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Background: Patients with lung cancer often experience reduced functional capacity and quality of life after surgery. The current study investigated the impact of a short-term, home-based, multimodal prehabilitation program on perioperative functional capacity in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for nonsmall cell lung cancer (NSCLC)., Methods: A randomized controlled trial was conducted with 73 patients. Patients in the prehabilitation group (n = 37) received a 2-week multimodal intervention program before surgery, including aerobic and resistance exercises, respiratory training, nutrition counseling with whey protein supplementation, and psychological guidance. Patients in the control group (n = 36) received the usual clinical care. The assessors were blinded to the patient allocation. The primary outcome was perioperative functional capacity measured as the 6-minute walk distance (6MWD), which was assessed at 1 day before and 30 days after surgery. A linear mixed-effects model was built to analyze the perioperative 6MWD. Other outcomes included lung function, disability and psychometric evaluations, length of stay (LOS), short-term recovery quality, postoperative complications, and mortality., Results: The median duration of prehabilitation was 15 days. The average 6MWD was 60.9 m higher perioperatively in the prehabilitation group compared to the control group (95% confidence interval [CI], 32.4-89.5; P < .001). There were no differences in lung function, disability and psychological assessment, LOS, short-term recovery quality, postoperative complications, and mortality, except for forced vital capacity (FVC; 0.35 L higher in the prehabilitation group, 95% CI, 0.05-0.66; P = .021)., Conclusions: A 2-week, home-based, multimodal prehabilitation program could produce clinically relevant improvements in perioperative functional capacity in patients undergoing VATS lobectomy for lung cancer.

Background: Little information exists on the lipidemic effects of ozone exposure. Few studies have focused on the different patterns of the association among older adults population, and little attention has been given to comprehensive lipid indices when evaluating the effect of O3 exposure on the metabolism., Methods: We conducted a longitudinal study involving 201 older adults in Beijing, China between 2016 and 2018. A mixed regression model was applied with random effects to investigate the relationship between O3 and lipid profiles., Results: O3 exposure positively correlated with TC, LDL-C, CRI-I, CRI-II and AC at short-term and medium-term exposure periods. The largest increases in TC, LDL-C, CRI-I and CRI-II were found in the 28-days moving average indicating accumulative effects over prolonged exposure period. A 10 μg/m 3 increase of O3 at the 28-days moving average was associated with a significant increase of 3.9% (95% CI: 1.0, 6.9) in TC, 8.2% (95% CI: 4.2, 12.4) in LDL-C, 4.8% (95% CI: 1.1, 8.5) in CRI-I and 7.0% (95% CI: 2.7, 11.5) in CRI-II. Stratification by health status and characteristics revealed different patterns of lipid changes among older adults, lipid status, age, sex and BMI may modify the relationship between O3 exposure and lipid profiles., Conclusions: Our findings suggest that short-term and medium-term O3 exposure is associated with lipid profiles abnormalities among the older adults. Evidence also suggests there are patterns within population which differ according to both health status and demographic characteristics., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Diabetes mellitus (DM) is a common chronic disease worldwide. Ambient air pollution has long been proven to be associated with type 2 diabetes mellitus (T2DM) progression, but the underlying mechanism is not clear yet. In addition, previous studies mainly focused on the prevention of healthy people against the incidence of T2DM. We designed a panel study including two follow-ups and enrolled 39 patients with T2DM living in Beijing. Linear mixed model was fitted to assess the association between two pairs of variables (ambient air pollution exposure and C3 levels, ambient air pollution exposures and T2DM index). Mediation analysis of C3 between ambient air pollution exposure and indicators of T2DM progression was conducted. We found that PM2.5 exposures is are negatively associated with serum complement C3. Given that C3 might act as a protector of pancreas β cell, PM2.5 exposures could accelerate disease in T2DM populations. No mediation effects were found. This study reveals that exposures to PM2.5 can cause progression of diseases among T2DM populations.

Epidemiological studies have demonstrated association between the total mass of fine particulate matter (PM 2.5 ) exposures and inflammation. There are few studies exploring the associations between PM 2.5 constituents and the biomarkers of inflammation in older adults and the underlying biological mechanisms are not exact. In this study, we examined the associations between PM 2.5 and its constituents (organic carbon (OC), elemental carbon (EC), total carbon (TC), polycyclic aromatic hydrocarbons (PAHs) and complement three factor (C3), an important biomarker of inflammation in a repeated panel of 175 older adults in Beijing, China. We have constructed three different linear mixed effect models (single-pollutant model, constituent-PM 2.5 joint model, and constituent-residual model) to evaluate the association of PM 2.5 and its constituents and complement C3, controlling for concentration of high sensitive C-reactive protein (hs-CRP), day of week, mean temperature, relative humidity, location and potential individual confounders. We found robust positive associations of OC, EC, TC, PAHs and PM 2.5 mass concentration with complement C3 at different lag patterns. The cumulative effects of pollutants increased across average of 2-5 days. Individuals aged 65 and above, or with diabetes, or BMI ≥30, or with no-cardiopathy, or with hypertension also exhibited positive associations between PM 2.5 and complement C3. The results revealed that short-term exposure to PM 2.5 and its constituents could result in a significant increase in serum level of complement C3. These findings suggested a possible involvement of complement C3 in the effect of PM 2.5 on inflammatory reaction., (Copyright © 2019. Published by Elsevier Ltd.)

Due to lack of data from multiple air quality monitoring stations, studies about spatial association between concentrations of ambient pollutants and mortality in China are rare. To investigate the spatial variation of association between concentrations of particulate matter less than 10 μm in aerodynamic diameter (PM 10 ) and nitrogen dioxide (NO 2 ) and cardiovascular mortality in Beijing, China, we collected data including daily deaths, concentrations of PM 10 and NO 2 , and meteorological factors from January 1, 2009, to December 31, 2010, in all 16 districts of Beijing. Generalized additive model (GAM) and generalized additive mixed model (GAMM) were used to examine the citywide and district-specific effects of PM 10 and NO 2 on cardiovascular mortality. The citywide effect derived from GAMM was lower than that derived from GAM and the strongest effects were identified for 2-day moving average lag 0-1. For every 10 μg/m 3 increases in concentrations of PM 10 and NO 2 , the corresponding daily cardiovascular mortality increases in 0.31% (95%CI 0.15%, 0.46%) and 1.63% (95%CI 1.11%, 2.13%), respectively. The death risk associated with air pollutants varied across different geographic districts in Beijing. We found spatially varied adverse effects of air pollution on cardiovascular deaths in Beijing. But there was insufficient evidence to show the significant spatial heterogeneity in mortality effects of PM 10 and NO 2 in this study.