Advances in the potential of nebulized inhalation for the treatment of pulmonary arterial hypertension.

Pulmonary hypertension is a pathophysiologic manifestation of a heterogeneous group of diseases, with the main pathophysiologic mechanisms being persistent pulmonary vasoconstriction and irreversible vascular remodeling. The impact significantly affects the prognosis of patients with pulmonary hypertension. If it is not treated and intervened in time, it may lead to right ventricular failure and further endanger the patient's life. Within the past decade or so, nebulized inhalation therapy is considered to have advantages in the treatment of pulmonary hypertension as a safe, limited, and rapid therapy, for example, inhaled vasodilators (prostate analogs, nitroglycerin, carbon monoxide analogs sildenafil, and nitroprusside), inhaled anti-inflammatory and antiproliferative agents (simvastatin, and selatinib), and inhaled peroxides (levocetirizine) have been recognized as emerging therapeutic approaches in the treatment of pulmonary hypertension as emerging therapeutic approaches. Therefore, this article provides a brief review of recent advances in the potential of nebulized inhaled vasodilators, anti-inflammatory and antiproliferative agents, and anti-peroxides for the treatment of pulmonary hypertension, with the aim of providing different therapeutic options for the treatment of pulmonary hypertension, enhancing the quality of survival, alleviating symptoms, and improving the prognosis of patients with this condition.

Cuproptosis-Related LncRNA-Based Prediction of the Prognosis and Immunotherapy Response in Papillary Renal Cell Carcinoma.

Cuproptosis, a new cell death pattern, is promising as an intervention target to treat tumors. Abnormal long non-coding RNA (lncRNA) expression is closely associated with the occurrence and development of papillary renal cell carcinoma (pRCC). However, cuproptosis-related lncRNAs (CRLs) remain largely unknown as prognostic markers for pRCC. We aimed to forecast the prognosis of pRCC patients by constructing models according to CRLs and to examine the correlation between the signatures and the inflammatory microenvironment. From the Cancer Genome Atlas (TCGA), RNA sequencing, genomic mutations and clinical data of TCGA-KIRP (Kidney renal papillary cell carcinoma) were analyzed. Randomly selected pRCC patients were allotted to the training and testing sets. To determine the independent prognostic impact of the training characteristic, the least absolute shrinkage and selection operator (LASSO) algorithm was utilized, together with univariate and multivariate Cox regression models. Further validation was performed in the testing and whole cohorts. External datasets were utilized to verify the prognostic value of CRLs as well. The CRLs prognostic features in pRCC were established based on the five CRLs (AC244033.2, LINC00886, AP000866.1, MRPS9-AS1 and CKMT2-AS1). The utility of CRLs was evaluated and validated in training, testing and all sets on the basis of the Kaplan-Meier (KM) survival analysis. The risk score could be a robust prognostic factor to forecast clinical outcomes for pRCC patients by the LASSO algorithm and univariate and multivariate Cox regression. Analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) data demonstrated that differentially expressed genes (DEGs) are primarily important for immune responses and the PI3K-Akt pathway. Arachidonic acid metabolism was enriched in the high-risk set by Gene Set Enrichment Analysis (GSEA). In addition, Tumor Immune Dysfunction and Exclusion (TIDE) analysis suggested that there was a high risk of immune escape in the high-risk cohort. The immune functions of the low- and high-risk sets differed significantly based on immune microenvironment analysis. Finally, four drugs were screened with a higher sensitivity to the high-risk set. Taken together, a novel model according to five CRLs was set up to forecast the prognosis of pRCC patients, which provides a potential strategy to treat pRCC by a combination of cuproptosis and immunotherapy.

A case-control study on the association between a healthy lifestyle and obesity among adult twins in Shanghai / 中华流行病学杂志

Objective: To investigate the associations between the numbers of healthy lifestyles and overweight/obesity and abdominal obesity in adult twins in Shanghai. Methods: Based on the Shanghai Twin Registry System Phase Ⅱ survey data in 2017-2018, a case-control study was conducted to analyze the association between healthy lifestyles and obesity and further adjusted for confounders by a co-twin control study. Results: A total of 7 864 adult twins (3 932 pairs) were included. In the co-twin case-control analysis for monozygotic twins, compared with participants with 0 to 2 healthy lifestyles, those with 3 and 4 to 5 healthy lifestyles had a 49% (OR=0.51, 95%CI: 0.28-0.93) and 70% (OR=0.30, 95%CI: 0.13-0.69) lower risk of overweight/obesity, respectively, and a 17% (OR=0.83, 95%CI: 0.44-1.57) and 66% (OR=0.34, 95%CI: 0.14-0.80) lower risk of abdominal obesity, respectively. For each additional healthy lifestyle, the risk of developing overweight/obesity was reduced by 41% (OR=0.59, 95%CI: 0.42-0.85), and the risk of developing abdominal obesity was reduced by 37% (OR=0.63, 95%CI: 0.44-0.90). Conclusion: An increasing number of healthy lifestyles was associated with a marked decreased risk for both overweight/obesity and abdominal obesity.

Effect of interleukin-6 on nucleated erythrocytes in lipopolysaccharide-induced preeclampsia rats / 解剖学报

Objective To explore the effect of interleukin (IL)-6 on nucleated erythrocytes in lipopolysaccharide (LPS)-induced preeclampsia rats. Methods ELISA and immunohistochemistry were used to detect the IL-6 in peripheral blood and placenta of preeclampsia and normal pregnancy; Flow cytometry and immunofluorescence were used to detect the maternal nucleated erythrocytes. Pregnant SD rats were randomly divided into 3 groups: the control, LPS and LPS +anti-IL-6 group; IL-6, the proportion of nucleated erythrocytes, JAK2/MEK and PI3K/Akt signal-related genes were detected. Results The IL-6 of preeclampsia was higher than that of normal patients. Compared with the Control group, IL-6, the proportion of nucleated erythrocytes and JAK2, P85, Akt, P65, IL-IB mRNA of LPS group increased, the fetal weight decreased; Compared with the LPS group, IL-6, the proportion of nucleated erythrocytes and JAK2, P85, Akt, P65 and IL-IB mRNA of the LPS + anti-IL-6 group decreased. Conclusion The up-regulation of IL-6 of preeclampsia patients is accompanied by increased nucleated erythrocytes in peripheral blood. Neutralizing IL-6 in vivo may down-regulate JAK2/ PI3K/Akt/NF-KB-signal-mediated IL-IB to protect preeclampsia rats.

Impact of Prior Digestive System Disease on In-Hospital Gastrointestinal Bleeding in Patients with Acute Myocardial Infarction.

OBJECTIVE: Patients presenting with acute myocardial infarction (AMI) with prior digestive system disease are more likely to suffer from gastrointestinal (GI) bleeding than those without these diseases. However, few articles reported how the different conditions of the digestive tract produced different risks of GI bleeding. METHODS: A single-center study on 7464 patients admitted for AMI from December 2010 to June 2019 in the Beijing Chaoyang Heart Center was retrospectively examined. Patients with major GI bleeding (n = 165) were compared with patients without (n = 7299). Univariate and multivariate logistic regression models were constructed to test the association between GI bleeding and prior diseases of the digestive tract, including gastroesophageal reflux disease, chronic gastritis, peptic ulcer, hepatic function damage, diseases of the colon and rectum, and gastroenterological tract tumors. RESULTS: Of the 7464 patients (mean age, 63.4; women, 25.6%; STEMI, 58.6%), 165 (2.2%) experienced major GI bleeding, and 1816 (24.3%) had a history of digestive system disease. The risk of GI bleeding was significantly associated with peptic ulcer (OR = 4.19, 95% CI: 1.86-9.45) and gastroenterological tumor (OR = 2.74, 95% CI: 1.07-7.04), indicated by multivariate logistic regression analysis. CONCLUSION: Preexisting peptic ulcers and gastroenterological tract tumors rather than other digestive system diseases were indicators of gastrointestinal bleeding in patients with AMI who undergo standard antithrombotic treatment during hospitalization.

The long-term impact of a chronic total occlusion in a non-infarct-related artery on acute ST-segment elevation myocardial infarction after primary coronary intervention.

OBJECTIVES: To investigate the long-term outcome of patients with acute ST-segment elevation myocardial infarction (STEMI) and a chronic total occlusion (CTO) in a non-infarct-related artery (IRA) and the risk factors for mortality. METHODS: The enrolled cohort comprised 323 patients with STEMI and multivessel diseases (MVD) that received a primary percutaneous coronary intervention between January 2008 and November 2013. The patients were divided into two groups: the CTO group (n = 97) and the non-CTO group (n = 236). The long-term major adverse cardiovascular and cerebrovascular events (MACCE) experienced by each group were compared. RESULTS: The rates of all-cause mortality and MACCE were significantly higher in the CTO group than they were in the non-CTO group. Cox regression analysis showed that an age ≥ 65 years (OR = 3.94, 95% CI: 1.47-10.56, P = 0.01), a CTO in a non-IRA(OR = 5.09, 95% CI: 1.79 ~ 14.54, P < 0.01), an in-hospital Killip class ≥ 3 (OR = 4.32, 95% CI: 1.71 ~ 10.95, P < 0.01), and the presence of renal insufficiency (OR = 5.32, 95% CI: 1.49 ~ 19.01, P = 0.01), stress ulcer with gastraintestinal bleeding (SUB) (OR = 6.36, 95% CI: (1.45 ~ 28.01, P = 0.01) were significantly related the 10-year mortality of patients with STEMI and MVD; an in-hospital Killip class ≥ 3 (OR = 2.97,95% CI:1.46 ~ 6.03, P < 0.01) and the presence of renal insufficiency (OR = 5.61, 95% CI: 1.19 ~ 26.39, P = 0.03) were significantly related to the 10-year mortality of patients with STEMI and a CTO. CONCLUSIONS: The presence of a CTO in a non-IRA, an age ≥ 65 years, an in-hospital Killip class ≥ 3, and the presence of renal insufficiency, and SUB were independent risk predictors for the long-term mortality of patients with STEMI and MVD; an in-hospital Killip class ≥ 3 and renal insufficiency were independent risk predictors for the long-term mortality of patients with STEMI and a CTO.

Epidemiological characteristics and transmission routes of COVID-19 asymptomatic infected patients in Shaanxi Province / 西安交通大学学报(医学版)

【Objective】 To assess the epidemiological characteristics and transmission risk of asymptomatic COVID-19 infection in Shaanxi Province. 【Methods】 A dense population database of COVID-19 cases in Shaanxi Province was constructed as of March 26, 2020, and 28 asymptomatic infected patients were selected through case epidemiological investigation report for descriptive analysis. 【Results】 In Shaanxi Province, the majority of asymptomatic COVID-19 infections were in the 20-59 years old group, and women took up a higher proportion than men. 82.14% of asymptomatic infections were found in the centralized isolation state. Nearly 80% of asymptomatic infections and confirmed cases were mainly exposed by living together in the family. The median number of days from last contact with the source of infection for all asymptomatic infected persons was 13, with 3 (10.71%) showing clinical symptoms. Epidemiological investigations showed that asymptomatic infections could spread as a result of shared family life. 【Conclusion】 At present, imported cases in Shaanxi Province continue to exist. Considering the concealed transmission of asymptomatic infections, prevention and control work is still facing challenges.

Analysis of the path from discovery of novel coronavirus disease 2019 cases to its diagnosis in Shaanxi Province / 西安交通大学学报(医学版)

Objective: To explore the problems and experience in the prevention and control of novel coronavirus disease 2019 (COVID-19) by analyzing the path from its discovery to its diagnosis in Shaanxi Province. Methods: We collected the important data of COVID-19 epidemic situation in Shaanxi Province as of March 26, 2020, the trajectory of the diagnosed cases, contact history, close contacts and other important information for a descriptive epidemiological analysis. Results: Totally 72.65% (178/245) of the confirmed COVID-19 cases in Shaanxi Province were not in isolation or management at the time of onset, which resulted in an infection rate of 1.37% in close-knit populations. The duration between the onset of local COVID-19 cases in Shaanxi and the delay in confirmed diagnosis was relatively long (6.30 days), and the mean incubation period was 7.27 days. The delay time (7.29 days) between onset and diagnosis of preepidemic cases was longer than that (6.19 days) of later epidemic cases. Conclusion: According to the epidemic situation, we should gradually sort out the loopholes in previous work and at the same time make timely evaluation of the new problems arising under the new situation and constantly adjust the prevention and control strategies.

Predictive role of monocyte-to-lymphocyte ratio in patients with Klebsiella pneumonia infection: A single-center experience.

The aim of the study is to explore whether monocyte-to-lymphocyte ratio (MLR) provides predictive value of the severity in patients with Klebsiella pneumonia infection (KPI).Patients in a tertiary medical center with Klebsiella pneumonia infection from 2014 to 2017 were recruited in this study. Patients with Klebsiella pneumonia infection were stratified into two groups based on the National Early Warning Score (NEWS). MLR was calculated by dividing monocytes count by lymphocytes count obtained from routine blood examination. The area under the curve (AUC) values was determined using the receiver-operating characteristic (ROC) curve. The correlation between the variables was tested with Pearson or Spearman correlation analysis. Ordinal logistic regression analysis was used to assess the relationship between MLR and the severity of Klebsiella pneumonia infection.One hundred fifty-two patients were finally enrolled for analysis. Among those, 43 (28.29%) cases had severe KPI. MLR was found to be an independent risk factor of the serious Klebsiella pneumonia infection (OR: 23.74, 95% CI: 5.41-104.11, P < .001). Besides, MLR was positively correlated with NEWS score (r = 0.57, P < .001). In the receiver-operating characteristic (ROC) curve analysis, MLR, with an optimal cut-off value of 0.665, predicted the severe coronary lesion with a sensitivity of 79.4% and specificity of 84.4%.MLR was an independent predictor of the severe Klebsiella pneumonia infection. Compared with neutrophil-to-lymphocyte ratio (NLR), MLR has a better performance to evaluate the severity of Klebsiella pneumonia infection.

Application effects of mechanical chest compression combined with manual chest compression in cardiopulmonary resuscitation for patients with in-hospital cardiac arrest: a Meta-analysis / 中国中西医结合急救杂志

Objective To systematically evaluate the effects of mechanical chest compression (CC) combined with manual CC and single-manual CC on the outcome indexes of cardiopulmonary resuscitation (CPR) for patients with in-hospital cardiac arrest (IHCA). Methods The relevant publicly published literatures about the effects of mechanical CC combined with manual CC and single-manual CC on the outcome of CPR were searched by using the following Chinese keywords for retrieval: "cardiac arrest, asystole, sudden death, artificial recovery, artificial press, artificial CC, unarmed CPR, unarmed resuscitation, unarmed compressions, unarmed chest compressions, unarmed, artificial, resuscitation instrument, resuscitation machine, resuscitator, CPR, LUCAS, Autopulse, Thumper, MSCPR-1A"in databases such as China Biomedical Literature (CBM), VIP, Wanfang, and China National Knowledge Internet (CNKI) from their dates of foundation to March 11, 2019, and using the following key words in English "heart arrest, cardiac arrest, cardiopulmonary arrest, Cardiopulmonary Resuscitation, Resuscitation, Cardio-Pulmonary Resuscitation, CPR, compression, mechanical, automatic, automated, load distributing band, LBD, Autopulse, LUCAS" to retrieve all the published articles especially concerning the topics on the application effects of mechanical combined with manual CC for IHCA patients' CPR in the America National Library database (PubMed), Excerpta Medica (EMbase), Web of Science, and Cochrane Library from the establishment of the databases to March 11, 2019. The indexes of outcomes included return of spontaneous circulation (ROSC) rate, survival rate after hospital discharge and incidence of complications. The literatures were extracted independently by two reviewers, the qualities of the included randomized controlled trials (RCTs) were evaluated according to the Cochrane bias risk assessment tool, and the qualities of the included observational studies were evaluated according to the literature quality assessment form (NOS). Meta analysis was performed by using RevMan 5.3 software, and publication bias was assessed by using funnel plot. Results Twenty-one studies were enrolled, including 11 RCT articles and 10 observational studies; there were 2 005 participants. The results of this Meta-analysis showed that compared with manual CC, the ROSC rate and after discharge survival rate of IHCA patients were obviously higher in combined CC group [ROSC: odds ratio (OR) = 2.50, 95% confidence interval (95%CI) = 2.03-3.09, P < 0.000 01; discharge survival rate: OR = 2.71, 95%CI = 1.91-3.85, P < 0.000 01]; the incidence of complications of combined CC was lower than that in single manual CC (OR = 0.30, 95%CI = 0.13-0.68, P = 0.004). The funnel plots indicated that there was no apparent bias in the ROSC; because the enrolled studies were relatively few, it was difficult to evaluate the symmetrical characteristics of the funnel plots for discharge survival rate and the complication rate. Conclusions For IHCA patients, combined CC can improve ROSC, discharge survival rate, and reduce the occurrence of complications. It is suggested that during the actual rescue of IHCA patients, it is better to use combined CC, that is to say, manual CC should be adopted immediately in the early stage and then replace the mechanical CC device as soon as possible.

Interleukin-10-Overexpressing Mesenchymal Stromal Cells Induce a Series of Regulatory Effects in the Inflammatory System and Promote the Survival of Endotoxin-Induced Acute Lung Injury in Mice Model.

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are life-threatening inflammatory conditions with no effective pharmacological treatment. Previous studies suggested that mesenchymal stromal/stem cell (MSC) infusion resulted in better survival in mouse ALI models and presented low toxicity in human subjects. Therefore, in this study, we investigated the possibility of treating a murine model of ALI using MSCs with constant interleukin-10 overexpression (IL-10-MSC) by retroviral infection. ALI in mice was induced by intratracheal lipopolysaccharides (LPS) instillation. After 96 h, 80% of mice receiving IL-10-MSCs survived, whereas the survival rate of the mice receiving other treatments was only 20-50%. Mice receiving IL-10-MSCs also demonstrated significantly less weight loss (p < 0.01), and lower protein level and TNF concentration in the BAL (p < 0.01). Interestingly, IL-10-MSCs given to mice 3 and 1 day before ALI induction still conferred significant protection against ALI. While direct IL-10 transfusion resulted in an intensive, but transient peak in serum IL-10 level, IL-10-MSCs provided a milder, but more persistent increase in serum IL-10 level, together with significantly higher levels of IL-10-producing T cells and B cells, both in the spleen and in the lung. IL-10-MSCs given 3 days before LPS challenge resulted in higher pulmonary infiltration of IL-10-producing T cells and B cells in mice. On average, mice that survived the LPS challenge for 96 h presented higher pulmonary infiltration of IL-10-producing T cells and B cells than mice that deceased within the experimental period. Together, these results demonstrated that IL-10-MSCs offered superior protection against LPS-induced ALI when given before or at the time of ALI induction, and significantly increased the frequencies of IL-10-expressing T cells and B cells. IL-10-MSCs may thus represent a promising new treatment option in ALI/ARDS.

Preliminary clinical application of transcatheter closure of ventricular septal defect via radial approach / 介入放射学杂志

Objective To explore the feasibility and efficacy of transcatheter closure of ventricular septal defect (VSD) through radial artery combined femoral vein approach. Methods A total of 11 patients with congenital VSD, who were admitted to authors' hospital during the period from June 2017 to November2017, were enrolled in this study. The patterns of lesion included intracristal type (n=3) and perimembranous type (n=8), and in 3 patients the VSD was associated with concant ventricular septal aneurysm. Transcatheter closure of VSD via radial approach was carried out in all patients. The mean age of the patients was (37.82±12.44) years old, and the average body weight was (62.79±14.95) kg. The transthoracic echocardiography (TTE) showed that the mean diameter of VSD was (5.87±1.91)mm. The effect of transcatheter closure therapy was assessed by intraoperative TTE and left ventriculography. All patients were followed up with electrocardiogram and TTE at 24 hours and one, 3, 6 months after transcatheter closure therapy. Results Successful closure was achieved in 10 patients, and one patient had to be transferred to surgery because the catheter could not pass through the defect. The mean diameter of the implanted occluders was (7.50±3.60)mm, the average procedural time and fluoroscopy time were (47.20±5.45) min and (13.00±3.65) min respectively. The postoperative average in-bed time was (99.00±11.97) min. Two patients developed radial artery spasm during the operation. During the follow-up period lasting for a mean of (3.50±1.90) months, no serious complications, such as dropping of occluder, residual shunt, atrioventricular block, aortic regurgitation, radial artery occlusion, etc. occurred in the 10 patients. Conclusion For the treatment of VSD, transcatheter closure through radial artery combined with femoral vein approach is safe and effective. Therefore, this technique is worthy of clinical application.

Relationships between Dietary Diversity and Nutritional Status in Elderly Inpatient / 肠外与肠内营养

Objective: To identify the relationship between Dietary Diversity and Nutritional Status in Elderly Inpatient. Methods: 136 elderly inpatients were selected in a tertiary hospital in Yunnan Provience. Food frequency questionnaire was used to collect dietary information and DDS9 was calculated; We used Mini Nutritional Assessment (MNA) to evaluate nutritional status, then analyzed the effect of Dietary Diversity on nutritional status in elderly inpatients. Results:① Patients at risk of malnutrition and with confirmed malnutrition in participants were 46. 3％, 33. 8％,, respectively. ② The incidence of insufficient diversity, moderate diversity and adequate diversity were 19. 9％, 77. 2％ and 2. 9％, respectively; the total scores of dietary diversity were (4. 68 ± 1. 27). However, apart from vegetables, the rest 8 kinds of food all showed lower scores of intra-group variety; while the consumption of beans, nuts and seafood was seriously inadequate. ③ The incidence of malnutrition risk and confirmed malnutrition in insufficient-diversity group and moderate-diversity group were 5. 109 times and 1. 094 times of adequacy group (P＜ 0. 05). Conclusion: Dietary diversity is strongly associated with putritional status in elderly inpatient. Improvement of dietary diversity status is potentially beneficial in the prevention of malnutrition.

Expression of HOXB7 protein in colorectal cancer and its clinical significance / 重庆医学

Objective To investigate the expression of HOXB7 in colorectal cancer and its relationship with clinicopathological factors and prognosis.Methods Eighty-seven patients with colorectal cancer were retrospectively analyzed.The expression of HOXB7 mRNA and protein in colorectal cancer tissues was detected by RT-PCR and immunohistochemical methods.Their correlation with clinicopathological parameters and prognosis was analyzed.Results The relative expression level of HOXB7 mRNA in colorectal cancer tissue was(42.4 ± 16.3),which was significantly higher than(19.4 ± 7.6) in the paracancerous normal tissue(P＜0.05).The positive expression rate of HOXB7 protein in colorectal cancer tissues was 73.9％,which was obviously higher than 10.3 ％ in the paracancerous normal tissue (P＜ 0.05);expression of HOXB7 protein was significantly correlated with the TNM stage,lymph node metastasis and distant metastasis(P＜0.05),moreover the patients with HOXB7 positive expression had poorer prognosis.Conclusion HOXB7 protein expression is up-regulated in colorectal cancer tissue,and its high expression is correlated with the clinicopathological factors and prognosis in the patients with colorectal cancer.

Surveillance on iodine nutritional status among target population in Shanghai / 上海预防医学

Objective To ascertain iodine nutritional status of pregnant women and children in Shanghai since the implementation of "Salt Iodine Content Standard" in 2011.Methods By population proportion probability sampling,30 sub-districts(towns) were chosen,with one primary school was randomly sampled in eachsub-districts(towns).And 50 students aged 8-10 in every school were randomly selected to test their urinary iodine and thyroid volume,and their household iodized salt concentration determined.And 20 pregnant women were selected to test their urinary iodine in each sub-districts(towns).Results The goiter rate of 8-10 aged children was 0.9%.The medians of urinary iodine concentration of 8-10 aged children and pregnant women were 171.40 μg/L and 126.53 μg/L,respectively.The consumption rates of qualified iodized salt were 72.52%.The median of iodine content concentration in salt was 24.8 mg/kg.Conclusion In Shanghai,the goiter rate of children was lower than that of the national standard.Iodine nutritional status of children was proper,but the pregnant women were deficient in iodine nutrition.Therefore,iodized salt concentration should be improved to the optimal level.Health education for pregnant women should be strengthened.

Comprehensive assessment on iodine nutrition and dietary iodine intake among Shanghai residents / 上海预防医学

Objective To assess the changes in iodine status and dietary iodine intake among Shanghai residents since common salt was iodized 20 years ago.Methods As-CE Catalysis spectrophotometry was used to determinate the urine iodine level in school-age children,pregnant women,wet nurse and adults of Shanghai between 1995 and 2015.B ultrasonic was used to determinate the thyroid volume of school-age children.And then the goiter rate was calculated.Direct titration or arbitration methods were applied to detect the household salt iodine level quantitatively.The survey was conducted by using 3 days 24-hour dietary questionnaire and condiment weighing methods to analyze the level of iodine intake and sources for the cases of all iodized salt consumption and all consumption of non-iodized salt.Results The median urine iodine concentration (UIC) of school age children was 72.3 μg/L in 1995,rose to 214-231 μg/L from 1997-1999,and then became stable between 100 μg/L and 200 μg/L since 2002.The goiter rate was below 5% among children aged 8-10 from 1995-2015 in Shanghai.The median urine iodine of pregnant women was between 126.5 μg/L and 139.8 μg/L.The median UIC of other populations were all between 100 μg/L and 200 μg/L: with adults,lactating women,infants and young children and women of childbearing age,the median urinary iodine was 138.4,123.1-131.1,150.1 and 125.6 μg/L.The qualified iodized salt at household consumption rate was 90% from 2001 to 2009,the percentage declined year by year from 2010.In the cases of all taking iodine salt,the median iodine intake volume for male aged 7-10,11-13,14-18 and over 18 was 200.3,235.5,252.7 and 215.4 μg/L;women aged 7-10,11-13,14-18 and over 18 was 193.0,213.8,208.3 and 186.1 μg/L.The contribution rate of iodine salt in the diet were 51.6%-54.1% and 49.1%-53% in men and women.Kelp,seaweed and fish and shrimp on the contribution of iodine are 7.6%-16.6% and 4.5%-7.4%.Conclusion In the past about 20 years,iodine nutritional status of residents in Shanghai has stabilized totally in a appropriate and safe level.However,the iodine nutrition of pregnant women was insufficient.As iodized salt is the major source of dietary iodine in coastal areas,it is still necessary to continue the policy of universal salt iodized in Shanghai to ensure residents'' needs for iodine and control the risk of iodine deficiency.

Prevalence of Thyroid Nodules and Its Relationship with Iodine Status in Shanghai: a Population-based Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study was designed to evaluate the prevalence of thyroid nodules (TNs) and its relationship with urine iodine concentrations (UICs) after the regional rapid economic growth and lifestyle changes.</p><p><b>METHODS</b>A cross-sectional survey was conducted in the general population aged 15-69 years. A questionnaire regarding general and personal characteristics and relevant information was administered. Ultrasonography of the thyroid was performed, and serum triiodothyronine (T3), tetraiodothyronine (T4), serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and TSH receptor antibody (TRAb) levels were measured for each individual subject.</p><p><b>RESULTS</b>The prevalence rates of TNs in the whole population, females and males were 27.76%, 34.04%, and 21.60%, respectively. The prevalence of multiple nodules increased with age, whereas the prevalence peaks differed between males and females. The median UICs in the whole population and females with non-TNs were higher than those of subjects with TNs (P=0.0035, P=0.0068). The median UICs in subjects with a single TN were higher than those in subjects with multiple TNs (P=0.0164, P=0.0127). The result showed a U-shaped curve relationship between UIC and prevalence of TNs. The prevalence of TNs was the lowest when the UIC was 140-400 μg/L.</p><p><b>CONCLUSION</b>The prevalence of TNs was nearly 30% and increased with age. The relationship between UIC and prevalence of TNs is U-shaped, with an increase in risk when the UIC was <140 μg/L and >400 μg/L. Very low or high UIC levels need attention and correction.</p>

Application of R-based multiple seasonal ARIMA model, in predicting the incidence of hand,foot and mouth disease in Shaanxi province / 中华流行病学杂志

Objective To apply the 'auto-regressive integrated moving average product seasonal model' in predicting the number of hand,foot and mouth disease in Shaanxi province.Methods In Shaanxi province,the trend of hand,foot and mouth disease was analyzed and tested,under the use of R software,between January 2009 and June 2015.Multiple seasonal ARIMA model was then fitted under time series to predict the number of hand,foot and mouth disease in 2016 and 2017.Results Seasonal effect was seen in hand,foot and mouth disease in Shaanxi province.A multiple seasonal ARIMA (2,1,0) × (1,1,0)12 was established,with the equation as (1-B)(1-B12)(1-1.000B)Ln(Xt) =(1-0.532B-0.363B2) (1-0.644B12-0.454B212)εt.The mean of absolute error and the relative error were 531.535 and 0.114,respectively when compared to the simulated number of patients from Jun to Dec in 2015.Results under the prediction of multiple seasonal ARIMA model showed that the numbers of patients in both 2016 and 2017 were similar to that of 2015 in Shaanxi province.Conclusion Multiple seasonal ARIMA (2,1,0) × (1,1,0)12 model could be used to successfully predict the incidence of hand,foot and mouth disease in Shaanxi province.

Application of R-based multiple seasonal ARIMA model, in predicting the incidence of hand,foot and mouth disease in Shaanxi province / 中华流行病学杂志

Objective To apply the 'auto-regressive integrated moving average product seasonal model' in predicting the number of hand,foot and mouth disease in Shaanxi province.Methods In Shaanxi province,the trend of hand,foot and mouth disease was analyzed and tested,under the use of R software,between January 2009 and June 2015.Multiple seasonal ARIMA model was then fitted under time series to predict the number of hand,foot and mouth disease in 2016 and 2017.Results Seasonal effect was seen in hand,foot and mouth disease in Shaanxi province.A multiple seasonal ARIMA (2,1,0) × (1,1,0)12 was established,with the equation as (1-B)(1-B12)(1-1.000B)Ln(Xt) =(1-0.532B-0.363B2) (1-0.644B12-0.454B212)εt.The mean of absolute error and the relative error were 531.535 and 0.114,respectively when compared to the simulated number of patients from Jun to Dec in 2015.Results under the prediction of multiple seasonal ARIMA model showed that the numbers of patients in both 2016 and 2017 were similar to that of 2015 in Shaanxi province.Conclusion Multiple seasonal ARIMA (2,1,0) × (1,1,0)12 model could be used to successfully predict the incidence of hand,foot and mouth disease in Shaanxi province.

Cause and control of Radix Ophiopogonis browning during storage / 中国天然药物

In the storage of Radix Ophiopogonis, browning often happens to cause potential risk with regard to safety. Previously few reports investigate the browning of Radix Ophiopogonis. In this research, the causes and mechanisms of the browning of Radix Ophiopogonis were preliminarily elucidated. Content determination by high-performance liquid chromatography (HPLC) and spectrophotometry, enzyme activity determination by colorimetry, and morphological observation by electron microscopy were performed in the present study. Uniform design and three-dimensional response surfaces were applied to investigate the relationship between browning and storage factors. The cortex cell wall of browned Radix Ophiopogonis was ruptured. Compared with the normal Radix Ophiopogonis, cellulase and polyphenol oxidase enzymes were activated, the levels of 5-hydroxymethylfurfural (5-HMF), total sugars, and reducing sugars were increased, while the levels of polysaccharides and methylophiopogonanone A were decreased in browned Radix Ophiopogonis. The relationship between the storage factors and degree of browning (Y) could be described by following correlation equation: Y = - 0.625 4 + 0.020 84 × X3 + 0.001 514 × X1 × X2 - 0.000 964 4 × X2 × X3. Accompanied with browning under storage conditions, the chemical composition of Radix Ophiopogonis was altered. Following the activation of cellulase, the rupture of the cortex cell wall and the outflow of cell substances flowed out, which caused the Radix Ophiopogonis tissue to become soft and sticky. The main causes of the browning were the production of 5-HMF, the activation of polyphenol oxidase, Maillard reactions and enzymatic browning. Browning could be effectively prevented when the air relative humidity (HR), temperature, and moisture content were under 25% RH, 12 °C and 18%, respectively.