Objective To establish a new method for assessing the effects of environmental factors on human health.Methods Based on the environment part of the frame for comparative risk assessment(CRA) of WHO,the frame and index system for environmental contamination risk assessment which accorded with the situation in China was developed.With the prevalence of different exposure level,RR and the choice of counterfactual scenario,the potential impact fraction(PIF) was estimated.Then an example on the study of liver cancer related with water pollution was used to show the new frame.In this example,the contaminated water was regarded as the environmental factor,incidence of liver cancer was regarded as variable of health,and the analysis was performed with spatial interpolation,counterfactual analysis and CRA theory.Results The quantity of COD of river water in this area was estimated with ordinary Kriging interpolation,and the accumulated exposure of COD was calculated with the trend of annual COD,and the number of population exposed to COD was estimated at same time.In accordance with the different level of pollution and the RR relate to liver cancer,the trend with monotonically increasing showed.At same time,the values of PIF illuminated that 75.72% in male and 66.39% in female would avoid death for liver cancer if the level of contaminated water could be reduced to the level of the control areas.Conclusion The frame includes CRA,spatial analysis and counterfactual analysis is a good approach to assess the health effects of environmental factors.

Objective To investigate the value of salivagram in the diagnosis of pediatric pulmonary aspiration.Methods A total of 469 pediatric patients (age:6 weeks-16 years,average age (4.5±3.1) years;229 males,240 females) underwent salivagram.Signed informed consents were obtained.99Tcm-SC (11.1 MBq,100 μl) was dropped into the root of tongue.After the dropping,the posterior dynamic acquisition was started for 60 min,and then the anterior and posterior static images were acquired for 5 min.All patients were followed up for 3-6 months after the salivagram,and the salivagram results were analyzed.If radioactivity was shown in the main bronchus or bilateral lung fields,the pulmonary aspiration was diagnosed.Results Salivagram demonstrated positive results in 20.7％ (97/469) of the patients.However,3 patients with pulmonary aspiration showed negative results.There was no false positive result on salivagram.Conclusion Salivagram shows good results in the diagnosis of pediatric pulmonary aspiration.

Objective To explore the humanoid figure specialist nursing rounds in the heart of rotation of the role of nurse training. Methods The nurses receiving rotary nurse training from April to October 2013 were set as a control group , in which traditional nursing ward rounds were used. Those during November 2013 to May 2014, were set as experiment group, in which the human figure nursing ward rounds were used. The two groups were compared in terms of satisfaction of inpatients and effects of the nursing ward rounds. Result The level of inpatient′s satisfaction in the experiment group was significantly higher than that of the control group and the effect of nursing ward rounds was significantly better than that of the control group (all P<0.05). Conclusion The nurse′s rotation training on humanoid figure specialist nursing rounds in the cardiology department can improve the inpatients'satisfaction and the effect of nursing ward rounds.

Objective To evaluate medium-term results in critical limb ischemia (CLI) patients undergoing endovascularly revascularization based on concepts of angiosomes.Methods Clinical data were reviewed on 612 CLI patients who had isolated below-the-knee (BTK)lesions and were treated by endovascular technology from June 2006 to May 2012.Following the angiosome model of perfusion,286 patients (357 limbs)were treated by directly revascularizing the feeding artery.326 patients (455 limbs)were treated by revascularizing non-feeding artery to improve perfusion to ulcer indirectly.Primary endpoints included ulce-healing rate as of 3 months,amputation-free survival( AFS),freedom from major amputation (FFMA) and recurrence rate of CLI.Results During follow-up(mean,24 ± 18 months),ulce-healing rate during 3 months of direct treatment group was obviously higher than that of indirect group (82.4％ vs.66.4％,X2 =26.16,P ＜0.05).The fourth year AFS was 48％ ±5％ vs.37％ ±6％,t =3.44,P ＜0.05,and the fourth year FFMA was 73％ ±4％ vs.58％ ±3％,t =4.61,P ＜0.05.In recurrence rate of CLI,there wasn't significant difference between direct group and indirect group(42％ ±5％ vs.45％ ±6％,t =- 0.64,P ＞ 0.05 ).Conclusions Following the angiosome model of perfusion,direct revascularizing the feeding artery of CLI patients can obviously improve ulcer-healing rate during 3 months,medium-term AFS and FFMA.

Objective: To sequence V-region and P-region gene of surface protein of serotype c Streptococcus mutans clinical isolates with different adherent abilities. Methods: The clinical isolates of serotype c S.mutans included two groups with different spaP-pv AluI genotypes, which were derived from previous studies in our lab. The genome DNA was extracted. The spaP-pv (2 060-3 157 bp) was amplified by PCR, then sequenced and analyzed. Results: Seven sites of AluI 5′-AG↓CT- 3′were included in the sequences of spaP-pv of both genotypes strains. The sequences of spaP-pv of ten a-genotype strains were the same except several site mutations, and so were those of b-genotype strains. Two different DNA fragments were revealed between a and b geotype strains. And they were located in the V-region of spaP. Conclusion: The mutation of gene encoding V-region of S.mutans clinical isolates might be related to the differences of adherent abilities .

Objective To investigate the effect of treatment for la rg e-sized auricular nevus through split-thickness grafting over perichondrium. Methods In the six cases with large-sized and giant cong enital melanocytic nevi of the auricle, the auricular lesions were radically exc ised in stages, and each time followed by split-thickness skin grafting. The ou tcome was evaluated. Results The grafts completely surviv ed. During the time of follow-up ranging from one to two years, the grafts expe rienced no contraction, and auricular deformity did not occur. Conclu sion Treatment of large-sized auricular nevus through staged split -thickness skin grafting over perichondrium is simple and reliable.

Aim To investigate the molecular mechanism of Rosiglitazone on the expression of integrin ?1 in lung pulmonary carcinoma A549 cell line. Methods RT-PCR and flow cytometry methods were used to examine the expression of mRNA and cell total protein of PPAR? and integrin ?1 subunit. Results The expression of PPAR? mRNA and integrin ?1 mRNA had dose-dependent regulating action by Rosiglitazone,using PPAR? inhibitor GW9662 and ERK pathway inhibitor PD98059 could abolish the inhibition of PPAR? on the expression of integrin ?1. Conclusion The effect of PPAR? ligand Rosiglitazone on integrin ?1 expression is mediated through PPAR?-dependent signaling parthway. The mechanism may be partly involved in ERK pathway.

Objective To retrospectively analyse the factors related to the risk of malignant change in relation with various colorectal polyps. Methods Data on a total of 820 patients (900 polyps), who had undergone polypectomy between 1997 and 2001 were collected. The relation between colorectal cancer and polyps characteristics was assessed by Logistic Regression and Chi square. Results The risk of malignant change was significantly related with the size of polyps, histology of polyps, grade of dysplasia, pathological changes of mucosa, sessile or pedunculated polyps. Conclusion High grade dysplasia, large size, adenoma, absence of a stalk, and ulcerous mucosa were confirmed as the major predictors. The likelihood of malignant degeneration of colorectal polyps seemed to be correlated with the number of the above mentioned risk factors present

Objective To explore the value of neutrophils gelatinases related lipid a carrier protein (NGAL),renal injury molecule-1 (KIM-1) and serum creatinine (SCr) for early diagnosis in adult cardiac surgery after acute renal injury (AKI).Methods Blood and urine samples of 65 cardiac surgery patients before and 24,48,72 h after surgery were collected,SCr,urine NGAL and KIM-1 levels was detected,among whom AKI occurred in 34 cases(AKI group),did not occur in 31 cases (non AKI group),and they were compared with 20 cases of healthy physical examination (control group).Logistic regression model was used to judge the value of early diagnosis of SCr,urine NGAL and KIM-1.Results The incidence of AKI after cardiac surgery was 52.31％ (34/65).The SCr,urine NGAL and KIM-1 levels in AKI group and non AKI group before and 24,48,72 h after surgery were significantly higher than those in control group [SCr:(62.44 ±22.26),(77.38 ±24.38),(98.24 ±25.02),(98.14 ±45.26)μmol/L and (56.67 ±21.68),(59.25 ± 15.58),(55.40 ±22.91),(40.10 ±23.45)μmol/L vs.(16.43 ±5.01)μmol/L;urine NGAL:(4.81 ±0.65),(9.48 ±3.29),(11.87 ±3.93),(7.66 ± 1.52) μg/L and (4.67 ±0.53),(8.89 ± 2.64),(11.46 ± 3.60),(7.47 ± 1.63)μg/L vs.(2.87 ± 0.48) μg/L; KIM-1:(47.93 ± 5.54),(61.89 ± 12.44),(100.21 ± 27.32),(67.69 ± 8.72) μ g/L and (47.12 ± 4.08),(56.38 ± 9.27),(90.14 ± 27.26),(69.40 ±8.90) μ g/L vs.(32.21 ± 12.54)μ g/L] (P ＜ 0.01).Urine NGAL and KIM-1 levels in AKI group and non AKI group 24,48,72 h after surgery were significantly higher than those before surgery (P＜ 0.01).SCr,urine NGAL and KIM-1 levels in AKI group 24 h after surgery were significantly higher than those in non AKI group (P＜ 0.01).Twenty-four hours after surgery,the sensitivity and specificity of urine NGAL,KIM-1 in the diagnosis of AKI,compared with that of SCr had no statistical significance (P ＞ 0.05).Conclusions The adults who accept extracorporeal circulation cardiac surgery appear high incidence of AKI.Twenty-four hours after surgery,early biological markers-urine AKI,KIM-1,has similar sensitivity and specificity with traditional diagnostic gold standard of SCr.

Objective To investigate and compare the actions of vecuronium and atracurium on adult and embryonic-type nicotinic acetylcholine receptors (?-and ?-nAChR) at skeletal muscle cell membrane. Methods The adult and embryonic nAChRs were heterologously expressed in HEK 293 cells. Peak currents induced by actions of vecuronium and atracurium at ?-and ?-nAChR were recorded in HEK 293 cells, using whole cell patch clamp technique. Results Vecuronium and atracurium competitively inhibited ?-and ?-nAChR in HEK 293 cells. The inhibitor concentrations for half-maximal response (IC50) for vecuronium and atracurium ate-nAChR were (8.3 ? 2.6) ?mol/L and (24.2 ? 10.5) ?mol/L respectively; The IC50 values for vecuronium and atracurium at e-nAChR were (55.0 44 28.4) ?mol/L and (183.2 ? 39.2) ?mol/L respectively.Conclusion According to IC50 values for both adult and embryonic type nAChR, vecuronium is more potent than atracurium on e-and 7-nAChR. Embryonic nAChR is less sensitive to vecuronium and atracurium than adult-type nAChR.