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Background: The study evaluated the protective effect of 13-valent pneumococcal polysaccharide conjugate vaccine (PCV13) against all-cause hospitalized pneumonia in children in Beijing., Methods: Based on the vaccination record and inpatient medical record database of Beijing, children born in 2017 in Beijing, matched by age, gender, and district of the children with the ratio of 1:4, were selected as the vaccinated and unvaccinated groups according whether if vaccinated with PCV13. The incidence rate and 95 % confidence interval (95 %CI), vaccine effectiveness (VE) and direct medical costs of all-cause hospitalized pneumonia were calculated and compared within the same period of 12 months, 18 months, 24 months and 30 months after the birth of the child., Results: The decreased incidence rates of all-cause hospitalized pneumonia were observed at the four points in the PCV13 vaccinated group compared to the unvaccinated group, which were significant at the points of 12 months (0.42 % vs. 0.72 %, P = 0.001), 18 months (0.90 % vs. 1.26 %, P = 0.002) and 24 months (1.37 % vs. 1.65 %, P = 0.046). The VE of PCV13 against all-cause hospitalized pneumonia within 12 months was the highest as 41.9 % (95 % CI 19.6 %, 58.0 %), followed by 29.3 % (95 % CI 11.4 %, 43.5 %) within 18 months, 17.1 % (95 % CI 0.3 %, 31.1 %) within 24 months and it almost disappeared within 30 months. The VE of 4-dose vaccination within 18 months and 24 months were 39.9 % (95 % CI 20.3 %, 54.7 %) and 27.2 % (95 % CI 8.6 %, 42.0 %), respectively. The median hospitalization cost of the children in the vaccinated group was higher at the four points but without significance., Conclusions: PCV13 had a certain protective effect on all-cause hospitalized pneumonia, and the booster immunization strategy had the best protective effect with great public health significance to enter the immunization program., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Myopia and obesity in children and adolescents have become serious public health problems that endanger public health, especially in China. Unhealthy lifestyle behaviors are environmental drivers of both myopia and obesity. This protocol describes a study to evaluate the effectiveness of "22510SS", that is 2 h of daytime outdoor activities ('2'); Limit screen time to no more than 2 h per day ('2'); Consume at least 5 servings of fruits and vegetables daily ('5'); Attain 1 h of physical activity daily ('1'); Consume 0 sugar-sweetened beverages ('0'); Reasonable sleep duration ('S'); Regular supervision ('S'). A school-based, multifaceted intervention strategy for myopia and obesity prevention, and to assess and explore the implementation of "22510SS" with regards to acceptability, feasibility, adoption, usage and maintenance., Methods and Analysis: This study aims to develop a comprehensive intervention strategy "22510SS" based on the socio-ecological model, and A two-arm cluster randomized trial with a parallel-group of a 1:1 allocation ratio in 36 primary and secondary schools to test its evidence-based intervention programs on the effects and implementation of myopia and obesity epidemics in children and adolescents in grades 4 and 7. The primary outcomes will include differences in visual acuity, body mass index, outdoor activity indicators, screen time, fruit and vegetable intake, high-quality protein intake, sugar-sweetened beverage intake, sleep duration, and level of monitoring among children and adolescents. Secondary outcomes will assess the acceptability, feasibility, uptake, use, and maintenance of the intervention. Effects on the primary and secondary outcomes will be analyzed using linear and logistic regression analyses, as well as difference-in-difference analysis, taking into account cluster effects and possible confounding factors. Process assessments will also be conducted through quantitative and qualitative analyses, including acceptability, feasibility, gender, adoption, implementation, and sustainability., Discussion: This study will evaluate the effectiveness of "22510SS" and examine its implementation in the school-based network nesting family and clinic. Following this intervention study, the integrated intervention program focused on myopia and obesity among children and adolescents have great potential to be implemented in China to promote and support healthy lifestyle behavior change and reduce the risk of myopia and obesity in children and adolescents., Trial Registration: NCT05275959. Registered 23 Mach 2022., (© 2023. The Author(s).)

Background: Inflammation plays an important role in acute myocardial infarction (AMI). Procalcitonin levels rise in response to proinflammatory stimuli. This study aimed to investigate the effects of different doses of atorvastatin on the serum inflammatory profiles, especially procalcitonin and major adverse cardiovascular events (MACEs) in patients with AMI during hospitalization., Methods: The patients who were admitted to the Coronary Care Unit of The Third Medical Center of PLA General Hospital (Beijing, China) between January 2015 and December 2015 with a diagnosis of AMI were enrolled, and randomized to atorvastatin 20 mg/day postoperatively (20-mg group), 40 mg/day postoperatively (40-mg group) and 80 mg preoperatively+40 mg/day postoperatively (80/40-mg group). Serum procalcitonin and high-sensitivity C-reactive protein (hs-CRP) were evaluated before and at 1 and 3 days after percutaneous coronary intervention (PCI)., Results: A total of 112 patients with AMI (23 women and 89 men) were prospectively eligible for the study. There were no significant differences in most clinical data among the three groups. The 80/40-mg group showed significantly reduced serum procalcitonin levels at 1 and 3 days after PCI (P < 0.001) and reduced hs-CRP levels at 3 days P = 0.001) compared with 20-mg and 40-mg groups. Serum procalcitonin (OR, 4.593; 95% CI, 1.476-8.387; P = 0.005), hs-CRP (OR, 1.149; 95% CI, 1.012-1.338; P = 0.018), highly sensitive cardiac troponin T (OR, 1.255; 95% CI, 1.004-1.569, P = 0.009) and Gensini score (OR, 1.022; 95% CI, 1.045-1.062; P = 0.013) were independently associated with MACEs during hospitalization., Conclusion: The use of atorvastatin 80 mg before and 40 mg/day after PCI in patients with AMI can effectively reduce serum inflammatory factors. procalcitonin and hs-CRP were independently associated with in-hospital MACEs., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: To evaluate the safety and efficacy of excimer laser coronary atherectomy (ELCA) in patients with in-stent restenosis chronic total occlusions (ISR CTOs)., Background: ISR CTOs are a challenge in percutaneous coronary intervention (PCI). Although they can be treated by ELCA, limited data are available on the effects of ELCA treatment in these patients., Methods: Fifty-nine consecutive patients underwent PCI for ISR CTOs at Beijing Hospital between December 2017 and September 2020. According to whether or not ELCA was performed, they were divided into two groups. Quantitative coronary angiography (QCA) analyses were performed routinely, including measurement of the minimal lumen diameter and calculation of the percentage diameter stenosis. The procedural success rate, the frequency of peri-procedural complications, and the incidence rates of major adverse cardiac events (MACEs) over nine months were assessed. The primary endpoint in the study was the percentage diameter stenosis., Results: Procedure success was achieved in most patients in both groups (75.9%). Patients in the ELCA group exhibited a lower percentage diameter stenosis (24.5 ± 9.09 vs. 35.1 ± 18.6, p = 0.048) and a larger minimal lumen diameter (2.36 ± 0.29 mm vs. 1.78 ± 0.64 mm, p < 0.001) than those in the control group and the 9-month incidence rates of MACEs did not differ (9.5% vs 15.8%, p = 0.699)., Conclusions: This study demonstrated that ELCA may be a safe and effective technique in the treatment of ISR CTOs, and the use of ELCA can achieve good immediate angiographic results, as measured by QCA, without increasing peri-procedural complications or the incidence rates of 9-month MACEs., (© 2021. The Author(s).)

236 U has attracted more attention as an environmental tracer in recent years. However, in-depth study of 236 U in terrestrial environments is still rare in China. Data on 236 U and 137 Cs concentrations in soil and road dust samples collected from Beijing and Zhangjiakou, China were obtained to demonstrate the background and distinct characteristics of anthropogenic 236 U and 137 Cs. 236 U and 137 Cs were detected in the range of (1.10-7.90) × 10 7 atoms g -1 and below the method limits of detection to 5.30 Bq kg -1 . A clear characteristic was observed in road dust, where 236 U concentrations increased with decreasing of sample particle size. Soil samples showed an irregular characteristic, but the highest 236 U concentrations were observed in particle size fraction of <0.053 mm in both samples. This phenomenon was caused by U chemical properties, higher specific surface areas and organic compounds in fine particles. Anthropogenic radionuclides fingerprint characteristics in <0.053 mm samples were specially discussed. 236 U/ 238 U atom ratios were detected in the range of (0.627-3.38) × 10 -8 . A weak correlation between anthropogenic 236 U and natural U isotopes were observed. The intermediate correlation between 236 U and 137 Cs indicated somewhat distinct migration behavior of these two radionuclides in soil after release to the environment. The released amount of 236 U from global fallout during the period of atmospheric nuclear weapons testing was roughly estimated to be 1300 ± 448 kg. These results could be used as fingerprint information for anthropogenic 236 U migration behavior and tracer application in environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Rice intake is a major route of oral exposure to inorganic arsenic (iAs), a known human carcinogen. The recent risk assessment on iAs in rice conducted by the US Food & Drug Administration (FDA) didn't propose an action level for iAs in rice mainly because of the relatively low consumption rate in the general US population. However, this decision may not be applicable to high rice-intake populations, such as the Chinese population., Objective: The objective of this study was to probabilistically characterize the exposure of iAs via rice intake in Chinese population with a focus on the urban population., Methods: With the consideration of bioaccessibility of iAs in rice, iAs exposure is mainly determined by rice intake rate and iAs concentration in rice. To estimate the daily rice consumption, a dietary survey consisting of 1873 subjects was conducted in three major Chinese cities (Beijing, Guangzhou, and Hangzhou). Speciated As concentration in rice was measured using 480 rice samples collected from markets in these three cities. Monte Carlo simulation approach was applied to distributionally estimate the average daily dose (ADD) of iAs through rice intake., Results: The estimated distribution of daily iAs exposure of the study population has a mean of 10.5 μg/day with a 95th percentile interval from 0.1 to 75.3 μg/day. The estimated distribution of ADD has a mean of 0.179 μg/kg/day with a 95th percentile interval from 0.001 to 1.224 μg/kg/day. Greater level of iAs exposure (due to higher rice intake) was observed in males than females, and in summer than other seasons with lower temperature. Geographically, the ADD of iAs exposure from rice intake reduces from south to north., Conclusions: About 13% of the Chinese urban population are exposed to iAs via rice intake higher than the Reference Dose (RfD) level., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The anti-thyroglobulin antibody (TgAb) has been suggested to be more common in patients with papillary thyroid cancer (PTC). Here, we performed a retrospective study investigated the correlation between TgAb level and PTC in Chinese patients between 2011 and 2015. Patients with goiter who underwent thyroidectomy and received a confirmed pathological diagnosis were enrolled into the study. Clinical characteristics and preoperative thyroglobulin antibody (TgAb) level data were collected from all enrolled patients. Based on the preoperative TgAb test results, patients were divided into a TgAb negative (TgAb-) group (<60 IU/mL) and a TgAb positive (TgAb+) group (≧60 IU/mL). Of the 4,046 patients, 671 patients were TgAb+ while 3,375 patients were TgAb-. There were 535 (79.7%) patients with PTC in the TgAb+ group, and 2,154 (63.8%) patients with PTC in the TgAb- group. The prevalance of PTC was significantly higher in TgAb+ patients than in TgAb- patients. TgAb+ patients were stratified into four groups based on the TgAb titer. The prevalence of PTC did not increase with TgAb titer. No significant difference in TgAb level was noted in patients with different clinicopathologies, including TNM stage, lymph node metastasis, and multifocal carcinoma. Regression analysis suggested a higher risk of PTC malignancy among TgAb+ patients. Preoperative TgAb level ≥60 IU/mL might be associated with a higher risk of PTC. However, there was no titer-dependent association between elevated TgAb titer and PTC malignancy., (Copyright © 2020 Jia, Pang, Wang, Zhao, Jiang, Song, Fan, Wang, Zhao, Ba, Yang, Wang, Gu, Zang, Pei, Du, Mu and Lyu.)

China established a self-organized and market-driven recycling system, which was dominated by the informal sectors. In recent years, the amount of domestically-recycled waste paper grew slower than expectation in China, which may be resulted from a decline in economic sustainability of current recycling system. For understanding the waste paper recycling system in most cities in China, the economic mechanism remains unclear and the city-level data is extremely insufficient. In this work, an index of recycling sustainability (IRS, benefit divided by cost) is analyzed with a resolution of 1 km 2 grid in Beijing City, by adopting value chain and GIS methodology. Five degrees of IRS are defined, from high-degree (IRS > 1.10) to low-degree (IRS < 0.95). Different stakeholders in the informal waste paper recycling system were interviewed to fill the data gap. Results show that: (1) from 2015 to 2018, the informal recycling of waste paper accounted for approximate 80% in Beijing; (2) the number of informal recyclables distribution sites decreased from 27 to 11, and their average distance to the city-center rose from 27.5 km to 40.9 km; (3) in 2015 and 2018, the grids with high-degree IRS accounted for 99.5% and 89.2%, respectively, indicating a sustainable waste paper recycling industry in Beijing; and (4) according to the scenario analysis, if the operating cost rises by 30%, the grids with low-degree IRS accounts for 98.5%, indicating a nontrivial challenges when the recycling cost keeps increasing in the future. Policy recommendations are put forward for a more sustainable paper waste recycling system in China., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This paper focused on VOCs and their source apportionment in urban Beijing. Our monitoring measured 52 VOCs in July 2014 and January 2015. The concentration of VOCs was in the range of 14.5~95.2 ppb in July and 2.1~93.1 ppb in January, with the top five compounds of toluene (10.7%), ethane (6.9%), ethylene (6.3%), n-butane (5.7%), and propane (5.6%) in July and ethylene (14.7%), n-butane (14.2%), ethane (9.6%), propylene (8.0%), toluene (7.9%), and benzene (6.9%) in January. The ratio of VOCs to CO reached 0.059 in July and 0.022 in January on average. These differences implied a potential seasonal difference in the VOC source contribution. Then, we conducted a source apportionment study based on 21 major VOCs and CO by using probabilistic matrix factorization (PMF) receptor model. According to the similarity between the PMF analysis profiles and the known source profiles, combustion sources, petrochemical industry sources, solvent utilization sources, and gasoline evaporation sources were identified. The correlation coefficient (R) between the PMF analysis profile and the source profile reached 0.68~0.87 in July and 0.53~0.92 in January. The better apportionment performance in July was mainly due to the use of intensive VOC observations at a 3-h resolution. When we conducted another PMF source apportionment for July based on 12-h resolved concentration input, the R values decreased to 0.47~0.73. Thus, the PMF model depends heavily on the sample number of concentration inputs, and intensive observation is more propitious. Our PMF apportionment results showed that combustion sources, petrochemical industry, solvent utilization, gasoline evaporation, and other sources contributed ambient VOCs in Beijing urban areas of 13.7 ppb, 5.1 ppb, 7.7 ppb, 12.8 ppb, and 3.3 ppb in July and 13.2 ppb, 2.0 ppb, 5.7 ppb, 6.6 ppb, and 1.0 ppb in January, respectively, on a monthly average. These apportionment results match well with the 2013 VOC emission inventory calculated by this study, but also presented significant seasonal differences in the petrochemical industry and gasoline evaporation, in which VOC emissions strongly respond to environmental temperature.

Objectives: This study aims to summarise the features and trends of thyroid carcinoma in the past two decades in China., Design, Setting and Participants: Clinical data obtained from 10 798 patients treated by thyroidectomy from 1994 to 2015 at the Department of General Surgery of the People's Liberation Army General Hospital, Beijing, China were retrospectively analysed., Outcome Measures: Incidence and histopathological features of thyroid cancer were compared and the risk factors for local lymph node metastasis analysed., Results: Our data indicated a significant increase in the detection of thyroid cancer (from 16.8% to 69.8%, p < 0.01). Among the 5235 thyroid cancer cases, papillary thyroid carcinoma (PTC) was the most common histotype, accounting for 95.1% of all malignancies over the 22-year period. Among the 4979 PTCs, micro-PTCs (mPTC) with the largest diameter ≤10 mm has gradually become the dominant form, and its percentage in PTCs has increased from 13.3% in the biennial period of 1994-1995 to 51.2% in 2010-2011. Furthermore, the size of the tumour has decreased significantly from 2.3±1.1 cm in 1994 to 1.2±0.9 cm in the largest diameter (p<0.01), while the average age at diagnosis and female dominance remained unchanged during the period. Logistic regression showed that tumour nodules>1 cm and male gender were the main risk factors for local lymph node metastasis (LNM), whereas patients over 45 years had lower risk., Conclusions: During the 22-year period, an increased detection of thyroid cancer, particularly mPTC, was found while the occurrence of LNM decreased. Our results suggest that the current preoperative diagnosis and risk stratification are adequate, supporting the published guidelines for the diagnosis of thyroid cancer., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Powdery mildew is one of the most serious diseases that have a significant impact on the production of winter wheat. As an effective alternative to traditional sampling methods, remote sensing can be a useful tool in disease detection. This study attempted to use multi-temporal moderate resolution satellite-based data of surface reflectances in blue (B), green (G), red (R) and near infrared (NIR) bands from HJ-CCD (CCD sensor on Huanjing satellite) to monitor disease at a regional scale. In a suburban area in Beijing, China, an extensive field campaign for disease intensity survey was conducted at key growth stages of winter wheat in 2010. Meanwhile, corresponding time series of HJ-CCD images were acquired over the study area. In this study, a number of single-stage and multi-stage spectral features, which were sensitive to powdery mildew, were selected by using an independent t-test. With the selected spectral features, four advanced methods: mahalanobis distance, maximum likelihood classifier, partial least square regression and mixture tuned matched filtering were tested and evaluated for their performances in disease mapping. The experimental results showed that all four algorithms could generate disease maps with a generally correct distribution pattern of powdery mildew at the grain filling stage (Zadoks 72). However, by comparing these disease maps with ground survey data (validation samples), all of the four algorithms also produced a variable degree of error in estimating the disease occurrence and severity. Further, we found that the integration of MTMF and PLSR algorithms could result in a significant accuracy improvement of identifying and determining the disease intensity (overall accuracy of 72% increased to 78% and kappa coefficient of 0.49 increased to 0.59). The experimental results also demonstrated that the multi-temporal satellite images have a great potential in crop diseases mapping at a regional scale.