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Fifty typical redevelopment industrial sites in the Putuo, Baoshan, Minhang, and Jiangding districts of Shanghai were chosen to evaluate the ecological risk of heavy metals in the soil. The contents of heavy metal (Hg, Cd, Pb, Cr, and As) in 1847 soil samples, taken from vertical sections, were determined, and their risks were evaluated using the Nemero composite index and Hakanson potential ecological risk index. The average contents of Hg, Cd, Pb, Cr, and As in topsoil samples were 0.33, 0.37, 74.55, 69.23, and 9.05 mg·kg -1 , respectively. The contents of Hg, Cd, and Pb exceeded the soil background values of Shanghai, which were 2.75, 2.85, and 2.93 times the background values, respectively. The contents of five heavy metals in soil decreased gradually with increased depth. The contents of heavy metals in deep and saturated soils were close to, or below, the background values, indicating that the anthropic activity disturbance was mainly confined to the topsoil. The accumulation of Hg, Cd, and Pb was the most obvious in Putuo topsoil, with the average contents being 4.25, 4.85, and 3.09 times the background values, respectively. The average contents of Hg and Pb in Baoshan were 4.92 and 6.43 times the background values, respectively. The Nemero Composite Index of Baoshan and Putuo districts were 3.70 and 3.20, respectively, representing heavy pollution level at these sites. The Hakanson potential ecological risk indexes of the Putuo and Baoshang districts were 398.59 and 303.08, respectively, with considerable ecological risk levels. The content and ecological risk of heavy metals at the Minhang and Jiading sites were relatively low. In summary, the pollution of heavy metal in the redeveloped industrial sites is influenced by the operating time, industry type, and past management level of the enterprises. The heavy metal accumulation in the Putuo and Baoshan districts, whose industries developed earlier, were higher than those in the Minhang and Jiading districts. The pollution of heavy metal Hg, Cd, and Pb in soil should be a focus of future work.

Purpose: To develop and validate prediction models of overall survival (OS) for head and neck cancer (HNC) patients based on image biomarkers (IBMs) of the primary tumor and positive lymph nodes (Ln) in combination with clinical parameters., Material and Methods: The study cohort was composed of 289 nasopharyngeal cancer (NPC) patients from China and 298 HNC patients from the Netherlands. Multivariable Cox-regression analysis was performed to select clinical parameters from the NPC and HNC datasets, and IBMs from the NPC dataset. Final prediction models were based on both IBMs and clinical parameters., Results: Multivariable Cox-regression analysis identified three independent IBMs (tumor Volume-density, Run Length Non-uniformity and Ln Major-axis-length). This IBM model showed a concordance(c)-index of 0.72 (95%CI: 0.65-0.79) for the NPC dataset, which performed reasonably with a c-index of 0.67 (95%CI: 0.62-0.72) in the external validation HNC dataset. When IBMs were added in clinical models, the c-index of the NPC and HNC datasets improved to 0.75 (95%CI: 0.68-0.82; p=0.019) and 0.75 (95%CI: 0.70-0.81; p<0.001), respectively., Conclusion: The addition of IBMs from the primary tumor and Ln improved the prognostic performance of the models containing clinical factors only. These combined models may improve pre-treatment individualized prediction of OS for HNC patients., (Copyright © 2017. Published by Elsevier B.V.)

Objective: Obesity is a risk factor for both coronary artery disease (CAD) and chronic renal insufficiency (RI); patients with CAD are prone to obesity and RI. In this study, we try to analyze the effect of body composition on death in CAD patients with mild RI., Design: Retrospective cohort study., Subjects: A total of 1,591 consecutive CAD patients confirmed by coronary angiography were enrolled and met the mild RI criteria by estimated glomerular filtration rate: 60-90 mL/min., Main Outcome Measurements: The influence of body composition on mortality of CAD was detected in different body compositions, including body mass index (BMI), body fat (BF), and lean mass index (LMI). The end points were all-cause mortality. Cox models were used to evaluate the relationship of quintiles of body compositions with all-cause mortality., Results: A survival curve showed that the risk of death was higher in the low BMI group than in the high BMI group (log-rank for overall P = .002); LMI was inversely correlated with risk of death, such that a lower LMI was associated with a higher risk of death (log-rank for overall P < .001). No significant correlation was observed between BF and risk of death. Multifactorial correction show that LMI was still inversely correlated with risk of death (quintile 1: reference; quintile 2: hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.26-0.92; quintile 3: HR: 0.35, 95% CI: 0.17-0.70; quintile 4: HR: 0.41, 95% CI: 0.20-0.85; quintile 5: HR: 0.28, 95% CI: 0.12-0.67)., Conclusion: For CAD patients with mild RI, BMI or BF was unrelated to risk of death, while LMI was inversely correlated with risk of death. A weak "obesity paradox" was observed in this study., (Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Fibrinogen (Fib) was considered to be a potential risk factor for the prognosis of patients with coronary artery disease (CAD), but there was lack of the evidence from Chinese contemporary population. 3020 consecutive patients with CAD confirmed by coronary angiography were enrolled and were grouped into 2 categories by the optimal Fib cut-off value (3.17 g/L) for all-cause mortality prediction. The end points were all-cause mortality and cardiac mortality. Cumulative survival curves showed that the risk of all-cause mortality was significantly higher in patients with Fib ≥3.17 g/L compared to those with Fib <3.17 g/L (mortality rate, 11.5% vs. 5.7%, p < 0.001); and cardiovascular mortality obtained results similar to those mentioned above (cardiac mortality rate, 5.9% vs. 3.6%, p = 0.002). Subgroup analysis showed that elevated Fib levels were predictive for the risk of all-cause mortality in the subgroups according to age, medical history, and diagnosis. COX multivariate regression analysis showed that plasma Fib levels remained independently associated with all-cause mortality after adjustment for multiple cardiovascular risk factors (all-cause mortality, HR 2.01, CI 1.51-2.68, p < 0.001). This study has found that Fib levels were independently associated with the mortality risk in Chinese CAD patients.

The purpose of this study was to discuss the present situation of discharge medications in coronary artery disease (CAD) patients with different levels of renal function and assess the potential impact of these medications on the prognosis of this patient population.A retrospective cohort study was conducted. From July 2008 to Jan 2012, consecutive patients with CAD confirmed by coronary angiography of West China Hospital were enrolled and were grouped into 3 estimated glomerular filtration rate (eGFR) categories: ≥60, 30 to 60, and <30 mL/min/1.73 m. The endpoints were all-cause mortality and cardiac mortality.There are 3002 patients according to the inclusion criteria and follow-up requirement. The mean follow-up time was 29.1 ± 12.5 months. CAD patients with worse renal function included more cardiovascular risk factors (advanced age, history of hypertension or diabetes, and diagnosis of acute myocardial infarction). The cumulative survival curves of the patients according to renal function showed that the eGFR <30 mL/min and 30 mL/min ≤ eGFR <60 mL/min groups had a significantly higher risk of all-cause death and cardiovascular death than the group with an eGFR ≥60 mL/min. The prescription of evidence-based medicines (EBMs) at discharge (antiplatelet agents, beta-blockers, statins, and angiotensin-converting enzyme inhibitors [ACEIs] or angiotensin-receptor blockers [ARBs]) was a factor in reducing the risk of all-cause death and cardiovascular death. However, EBMs prescribed at discharge revealed an obvious underuse in renal insufficiency (RI) patients. The results of Cox regression showed that irrespective of the eGFR level, greater use of EBMs resulted in a greater reduction in the risk of all-cause death and cardiovascular death.A higher percentage of patients with CAD and concomitant RI suffered from cardiovascular disease (CVD) risk factors, whereas a lower percentage of these patients used EBMs to prevent CVD events. Strict use of EBMs, including beta-blockers, statins, and ACEIs or ARBs, can lead to more clinical benefits, even for patients with CAD and concomitant RI. Thus, treatment of this patient population with EBMs should be stressed.

Background: 'Obesity paradox' was not consistently observed in Asians with coronary artery disease (CAD)., Aim: The study investigated the association between body composition and outcomes in Chinese patients with CAD., Design: Cohort study., Method: A total of 3280 patients with angiographically validated CAD were consecutively included. Body fat (BF) percentage and lean mass index (LMI) were evaluated using the Clínica Universidad de Navarra-Body Adiposity Estimator. The rate of mortality from any cause was compared across groups classified by the quartiles of LMI., Results: During a median period of 24 months, 288 (8.8%) participants died. There was a close association between increasing LMI and reducing mortality rate. However, univariate analyses did not find protective effect of BF on survival. After adjusting for age, sex, diabetes, current smoking, systolic blood pressure, creatinine, white blood cell count, haemoglobin and medication, Cox regression analyses showed that the significant relation between higher quartiles (Q) of LMI and survival benefit (Q4, hazard ratio 0.58 (95% confidence interval: 0.36-0.94) vs. Q3, 0.60 (0.39-0.91) vs. Q2, 0.60 (0.41-0.88) vs. Q1, reference) remained., Conclusion: Low LMI but not BF predicts all-cause mortality in Chinese patients with CAD., (© The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Objective: To study the relationship between serum iron(SI) and essential hypertension (EHT) based on population-based samples., Methods: Using clustering multistage sampling method, all the people above 18 years old in the target population were investigated. Blood pressure was measured and the questionnaire was used to find out related factors. Five milliliters fast vein blood were drawn and the serum were used for testing on serum iron (SI) and other elements such as blood sugar, cholesterol (CHOL), triglyceride (TG), high density lipoprotein(HDL-C), low density lipoprotein (LDL-C), serum sodium, serum potassium, serum calcium etc. A case control study was carried out with EHT patients from the selected population as case group, and the other healthy peoples as controls. Database was created by Fox Pro and SPSS 10.0 was used for statistical analysis., Results: The concentrations of SI, with (17.75 +/- 7.66) micromol/ L in EHT group and (17.23 +/- 7.83) micromol/L in control group, showed statistical difference (P < 0.05) between the two groups. The concentrations of SI also showed statistical difference (P < 0.05) between the high DBP and normal group with the average level as (17.84 +/- 7.58) micromol/L in high DBP group and (17.26 +/- 7.85) micromol/L in normal group. Data from monovariate analysis showed that the increase of SI was a risk factor for EHT, DBP and SBP. By multivariate analysis for EHT, while SI still existed in the model (OR = 1.296, 95% CI: 1.057-1.590), but for SBP the results almost remained the same (OR = 1.285, 95% CI:1.102-1.498)., Conclusion: Data from the results showed that SI was probably a risk factor for EHT.