Discussion on the anti-tumor metastasis mechanism of Notoginseng Radix et Rhizoma based on internet pharmacology / 国际中医中药杂志

Objective:To analyze and explore the possible mechanism of anti-tumor metastasis of Notoginseng Radix et Rhizoma using Internet pharmacology. Methods:The active components and targets of Notoginseng Radix et Rhizoma were screened by retrieving Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP). GeneCards database was used to screen the anti-tumor metastasis-related targets, and compounds and disease targets were under mapping analysis. Key targets of Notoginseng Radix et Rhizoma for anti-tumor metastasis were screened through Venn map. With the help of Cytoscape 3.7.2 software, a compound-disease network diagram was constructed. String platform was used to build a PPI network. Bioconductor was used to enrich the target genes for KEGG signaling pathway and GO biological process analysis. Results:Totally 119 active components were selected from Notoginseng Radix et Rhizoma. There were 8 eligible active components, corresponding to 162 related targets, 121 targets related to anti-tumor metastasis, and 30 key targets screened by PPI network, including AKT1, MAPK1, JUN, RELA, IL6, etc. GO enrichment analysis mainly involved biological processes such as cytokine receptor binding, heme binding, RNA polymerase Ⅱ transcription factor binding, ubiquitin protein ligase binding, and steroid hormone receptor activity. 149 signal pathways related to Notoginseng Radix et Rhizoma anti-tumor metastasis were obtained by KEGG enrichment analysis, mainly involving multiple signal pathways, such as AGE-RAGE and PI3K-Akt, and hepatitis B, Kaposi's sarcoma-associated herpes virus infection, human cytomegalovirus infection and other viral infections and various tumors. Conclusion:Notoginseng Radix et Rhizoma can pass multiple active components, such as ginsenoside f2, ginsenoside rh2 β-, sitosterol, stigmasterol and quercetin, and multiple targets, such as AKT1, MAPK1, JUN, RELA and IL6, acting on multiple pathways such as PI3K-Akt, thereby playing the role of anti-tumor metastasis.

Progress in researches on thoracolumbar fractures of type A3N0/1 / 中华创伤骨科杂志

Type A (AOSpine type) thoracolumbar fractures are the most common. There has long been controversy over their treatment, especially for type A3N0/1, those without neurological injury. Although the fixation with pedicle screws via the anterior and posterior approaches has been widely carried out in clinical practice, such problems as unsatisfactory reduction, kyphosis recurrence and postoperative disc degeneration have not been resolved. In recent years, various attempts have been made to improve the prognosis of type A3 thoracolumbar fractures. This paper reviews the progress in researches on treatment of type A3N0/1 thoracolumbar fractures.

Correlation between cytokine levels and liver function damage in patients with occupational medicamentosa-like dermatitis due to trichloroethylene / 中国职业医学

OBJECTIVE: To investigate the correlation between plasma cytokine levels and liver functions in patients with occupational medicamentosa-like dermatitis due to trichloroethylene(OMDT). METHODS: A total of 22 OMDT patients were selected as research subjects using judgment sampling method. Blood samples were collected from patients on the 1 st, 2 nd, 3 rd, 4 th, and 5 th week of admission and the day of hospital discharge. The automatic biochemical instrument was used for detecting the index of serum liver function. The levels of cytokines including tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), interleukin(IL)-5, IL-6, and IL-10 in plasma were measured by enzyme-linked immunosorbent assay. The Spearman correlation analysis was performed to analyze the correlation between cytokines and liver function in 15 patients with exfoliative dermatitis. RESULTS: The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL), direct bilirubin(DBIL), glutamyl transpeptidase(GGT), and total bile acid(TBA) of OMDT patients on the 1 st week of admission increased(P<0.05), while total protein(TP) and albumin(ALB) decreased(P<0.05) compared with the results at discharge(a stage of recovery). The correlation analysis results of patients with exfoliative dermatitis showed that: the levels of TNF-α, IFN-γ and IL-6 were negatively correlated with the levels of TP and ALB respectively(P<0.05), the level of IL-5 was negatively correlated with TBIL(P<0.05), and the level of IL-10 was negatively correlated with ALB(P<0.05) in the 1 st week. The level of IL-6 was positively correlated with ALT(P<0.05) in the 2 nd week. The level of TNF-α was positively correlated with TBIL(P<0.05), the level of IL-10 was positively correlated with AST(P<0.05) in the 3 rd week. The levels of TNF-α and IL-10 were positively correlated with AST and ALT respectively(P<0.05), the level of IFN-γ was positively correlated with AST(P<0.05) in the 4 th week. The levels of IL-6 and IL-10 were positively correlated with ALT and GGT(P<0.05), and the levels of TNF-α and IFN-γ were positively correlated with AST(P<0.05) in the 5 th week. The level of TNF-α was negatively correlated with DBIL(P<0.05) and was positively correlated with TBA(P<0.05) at discharge.CONCLUSION:s Patients with OMDT are frequently accompanied with severe liver function damage at the early stage. The level of plasma cytokines(TNF-α, IFN-γ, IL-6 and IL-10) might correlate with the severity of liver dysfunction.

Changes of serum CRP and hs-CRP levels in patients with liver cancer and depression and their influence on prognosis / 实用肿瘤学杂志

Objective The objective of this study was to investigate the effect of depression on serum levels of C-reactive protein(CRP)and high-sensitivity C-reactive protein(hs-CRP),and prognosis in liver cancer patients. Methods A total of 251 patients with liver cancer undergoing hepatectomy were enrolled. The hospital anxiety and depression scale( HADS-D) and 9-item patients health questionnaire(PHQ9) were assessed for depression before 3 days for surgery. Patients were divided into depression group(n=95)and non-depression group(n=156) according to the scores. Preoperative serum levels of CRP,hs-CRP,ALT and AST were measured and compared between the depression and non-depression groups. Survival analysis Kaplan-Meier method was used to compare the disease-free survival(DFS)and total survival(OS)between the two groups. Results The serum levels of CRP, hs-CRP,ALT and AST in the depression group were significantly higher than those in the non-depression group(P<0. 05). The follow-up of 3. 5-year showed that 164 patients(65 in depression group and 99 in non-depression group)had recurrence or metas-tasis and 47 patients(22 in depression group and 25 in non-depression group) died. The DFS and OS in the depression group were significantly lower than those in the non-depression group(P< 0. 05). Cox multiple regression analysis showed that liver function grading,BCLC staging and depression were independent risk factors for the prognosis of liver cancer. Spearman correlation analysis showed that patients′degree of depression was positively correlated with serum levels of CRP and hs-CRP(P<0. 05),DFS and OS were negatively correlated with serum levels of CRP and hs-CRP(P<0. 05). Conclusion Depression may mediate elevated serum levels of CRP and hs-CRP,maintain inflammatory response in patients,lead to increased liver function damage,elevate levels of ALT and AST,and thus adversely affect the prognosis of patients with liver cancer.

Expression of tyrosine and threonine protein kinase in carcinogenic process of colorectal cancer and its relationship with prognosis / 中华肿瘤杂志

Objective@#To investigate the expression of TTK (tyrosine and threonine protein kinase) in the process of colorectal cancer (CRC) development and its relationship to prognosis in CRC patients.@*Methods@#Colitis-associated colon cancer model was induced by azoxymethane (AOM) and dextran sulfate sodium (DSS) in C57BL/6 mice. Mice at four different stages of colon cancer development were obtained, named AD1 (inflammation of the recovery), AD2 (mild dysplasia), AD3 (adenoma) and AD4 (adenocarcinoma), as well as negative control (no treatment). The expression of TTK was measured by real time fluorescent quantitative PCR (qPCR) and immunohistochemical staining in mouse colon tissues and 24 pairs of CRC specimens. The relationship between TTK and prognosis was analyzed in a set of CRC genome-wide gene expression microarray data that was obtained from Gene Expression Omnibus (GEO) of National Center for Biotechnology Information (NCBI).@*Results@#The genome-wide microarray data from mouse AOM-DSS model indicated that the expression of TTK mRNA was gradually elevated during the development of colon cancer. The subsequent qPCR results showed that TTK mRNA levels in negative control, AD1, AD2, AD3 and AD4 groups were 1.05±0.42, 1.10±0.03, 1.38±0.15, 1.33±0.17 and 2.12±0.22, respectively. And TTK expression in AD2, AD3 and AD4 groups were significantly higher than that in negative control (P<0.05). The protein expression of TTK showed by immunohistochemical staining had similar tendency as the results of TTK mRNA. Besides that, the TTK mRNA levels in tumor tissues (0.71±0.10) from 24 CRC patients were significantly higher than those in paired adjacent normal tissues (0.18±0.04; P<0.001). The positive expression rate of TTK protein in 5 pairs of CRC clinical samples was 80.0%, and it was significantly higher than that in adjacent normal tissues (30.8%, P=0.014). Furthermore, according to a public transcriptomic data (GSE17536), the high levels of TTK were associated with poor prognosis in CRC patients.@*Conclusions@#Elevated expression of TTK is related to colonic carcinogenesis in both of mouse model and human CRC samples. TTK is a poor prognostic factor in CRC.

Correlation analysis between psychological counseling behaviors of accompanying family members and anxiety and depression of inpatients with hepatocellular carcinoma / 中国实用护理杂志

Objective To understand the correlation between psychological counseling behaviors of accompanying family members and anxiety and depression of inpatients with hepatocellular carcinoma. Methods Used self-designed questionnaires to investigate the behaviors of 45 accompanying family members psychological counseling for their relative hospitalized patients with hepatocellular carcinoma, at the same time, evaluated the anxiety and depression among those 45 hospitalized patients with hepatocellular carcinoma, then analyzed the correlation between the accompanying family members' psychological counseling behaviors and hepatocellular carcinoma in patients' anxiety and depression. Results Among the accompanying family members,53.3%(24/45) were the spouses of the patients. During the accompanying nursing time, there were 20.0%(9/45) accompanying families told to their relative patients less than 2 hours per day, and 80.0%(36/45) told to the patients over 2 hours per day. The proportion of anxiety and depression in the hospitalized patients with hepatocellular carcinoma was 28.9%(13/45) and 77.8% (34/45) respectively. Whether the relationship between the accompanying family members and the patients with hepatocellular carcinoma were spouse relationship was related to the incidence of depression in the patients (χ2=10.470, P=0.005), and whether the time accompanying family members spent in talking with the patients over 2 hours every day was correlative with the incidence of anxiety and depression in the patients (χ2=7.012, P =0.030 andχ2=6.438, P=0.040). The patients who accompanying families told to them less than 2 hours per day suffered a higher depression rate (8/9), and among the patients who accompanying families told to them over 2 hours per day, the lowest rate of anxiety (1/12) was found in the patients who accompanying families told to them around 4.1-6.0 hours per day. Conclusions The patients who are accompanied and cared by their spouses have lower depression rate and lesser depression extent. The accompanying families talk to the patients total 4.1-6.0 hours per day could most favorably reduce the incidence of anxiety and depression in the hospitalized patients with hepatocellular carcinoma.

Prognostic significance of preoperative serum gamma glutamyl transpeptidase level in patients with hepatocellular carcinoma after liver resection / 中华普通外科杂志

Objective To evaluate the prognostic significance of preoperative serum gamma glutamyl transpeptidase (GGT) level in patients with hepatocellular carcinoma (HCC) after liver resection.Methods A total of 432 patients undergoing hepatectomy for HCC were divided into normal GGT group (175 patients with GGT ≤ 50 U/L) and high GGT group (257 patients with GGT ＞ 50 U/L).After balancing baseline characteristics by propensity score analysis,disease-free survival (DFS) and overall survival (OS) were compared between the two groups.Independent risk factors influencing DFS and OS were identified by Cox multivariate analyses.Results Propensity score analysis identified 124 matched pairs of patients from each group.In the propensity-matched cohort,DFS at 1,3,and 5 years in normal GGT group (69.3％,36.1％,12.8％) was significantly higher than that in high GGT group (60.6％,18.7％,7.5％;P=0.039).OSat1,3,and5 years innommlGGTgroup (90.7％,73.7％,66.1％) was also significantly higher than that in high GGT group (89.2％,63.6％,43.3％;P =0.024).COX multivariate analyses revealed that alpha-fetoprotein ≥400 ng/ml,GGT ＞ 50 U/L,macrovascular invasion,tumor size ≥ 10 cm,and tumor number ≥3 were independent risk factors for DFS in patients with HCC after liver resection.Albumin ＜ 35 g/L,GGT ＞ 50 U/L,macrovascular invasion,tumor size ≥ 10 cm,and tumor number ≥ 3 were identified as independent risk factors for OS.Conclusions Preoperative serum GGT level is an independent factor predicting tumor recurrence and long-term survival in HCC patients after liver resection.

Retrospective analysis of perioperative complications and risk factors of posterior lumbar interbody fusion for recurrent lumbar disc herniation / 中华骨科杂志

Objective To retrospectively analyze the perioperative complications of posterior lumbar interbody fusion (PLIF) for recurrent lumbar disc herniation and identify potential risk factors that correlate with those complications.Methods All of 71 patients with recurrent lumbar disc herniation were treated surgically with PLIF,discharged from our department between January 2008 and December 2014.Demographic and operation data were collected and perioperative complications were recorded.We analyzed whether the clinical factors (age,gender,BMI,co-morbidity,smoking,time of recurrence,blood loss,operation segment,operation time) were in correlation with perioperative complication by univariate analysis.Then we integrated the statistically significant indicators into Logistic regression equation to determine the related risk factors for complication.Results The study group consisted of 71 cases,including 42 males and 29 females.The age was 19 to 64 years old with an average of 50.6 years old,and the average BMI was 23.6 kg/m2.26 cases had perioperative complications,while there were two or more complications in 5 patients,and no mortalities.Neurologic deterioration or neuropathic pain (10 cases,14.1％) and dural tears (6 cases,8.5％) were the most common intraoperaitive complications.The other complications included nerve root or cauda equine injury,deep or superficial wound infection,urinary tract infection,respiratory system complication,cardio-vascular complication and delirium.Univariate analysis suggested that age,gender,co-morbidity,smoking,time of recurrence,operation segment,operation time were not associated with perioperative complication.The multivariate Logistic regression analysis showed BMI and blood loss were closely related to perioperative complication.Conclusion Complications of posterior spinal fusion surgery for recurrent lumbar disc herniation are affected by many factors.The most common complications are transient neurologic deterioration or neuropathic pain and dural tears.BMI and blood loss are independent risk factors.

Expression and clinical significance of ELOVL6 gene in high-grade serous ovarian carcinoma / 中华妇产科杂志

Objective To investigate the expression of elongation of very long-chain fatty acids family member 6 (ELOVL6) in high-grade serous ovarian carcinoma (HSOC), and explore the correlation between its expression and clinical prognosis in these patients. Methods The expression of ELOVL6 at mRNA and protein levels were respectively detected by reverse transcription (RT)-PCR and immune histochemistry method in 12 cases with normal ovarian tissues and 172 cases with HSOC from primary tumor site, forty of which had paired peritoneal metastatic tissues. Results (1) The results tested by RT-PCR showed that ELOVL6 expression in normal ovarian tissue was 4.8±1.1, while 1.2±0.7 in primary tumors and 1.8 ± 0.9 peritoneal metastatic sites in HSOC. Compared with normal ovarian tissue, the level of ELOVL6 mRNA was significantly lower in HSOC (P0.05). The total median survival was 52 months in ELOVL6-positive group and 44 months in ELOVL6-negative group (P>0.05). Conclusion Low expression of ELOVL6 may correlate with the poor differentiation and drug resistance in HSOC.

Expression of miR-181b in Colitis-associated Colon Carcinogenesis / 胃肠病学

Background:miR-181b is related to the progression of many tumors,however,its expression in colitis-associated colon cancer is not clear. Aims:To investigate miR-181b expression and its potential target genes in the process of colitis-associated colon carcinogenesis. Methods: Colitis-associated colon cancer model was established by combined administration of azoxymethane(AOM)and dextran sulfate sodium(DSS)in mice. The expression of miR-181b in colon tissue at different time points was measured by real time fluorescent quantitative PCR(qPCR). Target genes of miR-181b were screened preliminarily by genome microarray combined with miRNA target gene prediction softwares TargetScan, PicTar and miRDB. Expressions of target genes in colitis-associated colon cancer mice were detected by qPCR. Results:The expression of miR-181b was gradually elevated during the development of colitis-associated colon cancer. However, AOM or DSS alone did not change expression of miR-181b. Genome microarray combined with miRNA target gene prediction softwares showed that Ipmk,E2f5,Klf6,Prkcd,Bai3,Hic2 might be the target genes of miR-181b. qPCR showed that expressions of Ipmk,Prkcd,Bai3,Hic2 were significantly decreased in colitis-associated colon cancer than in control group. Conclusions:Expression of miR-181b in colon is upregulated with the development of colitis-associated colon cancer,but is irrelevant with simple chronic inflammation.

Changes of expression of miR-155 in colitis-associated colonic carcinogenesis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the changes of miR-155 and its target genes in colitis-associated carcinogenesis.</p><p><b>METHODS</b>Colitis-associated colon cancer was induced by azoxymethane (AOM) and dextran sulfate sodium (DSS) in C57BL/6 mice. Mice of three different stages during the development of colon cancer were obtained, named AD1, AD2 and AD3, respectively. A control group of mice without any treatment and a DSS only group representing chronic inflammation without cancer were set up as well. Colon tissue was collected and expression of miR-155 in the colon tissues was measured by real-time fluorescent quantitative PCR. TargetScan and PicTar were used to predict potential target genes of miR-155, which were then preliminarily screened with our gene expression microarray database of AOM-DSS mouse model. Regular PCR was used to confirm the changes of the expression of these potential target genes in AOM-DSS mouse model.</p><p><b>RESULTS</b>Colitis-associated colon cancer was effectively induced by azoxymethane and dextran sulfate sodium in C57BL/6 mice. Histological examination revealed that the evolution process was sequentially from normal, mild dysplasia, moderate dysplasia, and severe dysplasia to adenocarcinoma in the AOM-DSS mouse model. The level of miR-155 was gradually elevated with the formation of colitis-associated colon cancer. There was no significant difference between the levels of miR-155 expression in the DSS group (0.005 6 ± 0.003 7) and control group (0.012 0 ± 0.005 1) (P > 0.05), but the level of miR-155 in the AD3 group (0.054 4 ± 0.027 0) was significantly higher than that of the DSS group (0.005 6 ± 0.003 7)(P < 0.01). No significant change of miR-155 expression was found in the DSS only group. The relative expression levels of miR-155 in the control group, DSS only group and AD3 group were 0.012 0 ± 0.005 1, 0.005 6 ± 0.003 7, 0.054 4 ± 0.027 0, respectively. Data analysis with the gene expression microarray showed that Tle4, Kcna1, Itk, Bcorl1, Cacna1c, Rspo2 and Foxo3 were potential target genes of miR-155 in the AOM-DSS mouse model. Changes of Kcna1 and Cacna1c in the AOM-DSS mouse model were validated to be consistent with the changes obtained with the gene expression microarray.</p><p><b>CONCLUSION</b>The up-regulation of miR-155 is related to colitis-associated carcinogenesis, but is irrelevant to chronic inflammation in the mouse model.</p>

Randomized controlled clinical trial of domestic oseltamivir in patients with influenza / 中华传染病杂志

Objective To investigate the efficacy and safety of domestic oseltamivir in patients with influenza. Methods A randomized, single-blinded, controlled clinical trial was performed.Patients in the study group received domestic oseltamivir, while the patients in control group received foreign oseltamivir. The doses were both 75 mg every time, twice a day. The treatment durations in both groups were 5 days. Chi square test was performed to compare baseline characteristics and the difference of side effects. Paired t test was used to compare the efficacy. Results Two hundred and nine patients were enrolled in this study (98 cases in study group. 111 cases in control group). The trend in body temperature change was similar in the two groups (t = 0. 061, P>0. 05). The score of symptom severity decreased more quickly in patients treated with foreign oseltamivir compared to those treated with domestic oseltamivir during the period from 24 h to 48 h. However, the difference between the two groups diminished gradually and was not statistically significant at 72 h (t=0. 875,P>0. 05). The safety of the domestic and foreign oseltamivir were comparable(X2 = 0. 197,P>0. 05). Conclusion The domestic oseltamivir is as effective and safe as the foreign oseltamivir.

Factors that affect therapeutic effects of stem cell transplantation on myocardial infarction / 中国组织工程研究

After acute myocardial infarction, how realizes revasculadzation of the infarct area as well as prolongs the postponement left ventricle reconstruction and restores heart normal contraction function has been the hot spot. The research demonstrated that the transplanted stem cells may be in field planting of the heart infarct region, simultaneously through nutrition effects of secreting vascular endothelial cells and differentiation into myocardial cells, vascular endothelial calls, and can improve ventricle reconstitution and recovery cardiac function. However, stem call effects on myocardial infarction have close correlation to stem call tissue source. Various preconditioning also can affect repair of stem cells. Meanwhile, choice of suitable stem cell donors and recipients, correction of transplanted window and pathway are key factors for obtaining good clinical curative effects.

The Observation of Effect on the Treatment of Pulmonary Carcinoma in Middle-advanced Stage by Percutaneous Intratumor Carboplatin Injection under CT Guided in Combination with Artery Chemotherapy / 实用放射学杂志

Objective To investigate the feasibility and clinical value of pulmonary carcinoma in middle-advanced stage bypercutaneous intratumor carboplatin injection(PCI) under CT guided in combination with bronchial artery infusion(BAI) and intrathoracic artery infusion(IAI).Methods There were totally 58 cases with central bronchial carcinoma in stage Ⅲ and Ⅳ.Of them,30 cases(treatment group) were treated by BAI+IAI and PCI,while 28 patients(control group) were treated by BAI and PCI.Therapeutic effect was evaluated according to the improvement of the following variables:CT,life quality and survival period after treatment.Results The responsive rate in the treatment group(73.3%) was significantly higher than that in the control group(46.4%),the life quality and survival period were much improved.Conclusion Percutaneous intratumor carboplatin injection in combination with BAI and IAI is a effective method for bronchial carcinoma in Ⅲ and Ⅳ stages,it can not only improve the shorten effect,prolong survival period,but also can improve patients life quality.

Construction of HBsAg gene recombinant adenoviruses and packing in 293 cells / 中国免疫学杂志

Objective:After construction and identification of HBsAg gene recombinant backbone adenoviral vector,it is to prouduct HBsAg gene recombinant adenoviruses by packing PAd-Easy-1-HBs in 293 cells.Methods:The gene of interest was amplified from plasmid pEcob-6 PCR, the gene of interest which contained HBsAg gene was cloned into on adenoviral shuttle vector pAd-track-cmv. The pAd-track-cmv-HBs was linearized by digesting with restriction endonuclease Pme-1, and subsequently cotransformed into E.coli BJ-5183 cells with an adenoviral backbone vector pAd-Easy-1, Homologous recombinants were performed in bacterial cells. Finally, the linearized backbone adenoviral vector was transfected into adenoviruses packing cells lines,e.g. 293 cell by lipofectamine transfection. Transfections and viral productions can be minotored by green fluorescent protein(GFP). The expression of HBsAg in supermatant was investigated by ELISA. It was a certain HBsAg vaccine to amplify recombinant adenoviruses by repeating the infevtion cell to collect the viral supermatant.Results:GFP expression was visible by fluorescence microscopy after transfection. Adenoviral titer was monitored by GFP expression. GFP expression was visible after repeating the infection cell using the viral supernatant in more than 90 percent of the cells.The HBsAg also expressed in supermatant.Conclusion:HBsAg gene recombinant adenoviral backbone vector has been constructed successfully. HBsAg gene recombinant adenoviruses have been producted by packing in 293 cells. The study provides the possibility of further researches on the development of new anti-HBV vaccines.

Investigation on Fluoride Intake in Residents in Pastoral Area of Beier Lake / 环境与健康杂志

ve To investigate the intake of fluoride of residents in pastoral area of Beier Lake and its main source. Methods Two of the typical endemic fluorosis villages were selected as observation sites in Xinbaerhuyouqi County of Inner Mongolia Autonomous Region. The amount of milk-tea drank by residents was investigated, the drinking water samples, brick-tea samples and milk-tea samples were collected from 10 families randomly selected as observation families. The contents of fluoride of 3 kinds of samples were determined by iron selective electrode method. Results The contents of fluoride in drinking water samples, brick-tea samples and milk-tea samples reached higher levels, namely, 4.12-4.37 mg/L, 780.3-800.0 mg/L and 5.80-5.88 mg/L respectively in two investigation sites. The intake of fluoride from milk-tea of adults was (8.70 ?3.91) mg/d and (9.50?3.22) mg/d respectively, of which, 75.34% and 70.07% came from drinking water, 24.66% and 29.93% came from brick-tea in two observation sites. Conclusion The two observation sites with the higher levels of fluoride intake far exceeding the related Na-tional Standards were composite endemic fluorosis area with a fluoride exposure route mainly via drinking water.