Interaction of biomass fuels use and metals exposure on hypertension: A prospective cohort study in rural areas along the Yangtze River, China.

Humans maybe simultaneously exposed to multiple-metals and indoor air pollution in daily life. However, limited prospective studies have assessed the interaction between multiple metals exposure and biomass fuels use on hypertension in China. The prospective cohort study in rural areas along the Yangtze River included 2625 adults in 2014-2015, and they were followed up till 2019. Among 1248 rural residents who were without hypertension at baseline, 377 hypertension events (30.21%) were observed after 4.5 years of average follow-up time. First-morning urine samples of residents were collected at baseline, the association between urinary metals level and hypertension were assessed using quantile g-computation. Additionally, we also examined the effect of biomass fuels use, fuels switching, and cookstove ventilation on the association of metals exposure with hypertension. Quantile g-computation analyses showed a positive joint effect of 17 metals on hypertension, with the odds ratio (OR) of 1.68 (95% CI: 0.89, 3.14) when increasing all seventeen metals by one quartile, and cadmium, lithium, copper contributed the largest positive weights. Biomass fuels use can interact with cadmium exposure on hypertension with OR for interaction of 1.28 (95%CI: 1.00, 1.73), and increase the association between copper, manganese and zinc exposure and systolic blood pressure, lithium exposure and diastolic blood pressure at the follow-up visit. Moreover, switching from biomass fuels to clean fuels during follow up, cookstove ventilation can alleviate the risk of higher blood pressure from metals exposure. In rural areas along the Yangtze River, China, biomass fuels use for cooking can interact with multiple-metals exposure on hypertension. Residents who switched from biomass fuels to clean fuels and who used ventilation had a lower risk of hypertension. Further cohort studies are needed to clarify the mechanism of combined effects of metals exposure and biomass fuels use on the human health.

[Evaluating radiation dose of 128-slice dual-source computed tomographic coronary angiography with different electrocardiogram pulsing models].

OBJECTIVE: To determine the effects of heart rate frequency (HRF) and heart rate variability (HRV) on radiation exposure and image quality in a large cohort of patients undergoing DSCT (dual-source computed tomograph) coronary angiography with three different electrocardiogram (ECG) pulsing models, to prospectively investigate CT image quality parameters by using different protocols and to calculate the radiation dose estimates for noninvasive coronary angiography performed by DSCT. METHODS: Over a 1-month period, 253 consecutive patients were recruited and categorized into 3 groups: Group A:low HRF (≤ 75 beats/min) with normal-minor heart rate variability (HRV) (mean interbeat difference (IBD), 0 - 3), coronary CT angiography proceeding with prospective ECG-triggered flash spiral scan; Group B: intermediate-high HRF (> 75 beats/min) with normal-minor HRV (IBD, 0 - 4), with prospective ECG-triggered sequence scan; Group C: intermediate-high HRF (> 75 beats/min) with moderate-severe HRV (IBD ≥ 5) with retrospective ECG-gated spiral scan. RESULTS: CT coronary angiography yielded excellent image quality in 87.7% of patients (222/253). No significant differences were found among three groups with different HRF and HRV in image quality and diagnostic performance. Radiation exposure was significantly higher in patients with low versus high HRF and in patients with severe versus normal HRV. Significant difference (P < 0.001) was found among the effective doses of group A (mean ± standard deviation, 0.602 ± 0.363 mSv), group B (1.253 ± 0.804 mSv) and group C (9.039 ± 5.657 mSv). CONCLUSION: The higher temporal resolution of dual-source spiral CT coronary angiography performed with adaptive ECG pulsing results in preserved diagnostic image quality and performance independent of HRF or HRV at the cost of limited dose reduction in arrhythmic patients.

Correlation of CT perfusion images with VEGF expression in solitary brain metastases.

OBJECTIVES: To obtain permeability surface (PS) values using multi-slice helical CT perfusion imaging and to evaluate the spatial distribution correlation between PS values and vascular endothelial growth factor (VEGF) expression in solitary brain metastases. METHODS: Imaging was performed on 21 patients, PS values being calculated from the central, border and peripheral parts of tumours. VEGF expression was determined by immunohistochemical staining. RESULTS: Rim enhancement was found in 16 cases, the border of the tumour featuring PS elevation with high VEGF expression in 13 cases. In the 5 cases with nodular enhancement, the border and the central part had high permeability and VEGF expression was high in all cases, the correlation being significant (P<0.01) . CONCLUSION: VEGF expression in brain metastases positively correlates with PS values from CT perfusion imaging, so that the latter can be used in the surveillance of angiogenic activity in brain metastases.