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Background: The prevalence and characteristics of inappropriate use of proton pump inhibitors (PPIs) to prevent stress-related mucosal disease (SRMD) during the perioperative period and its associated factors are rarely reported. This study aimed to investigate the prevalence and characteristics of inappropriate prophylactic use of proton pump inhibitors (PPIs) during the perioperative period and identify its associated factors in a tertiary care and academic teaching hospital in China and to provide evidence for regulation authorities and pharmacists to take targeted measures to promote rational drug use. Methods: Inpatients who underwent surgical operations and received prophylactic use of PPIs from June 2022 to November 2022 were included in this retrospective study. The appropriateness of perioperative prophylactic use of PPIs was evaluated by clinical pharmacists. Associated factors with inappropriate perioperative prophylactic use of PPIs were analyzed by univariable and multivariable logistic regression. Results: Four-hundred seventy-two patients were finally included in this study, of which 131 (27.75%) patients had at least one problem with inappropriate perioperative prophylactic use of PPIs. The three most common problems were drug use without indication (52.0%), inappropriate usage and dosage (34.6%), and inappropriate duration of medication (6.7%). Multiple logistic regression analysis showed that oral dosage form of PPIs [OR = 18.301, 95% CI (7.497, 44.671), p < 0.001], discharge medication of PPIs [OR = 11.739, 95% CI (1.289, 106.886), p = 0.029], and junior doctors [OR = 9.167, 95% CI (3.459, 24.299), p < 0.001] were associated with more inappropriate prophylactic use of PPIs. Antithrombotics [OR = 0.313, 95% CI (0.136, 0.721), p = 0.006] and prolonged postoperative hospital stay (longer than 15 days) [OR = 0.262, 95% CI (0.072, 0.951), p = 0.042] were associated with less inappropriate prophylactic use of PPIs. Conclusions: The inappropriate prophylactic use of PPIs during the perioperative period is common. Regulation authorities and pharmacists should take more targeted measures to promote the rational prophylactic use of PPIs during the perioperative period. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of neutrophil-to-lymphocyte ratio (NLR) and preoperative prognostic nutritional index (PNI) on prognosis of gastric cancer (GC) after adjuvant FOLFOX chemotherapy. Materials and Methods: Data on 749 GC patients who received operation after by adjuvant FOLFOX chemotherapy between January 2013 and December 2015 were enrolled in this study, retrospectively. Receiver-operating characteristic curve analysis was employed to assess optimal cutoff thresholds for PNI and NLR. The GC subjects having a low PNI (<52.8) and high NLR (>1.79) received a score of 2. Any variable that met these standards was scored as 1. If none of the two variables met these standards of the patient was assigned a score of 0. Correlation between PNI-NLR score and GC stage was also evaluated. Results: The mean overall survival (OS) and 5-year OS rate for subjects with PNI-NLR = 2 was lower than those of subjects with PNI-NLR = 1, or 0 (40.9% vs. 52.1%, 76.4% [46.0 vs. 61.0], 68.0 months, p ≤ 0.001). In multivariate analyses, the PNI-NLR score (p ≤ 0.001) and WHO grade (p ≤ 0.001) showed potential to independently influence OS. Conclusions: High PNI-NLR scores can independently affect worse prognosis of GC. Thus, it can be utilized to differentiate low risk from high risk subjects. [ABSTRACT FROM AUTHOR]

In China, reports on the epidemiology of adenocarcinomas of the nasal cavity and paranasal sinuses are limited. This study aimed to describe the experience of a single institution in China in treating these malignant tumours. We conducted a retrospective chart review of patients with adenocarcinoma of the nasal cavity and paranasal sinuses admitted between January 2019 and December 2021. Tumour staging was based on the American Joint Committee on Cancer, 8th edition, for sinonasal malignancies. The series included 10 men and 4 women (mean age, 54.5 [range, 14–80] years). Epistaxis and nasal obstruction were the most common clinical manifestations in 10 (71.4%) patients. Ten (71.4%) had stage T4 disease at diagnosis, but no patient had lymph node or distant metastasis. The posterosuperior septum (100.0%) and middle turbinate (92.8%) were the two sites most vulnerable to tumour invasion. All patients underwent endoscopic resection as the initial treatment; one patient died. In China, these malignancies are related to exposure to certain substances; however, diagnosis can be delayed. Endoscopic resection is a suitable treatment option for adenocarcinomas of the nasal cavity and paranasal sinuses. [ABSTRACT FROM AUTHOR]

The environment of healthcare institutes (HCIs) potentially affects the internal microecology of medical workers, which is reflected not only in the well-studied gut microbiome but also in the more susceptible oral microbiome. We conducted a prospective cross-sectional cohort study in four hospital departments in Central China. Oropharyngeal swabs from 65 healthcare workers were collected and analyzed using 16S rRNA gene amplicon sequencing. The oral microbiome of healthcare workers exhibited prominent deviations in diversity, microbial structure, and predicted function. The coronary care unit (CCU) samples exhibited robust features and stability, with significantly higher abundances of genera such as Haemophilus, Fusobacterium, and Streptococcus, and a lower abundance of Prevotella. Functional prediction analysis showed that vitamin, nucleotide, and amino acid metabolisms were significantly different among the four departments. The CCU group was at a potential risk of developing periodontal disease owing to the increased abundance of F. nucleatum. Additionally, oral microbial diversification of healthcare workers was related to seniority. We described the oral microbiome profile of healthcare workers in different clinical scenarios and demonstrated that community diversity, structure, and potential functions differed markedly among departments. Intense modulation of the oral microbiome of healthcare workers occurs because of their original departments, especially in the CCU. [ABSTRACT FROM AUTHOR]

What is Known and Objectives: Potential inappropriate medications (PIMs) can increase the risk of medication‐induced harm. However, there are no studies regarding PIMs in older and critically ill patients with cardiovascular diseases in China. Therefore, studies evaluating PIMs in these patients can help in the implementation of more effective interventions to reduce the risk of drug use. Our objective was to analyse the prevalence of PIMs in elderly patients admitted to the cardiac intensive care unit (CICU) comparing the 2019 Beers criteria (Beers criteria), Screening Tool of Older People's Potentially Inappropriate Prescriptions (STOPP) criteria version 2 (STOPP criteria) and criteria of potentially inappropriate medications for older adults in China (Chinese criteria); and analyse the factors influencing the PIMs. Methods: This cross‐sectional and retrospective study was performed with elderly patients (≥65 years) admitted to the CICU of the Beijing Tongren Hospital in China from January 2019 to June 2020. The PIMs were identified based on the Chinese, STOPP and Beers criteria at admission and discharge. The three criteria were compared using the Kappa statistic. Multiple regression analysis was used to investigate the influencing factors associated with PIMs. Results and Discussion: A total of 369 patients who met the inclusion/exclusion criteria were included in this study. According to the three criteria used to evaluate the PIMs, the prevalence was 78.3% and 72.6% at admission and discharge, respectively. The prevalence rate of PIMs determined by the Chinese criteria was 62.1% at admission versus 56.6% at discharge (p = 0.134); the Beers criteria was 53.9% at admission versus 46.9% at discharge (p = 0.056); by the STOPP criteria was 20.6% at admission versus 13.8% at discharge (p = 0.015). Moreover, 28.9% (STOPP criteria), 56.8% (Beers criteria) and 73.4% (Chinese criteria) of patients taking PIMs on admission still had the same problem at discharge. The most common PIMs screened by the Beers, STOPP and Chinese criteria were diuretics, benzodiazepines and clopidogrel, respectively. Besides, the three criteria showed poor agreement. Finally, the stronger predictor of PIMs was the increased number of medications (p < 0.05). What is New and Conclusion: The prevalence of PIMs in elderly patients admitted to the CICU was high. The Chinese, STOPP and Beers criteria are effective screening tools to detect PIMs, but the consistency between them was poor. The increased number of medications was a significant predictor of PIMs. [ABSTRACT FROM AUTHOR]

Energy saving is one of the main technique routes for net zero carbon emissions. Air compressor systems take up a large part of energy consumption in the industrial field. A pre-cooling air compressor system was proposed for energy saving by cooling the air before it flows in a compressor. The energy efficiency of the proposed system was analyzed. As additional energy consumption is required for air cooling, the feasibility of the pre-cooling method for energy saving was analyzed. As the efficiency of the pre-cooling air compressor system is mainly influenced by the environment temperature and humidity, applicability of the system in different regions and at different seasons was discussed. A pilot project was performed to verify the technical feasibility and economics of the proposed system. When the precooling temperature of the pilot system was set to 2 °C, the annual pneumatic-electrical ratio of the system can be increased by approximately 2% in several regions of China. This paper shows the pre-cooling air compressor system is feasible for energy saving. [ABSTRACT FROM AUTHOR]

Off-label drugs use is widespread in ophthalmology due to the delay in drug approvals and package inserts update. It has been found to vary among different medical institutions in China, leading to safety problems since inappropriate use. Guidance is urgently needed regarding how best to use the drugs for unapproved indications and routes of administration. We aimed to develop an evidence-based guideline to guide off-label drugs used in ophthalmology in China. The practice guideline was developed by the Hospital Pharmacy Professional Committee, Chinese Pharmaceutical Association, following the WHO handbook for guideline development. The guideline was initially registered in the International Practice Guidelines Registry Platform (IPGRP-2021CN096). The clinical questions included in the guideline were identified through a three-round Delphi vote. Databases search was performed in PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, Chinese National Knowledge Infrastructure, and WanFang Database from their inception to 31 March 2021. Systematic reviews and meta-analyses for each clinical question were conducted individually to synthesize available scientific evidence. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence and grade the recommendations' strengths. The multidisciplinary guideline groups were set up, including ophthalmologists, pharmacists, methodology experts, pharmacologists, pharmacoeconomists, and lawyers. The guideline identified 25 clinical questions included. A total of 32 systematic reviews, including 24 conducted by the systematic review group and eight high-relevance published within 2 years, were referred to address these questions. Finally, the guideline presented 32 recommendations addressing 25 clinical questions, involving five strong recommendations and 27 weak recommendations for the treatment of ocular fundus, corneal disease, glaucoma, and endophthalmitis. Current evidence from clinical studies supports the off-label drugs used in ophthalmology. We developed an evidence-based guideline using a rigorous multidisciplinary approach to guide these usages in route clinical practice. [ABSTRACT FROM AUTHOR]

Background: The prevalence and characteristics of drug-related problems (DRPs) and factors associated with the occurrence of DRPs in the neurology unit in China remain unknown. This study aimed to determine the prevalence, characteristics and severity ratings of DRPs and identify factors associated with the occurrence of DRPs in the neurology unit of a tertiary care and academic teaching hospital in China. Methods: A retrospective study of DRPs and pharmacists' interventions for neurology patients was performed during a non-consecutive 24-month study period. Patient demographics and clinical characteristics, and pharmacist's intervention records were collected. The characteristics and severity ratings of DRPs were categorized using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.00 and the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification respectively. Results: A total of 242 DRPs were detected for 974 admitted patients, an average of 0.25 DRPs per patient. Treatment safety was the major type of DRPs (106;43.8%) followed by treatment effectiveness (78;32.2%). The primary causes of DRPs were drug selection (124;44.1%) and dose selection (92;32.7%). Clinical pharmacists provided 525 interventions, and most interventions occurred at the prescriber level (241;45.9%). A total of 91.4% of these interventions were accepted, contributing to solving 93.0% of the identified problems. The majority of DRPs (210;86.8%) were rated at severity categories B to D (causing no patient harm). Multiple logistic regression showed that creatinine clearance, number of medications used, nasogastric feeding, diabetes, and infectious diseases were associated with more frequent DRPs (p < 0.05). Conclusions: DRPs are relatively common in the neurology unit in China, with primary causes of drug and dose selection, and clinical pharmacists can effectively reduce and prevent DRPs to optimize medication therapy. [ABSTRACT FROM AUTHOR]

Hydrogen and oxygen stable isotopes (δ2H and δ18O) in precipitation were analysed from June 2018 to May 2020 in Ningbo and were influenced by the subtropical monsoon climate in East China. The δ2H and δ18O values of precipitation in Ningbo varied from −90.0 to 6.0‰ and from −13.5 to −1.6‰, respectively. The local meteoric water line (LMWL) in Ningbo was obtained as δ2H = 9.27 δ18O + 35.95 and had a larger slope and intercept compared to the global meteoric water line (GMWL) because its water vapour sources were oceans. The more negative δ18O values and lower deuterium excess (D-excess) of precipitation in summer were due to water vapour sources from the East China Sea, the South Sea and the Western Pacific, which are controlled by the southeasterly monsoon. In contrast, the less negative δ18O and higher D-excess of precipitation in winter were influenced by water vapour sources from the North Asian continent and North China transported by the northwesterly monsoon. The precipitation amount effect was significant in Ningbo, especially in summer. The inverse temperature effect was appeared in Ningbo, except winter. These two effects may be caused mainly by the monsoon climate rather than by the secondary evaporation effect. [ABSTRACT FROM AUTHOR]

Background Rational drug use and drug safety are becoming increasingly important concerns in China with the increasing public access to drugs and the health-care system, and this has led to the development of pharmacovigilance in China. Aim of the review To provide a brief introduction about pharmacovigilance in China in terms of system development, utilization and challenges. Method Relevant studies on pharmacovigilance related to the study aim was undertaken through literature search to synthesize the extracted data. Results The creation and evolvement of China's pharmacovigilance system spans across 30 years since 1989. The system consists of four progressing administrative layers: county, municipal, provincial and national levels. China has passed over 20 laws and regulations related to pharmacovigilance covering the processes of drug development, manufacture, distribution and use with the aim to guard drug safety. An online spontaneous self-reporting Adverse Drug Reaction (ADR) Monitoring System was established in 2003. ADRs are mainly reported by medical institutions, pharmaceutical manufacturers, and drug distributors. Currently there is no mandatory ADR reporting requirement for pharmaceutical manufacturers, and a proposed regulation under public comment will likely change this. China has started to build active pharmacovigilance surveillance programs in addition to the passive ADR reporting system. The China Food and Drug Administration has established the intensive Safety Monitoring Program and the National Adverse Drug Reaction Monitoring Sentinel Alliance Program based on electronic health records to further the efforts of ADR reporting, monitoring and analysis. Conclusion The practice of ADR monitoring and pharmacovigilance in China have made great progress. More efforts are needed both in system building, and creation of laws and regulations to strengthen the safe use of medicines. [ABSTRACT FROM AUTHOR]

China will establish a national emission trading scheme (ETS) in 2017, and the excessive development of coal-to-materials may hinder China′s emission reduction goals, specifically to reduce carbon emissions intensity by 40–45% from 2005 to 2020. In this study, the status of China′s coal-to-materials projects is presented, based on which we forecasted the high, middle and low CO 2 emission scenarios for the coal-to-materials industry in 2020, which were determined to be approximately 580, 290, and 180 Mt CO 2 , respectively. The high scenario is approximately equivalent to the total emission from Canada, the world's 11th-largest emitter in 2014. The main purpose of this study is to research the impacts of ETS on the coal-to-materials industry in 2020. Oil-to-materials is an ineluctable and powerful competitor to the coal-to-materials industry, complicating this matter. Therefore, the Cournot model was applied to quantitatively analyze the competition between these two monopolistic entities and determine the influence of oil, coal and carbon prices on CO 2 emissions from coal-to-materials. The visual simulation of the results shows that ETS can improve the competitiveness of oil-to-materials, resulting in a decline in production of coal-to-materials. However, the effect of the carbon cost with historical price range of Chinese ETS pilots on mitigating CO 2 emissions from the coal-to-materials industry is limited. High oil prices and low coal prices can increase the emissions from coal-to-materials significantly. Our study also provides a tool to analyze the feasibility of ETSs for a set emission reduction goal. Additionally, the necessary sensitivity analysis was also provided. [ABSTRACT FROM AUTHOR]

Tree bark samples were collected from 15 sites across western China in 2013, and the polybrominated diphenyl ether (PBDE) and new polybrominated flame retardant (NBFR) concentrations in the samples were determined. The mean total PBDE concentration was 51.8 ng/g lipid weight, which was 85.2% to 99.4% lower than in Chinese eastern coastal areas and the E-waste recycling areas. The dominant PBDE congener was BDE209, and its mean concentration was 49 ng/g lipid weight. The mean 2,3,5,6-tetrabromo- p-xylene, pentabromobenzene, pentabromotoluene, and hexabromobenzene concentrations were 0.61 ng/g, 0.97 ng/g, 0.68 ng/g, and 0.68 ng/g lw, respectively. The PBDE and NBFR concentrations in the air at the sampling sites were estimated from the concentrations in the tree bark samples. The estimated mean total PBDE and total NBFR concentrations in air were 58.5 pg/m3 and 2.76 pg/m3, respectively. The sources of NBFR emissions were found to be different from the sources of PBDE emissions, as no relationship was found between the NBFR and PBDE concentrations, and it appeared that sources of measured hexabromobenzene, pentabromobenzene, and pentabromotoluene in tree bark in western China include industrial activity related to the aluminum industry. Environ Toxicol Chem 2016;35:1364-1370. © 2015 SETAC [ABSTRACT FROM AUTHOR]

Industrial parks (IPs) have always been an important driving force for China's economic development. China has a great number of IPs, and this number is continuing to increase. The rapid development of IPs has brought great pressure on national resources utilization and environmental protection. The Chinese government has committed to the green development of IPs. In recent years, a series of policies on the green development of IPs have been introduced and implemented. Different from the limitation on the number of IPs in previous studies, this study used a larger data set containing 911 IPs. These IPs were divided into eight types according to their leading industries. The long-tail effect model was attempted to be used to provide quantitative description and analysis of the numerical distribution patterns of the indicators of economic output, environmental pollution, and resource consumption in IPs. Based on the long-tail effect model, for this paper, the performance of green development (PGD) in different types of IPs and IPs in different regions was further analyzed. The results show that China's IPs exhibit the distribution pattern of a long-tail effect in all three aspects mentioned above. In terms of environmental pollution, for some types of IPs, the individual performance of IPs in the head part of the model is more prominent. For other types of IPs, the cumulative results caused by IPs in the tail part of the model should be of concern. The PGD of IPs is closely related to their types. There are also obvious differences in the PGD of IPs in eastern and western China. Based on detailed discussion of the research results, at the end, policy implications are provided for the government to make decisions on the green development of IPs. • Indicators' distribution in China's industrial parks exhibits the long-tail effect. • Green development strategies of industrial parks are related to industrial types. • Focus of green development of industrial parks in east and west China is different. [ABSTRACT FROM AUTHOR]

Polyurethane foam (PUF) passive samplers were deployed and tree bark samples were collected at 15 sites across western China in 2013, and the organochlorine pesticide (OCP) concentrations in the samples were determined. Dichlorodiphenyltrichloroethane and its degradation products (collectively called DDTs), hexachlorocyclohexanes (HCHs), and hexachlorobenzene (HCB) were the dominant OCPs in the PUF samples and tree bark samples. The mean DDTs, HCHs and HCB concentrations were 33, 22 and 18 ng/sample in the PUF samples, and 428, 74, and 43 ng/(g lipid weight (lw)) in the tree bark, respectively. The OCP concentrations in the air, calculated using PUF–air and tree-bark–air partitioning models, were of the same order of magnitude. Both sample types showed that relatively fresh inputs of DDT and HCHs to the environment have occurred in western China. Meanwhile, PUF passive samplers were compared with the use of tree bark samples as passive samplers. The OCP compositions in the PUF and tree bark samples were different. Only the relatively stable OCPs (such as HCB, β-HCH and p,p′ -dichlorodiphenyldichloro-ethylene (DDE)) were consistent in the PUF and tree bark samples. [ABSTRACT FROM AUTHOR]

[Display omitted] • Multi-stage hydrothermal alterations were observed in the Luohe Formation. • Different mineral assemblages were formed during different alteration processes. • The mineralization is controlled by both acidic and alkaline reducing fluids. To ascertain the characteristics of mineral assemblages associated with uranium mineralization and enrichment mechanism of deep sandstone-type uranium deposits, drill-core logging, petrography and mineralogy, scanning electron microscopy (SEM), electronic probe micro analysis (EPMA), whole-rock analysis, X-ray diffraction (XRD) were used to identify the types, redox state of uranium minerals, and typical uranium-related mineral assemblages in the sandstone of the Cretaceous Luohe Formation, southwestern Ordos Basin. The results showed that the clastic grains in the gray and red uranium-bearing sandstone have undergone relatively strong alteration, while alteration of the clastic grains in the gray and red calcareous sandstone is relatively weak. The alteration minerals mainly include pyrite, anatase, kaolinite, chlorite, calcite, apatite, and feldspar. Uranium contents is highly consistent with S, P 2 O 5 , CaO, and FeO concentrations in the vertical direction and has a weak correlation with the total organic carbon. Uranium ores are mainly pitchblende and titanium-bearing uranium minerals. The Luohe Formation experienced transformation from a weak alkaline oxidation environment during the diagenetic stage to a weak acid reduction conditions in the early mineralization stage and then to a weak alkaline reduction environment in the middle–late mineralization stages. Typical alteration minerals associated with uranium ores include two types, which are formed in acid reduction and alkaline reduction redox stages, respectively. The alteration minerals related to acidic fluid process are pyrite, anatase, kaolinite, and apatite; those related to alkaline fluid mechanism consist of calcite and chlorite. Deep-seated uranium mineralization was formed by both acidic and alkaline reducing fluids, being dominated by acidic fluid conditions. In-depth investigation of the alteration and uranium ore minerals are of great scientific value to infer the fluid type of mineralization stage and reveal the enrichment mechanism of uranium deposits. [ABSTRACT FROM AUTHOR]

Nitrogen oxides (NO x) from anthropogenic emissions oxidized to form nitrate (NO 3 −) and play a key role in air pollution. The aim of this study is to identify the NO x sources and their seasonal variations in Hangzhou, a typical city in East China. To achieve this, the chemical characteristics of water-soluble inorganic ions (WSIIs) and the stable isotopes of NO 3 − (δ15N–NO 3 - and δ18O–NO 3 -) were measured in fine particulate matter (PM 2.5) and total suspended particle (TSP) aerosol samples that were collected between December 2018 and November 2019. It was found that the annual average concentration of PM 2.5 (69.28 ± 34.69 μg/m3) in Hangzhou exceeded the Chinese air quality limit of 35.00 μg/m3. The results showed that NO 3 − accounted for the largest proportion of the WSIIs in both PM 2.5 and TSP, and that major ions were mainly in the form of NH 4 NO 3 , (NH 4) 2 SO 4 , Ca(NO 3) 2 , CaSO 4 in aerosol particles. High ratios of NO 3 −/SO 4 2− in PM 2.5 and TSP indicated that vehicle emissions became increasingly important source of aerosol pollution in Hangzhou during the study period. The δ15N–NO 3 - values ranged from +1.1‰ to +9.2‰ in PM 2.5 and from −1.0‰ to +8.5‰ in TSP in Hangzhou. A Bayesian isotopic mixing model (stable isotope analysis in R (SIAR)) was applied to quantify the NO x sources in Hangzhou. This revealed that vehicle emissions, coal combustion and biomass burning were the main NO x sources of PM 2.5 and TSP. The seasonal variation of the δ15N–NO 3 - values in PM 2.5 and TSP in the study area were due to seasonal changes in the NO x contributions from different sources. The SIAR model results indicated that coal combustion increased in association with heating in north China during the winter (winter: 38.4% for PM 2.5 and 36.4% for TSP, summer: 30.6% for PM 2.5 and 29.8% for TSP) and the microbial N cycle increased with a higher application of fertilizer to crops during the summer (winter: 5.3% for PM 2.5 and 5.6% for TSP, summer: 10.7% for PM 2.5 and 11.6% for TSP). The improved SIAR model combined with the equilibrium fractionation reported the lower contributions from coal combustion (15.5–20.2%) and the higher contributions from Microbial N cycle (22.9–29.3%), as compared to the SIAR model. The seasonal variation of the δ18O–NO 3 - values was influenced by differences in the oxidation of NO 2 via O 3 (forming HNO 3), whereby the N 2 O 5 pathway dominated during the winter and the OH pathway dominated during the summer. Image 1 • Annual average PM 2.5 concentration in Hangzhou exceeded China's standard level II. • The NO x sources of PM 2.5 and TSP were identified by nitrogen isotopes. • NO x sources: vehicle emissions > coal combustion > biomass burning > microbial N. • Vehicle emissions are an increasingly important source of PM pollution in Hangzhou. • Seasonal δ15N variations of PM 2.5 and TSP were caused by different NO x source contributions. [ABSTRACT FROM AUTHOR]

• It is confirmed that this study area has multi-stage fluid mixed mineralization. • Different types of sandstone undergo different oxidation or reduction processes. • Determined the main metallogenic stage of the sandstone-type uranium deposit. Some controversies still exist regarding the genesis of sandstone-type uranium deposits in the northeastern Ordos Basin. Herein, based on boreholes and well logging data, we selected sandstone samples representing different epigenetic alteration environments as the research object and comprehensively utilized polarizing microscopy, scanning electron microscopy, electron probe analysis, elemental analysis, and other test methods to research sandstone genesis. The main altered minerals in the sandstone of this area include limonite, pyrite, achavalite, carbonate, sulfate, clay, and uranium minerals. The complex characteristics of alteration minerals indicate multi-stage fluid mixed mineralization in this area. According to the relationship between the major elements in different types of sand bodies, the components were classified into three groups. The first is the reduction media group, including CaO, MnO, total oxygen carbon (TOC), S, U, and burning loss. The second is the detrital particle group, including SiO 2 , K 2 O, and Na 2 O, and the third contains the clay and volcano component group, including Fe 2 O 3 , P 2 O 5 , TiO 2 , FeO, MgO, and Al 2 O 3. Among these, the content of reduction media is positively correlated with uranium enrichment, whereas detrital particles and clay components reflect the influence of alteration on the sand body composition, which indirectly affects the uranium adsorption and precipitation. Through the normalization of rare earth element (REE) chondrites, we find that the distribution patterns of REEs in rocks with different geochemical environments show a fractionation of light and heavy rare earth elements (HREEs), a right-leaning enrichment of light rare earth elements (LREEs), and relatively flat HREE. Further, via the Post Archean Australian Shale (PAAS) normalization, we observe that the mudstone of the Zhiluo Formation exhibits a relatively flat curve, whereas the sandstones have strongly positive Eu anomalies. The difference in REE values for different types of sand bodies indicates that, although all types of rocks have a similar sedimentary environment, their original sediments underwent fluid alterations such as oxidation and reduction. Based on the uranium mineralization evolution history in the study area, the water-rock reaction process and mineral-alteration sequence were determined on the basis of alteration types and elemental concentrations. Our findings provide new insight into the petrological significance, mineralogy, and geochemical composition of uranium deposits in the Ordos Basin. [ABSTRACT FROM AUTHOR]

Objective: In the initial stages of the COVID-19 epidemic, frontline medical staff faced numerous psychological pressures, such as shortages of medical supplies, lack of treatment experience, and high risk of infection. This study plans to understand the mental resilience and psychosomatic status of first-line anti-epidemic medical team members to provide a reference for managing their mental health status and the improvement of mental resilience., Methods: From March 3 to March 5, 2020 a medical team serving as a first-line medical rescue group in Wuhan was chosen as the research subject, with 160 cases. The staff status questionnaire and the Chinese Version of the mental resilience scale were used simultaneously in a mobile phone questionnaire survey on the selected subjects using a cluster sampling method, which refers to the sampling strategy considering an independent cluster as a unit. (Chinese Version of the CD-RISC)., Results: The participants were frontline medical staff against COVID-19. A total of 156 samples were effective, with a 97.5% effective sample rate. The 156 cases investigated included 77 males (49.4%) and 79 females (51.6%), with an average age of 36.50±8.50. There were 22 (14.1%) cases with a junior college diploma or less, 97 (62.2%) cases with a bachelor's degree, and 37 (23.7%) cases with a master's degree or higher. Conversely, men were more tenacious than women (Cohen's d = 0.319, t = 1.997, P = .048). In terms of the psychosomatic state influence score, women had a greater psychosomatic influence than men (F = 3.076, P = .006)., Conclusion: The anti-epidemic task significantly impacts the psychosomatic state of first-line medical personnel, who may require improved social and psychological support. Women experience more stress than men. Frontline medical personnel should seek social support and learn positive stress management techniques. When facing medical emergencies, medical decision-makers also need to pay attention to strengthening the psychosocial support of frontline personnel.

Since its initial release in 2001, the human reference genome has undergone continuous improvement in quality, and the recently released telomere-to-telomere (T2T) version - T2T-CHM13 - reaches its highest level of continuity and accuracy after 20 years of effort by working on a simplified, nearly homozygous genome of a hydatidiform mole cell line. Here, to provide an authentic complete diploid human genome reference for the Han Chinese, the largest population in the world, we assembled the genome of a male Han Chinese individual, T2T-YAO, which includes T2T assemblies of all the 22 + X + M and 22 + Y chromosomes in both haploids. The quality of T2T-YAO is much better than those of all currently available diploid assemblies, and its haploid version, T2T-YAO-hp, generated by selecting the better assembly for each autosome, reaches the top quality of fewer than one error per 29.5 Mb, even higher than that of T2T-CHM13. Derived from an individual living in the aboriginal region of the Han population, T2T-YAO shows clear ancestry and potential genetic continuity from the ancient ancestors. Each haplotype of T2T-YAO possesses ∼ 330-Mb exclusive sequences, ∼ 3100 unique genes, and tens of thousands of nucleotide and structural variations as compared with CHM13, highlighting the necessity of a population-stratified reference genome. The construction of T2T-YAO, an accurate and authentic representative of the Chinese population, would enable precise delineation of genomic variations and advance our understandings in the hereditability of diseases and phenotypes, especially within the context of the unique variations of the Chinese population., (Copyright © 2023 Beijing Institute of Genomics, Chinese Academy of Sciences and Genetics Society of China. Published by Elsevier B.V. All rights reserved.)

The accuracy of determining atmospheric chemical mechanisms is a key factor in air pollution prediction, pollution-cause analysis and the development of control schemes based on air quality model simulations. However, the reaction of NH 3 and OH to generate NH 2 and its subsequent reactions are often ignored in the MOZART-4 chemical mechanism. To solve this problem, the gas-phase chemical mechanism of NH 3 was updated in this study. Response surface methodology (RSM), integrated gas-phase reaction rate (IRR) diagnosis and process analysis (PA) were used to quantify the influence of the updated NH 3 chemical mechanism on the O 3 simulated concentration, the nonlinear response relationship of O 3 and its precursors, the chemical reaction rate of O 3 generation and the meteorological transport process. The results show that the updated NH 3 chemical mechanism can reduce the error between the simulated and observed O 3 concentrations and better simulate the O 3 concentration. Compared with the Base scenario (original chemical mechanism simulated), the first-order term of NH 3 in the Updated scenario (updated NH 3 chemical mechanism simulated) in RSM passed the significance test (p < 0.05), indicating that NH 3 emissions have an influence on the O 3 simulation, and the effects of the updated NH 3 chemical mechanism on NOx-VOC-O 3 in different cities are different. In addition, the analysis of chemical reaction rate changes showed that NH 3 can affect the generation of O 3 by affecting the NOx concentration and NOx circulation with radicals of OH and HO 2 in the Updated scenario, and the change of pollutant concentration in the atmosphere leads to the change of meteorological transmission, eventually leading to the reduction of O 3 concentration in Beijing. In conclusion, this study highlights the importance of atmospheric chemistry for air quality models to model atmospheric pollutants and should attract more research focus., 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 © 2023 Elsevier Ltd. All rights reserved.)

Nitrogen (N) loss by surface runoff inevitably results in severe N pollution and eutrophication of aquatic ecosystems. In this study, surface runoff from different land uses in the East Tiaoxi River watershed was collected, and the N concentrations, sources and losses were measured using the dual isotope (δ 15 N-NO 3 - and δ 18 O-NO 3 - ), a Bayesian isotopic mixing (SIAR) model and Soil Conservation Service Curve Number (SCS-CN) method. The results showed that the N concentrations in surface runoff from agricultural lands were higher than those from urban areas and forestlands, and nitrate (NO 3 - ), particulate nitrogen (PN) and dissolved organic nitrogen (DON) were the major forms of N in surface runoff in the East Tiaoxi River watershed. The total loss rate of total nitrogen (TN) from surface runoff in the East Tiaoxi River watershed was 5.38 kg·ha -1 ·a -1 , with NO 3 - -N (46%) contributing the most to TN loss. The TN, and NO 3 - -N loss rates in surface runoff from tea planting lands (21.08 kg·ha -1 ·a -1 , 11.98 kg·ha -1 ·a -1 ) and croplands (16.93 kg·ha -1 ·a -1 , 10.96 kg·ha -1 ·a -1 ) were high, those from vegetable lands and urban areas were medium, and those from economic and natural forestlands were low in the East Tiaoxi River watershed. The NO 3 - -N contributions of chemical fertiliser (CF), soil N (SN), sewage/manure (SM), and atmospheric deposition (AD) in surface runoff in the East Tiaoxi River watershed were 124.32 × 10 3 , 104.84 × 10 3 , 82.25 × 10 3 and 58.69 × 10 3  kg·a -1 , respectively. The N pollutant losses in surface runoff from agricultural lands (croplands with rice growing, vegetable lands and tea planting lands) were responsible for most of the N pollutants being transported into the East Tiaoxi River systems., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Epidemic keratoconjunctivitis (EKC) is a highly contagious infectious ocular disease that has been widespread worldwide. Ophthalmic preparations of glucocorticoids (OPGs) are the supportive therapies for EKC; however, they are still controversial., Methods: We performed a systematic review and meta-analysis to evaluate the efficacy and safety of OPGs in patients with EKC. Electronic searches were conducted in PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, China National Knowledge Internet (CNKI), and Wanfang Database from inception to 25 Aug 2022. We included and analyzed randomized controlled trials (RCTs) and cohort studies that compared OPGs to other positive drugs or placebo in patients with EKC., Results: Six studies (five RCTs and one retrospective cohort) involving 286 patients were included in the analysis. Compared with artificial tears, OPGs could relieve ocular symptoms faster in the acute phase of epidemic keratoconjunctivitis (AEKC). There was no significant difference in the incidence of corneal subepithelial infiltrates (SEIs) in AEKC when OPGs were used for 7 days, but there was a substantial difference for 21 and 28 days. In the chronic phase of epidemic keratoconjunctivitis (CEKC), there was no significant difference in the rate of complete elimination of SEIs at 6 months of OPGs treatment compared with immunosuppressants [RR = 1.07,95%CI (0.71,1.61), p = 0.75], as well as in the recurrence rate of SEIs after 6 months [RR = 2.05,95%CI (0.82,5.12), P = 0.13]. OPGs significantly increased intraocular pressure (IOP) at 6 months compared with immunosuppressants [MD = - 1.13,95%CI (- 1.97, - 0.30), P = 0.007]. There was no significant difference in cessation of therapy due to drug intolerance between OPGs and immunosuppressants [RR = 0.69,95%CI (0.16,2.94), p = 0.62]., Conclusions: OPGs might relieve ocular symptoms and reduce the incidence of SEIs in AEKC, whereas not recommended the therapy in CEKC. More high-quality clinical evidence is required to confirm our findings., (© 2022. The Author(s), under exclusive licence to The Drug Information Association, Inc.)

Chemical boundary conditions (BCs) are important inputs for regional chemical transport models. In this study, we use the brute-force method (BFM), process analysis (PA) and response surface model (RSM) to quantify the effects of BCs on simulated O 3 concentrations in different regions of China by the weather research and forecasting with chemistry (WRF-Chem) model. We combine the model with an integrated gas-phase reaction rate (IRR) tool to further analyze the changes in the O 3 chemical mechanisms. Our results show that the simulated O 3 concentrations in western cities are significantly affected by the O 3 in the BCs (BC-O 3 ), which can increase the maximum simulated O 3 concentration, such as in Lanzhou (36.6 μg/m 3 , 26.3 %), Wuhai (30.1 μg/m 3 , 25.5 %) and Urumqi (50.7 μg/m 3 , 41.2 %). In contrast, O 3 generation in the eastern region is dominated by emissions. Subsequently, we compare the reaction rate changes in O 3 generation and consumption under the effects of BC-O 3 in the western city of Urumqi and the eastern city of Beijing. The results show that in Beijing, the O 3 concentration and the related chemical reaction rates undergo little change, while in Urumqi, the concentration and reaction rates have significant differences. The BC-O 3 significantly accelerates the O 3 photochemical reaction process in Urumqi, resulting in increased O 3 generation and consumption reaction rates; additionally, there may be a chemical reaction pathway for the formation of O 3 : BC-O 3 + NO → NO 2 + hv → O + O 2 → O 3 . BC-O 3 transmission is the main pathway of changes in the simulated O 3 concentration in the study area, and the chemical reactions between BC-O 3 and local pollutants are primarily characterized by O 3 consumption. In conclusion, the study shows the importance of BCs for regional model simulation while providing supporting information for O 3 formation in model studies., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Measurements of ozone (O 3 ) and its precursors were performed in the summer of 2019 in Lanzhou, a petrochemical industrial city, to better understand the reactivity of volatile organic compounds (VOCs) and their effects on O 3 production. During the campaign, the daily maximum 8-hour average (MDA8) O 3 , NO 2 , and total VOC (TVOC) concentrations reached 72.2 ± 19.9 ppb, 24.9 ± 10.8 ppb, and 50.8 ± 46.1 ppb, respectively. Alkanes, alkenes, halocarbons, aromatics, and alkynes contributed 45.3%, 24.0%, 16.5%, 10.0%, and 4.2% to TVOCs, respectively. The OH reactivity and relative incremental reactivity (RIR) of VOCs at different times were calculated. The results indicated that alkenes played a predominant role, accounting for an average of 68.5% of the initial VOC reactivity. Compared to other regions, alkenes are relatively more important for O 3 formation in the petrochemical industry area of Lanzhou, while aromatics are relatively less important. Generally, O 3 formation occurred in a VOC-limited regime in the morning and in a transitional regime in the afternoon. The response surface methodology (RSM) combined with a chemical box model was applied to obtain relationships between O 3 and its precursors and determine the most effective way to reduce the O 3 concentration. Reduction in the non-alkene concentration slightly affected the O 3 concentration. In contrast, the effect of nitrogen oxides (NO x ) was closely related to the alkene concentration, and NO x concentration reduction could lead to an increase in the O 3 concentration when alkenes were abated to less than 80% of the present concentration. To mitigate O 3 pollution near the petrochemical industrial area of Lanzhou, reducing the alkene concentration, especially the C4 alkene concentration (1,3-butadiene, cis-2-butene, and trans-2-butene), was the fastest and most effective control strategy. The results of this study serve as a reference for O 3 pollution control in petrochemical industrial areas., 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 © 2022. Published by Elsevier B.V.)

Background: Esophageal foreign body impaction is the most common cause of endoscopic emergency. However, there are limited available data on delayed endoscopic management of esophageal sharp-pointed food impaction., Aims: To investigate cases of esophageal sharp-pointed food impaction with endoscopic removal findings., Methods: This single-center retrospective study collected medical records to identify patients with esophageal sharp-pointed food impaction who underwent endoscopic removal between April 2018 and April 2020. The patients were divided into the early (endoscopic removal <12 h) and delayed intervention (>12 h) cohorts., Results: Overall, 133 and 696 patients received early and delayed intervention, respectively. The success rate of endoscopic foreign body removal was 96.45%. The most common foreign body was fish bone (66.90%), and the most common shape was "I" (56.26%). Patients from the delayed intervention cohort received general anesthesia with a higher risk for perforation, and no foreign body was identified. The duration of endoscopy, distance between the foreign body/wound and the incisor, and longest diameter of the foreign body were not different between the groups. In multivariate analysis, male sex (odds ratio = 1.792 [1.159, 2.771]; P = 0.009), longer duration of impaction (odds ratio = 2.212 [1.121, 4.365]; P = 0.022) and endoscopy (odds ratio = 1.502 [1.253, 1.800]; P < 0.001), and longest diameter of the foreign body (odds ratio = 1.632 [1.329, 2.003]; P < 0.001) were associated with a higher incidence of perforation in patients with foreign body impaction., Conclusions: Endoscopic removal is a safe and effective treatment method for sharp-pointed food impaction. Delayed endoscopic removal can increase the risk of esophageal perforation., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Coal and coal gangue spontaneous combustion (CGSC) occurs globally, causing significant environmental pollution. However, its emissions are poorly quantified and are overlooked in global or regional air pollutant emission inventories in previous studies, resulting in the underestimation of its impacts on climate, environment, and public health. This study quantified the emissions of various air pollutants originating from CGSC in Wuhai, a city in China, investigated emission characteristics, and estimated the contribution of CGSC emissions to fine particulate matter (PM 2.5 ) air pollution and related health impacts on a regional scale. The results revealed that the CGSC-related PM 2.5 emissions were approximately 4643 t a -1 (95% confidence interval (95% CI): 721; 10447), accounting for 26.3% of the total PM 2.5 emissions. Alkanes, alkenes, and aromatics accounted for 69.4, 17.9, and 2.9%, respectively, of the total emissions of volatile organic compounds (VOCs). Due to CGSC emissions, the ambient PM 2.5 concentration in Wuhai increased by 5.7 μg m -3 on average, while the nitrate concentration decreased. The number of premature deaths caused by exposure to ambient PM 2.5 associated with CGSC reached 381 (95% CI: 290; 452) in Wuhai and surrounding cities in 2017. Urgent control strategies and engineering techniques are needed to mitigate CGSC to protect public health.

Background: A few studies have evaluated the expression of chemokine receptors CXCR4 and CCR7 in diffuse large B-cell lymphoma (DLBCL); however, the association between CXCR4 and CCR7 with bone marrow (BM) involvement and their synergistic effect on prognosis is still unclear. Our study investigated this aspect., Methods: Specimens were obtained from 61 primary nodal DLBCL patients and 100 reactive proliferative lymphadenitis patients. CXCR4 and CCR7 expression levels were examined by immunohistochemical staining; the relationship between these levels and clinical parameters and the differences in overall survival were analyzed., Results: CXCR4 and CCR7 overexpression was observed in the malignant lymph node tissues from most DLBCL patients. CCR7 expression was significantly higher in the non-GCB than the GCB subtype; CXCR4 positivity rates showed no significant difference between the 2 subtypes. In DLBCL patients with BM involvement, CXCR4 was overexpressed in almost all BM samples, but CCR7 expression was low in BM. CXCR4 overexpression was associated with advanced Ann Arbor stages, MYC overexpression, and increased extranodal infiltration; CCR7 was associated with advanced Ann Arbor stages and elevated LDH. Like the case for CCR7, the survival rate of CXCR4-positive DLBCL patients was significantly lower than that of the CXCR4-negative patients. CXCR4 + CCR7 + patients had the lowest survival rate., Conclusions: There is a positive correlation between CXCR4 overexpression and BM involvement. CXCR4 and CCR7 overexpression is associated with poorer overall survival, especially in CXCR4 and CCR7 copositive patients. CXCR4, CCR7, Ki-67 index, and MYC were independent prognostic factors for DLBCL. Blocking CXCR4 and/or CCR7 can be a novel therapeutic strategy for DLBCL., (Copyright © 2019. Published by Elsevier Inc.)

Background: Although studies of self-rated health (SRH) are conducted widely in developed countries, comprehensive assessments of the determinants of SRH in Chinese are scarce, particularly for working Chinese individuals. Determinants of SRH might differ among worksites based on differences in the nature and stress associated with different jobs, work intensity, and the lifestyles of employees., Methods: Two thousand and forty questionnaires that addressed SRH, demographic characteristics, lifestyle, and the psychosocial work environment were administered to employees at two worksites. A total of 1644 subjects provided complete data for analysis (80.6% response rate)., Results: Participants from government departments had significantly better SRH than did those from high-tech enterprises (61.1% vs. 67.5%, respectively). Lifestyles were significantly less healthy at government departments compared with high-tech enterprises, whereas the psychosocial work environment was better. The results of unadjusted and adjusted models revealed differences between the potential health-influencing factors of participants based on their type of worksite. In logistic regression models, gender was strongly associated with SRH in all participants, whereas length of service was correlated with SRH only in participants from high-tech enterprises. In high-tech enterprises, good SRH was less common in physically inactive subjects vs. physically active participants (OR = 0.561). In government departments, passive smoking was negatively associated with SRH significantly. Social capital (OR = 1.073) and job control (OR = 1.550) were positively correlated with SRH in high-tech enterprises. Job control was the only psychosocial factor significantly associated with SRH in government departments., Conclusions: Participants from different types of worksite reported different SRH, healthy lifestyles, and psychosocial work environments. Moreover, the association between SRH and demographic characteristics, lifestyle, and the psychosocial work environment significantly differed by type of worksite.

Objectives: This study aims to describe secondhand smoke (SHS) exposure in restaurants in Shanghai and to explore the impact on the health of restaurant workers. Attitude to smoke-free restaurants among restaurant workers and customers was also determined in this study., Methods: A random sample of 242 workers, 284 customers, and 46 restaurant owners participated in face-to-face questionnaire interviews., Results: A total of 219 (90.7%) restaurant workers surveyed were found to be exposed to SHS during working hours with 24.2+/-18.6h of exposure on average per week. Exposure time each week was significantly associated with the symptoms of dyspnea and irritated eyes. Among the customers surveyed 73.9% supported the concept of a 100% smoke-free law in restaurants and 49.6% expressed that they would be more likely to eat in restaurants if smoking was banned in restaurants. And 58.6% of the restaurant owners surveyed regarded smoke-free laws banning smoking in restaurant as feasible and 56.5% estimated such bans would decrease the profit., Conclusion: Both restaurant workers and customers are substantially exposed to SHS. Although some restaurant owners are concerned about a decrease in profits, the fear of losing business is not supported by the response among customers. Therefore, introducing a law-banning smoking in restaurants appears to be feasible and acceptable in Shanghai.