Contamination assessment,source apportionment and associated health risks of PTEs in agricultural soil under five land-use patterns in Sanya,China

To understand the levels of potentially toxic elements(PTEs)contamination in soils and their effects on human health from different agricultural land use in Sanya,China.128 soil samples(64 topsoil samples and corresponding subsoil samples)were collected from the five representative land-use patterns.Inductively coupled plasma mass spectrometry(ICP-MS),Atomic fluorescence spectrometry(AFS),and Inductively coupled plasma optical emission spectrometry(ICP-OES)were used to determine the content of PTEs(As,Cd,Hg,Cu,Cr,Ni,Pb,Zn,Co,Mo,Sb,and V).Correlation analysis and factor analysis were used to determine the source of PTEs.Geo-accumulation index(I_(geo)),hazard quotient(HQ),and total carcinogenic risk index(TR)were used to measure the PTEs contamination and its relative health impacts.Results showed that the average values of 12 PTEs in topsoil were higher than the Hainan soil geochemical baseline,showing different degrees of PTEs accumulation effect.The concentration of PTEs in the topsoil was lower than those in the subsoil except for Cd and Hg.The I_(geo)revealed that the major accumulated element in soils was As followed by Mo.Source apportionment suggested that parent materials and agricultural practices were the dominant factors for PTEs accumulation in the topsoil.Noncarcinogenic risks of soil samples from five land-use patterns presented a trend of paddy field>dry field>woodland>orchard>garden plot.However,the HQ values of 12 PTEs were less than the recommended limit of HQ=1,representing that there are no non-carcinogenic risks of PTEs for children and adults in the study area.The TR values are within 6.95×10^(-6)-1.38×10^(-5),which corresponds to the low level.Therefore the PTEs in the agricultural soil of the study area show little influence on the health status of the local population.

Associations between Geriatric Nutrition Risk Index,bone mineral density and body composition in type 2 diabetes patients

BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.

Actuality and underlying mechanisms of systemic immuneinflammation index and geriatric nutritional risk index prognostic value in hepatocellular carcinoma

This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.

Malnutrition Assessed Using the Geriatric Nutritional Risk Index Is Associated with Preoperative Incidence of Deep Vein Thrombosis in Japanese Patients Undergoing Total Knee Arthroplasty

Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.

Correlation between preoperative systemic immune inflammation index, nutritional risk index, and prognosis of radical resection of liver cancer

BACKGROUND Radical surgery is the most commonly used treatment for hepatocellular carcinoma(HCC).However,the surgical effect remains not ideal,and prognostic evaluation is insufficient.Furthermore,clinical intervention is rife with uncertainty and not conducive to prolonging patient survival.AIM To explore correlations between the systemic immune inflammatory index(SII)and geriatric nutritional risk index(GNRI)and HCC operation prognosis.METHODS This retrospective study included and collected follow up data from 100 HCC.Kaplan–Meier survival curves were used to analyze the correlation between SII and GNRI scores and survival.SII and GNRI were calculated as follows:SII=neutrophil count×platelet count/lymphocyte count;GNRI=[1.489×albumin(g/L)+41.7×actual weight/ideal weight].We analyzed the predictive efficacy of the SII and GNRI in HCC patients using receiver operating characteristic(ROC)curves,and the relationships between the SII,GNRI,and survival rate using Kaplan–Meier survival curves.Cox regression analysis was utilized to analyze independent risk factors influencing prognosis.RESULTS After 1 year of follow-up,24 patients died and 76 survived.The area under the curve(AUC),sensitivity,specificity,and the optimal cutoff value of SII were 0.728(95%confidence interval:0.600-0.856),79.2%,63.2%,and 309.14,respectively.According to ROC curve analysis results for predicting postoperative death in HCC patients,the AUC of SII and GNRI combination was higher than that of SII or GNRI alone,and SII was higher than that of GNRI(P<0.05).The proportion of advanced differentiated tumors,tumor maximum diameter(5–10 cm,>10 cm),lymph node metastasis,and TNM stage III-IV in patients with SII>309.14 was higher than that in patients with SII≤309.14(P<0.05).The proportion of patients aged>70 years was higher in patients with GNRI≤98 than that in patients with GNRI>98(P<0.05).The 1-year survival rate of the SII>309.14 group(compared with the SII≤309.14 group)and GNRI≤98 group(compared with the GNRI>98 group)was lower(P<0.05).CONCLUSION The prognosis after radical resection of HCC is related to the SII and GNRI and poor in high SII or low GNRI patients.

Contamination and Potential Risks of Heavy Metals in the Sediments of the Chari and Logon Rivers in N’Djamena, Chad

The pollution of sediments by inorganic pollutants requires particularly important attention because of their toxicity, their persistence in the environment and their bioaccumulation by animal and plant life. The pollution of sediments by inorganic pollutants requires particularly important attention because of their toxicity, their persistence in the environment and their bioaccumulation by animal and plant living beings. This study focuses on the pollution of sediments of the Chari and Logon rivers in the city of N’Djamena by heavy metals. The objective of this study is to evaluate the degree of contamination, the geo-accumulation index and the degree of the Pollutant Loading Index of some heavy metals (Pb, Cr, Cu, Mn and Cd) and iron in the sediments of the sampled sites. The average concentrations of heavy metals and iron in the sediments are: Pb (10.00 ± 00 μg/Kg to 126 ± 16.52 μg/Kg);Cr VI (0.13 ± 00 mg/Kg to 0.21 ± 00 mg/Kg);Cd (trace);Cu (0.08 ± 0.02 mg/kg to 3.23 ± 0.64 mg/kg);Fe (0.25 ± 0.00 mg/kg to 5.79 ± 0.00 mg/kg);and Mn (0.2 ± 0.00 mg/Kg to 1.1 ± 0.00 mg/Kg);in order of highest to lowest abundance: Fe > Mn > Cd > Cu > Cr VI > Pb for the Logon;Fe > Cu > Mn > Cd > Cr VI > Pb for the Chari and Fe > Mn > Cu > Cd > Cr VI > Pb for the Confluent. The contamination factors for all heavy metals range from no contamination to low contamination for the sediments analyzed. The geo-accumulation indices indicate that the sampled sites are not polluted. The same is true for Er and RI which confirm an absence of ecological risks in the analyzed sediments.

The Hidden Earthquake Induced Liquefaction Risks in the Rohingya Refugee Camp Hills & Surrounding Areas of Ukhiya, Cox’s Bazar, Bangladesh—A Geotechnical Engineering Approach

Liquefaction is one of the major catastrophic geohazards which usually occurs in saturated or partially saturated sandy or silty soils during a seismic event. Evaluating the potential liquefaction risks of a seismically prone area can significantly reduce the loss of lives and damage to civil infrastructures. This research is mainly focused on the earthquake-induced liquefaction risk assessment based on Liquefaction Potential Index (LPI) values at different earthquake magnitudes (M = 5.0, 7.0 and 8.0) with a peak ground acceleration (amax) of 0.28 g in the Rohingya Refugee camp and surrounding areas of Ukhiya, Cox’s Bazar, Bangladesh. Standard Penetration Test (SPT) results have been evaluated for potential liquefaction assessment. The soils are mainly composed of very loose to loose sands with some silts and clays. Geotechnical properties of these very loose sandy soils are very much consistent with the criteria of liquefiable soil. It is established from the grain size analysis results;the soil of the study area is mainly sand dominated (SP) with some silty clay (SC) which consists of 93.68% to 99.48% sand, 0.06% to 4.71% gravel and 0% to 6.26% silt and clay. Some Clayey Sand (SC) is also present. The silty clay can be characterized as medium (CI) to high plasticity (CH) inorganic clay soil. LPI values have been calculated to identify risk zones and to prepare risk maps of the investigated area. Based on these obtained LPI values, four (4) susceptible liquefaction risk zones are identified as low, medium, high and very high. The established “Risk Maps” can be used for future geological engineering works as well as for sustainable planning, design and construction purposes relating to adaptation and mitigation of seismic hazards in the investigated area.

Ecological risk assessment of heavy metals in sediments of Xiawan Port based on modified potential ecological risk index

Modified potential ecological risk index （MRI） was proposed based on the potential ecological risk index （RI） and risk assessment code （RAC） by modifying an index. The modified index was relevant to the chemical speciation of heavy metals. Xiawan Port, a typical region contaminated by industrial production, was selected as a case study area. The total concentrations and chemical speciation of heavy metals in sediments of Xiawan Port were analyzed. The experimental data indicate that Xiawan Port is seriously polluted by heavy metals, especially by Cd. The risks of heavy metals are evaluated by RI, RAC and MRI, respectively. The resluts of MRI show that the risks of heavy metals are in the decreasing order of Cd〉Pb〉Cu〉Zn. Comparison of results by different methods reveals that MRI integrates the characters of RI and RAC. MRI is recognized to be useful for risk managemnt of heavy metals in sediments.

Triceps skinfold thickness trajectories and the risk of all-cause mortality:A prospective cohort study

BACKGROUND The measurement of triceps skinfold(TSF)thickness serves as a noninvasive metric for evaluating subcutaneous fat distribution.Despite its clinical utility,the TSF thickness trajectories and their correlation with overall mortality have not been thoroughly investigated.AIM To explore TSF thickness trajectories of Chinese adults and to examine their associations with all-cause mortality.METHODS This study encompassed a cohort of 14747 adults sourced from the China Health and Nutrition Survey.Latent class trajectory modeling was employed to identify distinct trajectories of TSF thickness.Subjects were classified into subgroups reflective of their respective TSF thickness trajectory.We utilized multivariate Cox regression analyses and mediation examinations to explore the link between TSF thickness trajectory and overall mortality,including contributory factors.RESULTS Upon adjustment for multiple confounding factors,we discerned that males in the‘Class 2:Thin-stable’and‘Class 3:Thin-moderate’TSF thickness trajectories exhibited a markedly reduced risk of mortality from all causes in comparison to the‘Class 1:Extremely thin’subgroup.In the mediation analyses,the Geriatric Nutritional Risk Index was found to be a partial intermediary in the relationship between TSF thickness trajectories and mortality.For females,a lower TSF thickness pattern was significantly predictive of elevated all-cause mortality risk exclusively within the non-elderly cohort.CONCLUSION In males and non-elderly females,lower TSF thickness trajectories are significantly predictive of heightened mortality risk,independent of single-point TSF thickness,body mass index,and waist circumference.

Prognostic impact of preoperative nutritional and immune inflammatory parameters on liver cancer

The immune response to tissue damage or infection involves inflammation,a multifaceted biological process distinguished by immune cell activation,mediator secretion,and immune cell recruitment to the site of injury.Several blood-based immune-inflammatory biomarkers with prognostic significance in malignancies have been identified.In this issue of the World Journal of Gastrointestinal Surgery,they examined the prognosis of liver cancer radical resection in relation to pre-operative systemic immune-inflammation and nutritional risk indices.Comparing older and younger individuals often reveals compromised nutritional and immu-nological statuses in the former.Therefore,performing preoperative evaluations of the nutritional status and immunity in geriatric patients is critical.In addition to being a primary treatment modality,radical resection is associated with a sig-nificant mortality rate following surgery.Insufficient dietary consump-tion and an elevated metabolic rate within tumor cells contribute to the increased proba-bility of malnutrition associated with the ailment,consequently leading to a sub-stantial deterioration in prognosis.Recent studies,reinforce the importance of nu-tritional and immune-inflammatory biomarkers.Prior to surgical intervention,geriatric nutritional risk and systemic immune-inflammatory indices should be prioritized,particularly in older patients with malignant diseases.

Malnutrition and Its Association with the Mortality of Patients with Femoral Intertrochanteric Fractures: A Retrospective Analysis of Japanese Patients

Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.

Heavy Metal Levels and Ecological Risk in Crude Oil-Contaminated Soils from Okpare-Olomu, Niger Delta, Nigeria

Crude oil spills have inflicted extensive disruption upon the Niger Delta ecosystem, resulting in crop loss and severe environmental damage. Such spills exacerbate heavy metal concentration within soil due to the presence of metallic ions. The Okpare-Olomu community has borne the brunt of crude oil pollution from illicit bunkering, sabotage, and equipment malfunction. This study targets an evaluation of ecological hazards linked to heavy metals (HMs) in crude oil impacted agriculturally soils within Okpare-Olomu in Ughelli South LGA of Delta State. In this study, 24 topsoil samples were obtained from areas affected by crude oil pollution;the heavy metal content was evaluated through atomic absorption spectrometry. The concentration ranges for HMs (mg/kg) in soil were: 24.1 - 23,174 (Cu);0.54 - 37.1 (Cd);9.05 - 54 (Cr);12 - 174 (Ni);18.5 - 8611 (Pb);and 148 - 9078 (Zn) at a soil depth of 0 - 15 cm. Notably, metal concentrations were recorded to be above permissible World Health Organization limits. Predominantly, Zn and Pb recorded higher heavy metal concentration when compared to other heavy metals analysed, notably at sampling points PT7 through PT24. Zinc and Pb contamination exhibited highly significant contamination factors, and contamination severity was evidenced across all sample points, signifying a grave risk level. Pollution load indices indicated pervasive extreme pollution levels. Geoaccumulation indices signaled moderate to strong pollution, mainly by Pb and Zn. Ecological risk assessments revealed variable levels of heavy metal contamination, from low to very high, with potential ecological risk reflecting markedly elevated levels. This study underscores the imperative for soil remediation to rectify ecological imbalances in agriculturally affected soil constituents.

Spatio-temporal Evolution and Optimization of Landscape Ecological Risk in Karst Mountainous Areas

[Objective]The ecological vulnerability and landscape ecological risk of karst mountainous areas have increased as a result of enhanced disturbance of natural resources by human activities.This paper aimed to explore the characteristics of ecological risk evolution under different landscape patterns in the region,with a view to providing reference for land classification protection,sustainable use of resources and regional ecological risk optimization in karst mountainous areas.[Method]Taking Huangping County,a typical karst mountainous area,as an example,eight evaluation factors of natural and landscape patterns were selected to construct a landscape ecological risk evaluation model,to quantitatively explore the spatio-temporal evolution of landscape ecological risk and the trend of risk level transfer in the study area from^(2)010-2018,and to reveal the complex relationship between ecological risk and topography in karst mountainous areas.[Result]①From 2010 to 2018,land use types changed to different degrees,with the most amount of woodland transferred out(1627.37 hm^(2))and the most amount of construction land transferred in(1303.93 hm^(2));a total of 3552.31 hm^(2) of land was transferred,with a change ratio of 2.13%,and there was a significant conversion between construction land,arable land,and woodland.②From 2010 to 2018,the landscape ecological risk in the study area changed significantly,and the landscape ecological risk index decreased from 0.3441 to 0.1733,showing an upward and then downward trend;the landscape ecological risk of the whole region was dominated by low-risk and lower-risk zones,and the ecological risk level generally shifted from a high level to a low level,and the ecological environment was improved.③There was a negative correlation between ecological risk and topographic position,and high-risk zones were mainly distributed among low topographic zones;with the change of time,the advantage of risk level for the selection of topography was gradually weakened,and the influence of anthropogenic factors on the ecological risk of the landscape was becoming more and more prominent.[Conclusion]This paper can provide theoretical basis for land use optimization and ecological protection in karst mountainous areas.

Analysis and Evaluation of Non-systematic Risks in Enterprise Informationization

Enterprise Informationization （El） is encountering a large variety of non-systematic risks in demanding and planning, designing and selecting, implementing and controlling, managerial and cultural aspects,due to which the investment in IT normally cannot simultaneously create the expected commercial values. Through analyzing the factors influencing non-systematic risks of EI, the paper established a risk evaluating index system and accordingly proposed a set of appropriate risk evaluating methodology, with which enterprise can well control informationization risks.

Validation of nutritional risk index method against patientgenerated subjective global assessment in screening malnutrition in colorectal cancer patients

Objective：To validate malnutrition screening tool of nutrition risk index （NRI） against patent-generated subjective global assessment （PG-SGA） as a gold standard tool in colorectal cancer patients before radiotherapy.Methods：Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA （gold standard method） and NRI.Serum albumin levels of patients were determined by colorimetric method.A contingency table was used to determine the sensitivity,specificity,and predictive value of the NRI in screening patients at risk of malnutrition,in comparison with the PG-SGA in patients before radiotherapy.Results：The findings of PG-SGA and NRI showed that 52％ and 45％ of patients in our study were moderately or severely malnourished respectively.The NRI had a sensitivity of 66％ and a specificity of 60％ against PG-SGA.The positive predictive value was 64％ and the negative predicative value was 62％.The agreement between NRI and PG-SGA was statistically insignificant （kappa =0.267; P＞0.05）.Conclusions：The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer.Moreover,NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer.It seems that the combination of anthropometric,laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients.

Nutritional risk index as a predictor of postoperative wound complications after gastrectomy

AIM： To investigate the correlation between the nutri- tional risk index （NRI） and postoperative wound com- plications.

Evaluation of the potential risks of heavy metal contamination in rice paddy soils around an abandoned Hg mine area in Southwest China

To assess the potential ecological and health risks of trace elements(Hg,Cd,As,Mn,Sb,Pb,Cu,Ni,Cr,and Zn),a total of 138 soil samples from rice paddies were collected during the rice harvest season in the Wanshan mining area,Guizhou Province,Southwest China.Factors of the pollution load index(PLI),geo-accumulation index(I-Geo),enrichment factor(EF),and risk index(RI)were determined.High concentrations of Hg,Sb,As,Zn,Cd,Cu,and Mn were observed in the soils.The PLI,I-Geo,and EF results all showed high levels of contamination by Hg and Sb and moderate levels of contamination by As,Pb,Zn,Cu,Cd,and Mn.There was no significant contamination from Ni and Cr.The RI was very high,with Hg as the dominant pollutant,as expected,indicating that the historical large-scale Hg mining,as well as artisanal mining,has had a significant impact on the Wanshan area.Moreover,coal combustion,manganese factories,and the use of agrochemicals by the local population could also have an impact on the soil through the introduction of heavy metal loads.To address the current state of contamination,pollutant remediation and the regulation control of the anthropogenic activities in Wanshan are urgently needed.

Disease Risk Comorbidity Index for Patients Receiving Haploidentical Allogeneic Hematopoietic Transplantation

We aimed to develop a disease risk comorbidity index(DRCI)based on disease risk index(DRI)and Hematopoietic Cell Transplantation-Specific Comorbidity Index(HCT-CI)in patients receiving haploidentical hematopoietic stem cell transplantation(haplo-HSCT).We identified the prognostic factors of disease-free survival(DFS)in a training subset(n=593),then assigned a weighted score using these factors to the remaining patients(validation subset;n=296).The multivariable model identified two independent predictors of DFS:DRI and HCT-CI before transplantation.In this scoring system,we assigned a weighted score of 2 to very high-risk DRI,and assigned a weighted score of 1 to high-risk DRI and intermediate-and high-risk HCT-CI(i.e.,haplo-DRCI).In the validation cohort,the three-year DFS rate was 65.2%(95%confidence interval(CI),58.2%–72.2%),55.8%(95%CI,44.9%–66.7%),and 32.0%(95%CI,5.8%–58.2%)for the low-,intermediate-,and high-risk group,respectively(P=0.005).Haplo-DRCI can also predict DFS in disease-specific subgroups,particularly in acute leukemia patients.Increasing score was also significantly predictive of increased relapse,increased non-relapse mortality(NRM),decreased DFS,and decreased overall survival(OS)in an independent historical cohort(n=526).These data confirmed that haplo-DRCI could effectively risk stratify haplo-HSCT recipients and provide a tool to better predict who will best benefit from haplo-HSCT.

Evaluating the Health Risks of Pneumonia from Airborne Bacterial Communities Using 16S rDNA Sequences of Pneumonia-related Pathogens

Objective Airborne microbial communities include a significant number of uncultured and poorly characterized bacteria.No effective method currently exists to evaluate the health risks of such complex bacterial populations,particularly for pneumonia.Methods We developed a method to evaluate risks from airborne microorganisms,guided by the principle that closer evolutionary relationships reflect similar biological characteristics,and thus used16 S rDNA sequences of 10 common pneumonia-related bacterial pathogens.We calculated a risk of breath-related(Rbr)index of airborne bacterial communities and verified effectiveness with artificial flora and a clinical project.Results We suggested applying Rbr80 to evaluate the health risks of airborne bacterial communities that comprise 80% of dominant operational taxonomic units(OTUs).The feasibility of Rbr80 was confirmed by artificial flora and by pneumonia data from a hospital.A high Rbr80 value indicated a high risk of pneumonia from airborne bacterial communities.Conclusion Rbr80 is an effective index to evaluate the pneumonia-associated risk from airborne bacteria.Values of Rbr80 greater than 15.40 are considered high risk.

Risk factors and ankle brachial indexes in cerebral infarction combined with peripheral arterial disease

BACKGROUND: Ankle brachial index (ABI) is widely involved in researches and clinical application of peripheral vascular injury of patients with diabetes mellitus (DM); however, the application in cerebral infarction (CI) is rare. OBJECTIVE: To investigate the possible risk factor of cerebral infarction plus peripheral arterial disease (PAD), compare metabolic characteristics of patients who having CI plus PAD or only having CI, and understand the significance of ABI on screening and diagnosing CI plus PAD of lower limb. DESIGN: Contrast observation based on CI patients. SETTING: Department of Neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region. PARTICIPANTS: A total of 124 CI patients were selected from Department of Neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2005 to April 2006, including 72 males and 52 females aged from 45 to 88 years. All patients met the diagnostic criteria of cerebrovascular disease established by National Academic Conference of Cerebrovascular Diseases in 1995 and determined as cerebral infarction with MRI or CT examination. All patients provided informed consent. There were 46 cases (37.2%) with CI plus PAD and 78 cases (62.8%) only with CI. METHODS: Blood pressure of bilateral ankles and upper extremities was measured at plain clinostatism with DINAMAP blood pressure monitor (GE Company). The ratio between average systolic pressure of lateral ankle and average systolic pressure of both upper extremities was regarded as ABI. The normal ABI was equal to or more than 0.9. If ABI < 0.9 occurred at one side, patients were diagnosed as PAD. On the second morning after hospitalization, blood was collected to measure fasting blood glucose (FBG), 2-hour postprandial blood glucose (PBG2h), glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Among them, blood glucose, lipid and other biochemical markers were measured with enzyme chemistry assay and HbA1c was measured with HbA1c meter based on high liquid phase. Measurement data and enumeration data were compared with t test and Chi-square test, and multiple factors were dealt with Logistic regression analysis and multivariate linear regression analysis. MAIN OUTCOME MEASURES: Results of correlation between ABI and metabolic markers with multivariate linear regression analysis; risk factors of CI plus PAD with Logistic regression analysis; comparisons of metabolic markers between PAD and non-PAD patients. RESULTS: All 124 patients with acute CI were involved in the final analysis. ① Comparisons of metabolic markers: Levels of serum LDL-C and uric acid (UA) were higher of PAD patients than those of non-PAD patients (t =2.051 9, 3.339 1, P < 0.05); however, there were no significant differences among other metabolic markers (P > 0.05). ② Results of multivariate linear regression analysis: PBG2h, LDL-C and UA were obvious correlation with ABI of posterior tibial artery of lower limb and dorsal pedis artery (partial regression coefficient = -0.231 to -1.010, P < 0.05). ③ Risk factors of CI plus PAD with Logistic regression analysis: Age, smoking history, sum of CI focus (≥3) and LDL-C were independent risk factor of CI plus PAD (OR =1.524-5.422, P < 0.05-0.01). CONCLUSION: ① Levels of serum LDL-C and UA of patients with CI plus PAD are high. ② ABI of lower limbs is correlation with PBG2h, LDL-C and UA. In addition, measuring ABI is beneficial for early diagnosing PAD of lower limbs of patients who have poorly controlled blood glucose, abnormal lipid and poor renal function. ③ Age, LDL-C and sum of CI focus (≥3) are independent risk factors of CI plus PAD. It is of significance for screening non-PAD patients to evaluate risk degrees and prognosis and select therapeutic methods based on ABI measurement.