Arsenic is a toxic metalloid, which may enter the human body through a variety of routes, including drinking water, food, and air. Previous studies have shown that arsenic exposure during pregnancy may cause pregnancy complications and adverse pregnancy outcomes, and maternal arsenic levels correlate with neonatal neurodevelopment and adult health. However, the negative impact of arsenic exposure during pregnancy on maternal and child health has not been widely accepted because of inconsistent study conclusions and unclear mechanisms. Based on international and national studies pertaining to the effect of arsenic exposure during pregnancy on maternal and child health during the period between 2007 and 2022, this review describes the influencing factors and biomarkers of arsenic exposure during pregnancy, associations of arsenic exposure during pregnancy with pregnancy complications and adverse pregnancy outcomes and impact of arsenic exposure during pregnancy on neonatal neurodevelopment, and discusses the mechanisms underlying negative health effects caused by arsenic exposure during pregnancy, so as to provide the evidence for assessing the hazards of arsenic exposure during pregnancy and formulating the control strategy.

Objective To compare the effects of three artificial abortion methods, Mifepriston with Misopro-fil,Rivanol with Mifepristone and Rivanol,in mid-term pregnancy. Methods 235 women who were pregnant for 12 to 28 weeks and volunteered to abort with drugs were selected and observed. The total subjects were randomly divided into three groups,study group Ⅰ (n=80),study group Ⅱ (n=78),and control group (n=77). In study group Ⅰ, each was given Mifepristone 50 mg, po, bid, for 3 days. On the fourth day, Misoprofil 200-1000 μg was administered though vagina. In study group Ⅱ, Rivanol(70-100 mg) was injected into amniotic cavity and at the same tame, Mife-pfistone,75 mg was given bid,po,for each case for 1 day. In study group Ⅲ,each case was injected with Rivanol (70-100 nag) only into amniotic cavity. Results The complete abortion rate in study group Ⅰ, Ⅱ and Ⅲ was 88.75% (71/80), 65.38% (51/78), 38.96% (30/77) respectively. The success rate was 98.75% (79/80), 71.79% (56/78),76.62% (59/77) respectively. The mean time from the initial uterine contraction to the expulsion of the fetus and placenta was (6.85±3.68) h, (8.87±3.58) h, (14.67±3.50) h respectively. The volume of in-trapartum and postpartum vaginal hemorrhage within 2 hours was (80.86±40.28) ml, (94.70±42.35) ml, (120. 68±43.30)ml respectively. The complete abortion rate and success rate in study group Ⅰ was significantly greater than that in study group Ⅱ and study group Ⅲ. In addition, the birth process was shorter and the vaginal hemorrhage was less significantly in study group Ⅰ than those in the other two groups (P<0.01). The complete abortion rate in study group Ⅱ was significantly greater than that in study group Ⅲ (P<0.01). Conclusions Mffepristone admin-istered with Misoprpfil has many advantages usages, such as high complete abortion rate and success rate, short birth process, and less volume of vaginal hemorrhage, when used for artificial abortion in mid-term pregnancy. They are es-pecially suitable for the mid-term artificial abortion under 20-week pregnancy. Rivanol administered with Mifepristone can raise complete abortion rate,shorten labor process and decrease vaginal hemorrhage when they are used in artifi-cial abortion. They are suitable for the mid-term artificial abortion above 16-week pregnancy. The stage of labor lasts long when using only Rivanol for artificial abortion. The pain is relatively heavier and the rate of incomplete abortion is higher.

Remarkable achievements have been made for lymphocyte infusion of lymphoma and leukemia, especially of lymphoproliferative disease within twenty-first century. The donor lymphocyte infusion or mobilized donor lymphocyte infusion (DLI/DSI) offer an opportunity of second remission for relapse patients post-transplantation. Cytokine-induced killer/DC cytokine-induced killer play an anti-tumor activity beyond non-MHC restricted. Cytotoxic lymphocyte infusion activated by synthetic tumor antigen produces targeted effects of anti-tumor. Transgenic CTL of anti-tumor TCR has brought the dawn in lymphoma and leukemia patients with defective lymphocytes. Maternal lymphocyte infusion play an anti-tumor/viral activity by avoiding the immune barrier of HLA mismatch.

Objective:To investigate and analyze the current status of patient satisfaction and the influencing factors at private hospitals in Guizhou Province,and thus to provide a scientific basis for the management of medical service at private hospitals.Methods:The satisfaction scores were statistically described and analyzed by the factor analysis and multiple linear regression analysis.Results:The overall satisfaction score of patients was (3.87 ± 0.85),of which the satisfaction of medical technology,drug price,inspection fee,and medical facilities was lower.The factor analysis showed that satisfaction of patients at private hospitals could be classified into the environment,the quality of service,medical expense,and service flow.Multivariate linear regression results showed that its standardized partial regression coefficient by the parameter descending order followed as medical expense,the environment,the quality of service,and then service flow.Conclusions:Private hospitals should set up a fair medical expenditure mechanism,improve the environment and quality of medical services,and optimize service flow in order to improve patient satisfaction.

Dermatitis, Contact ; diagnosis ; etiology ; therapy ; Dermatitis, Irritant ; diagnosis ; etiology ; therapy ; Humans

Objective To investigate the application of a self-made positioning device in CT-MRI image fusion in patients with laryngeal tumor,as well as the precision of image fusion and the changes in target volume delineation after fusion.Methods A total of 10 patients with laryngeal cancer were enrolled,and a self-made positioning device was used to collect CT and MRI images in a fixed position.These images were fused by mutual information combined with manual fusion.The precision of image fusion was assessed by the positional deviation of internal and external markers and degree of gross tumor volume (GTV) overlap (PCT-MRI) between CT and MRI images.GTV was contoured based on CT images (VCr),MRI images (VMRI),and fused images (VCT+MRI).The overlapped volume of VCT and VMRI(VCT-MRI) Was calculated,and the target volume was analyzed and compared.Results The positional deviations of three external markers in the three directions were 0.996±0.222 mm,1.146±0.291 mm,and 1.368±0.298 mm (P=0.000),respectively,while those of the internal markers were 0.476±0.151 mm,0.561±0.083 mm,and 0.724± 0.125 mm (P=0.000),respectively.VCT,VMRI,VCT+MRI,and VCT-MRI were 26.355±7.876 cm3,33.556± 7.407 cm3,40.036±7.627 cm3,19.875±8.588 cm3(P=0.000),respectively.PCT-MRI was 73.7％±9.8％.Conclusions The self-made positioning device can improve the consistency of position during the collection of CT and MRI images,and fused CT-MRI images can provide more information and improve the precision of target volume delineation.

Objective To discuss the research status and hotspots related to breeding, planting, harvest, processing and storage of Lycium L. in China. Methods Relevant literature about breeding, planting, harvest, processing and storage of Lycium L. in CNKI from January 2004 to December 2013 was retrieved by computers. CiteSpaceⅡ was introduced to carry out key word analysis, high-frequency key word obtaining, co-occurrence network of high-frequency key words, and dendrogram of high-frequency words. Results Totally 759 articles were included. Key words about breeding were “genetic diversity”, “male sterile”, “its sequence”, “callus issue”, and“anther culture”. Key words about planting were“output”,“quality”,“hard twig cuttage”,“irrigation amount”. Key words about harvesting and processing were“picking machine of Lycium L.”,“drying kiln of Lycium L.”,“hot air drying”, and “combined drying”. Key words about storage were “pesticide residue”, “heavy metal”, and“organophosphorus pesticide”. Co-occurrence network of high-frequency key words showed that the research hotspots were pesticide residue, test of heavy metal and the storage of fresh fruits. Dendrogram of high-frequency key words showed that the high-frequency key words were “package”, “refreshment”, and “lycium barbarum polysaccharide”. Conclusion The research hotspots of planting of Lycium L. are planting skills effecting the output and quality of Lycium L.; In the field of harvesting and processing of Lycium L., design and research of picking machine has replaced traditional manual picking. Modern hot air drying has already replaced traditional drying in the sun or drying skills; In the aspect of storage of Lycium L., the study on the refreshment of Lycium L. has attached attention.

Objective To test the accuracy of a three-dimensional dose verification system CompassR,which reconstructing dose distribution based on measurements and independent dose calculation,and to evaluate the feasibility of its application in clinical intensity-modulated radiotherapy (IMRT) quality assure.Methods A set of square-wave chart patterns of 2 cm,1 cm and 0.5 cm gaps was designed and 11 completed IMRT lung plans were selected for the test.EDR2 film and the ionization chamber were used for test and verifying of plane dose distribution and some special points dose of CompassR.The IMRT phantom plans were verified by CompassR with three-dimension based on anatomical information.Parameters including the volume γ pass rate and the average dose deviation were tested using dose volume histograms.Results In square-wave chart patterns test,the dose distribution reconstructed and calculated by CompassR coincided with the measurement using film.The γ pass rates (3％/3 mm,2％/2 mm) exceeded 90％.When the width of field is 0.5 cm,the γ pass rate was a little lower on account of the penumbra zone.Compared to the dose distribution profile which was measured by film,the maximum deviations of the dose distribution profile which was reconstructed and calculated by CompassR were 3.21％ and 2.70％.The absolute dose deviation of specific point in the IMRT plans was less than 3％,the maximum deviation occurred in the lung.Compared to film,the averageγpass rates on the isocenter plain in IMRT plan were (94.65 + 1.93)％ (3％/3 mm) which was reconstructed by CompassR.In three-dimensional dose verification,the volume γ pass rates of targets and risk organs were not less than 90％,and the deviation of average dose was less than 1％.Conclusions Accuracy of the tested system satisfies the demand of IMRT dose verification.CompassR could provide information of volumetric dosimetry and anatomical location of dose error,which is benefit for evaluating the clinical value of verification result.

Objective To study the clinical application of Compass (R) system,a novel 3D quality assurance system for the verification of esophageal carcinoma intensity-modulated radiotherapy (IMRT) plan.Methods 12 esophageal carcinoma IMRT plans were optimized with Eclipse 8.6 treatment planning system (TPS),and then Compass (R) reconstructed 3D dose distributions with the patient anatomy.Comparison was performed among the reconstructed and calculated with TPS,Dose-volume parameters (γ pass rate、average dose deviation) to the planning target volume (PTV) and critical structures were quantitative valuated.Furthermore two-dimensional dose verification were performed use MatriXX,γ pass rate were evaluated with 3％/3 mm criteria.Results The γ pass rate of actual gantry angle was found generally declined seemingly compared with 0 degree gantry angle in two dimensional verification,difference was statistically significant (P =0.018-0.001).In 3D dose verification,the γvolume of PTV were exceed 93％,the deviation of D95,D50,D2 were less than 3％;The γvolume of lungs and heart were exceed 95％,the average dose deviation were less than 3％;The γ pass rate of spinal cord and trachea were exceed 98％.The independent check verified more conformed with the TPS calculated.Dose deviations appeared in the radiation field edge area.Conclusions 3D dose verification can provide more information to comprehensively evaluate the plan which is benefit for evaluating the clinical value of verification.

ObjectiveTo investigate whether early goal-directed therapy (EGDT) could improve the mortality rate in patients with severe sepsis or septic shock.Methods Articles were retrieved from PubMed, Cochrane Library, Embase data, Wanfang data, and CNKI from January 1980 to May 2015. Inclusion criteria included the subjects concerning patients with severe sepsis or septic shock reported as randomized controlled trial (RCT), clinical controlled trial (CCT), case-control studies, cohort studies with complete data, which endpoints were the short-term mortality [in-hospital, intensive care unit (ICU) or 28-day] and long-term mortality (60-day, 90-day or 1 year). RevMan 5.2 software was used for Meta analysis of effect of EGDT on mortality rate in patients with severe sepsis or septic shock, and funnel plot was drawn to evaluate the quality of enrolled literature.Results There were 12 studies meeting inclusive criteria including 5 528 patients, 4 RCTs, 3 case-control studies, 4 cohort studies, and 1 quasi-experimental research. It was shown by Meta analysis that EGDT was associated with significant decrease in the short-term mortality [relative risk (RR) = 0.72, 95% confidence interval (95%CI) = 0.64-0.80,P< 0.000 01], but not associated with decrease of long-term mortality (RR = 0.99, 95%CI = 0.92-1.06,P = 0.81). The funnel plot showed that there was no publication bias. EGDT was recommended as grade C.Conclusions EGDT was associated with significant improvement in short-term mortality but not with long-term mortality in patients with severe sepsis or septic shock. Grade C was recommended by our study.