A gas chromatography-triple quadrupole mass spectrometry coupled with solid phase microextraction method ( SPME-GC/QQQ) was developed for the determination of chlorinated anilines ( CAs) residues in soil. The multi-reaction monitoring ( MRM ) parameters were optimized. The SPME conditions such as amount of soil sample, volume of added water, extraction temperature and absorption time were investigated. Optimum SPME conditions including 8 g of soil sample, 4 mL of water, 80℃ of extraction temperature and 40 min of absorption time were employed in the experiment. Method detection limits were within the range of 1-10 pg/g, while linearities were within the range of 5-1000 pg/g. Under the optimized conditions, the soil samples spiked with 200 pg/g targets were determined with recoveries of 96. 8%-144. 2%and relative standard deviations of 13 . 4%-27 . 8% ( n=5 ) . The proposed method combines simplicity and rapidity of SPME and high selectivity of MRM. It is especially suitable for the quick screening and determination of trace amounts of chlorinated anilines residues in soil.

Objective To investigate the level and proportional relationship of free fluorine and soluble fluoride in different brands of toothpaste,and analyze possible risk factors.Methods A total of 54 samples of commercially available toothpastes of domestic,joint venture and imported in Guiyang City were collected,and the levels of free fluoride and soluble fluorine were determined,respectively,using fluorideion selective electrode.method (GB 8372-2008).Results The number of the toothpaste was 32,12,10,respectively,in domestic,joint venture and imported.The levels of free fluorine ranged from 0.98 to 1 603.50 mg/kg,3.22 to 617.50 mg/kg and 306.80 to 1 590.80 mg/kg,respectively,in toothpastes of domestic,joint venture and imported; the number of exceeding the standard free fluorine was 3,0 and 1,respectively,in toothpastes of domestic,joint venture and imported; the rate of exceeding the standard free fluorine was 9.4％,0.0％ and 10.0％,respectively,in toothpastes of domestic,joint venture and imported.The levels of soluble fluorine ranged from 3.06 to 4 302.50 mg/kg,9.02 to 1 667.30 mg/kg and 9.18 to 4 013.20 mg/kg,respectively,in toothpastes of domestic,joint venture and imported; the number of exceeding the standard soluble fluorine was 9,2 and 3,respectively,in toothpastes of domestic,joint venture and imported; the rate of exceeding the standard soluble fluorine was 34.4％,16.7％ and 30.0％,respectively,in toothpastes of domestic,joint venture and imported.The proportion of free fluorine and soluble fluoride was:domestic 1.0 ∶ 2.7,joint venture 1.0 ∶ 2.7,imported 1.0 ∶ 2.5,respectively.The confidence limit (R/d) was 0.98.Conclusion The fluoride level in different brands of toothpaste has exceeded the standard,the content and proportion of soluble fluoride are obviously higher than those of free fluoride,and there is a risk on tooth damage from fluoride,and factories should strengthen quality control in adding fluoride.

Objective:To correlate serum levels of neuron specific enolase (NSE) and inflammatory factors with recovery of neurological function in patients with severe traumatic brain injury.Methods:Ninety-six patients with severe traumatic brain injury who received treatment from January 2018 to January 2020 in Taizhou Hospital were included in this study. These patients were divided into a mild-to-moderate group ( n = 51) and a severe group ( n = 45). Additional 60 healthy controls who concurrently received health examination were included in the healthy control group. Serum NSE level was detected by enzyme-linked immunosorbent assay, serum C-reactive protein (CRP) level by immunoturbidimetry, serum procalcitonin (PCT) level by chemiluminescent assay, and serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels by enzyme-linked immunosorbent assay. All patients were followed up for 3 months. Recovery of neurological function was evaluated by modified Rankin Scale. Results:Serum NSE level was (50.42 ± 13.25) μg/L and (36.79 ± 10.28) μg/L in the severe and mild-to-moderate groups, respectively, which was significantly higher than that in the healthy control group [(6.13 ± 1.78) μg/L, t = 25.641, 22.688, both P < 0.05). Serum NSE level in the severe group was significantly higher than that in the mild-to- moderate group ( t = 5.576, P < 0.05). Serum CRP, PCT, IL-6 and TNF-α levels were (78.95 ± 15.46) mg/L, (3.46 ± 0.75) μg/L, (432.15 ± 78.29) μg/L and (36.57 ± 8.98) μg/L] respectively in the severe group, (34.65 ± 7.48) mg/L, (1.68 ± 0.51) μg/L, (285.41 ± 36.75) μg/L and (17.54 ± 5.26) μg/L] respectively in the mild-to-moderate group and (3.25 ± 0.86) mg/L, (0.08 ± 0.02) μg/L, (73.52 ± 13.89) μg/L and (1.64 ± 0.50) μg/L, respectively in the healthy control group. Serum CRP, PCT, IL-6 and TNF-α levels in the severe and mild-to-moderate groups were significantly higher than those in the healthy control group ( t = 37.890, 34.922, 34.870, 30.099, 32.284, 24.315, 40.980, 23.312, all P < 0.05). Serum levels of these indicators in the severe group were significantly higher than those in the mild-to-moderate group ( t = 17.493, 13.414, 11.500, 12.451, all P < 0.05). In the severe group, neurological function recovered well in 34 patients and poorly in 17 patients. Serum NSE level in patients with poor neurological function recovery was significantly higher than that in patients with good recovery [(68.93 ± 14.25) μg/L vs. (34.61 ± 12.36) μg/L, t = 8.457, P < 0.05). Serum CRP [(113.24 ± 27.39) mg/L], PCT [(4.57 ± 0.87) μg/L], IL-6 [(598.90 ± 43.52) μg/L] and TNF-α [(58.78 ± 12.13) μg/L] levels in patients with poor recovery were significantly higher than those in patients with good recovery [(32.19 ± 6.90) mg/L, (2.23 ± 0.65) μg/L, (261.39 ± 26.56) μg/L and (14.53 ± 4.26) μg/L, t = 11.956, 9.788, 29.280 and 14.537, all P < 0.05). Serum NSE, CRP, PCT, IL-6 and TNF-α were positively correlated with poor prognosis ( r = 0.849, 0.743, 0.795, 0.683, 0.701, all P < 0.05). Conclusion:In patients with severe traumatic brain injury, serum NSE, CRP, PCT, IL-6 and TNF-α levels increase, which are positively correlated with poor prognosis.

Objective To estimate the clinical effect of fuzhenghuayu capsule in treatment of early hepatocirrhosis by liver instantaneous elastic imaging. Methods Eighty patients with early hepatocirrhosis were divided into experiment group and control group according to the treatment method with 40 cases each. All the patients in 2 groups were given the same antiviral treatment with entecavir dispersible tablets, and the patients in experiment group combined with fuzhenghuayu capsule. All treatment lasted for 6 months. The liver stiffness measurement (LSM) was measured before treatment and 1, 3 and 6 months after treatment by liver instantaneous elasticity imaging. The serum hyaluronic acid was measured, and the Child-Pugh score was evaluated at the same time. Results The LSM, hyaluronic acid and Child-Pugh scores 6 months after treatment in experiment group were significantly lower than those in control group:(19.3 ± 0.9) kPa vs. (29.6 ± 1.3) kPa, (215.6 ± 59.3)μg/L vs. (344.4 ± 39.6)μg/L and (2.1 ± 1.3) scores vs. (3.9 ± 0.9) scores, and there were statistical differences (P<0.05). No obvious adverse reactions related to the use of fuzhenghuayu capsule were found during the course of treatment. Conclusions Liver instantaneous elasticity imaging can be used to evaluate and monitor early hepatocirrhosis. Fuzhenghuayu capsule on patients with early hepatocirrhosis has a certain degree of curative effect.

OBJECTIVE: To analyze the influencing factors of drinking behavior of manufacturing workers and their impact on their quality of life. METHODS: A total of 594 manufacturing workers were selected as research subjects using stratified cluster sampling method. Their drinking behavior, physical activity status and quality of life were investigated by the Drinking Behavior Questionnaire, International Physical Activity Questionnaire-Short Form and Short Form 36 Health Survey Questionnaire, respectively. RESULTS: The overall drinking rate of the subjects was 32.2%(191/594). Multivariate logistic regression analysis results showed that male workers had higher risk of drinking behavior than female workers(P<0.01). The risk of drinking behavior of smoking workers was higher than that of non-smokers(P<0.01). The risk of drinking behavior of workers with medium or high physical activity levels was higher than that of workers with low activity levels(P<0.01). The results of multiple linear regression analysis showed that after adjusting for the effects of gender, age, marital status, education level, monthly income, household registration, length of service, work shift, weekly work hours, industry type, smoking, physical activity level and other confounding factors, drinking did not affect the physical or psychological quality of life of workers(P>0.05). CONCLUSION: Gender, smoking and physical activity may be important factors influencing the drinking behavior of manufacturing workers. Drinking may have no effect on quality of life of manufacturing workers.

Objective To study clinical application of Bard automated disposable instrument for percutaneous transtheracic biopsy guided by CT in diagnosis of pulmonary lesions. Methods Percutaneons transthoracic biopsy was performed with CT-guided Bard automated disposable instrument for 95 patients with pulmonary lesions but without established diagnosis by clinical and imaging procedures in order to obtain pathological diagnosis. Results Tissue specimens were obtained from all the 95 patients by Bard automated disposable instrument for percutaneous transthoracis biopsy, with a hundred percent of success. After the procedure, 68 of 95 were pathologically diagnosed as lung cancer (including adenocarcinoma in 44,squamous carcinoma in 19, alveolar cell carcinoma in three and small cell carcinoma in two), 10 as chronic inflammatory lesions, eight as tuberculosis, two as inflammatory pseudotumor, one as metastatic cancer, two as fungal infection, and four without an established diagnosis, with an overall diagnosis rate of 95.8%.Pneumothorax occurred in eight and mild haemoptysis in six of 95 patients, respectively, by the procedure.Conclusion Percutaneons transthoracic biopsy with Bard automated disposable instrument is an effective diagnostic procedure for patients with pulmonary lesions but their diagnoses were not established by routine examinations.

Objective To explore the method and clinical efficacy of microsurgical reconstructive surgery af-ter malignant tumors radical resection on the surface. Methods From June, 2015 to March, 2017, a total of 32 pa-tients in this group underwent radical resection of malignant tumors. All of them resulted in a large area of soft tissue defect with loss of function.The average defect area was 10.0 cm×12.0 cm.All types of free flap and pedicle flap were selected. Myocutaneous flaps or local flaps were used to repair large areas of soft tissue defect on the basis of micro-surgical techniques to protect the blood supply of the flaps and to reduce the damage to the donor area by evaluating the defect size, surrounding anatomical characteristics, and other factors. Results Thirty-two flaps survived com-pletely. After 4 to 18 months of followed-up, the color of flap was close to that of the surrounding skin. The texture was good. There was no bloated swelling, and the skin protective sensation was restored. There was no obvious scar hyperplasia, no chills, no pain and no other complications in the donor site. Conclusion After the radical mastec-tomy of the body surface, different types of flaps can be selected for the first-stage microsurgery according to the characteristics of the different parts and the tumor excision wounds to obtain a good clinical efficacy.

Objective:To explore the clinical value of magnetic resonance (MRI) multi-b-value scatter weighted imaging (DWI) combined with spectral imaging (MRS) in the diagnosis of prostate cancer.Methods:From November 2016 to August 2018, 33 patients with prostate cancer and 62 patients with benign prostatic lesions in the People's Hospital of Yongjia County were selected.DWI and MRS scans were performed and compared with pathological findings.Results:The DWI signal intensity of prostate cancer at the b value of 600s/mm 2, 1 000s/mm 2, 2 000s/mm 2 and 3 000s/mm 2 were significantly higher than those of benign prostatic lesions (all P<0.05). With the increase of b value, the sensitivity, specificity and accuracy of DWI in diagnosis of prostate cancer increased, under 3 000s/mm 2, the sensitivity, specificity and accuracy of DWI in the diagnosis of prostate cancer were 87.88%(29/33), 82.26% (51/62) and 84.21%(80/95), respectively.The sensitivity, specificity and accuracy of MRS in diagnosing prostate cancer were 69.70%(23/33), 79.03%(49/62) and 75.79%(72/95), respectively.The (choline+ creatine)/(citrate) (CC/C) value of prostate cancer (2.50±0.94) was significantly higher than that of benign prostatic lesions (0.93±0.23)( t=12.519, P<0.05). The sensitivity, specificity and accuracy of DWI at b value of 3 000s/mm 2 combined with MRS in the diagnosis of prostate cancer were 96.97%(32/33), 88.71%(55/62) and 91.58%(87/95), respectively. Conclusion:DWI combined with MRS has good application value in the diagnosis of prostate cancer.

To investigate the clinical efficacy of one-stage repairing the wounds after excision of soft tissue malignant tumor in lower limb with deep inferior epigastric perforator (DIEP) flaps. Methods From Au-gust, 2016 to July, 2018, 11 patients(8 males and 3 females; aged 35-76 years) with the soft tissue defects in the low-er limb underwent immediate reconstructive operations with DIEP flap after their tumor resection. The defects ranged in area from 11 cm×7 cm to 25 cm×10 cm after extended resection, including 5 cases of bone exposure. The DIEP flap area ranged from 11 cm×8 cm to 26 cm×18 cm.Among them, 9 cases were treated with free transplantation and 2 cases with pedicle transplantation.The donor sites were closed directly. The patients’ limb function, tumor recurrence and the healing of surgical incision had been followed-up. Results Eleven flaps survived and the donor sites healed directly. One flap had skin pigmentation due to postoperative vascular crisis, and the other flaps had satisfied texture and appearance. All patients were followed-up from 6 to 30 months. The lower limb movement was normal. All the donor sites had a good healing with no pain and abdominal complications. No tumor recurrence was observed during the followed-up period. Conclusion DIEP flap have many advantages, such as large cutting area, which is suitable for large-area wound repair after extended excision of soft tissue malignant tumor in lower limb. At the same time, the perforator vessel is constant and the caliber are thick, also the donor area is concealed and can be sutured directly.This kind of the technique for reconstruction of lower limb soft tissue defects after malignant tumor resection is well acceptable.

【Objective】 To evaluate the value of Six Sigma quality management method in improving the efficacy of red blood cell transfusion. 【Methods】 The five steps of definition, measurement, analysis, improvement and control in Six Sigma quality management were used to analyze the existing process capability and influencing factors, so as to formulate corresponding optimized measures and control plans for continuous improvement. The transfusion effect of RBCs in hemodynamically stable patients in our hospital from January to November in 2019 were assessed in three phases: January to March(prior to the application of Six Sigma), April to August (tracking the application of Six Sigma), and September to November(determining the effect of Six Sigma). The efficacy and process ability of RBC transfusion in patients with stable hemodynamics before and after the improvement were analyzed and compared. 【Results】 After the improvement, the effective rate of RBC transfusion for hemodynamically stable patients in our hospital increased from 76.9% to 90.5%(P<0.05). The Z value of process capacity increased from 0.408 0 to 1.330 8, with a significant improvement. 【Conclusion】 Application of Six Sigma quality management method can effectively improve the effect of red blood cell transfusion in patients with stable hemodynamics.