Objective:To learn about the operation of fluoride reduction and water improvement projects, the current situation of water fluoride level and the changing trend of fluorosis in drinking water-borne endemic fluorosis areas in Shaanxi Province, and to evaluate the effect of prevention and control measures.Methods:From March 2014 to December 2021, 15 endemic villages in drinking water-borne endemic fluorosis areas of Dali, Dingbian, Jingbian, Jingyang and Liquan counties in Shaanxi Province were selected as monitoring villages to investigate the operation of water improvement projects. Water samples were collected, and the water fluoride level was detected according to the "Standard Examination Methods for Drinking Water - Nonmetal Parameters" (GB/T 5750.5-2006). "Diagnosis of Dental Fluorosis" (WS/T 208-2011) was done to detect dental fluorosis in all children aged 8 - 12 who were born and lived in the monitoring village. Using "Diagnostic Standard for Endemic Skeletal Fluorosis" (WS/T 192-2008) and "Determination of Fluoride in Urine - Ion Selective Electrode Method" (WS/T 89-2015), X-ray examination and urine fluoride level test were performed on adults over 25 years old who had lived in the monitoring village for more than 5 years, respectively.Results:From 2014 to 2021, a total of 122 water improvement projects were investigated, all of which were in normal operation. The qualified rate of water fluoride increased from 81.25% (13/16) in 2014 to 100.00% (11/11) in 2021. A total of 5 595 children aged 8 - 12 were examined, 1 790 children with dental fluorosis were detected, with a detection rate of 31.99%. The detection rate of dental fluorosis in children decreased from 52.05% (304/584) in 2014 to 9.68% (93/961) in 2021, showing an overall downward trend (χ 2trend = 533.76, P < 0.001). In 2014, 791 adults were examined, and 256 patients with skeletal fluorosis were detected, the detection rate was 32.36%. In 2019, 770 adults were examined, and 88 patients with skeletal fluorosis were detected, with a detection rate of 11.43%. The detection rate of skeletal fluorosis in adults in 2019 was lower than that in 2014, and the difference was statistically significant (χ 2 = 99.54, P < 0.001). In 2014, 754 adult urine samples were collected, and the geometric mean of urine fluoride was 2.571 mg/L. In 2019, 770 adult urine samples were collected, and the geometric mean of urine fluoride was 1.292 mg/L. The geometric mean of urine fluoride in adults in 2019 was lower than that in 2014, and the difference was statistically significant ( Z = - 12.74, P < 0.001). Conclusions:From 2014 to 2021, the water improvement projects in drinking water-borne endemic fluorosis areas in Shaanxi Province are running normally, and the qualified rate of water fluoride has increased. The incidence of dental fluorosis in children and skeletal fluorosis in adults has decreased. In the later stage, it is necessary to continuously strengthen the monitoring and management of water improvement projects to prevent the rebound of water fluoride from causing residents' illness.

Objective:To explore the effect of postoperative intravenous drip of tranexamic acid on perioperative blood loss, coagulation function and knee joint function in patients undergoing total knee arthroplasty.Methods:A total of 100 patients who underwent unilateral total knee arthroplasty for the first time from August 2018 to August 2020 in Dingzhou People′s Hospital were selected and divided into the tranexamic acid group and the control group according to registration order, with 50 cases in each group. The tranexamic acid group was given intravenous infusion of tranexamic acid immediately after the operation, and the control group was given intravenous infusion with the same dose of normal saline after the operation. The postoperative drainage volume was evaluated at 12 h after the treatment, and the total blood loss and occult blood loss were calculated. The change value of hemoglobin, related indexes of the coagulation function at 24 h after the operation, the knee joint range of motion before and after the operation, and Hospital for Special Surgery knee score (HSS score) were recorded. The proportion of blood transfusion, the rate of deep vein thrombosis and the incidence of pulmonary embolism were compared.Results:The postoperative drainage, total blood loss and occult blood loss in the tranexamic acid group were significantly lower than those in the control group ( P<0.05). The change value of hemoglobin in the tranexamic acid group was significantly lower than that in the control group: (33.32 ± 8.87) g/L vs. (47.37 ± 9.26) g/L, t = 7.75, P<0.05. There was no statistically significant difference in related indexes of coagulation function in the two group at 24 h after the operation ( P>0.05). The range of motion of the knee joint and the HSS scores in the tranexamic acid group were significantly greater than those in the control group: (98.57 ± 7.28)° vs. (87.20 ± 8.05)°, (87.25 ± 8.30) points vs. (78.37 ± 10.20) points, t =7.41, 4.78, P<0.05. The proportion of postoperative blood transfusion, the rate of deep vein thrombosis and the incidence of pulmonary embolism in the tranexamic acid group were significantly lower than those in the control group: 14.0%(7/50) vs. 32.0%(16/50), 6.0%(3/50) vs. 20.0%(10/50), 4.0%(2/50) vs. 16.0%(8/50), χ2 = 4.57, 4.33, 4.00, P<0.05. Conclusions:Tranexamic acid can reduce perioperative bleeding in patients undergoing total knee arthroplasty, reduce the proportion of patients undergoing blood transfusion, without increasing the risk of thrombosis and pulmonary embolism complications. Besides, it doesnot affect the coagulation function, and can accelerate the recovery of knee joint function.

Objective:To investigate the differential performance of ultrasound between fibro-adipose vascular anomaly (FAVA) and venous malformations(VMs).Methods:From January 2015 to December 2020, the patients diagnosed with lower extremity FAVA by pathology in Henan Provincial People’s Hospital were enrolled as FAVA group. The patients diagnosed with lower extremity VMs by pathology were enrolled as the control group. The clinical and ultrasound imaging data were retrospectively analyzed. Through the single factor analysis of the two groups’data, the ultrasonic imaging indicators which may be valuable for distinguishing FAVA from VMs were screened. Further, the indicators valuable for differential diagnosis were determined by multi-factor Logistic regression analysis, and a multi-factor joint diagnosis model was constructed. The diagnostic efficiency of the joint diagnosis model was evaluated by the receiver operator characteristic curve (ROC curve), sensitivity, and specificity of the subjects.Results:A total of 20 patients with FAVA were involved, including 11 males and 9 females. The mean age was (18.1±12.2) years. Forty-six patients with VMs were involved, including 20 males and 26 females. The mean age was (19.9±13.6) years. Results of the single-factor analysis were differences in the lesion echo, fascial tail, blood flow, extrusion test, and posterior echo enhance characteristics between groups ( P<0.05). Multivariate analysis showed significant differences between groups in three aspects: fascial tail, extrusion test, and posterior echo enhancement ( P=0.001, 0.008, 0.007). The sensitivity and specificity of the multi-factor combined diagnosis model were 90.0% (95% CI: 68.3%-98.8%) and 93.5%(95% CI: 82.1%-98.6%), indicating high diagnostic efficiency. The ROC(AUC) area was 0.964(95% CI: 0.886-0.994), indicating high diagnostic efficiency. Conclusions:The ultrasonic imaging features of FAVA and VMs were different. The combined diagnosis of the fascial tail, compression test, and posterior echo enhancement has a higher auxiliary diagnostic value.

Objective:To investigate the differential performance of ultrasound between fibro-adipose vascular anomaly (FAVA) and venous malformations(VMs).Methods:From January 2015 to December 2020, the patients diagnosed with lower extremity FAVA by pathology in Henan Provincial People’s Hospital were enrolled as FAVA group. The patients diagnosed with lower extremity VMs by pathology were enrolled as the control group. The clinical and ultrasound imaging data were retrospectively analyzed. Through the single factor analysis of the two groups’data, the ultrasonic imaging indicators which may be valuable for distinguishing FAVA from VMs were screened. Further, the indicators valuable for differential diagnosis were determined by multi-factor Logistic regression analysis, and a multi-factor joint diagnosis model was constructed. The diagnostic efficiency of the joint diagnosis model was evaluated by the receiver operator characteristic curve (ROC curve), sensitivity, and specificity of the subjects.Results:A total of 20 patients with FAVA were involved, including 11 males and 9 females. The mean age was (18.1±12.2) years. Forty-six patients with VMs were involved, including 20 males and 26 females. The mean age was (19.9±13.6) years. Results of the single-factor analysis were differences in the lesion echo, fascial tail, blood flow, extrusion test, and posterior echo enhance characteristics between groups ( P<0.05). Multivariate analysis showed significant differences between groups in three aspects: fascial tail, extrusion test, and posterior echo enhancement ( P=0.001, 0.008, 0.007). The sensitivity and specificity of the multi-factor combined diagnosis model were 90.0% (95% CI: 68.3%-98.8%) and 93.5%(95% CI: 82.1%-98.6%), indicating high diagnostic efficiency. The ROC(AUC) area was 0.964(95% CI: 0.886-0.994), indicating high diagnostic efficiency. Conclusions:The ultrasonic imaging features of FAVA and VMs were different. The combined diagnosis of the fascial tail, compression test, and posterior echo enhancement has a higher auxiliary diagnostic value.

Objective To evaluate the application value of tranexamic acid in total knee arthroplasty. Methods 120 elderly patients with knee osteoarthritis admitted to Department of Joint Surgery in our hospital from December 2018 to March 2020 were selected as study subjects. They were divided into the control group and the observation group by random number table method, with 60 patients in each group. The control group was treated with total knee arthroplasty. The observation group received one tranexamic acid injection during and after total knee arthroplasty. Both groups were followed up for 6 months after the operation. The operation-related indexes in two groups, preoperative and postoperative coagulation function 48 h after operation, preoperative and postoperative knee joint function 6 months after operation were compared. The incidence of complications during hospitalization in the two groups was counted. Results The intraoperative blood loss, hidden blood loss and postoperative drainage volume of the observation group were lower than those in the control group (P<0.05). The postoperative drainage time, drying time and wound healing time in the observation group were all shorter than those in the control group (P<0.05). There was no significant difference in prothrombin time (PT), partial thromboplastin time (APTT) and whole blood fibrinogen (FIB) between two groups before the surgery and 48 h after operation (P>0.05). No statistically significant difference was observed between the two groups (P>0.05). Compared with those before operation, the pain, walking stability, walking distance, walking assistance, flexor extension and muscle strength scores of the subjects in the two groups increased 6 months after the operation. The index scores in the observation group were higher than those in the control group (P<0.05). During the treatment, the total complication rate was 8.33% in the observation group and 13.33% in the control group, with no statistically significant difference between the two groups (P>0.05). Conclusion Tranexamic acid can effectively reduce blood loss, postoperative drainage volume, and postoperative drainage time in total knee arthroplasty for elderly patients with knee osteoarthritis. It promotes wound healing, improves knee joint function, and has little effect on coagulation function and less postoperative complications.

Objective:To explore the factors of perioperative blood loss during total knee arthroplasty (TKA), and to analyze the influence of tranexamic acid on the amount of occult bleeding.Methods:A total of 100 patients who underwent TKA surgery in the knee surgery department of Dingzhou People′s Hospital from August 2018 to August 2020 were selected as the research subjects. According to whether tranexamic acid was used or not, they were divided into tranexamic acid group (68 cases) and non-tranexamic acid group (32 cases). The influence of the age, presence or absence of comorbidities, tourniquet use time, body mass index (BMI), platelet count (PLT) levels, and tranexamic acid use on TKA perioperative occult blood loss were analyzed.Results:Univariate analysis showed that factors such as age, presence or absence of comorbidities, tourniquet use time, BMI and PLT levels had a significant effect on occult blood loss, and the difference between different groups was statistically significant ( P<0.05), while gender and disease type, operation side, operation time and blood transfusion type had no significant effect on occult blood loss ( P>0.05); The latent blood loss in the tranexamic acid group was significantly lower than that in the non-tranexamic acid group: (662.47 ± 65.82) ml vs. (733.86 ± 59.86) ml, P<0.05. The proportion of allogeneic blood transfusion in the tranexamic acid group was significantly lower than that in the non-tranexamic acid group: 45.49%(31/68) vs. 68.75% (22/32), P<0.05. Postoperative drainage volume and perioperative total blood loss in the tranexamic acid group were significantly lower than those in the non-tranexamic acid group: (211.54 ± 85.63) ml vs. (427.61 ± 103.08) ml, (995.38 ± 187.11) ml vs. (1 276.42 ± 236.84) ml, P<0.05. Multivariate analysis showed that age, comorbidities, and tourniquet use time, and BMI were independent risk factors affecting the increase of perioperative occult blood loss ( P<0.05), and tranexamic acid was a protective factor ( P<0.05). Conclusions:Old age, comorbidities, excessive use time of tourniquets, and obesity can all cause the increase of perioperative occult blood loss during TKA. The use of tranexamic acid can effectively reduce the occult blood loss.

Objective:To investigate the clinicopathological features, and differential diagnosis of verrucous hemangioma (VH).Methods:Twenty-eight VH cases diagnosed from 2005 to 2020 in Henan Provincial People′s Hospital, Zhengzhou, China were analyzed retrospectively. Immunohistochemical studies were used to detect diagnostic markers. The mutation status of PIK3CA (exons 9 and 20) was detected using fluorescence PCR.Results:There were 13 males and 15 females in 28 cases, with the male to female ratio of 1.0∶1.2. There were 25 patients under the age of 18 years. The age range was from 10 months to 56 years (mean, 9.7 years; median, 4.5 years). There were 17 cases occurred in the lower extremities, 7 in the upper extremities and 4 in the trunk. All 28 cases were irregular red patches on the skin, which grew slowly. Some of them were thickened with uneven surface, which was light pink or red-white. Skin lesions of the 7 cases ranged from dark red and reddish brown, with a rough and hard surface. Satellite foci were present. Microscopically, 28 cases had a wide range of pathological features. Dilated, malformed vessels were observed from dermal papilla to deep soft tissue. Among them, the dermal papillary layer was mainly composed of many proliferating and expanding thin-walled capillaries and cavernous blood vessels. Thin-walled small vessels were found in the dermal reticular layer and subcutaneous fascia layer, with no obvious endothelial cell proliferation, occasional papillary hyperplasia, and lobular distribution of the malformed vessels in the fascia layer mixed with the fibroadipose tissue. There was epidermal papillary hyperplasia with hyperkeratosis and parakeratosis, lengthening and mutual fusion of epithelial horns. Immunohistochemistry showed that CD31, CD34, ERG and WT-1 were diffusely and strongly positive. The expression of GLUT-1 was present in superficial dermal vascular endothelial cells, but undetectable in the deep layer. The PIK3CA tests of 13 cases showed that no somatic mutations were found in exons 9 and 20. Twenty-five patients were followed up for 5 months to 10 years. Seven patients underwent multiple surgical resections and plastic surgeries due to the large size, and 8 patients had recurrence.Conclusions:VH is a rare congenital vascular malformation and more commonly occurs in infants and children. It tends to appear in limbs, especially lower limbs and distal limbs. Its morphology and immunophenotype are characteristic and should be distinguished from other vascular malformations and the resolution phase of infant hemangiomas. In about one third of the cases, postoperative recurrence may occur and long-term follow-up is often required.

Singular periosseous osteochondroma-like hyperplasia is often misdiagnosed, because of its atypical skin lesion. The clinical reports in China are rare. On May 29, 2018, a patient with osteochondroma-like hyperplasia of singular bone on the right foot was diagnosed at the Department of Dermatology, First Affiliated Hospital of Zhengzhou University. Tissue biopsy was performed for histopathological confirmation. The incision healed well after operation, and there was no recurrence observed in the follow-up period of 5 months.

OBJECTIVE: To explore the sub-chronic oral toxicity of 1,1-diamino-2,2-dinitroethene( FOX-7) in rats.METHODS: Ninety-six specific pathogen free healthy adult SD rats were randomly divided into control group,low-,medium-,and high-dose groups. Each group consisted of 24 rats,half of them were males and the other half were females.The low-,medium-,and high-dose groups of rats were exposed to 10,30,90 mg /( kg·d) body weigh of 1,1-diamino-2,2-dinitroethene by gavage for 90 days,once a day,6 days a week. The control group was given the same volume of 4%water starch solution. The toxic symptoms,the body weight,food utilization,routine blood,blood biochemical indicators,organ coefficients and histopathology changes of the rats were observed or tested. RESULTS: a) The body weights of male and female rats in the high-dose group in the 28 th day after exposure were lower than those of the control group for the same time and same sex( P < 0. 05). Food utilization in the male and female high-dose group in the 77 th and 90 th day after exposure were lower than those of the control group for the same time and same sex( P < 0. 05). b) Red blood cell counts,hemoglobin levels,hematocrit levels in the female rats of low-,medium-,and high-dose groups were lower than those of the female control group( P < 0. 05). Platelet counts in the female high-dose group was lower than that of the female control group( P < 0. 05). Red blood cell counts,hemoglobin level,hematocrit level and mean corpuscular hemoglobin concentration in the male high-dose group were lower than those of the male control group( P < 0. 05). The platelet counts in the male medium-,and high-dose group were lower than that of the male control group( P < 0. 05). c) Total cholesterol levels in female medium-,and high-dose group and blood urea nitrogen level in the female high-dose group were higher than those of the female control group( P < 0. 05). In high-dose group,the levels of total protein and uric acid were higher and lactate dehydrogenase level was lower than those of the control group( P < 0. 05). d) The spleen organ coefficients in the female high-dose group were higher and those in male medium- and high-dose groups were higher than those of the control group for same sex( P < 0. 05). The organ coefficients of liver and kidney in high-dose group were higher than those of the control group( P < 0. 05),the organ coefficients of testis and epididym in the male high-dose group were lower than those of the male control group( P < 0. 05). The testis convoluted tubule shrink and seminiferous cells decreased in the male high-dose group. e) The no observed adverse effect level of FOX-7 dinitroethene in female rats were less than10. 00 mg /( kg·d) and it was 10. 00 mg /( kg·d) in the male rats. CONCLUSION: FOX-7 could inhibit the growth of rats and damage the blood system and male reproductive system.

OBJECTIVETo detect the embryo toxicity and the teratogenicity of DNAN in rats and provide basic data to occupational protection.

METHODS120 adult female SD rats and 60 male rats are mating for 1: 1, and the pregnant rats were randomly divided into five groups by the pregnant time. The negative control group are gavaged with 4% starch, and the three experiment groups are gavaged with DNAN suspension with the dose of 5 mg/kg, 15 mg/kg and 45 mg/kg respectively, while the positive control give aspirin of 280 mg/kg. All rats of the five groups are administrated gavage from gestation day 5 (GD5) to GD19 continuously. The rats are dislocated in GD20, and the toxicity of embryo and toetus are detected.

RESULTSThe net weight growth in all three dose group are less than that of negative group, while the dead foetus in high dose group is more than negative group. Moreover, the body weight, body lenghth, tail lenghth and the anal genital distance of foetus rats in high dose group are all less than that of negative group. The foetus external malformations of three dose groups appear no significant compared with negative group.However, the prevalences of skeleton malformation in high dose group and the internal organs malformation in the median and high dose group appear significant higher than that of negative group. There are significantly maternal reproductive toxicity, embryo toxicity and toetus toxicity in positive group.

CONCLUSIONDNAN can induced maternal reproductive toxicity, embryo toxicity and the teratogenicity to rats.

Animals ; Anisoles ; toxicity ; Female ; Male ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Teratogens ; toxicity ; Toxicity Tests