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Attributable risk is an important indicator for planning and evaluating public health interventions. However, most current measures of the attributable risk of air pollutants have not considered temporal relationships between exposure and risk. More importantly, limited information is available regarding the attributable risk due to ambient air pollutants in basin regions like the Sichuan Basin, China. To quantify the association between PM 10 and deaths in the Basin region, we used a measure proposed recently within the framework of the distributed lag non-linear model to estimate the attributable risk in Chengdu, China. Meanwhile, we examined the association between PM 10 and years of life lost (YLL). Our analysis showed that population-attributable fractions for non-accidental, respiratory, and cardiovascular mortality were 0.569% (95% CI: -3.474%, 4.374%), 0.695% (95% CI: -5.260%, 6.457%), and 0.631% (95% CI: -6.973%, 7.390%), respectively. On average, a 1μg/m 3 increase in PM 10 was associated with cumulative increases of 0.26893, 0.30437, and 0.21924 YLL for non-accidental, respiratory, and cardiovascular mortality, respectively, referring to 20μg/m 3 . In addition, we found an inverse U-shaped pattern for the cumulative risk with 350μg/m 3 as the reverse point. With a 1μg/m 3 increase in PM 10 , YLL changed more significantly than mortality. Moreover, PM 10 demonstrated remarkable effects on YLL among men and the elderly., (Copyright © 2016 Elsevier B.V. All rights reserved.)

The effect modification of meteorological factors on the association between ambient Sulphur dioxide (SO 2 ) and mortality is critical for designing intervention policy. Existing studies did not result in consistent conclusions on the effect modification, and Years of life lost (YLLs) was rarely used as a health impact indicator to examine the modifying effect. This study aims to estimate the mean air temperature and relative humidity modification effects on the impact of SO 2 on daily mortality and YLLs in Chengdu, China. Mortality, YLLs, air pollution and meteorological data were collected for 2011-2014. Three analytical approaches based on generalized additive models (GAMs) were used, including bivariate response surface model, product term model, and stratification model. We found that the effects of SO 2 on mortality and YLLs depended on temperature at various lags, but did not depend on relative humidity. SO 2 exhibited larger adverse effects on mortality in high temperature level (22.8-29.4°C) days than in low temperature level (-0.3-9.3°C) days, with a 10μg/m 3 increment in SO 2 , non-accidental death increased by 0.8% (0.001, 0.015)at low temperature level, but increased by 1.4% (0.005, 0.024) at high temperature level. On the contrary, SO 2 showed greater adverse effects on YLLs in low temperature days than in high temperature days, with a 10μg/m 3 increment in SO 2 , non-accidental YLL increased by 40.580 (31.478, 49.682) at high temperature level, but increased by -2.703 (-14.668, 9.261) at low temperature level. We concluded that the effect of SO 2 on mortality and YLLs may depend on temperature in Chengdu, China. Our results highlight the importance of considering the interaction between SO 2 and temperature on health outcomes in future research. Also, policy makers should enhance the emission control of SO 2 in extreme temperature days in Chengdu., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Large and growing literature has explored whether temperature modified the effect of particular matter (PM) on mortality, but results of the modification effect are inconsistent. In this study, we reviewed information from 29 studies to get the qualitative evidence of the modification effects of temperature on PM to mortality, and the data from 16 of the 29 studies were extracted to conduct a meta-analysis. Temperatures were grouped into three level: "low", "middle" and "high" according to the original studies. The random effect model was used in the meta-analysis with the relative risk (RR) as the measure indicator. The RRs (95% confidence intervals, CIs) for non-accidental death, cardiovascular death and respiratory death per 10 μg/m3 increase in PM10 were 1.004 (1.003, 1.006), 1.005 (1.003,1.007), and 1.005 (1.000,1.010) in the low temperature level, 1.005 (1.004,1.006), 1.005 (1.004,1.007), and 1.008 (1.006, 1.010) in the middle temperature level, and 1.012 (1.010, 1.015), 1.016 (1.010, 1.022) and 1.019 (1.010,1.028) in the high temperature level, respectively. In conclusion, moderate evidence exists that temperature modifies the effect of PM10 on mortality. The effect of PM10 on respiratory death was the greatest, while the effect on non-accidental death was the smallest in the same temperature level. In addition, the effects of PM10 on all the three kinds of mortality were the biggest in the high-temperature level, and the smallest in the low-temperature level [ABSTRACT FROM AUTHOR]

Introduction. Although Chinese herbal medicine (CHM) treatment combined with conventional western therapy has been widely used and reported in many clinical trials in China, there is uncertainty about the efficacy of this combination in the treatment of patients after cardiopulmonary resuscitation (CPR). This systematic review aimed to assess whether the risk of mortality has decreased comparing the combination of CHM treatment with conventional western therapy. Methods. To identify relevant studies, the literature search was conducted in Medline, Embase, the Cochrane Library, CBM, CNKI, VIP, and Wanfang database. We included all randomized controlled trials (RCTs) that compared outcomes of patients after CPR taking combination of CHM treatment with those taking just conventional western therapy. Results. This meta-analysis showed that patients randomly assigned to combined CHM treatment group had a statistically significant 23% reduction in mortality compared with those randomly assigned to conventional western therapy group (RR: 0.77; 95% CI: 0.70–0.84). Conclusions. This meta-analysis provides evidence suggesting that a combined CHM therapy is associated with a decreased risk of mortality compared with conventional western therapy in patients after CPR. Further studies are needed to provide more evidence to prove or refute our conclusion and identify reasons for the reduction of mortality. [ABSTRACT FROM AUTHOR]