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During World War II, the Japanese Kwantung Army’s Unit 731 secretly conducted large-scale, inhumane, and unethical human experimentation in China, culminating in one of the most heinous medical atrocities, crimes against humanity, and war crimes in the Asia-Pacific theatre of the war. Despite the gravity of the subject matter and its historical significance, research on Unit 731 has, for a long time, been rather limited, but has gradually increased in recent decades. In this article, we identify several important characteristics and trends in research activities related to Unit 731, with a view to providing a general overview of the existing scholarship and to providing recommendations for future research.
From the 1950s to the 1970s, academic research started to accumulate. The second stage was one of rapid development from the 1980s to the 1990s. During this period, research efforts in Japan had a far-reaching influence and began to spread to China, Europe, and the U.S. Scholars from scientific, medical, and educational communities began participating in Unit 731 research successively. The third stage of multi-dimensional development began at the onset of the twenty-first century. Research expanded into comparative inquiries of Japanese medical atrocities and their Nazi counterpart; at the same time, research on many topics in diverse disciplines was also deepened and intensified. In addition to focusing on pragmatic issues such as reflections and actions of modern society and reconciliation, researchers have also been concerned with historical writing and collective memory.
Systematically monitoring the baseline sensitivity of troublesome weeds to herbicides is a crucial step in the early detection of their market lifespan. Florpyrauxifen-benzyl is one of the most important herbicides used in rice production throughout the world, and has been used for 5 yr in China. Barnyardgrass is one of the main targeted weed species of florpyrauxifen-benzyl. In total, 114 barnyardgrass populations were collected from rice fields in Jiangsu Province, China, and using whole-plant bioassays they were screened for susceptibility to florpyrauxifen-benzyl. The GR50 values (representing the dose that causes a 50% reduction in fresh weight of aboveground parts) of florpyrauxifen-benzyl for all populations ranged from 1.0 to 34.5 g ai ha−1, with an average of 6.8 g ai ha−1, a baseline sensitivity dose of 3.3 g ai ha−1, and a baseline sensitivity index of 34.5. Twenty-one days after treatment with florpyrauxifen-benzyl at the labeled dose (36 g ai ha−1), 90% of the barnyardgrass populations exhibited >95% reductions in fresh weight of aboveground parts. Compared with the baseline sensitivity dose, 63, 44, and 7 populations had, respectively, no resistance (55%), low resistance (39%), and moderate resistance (6%) to florpyrauxifen-benzyl. Furthermore, the GR50 distribution of barnyardgrass populations did not show a significant correlation with collection location, planting method (direct-seeding or transplanting), or rice species (Oryza sativa L. ssp. indica or ssp. japonica) at any of rice fields where seeds had been collected (P > 0.05). In conclusion, florpyrauxifen-benzyl remains effective for barnyardgrass control in rice fields despite serious resistance challenges.
A high-energy pulsed vacuum ultraviolet (VUV) solid-state laser at 177 nm with high peak power by the sixth harmonic of a neodymium-doped yttrium aluminum garnet (Nd:YAG) amplifier in a KBe2BO3F2 prism-coupled device was demonstrated. The ultraviolet (UV) pump laser is a 352 ps pulsed, spatial top-hat super-Gaussian beam at 355 nm. A high energy of a 7.12 mJ VUV laser at 177 nm is obtained with a pulse width of 255 ps, indicating a peak power of 28 MW, and the conversion efficiency is 9.42% from 355 to 177 nm. The measured results fitted well with the theoretical prediction. It is the highest pulse energy and highest peak power ever reported in the VUV range for any solid-state lasers. The high-energy, high-peak-power, and high-spatial-uniformity VUV laser is of great interest for ultra-fine machining and particle-size measurements using UV in-line Fraunhofer holography diagnostics.
Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990–2019.
Methods
We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age–period–cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors.
Results
During 1990–2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990–2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60–64 in women, and at the age of 75–84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5–9. Population living during 2000–2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively.
Conclusions
Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000–2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.
Tuberculosis (TB) infection prevention and control (IPC) in healthcare facilities is key to reducing transmission risk. A framework for systematically improving TB IPC through training and mentorship was implemented in 9 healthcare facilities in China from 2017 to 2019.
Methods:
Facilities conducted standardized TB IPC assessments at baseline and quarterly thereafter for 18 months. Facility-based performance was assessed using quantifiable indicators for IPC core components and administrative, environmental, and respiratory protection controls, and as a composite of all control types We calculated the percentage changes in scores over time and differences by IPC control type and facility characteristics.
Results:
Scores for IPC core components increased by 72% during follow-up when averaged across facilities. The percentage changes for administrative, environmental, and respiratory protection controls were 39%, 46%, and 30%, respectively. Composite scores were 45% higher after the intervention. Overall, scores increased most during the first 6 months. There was no association between IPC implementation and provincial economic development or volume of TB services.
Conclusions:
TB IPC policies and practices showed most improvement early during implementation and did not differ consistently by facility characteristics. The training component of the project helped increase the capacity of healthcare professionals to manage TB transmission risks. Lessons learned here will inform national TB IPC guidance.
In the absence of the necessary valley topography, karst depressions are sometimes used to construct conventional impoundments in order to contain tailings. Leakage is a primary concern for such impoundments. The purpose of the current study was to determine the characteristics and barrier performance of laterite mantling karst depressions, using, as an example, the Wujiwatang (WJWT) tailings impoundment, located in the Gejiu mining area, southwestern China. The geotechnical-hydrogeological properties, geochemistry, mineral compositions, and particle shapes of the laterite were investigated by geotechnical techniques, chemical analysis, X-ray diffraction (XRD), and scanning electron microscopy (SEM). The results showed that the laterite contained poorly sorted particles that covered a wide spectrum of grain sizes (<5 mm to <50 nm), and was unexpectedly categorized as silty clay or silt with a high liquid limit. The continuous gradation and small D90 value helped the laterite achieve saturated hydraulic conductivities in the range of <10–6 cm/s required for impoundment liners. The laterite beneath the tailings impoundment was finer-grained and had a lower permeability than that of the laterite on the depression walls within the same depression. Geochemically and mineralogically, the laterite was classified as true laterite and its major mineralogical constituents were gibbsite and goethite with chlorite occurring in trace amounts. The laterite was dominated by subspherolitic–spherolitic cohesionless grains (concretions) made up of Al, Fe, Ti, and Mn oxides and hydroxides. The laterite did not have plasticity indices in the clay range. Fortunately, slopewash prior to tailings containment selectively transported the finer oxide concretions to the depression floor, creating a natural low-permeability barrier for the WJWT tailings impoundment. This is undoubtedly important for the planning and design of future karst depression-type tailings impoundments around the world.
The efficient separation of hexane isomers from the light naphtha fraction is a significant challenge in the petrochemical industry. 5A zeolite adsorbent is used commercially to sieve alkane isomers. In this study, 5A zeolites were synthesized using a low-cost natural clay mineral precursor, i.e. palygorskite (PAL), with the addition of crystallization directing agent (CDA). By varying the mass ratio of CDA/deionized water, 5A zeolites were obtained as CDA-5%, CDA-7.5%, and CDA-10%. All products were submicron particles with an average particle size of 400–800 nm. A sieving test of CDA-induced 5A zeolites was carried out on hexane adsorbates including n-hexane (nHEX), 2-methylpentane (2MP), and 3-methylpentane (3MP). According to vapor-phase batch adsorption experiments, a significant equilibrium amount (0.149 g/g) of nHEX and only 0.0321 g/g 2MP and 0.0416 g/g 3MP were adsorbed on the 5A zeolite product with CDA-5%. The dynamic adsorption performance of 5A zeolite (CDA-5%) was evaluated by breakthrough curves of binary mixtures of nHEX/2MP and nHEX/3MP. Palygorskite 5A (PAL 5A) zeolite achieved maximum dynamic adsorption capacities of nHEX (0.16 g/g in both cases) at 200°C and 1.2 MPa total pressure. This work provided an economic alternative for the synthesis of 5A zeolites using natural clay minerals instead of chemical raw materials.
Dysmenorrhea is associated with epilepsy. Existing evidence is mostly limited to observational studies, which are liable to confounding and bias. This study investigated the causal relevance of dysmenorrhea on epilepsy using Mendelian randomization (MR). We extracted instrumental variants for dysmenorrhea and epilepsy from published genomewide association study data, focusing on individuals of East Asian descent. A comprehensive suite of MR estimations and sensitivity analyses was performed to ensure the robustness of the findings. Each outcome database was analyzed separately in both directions. For dysmenorrhea and epilepsy, 7 and 3 genetic variants respectively were selectively extracted as instrumental variants. The results suggest that dysmenorrhea is causally associated with an elevated risk of epilepsy (inverse variance weighted [IVW]: OR = 1.26; 95% CI [1.07, 1.47]; p = 4.42 × 10−3); conversely, no strong evidence was found to corroborate that epilepsy exerts a causal effect on the incidence of dysmenorrhea (IVW: OR = 1.04; 95% CI [0.82, 1.33]; p = .72). These findings provide novel insights into the causal relationship between dysmenorrhea and epilepsy, which may have implications for clinical decision-making in patients with epilepsy and dysmenorrhea.
Xiaonanshan is an archaeological site dated to 16.5–13.5 cal kyr BP, situated beside the Ussuri River in China. The lithic assemblages feature microblade debitage, bifacial points and stone adzes, which provide important new materials for this project to explore Neolithisation in the Amur River basin of northeast Asia.
There is still controversy about optimal dietary iodine intake as the Universal Salt Iodization policy enforcement in China. A modified iodine balance study was thus conducted to explore the suitable iodine intake in Chinese adult males using the iodine overflow hypothesis. In this study, thirty-eight apparently healthy males (19·1 (sd 0·6) years) were recruited and provided with designed diets. After the 14-d iodine depletion, daily iodine intake gradually increased in the 30-d iodine supplementation, consisting of six stages and each of 5 d. All foods and excreta (urine, faeces) were collected to examine daily iodine intake, iodine excretion and the changes of iodine increment in relation to those values at stage 1. The dose–response associations of iodine intake increment with excretion increment were fitted by the mixed effects models, as well as with retention increment. Daily iodine intake and excretion were 16·3 and 54·3 μg/d at stage 1, and iodine intake increment increased from 11·2 μg/d at stage 2 to 118·0 μg/d at stage 6, while excretion increment elevated from 21·5 to 95·0 μg/d. A zero iodine balance was dynamically achieved as 48·0 μg/d of iodine intake. The estimated average requirement and recommended nutrient intake were severally 48·0 and 67·2 μg/d, which could be corresponded to a daily iodine intake of 0·74 and 1·04 μg/kg per d. The results of our study indicate that roughly half of current iodine intakes recommendation could be enough in Chinese adult males, which would be beneficial for the revision of dietary reference intakes.
Late Palaeozoic igneous rock associations in response to subduction, accretion, and final closure of the eastern Palaeo-Asian Ocean play a significant role in understanding the geodynamic evolution of the southeastern Central Asian Orogenic Belt. Previous studies have identified a Permian arc magmatic belt associated with the southward-dipping subduction of the eastern Palaeo-Asian Ocean along the Solonker–Changchun suture zone. The genetic mechanism and associated geodynamic settings are of great importance in deciphering the evolution of the eastern Palaeo-Asian Ocean. This paper presents zircon U–Pb–Hf isotope and whole-rock geochemical analyses for a suite of magmatic rocks including the early Permian diorite porphyrites (ca. 281.0 Ma), andesites (ca. 276 Ma) and rhyolites (ca. 275 Ma) in the Kulun region. The diorite porphyrites and andesites have high SiO2 and total alkali contents, and low MgO contents and Mg no. values, with enrichments in large ion lithophile elements and depletions in high-field-strength elements. These geochemical characteristics, together with low-Sr and high-Yb contents, a weak concave-upward shape of middle rare earth elements and negative Eu anomalies, suggest that these intermediate igneous rocks were generated by partial melting of amphibolitic lower crust at a crustal depth of 30–40 km. The rhyolites have heterogeneous isotopic compositions, with ϵHf(t) values and TDM2 ages of –20.8 to +0.5 and 3578∼1494 Ma, implying that they were likely derived from partial melting of a mixed source dominated by recycled ancient crust with minor juvenile crustal materials. The rhyolites show potassic affinity with relatively high K2O and very low Na2O, which was attributed to liquid immiscibility of felsic magma and subsequent limited fractional crystallization of plagioclase. The regional igneous associations, metamorphic events, and coeval sedimentary rocks along the Solonker–Changchun suture zone indicate that the early Permian igneous rocks were formed in an active continental arc environment in response to southward subduction of the eastern Palaeo-Asian Ocean.
Evidence of couples’ BMI and its influence on birth weight is limited and contradictory. Therefore, this study aims to assess the association between couple’s preconception BMI and the risk of small for gestational age (SGA)/large for gestational age (LGA) infant, among over 4·7 million couples in a retrospective cohort study based on the National Free Pre-pregnancy Checkups Project between 1 December 2013 and 30 November 2016 in China. Among the live births, 256 718 (5·44 %) SGA events and 506 495 (10·73 %) LGA events were documented, respectively. After adjusting for confounders, underweight men had significantly higher risk (OR 1·17 (95 % CI 1·15, 1·19)) of SGA infants compared with men with normal BMI, while a significant and increased risk of LGA infants was obtained for overweight and obese men (OR 1·08 (95 % CI 1·06, 1·09); OR 1·19 (95 % CI 1·17, 1·20)), respectively. The restricted cubic spline result revealed a non-linear decreasing dose–response relationship of paternal BMI (less than 22·64) with SGA. Meanwhile, a non-linear increasing dose–response relationship of paternal BMI (more than 22·92) with LGA infants was observed. Moreover, similar results about the association between maternal preconception BMI and SGA/LGA infants were obtained. Abnormal preconception BMI in either women or men were associated with increased risk of SGA/LGA infants, respectively. Overall, couple’s abnormal weight before pregnancy may be an important preventable risk factor for SGA/LGA infants.
Previous analyses of grey and white matter volumes have reported that schizophrenia is associated with structural changes. Deep learning is a data-driven approach that can capture highly compact hierarchical non-linear relationships among high-dimensional features, and therefore can facilitate the development of clinical tools for making a more accurate and earlier diagnosis of schizophrenia.
Aims
To identify consistent grey matter abnormalities in patients with schizophrenia, 662 people with schizophrenia and 613 healthy controls were recruited from eight centres across China, and the data from these independent sites were used to validate deep-learning classifiers.
Method
We used a prospective image-based meta-analysis of whole-brain voxel-based morphometry. We also automatically differentiated patients with schizophrenia from healthy controls using combined grey matter, white matter and cerebrospinal fluid volumetric features, incorporated a deep neural network approach on an individual basis, and tested the generalisability of the classification models using independent validation sites.
Results
We found that statistically reliable schizophrenia-related grey matter abnormalities primarily occurred in regions that included the superior temporal gyrus extending to the temporal pole, insular cortex, orbital and middle frontal cortices, middle cingulum and thalamus. Evaluated using leave-one-site-out cross-validation, the performance of the classification of schizophrenia achieved by our findings from eight independent research sites were: accuracy, 77.19–85.74%; sensitivity, 75.31–89.29% and area under the receiver operating characteristic curve, 0.797–0.909.
Conclusions
These results suggest that, by using deep-learning techniques, multidimensional neuroanatomical changes in schizophrenia are capable of robustly discriminating patients with schizophrenia from healthy controls, findings which could facilitate clinical diagnosis and treatment in schizophrenia.
Coastal surveillance video helps officials to obtain on-site visual information on maritime traffic situations, which benefits building up the maritime transportation detection infrastructure. The previous ship detection methods focused on detecting distant small ships in maritime videos, with less attention paid to the task of ship detection from coastal surveillance video. To address this challenge, a novel framework is proposed to detect ships from coastal maritime images in three typical traffic situations in three consecutive steps. First the Canny detector is introduced to determine the potential ship edges in each maritime frame. Then, the self-adaptive Gaussian descriptor is employed to accurately rule out noisy edges. Finally, the morphology operator is developed to link the detected separated edges to connected ship contours. The model's performance is tested under three typical maritime traffic situations. The experimental results show that the proposed ship detector achieved satisfactory performance (in terms of precision, accuracy and time cost) compared with other state-of-the-art algorithms. The findings of the study offer the potential of providing real-time visual traffic information to maritime regulators, which is crucial for the development of intelligent maritime transportation.
Anaemia is a global public health problem affecting women worldwide, and reproductive-age women are at increased risk. We conducted a population-based cross-sectional study analysing the prevalence of overall anaemia and anaemia according to severity in Chinese pre-pregnant women to update current knowledge on anaemia epidemiology. Based on the National Free Preconception Check-up Projects supported by the Chinese government, 5 679 782 women participating in this project in 2017 were included in the present study. The cyanmethemoglobin method was applied to assess Hb concentrations. Univariate and multivariate logistic regressions were applied for associated factors. The prevalence of anaemia among Chinese pre-pregnant women was 21·64 % (mild: 14·10 %, moderate: 7·17 % and severe : 0·37 %). The prevalence of overall and severe anaemia was the highest in Tibet and the lowest in Beijing among thirty-one provinces. Women’s age, region, ethnic origin, educational level, occupation and pregnancy history were all correlated with anaemia. Women with B blood type (adjusted OR (aOR) = 0·89), higher BMI (overweight: aOR = 0·84; obesity: aOR = 0·70) and alcohol consumption (aOR = 0·69) were less likely to have anaemia, while those with rhesus negative blood type (aOR = 1·10), history of anaemia (aOR = 2·60), older age at menarche (aOR = 1·19), heavy menstrual blood loss (aOR = 1·39), longer menstrual period (aOR = 1·09) and shorter menstrual cycle (aOR = 1·08) were more likely to suffer from anaemia. Meat or egg eaters were not significantly associated with severe anaemia. Anaemia is of moderate public health significance among Chinese pre-pregnant women. Interventions should be considered to prevent anaemia to the greatest extent possible to avoid potential harm in this population.
Late Mesozoic igneous rocks are important for deciphering the Mesozoic tectonic setting of NE China. In this paper, we present whole-rock geochemical data, zircon U–Pb ages and Lu–Hf isotope data for Early Cretaceous volcanic rocks from the Tulihe area of the northern Great Xing’an Range (GXR), with the aim of evaluating the petrogenesis and genetic relationships of these rocks, inferring crust–mantle interactions and better constraining extension-related geodynamic processes in the GXR. Zircon U–Pb ages indicate that the rhyolites and trachytic volcanic rocks formed during late Early Cretaceous time (c. 130–126 Ma). Geochemically, the highly fractionated I-type rhyolites exhibit high-K calc-alkaline, metaluminous to weakly peraluminous characteristics. They are enriched in light rare earth elements (LREEs) and large-ion lithophile elements (LILEs) but depleted in high-field-strength elements (HFSEs), with their magmatic zircons ϵHf(t) values ranging from +4.1 to +9.0. These features suggest that the rhyolites were derived from the partial melting of a dominantly juvenile, K-rich basaltic lower crust. The trachytic volcanic rocks are high-K calc-alkaline series and exhibit metaluminous characteristics. They have a wide range of zircon ϵHf(t) values (−17.8 to +12.9), indicating that these trachytic volcanic rocks originated from a dominantly lithospheric-mantle source with the involvement of asthenospheric mantle materials, and subsequently underwent extensive assimilation and fractional crystallization processes. Combining our results and the spatiotemporal migration of the late Early Cretaceous magmatic events, we propose that intense Early Cretaceous crust–mantle interaction took place within the northern GXR, and possibly the whole of NE China, and that it was related to the upwelling of asthenospheric mantle induced by rollback of the Palaeo-Pacific flat-subducting slab.
Patients with schizophrenia and individuals with schizotypy, a subclinical group at risk for schizophrenia, have been found to have impairments in cognitive control. The Dual Mechanisms of Cognitive Control (DMC) framework hypothesises that cognitive control can be divided into proactive and reactive control. However, it is unclear whether individuals with schizotypy have differential behavioural impairments and neural correlates underlying these two types of cognitive control.
Method:
Twenty-five individuals with schizotypy and 26 matched healthy controls (HCs) completed both reactive and proactive control tasks with electroencephalographic data recorded. The proportion of congruent and incongruent trials was manipulated in a classic colour-word Stroop task to induce proactive or reactive control. Proactive control was induced in a context with mostly incongruent (MI) trials and reactive control in a context with mostly congruent (MC) trials. Two event-related potential (ERP) components, medial frontal negativity (MFN, associated with conflict detection) and conflict sustained potential (conflict SP, associated with conflict resolution) were examined.
Results:
There was no significant difference between the two groups in terms of behavioural results. In terms of ERP results, in the MC context, HC exhibited significantly larger MFN (360–530 ms) and conflict SP (600–1000 ms) amplitudes than individuals with schizotypy. The two groups did not show any significant difference in MFN or conflict SP in the MI context.
Conclusions:
The present findings provide initial evidence for dissociation of neural activation between proactive and reactive cognitive control in individuals with schizotypy. These findings help us understand cognitive control deficits in the schizophrenia spectrum.
Hypertension represents one of the most common pre-existing conditions and comorbidities in Coronavirus disease 2019 (COVID-19) patients. To explore whether hypertension serves as a risk factor for disease severity, a multi-centre, retrospective study was conducted in COVID-19 patients. A total of 498 consecutively hospitalised patients with lab-confirmed COVID-19 in China were enrolled in this cohort. Using logistic regression, we assessed the association between hypertension and the likelihood of severe illness with adjustment for confounders. We observed that more than 16% of the enrolled patients exhibited pre-existing hypertension on admission. More severe COVID-19 cases occurred in individuals with hypertension than those without hypertension (21% vs. 10%, P = 0.007). Hypertension associated with the increased risk of severe illness, which was not modified by other demographic factors, such as age, sex, hospital geological location and blood pressure levels on admission. More attention and treatment should be offered to patients with underlying hypertension, who usually are older, have more comorbidities and more susceptible to cardiac complications.
This study aimed to investigate the association between long-term survival and different management of major aortopulmonary collateral arteries in patients with pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries.
Methods:
From November, 2009 to October, 2018, a total of 98 consecutive patients with pulmonary atresia, ventricular septal defect, major aortopulmonary collateral arteries, and hypoplastic pulmonary arteries treated with modified Blalock–Taussig shunt or right ventricle–pulmonary artery connection were included. Fifty-five patients who received occlusion or ligation of major aortopulmonary collateral arteries during or after palliative procedure were occlusion group, and the other 43 patients were no occlusion group. The early and late outcomes were compared.
Results:
The mean duration of follow-up was 30.9 months in no occlusion group and 49.8 months in the occlusion group (p < 0.001). Multivariate analysis showed that only no occlusion of major aortopulmonary collateral arteries was predictive of total mortality (Hazard Ratio: 4.42, 95% CI: 1.27 to 15.42, p = 0.02). The Kaplan–Meier survival curves confirmed that patients without occlusion of major aortopulmonary collateral arteries demonstrated worse survival as compared with the occlusion group (p = 0.013). The Kaplan–Meier survival curves of patients who underwent different palliative procedures showed no differences.
Conclusions:
For patients with pulmonary atresia, ventricular septal defect and major aortopulmonary collateral arteries when a primary repair is not feasible, those without occlusion of major aortopulmonary collateral arteries have a higher risk of death following an initial palliative procedure compared with patients who underwent occlusion of major aortopulmonary collateral arteries. The occlusion of major aortopulmonary collateral arteries is not associated with a higher rate of complete repair or better improvement of pulmonary artery growth.