Minimizing air pollution exposure: A practical policy to protect vulnerable older adults from death and disability

Air pollution causes an estimated 200,000 deaths per year in the United States alone. Older adults are at greater risk of mortality caused by air pollution. Here we quantify the number of older adult facilities in Los Angeles County who are exposed to high levels of traffic derived air pollution, and propose policy solutions to reduce pollution exposure to this vulnerable subgroup. Distances between 20,362 intersections and 858 elder care facilities were estimated, and roads or highways within 500 of facilities were used to estimate traffic volume exposure. Of the 858 facilities, 54 were located near at least one major roadway, defined as a traffic volume over 100,000 cars per day. These 54 facilities house approximately 6000 older adults. Following standards established for schools, we recommend legislation mandating the placement of new elder care facilities a minimum of 500 ft from major roadways in order to reduce unnecessary mortality risk from pollution exposure.     

武汉市职业病防治工作的现状与对策

分析武汉市职业危害形势与职业病防治工作的现状,探讨职业病防治工作中存在的问题,提出如何加强职业病防治的建议,为相关监管部门的工作提供研究依据.     

室内环境与高龄者血压的关联性——以大连市供暖季为例

对中国大连市供暖季住宅室内环境与高龄者血压的关联性进行了调查研究,具体包括住宅热湿环境（温度、相对湿度）、化学污染（CO₂、CO、甲醛和TVOC）、物理污染（PM_2.5）和生物污染（附着真菌）与高龄者血压的关联性.研究表明,城市和农村住宅供热方式不同是导致住宅室内热环境舒适度差异的主要原因.在大连农村,处于室外的厕所与室内形成的大温差使得农村高龄者患心血管疾病的诱发风险比城市更高.城市高龄者的平均血压比农村低且波动小.城市住宅室内温湿度与血压均存在关联（P<0.01）,农村室内温湿度对血压的影响程度不如城市明显.另外,室内空气质量参数并未发现与血压存在显著关联.     

Prenatal diagnosis of purine nucleoside phosphorylase deficiency in the first and second trimesters of pregnancy

Prenatal diagnosis was performed in two successive pregnancies of a mother with a previous child with purine nucleoside phosphorylase (PNP) deficiency. In one pregnancy, an affected fetus was diagnosed in the 18th week of gestation after the demonstration of PNP deficiency in cultured amniotic fluid cells. Also an abnormal purine nucleoside profile was found in the amniotic fluid. The diagnosis of an affected fetus was confirmed by the analysis of cultured fetal skin fibroblasts and placental villi. The complete deficiency of PNP activity in placental villi confirms that the prenatal diagnosis of this disorder is possible by the direct investigation of chorionic villi. In the subsequent pregnancy, a heterozygous fetus was predicted in the tenth week of pregnancy by using chorionic villi.     

Fetal two-dimensional doppler echocardiography (colour flow mapping) and its place in prenatal diagnosis

One hundred and fifty fetuses between 16 and 38 weeks of gestation were studied by fetal echocardiography using colour-coded two-dimensional Doppler echocardiography. Two-dimensional, M-mode, and Doppler spectral analyses were also performed. In 14 fetuses, structural and/or functional abnormalities were detected. Abnormalities were correctly ruled out in all the other fetuses. The advantages of two-dimensional Doppler echocardiography are (1) rapid screening for flow abnormalities in the fetal heart, and thus shortening of the Doppler examination time; (2) rapid diagnosis of valvular regurgitation, valvular stenosis, and abnormal shunting of blood across the interatrial and interventricular septa; and (3) facilitation of the diagnosis of complex congenital heart defects which in certain cases is possible only by using two-dimensional Doppler echocardiography.     

Unexpected ultrasonographic prenatal diagnosis of autosomal dominant polycystic kidney disease

The prenatal diagnosis of autosomal dominant polycystic kidney disease (ADPKD) is now being reported with increasing frequency. We report three cases and review 12 cases of ADPKD diagnosed in the fetus by ultrasonographic findings. Increased echogenicity and renal enlargement are the main ultrasonographic signs of ADPKD. Renal cysts are uncommon. Diagnosis is easy in a family with a positive ADPKD history. Conversely, there may be no apparent family history, as in our three cases and three cases from the literature. We consider the problems of unexpected diagnosis, family investigation, and the prognosis of ADPKD in children with prenatally diagnosable forms.     

Prenatal diagnosis of chinese homozygous α-thalassaemia 1 and haemoglobin H disease by analysis of α- and φζ-globin genes in chorionic villi and amniocytes

Eighty-eight high-risk pregnancies, 81 for homozygous α-thalassaemia 1 and 7 for haemoglobin (Hb) H disease, were collected in this study. Chorionic villus sampling (CVS) was done in 63 cases and amniocentesis in 25 cases to obtain fetal cells. Southern blotting and DNA hybridization with α- and φζ-globin gene probes were used to determine the α-globin gene status. In two non-informative families with non-deletional mutations, DNA analysis failed to rule out the affected condition, and fetal blood sampling (FBS) and Hb electrophoresis were used for the final diagnosis. In the 81 fetuses at risk for homozygous α-thalassaemia 1, 17 (13 by CVS and 4 by amniocentesis) were afffected, 30 were α-thalassaemia 1 heterozygotes, 19 were normal, and the remaining 15 were either normal or heterozygous. In the seven fetuses at risk for Hb H disease, one was normal, three were α-thalassaemia 1 heterozygotes, two were α-thalassaemia 2 heterozygotes, and one was affected with Hb H disease and developed hydrops fetalis. DNA analysis on fetal cells enabled us to diagnose prenatally severe α-thalassaemias, to prevent the birth of infants with Hb H disease, and to minimize maternal obstetrical complications from harbouring a fetus with Hb Bart's hydrops fetalis.     

Prenatal diagnosis of adult polycystic kidney disease with DNA markers on chromosome 16 and the genetic heterogeneity problem

A prenatal diagnosis of adult polycystic kidney disease by DNA testing is reported. Evidence showing a linkage between the disease and the 3′HVR and 24.1 restriction fragment length polymorphisms (RFLPs) on chromosome 16 was obtained in the proband's family by linkage analysis of data and homogeneity testing with Italian families of the linked type. Fetal genotype prediction based on both flanking markers was confirmed by histological and ultrastructural findings in fetal kidneys.     

A new hypothesis for the etiology of Kaschin-Beck disease

Kaschin-Beck disease (KBD) could be exogeneous free radical induced endemic osteoarthropathy under conditions of lacking necessary antioxidant defences.especially selenium-cored defence in Chinese eco-en-vironment. Experimental evidences have been provided for the internal relations among previously suggested pathologic factors, i.e., selenium deficiency, organic matters of drinking waterand mycotoxins from contaminated grains, based on the facts that the former is a preventory factor while the others are exogenous freeradical carriers. ESR spectrum shows that these exogenous free radical carriers have a property of semi-quinone compounds and are toxic in in-vitro cartilage cell culture and animal tests in inducing lipid peroxidation process.