Objective To study Keshan disease and its developmental trend in Zhangjiakou City in 2010 and to provide a scientific basis for further prevention of the disease.Methods From the eight diseased counties of Zhangjiakou City,five diseased countries were selected; in each diseased county a diseased village was selected as the clinical investigating point.Physical examination and Electrocardiography (ECG) tracings were carried out to suspicious patients with Keshan disease.Suspected heart enlargement,and ECG abnormalities were taken anteroposterior chest X-ray to measure the cardiothoracic ratio.Results A total of 2519 people were examined,16 cases were diagnosed as chronic Keshan disease,79 as latent Keshan disease,and the detection rate was 0.64％ (16/2519) and 3.14％(79/2519),respectively.Total of 2519 ECG tracings were taken,and electrocardiogram abnormalities were 268 cases,with a abnormal rate 10.64％,and most of them were complete right bundle branch block[accounted for 17.16％ (46/268)].Totally 94 cases of anteroposterior chest X-ray films were taken and 42 cases were cardiac enlargement,with a detection rate 44.68％.The numbers of mild,moderate and severe cases were 20,12 and 10,respectively,and the constituent ratio was 47.62％ (20/42),28.57％ (12/42),23.81％ (10/42),respectively.Conclusions The incidence of Keshan disease in Zhangjiakou City is relatively low,and the condition is stable.But monitoring and comprehensive prevention and control measure still should be strengthened.

Objective To investigate the distribution of water-borne fluoride and the current status of water defluoridation project by improving drinking water quality in endemic fluorosis areas in Shandong province,and to provide scientific basis for making strategies in prevention and control of the disease. Methods According to "the National Technical Scheme for Endemic Disease Control in 2004, 2005 and 2006", 113 endemic fluorosis diseased counties(cities, and districts) of the province's 17 cities were screened in order to investigate the fluoride level in drinking water in fluorosis villages, recheck the fluoride level after implementing the water defluoridation project, and investigate the current status of the water defluoridation project. The fluoride level in drinking water was determined by F-ion selective electrode. Results There were a total of 5816 water defluoridation projects in the province. Most of them were carried out by drilling a deep well to get under-ground water. The wells still in good condition were accounted for 72.80% (4234/5816). Intermittent operated wells were accounted for 3.11% (181/5816). Abandoned wells were accounted for 24.09%(1401/5816). Level of water fluoride was determined in 6940samples from fluorosis villages(villages that not carry out the water defluoridation project as well as villages carried out the water defluoridation project with abandoned wells were included) and the value that lower or equal to 1.00mg/L was determined in 2987 villages which accounted for 43.04% (2987/6940). Level of water fluoride that over 1.00 mg/L was found in 3953 villages which accounted for 56.96% (3593/6940), and the highest level of water fluoride was 11.33 mg/L. Level of water fluoride were determined in 4415 samples from water defluoridation project and the value lower or equal to 1.00 mg/L was in 2983 wells which accounted for 65.53%(2983/4415). The value over 1.00 mg/L was in 1522 wells which accounted for 34.47%(1522/4415), the highest value of water fluoride was 9.71 mg/L. Conclusions Level of water fluoride in up to 1/2 of the villages and 1/3 of the projects, is still higher than the standard in Shandong province. Nearly 1/4 of the project has been abandoned. The current situation for endemic fluorosis control is still not good in the province, countermeasures for endemic fluorosis must be carried out as soon as possible and surveillance of water defluoridation project must be strengthened.

Objective To establish a network laboratory for blood cell analysis and better calibrate haematology analyzers in local lab.Methods According to GB/T 15481《General requirements for the competence testing and calibration laboratories》(idt ISO/IEC 17025),we established a network laboratory providing traceability for blood cell analysis.Complete blood count was traced to Calibration Laboratory in NCCL;The secondary standard haematology analyzer with the same model and calibrator with same lot number were used for verification for a long period.Fresh blood from healthy people was used to calibrate haematology analyzers.Results Gradually we have improved our laboratory quality management system, precision as well as accuracy,which was satisfactory.The unified blood sample was adopted to calibrate different equipments in our hospital and showed consistence when compared with calibration analyzer.The correlation coefficient of all tests is more than 0.99.The relative deviation of WBC,RBC,HCT,HGB and PLT are within?7%,?3.5%,?4%,?3% and?15%,respectively.Conclusions Secondary standard systems provides good comparable results with calibration laboratory.Its tracing mode and quality control scheme could ensure the traceability and accuracy of completed blood count.Furthermore,using elective fresh blood from healthy people,the comparable results from different analyzers were achievable.

Objective:To investigate the relationship between the distance from the upper and lower resection margin and the gastric cancer patients with R0 resection and no distant metastasis.Methods:Retrospective analysis of 281 patients with gastric cancer in our hospital,the relationship between the age,sex,tumor size,tumor size,vascular invasion,lymph node metastasis,TNM stage,type of gastric cancer,tumor location and operation mode was analyzed.To compare the survival time of patients with different upper and lower margins.Results:The increase of the distance from upper resection margin was significantly related to the tumor size＞5 cm,TNM stage,type of gastric cancer,tumor location,and the difference was statistically significant(P＜0.05);The distance of lower resection margin was significantly correlated with tumor size＞5cm,vascular invasion,lymph node metastasis and TNM stage,type of gastric cancer,and the difference was statistically significant (P＜0.05);Themedian survival timein patientsof upper resection marginr□3cm with 48 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin＞3cmwith 46 months (P＜0.001).Themedian survival timein patientsof lower resection margin□3cm with 45 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin＞3cm with 44 months (P＜0.001).Conclusion:Gastric cancer postoperative upper and lower resection margin was significantly related with tumor size,TNM staging factors,and the median survival time of upper and lower resection margin＞5 cm was significantly lower than that of the resection margin3 cm.

Objective To conduct the 7th investigation by Chinese Society of Radiation Oncology,Chinese Medical Association,and to further investigate the current situation of radiotherapy in mainland China,reasonably allocate personnel and equipment resources,and promote the development of radiotherapy in China.Methods From October 8,2015 to December 2015,the office for investigation of radiotherapy information was established,the list and contact information of radiotherapy units were provided by each province,and a special data submission system was used for a complete,rapid,and efficient investigation through the Internet.Results As of January 20,2016,there were 1 413 radiotherapy units in the mainland China with 52,496 employees in total,among which there were 15 839 radiotherapy physicians (4824 with senior professional titles),8 452 technical therapists (260 with senior professional titles),3 292 physicists (562 with senior professional titles),and 938 maintenance engineers (120 with senior professional titles).In the aspect of radiotherapy equipment,there were 1930 linear accelerators,96 Co-60 teletherapy units,173 X-knife units,212 γ-knife units,382 Ir-192 brachytherapy units,436 Co-60 brachytherapy units,1 051 X-ray simulators,1 353 CT simulators,642 MRI simulators,978 sets of multileaf collimators,1922 sets of treatment planning systems,and 974 sets of radiotherapy network systems.As for quality control devices,there were 1 792 dosimeters,2 143 ionization chambers,935 two-dimensional array dosimeters,540 threedimensional dosimetric verification systems,596 three-dimensional water tanks,844 anthropomorphic phantoms,and 1 168 water equivalent phantoms.In the aspect of therapeutic situation,there were 102,170 beds (including beds in departments of oncology in general hospitals),76612 episodes per day,and 919339 episodes per year.Conclusions The results of this investigation show significant increases in radiotherapy units,personnel,and equipment in recent years in mainland China.The distribution of radiotherapy units and equipment and the structure of radiotherapy personnel are becoming more reasonable,but there are still some problems.In some regions,current radiotherapy equipment cannot meet the medical needs,and there is a lack of professional technical personnel.

Objective To report the clinical effect of free transplanting for soft tissue defects pedieled with high site cutaneous branches of the transverse branch of lateral cirumflex femoral artery.Methods Cu- taneous branches of the descending branch of lateral circumflex femoral artery were found small or abscent in 7 patients.The anterolateral femoral skin flap was pedicled with high site cutaneous branches of the transverse branch to repair the soft tissue defects of the arm,hand,leg and foot,rather than with the descending ones. The size of the flap ranged from 15 cm?6 cm to 28 cm?13 cm,with part muscle valve,iliotibal tract and lat- eral femoral cutaneous nerve.The fractures were performed with internal or external fixation.Results All of the anterolateral femoral skin flap survived well postoperatively in the 7 cases and had good appearance and sensation at one stage.The function of the repaired extremities recovered well.Conclusion The anterolat- eral femoral skin flap pedicled with high site cutaneous branches of the transuvrse branch of lateral circumflex femoral artery has many advantages of good blood supply and large size.The flap was secluding,and can be taken with some muscle and lateral femoral cutaneous nerve.When cutaneous branches of the descending branch of lateral circumflex femoral artery is small or abscent,the anterolateral femoral skin flap with high site cutaneous branches of the transverse branch of lateral circumflex femoral artery is an optimal alternative.

Objective To investigate the prevailing status of endemic fluorosis in the south area of Shandong province and to provide a scientific basis for formulating control measures against the disease.Methods According to the present distribution of fluorosis areas in the south area of Shandong province and the Shandong Province Technical Scheme for Endemic Disease Control,13 counties(districts) in the south area of Shandong province were selected as the survey counties in 2009.Based on the state of endemic fluorosis,the disease was classified into light,moderate and severe types in the 13 monitoring counties (districts),and one diseased village was selected from each type as the survey spots.The drinking water fluoride level,the prevalence of dental fluorosis of children aged 8-12,adult clinical skeletal fluorosis and urinary fluoride level of the children and adults were surveyed in the 39 villages selected.The content of fluoride in drinking water and urine was dctermined by F-ion selective electrode while dental fluorosis of the children aged 8-12 was diagnosed by Dean method and adults skeletal fluorosis by the national standard for Diagnosis of Endemic Skeletal Fluorosis (WS 192-2008).Results A total of 172 water samples were tested in the 39 villages(26 villages with improved water and 13 villages with unimproved water) of the 13 counties(districts),the fluoride content of the 74 water samples(51 from 13 villages with unimproved water and 23 from 6 villages with improved water) exceeded the national standard(＞ 1.0 mg/L),and the rate of exceeded the standard was 43.02％(74/172) with 24 of ＞ 2.0-4.0 mg/L and 3 of ＞ 4.0 mg/L,and the maximum value of the water fluoride was 7.76 mg/L.A total of 1118 copies of children urine samples were tested,geometric mean of urinary fluoride was 1.82 mg/L; 764 copies of adults' urine samples were tested,geometric mean of urinary fluoride was 1.98 mg/L.A total of 1908 children aged 8-12 were examined of dental fluorosis,the detection rate was 45.18％ (862/1908),tooth defection rate was 9.12％ (174/1908),and dental fluorosis index was 1.07.A total of 25 295 adults were checked of clinical skeletal fluorosis,the detection rate was 5.96％(1509/25 296) with 670 moderate or scrious cases.Conclusions In the south area of Shandong province,excessive water fluoride is still serious,mainly in the diseased villages with unimproved water(including water improvement villages discarded water improvement thereafter).Urine fluoride remains at a relatively high level,and the dental and skeletal fluorosis are still comparatively serious.High tluoride hazard still exists to a certain degree.Therefore,the scientific control measures need to be strengthened to control the prevalent of endemic fluorosis.

Objective To understand the current situation of endemic fluorosis in Shandong Province,and to provide a scientific basis for development of control strategies.Methods In accordance with the requirements of the national Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis (Trial) and Shandong Provincial Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis (Trial),and to understand the progress of the province's water-improvement projects,10 counties were chosen in the province,and 10 water-improvement projects were selected in each county.Running condition of the water-improvement projects was investigated,and water fluoride content was tested.Three epidemic villages were chosen as fixed monitoring villages in each county.In each village,fluoride content in drinking water was determined,and dental fluorosis of all children aged 8 to 12 was diagnosed.Water fluoride content was determined by fluoride ion selective electrode method,and dental fluorosis of children aged 8 to 12 was diagnosed by Dean method.Results ① There were 3570 water defluoridation projects in the province,and water-improvement rate was 87.49％ (10 122/11 569).Normal operating projects accounted for 89.10％ (3181/3570),and the passing rate of water fluoride content was 73.14％ (2611/3570),with the maximum water fluoride as 9.71 mg/L.② In the 10 counties,a total of 86 waterimprovement projects were monitored.Normal operation,intermittent operation and scrapped projects accounted for 95.35％ (82/86),3.49％ (3/86) and 1.16％ (1/86),respectively,and passing rate of fluoride content in water was 50.00％ (43/86),and the maximum water fluoride was 5.32 mg/L.③ In the 27 monitored villages with improved water quality,the passing rate of fluoride content in water was 74.07％ (20/27),and the maximum water fluoride was 4.50mg/L.In the 3 monitored villages without improved water quality,villages of mean water fluoride ≤ 1.20 mg/L and ＞ 1.20 mg/L accounted for 33.33％ (1/3) and 66.67％ (2/3),respectively,and the maximum water fluoride was 1.53 mg/L.④ In the 27 monitored villages with improved water quality,the detection rate of dental fluorosis among children aged 8 to 12 was 57.65％(791/1372),and the detection rate of defect type dental fluorosis was 7.80％(107/1372); the index of dental fluorosis was 1.15.In the 3 monitored villages without improved water quality,the detection rate of dental fluorosis among children aged 8 to 12 was 50.97％ (80/155),and the detection rate of defect type dental fluorosis was 7.10％(11/155); the index of dental fluorosis was 1.16.Conclusions In Shandong Province,the running condition of water improvement project to reduce fluoride still needs to be further improved,and the water fluoride is seriously overweight and endemic fluorosis has not been effectively controlled.Preventive measures should be strengthened.

ObjectiveTo investigate the water fluoride level of the water improvement project and the prevalent condition of endemic fluorosis in 4 counties in Shandong province,and to provide a scientific basis for the development of control strategies to endemic fluorosis.MethodsAccording to “Shandong Province Survey Scheme of Endemic Fluorosis”,the service conditions of normal operated water improvement project and water fluoride content were investigated in Gaomi,Jiaxiang,Yuncheng and Boxing counties from May to November in 2010.The fluoride content in drinking water,the prevalence of dental fluorosis and urinary fluoride in children were investigated in nine major survey villages of the four counties.Water and urinary fluoride were determined by ion selective electrode and examination of dental fluorosis was done by using Dean method.ResultsA total of 288normal operated water improvement projects were examined in the 4 counties,the qualified rate of water fluoride (≤ 1.00 mg/L) of the projects was 51.39％(148/288),mean water fluoride was 1.35 mg/L and the maximum value was 6.27 mg/L.A total of 26 copies of drinking water samples were measured,the fluoride content ranged from 0.62mg/L to 4.36 mg/L,and mean water fluoride was 2.02 mg/L.A total of 685 children aged 8 to 12 were examined in the major investigated villages,the detection rate of dental fluorosis was 80.14％ (549/685),detectable rate of the defective dental fluorosis was 15.33％ (105/685),and dental fluorosis index was 1.56.Three hundred and seventynine copies of child urine samples were tested,the geometric mean of urinary fluoride were 0.66 - 13.28 mg/L,and the average was 3.04 mg/L.ConclusionsNearly 50％ of the water fluoride level of the water improvement project exceeds the standard ( ＞ 1.00 mg/L) in the 4 countries.The detection rate of dental fluorosis exceeds 80％ and urinary fluoride is significantly exceeds the standard in the major investigated villages.The endemic fluorosis is still serious and the situation of prevention and control of the disease is still grim.

Objective To investigate the current prevailing status of endemic fluorosis in the Yellow River basin of Shandong Province and to provide the scientific evidence for making strategies in prevention and control.Methods Nine counties were chosen to carry out the epidemiological investigation.The content of fluoride in drinking water was determined by F-ion selective electrode and dental fluorosis of children aged 8～12 years old was diagnosed by Deans method.Results Water fluoride content was determined in 1761 fluorosis villages,among which 606 villages had water fluoride content≤1.00 mg/L,accounting for 34.41%(606/1761);1155 villages had water fluoride content＞1.00 mg/L,which accounted for 65.59%(1155/1761).The highest water fluoride content was 11.33 mg/L.Water fluoride content of 618 water-improving and defluoridation projects had been determined,among which 449 projects had water fluoride content≤1.00 mg/L and accounted for 72.65%(449/618),169 projects had water fluoride content＞1.00 mg/L and accounted for 27.35%(169/618),the highest water fluoride content was 5.85 mg/L.The total rate of dental fluorosis of children aged 8～12 years old was 45.03%(25 579/56 804) and the index of dental fluorosis was 0.80. Conclusions In the Yellow River basin in Shandong Province,up to 50.00%in the villages the water fluoride content exceeds the county standard(≤1.00 mg/L).The prevalence of endemic fluorosis in the basin hasn't been effectively controlled.So the counterrneasures for endemic fluorosis should be carried out as soon as possible.