Objective:To investigate the arsenic metabolism pattern and possible influencing factors in the population in drinking-water-borne endemic arsenic poisoning (drinking-water-borne arsenic poisoning for short) areas.Methods:In December 2004, a cluster sampling method was used to select arsenic poisoning population (arsenic poisoning group) and healthy population (control group) in drinking-water-borne arsenic poisoning area of Bayannur City, Inner Mongolia Autonomous Region as the survey subjects. A questionnaire survey was conducted. Arsenic content in drinking water at home of survey subjects, the levels of urinary arsenic and its metabolites, including [trivalent arsenic (As Ⅲ), inorganic arsenic (iAs), monomethylarsenic acid (pentavalent, MMA V), dimethylarsenic acid (pentavalent, DMA V), total arsenic (tAs), percentage of inorganic arsenic (iAs%), percentage of monomethylarsenic acid (MMA%), percentage of dimethylarsenic acid (DMA%), primary methylation index (PMI), secondary methylation index (SMI)] were tested using high performance liquid chromatography-inductively coupled plasma mass spectrometry; nail arsenic and nail selenium levels were tested using atomic fluorescence spectrometer. The influencing factors of arsenic metabolism pattern were analyzed by multiple linear regression. Results:A total of 536 survey subjects were included, including 155 individuals in the arsenic poisoning group and 381 in the control group. The water arsenic level ranged from 0.0 to 825.7 μg/L. Compared with the control group, there was no significant difference in the distribution of gender, education level and dental fluorosis in the arsenic poisoning group ( P > 0.05), but there were significant differences in the distribution of age, marital status, smoking, drinking and water arsenic ( P < 0.05). Compared with the control group, the levels of urinary As Ⅲ, iAs, MMA V, DMA V, tAs, MMA%, MMA/DMA and nail arsenic in the arsenic poisoning group were higher ( P < 0.05), while the levels of urinary DMA%, SMI and nail selenium were lower ( P < 0.05); but there was no statistically significant difference in the levels of urinary iAs% and PMI ( P > 0.05). Gender, education level, depth of wells, water arsenic, total number of wells and nail arsenic were the influencing factors of urinary As Ⅲ (β = - 19.82, - 23.83, 0.61, 0.21, 7.26, 2.98, P < 0.05). Age, depth of wells, water arsenic and nail arsenic were the influencing factors of urinary tAs (β = 3.18, 3.25, 1.31, 15.59, P < 0.05). Gender, education level, depth of wells, water arsenic, total number of wells and nail arsenic were the influencing factors of urinary iAs (β = - 20.47, - 25.90, 0.64, 0.25, 7.87, 3.11, P < 0.05). Age, gender, education level, water arsenic and nail arsenic were the influencing factors of urinary MMA V (β = 0.52, - 17.07, - 21.84, 0.22, 2.77, P < 0.05). Age, depth of wells, water arsenic and nail arsenic were the influencing factors of urinary DMA V (β = 2.35, 2.47, 0.85, 9.22, P < 0.05). Conclusions:Compared with healthy individuals, there are differences in arsenic metabolism pattern among individuals with drinking-water-borne arsenic poisoning. Age, gender, education level, depth of wells, water arsenic, total number of wells and nail arsenic may be influencing factors of different arsenic metabolism patterns.

Objective: To determine the latent class of dietary patterns and their association with depressive symptoms among first grade students from multi ethnic middle schools in Yunnan Province, so as to provide a reference basis for promoting mental health among border middle school students. Methods: A cluster random sampling involving 8 500 first grade middle school students from 11 counties in Yunnan Province was conducted by a questionnaire survey between October to December 2022. The Children s Depression Inventory (CDI) was used to assess the depressive symptoms and the Food Frequency Questionnaire was used to collect eating behavior data. The latent profile analysis model was used to fit the latent class of dietary patterns among students. The association between the dietary pattern latent class and depressive symptoms was analyzed by Logistic regression. Results: The depressive symptom detection rate among firstgrade middle school students was 28.3%. Prevalence of depressive symptom in girls (30.9%) was higher than boys (25.5%) with a statistically significant difference ( χ 2=29.83, P <0.01). The dietary patterns among first grade middle school students were classified into four latent classes, as follows:class 1 (low consumption of all dietary components), class 2 (high consumption of fruit, milk and dairy products), class 3 (high consumption of vegetables and meat, and low consumption of processed foods) and class 4 (low consumption of milk, dairy products and eggs, and high consumption of processed foods). After adjusting for confounding variables, the class 3 dietary pattern was negatively correlated with depressive symptoms ( OR=0.62, 95%CI =0.52-0.74) and the class 4 dietary pattern was positively correlated with depressive symptoms ( OR= 1.28 , 95%CI =1.05-1.57) ( P <0.05), compared with the class 1 dietary pattern. Conclusions Multi ethnic first grade middle school students in Yunnan Province follow various dietary patterns. Unhealthy dietary patterns increase the risk of depressive symptoms. The dietary patterns of multi ethnic middle school students in Yunnan Province should be adjusted to promote the establishment of healthy dietary patterns and reduce the risk of depression symptoms in middle school students.

Objective:To investigate the relationship between the outcome of skin injury and urinary arsenic methylation metabolism levels in people exposed to arsenic through drinking water.Methods:Using cluster sampling method, permanent residents from drinking-water-borne endemic arsenic poisoning areas in Bayannur City, Inner Mongolia Autonomous Region were selected as survey subjects in 2004 (before water improvement). In 2017 (after water improvement), 74 survey subjects from 2004 were tracked and followed up. Urine samples were collected from survey subjects and high-performance liquid chromatography inductively coupled plasma mass spectrometry was used to detect the levels of arsenic methylation metabolites in urine. According to the "Diagnosis of Endemic Arsenic Poisoning" (WS/T 211-2015), the clinical grading (normal, suspicious, mild, moderate and severe) of skin injury of the survey subjects and the outcome of 2017 (improved, unchanged, aggravated) were assessed. A database was established and SPSS 25.0 software was used for statistical analysis.Results:The clinical grading ratios of skin injuries among survey subjects in 2004 and 2017 were compared, the differences were statistically significant (normal, suspicious, mild, moderate and severe: 38, 18, 4, 14 cases in 2004 and 27, 31, 3, 13 cases in 2017, χ 2 = 53.02, P < 0.001). Compared with 2004, in 2017, the levels of total arsenic (tAs), inorganic arsenic (iAs), monomethylarsenic (MMA), dimethylarsenic (DMA), percentage of inorganic arsenic (iAs%), and ratio of monomethylarsenic to dimethylarsenic (MMA/DMA) in the urine of survey subjects were low, and the differences were statistically significant ( Z = - 8.24, - 9.07, - 7.81, - 8.04, - 8.24, - 3.56, P < 0.001). The levels of dimethylarsenic percentage (DMA%), monomethylation rate (PMI) and dimethylation rate (SMI) were higher, and the differences were statistically significant ( Z = - 6.39, - 8.24, - 3.52, P < 0.001). In 2004, patients with different clinical grading of skin injuries had different outcomes in 2017 (χ 2 = 30.80, P < 0.001). There were statistically significant differences in tAs, iAs, MMA and DMA variation in urine among skin injury patients with different outcomes ( H = 10.62, 9.35, 8.80, 9.13, P < 0.05). Conclusions:Improving water can significantly reduce the levels of tAs, iAs, MMA, and DMA in the urine of arsenic exposed individuals. The outcome of skin injury in individuals exposed to arsenic through drinking water is related to the variation of urinary arsenic methylation metabolites tAs, iAs, MMA, and DMA.

Objective:To study the effect of water improvement on urinary arsenic methylation metabolism in population exposed to arsenic through drinking water.Methods:A cluster sampling method was used to select drinking water type arsenism areas in Bayannur City, Inner Mongolia Autonomous Region. Permanent residents lived in the arsenism areas for more than 10 years were selected as the survey subjects. Urine samples ( n = 874, 111, 145) were collected in 2004 (before water improvement), 2014 (4 years after water improvement) and 2017 (7 years after water improvement), respectively, and some subjects were followed up in 2014 and 2017. High performance liquid chromatography-inductively coupled plasma mass spectrometry (HPLC-ICP-MS) was used to detect different forms of arsenic metabolites in urine [inorganic arsenic (iAs), monomethylarsonic acid (MMA), dimethylarsenic acid (DMA)], and total arsenic (tAs), the iAs percentage (iAs%), MMA percentage (MMA%), DMA percentage (DMA%), monomethylation rate (PMI), dimethylation rate (SMI), and the ratio of MMA to DMA (MMA/DMA) were calculated. The content and distribution of urinary arsenic metabolites in people exposed to arsenic before and after water improvement were compared and analyzed. Results:Compared with 2004, the levels of iAs, MMA, DMA, tAs and iAs% in urine of arsenic exposed population in 2014 were lower ( Z =-14.12,-12.79,-14.27,-14.21,-6.90, P < 0.001), the levels of MMA%, DMA% and PMI were higher ( Z =-3.22,-2.91,-6.90, P < 0.05); in the same drinking water arsenic exposed population, compared with 2004, the levels of iAs, MMA, DMA, tAs and iAs% in urine ( n = 48) were lower ( Z =-5.57,-5.53,-5.54,-5.55,-2.86, P < 0.05) in 2014, and PMI level was higher ( Z =-2.86, P = 0.004). Compared with 2014, the levels of iAs% and MMA/DMA in urine of arsenic exposed population in 2017 were lower ( Z =-4.97,-2.25, P < 0.05), the levels of MMA, DMA, tAs, DMA%, PMI and SMI were higher ( Z =-4.01,-5.39,-4.77,-4.61,-4.97,-2.25, P < 0.05); in the same drinking water arsenic exposed population, compared with 2014, the level of iAs% in urine ( n = 28) was lower ( Z =-2.87, P = 0.004) in 2017, the levels of DMA% and PMI were higher ( Z =-2.32,-2.87, P < 0.05). Conclusion:Water improvement could significantly reduce the levels of urinary arsenic metabolites iAs, MMA, DMA and tAs and increase the level of DMA% in arsenic exposed population.

【Objective】 To investigate the effects of echinacoside （ECH） on mitochondrial biosynthesis and cardiomyocytes’ apoptosis in heart failure （HF） and to explore its related mechanisms. 【Methods】 The experimental animals were divided into three groups： the rat model of HF （HF） was induced by intraperitoneal injection of ISO， and pre-treated with ECH by intraperitoneal injection （ECH） and nomal control （ctrl group）. Cardiac function was detected by echocardiography after 2 weeks of treatment. The ultrastructure of myocardium was observed by transmission electron microscopy and the mitochondrial density and vacuolation rate were analyzed. The expressions of apoptosis-associated proteins were evaluated by Western blotting， and genes related to mitochondrial biosynthesis were examined by Real-time PCR. 【Results】 ECH increased 1eft ventricular ejection fraction （LVEF） and 1eft ventricular fraction shortening （LVFS）， but decreased 1eft ventricular end-systolic diameter （LVEDs） and 1eft ventrieular end-diastolic diameter （LVEDd） when compared to HF group （P<0.01） and improved cardiac function. The myocardial ultrastructure was significantly improved by ECH， the density of regular shapes of mitochondria was increased， and the percentage of vacuolated rate was reduced by ECH （P<0.01）. The expression of anti-apoptotic protein Bcl-2 was upregulated and that of pro-apoptotic protein Bax was downregulated in ECH group. The mRNA of mitochondrial biosynthesis related genes PGC-1， NFR-1， NFR-2 and TFAM was significantly upregulated in ECH group. 【Conclusion】 ECH promotes mitochondrial biosynthesis and inhibits cardiomyocytes’ apoptosis by up-regulating PGC-1/NFR signaling pathway， thus improving cardiac function.

Objective:To investigate the distribution of arsenic content in drinking water of residents in Inner Mongolia Autonomous Region, and to provide a scientific basis for formulation of detailed prevention and control measures for endemic arsenic poisoning.Methods:From 2017 to 2019, water arsenic survey was carried out in all natural villages in 103 banners (counties, districts) of 12 leagues (cities) in Inner Mongolia Autonomous Region, and drinking water samples were collected according to different water supply modes (engineering water supply, physical and chemical water purification, decentralized water supply). Among them, engineering water supply: one factory water sample was collected from each water modification project in dry season and wet season; and one terminal water sample was collected in historical arsenism area/high arsenic exposed villages covered by the project. Physical and chemical water purification: one water sample was collected from each household. Decentralized water supply: in historical arsenism area/high arsenic exposed villages, one water sample was collected from each household; in the villages with historical qualified water arsenic, one household was selected according to the five directions of east, south, west, north and middle, and one water sample was collected from each household. The content of arsenic in water was detected by atomic fluorescence spectrometry and a distribution map of water samples with excessive arsenic was drawn using ArcGIS 10.2 software.Results:A total of 90 455 water samples were collected, including 31 617 water samples for engineering water supply, 2 702 water samples for physical and chemical water purification, and 56 136 water samples for decentralized water supply. The medians of water arsenic content of engineering water supply, physical and chemical water purification, and decentralized water supply were 1.00, 1.00 and 0.50 μg/L, respectively, and the differences among different water supply modes were statistically significant (χ 2 = 1 147.831, P < 0.05). A total of 486 water samples with excessive arsenic were detected, the detection rate was 0.54% (486/90 455). The detection rates of water samples with excessive arsenic in engineering water supply and decentralized water supply were 1.48% (469/31 617) and 0.03% (17/56 136), the detection rate of water samples with excessive arsenic in engineering water supply was higher than that in decentralized water supply (χ 2 = 775.401, P < 0.05); there was no water samples with excessive arsenic in physical and chemical water purification. The top three areas with the detection rates of water samples with excessive arsenic were Bayannaoer [15.38% (343/2 230)], Hohhot [2.00% (86/4 293)], and Ordos [0.85% (50/5 848)]. ArcGIS 10.2 software showed that the water samples with excessive arsenic were mainly distributed in the western region in the shape of focal and block, and only existed sporadically in the eastern region. Conclusions:The detection rate of water samples with excessive arsenic in engineering water supply in Inner Mongolia Autonomous Region is high, the water samples with excessive arsenic are mainly distributed in the western region in the shape of focal and block, and sporadically in the eastern region. The management and supervision of engineering water supply should be strengthened, in areas where the water arsenic exceeds the standard, we should take physical and chemical water purification measures, such as change water sources, increase water purification equipment, and improve water purification technology to reduce arsenic hazards, so as to ensure that residents can drink qualified water.

Objective:To investigate the levels of urinary arsenic metabolites in arsenic-exposed people with different degrees of skin lesions.Methods:A cluster sampling method was used to select people with different degrees of skin lesions in the drinking water arsenic poisoning area of Bayannaoer City, Inner Mongolia Autonomous Region. According to the "Standard of Diagnosis for Endemic Arsenism" (WS/T 211-2001), the research subjects were divided into four clinical grading: normal, suspicious, mild, moderate and above on the basis of the degrees of skin lesions. Urine samples from any 1 middle section were collected, and the levels of urinary arsenic metabolites of different forms in different clinically graded people were detected by inductively coupled plasma mass spectrometry (ICP-MS).Results:A total of 522 people were included, including 309 males and 213 females; the age was (39.11 ± 12.38) years old, ranging from 11 to 65 years old. There were 337, 80, 31, 74 people in normal, suspicious, mild, moderate and above clinical grading, the levels of inorganic arsenic (iAs, medians: 15.46, 37.16, 104.46, 163.06 μg/L), monomethylarsonic acid (MMA, medians: 15.95, 33.27, 82.80, 123.84 μg/L), dimethylarsenic acid (DMA, medians: 78.16, 147.86, 301.28, 371.30 μg/L), total arsenic (tAs, medians: 113.90, 220.94, 501.25, 684.46 μg/L), iAs percentage (iAs%, medians: 15.66%, 15.53%, 21.67%, 21.65%), MMA percentage (MMA%, medians: 13.51%, 15.40%, 17.14%, 16.43%), DMA percentage (DMA%, medians: 70.37%, 67.98%, 63.25%, 61.23%), monomethylation rate (PMI, medians: 0.84, 0.84, 0.78, 0.78), dimethylation rate (SMI, medians: 0.84, 0.81, 0.79, 0.79), and ratio of MMA to DMA (MMA/DMA, medians: 0.20, 0.23, 0.27, 0.27) were compared in different clinically graded people, the differences were statistically significant ( H = 97.98, 96.44, 85.50, 95.08, 38.58, 29.94, 51.98, 38.58, 43.20, 43.20, P < 0.01). Compared with normal people, iAs, MMA, DMA, tAs, MMA%, and MMA/DMA levels significantly increased, and SMI level significantly decreased in suspicious, mild, moderate and above people ( P < 0.017); compared with normal people, iAs% level significantly increased, and DMA% and PMI levels significantly decreased in mild, moderate and above people ( P < 0.017). Conclusion:The levels of urinary arsenic metabolites in arsenic-exposed people with different degrees of skin lesions are different, showing a dose-response relationship.

Coronavirus disease 2019 (COVID-19) is now pandemic worldwide and has heavily overloaded hospitals in Wuhan City, China during the time between late January and February. We reported the clinical features and therapeutic characteristics of moderate COVID-19 cases in Wuhan that were treated via the integration of traditional Chinese medicine (TCM) and Western medicine. We collected electronic medical record (EMR) data, which included the full clinical profiles of patients, from a designated TCM hospital in Wuhan. The structured data of symptoms and drugs from admission notes were obtained through an information extraction process. Other key clinical entities were also confirmed and normalized to obtain information on the diagnosis, clinical treatments, laboratory tests, and outcomes of the patients. A total of 293 COVID-19 inpatient cases, including 207 moderate and 86 (29.3%) severe cases, were included in our research. Among these cases, 238 were discharged, 31 were transferred, and 24 (all severe cases) died in the hospital. Our COVID-19 cases involved elderly patients with advanced ages (57 years on average) and high comorbidity rates (61%). Our results reconfirmed several well-recognized risk factors, such as age, gender (male), and comorbidities, as well as provided novel laboratory indications (e.g., cholesterol) and TCM-specific phenotype markers (e.g., dull tongue) that were relevant to COVID-19 infections and prognosis. In addition to antiviral/antibiotics and standard supportive therapies, TCM herbal prescriptions incorporating 290 distinct herbs were used in 273 (93%) cases. The cases that received TCM treatment had lower death rates than those that did not receive TCM treatment (17/273 = 6.2% vs. 7/20= 35%, P = 0.0004 for all cases; 17/77= 22% vs. 7/9= 77.7%, P = 0.002 for severe cases). The TCM herbal prescriptions used for the treatment of COVID-19 infections mainly consisted of Pericarpium Citri Reticulatae, Radix Scutellariae, Rhizoma Pinellia, and their combinations, which reflected the practical TCM principles (e.g., clearing heat and dampening phlegm). Lastly, 59% of the patients received treatment, including antiviral, antibiotics, and Chinese patent medicine, before admission. This situation might have some effects on symptoms, such as fever and dry cough. By using EMR data, we described the clinical features and therapeutic characteristics of 293 COVID-19 cases treated via the integration of TCM herbal prescriptions and Western medicine. Clinical manifestations and treatments before admission and in the hospital were investigated. Our results preliminarily showed the potential effectiveness of TCM herbal prescriptions and their regularities in COVID-19 treatment.
Adult ; Aged ; Aged, 80 and over ; COVID-19/therapy* ; China ; Combined Modality Therapy ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Hospitalization ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective: To understand the epidemic situation and control effect of drinking-water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018, and provide a basis for further development and improvement of prevention and control strategies. Methods: In 2009-2018, 38 diseased villages were selected from 8 cities in Inner Mongolia Autonomous Region as fixed monitoring sites to investigate the water improvement situation of the village and the operation of the water improvement project, and to detect the arsenic content of the water; physical examinations were carried out on all the resident populations who were exposed or previously exposed to high levels of arsenic water in the monitoring villages, and the changes in the condition of arsenic poisoning patients were observed; 30 adult urine samples were collected from each monitoring village to detect urinary arsenic levels. Results: The water improvement rate of the 38 monitoring villages increased from 84.21% (32/38) in 2009 to 100.00% (38/38) in 2013, and continued to maintain; the normal operation rate of water improvement project increased from 64.29% (9/14) in 2009 to 100.00% (18/18) in 2016, and continued to maintain; the qualified rate of water arsenic content of water improvement project increased from 64.29% (9/14) in 2009 to 88.89% (16/18) in 2018; the proportion of qualified project covered population increased from 47.79% (4 846/10 140) in 2009 to 84.35% (5 370/6 366) in 2018. In 2009-2018 the detection rate of arsenic poisoning in the water arsenic content qualified village was 9.17% (3 968/43 276), and the detection rate in the unchanged water and water arsenic exceeded villages was 7.48% (805/10 759); there was no new case for ten consecutive years. There were significant differences in urinary arsenic levels of the water arsenic content qualified villages, the unchanged water and water arsenic exceeded villages between different years (H=424.04, 100.35, P < 0.05); the urinary arsenic level of water arsenic content qualified villagers was lower than that of the unchanged water and water arsenic exceeded villages in the same year (P < 0.05). Conclusions During the 10-year monitoring period, the prevalence of arsenic poisoning has been effectively controlled. The water improvement rate and the normal operation rate of the project remain in good condition, but the qualified rate of water arsenic still should to be improved.

Objective To provide a basis for development of preventive measures through dynamical monitoring of the changing trends of endemic fluorosis areas and the prevalence of drinking-water-borne endemic fluorosis.Methods Using simple random sampling method,thirty monitoring villages in 11 counties of Inner Mongolia were selected as fixed monitoring villages from 2012 to 2016.The operation of water improvement projects was investigated,and water fluoride content was tested.Dental fluorosis of all 8 to 12-year-old students was diagnosed in the villages.Stratified random sampling by age was used to select 50 adults over 25-year-old in each monitoring village,and skeletal fluorosis was examined by X-ray.Results ①In 2012-2016,the water-improved rate of monitoring villages was 78.67％ (118/150).Of all the water-improved projects,normal operating projects accounted for 92.98％ (106/114).The exceeded rate of water fluoride in water-improved village was 31.36％ (37/118).②The detection rate of dental fluorosis and community fluorosis index (CFI) in children aged 8-12 of the villages with normal operating projects and qualified fluoride content were 20.88％ (533/2 553) and 0.41;the detection rate of dental fluorosis and CFI of the villages with water-improved projects under abnormal operation or excessive fluoride were 49.53％ (318/642) and 0.98;the detection rate of dental fluorosis and CFI of the villages without water-improved projects were 37.14％ (442/1 190) and 0.76.③The detection rate of X-ray skeletal fluorosis in adults of the villages with normal operating projects and qualified fluoride content was 18.97％ (140/738);the detection rate of X-ray skeletal fluorosis in adults of the villages with water-improved projects under abnormal operation or excessive fluoride was 31.53％ (111/352);the detection rate of X-ray in adults of the villages without water improvement projects was 31.17％ (96/308).Conclusions Up to now,in Inner Mongolia Autonomous Region,some villages have not yet improved their drinking water quality,water fluoride content in some projects has exceeded the standard seriously,the prevalence of dental fluorosis in children aged 8-12 is very mild,there are still moderate and severe endemic areas.So the orevention and control measures of the water-improved defluoridation need to be further strengthened.