Cost-effectiveness of cytomegalovirus vaccination for females in China: A decision-analytical Markov study.

BACKGROUND: The global burden of disease caused by congenital cytomegalovirus (CMV) infection is high. Previous modeling studies have suggested that CMV vaccination may be cost-effective in developed countries. Congenital CMV infection is more likely driven by maternal non-primary infection in China. We aimed to measure the effectiveness and cost-effectiveness of population-level CMV vaccination in Chinese females. METHODS: A decision tree Markov model was developed to simulate potential CMV vaccination strategies in a multi-cohort setting, with a population size of 1,000,000 each for the infant, adolescent (10-year-old) and young adult (20-year-old) cohorts. The hypothetical vaccines were assumed to have 50% efficacy, 20 years of protection, 70% coverage, at a price of US$120/dose for base-case analysis. Costs and disability-adjusted life years (DALYs) were discounted by 3% per year and the vaccination would be considered cost-effective if an incremental cost-effectiveness ratio (ICER) was lower than 2021 Chinese per capita GDP (US$12,500). FINDINGS: For the pre-infection (PRI) vaccine efficacy type, the adolescent strategy was the most cost-effective, with an ICER of US$12,213 (12,134 to 12,291) pre DALY averted, compared with the next best strategy (young adult strategy). For pre- and post-infection (P&PI) efficacy type, the young adult strategy was the most cost-effective as it was cost-saving. In one-way analysis varying the PRI vaccine price, the infant strategy, adolescent strategy and the young adult strategy would be a dominant strategy over others if the vaccine cost ≤US$60, US$61-121 and US$122-251 per dose respectively. In contrast, the young adult strategy continued to be the preferred strategy until the P&PI vaccine price exceeded US$226/dose. Our main results were robust under a wide variety of sensitivity analyses and scenario analyses. INTERPRETATION: CMV vaccination for females would be cost-effective and even cost-saving in China. Our findings had public health implications for control of CMV diseases.

Ecological risk assessment of aquatic organisms induced by heavy metals in the estuarine waters of the Pearl River.

With the rapid economic development of China's coastal areas and the growth of industry and population, the problem of heavy metal contamination in estuarine waters is increasing in sensitivity and seriousness. In order to accurately and quantitatively describe the current status of heavy metal contamination and identify sensitive aquatic organisms with high ecological risks, five heavy metals in eight estuaries of the Pearl River were monitored at monthly intervals from January to December in 2020, and the ecological risks of aquatic organisms induced by heavy metals were evaluated using Risk quotients (RQ) and species sensitivity distributions (SSD) methods. The results showed that the concentrations of As, Cu, Pb, Hg and Zn in estuaries of the Pearl River were (0.65-9.25) µg/L, (0.07-11.57) µg/L, (0.05-9.09) µg/L, (< 0.40) µg/L and (0.67-86.12) µg/L, respectively. With the exception of Hg in Jiaomen water, the other heavy metals in each sampling site met or exceed the water quality standard of Grade II. The aquatic ecological risks of As, Pb and Hg were generally low in the waters of the Pearl River estuary, but individual aquatic organisms are subject to elevated ecological risks due to Cu and Zn. The content of Zn has a lethal effect on the crustaceans Temora Stylifera, and the content of Cu has a serious impact on the mollusks Corbicula Fluminea and has a certain impact on the crustaceans Corophium sp. and the fish Sparus aurata. Heavy metal levels and joint ecological risks (msPAF) in the Humen, Jiaomen, Hongqimen, and Hengmen estuaries were slightly higher than in other estuaries, and the Yamen estuary had the lowest contration of heavy metals and ecological risk. Research findings can serve as a basis for formulating water quality standards for heavy metals and for protecting aquatic biodiversity in the Pearl River Estuary.

Efficacy of machine learning assisted dental age assessment in local population.

INTRODUCTION: Although the dental age assessment is commonly applied in forensic and maturity evaluation, the long-standing dilemma from population differences has limited its application. OBJECTIVES: This study aimed to verify the efficacy of the machine learning (ML) to build up the dental age standard of a local population. METHODS: We retrospectively studied 2052 panoramic films retrieved from healthy Taiwanese children aged 2.6-17.7 years with comparable sizes in each age-group. The recently reported Han population-based standard (H method) served as the control condition. To develop and validate ML models, random divisions of the sample in an 80%-20% ratio repeated 20 times. The model performances were compared with the H method, Demirjian's method, and Willems's method. RESULTS: The ML-assisted models provided more accurate age prediction than those non-ML-assisted methods. The range of errors was effectively reduced to less than one per year in the ML models. Furthermore, the consistent agreements among the age groups from preschool to adolescence were reported for the first time. The Gaussian process regression was the best ML model; of the non-ML modalities, the H method was the most efficacious, followed by the Demirjian's method and Willems's methods. CONCLUSION: The ML-assisted dental age assessment is helpful to provide customized standards to a local population with more accurate estimations in preschool and adolescent age groups than do studied conventional methods. In addition, the earlier complete tooth developments were also observed in present study. To construct more reliable dental maturity models in the future, additional environment-related factors should be taken into account.

Value of endorectal ultrasonography in the assessment of invasion staging of low rectal cancer with local progression after neoadjuvant radiochemotherapy / Valor de la ultrasonografía endorectal en la evaluación de la estadificación de la invasión del cáncer rectal bajo con progresión local, después de administrar radioquimioterapia neoadyuvante

Abstract Although stages T3 and T4 rectal cancer can be reduced to T1 or T2 after neoadjuvant radiochemotherapy, the accuracy of the endorectal ultrasonography (ERUS) for the post-radiochemotherapy evaluation of low rectal cancer has seldom been reported. We aimed to investigate the value of ERUS in the assessment of invasion staging in low rectal cancer with local progression, and the factors affecting its accuracy, after neoadjuvant radiochemotherapy. A total of 114 patients administered with neoadjuvant radiochemotherapy for stages II and III low rectal cancer (local stage T3/T4) from February 2018 to December 2020 were enrolled in the study. The changes in local lesions were evaluated using ERUS before and after radiochemotherapy, and compared with the pathological T staging. The accuracy of post-neoadjuvant radiochemotherapy re-staging examined with ERUS was evaluated, and univariate analysis was used to identify the factors affecting the accuracy. After neoadjuvant radiochemotherapy, the blood flow distribution within the lesion significantly declined (P<0.05), the max length and max thickness of the longitudinal axis of the lesion were reduced (P<0.05), and the uT staging was decreased (P<0.05), when compared with lesions before the treatment. Compared with postoperative pathological T staging, the accuracies of ERUS in T1, T2, T3 and T4 stages were 11.11%, 28.57%, 27.27% and 100%, respectively. Univariate analysis indicated that review time of ERUS, post-operative T staging and Wheeler rectal regression stage were factors affecting the accuracy of ERUS re-staging. ERUS is more accurate for T4 re-staging, follow-up reviewed six weeks after neoadjuvant radiochemotherapy and low regression tumors, with a high application value for the assessment of the efficacy of neoadjuvant radiochemotherapy for low rectal cancer.

Resumen Aunque el cáncer de recto en estadios T3 y T4 se puede reducir a T1 o T2 después de la radioquimioterapia neoadyuvante, rara vez se ha informado la precisión de la ecografía endorrectal (ERUS) para la evaluación posterior a la radioquimioterapia del cáncer de recto inferior. Nuestro objetivo fue investigar el valor de ERUS en la evaluación de la estadificación de la invasión en el cáncer de recto inferior con progresión local, después de la radioquimioterapia neoadyuvante y los factores que afectan su precisión. Se incluyeron en el estudio un total de 114 pacientes a los que se les administró radioquimioterapia neoadyuvante para el cáncer de recto inferior en estadios II y III (estadio local T3/T4), desde febrero de 2018 hasta diciembre de 2020. Los cambios en las lesiones locales se evaluaron mediante ERUS antes y después de la radioquimioterapia y se compararon con la estadificación patológica T. Se evaluó la precisión de la re-estadificación examinada con ERUS, después de la radioquimioterapia neoadyuvante y se utilizó un análisis univariado para identificar los factores que afectan su precisión. Después de la radioquimioterapia neoadyuvante, la distribución del flujo sanguíneo dentro de la lesión disminuyó significativamente (P<0,05), la longitud máxima y el espesor máximo del eje longitudinal de la lesión se redujeron (P<0,05) y la estadificación uT disminuyó (P<0,05), en comparación con las lesiones antes del tratamiento. En comparación con la estadificación T patológica posoperatoria, las precisiones de ERUS en las etapas T1, T2, T3 y T4 fueron del 11,11%, 28,57%, 27,27% y 100%, respectivamente. El análisis univariable indicó que el tiempo de revisión de ERUS, la estadificación T postoperatoria y la etapa de regresión rectal de Wheeler fueron factores que afectaron la precisión de la re-estadificación con ERUS. ERUS es más preciso para la re-estadificación de T4, el seguimiento seis semanas después de la radioquimioterapia neoadyuvante y en tumores de baja regresión, con un alto valor de aplicación para la evaluación de la eficacia de la radioquimioterapia neoadyuvante para el cáncer rectal bajo.

Assessment of Hearing Screening Combined With Limited and Expanded Genetic Screening for Newborns in Nantong, China.

Importance: Early identification and intervention for newborns with hearing loss (HL) may lead to improved physiological and social-emotional outcomes. The current newborn hearing screening is generally beneficial but improvements can be made. Objective: To assess feasibility and evaluate utility of a modified genetic and hearing screening program for newborn infants. Design, Setting, and Participants: This population-based cohort study used a 4-stage genetic and hearing screening program at 6 local hospitals in Nantong city, China. Participants were newborn infants born between January 2016 and June 2020 from the Han population. Statistical analysis was performed from April 1 to May 1, 2021. Exposures: Limited genetic screening for 15 variants in 4 common HL-associated genes and newborn hearing screening (NHS) were offered concurrently to all newborns. Hearing rescreening and/or diagnostic tests were provided for infants with evidence of HL on NHS or genetic variants on screening. Expanded genetic tests for a broader range of genes were targeted to infants with HL with negative results of limited genetic tests. Main Outcomes and Measures: The detection capability for infants with hearing impairment who passed conventional hearing screening, as well as infants with normal hearing at risk of late-onset HL due to genetic susceptibility. Results: Among a total of 35 930 infants, 32 512 infants completed the follow-up and were included for analysis. Among the infants included in the analysis, all were from the Han population in China and 52.3% (16 988) were male. The modified genetic and hearing screening program revealed 142 cases of HL and 1299 cases of genetic variation. The limited genetic screening helped identify 31 infants who passed newborn hearing screening, reducing time for diagnosis and intervention; 425 infants with normal hearing with pathogenic SLC26A4 variation and 92 infants with MT-RNR1 variation were at risk for enlarged vestibular aqueduct and aminoglycoside-induced ototoxicity respectively, indicating early aversive or preventive management. Conclusions and Relevance: This study found that performing modified genetic and hearing screening in newborns was feasible and provides evidence that the program could identify additional subgroups of infants who need early intervention. These findings suggest an advantage for universal adoption of such a practice.

Can the electricity price subsidy policy curb NOX emissions from China's coal-fired power industry? A difference-in-differences approach.

Air pollution currently poses a serious threat to human health and sustainable development in China. In an attempt to reduce nitrogen oxides (NOX) emissions which are the major anthropogenic contributors to air pollution, China initiated an electricity price subsidy (EPS) policy in November 2011 for incentivizing coal-fired power plants to install denitrification units. However, the effectiveness of the policy in the reduction of NOX emissions and its sustainability are yet to be investigated. This study attempts to examine the effects of the EPS policy on NOX emissions and NOX removal, based on a panel-data set covering 113 prefectural-level cities in China during 2008-2015. Using a difference-in-differences (DID) regression model, we find that for each additional power plant in cities, the EPS policy significantly reduces NOX emissions by 1.1% and increases NOX removal by 2.8%. Furthermore, the results reveal that the overall effect of the EPS policy shows a positive trend with time accompanied by an increase in price subsidy, indicating that the efficacy of the policy designed for the reduction of harmful air pollutants is sustainable. In particular, we confirm that compensating for the construction and operation costs of denitrification units is an effective mechanism which encourages the coal-fired power plants to invest more in such units. The findings of the study accentuate the significant implication that economic-incentive policies play a crucial role in combating air pollution and environmental degradation.

Effect of nitrate on the phototreatment of Triton X-100 simulated washing waste containing 4,4'-dibromodiphenyl ether: Kinetics, products and toxicity assessment.

This study aimed to investigate the effects of nitrate on the ultraviolet (UV) treatment of simulated washing wastes containing Trion X-100 (TX-100) surfactant and 4,4'-dibromodiphenyl ether (BDE-15) pollutant. The presence of nitrate accelerated the photodegradation of BDE-15 and TX-100, because they reacted with reactive oxygen species (ROS) produced from conversion between nitrate and nitrite. Due to nitrite having a stronger radical quenching property than nitrate, nitrite hindered TX-100 decay while the photodegradation rate of BDE-15 was similar to that in the presence of nitrate. This indicated that nitrate/nitrite affected BDE-15 photodegradation by photosensitization and TX-100 loss by ROS attack. An increased TX-100 concentration increased the loss of total inorganic nitrogen possibly owing to an increase in organic nitrogen formation through TX-100 nitration reactions. At pH < 7 HOONO rapidly isomerized to NO3-, and at pH = 7-9 it homolyzed to ONOO-, which increased OH production to decay the BDE-15 and TX-100 and also increased NO2- formation. BDE-15 mainly underwent debromination, and some rearrangement, ring formation, nitration and hydroxylation products were detected, indicating that the produced OH and NO2 attacked the BDE-15 and products. Furthermore, broken-chain, carboxylation, hydroxylation and nitro products were detected by Liquid chromatography high resolution mass spectrometry (LC-HRMS). Escherichia coli was used to assess the toxicity of washing waste containing nitrate: the presence of nitrate will increase the wastes' toxicity during UV treatment. Therefore, the presence of nitrate is deleterious to the UV treatment of washing wastes, and it is important to remove nitrates and nitrites from washing waste before UV irradiation.

Degradation mechanism, intermediates and toxicology assessment of tris-(2-chloroisopropyl) phosphate using ultraviolet activated hydrogen peroxide.

Organophosphate flame retardants (OPFRs), one kind of emerging flame retardants, have received prevalent attention owing to their ubiquity in aquatic matrices and their characteristics of being refractory to biodegradation. In current research, the degradation mechanism of tris-(2-chloroisopropyl) phosphate (TCPP), one of OPFRs, and its toxicological evaluation using UV-driven hydroxyl radical oxidation were investigated. A pseudo-first order reaction was fitted with an apparent rate constant (Kobs) of 0.1328 min-1 on transformation of TCPP in the case of CH2O2 0.1 mM, pH 6.6-7.1 and 4.7 mW cm-2 UV irradiation. High resolution mass spectroscopy analyses identified nine degradation products (eg., C6H13Cl2O4P (m/z 251.0002), C9H17Cl2O5P (m/z 307.0266), C9H17Cl2O6P (m/z 323.0217), C9H18Cl3O5P (m/z 343.0033)) during transformation of TCPP. The removal efficiency dropped by inhibitory effect of natural organic matters and anions, implying that the complete mineralization of TCPP may be difficult in actual water treatment process. The toxicity assessment has shown an decrease in reactive oxygen species (ROS) and apoptosis, membrane potential (MP) elevation of Escherichia coli, and biological molecular function revision (eg., metabolism and DNA biosynthesis), indicating that toxicity of degradation products were conspicuously decreased in comparison with intact TCPP. To sum up, effective detoxification of TCPP can be realized by a UV driving radical-based oxidation, which will provide an alternative safe treatment method to control TCPP in water matrix.

Oxidation degradation of tris-(2-chloroisopropyl) phosphate by ultraviolet driven sulfate radical: Mechanisms and toxicology assessment of degradation intermediates using flow cytometry analyses.

Organophosphate flame retardants (OPFRs) were frequently detected in biotic and abiotic matrix owing to their persistence and recalcitrant degradation. Some specific OPFRs, such as tris-(2-chloroisopropyl) phosphate (TCPP), pose a significant potential risk to human health due to their high water solubility. Therefore, an environmentally sound and high efficient technique is in urgent need of controlling TCPP. This research is focused on degrading TCPP using ultraviolet-persulfate (UV/PS) technique. The degradation reaction of TCPP followed a pseudo-first order kinetics with an apparent rate constant (kobs) at 0.1653 min-1. As the photocatalytic reaction proceeded, TCPP was transformed to twelve degradation intermediates via the selective electron-transfer reactions induced by activated sulfate radical. Anions existence and pH value significantly inhibited the degradation efficiency, implying that it was hard for TCPP to reach up to complete mineralization in actual water treatment process. Additionally, toxicological assessment of degradation intermediate mixture was conducted using Flow cytometry (FCM) analyses, and the result showed that the intracellular reactive oxygen species (ROS) and cell apoptotic rates significantly declined, and membrane potential (MP) increased in comparison with original TCPP. On the other hand, the negative impacts of these degradation products on DNA biosynthesis in Escherichia coli were weakened based on cell cycle analysis, all of which indicated that toxicity of these degradation intermediates was obviously reduced via UV/PS treatment. To summarize, an appropriate mineralization is effective for TCPP detoxification, suggesting the feasibility of TCPP control using UV/PS treatment in water matrix.

Biodegradation of decabromodiphenyl ether (BDE-209) using a novel microbial consortium GY1: Cells viability, pathway, toxicity assessment, and microbial function prediction.

GY1, a novel microbial consortium with efficient ability to degrade decabromodiphenyl ether (BDE-209) has been isolated and the sequencing analysis has been conducted. The results revealed that Hyphomicrobium, Pseudomonas, Aminobacter, Sphingopyxis, Chryseobacterium, Bacillus, Pseudaminobacter, Stenotrophomonas, Sphingobacterium and Microbacterium were the dominant genera, and the function genes involved in BDE-209 conversion were predicted by PICRUSt. When BDE-209 concentration increased from 0.5 to 10mg/L, its degradation efficiency declined from 57.2% to 22.3%. Various kinds of debrominated metabolites were detected during the biodegradation process, including BDE-208, BDE-207, BDE-206, BDE-205, BDE-190, BDE-181, BDE-155, BDE-154, BDE-99, BDE-47, BDE-17 and BDE-7. Also, the proportion of necrotic cells was observed during GY1 mediated degradation of BDE-209 to reveal the changes of cells viability under BDE-209 stress. Subsequent analysis showed that the reaction of BDE-209 with GY1 was a detoxification process and bioaugmentation with GY1 effectively enhanced BDE-209 degradation in actual water and water-sediment system.

Characterisation and risk assessment of polycyclic aromatic hydrocarbons (PAHs) in soils and plants around e-waste dismantling sites in southern China.

Environmental pollution due to primitive e-waste dismantling activities has been intensively investigated over the last decade in the south-eastern coastal region of China. In the present study, we investigated the distribution and composition of polycyclic aromatic hydrocarbons (PAHs) in soils and plants around e-waste recycling sites in Longtang, Guangdong province, South China. The results indicated that PAH concentrations in rhizosphere soil and non-rhizosphere soil were in the range of 133 to 626 ng/g and 60 to 816 ng/g, respectively, while PAH levels in plant tissue were 96 to 388 ng/g in shoots and 143 to 605 ng/g in roots. PAHs were enriched in rhizosphere soils in comparison with non-rhizosphere soils. The concentrations of PAHs in plant tissues varied greatly among plant cultivars, indicating that the uptake of PAHs by plants is species-dependent. Different profiles of PAHs in the soil and the corresponding plant tissue implied that PAH uptake and translocation by plants were selective.The total daily intakes of PAHs and carcinogenic PAHs through vegetables at the e-waste recycling site were estimated to be 99 and 22 ng/kg/day, respectively, suggesting that potential health risks associated with the consumption of contaminated vegetables should not be ignored.

Worldwide human daily intakes of bisphenol A (BPA) estimated from global urinary concentration data (2000-2016) and its risk analysis.

To evaluate BPA's potential risk to health, it is important to know human daily intake. This study describes a simple but effective method to estimate the levels of human BPA intake among four different populations based on urinary concentration data. Nationally, of the 30 countries examined, the top ten countries for adult intake were Italy, Sweden, Denmark, France, Cyprus, Australia, Israel, Ghana, Jamaica, and Belgium. When the urinary excretion sample size was large enough and over 1000, it was found that the national estimated BPA daily intakes in the child group among countries, showed a good linear relationship with those of their corresponding adult group. Except the infant group with limited data, the global estimated BPA daily intakes for children and pregnant women were 2 and 1.4 times that of the adult group. Although the national and global estimated BPA daily intakes were generally below the temporary tolerable daily intake (tTDI) recommended by the European Food Safety Authority (EFSA), but some normal individuals' daily intakes exceeded the tTDI.

Assessment of Myofilament Ca2+ Sensitivity Underlying Cardiac Excitation-contraction Coupling.

Heart failure and cardiac arrhythmias are the leading causes of mortality and morbidity worldwide. However, the mechanism of pathogenesis and myocardial malfunction in the diseased heart remains to be fully clarified. Recent compelling evidence demonstrates that changes in the myofilament Ca(2+) sensitivity affect intracellular Ca(2+) homeostasis and ion channel activities in cardiac myocytes, the essential mechanisms responsible for the cardiac action potential and contraction in healthy and diseased hearts. Indeed, activities of ion channels and transporters underlying cardiac action potentials (e.g., Na(+), Ca(2+) and K(+) channels and the Na(+)-Ca(2+) exchanger) and intracellular Ca(2+) handling proteins (e.g., ryanodine receptors and Ca(2+)-ATPase in sarcoplasmic reticulum (SERCA2a) or phospholamban and its phosphorylation) are conventionally measured to evaluate the fundamental mechanisms of cardiac excitation-contraction (E-C) coupling. Both electrical activities in the membrane and intracellular Ca(2+) changes are the trigger signals of E-C coupling, whereas myofilament is the functional unit of contraction and relaxation, and myofilament Ca(2+) sensitivity is imperative in the implementation of myofibril performance. Nevertheless, few studies incorporate myofilament Ca(2+) sensitivity into the functional analysis of the myocardium unless it is the focus of the study. Here, we describe a protocol that measures sarcomere shortening/re-lengthening and the intracellular Ca(2+) level using Fura-2 AM (ratiometric detection) and evaluate the changes of myofilament Ca(2+) sensitivity in cardiac myocytes from rat hearts. The main aim is to emphasize that myofilament Ca(2+) sensitivity should be taken into consideration in E-C coupling for mechanistic analysis. Comprehensive investigation of ion channels, ion transporters, intracellular Ca(2+) handling, and myofilament Ca(2+) sensitivity that underlie myocyte contractility in healthy and diseased hearts will provide valuable information for designing more effective strategies of translational and therapeutic value.

COMPARISON OF MEDICAL COSTS AND CARE OF APPENDECTOMY PATIENTS BETWEEN FEE-FOR-SERVICE AND SET FEE FOR DIAGNOSIS-RELATED GROUP SYSTEMS IN 20 CHINESE HOSPITALS.

The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

Estimated human excretion rates of natural estrogens calculated from their concentrations in raw municipal wastewater and its application.

Natural estrogens are important endocrine disrupting compounds (EDCs), which may pose adverse effects on our environment. To avoid time-consuming sample preparation and chemical analysis, estimation of their concentrations in municipal wastewater based on their human urine/feces excretion rates has been generally adopted. However, the data of excretion rates available are very limited and show significant difference among countries. In the context of increasing reporting on the concentrations of natural estrogens in municipal wastewater around the world, this study presented a simple method to estimate their human excretion rates based on the concentrations of natural estrogens in raw sewage. The estimated human excretion rates of natural estrogens among ten countries were obtained, which totally covered over 33 million population. Among these, Brazilians had the largest excretion rates with estrone (E1) and 17ß-estradiol (E2) as 236.9 and 60 µg/day/P, respectively, while Iran had the lowest value of 2 µg/day/P for E1 and 0.5 µg/day/P for E2. The average estimated human excretion rates of E1, E2, and estriol (E3) are 17.3, 6.4, and 39.7 µg/day/P, respectively. When the estimated human excretion rates obtained were applied for prediction, the predicted results showed better accuracies than those based on human urinary/feces excretion rates. The method in this study is simple, cost-effective and time-saving, which may be widely applied.

Do we underestimate the concentration of estriol in raw municipal wastewater?

The main source of natural estrogens to municipal wastewater is human excretions via urine or feces, thus their concentrations in raw wastewater should show positive linear relationship with their human excretions. This study mainly focused on their concentration relationship in raw wastewater. Based on comparison between chemical analyses and predictions through human excretion rates, the observed concentrations of estriol (E 3) in municipal wastewater were found to be noticeably lower than the predicted values. The main cause for the disparity is that substantial conjugated E 3 also exists in raw wastewater. This work suggested that monitoring both E 3 and its conjugates is necessary to get more accurate E 3 removal performance of wastewater treatment plants (WWTPs).

[Analysis of intraoperative molecular assessment of sentinel lymph nodes in breast carcinoma].

OBJECTIVE: To evaluate the reliability and application of GeneSearch(TM) breast lymph node assay (Genesearch), a real-time fluorescence quatitative PCR method, in intraoperative assay of metastasis in sentinel lymph nodes (SLNs) from breast cancer patients. METHODS: Totally 140 SLNs from 80 patients with breast carcinoma were prospectively studied from May 2010 to August 2010. The 80 patients included 78 women and 2 men who ranged in age from 29 to 85 years, and the median age is 49 years. The expression of CK19 and mammaglobulin in all 140 SLNs were detected by Genesearch, and the results were compared with that of histological evaluation of both frozen and paraffin-embedded sections. RESULTS: Among SLNs, by histological analyses, there were 121 without metastasis, 17 with macrometastasis, 2 with micrometastasis, and none of isolated tumor cell. By Genesearch, there were 119 without metastasis and 21 with metastasis. Genesearch showed sensitivity of 89.4%, positive predictive value of 81.0%, negative predictive value of 98.3% and specificity of 96.7% by comparing to histological analyses. The concordance between Genesearch and histological analysis was 95.7%. The sensitivity of Genesearch was 15/17 for macrometastasis and 2/2 for micrometastasis. CONCLUSIONS: Genesearch detection presents high sensitivity and specificity in evaluating metastasis of sentinel lymph nodes in breast cancer, but strict performance technically is necessary to avoid false positive and false negative results. Inability of further subtyping for the positive cases might be the key limitations for wide application of this method.

Characterization and risk assessment of polychlorinated biphenyls in soils and vegetations near an electronic waste recycling site, South China.

This study aimed at identifying the levels of PCBs generated from e-waste recycling, and their potential impacts on the soils and vegetations as well. The ΣPCBs concentrations in soil and plant samples ranged from 7.4 to 4000 ng g(-1) and from 6.7 to 1500 ng g(-1), respectively. For the plant samples, Chrysanthemum coronarium L. from vegetable field and the wild plant Bidens pilosa L. from the burning site showed relatively higher PCB concentrations than other species. For the soil samples, the e-waste burning site had relatively higher PCB concentrations than the adjacent areas, and vegetable soils had higher PCB concentrations than paddy soils. The PCB concentrations showed a clear decreasing trend with the increasing distance from the e-waste recycling site. PCB 28, 99, 101, 138, 153, and 180 were the predominant congeners. Principal component analysis results showed a potential fractionation of PCB compositions from the burning site to the surroundings. The PCB congener pattern at the burning site was similar to Arochlor 1260, pointing to an input of non-domestic e-waste. Similar PCB congeners were found in soils and related vegetables, indicating they derived from the same source. The consumption of vegetables grown in soils near e-waste recycling sites should be strictly avoided due to the high PCBs in the plant tissues.

Effect of Shenmai Injection on ventricular diastolic function in patients with chronic heart failure: An assessment by tissue Doppler imaging.

OBJECTIVE: To assess the effect of Shenmai Injection (SMI) on left ventricular diastolic function (LVDF) in patients with chronic heart failure (CHF) by tissue Doppler imaging (TDI). METHODS: Sixty-four CHF patients were randomly assigned to two groups, the observation group and the control group. Basic treatment including polarized liquid therapy was given to all the patients. In addition, SMI was given to patients of the observation group. The treatment duration was 14 days. TDI was performed in all the patients 3 days prior to the initiation of the treatment and one week after the medication to measure the average movement velocity of the mitral ring of the left ventricle at the early systolic stage and late diastolic stage (Ea and Aa); the outcomes were compared with the corresponding parameters obtained from blood flow Doppler echocardiography, namely, the velocity of the E-wave (E) and A-wave (A). RESULTS: After treatment, Ea and Ea/Aa increased and Aa decreased significantly in the observation group (P<0.05). In the control group, although some improvement was seen, there was no statistically significant change (P>0.05). No statistical significance was shown between groups in these parameters after treatment. CONCLUSION: TDI assessment shows that SMI could effectively improve the LVDF in CHF patients.