Objective:To evaluate the prevention and control effect of coal-burning-borne endemic fluorosis in Ankang City of Shaanxi Province, so as to provide a scientific basis for formulating precise prevention and control strategies in the future.Methods:From 2019 to 2023, according to the requirements of the "Monitoring Program of Shaanxi Province for Coal-burning-borne Endemic Fluorosis (2019 Edition)", full coverage monitoring was carried out in all affected villages in seven affected counties under the jurisdiction of Ankang City. Using the simple random sampling method, 30 households in each affected village were selected to investigate the use of improved stoves and the formation of health-related behaviors. All children aged from 8 to 12 in the village were examined for the prevalence of dental fluorosis. At the same time, 6 monitoring villages were selected in 2019, and 8 monitoring villages were selected in 2023 to collect real-time urine samples from children aged 8 - 12 for determination of urinary fluoride level. The evaluation for control and elimination of disease areas was carried out in accordance with the "Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 Edition)".Results:From 2019 to 2023, a total of 203 880 households were monitored, the rate of qualified improved stoves and the correct use rate of qualified improved stoves were more than 95.00%. The utilization rate of improved stoves decreased from 16.34% (6 584/40 290) in 2019 to 8.89% (3 706/41 700) in 2023, showing a decreasing trend year by year (χ 2trend = 3 400.37, P < 0.001). The utilization rate of clean energy increased from 82.52% (33 247/40 290) in 2019 to 94.36% (39 350/41 700) in 2023, showing an upward trend year by year (χ 2trend = 7 506.09, P < 0.001). The correct drying rate of corn and pepper for human consumption were 100.00%. A total of 455 327 children aged 8 - 12 were examined, and 2 301 cases of dental fluorosis were diagnosed, with a detection rate of 0.51%. Children with dental fluorosis were mainly extremely mild and mild, accounting for 94.87% (2 183/2 301). The dental fluorosis index was 0.012, indicating no trend of fluorosis prevalence. The detection rate of dental fluorosis in children decreased from 0.81% (765/94 537) in 2019 to 0.24% (204/86 066) in 2023, showing a declining trend year by year (χ 2trend = 375.45, P < 0.001). The geometric mean urinary fluoride levels of children aged 8 to 12 in 2019 and 2023 were 0.48 and 0.42 mg/L, respectively, with statistically significant differences between groups ( Z = - 3.05, P = 0.002). As of 2023, 1 390 affected villages had met the elimination criteria. Conclusions:The prevention and control of coal-burning-borne endemic fluorosis in Ankang City has achieved remarkable results, with all seven affected counties reaching the elimination standard. In the future, we should strengthen the management of high fluoride coal mines, continue to promote the use of clean energy, strengthen health promotion and disease monitoring, and continuously consolidate and improve the results of prevention and control.

Objective To observe the effect of Shenfu injection on lung injury caused by hemor-rhagic shock(HS)in rats and explore the related potential mechanism.Methods Thirty-six SPF healthy male SD rats,aged 16-17 weeks,weighing 400-600 g,were randomly divided into three groups:sham op-eration group(group SH),HS group(group HS),and Shenfu injection group(group SF),12 rats in each group.In group SH,only the right femoral vein and femoral artery were separated after anesthesia,and ve-nous catheterization was not performed.HS model was established in groups SF and HS.In group HS,liquid resuscitation was performed through an intravenous catheter,and the resuscitation fluid consisted of the auto-blood lost and the compound sodium chloride injection equivalent to 1.5 times the blood loss and 10 ml/kg normal saline.In group SF,the resuscitation fluid consisted of the lost autoblood and the compound sodium chloride injection equivalent to 1.5 times the blood loss and Shenfu injection 10 ml/kg.The whole perfusion time was about 60 minutes.Six rats in the three groups were randomly anesthetized 24 and 48 hours after op-eration.The wet/dry weight ratio(W/D)of lung tissues was detected.The concentrations of interleukin-6(IL-6),IL-17,IL-10,and transforming growth factor-β(TGF-β)were detected by ELISA,the mRNA ex-pression of retinoic acid-related orphan nuclear receptor γt(RORγt),transcription factor forkhead box pro-tein 3(Foxp3),and hypoxia-inducible factor-1α(HIF-1α)in lung tissues were detected by PCR.The pro-tein contents of RORγt,Foxp3,HIF-1α,aquaporin 1(AQP1),and AQP5 in lung tissue were detected by Western blot.Pathological changesunder HE staining light microscope and lung injury scores were observed.Results Compared with 24 hours after operation,W/D,the concentrations of IL-6 and IL-17,mRNA ex-pression and protein content of RORγt and HIF-1α,and lung injury score were significantly decreased(P＜0.05),the concentrations of IL-10,and TGF-β,Foxp3 mRNA expression and protein content,and AQP1 protein content were significantly increased in group SF 48 hours after operation(P＜0.05).Compared with group SH,W/D,the concentrations of IL-6,IL-17,IL-10,and TGF-β,mRNA expression and protein content of RORγt,Foxp 3,and HIF-1α,and lung injury score were significantly increased(P＜0.05),AQP1 and AQP5 protein contents were significantly decreased in groups HS and SF 24 and 48 hours after operation(P＜0.05),and alveolar structure was damaged under light microscope and alveolar interstitium was filled with a large amount of edematous fluid,during which a large number of inflammatory cells infiltra-ted.Compared with group HS,W/D,the concentrations of IL-6 and IL-17,mRNA expression and protein content of RORγt and HIF-1α,and lung injury score were significantly decreased(P＜0.05),the concen-trations of IL-10 and TGF-β,Foxp3 mRNA expression and protein content,AQP1 and AQP5 protein con-tents were significantly increased in group SF 24 and 48 hours after surgery(P＜0.05),and the alveolar structure was improved under light microscope,and edema was reduced,and the number of inflammatory cells was reduced.Conclusion Shenfu injection can regulate the balance between pro-inflammatory factors IL-6 and IL-17,and anti-inflammatory factors IL-10 and TGF-β,increase the protein content of AQP1 and AQP5 in lung tissue,and decrease the W/D and injury score in lung tissue,thus alleviating lung injury in HS rats.The mechanism may be related to the regulation of HIF-1α-RORγt/Foxp3 balance.

Currently the diagnosis and bed cost accounting methods reflecting the overall level of regional public hospitals have not yet matured.It explores an relatively scientific and practically accounting method based on the financial annual report of public hospitals to gain the per visit costs and per bed-day costs in a certain area,which can help the decisions of the health administra-tive department.The data from a public hospital owned by Shenzhen Health Commission is used for feasibility verification.It aims to promote the innovation and application of cost accounting method of public hospitals,and for give play to the auxiliary deci-sion-making role for the health administrative department,promote the improvement of the fiscal investment mechanism,and help public hospitals with high-quality development.

Currently the diagnosis and bed cost accounting methods reflecting the overall level of regional public hospitals have not yet matured.It explores an relatively scientific and practically accounting method based on the financial annual report of public hospitals to gain the per visit costs and per bed-day costs in a certain area,which can help the decisions of the health administra-tive department.The data from a public hospital owned by Shenzhen Health Commission is used for feasibility verification.It aims to promote the innovation and application of cost accounting method of public hospitals,and for give play to the auxiliary deci-sion-making role for the health administrative department,promote the improvement of the fiscal investment mechanism,and help public hospitals with high-quality development.

Currently the diagnosis and bed cost accounting methods reflecting the overall level of regional public hospitals have not yet matured.It explores an relatively scientific and practically accounting method based on the financial annual report of public hospitals to gain the per visit costs and per bed-day costs in a certain area,which can help the decisions of the health administra-tive department.The data from a public hospital owned by Shenzhen Health Commission is used for feasibility verification.It aims to promote the innovation and application of cost accounting method of public hospitals,and for give play to the auxiliary deci-sion-making role for the health administrative department,promote the improvement of the fiscal investment mechanism,and help public hospitals with high-quality development.

Currently the diagnosis and bed cost accounting methods reflecting the overall level of regional public hospitals have not yet matured.It explores an relatively scientific and practically accounting method based on the financial annual report of public hospitals to gain the per visit costs and per bed-day costs in a certain area,which can help the decisions of the health administra-tive department.The data from a public hospital owned by Shenzhen Health Commission is used for feasibility verification.It aims to promote the innovation and application of cost accounting method of public hospitals,and for give play to the auxiliary deci-sion-making role for the health administrative department,promote the improvement of the fiscal investment mechanism,and help public hospitals with high-quality development.

Currently the diagnosis and bed cost accounting methods reflecting the overall level of regional public hospitals have not yet matured.It explores an relatively scientific and practically accounting method based on the financial annual report of public hospitals to gain the per visit costs and per bed-day costs in a certain area,which can help the decisions of the health administra-tive department.The data from a public hospital owned by Shenzhen Health Commission is used for feasibility verification.It aims to promote the innovation and application of cost accounting method of public hospitals,and for give play to the auxiliary deci-sion-making role for the health administrative department,promote the improvement of the fiscal investment mechanism,and help public hospitals with high-quality development.

Currently the diagnosis and bed cost accounting methods reflecting the overall level of regional public hospitals have not yet matured.It explores an relatively scientific and practically accounting method based on the financial annual report of public hospitals to gain the per visit costs and per bed-day costs in a certain area,which can help the decisions of the health administra-tive department.The data from a public hospital owned by Shenzhen Health Commission is used for feasibility verification.It aims to promote the innovation and application of cost accounting method of public hospitals,and for give play to the auxiliary deci-sion-making role for the health administrative department,promote the improvement of the fiscal investment mechanism,and help public hospitals with high-quality development.

Currently the diagnosis and bed cost accounting methods reflecting the overall level of regional public hospitals have not yet matured.It explores an relatively scientific and practically accounting method based on the financial annual report of public hospitals to gain the per visit costs and per bed-day costs in a certain area,which can help the decisions of the health administra-tive department.The data from a public hospital owned by Shenzhen Health Commission is used for feasibility verification.It aims to promote the innovation and application of cost accounting method of public hospitals,and for give play to the auxiliary deci-sion-making role for the health administrative department,promote the improvement of the fiscal investment mechanism,and help public hospitals with high-quality development.

Currently the diagnosis and bed cost accounting methods reflecting the overall level of regional public hospitals have not yet matured.It explores an relatively scientific and practically accounting method based on the financial annual report of public hospitals to gain the per visit costs and per bed-day costs in a certain area,which can help the decisions of the health administra-tive department.The data from a public hospital owned by Shenzhen Health Commission is used for feasibility verification.It aims to promote the innovation and application of cost accounting method of public hospitals,and for give play to the auxiliary deci-sion-making role for the health administrative department,promote the improvement of the fiscal investment mechanism,and help public hospitals with high-quality development.