Objective To learn the exposure levels and health hazards of long-term exposure to hexavalent chromium (Cr6+) through drinking water in a west county,and to provide a scientific basis for making preventive measures.Methods Five water points were selected to test the Cr6+ concentration of drinking water in the county in 2015,data of 3 water points with water Cr6+ concentrations exceeded the standard (Cr6+ ＞ 0.05 mg/L) were selected from 12 drinking water points in some west counties in the recent six years (2009-2014) as the exposed group,2water points that drinking water Cr6+ concentrations not exceeded the standard (Cr6+ ≤0.05 mg/L) in the county and adjacent to the exposed group were selected as the control group.Sixty villagers were selected as the investigation objects in each water point to conduct internal medicine,ears,nose,throat (ENT),dermatology and health examination,urinary chromium content,routine blood and urine test were done.Determination of hexavalent chromium concentration in drinking water was done according to The Drinking Water Standard Examination Method 1,5-diphenylcarbazide Spectrophotometry (GB/T 5750-2006);routine urine was tested using the 10 urine analyzer test;urinary chromium was tested using graphite furnace atomic absorption spectrometer;routine blood five classification was tested using automatic blood analyzer;determination of drinking water hexavalent chromium concentration was done according to The Hygienic Standard for Drinking Water (GB 5749-2006).Higher than 0.05 mg/L was judged as exceeded the standard;physical examination was done according to The Diagnostic Criteria of Occupational Chromium Nasal Disease (GB Z12-2002) and The Diagnostic Standard of Occupational Contact Dermatitis (GB Z20-2002).Results There were 184 and 109 people in the exposed group and the control group,respectively.The average concentration of Cr6+ exceeding the standard ratio was 2.82-3.22 in drinking water,the nasal septum nucosa perforation,skin erythema edema,skin ulcers were 4.9％ (9/184),4.3％ (8/184) and 4.3％ (8/184) in the exposed group,and the urinary chromium level (0.31 μg/L) in the exposed group was significantly higher than that of the control group (0.27 μg/L,Z =-4.078,P ＜ 0.05).Routine blood test result of mean corpuscular haemaglobin (MCH) was (29.56 ± 2.07) pg,platelet counts (PLT) was (222.38 ± 47.53) × 109/L and plateletcrit (PCT) was (0.25 ± 0.05)％ in the exposed group,it was all higher than those of the control group [(29.03 ±2.95) pg,(211.74 ±75.27)× 109/L,(0.24 ± 0.08)％,t =1,940,2.318,2.079,all P ＜ 0.05];standard difference coefficient of variation of red blood cell distribution width (RDW-CV) was (13.14 ± 1.05)％,lymphocyte number (LYMPH) was (2.01 ± 0.64) × 109/L in the exposed group,it was all lower than those of the control group [(13.38 ±1.54)％,(2.21 ± 1.02) × 109/L,t =-1.989,-1.956,all P ＜ 0.05].The positive rate of glycosuria,uric bravery red,and urine nitrite in routine urine test of exposed group was 17.39％ (32/184),23.36％ (43/184),7.61％ (14/184);it was all higher than those of the control group [(8.25％ (9/109),11.93％ (13/109),0.91％ (1/109),x2 =4.746,5.798,6.309,all P ＜ 0.05].Conclusions Urine chromium accumulation has been found in populations long-term exposed to 2.82-3.22 times excessive Cr6+ through drinking water,which has affected the population's health to some extent.Therefore,it is necessary to speed up the local drinking water improvement project.

Objective:A novel tuberculosis DNA vaccine integrating siRNA,fusional antigen and hIL-12 triple expression units was constructed in our laboratory.Methods:To evaluate the independent expression of the three expression units,two eukaryotic expression plasmid pVAX1-siRNA-PVAE[EGFP]-hIL12 with TB fusional gene Ag85B-ESAT6(PVAE) and enhanced green fluorescent protein(EGFP),and pVAX1-siEGFP-PVAE[EGFP]-hIL12 with siRNA coding sequence targeting EGFP instead of Mcl-1L were constructed.Then two plasmids were used to transfer human embryonic kidney 293 cells.Based on EGFP report gene,it was demonstrated that siRNA expression unit and fusional antigen gene were independently expressed.Results:The hIL12 expression at 48h and 72h post transfection were also detected by ELISA analysis up to 1571.63pg/ml and 2392.25pg/ml respectively in the cell culture fluid.Conclusion:The results demonstrated that the novel DNA vaccine with siRNA,TB fusional antigen and hIL12 three expression units in the same plasmid frame is successfully constructed and independently expressed in eukaryotic cells.It laid a foundation for further animal model study on anti-tuberculosis effects of this novel DNA vaccine.

Objective: The main objective of the present study is to develop the risk-adjusted capitation pay-ment standards to compensate health service providers. Methods:Descriptive statistical analysis was conducted to an-alyze the insured's enrollment and visit conditions, and the two-part model was conducted to obtain the appropriate compensation standard using data retrieved from information system of social health insurance for the period of 2014 to 2015 in Shenzhen City. Results:The estimated value of total expenditure per insured person per month is 6. 17 yuan. Age,sex,insurance level and with or without chronic disease or catastrophic disease were elicited as risk adjustors. The whole number insured people were divided into 52 groups by this four risk-adjustment factors whereby the rele-vant payment standards for each group was calculated. Conclusions:By adjusting capitation fee on the grounds of risk of disease and expected expense of medical services of the insured, the capitation payment standards can be calculat-ed virtually. This method will promote the process of capitation payment system reform and also lay a solid foundation for further research.

Objective To observe the clinical efficacy of acupuncture-moxibustion plusMEI Te-lan’s manipulations in treating lumbar intervertebral disc herniation (LIDH) due to blood stagnation.Method Totally 248 LIDH patients due to blood stagnation were randomized into a treatment group of 123 cases and a control group of 125 cases. The treatment group was intervened by acupuncture-moxibustion plusMEI Te-lan’s manipulations, while the control group was by acupuncture-moxibustion plus tuina at lower back. The short-form McGill Pain Questionnaire (SF-MPQ) and Oswestry disability index (ODI) were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate and recovery-markedly effective rate were respectively 80.5% and 52.0% in the treatment group, versus 72.8% and 20.0% in the control group. There was a significant difference in comparing the recovery-markedly effective rate between the two groups (P<0.05). In the treatment group, the Pain Rating Index (PRI) score, Visual Analogue Scale (VAS) score, Present Pain Intensity (PPI) score, and ODI score were significantly changed after 3-day, 6-day, and 20-day treatment compared to the scores before treatment (P<0.05). After 20-day treatment, the PRI, VAS, PPI, and ODI scores of the treatment group were significantly different from that of the control group (P<0.05).Conclusion Acupuncture-moxibustion plusMEI Te-lan’s manipulations is an effective method in treating LIDH due to blood stagnation.

Objective To investigate the usefulness of 3 T MRI 3D-FIESTA in the evaluation of the intraparotid components of the facial nerve and parotid duct, and compare them with surgical findings. Methods Twenty-two cases with parotid benign tumors were scanned with conventional and 3D-FIESTA sequences on 3 T MRI scanner. Postprocessed multiplanar images were obtained with the workstation. Parotid ducts and facial nerves and tumors were identified on these images. The relationship of the tumors to the facial nerves and Parotid ducts was confirmed at surgery. Results Various types of parotid benign tumors had their characteristics on 3 T MR imaging. Parotid benign tumors mainly showed hypo-intensity on T_1WI in 21 cases, and hyper-intensity on T_2WI in 22 cases. But on 3D-FIESTA images, they appeared hypo-intensity (10 cases) or high intensity (12 cases) due to different types. Facial nerves in parotid appeared as linear structures with hypo-inteusity. The indication of the main trunks were 16 and 18 cases for T_1WI and T_2WI images, while on 3D-FIESTA images, the main trunks and cervicofacial and temporofacial divisions of the facial nerves were found in 22, 21,22 cases. Parotid ducts appeared as structures with hypo-intensity on T_1WI and hyper-intensity on multiplanar images (14, 20, 22 cases). Compared with surgical results, the main trunks of the facial nerve were correctly showed by 3D-FIESTA images in 20 cases. However, in 2 cases they were not located in the operation because of shifting. Conclusion 3 T MR 3D-FIESTA imaging could depict the extracranial facial nerve and the parotid duct in the parotid gland, which is useful for preoperative evaluation of parotid gland tumors.

OBJECTIVETo search for an effective method for treatment of chronic hepatitis B.

METHODSOne hundred and twenty-three cases were randomly divided into a treatment group (n = 63) and a control group (n = 60). The treatment group were treated with injection of Huangqi injectio and Danshen Injectio into Ganshu (BL 18) and Zusanli (ST 36), once every other day; and the control group were treated with oral administration of Gankangning tablet and fufang yiganling tablet. The clinical symptoms, hepatic function, hepatitis B e antigen (HBeAg), hepatitis B virus-desoxyribose nucleic acid (HBV-DNA) were compared between the two groups.

RESULTSThe total effective rate was 93.7% in the treatment group and 76.7% in the control group with significant difference between the two groups (P < 0.01); and the treatment group in hepatic function and the effects of turning negative for HBeAg and HBV-DNA was better than the control group (P < 0.01).

CONCLUSIONAcupoint-injection has a better therapeutic effect on chronic hepatitis B.

Objective To probe the relationship between the patients′ prognosis and the gene of multidrugs and drug resistance in uveal melanoma. Methods The gene expression of cyclin D1, epithelial growth factor receptor (EGFR), non metastasis gene 23 (nm 23), P glucose protein (P gp), multidrug resistance relation protein (MRP) and lung resistance protein (LRP) expression in 96 cases of uveal melanoma were detected by depigment immunohistochemistry. The patients with complete anamnesis data were observed continuously, and the follow up results were classified. Results Among the 96 cases of uveal melanoma, the epithelioid cell type was in 21, the mixed cell type in 56, and the spindle cell type in 19; including 76 at intraocular stage and 20 at extraocular stage. As the level of metastasis suppress gene nm 23 expression decreased and the level of cyclin D1 and EGFR expression increased, the expression level of drug resistance genes increased. The levels of LRP and MRP had negative correlation to the expressions of nm 23 and postive correlation to the expressions of nm 23, Cyclin D1 and EGFR. In 58 patients′ who were observed continuously, 19 died in 5 years and 26 survived over 5 years. Conclusion There are significant association between patients′ prognosis and multidrug and drug resistance gene in uveal melanoma.

BACKGROUND: Decompression-internal fixation is needed in the treatment of atlantoaxial dislocation accompanying with spinal compression caused by cranium-neck junction area malformation and other diseases.Different internal fixation methods are chosen according to different conditions, including anterior atlantoaxial internal fixation, posterior atlantoaxial internal fixation or occipitocervical internal fixation. Transoralpharyngeal atlantoaxial plate internal fixation is a method for atlantoaxial anterior fixation. It is developed recently and used for difficult and complicated atlantoaxial dislocation induced by congenital disease, trauma or rheumatoid arthritis.OBJECTIVE: To probe into the clinical application of transoralpharyngeal atlantoaxial reduction plate system in the atlantoaxial dislocation caused by obsolete odontoid fracture.DESIGN: Single Sample observation SETTING: Department of Orthopaedics, Guangzhou General Hospital of Guangzhou Military Medical University of Chinese PLA PARTICIPANTS: Twelve patients with atlantoaxial dislocation caused by obsolete odontoid fracture were selected in the Department of Orthopaedics, General Hospital of Guangzhou Military Medical University of Chinese PLA from January 2003 to October 2005. Among them, 7 were male and 5 were female, they were aged 47 years on average ranging from 36 to 59 years. The mean injured time was 19 months ranging from 4.5 to 36 months; 6 patients were graded as C degree, 3 as D degree and 3 as E degree in Frank gradation.METHODS: Twelve obsolete odontoid fracture caused by atlantoaxial dislocation underwent transoralpharyngeal anterior decompression. Transoralpharyngeal atlantoaxial reduction plate system was used in reduction and fixation. Autogeneic ilium was implanted into bilateral articulatio atlantoepistrophica.MAIN OUTCOME MEASURES: ① Frank gradation of patients at the 4th week after operation. ② whether the internal fixation is loose or not after operationRESULTS: ①Frank gradation at the 4th week after operation: Among the 6 patients who were primarily graded as C degree, 4 patients improved to be E degree and 2 patients D degree; Three patients who were primarily graded as D degree all improved to be E degree; Patients who were primarily graded as E degree did not changed. ② Except for one patient who suffered dislocation again for loosening of screw caused by tumble, the other patients had firm fixation, ideal fusion and satisfying spinal decompression.CONCLUSION: Transoralpharyngeal atlantoaxial reduction plate system finishes atlantoaxial reduction and fixation once. It avoids conducting posterior fusion fixation operation after anterior decompression. It also avoids fetal injury for spinal cord caused by extreme atlantoaxial unsteadiness in the process of movement and turning over.

BACKGROUND:C2 transpedicle screw fixation for Hangman fractures has been paid more attention due to reliability and no loss of physiological function.However,there are lacks of biomechanical evidences for indication treatment because the fixation is single segmental.OBJECTIVE:To investigate the biomechanical stability of C2 transpedicle screw fixation for Hangman fractures.DESIGN,TIME and SEITING:This was a contrast study which was performed at the General Key Laboratory of Biomechanics,First Military Medical University of Chinese PLA from May to August 2004.MATERIALS:AO-universal titanium alloy transpedicle screw of 18 25 mm in length and 3.5 mm in diameter was adopted in this study.Six fresh C1-C4 cervical vetebrae samples were ordiually made into type Ⅰ,ⅡA,and Ⅱ Hangman fracture models.METHODS:After transpedicle screw fixation.Hangman fracture models were measured by non-destroyed style with spinal anterior flexion/posterior extension,left/right lateral curvature,and left/right axial direction.Loading/unlonding circulation was performed three times during each testing.Kinematics indicators were measured on the 3rd circulation.MAIN OUTCOME MEASURES:Spinal motor images at zero load and maximal load were obtained with laser photoscanning(0.1% in precision),and the corresponding systematic software was adopted to calculate 3D range of movement.RESULTS:The relative stability of type Ⅰ Hangman fracture models after C2 transpedicle screw fixation was 100.62%(inflexion),96.91%(posterior extension),99.19%(lateral curvature),and 97.12%(rotation)as compared to control group (P＞0.05).The relative stability of type Ⅱ Hangman fracture models after C2 transpedicle screw fixation was 47.84%(inflexion),21.29%(posterior extension),65.98%(lateral curvature),and 41.69%(rotation)as compared to control group (P＜0.05).CONCLUSION:Biochemical evaluation suggests that type Ⅰ and Ⅱ A Hangman fractures do fit for C2 transpedicle screw fixation,and the fixation may generate well physiological fixation or stability.However,stability of type Ⅱ Hangman fracture is poor,so it is not suitably adopted single transpedicle screw fixation.

Objective To validate a new standardized training program for urological surgeons to improve their laparoscopic surgical skills. Methods The laparoscopic surgical training program was carried out by using the traditional mechanical simulators and animal models. Thirty-three trainees participated the urological laparoscopic surgical training program. Initially, the novices were assigned to practise basic laparoscopic skills step by step on the simulator with fixed trocar positions. After a period of basic training, they were allowed to practise on animal models for some particular proce-dures. Results All trainees (33/33, 100.0%) participated were able to perform all basic techniques skillfully and completed laparoscopic anastomosis accurately after the training. The time required for performing the partial nephrectomy, dismembered pyeloplasty and ureteral reimplantation on animal models declined from 64.0±18.4, 127.54±17.5 and 75.84±11.6 min at the beginning to 30.94±3.8, 65.2±7. 5 and 37.7±7.2 min after practicing these procedures 8 times (P<0.01). They could un-derstand the crucial procedures of the laparoseopic surgeries after 6 to 8 special trainings on animal models. Fifteen trainees (15/33, 45.5%) had started to carry out laparoscopic surgeries after-finish- ing the training program. Conclusions Our program enables the participants to improve their techniques in complicated laparoscopic surgeries. The challenging parts of reconstructive laparoscopic surgeries such as laparoscopic dismembered pyeloplasty can be taught by using animal models. This program could be incorpo-rated easily by all urological departments developing a laparoscopie surgical training program.