Objective To understand the relationship between the fluoride contents and the total hardness, pH value, the depth of well in the endemic fluorosis areas of Hejian city. Methods 40 villages in 2 towns of Hejian city were selected randomly and the well water samples in these villages were collected and determined. Results The contents of fluoride in the well water were higher than the limit(1 mg/L) in Sanitary Standard for Drinking Water Quality (China, 2001), ranged 1.2～4.4 mg/L, with a mean of 2.80 mg/L. The fluoride contents increased as the total hardness decreased (r=-0.615, P

Objective: o explore the antibacterial effect of combined use of photon-induced photoacoustic streaming (PIPS) and silver nanoparticles (AgNPs) on Enterococcus faecalis biofilm in root canals. Methods: A total of 36 isolated teeth with single root canal were collected to establish an experimental root canal model of Enterococcus faecalis infection. Samples were randomly divided into six groups and 0.9% NaCl, 2% NaClO, 0.1% AgNPs solutions were used with conventional needle irrigation (CNI) or PIPS for root canals. Colony count method was used to measure the number of Enterococcus faecalis biofilm in root canals before and after treatment, and the percentage of colony count reduction was calculated. Results: The inhibitory effect of Enterococcus faecalis biofilm in all experimental groups was stronger than that in the control group (P<0.05). The decrease amplitude of 0.9% NaCl, 2% NaClO, 0.1% AgNPs assisted with PIPS was greater than that of 0.9% NaCl, 2% NaClO, 0.1% AgNPs assisted with CNI (P<0.05). The decrease in the 0.1% AgNPs assisted with PIPS group was significantly greater than that in the 2% NaClO assisted with PIPS group (P<0.05). Conclusion PIPS-assisted AgNPs solution washing can significantly improve the effect of clearing Enterococcus faecalis biofilm in root canals.

BACKGROUND:Umbilical cord-derived mesenchymal stem cel s are gaining more attention in clinical treatments. Cel viability prior to transplantation has a direct impact on clinical prognosis. Despite trypan blue staining is a widely performed procedure to assess the viability of umbilical cord-derived mesenchymal stem cel s, it cannot reflect the functional capacity of those cel s accurately because of some subjective factors. OBJECTIVE:To explore sensitive and accurate assay for the functions of umbilical cord-derived mesenchymal stem cel s. METHODS:Human umbilical cord-derived mesenchymal stem cel s were isolated and cultured in vitro. Cultured umbilical cord-derived mesenchymal stem cel s were preserved in 0.9%saline for 0, 2, 4 and 6 hours at 4 ℃. Various methods (trypan blue staining, AnnexinV-PI, terminal deoxynucleotidyl transferase dutp nick end labeling, cel counting kit-8, live-dead assay, cel adherent assay) were used to determine the viability of post-storage umbilical cord-derived mesenchymal stem cel s, and the results were compared with colony-forming efficiency, a measure of cel function. RESULTS AND CONCLUSION:Human umbilical cord-derived mesenchymal stem cel s cultured in vitro showed a spindle shape and attached growth, the third-generation umbilical cord-derived mesenchymal stem cel s were positive for CD29, CD44, CD105, and negative for CD 34 and CD 45. Umbilical cord-derived mesenchymal stem cel s incubated in the adipogenic and osteogenic medium were both positive. Cel viability measured with trypan blue correlated moderately with colony-forming efficiency, while the percentage of viable cel s measured with other methods correlated better with colony-forming efficiency, among which adherent assay was the most obvious. It is proved that cel adherent assay-measured viability is the most accurate indicator.

BACKGROUND:The viability of human umbilical cord-derived mesenchymal stem cel s is often declined with the commonly used transplantation storage solution in clinics, which may influence the therapeutic effects of cel ular transplantation. However, reasons for this are stil unknown. OBJECTIVE:To investigate the role of oxidative stress in the reduction of human umbilical cord-derived mesenchymal stem cel s viability in the storage process during clinical transplantation and to observe the effects of radical scavenger on the results. METHODS:Human umbilical cord-derived mesenchymal stem cel s were harvested and cultured in normal saline for 0, 2, 4 and 6 hours at room temperature. Intracel ular reactive oxygen levels were detected at those time points. Antioxidant enzyme activities and levels of malondialdehyde were measured to determine the intracel ular oxidative stress levels after storage. Cel adhesion rate changes were retested after adding N-acetyl cysteine to the storage solution. RESULTS AND CONCLUSION:The reactive oxygen levels in human umbilical cord-derived mesenchymal stem cel s were increased significantly after normal saline storage and levels of malondialdehyde were increased in a time-dependent manner. Activities of superoxide dismutase, catalase and glutathione peroxidase were al reduced. Addition of N-acetyl cysteine into the storage medium decreased the reactive oxygen levels and improved the human umbilical cord-derived mesenchymal stem cel s viabilities. Experimental findings indicate that, increased reactive oxygen species in human umbilical cord-derived mesenchymal stem cel s is one of the reasons for reduced cel viability. Adding the radical scavenger N-acetyl cysteine can improve the storage effects of human umbilical cord-derived mesenchymal stem cel s.

Objective To explore the diagnostic value of 18F-FDG PET/CT in biliary obstruction.Methods Totally,28 biliary obstruction patients were divided into benign obstruction group (n =11) and malignant obstruction group (n =17)according to the cause of obstruction.Imaging characteristics of 18F-FDG PET/CT and maximal standard uptake value (SUVmax) were compared between the two groups.Efficacy of PET/CT and MRI in the diagnosis of obstructive jaundice were compared.Results In 28 cases,no or mild dilatation of biliary tract accounted for 53.57％ (15/28),moderate to severe dilatation of biliary tract accounted for 46.42％ (13/28).Among the malignant obstruction group,2 cases of hilar cholangiocarcinoma,5 cases of bile duct carcinoma,6 cases of carcinoma of the head of pancreas,and 4 cases of ampullary carcinoma were included,18F-FDG PET/CT showed proximal high metabolic nodules of the obstruction site in 14 cases.Among the benign obstruction group,7 cases were bile duct inflammatory stricture,of which 4 cases with bile duct stones.18F-FDG PET/CT showed a slight increase with patchy or nodular mild metabolism in 6 cases.There were 4 cases of autoimmune pancreatitis.The imaging 18 F-FDG PET/CT demonstrated multi-segmental or multiple nodular enlargement of the pancreas,with generally increased metabolism.SUVmax of malignant obstruction group (6.88± 2.81) was significantly higher than that of benign obstruction group (4.20± 1.70;t=3.143,P＜0.05).The sensitivity,specificity and accuracy of 18F-FDG PET/CT and MRI in the diagnosis of malignant obstructive jaundice were 94.12％ (16/17) and 58.82％ (10/17;x2=4.086 5,P=0.043),81.82％ (9/11) and 63.64％ (7/11;x2=0.229 2,P=0.632),89.29％ (25/28) and 60.71％ (17/28;x2 =4.666 7,P=0.031),respectively.Conclusion 18F-FDG PET / CT has a great value in the diagnosis of obstructive jaundice,which is of great significance for clinical decision-making.

In this paper, we lay down a homogenization training standard for resident standardized training through a joint discussion among experts from three national resident standardized training bases. The aim of the homogenization of resident standardized training quality shall be reached through the synchronous implementation of tutorial system and comprehensive formative evaluation, the strengthening of training quality process management and the promotion and advancement of training quality of resident standardized training.

Objective To explore the problems in traditional Chinese medicine (TCM) scientific research project management and provide possible countermeasures.Methods Through cluster sampling,all the scientific research administrators and staff in a hospital were selected.A questionnaire about TCM hospital scientific research management was designed and used in our study.Results The majority of participants were basically satisfied with current scientific research management in TCM.Problems were analyzed including complex project application,singular evaluating standard,inflexible fund management,and backward professional concept.Conclusions The management of scientific research projects in TCM should combine professional characteristics,innovatively and comprehensively improve management concept,system,team and method.

Objective:To evaluate the efficacy of somatosensory evoked potential (SEP) monitoring for prevention of deep venous thrombosis (DVT) in lower extremity of patients undergoing spinal surgery.Methods:A total of 120 patients of both sexes, aged 40-70 yr, of American Society of Anesthesiologists physical status ⅠorⅡ, without impairment of coagulation function, undergoing posterior lumbar interbody fusion, were selected and divided into 3 groups ( n=40 each) using the random number table method and envelope method: basic preventive measure group (group A), compression stocking group (group B) and SEP monitoring group (group C). In group B, elastic stockings were worn at 1 h before surgery.SEP monitoring was performed during surgery, and the intensity of current stimulation was 25 mA in group C. The flow velocity of popliteal vein in both lower extremities was measured using color Doppler ultrasound apparatus during surgery.Venous blood samples were taken to measure plasma D-dimer concentrations at 1 day before surgery, at the end of surgery and at 24 h after surgery.The DVT developed in lower extremities was diagnosed by ultrasound method during surgery and within 24 h after surgery. Results:Compared with A and B groups, the blood flow velocity of popliteal vein was significantly increased, and the plasma D-dimer concentration and incidence of DVT developed in lower extremity during surgery were decreased in group C ( P<0.05). Conclusion:SEP monitoring can effectively prevent the occurrence of DVT in lower extremity while it is used as an electrophysiological monitoring of the spinal cord in patients undergoing spinal surgery.

Objective:To investigate the risk factors for biochemical recurrence after radical prostatectomy.Methods:The clinical data of 558 radical prostatectomy patients admitted to the First Affiliated Hospital of Air Force Military Medical University from January 2010 to December 2020 were retrospectively analyzed. The average age was 67.9 (40-87) years old, and the average body mass index was 24.56 (15.12-35.94) kg/m 2. The average PSA was 41.07 ng/ml, including 48 cases<10 ng/ml, 98 cases 10-20 ng/ml, and 412 cases>20 ng/ml. There were 123, 214, 118, 89, and 14 cases with biopsy Gleason 6-10 score, respectively. The clinical stage : 90 cases in ≤T 2b, 273 cases in T 2c, and 195 cases in ≥T 3 . 558 cases underwent radical prostatectomy, including 528 robotic-assisted laparoscopic surgery, 25 laparoscopic surgery, and 5 open-surgery. The risk factors for postoperative biochemical recurrence were analyzed by Cox regression. Results:A total of 63 patients had postoperative pathological stage pT 2a, 32 patients had pT 2b, 241 patients had pT 2c, and 222 patients had ≥pT 3. A total of 210 cases developed biochemical recurrence after surgery, and the mean time to biochemical recurrence was 33.3 (3-127) months after the radical prostatectomy. The biochemical recurrence rates at 1, 3, and 5 years were 9.7% (54/558), 21.5% (120/558), and 31.7% (177/558), respectively. Among pT 2a and pT 2b patients, 7 (11.1%) and 4 (12.5%) cases developed biochemical recurrence, respectively. Among pT 2c stage patients, 145 (60.17%) cases had positive cut margins, treated with androgen-deprivation therapy (ADT) after surgery. 68 (28.21%) cases of pT 2c stage patients had biochemical recurrence at mean 36.1 (3-106)months after the radical prostatectomy. Among ≥pT 3 patients, 147 patients with positive margins, perineural invasion, seminal vesicle invasion and positive pelvic lymph nodes were treated with postoperative androgen deprivation therapy (ADT) + radiotherapy. 98 of 147 patients (66.67%) had biochemical recurrence, and the average time to biochemical recurrence was 30.6 (24-98) months.75 patients of ≥pT 3 without positive margins, perineural invasion, seminal vesicle invasion or positive pelvic lymph nodes, were treated with postoperative ADT. 33 of them (44%) had biochemical recurrence, and the average time to biochemical recurrence was 32.5 (21-106) months. 5-and 10-year survival rates of 210 patients with biochemical recurrence were 89.05% (187/210) and 78.09% (164/210) respectively, 5- and 10-year tumor-specific survival rates were 92.57% and 87.69%, respectively. 46 of 210 cases died, of which 31 (67.39%) died from prostate cancer, and 15 cases (32.61%) died from cardiovascular and cerebrovascular diseases. Multifactorial Cox regression analysis showed that patient's age ≥70 years, initial PSA > 20ng/ml, ≥pT 3 and Gleason score ≥7 were independent risk factors for biochemical recurrence. Conclusions:After radical prostatectomy, patients were treated according to their pathological stage and surgical margins. Patients with positive margins have a higher risk of biochemical recurrence. The independent risk factors for biochemical recurrence included age ≥70 years, initial PSA > 20ng/ml, ≥pT 3 and Gleason score ≥7.

Objective: To study the causes and influencing factors of no seeking medical treatment among pneumoconiosis patients. Methods: Using stratified sampling method and typical survey method, we carried out the questionnaire survey in nine provinces in China including the east, the medium and the western region using a questionnaire on the seeking medical behavior pf pneumoconiosis patients and the influencing factors. The subjects include occupational pneumoconiosis cases and clinically diagnosed cases and the response rate is 94.3 percent. The data was entered twice with epidate3.1 and error detection and statistical analysis was completed with SPSS 20.0. Chi-square test was used for univariate analysis, and multivariate logistic regression was used for multivariate analysis. Results: One thousand and thirty-seven subjects were investigated with average age 55.9±11.2 years. Seventy percent of them were silicosis and 21.9 percent were coal worker’s pneumoconiosis with 67.5 percent of them residing permanently in the countryside, and 37.9 percent of their education background were primary school culture and 33.1 percent of them had junior high school culture. Thirty two point six percent of respondents had no personal income with a median monthly income of 1 200 yuan. Four hundred and thirty four of subjects hadn't seek medical treatment since they got the pneumoconiosis accounting for 41.9 percent with three hundred and thirty seven of them hospitalized directly. The reasons of no seeking medical treatment for the respondents mainly include the self-induction symptoms lighter, the high cost of treatment and cannot claiming the payment of the medical expenses, buying drugs in drugstore, thinking that no medicine can cure pneumoconiosis or no effect, complex procedures, too far away from medical institutions, no unaccompanied, needing a long time or no time, communication disorders, etc. accounting for 44.4 percent, 24.6 percent, 10.9 percent, 9.1 percent, 6.9 percent, 4.4percent, 3.2 percent, 2.9 percent, 1.9 percent, 1.5 percent, respectively. The results of multivariate analysis showed the main characteristics of subjects with restrictions to the outpatient health service utilization are as follows: demographic sociological indicators such as registered permanent residence area is western (OR_western=2.18, 95%CI:1.38-3.43) , more than seventy five years old (OR_{over 75}=6.82, 95%CI:2.04-22.9) , unemployment, temporary or permanent employment (OR _unemployment=1.90, 95%CI:1.17-3.08; OR_{temporary employment}=3.11, 95%CI:1.57-6.14; OR_{permanent employment}=2.10, 95%CI:1.18-3.74) , self-rated health score of 50 or above (OR_{self-rated-70}=2.04, 95%CI:1.18-3.51; OR_{self-rated-90}=3.00, 95%CI:1.97-5.37; OR_{self-rated 90}=2.95, 95%CI:1.74-8.07) ; with increase to the outpatient health service utilization are breath with difficulty (OR=0.57, 95%CI:0.41-0.78) , emphysema (OR=0.48, 95%CI:0.26-0.90) , hospitalized with pneumo-coniosis (OR=0.12, 95%CI:0.07-0.20) . Conclusion Pneumoconiosis patients no covered by injury insurance should be orderly included in the basic medical security system, and be given the medical treatment actively; It should be strengthened the health management for the pneumoconiosis patients and correctly guided the utilization of medical services.