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 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.

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 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 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.

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 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 summary the pathological and genetic features in nine Chinese limb girdle muscular dystrophy 2I (LGMD2I) patients.Methods Nine LGMD2I patients were recruited from Peking University First Hospital between 2011 and 2016, who came from nine unrelated and non-consanguineous families.The mean age of onset was (8.2±5.2) years (2 to 19 years), and the mean disease duration was (10.4±6.1) years (1 to 24 years).There were six males and three females, present with weakness in limb girdle muscles, four of whom accompanied with calf hypertrophy and three with scapular winging.Serum creatine kinase was 964-23 131 U/L (normal 25-190 U/L).Five of them who conducted electromyogram showed myogenic pattern.Muscle biopsy and next generation sequencing were performed in these patients, then sanger sequencing was performed to determine whether the variants co-segregated with the phenotype in these families.Results Muscle biopsy revealed myopathy features in six patients, dystrophic change in one, and only mild changes in two.Major histocompatibility complex-Ⅰ was positive in six cases, and rimmed vacuoles were found in two.There were seven mutations in fukutin-related protein (FKRP) gene.A reported mutation of c.545A>G (p.Y182C) appeared in eight cases, including three homozygotes and five compound heterozygotes.The mutation of c.1067T>C (p.Ile356Thr) was reported too.And c.1263C>A (p.Tyr421X), c.534G>T(p.Thr178Cys), c.1027G>C (p.Glu343Gln), c.1027G>T(p.Glu343X), c.1448A>G (p.Tyr483Cys) were found to be novel mutations.Conclusions LGMD2I showed large variation in myopathology.The missense mutation A545G(Y182C) is a hot spot of FKRP gene in our series.

Objective To report the clinical, pathological and genetic features in a Chinese family with distal hereditary motor ueuropathy type Ⅴ (dHMN-Ⅴ). Methods Four men and 5 women in 4 generations were involved. The onset of disease was from 13 to 40 years old. Six of them showed predominantly weakness of low extremities. Two women had only weakness and atrophy of hand muscle and 1 woman presented additionally pyramidal signs. The proband, a 20 year-old girl, presented asymmetrical atrophy and weakness of both hands since 13 years old. She had weakness of low extremities after 15 years old. Neurogenic changes were observed in the electromyography. Amplitude of compound muscle action potentials were markedly reduced, while the motor nerve conduction velocity were mildly decreased. Sensory nerve conduction velocity and amplitude of action potential were within the normal range. Sural nerve biopsy was performed in the proband. Berardinelli-Seip congenital lipodystrophy 2 (BSCL2) gene were sequenced in the proband and other 4 patients. Results Nerve biopsy showed mild loss of myelinated fibers with a few regeneration cluster of myelinated fibers. DNA analysis revealed a heterozygons 263A→G mutation in exon 3 of BSCL2 gene. Conclusions dHMN-V has been genetically and clinically confirmed in this family. The phynotype is obviously heterogeneous in onset time and clinical symptoms within the same family. The patients present mild pyramidal tract signs and axonal lesions in the sensory nerve.

Objective To describe the clinical, radiological and genetic features in a family with X-linked Charot-Marie-Tooth disease type 1 (CMT1X) with transient white matter lesions.Methods The proband is a 14-year-old boy who presented transient and recurrent dysarthria, mild numbness and weakness of the limbs for 2 years and 5 months.Later he developed leg weakness.His mother only presented pes cavus.MRI, electrophysiology and nerve biopsy were performed in the proband.Gap junction protein beta 1 (GJB1) gene was analyzed by PCR-sequencing on the proband, his parents and 50 non-illness control women.Results Electremyography showed marked reduced amplitude of the distal compound muscle action potentials and mild decrease of conduction velocities.MRI showed bilateral white matter lesions in centrum semiovale and corpus callnsum, which improved significantly after 6 months.Pathological examination revealed chronic axonal neuropathy and widened Schmidt-Lanterman incisures of myelinated fibers.I20T mutation in GJB1 gene was detected in the proband and his mother, but not in non-illness control women and his father.Conclusions Novel 120T mutation of GJBI maybe could result in CMT1X with predominant recurrent leucocncephalopathy.The white matter changes in MRI are reversibility.