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Objective To establish a liquid biopsy technique of KRAS gene G12D mutation and to assess its diagnostic value. Methods KRAS G12D mutation was analyzed by ddPCR in plasma DNA from 52 colorectal cancer patients and compared that of to 80 healthy subjects. KRAS gene sequencing in cancerous tissue of colorectal cancer patient being set as a golden standard, we evaluated the accuracy of ddPCR and analyzed the correlation between G12D mutation rate, plasma concentration;and their clinical manifestations in CRC. Results ddPCR indicated that KRAS G12D mutation rate and concentration(26.92％, 81.5 copies/mL) in the plasma samples of colorectal cancer patients were significantly higher than that of healthy subjects (8.75％, 16 copies/mL). Colorectal cancer patients with highly differentiated adenocarcinoma showed a significantly higher number of mutant copies than medium and low differentiated adenocarcinoma(P＜0.05);M2 patients had a significantly higher number of mutant copies than N1 and NO patients (P＜0.05);The concordance rate of KRAS gene mutation between cancerous tissue and plasma ctDNA was 87.50％ in CRC.Conclusions ddPCR is a fast, noninvasive and accurate method for plasma testing of ctDNA, and the test results could be used to monitor the course of the disease and as clinical guidelines.
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Objective To investigate the actual situation of implementation of the project to reduce water arsenic in endemic arsenic poisoning areas in Shanxi province,and to provide a scientific basis for prevention and control of the disease.Methods In June 2011,a questionnaire survey of 151 arsenic endemic villages was carried out in Shanxi province.The actual situation of implementation of the project to reduce water arsenic was investigated.Water samples were collected and arsenic level was determined by atomic fluorescence spectrometry.Results In the 151 arsenic poisoning villages 126 villages had changed the water,and the rate was 83.44％.In these villages,22 villages did not use the water improvement utilities properly.Of the 33 water improvement projects to reduce arsenic,23 operated normally.The projects covered 110 villages,beneficiary population of 97 920 people,accounting for 46.9％(97 920/208 736) of the total population.Water arsenic exceeded the national standards(≤0.05 mg/L) in 10 of the water improvement projects which covered 31 villages,including 15 nonendemic villages and 16 diseased villages.There were a population of 24 764 people in the diseased villages.Conclusions In Shanxi endemic arsenic poisoning areas,water improvement efforts need to be strengthened; the quality of water improvement project needs to be improved,and the project's later management and maintenance also need to be further strengthened.
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ObjectiveTo find out the quality of life of inhabitants living in endemic arsenism areas after drinking-water improvement and related influencing factors.MethodsCase group ( 118 people) of arsenicosis,and control group (237 people ) of nearby residents without arsenicosis in endemic arsenic areas after drinking-water improvement in Shanxi and Inner Mongolia and outside control group(116 people) not exposed to arsenic in nearby non-arsenic areas were selected to be interviewed using homogeneous validity and reliability of the World Health Organization quality of life(WHOQOL-BREF,Chinese Version) in 2010,and physical health,psychological,social relationships,environment scores and total score were calculated,respectively.Covariance analysis was used to find out the real difference in the three groups and multiple linear regression analysis was used to explore the influencing factors on quality of life.Results The scores of physical health,psychological,social relationships,environment and total score of case group were ( 12.14 ± 2.68),( 12.18 ± 2.22),( 14.81 ± 2.24),(11.33 ± 1.92),(69.27 ± 16.23) points,respectively,and those of internal control group were ( 13.39 ± 2.67),( 12.80 ± 1.88 ),( 15.16 ± 1.80),( 11.72 ± 1.62),(75.49 ± 14.50) points,respectively,those of control group were (13.91 ± 254),(13.67 ± 2.14),(15.07 ± 1.36),(12.64 ± 1.68),(78.41 ± 12.03) points,respectively.Them was significant difference in physical health,psychological,environment scores and total score among the three groups(F =7.57,10.74,13.44,10.77,all P ＜ 0.05),of which case group was significantly lower than those of the inside and outside control group(all P ＜0.01 ),while in the control group the psychological and environment scores were lower than those of the external control group(all P ＜ 0.01 ).Health,whether-or-not arsenicosis patient,annual per capita income,age and sex were influential factors of quality of life among inhabitants living in endemic arsenism areas after drinking-water improvement (all P ＜ 0.05 ).Conclusions Quality of life among inhabitants living in endemic arsenism areas after drinking-water improvement is lower than residents of non-arsenic areas.
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Objective To explore the long-term effect of endemic arsenism on oxidative stress and immune function, and to provide scientific basis for prevention and treatment of the disease in the areas. Methods In 2009, Using cluster sampling and typical investigation, the cross-sectional study was completed. The patient groups and the internal control group were selected in the arsenism areas after 5 years quality improvement of drinking water(Silizhuang village, Daying village and Gucheng village in Shanyin county, Gucheng city, Shanxi province) and they were divided into mild, moderate, severe case and internal control groups, respectively. The external control group was selected in a non-arsenism area(Yangzhuang village in Heshengbu city). The Oxidative stress indicators were determined and analyzed [serum superoxide dismutase (SOD) activity was determined with xanthine oxidase method, glutathione peroxidase(GSH-Px) activity was determined with 2-thio-2-nitrobenzoic acid method, and mmuuity malondisldohyde(MDA) levels was determined with thiobarbituric acid method]. The immune function was determined and analyzed [immunoglobulin G (IgG) was determined with radioimmunoassay method, and serum lysozyme was determined with turbidimetric method]. Results A total of 252 people were surveyed, in which the external control group, the internal control group, mild, moderate and severe patient groups were 56, 57, 49,44 and 46, respectively. Serum SOD activities were (72.19 ± 11.75), (66.96 ± 12.02), (49.79±11.07), (48.54 ±10.56) and (47.68 ± 10.68)kU/L, respectively. The difference of serum SOD activities between the groups was statistically significant(F = 52.42, P ＜ 0.01 ). Serum SOD activities in the external control group were significantly higher than other groups (all P ＜ 0.05). The value in the internal control group was significantly higher than the 3patient groups (all P ＜ 0.05). There were no significant differences between the case groups (P ＞ 0.05). Serum GSH-Px activities of the five groups were (197.41 ± 38.54), (195.02 ± 31.93), (187.26 ± 28.22), (187.24 ± 25.40),(186.88 ± 21.84)U/mg, respectively, and the difference between the groups was not significant(H = 4.21, P ＞0.05). Serum MDA levels of the five groups were (4.51 ± 2.14), (5.88 ± 2.00), (6.44 ± 2.83), (5.89 ± 2.57),(5.88 ± 2.40)μ mol/L, respectively, and the difference between the groups was statistically significant(F = 3.36,P ＜ 0.05). The external control group was significantly lower than other groups(all P ＜ 0.05). No significant difference was observed between other groups(all P ＞ 0.05). Serum IgG levels were(11.16 ± 2.08), (8.15 ± 1.44), (8.77 ±2.54), (9.19 ± 1.97), (8.44 ± 2.52)g/L, respectively, and the difference between the groups was statistically significant(H = 52.92, P ＜ 0.01 ). The external control group was significantly higher than other groups(all P ＜0.05). No significant difference was observed between other groups(all P ＞ 0.05). Serum lysozyme levels were (13.57 ± 5.16), (10.05 ± 3.96), (8.78 ± 3.35), (8.72 ± 3.76), (9.38 ± 4.26)mg/L, respectively, and the difference between the groups was statistically significant (H = 35.00, P ＜ 0.01 ). The external control group was significantly higher than other groups(all P ＜ 0.05). No significant difference was observed between other groups(all P ＞ 0.05). Conclusions The effect of arsenic on the body's oxidative stress response and immune function persists after 5 years of drinking low arsenic water. In addition to intensify arsenic removal from drinking water, it should also strengthen the monitoring of population's health in the diseased areas.
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Objective To explore into the condition of fluoride content of the drinking water and the present status of water-improving projects in the endemic fluomsis areas in Shanxi province,and to provide the evidence for making scientific and effective tactics in prevention and control.Methods In 2007,according to "The National Technical Scheme for Endemic Disease Control",screening for drinking water fluoride content was carried out in non-improving water villages of 15 counties(cities,districts).The investigation of all water-improving projects was carried out in 10 counties(cities).The fluoride content in drinking water was determined by fluoride selective ion electrode(GB/T 8538-1995).Results Screening for drinking water fluoride content was carried out in 969 non-improving water villages in 15 counties(cities,districts).Average water fluoride content was≤1.0 mg/L in 497 villages,accounting for 51.29%(497/969).Average water fluoride content was>1.0 mg/L in 472 villages.accounting for 48.71%(472/969).The overall standard drinking water fluoride content was mainlv>1.0-4.0mg/L,and the maximum average water fluoride content was 8.96 mg/L.The investigation of 290 water-improving projects was carried out in 10 counties(cities).Among 290 water-improving projects 213 water-improving projects were running normally,accounting for 73.45%(213/290);77 water-improving projects were running abnormally,accounting for 26.55%(77/290).Water fluoride content was≤1.0 mg/L in 158 projects,accounting for 54.48%(158/290).Water fluoride content was>1.0 mg/L in 132 projects,accounting for 45.52%(132/290).The maximal water fluoride content was 5.20 mg/L.Conclusions The situation of drinking water fluoride content over the national standard is serious in Shanxi province.The qualification rate was lower for the fluoride content of water-improving projects.Therefore,we should strength water-improving projects to raise the effectiveness of prevention and treatment and assure their quality.
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Objective To investigate the relationship between drinking-water type of endemic arsenicosis and adult carotid artery atherosclerosis. Methods In 2009, 285 participants aged over 40 from drinking-water type of endemic arsenism areas and 293 residents aged over 40 from control areas were investigated in Yingxian county,Shanxi province. Portable-type B mode color ultrasound was used to examine the carotid artery of all participants.The carotid atherosclerosis were diagnosed and graded through the ultrasonograms. Content of water arsenic and hair arsenic of 10 people randomly selected in every villages were detected. Results A total of 5 villages with drinkingwater type of endemic arsenicosis as observation group and 5 villages without drinking-water type of endemic arsenicosis as control group were investigated. The prevalence rates of adult carotid atherosclerosis within observation group were 35.09%(20/57), 55.74%(34/61), 38.46%(20/52), 36.51%(23/63) and 46.15%(24/52), respectively,and standardized prevalence rates were 32.5%, 33.8%, 34.9%, 46.2% and 47.3%, respectively and the prevalence rates of adult carotid atherosclerosis within control group were 18.18%(10/55), 30.77%(16/52), 20.00%(10/50),18.67% (14/75) and 21.31% ( 13/61 ), respectively; the standardize prevalence rates were 22.4%, 17.7%, 10.7%,24.6%, 18.9%, respectively. The standardize prevalence rates were higher in observation group [39.50%(113/285) ]than that in control group[39.50%(113/285), T = 26, P ＜ 0.01 ]. The severity of adult carotid atherosclerosis (composition of 4 - 7 scores ) was compared between observation group [ 17.70%(20/113 )] and control group [ 14.06% (9/64) ], and the difference was insignificant(x2 = 0.26, P ＞ 0.05). Conclusions The prevalence rate of carotid atherosclerosis in drinking-water type of endemic arsenicosis areas is higher than that of the control areas.The study provides evidence that arsenic poisoning can cause atherosclerosis.
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Objective To investigate the current situation and variation in the tendency of Kaschin-Beck disease (KBD) in Shanxi province, to assess the effectiveness of prevention measures, and to provide evidence for making scientific and effective tactics in prevention and control of the disease. Methods In 2008, according to "The National Technical Scheme for Kaschin-Beck Disease Control in 2007", children aged 7 - 12 years underwent clinical and X-ray examination in two historical severe KBD areas of Shanxi province, the observed position on Xray film was finger bone and carpal bone. Adults aged 16 years and above were clinically examined in 50 villages of 13 counties of KBD areas, Shanxi province. The diagnosis was based on "Diagnostic Standard of Kashin-Beck Disease"(GB 16003-1995), the adult patients were degreed according to the state of illness and divided into different groups according to their ages. Results A total of 181 children were examined, none of them was diagnosed as clinical KBD patient. The positive cases of X-ray were 2, X-ray detectable rate of metaphysis was 1.1% for children.In the 50 villages 13 871 of adults were examined and 801 KBD patients were found and the detectable rate was 5.77%. The detectable rate increased with age. The adult patients distributed mainly in the subpopulation aged 51years and above and these patients accounted for 70.66% (566/801) of total people examined. Degrees Ⅱ and Ⅲ patients at these ages accounted for 71.78%(206/287) of total degrees Ⅱ and Ⅲ patients. Conclusions The state of child KBD in Shanxi is under the national control standards. The detectable rate of adult KBD is higher. Relevant departments should pay close attention to the treatment of adult patients.
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Objective To investigate the relationship between arsenic in drinking water and skin lesions in endemic arsenism area in Shanyin County of Shanxi Province,in order to provide epidemiologic data for further arsenism research.Methods One hundred and eighty-nine endemic arsenism patients and 59 controls were randomly selected in 17 endemic amenism countries in Shanyin County of Shanxi Province.The content of arsenic in drinking water which wa8 collected indoom was half-quantitatively screened by a kit made by Chinese Center for Disease Control and Prevention,then quantitatively determined by HPLC-ICP-MS.Patients of endemic arsenism were diagnosed by "The Standard of Diagnosis for Endemic Amenism"(WS/T 211-2001).Results There were 64.9% (87/134)samples above the arsenic level(50μg/L)of drinking water and the median value of arsenic in drinking water was 91.43 μg/L in 134 water samples.The OR(95%CI)value between arsenic in drinking water and hyperkeratosis,hyperpigmentation,depigmentation was 2.46(1.22-4.94),3.34(1.50～7.44)and 2.86(1.50-5.46),respectively.The prevalence of hyperkeratosis,hyperpigmentation and depigmentation increased,as the arsenic in drinking water increased(≤10,≤50,≤200,＞200μg/L),especially in＞200μg/L group(OR=6.15,13.96,11.41,P＜0.05).The arsenic level in drinking water of Ⅲ degree of depigmentation patients(318.300μg/L)was higher(P＜0.05)than that of 0,Ⅰ and Ⅱ degree groups(86.670,131.800,1 10.590μg/L,P＜0.05).Conclusions Shanyin County is a medial arsenic pollution area. Arsenic in drinking water is considered as a risk factor of skin lesion. The degree of skin lesions increased,as the arsenic in drinking water increased.
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Objective To become aware of the present distribution of drinking water source with high fluoride in endemic fluorosis disease areas in Shanxi Province, and to provide the evidence for making scientific and effective tactics in prevention and control. Methods According to "The National Technical Scheme for Endemic Disease Control" in the year 2004 to 2006, the investigation points were selected in 60 counties at 8 cities of Shanxi Province. The fluoride levels of water were determined by fluoride selective ion electrode. Results The fluoride content of water was determined in 2990 villages in 60 counties. Water fluorides content of 1658 villages were above 1.00 mg/L, accounted for 55.45%(1658/2990). The highest water fluoride content was 9.72 mg/L. Villages with high fluoride water in Taiyuan, Datong, Xinding, Linfen, Yuncheng basins accounted for 89.63% (1486/1658) among villages with high fluoride in Shanxi Province. In Shanxi Province the villages with high fluoride water were mainly distributed over 5 basins and scattered on the other areas. The distribution of drinking water source with high fluoride were different in 5 basins(H=316.10, P<0.05). The Water fluorides content in Datong basin(2.32 mg/L) was significantly higher than that of the other basins (P<0.05) and the ratio of drinking water fluoride levels under the national standard was 81.16%(336/414) in Datong basin. Conclusions Drinking water source with high fluoride are widespread distributed in Shanxi Province and mainly distributed in 5 basins. The situation of drinking water fluoride levels under the national standard is serious. The task of prevention and control for endemic fluorosis is still arduous. Therefore, we should strength water improving to raise the effect of prevention and treatment.
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<p><b>OBJECTIVE</b>To explore the level and feature of neonate deformity in water arsenic exposure areas, as to finding out an evidence for the study and prevention of the arsenic exposure.</p><p><b>METHODS</b>The birth situation of neonate was surveyed from 1998 to 2004 in water arsenic exposure areas according to cross-sectional survey. The results were classified in accordance with ICD-10 and common surveillance of china. The population of Shanyin County served as the common people and the data were analyzed by SPSS 11.5 for windows.</p><p><b>RESULTS</b>The neonates surveyed were 2467 cases. There were 49 neonates deformity found in this investigation, giving a neonate deformity rate of 198.62 per 10,000 cases, which was shown significantly higher in water arsenic exposure areas than in the normal (U = 3.23, P < 0.01), with types of nervous system deformity, limbs deformity and congenital heart disease as in system classification. There was no significant difference of deformity rate in different sex neonates (chi2 = 0.32, P > 0.05).</p><p><b>CONCLUSION</b>The drinking high-arsenic water over a long period of time should be a risk factor of neonate deformity. Prevention and treatment of endemic arsenic exposure should be urgently needed.</p>