards regression models were used to analyze the risk factors of first-ever CVD events. RESULTS: There were 354 CVD events during follow up. The incidences of CVD events (1.80% vs. 1.28%) and cerebral infarction (1.10% vs. 0.57%) were significantly higher in the MS+ group than in the MS- group (all P < 0.05). After adjustment for other established CVD risk factors, the hazards ratio was 1.45 (95%CI: 1.10 - 1.92) for total CVD events and 1.84 (95%CI: 1.27 - 2.67) for cerebral infarction events in MS+ group. CONCLUSIONS: In this cohort, metabolic syndrome is linked with increased risk for CVD events.