Objective To investigate the hygienic quality of drinking water in rural areas of Xiamen and to provide scientific bases for the improvement of drinking water quality and protection of human health.Methods The well water samples were sampled randomly according to the proportion and the water quality was analysed and the incidences of water-borne diseases were investigated in Xiamen rural areas.Results Water sources for drinking water in most parts of Xiamen rural areas are shallow-layer ground-water.As being polluted by surface ranoff water,the indices of total bacte-rial count and coliform bacteria in the well water were heavily over the standard with the over standard rates61.6%and85.1%respectively.The contents of fluoride in drinking water were at the higher levels(the highest one was1.6mg /L)in some villages and still there were more villages where the iodine contents in drinking water was at the lower level.The iodine content in well water,spring water and tap water was11.1,2.5and4.45?g /L respectively,in which the unqualified rate was48.3%,90%and58.1%respectively.The incidence of dental fluorosis in school-age children was70%in the high fluoride areas and the incidence of endemic goiter was20.9%in the low iodine areas.Conclu-sion The main hygienic problem of drinking water in rural areas of Xiamen was biological pollution and lower iodine contents and higher fluoride contents in water in some areas.In order to eliminate the water-borne diseases,the most important rural sanitary measures need to be taken:improving the sanitary conditions around the wells,repairing the well wall s and using deep ground-water or drinking water and developing centralized water supply in the areas with unbal-anced health-related microelemeuts in drinking water if possible in some villages.

4 ml, which was 45.1% (23 of 51)(?2=20.7, P4 ml were 3.8% (4 of 105) and 29.4% (15 of 51) respectively, with statistically significant difference between the two groups (?2=21, P68Gy was 81.3% (65 of 80), and group ≤68Gy 56.6% (43 of 76)(?2=11.1, P

5 ml groups were 95.5% and 81.1% respectively. This difference was statistically significant (P5 ml groups were 4.5 % and 32.1%, respectively (P50 Gy was increased statistically, but the occurrence of complications was also increased. Conclusions Stereotactic radiosurgery improves the outcome of the elderly patients with brain metastases. Radiation dosage and tumor volume are significantly related with the therapeutic efficacy and the occurrence of complications.

Objective To evaluate the efficacy and safety of the damage-controlling surgery for the elderly patients with obstructive biliary diseases. Methods 278 elderly patients with obstructive biliary diseases were divided into the damage-controlling surgery group and definite surgery group.The obstructive biliary diseases were divided into the benign obstructive group and the malignant obstructive group. The complication rate and mortality between the 2 groups were analyzed and compared. Results One hundred and eighteen elderly patients were treated by damage-contolling surgery, its complication rate was 9.32 % and the mortality was 0 %. One hundred and sixty elderly patients,were treated by definite surgery, its complication rate was 24.38%, the mortality was 6.88%. There were significant differences in complication rate and mortality between the damage-controlling surgery group and the definite surgery group (all P＜0.01). The complication rate of the benign obstructive diseases group treated by damage-controlling surgery was 17.3%, the mortality was 0%. The complication rate of the benign obstructive diseases group treated by definite surgery was 16.3%, the mortality was 4.34%. There was no significant difference in the complication rate and mortality between the 2 groups (all P＞0.05). The complication rate and mortality of the malignant obstructive biliary diseases group treated by damage-controlling surgery were 4.45% and 0% respectively, and were 35.29% and 10.29% by definite surgery, there were significant differences in the complication rate and mortality between the 2 groups (P＜0.01 and P＜0.05). Conclusions Damage-controlling surgery may decrease the complication rate and mortality of the elderly patients with obstructive biliary diseases, and improve the operation safety of the elderly patients.

Objective To study the distribution of hemodynamics in carotid artery under the fluid-solid interaction at the typical point of time during a single cardiac cycle, and to explore the mechanism of the formation and development of carotid atherosclerotic plaque. Methods Numerical analysis the blood flow characteristics within a cardiac cycle in carotid artery was analyzed by using computational method of fluid dynamics. Based on the hemodynamic parameters, the influences of the cardiac systole and diastole on the blood flow distribution were analyzed. Results The distribution of blood flow in the carotid artery within a typical cardiac cycle was obtained. Compared with the findings in cardiac diastole, a larger area of blood stasis at the entrance of external carotid artery was observed. In this area, the flow velocity, the wall pressure and the wall shear stress were all lower, while the arterial wall deformation and von Mises equivalent stress were larger. Conclusion Under fluid-solid interaction, the low blood flow in carotid artery causes blood reflux, resulting in the deposition of lipid, fiber and other large molecular materials. The low wall pressure produced“negative pressure” effect, thus the normal blood flow is changed, the flow velocity becomes slow, and the blood supply of the brain becomes insufficient. The low wall shear stress destroys the blood flow near the wall, causing the increase of platelet activity and intimal hyperplasia. The larger arterial wall deformation variable and von Mises equivalent stress can cause stress concentration and increase vascular rupture risk.

Pulse waves contain abundant physiological and pathological information of human body. Research of the relationship between pulse wave and human cardiovascular physiological parameters can not only help clinical diagnosis and treatment of cardiovascular diseases, but also contribute to develop many new medical instruments. Based on the traditional double elastic cavity model, the human cardiovascular system was established by using the electric network model in this paper. The change of wall pressure and blood flow in artery was simulated. And the influence of the peripheral resistance and vessel compliance to the distribution of blood flow in artery was analyzed. The simulation results were compared with the clinical monitoring results to predict the physiological and pathological state of human body. The result showed that the simulation waveform of arterial wall pressure and blood flow was stabile after the second cardiac cycle. With the increasing of peripheral resistance, the systolic blood pressure of artery increased, the diastolic blood pressure had no significant change, and the pulse pressure of artery increased gradually. With the decreasing of vessel compliance, the vasoactivity became worse and the pulse pressure increased correspondingly. The simulation results were consistent with the clinical monitoring results. The increasing of peripheral resistance and decreasing of vascular compliance indicated that the incidence of hypertension and atherosclerosis was increased.
Aorta ; Arteries ; physiology ; Atherosclerosis ; Blood Pressure ; Cardiovascular Diseases ; Electricity ; Heart ; physiology ; Hemodynamics ; Humans ; Hypertension ; Models, Cardiovascular ; Vascular Resistance

ObjectiveTo compare the clinical and the pathological diagnosis of elderly with dementia, assess the related factors affecting the diagnosis.MethodsThe 42 autopsied elderly patients with dementia were assessed with the National Institute for Neurological Disorders and Stroke (NINDS) criteria and the ischemic scales of Hachinski, Rosen, Loeb and Gandolfo for the clinical diagnosis of dementia. Specificity was calculated using the neuropathologic diagnosis as a gold standard.ResultsThe patients were differentiated with pathology verified Alzheimer's disease (AD), vascular dementia (VaD), and “mixed” (AD plus VaD) dementia, Parkinson's disease dementia (PDD). Comparing clinical criteria and neuropathology, the consistent rate was 80.0% for AD, 52.4% for VaD, 18.2% for AD+VaD and 0.0% for PDD. The consistent rate between 3 scores and the pathological diagnosis was about 40%～70%. There were no significant differences between the average age of onset and the survival time, and the ischemic scales of Hachinski, Rosen, Loeb and Gandolfo among the 4 types of dementia. There was no significant difference in the specificity of the NINDS criteria among the 4 types of dementia.ConclusionDementia associated with cerebrovascular disease and Parkinson's disease is the main factor affecting the diagnosis of elderly with dementia. There is no significant difference for the diagnosis of dementia among the ischemic scales of Hachinski, Rosen, Loeb and Gandolfo.

Objective To observe the changes of serum soluble CD40 ligand (sCD40L) and fibrinogen in acute myocardial infarction (AMI) patients and to investigate the clinical predictive value of increased serum sCD40L and fibrinogen. Methods Serum sCD40L level of 60 AMI patients was determined by enzyme-linked im-munosorbent assay (ELISA). Plasma level of fibrinogen was measured. The patients were followed up for 2 years af-ter discharge from the hospital and were observed for cardiovascular event. Results AMI patients had higher sCD40L and fibrinogen levels than those of controls [(15.36±7.32) μg/L vs. (5.79±2.78) μg/L, (4.60±1.37)g/L vs. (3.03±0.82) g/L,P<0.001] ,which were significantly higher in the patients experiencing cardio-vascular event than those without cardiovascular event [(18.14±6.34) μg/L vs. (14.38±6.67) μg/L and (4.97±1.33)g/L vs. (4.20±1.24} g/L] (P<0.05). The patients with sCD40L≥14.5 μg/L or fibrinogen≥ 4.4 g/L experienced increased risk of adverse cardiovascular events (P<0.05). In AMI patients, sCD40L level was significantly higher in patients with diabetes than in nondiabetics [(18.38±6.71) μg/L vs. (14.46±6.48) μg/L, P<0.05)]. Fibrinogen level was related to sCD40L (r=0.27, P<0.05) and LVEF(r=-0.319, P<0.05). Conclusion Increased sCD40L and fibrinogen levels,which maybe related to the pathogenesis of AMI,can be found in AMI patients and can indicate an independent increased risk of major adverse cardiovascular events. Diabetes is independently associated with elevated sCD40L level in AMI patients.

Objective To assess the trends and characteristics of CD 4 +T lymphocyte counts among patients with acquired immune deficiency syndrome ( AIDS) in Tianjin City.Methods The demographic and clinical characteristics of AIDS patients diagnosed in Tianjin Second People′s Hospital from 2005 to 2017 were analyzed.The CD4 +T lymphocyte count and the frequency of CD 4+T lymphocyte count ＜200 cells／μL were analyzed according to age , transmission route and education level.The chi-square test was used for counting data.The rank sum test was used for the data that did not conform to normal distribution .Results The 3 062 patients were aged (38.2 ±11.9) years.There were 2 867 males (93.6%) aged (37.8 ±11.8) years, and 195 female patients ( 6.4%) aged (43.3 ±12.6) years.The CD4+T lymphocyte counts of these patients presented an increasing trend from 2005 to 2017, with statistically significant differences among different years (Z＝18.871, P＜0.05).The frequency of CD4 +T lymphocytes ＜200 cells／μL showed a decreasing trend , with statistically significant difference in different years (χ2 ＝7.017,P＜0.05).The CD4+T lymphocyte counts in patients of all age groups showed an increasing trend from 2005 to 2017, with statistically significant differences (Z＝6.849, 9.532, 7.146, 6.874, 8.038, 11.249, and 10.059, respectively, all P＜0.05).The CD4+T lymphocyte counts in homosexual patients presented an increasing trend , with statistical significance in different years (Z＝8.038, P＜0.05).The CD4+T lymphocyte counts in patients who received education more than 13 years (include 13 years) presented an increasing trend , with statistical significance (Z＝4.573, P＜ 0.05).Conclusions The median CD4+T lymphocyte counts of AIDS patients receiving primary treatment in Tianjin city are increasing by years , while the proportion of severe immunosuppression is decreasing.Patients who are infected through homosexual transmission and those with high level of education seek medical care earlier.

Objective: To understand the intention of pediatricians turnover in Shenzhen and its influencing factors. Methods: From September to December 2016, a multi-stage stratified cluster sampling method was used to select 948 pediatricians from Shenzhen to conduct a questionnaire survey. The questionnaire cover the following: 1. Basic information: general demographic characteristics(gender, age, marriage, education, etc.); 2. Work status survey: turnover intention, experiences with violence against medical workers, professional job satisfaction, and work stress, etc. Univariate analysis and multivariate analysis were used to identify factors for pediatrician′s turnover intention. Results: Among the 948 pediatricians in Shenzhen, 62.5% had turnover intention; age, title, education, seniority, monthly income, medical institution nature, medical institution level, length of sleep, job satisfaction, work stress, experience with violence and family support all affect the pediatrician′s turnover intention(P<0.05); multivariate logistic regression analysis showed that age, education, monthly income, job satisfaction, work stress and experience with violence were the influencing factors of pediatrician′s turnover intention(P<0.05). Conclusions The pediatrician′s turnover intention in Shenzhen is not low. Relevant measures should be taken by the government, hospital administrators, children patients and their family to ensure the supply of children′s medical services.