RESUMO
Objective@#: Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) are challenging lesions with high morbidity and mortality rates. Although research on BBAs is well documented in different populations, the study of BBAs in the Tibetan population is extremely rare. This study aimed to evaluate the characteristics of BBAs and analyze the treatment modalities and long-term outcomes in the Tibetan population in comparison with the Han population. @*Methods@#: The characteristics of patients with BBAs of the ICA from January 2009 to January 2021 at our institution were reviewed. The features of aneurysms, treatment modalities, complications, and follow-up outcomes were retrospectively analyzed. @*Results@#: A total of 130 patients (41 Tibetan and 89 Han patients) with BBAs of the ICA who underwent treatment were enrolled. Compared with the Han group, the Tibetan group significantly demonstrated a high ratio of BBAs among ICAs (8.6%, 41/477 vs. 1.6%, 89/5563; p<0.05), a high ratio of vasospasm (34.1%, 14/41 vs. 6.7%, 6/89; p=0.001), a high risk of ischemic events (43.9%, 18/41 vs. 22.5%, 20/89; p<0.05), and a low ratio of good outcomes (modified Rankin scale, 0–2) at the 1-year follow-up (51.2%, 21/41 vs. 74.2%, 66/89; p<0.05). The multivariate regression model showed that ischemic events significantly contributed to the prediction of outcomes at 1 year. Further analysis revealed that microsurgery and vasospasm were associated with ischemic events. @*Conclusion@#: In comparison with Han patients, the Tibetan population had a high ratio of BBA occurrence, a high incidence of ischemic events, and a high ratio of poor outcomes. The endovascular approach showed more benefits in BBA patients.
RESUMO
Objectives To understand the distribution level and health risk of disinfection by-products of drinking water in cities of China, and to provide references for drinking water safety management. Methods By systematically searching the literatures published from 2009 to 2019, the effective data were extracted and the exposure levels of disinfection by-products of drinking water in China was statistically analyzed. The health risk assessment model recommended by EPA was used to conduct risk assessments on THMs and HAAs disinfection by-products. Results The levels of various disinfection by-products were as follows: trihalomethane > haloacetic acid > haloacetonitrile > chloral hydrate > haloketones > nitrosamines. The main disinfection by-products in drinking water in southern China were higher than those in northern China. The total amount of disinfection by-products produced by liquid chlorine disinfection was higher than other disinfection methods. Conclusion The carcinogenic risk of various disinfection by-products in domestic urban drinking water was higher than the acceptable EPA level (1×10-6 ). Sodium hypochlorite disinfection instead of liquid chlorine disinfection was able to effectively reduce the health risk of disinfection by-products to humans. The health risk of the exposure to pollutants in drinking water was higher in children than in adults, which should be taken into special consideration