[Cumulative risk assessment of phthalates exposure in preschool children].

Objective: The urine concentrations of phthalate metabolites were used to estimate the cumulative risk assessment in preschool children in Ma'anshan of Anhui province. Methods: Based on the China-Anhui Birth Cohort, the demographic information and urine samples of 3 743 children were collected in Ma'anshan from April 2014 to April 2015. The concentrations of 7 metabolites' [monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl- 5-oxohexyl) phthalate (MEOHP) and mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP)] of 5 phthalates [dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP), butyl benzyl phthalate (BBzP), and di (2-ethylhexyl) phthalate (DEHP)] in the urine samples of the children were measured by solid-phase extration-triple quadrupole high performance liquid chromatography-tandem mass spectrometry-isotope method. In addition, the estimated daily intakes (EDIs) of 5 phthalates were calculated according to the metabolites' concentrations. Cumulative risk assessment was performed using hazard quotient (HQ) and hazard index (HI) methods. Results: The M (Q(R)) of seven metabolite concentrations were 29.58 (18.69-48.26), 26.65 (13.44-56.09), 256.86 (150.99-438.51), 0.12 (0.04-0.32), 6.27 (3.71-11.13), 17.94 (11.94-28.42) and 24.80 (16.05-40.32) µg/g creatinine, respectively. For the EDIs of 5 phthalates, DBP ranked first, followed by DEHP, DMP, DEP and BBzP with the M (Q(R)) of 7.54 (4.41-12.85), 3.35 (2.20-5.42), 0.75 (0.47-1.24), 0.71 (0.36-1.52) and 0.003 (0.001-0.009) µg/(kg·d), respectively. The HQ and HI varied with age, gender and sampling season, the differences were significant (P<0.05). Conclusions: These results indicated that risk of cumulative exposure to phthalates was high in preschool children aged 3-6 years in Ma'anshan. Age, gender and sampling season were influencing factors.

Is universal HLA-B*15:02 screening a cost-effective option in an ethnically diverse population? A case study of Malaysia.

BACKGROUND: A strong association has been documented between HLA-B*15:02 and carbamazepine-induced severe cutaneous adverse reactions (SCARs) in Asians. Human leucocyte antigen testing is potentially valuable in many countries to facilitate early recognition of patient susceptibility to SCARs. OBJECTIVES: To determine the cost-effectiveness of universal HLA-B*15:02 screening in preventing carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in an ethnically diverse Malaysian population. METHODS: A hybrid model of a decision tree and Markov model was developed to evaluate three strategies for treating newly diagnosed epilepsy among adults: (i) carbamazepine initiation without HLA-B*15:02 screening (current practice); (ii) universal HLA-B*15:02 screening prior to carbamazepine initiation; and (iii) alternative treatment [sodium valproate (VPA)] prescribing without HLA-B*15:02 screening. Base-case analysis and sensitivity analyses were performed over a lifetime time horizon. Incremental cost-effectiveness ratios were calculated. RESULTS: Both universal HLA-B*15:02 screening and VPA prescribing were dominated by current practice. Compared with current practice, universal HLA-B*15:02 screening resulted in a loss of 0·0255 quality-adjusted life years (QALYs) at an additional cost of 707 U.S. dollars (USD); VPA prescribing resulted in a loss of 0·2622 QALYs at an additional cost of USD 4127, owing to estimated differences in antiepileptic treatment efficacy. CONCLUSIONS: Universal HLA-B*15:02 screening is unlikely to be a cost-effective intervention in Malaysia. However, with the emergence of an ethnically diverse population in many other countries, this may render HLA-B*15:02 screening a viable intervention when an increasing proportion of the population is at risk and an equally effective yet safer antiepileptic drug is available.

[The role of four criteria in assessment of the severity and prognosis of hyperlipidemic acute pancreatitis].

OBJECTIVE: To explore the four criteria, including bedside index for severity in acute pancreatitis(BISAP), Ranson score, modified CT severity index(MCTSI) and acute physiology and chronic health evaluation scoring systemⅡ(APACHE Ⅱ) in assessment of severity and prognosis of hyperlipidemic acute pancreatitis. METHODS: A total of 326 patients with hyperlipidemic acute pancreatitis were studied retrospectively from August 2006 to July 2015. The discrepancy of the four criteria in assessment of severity and prognosis of hyperlipidemic acute pancreatitis was compared with chi-square test and receiver operating characteristic curve. RESULTS: The incidences of moderately severe acute pancreatitis and severe acute pancreatitis, local complications and mortality of patients with BISAP score≥3, Ranson score≥3, APACHE Ⅱ score≥8 and MCTSI score≥4 were significantly higher than BISAP score<3, Ranson score<3, APACHE Ⅱscore<8 and MCTSI<4 respectively (all P<0.05). As far as severity was concerned, the sensitivity and AUC of APACHEⅡ were 57% and 0.814, which were higher than the other systems. The second most sensitive criterion was BISAP. In assessment of local complications, the sensitivity and AUC of MCTSI were 68% and 0.791, which were higher than the other three. The most sensitive criterion to predict mortality was BISAP with sensitivity 89% and AUC 0.867, which was followed by APACHE Ⅱ. CONCLUSIONS: All four criteria can be used to determine the severity, local complications and mortality. Generally, BISAP is simple and easy to practice, and better than the other three.

Anthropogenic atmospheric nickel emissions and its distribution characteristics in China.

Nickel and its compounds are considered as potential human carcinogens, and atmospheric nickel is one of the major routes for human exposure. By applying the best available fuel-based or product-based emission factors and annual activity levels, a multiple-year comprehensive inventory of anthropogenic atmospheric nickel emissions in China is presented with temporal trend and spatial resolutions for the period of 1980-2009 from both fuels combustion sources and industrial producing processes. We estimate that the total atmospheric nickel emissions from all the sources have increased from 1096.07 t in 1980 to 3933.71 t in 2009, at an average annual growth rate of 4.5%. Therein, coal combustion is the leading source, attributing 63.4% of the national total nickel emissions in 2009; liquid fuels consumption ranks the second, contributing 12.4% of the totals; biofuels burning accounts for 8.4% and the remaining sources together contribute 15.8% of the totals. Significant spatial variations are demonstrated among provincial emissions and the most concentrated regions are the highly industrialized and densely populated areas like the Yangtze River Delta, the Pearl River Delta and the Beijing-Tianjin-Hebei region. Moreover, the overall uncertainties are estimated at -32.6%-37.7% by using Monte Carlo simulation, most of which come from non-ferrous metals smelting category, implying the urgent need for further investigation and field tests. This article may help to combat the increasing stress on air heavy metals pollution in China and provide useful information to calculate global mass balance models for hazardous trace elements.

Assessment of vehicular pollution in China.

As the motor vehicle population in China continues to increase at an annual rate of approximately 15%, air pollution related to vehicular emissions has become the focus of attention, especially in large cities. There is an urgent need to identify the severity of this pollution in China. Based on an investigation into vehicle service characteristics, this study used a series of driving cycle tests of in-use Chinese motor vehicles for their emission factors in laboratories, which indicated that CO and HC emission factors are 5-10 times higher, and NOx 2-5 times higher, than levels in developed countries. The MOBILE5 model was adapted to the Chinese situation and used to calculate the emission of pollutants from motor vehicles. Results show that vehicle emission is concentrated in major cities, such as Beijing, Guangzhou, Shanghai, and Tianjin. Motor vehicle emissions contribute a significant proportion of pollutants in those cities, with contribution rates of CO and NOx greater than 80% and 40%, respectively, in Beijing and Guangzhou. Urban air quality is far worse than the national ambient air quality standard. In conclusion, although China has a relatively small number of motor vehicles, most of them are concentrated within metropolitan areas, and their emissions are closely related to urban air pollution problems in large cities.

Accelerate social development to promote the advancement of society.

PIP: The statement of the vice minister of the Chinese State Planning Commission emphasized the achievements made by the government in improving the quality of life of the Chinese people, protecting the environment, controlling population growth, improving health and employment, improving public and social security, and promoting national solidarity. The Chinese government will look forward to sharing the Chinese experiences with social development at the forthcoming UN World Summit on Social Development in March, 1995. Since 1980 a national program for economic development has been in force. Since 1949 and the founding of the People's Republic and particularly since 1978, many advances have been made. The Chinese government has been able to provide adequate food and clothing for a population comprising 22% of the world's population living on 7% of the world's land. Not only have basic living standards been met, but per capital disposable income has increased. Ownership of durable consumer goods has increased to the level of moderately developed countries. Radio messages reach about 80% of the population, and television reaches about 83% of the population. Family planning programs have promoted a balance among population with ecology and socioeconomic development. The rate of natural increase has declined from 25.83 in 1970 to 11.45 in 1993. The crude birth rate for the same period declined from 33.43 to 18.09. The crude death rate has remained at about 6-7 per 1000 population. The total fertility rate has been reduced to 2.0. Life expectancy has increased from 65 years to 70 years. Illiteracy among the population 15 years and older has greater improved; the illiteracy rate among youth and adults was 7% in 1993. Environmental policies have brought industrial pollution under strict control. Sewage treatment plants have been built. Natural gas and centralized heating have been promoted. Sound agricultural practices have been promoted. Reforestation efforts have resulted in the planting of almost 10 billion new trees. 13.9% of land area was forested in 1993. 600,000 sq km of eroded land has been reclaimed. Natural preserves (776) cover 661,800 km. 97.7% of school-age children were enrolled in school in 1993. 53.7% of the senior middle school population was enrolled in technical education. 80.8% of rural population has access to safe drinking water.^ieng

Photochemically induced spinal cord ischaemia in rats: assessment of blood flow by laser Doppler flowmetry.

A photochemical technique was used to create central nervous system ischaemia in rats. Changes in blood flow in the spinal cord were assessed by laser Doppler flowmetry. The Th11 spinal cord segment was irradiated by an argon ion laser after intravenous injection of an organic dye, erythrosin B, to rats with or without a laminectomy. In the group of laminectomized rats, laser irradiation for 5 s did not influence cord blood flow, but 10 s irradiation caused a 25% decrease of blood flow, which normalized within 20 min. Decreases of 50 and 80% in spinal cord blood flow were noted after 20 s and after 1 min of laser irradiation, respectively, with no recovery observed after 20 min. In the group of rats without a laminectomy, 1 min of laser irradiation caused approximately a 25% decrease of spinal cord blood flow, which gradually recovered within 12 min, whereas 5 min of laser irradiation caused a more severe reduction of spinal cord blood flow (45%) with some recovery was observed 30 min later. We could thus confirm that the interaction between a photosensitizing dye and laser irradiation reduced the regional spinal cord blood flow and the extent of this effect could be modified by varying the duration of laser irradiation. The present results therefore provide further support for using this photochemical technique to create animal models of central nervous system ischaemia.