A Systematic Assessment of Blood Lead Level in Children and Associated Risk Factors in China

In this study, we searched multiple databases for all relevant original articles (1996-2013). To investigate blood lead levels (BLL) and possible risk factors for lead exposure among children in China A total of 388 articles met our inclusion criteria. The overall geometric mean (GM) BLL was 71 μg/L, and the prevalence of elevated BLL (EBLL, defined as BLL ≥100 μg/L) was 18.48% among children. The prevalence of EBLL remained significantly higher among boys. In children less than 6 years of age, there were significantly increasing trends in both BLL and prevalence of EBLL in an age-dependent manner. The ban on leaded gasoline significantly reduced the BLL as well as EBLL prevalence; however, children whose parents had lower educational levels or were exposed to lead in the workplace had a higher EBLL prevalence. Despite its decline over time, the average BLL among children in China remains higher than the average level most recently reported in the United States. Childhood lead poisoning remains a public health problem in China.

Associated risk factors in the early stage of diabetic retinopathy

Background:To investigate the retinal capillary density(RCD)of the macula using optical coherence tomography angiography(OCT-A)in type 2 diabetic patients and to further determine the association with risk factors.Methods:A total of 212 eyes from 212 subjects were recruited;subjects included diabetics with no retinopathy(NDR,n=90 eyes),diabetics with mild retinopathy DR(MDR,n=36 eyes),and healthy participants(Control,n=86 eyes).All participants underwent OCT-A scanning.RCD was quantified by superficial and deep retinal capillary layers(SRCL and DRCL)from OCT-A images.Results:RCD in SRCL and DRCL was lower in NDR(P<0.001)as well as in MDR(P<0.001)when compared with control eyes.Diabetic patients were subdivided according to individual risk factors,complications related to diabetes,and hyperglycemia.Diabetic patients showed lower RCD in both the SRCL and DRCL when compared with healthy controls.Diabetics with age>55y,HbA1c>7%had significantly reduced DRCL(P<0.05)when compared with the other group of diabetics(age<55y,HbA1c<7%).Diabetics with a blood urea nitrogen(BUN)>8.2 mmol/L had significantly reduced SRCL and DRCL when compared to the other group of diabetics.Conclusions:Risk factors including older age,higher level of HbA1c,LDL-C and BUN,were associated with lower RCDs found in type 2 diabetic patients with and without mild DR by OCT-A.The impairment of retinal capillary by OCT-A may play a key role in the early monitoring of management in diabetes.

The"weekend effect"does not impact on outcome of trauma laparotomy–Experience from a level 1 trauma centre in New Zealand

Purpose:Trauma centres have been proven to provide better outcomes in developed countries for overall trauma,but there is limited literature on the systematic factors that describe any discrepancies in outcomes for trauma laparotomies in these centres.This study was conducted to examine and interrogate the effect of systematic factors on patients undergoing a trauma laparotomy in a developed country,intending to identify potential discrepancies in the outcome.Methods:This was a retrospective study of all laparotomies performed for trauma at a level 1 trauma centre in New Zealand.All adult patients who had undergone an index laparotomy for trauma between February 2012 and November 2020 were identified and laparotomies for both blunt and penetrating trauma were included.Repeat laparotomies and trauma laparotomies in children were excluded.The primary clinical outcomes reviewed included morbidity,length of hospital stay,and mortality.All statistical analysis was performed using R v.4.0.3.Results:During the 9-year study period,204 trauma laparotomies were performed at Waikato hospital.The majority(83.3%)were performed during office hours(170/204),and the remaining 16.7%were performed after hours(34/204).And 61.3%were performed on a weekday(125/204),whilst 38.7%were performed on the weekend/public holiday(79/204).Most of the parameters in office hours and after hours groups had no statistically significant difference,except lactate(p=0.026).Most of the variables in weekday and weekend groups had no statistically significant difference,except pH,lactate,length of stay,and gastrointestinal complications(p=0.012,p<0.001,p=0.003,p=0.020,respectively).Conclusion:The current trauma system at Waikato hospital is capable of delivering care for trauma laparotomy patients with the same outcome regardless of working hours or after hours,weekday or weekend.This confirms the importance of a robust trauma system capable of responding to the sudden demands placed on it.