Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery:A propensityscore-matching analysis

BACKGROUND Intestinal flora disorder(IFD)poses a significant challenge after laparoscopic colonic surgery,and no standard criteria exists for its diagnosis and treatment.AIM To analyze the clinical features and risk factors of IFD.METHODS Patients with colon cancer receiving laparoscopic surgery were included using propensity-score-matching(PSM)methods.Based on the occurrence of IFD,patients were categorized into IFD and non-IFD groups.The clinical characteristics and treatment approaches for patients with IFD were analyzed.Multivariate regression analysis was performed to identify the risk factors of IFD.RESULTS The IFD incidence after laparoscopic surgery was 9.0%(97 of 1073 patients).After PSM,97 and 194 patients were identified in the IFD and non-IFD groups,respectively.The most common symptoms of IFD were diarrhea and abdominal,typically occurring on post-operative days 3 and 4.All patients were managed conservatively,including modulation of the intestinal flora(90.7%),oral/intravenous application of vancomycin(74.2%),and insertion of a gastric/ileus tube for decompression(23.7%).Multivariate regression analysis identified that preoperative intestinal obstruction[odds ratio(OR)=2.79,95%CI:1.04–7.47,P=0.041]and post-operative antibiotics(OR=8.57,95%CI:3.31–23.49,P<0.001)were independent risk factors for IFD,whereas pre-operative parenteral nutrition(OR=0.12,95%CI:0.06–0.26,P<0.001)emerged as a protective factor.CONCLUSION A stepwise approach of probiotics,vancomycin,and decompression could be an alternative treatment for IFD.Special attention is warranted post-operatively for patients with pre-operative obstruction or early use of antibiotics.

Proposal for a new classification of anorectal abscesses based on clinical characteristics and postoperative recurrence

BACKGROUND Current surgical procedures for anorectal abscesses,including incision and drainage alone or combined concurrent fistulotomy,remain controversial primarily due to the unpredictability of postoperative recurrence or the progression to anal fistula.AIM To evaluate factors that predict postoperative recurrence of anorectal abscesses and propose a new classification to guide surgical procedures.METHODS In this retrospective study,525 patients with anorectal abscesses treated by incision and drainage alone,at a tertiary general hospital from August 2012 to July 2022,were included.A new classification for anorectal abscesses based on their propensity to develop into fistulas,considering 18 other potential risk factors,was established.These factors,from electronic medical records,were screened for significance using theχ^(2)test and subsequently analyzed with multivariate logistic regression to evaluate their relationship with postoperative recurrence of anorectal abscesses.RESULTSOne year post-follow-up,the overall recurrence rate was 39%:81.0%and 23.5%for fistula-prone and non-fistulaproneabscesses,respectively.Univariateχ^(2)analysis showed significant differences in recurrence rates based onanatomical classifications and pus culture results(P<0.05).Fistula-prone abscess,≥7 days between symptomonset and surgery,chronic diarrhea,preoperative antibiotic use,and local anesthesia were risk factors for recurrence,while diabetes mellitus was protective(P<0.05).Moreover,fistula-prone abscess[odds ratio(OR)=7.651,95%CI:4.049–14.458,P<0.001],≥7 days from symptom onset to surgery(OR=2.137,95%CI:1.090–4.190,P=0.027),chronic diarrhea(OR=2.508,95%CI:1.216–5.173,P=0.013),and local anesthesia(OR=2.308,95%CI:1.313–4.059,P=0.004)were independent risk factors for postoperative anorectal abscess recurrence using multivariatelogistic regression.Body mass index≥28(OR=2.935,95%CI:1.203–7.165,P=0.018)was an independentrisk factor for postoperative recurrence of non-fistula-prone abscess.CONCLUSIONThe choice of surgical procedure for treating anorectal abscesses should follow this new classification.Prompt andthorough incision and drainage can significantly reduce postoperative recurrence.

Development and application of hepatocellular carcinoma risk prediction model based on clinical characteristics and liver related indexes

BACKGROUND Hepatocellular carcinoma(HCC)is difficult to diagnose with poor therapeutic effect,high recurrence rate and has a low survival rate.The survival of patients with HCC is closely related to the stage of diagnosis.At present,no specific serolo-gical indicator or method to predict HCC,early diagnosis of HCC remains a challenge,especially in China,where the situation is more severe.AIM To identify risk factors associated with HCC and establish a risk prediction model based on clinical characteristics and liver-related indicators.METHODS The clinical data of patients in the Affiliated Hospital of North Sichuan Medical College from 2016 to 2020 were collected,using a retrospective study method.The results of needle biopsy or surgical pathology were used as the grouping criteria for the experimental group and the control group in this study.Based on the time of admission,the cases were divided into training cohort(n=1739)and validation cohort(n=467).Using HCC as a dependent variable,the research indicators were incorporated into logistic univariate and multivariate analysis.An HCC risk prediction model,which was called NSMC-HCC model,was then established in training cohort and verified in validation cohort.RESULTS Logistic univariate analysis showed that,gender,age,alpha-fetoprotein,and protein induced by vitamin K absence or antagonist-II,gamma-glutamyl transferase,aspartate aminotransferase and hepatitis B surface antigen were risk factors for HCC,alanine aminotransferase,total bilirubin and total bile acid were protective factors for HCC.When the cut-off value of the NSMC-HCC model joint prediction was 0.22,the area under receiver operating characteristic curve(AUC)of NSMC-HCC model in HCC diagnosis was 0.960,with sensitivity 94.40%and specificity 95.35%in training cohort,and AUC was 0.966,with sensitivity 90.00%and specificity 94.20%in validation cohort.In early-stage HCC diagnosis,the AUC of NSMC-HCC model was 0.946,with sensitivity 85.93%and specificity 93.62%in training cohort,and AUC was 0.947,with sensitivity 89.10%and specificity 98.49%in validation cohort.CONCLUSION The newly NSMC-HCC model was an effective risk prediction model in HCC and early-stage HCC diagnosis.

Impact renaming non-alcoholic fatty liver disease to metabolic associated fatty liver disease in prevalence,characteristics and risk factors

BACKGROUND Recently,a group of hepatologists proposed to rename non-alcoholic fatty liver disease(NAFLD)as metabolic associated fatty liver disease(MAFLD)with modified diagnostic criteria.It is important to note,however,that there are some differences between the diagnostic criteria used for NAFLD and MAFLD.Since the research on MAFLD is just beginning,however,evidence on its incidence and prevalence in the general population and in speci
c subpopulations remains limited.AIM To assess epidemiology of fatty liver in new definition and compare MAFLD with NAFLD.Exploring risk factors of MAFLD individuals.METHODS This was a retrospective,cross-sectional study.A total of 85242 adults were selected from the Chinese health management database in 2017–2022.The data of general information,laboratory indicators,lifestyle management and psychological status were obtained.MAFLD was diagnosed as ultrasound diagnosis of fatty liver and at least one between these three conditions:Overweight/obesity,type 2 diabetes mellitus(T2DM)or metabolic dysregulation.Metabolic factors were not considered in NAFLD diagnosis standard.The clinical characteristics of MAFLD and NAFLD were analysed using descriptive statistics.Continuous variables normally distributed were expressed as means±SD.Categorical variables were expressed as frequencies and proportions.Binary logistic regression was used to determine risk factors of the MAFLD.RESULTS The prevalence of MAFLD and NAFLD was 40.5%and 31.0%,respectively.The MAFLD or NAFLD population is more likely to be older(M:47.19±10.82 vs 43.43±11.96;N:47.72±11.17 vs 43.71±11.66),male(M:77.21%vs 44.43%;N:67.90%vs 53.12%)and high body mass index(M:26.79±2.69 vs 22.44±2.48;N:26.29±2.84 vs 23.29±3.12)than the non-MAFLD or non-MAFLD population.In multivariate analysis,general information(e.g.,≥2 metabolic abnormalities OR=3.38,(95%CI:2.99-3.81),P<0.001;diastolic blood pressure OR=1.01,(95%CI:1.00–1.01),P=0.002),laboratory results[e.g.,total bilirubin(TBIL)OR=0.98,(95%CI:0.98-0.99),P<0.001;serum uric acid(SUA)OR=1.01,(95%CI:1.01-1.01),P<0.001],and lifestyle factors[e.g.,drink beverage OR=0.32,(95%CI:0.17-0.63),P=0.001]were influence factors for MAFLD.Our study results offer new insight into potential risk factors associated with fatty liver disease,including SUA,TBIL and creatinine,all of which are related to chronic renal disease(CKD).CONCLUSION MAFLD is more prevalent than NAFLD,with two-fifths of individuals meeting the diagnosis criteria.MAFLD and NAFLD populations have different clinical characteristics.CKD may be related with MAFLD.

Characteristics of Hailstone Disaster and the Risk Zoning in Shijiazhuang

By using the hailstone disaster data,the spatio-temporal distribution characteristics of hailstone in Shijiazhuang,the relationship between the hailstone disaster and the weather system,the hailstone path were analyzed.Moreover,the risk zoning of hailstone disaster in every county(city) of Shijiazhuang was done according to the occurrence frequency of hailstone.The results showed that the spatio-temporal distribution characteristics of hailstone in Shijiazhuang were obvious,and there were 3 main paths.The zones where the paths passed were also the high risk areas of hailstone occurrence.The research provided the scientific guidance for the adjustment of agricultural industrial structure and the defense of hailstone disaster.

Risk factors and clinical characteristics of portal vein thrombosis after splenectomy in patients with liver cirrhosis

BACKGROUND:Portal vein thrombosis(PVT) is a potential lethal complication and may have negative influence on the prognosis after splenectomy in patients with liver cirrhosis.Prevention and timely detection of PVT are quite significant.There is a lack of knowledge about the clinical features and risk factors of PVT.Our study aimed to investigate the risk factors and clinical characteristics of PVT in order to figure out the high-risk individuals.METHODS:We collected the clinical data of 472 consecutive patients with non-neoplastic liver cirrhosis who had undergone splenectomy from January 2008 to December 2010 in our institution.Clinical and surgical characteristics of patients who developed PVT postoperatively and those who did not develop PVT were compared.Univariate and multivariate analyses of risk factors of PVT were performed.The mortality and rebleeding rate of the patients were also evaluated.RESULTS:Of the 472 patients,52 were excluded from the study.PVT developed in 71(71/420,16.9%) patients.Multivariate analysis revealed that wider preoperative portal vein diameter,postoperative thrombocytosis,prolonged prothrombin time and periesophagogastric devascularization were significantly correlated with PVT development [odds ratio(OR):5.701,2.807,1.850 and 2.090,respectively].The incidence of PVT in patients who took antiplatelet drugs was not lower than that in those who did not.Follow-up showed that patients in the PVT group had a tendency towards reduced overall survival but it was not statistically significant.Gastrointestinal bleeding occurred more often in the PVT group than that in the non-PVT group(P=0.044).CONCLUSIONS:Wider preoperative portal vein diameter,postoperative thrombocytosis,prolonged prothrombin time and periesophagogastric devascularization are independent risk factors of PVT.PVT is related with higher risk of postoperative gastrointestinal hemorrhage but has no significant impact on the overall survival.

Clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan

BACKGROUND Coronavirus disease 2019(COVID-19)has become a worldwide pandemic.We investigated the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan by retrospectively analyzing the epidemiological,clinical,and laboratory data for 218 COVID-19 patients and identifying the risk factors for liver injury by multivariate analysis.AIM To investigate the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan.METHODS The 218 patients included 94 males(43.1%),aged 22 to 94(50.1±18.4)years.Elevated aspartate aminotransferase(AST)and alanine aminotransferase(ALT)were present in 42(53.2%)and 36(45.6%)cases,respectively,and 79(36.2%)patients had abnormally elevated transaminase levels at admission.Patients with liver injury were older than those with normal liver function by a median of 12 years,with a significantly higher frequency of males(68.4%vs 28.8%,P<0.001)and more coexisting illnesses(48.1%vs 27.3%,P=0.002).Significantly more patients had fever and shortness of breath(87.3%vs 69.8%and 29.1%vs 14.4%,respectively)in the liver injury group.Only 12(15.2%)patients had elevated total bilirubin.ALT and AST levels were mildly elevated[1-3×upper limit of normal(ULN)]in 86.1%and 92.9%of cases,respectively.Only two(2.5%)patients had an ALT or AST level>5×ULN.Elevatedγ-glutamyl transpeptidase was present in 45(57.0%)patients,and 86.7%of these had aγ-glutamyl-transpeptidase level<135 U/L(3×ULN).Serum alkaline phosphatase levels were almost normal in all patients.Patients with severe liver injury had a significantly higher frequency of abnormal transaminases than non-severe patients,but only one case had very high levels of aminotransferases.RESULTS Multivariate analysis revealed that male sex,high D-dimer level,and high neutrophil percentage were linked to a higher risk of liver injury.The early stage of COVID-19 may be associated with mildly elevated aminotransferase levels in patients in Wuhan.Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19.CONCLUSION Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19.

Epidemiological Characteristics and Risk Factors of the Pertussis in Infants < 12 Months of Age in Tianjin, China

The epidemiologic characteristics of 631 infant pertussis cases 〈 12 months, which accounted for 57.42% of the total cases, were analyzed by descriptive epidemiology in Tianjin, between 2010 and 2015. The incidence of infants was 104.66/100,000, which was 118 times higher than in other age groups （P 〈 0.001）. The primary type of pertussis simultaneously presented in households was adult-to-infant （70.51%）. The parents were identified as the source of infection in 80.18% of cases for infants. The positive rate of placental antibody transfer was 31.06% and 3.13% for 3-month-old infants. Infants presented the highest age-specific pertussis incidence. The most important reason was parents were the important sources of infection, and secondly the lower level of antibodies in neonates and the rapid waning of maternal antibody titer.

Clinical Characteristics and Prognosis of Patients with Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis According to Serotype: A Retrospective Study of 349 Chinese Patients

Objective: According to clinical phenotypic classification, there is a significant overlap of clinical features between different anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV), and disease classification based on ANCA subtype helps to differentiate clinical phenotypes. We investigated the clinical features and outcomes of patients based on ANCA serotype classification. Methods: Clinical and laboratory data were collected retrospectively. We compared clinical manifestations and organ involvement based on serotype. The risk factors for death and renal survival were investigated with univariate and multivariate Cox regression models. Results: Patients with MPO-ANCA were predominant, whose median age and lung involvement at diagnosis was higher than that of the PR3-ANCA patients. Compared to the AAV patients without renal involvement, those with renal involvement have older, anemia, low complement C3, and hypoproteinemia, more likely to have cardiovascular and abdominal involvement, and have less lung involvement. Multivariate Cox analysis revealed that age ≥ 65 years (HR = 2.611, p p = 0.019), BVAS ≥ 15 (HR = 1.943, p = 0.001), low C3 (HR = 1.696, p = 0.008), and hypoproteinemia (HR = 1.438, p = 0.044) were associated with mortality. SCR ≥ 500 μmol/L (HR = 13.583, p p = 0.020), low C3 (HR = 1.506, p = 0.049) were independent detrimental factors for renal survival, and immunosuppressive treatment was a protective factor for renal survival (HR = 0.523, p = 0.003). Conclusions: Clinical manifestations varied by AAV categories. Age, SCR, BVAS, low C3 and hypoproteinemia at diagnosis were independent predictors of mortality. BVAS, low C3, SCR at diagnosis and immunosuppressive treatment were independently related to renal survival in ANCA positive patients.

Risk Factors for Multidrug-Resistant Tuberculosis and Characteristics of Cases: A Case-Control Study of Patients Attending ALERT General Hospital in Addis Ababa, Ethiopia

Background:Tuberculosis remains a major public-health problem in the world, despite several efforts to improve case identification and treatment. Particularly multidrug-resistant tuberculosis is becoming a major threat to tuberculosis control programs in Ethiopia which seriously threatens the control and prevention efforts and is associated with both high death rates and treatment costs. Methods: A case-control study was conducted to assess risk factors and characteristics of MDR-TB cases at ALERT Hospital, Addis Ababa, Ethiopia, where cases were 167 MDR-TB patients, while controls were newly diagnosed and bacteriologically confirmed pulmonary TB cases of similar number, who were matched by sex and age of 5-years interval. Results: The socio-demographic characteristics of the participants indicated that majority (53.3%) were males and 46.7% females;a little over half of cases (55.1%) were in the age group 26 - 45 years, whereas 46.7% of controls were in this age group. According to the multivariable logistic regression analysis, previous history of hospital admission was the only factor that was identified as predictor which increased risk to develop MDR-TB by almost twenty times (AOR = 19.5;95% CI: 9.17 - 41.62) and P-value of <0.05. All other studied factor such as being unemployed, family size, having member of household member with TB, and history of visiting hospital in past 12 months etc., didn’t show any statistically significant association. Conclusion: The study identified previous history of hospital admission as independent predictors for the occurrence of MDR-TB, while other studied variables didn’t show any strong association. The findings added to the pool of knowledge emphasizing the need for instituting strong infection control practice at health care facilities to prevent nosocomial transmission of MDR-TB.

A catastrophic debris flow in the Wenchuan Earthquake area,July 2013：characteristics,formation,and risk reduction

In the Wenchuan Earthquake area,many co-seismic landslides formed blocking-dams in debris flow channels. This blocking and bursting of landslide dams amplifies the debris flow scale and results in severe catastrophes. The catastrophic debris flow that occurred in Qipan gully(Wenchuan,Southwest China) on July 11,2013 was caused by intense rainfall and upstream cascading bursting of landslide dams. To gain an understanding of the processes of dam bursting and subsequent debris flow scale amplification effect,we attempted to estimate the bursting debris flow peak discharges along the main gully and analyzed the scale amplification process. The results showed that the antecedent and triggering rainfalls for 11 July debris flow event were 88.0 mm and 21.6 mm,respectively. The event highlights the fact that lower rainfall intensity can trigger debris flows after the earthquake. Calculations of the debris flow peak discharge showed that the peak discharges after the dams-bursting were 1.17–1.69 times greater than the upstream peak discharge. The peak discharge at the gully outlet reached 2553 m^3/s which was amplified by 4.76 times in comparison with the initial peak discharge in the upstream. To mitigate debris flow disasters,a new drainage channel with a trapezoidal V-shaped cross section was proposed. The characteristic lengths(h1 and h2) under optimal hydraulic conditions were calculated as 4.50 m and 0.90 m,respectively.

Identifying the risk factors for pancreatic fistula after laparoscopic pancreaticoduodenectomy in patients with pancreatic cancer

BACKGROUND Laparoscopic pancreaticoduodenectomy(LPD)is a surgical procedure for treating pancreatic cancer;however,the risk of complications remains high owing to the wide range of organs involved during the surgery and the difficulty of anastomosis.Pancreatic fistula(PF)is a major complication that not only increases the risk of postoperative infection and abdominal hemorrhage but may also cause multi-organ failure,which is a serious threat to the patient’s life.This study hypothesized the risk factors for PF after LPD.AIM To identify the risk factors for PF after laparoscopic pancreatoduodenectomy in patients with pancreatic cancer.METHODS We retrospectively analyzed the data of 201 patients admitted to the Fudan University Shanghai Cancer Center between August 2022 and August 2023 who underwent LPD for pancreatic cancer.On the basis of the PF’s incidence(grades B and C),patients were categorized into the PF(n=15)and non-PF groups(n=186).Differences in general data,preoperative laboratory indicators,and surgery-related factors between the two groups were compared and analyzed using multifactorial logistic regression and receiver-operating characteristic(ROC)curve analyses.RESULTS The proportions of males,combined hypertension,soft pancreatic texture,and pancreatic duct diameter≤3 mm;surgery time;body mass index(BMI);and amylase(Am)level in the drainage fluid on the first postoperative day(Am>1069 U/L)were greater in the PF group than in the non-PF group(P<0.05),whereas the preoperative monocyte count in the PF group was lower than that in the non-PF group(all P<0.05).The logistic regression analysis revealed that BMI>24.91 kg/m²[odds ratio(OR)=13.978,95%confidence interval(CI):1.886-103.581],hypertension(OR=8.484,95%CI:1.22-58.994),soft pancreatic texture(OR=42.015,95%CI:5.698-309.782),and operation time>414 min(OR=15.41,95%CI:1.63-145.674)were risk factors for the development of PF after LPD for pancreatic cancer(all P<0.05).The areas under the ROC curve for BMI,hypertension,soft pancreatic texture,and time prediction of PF surgery were 0.655,0.661,0.873,and 0.758,respectively.CONCLUSION BMI(>24.91 kg/m²),hypertension,soft pancreatic texture,and operation time(>414 min)are considered to be the risk factors for postoperative PF.

Socioenvironmental Drivers of Farmers’ Perceptions of Climate Change Risk in Agroforestry Parklands of West Atacora in Benin (West Africa)

Throughout the world, climate change is threatening the human population. In West Africa, smallholder farmers in indigenous agricultural societies typically hold considerable knowledge. Therefore, this study was conducted in West Atacora of Benin Republic to assess the drivers of farmers’ perceptions of climate change risk. We used a random sampling technique to select 360 households’ heads who were interviewed regarding different climate change risks perception. Binomial logistic regression was used to assess the drivers of farmers’ perceptions of climate change risks. The results showed that the farmers in drier areas had a higher perception of the global risk of climate change than those in humid areas. The same trend was observed for the seven different individual’s climate change risk investigated. The study identified also membership of farm organizations as main sociodemographic characteristic that explains farmers’ perception of climate change risk perception. These findings are helpful tools to sensitize the local people on climate change risk and cope with the risk in agricultural lands.

Study on the Characteristics of Pollutants in Surface Water Source Based on Risk Assessment

Supervision of urban water source area and the safety of drinking water is one of the important tasks in China's current environmental protection work. By reviewing screening methods of characteristic pollutants in urban water source area,screening system of pollutants based on the framework of environmental risk is introduced in detail: establish database of pollutants→determine the evaluation purpose→determine testing end and screening standard→assignment calculation→prioritization. At the same time,the application of health risk assessment and technology in the risk assessment of urban water source area is introduced,so as to provide technical support and theoretical basis for management and protection of urban water source area.

Distribution Characteristics of Pb and Its Ecological Risk in Different Farmland Soils of Changchun Suburb

Pb in the farmland surface soil of Changchun suburb was taken as the main research object. The field research and laboratory analysis were used to investigate Pb content, spatial distribution characteristics and its ecological risk in different farmland soils. The results showed that Pb content was during 18.85 - 41.34 mg/kg in farmland soil of Changchun suburb, and was higher than the background value of Jilin Province at 90% of the sampling sites. The spatial distribution of Pb content in farmland soil had obvious geographical features, and Pb content in southwest and northeast soils was higher. The high-content areas were relatively concentrated, and Pb content gradually reduced from the high-content island- shape center to its surrounding. The soil Pb contents in paddy field, dry field and vegetable field had insignificant difference with the background value, indicating that Pb accumulations in dry field, paddy field and vegetable field were not significant. The order of Pb content in different land use types was showed as follows： vegetable field 〉 dry field 〉 paddy field. Pb pollution of all samples belonged to light pollution. The average potential ecological risk of soil Pb in different land use types presented the following order： vegetable field 〉 dry field 〉 paddy field.

Pediatric Retinal Detachment in Indonesia: Clinical Characteristics, Risk Factors, and Treatment Outcomes

Purpose: To describe the clinical features and risk factors of pediatric retinal detachment among patients in Indonesia. Methods: This is a retrospective study involving 46 eyes of 34 children (younger than 18 years) diagnosed with pediatric retinal detachment. A detailed history was taken and a complete ophthalmic examination and a systemic examination were performed as required. Clinical characteristics, risk factors, and treatment choices were noted. Retinal detachment was categorized as tractional, exudative, or rhegmatogenous. Results: Mean patient age was 8.5 years (range, 0–18 years). Most patients (70%) were boys. Twelve (35%) patients had bilateral involvement at presentation. Tractional retinal detachment was found in 17 eyes (37%) and in this study was caused by retinopathy of prematurity (grade IV-V) in all cases. Exudative retinal detachment was found in 12 eyes (26%), the most common causes of which were panuveitis and Coat’s disease (both 50%). Rhegmatogenous retinal detachment was found in 17 eyes (37%), the most common risk factor for which was trauma (58%). Conclusions: Different approaches are needed to treat pediatric retina detachment in patients with different risk factors. Recognition of risk factors and early management will help to prevent childhood blindness due to retinal detachment.

Cold Wave Climate Characteristics and Risk Zoning in Jilin Province

Using the meteorological data of 50 stations in Jilin Province from 1961 to 2016, the demographic and economic data, and geographical information of all counties and cities aims to conduct the risk zoning of cold wave disasters in Jilin Province. The results show that, since 1961, the average number of cold wave occurrences per year in Jilin Province is 8.3 days, of which the highest number of occurrences occurred in February, followed by December and January, and the spring cold wave occurred mostly in March. From the map of cold-sea disaster risk zoning in Jilin Province, due to factors such as topography and land use distribution, the west and east of Jilin Province have a certain resilience to the disasters caused by cold waves, and the risk of disasters is low. The distribution of agricultural facilities and large areas of farmland in the central region are extremely sensitive to cold wave disasters and have a high risk of disasters. Areas with high risk of cold wave are mainly concentrated in Siping City, Changchun City, Liaoyuan City, Jilin City, northern Tonghua City and most of Baishan City. Areas with low cold wave risk are mainly concentrated in most of Baicheng City, most of Songyuan City and Yanbian Prefecture. And other places are moderately risky areas of cold waves.

Trace elements spatial distribution characteristics,risk assessment and potential source identification in surface water from Honghu Lake,China

Five trace elements including Zn, Cu, Cd, Cr and As were investigated in surface water from ten typical sampling sites in Honghu Lake. The consequence indicated that all of the detected trace element levels were within the allowed standard of China’s safe water guideline. The hazard quotients （HQ） and the hazard index （HI） value levels of all the five heavy metals in all sampling sites did not exceed the acceptable risk limits of non-carcinogenic value through the selected assessment method. Pearson’s correlation analysis and principal component analysis （PCA） indicated that Zn and Cu mainly originated from the natural alluviation and non-point agricultural sources, whereas Cr and As were mainly derived from industrial effluents. Moreover, Cd mainly originated from both non-point agricultural and industrial pollution sources. In addition, cluster analysis （CA） implied that cluster 1 （including S3, S5, S6 and S10） was considered the set of high pollution sites and cluster 2 （including S4 and S9） was identified as the set of moderate pollution sites.

Characteristics and Mortality Risk Factors of Influenza-Associated Encephalopathy/Encephalitis in Children in a Tertiary Pediatric Hospital in China, 2016-2019

Background: Seasonal influenza associated neurological complications had high mortality and morbidity rates in children. In this study, we aimed to investigate the clinical characteristics and mortality risk factors in children with influenza-associated encephalopathy. Methods: Retrospectively analyze the clinical data, laboratory tests, and imaging examinations of 68 children diagnosed with influenza-associated encephalopathy from January 2016 to December 2019 at Guangzhou Women and Children’s Medical Center, and the cases were divided into survival and non-survival groups by disease outcome and analyzed between two groups. Chi-square test or Mann-Whitney rank sum test was used for comparison between groups, and multivariate Logistic regression analysis was used for the analysis of risk factors for death. Results: Among the 68 children with influenza-associated encephalopathy, 40 were male, and 28 were female, aged from 3 months to 13 years, of which 66.18% (45/68) were under 5 years old. Pathogenetic tests showed that influenza virus type A accounted for 63.24% (43/68), and influenza virus type B accounted for 36.76% (25/68). Typical brain MRI changes in childhood influenza-associated encephalopathy were bilateral symmetrical lesions of the thalamus, basal ganglia, brainstem, and cerebellum. 68 patients had a mortality rate of 20.59% (14/68), with a significantly higher proportion of fever peak > 39°C, Acute Disturbance of Consciousness (ADOC), and cardiac arrest in the non-survival group than in the survival group (P < 0.05). Laboratory tests showed significantly higher in Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), Creatinine Kinase (CK), Lactate Dehydrogenase (LDH), lactate, and C-Reactive Protein (CRP). And CSF protein levels in the non-survival group compared with the survivor (P < 0.05), among them, elevated ALT, AST, LDH, and CSF protein were independent high-risk factors for death from influenza-associated encephalopathy. Conclusions: Children under 5 years of age with influenza are prone to combine neurological complications and have a higher mortality rate. Significant elevations in ALT, AST, LDH, and CSF proteins predict death from influenza-associated encephalopathy in children.

Distribution Characteristics of Methylmercury in Eriocheir sinensis Produced in Zhejiang Province and the Risk of Eating It

Based the detection of content of methylmercury in the meat and butter of Eriocheir sinensis cultured in Zhejiang Province by liquid chromatography-atomic fluorescence spectroscopy,the distribution characteristics of methylmercury were analyzed,and the exposure risk of methylmercury to consumers was evaluated. The results showed that the content of methylmercury in the crab meat was higher than that of the crab butter. According to China＇s national standard and industry standard,the content of methylmercury in the crab meat was lower than the limit and accorded with relevant regulations. According to the reference intake of methylmercury recommended by the World Health Organization（ WHO） and the United States Environmental Protection Agency（ US EPA）,the weekly intake of E. sinensis meat should not exceed 3.2 kg,and the daily intake should not exceed 200g.