Objective To investigate the correlation between plasma adiponectin level and microinflammation ,nutrition status in patients undergoing different blood purification treatment .Methods Totally 84 patients receiving maintenance hemodialysis over 6 months were randomly assigned to three groups for low‐flux hemodialysis(LFHD)group ,high‐flux hemodialysis(HFHD)group , high‐flux hemodialysis in combination with hemodiafiltration(HFHD+ HDF)group .The baseline and post treatment levels of total protein(TP) ,albumin(Alb) ,prealbumin(PA) ,hemoglobin(Hb) ,`ferritin(FER) ,C reactive protein(CRP) ,potassium(K+ ) ,sodium (Na+ ) ,calcium(Ca2+ ) ,phosphate(P3+ ) ,blood urea nitrogen(BUN) ,creatinine(Cr) ,urea acid(UA) ,intact parathyroid homone (iPTH) ,β2‐microglobulin(β2‐MG) ,cystatin C(Cys C) and adiponectin(ADPN) were compared among three groups .Results Be‐fore the treatment ,the levels of those biochemical indicators were of no significant difference among the three groups .After six months ,plasma ADPN level of HFHD ,HFHD+ HDF increased(P<0 .05) ,and were markedly higher than LFHD(P<0 .05) .In LFHD group ,serum PA ,β2‐MG increased(P<0 .05) after the treatment for six months .In HFHD group ,serum TP ,PA increased , and serum Fer ,CRP ,CysC decreased after the treatment(P<0 .05) .In HFHD+ HDF group ,serum PA ,Hb increased ,and serum Fer ,CRP ,β2‐MG ,Cysc ,BUN decreased after six months(P<0 .05) .After the treatment ,the serum Hb level of LFHD was lower than HFHD ,HFHD+ HDF(P<0 .05);the serum Fer ,CRP ,β2‐MG ,CysC of LFHD were higer than HFHD ,HFHD+ HDF(P<0 .05) .Correlation analysis showed that plasma ADPN level was inversely associated with Fer ,CRP ,CysC ,β2‐MG ,whereas was as‐sociated with PA ,Alb .Conclusion The different ways of hemodialysis could have an effect on the final levels of adiponectin in M HD patients .ADPN can be used as a meaningful indicator of microinflammation ,nutrition status in hemodialysis patients .

Objective To discuss the influence of Yifei-Kangxin capsule on MMP-1 in Wistar rats model with pulmonary heart disease. Methods 40 Wistar rats with pulmonary heart disease were averagely grouped as Normal Group, Model Group, Therapeutic Group and Comparative Group randomly by weight. The rats in Therapeutic Group were given Yifei-Kangxin capsule and the rats in Comparative Group were given Nifedipine. The course of treatment was 15 days. The rats were killed at the next 7th, 14th and 28th day separately to test MMP-1 in pulmonary tissue. Results After the treatment, the expression of MMP-1 in pulmonary tissue of the Therapeutic Group[7 d, 14 d, 28 d was(0.231±0.017)ng/m、(0.308±0.081)ng/m、(0.358±0.074)ng/m]was lower than the Model Group[7 d, 14 d, 28 d was(0.266±0.036)ng/m 、(0.315± 0.060)ng/m、(0.612±0.091)ng/m]. Conclusion Yifei-Kangxin capsule can inhibit the expression of MMP-1 in the rats model pulmonary heart disease.

Objective To establish and evaluate a method for determination of total arsenic in urine by test-tube rapid digestion hydride generation atomic fluorescence spectrometry.Methods After digestion of urine samples using graduated test-tube and graphite digestion apparatus,arsenic content in urine was determined with atomic fluorescence spectrometer.Then the test results were evaluated by using quality control measures,such as precision and accuracy experiments,and the results between different laboratories were reviewed and compared.Results The urinary arsenic was in a linear range of 0-0.300 mg/L,correlation coefficient (r) ＞ 0.999 3,detection limit was 0.000 21 mg/L,relative standard deviation (RSD) ≤4.62％ and the recoveries of standard addition were 93.9％-104.3％.The value of standard reference material measured was within the allowable range.The blind sample of the national urinary arsenic was qualified.Conclusions This method is suitable for large scale determination of urinary arsenic for its micro sample amount needed,less interference and strong practicability.The error results are in a controlled range.

Objective To find out the distribution of drinking-tea-borne fluorosis in the six ethnics in Qinghai Province, and to provide basic data for prevention and control of the disease. Methods In 2010, according to the requirement of “The National Surveillance Program of Drinking-Tea-borne Fluorosis”, six ethnics accounted for 99.59% of total population in Qinghai Province were investigated in 28 counties having brick-tea drinking habit. Three townships and a town in each county, two administrative villages(residents’ committee) in each township and town were chosen and 50 adults in each administrative village and residents ’ committee were selected to check skeletal fluorosis, dental fluorosis, urine fluoride and daily drinking amount of tea water. Five to six samples of drinking tea water were determined. Dental fluorosis was examined by Deans method; the fluoride content of brick-tea and urine were determined by fluoride ion selective electrode; the skeletal fluorosis was diagnosed based on “Endemic Osteofluorosis Clinical Indexing Diagnosis Standard”( WS 192-2008 ) . Results A total of 10 335 adults were surveyed, the number of Tibetan, Han, Hui, Mongolian, Tu and Salar ethnics were 4 972, 3 063, 1 196, 634, 235 and 235, respectively. The daily drinking amounts of tea water in Mongolian, Tibetan, Hui, Tu, Han and Salar ethnics were 2.53, 2.19, 1.74, 1.63, 1.22 and 1.07 L, respectively. Daily fluoride intakes in Tibetan, Mongolian, Tu, Hui, Han and Salar ethnics were 3.99, 2.78,2.27, 2.16, 1.78 and 1.28 mg, respectively. The medians of urinary fluoride concentration of the Tibetan, Tu, Hui, Han, Mongolian and Salar ethnics were 1.46, 1.19, 1.12, 0.98, 0.93 and 0.81 mg/L, respectively. The prevalence rates of dental fluorosis of the Hui, Han, Tibetan, Tu, Mongolian and Salar ethnics were 34.53%(413/1 196), 27.07%(829/3 063), 21.60%(1 074/4 972), 20.00%(47/235), 17.98%(114/634) and 6.38%(15/235), respectively. The incidence rates of clinical skeletal fluorosis of the Tibetan, Mongolian, Han, Hui, Tu and Salar ethnics were 13.42%(667/4 972), 11.04%(70/634), 9.31%(285/3 063), 7.61%(91/1 196), 5.53%(13/235) and 4.26%(10/235), respectively. Conclusions The distribution and prevalent status of drinking-tea-borne fluorosis in the six ethnics of Qinghai Province are different. Tibetan and Mongolian ethnics are the key population concerning the prevention and control of the disease.

Objective To observe the illness change trend of drinking water type endemic arsenic poisoning in Qinghai Province, comprehensively evaluate the effect of prevention and control measures, in order to provide a scientific basis for timely adjustment of the prevention and control measures. Methods From 2010 to 2013, according to the Drinking Water Type Endemic Arsenic Poisoning Monitoring Programs, 3 villages in 2 counties within Qinghai Province were randomly selected as monitoring sites. The arsenic content in drinking water of residents was measured, water improvement projects in all monitoring villages were investigated; at the same time an investigation of arsenic disease in resident population was conducted, and urinary arsenic content was monitored. Arsenic in drinking water and urine was determined by hydride generation atomic fluorescence spectrometry, and arsenic poisoning was diagnosed using Endemic Arsenic Poisoning Diagnostic Criteria (WS/T 211-2001). Results Of the three water improvement projects, two were water arsenic exceeded the standard, and one was intermittently operated. From 2010 to 2013, the arsenic poisoning detec tion rate in Baoning Village was 27.30% (193/707), 31.90%(245/768), 29.35%(221/753) and 28.22%(219/776); in Kecai Village was 32.62%(107/328), 34.83%(124/356), 31.26%(131/419) and 29.35%(118/402);and in Manimotai Village was 56.58%(43/76), 52.81%(47/89), 45.10%(46/102) and 34.69% (34/98), there was no significant difference statistically of the arsenic poisoning detection rates in the three monitored villages in the 4 years (χ2 =3.09, 0.04, 0.92, all P>0.05). From 2010 to 2013, women arsenic poisoning detection rate was 36.45%(203/557), 40.59%(246/606), 36.12%(225/623) and 34.77%(218/627), respectively;men was 25.27%(140/554), 28.01%(170/607), 26.57%(173/651) and 23.57%(153/649), respectively;women arsenic poisoning detection rates were higher than those of men (χ2 = 16.25, 21.32, 13.49, 19.38, all P < 0.05). Arsenic poisoning detection rate of people younger than 60 years old had a tendency to increase with age. In 2012 and 2013, 105 and 93 urine samples were tested, respectively; urinary arsenic geometric mean was 0.113 and 0.149 mg/L. Conclusions Water improvement projects and water quality are not optimistic, and prevalence of arsenic poisoning is still at a higher level. A sound long-term monitoring program should be established as soon as possible, the management and maintenance of water improvement projects should be strengthened, and the monitoring and prevention work should not be neglected.

OBJECTIVE：To overview t he s ystematic revi ews on JAK inhibitors in the treatment of rheumatoid arthritis （RA）， and to provide evidence-based basis for the treatment of RA with these drugs. METHODS ：The Cochrane Library ，PubMed， Embase，CNKI，Wanfang database and VIP were electronically searched to collect systematic reviews of JAK inhibitors in the treatment of RA from inception to Dec. 2020. After data extraction of included systematic review ，PRISMA statement ，AMSTAR2 scale and GRADE were used to evaluate the report quality ，methodological quality and the level of evidence for outcome indicators. RESULTS ：A total of 12 systematic reviews involving 103 outcomes were included. PRISMA score of systematic reviews was between 17.5 and 22.5，and the reported quality defects were mainly reflected in scheme ，registration and other aspects. AMSTAR 2 evaluation results showed that there were 6 studies of low quality and 6 studies of very low quality ，without high-quality study and medium-quality study. GRADE assessment results for outcome indicators showed low to medium quality of evidence. The summary of evidence showed that compared to placebo ，JAK inhibitor could alleviate various indicators of RA ； compared to adalimumab ，the advantage was not obvious. JAK inhibitors did not increase the incidence of serious adverse events ， but the systematic reviews were inconsistent in their effects on the incidence of total adverse events and liver injury. CONCLUSIONS：The efficacy of JAK inhibitors in the treatment of RA has certain advantages over placebo ，but more studies are needed to demonstrate the efficacy of JAK inhibitors in the treatment of RA compared to other drugs ；the advantage of safety is uncertain.