Lead is a kind of poisonous heavy metal which is widely existed in our environment. It is so harmful for children’s health. The whole society has paid much attention to this problem all the time. Blood lead level is an important index which can measure how seriously children have been exposed to lead. By consulting the papers on the studies of children's blood lead levels,the sources and influencing factors of blood lead levels of children in China were reviewed in the present paper,meanwhile,some suggestions were provided to decrease the lead contact probability and improve children's health.

lschemic postconditioning(IPo)is a way that after long ischemia on liver graft,animals are given one or several brief reperfusion-ischemia before persistent reperfusion to improve the hepatic tolerance and relieve the ischemie reperfusion injury.It has been proved an effective and controlled method to attenuate the ischemic reperfusion injury.Protective mechanism of ischemic postconditioning on hepatic graft is related with protecting sinus hepaticus endotheliocyte and hepatic microcirculation,relieving hepatic cells injury and inflammatory reaction induced by oxygen free radicals,relieving calcium ovedoad in hepatic cells and mitochondria,regulating apoptosis genes,transforming ion channels condition in mitochondria.This article will makes a brief review on protective mechanism ofhepatic ischemic posteanditioning.

Objective To explore the relationship between pathological changes of liver,serum ALT,expression of P-selectin in serum of mice and different dose of venom,the poisoning time induced by Agkistrodon Halys Pallas venom.Methods Using two -factor factorial design,72 male Kunming mice of clean grade were randomly ( random number) divided into 9 groups (n =8).As per the different doses of snake venom injected and different lengths of time after venom injected,the 9 groups were 0-dose (0.0 mg/kg) 3 hours after saline given group,0-dose 8 hours after saline given group,0-dose 24 hours after saline given group,low-dose (0.5 mg/kg) 3 hours after venom given group,low-dose 8 hours after venom given group,low-dose 24 hours after venom given,high-dose ( 1.0 mg/kg) 3 hours after venom given group,high-dose 8 hours after venom given group and high-dose 24 hours after venom given group.The pathological change of liver tissue was determined,and ALT and expression of P-selectin in serum were detected.Results In the venom given groups,the liver histopathologic scores,serum ALT value and expression of Pselectin in serum were significantly higher than those in control group ( P ＜ 0.05 ),and those in high-dose group were higher than those in low-dose group (P ＜ 0.05 ),and those in 8h groups were higher than those in 3h groups (P＜0.05),and those in 24 h groups were higher than those in 8 h groups (P ＜0.05).As the dose of venom increased and the length of time after venom given extended,the liver histopathologic scores,serum ALT and expression of P-selectin in serum were higher.A positive correlation between Pselectin expression and liver histopathologic scores was found after correlation analysis ( r =0.98,P ＜0.05 ).Conclusions Agkistrodon snake venom can cause acute liver injury with elevated ALT and Pselectin in mice.As higher dose of venom given and longer length of time after venom given extended,more serum ALT and P-selectin are produced.Between acute liver injury and high expression of P-selectin exists a correlation,suggesting overexpression of P-selectin is one of the mechanisms of acute liver injury induced by Agkistrodon Halys Pallas venom.

Objective To estimate the impact of cold wave on daily death of cerebra-cardiovascular diseases in Beijing by using case-crossover design. Methods The data of death counts was provided by Beijing Center for Disease Control and Prevention while the meteorological data was provided by Institute of Urban Meteorology,China Meteorological Administration (CMA),Beijing. The impact of six cold waves from Jan 1,1998 to Jun 30,2000 on daily death of cerebra-cardiovascular diseases were analyzed by using 1∶1 one-directional retrospective design and 1∶2 bi-directional symmetry control design. The cases were the people who dead during winter. Controls were the seventh day before or after the date of cases (or the fourteenth day). Results There were six cold waves in the investigation duration. The third cold wave in which minimum temperature declined obviously with decreasing humidity and increasing air pressure had significantly statistical significance in OR and the lag time of this cold wave was 0 day,the OR values were 1.500 (95%CI:1.032-2.181) for cardiovascular disease (CVD),respectively 1.913 (95%CI:1.066-3.432) for acute myocardial infarction,1.679 (95%CI:1.139-2.474) for cerebra-vascular disease(CBD) respectively. The other five cold waves do not have significant impact on cerebra-cardiovascular diseases. Conclusion Most cold waves studied in Beijing do not impact the daily death counts caused by cerebra-cardiovascular diseases. The cold wave with significant increased air pressure may increase the risk of death of cerebra-cardiovascular diseases without any lag time in Beijing.

OBJECTIVE:To develop a method for concentration determination of voriconazole in human plasma and apply it in the clinic. METHODS:UPLC-MS/MS method was adopted. Using ketoconazole as internal standard,the determination was per-formed on Shim-pack VP-ODS column with mobile phase consisted of water(containing 1‰ formic acid and 2 mmol/L ammonium acetate)-acetonitrile(gradient elution)at flow rate of 0.3 ml/min and column temperature of 40℃.The electrospray ion source,pos-itive ionizing pattern and multiple reaction monitoring were used;the mass transition ion-pairs of voriconazole and internal standard were m/z 351.2→282.2 and m/z 532.1→490.2. RESULTS:The linear range of voriconazole were 1-10 000 ng/ml (r=0.999 5,n=5),and the limit of quantitation was 1 ng/ml;RSDs of inter-day and intra-day were all lower than 10%;method recovery was higher than 90%(RSD<8%),and extraction recovery was higher than 70%(RSD<8%). The plasma concentrations of voriconazole in 10 patients with invasive fungal infection determined by this method were 507.33-7 011.24 ng/ml,and those of 3 patients were outside the recommended treatment concentration range. CONCLUSIONS:The established method is fast,accurate and sensitive,and can be applied for the therapeutic drug monitoring of voriconazole.

Objective To investigate the longitudinal systolic ventricular function of children with single ventricle, and to appraise the feasibility and clinical value of velocity vector imaging (VVI) on assessing it. Methods The study group consisted of 30 patients with functional single ventricle. The control group consisted of 30 age- and gender-matched normal children. Using Sequoia C512 echocardiography machine,the peak velocity(V),peak displacement(D) ,strain(S) ,and strain rate(SR) were measured. Results Basel and median velocities,as well as basel and median displacements of rudimentary chamber side(RCS), were lower than those of septum[Basel velocity (1. 93 ± 0. 71)cm/s vs (3. 53 ± 1. 07)cm/s;Median velocity (1.19±0. 57)cm/s vs (2. 03 ± 0. 90) cm/s; Basel displacement (2. 53 ± 1.65) mm vs (6.21 ± 2. 12)mm;Median displacement(1. 26 ± 1. 06)mm vs (3. 21 ± 1.37)mm]. The values of strain of all the six segments of single ventricle were significantly lower than Corresponding segments of the control group [ basel nonrudimentary chamber side(NRCS) ( - 16. 17 ± 4. 37) % vs ( - 19. 66 ± 3. 47) % ; Median NRCS ( - 15. 23 +4.36)% vs (-19.64± 4. 75)%; Apical NRCS (-13.84 ± 5.79)% vs ( - 16. 7 ± 4. 15)%; Basel RCS(-10. 54±5.35)% vs (-19.49±3. 74)%;Median RCS ( - 10. 16 ± 5. 26)% vs ( -20. 83 ± 3. 82)% ;Apical RCS ( - 10. 97 ± 5. 22) % vs C - 18. 11 ± 4.43) %]. Aside from basel strain rates of NRCS, strain rates of all the other five segments of single ventricle were significantly lower than Corresponding segments of the control group [Median NRCS ( - 1. 21 ± 0. 42)s-1 vs (- 1.49 ± 0. 24)s-1 ;Apical NRCS ( - 1.10 ±0.41)s-1 vs (-1.47 ± 0.24)s-1;Basel RCS ( - 1.07 ± 0. 35) s-1 vs (- 1. 49 ± 0. 22) s-1; Median RCS (-0.97± 0.34)s-1 vs ( -1.48 ± 0. 20)s-1 (Apical RCS ( - 0. 93 ± 0. 39)s-1 vs ( - 1. 48 ± 0. 22)s-1]. Conclusions Longitudinal systolic ventricular function is impaired in children with functionally single ventricle. VVI can be used to asses ventricular systolic performance in children with functionally single ventricular.

Objective To discuss the application of allowable total error (Tea) and allowable imprecision derived from biological variation in routine chemistry external quality assessment ( EQA) and internal quality control (IQC) and set up quality specifications of routine chemistry in our country.Methods Data of test items including K,Na,CI,Ca,P,Glu,Urea,UA,Cre,Alb,TP,TC,TG,AST,ALT,Tbil,ALP,AMY,CK,LDH,Fe,Mg,Cu,Zn and GGT was collected and evaluated by a nationwide EQA.At the same time the coefficients of variation (CVs) of these test items during the month were acquired from the IQC reports of each laboratory and then the results were analyzed.Results Percent of pass was different in these test items based on Tea derived from biological variation in EQA results.Except for items of CI,Mg,Cu and Zn,about 80％ of participant laboratories could achieve the minimum performance of biological variation.About 80％ of participant laboratories could achieve the desired performance of biological variation for K,P,Glu,Urea,UA,Cre,TC,TG,ALT,AST,Tbil,AMY,CK,LDH,Fe and GGT.About 80％ of participant laboratories could achieve the optimum performance of biological variation for Urea,UA,TC,TG,ALT,AST,Tbil,C K,and GGT.And the IQC results showed that acceptable percents of different items based on three allowable imprecision were different.More than 80％ of participant laboratories could achieve the minimum allowable imprecision for K,P,Glu,Urea,UA,TC,TG,ALT,AST,Tbil,AMY,CK,LDH,Dbil,Fe,GGT,the desirable imprecision for P,Urea,UA,TG,ALT,AST,Tbil,CK,Dbil,Fe,GGT and the optimum imprecision for TG,ALT,CK,Dbil,Fe.Conclusions The quality specifications derived from biological variation can be as evaluation criteria for EQA and IQC in order to know the detection ability of each laboratory more completely and objectively,set up quality specifications derived from allowable total error and allowable imprecision in routine chemistry and to provide basis for mutual recognition of routine chemistry test results.

Objective To summarize and analyze the results of national external quality assessment (EQA) of maternal serum prenatal screening in second trimester during 2004-2013,in order to provide a assistance for the quality improvement of the prenatal screening testing.Methods Five different concentration samples were distributed to each participated laboratories and were measured at each external quality assessment program during 2004 to 2013.The results reported in a specified time.The testing performance of alpha fetoprotein (AFP),total human chorionic gonadotropin (HCG),total β-human chorionic gonadotropin (β-HCG),free β-human chorionic gonadotropin (free β-HCG),unconjugated estriol (uE3) were evaluated.Results During 2004-2013,the number of laboratory participated increased from 57 to 500.The robust variation coefficient increased from 2.77％ to 18.98％ for AFP,5.6％ to 36.12％ for HCG,4.69％ to 24.38％ for β-HCG,2.66％ to 81.54％ for free β-HCG,and 3.83％ to 26.51％ for uE3.The percentage of passing rate reached 93％ (463/496) for AFP,66％ (35/53)for HCG,85％ (137/ 161) for β-HCG.The percentage of passing of free β-HCG (μg/L) increased from 52 ％ (24/46) to 94％ (248/264),but the passing percentage of free β-HCG (mIU/ml) were 47％ (18/38).The percentage of passing of uE3 reached 84％ (252/299).Conclusions The testing performance of AFP is best in prenatal screening,followed by β-HCG,other item testing have some problems.It is great important to improve the quality of maternal serum prenatal screening by strengthening external quality assessment and building comprehensive quality control system in China.

Objective To investigate the dates of 477 Chinese prenatal screening centers for previous half year analyse prena-tal screening status and provide recommendations for quality control.Methods All China prenatal screening centers were sent the data via the National Quality Assessment Scheme.This covered the software used,the risk cut-offs,monthly sample throughput,monthly median MoM of AFP,hCG,β-HCG,freeβ-HCG and uE3,monthly screening positive rate for trisomy 21,trisomy 18 and Open Neural Tube Defect.Results Screening protocol were versatile,with 73.48% (133/181)used two-marker model,24.31% (44/181)used three-marker model and 2.21% used four-marker model.About the software used, 350 laboratories never updated the screening parameters,89 laboratories had updated their median or parameter by manufac-turers,24 laboratories had updated the parameters by themselves.Cut-offs differed between laboratories.59.91% (275/459) used 1/270 as their cutoffs for trisomy 21.66.22% (296/447)used 1/350 as their cutoff for trisomy 18 and 96.52% (361/374)used cutoffs between 2.0~2.5 MOM for ONTD.Results of monthly median MOM:the percentage of laboratories that all six monthly median MOM within the target of 0.90~1.10 was 46.69% (155/332)for AFP,20.0% (4/20)for hCG, 29.17% (28/96)forβ-HCG,15.66% (31/198)for freeβ-HCG and 4.82% (11/228)for uE3.The percentage of laborato-ries that all six monthly median MOM within the target of 0.95~1.05 was 14.16% (47/332)for AFP,0% (0/20)for hCG,4.17% (4/96)forβ-HCG,12.63% (25/198)for freeβ-HCG and 4.82% (11/228)for uE3.About screening positive rate,there were difference of trisomy 2 1 positive rate in the same laboratory within the six month.Conclusion There were variations types of screening protocol,different kinds of soft platform,randomness of choice or update of medians or other important parameters and great difference in awareness of quality control.It would be taken effective and practical quality control measures to help laboratories improve quality control.

Objective To develop a rapid molecular biological method for detection of the asymptomatic infection of Leish?mania. Methods Two pairs of primers named RV1?RV2 and K13A?K13B were selected to be the fast diagnosis primers since they were designed according to the conserved region of Leishmania kinetoplast DNA(kDNA)minicircles. The PCR amplifica?tion products of Leishmania donovani promastigote from Shandong Province were sequenced to compare their conservatism. The method was applied to detect 105 venous blood samples from healthy home canine and 7 venous blood samples from home canine suffered from Kala?azar in Heishui County of Sichuan Province,and 75 venous blood samples from susceptible population(no leishmaniasis symptoms)and 7 venous blood samples from patients in Xinjiang Kashi area in order to verify the feasibility and accuracy of the method. Results The size of PCR products was consistent with the expected fragments with high conservative among Leishmania species. The positive rates of 105 home canine samples and 75 susceptible population samples were 37.14%(39/105)and 82.67%(62/75)rspectively,and the positive rates of home canine suffered from Kala?azar and patients were all 100%(7/7). Conclusion This rapid diagnosis method is suitable for detection of asymptomatic infection of Leishmania in Kala?azar endemic areas of China with high sensitive and specific,thus it has bright perspective to be used.