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Exploring the spatiotemporal variations of vegetation net primary productivity (NPP) and analyzing the relationships between NPP and its influencing factors are vital for ecological protection in the Beijing-Tianjin-Hebei (BTH) region. In this study, we employed the CASA model in conjunction with spatiotemporal analysis techniques to estimate and analyze the spatiotemporal variations of NPP in BTH and different ecological function sub-regions over the past two decades. Subsequently, we established three scenarios (actual, climate-driven and land cover-driven) to assess the influencing factors and quantify their relative contributions. The results indicated that the overall NPP in BTH exhibited a discernible upward trend from 2000 to 2020, with a growth rate of 3.83 gC·m -2 a -1 . Furthermore, all six sub-regions exhibited an increase. The Bashang Plateau Ecological Protection Zone (BP) exhibited the highest growth rate (5.03 gC·m -2 a -1 ), while the Low Plains Ecological Restoration Zone (LP) exhibited the lowest (2.07 gC·m -2 a -1 ). Geographically, the stability of NPP exhibited a spatial pattern of gradual increase from west to east. Climate and land cover changes collectively increased NPP by 0.04 TgC·a -1 and 0.07 TgC·a -1 , respectively, in the BTH region. Climate factors were found to have the greatest influence on NPP variations, contributing 40.49% across the BTH region. This influence exhibited a decreasing trend from northwest to southeast, with precipitation identified as the most influential climatic factor compared to temperature and solar radiation. Land cover change has profound effects on ecosystems, which is an important factor on NPP. From 2000 to 2020, 15.45% area of the BTH region underwent land cover type change, resulting in a total increase in NPP of 1.33 TgC. The conversion of grass into forest brought about the 0.89 TgC increase in NPP, which is the largest of all change types. In the area where land cover had undergone change, the land cover factor has been found to be the dominant factor influencing variations in NPP, with an average contribution of 49.37%. In contrast, in the south-central area where there has been no change in land cover, the residual factor has been identified as the most influential factor influencing variations in NPP. Our study highlights the important role of land cover change in influencing NPP variations in BTH. It also offers a novel approach to elucidating the influences of diverse factors on NPP, which is crucial for the scientific assessment of vegetation productivity and carbon sequestration capacity., 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.)

Liquid crystal monomers (LCMs) comprise a class of organic pollutants that have garnered considerable attention because of their dioxin-like toxicity (i.e., modulation of genes) and presence in various environments. However, limited information about the identities, occurrence, and distribution of LCMs has highlighted an urgent need for a high-throughput and sensitive analytical method. In this study, we developed and validated a rapid, simple, sensitive method that involves minimal solvent consumption. The method was applied for the simultaneous detection and identification of 78 LCMs in atmospheric total suspended particulate samples (d ae  < 100 μm) using gas chromatography coupled with triple quadrupole mass spectrometry. The results showed high degrees of linearity with correlation coefficients >0.995 in the concentration range of 5.0-500 ng/mL. The instrumental detection limits ranged from 0.7 to 5.3 pg, and the method detection limits ranged from 0.1 to 0.9 pg/m 3 . The accuracy of the method was between 70 % and 130 % for most analytes, and the relative standard deviations of six replicates were <15 % at three levels of spiking (10, 50, and 200 ng/mL). The developed analytical method was applied to analyze real air particulate samples from Beijing, China. Overall, 45 LCMs ranged from 65.5 to 145.7 pg/m 3 , with a mean concentration of 92.5 pg/m 3 . Among them, (trans,trans)-4-propyl-4'-ethenyl-1,1'-bicyclohexane (PVB) was the most abundant, with an average concentration of 33.6 pg/m 3 . The total estimated daily intakes of LCMs for adults and children were 15.6 and 46.6 pg/kg bw/day, respectively. Accordingly, the method described herein is suitable for quantifying LCMs in atmospheric particulate samples. This study will be valuable for investigating LCM environmental occurrence, behaviors, and risk assessments., 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 B.V. All rights reserved.)

Short-chain and medium-chain chlorinated paraffins (SCCPs and MCCPs) have garnered significant attention because they have persistence and potential toxicity, and can undergo long-distance transport. Chlorinated paraffins (CPs) inhaled in the size-fractionated particulate phase and gas phase can carry different risks to human health due to their ability to accumulate in different regions of the respiratory tract and exhibit varying deposition efficiencies. In our study, large-volume ambient air samples in both the size-fractionated particulate phase (Dp < 1.0 μm, 1.0-2.5 μm, 2.5-10 μm, and Dp ≥ 10 μm) and gas phase were collected simultaneously in Beijing using an active sampler. The overall levels of SCCPs and MCCPs were relatively high, the ranges being 57-881 and 30-385 ng/m 3 , respectively. SCCPs tended to be partitioned in the gas phase (on average 75% of the ΣSCCP concentration), while MCCPs tended to be partitioned in the particulate phase (on average 62% of the ΣMCCP concentration). Significant correlations were discovered between the logarithm-transformed gas-particle partition coefficients (K P ) and predicted subcooled vapor pressures (P L 0 ) (p < 0.01 for SCCPs and MCCPs) and between the logarithm-transformed K P values and octanol-air partition coefficients (K OA ) (p < 0.01 for SCCPs and MCCPs). Thus, the slopes indicated that organic matter absorption was the dominant process involved in gas-particle partitioning. We used the ICRP model to calculate deposition concentrations for particulate-associated CPs in head airways region (15.6-71.4 ng/m³), tracheobronchial region (0.8-4.8 ng/m³), and alveolar region (5.1-21.9 ng/m³), then combined these concentrations with the CP concentrations in the gas phase to calculate estimated daily intakes (EDIs) for inhalation. The EDIs for SCCPs and MCCPs through inhalation of ambient air for the all-ages group were 67.5-184.2 ng/kg/day and 19.7-53.7 ng/kg/day, respectively. The results indicated that SCCPs and MCCPs in ambient air do not currently pose strong risks to human health in the study area., 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.)

Objectives: To determine factors associated with late and delayed antiretroviral therapy (ART) initiation in China and provide evidence for HIV prevention. Methods: Logistics regression model was used to determine factors associated with three outcomes: late (CD4 cell count <200 cells/µL or clinical AIDS diagnosis prior to ART initiation), delayed (more than 1 month between HIV diagnosis date and ART initiation) and either late or delayed ART initiation. Results: Multivariable analysis revealed that male, heterosexual, HIV diagnosis before 2014, HBV/HCV seropositive, and tuberculosis were associated with increased odds of all three outcomes. Conversely, married or cohabiting patients were less likely to have delayed ART initiation and either late or delayed ART initiation, while people who inject drugs were more likely to have these two outcomes. Additionally, older age was associated with an increased risk of having either late or delayed ART initiation, but a decreased risk of delayed ART initiation. Conclusion: The proportion of late and delayed ART initiation decreased significantly after the release of the 2016 guidelines in China. To further improve late diagnosis and early treatment, precise interventions for key populations are required., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Mi, Zhou, Zeng, Wang, Gao and Cheng.)

This study was performed to investigate and compare the association of albuminuria with the brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) in a community-based population in Beijing. Subjects were enrolled from a follow-up survey conducted in 2018 from an atherosclerosis cohort in Shijingshan district, Beijing, China. The baPWV and cfPWV were measured using a BP-203 RPE III arteriosclerosis detection device and PulsePen, respectively. Albuminuria was defined as a urinary albumin-creatinine ratio of ≥30 mg/g. A multivariate logistic regression model was used to evaluate the impacts of different PWV measurements on the prevalence of albuminuria. In total, 5605 subjects were included in the analyses. Their mean age was 62.22 ± 7.55 years, and the prevalence of albuminuria was 8.22%. In the multivariate logistic regression model adjusted for potential covariates, both baPWV (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.03-1.10; P < 0.001) and cfPWV (OR, 1.07; 95% CI, 1.01-1.14; P = 0.018) were significantly associated with albuminuria. Furthermore, when baPWV and cfPWV were entered into the logistic regression model simultaneously, only baPWV was significantly associated with albuminuria using either continuous value (OR, 1.05; 95% CI, 1.01-1.10; P = 0.007) or classified into quartiles (highest vs. lowest value group: OR, 1.55; 95% CI, 1.01-2.37; P for trend = 0.019). Both cfPWV and baPWV were positively associated with albuminuria, while baPWV had a stronger relationship than cfPWV. Thus, baPWV measurement could be considered for the purpose of community health screening., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Electric vehicle charging points (EVCPs) are the foundation of the EV industry and are conducive to low-carbon transportation development. Research on EVCPs mainly focus on operation profits and layout, while no study assesses their economic premium. Aiming at providing a reference for the installation of EVCPs, this study employs a hedonic price model to evaluate the economic premium of CPs, based on apartment transactions and complex data on CPs in 2015 and 2016 in Beijing. The primary findings indicate the economic premium of CPs is significantly positive in both housing sale and rental markets. However, the impact of CPs on housing prices is heterogeneous in terms of complex floor area ratio and location. Specifically, the premium effect of CPs is more significant in larger complex and complex in the suburb. Following the above conclusions, we provide several policy pathways to promote the construction of CPs and their scientific location layout., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Pulse wave velocity (PWV) is the most widely used measurement of arterial stiffness in clinical practice. This study aimed to evaluate and compare the relationships between carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle PWV (baPWV) and the presence of carotid plaque. This study was designed cross-sectionally and included 6027 participants from a community-based cohort in Beijing. Logistic regression analyses were performed to evaluate and compare the associations of cfPWV and baPWV with the presence of carotid plaque. The mean (SD) cfPWV and baPWV were 8.55 ± 1.83 and 16.79 ± 3.36, respectively. The prevalence of carotid plaque was 45.26% (n = 2728). Both cfPWV (per 1 m/s increase: OR = 1.11, 95% CI: 1.07-1.16) and baPWV (OR = 1.04, 95% CI: 1.02-1.06) were independently associated with carotid plaque after adjusting for various confounders. Compared with bottom quartile (cfPWV ≤7.31 m/s and baPWV ≤14.44 m/s), the top quartile of cfPWV and baPWV had a significantly higher prevalence of carotid plaque (for cfPWV: OR = 1.59, 95% CI: 1.32-1.92; for baPWV: OR = 1.53, 95% CI: 1.26-1.86). However, the relationship of baPWV and carotid plaque was nonlinear, with a positive trend only when baPWV < 16.85 m/s. When comparing relationships between PWV indices and carotid plaque in one model, both cfPWV and baPWV were significantly associated with carotid plaque in participants with baPWV < 16.85 m/s; however, only cfPWV was independently associated with carotid plaque in participants with baPWV ≥16.85 m/s. Both cfPWV and baPWV were significantly associated with carotid plaque in the Chinese community-based population. Furthermore, cfPWV was more strongly correlated with carotid plaque than baPWV in participants with baseline baPWV ≥16.85 m/s., (© 2022 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.)

Aims: The aim of this study was to investigate the prevalence of potentially inappropriate medication (PIM) prescribing and its number-dependent association (PIM = 1, 2, ≥3) with all-cause hospitalizations, emergency department (ED) visits, and medication expenditures in Beijing, China., Methods: A retrospective cohort analysis was conducted to analyse PIM prescribing in community-dwelling older adults aged ≥65 years within the Beijing Municipal Medical Insurance Database (data from July to September 2016). The prevalence of PIMs was estimated based on the 2015 Beers Criteria. Logistic models were utilized to investigate the associations between PIM use and all-cause hospitalizations and ED visits. Generalized linear models with the logic link and gamma distribution were used to analyse associations between PIM use and medication expenditures., Results: Among the 506 214 older adults, the prevalence of PIM was 38.07%. After adjusting for covariables, prescribing two and three or more PIMs was associated with increased risks of hospitalizations (PIM = 2: odds ratio [OR] 1.34, 95% confidence interval [CI]: 1.22-1.47; PIM ≥ 3: OR = 1.47, 95% CI: 1.32-1.63) and ED visits (PIM = 2: OR = 1.29, 95% CI 1.12-1.48; PIM ≥ 3: OR = 1.23, 95% CI: 1.04-1.44). Exposures to two and three or more PIMs were associated with higher medication expenditures for inpatient visits (PIM = 2: incidence rate ratio [IRR] = 1.08, 95% CI 1.01-1.16; PIM ≥ 3: IRR = 1.18, 95% CI: 1.08-1.28). Vasodilators were the most frequent PIM prescribing group among patients who were hospitalized or had to visit the ED., Conclusions: PIMs were prescribed at a high rate among community-dwelling older adults in Beijing. Two or more PIMs were associated with increased risks of hospitalizations, ED visits, and increased inpatient medication expenditures. Effective interventions are needed to target unnecessary and inappropriate medications in older adults., (© 2022 British Pharmacological Society.)

To reduce the heavy reliance of public hospitals on drug sales and use of advanced technologies and to contain the escalating medical expenditures, Beijing implemented two rounds of comprehensive public hospital reform in 2017 and 2019, respectively. The first round focused on separating drug sales from hospital revenue (reform1), and the second round extended to include zero markup on medical consumables and price adjustments for medical services (reform2). To estimate how these two rounds of reform have affected public hospitals' revenue structures, we used observational data of medical revenues from 2016 to 2019 covering 354 healthcare facilities. A Panel-interrupted time-series (PITS) model was used to analyze the effects. The results suggest that the reforms have changed the structure of public hospitals' revenues. The proportion of drug sales in hospital revenues fell from 43.96% in 2016 (pre-reform) to 34.08% in 2019 (post-reform); the proportions of medical consumables decreased by 0.73% after reform 2; and the proportion of medical consultation service fees increased from 15.16% in 2016 to 24.51% in 2019. PITS analysis showed that the proportion of drug sales dropped by 5.46% in the month of reform 1, and it dropped by 0.20% per month on average after reform 2(p < 0.001). The proportion of medical consumables decreased by 0.04% per month on average after reform 2 (p < 0.001). The proportion of medical consultation service increased by 7.13% in the month of reform 1, and it increased by 0.14% per month on average after reform 2(p < 0.001). Similar trends were seen in hospital revenue structures from both inpatient services and from outpatient and accident and emergency services. Thus, Beijing's reforms successfully contained rising medical expenditures and optimized hospitals' revenue structures. These reforms can provide a reference for further public hospital reforms in China and other countries with similar systems., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Polycyclic aromatic hydrocarbons (PAHs) are mutagenic and carcinogenic. 16 PAHs as priority pollutants listed by the US Environmental Protection Agency were usually monitored. Therefore, multiple potentially toxic polycyclic aromatic compounds (PACs) are not monitored. In this study, atmospheric particulate matter samples from Beijing were analyzed using atmospheric pressure photoionization (APPI) Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry and comprehensive two-dimensional gas chromatography-time-of-flight (GC × GC-TOF) mass spectrometry. The FT-ICR data detected high molecular weight PAHs, alkylated PAHs (APAHs) and heteroatom PAHs. The GC × GC-TOF data tentatively identified 386 PACs in five categories of identification confidence. Twenty-one spectra in the unknown class were manually resolved. Eighty-two PACs with high identification confidence were proposed for further research. The identities of five PAHs and five APAHs that are currently not regulated were confirmed using available standards and quantified in some samples. Some of these PACs, such as dibenzo[a,e]pyrene (C 22 H 14 ) and 1-methylpyrene (C 17 H 12 ), should be of concern because of their contamination levels and the high toxicities of themselves and/or their derivatives. This study highlights the possibility of expanding the traditional lists of PAHs to improve pollution control and risk assessment accuracy.

The associations between children's pocket money and their eating behaviors and weight status have not been examined using longitudinal data in China. Examined child and parental factors associated with children's pocket money, and longitudinal effects of pocket money on children's eating behaviors and weight status. Data were collected in 2015, 2016, and 2017 from 3261 school-age children and their parents in mega-cities across China (Beijing, Shanghai, Nanjing, Xi'an, Chengdu). Children's weight, height, and waist circumference were measured; pocket money and eating behaviors were self-reported. Mixed effect models were used. Older children received more pocket money than younger children (incident rate ratio (IRR) = 1.21, 95% confidence interval (CI): 1.15, 1.26). Fathers gave their children more pocket money than mothers did (IRR = 1.22, 95% CI: 1.16, 1.30). Children with fathers having ≥ college education received more pocket money than the others did (IRR = 1.20, 95% CI: 1.04, 1.40). Some nutrition-related parenting behaviors and attitude were also associated with children's pocket money. Compared with children receiving no weekly pocket money, those having 1-10 or 10-30 or >30-yuan weekly pocket money were 12.0-136% more likely to consume unhealthy foods and were 66-132% more likely to be overweight or obese. Some child and parental factors were associated with children's pocket money, which increased risks of having unhealthy eating behaviors and being overweight and obese.

Objectives: This study sought to investigate the relationship between occlusion length and long-term outcomes of patients with recanalised chronic total occlusion (CTO) lesion., Design: A retrospective cohort study., Setting: Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China PARTICIPANTS: Consecutive patients with successfully recanalised CTO were included from January 2010 to December 2013., Primary and Secondary Outcome Measures: The primary endpoint of the present study was a composite event of all-cause death and myocardial infarction (MI). The secondary endpoints included target lesion revascularisation (TLR) and target vessel revascularisation (TVR)., Results: A total of 1987 patients were included and 1801 (90.6%) subjects completed 5-year follow-up in this study. Based on occlusion length, the patients were divided equally into two groups: short (length <15 mm, n=957) and long (length ≥15 mm, n=1030) CTO group. Kaplan-Meier survival curve showed no significant difference in the risk of the composite primary endpoint between short and long CTO groups (p=0.242). Receiver operating characteristic curve analysis also established occlusion length ≥15 mm as a cut-off value for predicting TLR and TVR, with an area under the curve of 0.604 (95% CI: 0.569 to 0.638, p<0.001) and 0.605 (95% CI: 0.572 to 0.638; p<0.001). Kaplan-Meier analysis revealed that the risks for TLR (p=0.002) and TVR (p=0.002) were higher in a patient with long CTO lesion. Multivariate Cox analysis also identified long CTO lesion as an independent predictor of TLR (HR: 1.539, 95% CI: 1.033 to 2.293; p=0.034) and TVR (HR: 1.476, 95% CI: 1.012 to 2.151; p=0.043)., Conclusion: Patients with long CTO lesion did not show a higher risk of death and MI after recanalisation, but had higher risks of TLR and TVR. Lesion with occlusion length ≥15 mm should be under close surveillance for restenosis after recanalisation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Aim: To explore the prevalence of unknown diabetes (DM) or prediabetes (pre-DM) in "nondiabetic" patients and its association with 2-year clinical outcomes after primary percutaneous coronary intervention (PCI)., Methods and Results: 5202 consecutive "nondiabetic" patients who underwent primary PCI at Fuwai Hospital from January to December 2013 were prospectively enrolled. The patients were grouped according to their glycemia status: unknown DM (HbA1c ≥ 47 mmol/L; FPG≥ 7.0 mmol/L), pre-DM (HbA1c 39-47 mmol/L; FPG: 5.6-6.9 mmol/L) and normoglycemia (NG, HbA1c < 39 mmol/L; FPG < 5.6 mmol/L). The main endpoint was 2-year major adverse cardiovascular events (MACE), including cardiac death, myocardial infarction, and target vessel revascularization. A total of 905 patients had unknown DM, and 3407 patients had pre-DM. Unknown DM and pre-DM were associated with aging (p < 0.001); a greater proportion of hypertension (p < 0.001), previous myocardial infarction (p < 0.001), and chronic kidney disease (p = 0.004). During the 2-year follow-up, the rate of MACE was significantly higher in the unknown DM and pre-DM groups than in the NG group (8.1% vs. 5.8% vs. 4.1%, respectively, p = 0.001). Multivariate analyses demonstrated that unknown DM was associated with a 1.9-fold higher event risk compared to NG (95% CI: 1.2-2.8)., Conclusions: The prevalence of abnormal glucose metabolism was high in "nondiabetic" Chinese PCI patients. Patients with unknown DM and pre-DM had higher event risks than those with NG. In "nondiabetes" patients requiring PCI, routine assessment of HbA1c and FPG appears to be of value to identify patients with an increased event risk., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2019. Published by Elsevier B.V.)

Background: To evaluate and compare the results of three different cervical cancer screening strategies including cytology screening, HR-HPV screening which taking HR-HPV testing as primary test and co-testing which taking both tests at the same time, then provide evidence to explore whether the cervical cancer screening can be conducted in community healthcare centers in Beijing., Methods: 182,119 women aged between 35 and 64, who were screened in the primary healthcare facilities of nine districts in Beijing from January 2014 to March 2015, were enrolled in this study. Cytology screening was performed in participants during January 2014 and December 2014 as a conventional arm. HR-HPV screening strategy and co-testing were randomly allocated to participants on districts level as experimental arm 1 and 2 during January 2015 and March 2015. Cervical Intraepithelial Neoplasia grade 2 or worse (CIN 2+) was defined as endpoint. The screening results and costs to detect a case of three strategies were calculated., Results: The positivity rate, colposcopy referral rate and biopsy referral rate of co-testing were 8.46%, 6.36% and 4.65% respectively, which were all significantly higher than the other two screening strategies. The detection rate of CIN 2+ by co-testing was 5.06‰ and was much more than the other two screening strategies, while the HR-HPV screening had the highest PPV of 14.40%. The HR-HPV screening ignores some lesion which can be found by co-testing. Co-testing refers a woman to colposcopy with a positive screening result at the least cost, but it costs the most to detect a CIN 2+ case., Conclusions: To detect more cases of CIN 2+, co-testing performs better although with the most cost. And the primary healthcare facilities in Beijing have the capability to carry out the cervical cancer screen programs and prompts women with positive screen results to the hospital., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Although Chinese government has implemented a series of laws, regulations, and policies to deal with air pollutants, air pollution is still one of the biggest concerns in China. Most of the cities in China suffered from extremely high air pollution levels and cannot meet the national air quality standards. In this study, we attempt to measure individuals' average marginal willingness to pay (MWTP) in Beijing with the hedonic price model. We combine an extensive housing transaction dataset with emission data of six air pollutants from 2013 to 2016 in Beijing, China. When estimating the hedonic price function, we apply both ordinary least squares (OLS) and panel model with various fixed effects to better control for unobservables. The empirical results reveal that the concentrations of CO, NO 2 , PM 2.5 , and PM 10 are significantly negatively correlated with housing prices. However, we found an insignificant relationship with the concentration of SO 2 and the concentration of O 3 appears to positively increase the housing values. Policy implications based on these results were also discussed.

Background: With the advancements of percutaneous coronary interventions (PCI), it is not clear whether unprotected left main (ULM) coronary artery disease (CAD) remains an independent predictor of adverse outcomes after PCI therapy. We have therefore carried out a large cohort study to investigate the impact of ULM disease on 2-year clinical outcomes in Chinese patients undergoing contemporary PCI treatment., Methods and Results: From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI were prospectively collected. Two-year clinical outcomes were compared for patients undergoing ULM PCI and non-ULM PCI. Among the 10 724 patients, 272 (2.5%) patients underwent ULM PCI. Overall, these patients had higher baseline clinical risks of CAD and more extensive CAD compared with non-ULM PCI patients. During the 2-year follow-up, patients who underwent ULM PCI experienced higher incidence of cardiac death (2.2 vs. 0.7%; log-rank P=0.002), myocardial infarction (7.0 vs. 1.9%; log-rank P<0.001), stroke (2.9 vs. 1.3%; log-rank P=0.02), and definite and probable stent thrombosis (3.3 vs. 0.5%; log-rank P<0.001), than patients who underwent non-ULM PCI. However, the rates of revascularization (7.4 vs. 8.7%; log-rank P=0.48), target vessel revascularization (5.5 vs. 5.0%; log-rank P=0.66), and major adverse cardiac and cerebrovascular events (15.1 vs. 12.0%; log-rank P=0.11) were not significantly different between the groups. When performing adjusted Cox regression after propensity score matching, ULM PCI was not an independent risk factor of any clinical events (all P>0.05)., Conclusion: In this large cohort of patients who underwent modern PCI, ULM PCI patients had higher baseline clinical risks and poorer prognosis during 2-year follow-up. However, after multivariate analysis, ULM PCI was not an independent risk factor of any clinical adverse events.

In recent years, the haze incidents have occurred frequently in China. Therefore, more attention should be taken in comprehensively determination and analysis of the extended-ranges of volatile organic compounds (VOCs). Here, up to 99 non-methane VOCs (NMVOCs), including not frequently reported partial halocarbons and oxygenated VOC (OVOC) species, were monitored in atmosphere of Beijing. The mean concentration of total NMVOC (TNMVOC) decreased in the order of winter polluted days (216.05 μg m -3 ) > summer polluted days (127.01 μg m -3 ) > summer normal days (95.63 μg m -3 ) > winter normal days (50.25 μg m -3 ). The ethane to n-butane, ethylene to 1-butene, BTEX, acetaldehyde, acetone, n-hexanal, dichloromethane, chloroform and 1,2-dichloroethane, were determined to be the main composition in their respective alkane, alkene, aromatic, OVOC and halocarbon classes. The minor propylbenzene, diethylbenzene, ethyltoluene, and trimethylbenzene isomer ratios were within the narrow range of 1.3-3.21. Generally, the most abundant NMVOCs were alkanes in winter but OVOCs in summer. TNMVOC significantly positively correlated with PM 10 , PM 2.5 , CO, RH, SO 2 (winter), NO 2 (winter), but negatively with windspeed, SSD and PRS (winter). The opposite correlation was observed between TNMVOC and O 3 in winter and summer. There was no meaningful correlation between TNMVOC and T, PRS (summer), SO 2 (summer) and NO 2 (summer). 3D surface graphs, built by MATLAB, were drawn to investigate the relationship between PM 2.5 and NMVOC taking air quality parameters into account. The PM 2.5 concentration increased non-linearly as TNMVOC concentration increased, with various surface graphs. Unlike other air quality parameters, O 3 affected the relationship differently between winter and summer. The findings presented herein may provide a new train of thought for occurrence of haze., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objectives: We aimed to investigate the prevalence of iron deficiency (ID) in congenital heart disease associated with pulmonary arterial hypertension (CHD-PAH) and to explore the influence of ID on CHD-PAH patients. What was associated with ID in these patients was also looked into., Design: One hundred and fifty-three patients who were newly diagnosed with CHD-PAH were enrolled. Patients were divided into iron-deficient and iron-replete groups according to the following criteria. ID was defined as transferrin saturation <20% in male and transferrin saturation <25% in female. Clinical data of all participants were collected and compared. Logistic regression was performed to explore factors associated with ID in CHD-PAH., Results: Thirty-nine percent of 153 CHD-PAH patients were founded with ID. Iron-deficient group had greater proportion of female patients, shorter six minutes walking distance (6-MWD), higher N-terminal pro-brain natriuretic peptide levels, lower creatinine levels, greater ratio of diastolic right ventricle diameter to left ventricle diameter. Female (OR = 15.44, 95%CI 4.91-48.54, p < .01), 6-MWD (OR = 0.99, 95%CI 0.98-1.00, p = .02) and mean right atrial pressure (OR = 1.13, 95%CI 1.02-1.26, p = .02) were independently associated with ID in the overall CHD-PAH patients. Menstruation was independently associated with ID in the female subgroup (OR = 3.88, 95%CI 1.09-13.84, p = .04)., Conclusions: ID was highly prevalent in CHD-PAH patients. Worse exercise tolerance and right heart function were observed in iron-deficient patients with CHD-PAH. Female, 6-MWD, mean right atrial pressure and menstruation are important variables indicating the presence of ID in CHD-PAH.

Multiple studies have demonstrated the occurrences of short-chain chlorinated paraffins (SCCPs) and medium-chain chlorinated paraffins (MCCPs) in environmental matrixes, but human internal exposure to them has been studied rarely. Mass fractions and congener group patterns of SCCPs and MCCPs in paired maternal and cord serum were studied for the first time to investigate the placental transport mechanism and prenatal exposure risks of CPs. Samples were collected in Beijing, China, and analyzed using two-dimensional gas chromatography coupled to time-of-flight mass spectrometry. SCCP and MCCP mass fractions in maternal serum were 21.7-373 and 3.76-31.8 ng/g ww, respectively. They were 8.51-107 and 1.33-12.9 ng/g ww, respectively, in cord serum. Significant positive correlation between SCCP and MCCP levels in maternal serum was found ( p < 0.01), suggesting SCCPs and MCCPs may undergo similar accumulation, transfer, and transformation pathways. The predominant congener groups for SCCP and MCCP in maternal serum were C 10-11 Cl 6-7 and C 14 Cl 7-8 . The homologue profiles of CPs in cord serum were similar but with varied contribution percentage compared with those in maternal serum. By calculating and comparing cord-maternal serum ratios for each individual congener group, passive diffusion was recognized to be the possible placental transport form. The relationships between CP and thyroid hormone concentrations (THs) indicated that exposure to CPs might affect circulating TSHs. C 9 -CPs were also detected, improving our understanding of CPs in human serum.

Artery stiffness is an independent marker for atherosclerotic cardiovascular diseases. However, whether the brachial-ankle pulse wave velocity (ba-PWV) is related to new carotid plaque formation is unresolved. This study aimed to investigate the association between baseline ba-PWV and new carotid plaque formation in a Chinese community-based population without carotid plaques at baseline. This study population consisted of a total of 738 participants from an atherosclerosis cohort in Beijing, China. After a mean 2.3-year follow-up, the incidence of carotid plaques were 21.2% and 36.5% in the groups with ba-PWV < 1,400 cm/s and ≥1,400 cm/s, respectively. Compared with baseline ba-PWV < 1,400 cm/s group, ba-PWV ≥ 1,400 cm/s group was significantly associated with the incidence of new carotid plaque formation (odds ratio [OR] = 2.14, 95% CI: 1.50-3.03, P < 0.01), even after adjusting for common risk factors (OR = 1.52, 95% CI: 1.02-2.25, P = 0.04). Furthermore, there was a strong relationship between baseline ba-PWV and carotid plaque formation in subjects with ba-PWV < 1,400 cm/s, but no such relationship was found in subjects with baseline ba-PWV ≥ 1,400 cm/s. In conclusion, this study suggests that baseline ba-PWV is independently associated with the risk of carotid plaque formation in a Chinese community-based population.

Objective: The aim of this study was to evaluate the efficacy and safety of long-term treatment with Cimicifuga foetida extract in menopausal women., Methods: A prospective, randomized, controlled clinical trial was conducted. A total of 96 early postmenopausal women were randomly assigned to three groups: group A received 1 mg estradiol valerate daily plus 4 mg medroxyprogesterone acetate on days 19-30; group B received 1 mg estradiol valerate daily plus 100 mg micronized progesterone on days 19-30; group C received 100 mg C. foetida extract daily. The efficacy was evaluated. Safety parameters were recorded., Results: A total of 81 patients completed the treatment and follow-up visit. The modified Kupperman Menopausal Index scores decreased after 3 months in all groups. No significant changes were observed in the liver, renal function and components of metabolic syndrome in group C (p > 0.05). There were no significant differences in the incidences of metabolic syndrome among the three groups (p > 0.05). After 24 months, the endometrial thickness increased significantly in group B (p = 0.014), but not in the C. foetida extract group (p > 0.05)., Conclusions: C. foetida extract is safe and effective for the treatment of menopausal symptoms in postmenopausal women.

Objective: Coiled-coil-helix-coiled-coil-helix domain containing 5 (CHCHD5), a mitochondrial protein, is involved in the oxidative folding process in the mitochondrial intermembrane space. A previous study identified a hypertension-related single nucleotide polymorphism (SNP), rs3748024, in CHCHD5 in adults, but there are no reports regarding the association between CHCHD5 and obesity, which is a known risk factor for hypertension. The aim of the present study is to investigate the associations of the SNP rs3748024 with hypertension and obesity., Design: Cohort study., Setting: Institute of Pediatrics in China., Participants: We genotyped the SNP rs3748024 in the Beijing Child and Adolescent Metabolic Syndrome study. A total of 3503 children participated in the study., Primary and Secondary Outcome Measures: Genotyping of rs3748024 was conducted using the TaqMan Allelic Discrimination Assay. Lipids and glucose were analysed by an automatic biochemical analyser using a kit assay. The levels of adipocytokines (leptin, adiponectin and resistin) were measured by ELISA techniques., Results: There was a statistically significant association between rs3748024 and systolic blood pressure (SBP) (β=-0.853, 95% CI -1.482 to -0.024, p=0.044) under an additive model adjusted for age, gender and body mass index (BMI) after correction for multiple testing. The SNP was also significantly associated with BMI (β=-0.286, 95% CI -0.551 to -0.021, p=0.043), obesity (OR=0.828, 95% CI 0.723 to 0.949, p=0.018) and triglycerides (β=-0.039, 95% CI -0.070 to -0.007, p=0.044) after correction for multiple testing., Conclusions: We demonstrate for the first time that the SNP rs3748024 in CHCHD5 is associated with SBP, BMI, obesity and triglycerides in Chinese children. Our study identifies a new risk locus for hypertension and obesity in a child population. The function of CHCHD5 remains to be further studied to help elucidate the pathogenic role of CHCHD5 in hypertension and obesity., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The occurrence and distribution of 13 target compounds, including eight parabens, four chlorinated parabens and p-hydroxybenzoic acid (PHBA), were detected in surface water samples at 35 sampling sites in the Beijing River system, China. The surface water samples were collected from the main rivers and lakes in the urban area monthly from July 2013 to June 2014 (except the frozen period). Laboratory analyses revealed that parabens were ubiquitous in the surface water of Beijing. PHBA was the predominant compound in the surface water samples, with the average concentration of 239ngL(-1), followed by the total amount of chlorinated parabens (average 50.1ng/L) and parabens (average 44.3ng/L). It is noteworthy that octylparaben with longer chain was firstly detected in the surface water. Significant difference was observed for paraben concentrations from different sampling sites, and the highest level of parabens was found in the Xiaotaihou River, which was mainly due to the untreated sewage discharge. Seasonal variation of target compounds in the urban surface water was also studied, and parabens exhibited a different temporal variation from chlorinated derivatives. A combination of factors including high residual chlorine level and water temperature as well as intense ultraviolet radiation might enhance the persistence of chlorinated parabens in chlorinated water during the wet season. Risk assessment showed that parabens and their chlorinated derivatives are not likely to produce biological effects on aquatic ecosystems at current levels in the surface water of Beijing., (Copyright © 2015 Elsevier B.V. All rights reserved.)