Exploring human health risk assessment based on the screening of primary targeted metal and chemical balance simulation of ionic speciation in an industrial area, China.

A comprehensive human health risk assessment methodology based on major hazard element screening and morphological evolution simulation is proposed. The primary targeted metal (PTM) screened by classical health risk assessment was introduced into chemical balance simulation to obtain speciation distribution and corresponding risk. According to the results of risk assessment of morphological evolution of primary targeted metal (PTM), a potential methodology for the remediation is proposed, which could reduce the risk level efficiently and quickly by changing the pH of soil environment with additional acid and alkali substances. A case study was performed in a dye factory in Suzhou city, Jiangsu Province, China. The results of classical health risk assessment showed that the regional health risk index for children exceeded tolerance value of 1, in which Cr accounted for high risk level of 61%. Chemical balance simulation results showed that CrO42- and CaCrO4 had the highest risk index, and the change of pH value would affect the proportion of CrO42- and CaCrO4 in Cr6+ ionic speciation, which may indirectly change the risk level. It is recommended to adjust the pH of the soil environment to quickly reduce regional human health risk. This study will provide a theoretical basis for public health protection and site restoration management.

The Prevalence and Management of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in China.

BACKGROUND: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) comprises microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic GPA (EGPA). Myeloperoxidase (MPO) and proteinase 3 (PR3) are the main antigens for ANCA. AAV is a common multisystem autoimmune disease and most of the studies on AAV have been conducted in Western countries. Nowadays in China many efforts are made to investigate this disease. SUMMARY: This review highlights the progress in the prevalence, management and outcomes of AAV in Chinese patients. With respect to the prevalence of AAV, though there are no precise data, AAV is not rare in the Chinese population. In Chinese patients with AAV there is a striking preponderance of MPA, and MPO-ANCA is much more common than PR3-ANCA. Even in patients with GPA there is a predominance of MPO-ANCA over PR3-ANCA. Propylthiouracil-induced AAV and ANCA-negative pauci-immune glomerulonephritis are stated in this review as well. With respect to the management of AAV, glucocorticoids in combination with cyclophosphamide remain the mainstay of induction therapy. Besides, we describe predictors of different outcomes in Chinese patients, including mortality, relapse, treatment resistance and end-stage renal disease. KEY MESSAGES: AAV is not rare in the Chinese population. The disease spectrum and subtypes of ANCA are different between patients with AAV in China and Western countries. The treatment strategy for AAV in China is in consistency with that in Western countries. Predictors of different clinical outcomes are provided. FACTS FROM EAST AND WEST: Treatment options for AAV are shared between the East and West, with corticosteroid combined with cyclophosphamide being the standard regimen for inductive therapy and switching to azathioprine after remission. The major cause of death in treated patients is infection related to immunosuppressive therapy within the first year after diagnosis, and this rate might be higher in China than in Western countries. Western studies demonstrated the efficacy and safety of rituximab for induction of remission in cases with relatively mild disease and maintenance therapy, but this agent is rarely used in China.