Hospitalization costs for children with pneumonia in Shanghai, China from 2019 to 2020.

Pneumonia is the leading cause of death in children under 5 years of age worldwide. In this study, we primarily analyzed the hospitalization costs for children diagnosed with pneumonia in one of the leading public hospitals in Shanghai, China. Furthermore, factors affecting the hospitalization costs for children with pneumonia were evaluated. Data on case diagnosis, hospitalization time, age and various hospitalization expenses were collected. Total hospitalization expense for the 149 cases was $177,750, with an average total cost of $1,193 per person and an average out-of-pocket cost of $642. The highest per capita expenses included fees for laboratory diagnosis ($418), general medical service ($235), western medicine ($253), and antibacterial drugs ($158). The leading diagnosis was bronchopneumonia, with 68 (46%) cases, an average hospital stays of 7.4 days, and average hospitalization expenses of $1,068. Considering the high burden of pneumonia in children, hospitals and governments must make more reasonable use of limited resources of the medical system. At the same time, various types of medical insurance should be added into the children's medical security system, encourage vaccination with pneumonia vaccines (13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine), and ensure that more children benefit from the vaccine by including it in the national immunization program.

Development and Application of the Placebo Response Model in Clinical Trials for Primary Sjögren's Syndrome.

This study aimed to develop a placebo response model for pharmaceutical clinical trials of primary Sjogren's syndrome,and to quantitatively analyze the distribution and related factors influencing the placebo response to further optimize the design of clinical trials and evaluate the results of single-arm clinical trials. Public databases, including PubMed, Embase, and Cochrane Library were searched for reports on randomized placebo-controlled trials for Sjögren's syndrome which used the change from baseline in ESSDAI score as the primary outcome. The model-based meta-analysis method was used to evaluate the time course and the related influencing factors of the placebo response for ESSDAI in such clinical trials. A virtual placebo control group was constructed based on the final placebo response model to determine the treatment efficacy of belimumab and cyclosporine A for primary Sjögren's syndrome in a single-arm study. A total of 12 studies involving 450 subjects were included in the analysis. The established model described the time-course characteristics of the changes in ESSDAI score from the baseline in the 48 weeks placebo group. We found that the onset time of placebo response was approximately 12 weeks, and its efficacy plateaued at 48 weeks. The baseline ESSDAI score had a significant effect on the maximum value of the placebo response; the maximum value of the placebo response decreased by 0.552 for every 1 score rise in the baseline ESSDAI score. The efficacy of belimumab and cyclosporine A in the single-arm trial was comparable to that of the placebo response at the same baseline; no significant therapeutic advantage was observed. The placebo response model established in this study could provide a basis for designing clinical trials for primary Sjogren's syndrome in the future. It may also provide a reliable external efficacy control standard for single-arm clinical trials.

Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study.

BACKGROUND: In China, depressive disorders have been estimated to be the second leading cause of years lived with disability. However, nationally representative epidemiological data for depressive disorders, in particular use of mental health services by adults with these disorders, are unavailable in China. The present study, part of the China Mental Health Survey, 2012-15, aims to describe the socioeconomic characteristics and the use of mental health services in people with depressive disorders in China. METHODS: The China Mental Health Survey was a cross-sectional epidemiological survey of mental disorders in a multistage clustered-area probability sample of adults of Chinese nationality (≥18 years) from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Trained investigators interviewed the participants with the Composite International Diagnostic Interview 3.0 to ascertain the presence of lifetime and 12-month depressive disorders according to DSM-IV criteria, including major depressive disorder, dysthymic disorder, and depressive disorder not otherwise specified. Participants with 12-month depressive disorders were asked whether they received any treatment for their emotional problems during the past 12 months and, if so, the specific types of treatment providers. The Sheehan Disability Scale (SDS) was used to assess impairments associated with 12-month depressive symptoms. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted according to the age-sex-residence distribution data from China's 2010 census population survey to adjust for differential probabilities of selection and differential response, as well as to post-stratify the sample to match the population distribution. FINDINGS: 28 140 respondents (12 537 [44·6%] men and 15 603 [55·4%] women) completed the survey between July 22, 2013, and March 5, 2015. Ethnicity data (Han or non-Han) were collected for only a subsample. Prevalence of any depressive disorders was higher in women than men (lifetime prevalence odds ratio [OR] 1·44 [95% CI 1·20-1·72] and 12-month prevalence OR 1·41 [1·12-1·78]), in unemployed people than employed people (lifetime OR 2·38 [95% CI 1·68-3·38] and 12-month OR 2·80 [95% CI 1·88-4·18]), and in people who were separated, widowed, or divorced compared with those who were married or cohabiting (lifetime OR 1·87 [95% CI 1·39-2·51] and 12-month OR 1·85 [95% CI 1·40-2·46]). Overall, 574 (weighted % 75·9%) of 744 people with 12-month depressive disorders had role impairment of any SDS domain: 439 (83·6%) of 534 respondents with major depressive disorder, 207 (79·8%) of 254 respondents with dysthymic disorder, and 122 (59·9%) of 189 respondents with depressive disorder not otherwise specified. Only an estimated 84 (weighted % 9·5%) of 1007 participants with 12-month depressive disorders were treated in any treatment sector: 38 (3·6%) in speciality mental health, 20 (1·5%) in general medical, two (0·3%) in human services, and 21 (2·7%) in complementary and alternative medicine. Only 12 (0·5%) of 1007 participants with depressive disorders were treated adequately. INTERPRETATION: Depressive disorders in China were more prevalent in women than men, unemployed people than employed, and those who were separated, widowed, or divorced than people who were married or cohabiting. Most people with depressive disorders reported social impairment. Treatment rates were very low, and few people received adequate treatment. National programmes are needed to remove barriers to availability, accessibility, and acceptability of care for depression in China. FUNDING: National Health Commission and Ministry of Science and Technology of People's Republic of China. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.

The molecular characters and antibiotic resistance of Clostridioides difficile from economic animals in China.

BACKGROUND: It has been performed worldwidely to explore the potential of animals that might be a reservoir for community associated human infections of Clostridioides difficile. Several genetically undistinguished PCR ribotypes of C. difficile from animals and human have been reported, illustrating potential transmission of C. difficile between them. Pig and calf were considered as the main origins of C. difficile with predominant RT078 and RT033, respectively. As more investigations involved, great diversity of molecular types from pig and calf were reported in Europe, North American and Australia. However, there were quite limited research on C. difficile isolates from meat animals in China, leading to non-comprehensive understanding of molecular epidemiology of C. difficile in China. RESULTS: A total of 55 C. difficile were isolated from 953 animal stool samples, within which 51 strains were from newborn dairy calf less than 7 days in Shandong Province. These isolates were divided into 3 STs and 6 RTs, of which ST11/RT126 was predominant type, and responsible for majority antibiotic resistance isolates. All the isolates were resistant to at least one tested antibiotics, however, only two multidrug resistant (MDR) isolates were identified. Furthermore, erythromycin (ERY) and clindamycin (CLI) were the two main resistant antibiotics. None of the isolates were resistant to vancomycin (VAN), metronidazole (MTZ), tetracycline (TET), and rifampin (RIF). CONCLUSIONS: In this study, we analyzed the prevalence, molecular characters and antibiotic resistance of C. difficile from calf, sheep, chicken, and pig in China. Some unique features were found here: first, RT126 not RT078 were the dominant type from baby calf, and none isolates were got from pig; second, on the whole, isolates from animals display relative lower resistant rate to these 11 tested antibiotics, compared with isolates from human in China in our previous report. Our study helps to deep understanding the situation of C. difficile from economic animals in China, and to further study the potential transmission of C. difficile between meat animals and human.

Uncovering the relationship between food-related discussion on Twitter and neighborhood characteristics.

OBJECTIVE: Initiatives to reduce neighborhood-based health disparities require access to meaningful, timely, and local information regarding health behavior and its determinants. We examined the validity of Twitter as a source of information for neighborhood-level analysis of dietary choices and attitudes. MATERIALS AND METHODS: We analyzed the "healthiness" quotient and sentiment in food-related tweets at the census tract level, and associated them with neighborhood characteristics and health outcomes. We analyzed keywords driving the differences in food healthiness between the most and least-affluent tracts, and qualitatively analyzed contents of a random sample of tweets. RESULTS: Significant, albeit weak, correlations existed between healthiness and sentiment in food-related tweets and tract-level measures of affluence, disadvantage, race, age, U.S. density, and mortality from conditions associated with obesity. Analyses of keywords driving the differences in food healthiness revealed foods high in saturated fat (eg, pizza, bacon, fries) were mentioned more frequently in less-affluent tracts. Food-related discussion referred to activities (eating, drinking, cooking), locations where food was consumed, and positive (affection, cravings, enjoyment) and negative attitudes (dislike, personal struggles, complaints). DISCUSSION: Tweet-based healthiness scores largely correlated with offline phenomena in the expected directions. Social media offer less resource-intensive data collection methods than traditional surveys do. Twitter may assist in informing local health programs that focus on drivers of food consumption and could inform interventions focused on attitudes and the food environment. CONCLUSIONS: Twitter provided weak but significant signals concerning food-related behavior and attitudes at the neighborhood level, suggesting its potential usefulness for informing local health disparity reduction efforts.

Family socioeconomic position and abnormal birth weight: evidence from a Chinese birth cohort.

BACKGROUND: Birth weight is a strong determinant of infant short- and long-term health outcomes. Family socioeconomic position (SEP) is usually positively associated with birth weight. Whether this association extends to abnormal birth weight or there exists potential mediator is unclear. METHODS: We analyzed data from 14,984 mother-infant dyads from the Born in Guangzhou Cohort Study. We used multivariable logistic regression to assess the associations of a composite family SEP score quartile with macrosomia and low birth weight (LBW), and examined the potential mediation effect of maternal pre-pregnancy body mass index (BMI) using causal mediation analysis. RESULTS: The prevalence of macrosomia and LBW was 2.62% (n = 392) and 4.26% (n = 638). Higher family SEP was associated with a higher risk of macrosomia (OR 1.30, 95% CI 0.93-1.82; OR 1.53, 95% CI 1.11-2.11; and OR 1.59, 95% CI 1.15-2.20 for the 2nd, 3rd, and 4th SEP quartile respectively) and a lower risk of LBW (OR 0.69, 95% CI 0.55-0.86; OR 0.76, 95% CI 0.61-0.94; and OR 0.61, 95% CI 0.48-0.77 for the 2nd, 3rd, and 4th SEP quartile respectively), compared to the 1st SEP quartile. We found that pre-pregnancy BMI did not mediate the associations of SEP with macrosomia and LBW. CONCLUSIONS: Socioeconomic disparities in fetal macrosomia and LBW exist in Southern China. Whether the results can be applied to other populations should be further investigated.

Cost-effectiveness of lenalidomide plus low-dose dexamethasone for newly diagnosed multiple myeloma patients ineligible for stem cell transplantation in China.

Aim: To assess the cost-effectiveness of lenalidomide plus low dose dexamethasone (Rd) relative to bortezomib-contained therapy (BCT) for newly diagnosed multiple myeloma patients ineligible for stem cell transplantation (ndMM) in China. Materials & methods: A literature review was conducted to identify appropriate evidence for developing a cost-effectiveness model comparing Rd with BCT for lifetime health outcomes and direct medical costs in Chinese ndMM patients. Results: The estimated incremental cost-effectiveness ratio per gained quality-adjusted life years for Rd versus BCT was ¥49,793. The chance for Rd to be cost effective, under the cost-effectiveness thresholds of three-times the 2018 Chinese gross domestic goods per capita, was 90.8%. Conclusion: The cost-effectiveness of Rd relative to BCT for ndMM in Chinese patients is highly attractive.

Comparison of the INTERGROWTH-21st standard and a new reference for head circumference at birth among newborns in Southern China.

BACKGROUND: Previous studies proposed that there were racial or ethnic disparities in fetal growth, challenging the use of international standards in specific populations. This study was to evaluate the validity of applying the INTERGROWTH-21st standard to a Chinese population for identifying abnormal head circumference (HC), in comparison with a newly generated local reference. METHODS: There were 24,257 singletons delivered by low-risk mothers in four perinatal health-care centers in Southern China. New HC reference was constructed and comparison in distribution of HC categories was performed between the INTERGROWTH-21st standard and new reference after applying these two tools in study population. Logistic regression was used to examine the association between abnormal HC and adverse neonatal outcomes. RESULTS: There were 4.40% of the newborns identified with microcephaly (HC > 2 standard deviation below the mean) using the INTERGROWTH-21st standard, comparing to the proportion of 2.83% using new reference. The newborns identified with microcephaly only by the INTERGROWTH-21st standard were not at a higher risk of adverse neonatal outcome, compared with those identified as non-microcephaly by both tools (OR 0.73, 95% CI 0.47-1.13). CONCLUSION: The new HC reference may be more appropriate for newborn assessment in Chinese populations than the INTERGROWTH-21st standard.

Arsenic pollution of sediments in China: An assessment by geochemical baseline.

Arsenic (As) contamination in sediments has been reported worldwide. However, few studies have investigated As contamination on a national scale in China. This study aims to address this gap by analyzing the existing literature on As contamination and sediment samples collected from ten main river basins: the Songhua River Basin (SRB), Liao River Basin (LRB), Hai River Basin (HRB), Yellow River Basin (YRB), Huai River Basin (HuRB), Yangtze River Basin (YtRB), Pearl River Basin (PRB), Southeastern River Basin (SeRB), Southwestern River Basin (SwRB), and Northwestern River Basin (NwRB). Regional geochemical baseline (RGB) values of As in the sediments of river basins were calculated to estimate human contributions of As using normalization and cumulative frequency distribution curves. The established RGB values in the SRB, YtRB, and PRB were higher than the corresponding regional soil background (RSB), possibly because of the high intensity of human activities in the SRB, YtRB, and PRB. Taking RGB and RSB values as the background references, contamination assessment yielded important information on As contamination in China. With high As contributions from Yunnan province, the PRB suffered from the highest level of contamination, and the mean human contribution of As in the PRB was 64.4%. The contamination levels in the less developed southwestern regions were even higher than in some river basins in economically developed regions (e.g., YRB). In addition, As in the PRB and YtRB was found to be partially contributed by industrial wastewater discharge, and the response of As contamination in sediments to industrial wastewater discharge was analyzed. The temporal change (2004-2016) of As in sediments from the PRB, YtRB, and YRB corresponded well with that of As discharged in wastewater within the corresponding river basins. This study thus serves as a valuable foundation for policies focused on ameliorating As contamination in China.

The role of social support in family socio-economic disparities in depressive symptoms during early pregnancy: Evidence from a Chinese birth cohort.

BACKGROUND: Few studies have examined the association between a composite measure of family socio-economic position (SEP)2 and depressive symptoms among Chinese pregnant women, nor any potential underlying mechanisms which may be amenable to preventative interventions. METHODS: We investigated the association between a composite SEP measure and depressive symptoms during early pregnancy, and tested for mediation by social support and moderation by parity in the Born in Guangzhou Cohort Study (n = 12,382) using adjusted logistic regression and causal mediation analysis. RESULTS: In this population, 18.4% of women experienced depressive symptoms before the 20th gestational week. Compared with the highest quartile, the lowest SEP score quartile was associated with a higher risk of depressive symptoms (OR 1.50, 95% CI 1.31-1.71), which was more pronounced among multiparous women than nulliparous women (P for interaction <0.001). Social support mediated the association between SEP and depressive symptoms, with greater proportion mediated in nulliparous women (73.4% for the lowest SEP score quartile) than multiparous women (30.5%). LIMITATIONS: Depressive symptoms were measured by Self-rated Depression Scale, which is not designed as a clinical diagnosis tool for depression. We only had information on perceived social support but not actual social support, although these two parameters were modestly correlated. CONCLUSION: Lower SEP was associated with higher risk of depressive symptoms in pregnant women, driven by social support. And the association between SEP and depressive symptoms and mediation by social support were modified by parity. Whether this association extends to the post pregnancy period or is amenable to cost-effective interventions should be investigated in further studies.

Lead contamination in sediments in the past 20 years: A challenge for China.

Lead (Pb) contamination was recognized in China early in the 1920s. However, the response of Pb contamination in sediments to China's rapid economic and social development remains uncertain to date. We conducted a literature review of over 1000 articles from 1990 to 2016 and the first national-scale survey of Pb contamination in China. A literature review showed that available research in China focused on the economically highly developed river basins, including the Pearl River Basin (PRB), Yellow River Basin (YRB), and Yangtze River Basin (YtRB), whereas those in the less developed southeastern, southwestern, and northwestern river basins received limited attention. The YtRB and YRB had higher Pb contamination levels than other basins, corresponding with the rapid economic development in those regions. However, the less economically developed river basins in the southeastern and northwestern regions of China were also contaminated by Pb. Analysis of 146 studies in the PRB, YRB, and YtRB revealed that Pb contamination in PRB sediments showed a tendency to improve over time, whereas that from the YtRB exhibited a tendency to worsen. For the YRB, there was a slight increase from 1990 to 2006 and a decreasing trend from 2007 to 2014. The overall temporal trend in Pb levels in PRB and YRB sediments corresponded with that of the Pb discharged in wastewater in the surrounding cities, indicating that industrial wastewater discharge was possibly one of the main anthropogenic sources of Pb in those sediments. For the YtRB, the increasing trend in Pb concentrations was related to the considerably high atmospheric Pb emissions in the surrounding cities and its geographical characteristics. These findings suggested that China should develop systematic and consistent approaches for monitoring Pb contents in sediments and adopt a regional economic development policy focusing on pollution prevention.

Investigation of a potential drug-drug interaction between salbutamol and ambroxol and bioequivalence of a new fixed-dose combination containing these two drugs in healthy Chinese subjects.

OBJECTIVES: The aims of the study were to investigate the potential drug-drug interaction between salbutamol and ambroxol, the bioequivalence of the new fixed-dose combination containing salbutamol and ambroxol compared with co-administration of the two separate formulations, and to describe the safety and tolerability of the fixed-dose combination formulation in healthy Chinese volunteers. MATERIALS AND METHODS: An open-label, single-dose, four-treatment, four-period crossover study for evaluation of drug-drug interaction and bioequivalence (n = 24) was performed. Each participant received salbutamol 4 mg, ambroxol 15 mg, salbutamol 4 mg co-administered with ambroxol 15 mg or fixed-dose combination formulation (salbutamol 4 mg and ambroxol 15 mg). Plasma concentrations of two analytes were determined with the use of validated LC-MS/MS method. Safety and tolerability were assessed by recording adverse events. RESULTS: Co-administration of salbutamol and ambroxol was not associated with a significant influence on single salbutamol or ambroxol pharmacokinetics. After statistical comparisons of log-transformed Cmax and AUC of salbutamol and ambroxol between fixed-dose combination and concomitant treatments, all 90% confidence intervals of geometric mean ratios were within the predefined equivalence range of 80 - 125%. No serious adverse events were reported, and all treatments were safe and well tolerated in Chinese healthy subjects. CONCLUSION: There were no significant drug-drug pharmacokinetic interactions between salbutamol and ambroxol after oral administration. The new formulation was bioequivalent to the co-administration of two drugs in separate dosage forms.
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Assessment of Cr pollution in tributary sediment cores in the Three Gorges Reservoir combining geochemical baseline and in situ DGT.

The mobility and transfer of trace metals in sediments are vital to understanding trace metals environmental behavior in water environment. However, as a predominant aquatic carcinogen, an effective method for assessing the release and deposition for Cr at the sediment-water interface (SWI) is still not clearly understood. Here we established a comprehensive methodology to evaluate the release risk of Cr at the SWI combining regional geochemical baseline (RGB) and diffusive gradients in thin films (DGT). Sediment cores and water samples were collected in the two tributaries and mainstream of the Three Gorges Reservoir, which is the world's largest man-made hydroelectric station. Results showed that the calculated Cr carcinogenic risks in surface water did not exceed US EPA maximum recommended level. The RGB of Cr (85.53 ±â€¯14.44 mg/kg) were calculated and the differentials between Cr concentration and RGB in surface sediments showed the average anthropogenic contribution rate was 6.03% and the upstream of Meixi River (MX-S) and mainstream were influenced by anthropogenic activities. The net diffusive flux using DGT showed that Cr in the midstream of Caotang River and MX had the potential to move upwards into the overlying water. Furthermore, combining the results of differential (Cr concentration vs. RGB) and the net flux, MX-S was the only site with a risk of Cr release. To the best of our knowledge, this study is the first attempt to combine RGB and DGT to scientifically assess metal release at SWI and provided a new perspective to comprehensively assess metal pollution in water environment.

Geriatric Assessment to Predict Survival and Risk of Serious Adverse Events in Elderly Newly Diagnosed Multiple Myeloma Patients: A Multicenter Study in China.

BACKGROUND: Elderly multiple myeloma (MM) patients often tend to suffer a variety of diseases, so the treatment of choice is very difficult for the elderly myeloma patients. The overall survival (OS) time and side effects with elderly patients are unclear in China. The study tried to find out the role of geriatric assessment in the Chinese elderly MM. METHODS: We retrospectively analyzed the data of 628 newly diagnosed patients from six hospitals from June 2011 to June 2013. A geriatric assessment had been performed to assess comorbidities, cognitive, and physical status for these patients. The primary endpoint was to evaluate different physical states of elderly patients with OS time and treatment-related side effects. RESULTS: An additive scoring system (range: 0-5), based on age, Katz's Activity of Daily Living (ADL) and Lawton's Instrumental Activity of Daily Living (IADL) ≤5 and Charlson Comorbidity Index (CCI) was developed to identify three groups: fit (score = 0); intermediate-fitness (score = 1); and frail (score ≥2). The 3-year OS was 63% in fit patients, 63% in intermediate-fitness patients, and 49% in frail patients ≥3 hematologic adverse events (AEs) were documented in 45 (35.4%) fit, 34 (34%) intermediate-fitness, and 121 (30.2%) frail patients. The risk of a grade ≥3 hematologic AEs was not significantly increase in intermediate-fitness (hazard ratios [HR]: 0.99, 95% confidence interval [CI]: 0.54-1.47, P = 1.000) and in frail patients (HR: 1.16, 95% CI: 0.70-1.93, P = 0.558) compared with fit ones. CONCLUSIONS: MM occurs earlier in life and being advanced when the diagnosis is made in the mainland of China. The overall survival in frailty with International Staging System (ISS) II/III was the worst in all patients.

Nitrogen and phosphorus in sediments in China: A national-scale assessment and review.

A national-scale investigation of total nitrogen (TN), total phosphorus (TP), total organic carbon (TOC), and pH in sediments was performed. The sediment samples investigated in this study were collected from 10 major basins in China (Songhua River Basin (SRB), Liao River Basin (LRB), Hai River Basin (HRB), Yellow River Basin (YRB), Huai River Basin (HuRB), Yangtze River Basin (YtRB), Southeastern River Basin (SeRB), Pearl River Basin (PRB), Southwestern River Basin (SwRB), and Northwestern River Basin (NwRB)). And then, a pollution assessment was performed by comparing the data with established sediment quality guidelines (SQGs) and organic nitrogen index values. Results demonstrated that the mean TN content in the sediments of the 10 basins was 1.070g/kg, while the mean TP content was 0.733g/kg. The TN contents displayed significantly positive correlations with the TP contents in the sediments of SRB, LRB, YtRB, SeRB, PRB, and NwRB. Moreover, the concentrations of TN in the sediments of nine basins (SRB, LRB, HRB, YRB, HuRB, YtRB, SeRB, PRB, and NwRB) and TP concentrations of four basins (LRB, YtRB, SeRB, and PRB) were possibly related to the TOC contents, and the distributions of TN concentrations in eight basins (SRB, LRB, HRB, YRB, YtRB, SeRB, PRB, and NwRB) as well as the TP concentrations in LRB might be affected by the pH of sediments. By comparing the data in our study with those obtained in other periods (1990-2013), we found that the TN contamination situation in HuRB and the TP contamination situation in PRB have potentially worsened over time, which deserves more attention. According to the results of SQGs and organic nitrogen index assessment, among the 10 basins, SeRB was the worst watershed polluted by N and HRB was the worst watershed polluted by P.

Clinical and psychometric validation of the quality of life assessment system for advanced gastric cancer based on traditional Chinese medicine.

OBJECTIVE: To establish questionnaire scaling and reliability and examine the clinical and psychometric validity of the quality of life assessment based on Traditional Chinese Medicine for advanced gastric cancer (QLASTCM-Ga). METHODS: The QLASTCM-Ga was developed based on programmed decision procedures with multiple nominal and focus group discussions, in-depth interview, pretesting and quantitative statistical procedures. The questionnaire was administered to 240 patients diagnosed with advanced gastric cancer before and after treatment. Structured group methods were employed to establish a general and a specifific module respectively. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness. RESULTS: The three identified scales of the QLASTCM-Ga and the total score demonstrated good psychometric properties. Test-retest reliability of the total scale and all domains ranged from 0.90 to 0.94, and internal consistency ranged from 0.86 to 0.93. Correlation and factor analysis demonstrated good construct validity. Signifificant difference in the subscales and the total score were found among groups differing in traditional Chinese medicine syndrome, supporting the clinical sensitivity of the QLASTCM-Ga. Statistically signifificant changes were found for each scale and the total score. Responsiveness was also good. CONCLUSIONS: The QLASTCM-Ga demonstrates good psychometric and clinical validity to assess quality of life in patients with advanced gastric cancer undergoing traditional Chinese medicine therapy. This study is an important fifirst step for future research in this area.

Pollution characteristics and health risk assessment of heavy metals in street dusts from different functional areas in Beijing, China.

Street dusts from Heavy Density Traffic Area, Residential Area, Educational Area and Tourism Area in Beijing, China, were collected to study the distribution, accumulation and health risk assessment of heavy metals. Cr, Cu, Zn, Cd and Pb concentrations were in higher concentrations in these four locations than in the local soil background. In comparison with the concentrations of selected metals in other cities, the concentrations of heavy metals in Beijing were generally at moderate or low levels. Ni, Cu, Zn and Pb concentrations in the Tourism Area were the highest among four different areas in Beijing. A pollution assessment by Geoaccumulation Index showed that the pollution level for the heavy metals is in the following order: Cd>Pb>Zn>Cu>Cr>Ni. The Cd levels can be considered "heavily contaminated" status. The health risk assessment model that was employed to calculate human exposure indicated that both non-carcinogenic and carcinogenic risks of selected metals in street dusts were generally in the low range, except for the carcinogenic risk from Cr for children.

Multi-target drugs: the trend of drug research and development.

Summarizing the status of drugs in the market and examining the trend of drug research and development is important in drug discovery. In this study, we compared the drug targets and the market sales of the new molecular entities approved by the U.S. Food and Drug Administration from January 2000 to December 2009. Two networks, namely, the target-target and drug-drug networks, have been set up using the network analysis tools. The multi-target drugs have much more potential, as shown by the network visualization and the market trends. We discussed the possible reasons and proposed the rational strategies for drug research and development in the future.

The organic contamination survey and health risk assessment of 16 source water reservoirs in Haihe River basin.

Although contamination by organic pollutants has previously been reported to occur in the Haihe River basin, few studies have been carried out on the levels of source water reservoir contamination and the health risk in the Haihe River basin. To understand the organic pollution status of the reservoirs in the Haihe River basin, samples were collected from 16 source water reservoirs. The samples were analyzed for the representative organic pollutants, which included benzene homologues, chlorobenzene compounds, organophosphorus pesticides, and nitrobenzene compounds, a total in all of 17 compounds. It was observed that the concentrations of the 17 compounds in the 16 reservoirs were all less than the limit laid down by Chinese surface water quality standards. In addition, benzene, toluene, nitrobenzene, p-nitrochlorobenzene, 2,4-dinitrotoluene and 2,4-dinitrochlorobenzene, dichlorvos, demeton, dimethoate methyl parathion, malathion and parathion were frequently detected in the 16 source water reservoirs, especially the organophosphorus pesticides; the detection rates of dichlorvos, dimethoate, methyl parathion, malathion and parathion were all 100% in the 16 source water reservoirs. The detection rate of target compounds suggested that organic pollution had been common in the source water of the Haihe River basin. The health risk assessment results suggested that the noncarcinogenic risk hazard quotient values of the target compounds were less than one, and the cancer risk values were all below 1 × 10(-6), which indicated that the heath risk produced by the target compounds in the 16 reservoirs was at an acceptable level.

[Distribution and ecological risk assessment of polycyclic aromatic hydrocarbons in agricultural soil of the Chongming Island in Shanghai].

The concentration and ecological risk of Polycyclic aromatic hydrocarbons (PAHs) were investigated in thirty-three surface soil samples collected from cultivated land in Chongming Island in July 2008. Those samples were extracted using an accelerated solvent extractor (ASE) and determined by GC-MS. Results showed that the concentrations of PAHs ranged between 24.92-1014.61 ng x g(-1) (dry weight), with a mean value of 192.83 ng x g(-1). The sixteen priority PAHs with exception of Indeno(1, 2, 3-cd) pyrene (IcdP) and Dibenzo(a, h)anthracene (DahA) were all detected in all the samples. The dominant compounds were 2-3 ring and 4 ring PAHs, which accounted for 42.6% and 42.2%, respectively, while the 5-6 ring PAHs accounted for 15.7%. PAHs in soil were mainly derived from the fossil oil and the combustion of wood and coal, as determined by the concentration ratio method. The non-industrial combustion and automobile exhaust emissions in Chongming Island may be two of the important sources of PAHs in farmland soil. The analysis of ecological risk showed that the agricultural soil of Chongming Island had low ecological risk.