The recent data on drinking water contamination suggest that pollutions caused by various treatments and consumption behaviors have been a universal public health problem. Contaminants come from materials for supply disinfections purifications secondary water supply system containers for preparation and storage. Overall management and control should be taken to prevent drinking water pollutions including replacement of hazard materials for water supply application of qualified disinfectors and purificants consumption of safety health container. The government should constitute and revise the related laws and regulations to supervise the whole process of water supply and treatment productions and distributions of disinfectors,purificants and drinking water containers.

Adult ; Aged ; Female ; Fistula ; surgery ; Humans ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Pharyngeal Diseases ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

Objective: To investigate the early effctiveness of oblique lateral interbody fusion (OLIF) combined with pedicle screw fixation via small incision Wiltse approach for the treatment of lumbar spondylolisthesis. Methods: Between January 2016 and December 2016, 21 patients with lumbar spondylolisthesis were treated with OLIF and pedicle screw fixation via small incision Wiltse approach. There were 9 males and 12 females, aged 57-73 years, with an average age of 64.5 years. The disease duration was 24-60 months, with an average of 34.6 months. All cases were spondylolisthesis at L 4 (15 cases of degreeⅠ, 6 cases of degreeⅡ); 1 case had vertebral arch isthmus, and 20 cases had spinal stenosis. Japanese Orthopaedic Association (JOA) scoring system was used to evaluate the effectiveness before operation and at last follow-up. Before operation and at 2 days after operation, anteroposterior and lateral X-ray films and CT were taken to measure the sagittal diameter and cross-sectional area of the spinal canal, and calculate the intervertebral height and degree of spondylolisthesis. At 6 months after operation, the intervertebral fusion was evaluated by CT. Results: The operation time was 120-180 minutes, with an average of 155 minutes; the intraoperative blood loss was 100-340 mL, with an average of 225.5 mL. One patient had slight injury of lower endplate, 1 patient had numbness of thigh and weakness of hip flexion after operation, 1 patient had sympathetic nerve trunk injury. All the cases were followed up 12-18 months, with an average of 14.3 months. The symptoms of low back pain, leg pain, and numbness of lower limbs significantly relieved after operation, and there was no complication such as protrusion of fusion cage, screw breakage, and endplate collapse. At 2 days after operation, the intervertebral height, degree of spondylolisthesis, sagittal diameter of spinal canal, and cross-sectional area of spinal canal significantly improved compared with preoperative ones ( P<0.05). At 6 months after operation, CT showed that 1 patient had poor interbody fusion (grade Ⅲ), the other 20 patients had good interbody fusion (grade Ⅰ and Ⅱ), and the interbody fusion rate was 95.2%. At last follow-up, JOA score of lumbar spine significantly increased compared with that before operation ( t=24.980, P=0.000). Conclusion: OLIF combined with pedicle screw fixation via small incision Wiltse approach for the lumbar spondylolisthesis has minimally invasive features, such as less trauma, fewer complications, and higher intervertebral fusion rate. It is a safe and effective method.

Objective To study the effects and mechanisms of myocardial injury in schistosome-infected mice.To investigate the effects and mechanisms of quercetin on myocardial injury due to the development of hepatic fibrosis after being treated by Praziquantel.Methods Eighty mice were divided into four groups:group A,group B,group C,and group D.Group A,group B,and group C were infected with Schistosoma japonicum cercariae.After 8 weeks,group A was treated with Praziquantel 500 mg/kg for 2 d,group B was treated with quercetin 30 mg/(kg?d) for 8 weeks after being treated with Praziquantel 500 mg/kg for 2 d.Group C was taken as experimental control without any treatment.Group D was taken as normal control.At the week 16,all mice were sacrificed and a part of liver tissue and myocardium tissue were preserved.HE Staining,electric microscope,RT-PCR,and immunohistochemical technique were applied to observing the changes of hepatic and cardiac histopathology,myocardial ultramicrostructure,the expression of myocardial c-fos,c-jun mRNA,and the contents of myocardial transforming growth factor-?1 (TGF-?1),typeⅠand typeⅢcollagen in mice infected with S.japonicum before and after treatments. Results There was different degree of myocardial injury among three groups of experimental control, Praziquantel treatment,Praziquantel combined with quercetin treatment.Praziquantel treatment relieved the degree of hepatic fibrosis and myocardial injury.The content of myocardial c-fos mRNA,c-jun mRNA,TGF-?1,typeⅠand typeⅢcollagen were obviously reduced compared to the experimental control. When Praziquantel treatment combined with quercetin,the degree of hepatic fibrosis and myocardial injury were further relieved.Although the content of myocardial c-fos mRNA,c-jun mRNA,TGF-?1, typeⅠand thypeⅢcollagen were still higher than those in normal control,those were reduced significantly compared to the group treated with Praziquantel.Conclusion Hepatic cirrhosis due to advanced schistosomiasis may lead to cardiac remodeling by stimulating the expression of immediate early gene and promoting the overexpression of TGF-?in myocardium.Anti-fibrosis therapy can reduce the degree of cardiac remodeling.Quercetin may protect myocardium through reducing the degree of hepatic fibrosis and inhibiting the expression of immediate early gene,which could decrease the level of myocardial TGF-?1.

Objective To investigate the epidemiology of drug-resistant tuberculosis (TB) in five rural counties of eastern China and analyze the biological,demographic and social risk factors.Methods Subjects of this study were all the diagnosed TB patients registered in the five study sites in Shandong Province,Jiangsu Province and Zhejiang Province during one year of 2008- 2009.Questionnaire interview was conducted in all the subjects to acquire the socio-demographic and clinical information.Sputum samples were collected for culturing and isolating of Mycobacterium tuberculosis (M.TB) strains.All the M.TB isolates were further tested for the susceptibility to first-line drugs including rifampin,isoniazid,ethambutol and strepomycin by proportion method.Mantel-Haenszel chi-square test,Fisher's exact test,ANOVA and nonconditional Logistic regression modeling were applied for data analysis.Results Among the total 380 M.TB isolates,105 were resistant to at least one of the first-line drugs.The total drug resistant TB prevalence was 27.6％.Multidrug-resistant tuberculosis (MDR-TB) was observed in 8.4％ of newly treated TB patients,whereas it was 23.3％in previously treated TB patients.After adjusted by county,gender and age of the subjects,multivariate analysis showed that previous treatment history (OR=3.900,95％CI: 1.737-8.704),tuberculosis cavity (OR - 1.987,95 ％ CI: 1.001 - 3.942) were independent factors influencing the occurrence of MDR-TB.Conclusions The prevalence of drug resistant TB in rural area of eastern China is relatively low compared with the average level in China,while it is still higher than the global average level.The present study highlights that TB patients with previous treatment history,cavitaryTB are correlated with MDR-TB,and elderly patients are at high risk of MDR-TB.

Objective To investigate the impact of isoniazid (INH)-resistant Mycobacterium tuberculosis (Mtb) on the prevalence and dissemination of multi-drug resistant tuberculosis (MDR-TB).Methods A total of 251 patients diagnosed with tuberculosis in designated hospitals of Guanyun,Jiangsu and Deqing,Zhejiang from 2010 to 2011 were included in the study.The drug susceptibility tests (DST) were performed on all the Mtb isolates available from the sputum cultures.Mycobacteral interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) was conducted for genotyping for all available Mtb isolates.Chi-square test,Fisher exact test,ANOVA and non-conditional Logistic regression modelling were applied for data analysis.Results Among 251 patients with Mtb isolates and DST results available,72 (28.7％) were resistant to INH,including 13 were INH mono-drug resistant.Of the remaining 59 INH-resistant Mtb,34 (13.5％) were resistant to rifampin TB and 25 were resistant to streptomycin and/or ethambutol.The clustering analysis based on MIRU-VNTR genotyping revealed 29 clustered genotypes (including 105 isolates) and 146 unique genotypes (including 119 isolates).Twentyfive clusters contained drug resistant Mtb and 16 clusters of them comprised by 37 INH-resistant isolates and 20 MDR-TB isolates,which accounted for 51.4％ of the INH-resistant isolates and 58.8％ of the MDR-TB isolates.Single factor analysis showed that sex,age,previous tuberculosis treatment history and sputum smear results were all related to INH-resistant tuberculosis and MDR-TB (all P ＜ 0.05).Multiple factors analysis showed that previous tuberculosis treatment history was risk factor of MDR-TB (OR=8.40,95 ％CI:3.342-21.105),while the risk factors of INH-resistant tuberculosis were previous tuberculosis treatment history (OR=3.52,95％CI:1.570-7.910),pulmonary caviry (OR=2.27,95％CI:1.075-4.799) and sputum smear results (OR=0.50,95％CI:0.275-0.892).Conclusions That INH-resistant strain may evolve to the MDR-TB after recent transmission is a possible trend.Patients with previous treatment history and advanced age are at high risk of INH-resistant tuberculosis and MDR-TB.

Objective To investigate the effect and safety of primary percutaneous coronary intervention (PCI) of acute ST-segment elevation myocardial infarction (STEMI) in elderly patients.Methods 103 consecutive patients with STEMI treated by primary PCI were divided into two groups according to the age:the elderly group [aged≥65 years,with a mean age of (75.7 ±6.2) years(n =49],the non-elderly group [aged＜65 years,with a mean age of (43.0±8.6) years(n =54].Clinical characteristics,complications related to PCI procedure and success rate were analyzed,and major cardiovascular events (MACE) were followed up for(5.7 ± 1.2) months.Results The proportion of female,patients with Killip ≥ Ⅲ,three vessels disease and higher level of serum brain natriuretic peptide were higher in elderly group than in non-elderly group (all P＜0.05).No significant difference was observed between the two groups in success rate and complications of PCI procedure (both P＞0.05).Patients were followed up for (5.7± 1.2) months.The in-hospital and one-month mortalities were higher in elderly group than in non-elderly group [8.2％ (4 cases)vs.0％ (0 case),10.2％(5 cases) vs.0 ％ (0 case),respectively,all P＜0.05].There was no significant difference in six-month mortality and MACE between the two groups.Multivariate logistic regression analysis showed that Killip ≥ Ⅲ was related with the increase of one-month mortality in patients with STEMI undergoing primary PCI,whereas age was not.Conclusions Primary PCI is effective and safe in elderly patients with STEMI.

BACKGROUND:Basic fibroblast growth factor (bFGF) plays an important role in the ligament tissue healing process, and bone marrow mesenchymal stem cel s transfected with growth factors can be used as seed cel s in ligament tissue engineering.
OBJECTIVE:To observe biological effect of bone marrow mesenchymal stem cel s transfected with recombinant adenovirus vectors carrying bFGF in three-dimensional co-culture with ligament fibroblasts.
METHODS:Passage 3 bone marrow mesenchymal stem cel s were divided into three groups:control group, Ad-EGFP group and Ad-bFGF group. Under a phase contrast microscope, the changes in cel morphology were observed and the rate of transfection was analyzed by flow cytometry. Proliferation of bone marrow mesenchymal stem cel s and ligament fibroblasts was analyzed by MTS, the expression of bFGF protein in bone marrow mesenchymal stem cel s was determined by ELISA. Scleraxis, col agen type I, col agen type III, decorin and cartilage oligomeric matrix protein levels were detected in BMSCs and ligament fibroblasts using real-time fluorescent quantitative PCR.
RESULTS AND CONCLUSION:Recombinant adenovirus-mediated bFGF gene could transfect bone marrow mesenchymal stem cel s efficiently. After co-culture for 3, 6 days, compared with the control group and Ad-EGFP group, in the Ad-bFGF group, the proliferation ability of bone marrow mesenchymal stem cel s and ligament fibroblasts was enhanced (P<0.01), the expression of bFGF protein in supernatant was obviously higher (P<0.01), the col agen type I, col agen type III, decorin and cartilage oligomeric matrix protein mRNA expression decreased in the ligament fibroblasts (P<0.01), but the mRNA expression of Scleraxis, col agen type I, col agen type III in bone marrow mesenchymal stem cel s increased (P<0.01). The results suggest that the co-culture of Ad-bFGF-transfected bone marrow mesenchymal stem cel s with ligament fibroblasts promotes the proliferation of ligament fibroblasts while decreases the col agen synthesis at the same time, and stimulates the proliferation and differentiation of bone marrow mesenchymal stem cel s into ligament fibrolasts.

Objective To study the anti-tumor effect of 5-aza-2′-deoxycytidine(5-aza-dC) on breast carcinoma xenografted in nude mice. Methods The model of breast carcinoma xenografted in nude mice was established.Ten mice were randomized into the treatment group(treated with 5-aza-dC) and control group(treated with PBS).The mass of the tumors before and after treatment were measured in the two groups,and the inhibition rate of the tumor was calculated and the growth curve was drawn.Immunohistochemistry and Western blotting were employed to detect the expression of normal epithelial cell specific-1(NES1)gene. Results The inhibition rate of the tumor in the treatment group was 57.44%,which was significantly different from the control group(P

Objective To evaluate the length of hospital stay and the incidences of complications after omentoplasty with non-omentoplasty for the patients with esophageal cancer.Methods The databases including Pubmed,Embase,The Cochrane Library,Web of Science,CBM,CNKI,VIP and Wanfang data were searched for collecting randomized controlled trials on the omentoplasty.According to the inclusive and exclusive criteria,the datas were extracted.Two reviewers independently screened literatures and assessed the qualities of the included studies and extracted data.Meta-analysis was performed by using of RevMan 5.2 software.Results A total of 6 RCTs including 2 167 patients from 206 original articles were included in this analysis.In terms of the anastomotic leakage after esophagectomy and the hospital stays,the incidence of anastomotic leakage (OR =0.19,95％ CI:0.09 ～ 0.39,Z =4.55,P ＜ 0.000 01) and hospital stays (MD =-1.91,95％ CI:-2.26--1.57,Z =10.87,P ＜ 0.000 01) with omentoplasty was significantly lower than those of the non-omentoplasty,with significant differences.However,in terms of anastomotic stricture (OR =0.76,95％ CI:0.29-2.01,Z=0.55,P=0.58) and mortality rate (OR =0.72,95％ CI:0.24-2.21,Z=0.57,P=0.57),there wrer no significant differences.Conclusion Comparing with non-omentoplasty,the use of omentoplasty has beneficial effects for the postoperative complication such as anastomotic leakage and hospital stays,and does not increase the incidence of anastomotic stricture and mortality rate.