Does the timing of surgery affect outcomes in young and middle-aged patients undergoing surgical stabilization of rib fractures? Feedback was based on real data from physicians, patients, and family caregivers.

BACKGROUND: There is a general clinical consensus that early surgical stabilization of rib fractures (SSRF, ≤ 48-72 h after admission) can benefit patients, and this is only regarding the surgeon's opinions. This study assessed the true outcomes of young and middle-aged patients at different surgical timings. METHODS: This retrospective cohort study was conducted among patients aged 30-55 years who were hospitalized with a diagnosis of isolated rib fractures and underwent SSRF between July 2017 and September 2021. The patients were divided into early (≤ 3 days), mid- (4-7 days) and late (8-14 days) groups, according to the interval (days) between surgery and injury date. The impact of different surgical timings on clinical outcomes, patients, and families was assessed by comparing SSRF-related data during hospitalization and follow-up studies of clinicians, patients themselves, and family caregivers 1-2 months after surgery. RESULTS: In this study, 155 complete patient data were finally included, including 52, 64, and 39 patients in the early, mid, and late groups, respectively. Length of operation, preoperative closed chest drainage rate, length of hospital stay, intensive care unit length of stay, duration of invasive mechanical ventilation in the early group were lower than those in the intermediate and late groups. Additionally, hemothorax and excess pleural fluid incidence after SSRF was lower in the early group than in the intermediate and late groups. Postoperative follow-up results showed that patients in the early group had higher SF-12 physical component summary scores and shorter duration of absence from work. Family caregivers had lower Zarit Burden Interview scores than those in the mid- and late groups. CONCLUSION: From the experience of our institution's SSRF, early surgery is safe and offers additional potential benefits for young and middle-aged patients and families with isolated rib fractures.

Development and validation of a pulmonary complications prediction model based on the Yang's index.

Background: Blunt chest trauma patients with pulmonary contusion are susceptible to pulmonary complications, and severe cases may develop respiratory failure. Some studies have suggested the extent of pulmonary contusion to be the main predictor of pulmonary complications. However, no simple and effective method to assess the severity of pulmonary contusion has been available yet. A reliable prognostic prediction model would facilitate the identification of high-risk patients, so that early intervention can be given to reduce pulmonary complications; however, no suitable model based on such an assumption has been available yet. Methods: In this study, a new method for assessing lung contusion by the product of the three dimensions of the lung window on the computed tomography (CT) image was proposed. We conducted a retrospective study on patients with both thoracic trauma and pulmonary contusion admitted to 8 trauma centers in China from January 2014 to June 2020. Using patients from 2 centers with a large number of patients as the training set and patients from the other 6 centers as the validation set, a prediction model for pulmonary complications was established with Yang's index and rib fractures, etc., being the predictors. The pulmonary complications included pulmonary infection and respiratory failure. Results: This study included 515 patients, among whom 188 developed pulmonary complications, including 92 with respiratory failure. Risk factors contributing to pulmonary complications were identified, and a scoring system and prediction model were constructed. Using the training set, models for adverse outcomes and severe adverse outcomes were developed, and area under the curve (AUC) of 0.852 and 0.788 were achieved in the validation set. In the model performance for predicting pulmonary complications, the positive predictive value of the model is 0.938, the sensitivity of the model is 0.563 and the specificity of the model is 0.958. Conclusions: The generated indicator, called Yang's index, was proven to be an easy-to-use method for the evaluation of pulmonary contusion severity. The prediction model based on Yang's index could facilitate early identification of patients at risk of pulmonary complications, yet the effectiveness of the model remains to be validated and its performance remains to be improved in further studies with larger sample sizes.

[Exhaust Smoke of Non-Road Vehicles in Typical Cities of Eastern China].

In typical cities of East China, more than 900 non-road vehicles were tested for exhaust smoke. Based on the investigation of the properties of these non-road vehicles, exhaust smoke intensities for different kinds of non-road vehicles are recommended. We also quantitatively study the differences in smoke intensity among vehicle age, vehicle power, test conditions, and fuels. The results showed that smoke intensity of non-road vehicles was (1.02±0.57) m-1 and that Ringelmann smoke was 2.10±0.19. In comparison to Chinese national standard (GB 36886), approximately 12%-25% of tested non-road vehicles' smoke intensity exceeded the standard limit. The smoke intensity of 80% of tested non-road vehicles was higher during start-up than under free acceleration. In comparison to ordinary diesel, the smoke intensities of tested non-road vehicles that used automotive diesel were lower. The instantaneous increase in fuel injection during start-up, as well as poor fuel quality, can directly affect the exhaust smoke of non-road vehicles.

[Emission Inventory and Pollution Characteristics of Industrial VOCs in Hangzhou, China].

For the 2022 Asian Games, a series of major events were held in Hangzhou City in 2016 at the international summit, where research on VOC emission inventories, especially on industrial VOCs, has attracted the attention of local residents and management departments. By taking a bottom-up approach, 3518 enterprises in more than 30 industries in Hangzhou were investigated and an industrial VOCs emission inventory for Hangzhou was established. Based on the data on regional emissions, emissions intensity, and spatial distribution, the industrial VOCs emissions in Hangzhou were systematically analyzed. The VOC emissions from industrial sources in Hangzhou amounted to 36839.5 tons in 2015. Printing and reproduction of recorded media; chemical raw materials and chemical products manufacturing; and the metal, textile, rubber, and plastics products industries were the most important sources of industrial VOC emissions in Hangzhou. The largest industrial VOC emissions were measured in Xiaoshan District, followed by Fuyang District and Dajiangdong Industrial Agglomeration Area. The highest VOC emissions intensity was detected in Fuyang District, Jiande City, and Lin'an City. Industrial VOC emissions were mainly concentrated in more intensive industrial areas in Xiaoshan, Fuyang, Yuhang, and Dajiangdong Districts.

[Treatment Status and Emission Characteristics of Volatile Organic Compounds from Typical Industrial Sources].

The status of treatment equipment, the emission characteristics, and the ozone formation potential (OFP) of volatile organic compounds (VOCs) for 11 typical enterprises, which were categorized into the 8 major VOC emission industries identified by the emission inventory of a typical city in the Yangtze River Delta, are discussed in this paper. There was a large difference in the removal efficiency of non-methane hydrocarbon (NMHC) between different treatment techniques, and even an increase in concentration occurred after some of the treatments. The current treatment equipment for VOCs needs further optimization. The emissions of NMHC, benzene, toluene, and xylene in most of the surveyed enterprises exceeded their corresponding standards, with toluene the worst offender. The most abundant compounds in the eight emission industries were aromatic hydrocarbons and oxygenated VOCs, whereas aromatic hydrocarbons contributed the most to ozone formation potential. There were large differences in emission characteristics of VOCs from different industries. Priority should be placed on the industries that have large OFP when control strategies of VOCs are considered.

[Air Pollutant Emission Inventory of Non-road Machineries in Typical Cities in Eastern China].

Based on site investigation of non-road vehicles in Shanghai and Hangzhou located in east China, non-road vehicle emission inventory in 2014 was established in these cities as well as its emission inventory technology. Characteristics of non-road vehicle were also analyzed, including classification, type of fuel, power and emission standard. The results showed that diesel consumed by non-road vehicles was 6.1×105 t in Shanghai and 3.2×105 t in Hangzhou; NOx emission was 3.09×104 t in Shanghai and 1.72×104 t in Hangzhou; PM2.5 emission was 1.41×103 t in Shanghai and 8.1×102 t in Hangzhou, 2014. Emissions from excavators and other construction equipment contributed the most in non-road vehicle emission inventory. Non-road vehicle has become one of the important sources of urban air pollution, whose NOx emissions accounted for 11.1% of all urban sources in Shanghai and 16.1% in Hangzhou, and accounted for 18.5% of mobile sources in Shanghai and 32.2% in Hangzhou.

Association of microRNA-126 expression with clinicopathological features and the risk of biochemical recurrence in prostate cancer patients undergoing radical prostatectomy.

OBJECTIVE: Numerous studies have suggested that microRNA-126 (miR-126) is involved in development of various cancer types as well as in malignant proliferation and invasion. However, its role in human prostate cancer (PCa) is still unclear. The aim of this study was to investigate miR-126 expression in PCa and its prognostic value for PCa patients undergoing radical prostatectomy. METHODS: A series of 128 cases with PCa were evaluated for the expression levels of miR-126 by quantitative reverse-transcription PCR (qRT-PCR). Kaplan-Meier analysis and Cox proportional hazards regression models were used to investigate the correlation between miR-126 expression and prognosis of PCa patients. RESULTS: Compared with non-cancerous prostate tissues, the expression level of miR-126 was significantly decreased in PCa tissues (PCa vs. non-cancerous prostate: 1.05 ± 0.63 vs. 2.92 ± 0.98, P < 0.001). Additionally, the loss of miR-126 expression was dramatically associated with aggressive clinical pathological features, including advanced pathological stage (P = 0.001), positive lymph node metastasis (P = 0.006), high preoperative PSA (P = 0.003) and positive angiolymphatic invasion (P = 0.001). Moreover, Kaplan-Meier survival analysis showed that PCa patients with low miR-126 expression have shorter biochemical recurrence (BCR)-free survival than those with high miR-126 expression. Furthermore, multivariate analysis indicated that miR-126 expression was an independent prognostic factor for BCR-free survival after radical prostatectomy. CONCLUSION: These findings suggest for the first time that the loss of miR-126 expression may play a positive role in the malignant progression of PCa. More importantly, the downregulation of miR-126 may serve as an independent predictor of BCR-free survival in patients with PCa. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1740080792113255.