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Osteosarcoma (OS) is the most common primary bone tumor in children and adolescents. It is an aggressive tumor with a tendency to spread to the lung, which is the most common site of metastasis. Patients with advanced OS with metastases have poor prognoses despite the application of chemotherapy, thus highlighting the need for novel therapeutic targets. The tumor microenvironment (TME) of OS is confirmed to be essential for and supportive of tumor growth and dissemination. The immune component of the OS microenvironment is mainly composed of tumor-associated macrophages (TAMs). In OS, TAMs promote tumor growth and angiogenesis and upregulate the cancer stem cell-like phenotype. However, TAMs inhibit the metastasis of OS. Therefore, much attention has been paid to investigating the mechanism of TAMs in OS development and the progression of immunotherapy for OS. In this article, we aim to summarize the roles of TAMs in OS and the major findings on the application of TAMs in OS treatment.
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Objective To grasp the current situation of drinking water-borne endemic fluorosis in Shandong Province,and provide a scientific basis for formulating preventive strategies.Methods In 2016,according to the "National Surveillance Scheme of Drinking Water-Borne Endemic Fluorosis" and "Shandong Provincial Surveillance Scheme of Drinking Water-Borne Endemic Fluorosis",10 counties (cities,districts) were selected in Shandong Province,3-5 villages were selected in each county (city,district),to investigate the operation of water improvement and fluorine reduction project and the water fluorine,and 1 tap water sample in each village was collected to detect water fluorine.At the same time,dental fluorosis examination was performed on all children aged 8-12 years old and fluorosis X-ray examination was performed on adults aged ≥25 years old.Water fluorine was detected by ion selective electrode method;the water fluorine was determined according to "Standards for Drinking Water Quality" (GB 5749-2006);criteria for diagnosis,grading and epidemic intensity of dental fluorosis were based on "Diagnosis of Dental Fluorosis" (WS/T 208-2011);the diagnostic and grading criteria for skeletal fluorosis were based on the "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008).Results All the 32 villages in 10 counties (cities,districts) changed water,water improvement and fluorine reduction project ran normally,24 villages had qualified water fluorine (≤ 1.20 mg/L),and 8 villages had water fluorine exceeding the standard.The detection rate of dental fluorosis in children was 25.75％ (419/1 627),and the difference between 10 counties (cities,districts) was statistically significant (x2 =288.55,P ＜ 0.01);the dental fluorosis index was 0.48,and the defect rate was 2.77％ (45/1 627).The detection rate of skeletal fluorosis in adults was 4.72％ (72/1 525),and the difference between 10 counties (cities,districts) was statistically significant (x2 =18.83,P ＜ 0.01).Conclusions The problem of water fluorine exceeding the standard in water improvement and fluorine reduction project in Shandong Province is still serious.The condition of fluorosis has not been fully controlled,and the prevention and treatment measures need to be further strengthened.
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Objective To analyze the relationship between blood glucose,blood lipid and body mass index (BMI) in elderly patients with hypertension.Methods Form January 2016 to December 2017,376 hypertensive patients over 65 year old in Jinan city were enrolled in this study.The sex,age,BMI,fasting blood glucose and blood lipid were investigated and tested.The prevalence of coronary heart disease and diabetes mellitus in hypertensive patients were investigated,and the relationship between BMI and blood glucose,blood lipid and liver function index were explored.Results Of 376 hypertensive patients,the detection rate of diabetes mellitus was 21.01％ (79/376),221 cases were diagnosed with coronary heart disease,with the detection rate of 58.78％.With the rise of BMI,fasting blood glucose showed an upward trend.Person correlation analysis showed that there was a significant positive correlation between BMI and fasting blood glucose(r =0.167,P =0.003).The difference between TG and TC in different BMI groups was statistically significant(FTG =12.48,P ＜ 0.001;Frc =4.83,P ＜ 0.001).The content of alanine transaminase in the overweight group and obese group was significantly higher than that in the normal body weight group,the difference was statistically significant(F =5.24,P =0.005).Conclusion For elderly hypertensive patients,it is urgent to test blood glucose and coronary heart disease screening.For people over the age of 65,obesity is still an important risk factor for hyperlipidemia and hyperglycemia.Therefore,body weight control is needed in elderly patients with hypertensive.
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Objective To explore the effect of health education on endemic fluorosis in Shandong Province,and provide evidence for further development of health education measures.Methods From 2011 to 2015,using prospective method,19 endemic fluorosis counties (cities,districts) were selected as project counties in Shandong Province each year,and 3 townships (towns) were selected in each project county.Health educational activities on prevention and treatment of endemic fluorosis were carried out in the classes of grade 4-6 in the central primary school;3 administrative villages were selected in each township (town) to carry out community health education activities.Before and after the health education activities,questionnaire surveys on the health education of endemic fluorosis prevention knowledge were conducted among 30 students of grade 5 in the central primary school and 15 housewives lived near the schools in each township (town).Results The results of health education evaluation showed that the'awareness rate of prevention and treatment of endemic fluorosis in school students and housewives were 95.64％ (27 770/29 037) and 92.09％ (14 341/15 573),respectively,which were significantly higher than those before the intervention [69.40％ (20 157/29 043) and 67.40％ (10 375/15 393)],and the differences were statistically significant (x2 =6 926.73,2 928.85,P ＜ 0.05).Among the primary school students and housewives,the knowledge awareness rates of prevention and treatment of endemic fluorosis were increased by 26.24％ and 24.69％,respectively.Conclusion After implementation of endemic fluorosis health education intervention,the awareness rate of prevention and treatment knowledge in local fluorosis areas in Shandong Province is significantly increased,which means we can further expand the scope of health education.
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Objective To analyze the influencing factors of water iodine in Shandong Province.Methods The county-based study set Shandong Province as a research site.The water iodine data of county (city) from 2008 to 2010 were obtained from Shandong Institute for Prevention and Control of Endemic Disease.Water iodine content was used as a dependent variable,and soil type,hydrogeological type,topography and distance to the Yellow River were analyzed as independent variables.Normality test and general linear regression analysis of the dependent variables were performed using SAS 9.3 software;geographically weighted regression (GWR) analysis was performed using SAM V4.0 software;related electronic maps were drawn using ArcGIS 9.3 software.Results A total of 108 164 water iodine content data were collected.General linear regression analysis showed that the constructed regression model was statistically significant (F =16.29,P ＜ 0.01),and the soil type was included in the model with a determination coefficient (R2) =0.51.GWR analysis showed that R2 =0.63 and the adjustive determination coefficient (R2adj) =0.59.Considering the autocorrelation of the variable space,the model's goodness of fit was better than that of the traditional general linear regression model.GWR analysis showed that soil type and distance to the Yellow River were major factors related to water iodine in Shandong Province.There was a negative correlation between soil type and spatial variability of water iodine in most areas of Shandong Province,the correlation coefficients weakened gradually from west to east,indicating a geographic gradient variability.The correlation coefficients of distance to the Yellow River and spatial variability of water iodine were negative in some areas,while they were positive in other areas,indicating a clear geographical variability from southwest to northwest.Conclusion The soil type and the distance to Yellow River are important factors affecting the spatial distribution of water iodine in Shandong Province.
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Objective To understand the implementation effects of control measures and the dynamic prevalence of drinking water-borne endemic fluorosis in Shandong Province.Methods From 2013 to 2017 in Shandong Province drinking water-borne endemic fluorosis areas,in accordance with the method of simple random sampling,10 monitored counties were selected,10 water fluorine decreasing projects were investigated of its running effect,and water fluoride was detected.In each monitored county,3 villages in the diseased areas were selected as fixed monitored villages.If the monitored village had changed its water,the operation of the project would be investigated.If the monitored village had not changed the water,one water sample would be collected according to 5 directions of east,west,south,north and middle to determine the water fluorine.All children aged from 8 to 12 in the village were also examined for dental fluorosis.X-ray fluorosis and urinary fluorosis in adults aged over 25 were detected in 2013 and 2017.Results From 2013 to 2017,in monitored counties,the normal operation rate of improved-water defluoridation projects was 99.19％ (368/371),the qualified rate of water fluoride content was 66.85％ (248/371).In 128 improved water projects,the normal operation rate was 100.00％ (128/128),the qualified rate of water fluoride content was 67.19％ (86/128).The average detection rate of dental fluorosis and community fluorosis index (CFI) in children aged 8-12 were 33.92％ (2 608/7 689) and 0.68 in all monitored counties from 2013 to 2017.The detection rate presented a declining trend year by year (x2 =152.47 P ＜ 0.01).The average detection rate and CFI in the villages with normal operation projects and qualified fluoride content were 26.10％ (1 311/5 023) and 0.47.The detection rate presented a declining trend year by year (x2 =207.67 P ＜ 0.01).The detection rate and CFI in the villages with water improvement projects under abnormal operation or excessive fluoride were 48.65％ (1 297/2 666) and 0.90.The detection rate of dental fluorosis in the villages with normal operation projects and qualified fluoride content was lower than the rate of the villages with water improvement projects under abnormal operation or excessive fluoride (x2 =193.98,P ＜ 0.01).In 2013 and 2017,X-ray detection rates of skeletal fluorosis in adults aged over 25 were 8.04％ (119/1 481) and 6.04％ (81/1 342),respectively.The adult urinary fluoride geometric mean values (1.24,1.49 mg/L) were lower than the normal limit of 1.6 mg/L both in qualified villages of water ffuoride content and exceeding-standard villages in 2017.Conclusions In Shandong Province,the effective water improvement has acquired some effects in control of drinking water-borne endemic fluorosis.But the water fluoride content of improved water defluoridation projects exceeds the national standard seriously and fluorosis has not been effectively controlled.
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Objective To detect the spatial distribution characteristics of water fluoride in Shandong Province.Methods The county-based study set Shandong Province as a research site.The county level fluoride database was matched with electronic maps to build geographic information system (GIS) spatial data platform.Global Moran's I and Local Moran's I index were calculated,respectively,and the cluster range of water fluoride distribution in Shandong Province was studied through SaTScan software.Results The water fluoride was normal (≤ 1.0 mg/L) in 54 counties in Shandong Province,mainly located in Weihai and Yantai in the eastern,Dongying in northern,and vast region in middle and southeastern of Shandong Province.Eighty-six counties were high water fluoride counties (＞ 1.0 mg/L),mainly distributed in the southwest,northwest and north-central of Shandong Province,showing a significant geographical feature.Global spatial autocorrelation analysis showed that the distribution of water fluoride content in Shandong Province showed significant positive spatial autocorrelation (Moran's I =0.44,Z =6.83,P ＜ 0.01).Local Moran's I analysis showed water fluoride in 13 counties had local spatial autocorrelation,being all high-high clusters.And these results were statistically significant (P ＜ 0.05).A cluster area was detected through SaTScan spatial analysis software,including 15 counties.The center was located in Dongming County of Heze City,with radius of 130.08 km.The results and the local spatial autocorrelation results were basically consistent.Conclusions There are apparent spatial autocorrelation and spatial cluster in water fluoridation in Shandong Province.Spatial autocorrelation and SaTScan software can be combined in exploring the spatial distribution of water fluoride.
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Objective To investigate the endemic fluorosis of drinking water type in 3 counties in the northwest of Shandong Province,and to provide scientific basis for prevention and control of endemic fluorosis.Methods Seven villages in 3 counties of Ningjin,Xiajin and Wucheng were investigated to achieve the results including fluoride of drinking water,8-12 year-old children's dental fluorosis incidence rate,the fluoride of urine,prevalence of skeletal fluorosis by clinical and X-ray diagnosis in adults over 30-year old,and the bone mineral density.At the same time,set up a control point to detect the adult bone density in non-ward village of each investigated county,The water and urine fluoride were checked by selective electrode method,dental fluorosis was diagnosed by Dean method (WS/T 208-2011) and the diagnosis of adult fluorosis was performed in accordance with the diagnostic criteria of endemic fluorosis (WS 192-2008),and bone mineral density was measured by EXA-3000.Results The villages in Ningjin and Wucheng had finished defluoridation,where the water fluoride was at normal level.In the 7 villages,the total detection rate of 8-12 year-old children's dental fluorosis was 85.09％ (411/483),dental fluorosis index was 1.88;the dental fluorosis detection rate in Wucheng,Xiajin and Ningjin was 92.48％ (295/319),88.76％ (79/89) and 49.33％ (35/75),respectively,the difference was statistically significant (x2 =90.26,P ＜ 0.01).The average urine fluoride geometric mean of children (206) and adults (298) was 3.29 and 3.41 mg/L,respectively.The urine fluoride of Xiajin was the highest in the 3 counties,and the average urine fluoride geometric mean of the two groups was as high as 5.11 and 6.30 mg/L,respectively.The total detection rate of clinical and radiographic skeletal fluorosis in adults was 30.07％ (92/306) and 14.38％ (44/306),respectively.The osteoporosis detection rate of adults in endemic fluorosis area and non-endemic fluorosis area was 33.11％ (100/302) and 8.99％ (17/189),respectively.The difference was statistically significant (x2 =37.25,P ＜ 0.01);the average bone mineral density in endemic area and non-endemic area was 0.416 and 0.475 g/cm2,respectively,the difference was statistically significant (t =8.508,P ＜ 0.01).Conclusions The endemic fluorosis in the 3 counties in the northwest of Shandong Province is still existed.The defluoridation has not been completed in Xiajin County.Therefore,it is necessary to implement defluoridation measures of the drinking water as soon as possible and strengthen the water fluoride monitoring so as to prevent and control endemic fluorosis.
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Objective To investigate the current prevalent status of endemic fluorosis in the alluvial plain area of the Yellow River in Shandong Province,in order to provide a scientific basis for developing control measures against the disease.Methods Six counties were selected as survey counties by random sampling,ten improvedwater projects were selected in each survey county,for the projects,the operating effect was investigated and water fluoride content was tested;three epidemic villages were chosen as survey villages in each county,the operating condition and the fluoride level of water were investigated in the villages with water improvement projects.Dental fluorosis of children aged 8 to 12 was surveyed,the urinary fluoride and skeletal fluorosis X-ray diagnosis were checked of adults over the age of 25.Water fluoride and urinary fluoride contents were detected via the F-ion selective electrode method,and the prevalence of dental fluorosis of all children aged 8 to 12 was diagnosed based on Clinical Diagnostic Criteria of Dental Fluorosis (WS/T 208-2011),skeletal fluorosis X-ray diagnosis was done based on the National Standard for Diagnosis of Endemic Skeletal Fluorosis (WS 192-2008).Results ①In the six counties,58 improved-water defluoridation projects were investigated,all projects were operated normally,the qualified rate of water fluoride content was 44.83％ (26/58).②A total of 19 villages that had water-improving and defluoridation projects were investigated,and all projects were operated normally,the qualified rate of water fluoride content was 42.11％ (8/19).③The overall rate of dental fluorosis among children aged 8 to 12 years old was 49.28％ (480/974),with the index of dental fluorosis as 1.01 in 19 villages,the prevalence of dental fluorosis was mild.In the qualified villages of water fluoride concentration,the positive rate of dental fluomsis among children aged 8 to 12 was 33.41％ (148/443),dental fluorosis index was 0.65,and the prevalence of dental fluorosis was extremely low;in the exceeding-standard villages of water fluoride content,the positive rate of dental fluorosis among children aged 8 to 12 was 62.52％ (332/531),dental fluorosis index was 1.36,and the prevalence of dental fluorosis was mild;the detection rate of dental fluorosis among children aged 8 to 12 of the villages with qualified fluoride content was lower than the rate of the villages with excessive fluoride (x2 =81.91,P ＜ 0.01).④X-ray detection rate of skeletal fluorosis in adults over the age of 25 was 6.14％ (53/863) in 17 villages,there was no statistically significant difference between the qualified villages and the exceeding-standard villages of water fluoride concentration (x2 =1.55,P ＞ 0.05),X-ray detection rate of skeletal fluorosis in adults was 5.04％ (20/397) and 7.08％ (33/466),respectively.In the qualified villages and the exceeding-standard villages of water fluoride,urinary fluoride geometric average and the exceeding rate of urinary fluoride were 1.50 mg/L,44.16％ (170/385) and 2.09 mg/L,62.58％ (286/466),respectively.In the qualified villages of water fluoride,the exceeding rate of adult urinary fluoride was lower than that in the exceeding-standard villages (x2 =28.58,P ＜ 0.01).Conclusions The prevention and control measures on endemic fluorosis have had some effects in the alluvial plain area of the Yellow River in Shandong Province.But the water fluoride content of water improving defluoridation projects still exceeds the national standard seriously,and endemic fluorosis has not been effectively controlled.Prevention measures should be further strengthened.
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Objective To study the prevalence of drinking water type of endemic fluorosis in Shandong Province,and to provide a scientific basis in making strategies for prevention and control of the disease.Methods Ten counties (cities,districts) were selected by random number table method to carry out the epidemiological study,and to study the progress and effect of water-improving and defluoridation projects.Three villages in each county (city,district) were chosen to determine fluoride content of drinking water and to check the prevalence of dental fluorosis of children 8 to 12 years old.Water fluoride content was determined with fluoride ion-selective electrode,and dental fluorosis was diagnosed by the Deans method.Results In the 10 counties (cities,districts),a total of 515 water-improving and defluoridation projects were built covering 3 207 fluorosis villages,and the waterimproving rate was 81.71％ (3 207/3 925).A total of 85 water-improving and defluoridation projects were investigated in the 10 counties (cities,districts),and all of the projects were operating normally.The number of projects that water fluoride concentration ≤ 1.20 mg/L was 51; the qualified rate of water fluoride concentration was 60.00％ (51/85),and the maximum value of water fluoride was 4.38 mg/L.A total of 29 villages that had waterimproving and defluoridation projects were investigated in the 10 counties (cities,districts),and the number of villages that mean of water fluoride ≤ 1.20 mg/L was 21,accounting for 72.41％ (21/29); ＞ 1.20 mg/L was 8,accounting for 27.59％ (8/29),and the maximum value of water fluoride was 4.02 mg/L.In the 21 qualified villages of water fluoride concentration,a total of 1 023 children aged 8 to 12 were examined; the positive rate of dental fluorosis was 38.12％ (390/1 023); dental fluorosis index was 0.67,and the prevalence of dental fluorosis was extremely low.In the 8 exceeding-standard villages of water fluoride content,a total of 449 children aged 8 to 12 were examined; the positive rate of dental fluorosis was 54.79％ (246/449); dental fluorosis index was 1.18,and the prevalence of dental fluorosis was mild.Conclusion In Shandong Province,the water fluoride content of waterimproving and defluoridation projects exceeds the national standard seriously,and the condition of children's dental fluorosis is still serious,and the measures of water-defluoridation should be further strengthened.
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Objective To understand the status of endemic fluorosis in Shandong Province.Methods In accordance with the requirements of the National Surveillance Scheme of Drinking-Water-Type Endemic Fluorosis (Trial) and Shandong Provincial Surveillance Scheme of Drinking-Water-Type Endemic Fluorosis (Trial),ten counties (cities,districts) were chosen in the province,and ten water-improvement projects were selected in each county (city,district).The operating effect of water-improvement projects was investigated; one peripheral water sample of each project was collected,and water fluoride content was tested.Three epidemic villages were chosen as fixed monitoring villages in each county (city,district).In the villages that had changed water source,one peripheral water sample was collected; in unchanged water source villages,one water sample was collected following five different directions of the east,the west,the south,the north and the center of the water source location; and the water fluoride content was tested.All students aged 8 to 12 were checked for dental fluorosis in the monitoring villages.The fluoride content in drinking water was detected by fluoride ion selective electrode method,and dental fluorosis was diagnosed by Dean's method.Results ① In the 10 counties (cities,districts),a total of 85 water-improving projects were monitored,and all the projects were in normal operation; the water fluoride contents of 47 projects were qualified,and the qualified rate of water fluoride content was 55.29％(47/85),with the maximum of water fluoride content was 4.74 mg/L.② In the 30 fixed monitoring villages,27 monitored villages had water-improving projects; water fluoride contents of 19 villages were qualified,the qualified rate of water fluoride content was 70.37％ (19/27),with the maximum of water fluoride content was 4.77 mg/L.In the 3 monitored villages without water-improving projects,villages of mean water fluoride contents ≤ 1.20 mg/L and ＞ 1.20 mg/L were two and one,respectively,with the maximum of water fluoride content was 1.55 mg/L.③ In the 19 monitored villages with water-improving projects that in normal operating condition with qualified water fluoride content,the detected rates of dental fluorosis and the defect type of dental fluorosis among children aged 8 to 12 years old were 52.37％(508/970) and 6.39％(62/970),respectively,and the index of dental fluorosis was 1.02.In the 8 monitored villages with water-improving projects that in normal operating condition with water fluoride content that exceeded the national standard,the detected rates of dental fluorosis and the defect type of dental fluorosis were 62.39％ (297/476) and 8.82％ (42/476),respectively,and the index of dental fluorosis was 1.67.In the 3 monitored villages without water-improving projects,the detected rates of dental fluorosis and the defect type of dental fluorosis were 49.45％ (90/182) and 7.14％ (13/182),respectively,and the index of dental fluorosis was 1.25.Conclusions In Shandong Province,the water fluoride content of water-improving defluoridation projects exceeds the national standard seriously,and water quality of the projects still need to be further improved.The projects of water-improving defluoridation play a certain role in control of dental fluorosis condition,but the condition of children' s dental fluorosis is still very serious.So preventive and control measures for endemic fluorosis should be further strengthened.