Abstract  The monitoring of snow cover pollution by heavy metals and elements (zinc, copper, lead, cadmium, arsenic, nickel, chromium, strontium, manganese, fluorine, lithium) was performed in 20 districts of the Moscow region in 2009, 2012 and 2013. The assessment of the levels of contamination by heavy metals and elements was given by means of comparison of them with the average values in the snow cover near Moscow in the end of the last century and in some areas of the world, that no exposed to technological environmental impact. 7 districts of Moscow region were characterized by a high content of lead and cadmium in the snow water. It requires the control of water, soil and agricultural products pollution.

Abstract  BACKGROUND: Since 2006, artemisinin-based combination therapies (ACT) have been used to treat uncomplicated Plasmodium falciparum malaria in Senegal, as recommended by WHO. Recently, decreased parasite clearance with artemisinin derivatives has been reported in Cambodia and Thailand. The effectiveness of artemisinin derivatives in Africa must be monitored. This study was conducted to evaluate the efficacy and the tolerability of three ACT widely used in Senegal.

METHODS: From October 2010 to February 2011, a descriptive and analytical sequential study was conducted in adults and children to evaluate these three combinations: artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ), and dihydroartemisinin-piperaquine (DHAPQ). The study took place at the health posts of Deggo and Pikine and the health center of Guédiawaye, in the suburbs of Dakar. The primary endpoint was the PCR-corrected adequate clinical and parasitological response (ACPR) at day 28 (D28); the secondary endpoints included ACPR at D42, clearance times for parasites, fever, and gametocytes, and the incidence of adverse events.

RESULTS: The study included 393 patients: 139 in the AL group, 130 in the ASAQ group, and 124 in the DHAPQ group. In the intent-to-treat population, PCR-corrected ACPR at day 28 was 92.8% in the AL, 89.2% in the ASAQ, and 91.1% in the DHAPQ (p = 0.58) groups, and in the per-protocol population, 98.4%, 98.3%, and 100% respectively (p = 0.39). At D42, ACPR was 99.2% in the AL, and 99.1% in each of the ASAQ and DHAPQ arms (p = 1). No early therapeutic failure (ETF) was observed. The combinations were well tolerated, with no serious adverse events reported during the follow-up period.

CONCLUSION: These combinations are still effective and well-tolerated. Continued monitoring is nonetheless essential to detect early artemisinin resistance in Africa.

Abstract  OBJECTIVE: To investigate the effect of occupational toluene diisocyanate(TDI) exposure on matrix metalloproteinases-9 (MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1), and analysis of the correlation of MMP-9,TIMP-1,MMP-9/TIMP-1 and lung function.

METHODS: In October 2014, based on cluster sampling, we conducted a cross-sectional study in a TDI production factory located in China's western region. 61 exposed workers were recruited from workers engaged in packing, operating and checking. Based on different levels of the external exposure, the packers were classified as high exposed group, while operators and checkers as low exposed group. 58 factory managers, matching age and agent, were selected as controls, having same work intense and not contacting the TDI or other allergens. The questionnaire surveys were used to obtain the agent, age, work age, smoking and drinking, personal and family allergic history, occupational history, and the recent health conditions. The levels of MMP-9 and TIMP-1 in serum of subjects were determind by ELISA. The time weighted average concentrations (8h-TWA) were used to describe the levels of TDI air exposure in working environment. Spearman correlation assay was used to investigate the correlation of MMP-9, TIMP-1, MMP-9/TIMP-1 and lung function, exposure time.

RESULTS: 8-hour TWA means of TDI air levels in exposed group, packers, operators and checkers were 0.39, 0.76, 0.25 mg/m(3), respectively . According to the external exposure concentration, the packers were classified as high exposed group, and the operators and checkers were classified as low exposed group. In controls, low exposed group and high exposed group, the levels of MMP-9, respectively, were (807.21±347.70),(586.91±317.50),(388.94±312.01) ng/ml (χ(2)=16.69, P<0.001), respectively, and the P50(P25-P75) of MMP-9/TIMP-1 were 4.67(2.87-6.68), 2.3(1.44-3.48), 1.11(0.59-1.48) (χ(2)=39.42, P<0.001), respectively, and the concentrations of TIMP-1, were (173.44±72.67), (236.12±51.98), (302.81±44.39) ng/ml (F=20.09, P< 0.001), respectively. The levels P50(P25-P75) of FVC, FEV1.0 and FEV1.0/FVC in exposed group were, 92.8% (86.0%-101.8%), 85.5%(76.7%-92.8%), 112.5(108.2-118.5), respectively, which were lower than that in control group (124.3%(107.9%-144.2%), 142.7%(119.1%-155.7%), 129.2(123.5-134))(Z values were 7.70, 8.97, 8.62, and all P<0.001). Spearman rank correlation analysis showed that levels of MMP-9 were positively associated with FEV1.0, and FEV1.0/FVC (r values were 0.27, 0.25, respectively, all P<0.05), and The levels of TIMP-1 were negatively associated with FVC, FEV1.0, and FEV1.0/FVC (r valuse were -0.33, -0.39, -0.39, all P<0.05).The levels of MMP-9 were negatively correlated with exposure time(r=-0.26, P=0.040). The positive correlations of MMP-9/TIMP-1 with FVC, FEV1.0, and FEV1.0/FVC were also found (r valuse were 0.34, 0.44, 0.40, all P<0.05).

CONCLUSION: TDI exposure could induce the downs of MMP-9 and MMP-9/TIMP-1 associated with lung functions. The MMP-9 and MMP-9/TIMP-1,in a way, could reflect the respiratory inflammatory injury caused by TDI exposure.

Abstract  The p-arsanilic acid (ASA) is an important organoarsenical compound and its removal is more difficult compared to inorganic arsenic, however, little attention has been paid to the removal of ASA in aqueous environment. The influence of P25 on the adsorption of ASA, effect of P25 dosage, pH and illumination intensity on the photo-catalysis, the production analysis and main mechanism of photo-degradation were investigated in this study. The results showed that in the P25 catalysis process, simulated natural light could degrade ASA into As (V) by oxidation. The total As was reduced to about 0.34 mg x L(-1) within 0.5 h under the following condition: the initial concentration of ASA was 2 mg x L(-1) and the dosage of TiO2 was 1 g x L(-1). The result showed that the removal rate of ASA in acidic conditions was much higher than that in alkaline conditions. The optimal strength of light was 68.5 mW x Cm(-2). Hydroxide radical played a major role in photocatalytic oxidation of ASA by P25.

Abstract  This is the second paper on the Project Manfredonia Environment and Health launched on February 2015 and based on a participatory approach. After a serious industrial accident on 1976 with release of several tons of arsenic, the management of environmental issues produced distrust and suspicion towards institutions and these feelings are still alive in the civil society. The Project is therefore based on a strong public engagement on each phase of the epidemiological investigation. In this article we report the second phase in which all the stakeholders consider all possible analysis results and the implications in terms of public health action plans. This step is relevant in order to acknowledge the limitation of the epidemiologic study due to uncertainties and assure transparency to the decision processes.

Abstract  OBJECTIVE: To observe and primarily evaluate the feasibility and validity of continuous blood purification (CBP) during the early stage of severe burn.

METHODS: Forty-one patients with severe burn admitted to our ward from January 2013 to July 2015, conforming to the study criteria, were divided into conventional treatment group (CT, n=21) and blood purification group (BP, n=20) according to the random number table and patient's personal consent. Patients in group CT received CT conforming to the traditional resuscitation principle for severe burn, while patients in group BP received CT and blood purification treatment in the mode of continuous venous-venous hemodiafiltration in addition up to post injury hour (PIH) 72. On post injury day (PID) 1, 2, 3, the vital signs, volume of fluid input, and volume of the urine output were observed and recorded; femoral artery blood was drawn to determine lactate, bicarbonate radical, and base excess, and oxygen index was calculated. At PIH 12, 24, 48, 72, femoral vein blood was drawn to determine white cell count, platelet count, neutrophils, creatine kinase-MB, creatine kinase, lactic dehydrogenase, aspartate transaminase (AST), alanine aminotransferase (ALT), creatinine, urea nitrogen, and blood glucose (the ratio of AST to ALT was calculated). The incidence of infection, sepsis, and multiple organ dysfunction syndrome (MODS) and the mortality of patients were recorded during 2 months after injury. Data were processed with chi-square test, analysis of variance for repeated measurement, t test and Wilcoxon test, and the values of P were adjusted by Bonferroni.

RESULTS: The observation was completed in the 41 patients without exclusion. (1) There were no statistically significant differences in vital signs, volume of fluid input, and volume of the urine output of patients between two groups on PID 1, 2, 3 (with t values from -1.64 to 1.48, P values above 0.05). (2) Compared with that in group CT, the level of lactate of patients in group BP declined significantly on PID 2 and 3 (with Z values respectively -2.37 and -2.46, P values below 0.05). Compared with those in group CT, the levels of bicarbonate radical and base excess of patients in group BP declined significantly on PID 3 (with t values both as -2.51, P values below 0.05). The oxygen index of patients in group BP on PID 3 was (370±98) mmHg (1 mmHg=0.133 kPa), which was significantly higher than that in group CT [(305±81) mmHg, t=2.27, P<0.05]. (3) There were no statistically significant differences in white cell count, platelet count, neutrophils, creatine kinase, lactic dehydrogenase, AST, ALT, and AST to ALT ratio of patients between two groups at PIH 12, 24, 48, 72 (with t values from -1.47 to 1.19, Z values from -1.58 to -0.03, P values above 0.05). At PIH 24, 48, 72, the levels of creatine kinase-MB and blood glucose of patients in group BP were respectively (81±43), (55±34), (58±40) U/L and (7.9±2.0), (6.7±0.9), (6.9±1.8) mmol/L, which were significantly lower than those in group CT [(179±184), (124±71), (103±57) U/L and (10.1±3.8), (9.1±2.4), (8.8±4.1) mmol/L, with Z values from -3.73 to -2.02, P<0.05 or P<0.01]. Compared with those of patients in group CT, creatinine at PIH 48 and urea nitrogen at PIH 24, 48, 72 were obviously lower in group BP (with t values from -4.23 to -2.44, P<0.05 or P<0.01). (4) During the two months after injury, the infection rate of patients in group BP was 60.0% (12/20), which was significantly lower than that in group CT [95.2% (20/21), χ(2)=5.51, P<0.05]. The incidence of sepsis and MODS and the mortality of patients in group BP were all lower than those in group CT, but there were no statistically significant differences (with χ(2) values from 0.22 to 2.93, P values above 0.05).

CONCLUSIONS: Conducting CBP in the early stage of severe burn is safe and feasible, which does not obviously affect the vital signs, volumes of fluid input and urine output, or platelet count of patients, additionally, it could help protect the function of vital organs, eliminate stress hyperglycemia, and reduce infection rate. Clinical trial registration Chinese Clinical Trial Registry, ChiCTR-TRC-12002616.

Abstract  Genetic polymorphism is associated with the occurrence of at least 2 different alleles in the locus with a frequency higher than 1% in the population. Among polymorphisms we can find single nucleotide polymorphism (SNP) and polymorphism of variable number of tandem repeats. The presence of certain polymorphisms in genes encoding DNA repair enzymes is associated with the speed and efficiency of DNA repair and can protect or expose humans to the effects provoked by xenobiotics. Chemicals, such as lead, arsenic pesticides are considered to exhibit strong toxicity. There are many different polymorphisms in genes encoding DNA repair enzymes, which determine the speed and efficiency of DNA damage repair induced by these xenobiotics. In the case of lead, the influence of various polymorphisms, such as APE1 (apurinic/apyrimidinic endonuclease 1) (rs1130409), hOGG1 (human 8-oxoguanine glycosylase) (rs1052133), XRCC1 (X-ray repair cross-complementing protein group 1) (rs25487), XRCC1 (rs1799782) and XRCC3 (X-ray repair cross-complementing protein group 3) (rs861539) were described. For arsenic polymorphisms, such as ERCC2 (excision repair cross-complementing) (rs13181), XRCC3 (rs861539), APE1 (rs1130409) and hOGG1 (rs1052133) were examined. As to pesticides, separate and combined effects of polymorphisms in genes encoding DNA repair enzymes, such as XRCC1 (rs1799782), hOGG1 (rs1052133), XRCC4 (X-ray repair cross-complementing protein group 4) (rs28360135) and the gene encoding the detoxification enzyme PON1 paraoxonase (rs662) were reported. Med Pr 2018;69(1).

Abstract  OBJECTIVE: To investigate heavy metals contamination level in food in Shaoxing, and to provide basis evidence for supervising heavy metals pollution in food and environmental pollution control in Shaoxing.

METHODS: Food samples in 2014 were detected for lead, cadmium, mercury, arsenic, nickel, copper and chromium by national standard methods, and the results were evaluated by GB 2762-2012 Pollutants limits in food.

RESULTS: 1384 samples from 10 food categories were collected and tested for lead, cadmium, mercury and arsenic, the over standard rates were 2.0%, 3.0%, 1.5% and 0.22%, respectively, the median were 0.019, 0.0085, 0.0024 and 0.015 mg/kg, respectively; 273 samples were collected and tested for nickel, the detection rate was 48.4%, the median was 0.010 mg/kg; 255 samples were collected and tested for chromium, the detection rate was 14.9%, the median was 0.0050 mg/kg; 486 samples were collected and tested for copper, the detection rate was 94.0%, the median was 1.34 mg/kg. The heavy metals over standard rate of aquatic products, animal internal organs and grain were relatively high, 16.9%, 7.9% and 7.3% cadmium in swimming crabs exceeded standard seriously, the over standard rate was 38.9%.

CONCLUSION: The overall pollution of heavy metals in food are not high in Shaoxing in 2014, but some food (aquatic products, animal internal organs and grain) pollution are relatively outstanding, and have the over standard problems of lead, cadmium, mercury and arsenic.

Abstract  AIM: To assess the changes in several biomarkers in patients with atherosclerosis of brachiocephalic arteries and shape a biomarker profile of cerebral atherosclerosis as an integrative index.

MATERIAL AND METHODS: The study included 124 patients with atherosclerotic lesions of internal carotid arteries (82 men and 42 women) aged from 37 to 73 years. The patients were stratified by history of prior stroke into 'asymptomatic' and 'symptomatic'. Along with general clinical and neurological examinations, ultrasound analysis of brachiocephalic arteries, neuroimaging, identification of biomarkers reflecting different stages of atherogenesis and evaluation of pathomorphological parameters of atherosclerotic plaques removed during carotid endarterectomy surgery were performed.

RESULTS: Concentrations of NO2, NO3 and NO in blood plasma significantly differed between groups: 58.4, 43.3 and 15 mcmol/l, respectively, in the symptomatic group and 45, 19.2 and 25.8 mcmol/l in the asymptomatic group. The pro-inflammatory character of changes in atherosclerosis was confirmed by the increase in the concentration of lipoprotein-associated phospholipase A2 in patients with stroke (354.72±44.16 ng/ml versus 298.45±54.12 ng/ml). The level of the atheroprotective marker adiponectin decreased significantly in 'symptomatic' patients. Significant changes towards the prothrombotic state of blood were identified via levels of blood markers of fibrinolytic activity: plasminogen tissue activator and plasminogen activator inhibitor-1.

CONCLUSION: Together with other diagnostic methods, identification of biomarkers can increase the accuracy of prognosis and prevention of sudden cardiovascular death. The authors have developed a scale of biomarker 'burdeness' of the patient with cerebral atherosclerosis that may be a first step to individualized prevention of associated ischemic complications.

Abstract  OBJECTIVE: To investigate the arsenic levels in endemic arsenism in Datong City, Shanxi Province.

METHODS: A total of 85 inhabitants from one village in endemic arsenism area in Datong City, Shanxi Province were collected as research subjects. The People's Republic of China health industry standard for endemic arsenism was used to identify and diagnosis the patients. Daily drinking water and soil were collected and detected by atomic fluorescence spectrometry. The content of vegetables were detected by inductively coupled plasma mass spectrometry (ICP-MS).

RESULTS: In the study, 85 samples were collected. Arsenic concentration in the daily drinking water were 14.41 - 90.34 μg/L, and the median value was 43.88 μg/L. The arsenic concentration of vegetables were 0.001 - 0.771 mg/kg, and 43.04% of samples, were higher than the maximal permissible limit of As in food. The results that the arsenic concentration of vegetables constant changes in the leaf vegetables > tubers > fruit vegetables. The health risk of intaking arsenic pollution in vegetables up to 71.77%. The arsenic levels in village of four directions were not exceeded the Chinese standards.

CONCLUSIONS: Arsenic concentration in drinking water and vegetables are high in waterborn endemic arsenicosis area of Shanxi province. Arsenic in drinking water has been considered as a primary cause of arsenism, but direct intake of arsenic from vegetables can not be ignored.

Abstract  OBJECTIVE: To observe theexpression variations of estrogen receptor alpha (ERalpha) in different periods of mice offspring and the gender-dependent differences in the lung tissue with parental arsenic exposure.

METHODS: Parental female mice were exposed to arsenic by gavage from gestational day 8th to offspring infancy, and offspring were exposed to arsenic by drinking water after infancy. The expression level of ERalpha mRNA and protein in lung tissue of the male and female offspring in different developmental periods and different doses (low, middle, high) of sodium arsenite exposure were detected by real-time PCR and Western blot.

RESULTS: ERalpha mRNA expression in female lung tissue was lower than male in embryonic period (P<0.05); ERalpha mRNA expression in female lung tissue was higher than that of male in infant and adult periods (middle dose of infancy P<0.05, middle and high doses of adulthood P<0.05); No statistical significances were observed in embryo, infancy and adulthood control groups. ERalpha mRNA expression in female lung tissue of infancy and adulthood was higher than that in embryonic period (low, middle and high dose groups P<0.05). ERa protein expression in arsenic exposed female lung tissue was higher than that of male in infant and adult periods, it was also increased by compared with corresponding control groups (P<0.05). The expression level of ERalpha protein in exposed adult female and male offspring were higher than that of infancy.

CONCLUSION: Arsenic infected during pregnancy can increase the lung tissue's ERalpha expression level of female offspring in infancy and adulthood. This result is significant to elucidate the role of environment pollutants in gender difference of lung cancer's occurrence.

Abstract  Naturally occurring inorganic arsenic is known to increase the risk of cancers of the skin and several other organs, including the urinary bladder, lung, and liver. Epidemiological studies have also indicated that gestational arsenic exposure is associated with increased incidences of cancers in several organs, including the bladder and liver, in adulthood. Previous studies have shown that epigenetic changes are involved in arsenic-induced carcinogenesis. Among epigenetic changes, DNA methylation changes that are specific to arsenic-induced tumors would be useful for distinguishing such tumors from tumors induced by other factors and for clarifying arsenic carcinogenesis. It has been reported that gestational arsenic exposure of C3H mice, whose males tend to spontaneously develop liver tumors, increases the incidence of tumors in the male offspring. Using the same experimental protocol, we found a number of regions where the DNA methylation status was altered in the liver tumors compared with the normal liver tissues by the methylated DNA immunoprecipitation (MeDIP)-CpG island microarray method. Among such regions, we demonstrated using real-time methylation-specific PCR and bisulfite sequencing that a gene body region of the oncogene Fosb underwent alteration in DNA methylation following gestational arsenic exposure. We also showed that the Fosb expression level significantly increased following gestational arsenic exposure. These findings suggest that the DNA methylation status of the Fosb region is implicated in tumor augmentation and can also be utilized for characterizing tumors induced by gestational arsenic exposure.

Abstract  A pot experiment was carried out to study the effects of soil moisture on the growth and arsenic uptake of As-hyperaccumulator Pteris vittata L. The results showed that the remediation efficiency of As was the highest when the soil moisture was between 35%-45%. P. vittata grew best under 45% water content, and its aboveground and underground plant dry weights were 2.95 g x plant(-1) and 11.95 g x plant(-1), respectively; the arsenic concentration in aboveground and roots was the highest under 35% water content, and 40% content was the best for accumulation of arsenic in P. vittata. Moreover, controlling the soil moisture to 35%-45% enhanced the conversion of As(V) to As(III) in aboveground plant, and promoted arsenic detoxification in P. vittata. These above results showed that soil moisture played an important role in the absorption and transport of arsenic by P. vittata. The results of this study can provide important guidance for the large-scale planting of P. vittata and the moisture management measures in engineering application.

Abstract  OBJECTIVE: To evaluate the safty and feasibility of the D2 radical resection of omental bursa and No.12p and No.8p for gastric carcinoma (GC).

METHODS: Clinical data of 1801 GC patients undergoing D2 radical resection of omental bursa and No.12p and No.8p at Fujian Medical University Cancer Hospital from January 2000 to January 2010 were analyzed retrospectively. Inclusion case criteria: (1)age of 18 to 90 years;(2)pathologically diagnosed as GC and receiving D2 radical resection of omental bursa and No.12p and No.8p;(3)complete clinical, pathological and follow-up data; (4)operation performed by same leading surgeon;(5)exclusion of other gastric malignancies, postoperative relapse of GC, and other simultaneous or heterochronous primary malignancies. Surgical procedure points: (1)The outer part of the peritoneum of duodenum descending was cut; the serosa was migrated to the anterior leaf of the gastrointestinal ligament. (2)The posterior lobe of the gastrocolic ligament and the transverse mesocolon were separated bluntly from left side to reach the omentum attaching to the colon portion; incision was made at the edge of the omentum attaching to the transverse colon behind the gastrocolic ligament; the leaves were turned to the anterior mesenteric anterior leaflets, and the entire anterior leaflet of the transverse mesentery was free.(3)The pancreas was separated, and resection of the posterior wall of the omentum sac continued up so that the entire retinal capsule was free; along the edge of the liver the attachment of the omentum was cut to reach the front of esophagus, and transverse incision was made in abdominal peritoneal layer of the esophagus, and then turned to the spleen on the pole; from the obturator to the esophagus incision was performed behind the peritoneum for the net; the uppermost edge of the resection of the capsule was performed as the posterior peritoneal incision to the right edge of the esophagus and was connected with the posterior parietal lobe of the previous resection; the posterior peritoneum was attached along the right edge of the esophagus and descended to the celiac artery; the posterior wall of the omental sac was removed. In the meantime, the liver duodenum ligament was cut, and the portal vein, hepatic artery trilocular was formed. Then the ligament lymph nodes were cleared.(4)The lymph nodes of celiac artery and its major branches were cleared; the envelope in front of pancreas and the part of the pancreas in posterior abdomen were resected; spleen and part of the pancreas tail were free.

RESULTS: A total of 1801 cases were enrolled, including 1292 males and 509 females with a ratio of 2.54 with a mean age of(58.9±11.5)(18 to 89) years. The proportion of cases with T1a, T1b, T2, T3, T4a and T4b was 4.8% (87 cases), 6.6% (118 cases), 10.7% (193 cases), 17.5% (315 cases), 55.7% (1003 cases) and 4.7%(85 cases) respectively. All the patients completed operations successfully. The mean number of harvested lymph node was 28.5±13.7(10 to 85). Lymph node metastasis was found in 1439 cases (79.9%), including 180 cases (10.0%) in No.12p and 232 cases(12.9%) in No.8p respectively. Subgroup analysis showed that in T1a, T1b, T2, T3, T4a and T4b stage, the proportion of No.12p was 0, 1.7% (2/118), 5.2%(10/193), 10.5% (33/315), 12.4% (124/1003) and 12.9%(11/85) respectively, and the proportion of No.8p was 0, 0.8%(1/118), 2.1%(4/193), 4.8%(15/315), 18.9%(190/1003), and 25.9%(22/85) respectively. Postoperative complications were found in 195 patients (10.8%), including 63 cases(3.5%) of peritoneal infection, 52 cases (2.9%) of pulmonary infection, 33 cases(1.8%) of pancreatic leakage, 37 cases (2.1%) of anastomotic fistula, 45 cases (2.5%) of intestinal obstruction and 13 cases(0.7%) of gastroplesia. The 5-year overall survival rate was 53.6%.

CONCLUSION: D2 radical resection of omental bursa and No.12p and No.8p is safe and feasible in the treatment of gastric cancer.

Abstract  Heavy metal is one of pollutants existed widely in the environment, its relationship with cardiovascular disease has attracted more and more attention. In this review, the concentrations of heavy metals, including lead, cadium and asenic, in the body from several national surveillance networks and the epidemiological studies on the effects of the exposure of three heavy metals on cardiovascular system were summarized. It is suggested to strengthen nationwide surveillance for body concentrations of heavy metals in general population in order to provide baseline data for quantitative evaluation of the risk of heavy metal exposure on cardiovascular disease.

Abstract  OBJECTIVE: To observe the efficacy of auricular point sticking therapy for abnormal blink in children and the impact on the breakup time of tear film.

METHODS: A total of 123 cases (246 eyes) with abnormal blink were randomly assigned into two groups, 62 cases (124 eyes) to an observation group, 61 cases (122 eyes) to a control group. The observation group received auricular point sticking therapy with western medicine; the treatment was given 6 d per week; the next day received no treatment and changed dressing. The auricular points were yan (LO5), pingjianqian (TG2i), pingjianhou (AT1 i), gan (CO12), pi (CO13), wei (CO4). The western medicine pateints took 1 oral multivitamins tablets per day, and received sodium hyaluronate eye drops and tobramycin eye drops in turn, 3 times per day, 7 day as a course; treatment was lasting 3 courses. Patients in the control group only received western medicine. The blink frequency score and breakup time of tear film of children were observed, the curative effect of the two groups was compared.

RESULTS: After treatment, the blink frequency score was lower significantly (P<0.01), and lower significantly in subjects in the observation group compared to those in the control group (P<0.01). After treatment, less than 10 s were 51 eyes (41.8%) and greater than 10 s (including 10 s) were 71 eyes (58.2%) in the 122 eyes from the control group; in the observation group, less than 10 s were 13 eyes (10.5%) and greater than 10 s (including 10 s) were 111 eyes (89.5%); there was significant difference between the two groups (P<0.01). The effective rate of the observation group was 91.9% (114/124), which was higher than the control group 65.6% (80/122); the difference was statistically significant (P<0.01).

CONCLUSION: The efficacy of auricular point sticking therapy combine western medicine is better in treating children with abnormal blink compared to western medicine by reducing the breakup time of tear film. This suggests that reduction of tear film stability is one of the main reasons which causes frequent eye blink, and breakup time of tear film can be used as the testing standard.

Abstract  Acute promyelocytic leukaemia has changed from being a highly fatal to a highly curable disease. Over time, key discoveries have identified the genetic and molecular abnormalities, which cause the disease. First choice of treatment has now changed from all-trans retinoic acid (ATRA) and chemotherapy to a chemo-free combination of arsenic trixoide and ATRA. This new regimen has shown equal responses and overall cure rates compared with the previous standard of care containing conventional chemotherapy, but with much lower toxicity. This will pave the way for better and easier treatment for elderly and frail patients.

Abstract  PURPOSE: The aim of the study was evaluation and comparison of clinical results of two types of rotationally asymmetric multifocal intraocular lens (LENTIS Mplus and LENTIS MplusX).

MATERIAL AND METHODS: The study included 247 eyes of 124 patients aged 25 - 76 years (mean, 58 years). After phacoemulsification multifocal intraocular lens LENTIS Mplus (group A, n = 141) or LENTIS MplusX (group B, n = 106) was implanted. Patients were divided into two groups according to the type of intraocular lens. Patients were evaluated at 1 month, 3 months and 6 months after surgery. We assessed the uncorrected visual acuity, best corrected visual acuity, subjective refraction, contrast sensitivity and subjective satisfaction.

RESULTS: Mean preoperative monocular uncorrected distance visual acuity (UCDVA) in the group A was 0,40 ± 0,27; in the group B 0,34 ± 0,25. Postoperatively UCDVA was statistically significant improved in both groups (group A: 1,01 ± 0,20; group B: 0,90 ± 0,15). Mean preoperative monocular uncorrected near visual acuity (UCNVA) was Jaeger (J) 12,82 ± 4,16 (group A), resp. J 12,73 ± 3,99 (group B). Postoperatively UCNVA was statistically significant improved in both groups (group A: J 1,81 ± 1,42; group B: J 1,54 ± 1,72). There was not found statistically significant difference between both groups in these parameters. Contrast sensitivity was evaluated in patients who have undergone clear lens extraction in both eyes. There was not found the statistically significant reduction of contrast sensitivity in both groups. Subjective satisfaction was assessed in the range of marks 1-5. The average mark of the subjective satisfaction ratings in the group A was 1,37; in the group B 1,25.

CONCLUSION: Our study found the multifocal intraocular lens LENTIS Mplus and LENTIS MplusX give high-quality distance and near vision and provide high degree of spectacle independence. There was not found statistically significant difference in all parameters between the Group A (implantation Mplus LENTIS) and the Group B (implantation LENTIS MplusX) in our study. However, in our study we have observed higher subjective satisfaction and lower incidence of optical phenomena in the Group of patients with the implantation of intraocular lens LENTIS MplusX.Key words: LENTIS Mplus, LENTIS MplusX, visual acuity, contrast sensitivity, optical phenomen.

Abstract  Objective: To investigate the trend of esophageal and stomach cancer incidence and mortality in Feicheng during 2000 to 2013, and to evaluate the effects of the national project of screening for upper digestive tract cancers from 2006 to 2015 in Feicheng.Methods:We collected 26 569 cases, which were coded of C15 and C16 in the 10th edition of international classification of diseases (ICD) during the period of 2000-2013. The data came from cancer registration system of Feicheng, Shandong Province, China. These cases already covered 21 679 882 person-year. The annual percent change (APC) of incidence and mortalit were analyzed. The risk factors of upper gastrointestinal cancer were investigated and evaluated for people aging 40-69 in three street offices and eleven townships of Feicheng, and endoscopic screening was conducted among people who was in high risk. The corresponding data were used to analyze the early detection project of upper gastrointestinal cancer screening and early diagnosis, with the index of detection rate, early diagnosis rate, early treatment rate and other indicators.Result:There were 26 569 new cases of esophageal cancer and gastric cancer occurred in Feicheng from 2000 to 2013. The incidence of esophageal cancer gradually increased since 2000 with 76.06 per 100 000 people (575/756 005) and reached the peak in 2010 with incidence rate of 118.76 per 100 000 people (852/717 429), with the annual percent change at about 4.3% (95%CI:2.7%-5.9%) and showed a downward trend after then but has no significance, with APC about-7.1% (95%CI:-15.8%-2.5%). The incidence of gastric cancer was increased from 2000 with an incidence rate of 37.70 per 100 000 people (285/756 005) to 2013 with an incidence rate of 54.59 per 100 000 (538/985 512), with an annual percent change of about 3.3% (95%CI:2.1%-4.5%). Esophageal cancer and gastric cancer mortality showed a relatively stable trend during 2000 to 2013, esophageal cancer with APC about 0.1% (95%CI: -1.3%-1.5%) and stomach cancer with APC about 0.8% (95%CI: -0.5%-2.0%). From 2006 to 2015, 58 579 residents aged 40-69 years old participated cancer screening project covered 206 105 populations in Feicheng. There were 1 124 invasive cancers and in situ cases from upper digestive tract were detected, with the detective rate at 1.92%. Among those cases, 941 cases were in early stage with the early diagnosis rate of 83.72%, and about 88.97% of detected patients received appropriate treatment after diagnosis.Conclusion:The incidence of esophageal cancer and gastric cancer with a very high level of incidence and mortality, this made the prevention and control situation was still very serious. The project of cancer screening, early diagnosis and treatment on upper digestive tract cancers in Feicheng plays a positive role on cancer control.

Abstract  Field plot experiments were conducted to study the effect of two-year consecutive As stress [As(V): 0, 20, 80, 140, 200 and 260 mg·kg-1] on contents of As, saponin and flanovoids, the enzyme activities of phenylalanine ammonia lyase (PAL), chalcone synthase (CHS), and squalene synthase (SS) in main root, fibrous root and rhizome and shoot, and proteome of three-year old Panax notoginseng in Wenshan prefecture, Yunnan Province, China. The results showed that total saponin content of fibrous root decreased with increase in As treatment concentration. Total saponin contents of shoot and rhizome increased with 140 mg·kg-1 As treatment compared with control. SS activity of rhizome was higher than that of shoot. Flavonoid contents of diffe-rent plant parts decreased with increase in As treatment concentration. With 140 mg·kg-1 As treatment, activities of PAL and CHS in rhizome were higher than that in shoot. CHS activities in shoot and rhizome were lower, and PAL activities were higher than those of the control. As contents in different plant parts of P. notoginseng increased with increase in As treatment concentration. The highest As content was observed in fibrous root. With 140 mg·kg-1 As treatment, twenty-one diffe-rential proteins (ratio >2, P<0.05) were identified in the inoculated compared to the control. The down-regulated proteins included phosphoribulokinase, heat shock protein, NAD(P)-binding rossmann-fold superfamily proteinisoform, monodehydroascorbate reductase and cytochrome b6-f complex iron-sulfur subunit. The up-regulated proteins included CDC27 family protein, acidic endochitinase isoform, symbiosis receptor-like kinase precursor, isoflavone reductase-like protein, phospho-2-dehydro-3-deoxyheptonate aldolase, putative protein kinase superfamily protein, malate dehydrogenase, glyoxalase I isoform and glutamine synthetase cytosolic isozyme. In general, with two-year consecutive As stress, As contents in different plant parts of P. notoginseng increased, which not only affected the photosynthesis and energy, but also decreased the antioxidation and resilience, and induced the increased expression of protein involved in detoxication, resulted in decrease in the contents of flavonoid and saponin. The tolerant threshold value of P. notoginseng for As was 140 mg·kg-1.

Abstract  Speciation and bioavailability of arsenic in the rhizosphere and non-rhizosphere soils at different growth stages (tillering stage, jointing stage, booting stage, filling stage and maturing stage) of rice (Oryza sativa L.) were studied using toxicity characteristic leaching procedure (TCLP) and arsenic speciation analysis. Pot experiments were conducted and the soil samples were taken from a certain paddy soil in Hunan Province contaminated by mining industry. The results showed that: (1) With the extension of rice growth period, pH values and TCLP extractable arsenic levels in the rhizosphere and non-rhizosphere soils increased gradually. Soil pH and TCLP extractable arsenic levels in non-rhizosphere soils were higher than those in the rhizosphere soils at the same growth stage. (2) At the different growth stages of rice, contents of exchangeable arsenic (AE-As) in rhizosphere and non-rhizosphere soils were lower than those before the rice planting, and increased gradually with the extension of the rice growing period. Contents of Al-bound arsenic (Al-As), Fe-bound arsenic (Fe-As) and Ca-bound arsenic (Ca-As) increased gradually after rice planting, but not significantly. Residual arsenic (O-As) and total arsenic (T-As) decreased gradually after rice planting, by 37.30% and 14.69% in the rhizosphere soils and by 31.38% and 8.67% in the non-rhizosphere soils, respectively. (3) At the different growth stages of rice, contents of various forms of arsenic in the soils were in the following order: residual arsenic (O-As) > Fe-bound arsenic ( Fe-As) > Al-bound arsenic (Al-As) > Ca-bound arsenic (Ca-As) > exchangeable arsenic (AE-As). In the pH range of 5.0- 5.8, significant positive linear correlations were found between most forms of arsenic or TCLP extractable arsenic levels and pH values, while the Ca-bound arsenic was poorly correlated with pH values in the rhizosphere soils.

Abstract  The hygienic analysis of centralized and decentralized water supply in rural population in Irkutsk region was performed. About 403 thousand of the upstaters use water wells, voids and springs. In drinking water there were detected significant concentrations of iron, nitrates, manganese. On the base of the application of risk assessment methodology there was calculated noncarcinogenic risk for adults (HI = 1.2-1.3) and children (HI = 1.1-2.9). Carcinogenic risk for water from groundwater sources supply is 1.56 · 10(-5)-2.1 · 10(-4) for 22.2 thousand of upstaters. There were determined priority carcinogenic ingredients: arsenic (contribution is 56.3-100%) and hexad chromium (contribution is 29.9-35.8%).

Abstract  The incidence of epithelial skin neoplasms, such as squamous cell carcinoma and basal cell carcinoma is significantly increasing worldwide. Leisure time solar UV exposure is causative in the overwhelming majority of cases in the general population; however, occupational exposure is responsible for a certain percentage of cases. Employees with a relevant exposure to polycyclic aromatic hydrocarbons in soot, raw paraffin, coal tar, anthracene, pitch or similar substances, to sunlight in outdoor occupations as well as to arsenic and ionizing radiation have a significantly increased risk to develop occupational skin cancer compared to the general population. In the official occupational disease list in the appendix of the German by-law on occupational diseases, the following occupational diseases concerning skin cancer are listed: BK 5102 "skin cancer and carcinoma in situ caused by soot, raw paraffin, coal tar, anthracene, pitch or similar substances" (e.g. various solid paraffins, asphalt and mazut as well as mineral oils, grease, cylinder and drilling oils), BK 5103 "squamous cell carcinoma or multiple actinic keratosis caused by natural UV radiation", BK 1108 "diseases caused by arsenic and its compounds" and BK 2402 "diseases caused by ionizing radiation". For further occupational exposure to carcinogenic substances and potential occupationally acquired skin tumors, no official lists are currently available. These cancers might be considered under a special opt out paragraph in the German Social Law (§ 9 para 2 SGB VII). Tumors in scars after occupational skin trauma or occupational burns are compensated as consequences of work accidents. The current official list of occupational skin cancers and new developments for expert opinions are described in this article.

Abstract  OBJECTIVE: To observe the effect of chronic arsenic exposure on cerebral cortex and serum metabolics of mice and explore the mechanism of arsenic neurotoxicity.

METHODS: Twelve 3-week-old male C57BL/6J mice were randomly assigned into exposure group and control group and exposed to sodium arsenite (50 mg/L) via drinking water and deionized water for 12 weeks, respectively. After the exposure, arsenic level in the cerebrum was determined by hydride generation-atomic fluorescence spectrometry. The metabolites in the cerebral cortex and serum were determined using gas chromatography-mass spectrometry (GC/MS) analysis. Principal component analysis (PCA) was used to analyze the difference of the metabolites between the exposure and the control groups. Online tools for analyzing metabolic pathways were used to identify the related metabolites pathways.

RESULTS: Arsenic content in the brain of exposure group was significantly higher than that in the control group (P<0.05). The mice exposed to arsenic had a higher level of citric acid, phenylalanine, tyrosine, histidine and lysine in the cerebral cortex (P<0.05). Serum levels of serine, glycine, proline, aspartate and glutamate were significantly higher while α-ketoglutaric acid level was significantly lower in the exposure group than in the control group (P<0.05). PCA analysis showed a significant difference in cerebral cortex and serum metabolites between the two groups.

CONCLUSION: Chronic arsenic exposure may affect the function of the central nervous system by interfering with amino acid metabolism and tricarboxylic acid cycle, which may be one of the mechanisms of arsenic neurotoxicity.

Abstract  OBJECTIVE: To investigate the potential association between 23 urinary metals and mean platelet volume (MPV) among a community population in Wuhan.

METHODS: A total of 3 053 community residents who lived in the sampling buildings for more than 5 years, aged from 18 to 80 years, were recruited using a stratified, cluster sampling approach in Wuhan city, China. Blood and urine samples were obtained from participants in the morning under fasting conditions. Urinary metals, including aluminum, titanium, vanadium, chromium, manganese, iron, cobalt, nickel, copper, zinc, arsenic, selenium, rubidium, strontium, molybdenum, cadmium, tin, antimony, barium, tungsten, thallium, lead and uranium, were measured by inductively coupled plasma mass spectrometry. The MPV contents were determined using a fully automated clinical chemistry analyzer. Participants with missing data on covariates or cardiovascular disease were excluded. According to the reference intorvals of MPV for Chinese adults, the participants were classified into normal (7.0-11.0 fl) and high MPV (>11.0 fl) subgroups. Data from 2 203 participants were used to evaluate the associations between urinary metals and MPV levels using generalized linear regression models, and the risk of abnormal elevation of MPV using multivariable logistic regression models. The false discovery rate (FDR)-corrected P-value from 23 hypothesis tests was used to adjust for multiple testing.

RESULTS: After adjusting for potential confounders, urinary concentrations of arsenic (P50=2.431 μg/mmol creatinine) and molybdenum (P50=4.035 μg/mmol creatinine) were significantly associated with increased MPV levels and the risk of abnormal elevation of MPV. In contrast, urinary aluminum (P50=2.706 μg/mmol creatinine) and thallium (P50=0.046 μg/mmol creatinine) were associated with decreased MPV levels, but also the risk of abnormal elevation of MPV. The regression coefficients and 95% CIs were 0.119 (0.043-0.196) for arsenic (FDR-adjusted P=0.018), 0.119 (0.042-0.195) for molybdenum (FDR-adjusted P=0.018), -0.115 (-0.195--0.034) for aluminum (FDR-adjusted P=0.029), and -0.307 (-0.386- -0.228) for thallium (FDR-adjusted P<0.001), respectively. When comparing the extreme quartiles for arsenic, molybdenum, aluminum and thallium, adjusted OR and the 95%CIs were 1.830 (1.382-2.423), 1.496 (1.125-1.989), 0.566 (0.412-0.779) and 0.302 (0.219-0.416), respectively, and FDR-adjusted P-values were <0.001,<0.014,<0.008 and<0.001, respectively. Moreover, significant associations were found between an increased risk of abnormal MPV elevation with urinary iron (P50=6.716 μg/mmol creatinine) , antimony (P50=0.014 μg/mmol creatinine) and uranium (P50=0.003 μg/mmol creatinine) , and a decreased risk with urinary tungsten (P50=0.010 μg/mmol creatinine) and lead (P50=0.265 μg/mmol creatinine) . When comparing the extreme quartiles for iron, antimony and uranium, the respective adjusted OR (95%CI) were 1.866 (1.395-2.496), 1.507 (1.111-2.043) and 1.452 (1.063-1.984), and the respective FDR-adjusted P-values were <0.001,<0.022 and<0.012. The respective adjusted OR (95%CI) were 0.551 (0.417-0.726) and 0.534 (0.394-0.725), and the respective FDR-adjusted P-values were<0.001 and<0.001, when comparing the extreme quartiles for tungsten and lead. Based on multi-metal models, urinary chromium (P50=0.120 μg/mmol creatinine) and selenium (P50=0.646 μg/mmol creatinine) were associated with increased risk of abnormal MPV, while urinary nickel (P50=0.193 μg/mmol creatinine) was associated with decreased risk of abnormal MPV. When comparing the extreme quartiles for chromium, selenium and nickel, adjusted OR (95% CI) were 1.578 (1.054-2.363), 1.718 (1.159-2.549) and 0.535 (0.373-0.767), respectively, and the FDR-adjusted P-values were 0.017, 0.028 and 0.002, respectively.

CONCLUSION: In the general population of Wuhan city, exposure to aluminum, chromium, iron, nickel, arsenic, selenium, molybdenum, antimony, tungsten, thallium, lead and uranium were all associated with abnormal MPV elevation.