ObjectiveTo evaluate prognostic factors and the surgical results of pulmonary carcinoid tumors.Methods We retrospectively reviewed the medical records of 62 patients who were diagnosed as pulmonary carcinoid tumors between January 2000 and October 2010 at Department of Thoracic Surgery,Shanghai Chest Hospital.The following information was available for each of the 62 patients:age,sex,pathological type,and TNM stage.ResultsThere were no operative death.The 3-year and 5-year survival rates after surgery were 92.1％ and 77.8％,respectively.Of the 62 patients,42 were diagnosed as typical carcinoid tumor,and among them,4 patients (8.3％) had lymph node metastases.Their 3-year and 5-year survival rates were 97.8％ and 94.7％,respectively.The remaining 20 patients were diagnosed as atypical carcinoid tumor,and among them,6 patients (37.5％) had lymph node metastases.Their 3-year and 5-year survival rates were 84.4％ and 58.8％,which were statistically significant compared with typical carcinoid tumor( P =0.0047 ).There was significant difference in survival rate between the patients with lymph node metastases and the patients without lymph node metastases (P =0.0048).CondusionThe main risk factors affecting survival rate of those patients who were diagnosed as pulmonary carcinoid tumors were pathological types and lymph node metastases.

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.

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.

The immune effect of CD4~+CD28~-T cells on Graves'ophthalmopathy(GO)was investigated.The expressions of interferon-γ(IFN-γ),interleukin-2(IL-2),and IL-4 in CD4~+ CD28~-T ceils were assayed by flow cytometry in GO patients,Graves'disease(GD)patients without ophthalmopathy,and healthy control subjects.The results showed that the percentage of CD4~+CD28~-T cells significantly increased in GO patients(P<0.05),with increased IFN-γ expression(P<0.05)and decreased IL-2 expression(P<0.05).These changes were closely correlated with clinical activity score(P<0.05).There were no significant differences in IL-4 expression among three groups.The resuh suggests that CIM~+ CD28~- T cells which hishly secrete IFN-γare related to the pathological lesion of GO.

BACKGROUND: It is necessary to establish a high throughput screening system for anti -inflammatory drugs for rheumatoid arthritis.OBJECTIVE: To construct an eukaryotic expression vector p4CCL20-ZsGreen1-DR with the NF-kB cis-acting element 4×CCL20motif as an enhancer, SV40 as a promoter, and ZsGreen1-DR as a reporter gene.METHODS: The target fragment SV40 was PCR amplified using PGL2-control plasmid as a template. KpnⅠ/Bam HⅠ restriction sites were introduced into the flank of the target fragment. Then, pSV40-ZsGreen1-DR vector was constructed by cloning the target fragment into pZsGreen1-DR plasmid. Finally, p4CCL20-ZsGreen1-DR plasmid was constructed by cloning the double strand DNA of 4×CCL20 motif (with BglⅡ and EcoRⅠ sticky ends at the 5’ and 3’ terminus, respectively) into the corresponding restriction sites of pSV40-ZsGreen1-DR vector (upstream of SV40 promoter).RESULTS AND CONCLUSION: DNA sequencing demonstrated successful construction of p4CCL20-ZsGreen1-DR plasmid.The construction of p4CCL20-ZsGreeR plasmid might be useful to establish a high throughput screening system for anti -inflammatory drugs.

Objective To investigate the value of emergency bedside focused assessment with sonography for trauma (FAST) in combination with regional organ focused ultrasonography in patients with closed abdominal trauma.Methods Two hundred and thirty-seven patients with closed abdominal trauma underwent bedside ultrasonography in the Emergency Department at General Hospital of Chengdu Military Command.In patients with unstable hemodynamics or severe craniocerebral injury,ultrasonography was ended immediately after FAST screening.In patients with stable vital signs,the focused regional organ injury after FAST screening was determined based on the mechanism of trauma,action location and direction of external force,abdominal symptoms,and signs.The results of operation and CT scanning were considered as golden criteria and used to compare with those of ultrasonography.Results (1) The diagnostic sensitivity of FAST to abdominal organ rupture and ascites due to abdominal organ rupture calling for emergency operation was 79.3％ and 100％,respectively.The total specificity of FAST was 98.2％,positive predictive value 93.9％,and negative predictive value 86.7％.(2) The diagnostic accordance rate of single visceral injury examined by regional organ focused ultrasonography was 91.2％ and that of multiple visceral injury was 63.6％.The missed diagnoses were predominantly contusion and microlaceration.Conclusions FAST can quickly screen out the patients with unstable hemodynamics due to abdominal organ rupture calling for emergency management.Regional organ focused ultrasonography can increase the rate of correct diagnosis of visceral injury and decrease the rate of missed diagnosis.

Objective To compare the value of abdominal aorta occlusion and internal iliac artery ligation in preventing massive bleeding during surgical treatment of complex acetabular fractures.Methods The study enrolled 67 cases of complicated acetabular fractures,of which 35 had control of hemorrhage via abdominal aorta blockage and 32 via internal iliac artery ligation.Intraoperative bleeding and postoperative drainage volumes were compared of the two operations.Results Of the two operations to control hemorrhage,abdominal aorta occlusion was significantly different from internal iliac artery ligation with regard to amount of blood loss [(648.00 ± 170.20) ml vs (231.18 ± 21.90) ml,t =1.693,P ＜ 0.05],but there was no significant difference between abdominal aorta occlusion and internal iliac artery ligation in postoperative drainage volume [(1 631.50 ± 675.50) ml vs (236.00 ±23.80) ml].Conclusion During surgical treatment of complex acetabular fractures,abdominal aorta occlusion is superior to internal iliac artery ligation in preventing bleeding and can be safe and effective for the fact that the bilateral common iliac arteries are occluded completely for a clear operation field.

Objective To investigate the current status of endemic fluorosis in Shandong province, and to provide scientific evidence for the development of control strategies. Methods According to "The National Technical Scheme for Endemic Disease Control in 2007", 19 counties were chosen to carry out the epidemiological investigation in 2008. Water and urinary fluoride were determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 were diagnosed by Dean method and skeletal fluorosis of adults over the age of 16 were examined clinically and by X-rays. Results In 19 counties, 186 villages were surveyed, 44 villages were found with mean water fluoride ≤ 1.00 mg/L, accounting for 23.66%(44/186);the value ＞ 1.00 mg/L in 142 villages,accounting for 76.34% (142/186);maximum water fluoride 8.88 mg/L. Total detection rate of dental fluorosis of children aged 8 to 12 was 66.35% (4518/6809), dental fluorosis index was 1.55, and defect rate was 15.39%(1048/6809). Children with urinary fluoride ＞ 1.40 mg/L was 83.29%(2149/2580), and the maximum value was 31.92 mg/L. Detection rates of skeletal fluorosis clinically and by X ray among adults over 16 years were 6.37%(5577/87 607) and 20.23% (229/1132), respectively. Conclusions Endemic fluorosis in Shandong province is still serious, prevention efforts need to be further increased.

Objective To investigate the current status of endemic fluorosis in Shandong province,and to provide a scientific basis for the development of preventive strategies.Methods In accordance with the requirements of the national Technical Implementation Plan for Endcmic Disease Control Project in 2009 and Drinking-Water-Borne Endemic Fluorosis Monitoring Program (trial),ten counties were selected to carry out the epidemiological investigation,to understand the progress and the effect of the water improvement projects; three villages were selected in each county,to determine fluoride content of drinking water,to check dental fluorosis of children aged 8 to 12 and skeletal fluorosis of adults over the age of 25.Water fluoride content was determined by fluoride ion selective electrode method,children dental fluorosis was diagnosed with Dean method and adults skeletal fluorosis by the National Standard for Diagnosis of Endemic Skeletal Fluorosis (WS 192-2008).Results There were a total of 687 improved-water defluoridation projects of the 10 counties,the improved-water rate was 83.34％ (3247/3896).The investigation was taken place in 84 improved-water projects of the 10 counties,the projects running normally accounted for 98.81％ (83/84); 41 projects had water fluoride concentration ≤1.20 mg/L,and the pass rate was 48.81％(41/84),with the maximum water fluoride as 5.76 mg/L.In the 26 villages with improved-water projects of the 10 counties,villages with a mean water fluoride ≤ 1.20 mg/L were 15,which accounted for 57.69％ (15/26),＞ 1.20 mg/L were 11,which accounted for 42.31％ (11/26),with the maximum water fluoride as 5.58 mg/L.In the 4 yet to improve water quality villages of the 10 counties,1 village had mean water fluoride ≤ 1.20 mg/L,3 villages had mean water fluoride ＞ 1.20 mg/L,with the maximum water fluoride as 2.92 mg/L.A total of 1331 children aged 8 to 12 were checked in the 26 improved water villages,the detection rate of dental fluorosis was 59.73％ (795/1331),the index of dental fluorosis was 1.17 and the defect rate was 10.14％ (123/1331).A total of 138 children aged 8 to 12 were checked in the 4 yet to improve water quality villages,the detection rate of dental fluorosis was 51.45％(71/138),the index of dental fluorosis was 0.95 and the defect rate was 0.72％ (1/138).In water quality improved villages and yet to improve water quality villages,X-ray detection rates of skeletal fluorosis were 8.80％ (113/1284) and 3.05％ (6/197),respectively,in adults over the age of 25.Conclusions The water fluoride content of improved-water defluoridation projects exceeds the national standard seriously and fluorosis has not been effectively controlled in Shandong province.

AIMTo develop a rapid and feasible method based on micellar electrokinetic capillary chromatography (MECC) for the simultaneous determination of antiepileptic drugs (AEDs)--phenytoin (PHT), phenobarbital (PB), carbamazepine (CBZ), primidone (PRM) and clonazepam (CZP) in human plasma.

METHODSSeveral factors that impact the separation of AEDs with MECC were investigated, such as concentration of sodium dodecyl sulfate (SDS), buffer compositions, pH, organic modifier, internal diameter and temperature, and an optimized MECC running condition was obtained the running buffer consisted of 8 mmol x L(-1) phosphate, 3 mmol x L(-1) sodium tetraborate, and 50 mmol x L(-1) sodium dodecylsulfate (SDS) (pH 8.0), containing acetonitrile (ACN) (18%) as organic modifier. Detection at 210 nm, run at 25 kV at 30 degrees C in a untreated fused silica capillary (50/45.5 cm length, 50 microm ID).

RESULTSThe reproducibility of both migration time and relative peak area with MECC analysis were appropriate for the intra- and inter-assay coefficients. The evaluated drugs concentration intervals of PRM 1.0-40.0 microg x mL(-1), PB 1.0-60.0 microg x mL(-1), PHT 1.0-40.0 microg x mL(-1), CBZ 1.0-40.0 microg x mL(-1), CZP 0.2-8.0 microg x mL(-1) were linear with correlation coefficients higher than 0.999 1, and coefficients of the variation of the points of the calibration curve lower than 10%. The recoveries of AEDs varied from 80.0% to 100.0%, depending on the drug, with coefficients of the variation lower than 10.0%.

CONCLUSIONThe MECC technique is showed to be rapid, simple, efficient and low cost when applied to monitoring therapeutic drugs in patient treated with a combination of PHT and other AEDs such as hepatic enzyme-inducing agents.

Anticonvulsants ; blood ; Buffers ; Carbamazepine ; blood ; Chromatography, Micellar Electrokinetic Capillary ; methods ; Clonazepam ; blood ; Epilepsy ; blood ; Humans ; Hydrogen-Ion Concentration ; Phenobarbital ; blood ; Phenytoin ; blood ; Primidone ; blood ; Sensitivity and Specificity ; Sodium Dodecyl Sulfate