[Investigation and analysis of acute poisoning of organic fluorine mixed gas in a fluorine polymerization plant].

In January 2021, an acute chemical poisoning incident occurred at a fluorine polymerization plant. Through the analysis of the occupational health situation of the enterprise, combined with the clinical manifestations of the poisoned patients and the laboratory examination results, it was determined that the incident was an acute poisoning incident caused by the inhalation of organic fluorine mixed gas in the fluorine polymerization plant. Subsequently, it was clarified that the accident was caused by the illegal operation of the employees of the fluorine polymerization plant, which caused the discharge of the organic fluorine mixed gas containing high concentration of octafluoroisobutene, resulting in the poisoning of the on-site construction personnel. In order to avoid the occurrence of similar incidents, enterprises should implement the main responsibility of safety production, regularly organize supervision and inspection, eliminate illegal operations, conduct safety education and training for the staff of the unit and outsourced staff, and improve the emergency rescue ability of sudden poisoning incidents.

[Anatomical relationship between the brachiocephalic trunk and the trachea and the clinical implications].

OBJECTIVE: To observe the anatomical features and relative position of the brachiocephalic trunk and the trachea to provide an anatomical basis for diagnosis and treatment of mechanical airway obstruction and for facilitating the performance of tracheotomy. METHODS: A total of 91 formalin- fixed adult cadavers (70 male and 21 female) were used in this study. The whole length of the larynx and the trachea were separated and exposed from the neck to the chest, followed by separation of the aortic arch and its 3 branches to observe the anatomical position of the brachiocephalic trunk and the trachea. RESULTS: The brachiocephalic trunk and the trachea did not intersect in 3.30%, partially intersected in 71.43%, and completely intersected in 25.27% of the 91 cadaveric specimens. The male specimens all showed greater outer diameter of the aortic arch, the brachiocephalic trunk and the trachea with a greater length of the trachea than the female specimens (P < 0.05), while the distances from the aortic arch to the brachiocephalic trunk or the cricoid cartilage did not differ significantly between them (P > 0.05). The number of the tracheal cartilage rings above the brachiocephalic trunk ranged from 3 to 10, and the mean number did not differ significantly between the male and female specimens (P > 0.05). CONCLUSION: The brachiocephalic trunk has complex anatomical relationship with the trachea, and caution should be taken to avoid injuries of the brachiocephalic trunk and the aortic arch in the diagnosis and treatment of mechanical respiratory obstruction and during tracheotomy.

[Long-term mortality risk of valvular heart disease adults over 35 years old in Chinese communities].

Objective: To investigate the risk and influencing factors of long-term mortality of valvular heart disease (VHD) adults aged 35 years and over in Chinese communities. Methods: A cohort study was carried out. The data of the subjects who underwent echocardiography were collected from the Chinese Hypertension Survey between 2012 and 2015 and survival outcomes were followed up between 2018 and 2019. Kaplan-Meier survival curves were plotted and compared using log-rank test. Cox proportional hazards models were used to analyze the influence of VHD on mortality. Results: During an average follow-up time of (4.6±0.9) years, a total of 23 237 participants (10 881 males and 12 356 females) were pooled into the final analysis from 5 eastern, 5 central, and 4 western provinces, cities and autonomous regions in China, with a mean age of (56.9±13.2) years. Among the included participants, 1 004 had VHD (467 males and 537 females), with a mean age was of (68.1±12.6) years. In the Kaplan-Meier analysis, participants with VHD had a significantly increased risk of all-cause mortality (log-rank χ2=351.82, P<0.001) and cardiovascular mortality (log-rank χ2=284.14, P<0.001) compared with those without VHD. Multivariate Cox regression analysis showed that compared with those without VHD, the participants with rheumatic VHD had a 45% increased risk of all-cause mortality (HR=1.45, 95%CI: 1.12-1.89) and degenerative VHD increased the risk of cardiovascular mortality by 69% (HR=1.69, 95%CI: 1.19-2.38). The risk factors of cardiovascular mortality for VHD were age 55 years and over (55-<75 years: HR=4.93, 95%CI: 1.17-20.85;≥75 years: HR=11.92, 95%CI: 2.85-49.80) and diabetes mellitus (HR=1.71, 95%CI: 1.00-2.93). Conclusions: VHD is a risk factor of all-cause mortality and cardiovascular mortality among adults aged 35 years and over. Age 55 years and over and diabetes mellitus are adverse prognostic factors for patients with VHD.

Following the Nonthermal Phase Transition in Niobium Dioxide by Time-Resolved Harmonic Spectroscopy.

Photoinduced phase transitions in correlated materials promise diverse applications from ultrafast switches to optoelectronics. Resolving those transitions and possible metastable phases temporally are key enablers for these applications, but challenge existing experimental approaches. Extreme nonlinear optics can help probe phase changes, as higher-order nonlinearities have higher sensitivity and temporal resolution to band structure and lattice deformations. Here the ultrafast transition from the semiconducting to the metallic phases in polycrystalline thin-film NbO_{2} is investigated by time-resolved harmonic spectroscopy. The emission strength of all harmonic orders shows a steplike suppression when the excitation fluence exceeds a threshold (∼11-12 mJ/cm^{2}), below the fluence required for the thermal transition-a signature of the nonthermal emergence of a metallic phase within 100±20 fs. This observation is backed by full ab initio simulations as well as a 1D chain model of high-harmonic generation from both phases. Our results demonstrate femtosecond harmonic probing of phase transitions and nonthermal dynamics in solids.

Effect of resistance exercise on peripheral inflammatory biomarkers in healthy adults: a meta-analysis of randomized controlled trials.

OBJECTIVE: This study aimed to evaluate the effect of resistance exercise on peripheral inflammatory biomarkers in healthy adults. MATERIALS AND METHODS: Four databases, including PubMed, Web of Science, Cochrane Library, and SPORTDiscus, were searched from inception until April 1st, 2022. A meta-analysis was conducted using a random-effects model, followed by sensitivity analysis, subgroup analysis, meta-regression analysis, and publication bias analysis. RESULTS: 15 randomized controlled trials were included in the meta-analysis. The pooled results showed that resistance exercise significantly decreased TNF-α levels (SMD = -0.81, 95% CI: -1.42 to -0.20, p = 0.009) but did not affect IL-6 and CRP levels. Individuals with BMI 18.5-24.9 exhibited significantly decreased IL-6 levels, while moderate strength resistance exercise could significantly decrease TNF-α levels. Finally, age might be a confounding factor influencing the effect of resistance exercise on IL-6. CONCLUSIONS: Resistance exercise could reduce TNF-α levels in healthy adults, and resistance exercise with moderate intensity could reduce TNF-α levels more effectively.

Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: The Role of Frailty.

OBJECTIVES: To investigate whether frailty modifies the association of systolic blood pressure (SBP) with cardiovascular mortality and all-cause mortality in community-dwelling older adults. DESIGN: A prospective cohort study. SETTING: A population-based study of nationally representative older Chinese adults in a community setting. PARTICIPANTS: This study included participants aged 65 years or older from the Chinese Longitudinal Healthy Longevity Survey 2002-2014 and followed up to 2018. MEASUREMENTS: Participants were divided into two groups according to a frailty index based on the accumulation of a 44-items deficits model. The association between SBP and mortality was analyzed using multivariable-adjusted Cox proportional hazards models. RESULTS: Among 18,503 participants included, the mean age was 87.2 years and the overall median follow-up time was 42.7 months. We identified 7808 (42.2%) frail participants (mean frailty index=0.33), in which 7533 (96.5%) died during the follow-up. Effect modification by frailty was detected (P for interaction=0.032). Among frail participants, a U-shaped association was found with hazard ratios of 1.16 (95% CI, 1.02-1.32) for SBP < 100 mmHg, and 1.11 (95% CI, 1.00-1.24) for SBP ≥ 150 mmHg compared with SBP 120-130 mmHg. For non-frail older adults, a tendency toward higher risk among those with SBP ≥ 130 mmHg was observed. The analyses towards cardiovascular mortality showed similar results. CONCLUSION: Our results suggest the presence of effect modification by frailty indicating a possible negative effect for elevated SBP in non-frail older adults and a U-shaped relationship of SBP in frail older adults with respect to mortality even after adjusting for diastolic blood pressure.

Effects of aerobic exercise on inflammatory factors in healthy adults: a meta-analysis.

OBJECTIVE: With this meta-analysis we aimed at systematically evaluating the intervention effects of aerobic exercise on inflammatory factors in healthy adults and identifying an optimal aerobic exercise program with anti-inflammatory effects. MATERIALS AND METHODS: Four databases, including PubMed, Web of Science, Cochrane Library and SPORTDiscus, were searched from inception until April 30, 2021. Stata version 11.0 was used for data analysis. RESULTS: A total of 15 studies with 1160 participants were included. The pooled estimates showed that aerobic exercise could significantly reduce TNFα levels (SMD=-0.30, 95% CI: -0.58 - -0.03, p=0.032), while the levels of IL-6 (SMD=-0.14, 95% CI: -0.32-0.03, p=0.109) and CRP (SMD=-0.09, 95% CI: -0.34-0.16, p=0.484) were not significantly affected. CONCLUSIONS: Aerobic exercise exerts a positive effect by preventing inflammation-related diseases.

[Protective effect of Epothilone D against traumatic optic nerve injury in rats].

OBJECTIVE: To investigate the therapeutic effect of Epothilone D on traumatic optic neuropathy (TON) in rats. METHODS: Forty-two SD rats were randomized to receive intraperitoneal injection of 1.0 mg/kg Epothilone D or DMSO (control) every 3 days until day 28, and rat models of TON were established on the second day after the first administration. On days 3, 7, and 28, examination of flash visual evoked potentials (FVEP), immunofluorescence staining and Western blotting were performed to examine the visual pathway features, number of retinal ganglion cells (RGCs), GAP43 expression level in damaged axons, and changes of Tau and pTau-396/404 in the retina and optic nerve. RESULTS: In Epothilone D treatment group, RGC loss rate was significantly decreased by 19.12% (P=0.032) on day 3 and by 22.67% (P=0.042) on day 28 as compared with the rats in the control group, but FVEP examination failed to show physiological improvement in the visual pathway on day 28 in terms of the relative latency of N2 wave (P=0.236) and relative amplitude attenuation of P2-N2 wave (P=0.441). The total Tau content in the retina of the treatment group was significantly increased compared with that in the control group on day 3 (P < 0.001), showing a consistent change with ptau-396/404 level. In the optic nerve axons, the total Tau level in the treatment group was significantly lower than that in the control group on day 7 (P=0.002), but the changes of the total Tau and pTau-396/404 level did not show an obvious correlation. Epothilone D induced persistent expression of GAP43 in the damaged axons, detectable even on day 28 of the experiment. CONCLUSION: Epothilone D treatment can protect against TON in rats by promoting the survival of injured RGCs, enhancing Tau content in the surviving RGCs, reducing Tau accumulation in injured axons, and stimulating sustained regeneration of axons.

Silymarin protects the rats against paraquat-induced acute kidney injury via Nrf2.

BACKGROUND: Paraquat (PQ) poisoning induces severe acute kidney injury and causes extremely high rate of death. In this study, we aimed to investigate the protective effects of silymarin on PQ-induced acute kidney injury and explore the underlying mechanisms. METHODS: A rat model was established through intraperitoneal injection of PQ. Rats were administrated with saline or silymarin for 3 days. Then, survival rate, physiological parameters, and renal injury score were evaluated. The apoptosis and oxidative stress in kidney tissues were determined through hematoxylin and eosin staining, quantitative reverse transcription polymerase chain reaction, Western blot, and enzyme-linked immunosorbent assays. RESULTS: Silymarin administration could significantly increase the survival rate of PQ-poisoned rats. It was found that silymarin treatment improved renal function, decreased injury score in kidney tissues, and inhibited the apoptosis and oxidative stress in PQ-induced acute kidney injury through the activating the signaling pathway of Nrf2 and promoting its nuclear translocation. CONCLUSION: Silymarin exhibited a protective effect against PQ-induced kidney injury, suggesting that treatment with this flavonoid could be a potential therapeutic agent for the treatment of acute kidney injury.

[Analysis of families with fetal congenital abnormalities but negative prenatal diagnosis by whole exome sequencing].

Objective: To evaluate the value of whole exome sequencing (WES) in prenatal clinical application. Methods: A total of 1 152 cases of congenital abnormal [including structural malformation, nuchal translucency (NT) thickening and intrauterine growth restriction] with traditional prenatal diagnosis [including G-band karyotype analysis and chromosome microarray analysis (CMA)] negative were analyzed. The congenital abnormal fetuses were divided into retrospective group and prospective group according to the time of WES detection, that is whether the pregnancy termination or not. According to the specific location of fetal malformation and their family history, the cohort was divided into subgroups. The clinical prognosis of all fetuses were followed up, and the effect of WES test results on pregnancy decision-making and clinical intervention were analyzed. According to the follow-up results, the data of fetuses with new phenotypes in the third trimester or after birth were re-analyzed. Results: Among 1 152 families who received WES, 5 families were excluded because of nonbiological parents. Among the remaining 1 147 families, 152 fetuses obtained positive diagnosis (13.3%,152/1 147), including 74 fetuses in the retrospective group (16.1%,74/460) and 78 fetuses in the prospective group (11.4%,78/687). In fetuses with negative CMA and G-band karyotype analysis results but new phenotypes in the third trimester or after birth, the positive rate by WES data re-analysis was 4.9% (8/163). A total of 34 (21.3%, 34/160) fetuses were directly affected by the corresponding positive molecular diagnosis. Among 68 cases of live births with diagnostic variation grade 4, 29 cases (42.7%, 29/68) received appropriate medical intervention through rapid review of WES results. Conclusions: WES could increase the detection rate of abnormal fetuses with negative G-banding karyotype analysis and CMA by 13.3%. Prenatal WES could guide pregnancy decision-making and early clinical intervention. It might be an effective strategy to pay attention to the special follow-up of the third trimester and postnatal fetus and to re-analyze the WES data.

Simultaneous Nodal Superconductivity and Time-Reversal Symmetry Breaking in the Noncentrosymmetric Superconductor CaPtAs.

By employing a series of experimental techniques, we provide clear evidence that CaPtAs represents a rare example of a noncentrosymmetric superconductor which simultaneously exhibits nodes in the superconducting gap and broken time-reversal symmetry (TRS) in its superconducting state (below T_{c}≈1.5 K). Unlike in fully gapped superconductors, the magnetic penetration depth λ(T) does not saturate at low temperatures, but instead it shows a T^{2} dependence, characteristic of gap nodes. Both the superfluid density and the electronic specific heat are best described by a two-gap model comprising of a nodeless gap and a gap with nodes, rather than by single-band models. At the same time, zero-field muon-spin relaxation spectra exhibit increased relaxation rates below the onset of superconductivity, implying that TRS is broken in the superconducting state of CaPtAs, hence indicating its unconventional nature. Our observations suggest CaPtAs to be a new remarkable material that links two apparently disparate classes, that of TRS-breaking correlated magnetic superconductors with nodal gaps and the weakly correlated noncentrosymmetric superconductors with broken TRS, normally exhibiting only a fully gapped behavior.

The effect of acetylation on the protein stability of BmApoLp-III in the silkworm, Bombyx mori.

Acetylation is an important, reversible posttranslational modification to a protein. In a previous study, we found that there were a large number of acetylated sites in various nutrient storage proteins of the silkworm haemolymph. In this study, we confirmed that acetylation can affect the stability of nutrient storage protein Bombyx mori apolipophorin-III (BmApoLp-III). First, the expression of BmApoLp-III could be upregulated when BmN cells were treated with the deacetylase inhibitor panobinostat (LBH589); similarly, the expression was downregulated when the cells were treated with the acetylase inhibitor C646. Furthermore, the increase in acetylation by LBH589 could inhibit the degradation and improve the accumulation of BmApoLp-III in BmN cells treated with cycloheximide and MG132 respectively. Moreover, we found that an increase in acetylation could decrease the ubiquitination of BmApoLp-III and vice versa; therefore, we predicted that acetylation could improve the stability of BmApoLp-III by competing for ubiquitination and inhibiting the protein degradation pathway mediated by ubiquitin. Additionally, BmApoLp-III had an antiapoptosis function that increased after LBH589 treatment, which might have been due to the improved protein stability after acetylation. These results have laid the foundation for further study on the mechanism of acetylation in regulating the storage and utilization of silkworm nutrition.

Phase Space Dynamics of a Plasma Wakefield Dechirper for Energy Spread Reduction.

Plasma-based accelerators have made impressive progress in recent years. However, the beam energy spread obtained in these accelerators is still at the ∼1% level, nearly one order of magnitude larger than what is needed for challenging applications like coherent light sources or colliders. In plasma accelerators, the beam energy spread is mainly dominated by its energy chirp (longitudinally correlated energy spread). Here we demonstrate that when an initially chirped electron beam from a linac with a proper current profile is sent through a low-density plasma structure, the self-wake of the beam can significantly reduce its energy chirp and the overall energy spread. The resolution-limited energy spectrum measurements show at least a threefold reduction of the beam energy spread from 1.28% to 0.41% FWHM with a dechirping strength of ∼1 (MV/m)/(mm pC). Refined time-resolved phase space measurements, combined with high-fidelity three-dimensional particle-in-cell simulations, further indicate the real energy spread after the dechirper is only about 0.13% (FWHM), a factor of 10 reduction of the initial energy spread.

[Analysis of spatial-temporal distribution of pesticide poisoning in Quzhou, 2013-2017].

Objective: To analysis the epidemic and spatial characteristics of pesticide poisoning in Quzhou during 2013-2017, and to provide scientific basis for the prevention and control of influenza in Quzhou in the future. Methods: The incidence data of pesticide poisoning from January 1, 2013 to December 31, 2017 in Quzhou collected from China Information System For Disease Control And Prevention. The descriptive analysis conducted by using SPSS18.0 software, and the Sa T Scan 9.2 software was used to complete space-time scan. Finally, ArcMap10.2 software was used to visualize the results. Results: There were 1819 cases of pesticide poisoning in Quzhou from 2007 to 2016, among which 298 cases were reported for productive poisoning, the incidence peak was from August to September, the highest number of patients in productive poisoning was in the age group of 46-60 years old and over 61 years old, with 109 patients in each group, and the number of male patients was significantly higher than that of female (χ(2)=63.857, P<0.01) . 1521 cases of non-productive pesticide poisoning were reported, among which the proportion of suicide poisoning (57.65%) was far higher than that of accidental poisoning (28.97%) , the number of female suicide poisoning was higher than that of male (χ(2)=5.510, P=0.019) , the proportion of accidental poisoning was the highest in the ≤15 years age group (89.00%, 89/100) , furthermore the number of suicide poisoning was the highest in the ≥61 years age group (314) . The incidence of pesticide poisoning could be detected by temporal-spatial scanning statistics, the time clustering is from August to September, the spatial clustering is in Jiangshan city, there are consistent with the descriptive of pesticide poisoning. Conclusion: The pesticide poisoning in Quzhou is mainly caused by non-productive suicide poisoning, and the spatial clustering is in Jiangshan city. Relevant departments should carry out targeted prevention and control measures according to the different characteristics of pesticide poisoning in clustered and non-clustered areas.

[Relationship between overnight urinary sodium to potassium ratio and the risk of cardiovascular disease].

Objective: To explore the relationship between overnight urinary sodium to potassium ratio and the risk of cardiovascular disease (CVD). Methods: A subsample of 10 percent of the participants (35-59 years old) from the People's Republic of China-United States Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology (prospective survey) were used. Three consecutive overnight urine samples were collected in the autumn of 1983-1984 and the spring in 1985-1986, respectively. Urinary sodium and potassium were detected and calculated for 8 hours excretion. The occurrences of cardiovascular events were recorded in 2 years interval from 1987-1988 until December 31, 2005. Participants were divided into first ratio group, second ratio group, and third ratio group based on the tertiles of sodium to potassium ratio. Cox proportional hazard regression model was used to determine the relationship between sodium to potassium ratio and risk of CVD. In addition, participants were divided into 2 subgroups by the median of overnight urinary sodium and potassium, and then combined each other for 4 subgroups including low sodium-low potassium group, low sodium-high potassium group, high sodium-low potassium group, and high sodium-high potassium group, to explore the relationship between different sodium-potassium combinations and the risk of CVD. Results: A total of 954 participants were included in the final analysis, of whom 459 (48.1%) were males. There were 318 cases in the first, second and third ratio group, respectively. There were 347 cases in low sodium-low potassium group and high sodium-high potassium group, and 130 cases in low sodium-high potassium group and high sodium-low potassium group. After a median follow-up of 18.6 (18.3, 19.3) years, cardiovascular events occurred in 81 participants, including 64 stroke and 20 coronary heart disease events. Multivariate analysis showed that comparing with the first ratio group, the hazard ratios (HR) in the second and the third ratio groups were 2.04 (95%CI 1.06-3.95, P=0.034) and 2.07 (95%CI 1.07-4.03, P=0.032), respectively. The CVD risk in low sodium-low potassium group was 24% higher than the low sodium-high potassium group (reference), but this result did not reach statistical significant level (P=0.685). The risks in high sodium-high potassium group (HR=3.32, 95%CI 1.26-8.76,P=0.015) and high sodium-low potassium (HR=3.04, 95%CI 1.05-8.83, P=0.041) group were both significantly increased. Conclusions: Overnight urinary sodium to potassium ratio is positively correlated with the risk of cardiovascular events. High urinary sodium plays a more important role for the increased risk of cardiovascular events than low potassium.

Modeling of Li diffusion in nanocrystalline Li-Si anode material.

To quantify the Li diffusion behavior in nanocrystalline anode materials for lithium-ion batteries (LIBs), a hybrid model of the first principles calculation and diffusion kinetics was developed. The dependence of the Li diffusion on the electronic structure, solute concentration, grain size and temperature was described for the nanocrystalline Li-Si system. In contrast to conventional polycrystalline materials in which the activation barrier for Li diffusion decreases with the increase of concentration before amorphization, there exists a coordination effect of the solute concentration and grain size on the Li diffusion in nanocrystalline materials. A maximum diffusion coefficient can be obtained in the nanocrystalline Li-Si by a combination of the concentration and grain size, which is increased by two orders of magnitude from that in the coarse-grained counterpart. The present work advanced the understanding of the Li diffusion mechanisms during lithiation/delithiation of LIBs and may facilitate the development of nanocrystalline anode materials.

Whole exome sequencing as a diagnostic adjunct to clinical testing in fetuses with structural abnormalities.

OBJECTIVES: To evaluate the diagnostic yield of prenatal whole exome sequencing (WES) for monogenic disorders in fetuses with structural malformations and normal results on cytogenetic testing, and to describe information on pathogenic variants that is provided by WES. METHODS: Karyotyping, chromosomal microarray analysis (CMA) and WES were performed sequentially on stored samples from a cohort of 3949 pregnancies with fetal structural abnormalities detected on ultrasound and/or magnetic resonance imaging, referred between January 2011 and December 2015. Diagnostic rates of the three techniques were investigated overall, for phenotypic subgroups and for proband-only vs fetus-mother-father samples. Information on pathogenic variants was identified by WES. RESULTS: Overall, 18.2% (720/3949) of fetuses had an abnormal karyotype. Pathogenic copy number variants were detected on CMA in 8.2% (138/1680) of fetuses that had a normal karyotype result. WES performed on a subgroup of 196 fetuses with normal CMA and karyotype results revealed the putative genetic variants responsible for the abnormal phenotypes in 47 cases (24%). The molecular diagnosis rates for fetus-mother-father and proband-only samples were 26.5% (13/49) and 23.1% (34/147), respectively. Variants of uncertain significance were detected in 12.8% (25/196) of fetuses, of which 22 were identified in the fetal proband-only group (15%; 22/147) and three in the fetus-mother-father group (6.1%; 3/49). The incidental finding rate was 6.1% (12/196). CONCLUSIONS: WES is a promising method for the identification of genetic variants that cause structural abnormalities in fetuses with normal results on karyotyping and CMA. This enhanced diagnostic yield has the potential to improve the clinical management of pregnancies and to inform better the reproductive decisions of affected families. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

[A new perspective of survival data on clinical epidemiology: introduction of competitive risk model].

Competing risks occur frequently in the analysis of survival data that should be dealt with competing risk models. Competing risk is an event whose occurrence precludes the occurrence of the primary event of interest. Previous commonly used Kaplan-Meier method tends to overestimate the cumulative survival functions, while the traditional Cox proportional hazards model falsely evaluates the effects of covariates on the hazard related to the occurrence of the event. There are few domestic reports mentioning the concept, application and methodology of competing risk model as well as the implementation procedures or resolution of model conditions and parameters. The current work aims to explain the core concept and methodology of the competing risk model and to illustrate the process of analysis on cumulative incidence rate, using both the cause-specific hazard function model and the sub-distribution hazard function model. Software macro code in SAS 9.4 is also provided to assist clinical researchers to further understand the application of the model so to properly analyze the survival data.