Spatial distribution and risk assessment of polycyclic aromatic hydrocarbons in soils from contaminated sites in Eastern China.

A total of 16 polycyclic aromatic hydrocarbons (PAHs) were measured in 28 soil column samples from two contaminated industrial sites in Eastern China. The total concentration of 16 PAHs (∑PAHs) in the surface soil (0-20 cm) was measured up to 52,600 ng/g (dry weight basis) with a remarkable spatial difference in the studied contaminated sites. The concentrations of the ∑PAHs in soils decreased with the increase in soil depth (0-10 m). The surface and subsurface soil presented a tenfold higher concentration than the soil with depth greater than 4 m. Additionally, the vertical migration tendency of the PAHs was found to be correlated significantly with their hydrophobicity (R2 = 0.79, P < 0.01). Naphthalene (with lowest octanol-water partition coefficient among the studied PAHs) showed the greatest average soil depth at which its peak concentration occurred. Furthermore, risk quotient analysis by using benzo[a]pyrene as reference compound showed that 71.4% of the samples exhibited high ecological risk for soil. Moreover, the total carcinogenic risk of the PAHs in the surface soil samples was assessed at 5.61 × 10-5-1.28 × 10-4 and 4.41 × 10-6-9.43 × 10-5 for male and female workers, respectively, in which 67.9%-71.4% of the samples showed potential risk. Generally, these results suggest a further consideration of ecological and health risks associated with PAHs in contaminated sites in Eastern China.

Using a novel strategy to investigate the spatially autocorrelated and clustered associations between short-term exposure to PM2.5 and mortality and the attributable burden: A case study in the Sichuan Basin, China.

Due to the lack of statistical methods, few studies have investigated the spatial autocorrelated distribution in the association between short-term exposure to PM2.5 and mortality and used a statistical manner to explore the association-clustered regions, which play important roles in identifying high-sensitivity/susceptibility regions. The Sichuan Basin (SCB) is one of the most PM2.5-polluted areas, and the extreme economic imbalance may cause considerable spatial heterogeneity and clustering in PM2.5-mortality association. In this work, we used a recently proposed strategy by us to investigate the spatially autocorrelated and clustered association between daily PM2.5 and cardiorespiratory mortality from 2015 to 2019 in 130 counties of the SCB. First, generalized additive models were independently constructed to obtain the county-level association estimations. Then, an estimation-error-based spatial scan statistic was used to detect the association-clustered regions. Third, multivariate conditional meta autoregression was used to obtain the spatially autocorrelated association distribution, based on which the attributable deaths were mapped and their inequality was evaluated using the Gini coefficient and Lorenz curve. Results showed that two significantly association-clustered regions were detected. One is mainly located in the megacity Chengdu where PM2.5 presented a significantly stronger association with no threshold effect at low-level PM2.5 but a threshold at high-level PM2.5. In the other cluster, a threshold effect at low-level PM2.5 but no threshold at high-level PM2.5 were found. The mortality risk at low/middle-level PM2.5 decreased from Chengdu as the center to the surrounding areas. A total of 29,129 (2.0 %) deaths were attributable to the excess PM2.5 exposure. The attributable deaths also decreased from Chengdu as the center to the surrounding areas with Gini coefficients of 0.43 and 0.3 for absolute and relative attributable deaths, respectively. This novel strategy provided a new epidemiological perspective regarding the association and implicated that Chengdu is significantly deserving of more attention regarding PM2.5-related health loss.

Novel Brominated Flame Retardants in Dust from E-Waste-Dismantling Workplace in Central China: Contamination Status and Human Exposure Assessment.

Novel brominated flame retardants (NBFRs) have been widely used as alternatives to legacy BFRs. However, information on the contamination status and human exposure risks of electronic waste (e-waste)-derived NBFRs in the e-waste workplace is limited. In this study, six NBFRs and the legacy BFRs, hexabromocyclododecanes (HBCDs), were analyzed in 50 dust samples from an e-waste-dismantling workplace in Central China. The dust concentration of NBFRs in e-waste-dismantling workshops (median, 157−169 ng/g) was found to be significantly higher than those in an outdoor environment (17.3 ng/g) (p < 0.01). Differently, the highest median concentration of HBCDs was found in dust from the dismantling workshop for cellphones and computers (367 ng/g) among studied areas. The bis(2-ethylhexyl)-3,4,5,6-tetrabromo-phthalate (BEHTBP) was the predominant compound, which contributed 66.0−88.0% of measured NBFR concentrations. NBFRs might originate from plastic and rubber materials in wastes based on the correlation and principal component analysis. Moreover, the total estimated daily intakes (average scenario) of NBFRs were calculated at 2.64 × 10−2 ng/kg bw/d and 2.91× 10−2 ng/kg bw/d for the male and female dismantling workers, respectively, via dust ingestion, inhalation, and dermal contact pathways, which were lower than the reference dose values, and thus indicated a limited human exposure risk for NBFRs at the current level. Although the dust concentrations and daily intakes of NBFRs were still lower than those of other emerging pollutants (e.g., organophosphate and nitrogenous flame retardants) measured in the same sampling set, the elevated levels of NBFRs suggested the progressive BFR replacement process in China, which deserves more attention regarding their adverse effects on both the environment and human health.

Socio-demographic characteristics and inequality in exposure to PM2.5: A case study in the Sichuan basin, China.

The Chengyu Metropolitan Area (CYMA), located in the Sichuan Basin, is an unevenly developed region with high PM2.5 concentrations and a population of approximately 100 million. Although exposure inequality in air pollution has received increasing concern, no related research has been carried out in the CYMA to date. In this work, we used the concentration index to assess inequality of PM2.5 population-weighted exposure in the CYMA among different subgroups, including age, education, gender, occupation and GDP per capita in the city of residence. Our findings revealed that the non-disadvantaged subgroups (people aged 15-64, people with senior and higher education, people with high-income occupations and residents of cities with high GDP per capita) had a higher PM2.5 exposure in the CYMA, with the concentration indices of -0.03 (95% CI: 0.064, -0.001), -0.14 (95% CI: 0.221, -0.059), -0.15 (95% CI: 0.238, -0.056) and -0.27 (95% CI: 0.556, 0.012), opposite to previous studies in developed countries such as the United States and France. In addition, exposure differences among cities were much larger than those among populations in the CYMA. These findings may benefit the government in identifying disproportionately exposed subgroups in developing regions, and suggest that related measures should initially be carried out for cities exposed to high PM2.5 concentrations rather than for populations exposed to high PM2.5 concentrations.

[Chinese medicine dispensing granules: history, status quo, and development prospect in "post-pilot era"].

Chinese medicine dispensing granules, the result of the efforts to transform Chinese medicinal decoction pieces in China, features portability and ease of storage. Thus, it is destined to be an indispensible dosage form in the modernization drive of Chinese medicine. The Announcement on Ending the Pilot Project of Chinese Medicine Dispensing Granules was released in February 2021 and relevant regulations went into force in November 2021, which marks the a new journey for the development of Chinese medicine dispensing granules and the beginning of the "post-pilot era". However, it faces the challenges in quality and standard. This study reviewed the history of Chinese medicine dispensing granules, analyzed the technical progress, market, and main problems in development, and proposed suggestions and prospects for its development in the "post-pilot era", which is expected to serve as a reference for its industry development and rational use.

Percutaneous spinal endoscopy with unilateral interlaminar approach to perform bilateral decompression for central lumbar spinal stenosis: radiographic and clinical assessment.

BACKGROUND: Recently, a percutaneous spinal endoscopy unilateral posterior interlaminar approach to perform bilateral decompression has been proposed for use in treatment of lumbar spinal stenosis, As a development and supplement to traditional surgery, its advantages regarding therapeutic effects and prognosis, such as minor soft tissue damage, little intraoperative blood loss, and a quick return to daily life. However, there are few analyses of this surgery with a follow-up of more than 1 year,we conducted this study in order to quantitatively investigate radiographic and clinical efficacies of this surgery for central lumbar spinal stenosis. MATERIALS AND METHODS: Forty-six patients with central lumbar spinal stenosis were enrolled from January 2017 to July 2018. The visual analog scale (VAS) for back pain and leg pain, Oswestry disability index (ODI), modified MacNab criteria were used to evaluate clinical efficiency at preoperative and postoperative time points. The intervertebral height index (IHI), cross-sectional area of the spinal canal (CSAC), calibrated disc signal (CDS) and spinal stability were examined to assess radiographic decompression efficiency via magnetic resonance imaging and X-ray at preoperative and postoperative time points. RESULTS: The VAS score for lower back pain and leg pain improved from 7.50 ± 0.78 to 1.70 ± 0.66 and from 7.30 ± 0.79 to 1.74 ± 0.68, respectively, and the ODI improved from 72.35 ± 8.15 to 16.15 ± 4.51. In terms of modified MacNab criteria, 91.3% of the patients achieved good or excellent outcomes. Furthermore, significant changes after surgery were observed for the percentage of CSAC, increasing from 125.3 ± 53.9 to 201.4 ± 78 mm2; however, no significant differences were observed for the remaining measurement indicators. CONCLUSIONS: The clinical and radiographic efficacies of this surgery for central lumbar spinal stenosis were good in short-term follow-up, and this surgery did not cause meaningful changes in IHI, CDS, and spine stability in short-term follow-up. The effect of long-term follow-up needs further investigation.

Guiding Lay Navigation in Geriatric Patients With Cancer Using a Distress Assessment Tool.

BACKGROUND: There is growing interest in psychosocial care and evaluating distress in patients with cancer. As of 2015, the Commission on Cancer requires cancer centers to screen patients for distress, but the optimal approach to implementation remains unclear. METHODS: We assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014. RESULTS: Of the 5,121 patients enrolled in our lay patient navigation program, 4,520 (88%) completed at least one assessment using a standardized distress tool (DT). Navigators used the tool to structure both formal and informal distress assessments. Of all patients, 24% reported distress scores of 4 or greater and 5.5% reported distress scores of 8 or greater. The most common sources of distress at initial assessment were pain, balance/mobility difficulties, and fatigue. Minority patients reported similar sources of distress as the overall program population, with increased relative distress related to logistical issues, such as transportation and financial/insurance questions. Patients were more likely to ask for help with questions about insurance/financial needs (79%), transportation (76%), and knowledge deficits about diet/nutrition (76%) and diagnosis (66%) when these items contributed to distress. CONCLUSIONS: Lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.

[Comparative study on four kinds of assessment methods of post-marketing safety of Danhong injection].

OBJECTIVE: To study the adverse reaction of Danhong injection with four kinds of methods, central monitoring method, chart review method, literature study method and spontaneous reporting method, and to compare the differences between them, explore an appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection. METHOD: Set down the adverse reactions' questionnaire of four kinds of methods, central monitoring method, chart review method, literature study method and collect the information on adverse reactions in a certain period. Danhong injection adverse reaction information from Henan Province spontaneous reporting system was collected with spontaneous reporting method. Carry on data summary and descriptive analysis. RESULT: Study the adverse reaction of Danhong injection with four methods of central monitoring method, chart review method, literature study method and spontaneous reporting method, the rates of adverse events were 0.993%, 0.336%, 0.515%, 0.067%, respectively. Cyanosis, arrhythmia, hypotension, sweating, erythema, hemorrhage dermatitis, rash, irritability, bleeding gums, toothache, tinnitus, asthma, elevated aminotransferases, constipation, pain are new discovered adverse reactions. CONCLUSION: The central monitoring method is the appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection, which could objectively reflect the real world of clinical usage.