Risk stratification for 1- to 2-cm gastric gastrointestinal stromal tumors: visual assessment of CT and EUS high-risk features versus CT radiomics analysis.

OBJECTIVES: To investigate the ability of CT and endoscopic sonography (EUS) in predicting the malignant risk of 1-2-cm gastric gastrointestinal stromal tumors (gGISTs) and to clarify whether radiomics could be applied for risk stratification. METHODS: A total of 151 pathologically confirmed 1-2-cm gGISTs from seven institutions were identified by contrast-enhanced CT scans between January 2010 and March 2021. A detailed description of EUS morphological features was available for 73 gGISTs. The association between EUS or CT high-risk features and pathological malignant potential was evaluated. gGISTs were randomly divided into three groups to build the radiomics model, including 74 in the training cohort, 37 in validation cohort, and 40 in testing cohort. The ROIs covering the whole tumor volume were delineated on the CT images of the portal venous phase. The Pearson test and least absolute shrinkage and selection operator (LASSO) algorithm were used for feature selection, and the ROC curves were used to evaluate the model performance. RESULTS: The presence of EUS- and CT-based morphological high-risk features, including calcification, necrosis, intratumoral heterogeneity, irregular border, or surface ulceration, did not differ between very-low and intermediate risk 1-2-cm gGISTs (p > 0.05). The radiomics model consisting of five radiomics features showed favorable performance in discrimination of malignant 1-2-cm gGISTs, with the AUC of the training, validation, and testing cohort as 0.866, 0.812, and 0.766, respectively. CONCLUSIONS: Instead of CT- and EUS-based morphological high-risk features, the CT radiomics model could potentially be applied for preoperative risk stratification of 1-2-cm gGISTs. KEY POINTS: • The presence of EUS- and CT-based morphological high-risk factors, including calcification, necrosis, intratumoral heterogeneity, irregular border, or surface ulceration, did not correlate with the pathological malignant potential of 1-2-cm gGISTs. • The CT radiomics model could potentially be applied for preoperative risk stratification of 1-2-cm gGISTs.

Construction and validation of a revised satisfaction index model for the Chinese urban and rural resident-based basic medical insurance scheme.

BACKGROUND: Quality is the most important factor in satisfaction. However, the existing satisfaction index model of urban and rural resident-based basic medical insurance scheme (SIM_URRBMI) lacks the segmentation of perceived quality elements, it couldn't provide a reference for quality improvement and satisfaction promotion. This study aims to construct a revised SIM_URRBMI that can accurately and detailly measure perceived quality and provide feasible and scientific suggestions for improving the satisfaction of urban and rural residents' basic medical insurance scheme (URRBMI) in China. METHODS: Based on the theoretical framework of the American Customer Satisfaction Index, the elements of perceived quality were refined through literature review and expert consultation, and a pool of alternative measurement variables was formed. A three-stage randomized stratified cluster sampling was adopted. The main decision makers of URRBMI in the families of primary school students in 8 primary schools in Changsha were selected. Both the classic test theory and the item response theory were used for measurement variables selection. The reliability and validity of the model were tested by partial least squares (PLS)-related methods. RESULTS: A total of 1909 respondents who had URRBMI for their children were investigated. The SIM_URRBMI1.0 consists of 11 latent variables and 28 measurement variables with good reliability and validity. Among the three explanatory variables of public satisfaction, perceived quality had the largest total effect (path coefficient) (0.737). The variable with the greatest effect among the five first-order latent variables on perceived quality was the quality of the medical insurance policy (0.472). CONCLUSIONS: The SIM_URRBMI1.0 consists of 28 measurement variables and 11 latent variables. It is a reliable, valid, and standard satisfaction measurement tool for URRBMI with good prediction ability for public satisfaction. In addition, the model provides an accurate evaluation of the perceived quality, which will greatly help with performance improvement diagnosis. The most critical aspects of satisfaction improvement are optimizing the scope and proportion of reimbursement as well as setting appropriate level of deductible and capitation of URRBMI.

[Soil-crop Distribution and Health Risk Assessment of Organochlorine Pesticides on Typical Agricultural Land in Southern Leizhou Peninsula].

The residual content of organochlorine pesticides (OCPs) in soil and crops of typical agricultural land in the southern Leizhou peninsula were determined using gas chromatography-mass spectrometry (GC-MS). Additionally, the bioconcentration factors of organochlorine pesticides in eight crops were investigated, and the human health risk was evaluated. The results indicated that 10 types of OCPs were detected to varying degrees; HCHs and heptachlor were the main OCPs in the study area, with the residual contents of 23.83-111.51 ng·g-1 and 11.01-25.97 ng·g-1 in soil and 7.54-61.28 ng·g-1 and 3.96-30.97 ng·g-1 in crops, respectively. A small number of soil and crop samples were found to exceed the standard. The ratio of α-HCH/γ-HCH was less than 1 in 87.50% of the soil samples, and ß-HCH/α-HCH was larger than 1. This indicates that the HCHs were probably derived from the recent use of lindane and historical residual pollution, whereas the heptachlor was mainly derived from underground insect pests and the application of termite control agents. The enrichment ability of OCPs was significantly different among different crops. The bioaccumulation capacity of vegetables was higher than that of fruit. Furthermore, bulb vegetables (leeks) were significantly stronger than other vegetables. A human health risk assessment of OCPs showed that OCP-combined pollution would not cause significant health risks to the population in the study area. However, the maximum value of HI in some crop samples was greater than 1, indicating that there were still potential risks, which should not be ignored.

Gd-EOB-DTPA-enhanced MRI-a noninvasive and short-term assessment method for liver necroinflammation after direct-acting antiviral (DAA) therapy in patients with chronic hepatitis C.

PURPOSE: To assess liver necroinflammation in HCV patients undergone antiviral therapy by Gd-EOB-DTPA-enhanced MRI with histopathologic analyses as reference. METHODS: HCV patients were enrolled in this prospective study before antiviral treatment between 09-2016 and 07-2017. Unenhanced MR, Gd-EOB-DTPA-enhanced MR, and liver biopsy were performed before and 24 weeks after treatment of daclatasvir with asunaprevir (DAA). DWI was obtained using a breath-hold single-shot echo planar spin-echo sequence. Twenty minutes after administration of Gd-EOB-DTPA, the relative enhancement (RE) and the contrast enhancement index (CEI) were recorded. Liver necroinflammatory activity grades (G0-18) were categorized on the Ishak Scoring systems. CEI, RE, and DWI of baseline and 24 weeks after treatment were compared by paired t test. Relationship between MR parameters and histologic scores was evaluated by Pearson's correlation. Receiver operating characteristic analysis evaluated the measurements' diagnostic performance. MRI variability between two readers was assessed using the intraclass correlation coefficient.Results RESULTS: A decrease of liver necroinflammatory activity grade (p < 0.0001) was detected in final cohort (n = 21; mean age 44 years; 23 to 67 years; 11 F, 10 M). Statistical results of 42 person-times in 21 patients at baseline and follow-up showed CEI and ADC were significantly different (p = 0.006 and 0.036) across histologic grades of liver necroinflammation. Significant increase of CEI, RE, and ADC (p = 0.0004, 0.0032, 0.0110) 24 weeks after DAA treatment was seen. Additionally, CEI was correlated to necroinflammatory grade (r = - 0.596, p = 0.006). AUROC for CEI, ADC, and CEI combined with ADC to differentiate patients with none and mild (G0-6) from patients with moderate and severe necroinflammation (G7-18) was 0.834 (95% CI 0.712-0.956, 0.724(95% CI 0.565-0.884) and 0.837(95% CI 0.717-0.956). CONCLUSION: Gd-EOB-DTPA-enhanced MRI by CEI could be used as a noninvasive imaging biomarker to distinguish grades of necroinflammatory activity in patients with HCV after DAAs therapy at early stage and CEI combined with ADC could get a better diagnostic accuracy.

Does tourism industry agglomeration reduce carbon emissions?

The global level of climate change agreement and the extensive development of China's industrialization process have caused China to face severe pressures regarding energy conservation and emission reduction. Tourism industry plays an important role in promoting steady economic growth and improving ecological environment in China. The agglomeration economic effect it produces can reduce carbon emissions, but the crowding effect may not be conducive to low carbon development. Therefore, how to reduce carbon emissions while promoting the development of tourism industry has become an urgent problem. This paper measures the level of tourism industry agglomeration and carbon emission in 30 regions of China and uses the method of spatial econometrics to analyze the impact of tourism industry agglomeration on carbon emissions. The empirical results prove that tourism industry agglomeration can reduce the carbon emissions of local and neighboring regions in China. However, this does not mean that the larger the scale of tourism industry agglomeration, the more conducive to the reduction of carbon emissions. For developed tourism groups, the impact of agglomeration effect on carbon emissions of local and adjacent areas shows a U-shaped relationship. When the agglomeration level exceeds 1.963, the expansion of agglomeration scale will increase local carbon emissions. For underdeveloped tourism areas, there is an inverted U-shaped relationship between agglomeration level and carbon emissions both in local and adjacent areas. When the agglomeration level reaches 1.883, the expansion of agglomeration scale will reduce local carbon emissions. The conclusions provide a basis for Chinese government to guide the low-carbon development of the tourism industry from another perspective.

Enhanced Rim on MDCT of Colorectal Liver Metastases: Assessment of Ability to Predict Progression-Free Survival and Response to Bevacizumab-Based Chemotherapy.

OBJECTIVE. The purpose of this article is to evaluate the enhanced rim on the portal venous phase (PVP) on MDCT as a predictor of 1-year progression-free survival (PFS) and response to bevacizumab-based chemotherapy in patients with colorectal liver metastases (CRLM). MATERIALS AND METHODS. We retrospectively identified 111 patients with primary unresectable CRLM treated with bevacizumab-based chemotherapy at two institutions between 2012 and 2018. Pretreatment contrast-enhanced MDCT images were reviewed and data on clinical characteristics were collected from the electronic medical records. Univariable and multivariable analyses were conducted to assess several imaging features and clinical characteristics as potential predictors of 1-year PFS and objective response rate (ORR). RESULTS. After 1 year of follow-up, liver metastatic tumor progression was detected in 52 patients (46.8%) after bevacizumab-based chemotherapy. A log-rank test showed that enhanced rim on PVP (chi-square test, 5.862; p = 0.015) and the occurrence of liver resection surgery (chi-square test, 7.836; p = 0.005) were significant predictors of 1-year PFS. Multivariable analysis showed that enhanced rim on PVP images was an independent predictor of 1-year PFS (hazard ratio, 0.510; 95% CI, 0.282-0.926; p = 0.027) and ORR (odds ratio, 4.694; p < 0.001). CONCLUSION. The presence of an enhanced rim on PVP MDCT is an independent predictor of survival and response to bevacizumab-based chemotherapy among patients with CRLM.

Mixed methods research on satisfaction with basic medical insurance for urban and rural residents in China.

BACKGROUND: There have been few studies on satisfaction with integrated basic medical insurance for urban and rural residents (URRBMI), and satisfaction with URRBMI is not very high because of the complexity of its policies and differences among the insured. The aim of the present study was to explore the factors that influence satisfaction with URRBMI in China and to provide scientific suggestions to the government for how to effectively manage and improve the policy. METHODS: An explanatory sequential design of mixed methods research was used. A quantitative research using a three-stage stratified cluster sampling method was used to randomly select the guardians of pupils who participated in URRBMI (n = 1335). The quantitative research was conducted to calculate the latent variables' scores and path coefficients between latent variables using SmartPLS3.0. With public trust, public satisfaction, and perceived quality as the target variables, important-performance analysis (IPA) was used to explore the important but underperforming factors, which were the key elements to improving satisfaction with URRBMI. A purposeful sampling strategy according to satisfaction level was used to obtain qualitative research subjects from among the quantitative research subjects. A qualitative research was conducted using semi-structured interviews, and the thematic analysis method was used to summarize the interview data. RESULTS: The three strongest paths were perceived quality to public satisfaction, with a total effect of 0.737 (t = 41.270, P < 0.001); perceived quality to perceived value, with a total effect of 0.676 (t = 31.964, P < 0.001); and public satisfaction to public trust, with a total effect of 0.634 (t = 31.305, P < 0.001). IPA revealed that public satisfaction and perceived quality were key factors for public trust and that perceived quality was of high importance for public satisfaction but had low performance. The policy quality was a determining factor for perceived quality. The qualitative research results showed that the most unsatisfactory aspect for the insured was the policy quality. CONCLUSIONS: This study found that improving quality is key to improving public satisfaction with and public trust in URRBMI. The government should improve the compensation level by broadening the channel of financing for the URRBMI fund, rationally formulating reimbursement standards, and broadening the scope of the drug catalog and the medical treatment projects. The government should establish a stable financing growth mechanism and effective methods of providing health education to improve public satisfaction and public trust.

[Measurement of Traffic Carbon Emissions and Pattern of Efficiency in the Yangtze River Economic Belt (1985-2016)].

The "top-down" method was used to measure the traffic carbon emissions from 1985 to 2016 in the Yangtze River Economic Belt and analyze its spatial pattern and temporal evolution characteristics. Considering the unexpected output, a three-stage DEA model was constructed to evaluate and compare the traffic carbon emission efficiency of the Yangtze River Economic Belt, excluding the influence of external environment variables and random errors. The study found that first, the total traffic carbon emissions in the Yangtze River Economic Belt showed a rising trend, among which the carbon emissions from petroleum energy consumption accounted for the largest proportion. Sichuan, Hubei, and Hunan and the Su-Zhe-Hu Region were the high-value areas of traffic carbon emissions in the upper, middle, and lower reaches of the Yangtze River, respectively. Second, from the east to west, the center of traffic carbon emissions generally showed a changing track of moving east first and then west; from the north to south, it highlighted the characteristics of increasing concentrated distribution along the Yangtze River in space. Third, there was an obvious spatial differentiation in the traffic carbon emission efficiency values of different provinces; from 2007 to 2016, the efficiency value of the eastern region was the highest, but the value of the central region changed from higher than that in the western region to lower than that in the western region. Finally, external environmental factors had a significant impact on the efficiency of traffic carbon emissions, in which the optimization of industrial structure was found to be conducive to the improvement of traffic carbon emission efficiency, while the influence of government intervention was changed from "innovation compensation" effect to "compliance cost" effect.

An assessment of the Chinese medicinal Dendrobium industry: Supply, demand and sustainability.

ETHNOPHARMACOLOGICAL RELEVANCE: A high proportion of species native to China from the genus Dendrobium (Orchidaceae) have been used as folk medicine for more than 2300 years. The fresh or dried stem of many Dendrobium species are regarded as "superior grade" tonic in Traditional Chinese Medicine (TCM), for their traditional properties of nourishing the kidney, moisturizing the lung, benefiting the stomach, promoting the production of body fluids and clearing heat. AIM OF THE STUDY: This review aims to provide comprehensive and updated information on the diversity of Dendrobium species used in TCM and the development of the Dendrobium industry. The supply and demand of the Chinese medicinal Dendrobium are investigated. Moreover, we discuss the problems the industry faces and the relationship between the cultivation and species conservation. MATERIALS AND METHODS: The available information on many Dendrobium species (especially D. officinale) was collected from the electronic databases (using Pubmed, CNKI, Baidu scholar, Google scholar and Web of Science). We also obtained information from communication with specialists with profound knowledge in related research field and industry practitioners. Information was also obtained from website of the Forestry Bureau or relevant government departments, online databases, books, Ph.D. dissertations and M.Sc. theses. RESULTS: Approximately 41 species in genus Dendrobium have been recorded in TCM. The development of the Dendrobium industry could be divided into three phases: (a) the wild-collection phase, (b) the massive commercial artificial-sheltered cultivation phase and (c) the diversified ecologically-friendly cultivation phase. The development of seedlings production technology, the improvement of substrates and the integration of cultivation technology support the rapid increase of Dendrobium herbs in the Chinese TCM market. Doubts around the quality and efficacy of product in artificial-sheltered cultivation, the lack of product standards and the low level of product development have limited the utilization for TCM and hampered the development of the Dendrobium industry. Both the artificial-sheltered cultivation and ecologically-friendly cultivation contribute to the conservation of Dendrobium species, through the use seedlings derived from seeds of sexual reproduction rather than meristematic-based clonal propagation. CONCLUSIONS: This review summarizes the species and cultivation history of medicinal herbs in the Dendrobium. The review can help inform future scientific research towards the TCM in Dendrobium, including mycorrhizal technology and microorganism fertilizer, pharmacological studies, the directed cultivation of varieties and diversified product. It is suggested that Dendrobium cultivation has a great potential to link the commercial TCM industry together with initiatives of biodiversity conservation.

U-Shaped Relationship between Years of Residence and Negative Mental Health Outcomes among Rural-to-Urban Children in Migrant Schools in Beijing, China: The Moderating Effects of Socioeconomic Factors.

AIM: This study aimed to test the relationship between length of residence and mental health in a school-based sample of migrant children who studied in migrant schools. METHODS: A total of 7,296 rural-to-urban migrant children were recruited from 58 schools in Beijing and assessed by the State-Trait Anxiety Inventory and Children's Depression Inventory. RESULTS: A quadratic relationship was found between mental health and length of residence. The results suggested that the scores for anxiety and depression were high during the initial resettlement after migrating and then decreased. However, after approximately 8 years, the scores increased. Our findings also showed a significant moderating effect of family socioeconomic status on the relation between mental health and length of residence. CONCLUSION: This study provided empirical evidence for a better understanding of psychosocial factors on the mental health of migrant children during the process of urbanization in China.

Presence, distribution and risk assessment of polycyclic aromatic hydrocarbons in rice-wheat continuous cropping soils close to five industrial parks of Suzhou, China.

Polycyclic aromatic hydrocarbons (PAHs) accumulated in agricultural soils are likely to threaten human health and ecosystem though the food chain, therefore, it is worth to pay more attention to soil contamination by PAHs. In this study, the presence, distribution and risk assessment of 16 priority PAHs in rice-wheat continuous cropping soils close to industrial parks of Suzhou were firstly investigated. The concentrations of the total PAHs ranged from 125.99 ng/g to 796.65 ng/g with an average of 352.94 ng/g. Phenanthrene (PHE), fluoranthene (FLT), benzo [a] anthracene (BaA) and pyrene (PYR) were the major PAHs in those soil samples. The highest level of PAHs was detected in the soils around Chemical plant and Steelworks, followed by Printed wire board, Electroplate Factory and Paper mill. The composition of PAHs in the soils around Chemical plant was dominated by 3-ring PAHs, however, the predominant compounds were 4, 5-ring PAHs in the soils around other four factories. Meanwhile, the concentration of the total PAHs in the soils close to the factories showed a higher level of PAHs in November (during rice harvest) than that in June (during wheat harvest). Different with other rings of PAHs, 3-ring PAHs in the soils around Chemical plant and Steelworks had a higher concentration in June. The results of principal component analysis and isomeric ratio analysis suggested that PAHs in the studied areas mainly originated from biomass, coal and petroleum combustion. The risk assessment indicated that higher carcinogenic risk was found in those sites closer to the industrial park.

A simple risk chart for initial risk assessment of 30-day mortality in patients with cardiogenic shock from ST-elevation myocardial infarction.

AIMS: Early risk stratification is important in patients with cardiogenic shock from ST-elevation myocardial infarction (STEMI). We aimed to develop a simple risk chart that includes clinical parameters that are readily available at time of hospital admission to assess risk of 30-day mortality. METHODS AND RESULTS: A series of 544 STEMI patients admitted to undergo primary percutaneous coronary intervention and presenting with cardiogenic shock were included between 2000 and 2012. Overall 30-day mortality was 38.4% and did not change over the years (p-trend=0.64). Baseline variables that were available at time of hospital admission were entered into a logistic regression model in a forward stepwise manner. Only age (odds ratio (OR) per year 1.05, 95% confidence interval (CI) 1.04-1.07, p<0.001), initial serum lactate level (OR per mmol/l 1.17, 95% CI 1.11-1.24, p<0.001) and initial creatinine level above the upper limit of normal (OR 2.89, 95% CI 1.90-4.37, p<0.001) remained independent predictors, and were subsequently used to develop a risk chart that stratifies risk of 30-day mortality into categories ranging from 0-20% to 80-100%. The calibration plot showed a close relationship between expected and observed mortality. The risk chart had a higher discriminative accuracy than the GRACE score (c-index 0.75 vs. 0.66, p=0.009). Adding variables that were obtained from coronary angiography and during clinical course did not significantly improve discriminative accuracy of risk chart (c-index 0.77, p=0.48). CONCLUSION: Mortality of patients with cardiogenic shock from STEMI undergoing primary percutaneous coronary intervention can be well predicted already at time of hospital admission by a risk chart that uses only three variables, namely, age, initial serum lactate and creatinine level.

[Size distribution characteristics of particulate mercury on haze and non-haze days].

With the rapid economic development, China suffers from the severe haze and atmospheric mercury pollution. Particulate mercury transport has an important significance in its global cycle. In order to investigate the distribution characteristics of particulate mercury, 12 degrees Nano-moudi (6.2-9.9 µm, 3.1-6.2 µm, 1.8-3.1 µm, 1.0-1.8 µm, 0.56-1.0 µm, 0.32-0.56 µm, 0.18- 0.32 µm, 0.10-0.18 µm, 0.056-0.10 µm, 0.032-0.056 µm, 0.018-0.032 µm, 0.010-0.018 µm) impactor was used to measure the size distributions of atmospheric particulate mercury on both haze and non-haze days in Shanghai. The results indicated that particulate mercury levels were positively correlated with those of the particles. The average concentration of particulate mercury (0.31 ng x m (-3)) on haze days was 2-3 times than that on non-haze days (0.11 ng x m(-3)). The mass size distributions of aerosols and particulate mercury showed bimodal distributions. The peak shifted from 0.56-1.0 µm and 3.1-6.2 µm on haze days to 0.32-0.56 µm and 3.1-6.2 µm on non-haze days. The particles with aerodynamic diameter smaller than 1 µm which could stay for a long time and transport for a long distance, had higher particulate mercury concentrations. The average contribution of particulate mercury to total PM aerosol were higher on haze days (0.029 ng x µg(-1)) than on non-haze days (0.015 ng x µg(-1)), indicating that secondary particles typically grew faster than mercury during the haze pollution events. The particulate mercury concentration in accumulation mode was 2.06 ng x m(-3) on haze days, while it was 0.55 ng x m(-3) on non-haze days. The large increase of the accumulation mode particles was a main reason for the formation of haze. Emissions from the coal burning as well as road surface dust and dust from long-range transport accounted for the serious pollution on haze days.

Gastrointestinal hemorrhage in warfarin anticoagulated patients: incidence, risk factor, management, and outcome.

BACKGROUND: Warfarin reduces the incidence of thromboembolism but increases the risk of gastrointestinal bleeding (GIB). GIB during warfarin anticoagulation is rarely evaluated in Asian patients. AIMS: This study aimed at investigating the incidence, risk factors, management, and outcome of GIB in Taiwanese patients treated with warfarin. METHODS: We analyzed a cohort of warfarin anticoagulated patients between July 1993 and May 2012. Clinical data were retrieved in a chart-reviewing manner. RESULTS: A total of 401 warfarin anticoagulated patients were enrolled. The incidence of GIB was 3.9% per patient-years. Multivariate analysis with Cox regression showed that age >65 years old (RR: 2.5, 95% CI: 1.2-5.5), a mean international normalized ratio >2.1 (RR: 2.1, 95% CI: 1.0-4.2), a history of GIB (RR: 5.1, 95% CI: 1.9-13.5), and cirrhosis (RR: 6.9, 95% CI: 2.0-24.5) were independent factors predicting GIB. 27.3% of the GIB patients had rebleeding after restarting warfarin while thromboembolic events were found in 16.7% of the patients discontinuing warfarin therapy. CONCLUSIONS: Warfarin was associated with a significant incidence of GIB in Taiwanese patients. The intensity of anticoagulation should be monitored closely during warfarin therapy, especially in patients with risk factors of GIB.

[Assessment and correlation analysis of heavy metals pollution in soil of Dajinshan Island].

The Dajinshan Island is the highest altitude point in the nature land of Shanghai. In order to find out the status of soil heavy metals pollution of the Dajinshan Island and its correlation, this paper used the methods of grid and serpents sampling to collect samples, and applied the single factor pollution index method and potential ecological harm index method to assess the pollutions status. The results showed that the main contributor of soil heavy metal pollution in Dajinshan Island was Cd, with an over-standard rate of 85.4%, followed by Pb, with an over-standard rate of 26.8%, whereas Zn and Cu were not excessive. In addition, there was significant positive correlation between Pb-Cu, Pb-Zn and Cu-Zn at the level of P = 0.05, suggesting that they had high homology and were easily influenced by the soil forming materials. This was an indirect evidence that the Dajinshan Island was well protected and not much affected by human activities.

[The study on the value of using the chronic obstructive pulmonary disease and asthma physiology score to assess the severity of acute exacerbation in patients with chronic obstructive pulmonary disease complicated by type II respiratory failure].

OBJECTIVE: To explore the value of the chronic obstructive pulmonary disease (COPD) and asthma physiology score (CAPS) in evaluating the severity and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by type II respiratory failure. METHODS: Eighty-two cases with AECOPD complicated by type II respiratory failure between January 2005 and March 2009 were retrospectively analyzed. The severity in survivors and non-survivors was evaluated by CAPS and acute physiology and chronic health evaluation system (APACHE II score, APACHE III score), and retrospective and statistical analyses of all data were performed. RESULTS: CAPS, APACHE II score, APACHE III score, duration of invasive positive pressure ventilation (IPPV) and days in intensive care unit of 19 cases in the death group were 34.21+/-9.89, 22.53+/-7.49, 75.11+/-18.07, (25.06+/-24.64) days, (32.42+/-25.49) days , respectively, while 63 cases of the survival group were 27.41+/-8.15, 18.65+/-5.34, 64.11+/-15.92, (5.23+/-5.50) days, (12.51+/-20.70) days, respectively, and there were significant differences between two groups (P<0.05 or P<0.01). The areas under receiver operating characteristic (ROC) curves of CAPS, APACHE II score and APACHE III score were 0.712 (P=0.005), 0.654 (P=0.043) and 0.655 (P=0.042), respectively. When CAPS score was 30.5, Youden index was the highest (0.435). The mortality rate had a positive correlation with CAPS. When the CAPS score was over 30, there was a tendency of increase in mortality rate. CONCLUSION: CAPS is very useful to evaluate the severity and prognosis of patients with AECOPD complicated by type II respiratory failure. It is easy to perform, and better than APACHE II and APACHE III.

Screening of flocculant-producing microorganisms and flocculating activity.

A strain saccharomycete STSM-1 with high flocculanting activity was isolated from activated sludge with conventional methods. The high production rate and the low cost STSM-1 medium was obtained by selecting different kinds of media, carbon source, nitrogen source and inorganic salt ion. The best flocculant-producing conditions were found by changing medium initial pH, culture temperature and ventilation flow. The best flocculating effect was obtained by changing positive ion types, density and concentration of flocculant.

[Study on the epidemiology and risk factors of renal calculi in special economic zone of Shenzhen city].

OBJECTIVE: To study the epidemiological characters and risk factors of renal calculi in Shenzhen for future intervention. METHODS: Risk factors of renal calculi were analyzed by factor analysis and linear structural relation model, followed by fitting and evaluating the model. RESULTS: The prevalence rates of renal calculi were 8.00% and 5.12% in males and females. The results of LISEREL showed that the total effect of age and sex affecting the development of renal calculi was 0.4614, with directly effect 0.3600 and indirect 0.1014. The direct effects of blood uric acid, blood calcium and body mass index, blood cholesterol, blood sugar were 0.3400 and 0.3200 respectively. The indirect effect of education, exercise and dietary habit affected the development of renal calculi through index of biochemistry and obesity, were -0.0416 and 0.1882. CONCLUSION: Sex, age, obesity and high blood cholesterol, high blood sugar, high blood uric acid, high blood calcium were the direct influencing factors to renal calculi. At the same time, education, exercise and dietary habit were also associated with the disease.