[Source Apportionment and Ecological Risk Assessment of Polycyclic Aromatic Hydrocarbons in Surface Water from Yangtze River, China: Based on PMF Model].

To study the features and ecological risk of PAHs in surface water from Yangtze River, 19 water samples were collected from the main stream and branch of Yangtze River in August 2015. Solid phase extraction method was used to extract PAHs, and the concentrations of the 16 priority PAHs were determined using GC-MS. The results indicated that the concentration of total PAHs (∑PAHs) in the surface water ranged from 17.7-110 ng·L-1 with an average value of 42.6 ng·L-1. The predominant PAHs in the water were PAHs with 2-3 rings, accounting for 67.7% of ∑PAHs. The results of molecular diagnostic ratios indicated that the origin of PAHs was mostly combustion sources, including fossil fuel and biomass combustion. PMF model was used to quantitatively acquire the source contribution of PAHs, which indicated that four sources were identified and their contribution rates were respectively biomass and coal combustion (40.1%), petroleum source (19.6%), traffic source (17.5%) and coke oven source (22.8%). The results of ecological risk assessment indicated that PAHs with 2-3 rings had a relatively high risk level, and Wujiang station and lower reach had a relatively high risk level based on risk quotient. Overall, the ecological risk of PAHs in the Yangtze River was at a relatively low level.

Chinese Herbal Medicines Might Improve the Long-Term Clinical Outcomes in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: Results of a Decision-Analytic Markov Model.

Aims. The priority of Chinese herbal medicines (CHMs) plus conventional treatment over conventional treatment alone for acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) was documented in the 5C trial (chictr.org number: ChiCTR-TRC-07000021). The study was designed to evaluate the 10-year effectiveness of CHMs plus conventional treatment versus conventional treatment alone with decision-analytic model for ACS after PCI. Methods and Results. We constructed a decision-analytic Markov model to compare additional CHMs for 6 months plus conventional treatment versus conventional treatment alone for ACS patients after PCI. Sources of data came from 5C trial and published reports. Outcomes were expressed in terms of quality-adjusted life years (QALYs). Sensitivity analyses were performed to test the robustness of the model. The model predicted that over the 10-year horizon the survival probability was 77.49% in patients with CHMs plus conventional treatment versus 77.29% in patients with conventional treatment alone. In combination with conventional treatment, 6-month CHMs might be associated with a gained 0.20% survival probability and 0.111 accumulated QALYs, respectively. Conclusions. The model suggested that treatment with CHMs, as an adjunctive therapy, in combination with conventional treatment for 6 months might improve the long-term clinical outcome in ACS patients after PCI.

[Assessing Chinese herbal medicines for benefiting qi and activating blood circulation in treating unstable angina based on Markov model: a long-term clinical effectiveness exploration].

OBJECTIVE: To assess the long-term clinical effectiveness of Chinese herbal medicines for benefiting qi and activating blood circulation (CHMBQABC) plus routine Western medical intervention in treating unstable angina (UA) patients of qi deficiency blood stasis syndrome (QDBSS) after percutaneous coronary intervention (PCI) based on Markov model. METHODS: A Markov model was established based on prognosis and sequelae of UA patients after PCI treated by CHMBQABC plus routine Western medical intervention or by routine Western medical intervention. According to the transition probabilities of 40 Markov cycles and quality-adjusted life years (QALYs) averagely gained, we assessed the therapeutic advantage of CHMBQABC plus routine Western medical intervention. RESULTS: By the prediction of Markov model for 20 years, the transition probabilities of revascularization, non-fatal myocardial infarction, non-fatal stroke, and all-cause death in the CHMBQABC plus routine Western medical intervention group was 56.65%, 6.53%, 5.16%, and 31.66%, respectively, and the QALYs averagely gained was 12.95; while the transition probabilities of revascularization, non-fatal myocardial infarction, non-fatal stroke, and all-cause death in the Western medical intervention group was 55.31%, 6.87%, 5.25%, and 32.57%, respectively, and the QALYs averagely gained was 12.84. Compared with the Western medical intervention group, the QALYs averagely gained was 0.11 in the CHMBQABC plus routine Western medical intervention group. CONCLUSION: Based on predicted results of the Markov model, CHMBQABC plus routine Western medical intervention got better efficacy in treating UA patients after PCI, indicating CHMBQABC plus routine Western medical intervention could improve the long-term clinical effectiveness for UA patients of QDBSS after PCI.