Objective To observe the effects of comprehensive prevention and control measures through the trend change analysis of the prevalence of dental fluorosis of children and urinary fluoride in Guizhou.Methods Three villages were selected in each county from Qianxi,Pu'an and Renhuai,in 2009,2011 and 2013.Dental fluorosis of all children aged 8-12 were examined using the reference Diagnosis of Dental Fluorosis (WS/T 208-2011);50 children were selected randomly from each village to detect urinary fluoride content according to the reference Determination of Fluoride in Urine-ion Selective Electrode Method (WS/T 89-1996).Results The detectable rates of dental fluorosis of children aged 8-12 from Qianxi,Pu'an and Renhuai were 53.20％ (490/921),89.97％ (547/608) and 51.73％ (629/1 216),respectively,in 2009,46.68％ (281/602),63.60％ (332/522) and 43.84％ (530/1 209),respectively,in 2011 and 34.04％ (256/752),14.29％ (80/560) and 26.97％ (243/901),respectively,in 2013,and the detection rate in each county was reduced year by year (x2 =60.46,674.96,125.95,all P ＜ 0.01).In 2009,3 counties' urinary fluoride levels of children aged 8-12 were (1.21 ± 1.29),(0.89 ± 0.80) and (1.00 ± 0.59) mg/L,respectively,which were significantly higher than those of 2013 [(0.94 ± 0.52),(0.68 ± 0.26) and (0.87 ± 0.33) mg/L,t =3.743,4.778,3.743,all P ＜ 0.01].Conclusions The dental fluorosis prevalence and urinary fluorine content of children aged 8-12 are falling obviously through comprehensive prevention and control measures.The target to control and eliminating the disease of endemic fluorosis is not reached.It should be continue to strengthen management after comprehensive prevention and control measures.

Objective Through investigation of children fluorosis illness,family households improved stoves and related life styles,to provide a scientific basis for sustainable control of endemic fluorosis.Methods In 2013,in Huishui County and Baiyun District,3 towns were selected in each county(district),and 3 villages were selected in each town.All 8-12 years old children in the school of these villages were checked dental fluorosis,which was diagnosed according to Dental Fluorosis Diagnosis (WS/T 208-2011); at the same time,10 families were selected to survey the situation of improved stoves and related life styles.Results Dental fluorosis detection rate of 8-12 years old children in Huishui and Baiyun were 2.75％ (23/836) and 2.26％ (11/487),which were all lower than 30％.Qualified rate of improved stoves and qualified stoves correct utilization rate were all 100.0％ (90/90).For human consumption,the correct rate of corn drying was 100.0％ (90/90) ; the correct rates of chili drying were 98.9％ (89/90) and 100.0％ (90/90).Conclusions The prevention effect is obvious,which has reached the control standards.We should continue to improve the long-term mechanism of comprehensive control measures,and to achieve substantial elimination of coal-burning endemic fluorosis.

Objective To evaluate the effectiveness of comprehensive prevention and control measures on coal-burning-borne endemic tluorosis in Xishui,on residents healthy behavior and situation of the disease.Methods In 2013,five towns were selected according to their location of east,south,west,north and centre.Three villages and one elementary school in each town were chosen,and 20 families' related behavior and fluorine prevention knowledge questionnaire in each village were surveyed.All the students from one class aged 8-12 of grade 3-6 in each school were selected,according to the Diagnosis of Dental Fluorosis,dental fluorosis was examined and fluorine knowledge questionnaire was surveyed.At the same time,the detection rate of dental fluorosis of children aged 8-12,information of the knowledge about prevention and cure of fluorosis and related behavior of target groups in 2007,and the urinary fluoride contents of children aged 8-12 in 2000 were collected.Analysis and comparison of the data in 2000,2007 and 2013 were done.Results After the intervention,the witting rates of students and family householders 90.95％ (11 773/12 945),84.27％ (3 792/4 500),were significantly higher than those of before the intervention [19.29％ (1 039/5 385),26.27％ (394/1 500),x2 =9 279.14,1 794.22,all P ＜ 0.01].Proper utilization rate of cooking stove was 100.00％ (37/37),iron stove utilization rate was 99.64％ (279/280),dry chili correct rate was 100.00％ (299/299) and before the intervention,these values were 3.20％ (43/1 345),90.28％ (1 207/1 337)and 62.14％ (855/1 376),respectively,and the differences were statistically significant (x2 =601.12,27.28,27.28,all P ＜ 0.01).Children's dental fluorosis detection rate was 24.21％ (206/851),compared with that of before the intervention,61.62％ (2 150/3 489),the difference was statistically significant (x2 =385.93,P ＜ 0.01).Children's urine fluoride was (0.51 ± 0.29) mg/L,and before the intervention [(1.55± 1.59) mg/L],the difference was statistically significant (t'=10.25,P ＜ 0.01).Conclusions The effect of comprehensive prevention and control measures against coal-burning-borne endemic fluorosis in Xishui are remarkable.The residents health related behavior has been formed and the condition is reduced markedly.

Objective To investigate the epidemic situation of coal-burning-fluorosis,and to explore key areas for implementing prevention and control measures in Guizhou Province.Methods Survey data of dental fluorosis of children aged 8-10,anti-fluoride knowledge and health-related behaviors of target students and their families before implementing the comprehensive disease control measures in 2010,were analyzed and evaluated using the method of factor analysis in 23 diseased districts.Results ①The three main factors (F) related to the endemic of coal-burning-fluorosis were economic factor (F 1),knowledge factor (F2) and behavior factor (F3):F1 included the detection rate of 8 to 12 years old children's dental fluorosis,iron stove ownership,corn correct drying rate and chili correct drying rate; F2 included stove correct utilization rate,students awareness and head of the household awareness; F3 included corn food washing rate before cooking and chili food washing rate.②In the economic factor score arrangement,the first three were Zunyi,Xiuwen and Qingzhen.In the F2 score arrangement,the first three were Zunyi,Xishui and Xixiu.In the F3 score arrangement,the first three was Liuzhi,Bijie and Xixiu.③After comprehensive score,Zunyi,Qingzhen,Xishui,Xixiu,Puding and Liuzhi Counties were found to be relatively stronger in control of the epidemic of coal-burning-fluorosis; Xiuwen,Renhuai,Guanling and so on 13 counties were found to be relatively moderate,and Tongzi,Hezhang,Shuicheng and Nayong Counties were found to be relatively weak.Conclusions ①The endemic of coal-burning-fluorosis is related with many factors,and the indexes we selected in this study have a strong correlation and sensitivity,which may be used in evaluating the prevention effect of control measures to coal-buming-fluorosis.②The endemic of coal-burning-fluorosis in Guizhou Province is quite different,and key prevention and control measures can be applied according to a comprehensive factor analysis.

Objective To explore the changes of children's dental fluorosis before and after implementation of comprehensive prevention and control intervention in coal-burning-borne endemic fluorosis areas of Guizhou Province,and to provide a scientific basis for making corresponding prevention and control measures.Methods In 2010,according to a simple random cluster sampling method,1/5 of the villages out of 1/5 of the towns of Zunyi,Kaiyang and Longli Counties,were selected as investigation sites for inspection of dental fluorosis in 8-12 years old children and a longitudinal comparison was done with historical related dental fluorosis (year 1986 and 2000).Dental fluorosis of children was diagnosed by Dean method.Results In Zunyi,Kaiyang and Longli Counties,the detection rates of 8-12 years old children's dental fluorosis were 23.76％(202/850),15.77％ (79/501) and 11.17％(42/376),respectively.The detection rates of dental fluorosis in the 8,9,10,11 and 12 years old age group of children were 11.52％(19/165),17.19％(44/256),20.20％ (81/401),18.61％ (75/403) and 20.72％ (104/502),respectively,and there was no significant difference between groups (x2 =2.90,P ＞ 0.05).The survey results of this investigation in the three counties in 2000 were 34.20％(7 805/22 821),39.77％(1 782/ 4 481),60.88％(2 806/4 609),and the differences were statistically significant between the results of 2010 and 2000(x2 =37.81,110.91,350.76,all P ＜ 0.01).And compared with the results of 1986[34.29％ (9 463/27 596),36.30％ (2 708/7 460),35.72％ (1 896/5 308)],the difference of Zunyi County was not statistically significant (x2 =0.045,P ＞ 0.05),but for Kaiyang and Longli the differences were statistically significant(x2 =14.35,626.39,all P ＜ 0.01).Conclusions The effect of comprehensive prevention and control intervention is very obvious.In the 3 counties,the incidence rates of 8-12 years old children's dental fluorosis are already dropped to below 30％ of the control standard.Subsequent management should be carried out and the state of disease should be evaluated for organization-assessment acceptance in accordance with relevant hygiene standards in a planned way.

Objective To evaluate the effects of health education and improved stoves on control of coalburning-borne endemic fluorosis in Guizhou Province.Methods In 2014,according to the detectable rate of dental fluorosis of children aged 8-12 before implementing control measures,11 counties were divided into three layers:low detection rate (detection rate was less than 60％),medium detection rate (detection rate from 60％ to 90％) and high detection rate (detection rate was greater than 90％).One county was selected from each layer and two towns were selected in each county.According to the Diagnosis of Dental Fluorosis (WS/T 208-2011),dental fluorosis of all children aged 8-12 was examined in all towns;At the same time,in the 2 villages in each town,20households and students of one class in grade 4 to 6 were selected to survey knowledge about prevention and control of coal-burning-borne endemic fluorosis;and to survey the situation of improved stoves,drying and elutriation of corn and chillies,and related life behavior.Results The detectable rate of dental fluorosis of children aged 8-12was 5.49％ (198/3 607),8.33％ (72/864),12.46％ (179/1 437),and it was significantly lower than before implementing control measures [41.88％ (931/2 223),61.91％ (4 863/7 855),91.25％(2 439/2 673),x2 =1 166.43,909.56,2 508.96,all P ＜ 0.01].Correct answer rates of students about knowledge on endemic fluorosis were 78.03％ (792/1 015),84.93％ (1 465/1 725) and 80.18％ (910/1 135),the correct answer rates of knowledge were significantly higher than those before implementing control measures [23.19％ (640/2 760),47.41％ (2 368/4 995) and 40.25％ (3 405/8 460),x2 =947.96,736.61,644.69,all P ＜ 0.01].Correct answer rates of family householders about knowledge on endemic fluorosis were 86.75％ 047/400),95.25％ (381/400) and 86.25％ (345/400),the correct answer rates of knowledge were higher than those before implementing control measures [17.78％ (80/450),37.20％ (279/750) and 25.27％ (139/550);x2 =402.97,359.49,344.55,all P ＜ 0.01].The percentages of households whose stoves were qualified and can be used correctly to the total households were 96.25％ (77/80),96.25％ (77/80) and 93.75％ (75/80),and before implementing control measures [4.92％ (348/7 078),21.51％ (7 461/34 693) and 6.73％ (475/7 062)],and the differences were statistically significant (x2 =1 181.55,262.63,842.82,all P ＜ 0.01).The percentages of households using clean energy in heating season to the total households increased from 0 (0/7 078),0 (0/34 693),0(0/7 062) to 98.75％ (79/80),98.75％ (79/80),96.25％ (77/80).The rates of the three counties whose inhabitants could bake the chillies correctly were 96.25％ (77/80),95.00％ (76/80) and 97.50％ (78/80),which were significantly higher than before implementing control measures [5.55％(5/90),26.00％ (39/150),52.73％ (58/110),x2=139.52,99.36,45.64,all P ＜ 0.01].Who cooked chillies after washing were 93.75％ (75/80),95.00％ (76/80),93.75％ (75/80),which were significantly higher than before implementing control measures [74.44％ (67/90),87.33％ (131/150),34.55％ (38/110),x2 =11.47,3.91,67.36,all P ＜ 0.05].Conclusion The effects of health education and improving stoves on coal-burning-borne endemic fluorosis in the three counties of Guizhou Province are remarkable.

Objective To explore clinical application of single utility port or single port video-assisted thoracoscopic lobectomy.Methods Conducting a prospective study to 191 patients with lung disease who underwent complete video-assisted thoracoscopic surgery (VATS) lobectomy in Department of Thoracic Surgery of The People's Hospital of Wuhan University from June 2013 to Dec 2014.Results Of the 191 patients, 35 underwent left upper lobectomy, 42 underwent left lower lobectomy, 43 underwent right upper lobectomy, 11 underwent right middle lobectomy, 47 underwent right lower lobectomy, and 13 underwent bilobectomy.Operations were successful in all patients with 3 patients transferred for open thoracotomy for severe adhesion or bleeding.A total of 7 of 78 upper lobectomy and 8 of 113 middle or lower lobectomy was done with adding another incision for severe adhesion.The mean operative time was 50 ～ 190 (80.3 ±43.2) min.The mean blood losing was 90 ～ 350 (145.4 ± 56.2) ml.Thirty nine patients underwent upper lobectomy, who were placed two chest tubes, respectively.The upper chest drainage duration was (1.5 ±0.8) d, and the lower chest drainage duration was (4.2 ± 1.3) d.Forty eight patients underwent lower lobectomy, middle lobectomy, or bilobectomy, who were placed one chest tube, respectively.The chest drainage duration was(4.0 ± 1.7)d.The mean recovery time after operation was (6.1 ± 2.5) d.Seventy six patients were diagnosed with lung cancer, and the average number of dissected lymph nodes from each patient was (14.7 ±6.9).The lung cancer was classified as tumor node metastasis (TNM) stage Ⅰ A, Ⅰ B,ⅡA, ⅡB and ⅢA in 67, 61, 34, 22 and 7 cases, respectively.No serious complications, such as bronchopleural fistula or death, occurred in perioperation.Conclusions In consideration of placing two chest tubes after upper lobectomy and placing one chest tube after lower lobectomy, middle lobectomy, or middle and lower lobectomy, we think single utility port-VATS (2-port) for upper lobectomy and single port-VATS lobectomy for lower lobectomy, middle lobectomy, or middle and lower lobectomy are technically safe and have the advantages of drainage, lessening pain, rapid postoperative recovery, and have no significant difference in operation time, the incidence of complications and the number of removed lymph nodes, compared to traditional 3-port-VATS.

Objective To elucidate the clinicopathological characteristic, differential diagnosis, treatment and prognosis of systemic amyloidosis. Methods An inpatient diagnosed as systemic amyloidosis was analyzed for clinical and pathological features as well as laboratory findings. The related literature was reviewed. Results The patient was confirmed to have amyloidosis of the muscle. Muscle involvement was the most prominent and first manifestation, and the patient had widespread visceral involvements, which included cardiovascular system, kidney, respiratory as well as gastrointestinal tracts and tongue. The biopsy of the muscle, mucosa of stomach and intestine, and cutaneous tissue revealed amyloid material deposited in the skeletal and smooth muscle as well as vessel walls. Conclusion Amyloid myopathy is a rare manifestation in systemic amyloidosis. Skeletal muscle weakness and stiffening may be an important clue to the diagnosis of systemic amyloidosis.

Objective To investigate the prevalence of dental fluorosis in children aged 8-12 in coalburning-borne endemic fluorosis areas in 23 counties in Guizhou Province,and to evaluate the effects of prevention and control measures.Methods In 2014,five towns were selected according to their location of the east,the south,the west,the north and the center of the 23 counties,one primary school in each town was chosen.All the students aged 8-12 in each school were selected,according to the Diagnosis of Dental Fluorosis (WS/T 208-2011),dental fluorosis was examined.At the same time,the detection rate of dental fluorosis of children aged 8-12 was investigated in 23 counties in 2000 and 2007.Analysis and comparison of the data in 2000,2007 and 2014 were done.Results The total detectable rate of dental fluorosis of children aged 8-12 was 32.31％ (5 803/17 962).The detection rate of 3 counties was lower than 15％,12 counties ranged from 15％ to 30％ and 8 counties more than 30％.Very light,mild,moderate,and severe cases of dental fluorosis cases accounted for 48.39％ (2 808/5 803),30.43％ (1 766/5 803),15.16％ (880/5 803) and 6.01％ (349/5 803).Male and female children's overall detection rate was 33.05％ (3 083/9 329) and 31.51％ (2 720/8 633),the difference was statistically significant (x2=4.86,P ＜ 0.05).The detection rates of dental fluorosis of children aged 8,9,10,11 and 12 were 17.79％ (224/1 259),26.02％ (871/3 348),30.28％ (1 255/4 144),34.07％ (1 595/4 682) and 41.02％ (1 858/4 529),indicating that the detection rate increased with age (x2 =345.78,P ＜ 0.01).After longitudinal comparison of the detection rates of dental fluorosis of children aged 8-12 in 2000,2007 and 2014,we found that 17 counties were gradually decreased (all P ＜ 0.05) except Xiuwen,Weining,Qianxi,Qingzhen,Liuzhi and Xixiu (x2 =0.84,4.19,3.67,5.03,1.98,2.37,all P ＞ 0.05).The ratio of dental fluorosis detection rate ＜ 15％,15％-30％ and ＞ 30％ was accounted for 21.74％ (25/115),32.17％ (37/115) and 46.09％ (53/115),respectively,in the 115 villages.Conclusion The detection rate of dental fluorosis of children aged 8-12 in coal-burning-borne endemic fluorosis areas is significantly dropped,and the comprehensive prevention and control effect is gradually apparent.

Objective To investigate the usage of the stoves in the severe endemic areas of coal burning fluorosis, sum up experience timely, find problems and adjust strategy for making prevention and control measures. Methods In 23 counties of Guizhou Province in the severe endemic areas of coal burning fluorosis, a town was selected according to the east, west, south, north and center positions, three villages were selected from each town, and 20 families were selected from each village;household stoves and usage were investigated in 2013. And the data of 14 conties was compared with the survey results of 2007. Results A total of 6 916 families from 341 villages in 115 towns of the 23 counties were investigated. Average utilization rate of coal-fired furnace and electric cooker was relatively high, which was 91.34%(6 317/6 916) and 92.93%(6 427/6 916), respectively. Utilization rate of coal stove, firewood oven, gas stove and liquefied gas stove oven was 7.75% (536/6 916)-21.56%(1 491/6 916). The correct utilization rate of coal-fired furnace was 92.80%(5 862/6 317). The correct utilization rate of coal stove was 66.80%(839/1 256); 92.93%(6 427/6 916)of the families used electric cooker year around. Totally 89.82%(5 674/6 317) of the farmers used iron stove in winter. Compared with those of 2007, in 14 of the counties; the differences of coal-fired furnace, coal stove, firewood oven, electric cooker, gas stove, and liquefied gas stove utilization rate were statistically significant (χ2= 888.35, 6 210.71, 165.54, 9 194.29, 36.98, 729.76, all P<0.05). Conclusion After positive and effective comprehensive treatment for many years, great c hanges have taken place in energy structure, clean energy is widely used, the correct utilization rate of coal-fired stoves is increased, and indoor fluorine pollution caused by coal-burning is under control.