Objective To investigate the prevalence of adult skeletal fluorosis in drinking-water-borne endemic fluorosis areas in Liaoning Province and to observe the effects of preventive measures.Methods Three water-changed villages were selected from six drinking-water-borne endemic fluorosis counties,Faku County,Liaoyang County,Haicheng City,Linghai City,Fu Mongolia County,and Jianping County.Totally 18 diseased villages were selected as the investigation sites.The operating condition of the improvement projects was investigated and the fluoride level of drinking water was tested.People over the age of 25 and living in the local for more than 5 years in each survey site were selected and divided into five groups according to age groups of 25-,35-,45-,55-,and ≥65 years old.Ten people in each age group were selected,half male and half female,to examine skeletal fluorosis by X-ray.Clinical symptoms and bone change,including sclerotin,bones,and joints changes were also examined.Results The water fluorine values of two villages were 1.32 and 1.69 mg/L,more than the national standard (1.2 mg/L),while other 16 villages were between 0.5-1.0 mg/L.X-ray images were analyzed for diagnosis of skeletal fluorosis in 905 adults,and 46 cases were diagnosed as skeletal fluorosis in the 18 monitored villages.Xray detection rate was 5.08％,of which the X-ray detection rate of adult fluorosis in water fluoride qualified monitoring villages was 4.11％ (33/803).The detection rate of adult skeletal fluorosis was 12.75％ (13/102) in water fluoride unqualified monitoring villages.There was a significant difference of the total detection rates between the two groups of monitored villages (x2 =13.99,P ＜ 0.05).Skeletal fluorosis was mainly happened in the age group over the age of 45,account for 89.13％ (41/46).Peri-bone changes were observed in the 46 cases of patients with skeletal fluorosis.Conclusions The condition of skeletal fluorosis has been effectively alleviated after implementing the improvement measures.Prevention and treatment can effectively control the occurrence of fluorosis.

Objective To observe the effect ofmycophenolate mofetil combined with prednisone in treatment of old patients with refractory nephrotic syndrome.Methods From June 2009 to June 2010,67cases of old patients with refractory nephrotic syndrome were divided into two groups by random digits table,32 cases in control group were treated with cyclophosphamide combined with prednisone and 35 cases in observation group were treated with mycophenolate mofetil combined with predrisone.The clinical effect and the levels of urinary protein,serum creatinine and serum uric acid between two groups were compared.Results There was no significant difference in total effective rate between two groups [68.8％(22/32) vs.74.3％ (26/35)] (P ＞ 0.05 ).After treatment,the levels of urinary protein,serum creatinine and serum uric acid in two groups were decreased (P＜ 0.05 ),but there were no significant differences between two groups (P ＞ 0.05 ).The adverse reaction rate in observation group was significantly lower than that in control group (P ＜ 0.05).Conclusion Mycophenolate mofetil combined with prednisone in treatment of old patients with refractory nephrotic syndrome has good effect and low adverse reaction,and it can be applied in clinic.

Objective To investigate the inhibition mechanism of sodium selenite on HCT116 cells.Methods In the present study,we explored the cytotoxicity induced by sodium selenite and the underlying mechanism by MTS assay,WesternBlot,and small RNA interference technique.Results It was found that the sodium selenite at 5uM concentration could indeed reduce the viability of colon cancer cell line HCT116 by a large margin through increasing the generation of reactive oxygen species (ROS),and that the increased levels of ROS could activate c-Jun Nh2-terninal kinase 1 (JNK1).Additionally,knockdown expression of JNK1 or p53 by using RNAi attenuated the cytotoxicity induced by sodium selenite,indicating that both of JNK1 and p53 are required in the process of cell death induced by sodium selenite.Conclusion The sodium selenite could induces cell death in HCT116 through oxidative stress by involvement of JNK1 and p53,both of which play a critical role in toxicity of sodium selenite.

AIM: The effects of selenium dioxide (SeO_2) on proliferation, apoptosis, intracellular reactive oxygen species (ROS) and Ca~(2+) levels in three leukemia cell lines NB4, K562 and HL-60 were investigated. METHODS: Three leukemia cell lines were treated with 3-30 ?mol/L SeO_2. Flow cytometry was used to detect apoptosis rate, and analyze the changes of ROS and Ca~(2+) level within cells. RESULTS: SeO_2 at 10 and 30 ?mol/L inhibited proliferation in three leukemia cell lines. Treatment with 30 ?mol/L SeO_2 for 48 h induced 54.0%, 46.5%, 49.6% apoptosis in NB4, K562, and HL-60 cells, respectively, and also markedly decreased ROS and Ca~(2+) levels among three cell lines. The rate of ROS positive cells in NB4 and HL-60 decreased with the increase in SeO_2 concentrations. ROS was clearly reduced with 30 ?mol/L SeO_2 in K562. Ca~(2+) levels were tardily declined with 10, 30 ?mol/L SeO_2 in NB4 and HL-60 cells. Ca~(2+) levels were clearly reduced with 30 ?mol/L SeO_2 in K562. CONCLUSION: SeO_2 induces apoptosis in three leukemia cells. The declines of intracellular ROS and Ca~(2+) levels are involved in apoptosis induced by SeO_2.

Objective To compare the safety and therapeutic effect between laparoscope and open neoplasty of gastroduodenal ulcer perforated.Methods Among 93 patients with gastroduodenal ulcer perforated,54 patients were given laparoscope neoplasty of gastroduodenal ulcer perforated (laparoscope group),39 patients were given open neoplasty of gastroduodenal ulcer perforated (open group).The informations during the period of operation in the 2 groups were compared.Results There was no death in the 2 groups,2 cases in laparoscope group converted to open operation.The operation time of laparoscope group was significantly longer than that of open group [(74.85 ± 15.80) min vs.(62.97 ± 12.14) min],there was statistical difference (P ＜ 0.01).There were no statistical differences in the time of postoperative indwelling gastric tube,hospitalization time and complication rate between the 2 groups (P ＞ 0.05).The rate of postoperative analgesia of laparoscope group was significantly lower than that of open group [20.4％ (11/54) vs.74.4％ (29/39)],there was statistical difference (P ＜ 0.01).Conclusion Laparoscope neoplasty of gastroduodenal ulcer perforated is effective and safe,and has high application value.

Objective To explore the condition of MYC/BCL2 protein coexpression in 245 patients with diffuse large B-cell lymphoma (DLBCL)and to find the correlations among MYC/BCL2 protein coexpres-sion,the germinal center B-cell-like (GCB)subtype and non-GCB subtype.Methods Paraffin-embedded lymphoma samples from 245 patients with DLBCL were studied using immunohistochemistry for MYC,BCL2, CD10,BCL6,MUM1 and KI67.And the protein expressions of them were analyzed.Results In the speci-mens of 245 patients with DLBCL,the patients with non-GCB were 163 (66.5%),and the patients with GCB were 82 (33.5%).The group of MYC/BCL2 protein coexpression comprised 35.9% (88/246)of the all patients.Non-GCB subtype group had a significantly higher frequency of MYC/BCL2 protein coexpression than the GCB subtype group (41.7%∶24.4%;χ2 =7.116,P=0.008).Conclusion The data shows that MYC/BCL2 protein coexpression occurs significantly more commonly in the non-GCB subtype.We can predict prog-nosis and choose therapeutic regimen base on the assessment for MYC and BCL2 protein expression.

Objective To investigate the clinical efficacy and safety of lyophilized recombinant human brain natriuretic peptide(rhBNP) in the treatment of patients with congestive heart failure (CHF).Methods 120 CHF patients were randomly divided into two groups.58 cases in the observation group were given lyophilized rhBNP,and 62 patients in the control group were given sodium nitroprusside.The clinical effect,changes of echocardiographic indicators and hemodynamic parameters,adverse reactions were observed.Results After treatment,the total effective rate of the observation group was 91.37％,which was significantly higher than that of the control group(x2 =4.23,P ＜ 0.05).The LVEF and NT-proBNP levels in observation group were (59.0 ± 8.2)％ and (535.4 ± 123.8)ng/L,which had higher improvement than control group (P ＜ 0.05).The incidence rate of adverse reactions between the two groups had no significant difference (P＞ 0.05).Conclusion Lyophilized rhBNP in the treatment of CHF has significant effect,and it is worthy of clinical application and promotion.

Objective:To describe a method based on analysis of the histogram of intensity values pro-duced from the magnetic resonance imaging (MRI)for quantifying the degree of fatty infiltration. Methods:The study included 25 patients with dystrophinopathy.All the subjects underwent muscle MRI test at thigh level.The histogram Mvalues of 250 muscles adjusted for subcutaneous fat,representing the degree of fatty infiltration,were compared with the expert visual reading using the modified Mercuri scale.Results:There was a significant positive correlation between the histogram Mvalues and the scores of visual reading (r =0.854,P <0.001).The distinct pattern of muscle involvement detected in the pa-tients with dystrophinopathy in our study of histogram M values was similar to that of visual reading and results in literature.The histogram M values had stronger correlations with the clinical data than the scores of visual reading as follows:the correlations with age (r =0.730,P <0.001 )and (r =0.753, P <0.001);with strength of knee extensor (r =-0.468,P =0.024)and (r =-0.460,P =0.027) respectively.Meanwhile,the histogram Mvalues analysis had better repeatability than visual reading with the interclass correlation coefficient was 0.998 (95% CI:0.997 -0.998,P <0.001)and 0.958 (95%CI:0.946 -0.967,P <0.001)respectively.Conclusion:Histogram Mvalues analysis of MRI with the advantages of repeatability and objectivity can be used to evaluate the degree of muscle fatty infiltration.

Objective:To report thigh muscle magnetic resonance imaging (MRI)tests of four Chinese patients with dystrophinopathy with edema changes in adductor longus muscles that mimics adductor en-thesopathy.Methods:Four boys,who were from four unrelated families and aged from 5 to 11 years, were investigated because of the clinical manifestations including myalgia or muscle weakness or the inci-dental findings of elevated serum creatine kinase levels,and were diagnosed with dystrophinopathy by gene test of Duchenne muscular dystrophy (DMD).Their creatine kinase levels were increased from 4 087 IU /L to 32 700 IU /L (Normal range:75 -175 IU /L).The muscle biopsy of three patients all demonstrated a dystrophic pattern including necrosis,regeneration,hypertrophy,atrophy and connective tissue proliferation,with different proportions of dystrophin-negative muscle fibers.The gene test of DMD showed an out-frame deletion of exons in three of the four patients,involving either exons 45 or exons 49 -52 deletion or exon 62 duplication,and c.2665 C >T with nonsense mutation in the other one. Muscle MRI tests of the bilateral thighs were performed with T1 weighed sequence and slow tau inversion recovery sequence.The degree of fatty infiltration changes was scored.Results:MRI of the thigh mus-cles showed mild to severe fatty infiltration changes in T1 weighed sequence with the total scores from 2 to 13.The most severe fatty infiltration changes were in the long head of biceps femoris and adductor mag-nus.Obvious hyperintensities appeared mainly in the adductor longus muscles on slow tau inversion re-covery (STIR)images in all the patients without any abnormal signals in the attachment of the ligament, indicating edema changes of the adductor longus muscles which mimiced adductor enthesopathy.Two of the four patients presented with edema changes in the bilateral adductor longus muscles,while the other two were with only unilateral changes.Furthermore,other thigh muscles,including adductor magnus, semitendinosus,sartorius and rectus femoris muscles,could also have mild edema changes in two of the four patients.Conclusion:Dystrophinopathy can manifest as edema changes in the adductor longus mus-cles in thigh muscle MRI tests,which is a typical lesion in adductor enthesopathy.The adductor longus muscles in the dystrophinopathy patients may be easy to be impaired due to traction injury during sports.

Objective To study the diagnostic value of imageology for pyelic carcinoma.Methods The accuracy of qualitative diagnosis and sensitivity were analyzed by comparing various imaging examinations in 19 patients with pathologically proved pyelic carcinomas.Results Irregular filling defect and hydronephrosis were seen in the renal pelvis and calyces on intravenous pyelography(IVP).On CT scan,when the tumor was small,soft tissue mass was in the renal pelvis and the calyces.When the renal parenchyma involved by tumors,the soft tissue masses with unhomogeneous density,liquefaction necrosis in the renal pelvis and the parenchyma were seen.On contrast-enhanced CT scan,enhancement from slight to moderate was found in the lesion.The lesions were detected by IVP in 9/12 cases,by BUS in 10/16 cases,by CT in 18/19 cases and by MRI in 3/3 cases.Conclusion IVP and CT are the first method of choice to diagnose the pyelic carcinoma,BUS can be used as a screening method.While in evaluating the tumor involving the parenchyma of the ren or distant metastasis,CT and MRI are superior to IVP.