Objective To evaluate the photo quality of X-ray films of endemic fluorosis in Shandong Province,and to provide a basis for correct implementation of X-ray examination.Methods Three villages were selected as survey sites in each of the 20 endemic fluorosis counties (cities,districts) of Shandong Province;anteroposterior X-ray films of the villagers forearm(including elbow) and leg(including knee) were taken; 20 films were taken in each village,each film comprising two recording sites.X-ray examination carried out in the 42 patients' villages of 14 counties(cities,districts) were undertaken by the Institute for Endemic Disease Control,Shandong Province,a total of 840 X-ray films shoot,which was edited group A,and the remaining six counties (cities,districts) were undertaken by the local Hospital,shooting X-ray films 360 copies,compiled for group B.The quality of X-ray film examination was determined in accordance with technical requirements and diagnostic indicators.The difference of photo quality between group A and group B was compared at three levels:sub-surface defects photos,structural defects and comprehensive quality.Results In evaluation of surface defects in the photo,the total detection rate of the defects indicators in group A of forearm was 7.98％(67/840),while the rate of leg was 9.77％(82/840).And the rates of group B were 35.27％(127/360) and 39.16％(141/360),respectively,and the differences were statistically significant between the two groups(x2forearm=138.6,P ＜ 0.01 ; x2leg =144.0,P ＜ 0.01).In assessment of structural defects,the total forearm defection rate of group A was 7.14％(60/840),and the leg was 8.33％ (70/840).And the rates of group B were 27.22％ (98/360) and 31.38％ (113/360),respectively.The differences were statistically significant(x2forearm =88.867,P ＜ 0.01; x2leg =103.6,P ＜ 0.01).In the photo quality comprehensive assessment,the excellent rate of forearm in group A was 72.73％(611/840),and the leg was 71.67％ (602/840),while the poor quality rates in the same parts were 9.89％ (83/840) and 11.43％ (96/840),respectively.And the excellent rates of Group B were 44.14％(159/360) and 42.22％(152/360),poor quality rates were 34.74％(125/360) and 38.06％(137/360).The differences were statistically significant(Z value were-20.161 and-16.229,respectively,P ＜ 0.01).Conclusions X-ray films taken in the counties (cities,districts) have more defects,and image is poor.The reason for that is that the skill levels of local hospital X-ray technician are low,and photos quality is not strictly followed requirements.Supervision team of professional technicians should be established to provide professional supports.It is more important to take mobile X-ray examination by the provincial institutes,and to provide a reliable technical support.

Objective To evaluate the value of the muhifunctional angle regulator with shields in skeletal fluorosis X-ray radiography.Methods Conventional radiography,regulator with shields and regulator for radiography were used to examine the forearms and shanks of 78 patients,and then the quality of the photos and the diagnostic results were compared.The dose rates on patients' foresides,sides,and bottoms of division 1 and 2 m were measured by pressure ionization instrument.Results Regulator with shields and regulator for radiography had a higher rate of good quality than conventional radiography by 39 %,and consequently the diagnostic accuracy rate were improved by 37%(X2 = 43.33,43.98 and 17.76,14.56,P < 0.01).By conventional radiography the average dose rates on forearms and shanks I and 2 m away from X-ray axis were 1198,934 and 1439,1175 μSv/h,respectively;while regulator with shields and single regulator were used,corresponding average dose rates were 80.6,39.4 and 95.6,59.5/JSv/h and 375.7,187 and 447,226.3 μSv/h,respectively.Conclusions Angle regulator with shields is effective devices to examine the forearms and shanks of the patients who are suffering from dysfunction of skeletal fluorosis.

Objective To investigate the fluoride content in drinking water as well as the current status of endemic fluorosis in 5 counties of Shandong Province,in order to provide a scientific basis for making prevention and control strategies.Methods According to the survey data of fluoride content in drinking water in Shandong Province between 2005 to 2007,an epidemiological investigation was carried out in Mudan,Jiaxiang,Wucheng,Pingdu and Boxing Counties from September to November 2013.The fluoride content in drinking water and urine and dental fluorosis of children aged 8 to 12 were investigated in 3-4 major survey villages selected in the five counties.The fluoride content in drinking water was detected by fluoride ion selective electrode method,and dental fluorosis was diagnosed by Deans method.Results Fifty-eight drinking water samples were investigated in 16 villages of the five counties.Water fluorine content in Wucheng,Mudan,Pingdu,Boxing and Jiaxiang counties was 4.14,3.84,1.83,1.33 and 0.43 mg/L,respectively.There were 4 counties' fluorine content exceeding the national standard (1.20 mg/L) except Jiaxiang County.The exceeding rate was 100％ in Wucheng and Mudan counties.Urine fluorine content of 320 children aged 8 to 12 in Wucheng,Mudan,Boxing,Pingdu and Jiaxiang counties was 4.51,4.62,1.82,1.30,1.01 mg/L respectively;the total detection rate of dental fluorosis of 574 children was 61.85％ (355/574),the rate of dental damage was 12.89％ (74/574),and dental fluorosis index was 1.27;the detection rate of dental fluorosis in Wucheng,Mudan,Boxing,Pingdu and Jiaxiang Counties was 90.18％ (101/112),97.73％ (86/88),62.22％ (84/135),54.90％ (28/51) and 29.79％ (56/188),respectively.Conclusions The exceeding rate of water fluorine content is very high in 5 counties of severe endenic fluorosis areas in Shandong Province.The urinary fluorine level of the population is still high and the prevalence of dental fluorosis of children is high.Endemic fluorosis in Shandong Province has not yet been effectively controlled,control situation is still grim.

To explore the clinic characters,treatments and prognosis of patients with primary bone lym-phoma( PLB ) .The clinical symptoms, signs, X -ray features, pathological morphology, immunophenotype and treatment of 7 patients with PLB were analyzed retrospectively and the pertinent literatures were reviewed.The re-sults showed that the main complains of 7 cases of PBL were local pain.The CT showed osteolytic bone destruc-tion and soft tissue swelling.There were 3 cases of diffuse large B cell lymphoma,1 case of Burkitt-type lympho-ma,1 case of periferal T-cell lymphoma,1 case of anaplastic large cell lymphoma,and 1 case of Hodgkins lym-phoma.2 patients presented with stageⅠ,4 with stageⅡ,and 1 with stage 3.The therapeutic procedure includes local radiotherapy combined with chemotherapy and targeted therapy.The clinical presentation of PLB is not spe-cial.The diagnosis and identification of histological type of PLB should be established by histopathological and im-munohistochemistry examinations.Early diagnosis and active therapy could improve the prognosis of PLB.Combi-nation therapy including radiotherapy and chemotherapy is the optimal treatment for PLB.

Objective To evaluate the efficacy of rituximab-containing regimens on post-transplantation lymphoproliferative disorder (PTLD) following haploidentical hematopoietic stem cell transplantation (HSCT). Methods The clinical data of 3 cases of PTLD after haploidentical HSCT were analyzed retrospectively. Time to development of PTLD ranged from 57 to 164 days after HSCT.The main symptoms included fever, superficial lymph node enlargement. Epstein-Bart virus (EBV)-positive B-cell PTLD was diagnosed by biopsy of lymph node. Management of 3 patients consisted of withdraw of immunosuppressive treatment, anti-viral therapy, rituximab (375 rng/m2 , per week for four weeks) monotherapy or chemotherapy plus rituximab. Results All the patients had complete remission after treatment. Conclusion PTLD is a serious complication of HSCT especially haploidentical HSCT. Rituximab-containing regimens are potentially effective, well-tolerated with mild toxicity and improve the prognosis of PTLD following haploidentical HSCT.

Objective This study aimed to establish a reliable primary culture protocol for preparing murine spleen-derived mesenchymal stem cells ( MSCs) by tissue explant culture.Methods Healthy mouse spleens were crushed by syringe handle to harvest spleen mesenchymal tissues.Then the tiny pieces of spleen tissue were digested by collagenase II before seeded into culture flasks.The morphological characteristics of spleen tissue-derived cells were observed under the inverted microscope.Further, the surface antigen profile of the cells was analyzed by flow cytometry (FACS).The cells were induced to differentiate into osteoblasts and adipocytes.Results The murine spleen-derived MSCs exhibited a spindle-shaped appearance.The FACS results showed that the spleen-derived MSCs highly expressed CD29, CD44, CD105 and Sca-1, but weakly expressed CD11b, CD34, CD45 and Ia. In addition, the spleen-derived MSCs steadily differentiated into osteoblasts and adipocytes in the induction medium.Conclusions A method of primary culture of murine spleen-derived MSCs by explant culture is successfully established.The harvested MSCs exhibit high purity and cell proliferation ability, and provide a reliable cell model for related researches.

BACKGROUND:Spinocerebel ar ataxia is a inherited neurodegenerative disease with progressive cerebel ar masonic movement disorders as the main clinical manifestation. So far, no drug is available to control the disease progression. OBJECTIVE:To observe the clinical effect of umbilical cord mesenchymal stem cells in treating spinocerebel ar ataxia by intrathecal injection. METHODS:Thirty-eight cases of spinocerebel ar ataxia were given umbilical cord mesenchymal stem cells by intrathecal injection, 1×106/kg once a week, four times as a course. These 38 cases received 52 courses. Among them, 27 cases received 1 course, 8 cases received 2 courses and 3 cases received 3 courses. International Cooperative Ataxia Rating Scale (ICARS) and Activity of Daily Living Scale (ADL) were used to evaluate patients’ neural functions (the greater scores, the more severe damage) and ability of daily living (the lower score, the stronger the ability of daily living). After treatment, al patients were subjected to fol ow-up visit. RESULTS AND CONCLUSION:The total effective rate of 52 courses of treatment was 84.62%. ICARS and ADL scores were significantly decreased at 1 month after treatment (P<0.01). In most of effective patients, unstable walking and standing, slow movement, upper limb fine motor disorder, writing difficulties, dysarthria, eye movement disorders were improved. After treatment, common adverse effects were dizziness (1 case), low back pain (2 cases), headache (1 case), and fever (2 cases). Al these symptoms disappeared within 1-3 days. No treatment-related adverse events happened in the median fol ow-up of 39 months (11-59 months). The il ness of effective patients had been stable for 1-19 months, average (5.95±4.84) months. Intrathecal injection of umbilical cord mesenchymal stem cells is safe to ameliorate clinical symptoms to some extent within a certain time. It may delay the progression of spinocerebel ar ataxia. Multiple courses of treatment can help to further improve neurological function in most patients.

Objective To investigate the endemic fluorosis of drinking water type in 3 counties in the northwest of Shandong Province,and to provide scientific basis for prevention and control of endemic fluorosis.Methods Seven villages in 3 counties of Ningjin,Xiajin and Wucheng were investigated to achieve the results including fluoride of drinking water,8-12 year-old children's dental fluorosis incidence rate,the fluoride of urine,prevalence of skeletal fluorosis by clinical and X-ray diagnosis in adults over 30-year old,and the bone mineral density.At the same time,set up a control point to detect the adult bone density in non-ward village of each investigated county,The water and urine fluoride were checked by selective electrode method,dental fluorosis was diagnosed by Dean method (WS/T 208-2011) and the diagnosis of adult fluorosis was performed in accordance with the diagnostic criteria of endemic fluorosis (WS 192-2008),and bone mineral density was measured by EXA-3000.Results The villages in Ningjin and Wucheng had finished defluoridation,where the water fluoride was at normal level.In the 7 villages,the total detection rate of 8-12 year-old children's dental fluorosis was 85.09％ (411/483),dental fluorosis index was 1.88;the dental fluorosis detection rate in Wucheng,Xiajin and Ningjin was 92.48％ (295/319),88.76％ (79/89) and 49.33％ (35/75),respectively,the difference was statistically significant (x2 =90.26,P ＜ 0.01).The average urine fluoride geometric mean of children (206) and adults (298) was 3.29 and 3.41 mg/L,respectively.The urine fluoride of Xiajin was the highest in the 3 counties,and the average urine fluoride geometric mean of the two groups was as high as 5.11 and 6.30 mg/L,respectively.The total detection rate of clinical and radiographic skeletal fluorosis in adults was 30.07％ (92/306) and 14.38％ (44/306),respectively.The osteoporosis detection rate of adults in endemic fluorosis area and non-endemic fluorosis area was 33.11％ (100/302) and 8.99％ (17/189),respectively.The difference was statistically significant (x2 =37.25,P ＜ 0.01);the average bone mineral density in endemic area and non-endemic area was 0.416 and 0.475 g/cm2,respectively,the difference was statistically significant (t =8.508,P ＜ 0.01).Conclusions The endemic fluorosis in the 3 counties in the northwest of Shandong Province is still existed.The defluoridation has not been completed in Xiajin County.Therefore,it is necessary to implement defluoridation measures of the drinking water as soon as possible and strengthen the water fluoride monitoring so as to prevent and control endemic fluorosis.

Objective To investigate the clinical features, diagnosis, treatment and prognosis of myelodysplastic syndromes (MDS) with mature plasmacytoid dendritic cells (PDC) proliferation. Methods The clinical data of one case of MDS with excess blasts (EB)﹣1 with mature PDC proliferation in Air Force Medical Center was retrospectively analyzed, and the literature was reviewed. Results The patient′s physical examination revealed anemia and thrombocytopenia. Bone marrow smears showed 0.064 of myeloblasts and 0.152 of dendritic cells. Immunophenotyping showed two groups of abnormal proliferation cells, namely, myeloblasts and mature PDC. Decitabine treatment was given, and the red blood cells and platelets were infused intermittently. The condition of patient was basically stable. Conclusions MDS with mature PDC proliferation is extremely rare. No special clinical manifestations are found, and the diagnosis is based on bone marrow cytology and immunophenotyping. There is no standard regimen for treatment of MDS with mature PDC proliferation, and the prognosis depends on the progression of MDS.

Objective To investigate the protective effect of ligustrazine on the transporting function of hepatocellular mitochondria membrane in the rats with sepsis-induced acute liver injury (SALI). Methods The Sprague-Dawley (SD) rats were randomly divided into sham operation group, SALI group [established by cecal ligation and puncture (CLP)], ligustrazine treatment group (injection of ligustrazine 60 mg/kg through tail vein after CLP) and ligustrazine preventive group (7 days before CLP, ligustrazine was injected daily through tail vein for 60 mg/kg), and there were 12 rats in each group. Abdominal aorta blood and liver were harvested at 10 hours after operation. The content of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and mitochondrial aspartate aminotransferase (m-AST) were determined by enzyme coupling rate method. The content of ATP was detected by colorimetric and chemical fluorescein method. The activity of mitochondrial ATPase was detected by phosphorus quantification. The expressions of mitochondrial membrane aquaporin 8 (AQP8) and carnitine palmitoyl transferase (CPT) were detected by Western Blot. Results Compared with sham operation group, the levels of serum ALT, AST and m-AST were significantly increased in SALI group, ligustrazine treatment group and ligustrazine preventive group, and the content of ATP was reduced, the activity of mitochondrial membrane ATPase, the expressions of AQP8 and CPT-1A were significantly decreased. Compared with SALI group, the levels of serum ALT, AST and m-AST were significantly decreased in ligustrazine treatment and ligustrazine preventive groups [ALT (U/L): 123.8±32.8, 105.0±44.5 vs. 233.0±110.1; AST (U/L):427.0±117.9, 303.9±110.3 vs. 742.6±441.4; m-AST (U/L): 239.6±64.9, 168.2±60.0 vs. 412.8±252.6; all P <0.01], the content of ATP were significantly increased (nmol/mg: 29.5±10.3, 34.6±11.2 vs. 19.3±8.8, both P < 0.01), the activity of ATPase in hepatocellular mitochondrial membrane were significantly increased [Na+-K+-ATPase (U/mg):3.91±0.30, 3.97±0.35 vs. 2.87±0.82; Mg2+-ATPase (U/mg): 3.75±0.38, 3.88±0.35 vs. 2.64±1.06; Ca2+-ATPase (U/mg): 3.15±0.58, 2.98±0.31 vs. 1.75±1.25; Ca2+-Mg2+-ATPase (U/mg): 3.82±0.31, 3.91±0.42 vs. 2.57±1.01, all P < 0.01], the expressions of AQP8 and CPT-1A were significantly increased [percentage increase from sham operation group (100%), AQP8/COX-Ⅳ: (79.12±7.79)%, (88.40±9.22)% vs. (62.08±11.91)%; CPT-1A/COX-Ⅳ:(87.92±10.06)%, (84.91±17.48)% vs. (72.11±7.82)%, all P < 0.01]. The levels of serum AST and m-AST in ligustrazine preventive group were significant lower than those in ligustrazine treatment group [AST (U/L): 303.9± 110.3 vs. 427.0±117.9; m-AST (U/L): 168.2±60.0 vs. 239.6±64.9, both P < 0.05]. There was no significant difference in the expression of CPT-2 in mitochondrial membrane between the four groups. Conclusions Ligustrazine could play a protective role on the mitochondrial membrane function of transporting water, ion and fat in the rats with SALI. The preventive function of ligustrazine is better than the treatment effect of the rats with sepsis.