[Spatial Distribution and Risk Assessment of Heavy Metals in Surface Sediments from the Middle and Upper Reaches of the Yangtze River].

The hydrological regime of rivers significantly changes after dam impoundment, which in turn affects the particle composition and heavy metal fractions of the river sediments. From June to July 2019, the sediments from 26 sampling sections were collected along the main stream of the Yangtze River from Panzhihua City in the upper reaches of the Yangtze River to Hukou City in the middle reaches of the Yangtze River. The concentrations and fractions of As, Cd, Co, Cr, Cu, Ni, Pb, and Zn were measured using the BCR three-step extraction procedure. The pollution status and potential ecological risk of heavy metals in sediments were evaluated using the geo-accumulation index, the sediment quality guideline, and the risk assessment coding method (RAC). The results showed that the average particle size of sediments in the upper reaches of the Yangtze River (Jinsha River cascade reservoir section and the Three Gorges reservoir section) decreased from upstream to downstream, the total concentrations of As and Zn increased, and the variation trend in the middle reaches was not obvious. The content of clay particles was significantly positively correlated with the acid-soluble fraction concentrations of Cd and Ni. Cd was mainly in the residual fraction (59.26%) and acid-soluble fraction (24.67%). Large parts of Cr and Ni were residual fractions accounting for 92.41% and 83.41%, respectively. As, Co, Cu, Pb, and Zn were mainly in the residual fraction and the reducible fraction. The order of decrease for the pollution degree (Igeo) of As, Cd, Co, Cr, Ni, and Zn was the Jinsha River, the middle reaches of the Yangtze River, and the Three Gorges Reservoir. The decrease order of bioavailability (RAC) of Cd, Co, Cr, Cu, Ni, and Zn was the Three Gorges Reservoir, the Jinsha River, and the middle reaches of the Yangtze River. The bioavailability of As and Pb decreased in the order of the middle reaches of the Yangtze River, the Three Gorges, and the Jinsha River. According to the classification of the RAC, Cd in the Three Gorges Reservoir area exhibited a high risk with the RAC accounting for 48.44%. Cu, Ni, and Zn showed a low or medium risk.

Security and Radical Assessment in Open, Laparoscopic, Robotic Colorectal Cancer Surgery: A Comparative Study.

PURPOSE: This retrospective study was designed to assess the safety and effectiveness of open, laparoscopic, robotic colorectal cancer surgery. METHODS: Three hundred patients with colorectal cancer who underwent curative resection in the First Affiliated Hospital of Zhengzhou University between February 2014 and May 2016 were included. Patients were classified into open surgery group, laparoscopic surgery group, and robot-assisted group. RESULTS: The blood loss in laparoscopic surgery group was less than that in open surgery group, and the blood loss in robot-assisted group less was than the open surgery group. The number of lymph node dissection in robot-assisted group was significantly larger than that in the open group ( P < .05). The distance between the lower edge of the tumor group and the distal margin in robotic group was longer than that of the laparoscopic surgery group and the open group ( P < .05). Three (2.8%) cases of urinary retention occurred in the open surgery group, 4 (3.92%) cases in the laparoscopic surgery group, and 1 (1.1%) case in the robot-assisted group, while 2 (1.87%) cases of sexual dysfunction occurred in the open surgery group, 2 (1.96%) cases in the laparoscopic surgery group, and 1 (1.1%) case in the robot-assisted group. The urinary retention and sexual dysfunction rate did not differ between the 3 groups ( P > .05), but the minimally invasive group showed a certain advantage over the open group. CONCLUSION: Compared to the traditional open surgery, minimally invasive surgery (especially in robot-assisted group) has advantages such as less intraoperative bleeding, rapid postoperative recovery, and radical cure; open group, laparoscopic surgery group, and robot-assisted group have a similar incidence of postoperative complications, but reduction in the incidence of anastomotic leakage and intestinal obstruction. Robot-assisted group has the potential advantage for pelvic autonomic nerve protection.

Potential cost-effectiveness of a rotavirus immunization program in rural China.

BACKGROUND: To assess the incidence and economic burden of rotavirus diarrhea and the potential cost-effectiveness of a rotavirus immunization program in rural Zhengding County in Hebei Province, China. METHODS: Population-based surveillance was conducted during the peak season for diarrhea among children who were <5 years of age in Zhengding County from 14 October 2004 through 19 January 2005. The cost of illness was measured from the perspectives of both patient and society. A decision-analytic model was applied to the cost-effectiveness analysis using real data derived from surveillance and from a cost-of-illness study. RESULTS: During the surveillance period, 500 episodes of diarrhea were registered. Of these 500 episodes, 125 (25%) occurred in patients who were positive for rotavirus. Of these 125 episodes, 63 (50%) occurred in patients who were hospitalized. The overall incidence rate of rotavirus infection was 61.4 cases per 1000 children per year during the 14-week epidemic season. For a Chinese cohort of 5000 newborns, a universal rotavirus immunization program would prevent 1764 cases of rotavirus diarrhea, averting 882 hospitalizations of patients