ObjectiveTo investigate the relationship between temperature extremes and daily number of deaths in Jinan, a temperate city in northern China.MethodsData ondaily number of deaths and meteorological variables over the period of 2011–2014 were collected. Cold spells or heat waves were defined as ≥3 consecutive days with mean temperature ≤5th percentile or ≥95th percentile, respectively. We applied a time-series adjusted Poisson regression to assess the effects of extreme temperature on deaths.ResultsThere were 152 150 non-accidental deaths over the study period in Jinan, among which 87 607 people died of cardiovascular disease, 11 690 of respiratory disease, 33 001 of stroke and 6624 of chronic obstrutive pulmonary disease (COPD). Cold spells significantly increased the risk of deaths due to non-accidental mortality (RR 1.08, 95% CI 1.06 to 1.11), cardiovascular disease (RR 1.06, 95% CI 1.03 to 1.10), respiratory disease (RR 1.19, 95% CI 1.11 to 1.27), stroke (RR 1.11, 95% CI 1.06 to 1.17) and COPD (RR 1.27, 95% CI 1.16 to 1.38). Heat waves significantly increased the risk of deaths due to non-accidental mortality (RR 1.02, 95% CI 1.00 to 1.05), cardiovascular disease (RR 1.03, 95% CI 1.00 to 1.06) and stroke (RR 1.06, 95% CI 1.00 to 1.13). The elderly were more vulnerable during heat wave exposure; however, vulnerability to cold spell was the same for the whole population regardless of age and gender.ConclusionsBoth cold spells and heat waves have increased the risk of death in Jinan, China.

We aimed to assess the acute effects of ambient air pollution and weather conditions on mortality in the context of Chinese smog episodes. A total of 209,321 deaths were recorded in Jinan, a large city in eastern China, during 2011–15. The mean concentrations of daily particulate matter ≤10 μm (PM10), fine particulate matter (PM2.5), sulfur dioxide (SO2) and nitrogen dioxide (NO2) were 169 μg/m3, 100 μg/m3, 77 μg/m3, and 54 μg/m3, respectively. Increases of 10 μg/m3 in PM10, PM2.5, SO2 and NO2 were associated with 1.11% (95% CI 0.96–1.26%), 0.71% (95% CI 0.60–0.82%), 1.69% (95% CI 1.56–1.83%), and 3.12% (95% CI 2.72–3.53%) increases in daily non-accidental mortality rates, respectively. Moreover, the risk estimates for these 4 pollutants were higher in association with respiratory and cardiovascular mortality. The effects of all the evaluated pollutants on mortality were greater in winter than in summer. Smog episodes were associated with a 5.87% (95% CI 0.16–11.58%) increase in the rate of overall mortality. This study highlights the effect of exposure to air pollution on the rate of mortality in China.

An ecological study and a case-crossover analysis were conducted to evaluate the impact of heat waves on nonaccidental deaths, and to identify contributing factors of population vulnerability to heat-related deaths in Jinan, China. Daily death data and meteorological data were collected for summer months (June to August) of 2012-2013. Excess mortality was calculated and multivariate linear regression models were used to assess the increased risk of heat waves on deaths. Univariate and multivariate logistic regression models were performed to estimate the odd ratios (ORs) of risk factors and their 95 % confidence intervals (CIs). Overall, heat waves were related to 24.88 % excess deaths of total nonaccidental deaths and 31.33 % excess deaths of circulatory diseases, with an OR of 16.07 (95 % CI 8.80-23.33) for total nonaccidental deaths and 12.46 (95 % CI 7.39-17.53) for deaths of circulatory diseases. The case-crossover analysis indicated that older people were more likely to die during heat waves (OR = 1.233, 95 % CI 1.076-1.413) and more deaths occurred outside a hospital during heat waves (OR = 1.142, 95 % CI 1.006-1.296). In conclusion, heat waves have caused excess deaths and significantly increased the risk of circulatory deaths. The risk factors identified in our study have implications for public health interventions to reduce heat-related mortality during extreme heat events.

Summer extreme heat threatens the health of individuals, especially persons who are involved in outdoor activities. Ensuring the normal function of a city, bus drivers are among those who participate in outdoor physical activities and are exposed to excessive heat in hot summer weather. This qualitative study was performed to explore professional bus drivers’ in-depth views of extreme heat risks to their health, and ultimately develop targeted advice and policy interventions for city bus drivers. An interview-based study was performed among professional bus drivers in Jinan, China, including four focus groups with professional bus drivers (n = 37) and three interviews with their managers (n = 14). Five central themes or categories from the bus driver interviews were found: concerns about summer heat; health effects related to extreme heat; adaptive measures; barriers in implementing these adaptive measures; and suggested interventions. The beneficial role of cooling facilities (particularly air-conditioning) during extreme heat are addressed. The barriers not only impede the implementation of behavioral adaptive measures but also enhance the negative attitudes of bus drivers towards their effectiveness. The responsibilities of managers in promoting preventive actions are addressed.

Decidualization is a critical process for successful embryo implantation and subsequent placenta formation. The characterization and physiological function of lncRNA during decidualization remain largely unknown. In the present study, we conducted RNA-sequencing analysis to compare gene expression between decidua of days 6 and 8, and normal pregnant endometrium (day 4). A total of 2332 high-confidence putative lncRNA transcripts were expressed. Functional clustering analysis of cis and trans lncRNA targets showed that differentially expressed lncRNAs may regulate multiple gene ontology terms and pathways that have important functions in decidualization. Subsequent analyses using qRT-PCR validated that eight of all lncRNAs were differentially regulated in mice uteri during decidualization, both in vivo and in vitro. Furthermore, we showed that differentially expressed lncRNA of Hand2os1 was specifically detected in stromal cells on days 2 to 5 of pregnancy and was strongly upregulated in decidual cells on days 6–8 of pregnancy. Similarly, Hand2os1 expression was also strongly expressed in decidualized cells following artificial decidualization, both in vivo and in vitro. In uterine stromal cells, P4 was able to significantly upregulate the expression of Hand2os1, but upregulation was impeded by RU486, whereas E2 appeared to have no regulating effect on Hand2os1 expression. Concurrently, Hand2os1 significantly promoted the decidual process in vitro and dramatically increased decidualization markers Prl8a2 and Prl3c1. Our results provide a valuable catalog for better understanding of the functional roles of lncRNAs in pregnant mouse uteri, as it relates to decidualization.