Correlation of Peripheral Blood Inflammatory Indicators to Prognosis After Intravenous Thrombolysis in Acute Ischemic Stroke: A Retrospective Study.

Purpose: According to many previous studies, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and hypersensitive C-reactive protein (CRP) are commonly used as important indicators to assess the prognosis of intravenous thrombolysis in AIS patients. Based on this, we used two novel biomarkers C-NLR (CRP/neutrophil-to-lymphocyte ratio) and C-LMR (CRP×lymphocyte-to-monocyte ratio) to investigate their correlation with 90-day outcomes in AIS patients after intravenous thrombolysis. Patients and Methods: A total of 204 AIS patients who received intravenous thrombolysis at the Stroke Center of Jiangsu Province Hospital of Chinese Medicine from January 2021 to December 2022 were retrospectively included. All patients were followed up 90 days after thrombolysis to assess their prognosis. Patients with a modified Rankin scale score (mRS) of 3-6 were included in the unfavorable outcome group, and those with a score of 0-2 were included in the favorable outcome group. Logistic regression analysis, receiver operating characteristic (ROC) curve, and Kaplan-Meier survival curve were used to investigate the association between C-NLR, C-LMR, and 90-day prognosis in AIS patients treated with early intravenous thrombolysis. Results: C-NLR (OR=1.586, 95% CI=1.098~2.291, P=0.014) and C-LMR (OR=1.099, 95% CI=1.025~1.179, P=0.008) were independent risk factors for 90-day prognosis of AIS patients treated with early intravenous thrombolysis. The higher C-NLR and C-LMR were associated with unfavorable prognosis. Conclusion: C-NLR and C-LMR can be used as biomarkers to predict prognosis of AIS patients treated with early intravenous thrombolysis.

Construction and evaluation of prognostic models of ECMO in elderly patients with cardiogenic shock based on BP neural network, random forest, and decision tree.

OBJECTIVE: To analyze the predictive effect of a back propagation (BP) neural network, random forest (RF) and decision tree model on the prognosis of elderly patients with cardiogenic shock after extracorporeal membrane oxygenation (ECMO). METHODS: This is a retrospective analysis of the clinical data of elderly patients with cardiogenic shock (258 cases) who underwent ECMO in People's Hospital of Guangxi Zhuang Autonomous Region from January 2016 to January 2022. All patients were followed up for 6 months after ECMO treatment. The prognosis was evaluated, and the prognostic factors were analyzed. BP neural network, RF and decision tree were used to establish predictive models, and the predictive performance of the models was evaluated. RESULTS: Among the 258 elderly patients with cardiogenic shock, 52 (20.16%) died 6 months after the ECMO treatment. Based on BP neural network, RF, and decision tree, predictive models for the prognosis and death of elderly patients with cardiogenic shock were constructed. A test set was used to predict the performance of the three models. The results showed that the predictive performances of the three models were all more than 80.00%. The accuracy, sensitivity, and specificity of the RF model were 0.987, 1.000, and 0.929 respectively, which were higher than those of the decision tree model. The area under the receiver operating characteristic curve (AUC) of the RF model was 1.000, which was higher than 0.916 for the decision tree model. DeLong test showed that there was a significant difference in the AUC of the RF model compared to the decision tree test set (D=-2.063, P=0.042 < 0.05). CONCLUSION: The predictive performance is good in all the three models, which have a high application value for prognosis of ECMO in elderly patients with cardiogenic shock. In clinical practice, predictive models should be selected according to the actual situation, so clinicians and patients can make decisions.

Gridless Underdetermined Direction of Arrival Estimation in Sparse Circular Array Using Inverse Beamspace Transformation.

Underdetermined DOA estimation, which means estimating more sources than sensors, is a challenging problem in the array signal processing community. This paper proposes a novel algorithm that extends the underdetermined DOA estimation in a Sparse Circular Array (SCA). We formulate this problem as a matrix completion problem. Meanwhile, we propose an inverse beamspace transformation combined with the Gridless SPICE (GLS) algorithm to complete the covariance matrix sampled by SCA. The DOAs are then obtained by solving a polynomial equation with using the Root-MUSIC algorithm. The proposed algorithm is named GSCA. Monte-Carlo simulations are performed to evaluate the GSCA algorithm, the spatial spectrum plots and RMSE curves demonstrated that the GSCA algorithm can give reasonable results of underdetermined DOA estimation in SCA. Meanwhile, the performance of the algorithm under various configurations of SCA is also evaluated. Numerical results indicated that the GSCA algorithm can provide access to solve the DOA estimation problem in Uniform Circular Array (UCA) when random sensor failures occur.

The relationship between intracranial arterial dolichoectasia and intracranial atherosclerosis.

OBJECTIVE: We aimed to investigate the relationship between intracranial arterial dolichoectasia (IADE) and intracranial atherosclerosis (ICAS). METHODS: Patients with acute ischemic stroke were screened via the Nanjing Stroke Registry Program. Patients were diagnosed with IADE (diameter, height of bifurcation, and laterality of basilar artery) based on magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) results. Intracranial atherosclerosis was defined as a ≥50 % diameter reduction in internal carotid artery, middle cerebral artery, posterior cerebral artery, or anterior cerebral artery on MRA, computed tomography angiography, or digital subtraction angiography. We also evaluated the presence and degree of white matter changes and lacuna infarctions on MRI. RESULTS: Of the 469 enrolled patients, 61 (13 %) had IADE. Patients with IADE were older (64.1 ± 9.9 vs. 59.6 ± 11.4 years, P = 0.004) and had a higher prevalence of hypertension (78.7 % vs. 61.0 %, P = 0.008) than patients without IADE. Patients with ICAS were older (62.6±10.5 vs 58.1±11.6 years, P < 0.001), had higher prevalence of hypertension (72.9 % vs. 55.0 %, P < 0.001) and a previous history of stroke (21.6 % vs. 9.2 %, P < 0.001), had higher levels of serum low-density lipoprotein cholesterol (2.57±0.82 vs. 2.31±0.86mmol/l P = 0.002), and had high counts of white blood cells (7.90±3.29 vs 7.10±2.44, P = 0.004). No association was detected between IADE and extracranial carotid atherosclerosis [odds ratio (OR)=0.618; 95 % confidence interval (CI), 0.280-1.367; P = 0.235]. After adjusting for age, sex, hypertension, and ischemic heart disease, patients with IADE had a lower ICAS rate than that in those without IADE (OR 0.417, 95 % CI, 0.213-0.816, P = 0.011). Unlike patients with ICAS, patients with IADE were more likely to have infratentorial stroke lesions (OR=2.952, 95 % CI, 1.207-7.223, P = 0.018), multi-lacuna (OR=2.142, 95 % CI, 1.158-3.964, P = 0.015), and white matter changes (OR = 2.782; 95 % CI, 1.522-5.085, P = 0.001). CONCLUSIONS: IADE was associated with advanced age, hypertension, multi-lacuna, and white matter changes but was not associated with ICAS.

TIM-3 Participates in the Invasion and Metastasis of Nasopharyngeal Carcinoma via SMAD7/SMAD2/SNAIL1 Axis-Mediated Epithelial-Mesenchymal Transition.

BACKGROUND: T-cell immunoglobulin and mucin domain-containing molecule-3 (TIM-3) was originally found to negatively regulate immune response and mediate immune escape in tumors. Subsequently, an increasing body of evidence has shown that TIM-3 exerts positive functions in the development and progression of several tumors. However, the role of TIM-3 in nasopharyngeal carcinoma (NPC) remains unknown. METHODS: Data from the Cancer Genome Atlas-head and neck squamous cell carcinoma and immunohistochemistry were analyzed to compare the expression of TIM-3 in NPC and non-cancerous nasopharyngitis tissues. Cell proliferation was evaluated using the Cell counting kit-8 in vitro and xenograft experiment in nude mice in vivo. Flow cytometry was used to evaluate the cell cycle. The migration and invasion of NPC cells were assessed through wound healing and Transwell assays. In addition, Western blotting was used to analyze the expression of specific proteins. RESULTS: Higher expression of TIM-3 was detected in NPC tissues than normal nasopharyngeal tissues and positively correlated with the clinical stage and T classification; however, it was not correlated with gender, age, and N classification. Furthermore, overexpression of TIM-3 using lentiviral vectors increased the malignancy of 6-10B and CNE-2 cell lines that lowly express TIM-3, by promoting cell proliferation, migration, and invasion in vitro and in vivo. In addition, overexpression of TIM-3 was associated with upregulation of matrix metalloproteinase 9 (MMP9) and MMP2, and led to epithelial-mesenchymal transition (EMT) by increasing the levels of mesenchymal markers (ie, N-cadherin, Vimentin) and decreasing those of the epithelial marker E-cadherin. Further study showed that SMAD7 was downregulated in the TIM-3 overexpression group. Relatively, phosphorylated SMAD2 and downstream molecule SNAIL1 were also upregulated in this group. CONCLUSION: TIM-3 exerts a tumor-promoting function in NPC by mediating changes in the SMAD7/SMAD2/SNAIL1 axis. These findings provide a new idea for the study of invasion, metastasis, and treatment of NPC.

Small cell carcinoma of the upper urinary tract and factors associated with progress survival: a systematic review and pooled analysis.

INTRODUCTION: Little is known about small cell carcinoma of the upper urinary tract (UUT-SCC), the aim of this study is to identify the risk factors in relation to survival of patients with UUT-SCC. EVIDENCE ACQUISITION: Literature search on UUT-SCC was performed in databases including MEDLINE, EMBASE, Wangfang, and CNKI. Studies were eligible for inclusion if outcomes of patients with histopathologically confirmed UUT-SCC were reported. The relevant data on clinic, pathology, and therapy were collected. Progress survival was evaluated using the Cox regression model with the robust sandwich estimates of the covariance matrix. EVIDENCE SYNTHESIS: There were 55 eligible publications identified, contributing 76 patients in total. The median of overall survival (OS) was 14 months. In univariable analyses, pathological stage and platinum-based chemotherapy regimen were associated with OS (pT3-pT4 versus pT1-pT2, HR=3.228, P=0.005; other chemotherapies versus platinum-based, HR=6.249, P=0.035). The median of cancer-specific survival (CSS) was 15 months. In univariable analyses, pathological stage and platinum-based chemotherapy regimen were associated with CCS (pT3-pT4 versus pT1-pT2, HR=3.332, P=0.004; non-platinum based versus platinum-based, HR=7.784, P=0.025). CONCLUSIONS: In multivariable analyses, no variables were associated with OS and CSS. UUT-SCC is a rare tumor characterized by an aggressive clinical course. Pathological stage and platinum-based chemotherapy regimen are the most important factors related to OS and CSS.

A case of methylprednisolone treatment for metronidazole-induced encephalopathy.

BACKGROUND: Metronidazole, a common antimicrobial agent, can induce encephalopathy in rare cases. After discontinuing metronidazole, most patients show clinical improvement. However, in the face of deteriorating conditions, there have done not to have reports of effective drug treatment. CASE PRESENTATION: A 57-year-old man was admitted to our hospital due to dysarthria and ataxic gait after taking metronidazole at the dose of about 32 g for 20 days. Neurological examination showed that his upward and outward movements of bilateral eyeballs were limited, and horizontal and vertical nystagmus were noted. The brain magnetic resonance imaging showed hyper-intensities in the bilateral cerebellar dentate nuclei, medulla oblongata, midbrain and red nuclei in T2W and FLAIR images. However, the patient's clinical symptoms worsened after drug cessation. High-dose intravenous methylprednisolone pulse therapy was applied, and this led to a drastic improvement of his symptoms and signs. CONCLUSIONS: In our case, we suggest that early methylprednisolone intervention can prevent the progression of metronidazole-induced encephalopathy and accelerate neurological recovery. We infer that the progression of encephalopathy is related to the delayed toxicity caused by high dose or concentration of metronidazole.

Micheliolide inhibits gastric cancer growth in vitro and in vivo via blockade of the IL-6/STAT3 pathway.

Upregulation of pro-inflammatory cytokine interleukin (IL)-6 is observed in gastric cancer tissue, and high IL-6 serum levels predict a poor prognosis of gastric cancer patients. The IL-6/STAT3 pathway has been confirmed to play essential roles in the process of carcinogenesis, including gastric cancer. Thus, blockade of the IL-6/STAT3 pathway may be a potentially effective therapeutic option for gastric cancer. Micheliolide (MCL), a guaianolide sesquiterpene lactone, possesses anti-inflamma tory properties and can attenuate the IL-6 level. In addition, MCL has been widely reported to possess anti-tumor activity. But the anti-cancer effect of MCL on gastric cancer is unclear. In this study, we detected the effects of MCL on gastric cancer cell proliferation and apoptosis by performing MTT, colony formation, TUNEL and western blot assays, and found that MCL inhibited gastric cancer cell proliferation and promoted apoptosis in vitro. We further investigated the molecular mechanism by which MCL played an efficient role against gastric cancer, and found that the IL-6/STAT3 pathway is involved in the anti-cancer effect of MCL on gastric cancer. In vivo experiments further confirmed this conclusion. Taken together, MCL inhibits gastric cancer growth in vitro and in vivo via blockade of IL-6/STAT3 pathway.

Bifidobacterium may benefit the prevention of necrotizing enterocolitis in preterm infants: A systematic review and meta-analysis.

AIM: A systematic review and meta-analysis was designed to evaluate the efficacy and safety of Bifidobacterium for preventing necrotizing enterocolitis (NEC) in preterm infants. METHODS: We searched the Cochrane Library, PubMed, EMBASE and Web of Science to December 2017. Risk ratio (RR) with 95% confidence intervals (CIs) were estimated to compare the outcomes of the groups. For the pooled RR estimating the incidence of NEC, we also performed subgroup analysis. Besides, sensitivity analysis was performed to examine the stability of the combined results. Two reviewers assessed trial quality and extracted data independently. The work has been reported in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the methodological quality of systematic reviews) Guidelines. All statistical analyses were performed using standard statistical procedures provided in Review Manager 5.2. RESULTS: Twenty four randomized, placebo-controlled studies (N = 6155 participants) were included in this analysis, of which twenty two studies were used for assessing the efficacy of Bifidobacterium for preventing NEC and seventeen for assessing the safety (sepsis and death). When comparing Bifidobacterium groups with control groups, the relative risk of developing NEC (RR 0.38, 95% CI 0.25-0.58; P < 0.00001) or death (RR 0.74, 95% CI 0.60-0.92; P = 0.006) was significantly lower in the Bifidobacterium groups. No significant difference in the incidence of sepsis was found (RR 0.87, 95% CI 0.73-1.03; P = 0.11). In addition, significant results for NEC were also found in all subgroups we made. CONCLUSIONS: Bifidobacterium may have a beneficial effect and be safe in preventing necrotizing enterocolitis in preterm infants.

Effects of Linderae radix extracts on a rat model of alcoholic liver injury.

Traditional treatments have a poor effect on alcoholic liver diseases. Linderae radix (LR), the dried root of Lindera aggregata (Sims) Kosterm., has been frequently used in traditional Chinese medicine for treating various diseases, and has been shown to exhibit a protective effect on liver injury. In the present study, LR extracts were made using various solvents, and then administrated to rats to establish a model of ethanol-induced liver injury. The study aimed to investigate the therapeutic effects and potential mechanism of LR extracts on acute alcoholic liver injury. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycercide (TG), cholesterol (TC), methane dicarboxylic aldehyde (MDA) and superoxide dismutase (SOD) were determined using an automatic biochemistry analyzer. In addition, pathological examination was performed by hematoxylin-eosin staining. The levels of MDA and SOD, and the expression levels of nuclear factor (NF)-κB, tumor necrosis factor (TNF)-α and interleukin (IL)-1ß in liver tissue were investigated immunohistochemically. The expression of cytochrome P450 2E1 (CYP2E1) mRNA was quantified by reverse transcription-quantitative polymerase chain reaction. The results indicated that LR extracts improved the histopathological status and decreased the serum levels of ALT, AST, TG, TC and MDA. Furthermore, the levels of MDA and inflammatory mediators (NF-κB, TNF-α and IL-1ß) were decreased in liver tissues, and the overexpression of CYP2E1 mRNA induced by ethanol treatment. LR extracts exhibited a protective effect on alcoholic liver injury and the mechanism may be associated with the anti-inflammatory and anti-oxidative action.

[Efficacy and prognosis of trigeminal neuralgia treated with surgical excision or gamma knife surgery].

OBJECTIVE: To evaluate the curative effects and complications when using microvascular decompression (MVD) or gamma knife surgery (GKS) to treat trigeminal neuralgia (TN). And to investigate the prognosis for TN after these treatments. METHODS: Sixty-one TN patients treated using MVD and eighty-six TN patients treated using GKS were enrolled by means of telephone, letter or out-patient recheck; the patients had originally presented from December 1996 to June 2010. A chi-square test was applied to follow-up data on pain relief after 1 month, 6 months and 12 months, and at the final follow-up. RESULTS: One hundred and two patients were followed for 3-151 months. Cumulative pain relief rates at 1, 6, 12 months and at end times were 90.48%, 95.24%, 92.86%, and 95.24%, respectively, for forty-two MVD-treated patients, and 23.33%, 83.33%, 86.67% and 90% for sixty GKS-treated patients, respectively. The effects of two methods for treatment of TN was not statistically different (χ(2) = 2.053, P=0.152). Pain relief rates in the short-term (first month) demonstrated statistically significant differences (P<0.01), but pain relief rates in the long-term showed no significant differences (P>0.05). CONCLUSION: Immediate pain relief with MVD treatment is higher than with GKS, but in the long term both treatments were comparable.

Personal and ambient exposures to air toxics in Camden, New Jersey.

Personal exposures and ambient concentrations of air toxics were characterized in a pollution "hot spot" and an urban reference site, both in Camden, New Jersey. The hot spot was the city's Waterfront South neighborhood; the reference site was a neighborhood, about 1 km to the east, around the intersection of Copewood and Davis streets. Using personal exposure measurements, residential ambient air measurements, statistical analyses, and exposure modeling, we examined the impact of local industrial and mobile pollution sources, particularly diesel trucks, on personal exposures and ambient concentrations in the two neighborhoods. Presented in the report are details of our study design, sample and data collection methods, data- and model-analysis approaches, and results and key findings of the study. In summary, 107 participants were recruited from nonsmoking households, including 54 from Waterfront South and 53 from the Copewood-Davis area. Personal air samples were collected for 24 hr and measured for 32 target compounds--11 volatile organic compounds (VOCs*), four aldehydes, 16 polycyclic aromatic hydrocarbons (PAHs), and particulate matter (PM) with an aerodynamic diameter < or = 2.5 microm (PM2.5). Simultaneously with the personal monitoring, ambient concentrations of the target compounds were measured at two fixed monitoring sites, one each in the Waterfront South and Copewood-Davis neighborhoods. To understand the potential impact of local sources of air toxics on personal exposures caused by temporal (weekdays versus weekend days) and seasonal (summer versus winter) variations in source intensities of the air toxics, four measurements were made of each subject, two in summer and two in winter. Within each season, one measurement was made on a weekday and the other on a weekend day. A baseline questionnaire and a time diary with an activity questionnaire were administered to each participant in order to obtain information that could be used to understand personal exposure to specific air toxics measured during each sampling period. Given the number of emission sources of air toxics in Waterfront South, a spatial variation study consisting of three saturation-sampling campaigns was conducted to characterize the spatial distribution of VOCs and aldehydes in the two neighborhoods. Passive samplers were used to collect VOC and aldehyde samples for 24- and 48-hr sampling periods simultaneously at 22 and 16 grid-based sampling sites in Waterfront South and Copewood-Davis, respectively. Results showed that measured ambient concentrations of some target pollutants (mean +/- standard deviation [SD]), such as PM2.5 (31.3 +/- 12.5 microg/m3), toluene (4.24 +/- 5.23 microg/m3), and benzo[a]pyrene (0.36 +/- 0.45 ng/m3), were significantly higher (P < 0.05) in Waterfront South than in Copewood-Davis, where the concentrations of PM2.5, toluene, and benzo[a]pyrene were 25.3 +/- 11.9 microg/m3, 2.46 +/- 3.19 microg/m3, and 0.21 +/- 0.26 ng/m3, respectively. High concentrations of specific air toxics, such as 60 microg/m3 for toluene and 159 microg/m3 for methyl tert-butyl ether (MTBE), were also found in areas close to local stationary sources in Waterfront South during the saturation-sampling campaigns. Greater spatial variation in benzene, toluene, ethylbenzene, and xylenes (known collectively as BTEX) as well as of MTBE was observed in Waterfront South than in Copewood-Davis during days with low wind speed. These observations indicated the significant impact of local emission sources of these pollutants and possibly of other pollutants emitted by individual source types on air pollution in Waterfront South. (Waterfront South is a known hot spot for these pollutants.) There were no significant differences between Waterfront South and Copewood-Davis in mean concentrations of benzene or MTBE, although some stationary sources of the two compounds have been reported in Waterfront South. Further, a good correlation (R > 0.6) was found between benzene and MTBE in both locations. These results suggest that automobile exhausts were the main contributors to benzene and MTBE air pollution in both neighborhoods. Formaldehyde and acetaldehyde concentrations were found to be high in both neighborhoods. Mean (+/- SD) concentrations of formaldehyde were 20.2 +/- 19.5 microg/m3 in Waterfront South and 24.8 +/- 20.8 microg/m3 in Copewood-Davis. A similar trend was observed for the two compounds during the saturation-sampling campaigns. The results indicate that mobile sources (i.e., diesel trucks) had a large impact on formaldehyde and acetaldehyde concentrations in both neighborhoods and that both are aldehyde hot spots. The study also showed that PM2.5, aldehydes, BTEX, and MTBE concentrations in both Waterfront South and Copewood-Davis were higher than ambient background concentrations in New Jersey and than national average concentrations, indicating that both neighborhoods are in fact hot spots for these pollutants. Higher concentrations were observed on weekdays than on weekend days for several compounds, including toluene, ethylbenzene, and xylenes (known collectively as TEX) as well as PAHs and PM2.5. These observations showed the impact on ambient air pollution of higher traffic volumes and more active industrial and commercial operations in the study areas on weekdays. Seasonal variations differed by species. Concentrations of TEX, for example, were found to be higher in winter than in summer in both locations, possibly because of higher emission rates from automobiles and reduced photochemical reactivity in winter. In contrast, concentrations of MTBE were found to be significantly higher in summer than in winter in both locations, possibly because of higher evaporation rates from gasoline in summer. Similarly, concentrations of heavier PAHs, such as benzo[a]pyrene, were found to be higher in winter in both locations, possibly because of higher emission rates from mobile sources, the use of home heating, and the reduced photochemical reactivity of benzo[a]pyrene in winter. In contrast, concentrations of lighter PAHs were found to be higher in summer in both locations, possibly because of volatilization of these compounds from various surfaces in summer. In addition, higher concentrations of formaldehyde were observed in summer than in winter, possibly because of significant contributions from photochemical reactions to formaldehyde air pollution in summer. Personal concentrations of toluene (25.4 +/- 13.5 microg/m3) and acrolein (1.78 +/- 3.7 microg/m3) in Waterfront South were found to be higher than those in the Copewood-Davis neighborhood (13.1 +/- 15.3 microg/m3 for toluene and 1.27 +/- 2.36 microg/m3 for acrolein). However, personal concentrations for most of the other compounds measured in Waterfront South were found to be similar to or lower than those than in Copewood-Davis. (For example, mean +/- SD concentrations were 4.58 +/- 17.3 microg/m3 for benzene, 4.06 +/- 5.32 microg/m3 for MTBE, 16.8 +/- 15.5 microg/m3 for formaldehyde, and 0.40 +/- 0.94 ng/m3 for benzo[a]pyrene in Waterfront South and 9.19 +/- 34.0 microg/m3 for benzene, 6.22 +/- 19.0 microg/m3 for MTBE, 16.0 +/- 16.7 microg/m3 for formaldehyde, and 0.42 +/- 1.08 ng/m3 for benzo[a]pyrene in Copewood-Davis.) This was probably because many of the target compounds had both outdoor and indoor sources. The higher personal concentrations of these compounds in Copewood-Davis might have resulted in part from higher exposure to environmental tobacco smoke (ETS) of subjects from Copewood-Davis. The Spearman correlation coefficient (R) was found to be high for pollutants with significant outdoor sources. The R's for MTBE and carbon tetrachloride, for example, were > 0.65 in both Waterfront South and Copewood-Davis. The R's were moderate or low (0.3-0.6) for compounds with both outdoor and indoor sources, such as BTEX and formaldehyde. A weaker association (R < 0.5) was found for compounds with significant indoor sources, such as BTEX, formaldehyde, PAHs, and PM2.5. The correlations between personal and ambient concentrations of MTBE and BTEX were found to be stronger in Waterfront South than in Copewood-Davis, reflecting the significant impact of local air pollution sources on personal exposure to these pollutants in Waterfront South. Emission-based ambient concentrations of benzene, toluene, and formaldehyde and contributions of ambient exposure to personal concentrations of these three compounds were modeled using atmospheric dispersion modeling and Individual Based Exposure Modeling (IBEM) software, respectively, which were coupled for analysis in the Modeling Environment for Total Risk (MENTOR) system. The compounds were associated with the three types of dominant sources in the two neighborhoods: industrial sources (toluene), exhaust from gasoline-powered motor vehicles (benzene), and exhaust from diesel-powered motor vehicles (formaldehyde). Subsequently, both the calculated and measured ambient concentrations of each of the three compounds were separately combined with the time diaries and activity questionnaires completed by the subjects as inputs to IBEM-MENTOR for estimating personal exposures from ambient sources. Modeled ambient concentrations of benzene and toluene were generally in agreement with the measured ambient concentrations within a factor of two, but the values were underestimated at the high-end percentiles. The major local (neighborhood) contributors to ambient benzene concentrations were from mobile sources in the study areas; both mobile and stationary (point and area) sources contributed to the ambient toluene concentrations. This finding can be used as guidance for developing better emission inventories to characterize, through modeling, the ambient concentrations of air toxics in the study areas. (ABSTRACT TRUNCATED)

[Comparison of prognosis of skull base chordoma treated by surgical resection and gamma knife surgery].

OBJECTIVE: To analyze the complication, survival and life quality, and to explore the efficacy and prognosis of skull base chordoma treated by open surgery and gamma knife surgery (GKS). METHODS: Thirty-eight patients with skull base chordomas who underwent an open surgery and another 19 patients who underwent GKS between January 2002 and January 2010 were followed up. The Karnofsky performance scale (KPS) at admission,discharge and follow-up, and recurrent rates were calculated through SPSS life-table, and survival rate curve was used to evaluate the efficacy and prognosis. RESULTS: Forty patients were followed up, and the survival rate of 1, 3 and 5 years was 92.6%, 74.3% and 60% in 27 patients with open surgery, and 100%, 83.3% and 62.5% in 13 patients with GKS respectively. There was no significant difference between the 2 groups (χ(2)=0.867, P=0.353). There was no significant difference in the KPS score between the 2 groups (P=0.138). CONCLUSION: Despite the poor prognosis of skull base chordoma, GKS can effectively improve the survival rate and present life quality of patients with skull base chordoma.

Impact of biogenic emission uncertainties on the simulated response of ozone and fine particulate matter to anthropogenic emission reductions.

The role of emissions of volatile organic compounds and nitric oxide from biogenic sources is becoming increasingly important in regulatory air quality modeling as levels of anthropogenic emissions continue to decrease and stricter health-based air quality standards are being adopted. However, considerable uncertainties still exist in the current estimation methodologies for biogenic emissions. The impact of these uncertainties on ozone and fine particulate matter (PM2.5) levels for the eastern United States was studied, focusing on biogenic emissions estimates from two commonly used biogenic emission models, the Model of Emissions of Gases and Aerosols from Nature (MEGAN) and the Biogenic Emissions Inventory System (BEIS). Photochemical grid modeling simulations were performed for two scenarios: one reflecting present day conditions and the other reflecting a hypothetical future year with reductions in emissions of anthropogenic oxides of nitrogen (NOx). For ozone, the use of MEGAN emissions resulted in a higher ozone response to hypothetical anthropogenic NOx emission reductions compared with BEIS. Applying the current U.S. Environmental Protection Agency guidance on regulatory air quality modeling in conjunction with typical maximum ozone concentrations, the differences in estimated future year ozone design values (DVF) stemming from differences in biogenic emissions estimates were on the order of 4 parts per billion (ppb), corresponding to approximately 5% of the daily maximum 8-hr ozone National Ambient Air Quality Standard (NAAQS) of 75 ppb. For PM2.5, the differences were 0.1-0.25 microg/m3 in the summer total organic mass component of DVFs, corresponding to approximately 1-2% of the value of the annual PM2.5 NAAQS of 15 microg/m3. Spatial variations in the ozone and PM2.5 differences also reveal that the impacts of different biogenic emission estimates on ozone and PM2.5 levels are dependent on ambient levels of anthropogenic emissions.

Modeling of personal exposures to ambient air toxics in Camden, New Jersey: an evaluation study.

This study presents the Individual Based Exposure Modeling (IBEM) application of MENTOR (Modeling ENvironment for TOtal Risk studies) in a hot spot area, where there are concentrated local sources on the scale of tens to hundreds of meters, and an urban reference area in Camden, NJ, to characterize the ambient concentrations and personal exposures to benzene and toluene from local ambient sources. The emission-based ambient concentrations in the two neighborhoods were first estimated through atmospheric dispersion modeling. Subsequently, the calculated and measured ambient concentrations of benzene and toluene were separately combined with the time-activity diaries completed by the subjects as inputs to MENTOR/IBEM for estimating personal exposures resulting from ambient sources. The modeling results were then compared with the actual personal measurements collected from over 100 individuals in the field study to identify the gaps in modeling personal exposures in a hot spot. The modeled ambient concentrations of benzene and toluene were generally in agreement with the neighborhood measurements within a factor of 2, but were underestimated at the high-end percentiles. The major local contributors to the benzene ambient levels are from mobile sources, whereas mobile and stationary (point and area) sources contribute to the toluene ambient levels in the study area. This finding can be used as guidance for developing better air toxic emission inventories for characterizing, through modeling, the ambient concentrations of air toxics in the study area. The estimated percentage contributions of personal exposures from ambient sources were generally higher in the hot spot area than the urban reference area in Camden, NJ, for benzene and toluene. This finding demonstrates the hot spot characteristics of stronger local ambient source impacts on personal exposures. Non-ambient sources were also found as significant contributors to personal exposures to benzene and toluene for the population studied.

Spatial variation of volatile organic compounds in a "Hot Spot" for air pollution.

The spatial variations of volatile organic compounds (VOCs) were characterized in the Village of Waterfront South neighborhood (WFS), a "hot spot" for air toxics in Camden, NJ. This was accomplished by conducting "spatial saturation sampling" for 11 VOCs using 3500 OVM passive samplers at 22 sites in WFS and 16 sites in Copewood/Davis Streets (CDS) neighborhood, an urban reference area located ∼1000 m east of the WFS. Sampling durations were 24 and 48 h. For all 3 sampling campaigns (2 in summer and 1 in winter), the spatial variations and median concentrations of toluene, ethylbenzene, and xylenes (TEX) were found significantly higher (p < 0.05) in WFS than in CDS, where the spatial distributions of these compounds were relatively uniform. The highest concentrations of methyl tert-butyl ether (MTBE) (maximum of 159 µg m(-3)) were always found at one site close to a car scrapping facility in WFS during each sampling campaign. The spatial variation of benzene in WFS was found to be marginally higher (p = 0.057) than in CDS during one sampling campaign, but similar in the other two sampling periods. The results obtained from the analyses of correlation among all species and the proximity of sampling site to source indicated that local stationary sources in WFS have significant impact on MTBE and BTEX air pollution in WFS, and both mobile sources and some of the stationary sources in WFS contributed to the ambient levels of these species measured in CDS. The homogenous spatial distributions (%RSD < 24%) and low concentrations of chloroform (0.02-0.23 µg m(-3)) and carbon tetrachloride (0.45-0.51 µg m(-3)) indicated no significant local sources in the study areas. Further, results showed that the sampling at the fixed monitoring site may under- or over-estimate air pollutant levels in a "hot spot" area, suggesting that the "spatial saturation sampling" is necessary for conducting accurate assessment of air pollution and personal exposure in a community with a high density of sources.