Accidents, Occupational ; Acute Disease ; Adult ; Ethylene Oxide ; poisoning ; Female ; Humans ; Male ; Middle Aged ; Operating Rooms ; Young Adult

At present,there is not a clear guideline for residual solvents in the new drugs in our country. In practice,the ICH Q3C is our important reference in general,but in practical research and evaluation of new drugs,some adjustment should be made on principles of ICH Q3C,making it suitable for the reality of the pharmaceutical industry in our country. In this article, we put forward some suggestions to improve the quality control of residual solvents in our country,and some initial ideas were provided to solve the question in practice.

Objective To investigate the mechanism of insulin resistance (IR) with coronary heart disease (CHD) by the relationship study between IR and the risk factors of CHD as well as the severity of coronary lesions. Methods One hundred and twenty three patients with at least one vessel ≥50% luminal narrowing were analyzed from our consecutive angiographic data base, excluding patients concomitant with hepatic, renal, pancreatic diseases, thyroid disorders and diabetes mellitus (DM) with insulin therapy. Oral glucose tolerance test (OGTT), blood lipid, plasma insulin were performed in all patients. Insulin resistance was assessed by homeostasis model assessment (HOMA) to investigate the relationship study between insulin resistance and the risk factors of CHD,severity of coronary lesions as well as the clustering of risk factors (hypertension, overweight, impaired glucose tolerance/DM, high serum triglycerides, low high density lipoprotein cholesterol). Results The level of IR was correlated with the levels of body mass index (BMI), fasting glucose, postprandial glucose, fasting insulin, postprandial insulin, hypertension, serum triglycerides, and high density lipoprotein cholesterol. Meanwhile the level of IR was associated with clustering of risk factors and the extent and the severity of coronary lesions. Conclusion Insulin resistance may be the basis for disease. In the primary and secondary prevention of CHD, we should not only treat syndromes but also reduce the level of IR.

Objective To study the feasibility,safety,and efficacy of hysteroscopic treatment of submucous leiomyomas and endometrial polyps.Methods Hysteroscopic resections were performed in 38 cases of submucous leiomyomas and 40 cases of endometrial polyps from January 2002 to July 2004,including 31 cases of transcervical resection of myoma(TCRM),7 cases of TCRM combined with transcervical resection of the endometrium(TCRE), 35 cases of transcervical resection of polyp(TCRP),and 5 cases of TCRP combined with TCRE.Results The operation was completed smoothly on one session in all the 78 cases.The intraoperative blood loss was ≥ 400 ml in 2 cases.There were 1 case of overhydration.No uterine perforation or infection occurred after operation.The patients were followed at 1,3,6,and 12 months after operation,respectively,and the surgical outcomes were assessed at 12 postoperative months.Follow-up findings revealed 8 cases of amenorrhea(10.3%),12 cases of irregular spotting(15.4%),33 cases of hypomenorrhea(42.3%),22 cases of normal menstrual flow(28.2%),and 3 cases of no improvement(3.8%).Conclusions Hysteroscopic resections for submucous leiomyomas and endometrial polyps offer advantages of good reliability and fewer complications,being worthy of recommendation.

Objective To determine the relationship between subclinical hypothyroidism and asymptomatic myocardial ischemia in type 2 diabetes mellitus.Methods All of 399 asymptomatic subjects who underwent coronary CT angiography with type 2 diabetes mellitus but without thyroid disease were enrolled retrospectively.Totally patients were divided into subclinical hypothyroidism group (17 patients,type 2 diabetes mellitus with subclinical hypothyroidism) and euthyroid group(382 patients,type 2 diabetes mellitus with normal thyroid function).Results The incidence of subclinical hypothyroidism in type 2 diabetes mellitus was 4.3％(17/399).The ratio of male and smoking in subclinical hypothyroidism group was significantly lower than that in euthyroid group (3/17 vs.194/382,P =0.007;2/17 vs.136/382,P =0.043).The incidence of asymptomatic myocardial ischemia in subclinical hypothyroidism group was 5 cases and in euthyroid group was 130 cases,and there was no significant difference(P=0.694).The age,course of type 2 diabetes mellitus,level of glycosylated hemoglobin and low density lipoprotein cholesterol between two groups had no significant difference(P＞ 0.05).Conclusion Subclinical hypothyroidism is not an independent risk factor for asymptomatic myocardial ischemia in type 2 diabetes mellitus.

Objective To study the influence of early intensive blood pressure (BP) lowering treatment on peri-he?matomal secondary neuronal injury and prognosis after acute intracerebral hemorrhage. Methods A randomised con?trolled trial consisting of 36 consecutive patients within 6 h of intracerebral hemorrhage onset were randomly assigned to intensive BP lowering group and guideline BP lowering group. All patients underwent MR spectroscopy at 72 h and were followed up 90 days. N Acetyl Aspartate/Creatine (NAA/Cr) and lactic acid wave around peri-hematomal at 72 h, neuro?logic function at early stage, and death and/or disability at 90d were compared between these two group. Results Spec?trum lines were obtained from thirty-one patients:14 from intensive BP lowing group and 17 from guideline BP lowering group. There was no significant difference in the percentage declines of NAA/Cr at 72 h between the two groups (13.3%± 4.2% vs. 11.9%± 2.8%, P = 0.308). There was no statistical differences either in neurologic function at 7 d or in death and/or disability at 90 d (P>0.05). Conclusions Early intensive BP-lowering treatment had no role on peri-hematomal secondary neuronal injury and prognosis after acute intracerebral hemorrhage. Further high-quality and large-scale ran?domised controlled trial are necessary to verify this result.

Disease Outbreaks ; prevention & control ; Humans ; Influenza A Virus, H5N1 Subtype ; Influenza Vaccines ; Influenza, Human ; prevention & control

Objective To investigate association of pancreatic fat content and lipid levels in individuals with newly diagnosed type 2 diabetes.Methods Fifty four subjects with newly diagnosed type 2 diabetes and 22 volunteers without type 2 diabetes were enrolled in this study.Pancreatic fat content was determined with magnetic resonance imaging.Lipid levels were measured.Results The pancreatic fat content in patients with newly diagnosed type 2 diabetes and control subjects was (17.13 ± 10.35) ％ and (11.62 ±7.15)％, respectively (P =0.025).Median pancreatic fat content of subjects with newly diagnosed type 2 diabetes correlated negatively with total cholesterol level (r =-0.361, P =0.007) and triglycerides level (r =-0.346, P =0.010).Conclusions Increased levels of serum total cholesterol and low density lipoprotein cholesterol might relieve the extent of pancreatic fat content.

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.

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.