In 2004, a project on environmental hygiene has been conducted at An Duong district to improve water supply system and sanitary latrines in the community. This study was designed for evaluating the project activities at two communes of An Duong, Hai Phong and some encouraging results have been yielded.
Environment ; Water ; Rural Health

Results of retrospective survey of some water-born diseases in people at 3 urban districts, Hai Phong city showed that: the prevalence of low infected diseases were typhoid, hepatitis, malaria, haemorrhagic fever, eye disease; diarrhea, intestinal amebiasis, helminth were high infection but tended to decrease from 1997 to 2002. The prevalence of haemorrhagic fever and malaria on 100,000 people in Hai Phong city decreased by the year, reduction 7-49 folds compared to the whole country and there were only sporadic cases. The prevalence of the highest diseases was in the age of 60 (7.5%)
Water ; Disease ; Urban Health ; Urban Population

Objective To improve the clinical blood level Through explore the feasibility of blood free surgery for congenital heart disease.Methods Collected 160 patients with congenital heart disease during January 2014 to December 2016 in our hospital,patients were divided into bloodless surgery experimental group (n =69) and blood transfusion treatment group (n=91) according to perioperative blood use.The basic data which including age,weight and GCS score,preoperative and postoperative hemoglobin(Hb),operation and postoperative pleural effusion drainage,intraoperative extracorporeal circulation time,mechanical ventilation time and blocking time,ICU stay,postoperative hospital stay,total hospital stay,reintubation and re-surgery of the two groups were compared.To investigate the effect of the implementation of bloodless surgical strategy for patients with congenital heart disease.Results 1) The difference between the two groups in age,body weight and GCS was not statistically significant (P＞0.05);2) The differences of Hb and intraoperative and postoperative pleural effusion drainage between two groups were not statistically significant (P＞0.05);3) The differences with cardiopulmonary bypass time,mechanical ventilation time,blocking time,re-intubation,re-surgery and ICU days of two groups were also not statistically significant (P ＞ 0.05);but bloodless surgery patients' postoperative hospitalization days and total hospitalization time was significantly lower than the control group (P＜0.05).Conclusion The implementation of bloodless surgery in congenital heart disease is safe and feasible.It can shorten the patient's hospitalization time.It is worth popularizing in clinical surgical treatment.

Objective To establish chronic sleep deprivation mouse model,evaluate the learning and memory ability of mice and observe autophagy and apoptosis levels in mouse brain.Methods C57BL/6 mice (n =20) were randomly separated into sleep deprivation group and control group.After 2-month sleep deprivation by using an adapted multiple platform method,the behavioral performance of mice was measured by IntelliCage system.The expression of microtubule associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ) and Beclin-1 was detected by Western blotting.Confocol microscopy was used to observe autophagosome.In addition,terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining was performed to detect neuronal apoptosis level in mouse brain.Results The results of behavioral test showed that the incorrect visit ratio was much higher in sleep deprivation group than that in control group.Moreover,the expression of LC3-Ⅱ (sleep deprivation group 1.681 ± 0.186,control group 1.125 ±0.048,t =2.892,P =0.027 6) and Beclin-1 (sleep deprivation group 1.144 ±0.048,control group 1.006 ± 0.017,t =2.721,P =0.018 6) in mouse hippocampus and cortex was significantly elevated in sleep deprivation group than those in control group.Accordingly,the confocal microscopy observation also revealed an increased nuclear LC3-positive puncta in hippocampus and cortex of sleep deprived mice (hippocampus in sleep deprivation group 1.665 ± 0.153,in control group 0.819 ± 0.072,t =5.024,P =0.002 4;cortex in sleep deprivation group 1.925 ± 0.175,in control group 1.195 ± 0.111,t =3.521,P =0.012 5).In addition,TUNEL staining showed a much higher percentage of TUNEL-positive nuclei in these brain regions (hippocampus in sleep deprivation group 47.24 ± 4.15,in control group 19.26 ± 3.72,t =5.025,P =0.007 4;cortex in sleep deprivation group 42.25 ± 1.25,in control group 27.50 ± 3.23,t =4.262,P =0.005 3).Conclusions Chronic sleep deprivation can impair the learning and memory,increase the expression of LC3-Ⅱ and Beclin-1,elevate the formation of autophagosome,and promote apoptosis in mouse brain.These findings suggest that autophagy and apoptosis might be involved in the cognitive impairment induced by chronic sleep deprivation.

To discuss the value of the diagnosis and treatment for the submucous myomas by hysteroscope. According to the data of hysteroscopic resection in the treatment of submucous fibroids, the authors suggested that the submucous myomas should be divided into four types and the detailed appearance of each type were discussed. Conclusions: Four types of the submucous myomas were distinguished and the surgical treatment of each type were chosen correspondingly under hysteroscope.

Objective To compare gait patterns in patients with metal-on-metal resurfacing hip arthroplasty(RHA)and big-femoral-head total hip arthroplasty(BHA)at one year postoperatively.Methods From June 2006 to March 2009,two groups of 30 RHA and BHA patients participated in the study.Gait parameters,knee and hip joint range of motions(ROMs)in gait cycles were measured at one year postoperatively by Vicon gait analysis system,and the values were used to calculate affected/unaffected ratios of patients themselves.Results No significant difference were found in affected/unaffected ratios of cadence,single limb support time,foot off,peak value of vertical ground reaction force,the hospital for special surgery score and the university of California at Los Angeles activity assessment between the two groups.However,several ROM affected/unaffected ratios in RHA group(hip range of flexion/extension,abduction/adduction,and rotation were 1.0323,0.9747,and 1.0558,respectively.The knee range of flexion/extension for affected/unaffected ratios was 1.0027)were significantly higher than those in BHA group(the corresponding values were 0.8615,0.7824,0.8162,0.9472,respectively).The P values were 0.007,0.005,0.006,and 0.037,respectively.Conclusion(1)Gait parameters of patients who underwent RHA and BHA were close to normal values at one year postoperatively.(2)At the follow up time point,joint ROMs of RHA patients are larger than those of BHA patients during gait cycle.(3)RHA can retain enough bone stock for future revision option,moreover,it can achieve maximum recovery of joint function.

Background When focusing on a target,the accommodative system exhibits small variations in power within a range,termed microfluctuations.Exploring the correlation between the characters of microfluctuations and the aberrations of the eyes through a critical period-teenager can deepen the understanding of the onset and development of myopia.Objective This study was to investigate the correlation between accommodative microfluctuations and wavefront aberrations of human eyes,and to explore the role of accommodative microfiuctuations in the development of myopia.Methods A cross-sectional study was designed and performed.Fifty-four teenagers aged from 12 to 15 years were enrolled in this study in Eye Hospital,Wenzhou Medical University from 2010 to 2011,including 19 emmetropic subjects,18 incipient myopic subjects and 17 progressive myopic subjects,who were chosen based on the refractive changes for the last two years.The accommodative response and microfluctuations were measured by WAM-5500 infrared autorefractor with RSVP at 25,33 and 50 cm respectively,each RSVP distance was tested for 5 minutes.The accommodative values were divided into low frequency component (LFC) (0-0.6 Hz),middle frequency component(MFC) (0.6-0.9 Hz) and high frequency component (HFC) (1.0-1.4 Hz) after Fourier spectrum analysis.The wavefront aberrations of the whole eye and corneal were recorded by i-Trace aberrometer and Humphrey corneal topography.The differences of accommodative response,microfluctuations and aberrations were evaluated and compared among the emmetropic group,incipient myopic group and progressive myopic group.The correlations of accommodation and aberrations were analyzed.This study followed Declaration of Helsinki,and informed consent was obtained from each subject.Results Under the 25 cm and 33 cm reading distance,the accommodative response values were (2.78 ± 0.35) D and (2.19 ± 0.27) D in the emmetropic group,which were significantly higher than (2.44±0.33) D and (1.89±0.35)D in the progressive myopic group (P=0.002,0.003).LFC,MFC and HFC were remarkably increased as the reading distance decreased (Fdistance =8.480,14.270,21.400;all at P ＜0.01).A significant difference was seen in LFC among different reading distances (Fgroup =4.115,P＜0.05),and the LFCs in the progressive myopic group were considerably higher than those in the emmetropic group in the 25,33 and 50 cm reading distances (P=0.044,0.038,0.032).No significant differences were found in MFC and HFC among the three groups (Fgroup =0.859,0.682;both at P＞0.05).Under the 25 cm and 33 cm reading distances,significant positive correlations were found between LFC and corneal coma,intraocular coma,whole ocular aberrations or intraocular higher order aberrations (all at P＜0.05),however,no significant correlations were seen between MFC or HFC and wavefront aberrations (all at P＞0.05).Conclusions In teenagers,the accommodative response of emmetropia is much stronger than that of progressive myopia,and the accommodative microfluctuation in emmetropia and incipient myopia is much less than that in progressive myopia.These shifts are possibly associated with the variability,and microfluctuations of accommodation is greater in progressive myopes than emmetropes.There are certain correlations between wavefront aberrations and accommodative microfluctuations.The refractive group differences in the accommodative microfluctuations may be related to differences in the wavefront between myopes and emmetropes.Under near reading distance,LFC is correlated with higher order aberrations.

Objective To compare the effect of different ways of water supply and whether or not drain water from waterlines for overnight on bacterial counts in dental unit waterlines(DUWLs).Methods In the first phase,6 sets of DUWLs were randomly divided into 2 groups (external storage tank water supply group and municipal water sup-ply group);in the second phase,6 sets of DUWLs were all changed to use external storage tank and randomly di-vided into 2 groups (draining water for overnight group and without draining water for overnight group),bacterial count before and within one week of disinfection between two groups at two phases were compared respectively. Results In the first phase,handpiece water of DUWLs was most seriously contaminated by bacteria,the average colony count was 4117 CFU/mL,qualified rate was 15.38%.Before disinfection,no significant difference in bacte-rial count were found among each groups (all P>0.05),bacterial count of DUWLs of all groups severely exceeded the standard(all >3000 CFU/mL).Comparison of bacterial count in DUWLs from different water supply routes after disinfection was not significantly different on day 1(P>0.05),but were significantly different at day 2-7(all P<0.05).On the second day after disinfection,municipal water supply group began to exceed bacteria standard;on the third day after disinfection,external storage tank group began to exceed bacteria standard.Bacterial count in DUWLs after disinfection between draining water for overnight group and without draining water for overnight group was no significantly different on day 1(P>0.05),but were significantly different on day 2-7(all P<0.05). On the fourth day of disinfection,bacterial count of without draining water for overnight group exceeded standard.On day 7 of disinfection,bacterial count in draining water for overnight group exceeded>100 CFU/mL.Conclusion Use of external storage tank,daily change of sterile distilled water,and daily emptying water for overnight can effectively reduce bacterial count in DUWLs.

PurposeThe increased radionuclide uptake of maxillary frontal process on bone scan is not uncommon but dififcult to diagnose with relatively rare research. This study aims to explore this phenomenon through investigating its biological behavior and causes.Materials and Methods Twenty-one patients with increased uptake of maxillary frontal process but without typical feature of metastasis on bone scan were retrospectively enrolled in the study. The scintigraphic features were evaluated and compared with the bone scans in the follow up. The corresponding CT imaging features including the lesions'location, number, size, shape and attenuation were analyzed.Results Seventeen patients had unilateral involvement and 4 had bilateral ones. One patient was found accompanied with other cranial lesions. All the lesions remained stable and no new lesions were detected on the following bone scans in 14 patients. Sixteen lesions with increased radionuclide uptake in 12 patients were detected on bone scintigraphy, 15 of which were positive on CT and 14 of which were located around the nasolacrimal canal at the base of frontal process. All the lesions were well demarcated with mean axial maximum diameter of 7.1 mm. Ten had homogeneous ground-glass density and 5 showed heterogeneous with internal lower attenuation.Conclusion Lesions of maxillary frontal process with increased radionuclide uptake detected on bone scan are likely to be benign. Fibrous dysplasia-like lesions might help account for abnormal uptake indicated by CT.

Objective:To investigate the risk factors of central lymph node metastasis (CLNM) in cN0 paillary thyroicl microcarcinoma (PTMC) and to establish a nomogram model for predicting the probability of cN0 PTMC CLNM.Methods:The clinicopathological data of 192 patients with cN0 PTMC admitted to the Department of General Surgery of the Second Hospital of Lanzhou University from Aug. 2016 to Aug. 2020 were retrospectively analyzed. There were 41 males and 151 females, 50 with CLNM and 142 without CLNM. The patients were divided into 2 groups according to the presence or absence of pathologically confirmed CLNM. Patient’s age, gender, tumor diameter, multiple, with Hashimoto’s disease, with nodular goiter, with or without near the posterior dorsal membrane, aspect ratio >1, with or without extratumoral infiltration, with or without lymphadenopathy, TSH levels, and TG levels were statistically analyzed. Pearson chi-square test was used to analyze the count data of hypothesis test, and the R language software package was used for Logistic multivariate analysis. The entry conditions were screened by stepwise regression to establish a nomogram prediction model, and the Bootstrap method was used for model verification. P<0.05 was considered statistically significant. Results:Multivariate logistic analysis showed that extratumoral invasion ( P=0.032) , presence of lymphadenopathy ( P=0.010) , and TG>68 μg/L ( P=0.007) were risk factors for central lymph node metastasis. The optimal model was established by stepwise regression. The factors included tumor diameter ≥0.5 cm, nodular goiter, extratumoral invasion, lymphadenopathy and TG>68 μg/L (AIC: 212.27) . The nomogram model was established according to the above risk factors. The consistency index (c-index) was 0.711. The results of calibration graph drawing and internal and external validation demonstrated its good consistency and applicability. Conclusion:Extratumoral invasion, lymphadenopathy, and TG>68 μg/L are risk factors for cN0 PTMC CLNM, and the nomogram established in the study can effectively predict the CLNM rate in patients with cN0PTMC and contribute to clinicians’ diagnosis and treatment decisions.