[Burden of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption in China].

Objective: To describe the prevalence of alcohol consumption and the burden of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption in adults aged ≥20 years in 31 provinces in China from 2005 to 2018. Methods: Data from several national representative surveys was used to estimate provincial alcohol exposure level of adults aged ≥20 years from 2005 to 2018 by using kriging interpolation and locally weighted regression methods. Global disease burden research method and data, and China's death cause surveillance data were used to calculate the population attributable fraction (PAF) of hemorrhagic stroke and hypertensive heart disease and the deaths due to alcohol consumption in men and women aged ≥20 years in 31 provinces in China. China census data of 2010 were used to calculate the attributable standardized mortality rate. Results: In 2005 and 2018, the prevalence of alcohol consumption was 58.7% (95%CI: 57.8%-59.5%) and 58.4% (95%CI: 57.6%-59.3%), respectively, in men and 17.0% (95%CI: 16.6%-17.4%) and 18.7% (95%CI:18.1%-19.3%), respectively, in women. The daily alcohol intake was 24.6 (95%CI: 23.8-25.3) g and 27.7 (95%CI: 26.8-28.7) g, respectively, in men and 6.3 (95%CI: 6.0-6.5) g and 5.3 (95%CI: 5.0-5.6) g, respectively, in women. Alcohol exposure level was higher in the provinces in central and eastern China than in western provinces. The lowest exposure level was found in northwestern provinces. From 2005 to 2018, the PAF of hemorrhagic stroke death due to alcohol consumption increased from 5.5% to 6.8%, the attributable deaths increased from 50 200 to 59 100, while the PAF of hypertensive heart disease death due to alcohol consumption increased from 7.0% to 7.7%, the attributable deaths increased from 15 200 to 29 300. The PAF of hypertensive heart disease and hemorrhagic stroke was higher in men than in women, and in central and eastern provinces than in western provinces. In 2018, the standardized mortality rates of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption were 4.58/100 000 and 2.11/100 000, respectively. Conclusions: The prevalence of alcohol consumption in men and daily alcohol intake of drinkers were relatively high in China, especially in eastern provinces. Alcohol exposure level was lower in women than in men. Regional measures should be taken to reduce the alcohol intakes in men and current drinkers in order to reduce the health problems caused by alcohol consumption.

[Risk for type 2 diabetes mellitus death attributed to insufficient whole grain intake in seven regions of China, 2005-2018].

Objective: To estimate the risk for type 2 diabetes mellitus (T2DM) death attributed to insufficient whole grain intake in seven regions of China from 2005 to 2018. Methods: Based on China National Nutrition and Health Surveys and China Adult Chronic Disease and Nutrition Surveillance, ordinary Kriging method and locally weighted regression were used to estimate the level of whole grain intake of Chinese residents from 2005 to 2018. Based on the results of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 and Chronic Diseases Risk Factors Surveillance in China, we calculated the population attributable fraction (PAF), attributable death number and attributable mortality rate of T2DM due to insufficient whole grain intake in people aged ≥20 years in different regions of China, and we used the 2010 Chinese census data to compare the changes in T2DM deaths attributed to insufficient intake of whole grains in seven regions of China. Results: The whole grain intake levels of Chinese people over 20 years old in 2002, 2010 and 2015 were 19.0 g/d, 14.3 g/d and 19.8 g/d, respectively. The estimated overall whole grain intake level was 20.1 g/d in Chinese residents in 2018, and the intake level was 19.4 g/d in men and 20.8 g/d in women. Among the seven regions, the intake level was highest in northern China (47.4 g/d) and lowest in southwestern China (6.0 g/d). In 2018, the PAF was lowest in northern China (12.8%) and highest in southwestern China (19.3%). From 2005 to 2018, the PAF varied in the seven regions, and the PAF in northeastern China fluctuated around 18.5%. Other regions showed downward trends, especially in northern China and northwestern China, decreased by 26.4% and 21.2%, respectively. Over the past 14 years, the number of attributable deaths in the seven regions showed upward trends, with the highest annual average growth rate of 6.7% in southern China and the lowest annual average growth rate of 2.4% in northern China. In 2018, the standardized T2DM mortality rate attributed to insufficient whole grain intake in China was 3.13/100 000, and the attributable mortality was 3.21/100 000 in men and 3.05/100 000 in women. The standardized attributable mortality rate was highest in southwestern China (3.97/100 000) and lowest in northern China (1.78/100 000). From 2005 to 2018, the standardized attributable mortality rate increased by 11.5% in men and decreased by 8.1% in women. The standardized attributable mortality rate in southwestern, southern and central China increased by 23.7%, 21.3% and 4.2%, respectively. The standardized attributable mortality rate in northern, northwestern, eastern and northeastern China decreased by 20.9%, 11.0%, 4.5% and 3.9%, respectively. Conclusion: The whole grain intake level of Chinese residents was low, and the whole grain intake of residents in all seven regions should be increased, especially in the southwest, and men should have more whole grain intake than women to reduce the death risk in patients with T2DM.

[Treatment and prognosis of multiple primary malignant neoplasms complicated with renal cell carcinoma].

OBJECTIVE: To investigate the treatment and prognosis of multiple primary malignant neoplasms (MPMN) complicated with renal cell carcinoma (RCC), and to make risk stratification. METHODS: A retrospective study of 27 cases of MPMN with RCC in two centers, including the different tumors of MPMN, specific treatment methods, and the interval between primary cancers. At the same time, the survival conditions, including recurrence, metastasis and survival, were followed up for statistical analysis. The interval between the two kinds of primary cancer within 6 months was simultaneous MPMNs, and more than 6 months was metachronous MPMNs. For simple risk stratification of cases, as long as one of the MPMNs had a stage Ⅲ or higher malignancy, which was defined as high risk. RESULTS: Among the 27 patients, 20 were male and 7 were female, with age at the time of diagnosis was 42-82 years, with an average age of (61.3±11.7) years. The age at the diagnosis of renal cancer was 43-87 years, with an average age of (66.0±11.3) years. There were 21 cases with duplex primary malignant neoplasms, 4 cases with triple primary malignant neoplasms, and 2 cases with quadruple primary malignant neoplasms. The interval between first cancer and second cancer was 0-360 months, with a median of 18 months. There were 17 cases of metachronous multiple primary malignant neoplasms and 10 cases of simultaneous multiple primary malignant neoplasms. The most common system of MPMN with comorbid RCC involved urologic system, digestive system and respiratory system. The most common locations of MPMN with comorbid RCC were bladder cancer, lung cancer and colon cancer. Follow-up time calcu- lated from the last cancer was 2-156 months, with a median of 32 months. And 14 cases survived and 13 cases died, with 11 cases being tumor related. Tumor stage was the risk factor of prognosis. Any kind of tumor stage in stage Ⅲ or above had a relatively poor prognosis. CONCLUSION: MPMN complicated with RCC is relatively rare. Standard treatment should be used for each cancer type during the treatment process. The prognosis mainly depends on the highest stage of each tumor. Simple risk stratification shows that the prognosis of the high-risk group is worse. This simple stratification method may be helpful to predict the prognosis.

[Analysis of epidemiological characteristics of report cases of rotavirus diarrhea in children under 5 years old in China, 2005-2018].

Objective: To analyze the epidemiological characteristics of rotavirus in children under 5 years old in China (excluding China Hong Kong, Macau and Taiwan data, the same below) from 2005 to 2018. Method: Data on other infectious diarrhea in the country from 2005 to 2018 were downloaded from the National Notifiable Disease Report System was to build a database for report cases of rotavirus diarrhea in children under 5 years of age, and descriptive epidemiological methods were used to analyze the data. Result: In 2005-2018, a total of 820 588 cases of rotavirus infection in children under 5 years old were reported nationwide, with male 500 944 cases, and with an average annual incidence of 63.7/100 000. The reported incidence showed a fluctuating upward trend increased from 8.4/100 000 to 178.1/100 000. The number of reporting provinces increased from 17 to 30. The reported incidence showed a peak of season from November to following February. The reported cases of rotavirus diarrhea in children under 5 months of age was 13.1%(107 845 cases), and the high-incidence age ranged from 6 months to 2 years old, accounting for 70.3% (576 874 cases), with a peak of 11-13 months (163 947 cases). The top three provinces (cities) reporting the incidence rate were Zhejiang (535.2/100 000), Guangdong (334.3/100 000) and Beijing (317.3/100 000), the provinces with the low reported case rates were Shanxi (0.9/100 000), Heilongjiang (1.6/100 000) and Liaoning (2.5/100 000), but there was no case reported in Tibet; The report cases of south region (745 526 cases) were 9.9 times north region (74 935 cases).The cases of rotavirus infection and other diarrhea pathogens were detected simultaneously accounted for 1.8% (15 030 cases) and mainly were positive for rotavirus and adenovirus (90.1%, 13 544 cases). Conclusion: The rate of rotavirus infection in children has increased rapidly since the age of 6 months, and 84.4% of the reported cases were infants before the age of 2 years.

[Therapeutic effect of ginkgo biloba extract on postoperative delirium in aged patients].

Objective: To observe whether Ginkgo biloba extract (EGb761) can improve postoperative delirium in elderly patients. Methods: Eighty elderly patients undergoing tumor surgery at Zhejiang Cancer Hospital and complicated with postoperative delirium(POD) between June 2013 and July 2016 were randomly divided into treatment group (group A) and control group (group B) according to the random number table method. Patients in group A received ginkgo biloba extract (EGb761) drops oral treatment (3 times/d, 80 mg each time) in addition to oxygen inhalation and appeasement treatment. Patients in group B underwent routine oxygen inhalation and appeasement treatment. POD assessment was performed twice between the hours of 8: 00 am and 8: 00 pm daily after the diagnosis of POD. Observed indicators include sex ratio, age, body mass index (BMI), educated level, type of surgery, anesthesia method, duration of surgery, intraoperative mean arterial blood pressure, intraoperative blood loss, type of POD, visual analogue scale (VAS) scores when diagnosis of POD, the onset time of POD, initial RASS scores, duration of POD. Results: A total of 80 patients with POD were enrolled, 23 patients were excluded for did not cooperate with the tests of POD or refused to participate in the study. Finally, 57 elderly patients completed the study, 29 patients in the medication group (A group) and 28 patients in the control group (B group). There was no significant difference in sex ratio, age, BMI, education level, operation type, anesthesia method, operation duration, intraoperative mean arterial pressure, intraoperative blood loss, POD type and VAS score (all P>0.05). There was no significant difference between the two groups in POD onset time and initial RASS score (all P>0.05). The duration of POD in group A and group B was 16 (16)h and 48 (35) h respectively, the difference was statistically significant (U=161.500, P<0.001). Conclusion: Ginkgo biloba extract (EGb761) can shorten the course of POD in elderly patients.

Extraordinary high ductility/strength of the interface designed bulk W-ZrC alloy plate at relatively low temperature.

The refractory tungsten alloys with high ductility/strength/plasticity are highly desirable for a wide range of critical applications. Here we report an interface design strategy that achieves 8.5 mm thick W-0.5 wt. %ZrC alloy plates with a flexural strength of 2.5 GPa and a strain of 3% at room temperature (RT) and ductile-to-brittle transition temperature of about 100 °C. The tensile strength is about 991 MPa at RT and 582 MPa at 500 °C, as well as total elongation is about 1.1% at RT and as large as 41% at 500 °C, respectively. In addition, the W-ZrC alloy plate can sustain 3.3 MJ/m(2) thermal load without any cracks. This processing route offers the special coherent interfaces of grain/phase boundaries (GB/PBs) and the diminishing O impurity at GBs, which significantly strengthens GB/PBs and thereby enhances the ductility/strength/plasticity of W alloy. The design thought can be used in the future to prepare new alloys with higher ductility/strength.

Expression profiles of DNA repair-related genes in rat target organs under subchronic cadmium exposure.

We aimed to evaluate the toxicity of long-term exposure to different cadmium (Cd) doses in rats and expression profiles of DNA repair-related genes. The model rats were exposed to different concentrations of CdCl2 for 3 months, and 5 DNA repair-related genes - hMSH2, MLH1, XRCC1, hOGG1, ERCC1 - were cloned in different tissues, including the liver, kidney, heart, and lung. Accumulated amounts of Cd were detected in the tissues. Gene and protein detections were conducted via fluorescence quantitative real-time polymerase chain reaction and Western blotting, respectively. Methylated sequences of the 5 DNA repair-related gene promoters were used to investigate whether the low expression levels of the genes were related to methylation of the promoter. In the Cd-exposed group, 3 DNA repair genes (i.e., XRCC1, hOGG1, and ERCC1) significantly decreased in the rat liver, kidney, heart, and lung according to the ß-actin internal standard (P < 0.01). Western blotting indicated the same trend for the different tissues. Each of the DNA repair genes had special characteristics; for example, hOGG1 gene expression decreased by 75% in the kidney, and XRCC1 gene expression decreased by 5% in the liver and heart when compared to the control group (P < 0.01). A negative correlation between the DNA repair gene expression levels and the cumulative levels of Cd was also suggested by malignancy pathology. The expression levels of 3 DNA repair genes (i.e., ERCC1, XRCC1, and hOGG1) played an important role in the rat response to Cd exposure but not DNA methylated protection.

Experimental study of COX-2 selective and traditional non-steroidal anti-inflammatory drugs in total hip replacement.

This study investigated the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on peri-operative blood loss during elective total hip replacement. Patients were randomized to receive enteric-coated diclofenac 50 mg (n = 18), rofecoxib 12.5 mg (n = 17) or placebo (n = 16) administered orally three times daily for 2 weeks prior to surgery. Severe adverse effects resulting in discontinuation of trial participation occurred in six patients in the diclofenac group, five patients in the rofecoxib group and two patients in the placebo group; all drop-outs occurred at various times after surgery. Compared with placebo, peri-operative blood loss increased by 32% in the diclofenac group and by 7% in the rofecoxib group. Total mean +/- SD blood loss was 1040 +/- 136 ml in the diclofenac group, 844 +/- 83 ml in the rofecoxib group and 789 +/- 82 ml in the placebo group. Thus, administering a non-selective NSAID 2 weeks prior to elective total hip replacement significantly increases peri-operative blood loss.

Circumferential osteotomy of the medial acetabular wall in total hip replacement for the late sequelae of childhood septic arthritis of the hip.

We performed 52 total hip replacements in 52 patients using a cementless acetabular component combined with a circumferential osteotomy of the medial acetabular wall for the late sequelae of childhood septic arthritis of the hip. The mean age of the patients at operation was 44.5 years (22 to 66) and the mean follow-up was 7.8 years (5 to 11.8). The mean improvement in the Harris Hip Score was 29.6 points (19 to 51) at final follow-up. The mean cover of the acetabular component was 98.5% (87.8% to 100%). The medial acetabular wall was preserved with a mean thickness of 8.3 mm (1.7 to 17.4) and the mean length of abductor lever arm increased from 43.4 mm (19.1 to 62) to 54.2 mm (36.5 to 68.6). One acetabular component was revised for loosening and osteolysis 4.5 years postoperatively, and one had radiolucent lines in all acetabular zones at final review. Kaplan-Meier survival was 94.2% (95% confidence interval 85.8% to 100%) at 7.3 years, with revision or radiological loosening as an end-point when two hips were at risk. A cementless acetabular component combined with circumferential medial acetabular wall osteotomy provides favourable results for acetabular reconstruction in patients who present with late sequelae of childhood septic hip arthritis.