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BACKGROUND During rapid urbanization of cities in the Beijing-Tianjin-Hebei Region, the extensive economic development mode of 'high energy consumption, high pollution and high emission' has caused a series of atmospheric pollution problems. It is crucial to coordinate the relationship between economic development and atmospheric environmental quality. OBJECTIVES To investigate the relationship between the urbanization and the atmospheric environmental quality of the three cities of Beijing, Tianjin and Shijiazhuang. METHODS Based on the data of various indicators of atmospheric environmental quality and urbanization in Beijing, Tianjin, and Shijiazhuang from 2004 to 2017, the entropy method was used to study the evolution of atmospheric environmental quality in the process of urbanization in multiple dimensions. The annual average concentration of urban atmospheric pollutants SO2, NO2, PM10, and the number of days better than level 2 were 4 atmospheric environmental quality indicators, and 10 development indicators including regional GDP, per capita GDP, proportion of tertiary industries, and built-up area were selected to construct comprehensive index models and regression fitting. RESULTS The impact of urbanization on atmospheric environmental quality was the result of the combined effect of various factors. The relationship between comprehensive urbanization index and comprehensive atmospheric environmental pollution index in Beijing, Tianjin and Hebei was 'inverted U-shaped', 'positive U-shaped' and 'inverted N-shaped', respectively. The 10 urbanization indicators were classified into structural effects, scale effects and activity effects, and further analyze the impact of various effects on the atmospheric environmental pollution index. For Beijing, the dependent variables of the three types of effects all had negative impacts on atmospheric environmental quality. For Tianjin, the built-up area in the structure effect and scale effect, and the per capita GDP, GDP, resident consumption level and the total retail sales of consumer goods in the activity effect had negative correlations with atmospheric environmental quality. The impact of each dependent variable of the three effects on atmospheric environmental quality was unclear for Shijiazhuang. CONCLUSIONS The EKC hypothesis can reflect the relationship between the urbanization and atmospheric environmental quality to a certain extent. For the cities like Beijing that have basically completed the transformation of economic development, the EKC hypothesis is established obviously. But for the cities like Tianjin and Shijiazhuang that have not completed the economic restructuring, the relationship between urbanization and atmospheric environmental quality is uncertainty. Further study should be necessary.

Due to the unclear quality of the current guidelines, users may be confused about how to diagnose and treat achalasia. The objective of this work is to systematically evaluate the methodological quality of the current guidelines for diagnosing and treating achalasia and to determine the heterogeneity among recommendations. We systematically searched literature databases to retrieve relevant guidelines for the diagnosis and treatment of achalasia. The Appraisal of Guidelines for Research and Evaluation II tool was used to evaluate the quality of the included guidelines. Key recommendations in the guidelines were extracted, and the reasons for the heterogeneity of the key recommendations between different guidelines were further analyzed. Seven guidelines on the diagnosis and treatment of achalasia are included in this study. The overall score of three guidelines exceeded 60%. The average score in domain 5 was the lowest, at 41.8%. The average scores in domain 2, domain 3, and domain 6 were also low, at 45.4%, 57.1% and 56.9%, respectively. The main recommendations and quality of evidence for different guidelines vary greatly, mainly due to the different emphases among different guidelines, the lack of systematic retrieval, or the unfairness of evidence use in some guidelines. There are considerable differences in the methodological quality of diagnosis and treatment guidelines for achalasia. Additionally, the differences in the main recommendations and evidence support among guidelines are also obvious. Guideline developers should improve the above related factors to decrease the heterogeneity, and they should further formulate or update the guidelines for the diagnosis and treatment of achalasia. [ABSTRACT FROM AUTHOR]

Background: To systematically evaluate the quality of the guidelines for the diagnosis and treatment of Helicobacter pylori infection and to analyze the differences and reasons for the key recommendations in the guidelines. Methods: Databases and websites were systematically searched to obtain guidelines for the diagnosis and treatment of Helicobacter pylori infection. Four independent reviewers used the Guideline Evaluation Tool (AGREE II) to evaluate the included guidelines. The intraclass correlation coefficient (ICC) and Fleiss' kappa coefficient were used to measure the consistency of evaluation guidelines between guide reviewers. Differences between guidelines and the reasons for the differences were analyzed by comparing the recommendations of different guidelines and the evidence supporting the recommendations. Results: A total of 17 guidelines for Helicobacter pylori infection were included in this study. The AGREE II scores of these guidelines were low overall, with 4 of them had a score of over 60%, which indicates that the guidelines are recommended, and 13 of them having a score ranging from 30 to 60%, which indicates that the guidelines are recommended but need to be revised, while no guideline had a score of 30% or less, which indicates that they were not recommended. The analysis of these guidelines found that there were some differences in the main recommendations. Not all guidelines recommend sequential therapy as the recommended therapy. Whether bismuth quadruple therapy should be used as the recommended first‐line therapy is unclear. The antibiotic resistance rate is different in different regions. Combined with the local antibiotic sensitivity test, the eradication rate of Helicobacter pylori can be improved. Conclusion: There are significant differences in the quality of Helicobacter pylori infection guidelines and the key recommendations. Improving the deficiencies of existing guidelines is an effective way to develop high‐quality guidelines and make reasonable recommendations for the treatment of Helicobacter pylori infection in the future. [ABSTRACT FROM AUTHOR]

We report the experimental production of degenerate Fermi gases of 6Li atoms in an optical dipole trap. The gray-molasses technique is carried out to decrease the atomic temperature to 57 μK, which facilitates the efficient loading of cold atoms into the optical dipole trap. The Fermi degeneracy is achieved by evaporative cooling of a two-spin mixture of 6Li atoms on the Feshbach resonance. The degenerate atom number per spin is 3.5 × 104, and the reduced temperature T/TF is as low as 0.1, where TF is the Fermi temperature of the non-interacting Fermi gas. We also observe the anisotropic expansion of the atom cloud in the strongly interacting regime. [ABSTRACT FROM AUTHOR]

Background& Aims: Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition.Methods: Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness.Results: One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P < 0.05). The median postoperative length of stay in the multimodal EON group was 8 days (6, 12) versus 10 days (7, 18) in the conventional care group (P < 0.001). The total cost of treatment and nutritional support were also less in the multi-modal early oral nutrition group (P < 0.001). The effectiveness was 84.9 and 79.9% in the multimodal EON and conventional care group, respectively (P = 0.475). However, the cost-effectiveness ratio was USD 537.6 (506.1, 589.3) and USD 637.8 (593.9, 710.3), respectively (P < 0.001).Conclusion: The multi-modal early oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal surgery.Trial Registration: Registration number: ChiCTR-TRC-14004395 . Registered 15 March 2014. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of nutritional support on clinical outcomes in patients at nutritional risk who receive nutritional support that meets guideline standards and those who do not.Methods: This prospective cohort study enrolled hospitalized patients from the Second Affiliated Hospital of Kunming Medical University from February 2010 to June 2012. The research protocols were approved by the university's ethics committee, and the patients signed informed consent forms. The clinical data were collected based on nutritional risk screening, administration of enteral and parenteral nutrition, surgical information, complications, and length of hospital stay.Results: During the study period, 525 patients at nutritional risk were enrolled in the cohorts. Among patients who received nutritional support that met the guideline standards (Cohort 1), the incidence of infectious complications was lower than that in patients who did not meet guideline standards (Cohort 2) (17.1 % vs. 26.9 %, P = 0.01). Subgroup analysis showed that individuals who received a combination of parenteral nutrition (PN) and enteral nutrition (EN) for 7 or more days had a significantly lower incidence of infectious complications (P = 0.001) than those who received only PN for 7 or more days or those who received nutritional support for less than 7 days or at less than 10 kcal/kg/d. Binary logistic regression analysis showed that, after adjusting for confounding factors, nutritional support that met guideline standards for patients with nutritional risk was a protective factor for complications (OR: 0.870, P < 0.002).Conclusions: In patients at nutritional risk after abdominal surgery, nutritional support that meets recommended nutrient guidelines (especially regimens involving PN + EN ≥ 7 days) might decrease the incidence of infectious complications and is worth recommending; however, well-designed trials are needed to confirm our findings. Nutritional support that does not meet the guideline standards is considered clinically undesirable. [ABSTRACT FROM AUTHOR]