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Public health and social measures (PHSMs) are one of the most important measures in the prevention and control of COVID-19 and have also been effective in suppressing the spread of influenza viruses, but their effectiveness has not been fully investigated. This study aimed to review the progress of research on the impact of PHSMs on influenza during the COVID-19 pandemic based on the latest evidence of the effectiveness of various PHSMs in controlling transmission of influenza viruses, to provide scientific evidence for optimizing influenza prevention and control strategies.
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COVID-19 , Influenza Humana , Pandemias , Saúde Pública , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controleRESUMO
In recent years, the high temperature and heatwaves have seriously affected the health of Chinese residents, and there is an important need for public health protection guidelines for high temperature and heatwaves in China. The National Bureau of Disease Control and Prevention has organized experts to fully investigate the evidence from epidemiological research on the health of populations in high temperature and heatwaves globally and in China, analyze the health hazards and protection needs of different populations, and put forward practical and effective individual protection measures and health recommendations. For this reason, the "Guideline for Public Health Protection against High Temperature and Heatwaves" (referred to as the "Guideline") was officially issued in June 2023. This article interprets the background and significance of the Guideline, the principles of compilation, the main considerations, the main contents, the implementations and promotions and other aspects, to improve the understanding of the content of the Guideline and strengthen the publicity and implementations.
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Guias como Assunto , Temperatura Alta , Saúde Pública , Humanos , ChinaRESUMO
Objective: To explore the relationship between metabolic score for insulin resistance (METS-IR) and chronic kidney disease (CKD) and albuminuria in the Chinese population. Methods: This cross-sectional study was conducted from January to December 2018 among residents aged 20 to 70 years in ten regions of eight provinces in China; all residents had lived in their region for more than 5 years. Various parameters were measured, included fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin (HbA1c), blood lipids, renal function, urinary albumin/creatinine ratio (UACR), etc. Data of 5 060 subjects meeting the criteria were included in the study. CKD was defined as estimated glomerular filtration rate (eGFR)<60 ml·min-1·1.73 m-2 or UACR≥30 mg/g. Albuminuria was defined as UACR≥30 mg/g. METS-IR was calculated and categorized into quartiles: Q1, METS-IR≤32.19; Q2, METS-IR 32.20-37.10; Q3, METS-IR 37.11-42.58; and Q4, METS-IR>42.58. The correlation between METS-IR and CKD and albuminuria was analyzed by binary logistic regression, and subgroup analyses were performed. Results: There were 1 266, 1 266, 1 265, and 1 263 participants included in Q1-Q4 groups, respectively. With the increase of METS-IR quartile, various parameters increased, including age, fasting blood glucose, HbA1c, triglycerides, serum uric acid, waist circumference, body mass index, and systolic and diastolic blood pressure, and the proportion of males also increased (all P<0.05). The proportion of patients with CKD and albuminuria increased significantly with the increase in interquartile range (Q) of METS-IR (all P<0.05). Logistic regression analysis showed that for every 1-unit increment of METS-IR, the risk of CKD and albuminuria were both increased by 2% [for both: odds ratio (OR)=1.02, 95% confidence interval (CI) 1.01-1.03]. Compared with the lowest METS-IR group (Q1), the ORs for CKD and albuminuria in the highest METS-IR group (Q4) were 1.57 (95%CI 1.17-2.10) and 1.46 (95%CI 1.09-1.96), respectively. In the subgroup analyses, increased METS-IR was significantly associated with CKD and albuminuria among women (CKD: OR=1.62, 95%CI 1.14-2.31; albuminuria: OR=1.53, 95%CI 1.07-2.18), individuals with HbA1c<7% (OR=1.64, 95%CI 1.21-2.23; OR=1.55, 95%CI 1.14-2.11), individuals with eGFR≥90 ml·min-1·1.73 m-2 (OR=1.78, 95%CI 1.27-2.49; OR=1.80, 95%CI 1.28-2.53), and the Chinese Han population (OR=1.56, 95%CI 1.13-2.17; OR=1.41, 95%CI 1.01-1.96). Conclusions: METS-IR is significantly associated with CKD and albuminuria in a Chinese population. Furthermore, the higher the METS-IR, the higher the risk of CKD and albuminuria.
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Resistência à Insulina , Insuficiência Renal Crônica , Masculino , Humanos , Feminino , Albuminúria , Glicemia , Estudos Transversais , Ácido Úrico , População do Leste Asiático , Taxa de Filtração GlomerularRESUMO
Objective: To investigate the efficacy and safety of dexithabine (DAC) combined with HAAG regimen [harringtonine (HHT), cytarabine (Ara-C), aclarubicin (Acla) and recombinant human granulocyte colony stimulating factor (G-CSF)] in the treatment of acute myeloid leukemia (AML). Methods: The clinical data of 89 AML patients in People's Hospital Affiliated to Shandong First Medical University from January 2019 to January 2021 were retrospectively analyzed. The patients were divided into observation group (n=48) and control group (n=41) according to the treatment plan. The observation group included 25 males and 23 females, aged (44.4±9.3) years old, and was treated with DAC combined with HAAG. The control group included 24 males and 17 females, aged (42.2±10.1) years old, and was treated with DAC regimen. After 3 cycles of treatment, the treatment efficacy of the two groups was judged, including complete remission, partial remission and no remission. The level of serum P-glycoprotein (P-gp) in the two groups was detected by direct immunofluorescence-labeled monoclonal antibody flow cytometry. The enzyme-linked immunosorbent assay was used to detect the level of soluble urokinase-type plasminogen activator receptor (suPAR). Meanwhile, the incidence of adverse reactions such as digestive tract reaction, liver and kidney dysfunction, hemorrhage and infection during treatment were recorded. Results: After 3 cycles of treatment, the observation group had complete remission, partial remission and no remission in 10 cases, 21 cases and 17 cases, respectively, and the control group had 3 cases, 11 cases and 27 cases, respectively. The overall efficacy of the observation group was better than that of the control group (Z=-2.919, P=0.004). The levels of serum P-gp and suPAR in the observation group were (5.2±1.8) % and (464.4±103.4) ng/L, respectively, which were significantly lower than those in the control group [(8.8±1.9) % and (660.6±110.4) ng/L, respectively] (both P<0.05). During the treatment, the incidence of digestive tract reaction, liver and kidney dysfunction, hemorrhage and infection in the observation group was 29.2% (14/48), 22.9% (11/48), 16.7% (8/48) and 33.3% (16/48), respectively, while in the control group was 26.8% (11/41), 21.9% (9/41), 14.6% (6/41) and 24.4% (10/41), respectively, with no statistically significant difference (all P>0.05). Conclusions: The overall efficacy of DAC combined with HAAG in the treatment of AML is better than that of DAC alone. Moreover, the incidence of adverse reactions in DAC combined with HAAG is similar to that of DAC alone, with a high safety profile.
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Leucemia Mieloide Aguda , Receptores de Ativador de Plasminogênio Tipo Uroquinase , Masculino , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Decitabina/uso terapêutico , Receptores de Ativador de Plasminogênio Tipo Uroquinase/uso terapêutico , Estudos Retrospectivos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Citarabina/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , Resultado do Tratamento , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , RecidivaRESUMO
Formaldehyde, as an important pollutant in indoor air, has always been of great concern. In the newly issued "Standards for indoor air quality (GB/T 18883-2022)", the standard limit of formaldehyde has been restricted to 0.08 mg/m3. In order to better promote the implementation and application of this new standard, this study reviewed and interpreted the relevant technical content for determining the standard limit, including the indoor concentration and human exposure levels of formaldehyde, the health effects of formaldehyde, and the derivation of safety reference values. It also proposed prospect for the future development and revision of quality standards for formaldehyde in indoor air.
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Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluentes Ambientais , Humanos , Poluentes Atmosféricos/análise , Formaldeído/análise , ChinaRESUMO
There are clear indoor air pollution sources of trichloroethylene and tetrachloroethylene. A large number of epidemiological evidence has confirmed their carcinogenic toxicity and non-carcinogenic toxicity. Several countries and international organizations have paid attention to indoor air trichloroethylene and tetrachloroethylene. It has been also assessed that there should be certain potential health risk of indoor air trichloroethylene and tetrachloroethylene in China. Based on the latest research results of health risk assessment of indoor air trichloroethylene and tetrachloroethylene, the "Standards for indoor air quality (GB/T 18883-2022)" added trichloroethylene and tetrachloroethylene as indicators. The index limit of trichloroethylene is 6 µg/m3 for an 8-hour average concentration. The index limit of tetrachloroethylene is 120 µg/m3 for an 8-hour average concentration. The technical contents related to the determination of the standard limits of trichloroethylene and tetrachloroethylene in indoor air were analyzed and discussed, including the sources, the exposure, the health effects, the determination of the limit values, and the recommendations for standard implementation. It also proposed recommendations for the implementation of"Standards for indoor air quality (GB/T 18883-2022)".
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Poluição do Ar em Ambientes Fechados , Tetracloroetileno , Tricloroetileno , Humanos , Tetracloroetileno/análise , Tricloroetileno/análise , ChinaRESUMO
Benzene, as a major indoor pollutant, has received widespread attention. In order to better control indoor benzene pollution and protect people's health, the limit value of benzene in the"Standards for indoor air quality (GB/T 18883-2022)'' was reduced from 0.11 mg/m3 to 0.03 mg/m3. This study reviewed and discussed the relevant technical contents of the determination of benzene limit value, including the exposure status of benzene, health effects, and derivation of the limit value. It also proposed prospects for the future direction of formulating indoor air benzene standards.
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Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluentes Ambientais , Humanos , Poluição do Ar em Ambientes Fechados/prevenção & controle , Benzeno/análise , Poluentes Atmosféricos/análise , China , Monitoramento AmbientalRESUMO
The pollution and health effects of indoor inhalable particulate matter (PM10) and fine particulate matter (PM2.5) are increasingly receiving public attention. The"Standards for indoor air quality (GB/T 18883-2022)"has revised the standard limit for PM10 and added the standard limit for PM2.5. This study analyzed and interpreted the relevant technical contents of the revision of the standard limits for two indicators, including the exposure status, health effects, and the basis for the determination of the limit value. It also proposed prospects for the future development and revision of standard limits for indoor particulate matters.
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Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluição do Ar , Humanos , Material Particulado/análise , Poluentes Atmosféricos/análise , Tamanho da Partícula , Monitoramento Ambiental , ChinaRESUMO
Objective: To investigate the analytical performance verification protocols and performance specifications of platelet-dependent von Willebrand factor (VWF) activity testing (VWF:GPIbM) for clinical laboratories. Methods: According to Clinical Laboratory Standards Institute (CLSI) documents and National Health Standard of China, the performance verification of VWF:GPIbM was designed and implemented using Sysmex CS-5100 instrument and its corresponding reagents. (1) Precision verification: Two commercial quality control samples (with normal and low activity levels) and three plasma pools (with activity range from 5.0% to 150.0%) were prepared. Each sample was tested five times daily for five consecutive days. The coefficient of variation (CV) of intra-and inter-run precisions were calculated, and the precision evaluation criterion was set according to package inserts. (2) Trueness verification: The calibrator was diluted to five reference materials with activity values of 5.2%, 31.2%, 62.4%, 104.0% and 138.7%, and each reference material was tested five times daily for five consecutive days. The bias between the measured value and the reference value was calculated, and the trueness evaluation criterion was set according to the total allowable error. (3) Linearity verification: Ten pooled plasmas with theoretical value range from 3.6% to 160.4% were prepared for the linearity verification of two calibration curves set by the manufacturer (i.e. low range and normal range calibration curve). Each pooled plasma was tested three times in a single run. The slope and R2 of linear regression of mean of measured value and theoretical value, as well as bias, were calculated, and the linearity evaluation criterion was set according to National Health Standard of China and package inserts. (4) Limit of quantitation verification: The calibrator was diluted to two reference materials with activity values of 3.3% and 2.7%, and each material was tested twelve times. The limit of quantitation evaluation criterion was set according to CLSI document. Results: The CVs of intra-and inter-run were 1.0%-2.5% and 1.1%-2.6%, respectively. The biases of trueness verification were -0.4%, 1.0%, -2.6%, 0.3% and -2.7%, respectively. The linearity verification results of low range (3.6%-31.8%) and normal range (28.4%-160.4%) showed that the slopes of regression equation were 1.021 7 and 0.996 2, respectively, R2 were 0.993 5 and 0.993 9, respectively, and the biases with 0-1.8% and -10.1%-0 of plasmas met the criterion. The biases ranged from -0.4% to 0.3% of test results in the verification of limit of quantitation met the criterion. Conclusion: The verification results of VWF:GPIbM assay for precision, trueness, linearity and limit of quantification meet the performance requirements indicated in the package inserts and the criteria set in this study, which can be taken as a reference of performance verification for the clinical laboratories.
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Plaquetas , Fator de von Willebrand , Testes de Coagulação Sanguínea/métodos , Modelos Lineares , Valores de Referência , Reprodutibilidade dos TestesRESUMO
Objective: To analyze the clinical features and risk factors of herpes zoster and the risk factors of postherpetic neuralgia (PHN). Methods: A total of 2 840 patients diagnosed with herpes zoster in Peking University People's Hospital from January 2021 to April 2022 were included. The patients with herpes zoster were aged (59±16), and of which 1 314 (46.3%) patients were male. The patients were divided into PHN group and non-PHN group according to whether the patients with herpes zoster developed PHN. And there were 442 (15.6%) patients developed PHN aged (68±12), and of which 189 (42.8%) were male. The information and medical history of PHN group and non-PHN group were collected. The information of the use of glucocorticoids, immunosuppressive agents, biological agents and targeted medicine within 2 months before herpes zoster occurred, history of surgery within 6 months before herpes zoster occurred, and the duration of PHN were collected. Logistic regression analysis was used to analyze the risk factors of PHN. Results: Out of 2 840 patients, 2 056 (72.4%) with herpes zoster aged 50 years and above. Intercostal nerves was mostly involved in patients with herpes zoster, with a total of 1 532(53.9%). Hypertension (465 cases, 16.4%) accounted for the highest number of patients with chronic diseases, followed by diabetes (337 cases, 11.9%) and coronary heart disease (283 cases, 10.0%). Rheumatoid arthritis (41 cases, 1.4%) accounted for the highest number of patients with connective tissue diseases, followed by Sjogren's syndrome (31 cases, 1.1%), systemic lupus erythematosus (28 cases, 1.0%). Logistic regression analysis showed that age≥50 years old (OR: 4.581; 95%CI: 3.131-6.705),lesion on the upper limb and shoulder (OR: 1.858; 95%CI: 1.129-3.059), hypertension (OR: 1.963; 95%CI: 1.513-2.546) and immunosuppressive treatments (OR: 2.170; 95%CI: 1.254-3.753) were independent risk factors for PHN (all P<0.05). Conclusions: Herpes zoster mostly occurs in people aged 50 and above, and mainly affected intercostal nerves. The most common complications are hypertension and rheumatoid arthritis. Age≥50, lesion on upper limbs and shoulders, hypertension, and immunosuppressive treatments may be independent risk factors of PHN.
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Artrite Reumatoide , Herpes Zoster , Hipertensão , Neuralgia Pós-Herpética , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Neuralgia Pós-Herpética/complicações , Herpes Zoster/complicações , Herpesvirus Humano 3 , Fatores de Risco , Hipertensão/complicações , Artrite Reumatoide/complicaçõesRESUMO
With the global climate change process is accelerating, China is facing great challenges. It is urgent to carry out scientific study, aiming at the major needs of health adaptation action to climate change under the 'double carbon' target. This special issue on Climate Change and Health highlights and reports on China's latest scientific findings in this field. The health risks of non-optimal temperature, drought, ultraviolet radiation and other meteorological factors and cold spells in China are clarified, and the research methods of health risk early warning of heat waves are summarized. Future researches need to further elucidate the scientific evidence of the impact of meteorological factors and extreme weather events on population health in China systematically. Focus on innovating and developing technical methods and tools such as health risk early warning models. Accelerate the transformation and application of relevant scientific and technological achievements in China. To provide scientific and technological support for the health adaptation action to climate change under the 'double carbon' goal.
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Carbono , Mudança Climática , Humanos , Raios Ultravioleta , Objetivos , ChinaRESUMO
Objective: To estimate the excess mortality attributed to non-optimal ambient temperature in China. Methods: Mortality data and meteorological data from 239 counties in 2013-2018 were collected to simulate the quantitative exposure-response relationship between the temperature and mortality using distributed lag nonlinear models for time series studies. Then the number of non-optimal-temperature-related excess deaths was assessed and the spatial distribution was explored. Results: There were averagely (12±8) cases of all-cause deaths per day per county from 2013 to 2018. The average daily temperature was (14.98±10.31)â, and the daily average relative humidity was (68.79±17.25)%. The daily average O3 concentration was (58.95±34.96) µg/m³, and the daily average PM2.5 concentration was (54.97±45.56) µg/m³. The exposure-response curve between daily average temperature and all-cause mortality showed a "U" shape, and the theoretical minimum mortality temperature (MMT) corresponding to the minimum number of deaths was 21.60 â. When the temperature was higher than MMT, the heat-related health effect increased with the temperature rising. When the temperature was lower than MMT, the cold-related effect increased with the temperature decreasing. The attributable fraction (AF) of death caused by non-optimal temperature was 8.76% (95%CI: 8.07%-9.10%), and the AF of death caused by cold effect and heat effect was 7.21% (95%CI: 6.51%-7.57%) and 1.55% (95%CI: 1.46%-1.61%), respectively. The excess deaths from non-optimal temperature in 2015 were 519 122, 72.98% of which could be attributed to low temperature. The number of excess deaths caused by non-optimal temperature mainly showed a decreasing trend from the east to the west, relatively high (117 522) in East China. Heilongjiang Province (in Northeast China) had the most excess deaths (26 924) caused by low temperature, and Guangdong Province(in South China) had the most excess deaths (27 763) caused by high temperature. Conclusion: The non-optimal temperature has a significant impact on health and causes a considerable burden of disease in China with obvious spatial heterogeneity.
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Efeitos Psicossociais da Doença , Humanos , China/epidemiologia , Material Particulado/análise , TemperaturaRESUMO
Objective: To analyze the North-South difference of the relationship between cold spells and mortality risk of cardiovascular diseases in China. Methods: The time series analysis method was used to collect the daily counts of cardiovascular mortality data, meteorological data and PM2.5 concentration in the cold season (November to March of the following year) from January 1, 2013 to December 31, 2018 in 280 districts and counties in China. The non-constrained distributed lag linear model was used to analyze the relationship between cold spells and mortality risk of cardiovascular diseases and its North-South difference in China. Results: From 2013 to 2018, the mean of daily average temperature of the cold season in 280 districts and counties was 5.4 â. The mean of daily average relative humidity was 64.4%, and the mean of daily average PM2.5 concentration was 73.7 µg/m3. The average cold spell days in each county was 11.7 days per year,the mean of daily average temperature on cold spell days was (-2.4±6.7) â, and M (Q1, Q3) was -1.5 (-5.1, 1.1) â. The average of daily number of cardiovascular disease deaths in each county/district was (6±5) cases, and M (Q1, Q3) was 5 (2, 8) cases. The percentage change (95%CI) in the South was 4.94% (3.69%, 6.20%) (lag 0 d), higher than that in the North [the percentage change (95%CI) was 1.49% (1.14%-1.84%) (lag 0-7 d)]. In the North, the mortality risk of ≥75 years old was relatively low among three age groups, with a percentage change (95%CI) about 1.63% (1.33%-1.93%) (lag 0-21 d). In the South, the mortality risk of ≥ 75 years old was relatively high among three age groups, with a percentage change (95%CI) about 5.18% (3.78%-6.59%) (lag 0 d). Conclusion: The mortality risk of cardiovascular diseases caused by cold spells in the South is higher than that in the North of China, and the risk peak occurs earlier in the South.
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Doenças Cardiovasculares , Humanos , Idoso , Temperatura Baixa , Temperatura , China/epidemiologia , Material Particulado/análise , MortalidadeRESUMO
Global warming has caused frequent heat waves worldwide. In order to respond to heat waves and enhance the public's protection abilities, Europe, the United States and other countries have extensively carried out research on heat-health early warning, and initially achieved good health benefits based on a heat-health early warning system. However, the research on heat-health early warning is still limited in China, especially on health risks at the population level. Based on evidence-based thinking, our study combs the research progress of heat-health early warning from four aspects: early warning indicators, early warning models, early warning thresholds, and early warning ranks, and clarifies the key points of the construction of heat-health early warning models and rank schemes, in order to provide early warning technology for the rapid development of national heat-heath early warning in China.
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Temperatura Alta , Saúde da População , Humanos , Fatores de Risco , Europa (Continente)/epidemiologia , ChinaRESUMO
Objective: To investigate the current situation of cell phone use and sleep quality among college students, establish a sleep quality trajectory model and explore the influence of cell phone use on the sleep quality trajectory. Methods: Based on data from the College Student Behavior and Health Cohort Study 2019-2020, a latent class growth modeling was used to establish a sleep quality trajectory model among college students. The baseline influencing factors of sleep quality trajectories among college students were analyzed by χ2 test, and the effects of cell phone use on sleep quality trajectories were analyzed by binary logistic regression. Results: A total of 1 092 college students were included in the analysis. The detection rates of cell phone use and poor sleep quality were 24.5% and 13.3%. Latent class growth model identified two groups of sleep quality trend trajactories: an improved sleep quality group (86.0%) and a decreased sleep quality group (14.0%). The result of binary logistic regression showed that the cell phone use was a risk factor of sleep quality trajectories. Conclusion: The cell phone use during college period could increase the risk of poor sleep quality. Targeted intervention measures about cell phone use should be adopted to improve the sleep quality among college students.
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Uso do Telefone Celular , Telefone Celular , Distúrbios do Início e da Manutenção do Sono , Humanos , Qualidade do Sono , Estudos de Coortes , Inquéritos e Questionários , Estudantes , SonoRESUMO
Objective: To explore the association between short-term exposures to fine particulate matter (PM2.5) on blood lipids in the elderly. Methods: In this panel study, five repeated measurements were performed on 76 people aged 60-69 in Jinan city. Each participant had a PM2.5 monitor for 72 hours before each health examination, including a questionnaire survey, physical examination, and biological sample collection. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were examined, and non-HDL-C concentrations were calculated by subtracting HDL-C from TC. The generalized linear mixed-effects model was used to quantify the association of personal PM2.5 exposure at different lag with blood lipids and dyslipidemia. Results: The age of 70 participants was (65.0±2.8) years, of which 48.6% (34/70) were males. The BMI of participants was (25.0±2.5) kg/m2. Their TC, TG, LDL-C, HDL-C, and non-HDL-C concentrations were (5.75±1.32), (1.55±0.53), (3.27±0.94), (1.78±0.52), and (3.97±1.06) mmol/L, respectively. Generalized linear mixed-effects model showed that after adjusting for confounding factors, at lag 72 hours, each 10 µg/m3 increase in PM2.5 was associated with the percentage change in TC, LDL-C, HDL-C and non-HDL-C about 1.77% (95%CI: 1.22%-2.32%), 1.90% (95%CI: 1.18%-2.63%), 1.99% (95%CI: 1.37%-2.60%) and 1.74% (95%CI: 1.11%-2.37%), and the OR values (95%CI) of hypercholesterolemia, hypertriglyceridemia and hyperbetalipoproteinemia were 1.11 (1.01-1.22), 1.33 (1.03-1.71) and 1.15 (1.01-1.31), respectively. Conclusion: There is a significant association of short-term PM2.5 exposure with the concentration of blood lipids and the risk of dyslipidemia in the elderly.
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Dislipidemias , Material Particulado , Idoso , China , Colesterol , HDL-Colesterol , LDL-Colesterol , Feminino , Humanos , Lipídeos , Masculino , Pessoa de Meia-Idade , Material Particulado/análise , TriglicerídeosRESUMO
Objective: To evaluate the recognition of acute respiratory infection (ARI) by a pretrained model based on electronic medical records (EMRs). Methods: 38 581 EMRs were obtained from Chongqing University Three Gorges Hospital in December 2021. Bidirectional encoder representation from transformers (BERT) pretrained model was used to identify ARI in EMRs. The results of medical professionals were considered as the gold standard to calculate the sensitivity, specificity, Kappa value, and area under the curve of the receiver operating characteristic (AUC). Results: There were 3 817 EMRs in the test set, with 1 200 ARIs. A total of 1 205 cases were determined as ARI by the model, with a sensitivity of 92.67% (1 112/1 200) and a specificity of 96.45% (2 524/2 617). The model identified ARI with similar accuracy in males and females (AUCs 0.95 and 0.94, respectively), and was more accurate in identifying ARI cases in those aged less than 18 than in adults 18-59 and adults 60 and older (AUCs 0.94, 0.89 and 0.94, respectively). The current model had a better identification of ARIs in outpatient patients than that in hospitalized patients, with AUCs of 0.74 and 0.95, respectively. Conclusion: The use of the BERT pretrained model based on EMRs has a good performance in the recognition of ARI cases, especially for the outpatients and juveniles. It shows a great potential to be applied to the monitoring of ARI cases in medical institutions.
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Registros Eletrônicos de Saúde , Infecções Respiratórias , Adulto , Masculino , Feminino , Humanos , Infecções Respiratórias/diagnóstico , Pacientes AmbulatoriaisRESUMO
Objective: To describe the clinical characteristics of pulmonary cryptococcosis(PC)coexisting with lung cancer. Methods: We reported 3 cases of PC coexisting with lung cancer confirmed by pathology in Qingdao Municipal Hospital from January 2017 to December 2021.We reviewed the literature with"pulmonary cryptococcosis" and "lung cancer" as the keywords to search Wanfang database, China HowNet and PubMed database. Results: The patients consisted of 2 males and 1 female. Two patients were diagnosed with nodular type of PC and one with diffuse mixed type of PC. One patient had underlying cardiovascular diseases and the other two had no medical history. The clinical manifestations varied including fever, cough, sputum, and no specific symptoms. All the patients received surgery and postoperative medical therapy, and all 3 patients were pathologically confirmed with adenocarcinoma. A total of 18 cases were retrieved from related literatures. To our knowledge, one of our cases was the first one with diffuse mixed type of PC coexisting with lung cancer. Conclusions: Coexistence of pulmonary cryptococcosis and lung cancer is rare and the clinical symptoms are nonspecific. When PC coexists with lung cancer, it is extremely easy to be misdiagnosed. Therefore, PC should be considered in the differential diagnosis of pulmonary nodules and multiple imaging changes.
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Criptococose , Neoplasias Pulmonares , Tosse/diagnóstico , Criptococose/complicações , Criptococose/diagnóstico , Criptococose/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologia , Masculino , Estudos RetrospectivosRESUMO
The high incidence of chronic liver disease is a serious threat to public health, and the current comprehensive internal medicine treatment is ineffective. Liver transplantation is limited by the shortage of liver source and post-transplant rejection, and thus unmet the clinical needs. More importantly, cell therapy shows great promise for the treatment of chronic liver disease. Over recent years, domestic and foreign scholars have carried out a variety of cell therapy preclinical and clinical trials for critical liver disease, and achieved certain results, providing new methods for the treatment of chronic liver diseases. This review discusses the cell therapy research status and application progress, various existing problems and challenges, and key issues of mesenchymal stem cells in the treatment of chronic liver diseases.
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Hepatopatias , Transplante de Fígado , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Terapia Baseada em Transplante de Células e Tecidos , Humanos , Hepatopatias/terapia , Transplante de Fígado/métodosRESUMO
With the application of high-resolution chest imaging system and lung cancer screening program, patients with multiple primary lung cancer (MPLC) are becoming a growing population in clinical practice. However, the diagnostic criteria of MPLC and its differentiation from intrapulmonary metastasis of lung cancer (IM) are still controversial, especially in cases with similar histology. On the basis of reviewing the existing literature, this paper discusses the changes of the diagnostic criteria of MPLC and the differential diagnosis methods of imaging, histology and molecular genetics of MPLC and IM, and briefly introduces the application of multidisciplinary diagnosis, algorithm, predictive model and artificial intelligence in the differential diagnosis of MPLC. In addition, we also discuss the latest progress in the treatment of MPLC. Radical surgery is the main method for the treatment of MPLC. Stereotactic body radiation therapy (SBRT) is safe and feasible for inoperable MPLC patients, and targeted therapy and immunotherapy can also be used in MPLC after appropriate patient selection.