Objective To study the state and trends of Kesan disease in Henan province from 2004 to 2009. Methods Surveillance sites were selected: Guxian village of Luoning country from 2004 - 2007, Zuyang town of Lingbao city in 2008, and Shahe village of Lushi country in 2009. All residents of surveillance sites were examined by clinical and electrocardiogram, and suspected patients were inspected by chest X-ray to measure ardiothoracic ratio. Hair and wheat flour samples were collected and selenium levels were detected with hydride generation atomic fluorescence spectrometry. Results From 2004 to 2009, a total of 4034 people were examined.The numbers of chronic and latent KSD patients were 21 and 75 cases,respectively, and the incidence rates were 0.52%(21/4034) and 1.86%(75/4034), respectively . The number of abnormal electrocardiogram was 751 cases, and the incidence rate was 18.62%. The highest proportion of abnormal electrocardiogram was ST-T changes,accounting for 24.63%(185/751), followed by high-voltage, accounting for 18.11%(136/751), and left ventricular accounting for 13.85% (104/751). Sixty-one grain samples were collected and the wheat flour selenium level was averaged 0.034 mg/kg. Thirty hair samples were collected and the selenium median was 0.285 mg/kg. Conclusions The state of Keshan disease is in a steady state in Henna province, but higher rates of abnormal electrocardiogram is a serious problem and should be studied and prevented.

Objective To understand Kaschin-Beck disease(KBD) status in Henan Province and provide the basis for the further prevention and treatment of KBD. Methods Children aged 7 to 12 in 3 villages(Yaodian, Miaowa and Zhuyang) with the same environment such as topography, physiognomy,production mode and living habits in Shan County and Lingbao City were selected to undertake KBD clinical examination in 2008, X-ray examination of right hand and child hair samples and food samples were collected to determine the content of selenium. Selenium was determined using 2,3-Diaminonaphthalene method. Adults who were 16 years or older in 5 counties(Luoning, Lingbao, Mianchi, Shah and Lushi) were selected and examined for KBD. Results One hundred and ninty children aged 7 to 12 were clinically examined and clinical KBD were found, whereas 3 children were diagnosed as KBD by X-ray examination, the positive rate was 1.58% (3/190). All 20 521 adults were clinically examined and KBD prevelance rate was 6.10%(1251/20 521), including degree Ⅰ (3.97%,814/20 521), degree Ⅱ (1.77%, 364/20 521 ), degree Ⅲ (0.36%, 73/20 521). The average selenium contents in hair and food samples were (0.319±0.128)mg/kg and (0.031±0.009)mg/kg, respectively. Conclusions Child KBD in Henan Province is under control or almost under control, whereas the prevalence of adult KBD was relatively serious, which suggested that secondary prevention with the objective of clinically treating KBD patients should be strengthened.

Abdominal Cavity ; Adolescent ; Child ; Female ; Humans ; Neoplasms, Muscle Tissue

OBJECTIVE To observe the protection of vitamin C on the cardiac injury induced by 50 nm titanium dioxide inmice.METHODS Kunming mice were ad mistered by ig of vitamin C 100,200 and 400 mg·kg -1 for 2 d.And then the mice were ad mistered by ig of nano-TiO2 2 g·kg -1 and vitamin C (100.0,200.0 and 400.0 mg·kg -1 )for 3 d,the interval of treatment with nano-TiO2 and vitamin C was 4 h.The mice were scarified 24 h later after the last ad ministration.Electrocardiogra m (ECG)was determinated by physiological recorder.The myocardial enzy mes activities in serum and superoxide dismutase (SOD)and glutathione peroxidase(GSH-Px)activities in serum and myocardial tissue were determinated by bioche mical method.Cometassay was used to detect the DNA da mage of the heart. Heart tissue was used for histopathological exa mination by HE staining.RESULTS Co mpared with the control,ECG showed higher S-T and T-wave a mplitude of nano-TiO2 2 g·kg -1 (P<0.05).The myocar-dial enzy mes activities significantly increased and activities of SOD and GSH-Px significantly decreased in nano-TiO2 group,compared with the control group(P <0.05).Cometassay showed that olive tail mo ment (OTM)was significantly increased after nano-TiO2 2 g·kg -1 ,compared with the control group (P<0.05).The histopathology showed ede ma of myocardial cells,myofibril disorders and increasing infla mmatory cells.Vita min C 100,200 and 400 mg·kg -1 can decrease S-T in ECG,OTM,myocardial enzy mes activities,increase the SOD and GSH-Px activities in serum and myocardial tissue;reduce myocardial hypertrophy and infla mmatory cells.CONCLUSION nano-TiO2 can induce myocardial injury inmice and vitamin C can alleviate the da mage.The mechanism may be associated with the antioxidant ability of vitamin C inmyocardial tissue.

Objective To investigate the predictive value of preoperative Aspartate Transaminase and Platelet Ratio Index (APRI) for postoperative complications in patients with hepatocellular carcinoma after liver resection.Methods The clinical data of 278 patients who underwent hepatic resection for hepatocellular carcinoma from January 2010 to December 2013 were retrospectively analyzed.The receiver operating characteristic (ROC) curve was used to determine the cutoff value of APRI.Based on this preoperative APRI,patients were divided into the low-risk group (APRI ≤ 0.37) and the high-risk group (APRI ＞ 0.37).Using univariate analysis and multivariate logistic regression,21 risk factors that might be relevant to postoperative complications were analyzed.Results 159 patients (57.2％) developed postoperative complications.The AUC for APRI in predicting complications was 0.677 (0.615-0.740,P ＜ 0.05).At a cutoff value of APRI at 0.37,the sensitivity was 0.616 and the specificity was 0.697.Univariate analysis and logistic regression analysis showed that APRI (P ＜ 0.05,OR =2.138),degree of ASA (P ＜ 0.05,OR =1.864),prognostic nutritional index (PNI) (P ＜ 0.05,OR =0.354) and volume of blood loss during operation (P ＜ 0.05,OR =2.836) were independent risk factors of postoperative complications.Conclusions A high APRI (＞ 0.37) was a simple and practicable preoperative index to predict postoperative complications in patients with hepatocellular carcinoma after hepatectomy.

Objective To observe the change of conditions and study the epidemiology of Keshan disease from 1995 to 2009 in Henan province.Methods From 1995 to 2009,seriously ill township (village) of Keshan disease were selected as monitoring sites,and one cross-sectional survey was conducted annually.Resident population were asked of their disease history,and were taken clinical examination.Suspicious or suspected cases of Keshan disease and people with abnormal ECG were taken 2 m X-ray.Hair and wheat flour samples were collected for selenium testing.Results From 1995 to 2009,about 6632 people were checked,130 chronic and 52 latent cases of Keshan disease were identified,the total detection rates were between 1.12％ and 5.06％.The detectable rate for abnormal electrocardiogram and heart enlargement found through chest X-ray examination were 10.24％ -30.65％ and 32.4％ - 77.8％,respectively.The content of hair selenium tended to increase,the highest was in 2009 (357.12 μg/kg),and the lowest was in 1997( 142.68 μg/kg).Conclusion Keshan disease is stable in Henan province,and prevention and control measures should be strengthen gradually.

Objective To investigate the current status and influencing factors of work engagement in emergency nurses, put forward a feasible strategy, improve the emergency department nurses work engagement for the emergency department to build effective human resource management to provide the reference. Methods A total 226 emergency nurses from 8 hospital of first-class in Tianjin city were recruited by the convenience sampling method and investigated with a self designed, the Medical Personnel′s Work Engagement Questionnaire. Results The total score of Medical Personnel′s Work Engagement Questionnaire was 111-166(137.32 ± 12.48) points and the scores were the highest in interpersonal concordance (4.20 ± 0.46) points and the lowest in work vigor (3.01 ± 0.61) points. Variance analysis and multiple linear regression analysis showed that gender, employment category and number of years as an emergency nurses were the influencing factors of work engagement, which could explain 51.3%of the variance. Conclusions Work engagement emergency of nurses is at a relatively moderate-to-high level, through establishing an effective incentive mechanism, increasing social benefits, accelerating the construction of emergency specialist nurse training system and paying attention to occupational development, work engagement level and quality of emergency medical care can be improved.

Objective To evaluate the effect of health education on endemic diseases in Henan province in 2010.Methods According to the requirements of The Education Program for Endemic Diseases Control in 2009 Henan Province,50 counties (districts) of 18 cities with endemic diseases were selected.Referring to the health education questionnaire in the program,knowledge of endemic diseases were asked of pupils and housewives.Intervention effects were evaluated two months after teaching pupils and housewives in counties,towns,villages and schools with the knowledge of endemic diseases and the questionnaire was used.Results Among 50 counties investigated,5523 pupils and 3206 housewives were surveyed in the baseline according to the requirement,and 5417 pupils and 2891 housewives were surveyed for outcome evaluation.The results showed that after this education,pupils' knowledge about endemic diseases increased from 66.31％(10 987/16 569) in the baseline survey to 93.84％(15 250/16 251),the difference have statistical significant(x2 =3877.78,P ＜ 0.01) ; housewives from 67.56％(6133/9078)to 92.67％(8037/8673),the difference have statistical significant(x2 =1736.33,P ＜ 0.01).After the education,the pupils' knowledge about the iodine deficiency disorders,drinking-water-borne fluorosis and arsenic poisning,coal-burning-borne fluorosis increased from 70.15％ (6263/8928),62.29％(4423/7101),42.96％ (185/270),68.52％ (116/270) to 94.19％ (8344/8859),93.05％ (6376/6852),99.63％ (261/270),96.67％ (269/270),the difference have statistical significant (x2 =1749.85,1939.26,211.83,74.43,all P ＜ 0.01),housewives' knowledge about the iodine shortage diseases,drinking-water-borne fluorosis,the endemic fluorine,the arsenic poisoning increased from 73.27％ (3330/4545),62.79％ (2677/4263,30.37％ (85/135),62.96％(41/135) to 93.96％(4228/4500),91.08％(3555/3903),97.04％(123/135),91.11％(131/135),the difference have statistical significant (x2 =751.03,924.65,129.75,30.23,all P ＜ 0.01).Conclusions Health education intervention has a marked effect in increasing the peoples' knowledge of endemic diseases.Therefore health education should be enhanced in the future.

Objective To investigate the effects of uncoupling protein 2 (UCP2) on the myocardial cells of mice with type 2 diabetes mellitus combined with hyperuricemia (HUA), and clarify the mechanism thereof. Methods The mouse cardiac myocytes (MCM) cultured with 25mmol/L high glucose (HG) medium were divided into two groups: HG plus 300μmol/L sodium palmitate for 18 hours as high glucose and high fat (HG+HF) group, and HG+HF plus 1500μmol/L uric acid (UA) for 18 hours as HG+HF+HUA group. Then the myocardial cells in HG+HF+HUA group, by use or not use UCP2 inhibitor genipin, were further divided into two groups: vehicle group and genipin group. In order to verify the mechanism of UCP2 in myocardial cells injury caused by high glucose, high lipid and high uric acid, the myocardial cells were divided again into genipin group and genipin+N-acetylcysteine (NAC) group. Accordingly, the apoptosis of myocardial cells were measured by flow cytometry at specific time, the mRNA and protein expressions of UCP2 were determined by q-PCR and Western blotting, and the levels of reactive oxygen species (ROS) were detected by DHE staining and ELISA. Results The apoptosis rate of myocardial cells increased obviously, and the expression levels of UCP2 decreased and of ROS elevated significantly in HG+HF+HUA group than in HG+HF group (P<0.05). As the expression levels of UCP2 decreased by genipin intervention, the apoptosis rate of myocardial cells and ROS level in HG+HF+HUA group increased more obviously (P<0.05). In contrast, such an effect was reversed by the application of antioxidants NAC (P<0.05). Conclusion UCP2 can inhibit oxidative stress and alleviate the apoptosis of myocardial cells induced by high glucose, high fat and high uric acid.

Objective:To investigate any change in the effective connectivity between the bilateral anterior central gyruses after transcranial magnetic stimulation (TMS).Methods:Twenty-one healthy subjects were examined using resting state functional magnetic resonance imaging (rs-fMRI) before and after receiving continuous theta burst stimulation (cTBS). The brain atlas of the Institute of Automation of the Chinese Academy of Sciences was used for fine partitioning of the bilateral anterior central gyruses. Granger causality analysis was used to compare any changes in the effective connectivity between them.Results:After the cTBS inhibited the right M1 area, significant changes in effective connectivity among the sub-regions of the bilateral M1 area were observed. The effective connectivity of the right upper limb to the left upper limb and the left head to face were weakened, while that of the left upper limb to the right head, as well as of the face to the right upper limb was enhanced.Conclusion:For people whose right M1 area has been inhibited by cTBS, the effective connectivity changes in both upper limb functional areas of the M1 region reflect inter-hemispheric inhibition. Opposite changes were found in the trunk and upper limbs.