Objective:To analyze the differences in determination of fluoride level in drinking water by ion-selective electrode method and high-throughput rapid determination method.Methods:The precision test was carried out by using the two methods to measure two kinds of fluoride standard substances, water samples of external quality control assessment from 2021 to 2023 (two kinds each year) and the fluoride level in three drinking water samples (for 5 times/each sample). Accuracy testing was conducted by measuring the external quality control assessment water samples and the spiked recovery rates drinking water, and water samples were grouped (water fluoride ≤1.00, > 1.00 mg/L) and analyzed according to the "Hygienic Standards for Drinking Water" (GB 5749-85). SPSS 23.0 software was used for statistical analysis of the measurement results.Results:(1) The correlation coefficients ( r) of the working curves of the two methods were both > 0.990, meeting the quality control requirements. (2) In the precision test, when comparing the results of the two methods for detecting two kinds of fluoride standard substances, there was no statistically significant difference ( F = 0.36, 0.15, P = 0.564, 0.707), and the coefficients of variation ( CV) were all < 5%. The CV of the detection results of the external quality control assessment water samples and drinking water samples were < 5%. (3) In the accuracy test, when the fluoride concentration in water was ≤1.00 mg/L, there was no statistically significant difference in the spiked recovery rates between the two methods ( F = 0.49, P = 0.504). When the fluoride concentration in water was > 1.00 mg/L, there was a statistically significant difference in the spiked recovery rates between the two methods ( F = 24.75, P = 0.003). Conclusions:The ion-selective electrode method has the advantages of wide detection range and wide adaptability, while the high-throughput rapid determination method has high accuracy. Testing personnel can weigh and choose the appropriate determination method based on the actual laboratory conditions and sample concentration range.

Objective:To study and evaluate the efficacy of hemolytic protection method for extracting DNA from Plasmodium dried blood spots (DBS). Methods:Centrifugal column method, resin method, and hemolytic protection method were used, respectively, to extract DNA from the same batch of DBS (1.0, 10.0, 100.0, 1 000.0, 10 000.0 parasites/μl blood) that were prepared and preserved according to unified standards. Dilute DNA extracted from 1.0 parasites/μl blood DBS by 10 times to prepare 0.1 parasites/μl blood template DNA. Nested PCR was used to detect templates prepared by the three different methods (with template DNA of ≥1.0 parasites/μl blood DBS repeated 3 times). The limit of detection (LOD) and detection rate were compared by repeating the detection of 0.1 parasites/μl blood template DNA for 30 times. The ultra-micro ultraviolet spectrophotometer was used to measure the concentration and purity of DNA extracted from DBS (10.0, 100.0, and 1 000.0 parasites/μl blood), three times each, and the DNA recovery amount was calculated. Meanwhile, the applicability and cost of different methods were analyzed.Results:The nested PCR detection rate of the template DNA of ≥1.0 parasite/μl blood DBS extracted by the three methods was all 3/3. For the 0.1 parasite/μl blood template DNA, the nested PCR detection rates were 0 (0/30), 73.33% (22/30), and 100% (30/30), respectively, and there was a significant difference (χ 2 = 65.95, P < 0.001). The LOD was 1.0, 0.1, 0.1 parasite/μl blood, respectively. When comparing the DNA concentration, purity, and recovery amount extracted by the 3 methods, all showed significant differences ( H = 23.25, 17.50, 23.25, P < 0.001). The centrifugal column method has 9 steps, an extraction time of 2.5 h, and the cost for each sample was 33.32 yuan. The resin method has 7 steps, an extraction time of 20.0 h, and the cost for each sample was 7.11 yuan. The hemolytic protection method has 4 steps, an extraction time of 1.0 h, and the cost for each sample was 1.96 yuan. Conclusion:Hemolytic protection method is an efficient, sensitive, rapid, and economical method for extracting DNA from Plasmodium DBS.

Objective:To investigate the external quality control assessment results of iodine deficiency disorders (IDD) laboratories at all levels in Yunnan Province, so as to provide technical support for IDD monitoring.Methods:In 2023, all IDD laboratories at provincial, city (prefecture) and county level in Yunnan Province tested the assessment samples randomly provided by the National IDD Reference Laboratory based on their participation in external quality control assessment projects (urinary iodine, salt iodine, water iodine). For laboratories that do not use fully automatic iodine detectors, urinary iodine detection was carried out using the "Determination of Iodine in Urine - Part 1: As 3+-Ce 4+ Catalytic Spectrophotometry" (WS/T 107.1-2016), salt iodine detection was carried out using the direct titration method in the "General Test Methods in Salt Industry-Determination of Iodine"(GB/T 13025.7-2012), and water iodine detection was carried out using the cerium sulfate catalytic spectrophotometry. The test results were evaluated using standard value ± uncertainty. Results:A total of 146 IDD laboratories in Yunnan Province participated in the external quality control assessment, including 1 at the provincial level, 16 at the city (prefecture) level, and 129 at the county level. The feedback rate and qualification rate of urinary iodine, salt iodine in the provincial, city (prefecture) and county level IDD laboratories were all 100% (146/146). The feedback rate and the qualified rate of urinary iodine, salt iodine and water iodine in county level IDD laboratories were all 100%(17/17).Conclusion:In 2023, all external quality control assessment results of IDD laboratories in Yunnan Province are qualified, with stable testing quality, providing reliable laboratory technical support for IDD monitoring.

In order to promote the construction of a multi-point trigger intelligent surveillance and early warning system of the plague in China, the development process, application practice, advantages, and limitations of the plague surveillance and early warning system in China and its role in plague prevention and control are reviewed and analyzed. It is suggested to include multiple departments, carry out a multi-channel monitoring mechanism for plague from different perspectives, further improve the plague surveillance and early warning system, and enhance surveillance and early warning capability.

Objective:To compare the effect of two hemostatic drugs, tranexamic acid and hemocoagulase, on postoperative bleeding in adult patients with Kashin-Beck disease undergoing total knee arthroplasty.Methods:A retrospective analysis was conducted to select 80 adult patients with Kashin-Beck disease who underwent unilateral primary total knee arthroplasty at Linyou County Hospital from January 2021 to March 2023. According to the inclusion and exclusion criteria, 19 cases with chronic anemia, long-term oral anticoagulants implanted with cardiac stents, and hematological diseases were excluded. Among the remaining 61 adult patients, 24 cases with preoperative intravenous application combined with intraoperative local application of tranexamic acid in articular cavity were selected as the experimental group, and 37 cases with preoperative intravenous application combined with intraoperative local application of hemocoagulase in articular cavity were selected as the control group. The preoperative general condition, postoperative drainage volume, total perioperative blood loss, occult blood loss, and hemoglobin levels at different time points before and after surgery were compared between the two groups of patients.Results:There was no statistically significant difference in age, gender distribution, body mass index, preoperative hemoglobin level, preoperative prothrombin time, and preoperative activated partial thromboplastin time between the two groups of patients ( P > 0.05). The total perioperative blood loss [(1 027.78 ± 472.71) ml], drainage volume 48 h after surgery [(336.67 ± 112.74) ml] in the experimental group were all lower than those in the control group [(1 390.39 ± 454.01), (498.65 ± 187.57) ml], and the differences were statistically significant ( P < 0.05). The hemoglobin levels on the second and fifth day after surgery were significantly higher than those in the control group, and the differences were statistically significant ( P < 0.05). Conclusion:For total knee arthroplasty for adult patients with Kashin-Beck disease, preoperative intravenous application combined with intraoperative local application of tranexamic acid in articular cavity is superior to hemocoagulase, which can effectively reduce total perioperative blood loss and postoperative drainage volume, and is worthy of clinical promotion.

Objective:To study the correlation between hair fluorine level and hypertension of permanent residents in high altitude areas of Tibet Autonomous Region (Tibet).Methods:A random cluster sampling method was used to select 5 villages in the high altitude areas of Tibet from June to August 2021 and June to August 2022, respectively, and questionnaire survey, physical examination, and biochemical indicator testing were conducted on permanent Tibetan residents in the above mentioned villages. At the same time, hair samples were collected, the hair fluorine level was determined by ion selective electrode method, and the correlation between various indicators and hair fluorine level and hypertension was analyzed.Results:A total of 227 individuals were included, with hair fluorine level of (15.06 ± 0.16) mg/kg. Correlation analysis showed that there was no correlation between the study subjects' systolic blood pressure, diastolic blood pressure, body mass index, pulse, neck circumference, chest circumference, uric acid level and hair fluorine level ( P > 0.05). Abdominal circumference, hip circumference, and hemoglobin level were positively correlated with hair fluorine level ( r = 0.23, 0.14, 0.29, P < 0.05), while blood glucose level and finger pulse oxygen were negatively correlated with hair fluorine level ( r = - 0.23, - 0.24, P < 0.001). Binary logistic regression analysis showed that age ( OR = 1.04, 95% CI: 1.01 - 1.06), chest circumference ( OR = 1.10, 95% CI: 1.01 - 1.20), and hair fluorine level ( OR = 1.22, 95% CI: 1.02 - 1.46) had an impact on hypertension ( P < 0.05). Conclusion:There is a certain correlation between hair fluoride level and hypertension in the population of high altitude areas in Tibet.

Objective:To investigate the expression levels of serum receptor activator of nuclear factor-κB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG) in children with dental fluorosis.Methods:In April 2018, a case-control study was conducted to select 8 - 12 year old children diagnosed with dental fluorosis residing within 1.5 km of an aluminum smelting facility in Guangxi Zhuang Autonomous Region as the dental fluorosis group ( n = 49) according to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011). The control group ( n = 98) comprised healthy children aged 8 - 12 years old without dental fluorosis lived more than 5.0 km from the aluminum smelting facility. Fasting venous blood samples were collected from all participants. Blood fluoride level were measured using an ion-selective electrode method. Serum RANK, RANKL, and OPG levels were determined using double-antibody sandwich enzyme-linked immunosorbent assay. Results:The levels of serum fluoride [ M ( Q1, Q3): 0.033 (0.032, 0.036) vs 0.026 (0.025, 0.028) mg/L], RANK [1.21 (0.87, 1.64) vs 0.73 (0.50, 1.13) μg/L], RANKL [81.3 (50.6, 118.6) vs 134.3 (98.1, 199.2) ng/L], OPG [433.3 (321.6, 574.3) vs 509.1 (406.8, 709.3) μg/L], and OPG/RANKL ratio [5.6 (3.1, 7.8) vs 3.6 (2.9, 5.0)] were compared between the fluorosis group and the control group, and the differences were statistically significant ( Z = 8.35, 3.83, 3.99, 2.35, 2.47, P < 0.05). Correlation analysis revealed that dental fluorosis severity was positively correlated with serum fluoride level( r s = 0.68, P < 0.001). Serum fluoride level was negatively correlated with both serum RANKL and OPG levels ( r s = - 0.49, - 0.17, P < 0.05). Conclusion:The level of serum RANK in children with dental fluorosis is higher than that in healthy children, while the levels of RANKL and OPG are lower than those in healthy children.

Objective:To investigate the current situation of water-borne endemic fluorosis in Anhui Province, and provide basic data for the adjusting the prevention and control measures.Methods:Using cross-sectional survey method, all villages in the water-borne endemic fluorosis areas were investigated in Anhui Province from 2019 to 2022. In water-borne endemic fluorosis village, the situation of water improvement project and the fluoride level of drinking water were investigated, and dental fluorosis of all children aged 8 - 12 was examined. The criteria for determining the achievement of control targets for water-borne endemic fluorosis in affected counties were based on the "Evaluation Measures for Control and Elimination of Key Endemic Diseases (2019 Edition)".Results:From 2019 to 2022, the rate of water improvement village in water-borne endemic fluorosis areas were 88.47% (1 527/1 726), 100% (1 726/1 726), 100% (1 726/1 726) and 100% (1 726/1 726), respectively. The qualified proportion of water fluoride in water-borne endemic fluorosis villages was 33.84% (584/1 726), 63.09% (1 089/1 726), 70.74% (1 221/1 726) and 74.33% (1 283/1 726), respectively. The prevalence rates of dental fluorosis in children aged 8 - 12 were 25.48% (45 461/178 440), 15.78% (27 959/177 200), 13.68% (23 505/171 880) and 12.66% (23 315/184 200), respectively. The proportion of affected counties that had achieved the control target of water-borne endemic fluorosis was 16% (4/25), 60% (15/25), 36% (9/25) and 40% (10/25), respectively.Conclusions:The water-borne endemic fluorosis areas in Anhui Province have improved the water fluoride qualification rate and reduced the incidence of fluorosis in children through prevention and control measures such as water improvement and fluoride reduction. However, the prevention and control efforts in key areas and counties need to be further improved.

Objective:To investigate the application in evaluating the course and the clinical effects of serum cytokines interleukin (IL)-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) levels, as well as neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with brucellosis.Methods:Using case-control method, from February 2023 to March 2024, 274 confirmed brucellosis patients [divided into acute and chronic groups ( n = 165, 109) according to the course of the disease] and 70 healthy individuals (control group) were selected at Beidahuang Group General Hospital for serum cytokines detection using cytometric bead array (CBA) method. Blood routine test, serum agglutination test (SAT) and blood culture were performed at the same time, and NLR and PLR were calculated. Cytokine levels, NLR, and PLR were compared in patients with different disease duration, with or without complications, with different SAT titers [high ( > 1 ∶ 100) and low (≤1 ∶ 100)], and with different blood culture results, and the effects of each indicator on the course of brucellosis were analyzed by logistic regression. Results:The levels of IL-2, IL-6, IL-10, IL-17, TNF-α and IFN-γ in the acute group [ M ( Q1, Q3): 0.32 (0.15, 0.70), 18.97 (10.70, 36.86), 2.54 (1.49, 4.36), 1.41 (0.38, 3.05), 1.31 (0.77, 2.33), 11.60 (2.30, 36.75) ng/L] were higher than those in the chronic group [0.18 (0.06, 0.43), 1.68 (0.75, 5.74), 0.88 (0.40, 1.93), 0.29 (0.09, 0.87), 0.59 (0.31, 1.07), 0.72 (0.33, 1.42) ng/L] and control group [0.10 (0.05, 0.30), 1.52 (0.09, 2.80), 0.72 (0.35, 1.16), 0.08 (0.03, 0.20), 0.55 (0.20, 0.96), 0.68 (0.41, 1.25) ng/L, P < 0.05]. The IFN-γ level in the group with complications of brucellosis was lower than that in the group without complications, while the NLR and PLR were higher than those in the group without complications ( P < 0.05). The levels of IL-6, IL-17, TNF-α, and IFN-γ in the high titer group were higher than those in the low titer group, and the NLR was lower than that in the low titer group ( P < 0.05). The levels of IFN-γ and TNF-α of blood culture positive patients in the acute group were higher than those of blood culture negative patients ( P < 0.05). Univariate analysis showed that all 7 cytokines could affect the course of brucellosis ( P < 0.05). Multivariate analysis showed that IL-6, TNF-α, and IFN-γ were independent influencing factors of the course of brucellosis [ OR (95% CI) = 0.87 (0.83, 0.91), 0.55 (0.32, 0.97), 0.80 (0.72, 0.88), P < 0.05]. Conclusions:The levels of cytokines IL-2, IL-6, IL-10, IL-17, TNF-α, and IFN-γ can reflect the course progression of brucellosis patients, IL-6, IFN-γ and TNF-α can also serve as independent influencing factors for brucellosis progression. NLR and PLR may become inflammatory markers for predicting Brucella infection.

Objective:To investigate the current situation and changing trends of coal-burning-borne endemic fluorosis (coal-burning-borne fluorosis) areas in Henan Province, and evaluate the effectiveness of prevention and control measures.Methods:From 2019 to 2021, monitoring was carried out in all villages affected by coal-burning-borne fluorosis in Henan Province. A simple random sampling method was used to select 30 households in each affected village each year to investigate the use of stoves and the formation of related healthy living behaviors. According to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011), all children aged 8 to 12 in the affected villages were examined for dental fluorosis. The evaluation for control and elimination of the 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 2021, a total of 7 472 households were monitored, the rate of qualified improved stoves were all ≥99.80%, the correct use rate of qualified improved stoves and correct drying of corn and pepper were reached 100%. From 2019 to 2021, the prevalence of dental fluorosis in children was 5.38% (237/4 405), 5.18% (232/4 477), and 3.68% (145/3 937), respectively, showing a declining trend (χ 2trend = 12.73, P < 0.001). The prevalence of dental fluorosis among children in affected villages was less than 15%. From 2019 to 2021, all affected villages in coal-burning-borne fluorosis in Henan Province had met the elimination criteria. Conclusion:Coal-burning-borne fluorosis areas in Henan Province have been continuously eliminated, with significant prevention and control effects, and the disease has been effectively controlled.