[Quantification of the Influence of Industrial Emissions on Volatile Organic Compounds (VOCs) Using PMF Model: A Case Study of Jiangbei Industrial Zone in Nanjing]

Volatile organic compounds(VOCs)are important precursors of ozone and secondary organic aerosol. The effect of industrial emissions on ambient VOC concentrations in the Jiangbei Industrial Zone in Nanjing was evaluated using the ambient VOCs measurements taken at Nanjing University of Information Science and Technology (NUIST) during March 2017. The monitoring data showed that the sum of 92 measured VOCs (TVOCs) ranged from 10.3×10^-9 to 200.5×10^-9. Some VOC species, such as ethylene, propene, benzene, styrene, and dichloromethane had abnormally high values. Positive matrix factorization model (PMF) was used to identify the main sources of VOCs. The results showed that industrial emissions on average accounted for 50.0% of TVOCs, while petrochemical industry, chemical industry, and paints & solvents use accounted for 14.9%, 19.3% and 15.8%, respectively. During a VOC pollution episode, the contribution of industrial emissions reached 74.9%. The direction of industrial sources was determined by combining the wind speed and wind direction data.

[Clinical outcome of therapeutic cervical cerclage in short cervix syndrome]

Objective: To investigate the clinical effect of therapeutic cervical cerclage on short cervix syndrome for anti-premature birth in the second trimester. Methods: Totally 44 singleton pregnant patients were diagnosed as short cervix syndrome, which was cervical length ≤2.5 cm without cervical dilatation, and received treatment from January 2008 and July 2015 in Peking University Third Hospital were collected. Among them, 30 patients who received therapeutic cervical cerclage were defined as cerclage group and another 14 cases who received conservative treatment were defined as un-cerclage group. The days of conservative treatment, delivery rate of different gestational weeks, birth weight of newborns, neonatal survival rate within 7 days of birth were analyzed between the two groups. Results: There were no significant differences between the two groups in days of pregnancy conservative treatment [103 (84-141) vs 105 (85-114) days], delivery weeks [38.0 (35.5-39.4) vs 38.5 (37.3-39.5) weeks], birth weight of newborns [3 120 (2 750-3 400) vs 3 130 (2 760-3 545) g], and survival rate of newborns [100% (30/30) vs 13/14]. The fetuses of both groups were all delivered after 28 weeks. There was no significant difference in accumulated delivery rate between the two groups after 32 weeks, 34 weeks, and 37 weeks, respectively (all P>0.05) . Conclusions: The treatment of cervical cerclage is not superior to conservative means in single pregnancy of cervical length ≤2.5 cm without cervical dilatation. For such patients with short cervix syndrome, the treatment of cervical cerclage may not be necessary, but dynamic monitoring and search for the causing factors and prompt treatment are more important.

Renal Ewing's sarcoma/primitive neuroectodermal tumor: a case report and literature review

Ewing's sarcoma/primitive neuroectodermal tumor (EWS/PNET) in the kidney is a rare but high-grade malignant tumor that affects predominantly elder children and adolescents. Patients mostly present with nonspecific symptoms such as abdominal pain and gross hematuria. Since EWS/PNET has a rapid clinical progression with early metastasis and death, it is essential to make an accurate and early diagnosis. Once diagnosed, multimodality treatment, including radical surgery combined with adjuvant chemotherapy, and radiotherapy if necessary, is recommended. Unfortunately, there are no characteristic signsthat have been described in ultrasonography or any other imaging modalities so far. The diagnosis of EWS/PNET is now based on a classical histological and immunohistochemical investigation complemented by a demonstration of specific chromosomal changes. Strong immunoreactivity to CD99 is ubiquitous, and t(11;22) translocation is seen in approximately 90% of EWS/PNET. Herein, we report a patient with such condition. The patient was a young woman, and she presented with sudden right flank pain clinically. Ultrasonography revealed a large heterogeneous mass in the lower pole of her right kidney. The tumor compressed the renal pelvis and led to upper pole caliectasis. Color Doppler demonstrated blood flow with a pulsatile arterialized waveform within the mass. The patient received radical nephrectomy with right renal vein and vena cava thrombectomy. A search for other sites of tumor involvement yielded negative results. And six cycles of chemotherapy were sequentially performed. The diagnosis of EWS/PNET was confirmed based on primitive small round cell histology and characteristic immunohistochemical results. She was still alive with no evidence of recurrence five years after initial diagnosis. We would like to point out that ultrasound is still a useful method for initial assessment, and ultrasound-guided fine needle aspiration may play an important role in determining preoperative diagnosis.

[Influence of intrahepatic cholestasis during pregnancy on the incidence of preterm birth]

Objective: Intrahepatic cholestasis during pregnancy (ICP) and its relation to incidence of preterm birth (PTB) were under study. Methods: A prospective cohort study was carried out that including all the hospitalized pregnant women with live singleton births, from January 2014 to March 2015 in Anqing Municipal Hospitals. Informed consent was followed in every pregnant woman with related demographic information collected through questionnaire and hospital electronic medical record system. Both univariate and multi-variate statistical methods were used to analyze the relations between ICP and incidence of PTB. Results: A total of 2 758 pregnant women were included in this study. The incidence proportions of ICP and PTB appeared as 7.25% and 16.28% respectively. Results from the logistic regression analysis showed that ICP increased the risk of both overall PTB (RR=2.33, 95%CI: 1.67-3.25) and medically indicated PTB (RR=8.46, 95%CI: 5.45-13.12), but not the spontaneous PTB (RR=0.94, 95%CI: 0.57-1.54). Conclusion: ICP seemed to have increased the risk on medically indicated PTB but not the spontaneous PTB.

[A clinical analysis of six patients with Brucella endocarditis and literature review]

Objective: To analyze the epidemiology and clinical characteristics of patients with Brucella endocarditis in order to improve the understanding and treatment of Brucella endocarditis. Methods: The clinical data including demographic characteristics, clinical features, laboratory data, echocardiography, treatment and clinical outcome of 6 patients with Brucella endocarditis were collected and analyzed. Results: In our database consisting of 211 brucellosis patients with positive blood culture, 6 patients (2.8%) with Brucella endocarditis were selected from May 2007 to December 2016 in Peking Union Medical College Hospital.The age range was 25-55 years, among whom 5 patients were men.The majority were farmers and all patients reported the history of closely contact with livestock.All of them had fever and 3 of them had arthralgia.Four patients had aortic involvement (4/6) and 2 of them presented with symptoms of left ventricular failure at admission.Blood culture of Brucella and serum agglutination test of Brucella were positive in all of them.Combined antibiotics treatments were given to all patients.Valve replacement surgery was performed in four patients, among them, three patients well recovered, one lost. Among all the patients, four were followed up continually and other two were lost. Conclusions:Brucella endocarditis has a predominance of aortic involvement and is prone to left ventricular failure.Early antibiotic treatment combined with valve-replacement surgery is effective to improve the prognosis.

[Research of prevalence of schistosomiasis in Hunan province, 1984-2015]

Objective: To analyze the prevalence of schistosomiasis in Hunan province, and provide scientific evidence for the control and elimination of schistosomiasis. Methods: The changes of infection rates of Schistosoma (S.) japonicum among residents and cattle in Hunan from 1984 to 2015 were analyzed by using dynamic trend diagram; and the time regression model was used to fit the infection rates of S. japonicum, and predict the recent infection rate. Results: The overall infection rates of S. japonicum in Hunan from 1984 to 2015 showed downward trend (95.29% in residents and 95.16% in cattle). By using the linear regression model, the actual values of infection rates in residents and cattle were all in the 95% confidence intervals of the value predicted; and the prediction showed that the infection rates in the residents and cattle would continue to decrease from 2016 to 2020. Conclusion: The prevalence of schistosomiasis was in decline in Hunan. The regression model has a good effect in the short-term prediction of schistosomiasis prevalence.

The value of radiographic indexes in the diagnosis of discogenic low back pain: a retrospective analysis of imaging results

To explore value of different radiographic indexes in the diagnosis of discogenic low back pain (LBP). A total number of 120 cases (60 patients diagnosed with discogenic LBP and 60 healthy people) were retrospectively analysed to identify factors in the diagnosis of discogenic LBP by using univariate and multivariate analyses. A receiver operating characteristic (ROC) curve was drew to show the predictive accuracy of the finally enrolled factors. Among all the included patients, 60 were strictly admitted in the discogenic LBP group while the other 60 were enrolled in the control group. Five results shows significant differences between discogenic LBP and control groups, including Cobb angle, lumbar stability, height of the disc, Modic change and High intense zone (HIZ) based on the results of univariate analysis; lumbar stability, Modic change and HIZ show high value in the diagnosis of lumbar discogenic pain based on the multivariate logistic analysis. The ROC curve shows that good diagnostic accuracy was obtained from the enrolled diagnostic factors including lumbar stability (Angular motion, more than 14.35°), Modic change and HIZ.

[Volatile Organic Compounds(VOCs) Source Profiles of Industrial Processing and Solvent Use Emissions: A Review]

Industrial processing and solvent use are two most important industrial sources of volatile organic compounds (VOCs) in China, and the source profile study has attracted increasing attention recently. Studies of VOCs source profiles from industrial processing and solvent use since the year of 2000 were summarized in this study, focusing on the comparison among different studies and the potential impact of different research methods. In general, studies were very limited and focused on few sources. Specifically, only 8 of 32 sub-categories of the industrial processing (according to the source classification method of the National Guidelines for VOCs Inventories Preparation) have been reported, and in terms of the solvent use sources, 4 of 10 sub-categories have been reported. There were large differences among the VOCs patterns of different sub categories emissions of industrial processing or solvent use. In terms of studies of the similar emissions, significant differences of VOCs profiles were resulted from the different research methods, such as the different sampling methods and VOCs analysis techniques. In addition, the non-uniformity of VOC species in the source profile caused difficulty for the comparison of different research results. Oxygen-containing VOCs were important components of the above two types of pollution sources and needed to be included in the measurement. An opening and interactive database of VOCs from industrial processing and solvent use is critically essential in the future, and mechanisms of sharing and inputting relative research results should be formed to encourage researchers to join the database establishment. Correspondingly, detailed quality assurance and quality control procedures are also very important, which include the detailed information such as research objectives, sampling and analysis methods, research region and time, and test times, et al. Based on the community above, a better uncertainty analysis could be carried out for the VOCs emissions profiles, which is critically important to understand the VOCs emission characteristics of the industrial processing and solvent use.

Directionality of non-permissive HLA-DPB1 T-cell epitope group mismatches does not improve clinical risk stratification in 8/8 matched unrelated donor hematopoietic cell transplantation

In 8/8 HLA-matched unrelated donor (UD) hematopoietic cell transplants (HCT), HLA-DPB1 mismatches between alleles from different T-cell epitope (TCE) groups (non-permissive mismatches) are associated with significantly higher risks of mortality compared with those between alleles from the same TCE group (permissive mismatches); however, the relevance of mismatch directionality, that is (host vs graft (uni-directional HvG), graft vs host (uni-directional GvH) or both (bi-directional) in the non-permissive setting is unknown. We show here significantly higher in vitro relative responses (RR) to bi-directional mismatches compared with uni-directional HvG or GvH mismatches in a total of 420 one-way mixed lymphocyte reactions between 10/10 matched pairs (RR 27.5 vs 7.5 vs 15.5, respectively, P<0.001). However, in 3281 8/8 matched UD HCT for leukemia or myelodysplastic syndrome, the hazards of transplant-related mortality (TRM) were similar for uni-directional HvG or GvH mismatches and bi-directional mismatches (hazard ratio (HR) 1.32, P=0.001 vs HR 1.28, P=0.005 and HR 1.34, P=0.046), compared with permissive mismatches. Similar results were observed for overall survival. No statistical differences between the uni- and the bi-directional non-permissive groups were detected in pairwise comparisons for any of the outcomes tested. We conclude that consideration of directionality does not improve risk stratification by non-permissive HLA-DPB1 TCE mismatches in UD searches.

Risk Factors for Surgical Results of Hirayama Disease: A Retrospective Analysis of a Large Cohort

OBJECTIVE

To explore risk factors affecting surgical results of Hirayama disease.

METHODS

A retrospective analysis of 210 patients was performed to identify risk factors affecting surgical results of Hirayama disease by using univariate and multivariate analyses. A receiver operating characteristic curve and area under the curve were applied to evaluate the significant results of the multivariate analysis and the optimal reference value.

RESULTS

The mean follow-up period was 27.3 months (range, 14-45 months), and 194 patients with clinical and radiographic data completed the final follow-up. Multivariate analysis identified age of patients (cutoff value 22.5 years), duration of the disease (cutoff value 33 months), physiologic reflex, and pathologic reflex as independent risk factors for surgical results of Hirayama disease. The receiver operating characteristic curve analysis and area under the curve showed that good reference value was obtained for the risk factors.

CONCLUSIONS

Age of patient, duration of the disease, physiologic reflex, and pathologic reflex are the main risk factors affecting surgical results of Hirayama disease. Receiver operating characteristic analysis shows that good reference value was obtained for the risk factors.

Combined 3D-tomography and 3D-power Doppler for vascular imaging of the liver

This study aimed to investigate the role of three-dimensional color tomographic ultrasound (3D-CTU) and three-dimensional color power Doppler (3D-CPD) imaging in diagnostics of liver lesions. Based on 3D-anatomical sectional structures of the liver, we used 3D-CTU and 3D-CPD techniques to reconstitute 3D-images of lobes, segments, and intra-segmental blood vessels, and lesions of the liver. With the use of this technique, we were able to generate 3D vascular patterns of liver lobes, segments and tumor lesions, and their spatial relationship. The observed vascular patterns of intra- and peri-tumor (including surrounding lobes and segments) and the spatial relation can be used for accurate positioning of liver lesions.

[Efficacy and safety of tertiary hospital guided and community-driven family self-help cardiac rehabilitation model]

Objective: To explore the efficacy and safety of tertiary hospital guided and community-driven family self-help cardiac rehabilitation model. Methods: This study was a prospective randomized controlled study, 80 patients from Beijing Electrical Power Hospital and Beijing Jingmei Group General Hospital with acute coronary syndrome were included from June to December 2015 and divided into 2 groups. Patients in rehabilitation group (n=52) received tertiary hospital(Peiking University Peoples' Hospital) guided and community-driven family self-help cardiac rehabilitation for 3 months, and patients in control group (n=28) received routine secondary treatment for 3 months. Following parameters including 6 minutes walk distance, score of life quality (evaluated by Short Form-12), score of anxiety (evaluated by Generalized Anxiety Disorder-7), score of depression (evaluated by Perceived Health Questionnaire-9), self-management competency (evaluated by questionnaire) were collected at baseline and after treatment for 3 months. Results: Compared with control group, 6 minutes walk distance was longer in rehabilitation group((60.2±6.8) meters vs. (24.9±10.5)meters, P<0.01). The difference values between after and before intervention of life quality scores((0.14±3.90)scores vs.(-7.44±5.85)scores, P>0.05), anxiety scores((-0.16±2.12 ) scores vs.(0.70±1.13)scores, P>0.05) and depression scores((-1.17±2.79) scores vs.(0.60±0.36)scores, P>0.05) were similar between the 2 groups. The amplification of patients with regular exercise (50.26% vs. 0, P<0.05), limit sugary foods usually and always (53.22% vs. 3.98%, P<0.05), eat 200-400 g fruits usually and always (78.61 % vs. 0, P<0.05), eat 300-500 g vegetables usually and always (9.74% vs. 0, P<0.05), and answering very confident to questions such as let the physicians know about your diseases (40.17% vs. 5.00%, P<0.05), know how to take medicines (44.52% vs. 5.00%, P<0.05), know how much exercise was right for yourself (26.43% vs.0, P<0.05) were significantly higher in rehabilitation group than in control group. There were no cardiac rehabilitation training related cardiovascular events. Conclusion: Tertiary hospital guided and community-driven family self-help cardiac rehabilitation model is an effective and safe management model of cardiovascular disease in chronic phase, and it is necessary to further expand the study population to verify the efficacy of this model.

Can an Endplate-conformed Cervical Cage Provide a Better Biomechanical Environment than a Typical Non-conformed Cage?: A Finite Element Model and Cadaver Study

OBJECTIVES

To evaluate the biomechanical characteristics of endplate-conformed cervical cages by finite element method (FEM) analysis and cadaver study.

METHODS

Twelve specimens (C2 -C7 ) and a finite element model (C3 -C7 ) were subjected to biomechanical evaluations. In the cadaver study, specimens were randomly assigned to intact (I), endplate-conformed (C) and non-conformed (N) groups with C4-5 discs as the treated segments. The morphologies of the endplate-conformed cages were individualized according to CT images of group C and the cages fabricated with a 3-D printer. The non-conformed cages were wedge-shaped and similar to commercially available grafts. Axial pre-compression loads of 73.6 N and moment of 1.8 Nm were used to simulate flexion (FLE), extension (EXT), lateral bending (LB) and axial rotation (AR). Range of motion (ROM) at C4-5 of each specimen was recorded and film sensors fixed between the cages and C5 superior endplates were used to detect interface stress. A finite element model was built based on the CT data of a healthy male volunteer. The morphologies of the endplate-conformed and wedge-shaped, non-conformed cervical cages were both simulated by a reverse engineering technique and implanted at the segment of C4-5 in the finite element model for biomechanical evaluation. Force loading and grouping were similar to those applied in the cadaver study. ROM of C4-5 in group I were recorded to validate the finite element model. Additionally, maximum cage-endplate interface stresses, stress distribution contours on adjoining endplates, intra-disc stresses and facet loadings at adjacent segments were measured and compared between groups.

RESULTS

In the cadaver study, Group C showed a much lower interface stress in all directions of motion (all P < 0.05) and the ROM of C4-5 was smaller in FLE-EXT (P = 0.001) but larger in AR (P = 0.017). FEM analysis produced similar results: the model implanted with an endplate-conformed cage presented a lower interface stress with a more uniform stress distribution than that implanted with a non-conformed cage. Additionally, intra-disc stress and facet loading at the adjacent segments were obviously increased in both groups C and N, especially those at the supra-jacent segments. However, stress increase was milder in group C than in group N for all directions of motion.

CONCLUSIONS

Endplate-conformed cages can decrease cage-endplate interface stress in all directions of motion and increase cervical stability in FLE-EXT. Additionally, adjacent segments are possibly protected because intra-disc stress and facet loading are smaller after endplate-conformed cage implantation. However, axial stability was reduced in group C, indicating that endplate-conformed cage should not be used alone and an anterior plate system is still important in anterior cervical discectomy and fusion.

[Effects of high-intensity focused ultrasound on apoptosis-associated gene expression in xenografts with human pancreatic cancer]

Objective: To identify the expression of apoptosis-associated genes of high- intensity focused ultrasound(HIFU) in xenograft with human pancreatic cancer. Methods: Mice implated with human pancreatic cancer cells (YY-1) were divided into HIFU group or control group. Tumor cell apoptosis was verified by TUNEL. The expression of the apoptosis-associated genes was analyzed by Agilent Human Gene Expression. Selected genes was validated by quantitative real-time PCR(RT-PCR)and Western blot. Results: The rate of tumor cell apoptosis in HIFU group was higher than that of control group at 7, 14 days after HIFU treatment ((63.6%±15.2%)vs (19.0%±2.4%), P<0.01)and ((41.4%±7.3%)vs(18.0%±2.4%), P<0.01). Gene expression profiling revealed a total of 69 differentially expressed genes in related to apoptosis pathway, among which 44 genes were up-regulated, and 25 genes down-regulated. The RT-PCR results of selected 4 genes were consistent with those of gene expression profiling. The results of Western blot analysis at 7, 14 days after HIFU treatment showed that the expressions level of Bax protein in HIFU group was greater that of in control group ((0.39±0.11)vs (0.20±0.09), P<0.05)and ((0.46±0.12)vs(0.24±0.10), P<0.05), while the expressions level of Bcl-2 protein in HIFU group was lower than that of in control group ((0.68±0.14)vs(1.56±0.21), P<0.05)and((0.51±0.16)vs(1.57±0.22), P<0.05). Conclusions: HIFU could induce apoptosis and results in dramatic changes in gene expression, indicating that multiple pathways are involved. Although intrinsic pathway might be predominantly involved in HIFU-elicited apoptosis, further research is needed to clarify the detailed mechanisms.

[Radiographic assessment of vertebral artery injury in anterior cervical surgery in healthy adults]

Objectives: To study the relationship between the anatomical parameters of transverse foramen and intervertebral discs in the cross-section of the cervical spine in healthy adults, and to evaluate the risk of vertebral artery injury in the anterior cervical spine surgery. Methods: There were 24 healthy adults(12 male, 12 female) underwent neck CT angiography with clear vertebral artery and the adjacent structure imaging from June to December 2014 in Huashan Hospital, Fudan University. The anatomical parameters of vertebral artery V2 segment with lower cervical vertebrae and intervertebral discs were measured by cross-sectional images of C(3-6). The corresponding parameters of different sex and both sides of the same segment were analyzed by independent samples t-test and paired t test, respectively. The least significant difference(LSD) t test was used to compare the corresponding data between different segments. Results: The vertebral artery was not walking in the middle of the transverse foramen in healthy individual, but partial medial, partial front walking. Transverse diameter of transverse foramen in male and female were 6.62-6.89 mm and 6.21-6.45 mm, and sagittal diameter was 5.41-6.48 mm and 5.40-6.10 mm, respectively.The transverse foramen were slightly oval. The distance between vertebral artery and midline in male and female were 14.23-16.12 mm and 13.60-15.04 mm, respectively, which was much larger than the width of cervical vertebral corpectomy. Compared with C(3-4), intervertebral disc, the transverse distance between the vertebral artery and the uncovertebral joint of C(4-5), C(5-6) was smaller, and the distance from the vertebral artery to the posterior margin of the uncovertebral joint was relatively small, the difference was statistically significant (t=2.449, P=0.022). The distance from vertebral artery to the posterior margin of uncinate process was 1/5-2/5 of the distance between the anterior and posterior edge of the corresponding segmental vertebra. Conclusion: Based on this anatomical study, the risk of vertebral artery injury in conventional anterior cervical decompression is small, and the risk of vertebral artery injury in different segments is slightly different.

Robust Zero-Field Skyrmion Formation in FeGe Epitaxial Thin Films

B20 phase magnetic materials have been of significant interest because they enable magnetic Skyrmions. One major effort in this emerging field is the stabilization of Skyrmions at room temperature and zero magnetic field. We grow phase-pure, high crystalline quality FeGe epitaxial films on Si(111). Hall effect measurements reveal a strong topological Hall effect after subtracting the ordinary and anomalous Hall effects, demonstrating the formation of high density Skyrmions in FeGe films between 5 and 275 K. In particular, a substantial topological Hall effect was observed at a zero magnetic field, showing a robust Skyrmion phase without the need of an external magnetic field.

[An analysis of immunophenotyping of peripheral lymphocytes in adult patients with infectious mononucleosis and chronic active Epstein-Barr virus infection]

OBJECTIVE

To determine the immunophenotypic features of peripheral lymphocytes in adult patients with Epstein-Barr virus(EBV)-associated infectious mononucleosis(IM) and chronic active EBV infection (CAEBV).

METHODS

Eighteen IM patients, 12 CAEBV patients and 18 healthy donors were included. Lymphocyte subsets including CD3(-)CD19(+) B cells, CD3(-)CD16/56(+) NK cells, CD4(+) and CD8(+) T cells in peripheral blood were measured by flow cytometry. The expression of activation markers (HLA-DR and CD38) on CD8(+) T cells and CD28 expression on T cells were also determined. Kruskal-Wallis H and Mann-Whitney U tests were used to compare variables among groups.

RESULTS

IM patients had dramatically increased CD8(+) T cell counts than healthy donors (5.22×10(9)/L vs 0.54×10(9)/L, P<0.001). B cell counts moderately reduced in patients with IM than in healthy donors. No difference was found in absolute CD4(+) T cell and NK cell counts between IM and healthy donors. The levels of HLA-DR and CD38 on CD8(+) T cells significantly increased in IM patients compared with those in healthy controls. The intensity of CD28 on CD8(+) T cells significantly decreased, which was not seen on CD4(+) T cells. The median cell counts of B, NK, CD4(+) T and CD8(+) T subsets in CAEBV patients were 0.02×10(9)/L, 0.06×10(9)/L, 0.26×10(9)/L and 0.21×10(9)/L respectively, which were significantly lower than those in healthy donors (0.22×10(9)/L, 0.38×10(9)/L, 0.78×10(9)/L, 0.54×10(9)/L)and IM patients (0.12×10(9)/L, 0.40×10(9)/L, 0.91×10(9)/L, 5.22×10(9)/L). The positive rates of HLA-DR and CD38 on CD8(+) T cells in CAEBV patients were higher than those in healthy controls, but lower than those in IM patients.

CONCLUSIONS

The immunophenotypic pattern in adult patients with IM is characterized by a dramatic increase of extensively activated CD8(+) T cells, a moderate reduction of CD19(+) B cells and no significant change of CD4(+) T cells and CD16/56(+) NK cells. CAEBV is featured by an immunosuppression status as demonstrated by significantly decreased B, NK, CD4(+) T and CD8(+) T subsets.

Secondhand smoke exposure of children at home and prevalence of parental smoking following implementation of the new tobacco control law in Macao

OBJECTIVE

To investigate secondhand smoke exposure (SHS) of children at home and the prevalence of parental smoking after implementation of the new tobacco control law in Macao. This study explored whether the smoking ban in public places in Macao has decreased the prevalence of smoking or led to increased SHS exposure of children at home. As smokers cannot smoke in public places any more, they may smoke at home more frequently; a displacement effect of smoke-free legislation.

STUDY DESIGN

Cross-sectional survey.

METHODS

This study surveyed 337 fathers and 538 mothers. Questions from a subset of key questions from the Global Adult Tobacco Survey (2nd edition) were applied to assess the SHS exposure of children and the prevalence of parental smoking since the smoking ban. A classification tree analysis was used to analyse the factors increasing SHS exposure of children.

RESULTS

The prevalence of SHS exposure in children at home was 41.3%. The prevalence rates of paternal and maternal smoking were 43.7% and 3.8%, respectively. Compared with data reported by the Health Bureau of Macao SAR in 2011, the prevalence of parental smoking and the prevalence of SHS exposure of children at home have not decreased since the smoking ban. Analysis of the factors increasing the prevalence of SHS exposure of children indicated that fathers with an education level below high school were more likely to contribute to this increase, compared with fathers with a high school education or more (48.2% vs 32.4%, respectively). In addition, fathers represented the majority of smokers at home, accounting for 92.0% of 415 smoking parents. The prevalence of paternal smoking (82.0%) in the group of children with SHS exposure was much higher than that in the unexposed group (16.7%, Chi-squared test = 367.199, P = 0.000). The SHS exposure of children increased consistently with the decrease in paternal education level. This was consistent with the increasing prevalence of paternal smoking as paternal education level decreased. SHS exposure was most common among children whose fathers had an education level below high school and whose mothers were aged ≤29 years (75.0%).

CONCLUSIONS

This study did not find any decline in the prevalence of parental smoking after the smoking ban. These parents were more likely to smoke at home after the ban, leading to more frequent SHS exposure for their children.

A new phytase continuously hydrolyzes phytate and improves amino acid digestibility and mineral balance in growing pigs fed phosphorous-deficient diet

Ten ileal T-cannulated pigs (19.26 ± 1.06 kg) were used to evaluate the effects of a novel phytase on apparent ileal digestibility (AID) of AA and apparent total tract digestibility (ATTD) and hindgut disappearance of DM, GE, CP, crude fiber, NDF, and ADF as well as minerals balance. Pigs were fed in a duplicated 5 × 4 incomplete Latin square design (5 diets with 4 periods). Each period consisted of a 5-d adjustment period followed by a 3-d total collection of feces and urine and then a 2-d collection of ileal digesta. The 5 diets included a P-deficient basal diet (0.43% Ca and 0.38% total P) that was supplemented with 0 (negative control [NC]), 500, 1,000, or 20,000 phytase units (FTU)/kg phytase and a positive control (PC) diet that was P adequate (0.64% Ca and 0.52% total P). The addition of phytase to the NC diet improved ( < 0.05) AID of phytate from 11.1 to 62.8, 70.6, and 90.5% at the inclusion rates of 500, 1,000, and 20,000 FTU/kg, respectively. In general, phytase supplementation at a dose of 20,000 FTU/kg further increased ( < 0.05) AID of Ca, total P, and phytate and reduced ( < 0.05) the ileal phytate concentration compared with diets with 500 or 1,000 FTU/kg phytase. Pigs fed the diet with 20,000 FTU/kg phytase but not diets with 500 and 1,000 FTU/kg phytase showed improved ( < 0.05) ATTD of CP and AID of DM, GE, CP, Leu, Lys, Thr, Val, Asp, and Ser compared with pigs fed the PC or NC diet. However, hindgut disappearance of crude fiber and NDF ( < 0.05) were reduced in pigs fed the diet with 20,000 FTU/kg phytase compared with pigs fed the PC or NC diet. Pigs fed diets with 500 or 1,000 FTU/kg phytase had greater ATTD and retention of Ca and P than pigs fed the NC diet but less compared with pigs fed the diet with 20,000 FTU/kg phytase. Supplementation of 20,000 FTU/kg phytase to the NC diet improved ( < 0.05) digestibility of Na, Mn, and Zn as well as retention (%) of Zn. Increasing phytase supplementation doses from 0 to 1,000 FTU/kg linearly improved ( < 0.05) retention of Mg; meanwhile, digestibility of Mg and Mn and AID of Thr showed a linear increase trend ( = 0.084). In conclusion, supplementation of the novel phytase at doses up to 20,000 FTU/kg hydrolyzed most of the phytate (90%) and consequently further improved mineral and protein utilization.

Noble metal-titania hybrid nanoparticle clusters and the interaction to proteins for photo-catalysis in aqueous environments

We report a systematic study of the controlled synthesis of new hybrid spherical TiO₂ nanoparticle cluster (TiO₂-NPC) homogeneously decorated with noble metal nanoparticles (NPs) by gas-phase evaporation-induced self-assembly. Silver NP (AgNP) was used as the representative noble metal NP. The degradation of methyl blue (MB) in the aqueous solution was chosen as the representative system for the study of photocatalysis, which were tested and evaluated with respect to irradiation conditions and the presence of bovine serum albumin (BSA). The results show that particle size and chemical composition of the hybrid nanostructure were tunable by choosing the suitable concentration of precursors. The photocatalytic activity of AgNP-decorated TiO₂-NPC was strongly affected by the light irradiation and the ligand-nanoparticle interfacial interaction. The presence of BSA influenced molecular conjugation to the surface of the hybrid nanostructure. Under conditions of simultaneous competitive adsorption of MB and BSA, the combination of AgNPs improved the photocatalytic activity of the TiO₂-NPC-based catalysts. Our work describes a prototype methodology to fabricate TiO₂-NPC homogeneously decorated with noble metal NPs with well-controlled material properties. The mechanistic understanding developed in this study can be useful for the future optimization of material properties of hybrid nanostructures versus interfacial interactions with the surrounding molecules.

Expanding public health in China: an empirical analysis of healthcare inputs and outputs

OBJECTIVES

The Chinese Government claims that China's health policy is primarily focused on prevention. However, this does not appear to be the case. Researchers with an interest in China's health policy may be aware that the Chinese Government launched a health reform in 2009 to improve the health status of the entire population by 2020.¹ This health reform has been in place for 7 years, and only 4 years now remain to achieve the overall objectives by 2020. This study analyzed the main inputs and outputs of China's health reform in order to identify the main problems and highlight the major challenges. It is hoped that this study will provide some reference for health reform in China and other developing countries.

STUDY DESIGN

This study focused on health, with human resources and healthcare costs as the main input indicators, and 2-week prevalence of illness and prevalence of non-communicable diseases as the main output indicators. By longitudinal comparison of real data from 2009 to 2014, the effects of China's health reform were analyzed to identify the main challenges, enabling suggestions to be made for future reference.

METHODS

This was a retrospective analysis of empirical data. Data were collected between 2009 and 2014 as follows: (1) data on the distribution of healthcare professionals were collected from the Statistical Bulletin of China's Health Development, issued by the National Health and Family Planning Commission every year between 2009 and 2014; (2) data on government health expenditure were obtained from the Annual National Public Fiscal Expenditure Data, released by the Financial Ministry of the People's Republic of China from 2009 to 2014; (3) data on the prevalence of chronic diseases, 2-week prevalence of illness, residents' medical service demands, and utilization of health services were obtained from the Fourth and Fifth National Health Care Surveys in 2008 and 2013; and (4) data on total healthcare expenditure, medical expenditure and out-of-pocket payments were obtained from the 2015 China Statistical Yearbook.

RESULTS

From 2009 to 2014, China's healthcare human resources were distributed primarily in hospitals that focus on providing treatment. By 2014, 62.5% of the health professionals and technical personnel were distributed in hospitals. From 2009, the Chinese Government spent more money on health care than previously, with approximately 67% spent on disease treatment and 14.19% spent on disease prevention. However, the 2-week prevalence of illness increased by 5.2 percentage points, and the prevalence of chronic diseases increased by 9 percentage points. Meanwhile, residents' out-of-pocket payments for health care were as high as 50.61% of the total healthcare expenditure and were particularly high in rural areas.

CONCLUSION

China should adjust the direction of its health reform as soon as possible to focus on improving health status rather than treatment of disease. In the future, as China's population ageing trend intensifies, China must take effective measures or the country's non-communicable disease rates will continue to increase. To meet this challenge, China's health reform should take effective measures to control the rising trend of the incidence of non-communicable diseases. First, China should focus on the core goal of its health reform policy, which is disease prevention. Second, China should focus on strengthening public health systems to effectively prevent and control key epidemic diseases. Third, China should increase the number of public health personnel, improve the level of education and training of public health personnel and increase the input of funds into the field of public health as soon as possible.