As the intake routes and hazards to human health of heavy metals were well recognized,therefore the intake amount of heavy metals through foodchain has been effectively controlled and cut down. In many cases,oral ingested soil has become an important source of heavy metals in human. The traditional approach for estimating the bioavailability of heavy metals in oral ingested soil was animal (in vivo)test. Compared with animal test,in vitro test possesses several advantages including satisfactory replicability,time and cost effectiveness. Also,the results of in vitro tests showed well correlation to those of in vitro tests. The progress of development,current status and the methodology of in vitro tests in evaluating bioavailability of heavy metals in contaminated soil via oral intake were reviewed in this article. In vitro test could be used not only to estimate the bioavailability of heavy metals in soil in order to provide information for establishment of soil quality or clean-up criteria with regard to human health,but also to evaluate the effectiveness of soil remediation technologies. The in vitro test has been employed in many developed countries due to its above mentioned advantages. The use of in vitro test for screening of contaminated soil and evaluating the effectiveness of remediation technology is believed to be promising.

Objective:To investigate the effects of sorafenib on hypoxia inducible factor-1 (HIF-1) and vascular endothelial growth factor (VEGF) levels and recurrence in patients with intrahepatic cholangiocarcinoma with microvascular invasion.Methods:Ninety-two patients with intrahepatic cholangiocarcinoma who received treatment in Yiwu Central Hospital between November 2013 and November 2019 were included in this study. They were randomly assigned to undergo either conventional basic treatment (control group, n = 46) or conventional basic treatment and sorafenib treatment (study group, n = 46). Clinical efficacy, the incidence of adverse reactions and recurrence rate were compared between the two groups. Before and after treatment, HIF-1, alpha fetoprotein (AFP) and VEGF levels were also compared between the two groups. Results:After treatment, total effective rate in the study group was significantly higher than that in the control group [63.04% (29 /46) vs. 28.26% (13/46), χ2 = 11.215, P < 0.05]. After treatment, HIF-1, AFP and VEGF levels in each group were significantly lower than those before treatment (all P > 0.05). After treatment, HIF-1 [(165.23 ± 39.67) pg/mL], AFP [(109.16 ± 67.31) ng/mL] and VEGF [(297.28 ± 42.41) pg/mL] levels in the study group were significantly lower than those in the control group [(205.56 ± 40.23) pg/mL, (235.17 ± 106.41) ng/mL, (365.16 ± 40.91) pg/mL, t = 4.841, 6.788, 7.813, all P < 0.05]. There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Six-month follow-up revealed that the incidence of recurrence in the study group was significantly lower than that in the control group ( χ2 = 4.792, P < 0.05). Conclusion:Sorafenib can reduce the HIF-1, AFP and VEGF levels in patients with intrahepatic cholangiocarcinoma with microvascular invasion, improve the clinical efficacy, decrease the incidence of recurrence, but cannot increase the incidence of adverse reactions.

Objective To develop and identify the monoclonal antibodies (McAbs) against Region II~+ motif in circumsporozoite protein of Plasmodium falciparum. Methods BALB/c mice were immunized with 12 peptides within Region Ⅱ~+ in circumsporozoite protein of P. falciparum. Spleen cells isolated from the immunized mice were fused with myeloma cell. After three times screening with ELISA, 3 positive hybridoma cell lines were obtained. Results ELISA test indicated that the McAbs reacted with recombinant circumsporozoite protein fragment containing tandemly repeat region and conserved Region II~+. IFA test showed that the McAbs recognized not only the sporozoites of P. falciparum, but also the sporozoifes of P. yoelii. Conclusion McAbs obtained can probe the Region II~+ motif in circumsporozoite protein of P. falciparum, which might also recognize that of other Plasmodium species.

Objective:To understand the pathogen bacteria detection and drug sensitivity results in the children with staphylococ -cal scalded skin syndrome to provide data for the clinical treatment .Methods: Totally 374 children with staphylococcal scalded skin syndrome treated from January 2010 to June 2015 were selected .The children's wound secretion and blood samples were collected , and bacterial culture and drug sensitivity test were carried out .Results:Totally 223 pathogenic bacteria were detected out in the wound se-cretion samples;17 cases of blood culture were positive with the positive rate of 4.55%;187 strains of staphylococcus aureus were de-tected out;64 strains of MRSA were found out with the MRSA detection rate of 34.22% (64/187).The sensitivities of MSSA and MRSA to common antibacterial drugs were different .The susceptibility rates of MSSA and MRSA to vancomycin , teicoplanin , teicopla-nin and linezolid were all 100.00%.The sensitivity rates of MRSA to penicillin , oxacillin, piperacillin, piperacillin, cefoperazone so-dium, cefazolin, cefuroxime, cefoxitin, azithromycin and clindamycin were all zero .Conclusion: The pathogenic examination of staphylococcal scalded skin syndrome is very important , and antibiotics should be used reasonably according to the results of drug sensi-tivity.

BACKGROUND:In recent years, animal models of lumbar disc degeneration have been popularized to explore the effect of tissue engineering, cel engineering and genetic engineering technologies on intervertebral disc degeneration.
OBJECTIVE: To investigate the influence of biological patches on rabbit anulus fibrosus repair.
METHODS:L3-4, L4-5, L5-6 segments from rabbits were randomly divided into normal control group (the intervertebral disc was exposed correspondingly), control group (the annulus fibrosus was only cut with a surgical scalpel) and experimental group (the annulus fibrosus was cut and sutured with the surgical biomaterial). Six rabbits were selected randomly to take the lumbar X-ray and MRI preoperatively and 1, 2, 4, 8, 12 weeks postoperatively; one rabbit was chosen preoperatively and three rabbits selected respectively at 1, 2, 4, 8, 12 weeks postoperatively to execute hematoxylin-eosin and type II colagen immunohistochemistry.
RESULTS AND CONCLUSION:At postoperative 1, 2 and 4 weeks, the disc height index decreased significantly in the control and experimental groups. MRI and histopathological examination showed that the T2WI signal intensity and hematoxylin-eosin grading were both increased significantly in the control and experimental groups at 2 weeks after surgery (P < 0.05). With time, the number of nucleus pulposus cels gradualy reduced in the control and experimental groups. Annulus fibrosus defects were filed with granulation and fibrous tissues, and the biofilm was tightly fused with the annulus fibrosus. Findings from the type II colagen immunohistochemical staining showed that the histological staining of the nucleus pulposus was gradualy changed from positive to negative in the experimental and control groups. Therefore, cutting the annulus fibrosus can lead to severe disc degeneration at early period, and surgical biomaterials can be integrated with the annulus fibrosus wel to seal annulus fibrosus defects and further prevent nucleus pulposus protrusion. However, this approach cannot restrain the continuous process of disc degeneration.

Objective To understand the available preventive strategies of unplanned endotracheal extubation (UEX) among adult patients.Methods Twelve nurses were in-depth interviewed and data were processed and analyzed using categorization analysis method.Results Major themes were identified as follows:the incidence rate of UEX,tube fixation,efficacious physical restraint,appropriate sedation and training for younger nurses.Conclusions Nursing leaders should further standardize nursing process related to prevention of UEX,strengthen training for nurses,choose appropriate fixation method for patients and promote physical restraint and sedation care to prevent UEX and improve patient clinical outcomes.

Objective To investigate the risk factors for coronary artery lesions (CALs) in children with Kawasaki disease (KD) in Lanzhou. Methods One hundred and seventy-four children with diagnosed KD were divided into CAL group and non-CAL group based on the existence of concurrent CALs. The age, gender, fever duration, intravenous immunoglobulin (IVIG) start time, IVIG dose, C-reactive protein (CRP), serum albumin, erythrocyte sedimentation rate (ESR), platelet (PLT), red blood cell count (RBC), hemoglobin and so on were compared. Results Among the 174 children, 46 children (26.44%) were complicated by CALs and 128 children were not. The differences of average fever duration, IVIG starting time, IVIG dose, PLT, CRP, ESR and RBC were statistically signiifcant (P<0.05). Conclusions When KD children has the fever durations>10 d, start of IVIG af-ter 10 days of fever, increase of PLT, CRP and ESR and decrease of RBC, clinicians should be alert to the risk of concurrent CAL.

Objective To investigate the effect of dexmedetomidine on minimum alveolar concentration (MAC) of isoflurane required to inhibit the body movement during skin incision. Methods Forty-eight ASA Ⅰ or Ⅱ patients aged 40-60 yr with body mass index of 22-27 kg/m2 undergoing elective upper abdominal surgery under general anesthesia were randomly divided into 3 groups: control group (group C, n = 15);low dose dexmedetomidine group (group D1, n = 17) and high dose dexmedetomidine group (group D2, n = 16). The patients were unpremedicated. Dexmedetomidine 0.4 and 0.8 μg/kg in normal saline (NS) 15 ml was infused over 15 min before induction of anesthesia in D1 and D2 groups respectively. Anesthesia was induced with fentanyl-propofol-succinylcholine. The patients were mechanically ventilated after tracheal intubation. Anesthesia was maintained with isoflurane. MAC of isoflurane was determined by up-and-down technique. The initial end-tidal isofiurane concentration was set at 1.0%, 0.8% and 0.6% in C, D1 and D2 groups respectively. Each time the end-tidal isoflurane concentration was increased/decreased by 0.2%. Skin incision was made after 15 min of equilibration, when the twitch height returned to more than 90% of its control value. Movement of body and limbs including swallowing and coughing were carefully looked for when skin incision was made. MAC of isoflurane was the mean of end-tidal concentration of isoflurane of each crossover pair, and 95 % CI was calculated. Results MAC of isoflurane was significantly decreased in D1 and D2 groups as compared with group C and in group D2 as compared with group D1( P ＜ 0.05 or 0.01 ). Conclusion Dexmedetomidine can significantly decrease MAC of isoflurane required to inhibit the body movement during skin incision in a dose-dependent manner.

Objective To compare three dimensional arterial spin labeling(3D-ASL) and dynamic susceptibility contrast-perfusion weighted imaging(DSC-PWI) in evaluating the cerebral hemodynamic of Moyamoya disease. Methods Approved by the institutional review board, 26 cases of Moyamoya patients who were diagnosed by DSA were enrolled. Diffusion weighted image, 3D-TOF-MRA, 3D-ASL, DSC-WPI, and T1WI were performed in 3.0 T MR scanner. ROI were positioned in the abnormal perfusion areas and the control area according to the arterial dominant territory to obtain quantitative parameters of perfusion. Perfusion parameters including cerebral blood flow(CBF) of ASL, cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), and time to peak(TTP)of DSC-PWI , and relative parameters (ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, DSC-rTTP) that the ratio of abnormal perfusion area and the control area were calculated. Meanwhile, the areas of the lower perfusion region of ASL and TTP images in the same slice were measured. Difference of the above-mentioned parameters and areas was processed by paired Student′ t test. Furthermore, correlation of relative values of perfusion parameters(ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, and DSC-rTTP) was processed by Pearson correlation test. Results There were significant statistics differences between values of ASL-CBF, DSC-MTT, and DSC-TTP in abnormal perfusion [(28.18 ± 10.19)ml · 100 g-1 · min-1,(7.98 ± 2.22)s,(29.93 ± 3.95)s] and the control areas [(49.50 ± 11.37)ml · 100 g-1 · min-1,(6.07 ± 1.11)s,(27.34 ± 2.58)s] (t=-12.818, 4.193, 6.163, all P<0.01). There was no significant statistics difference in the lower perfusion area between ASL-CBF [(5 729.63 ± 4 563.79) mm2]and DSC-TTP[(5 875.33 ± 4 723.08)mm2](t=-1.774,P>0.05). Furthermore, the Pearson correlation test showed significant linear dependence between ASL-rCBF(0.56±0.14)and DSC-rMTT(1.34± 0.42), and DSC-rTTP(1.09 ± 0.69)(r=-0.630,-0.748, P<0.01). Conclusions There is a correlation between 3D-ASL and DSC-PWI in assessing the magnitude and areas of the reduction of blood perfusion of Moyamoya patients. Moreover, the ASL technique possesses advantages of non-invasion use of the gadolinium contrast.