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Evidence between air pollution and hospital visits for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is inconsistent and limited in China. In this study, we constructed a time-series study to evaluate the association between air pollution and AECOPD outpatient visits. Daily hospital outpatient visits for AECOPD in three top level hospitals in Lanzhou from January 2013 to December 2019, as well as the air pollutants and meteorological data in the same period, were collected. Then, generalized additive models with quasi-Poisson regression were utilized to estimate the associations with single-day lags from lag0 to lag7 and cumulative-day lag from lag01 to lag07. For example, lag0 referred to the concentration of air pollutants at the current day and lag1 referred to the previous-day air pollutant concentration and so on. Lag01 meant the average concentration of air pollutants at the current and previous day, and lag07 corresponded to the eight-day moving average value of the current and previous 7 days. In addition, stratified analyses were performed by gender, age, and season. The risk estimates were expressed in terms of the percentage changes (PC) in AECOPD outpatient visits per 10 µg/m

Many studies have explored the association between temperature and atopic dermatitis (AD); however, the results are inconsistent. We used a quasi-Poisson function fitted to a distributed lag nonlinear model (DLNM) to evaluate the association between daily average temperature and AD outpatient visits from January 1, 2013, to December 31, 2019, in Lanzhou, China. We found that the exposure-response association curve was inversely "s-shaped," low-temperature effects occurred at a lag of 11 days and then lasted for 10 days, and high-temperature effects occurred on the current day and then significantly decreased. Both low and high ambient temperatures can increase the risk of outpatient visits. Compared with median temperature (12.89°C), the cumulative relative risk (RR) of extreme high temperature and moderate-high temperature were 1.847 (95% confidence interval [CI]: 1.613, 2.114) and 1.447 (95% CI: 1.298, 1.614), respectively, at lag0-7 days, and the cumulative RRs of extremely low temperature and moderate-low temperature were 1.004 (95% CI: 0.904, 1.115) and 1.056 (95% CI: 0.925, 1.205), respectively, at lag0-21 days. Females were more sensitive to high temperatures than males, and high or low temperatures had significant effects on children ≤14 years of age. Graphical abstract.

Until now, few epidemiological studies have focused on the association between ambient particulate matter (PM) pollution and hospital outpatient visits for overall and cause-specific respiratory disease, especially in Lanzhou. This study aimed to evaluate the short-term effects of PM2.5, PMC, and PM10 on hospital outpatient visits for overall and subtypes of respiratory disease in Lanzhou, China, during 2007–2017, using a generalized additive model (GAM). We further assessed the impact of ambient size-fractioned PM on daily total and cause-specific respiratory morbidity, following a series of air quality improvement action in the area with overall and period-specific analyses. Positive associations were identified between PM2.5, PMC, and PM10 and daily morbidity rates from overall respiratory diseases, upper respiratory tract infection, lower respiratory tract infection, pneumonia, and COPD at different lag pattern. Each 10 μg/m3 increase in PM2.5 at lag07, PMC at lag03, and PM10 at lag06 corresponded to an increase of 1.353% (95% CI: 1.249%, 1.457%), 0.052% (95%CI: 0.015%, 0.089%), and 0.201% (95% CI: 0.165%, 0.236%) in daily hospital outpatient visits for total respiratory, respectively. We did not find significant effects of PM2.5, PMC, and PM10 on asthma. For specific subtypes of respiratory diseases, the effects of PM were strongest on pneumonia morbidity, with an increase of 3.712% (95% CI: 3.308%, 4.117%), 0.874% (95% CI: 0.698%, 1.051%), and 0.967% (95% CI: 0.836%, 1.099%) per 10 μg/m3 increment in PM2.5, PMC, and PM10, respectively. The exposure-response association was non-linear across the full range of exposures. With drastic reductions in annual PM levels, the three size-specific PM associate and respiratory morbidity risk showed decreasing trend over time. This study suggests that PM could exert adverse influences on the outcomes of all-cause and cause-specific respiratory outpatient visits in Lanzhou, China. PM2.5 would have significant effects on pneumonia and RTI. Strategies should be considered to further reduce levels of ambient PM2.5.

The relationship between fine particulate matter (PM2.5) and respiratory disease outcomes among children aged 0 to 14 years in Lanzhou, China, was evaluated. We utilized a generalized additive model linked by a quasi-Poisson distribution to examine the associations between PM2.5 and paediatric respiratory outpatient visits for time lags of 0 up to 7 days, and stratified by gender, age, and season. Cases of respiratory disease in children were collected from 3 large hospitals for the years 2014–2017 and then linked with air pollutant concentrations from 4 air quality monitoring stations by date. We observed positive and significant associations between PM2.5 and respiratory disease from the lag to lag 7, and from lag01 to lag07, with ER reaching the maximum value at lag07. For each 10 μg/m3 increase in PM2.5 (lag07), the associated increment in respiratory diseases was 2.83% (95% CI 1.80%–3.86%). Males were more sensitive to the adverse effects, and the association was more significant in spring (from March to May) and winter (from December to the next February). Overall, the child group (age 3–6 years) demonstrated a higher risk of respiratory disease after PM2.5 exposure. The associations between ambient PM2.5 and respiratory hospital outpatients among young children became partially attenuated after the adjustment for gaseous pollutants in subgroups. The exposure-response curves were positive and generally nonlinear but flatted at concentrations over 60 μg/m3. This research found a significant association between ambient PM2.5 levels and hospital outpatient visits in child with respiratory diseases in Lanzhou, China.

Extreme temperature is strongly associated with human health, but few studies are available for the effects of extreme temperatures on respiratory disease (RD) in rural villages in Jiuquan, China over 2018-2019. In this study, we evaluate the effect of daily mean temperature on RD hospitalizations in suburban rural villages. A distribution lag non-linear model was constructed to analyze the relationship between the temperature and the daily risk of RD hospitalizations; and stratified analysis by sex and age group was performed. The effect of daily mean temperature on RD hospitalizations was non-linear and lagging. With a reference 25th percentile of temperature (-1.8 °C), exposure to extremely low temperature (-15.8 °C, 1st percentile), or moderate low temperature (-8.3 °C, 10th percentile) were associated with 1.396 (95% CI: 1.251, 1.558) and 1.216 (95% CI: 1.180, 1.253) increased risks of RD hospitalizations over lag 0-21 days. For RD morbidity, the effects of moderate high temperature (90th percentile of temperature, 22.5 °C) appeared at on the exposed day (lag 0), with the largest hot effect (RR 1.008, 95% CI 1.001, 1.020), while the effects of extremely high temperature (99th percentile of temperature, 27.0 °C) were insignificant. The effect of ambient temperature varied with gender and age. Both cold and high temperatures have more serious influence on males than females. In contrast, the elderly (age ≥ 65) seemed to be more sensitive in extremely low temperature (RR = 3.471; 95% CI, 2.183, 5.518; lag 0-21). The effect of moderate high temperature on the65 years group appeared for the first time at lag 0 (RR = 1.012; 95% CI, 1.001, 1.029). Both high temperature and low temperature increased the RD hospitalization risk; the harmful effect and duration of low temperature were greater than that of high temperature; the ≥ 65-year group and male were more sensitive to low temperature.

There is limited evidence regarding the associations between air pollution and emergency hospital visits for upper respiratory tract infection (URTI) in the arid regions of northwest China. We collected daily emergency department (ED) visits for URTI from three hospitals in Lanzhou during January 2014 and December 2018, as well as daily air pollutants and meteorological factors. In the present study, generalized additive model with quasi-Poisson regression was used to evaluate the relationship between short-term exposure to ambient pollutants and daily emergency hospital visits for URTI in Lanzhou, China. Furthermore, subgroup analyses were conducted by gender (male and female), age (0-14, 15-64, and ≥ 65 years)), and season (cold season, warm season). The results of the single-pollutant model show that the associations of PM

It is difficult to find the hidden danger or defect of substation equipment accurately and quickly when the substation equipment is inspected manually. In this paper, an electric inspection robot equipped with ultraviolet camera was studied. The dual-light image detection module of visible and ultraviolet camera was built on the robot's head. The effect of air pressure on the results of ultraviolet imaging was studied experimentally. The results show that with the increase of air pressure, the spot area decreases obviously, and the corona discharge weakens. Robot patrol inspection equipped with ultraviolet camera is helpful to realize non-contact live detection, which is of great significance to improve the intelligent detection level of substation.

Air pollution has been accepted as an important risk factor for hypertension. However, little is known about the association between air pollution and hospitalization for hypertension. In this study, we explored the association between six criteria air pollutants and hypertension hospitalization in Lanzhou, China. An over-dispersed Poisson regression model combined with a distributed lag nonlinear model (DLNM) was used. In addition, we investigated the effect of modification by sex, age, and season. A total of 30,197 hospitalization cases were identified during the study period. A 10μg/m3 increase in PM2.5, PM10, SO2, and NO2 concentrations or 1 mg/m3 increment in CO was significantly associated with relative risks (RRs) of hospital admissions due to hypertension 1.026 [95% confidence interval (CI): 1.010, 1.043], 1.010 (95%CI: 1.005, 1.015), 1.042 (95%CI: 1.001, 1.085), 1.028 (95%CI: 1.003, 1.052), and 1.106 (95%CI: 1.031, 1.186), respectively. No significant influence of O38h was found on hypertension hospital admissions. The associations differed by individual characteristics; the elderly (≥ 65 years) and females were highly vulnerable. The effects of PM2.5, SO2, and CO were more evident in the cool season than in the warm season. From exposure-response curves, we observe a nearly linear relationship for PM2.5, PM10, SO2, NO2, and CO. This study suggests that exposure to PM2.5, PM10, SO2, NO2, and CO is associated with hypertension morbidity.

The relationship between fine particulate matter (PM

Until now, a number of epidemiological studies have focused on the association between ambient particulate matter pollution and chronic obstructive pulmonary disease (COPD), especially in developed countries. There are limited evidences on the association between short-term exposure to particulate matters (PM2.5, PMC, and PM10) and overall hospital outpatient visits for COPD at the same time in China. Thus, a time-series analysis on the short-term association between three subtypes of PM (PM2.5, PMC, and PM10) and daily hospital outpatients for COPD in Lanzhou, China was conducted, from 2014 to 2017.An over dispersed, generalized additive model was used to analyze the associations after controlling for time trend, weather conditions, day of the week, and holidays. Stratified analyses were also performed by age and gender. The results disclosed that a 10-μg/m3 increase in PM2.5 concentration at a lag of 0–7 days was associated with 1.190% (95% CI 0.176~2.215%). For PMc, therewere not statistically significant effects at any lag days, but we could find the greatest effect at lag07 that a 10-μg/m3 increase in concentration was associated with 0.014% (95% CI − 0.065~0.093%). PM10 also exerted a high effect for COPD (0.185% increase; 95% CI − 0.046~0.417%) when 6 days of exposures (lag6), however, no significance relationship could be found. For COPD among males, positive results were observed for PM2.5 with lags of 0–7 days, a 10-μg/m3 increase was 1.184% (95% CI 0.095~2.284%). The effect of PM2.5 on females was also most significant at lag07, a 10-μg/m3 increase was 1.254% (95% CI 0.053~2.469%). For those aged

The intelligent inspection robots in substations mostly use wheeled chassis, which have good passability when running on flat roads, but it is difficult to effectively cross obstacles under terrain conditions such as steps and stairs. A quadruped inspection robot for substation is designed to improve the walking ability of the robot with a four-leg alternate walking mode to optimize the leg structure design for road conditions such as steps and stairs in the substation. The robot is equipped with pan-tilt detection components and inspection equipment such as multi-degree-of-freedom manipulators can complete intelligent inspection and lightweight maintenance tasks in open substations, and achieve full coverage of the inspection area.

Significant progress has been made in air pollution control Lanzhou, China recently, however, there was only one study so far on the assessment on health gains from air quality improvement after adopting strict air pollution control measures. The present study aimed to estimate the short-term effects of six criteria air pollutants including PM2.5, PM10, NO2, SO2, CO and O3 on respiratory admissions in Lanzhou, China, then compare the results of our study with those earlier studies conducted in Lanzhou before the implementation of air pollution control measures. Data on daily hospital admissions from the three largest hospitals in Lanzhou and daily air pollution concentration and meteorological variable were collected during a 4-year period (2014-2017). A generalized additive model; adjusted for long-term trend, seasonality, and other potential confounders was done to quantitatively assess the influences of air pollutants on daily respiratory admissions and analyze the influences of different seasons, sexes, and age groups. The most apparent effects for PM2.5, PM10, SO2, CO and O3 on respiratory hospitalizations were observed at lag6, and lag7, respectively, and a 10μg/m3 increase in PM2.5, PM10, SO2, CO and O3 concentration were associated with 0.885% (95%CI: 0.414%~1.358%), 0.328% (95%CI: 0.145%~0.511%), 3.005% (95%CI: 1.689%~4.339%), 3.199% (95%CI: 0.912%~5.537%) for CO, 0.733% (95%Cl: 0.263%~1.205%) increase in respiratory admission, respectively. No remarkable association was found between NO2 and respiratory disease hospitalisation. Females and younger groups were more susceptible to air pollutant than males and elderly groups. Together, we demonstrated that the positive associations were more pronounced in the cold season than in the warm season. The findings in present study suggest that even in Lanzhou, where air quality has been improved dramatically, positive associations still exist between air pollution and daily number of total respiratory admission.

Yutong Meng,1,* Zhirui Li,1,2,* Ke Gong,1 Xiao An,2 Jiyuan Dong,1 Peifu Tang1 1Department of Orthopedics, Chinese PLA General Hospital, Beijing, China; 2Department of Orthopedics, Chinese PLA General Hospital Hainan Branch, Sanya, China *These authors contributed equally to this work Purpose: Obesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight. Patients and methods: A total of 304 patients with knee osteoarthritis treated with TKA from October 2013 to March 2015 were separated into tranexamic, non-tranexamic, obese, and non-obese groups. The demographic characteristics, surgical indices, and hematological indices were all recorded. We first investigated the ability of intravenous tranexamic acid to reduce intraoperative blood loss in knee osteoarthritis patients undergoing unilateral TKA. Second, we performed subgroup analysis to compare the effects of tranexamic acid between obese and non-obese patients separately. Results: Of the 304 patients, 146 (52.0%) received tranexamic acid and 130 (42.8%) were obese. In the analysis of the whole group, both the actual and occult blood loss volume were lower in the tranexamic acid group (bothP< 0.05). Tourniquet time was shorter in the tranexamic acid group (P 0.05). Conclusion: Tranexamic acid can reduce occult blood loss and tourniquet time in obese patients to a greater extent than in patients of normal weight. Therefore, obese knee osteoarthritis patients undergoing TKA can benefit more from tranexamic acid. Keywords: obese, knee osteoarthritis, total knee arthroplasty, blood conservation, tranexamic acid

There is growing support in the literatures that peri-operative outcomes are adversely affected by surgical case order in some certain surgical procedures. This study aimed to examine if similar phenomenon is also shared in total joint arthroplasty (TJA). A total of 6548 joints (5183 patients) treated with primary TJA by a total of five surgeons at our institution from December 2011 to December 2015 were retrospectively reviewed in this study. Demographic data, operative duration, blood loss, peri-operative adverse events, medical cost, and length of hospital stay were collected and analyzed. Logistic regression was used to determine risk factors for adverse events. Of the 6548 cases in this cohort, 1643 TJAs were classified as first round cases, 1744 TJAs were second round cases, 1600 TJAs were third round cases, and 1561 TJAs were fourth or later round cases. Mean operating time was shorter in the intermediate cases (45.0 vs. 41.0 vs. 41.8 vs. 54.1 min, P

To clarify the effects of tourniquet use on pain, early rehabilitation, blood loss, incidence rate of thrombosis in primary total knee arthroplasty (TKA) through a randomized controlled trial.Between Janurary 2014 and August 2015, 168 patients with knee osteoarthritis undergoing primary TKA were randomly allocated to tourniquet group (n = 84) or non-tourniquet group (n = 82). There was no significant difference in gender, age, body mass index, affected side, osteoarthritis grading, disease duration, preoperative range of motion (ROM), visual analogue scale (VAS), Hospital for Special Surgery (HSS) score, and hemoglobin (Hb) between 2 groups (P0.05). The operation time, hospitalization time, 90° knee flexion time, straight leg lifting time, and ambulation time were compared between 2 groups. Intraoperative blood loss, Hb decrease, postoperative VAS score, HSS score, ROM, and postoperative complications were recorded and compared.There was no significant difference in operation time (t = -1.353, P = 0.178). The patients were followed up 3-20 months (mean, 12 months) in tourniquet group, and 3-22 months (mean, 13 months) in non-tourniquet group. No significant difference was found in Hb decrease (t = -1.855, P = 0.066) and transfusion rate (23.81% of tourniquest group vs. 25.61% of non-tourniquest group) (χ² = 0.072, P = 0.788) between 2 groups. Significant difference was found in the incidence rate of thrombosis between tourniquet and non-tourniquet groups (10.71% vs. 2.44%) (χ² = 4.592, P = 0.032), and the intraoperative blood loss of tourniquet group was significantly less than that of non-tourniquet group (t = -16.066, P = 0.000). The 90° knee flexion time, straight leg lifting time, ambulation time, and hospitalization time of tourniquet group were significantly later than those of non-tourniquet group (P0.05). The tourniquet group had significantly higher VAS score at 3, 5, 7, and 14 days after operation (P0.05) and lower HSS score at 28 days after operation (t = -4.192, P = 0.000) than non-tourniquet group, but there was no significant difference in the ROM between 2 groups (t = 0.676, P = 0.500).The use of a tourniquet during TKA will increase knee pain and thrombotic events, but can not decrease total blood loss and transfusion rate. A tourniquet use during TKA is unfavorable for early rehabilitation progress.

Several studies have indicated that pain peaks at 24 to 48 hours after total knee arthroplasty (TKA) surgery. TKA has been associated with disruption in normal sleep patterns, swelling knee, and significant blood loss. However, a satisfactory regime to resolve these mentioned problems has yet to be found. In this study, a total of 420 patients were randomly allocated into two groups and treated with continuous irrigation of either 4000 mL cold saline with 0.5% epinephrine or normal temperature solution. Clinical outcomes including pain scores at rest during postoperative three days, drainage output, analgesic consumption, decreased hemoglobin, sleep quality, and satisfaction rate were analyzed. Mean scores and postoperative change in scores were calculated. Visual analog scale (VAS) pain scores in the treatment group were significantly reduced from 4 hours (P = 0.0016) to 24 hours (P = 0.0004) after TKA. Additional benefits including reduced analgesic consumption, improved satisfaction rate, and sleep quality were observed. In addition, a significant reduction in blood loss reflected by decreased Hb and drainage was found. In this study, irrigation with a cold 0.5% epinephrine solution was a beneficial and cost-effective treatment that decreased acute postoperative VAS pain scores immediately after and 1 day after surgery. Patients reported postoperative improvement in sleep quality and overall satisfaction rate with a decrease in morphine usage. In addition, a reduction of intraoperative blood loss might decrease the blood transfusion rate and related costs. Collectively, irrigation with cold 0.5% epinephrine offers a safe, simple, and effective treatment that might improve recovery and enhance quality of life of patients undergoing TKA.

A level IV fugacity model is used to simulate the fate and transfer of DDT in the Lanzhou area over a 67-year period from their introduction into agricultural field until 2019. The established model is successfully applied to simulate the transfer processes and the concentration distribution of DDT in four environmental compartments: air, water, soil, and sediment in Lanzhou area under non-steady state assumptions. Furthermore, the calculated results agree well with monitoring data from the literature in same period of time. We assume 20% of the total usage of DDT enters into air and 80% enters the soils. The results indicate that the main source of DDT in the area is agricultural application, the biggest bulk sink is soil (accounting for 99.8% of total amount in the environment). Among all the transfer processes, the deposition from air to soil, deposition from air to water, soil erosion, and sedimentation from water to sediment are the primary processes, and the degradation in soil and air are the key process of DDT disappearance.

A level IV fugacity model is described and illustrated by application to the fate of alpha-, beta-, gamma-, and delta-hexachlorocyclohexane (HCH) in the Lanzhou area over a 60-year period from their introduction into the agricultural field until 2019. The established model is successfully applied to simulate the transfer processes and the concentration distribution of HCHs under non-steady-state assumptions in four environmental compartments in the Lanzhou area: soil, air, water, and sediment. Furthermore, the calculated results agree well with monitoring data from the literature in the same period of time. We assume that 40% of the total use of HCHs isomers enters into the air and 60% enters the soil. The results indicate that the main source of HCHs in the area is agricultural applications; the biggest bulk sink is soil (accounting for 99.6% of total amount in the environment). Among all the transfer processes, the deposition and the diffusion at the air-soil and air-water interfaces are the primary processes, and degradation in soil and air is the key process of HCH disappearance.

To evaluate the effectiveness of anatomic femoral component prosthesis for severe development dysplasia of the hip (DDH) in total hip arthroplasty (THA).Between September 2009 and September 2013, 48 patients (51 hips) with severe DDH underwent THA with cementless anatomic femoral component prosthesis. There were 5 males (5 hips) and 43 females (46 hips) with an average age of 51 years (range, 28-67 years). The left hip was involved in 25 cases, the right hip in 20 cases, and bilateral hips in 3 cases. There were 39 cases (44 hips) of Crowe type III and 9 cases (7 hips) of Crowe type IV. The visual analogue scale (VAS) score was 5.72 +/- 1.84, and Harris score was 41.66 +/- 4.87 at preoperation. All patients had leg discrepancy with a length difference of (4.31 +/- 0.84) cm.The duration of surgery was 59-110 minutes (mean, 78.6 minutes), and the hospitalization days were 6-20 days (mean, 12.3 days). All patients obtained primary healing of incision without wound related complications of swelling, effusion, and infection. Two patients were found to have intramuscular venous thrombosis. All patients were followed up 10-54 months (mean, 29 months). Limp was observed at the early stage after operation in 9 patients and disappeared after 1 year, the other patients had normal gait. The VAS score 1.46?0.47, Harris score 88.66 +/- 3.48, and the leg length difference (1.15 +/- 0.33) cm at last follow-up all showed significant differences when compared with the preoperative values (P0.05). No prosthesis loosening or subsidence, heterotopic ossification, dislocation, and infection occurred.Anatomic femoral component prosthesis for severe DDH in THA can relieve pain, and improve the hip joint function and limb discrepancy. Short-term effectiveness was satisfactory, but the long-term effectiveness should still be observed in future.

This paper aims to study the effect of Shengjie Tongyu granules on the treatment of meteorological cardiovascular disease in clinical treatment. Tongxinluo capsule that is clinically recognized as the effective drug in treating coronary heart disease and angina and was adopted as positive control. The results showed that, angina score and TCM score of two groups were all significantly improved after the treatment (P0.01), but there was no statistical significance in comparison between groups (P0.05); total effective rate of angina in the treatment group (77.78%) was superior than the control group (62.52%) after the treatment; but the difference had no statistical significance (P0.05); total effective rate of TCM syndrome in the treatment group (75%) was superior than the control group (58.62%), and the difference had statistical significance (P0.05). All these findings suggested that, Shengjie Tongyu granules can effectively improve the clinical symptoms of patients with coronary heart disease and angina, with the curative effect similar to Tongxinluo capsule; meanwhile, it can increase HDL-C and improve abnormal lipid metabolism of angina patient. In the treatment process, there is no significant untoward effect, blood, routine urine test and hepatorenal function have no abnormality, which proves that this drug is safe.

Obesity not only gives rise to more blood loss volume but also correlates with postoperative rehabilitation and complications in surgical patients. It is not clear at present whether tourniquet utilization is associated with blood loss, rehabilitation, and complications, and it is imperative

This paper examines the feature extraction method based on force field transformation and develops a new two-stage approach for multi-pose ear feature extraction and recognition, i.e., force field transformation plus null space based kernel fisher discriminant analysis (NKFDA). Force field transformation assumes the pixel in the ear image as the particle that acts as the source of a force field. This transformation can strengthen the edges of ear image, which is the most important feature for ear to distinguish from one another. After the force field transformation, NKFDA is employed to extract feature for multi-pose ear image. Kernel technique can not only efficiently represent the nonlinear relation of data but also simplify the NLDA. The experimental results show that the proposed method is more robust and effective than the initial feature extraction method based on force field transformation, the potential well-based technique and demonstrate effectiveness for multi-pose ear recognition.