Objective To understand the prevailing status of coal-burning endemic fluorosis in Henan, and to provide scientific grounds for endemic fluorosis prevention. Methods Undertook general surveillance on factors such as coal using, living habit, main foods, the structure of the houses and the fluoride content in drinking-water among 1832 historical coal-burning endemic fluorosis villages within 13 counties in 2006 and 2007, and conducted focal point sampling survey on 216 villages which still using local high-fluoride. For all children aged 8-12 years of each village, conducted dental fluorosis examination and collected 30 immediate urinary samples for fluoride content determination. Results The fluoride content in drinking-water of all historical fluorosis villages was below 1.0 mg/L. Households having individual kitchens accounted for 93.7%(241 281/257 393), those with stoves having smoke evacuation devices accounted for 41.9% (107 917/257 393), those using local high-fluoride coal for cooking accounted for 28.6%(73 686/257 393), those using local high-fluoride coal for heating accounted for 24.1%(61 924/257 393). Villages with serf-supply of main foods accounted for 95.7%(1753/1832) of all fluorosis villages. Solar drying food was used in all households. Villages with dental fluorosis detection rate for children aged 8 to 12 years above 30.0% accounted for 16.2%(35/216), which axe all in Luoyang City. Among 77.8%(168/216) of fluorosis villages, children' s urinary fluoride concentrations were no higher than 1.50 mg/L. Conclusions Coal-burning endemic fluorosis areas in Henan Province were decreased greatly and the extent of the health hazard was becoming slightly. The detection rate of dental fluorosis for children aged 8 to 12 years of 8 counties had reached the standard for fluorosis control, whereas the other 5 counties had not yet, all located in Luoyang City.

INTRODUCTIONAdults with obstructive sleep apnoea (OSA) are well documented to be at high risk for cardiovascular abnormalities. Growing evidence suggests that OSA is also associated with cardiovascular consequences in children. The purpose of this review is to examine the available data on this association in children.

METHODSPrimary studies were extracted from a MEDLINE search limited to those published between 1970 and 2008. The keywords used included child, sleep disordered breathing, sleep apnoea, snoring, blood pressure and hearts. The relevant articles were selected by consensus between 2 authors.

RESULTSThe results suggested that OSA was consistently associated with hypertension. Meta-analysis of risk of hypertension in those with high apnoea-hypopnoea index was undertaken. A combined odds ratio equal to 3.15 was found (95% confidence interval, 2.01 to 4.93). There was evidence for increased sympathetic activation, decreased arterial distensibility and ventricular hypertrophy in children with OSA.

CONCLUSIONChildhood OSA is associated with blood pressure dysregulation. The association of OSA with other cardiovascular morbidities requires further study in view of the limited data available currently.

Atherosclerosis ; physiopathology ; Blood Pressure ; physiology ; Cardiovascular System ; physiopathology ; Cerebral Arteries ; physiopathology ; Child ; Endothelium, Vascular ; physiopathology ; Heart Rate ; physiology ; Humans ; Hypertension ; physiopathology ; Hypertrophy, Left Ventricular ; physiopathology ; Pulmonary Heart Disease ; physiopathology ; Regional Blood Flow ; Sleep Apnea, Obstructive ; complications ; physiopathology ; Ventricular Function

BACKGROUNDObstructive sleep apnea affects up to 2.9% of children. This study was to determine demographic and clinical characteristics of a group of children with obstructive sleep apnea syndrome (OSAS) as defined by sleep polysomnography (PSG).

METHODSA prospective study was conducted in a public-funded general hospital in Hong Kong of China. Children confirmed to have OSAS by PSG were followed up between January 1997 and December 1998. Tonsillectomy and adenoidectomy (T&A) was offered to those with moderate to severe OSAS, and medication was offered to those with mild OSAS. All children were followed up regularly in the sleep clinic and sleep PSG was repeated for those with marked relapse in symptoms.

RESULTSEighty-nine children (64 boys and 25 girls, mean age 7 years) were confirmed to have OSAS out of 352 children who underwent PSG during the study period. The most common symptoms of OSAS were snoring (100%) and sweating (81%) during sleep and nasal blockage (61%) and sleepiness (34%) during daytime. Severe OSAS occurred in 15 children. Moderate OSAS occurred in 33 children. Forty-one children had mild OSAS. Forty-nine children underwent T&A, 5 (boys, < 5 years) out of whom were found to have recurrent OSAS within 1 year.

CONCLUSIONA male predominance has been found in a group of Hong Kong children with OSAS. Boys undergoing T&A at an early age (< 5 years) will be more likely to develop repeated OSAS.

Adenoidectomy ; Adolescent ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Prospective Studies ; Recurrence ; Sleep Apnea, Obstructive ; surgery ; Tonsillectomy

Aims: Microencapsulation has been used to protect the viability of probiotics in harsh environments such as gastrointestinal conditions and food composition. The present study aimed to optimize the microencapsulation of Lactobacillus plantarum 299v (Lp299v) using co-extrusion by varying two parameters (calcium chloride (CaCl2) and oligofructose (FOS) concentrations) and storage stability of the beads produced in ambarella juice at refrigerated and room temperature. Methodology and results: Chitosan coated-alginate microcapsule prepared with 4.0% (w/v) FOS and 2.5% (w/v) CaCl2 showed highest microencapsulation efficiency (93%). The microcapsules were subjected to gastrointestinal treatment and storage test in ambarella juice. Both encapsulated Lp299v with and without FOS showed higher viabilities compared with free cells after incubated in simulated gastric juice (SGJ) and simulated intestinal juice (SIJ). After 5 h of incubation in SIJ, the viabilities of both encapsulated probiotic with and without FOS were more than 107 CFU/mL. The Lp299v were stored in ambarella juice under refrigerated (4 °C) and room temperature (25 °C) for 4 weeks. At 25 °C, all forms of Lp299v lost their viabilities after one week. On the other hand, at 4 °C, viable cells count of both encapsulated Lp299v with and without FOS were reported to be more than 107 CFU/mL after 4 weeks of storage. Conclusion, significance and impact of study Microencapsulation with FOS was able to improve Lp299v’s viability during storage in low pH fruit juices compared to those without FOS. The microencapsulated probiotics could be applied in ambarella juice for the development of functional food.

Objective To study the efficacy and security of postoperative radiotherapy alone and post-operative radiotherapy combined with chemotherapy in patients with high-grade cerebral glioma.Methods Fifty-nine patients with high-grade cerebral glioma confirmed by pathology, including 35 with grade Ⅲ and 24 with grade Ⅳ, admitted to our hospital from June 2004 to June 2008, were chosen in our study; these patients were randomly divided into 3 groups (A, B and C). All the patients underwent three-dimensional conformal radiation therapy (3D-CRT) with a dose of 54-66Gy/27-33f/5-7w by 6/10MV-X ray; and the median total dose was 60 Gy; group A (n=21, including 13 with grade Ⅲ and 8with grade Ⅳ) received chemotherapy with termozolomide (TMZ) at a dosage of 75 mg/m2·d during radiotherapy, following by 150-200 mg/ (m2·d) for 5 d, and enjoying 28 d per cycle for a total of 3-5cycles; group B (n=26, including 14 with grade Ⅲ and 12 with grade Ⅳ) received chemotherapy with the regimen of nimustine (ACNU) with a dosage of 90 mg/m2 on the 1st d and teniposide (VM-26) at a dosage of 60 mg/m2 on the 1st, 2nd and 3rd d, enjoying 6-8 weeks per cycle for a total of 4-6 cycles; group C (n=12,including 8 with grade Ⅲ and 4 with grade Ⅳ) received radiotherapy alone. Clinical evaluations of tumor response and adverse effects were performed periodically. The primary end points were disease progression-flee survival (PFS) and overall survival (OS) Results The effective rate in the group A, B and C was 81.0％, 71.4％ and 33.3％, respectively, indicating that significant differences exited between group C and both group A and B (P＜0.05). The incidence of gastrointestinal side effects and toxic response in the group B was obviously higher than that in the group A (P＜0.05). The 1-, 3- and 5-year survival rates in group A were 66.7％, 19.0％ and 9.5％, respectively, which were the highest among the 3groups; those in group B were 53.8％, 15.4％ and 3.8％, respectively; those in group C were 25％, 8％ and 0％, respectively. The PFS in all the patients was 8 months and OS was 15 months; log-rank test indicated that significant differences of PFS and OS existed between patients received concomitant chemoradiotherapy and radiotherapy (X2=10.710, P=0.005; X2=7.185, P=0.028); the incidence of PFS and OS in group A and B was significantly higher than that in group C (P＜0.05). Conclusion To post-operative patients with high-grade cerebral glioma, concomitant chemoradiotherapy can improve the effective rate and extend the PFS and OS. TMZ is recommended as the concomitant chemotherapy regimen, having similar therapy effect with ACNU plus VM-26, but enjoying less adverse effects.

With the technical advances and improvements in perioperative management and immunosuppressants, liver transplantation is the standard treatment for patients with end-stage liver diseases. In Asia, a shortage of deceased donor liver grafts is the universal problem to be faced with in all transplant centres. Many surgical innovations are then driven to counteract this problem. This review focuses on 3 issues that denote the development of liver transplantation in Asian countries. These include living donor liver transplantation (LDLT), split liver transplantation (SLT) and liver transplantation for hepatocellular carcinoma (HCC). Minimal graft weight, types of liver graft to donate and the inclusion of the middle hepatic vein with the graft are the main issues to be established in LDLT. The rapid growth and wide dissemination of LDLT has certainly alleviated the supply-and-demand problem of liver grafts in Asia. SLT is another attractive approach. Technical expertise, donor selection and graft allocation are the main determinants for its success. Liver transplantation plays a key role in the management of HCC in Asia. LDLT would be the main strategy in this aspect. The issue of extending the selection criteria for HCC patients for LDLT is still controversial. On the whole, future developments to increase the donor pool for the expanding recipient need in Asia would involve transplantation from non-heart beating donor and ABO incompatible transplantation.
Asia ; Carcinoma, Hepatocellular ; surgery ; History, 20th Century ; Humans ; Liver Neoplasms ; surgery ; Liver Transplantation ; history ; methods ; trends ; Living Donors

Objective To study the quantitative fiber tractography variations and 3D simulation patterns in patients with multiple sclerosis (MS),and assess the correlation between quantitative fiber tractography and scores of expanded disability status scale (EDSS).Methods MR diffusion tensor imaging was applied in 28 MS patients and 28 age-matched healthy volunteers.Then,quantitative tractography was generated in all subjects; and mean numbers of tracked lines and fiber density were measured.Paired-samples t tests were used to compare tracked lines and fiber density in MS patients with those in controls.Analysis of variance of ADC value and FA value was applied to MS patients having demyelinating plaque and normal appearing white matter,and controls.Linear regression model was used to determine the relationship between quantitative fiber tractography and scores of EDSS in MS patients.Results Tractography's tracked lines (2220±100) and fiber density (0.75±0.04) in MS patients were less than those in controls (2750±70) and (0.93±0.02,P＜0.05).In MS patients having plaque and normal appearing white matter,and controls,the ADC values of ROI were (1.23±0.13)× 10-3 mm2/s,(0.76±0.09)×10-3 mm2/s and (0.63±0.10)×10-3 mm2/s,respectively,with a gradual declined trend; and the FA values were 0.24±0.04,0.42±0.07 and 0.48±0.06,respectively,with a gradual increased trend; significant differences were noted between each 2 groups (P＜0.05).Both tracked lines and fiber density were found negative correlations with scores of EDSS in MS patients (P＜0.05).Conclusion Damages of white matter tracts in MS patients can be detected by diffusion tensor fiber tractography,and it provide more space information than conventional MRI.

Objective To compare the curative effects ofziprasidone and aripiprazole at acute stage on patients with drug-naive schizophrenia and their effects on metabolism of these patients.Methods Forty-six patients with drug-naive schizophrenia,admitted to our hospital from February 2010 to February 2011,were divided into ziprasidone treatment group (n=24,[165±13.51] mg/d) and aripiprazole treatment group (n=22,[28.86±3.06] mg/d); these patients were given the above treatment for 6 week.The scores of positive and negative syndrome scale (PANSS),body mass index (BMI),insulin resistance index (IRI),and levels of fasting blood glucose (FBG),insulin (INS),C-Peptide (CP),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),apolipoprotein-a (APOA) and apolipoprotein-b (APOB) were obtained before and at the end of treatment.Results At the end of treatment,2 patients (9.1％) were cured,7 (31.8％)achieved obvious improvement,9 (40.9％) achieved improvement,and only 4 (18.2％) did not achieve any improvement in the aripiprazole treatment group.However,at the end of treatment,no patient (0％)was cured,7 (29.2％) achieved obvious improvement,12 (50％) achieved improvement,and 5 (20.8％)did not achieve any improvement in the ziprasidone treatment group.The total scores of PANSS after the treatment in both groups decreased significantly as compared with those before treatment (P＜0.05).The BMI ([20.14±2.63] kg/m2) in the ziprasidone treatment group at the end of treatment was obviously increased as compared with that ([19.68±2.76] kg/m2) before treatment (P＜0.05).The FBG ([4.38±0.59]mmmol/L) at the end of treatment decreased significantly as compared with those before treatment ([4.79±0.59] mmmol/L),and the BMI ([19.65±2.15] kg/m2) was obviously increased as compared with that before treatment ([19.19±2.28] kg/m2) in the aripiprazole treatment group (P＜0.05).The metabolic index in the 2 groups was not significantly different at the end of the treatment (P＞0.05).Conclusion Both ziprasidone and olanzapine are effective in the treatment of patients with drug-naive schizophrenia;both of them have mild effects on weight of patients with drug-naive schizophrenia,but no obvious effects on other metabolic indices.

PURPOSE: Because the shock wave passes through various body tissues before reaching the stone, stone composition may affect the treatment efficacy of shock wave lithotripsy (SWL). We investigated the effect of various tissue components along the shock wave path on the success of SWL. MATERIALS AND METHODS: From October 2008 to August 2010, a total of 206 patients with kidney stones sized 5 to 20 mm were prospectively recruited for a study of the factors that affect the outcome of treatment with a Sonolith Vision lithotripter. Successful SWL was defined as either stone-free status or residual fragments <4 mm at 12 weeks. Logistic regression analysis was performed to assess the factors that predicted treatment outcomes. Potential predictors included the patient's age, shock wave delivery rate, stone volume (SV), mean stone density (MSD), skin-to-stone distance (SSD), and the mean thickness of the three main components along the shock wave path: renal cortical thickness (KT), muscle thickness (MT), and soft-tissue thickness (ST). RESULTS: The mean age of the patients was 53.8 years (range, 25-82 years). The overall treatment success rate after one session of SWL was 43.2%. The mean KT, MT, and ST were 26.9, 16.6, and 40.8 mm, respectively. The logistic regression results showed that a slower shock wave delivery rate, smaller SV, a lower MSD, and a thicker KT were found to be significant predictors for successful SWL. SSD, MT, and ST were not predictors of successful treatment. CONCLUSIONS: Among the main tissue components along the shock wave path, a thicker KT was a favorable factor for successful SWL after adjustment for SV, MSD, and the shock wave delivery rate.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney Calculi/*therapy ; Kidney Cortex/*radiography ; *Lithotripsy ; Logistic Models ; Male ; Middle Aged ; Prospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

Outdoor air pollution has been recently classified as a class I human carcinogen by the World Health Organization (WHO). Cumulative evidence from across the globe shows that polluted air is associated with increased risk of lung, head and neck, and nasopharyngeal cancers--all of which affect the upper aerodigestive tract. Importantly, these cancers have been previously linked to smoking. In this article, we review epidemiologic and experimental evidence of the genotoxic and mutagenic effects of air pollution on DNA, purportedly a key mechanism for cancer development. The alarming increase in cancers of the upper aerodigestive tract in Asia suggests a need to focus government efforts and research on reducing air pollution, promoting clean energy, and investigating the carcinogenic effects of air pollution on humans.
Air Pollution ; adverse effects ; Asia ; Carcinogens ; DNA Damage ; Head and Neck Neoplasms ; Humans ; Lung Neoplasms ; Mutagenesis ; Nasopharyngeal Neoplasms ; Smoking