Association between heatwaves and risk and economic burden of injury related hospitalizations in China.

BACKGROUND: Public health is greatly affected by heatwaves, especially as a result of climate change. It is unclear whether heatwaves affect injury hospitalization, especially as developing countries facing the impact of climate change. OBJECTIVES: To assess the impact of heatwaves on injury-related hospitalization and the economic burden. METHODS: The daily hospitalizations and meteorological data from 2014 to 2019 were collected from 23 study sites in 11 meteorological geographic zones in China. We conducted a two-stage time series analysis based on a time-stratified case-crossover design, combined with DLNM to assess the association between heatwaves and daily injury hospitalization, and to further assess the regional and national economic losses resulting from hospitalization by calculating excess hospitalization costs (direct economic losses) and labor losses (indirect economic losses). To determine the vulnerable groups and areas, we also carried out stratified analyses by age, sex, and region. RESULTS: We found that 6.542% (95%CI: 3.939%, 9.008 %) of injury hospitalization were attributable to heatwaves during warm season (May to September) from 2014 to 2019. Approximately 361,447 injury hospitalizations were attributed to heatwaves each year in China, leading to an excess economic loss of 5.173 (95%CI: 3.104, 7.196) billion CNY, of which 3.114 (95%CI: 1.454, 4.720) billion CNY for males and 4.785 (95%CI: 3.203, 6.321) billion CNY for people aged 15-64 years. The attributable fraction (AF) of injury hospitalizations due to heatwaves was the highest in the plateau mountain climate zone, followed by the subtropical monsoon climate zone and the temperate monsoon climate zone. CONCLUSIONS: Heatwaves significantly increase the disease and economic burden of injury hospitalizations, and vary across populations and regions. Our findings implicate the necessity for targeted measures, including raising public awareness, improving healthcare infrastructure, and developing climate resilience policies, to reduce the threat of heatwaves to vulnerable populations and the associated disease and economic burden.

Copper-Based Metal-Organic Framework Induces NO Generation for Synergistic Tumor Therapy and Antimetastasis Activity.

The interaction between platelets and circulating tumor cells (CTCs) contributes to distal tumor metastasis by protecting CTCs from immunological assault and shear stress, which can be disrupted by nitric oxide (NO) through inhibiting platelet-mediated adhesion. To eradicate primitive tumors and inhibit CTC-based pulmonary metastasis, a novel biomimetic nanomedicine (mCuMNO) is designed by encapsulating Cu+ -responsive S-nitrosoglutathione as a NO donor into a copper-based metal-organic framework (CuM). This work discovers that mCuMNO can target tumor regions and deplete local glutathione (GSH) to reduce Cu2+ to Cu+ , followed by triggering NO release and hydroxyl radicals (·OH) production, thereby interrupting platelet/CTC interplay and contributing to chemodynamic therapy. Detailed studies demonstrate that mCuMNO exhibits high efficiency and safety in tumor therapy and antimetastasis activity, sheding new light on the development of CuM-based tumor synthetic therapy.

Mutations in the TBX15-ADAMTS2 pathway associate with a novel soft palate dysplasia.

We reported de novo variants in specific exons of the TBX15 and ADAMTS2 genes in a hitherto undescribed class of patients with unique craniofacial developmental defects. The nine unrelated patients represent unilateral soft palate hypoplasia, lost part of the sphenoid bone in the pterygoid process, but the uvula developed completely. Interestingly, these clinical features are contrary to the palate's anterior-posterior (A-P) developmental direction. Based on developmental characteristics, we suggested that these cases correspond to a novel craniofacial birth defect different from cleft palate, and we named it soft palate dysplasia (SPD). However, little is known about the molecular mechanism of the ADAMTS2 and TBX15 genes in the regulation of soft palate development. Phylogenetic analysis showed that the sequences around these de novo mutation sites are conserved between species. Through cellular co-transfections and chromatin immunoprecipitation assays, we demonstrate that TBX15 binds to the promoter regions of the ADAMTS2 gene and activates the promoter activity. Furthermore, we show that TBX15 and ADAMTS2 are colocalization in the posterior palatal mesenchymal cells during soft palate development in E13.5 mice embryos. Based on these data, we propose that the disruption of the TBX15-ADAMTS2 signaling pathway during embryogenesis leads to a novel SPD.

Srag Regulates Autophagy via Integrating into a Preexisting Autophagy Pathway in Testis.

Spermatogenesis is an essential process for producing sperm cells. Reproductive strategy is successfully evolved for a species to adapt to a certain ecological system. However, roles of newly evolved genes in testis autophagy remain unclear. In this study, we found that a newly evolved gene srag (Sox9-regulated autophagy gene) plays an important role in promoting autophagy in testis in the lineage of the teleost Monopterus albus. The gene integrated into an interaction network through a two-way strategy of evolution, via Sox9-binding in its promoter and interaction with Becn1 in the coding region. Its promoter region evolved a cis element for binding of Sox9, a transcription factor for male sex determination. Both in vitro and in vivo analyses demonstrated that transcription factor Sox9 could bind to and activate the srag promoter. Its coding region acquired ability to interact with key autophagy initiation factor Becn1 via the conserved C-terminal, indicating that srag integrated into preexisting autophagy network. Moreover, we determined that Srag enhanced autophagy by interacting with Becn1. Notably, srag transgenic zebrafish revealed that Srag exerted the same function by enhancing autophagy through the Srag-Becn1 pathway. Thus, the new gene srag regulated autophagy in testis by integrated into preexisting autophagy network.

Combination of an autophagy inhibitor with immunoadjuvants and an anti-PD-L1 antibody in multifunctional nanoparticles for enhanced breast cancer immunotherapy.

BACKGROUND: The application of combination therapy for cancer treatment is limited due to poor tumor-specific drug delivery and the abscopal effect. METHODS: Here, PD-L1- and CD44-responsive multifunctional nanoparticles were developed using a polymer complex of polyethyleneimine and oleic acid (PEI-OA) and loaded with two chemotherapeutic drugs (paclitaxel and chloroquine), an antigen (ovalbumin), an immunopotentiator (CpG), and an immune checkpoint inhibitor (anti-PD-L1 antibody). RESULTS: PEI-OA greatly improved the drug loading capacity and encapsulation efficiency of the nanoplatform, while the anti-PD-L1 antibody significantly increased its cellular uptake compared to other treatment formulations. Pharmacodynamic experiments confirmed that the anti-PD-L1 antibody can strongly inhibit primary breast cancer and increase levels of CD4+ and CD8+ T cell at the tumor site. In addition, chloroquine reversed the "immune-cold" environment and improved the anti-tumor effect of both chemotherapeutics and immune checkpoint inhibitors, while it induced strong immune memory and prevented lung metastasis. CONCLUSIONS: Our strategy serves as a promising approach to the rational design of nanodelivery systems for simultaneous active targeting, autophagy inhibition, and chemotherapy that can be combined with immune-checkpoint inhibitors for enhanced breast cancer treatment.

Seasonal variation in association between temperature change and emergency department visits: A multi-site study in China.

BACKGROUND: There is limited evidence of effects and seasonal variation of temperature change on emergency department visits (EDVs). OBJECTIVE: To investigate the association between diurnal temperature range (DTR), temperature change between neighboring days (TCN) and a comprehensive collection of cause-specific EDVs in China. METHODS: We collected EDVs, weather, and air pollution data in 20 sites in China from 2014 to 2018. We applied a quasi-Poisson regression with distributed lag nonlinear model to evaluate DTR- and TCN-EDVs association. We used meta-analysis to pool site-specific estimates. We also conducted seasonal analysis and assess effects of modifiers. RESULTS: A 1 °C increase of DTR and TCN was associated with 0.29% [95% confidence interval (CI): 0.07%, 0.51%)] and 1.44% (95% CI: 0.93%, 1.96%) increase of total EDVs, respectively. People aged 18-44 were sensitive to DTR and TCN, while the elderly population was sensitive to TCN only in spring and autumn. In seasonal analysis, effects of temperature change on total EDVs were lower in summer. TCN increased risks of genitourinary diseases in summer, respiratory diseases in winter, injury in autumn, and mental diseases in spring. DTR increased the risk of respiratory diseases in autumn. CONCLUSION: Exposure to DTR and TCN was associated with elevated risk of EDVs but with great seasonal variations. Our results provided potential time and target populations for adaptive strategies and preventive measures.

Temperatures and health costs of emergency department visits: A multisite time series study in China.

BACKGROUND: Evidence is limited regarding the association between temperatures and health costs. OBJECTIVES: We tried to investigate the association between temperatures and emergency department visits (EDVs) costs in China. METHODS: Daily data on EDVs costs, weather, air pollution were collected from 17 sites in China during 2014-2018. A quasi-Poisson generalized additive regression with distributed lag nonlinear model was applied to assess the temperature-EDVs cost association. Random-effect meta-analysis was used to pool the estimates from each site. Attributable fractions and national attributable EDVs costs due to heat and cold were calculated. RESULTS: Relative risk (RR) due to extreme heat over 0-7 lag days was 1.14 [95% confidence intervals (CI): 1.08-1.19] and 1.11 (95% CI: 1.07-1.16) for EDVs examination (including treatment) and medicine cost, respectively. People aged 18-44 and those with genitourinary diseases were at higher risk from heat. 0.72% of examination cost and 0.57% of medicine cost were attributed to extreme heat, costing 274 million Chinese Yuan annually. Moderate heat had lower RR but higher attributable fraction of EDVs costs. Exposure to extreme cold over 0-21 lag days increased the risk of medicine cost for people aged 18-44 [RR: 1.30 (95% CI: 1.10-1.55)] and those with respiratory diseases [RR: 1.56 (95% CI: 1.14-2.14)], but had non-statistically significant attributable fraction of the total EDVs cost. CONCLUSIONS: Exposure to heat and cold resulted in remarkable health costs. More resources and preparedness are needed to tackle such a challenge as our climate is rapidly changing.

Research Progress of Zebrafish Model in Toxicology and Its Application Prospects in Forensic Science.

In recent years, zebrafish model has been widely concerned and recognized by scholars at home and abroad. As an animal model, zebrafish is of great research value because it is easy to feed, easy to operate, observe and analyze, and the model results can be highly combined with human body test data. Zebrafish model has been widely used in many fields, including basic medical science, clinical medicine, agricultural production, environmental toxicology and forensic science. This review introduces the biological characteristics of zebrafish, summarizes the research progress of zebrafish model in toxicology, and discusses the application prospect of zebrafish model in forensic science.

Loss-of-function mutation in the X-linked TBX22 promoter disrupts an ETS-1 binding site and leads to cleft palate.

The cleft palate only (CPO) is a common congenital defect with complex etiology in humans. The molecular etiology of the CPO remains unknown. Here, we report a loss-of-function mutation in X-linked TBX22 gene (T-box 22) in a six-generation family of the CPO with obvious phenotypes of both cleft palate and hyper-nasal speech. We identify a functional -73G>A mutation in the promoter of TBX22, which is located at the core-binding site of transcription factor ETS-1 (v-ets avian erythroblastosis virus E26 oncogene homolog 1). Phylogenetic analysis showed that the sequence around the -73G>A mutation site is specific in primates. The mutation was detected in all five affected male members cosegregating with the affected phenotype and heterozygote occurred only in some unaffected females of the family, suggesting an X-linked transmission of the mutation in the family. The -73G>A variant is a novel single nucleotide mutation. Cell co-transfections indicated that ETS-1 could activate the TBX22 promoter. Moreover, EMSA and ChIP assays demonstrated that the allele A disrupts the binding site of ETS-1, thus markedly decreases the activity of the TBX22 promoter, which is likely to lead to the birth defect of the CPO without ankyloglossia. These results suggest that a loss-of-function mutation in the X-linked TBX22 promoter may cause the cleft palate through disruption of TBX22-ETS-1 pathway.

Systematic review and meta-analysis of the adverse health effects of ambient PM2.5 and PM10 pollution in the Chinese population.

INTRODUCTION: As the largest developing country, China has some of the worst air quality in the world. Heavy smog in January 2013 led to unprecedented public concern about the health impact of exposure to particulate matter. Conducting health impact assessments of particulate matter has thus become an urgent task for public health practitioners. Combined estimates of the health effects of exposure to particulate matter from quantitative reviews could provide vital information for epidemiology-based health impact assessments, but estimates for the Chinese population are limited. METHODS: On December 31, 2013, we systematically searched the PubMed, Web of Science, and China National Knowledge Infrastructure databases using as keywords names of 127 major cities in Mainland China, Hong Kong, and Taiwan. From among the 1464 articles identified, 59 studies were manually screened. Random-effects or fixed-effects models were used to combine their risk estimates, the funnel plots with Egger test were performed to evaluate the publication bias and Meta regression were run to explore the association between exposure to particulate matter with aerodynamic diameters less than 10 and 2.5 µm (PM10 and PM2.5) and the resulting health effects by the Comprehensive Meta Analysis. RESULTS: In terms of short-term effects, the combined excess risks of total non-accidental mortality, mortality due to cardiovascular disease, and mortality due to respiratory disease were 0.36% (95% confidence interval [95%CI]: 0.26%, 0.46%), 0.36% (95%CI: 0.24%, 0.49%), and 0.42% (95%CI: 0.28%, 0.55%), for each 10 µg/m(3) increase in PM10. A 10 µg/m(3) increase in PM2.5 was associated with a 0.40% (95%CI: 0.22%, 0.59%) increase in total non-accidental mortality, a 0.63% (95%CI: 0.35%, 0.91%) increase in mortality due to cardiovascular disease, and a 0.75% (95%CI: 01.39%, 1.11%) increase in mortality due to respiratory disease. For constituent-specific mortality, increases of 0.40-3.11% were associated with an increase of 10 ng/m(3) for nickel in PM. The summary estimate ranges of hospital utilization were 0.08% ~ 0.72% and -0.58% ~ 1.32% for a 10 µg/m(3) increase in PM10 and PM2.5. In terms of long-term effects, a 10 µg/m(3) increase of PM10 corresponded to 23-67% increase in the risk of mortality. CONCLUSION: Short exposures to PM10 and PM2.5 are associated with increases in mortality, but evidence of constituent-associated health effects, long-term effects and morbidity in China is still inadequate.

Distributions of heavy metals in maternal and cord blood and the association with infant birth weight in China.

OBJECTIVE: To measure serum levels of heavy metals in Chinese pregnant women and their newborns, and to evaluate the association of these metals with infant birth weight. STUDY DESIGN: We measured serum concentrations of lead (Pb), thallium (Tl), cadmium (Cd), selenium (Se), arsenic (As), nickle (Ni), vanadium (V), cobalt (Co), and mercury (Hg) in 81 mother-infant pairs using an inductively coupled plasma mass spectrometry method. Multiple linear regression analyses were used to evaluate the associations of these heavy metals with infant birth weight. RESULTS: Se, Pb, As, and Cd showed the highest detection rates (98.8%) in both the maternal and cord blood, followed by Tl, which was detected in 79.0% and 71.6% of the maternal and cord blood samples, respectively. Pb had the highest concentrations in both the maternal and cord blood samples of all toxic metals detected, with concentrations of 23.1 ng/g and 22.0 ng/g, respectively. No significant associations were observed between any heavy metals and birth weight. However, Tl in the maternal and cord blood was most notably inversely associated with birth weight. CONCLUSION: Se intake was low in Chinese women and their newborns, whereas Pb had the highest concentrations in both the maternal and cord blood samples of all toxic metals detected. Tl was a unique pollution source in this population, and Tl levels were shown to have the largest effect on decreasing infant birth weight in this pilot study. Further research incorporating larger sample sizes is needed to investigate the effects of prenatal exposure to heavy metals--especially Tl and Pb--on birth outcome in Chinese infants.

[Meta-analysis of relationship between maternal formaldehyde exposure during pregnancy and spontaneous abortion].

OBJECTIVE: To evaluate the relationship between maternal formaldehyde exposure during pregnancy and spontaneous abortion. METHODS: A computerized literature search was carried out to collect articles published before 2014. The study types included case-control and cohort studies. And then the statistical analysis was conducted by using RevMan 5. 1 software. RESULTS: A total of 6 studies were included in Meta-analysis (totally 666 subjects and 3087 controls) according to the selection criteria. Because all the studies selected were homogeneous (I2 = 37% , P = 0. 16) , the fixed effect model was used for calculation of the combined OR values. Compared with the control, maternal formaldehyde exposure during pregnancy was significantly associated with spontaneous abortion (OR = 1. 64, 95% CI 1. 20 - 2. 24, P = 0. 002). CONCLUSION: Maternal formaldehyde exposure during pregnancy may increase the risk of spontaneous abortion.

[Species Identification Based on Morphological Variability of Femur].

OBJECTIVE: To study the morphological characteristics of femurs of adult human and 11 kinds of adult animals from cattle, horses, pigs, goats, sheep, dogs, cats, rabbits, geese, ducks, chickens, and to establish an effective species identification method among various species. METHODS: The 4 cm mid-diaphyseal segment of the femur from adult human (older than 20 years old) at autopsy was obtained. Addi-tionally, the 4 cm ones from 11 kinds of adult animals were obtained. After decalcification, all femurs were made into slices, and then were observed by optical microscope. The 25 indexes were selected and analyzed by step discriminant analysis according to differences between human and mammal, human and poultry, and human and 11 kinds of animals. RESULTS: The histological structure of bone mineral density of middle part of femur had obvious characteristics among the species. And the morphology and number of osteon showed the trend of obvious biological evolution. There were 11 indexes with significant differences between human and 11 kinds of animals to establish some mathematical models to discriminate all species. The correct discrimination rate was 96.3% between human and mammal. The correct discrimination rate was up to 100% between human and poultry, and was 89.4% among human, mammal and poultry. CONCLUSION: The mathematical models have good correct discrimination rate among human and the other animals, which could be applied in the practical species identification cases.

Extremely cold and hot temperatures increase the risk of diabetes mortality in metropolitan areas of two Chinese cities.

BACKGROUND: Numerous studies have reported the association between ambient temperature and mortality. However, few studies have focused on the effects of extreme temperatures on diabetes mortality, particularly in China. The objective of the present study was to assess the effects of extremely cold and hot temperatures on diabetes mortality in urban areas of Harbin and Chongqing in China to provide scientific evidence for public health policy implementation to respond to challenges in diabetes mortality because of extreme temperature events. METHODS: A double threshold B-spline distributed lag non-linear model (DLNM) was used to investigate the effects of extremely cold and hot temperatures on diabetes mortality from lag 0 to 30 days, after controlling for potential confounders including air pollutants. The unit risk, which is the elevated cumulative risk of diabetes mortality caused by each 1 °C change in extremely cold and hot temperatures during certain lag days, was estimated for extreme cold and heat using simple regression analysis. RESULTS: Significant associations between both extreme hot and cold temperatures and diabetes mortality were observed in Harbin and Chongqing for different lag lengths. In Harbin, the extreme cold effects on diabetes mortality were delayed by three days and lasted for six days (lag 3-8), with the highest risk (RR 95% CI: 1.223,1.054-1.418 for -23 °C) at lag 5. The hot effects were delayed one day and lasted for three days (lag 1-3), with the peak RR (1.343: 1.080-1.670 for 37 °C) at lag 2. In Chongqing, the cold effects on diabetes mortality were delayed by seven days and lasted for four days (lag 7-10), with the highest risk (1.201: 1.006-1.434 for 4 °C) at lag 7. The hot effects peaked (1.811: 1.083-3.027 for 41 °C) at lag 0 and lasted for 2 days (lag 0-1). The unit risk for cold and hot effects was 12.9% (95% CI: 2.5-33.7%) and 16.5% (95% CI: 3.8-39.1%) in Harbin and 12.5% (95% CI: -4.7 to 47.5%) and 19.7% (95% CI: 3.9-48.5%) in Chongqing, respectively. CONCLUSIONS: The results indicate that both extremely cold and hot temperatures increase diabetes mortality in different manners in Harbin and Chongqing. Diabetes education programs should include information on either managing or combating the effects of extreme hot and cold weather.

The association between prenatal exposure to organochlorine pesticides and thyroid hormone levels in newborns in Yancheng, China.

Organochlorine pesticides can interfere with the thyroid hormones that play an important role in early neurodevelopment. Although organochlorine pesticides have been banned in China since 1983, their residues are still detectable in the environment. However, few studies have investigated the adverse health effects of prenatal exposure to organochlorine pesticide residues on newborns in China. The present study, conducted in Yancheng City, Jiangsu Province, China, aimed to examine the association between the levels of organochlorine pesticides in maternal and cord sera and to assess the impact of prenatal exposure to organochlorine pesticides on thyroid hormone levels in cord serum. Eleven organochlorine pesticides in maternal and cord sera were measured in 247 mother-infant pairs recruited from Yancheng City between February 2010 and June 2010. The concentration of the thyroid hormones free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH) were determined in cord serum. Among the 11 tested organochlorine pesticides, the detectable levels of hexachlorobenzene (HCB), ß-hexachlorocycolohexane (ß-HCH) and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) in both maternal and cord sera were above 50%. The levels of ß-HCH and p,p'-DDE in maternal sera were positively associated with the levels in cord sera (r=0.421, P<0.01; r=0.288, P<0.01). After adjusting for confounders, the TSH level in cord serum samples was negatively associated with the HCB level (OR=0.535, 95% CI=(0.304-0.941)). Our data demonstrated that DDT, ß-HCH and HCB residues bioconcentrate in maternal and cord sera. Moreover, the correlation analysis suggested that organochlorine pesticides in maternal blood can transfer through the placenta and affect newborn thyroid hormone levels.

Association between high temperature and mortality in metropolitan areas of four cities in various climatic zones in China: a time-series study.

BACKGROUND: Numerous studies have reported on the associations between ambient temperatures and mortality. However, few multi-city studies have been conducted in developing countries including China. This study aimed to examine the association between high temperature and mortality outcomes in four cities with different climatic characteristics in China to identify the most vulnerable population, detect the threshold temperatures, and provide scientific evidence for public health policy implementations to respond to challenges from extreme heat. METHODS: A semi-parametric generalized additive model (GAM) with a Poisson distribution was used to analyze the impacts of the daily maximum temperature over the threshold on mortality after controlling for covariates including time trends, day of the week (DOW), humidity, daily temperature range, and outdoor air pollution. RESULTS: The temperature thresholds for all-cause mortality were 29°C, 35°C, 33°C and 34°C for Harbin, Nanjing, Shenzhen and Chongqing, respectively. After adjusting for potential confounders including air pollution, strong associations between daily maximum temperature and daily mortality from all-cause, cardiovascular, endocrine and metabolic outcomes, and particularly diabetes, were observed in different geographical cities, with increases of 3.2-5.5%, 4.6-7.5% and 12.5-31.9% (with 14.7-29.2% in diabetes), respectively, with each 1°C increment in the daily maximum temperature over the threshold. A stronger temperature-associated mortality was detected in females compared to males. Additionally, both the population over 55 years and younger adults aged 30 to 54 years reported significant heat-mortality associations. CONCLUSIONS: Extreme heat is becoming a huge threat to public health and human welfare due to the strong temperature-mortality associations in China. Climate change with increasing temperatures may make the situation worse. Relevant public health strategies and an early extreme weather and health warning system should be developed and improved at an early stage to prevent and reduce the health risks due to extreme weather and climate change in China, given its huge population, diverse geographic distribution and unbalanced socioeconomic status with various climatic characteristics.

Whole-Cell Display of Phospholipase D in Escherichia coli for High-Efficiency Extracellular Phosphatidylserine Production.

Phospholipids are widely utilized in various industries, including food, medicine, and cosmetics, due to their unique chemical properties and healthcare benefits. Phospholipase D (PLD) plays a crucial role in the biotransformation of phospholipids. Here, we have constructed a super-folder green fluorescent protein (sfGFP)-based phospholipase D (PLD) expression and surface-display system in Escherichia coli, enabling the surface display of sfGFP-PLDr34 on the bacteria. The displayed sfGFP-PLDr34 showed maximum enzymatic activity at pH 5.0 and 45 °C. The optimum Ca2+ concentrations for the transphosphatidylation activity and hydrolysis activity are 100 mM and 10 mM, respectively. The use of displayed sfGFP-PLDr34 for the conversion of phosphatidylcholine (PC) and L-serine to phosphatidylserine (PS) showed that nearly all the PC was converted into PS at the optimum conditions. The displayed enzyme can be reused for up to three rounds while still producing detectable levels of PS. Thus, Escherichia coli/sfGFP-PLD shows potential for the feasible industrial-scale production of PS. Moreover, this system is particularly valuable for quickly screening higher-activity PLDs. The fluorescence of sfGFP can indicate the expression level of the fused PLD and changes that occur during reuse.

Heatwave and urinary hospital admissions in China: Disease burden and associated economic loss, 2014 to 2019.

BACKGROUND: Many studies have shown that heatwaves are associated with an increased prevalence of urinary diseases. However, few national studies have been undertaken in China, and none have considered the associated economic losses. Such information would be useful for health authorities and medical service providers to improve their policy-making and medical resource allocation decisions. OBJECTIVES: To explore the association between heatwaves and hospital admissions for urinary diseases and assess the related medical costs and indirect economic losses in China from 2014 to 2019. METHODS: Daily meteorological and hospital admission data from 2014 to 2019 were collected from 23 study sites with different climatic characteristics in China. We assessed the heatwave-hospitalization associations and evaluated the location-specific attributable fractions (AFs) of urinary-related hospital admissions due to heatwaves by using a time-stratified case-crossover method with a distributed lag nonlinear model. We then pooled the AFs in a meta-analysis and estimated the national excess disease burden and associated economic losses. We also performed stratified analyses by sex, age, climate zone, and urinary disease subtype. RESULTS: A significant association between heatwaves and urinary-related hospital admissions was found with a relative risk of 1.090 (95 % confidence interval (CI): 1.050, 1.132). The pooled AF was 8.27 % (95%CI: 4.77 %, 11.63 %), indicating that heatwaves during the warm season (May to September) caused 248,364 urinary-related hospital admissions per year, with 2.42 (95%CI: 1.35, 3.45) billion CNY in economic losses, including 2.23 (95%CI: 1.29, 3.14) billion in direct losses and 0.19 (95%CI, 0.06, 0.31) billion in indirect losses, males, people aged 15-64 years, residents of temperate continental climate zones, and patients with urolithiasis were at higher risk. CONCLUSION: Tailored community health campaigns should be developed and implemented to reduce the adverse health effects and economic losses of heatwave-related urinary diseases, especially in the context of climate change.

Molecular mechanisms of 1,2-dichloroethane-induced neurotoxicity.

The production of industrial solvents and adhesives often utilizes 1,2-dichloroethane (1,2-DCE), a highly toxic halogenated hydrocarbon compound. Occupational 1,2-DCE poisoning occurs frequently and is a public health concern. Exposure to 1,2-DCE can damage the brain, liver, and kidneys. The main and most severe damage caused by exposure to 1,2-DCE is to the nervous system, especially the central nervous system. Current research on 1,2-DCE mainly focuses on the mechanism of brain edema. Several possible mechanisms of 1,2-DCE neurotoxicity have been proposed, including oxidative stress, calcium overload, blood-brain barrier damage, and neurotransmitter changes. This article reviews the research progress on 1,2-DCE neurotoxicity and the mechanism behind it to provide a scientific basis for the prevention and treatment of 1,2-DCE poisoning.

Soft palate dysplasia: properties and surgical techniques.

OBJECTIVES: We aimed to report a hitherto undescribed class of patients with the obvious phenotype of a novel soft palate dysplasia combining unilateral soft palate hypoplasia with a fully developed uvula. We also aimed to investigate and evaluate the corresponding surgical approaches. MATERIALS AND METHODS: Twelve patients were clinically diagnosed with soft palate dysplasia. Clinical examination, including radiographic tests was performed to characterize the congenital deformity. The effectiveness of velopharyngeal closure and speech were tested pre- and post-operation. RESULTS: Soft palate dysplasia was featured with velopharyngeal insufficiency, food regurgitation, and speech disorders. It was commonly manifested as structural deformities of the soft palate, tongue palatine arch, pharyngeal palatine arch, and pterygomandibular fold, but complete uvula shape. According to radiographic analysis, in five patients the lateral pterygoid processes were poorly developed and other malformations were present. Velopharyngoplasty based on the unilateral posterior pharyngeal flap can well restore the velopharyngeal closure and speech intelligibility without respiration obstruction. CONCLUSIONS: Soft palate dysplasia is characterized as congenital velopharyngeal insufficiency manifested as a primary soft palate defect. It is highly associated with other physical deformities but independent of conventionally known syndromes. The cause may be an abnormal development of the pterygoid process. Unilateral velopharyngoplasty based on the posterior pharyngeal flap is a great technique to repair soft palate dysplasia (SPD).Clinical Relevance For soft palate muscle defects without cleft palate, we proposed a surgical technique by which personalized design of the posterior pharyngeal flap could be fulfilled according to the degree of deformity. It can restore the symmetry of the soft palate.