Daily dietary intakes of nitrate, nitrite and vitamin C were investigated in Chanle county, Fujian province, where gastric cancer was very common, with a marked geographic variation in mortality. The average daily intake of nitrate of residents in Zhanggang village (high risk area) was 132.75 mg, which was significantly higher than that (84.65 mg) in Shouzhan village (moderate risk area), but similar to that (113.12 mg) in Meihua village (low risk area). However, nitrite intake in Zhanggang village was greatly higher than that in Shouzhan and Meihua villages (3.36 mg vs 0.21 and 0.37 mg, respectively). The average daily intake of vitamin C in Shouzhan village was 56.37 mg, significantly lower than that in Zhanggang village (123.09 mg) and in Meihua village (105.90 mg). The molar ratio of vitamin C intake to nitrite in the three villages was 3.22, 3.30 and 4.33, respectively. It was invesely associated with the mortality of gastric cancer. The results suggested that nitrate and nitrite might be etiological factors of gastric cancer in the county.

In this study,we analyzed the data of hemorrhagic fever with renal syndrome (HFRS) and host animals monitoring in Zhangzhou City,Fujian Province,China,2006-2015,in order to find out the epidemic situation and risk factors,and provide a scientific basis for the prevention and control strategy.A total of 171 HFRS cases,including 1 death,were reported in Zhangzhou in this decade.The incidence rate of 0.352/105 showed an upward trend (xtrend2 =58.60,P＜0.01).And 70 villages and towns in 11 counties have affected,accounting for 56.00％ of the counties in Zhangzhou City.The cases were mainly reported in some towns of Huaan,Nanjing and Zhaoan countries.The cases mainly occurred in countryside,which reported 142 cases.The cases in farmers accounted for the highest proportion (79.58 ％),and pig farming staff accounting for 23.01％ in farmer cases.Most cases were reported in municipal hospitals (86.55 ％).The common clinical manifestations of those cases were fever,nausea,vomiting,backache,headache,pain,oliguria or anuria,eyelid edema and so on,with 72.67％ of thrombocytopenia and of 83.09 ％ proteinuria positive.Compared with the proportion (80.49 ％) of mice in patients' house from 2006 to 2010,that (45.83％) from 2011 to 2015 decreased obviously;however,the proportion of mice or mice droppings in workplaces were rising from 60.98％ to 73.33％.Mean rodent density was 6.40％ and total infection rate in rats was 7.42％.The main kind of rats with virus infection was Rattus norvegicus,carrying Seoul virus Ⅱ.Results of this study indicate that Zhangzhou is one of the foci of HFRS rodent,and the epidemic is rising in recent years,the overall in the highly distributed,while some counties showed a rising trend year by year.Thus,monitoring and control efforts in prone areas should be increased,and to carry out clinics training of HFRS in primary health care institutions.

Objective To explore the diagnostic value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in diagnosis of different pathological types of lung cancer.Methods 45 patients were performed traditional MR and multi-b value DWI scan by GE discovery 750 MR.The values of Slow-ADC,Fast-ADC and ffast measured on a AW4.5 workstation were analyzed between the different pathological types of lung cancers.The correlations between these IVIM-DWI parameters and the serum tumor markers of lung cancer were analyzed.The diagnostic efficiency of these parameters were evaluated by receiver operator characteristic curve (ROC).Results 27 cases NSCLC(13 cases squamous carcinoma;14 cases adenocarcinoma )and 18 cases SCLC were finally included in this study.There were significant differences in Slow-ADC values between SCLC group and NSCLC group (P =0.00),the adenocarcinoma group (P=0.03),the squamous carcinoma group(P=0.01).There were no significant difference in Fast-ADC as well as ffast value between any two groups.The AUC of Slow-ADC value was 0.874.There existed negative correlation between squamous cell carcinoma antigen(SCC-Ag)of squamous carcinoma group and Slow-ADC(r=-0.730).Conclusion The Slow-ADC of IVIM-DWI parameters is useful in differential diagnosis of NSCLC and SCLC,which has the largest diagnostic efficiency.The correlation between SCC-Ag and Slow-ADC value has a certain meaning in diagnosing different pathological types of lung cancers.

Objective To investigate the current status of nurses'' needlestick injuries during venous blood sampling, evaluate effective prevention strategies.Methods A stratified cluster sampling method was used to investigate clinical nurses in China by questionnaire, contents of questionnaire included the general information of nurses, training and management on venous blood sampling among nursing staff, adherence to wearing gloves before blood sampling, the occurrence of needlestick injuries during the process of venous blood sampling in the past year and so on.Results A total of 2 861 questionnaires were distributed, and 2 575 valid questionnaires were recovered.93.17％ of the investigated nurses had participated in the training of venous blood sampling regularly;87.15％ received regular check of venous blood sampling;before venous blood sampling, only 72.74％ knew whether the patient had bloodborne infectious disease;only 61.01％ wore gloves during blood sampling.Incidence of needlestick injuries during venous blood sampling was 20.78％ in the past year.There was no significant differences in the incidence of needlestick injuries when using 3 different types of needles(Pearson x2=1.649, P=0.438).48.21％ of needlestick injuries occurred during disposing medical waste.Conclusion The training and management on nurses'' venous blood sampling is better in China, but incidence of needlestick injuries is still high.It is necessary to formulate safety operation regulations of venous blood sampling, standardize the operation procedures and specify the contents of training, so as to correct nurses'' unsafe behavior during venous blood sampling.

Objective To investigate blood plasma melatonin level in night-shift nurses and explore the relationship of blood plasma melatonin level with nervous system symptom (insomnia、anxiety、depression). Methods ELISA were used for detection of blood plasma melatonin level in 80 night-shift nurses of different age group. Results Blood plasma melatonin level of shift work nurses (36to40、41to45 yearold) were significant lower than the corresponding age group of the control group, the nervous system symptom of these age group night-shift nurses correlated to melatonin level of melatonin. Conclusions Blood plasma level of melatonin have a close relation to nervous system symptom(insomnia、anxietydepression).

Objective To analyze the satisfaction and the demands for the community healthcare of elderly patients with chronic diseases in the rural area. Methods A total of 428 elderly patients were investigated, and 64 urban elderly patients and 122 elderly patients from towns were included as the control group. Results The overall elderly patients′satisfaction in rural area was 40. 4%, which was significantly lower than that of 62. 5% in the urban area (Z= -3. 278, P<0. 05), but had no significant difference compared with 45. 1% in the town group (Z= -0. 246, P>0. 05). There were significant differences in the advancement of medical equipment, medical environment, the healthcare team′s attitude and technology level, and the healthcare education level between the rural and urban area were statistical significant (Z= -4. 743, -8. 587,-4. 945, -3. 685, -3. 624, -2. 766, -2. 399, respectively;P<0. 05). Except for disease consult, there were significant differences in the above aspects between the rural and county area ( Z= -4. 377, -7. 868,-3. 120, -2. 647, -3. 077, -3. 886, respectively;P<0. 05). For the rural area, 102 patients (23. 8%) acquired medical knowledge by newspapers and books and 11 patients (2. 6%) acquired medical knowledge by internet. Those number of patients in the urban area were 40 cases (62. 5%) and 10 cases (15. 6%). There were significant differences between the rural and urban area (χ2 =40. 545, 20. 137, respectively;P<0. 05). Those number of patients in the county area were 67 cases (54. 9%) and 18 cases (14. 8%). There were significant differences between the rural and county area(χ2 =43. 101, 28. 217, respectively;P <0. 05). Conclusions The satisfaction for the community healthcare of elderly patients in rural area is low, so it should be further improved.

Objective To investigate the microsurgical effect of spinal cord Intramedullary cavernous hemangioma.Methods The clinical data of 23 patients with spinal cord Intramedullary cavernous henangioma from January,2003 to March,2017 were analyzed retrospectively.McCormick clinical neurological function classification method and MRI examination were used to analyze the changes of neurological function and imaging changes beforeand-after operation.MRI and assess nerve function were reviewed 6-12 months after discharge.Results Twentytwo cases were totally resected,and subtotal excised in 1 case.The symptoms improved and even disappeared completely in 17 cases.There was no obvious improvement in 4 cases,2 cases were worse and no death cases.Twentyone cases were followed-up.The follow-up time was 3 months-9 years,and no tumor recurrence was found.Among the 14 cases of clinical neurological function Ⅰ-Ⅱ,10 cases recovered rapidly and most of the symptoms improved or even disappeared.Three cases had no obvious change.The other 1 case aggravated symptoms;Six cases of Ⅲ-Ⅳ patients in 7 cases of postoperative recovery,and 1 case of no change.According to preoperative neurological function grade Ⅰ-Ⅱ and Ⅲ-Ⅳ,the treatment effect of patients was compared,the difference was significant (x2=5.25,P＜0.05).Conclusion Microsurgical resection of spinal cord Intramedullary cavernous hemangioma is safe and effective.The preoperative nerve function,the relationship between the tumor and the spinal cord,and the surgical skill and the degree of resection are the important factors that affect the prognosis.

Objective To investigate the operative efficacy of pellucid septostomy in patients with septum pellucidum cysts and refractory epilepsy.Methods Nine patients with septum pellucidurn cysts and refractory epilepsy,admitted to our hospital from January 2012 to September 2017,chosen;diagnosis by MR imaging was performed in all patients and no other obvious epilepsy lesions were noted.All patients underwent bilateral endoscopic fenestration (pellucid septostomy) by right frontal approach.Follow-up was performed for 6-72 months.Results All patients took antiepileptic regularly.No overall tonic-clonic seizure was noted in 6-72 months of follow-up.Shrunk septum pellucidum cysts were noted in MR imaging.Conclusion Patients with septum pellucidum cysts and refractory epilepsy could be cured by pellucid septostomy.

Objective To evaluate the role of multiple dorsal midline plication (MDMP) procedure in correction of Donnahoo type Ⅲ chordee in postpubertal patient.Methods From September 2010 to July 2013,33 postpubertal patients with Donnahoo type Ⅲ chordee (＞ 20°) were treated with MDMP procedure.The age ranged from 18 to 37 years with an average of 29 years.Primary surgery was indicated in 18 patients including type Ⅲ chordee in 11 and type Ⅲ/Ⅳ in 7,with associated hypospadias in 12.Redo surgery was warranted in 15 patients including type Ⅲ chordee in 13 and type Ⅲ/Ⅳ in 2,with associated urethral defects necessitating repair in 12.Intraoperative artificial erection was induced to confirm the degree and length of chordee.Longitudinal plication sutures,4 dots each,were applied close to the midline in a parallel fashion on each apex of curvature,to achieve satisfactory orthoplasty with 16-dot to 64-dot plication according to the chordee status,and the urethral repair indicated was achieved simultaneously.Results Satisfactory orthoplasty was achieved with 16-dot plication in 16 patients,24-dot in 10,32-dot in 6,and 64-dot in 1 patient whose penile curvature was severe and long.Followup was obtained from 35 to 69 months with an average of 46 months.Three patients lost of followup.Urethroplasty-related complications were noted in 5 patients including urethrocutaneous fistula in 2,urethral dehiscence in 1,urethral diverticulum in 1,and urethral stricture in 1.Mild cicatrical curvature (less than 15 degree) was noted in 2 patients.No postoperative priapism,erectile dysfunction,and paraesthesia was noted,nor chordee recurrence.Conclusions When applied appropriately,MDMP is an effective procedure in correction of Donnahoo type Ⅲ chordee in postpubertal patient with good and long-standing orthoplasty.

OBJECTIVETo study differential expression of microRNA (miRNA) in peripheral blood mononuclear cells (PBMNC) from patients with different types of aplastic anemia (AA) and explore the role of miRNA in the pathogenesis of AA.

METHODSmiRNA microarray were used to determine the differential expression profile of miRNA in PBMNC from patients with AA. Real-time quantitative polymerase china reaction (RQ-PCR) was used to verify the differential expression of miRNA. Candidate miRNA were analyzed with bioinformatics tools.

RESULTSCompared with the normal controls, 6 miRNAs were up-regulated and 10 were down-regulated in patients with severe aplastic anemia (SAA), while 24 miRNAs were up-regulated and 12 were down-regulated in patients with chronic non-severe aplastic anemia (CAA). Compared with CAA patients, 4 miRNAs were up-regulated and 11 were down-regulated in SAA patients. Compared with normal controls, 3 miRNAs were up-regulated and 4 were down-regulated in both SAA and CAA patients. As verified by RQ-PCR, expression of miR-155-5p and miR-1260b were increased in both CAA and SAA patients compared with the normal controls (P<0.01). The expression of miR-155-5p and miR-1260b of CAA patients were higher than that of SAA patients (P<0.01). Bioinformatics analysis showed that target genes of miR-155-5p and miR-1260b may be involved in regulation of cell metabolism, gene expression and transcription, TNF signaling pathway, B cell receptor signaling pathway, Fc gamma R-mediated phagocytosis and other signaling process.

CONCLUSIONThere are characteristic differential expression profiles of miRNA in PBMNC from CAA and SAA patients, in which miRNA-155-5p and miRNA-1260b are both up-regulated. The common target gene predicted for miRNA-155-5p and miRNA-1260b is ETS1. miRNA-155-5p and miRNA-1260b may act synergistically to inhibit the expression of ETS1 and promote differentiation of Th17, therefore play an important role in the pathogenesis of AA.