Research progress on biomarkers of endemic arsenic poisoning / 中华地方病学杂志

The accumulation effect of arsenic and low arsenic exposure can cause sustained health damage to people in arsenic poisoning areas. Early diagnosis and prevention of arsenic poisoning have become the focus of current prevention and control, and biomarkers have important application value in early diagnosis and prevention of diseases. Therefore, the screening and application of sensitive and specific biomarkers of arsenic poisoning are of great significance for the continuous elimination of arsenic poisoning. In this paper, the research progress of biomarkers of endemic arsenic poisoning is reviewed, in order to provide reference for the continuous prevention and control, early monitoring and early warning of endemic arsenic poisoning.

Progress in arsenic carcinogenic signaling transduction pathway / 中华地方病学杂志

Arsenic, as a metal element, has metallic and non-metallic properties and is widely distributed in nature. In the list of carcinogens of the International Agency for Research on Cancer, arsenic is clearly listed as the first class of carcinogens. Chronic arsenic poisoning caused by arsenic contamination of drinking water is a major health problem facing human beings worldwide. This kind of pollution occurs naturally due to geological structure, and the most serious one can lead to cancer, among which skin cancer is the most specific. In addition, epidemiological studies have shown that long-term arsenic exposure can also lead to bladder cancer, lung cancer, and liver cancer, etc. However, there have been a number of different views on the potential mechanisms of arsenic carcinogenesis. Carcinogenesis through signal transduction pathway is one of the important molecular mechanisms, including Wnt, mitogen-activated protein kinase (MAPK), phosphatidylinositol 3 kinase-protein kinase B-mammalian target of rapamycin (PI3K/AKT/mTOR), nuclear factor kappa-B (NF-κB) and transforming growth factor-β (TGF-β). When there is a problem in the upstream and downstream or one of its links in the signal transduction pathway, the proliferation and differentiation of human cells are out of control, which can lead to cancer.

Analysis of urinary arsenic methylation metabolites in population exposed to arsenic through drinking water before and after water improvement / 中华地方病学杂志

Objective:To study the effect of water improvement on urinary arsenic methylation metabolism in population exposed to arsenic through drinking water.Methods:A cluster sampling method was used to select drinking water type arsenism areas in Bayannur City, Inner Mongolia Autonomous Region. Permanent residents lived in the arsenism areas for more than 10 years were selected as the survey subjects. Urine samples ( n = 874, 111, 145) were collected in 2004 (before water improvement), 2014 (4 years after water improvement) and 2017 (7 years after water improvement), respectively, and some subjects were followed up in 2014 and 2017. High performance liquid chromatography-inductively coupled plasma mass spectrometry (HPLC-ICP-MS) was used to detect different forms of arsenic metabolites in urine [inorganic arsenic (iAs), monomethylarsonic acid (MMA), dimethylarsenic acid (DMA)], and total arsenic (tAs), the iAs percentage (iAs%), MMA percentage (MMA%), DMA percentage (DMA%), monomethylation rate (PMI), dimethylation rate (SMI), and the ratio of MMA to DMA (MMA/DMA) were calculated. The content and distribution of urinary arsenic metabolites in people exposed to arsenic before and after water improvement were compared and analyzed. Results:Compared with 2004, the levels of iAs, MMA, DMA, tAs and iAs% in urine of arsenic exposed population in 2014 were lower ( Z =-14.12,-12.79,-14.27,-14.21,-6.90, P < 0.001), the levels of MMA%, DMA% and PMI were higher ( Z =-3.22,-2.91,-6.90, P < 0.05); in the same drinking water arsenic exposed population, compared with 2004, the levels of iAs, MMA, DMA, tAs and iAs% in urine ( n = 48) were lower ( Z =-5.57,-5.53,-5.54,-5.55,-2.86, P < 0.05) in 2014, and PMI level was higher ( Z =-2.86, P = 0.004). Compared with 2014, the levels of iAs% and MMA/DMA in urine of arsenic exposed population in 2017 were lower ( Z =-4.97,-2.25, P < 0.05), the levels of MMA, DMA, tAs, DMA%, PMI and SMI were higher ( Z =-4.01,-5.39,-4.77,-4.61,-4.97,-2.25, P < 0.05); in the same drinking water arsenic exposed population, compared with 2014, the level of iAs% in urine ( n = 28) was lower ( Z =-2.87, P = 0.004) in 2017, the levels of DMA% and PMI were higher ( Z =-2.32,-2.87, P < 0.05). Conclusion:Water improvement could significantly reduce the levels of urinary arsenic metabolites iAs, MMA, DMA and tAs and increase the level of DMA% in arsenic exposed population.

Demographic characteristics and treatment of patients with skeletal fluorosis in Inner Mongolia Autonomous Region in 2020 / 中华地方病学杂志

Objective:To understand the demographic characteristics and treatment intention, treatment status and therapeutic effect of patients with skeletal fluorosis in Inner Mongolia Autonomous Region (reffered to as Inner Mongolia) in order to provide a basis for next step treatment program.Methods:From March to June 2020, a face-to-face questionnaire survey was conducted among 3 570 patients with skeletal fluorosis in 11 leagues (cities) of Inner Mongolia to understand their basic information, treatment intention, treatment status and therapeutic effect. Patients with skeletal fluorosis of different demographic characteristics were compared with each other in their treatment intention and treatment status, and the therapeutic effects of different drugs were compared by χ 2 test. Results:A total of 3570 patients with skeletal fluorosis were investigated. There were slightly more women than men with skeletal fluorosis (1.29 ∶ 1.00, 2 014/1 556). The ages were mainly from 40 to 79 years old (95.4%, 3 406/3 570). Mongols patients accounted for 36.0% (1 285/3 570). Patients with low education (primary school and below) accounted for 82.2% (2 935/3 570). Eighty-five per cent (3 035/3 570) of the patients had drug treatment intention and 37.1% (1 325/3 570) of the patients had drug treatment. Thirty-seven point five per cent (1 338/3 570) of the patients had surgery intention and surgery was performed in 0.2% (8/3 570) of the patients. Combination therapy (98.5%, 194/197) and chondroprotective agents alone (98.3%, 173/176) were more effective than anti-inflammatory and analgesic agents alone (84.2%, 48/57) in the treatment of skeletal fluorosis ( P < 0.05). Surgery was effective (8/8). Conclusions:Most of the patients with skeletal fluorosis are middle-aged and elderly, and the patients with skeletal fluorosis in Mongols account for a certain proportion. At present, all the patients with skeletal fluorosis who have the will to be treated have not been effectively treated, and the means of treatment is relatively single. It should be advocated to carry out various forms of treatment of skeletal fluorosis, so that patients could relieve symptoms, reduce pain and improve their quality of life.

Physical activity level in physical education class of elementary school in Xi an / 中国学校卫生

Objective@#To assess physical activity level and characteristics in elementary physical education (P.E.) class among different weight status and grades students.@*Methods@#ActiGraphGT3X was used to measure physical activity of 60 students in grade 1, 2, and 4 during three P.E. classes. BMI was calculated according to the student s height and weight in the latest physical fitness test results, and the weight status was divided according to the national Physical Fitness Standards for Students in different grades of elementary schools. Independent sample t test and analysis of variance were used to explore the difference of physical activity.@*Results@#The proportion of moderate to high intensity physical activity (MVPA) in elementary school P.E. class was 21.9% (8.8 min). The proportion of MVPA in P.E. classes and the number of steps in normal weight students were 25.4% and (1 247.0± 326.3 ), respectively, which were significantly higher than those of underweight students, but not significantly different from those of overweight students. The MVPA of male and female PE classes in the second grade (27.0%, 26.4%) was significantly higher than that in the first grade, but there was no significant difference compared with that in the fourth grade ( P >0.05).@*Conclusion@#Moderate to high intensity physical activity is low in P.E. class in elementary school. Improving teachers awareness of promoting physical activity in PE class will benefit the MVPA in students.

Physical activity level in physical education class of elementary school in Xi an / 中国学校卫生

Objective@#To assess physical activity level and characteristics in elementary physical education (P.E.) class among different weight status and grades students.@*Methods@#ActiGraphGT3X was used to measure physical activity of 60 students in grade 1, 2, and 4 during three P.E. classes. BMI was calculated according to the student s height and weight in the latest physical fitness test results, and the weight status was divided according to the national Physical Fitness Standards for Students in different grades of elementary schools. Independent sample t test and analysis of variance were used to explore the difference of physical activity.@*Results@#The proportion of moderate to high intensity physical activity (MVPA) in elementary school P.E. class was 21.9% (8.8 min). The proportion of MVPA in P.E. classes and the number of steps in normal weight students were 25.4% and (1 247.0± 326.3 ), respectively, which were significantly higher than those of underweight students, but not significantly different from those of overweight students. The MVPA of male and female PE classes in the second grade (27.0%, 26.4%) was significantly higher than that in the first grade, but there was no significant difference compared with that in the fourth grade ( P >0.05).@*Conclusion@#Moderate to high intensity physical activity is low in P.E. class in elementary school. Improving teachers awareness of promoting physical activity in PE class will benefit the MVPA in students.

Pruritus in psoriasis: clinical characteristics, pathogenesis and treatment / 中华皮肤科杂志

In the past, psoriasis was considered as a non-pruritic skin disease. In recent years, it has been gradually realized that pruritus is one of the factors that aggravate the disease burden of patients with psoriasis. This review mainly elaborates epidemiologic and clinical characteristics of pruritus in psoriasis, focuses on the role of abnormal expression of neuropeptides and abnormal distribution of nerve endings in neurogenic inflammation in the pathogenesis of pruritus, and introduces the effect of treatment of psoriasis on relief of pruritus.

The study on relationship between arsenic methylation metabolism and skin lesions of population exposed to arsenic through drinking water / 中华地方病学杂志

Objective:To investigate the levels of urinary arsenic metabolites in arsenic-exposed people with different degrees of skin lesions.Methods:A cluster sampling method was used to select people with different degrees of skin lesions in the drinking water arsenic poisoning area of Bayannaoer City, Inner Mongolia Autonomous Region. According to the "Standard of Diagnosis for Endemic Arsenism" (WS/T 211-2001), the research subjects were divided into four clinical grading: normal, suspicious, mild, moderate and above on the basis of the degrees of skin lesions. Urine samples from any 1 middle section were collected, and the levels of urinary arsenic metabolites of different forms in different clinically graded people were detected by inductively coupled plasma mass spectrometry (ICP-MS).Results:A total of 522 people were included, including 309 males and 213 females; the age was (39.11 ± 12.38) years old, ranging from 11 to 65 years old. There were 337, 80, 31, 74 people in normal, suspicious, mild, moderate and above clinical grading, the levels of inorganic arsenic (iAs, medians: 15.46, 37.16, 104.46, 163.06 μg/L), monomethylarsonic acid (MMA, medians: 15.95, 33.27, 82.80, 123.84 μg/L), dimethylarsenic acid (DMA, medians: 78.16, 147.86, 301.28, 371.30 μg/L), total arsenic (tAs, medians: 113.90, 220.94, 501.25, 684.46 μg/L), iAs percentage (iAs%, medians: 15.66%, 15.53%, 21.67%, 21.65%), MMA percentage (MMA%, medians: 13.51%, 15.40%, 17.14%, 16.43%), DMA percentage (DMA%, medians: 70.37%, 67.98%, 63.25%, 61.23%), monomethylation rate (PMI, medians: 0.84, 0.84, 0.78, 0.78), dimethylation rate (SMI, medians: 0.84, 0.81, 0.79, 0.79), and ratio of MMA to DMA (MMA/DMA, medians: 0.20, 0.23, 0.27, 0.27) were compared in different clinically graded people, the differences were statistically significant ( H = 97.98, 96.44, 85.50, 95.08, 38.58, 29.94, 51.98, 38.58, 43.20, 43.20, P < 0.01). Compared with normal people, iAs, MMA, DMA, tAs, MMA%, and MMA/DMA levels significantly increased, and SMI level significantly decreased in suspicious, mild, moderate and above people ( P < 0.017); compared with normal people, iAs% level significantly increased, and DMA% and PMI levels significantly decreased in mild, moderate and above people ( P < 0.017). Conclusion:The levels of urinary arsenic metabolites in arsenic-exposed people with different degrees of skin lesions are different, showing a dose-response relationship.

Survey results of residents in a drinking water-borne endemic arsenism area in Togtoh County Inner Mongolia / 中华地方病学杂志

Objective:To investigate the prevalence of residents in a drinking water-borne endemic arsenism area in Togtoh County Inner Mongolia.Methods:In a drinking water-borne endemic arsenism area (Togtoh County of Inner Mongolia), eighty-five permanent residents (residence time ≥20 years) of Hedgehog Valley were selected as exposure group. In the same period, 58 people from a non-arsenism area (Lanjiayao of Helingeer County) were selected as the control group. The general situation of the respondents was investigated, and water arsenic, urine arsenic, blood glucose, blood lipids, blood pressure, liver function, renal function, electrocardiogram and abdominal B-ultrasound were analyzed in both groups. The exposure group was divided into the disease group and the non-disease group according to whether arsenic poisoning skin lesions occurred, and the general conditions and blood pressure changes in the two groups were analyzed.Results:In the exposure group and control group, there were no significant differences among the indicators such as sex, age, smoking, drinking and taking vitamin or calcium tablet ( P > 0.05). Arsenic concentration [Median (interquartile range)] in drinking water of the exposure group was 163.34 (35.34) μg/L, and in urine was 269.72 (152.54) μg/L. Arsenic concentration in drinking water of the control group was 2.96 (5.62) μg/L, and in urine was 24.21 (28.63) μg/L. There were no statistical differences in blood glucose, blood lipids between the exposure group and control group (χ 2 = 0.865, 0.886, P > 0.05); but liver function, renal function, sinus arrhythmia and fatty liver were significantly different statistically (χ 2 = 4.654, 4.355, 4.725, 12.423, P < 0.05); the detection rate of abnormal blood pressure in control group was higher than that of the exposure group (χ 2 = 16.289, P < 0.01). Skin lesions occurred in 24 patients (28.24%) in the exposure group and no skin lesions in 61 patients (71.76%). In disease group, 14 cases (58.33%, 14/24) smoked, the proportion of smoking was higher than that of cases in non-disease group(31.15%, 19/61, χ 2 = 5.360, P < 0.05); and the prevalence of hypertension (50.00%, 12/24) in cases of disease group was higher than that of cases in non-disease group (26.23%, 16/61, χ 2 = 4.406, P < 0.05). Conclusions:Long-term exposure to arsenic might injure liver function and renal function, and enhance the risk of arrhythmia and fatty liver. Smoking may be a risk factor for skin lesions in residents of drinking water-borne endemic arsenism area.

The efficacy of repetitive transcranial magnetic stimulation in the treatment of mild cognitive impairment: A meta-analysis / 中华物理医学与康复杂志

Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the cognition of patients with mild cognitive impairment (MCI).Methods:The PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, and VIP databases were searched for randomized controlled trials of rTMS treating MCI patients before March 2019. After screening the literature, extracting the data and two independent reviewers evaluating the quality of the included studies, the meta-analysis was conducted using version 5.3 of the RevMan software.Results:Nine studies covering 368 patients were included. The pooled results showed that compared with sham stimulation, rTMS treatment could effectively improve the cognitive ability (assessed using the Montreal instrument), episodic memory, verbal fluency and the amplitude of MCI patients′ P300 signals. P300 latency was also reduced. However, there was no significant difference, on average, in memory quotient or P300 latency between patients given rTMS plus donepezil hydrochloride and those given donepezil hydrochloride alone. Compared with the control groups, the rTMS treatment groups displayed slightly more frequent adverse reactions, mainly mild dizziness and scalp pain which disappeared within 1-2 hours without obvious residual effects.Conclusions:TMS treatment can effectively improve cognitive and memory function.

Analysis of monitoring results of drinking-water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018 / 中华地方病学杂志

Objective@#To understand the epidemic situation and control effect of drinking-water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018, and provide a basis for further development and improvement of prevention and control strategies.@*Methods@#In 2009-2018, 38 diseased villages were selected from 8 cities in Inner Mongolia Autonomous Region as fixed monitoring sites to investigate the water improvement situation of the village and the operation of the water improvement project, and to detect the arsenic content of the water; physical examinations were carried out on all the resident populations who were exposed or previously exposed to high levels of arsenic water in the monitoring villages, and the changes in the condition of arsenic poisoning patients were observed; 30 adult urine samples were collected from each monitoring village to detect urinary arsenic levels.@*Results@#The water improvement rate of the 38 monitoring villages increased from 84.21% (32/38) in 2009 to 100.00% (38/38) in 2013, and continued to maintain; the normal operation rate of water improvement project increased from 64.29% (9/14) in 2009 to 100.00% (18/18) in 2016, and continued to maintain; the qualified rate of water arsenic content of water improvement project increased from 64.29% (9/14) in 2009 to 88.89% (16/18) in 2018; the proportion of qualified project covered population increased from 47.79% (4 846/10 140) in 2009 to 84.35% (5 370/6 366) in 2018. In 2009-2018 the detection rate of arsenic poisoning in the water arsenic content qualified village was 9.17% (3 968/43 276), and the detection rate in the unchanged water and water arsenic exceeded villages was 7.48% (805/10 759); there was no new case for ten consecutive years. There were significant differences in urinary arsenic levels of the water arsenic content qualified villages, the unchanged water and water arsenic exceeded villages between different years (H=424.04, 100.35, P < 0.05); the urinary arsenic level of water arsenic content qualified villagers was lower than that of the unchanged water and water arsenic exceeded villages in the same year (P < 0.05).@*Conclusions@#During the 10-year monitoring period, the prevalence of arsenic poisoning has been effectively controlled. The water improvement rate and the normal operation rate of the project remain in good condition, but the qualified rate of water arsenic still should to be improved.

Evaluation of the therapeutic effects and micro-structural influence of rTMS on esophageal cancer patients with depression by using DTI / 实用放射学杂志

Objective To investigate the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS)on esophageal cancer patients with depression and the influence on the brain micro-structure by using the DTI technology.Methods Ten esophageal cancer patients with depression (6 male,4 female)were enrolled in this study according to the inclusion criteria.All patients received 1 0 days of rTMS treatment (stimulation frequency:10 Hz;stimulation site left:dorsolateral prefrontal cortex (DLPFC);stimulation intensity:1 10 % rest motor threshold).Before the first time and after the last time of the rTMS treatment,the DTI image acquisition and the coefficient assessment of hamilton depression scale(HAMD),self-rating depression scale(SDS),and self-rating anxiety scale (SAS)were conducted.Comparison of the mean fractional anisotropy (FA)of the depression related brain regions between pre-and post-rTMS was performed.Pearson correlation coefficient was calculated between the changes of FA value and the depression scale changes as well to understand their relationship.Results The HAMD,SAS and SDS were significantly decreased after pos-t rTMS (t＝7.69, P＝0.000;t＝12.86,P＝0.000;t＝10.51,P＝0.000)compared with pre-rTMS.Also,after rTMS depression patients showed significantly increased FA value in the bilateral hippocampus,left pallidum,bilateral thalamus,left middle frontal cortex,bilateral anterior cingulate cortex, and bilateral superior temporal cortex.Significant negative correlation was observed between the FA changes of the left pallidum and SAS(r＝－0.646,P＝0.044),and between the FA changes of right thalamus and HAMD (r＝－0.712,P＝0.021).Conclusion High frequency rTMS over the left DLPFC has significant antidepressant effect on esophageal cancer patients with depression.This may be related to the modulation of rTMS on the micro-structure of the left pallidum and right thalamus.

Analysis of monitoring results of drinking -water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018 / 中华地方病学杂志

Objective To understand the epidemic situation and control effect of drinking -water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018, and provide a basis for further development and improvement of prevention and control strategies. Methods In 2009 - 2018, 38 diseased villages were selected from 8 cities in Inner Mongolia Autonomous Region as fixed monitoring sites to investigate the water improvement situation of the village and the operation of the water improvement project, and to detect the arsenic content of the water; physical examinations were carried out on all the resident populations who were exposed or previously exposed to high levels of arsenic water in the monitoring villages, and the changes in the condition of arsenic poisoning patients were observed; 30 adult urine samples were collected from each monitoring village to detect urinary arsenic levels. Results The water improvement rate of the 38 monitoring villages increased from 84.21％ (32/38) in 2009 to 100.00％ (38/38) in 2013, and continued to maintain; the normal operation rate of water improvement project increased from 64.29％ (9/14) in 2009 to 100.00％ (18/18) in 2016, and continued to maintain; the qualified rate of water arsenic content of water improvement project increased from 64.29％ (9/14) in 2009 to 88.89％ (16/18) in 2018; the proportion of qualified project covered population increased from 47.79％ (4846/10140) in 2009 to 84.35％ (5370/6366) in 2018. In 2009 - 2018 the detection rate of arsenic poisoning in the water arsenic content qualified village was 9.17％ (3968/43276), and the detection rate in the unchanged water and water arsenic exceeded villages was 7.48％ (805/10759); there was no new case for ten consecutive years. There were significant differences in urinary arsenic levels of the water arsenic content qualified villages, the unchanged water and water arsenic exceeded villages between different years (H = 424.04, 100.35, P < 0.05); the urinary arsenic level of water arsenic content qualified villagers was lower than that of the unchanged water and water arsenic exceeded villages in the same year (P < 0.05). Conclusions During the 10-year monitoring period, the prevalence of arsenic poisoning has been effectively controlled. The water improvement rate and the normal operation rate of the project remain in good condition, but the qualified rate of water arsenic still should to be improved.

Skin changes in patients with endemic arsenism after changing drinking water for 12 years in Inner Mongolia / 中华地方病学杂志

Objective To understand the changes of skin lesions in population exposed to arsenic through drinking-water in Inner Mongolia after changing water source for 12 years,and to evaluate the long-term harmful effects and the delayed injury to human body due to arsenic exposure and the effect of changing water.Methods The stratified random cluster sampling investigation objects (data derived from the Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention) of the arsenic exposure area before water reform (2004) as the foundation,in 2017,we selected three administrative villages (changed water in 2005) in Bayan Nur City of Inner Mongolia as survey sites.The objects of this study were residents who had been living in the survey site and were eligible for previous survey (n =80,35 males and 45 females).To compare the skin damage of the residents exposed to arsenic before and after the water changed,the water samples of the survey objects were measured arsenic content.According to the content of water arsenic,the respondents were divided into low,medium and high exposure groups (10-,150-,≥300 μg/L),to analyze clinical classification in skin damage before and after changing water.Results The water arsenic content after changing [1.42 (0.18-33.45) μg/L] was lower than those before the changes [238.20 (14.56-824.70) μg/L,Z =-8.34,P ＜ 0.05].A total of 63 persons with skin keratinization,7 persons with hyperpigmentation and 19 persons with depigmentation were identified after the changes of drinking water source,while 38,3 and 18 persons were respectively found before the changes.The detection rate of skin keratinization after water changes was significantly higher than that before water changes [78.8％ (63/80) vs 47.5％ (38/80),x2 =16.78,P ＜0.05].According to the clinical classification of skin damage,23 patients were normal,44 patients were suspicious,10 patients were mild,and 3 patients were moderate or severe after the water changes,compared with those before the water changes (38,18,6 and 18 persons were respectively found),the clinical fractional suspicious detection rate of skin damage in the arsenic exposed population increased,and the medium-severe detection rate decreased,and the differences were statistically significant (x2 =17.80,12.33,P ＜ 0.05).The detection rate of the clinical score of moderate-severe skin damage in men was significantly decreased,and the difference was statistically significant (x2 =7.65,P ＜ 0.05).The normal detection rate of female skin lesions was reduced,and the rate of suspected detection was increased (x2 =5.48,7.65,P ＜ 0.05).In the high-and medium-dose groups,41.9％ (13/31) and 42.9％(12/28) of the arsenic exposure population had a reduced clinical classification of skin damage.The ratios of clinical classification severity of skin damage in the high-,medium-and low-dose groups were 25.8％ (8/31),25.0％ (7/28),and 42.9％ (9/21).The differences were statistical significantly by linear trend chi-square test (x2 =12.96,P ＜ 0.05).Conclusions The skin lesions exposed to arsenic could be effectively improved after changing water.But the skin lesions still appear in some cases due to long-term chronic arsenic exposure.The long-term effects caused by arsenic should be explored persistently.

Relationship between rationed X receptor α mRNA expression in blood and skin lesion of residents exposed to arsenic via drinking water / 中华地方病学杂志

Objective To detect retinoid X receptor α (RXRα) mRNA expression in blood of subjects exposed to different concentrations of arsenic via drinking water, to analyze the relationship between RXRα mRNA expression and skin lesion caused by arsenic,and further to explore the skin lesion mechanism of arsenic. Methods Study sites were selected by molecular epidemiology method from high arsenic drinking water area of Bayannur City. Two hundred and thirty-five subjects who had been lived in high arsenic area for more than 10 years were selected;blood samples and water samples were collected from the subjects; according to arsenic concentration in drinking water,they were divided into four groups,<10 μg/L(control group),10-<100 μg/L(low dose group),100- <200 μg/L (middle dose group), and ≥200 μg/L (high dose group). Skin hyperkeratosis and pigment abnormity examination were conducted. The RXRα mRNA expression level in blood samples was detected by real-time quantitative PCR, and then the relationship between expression of RXRα mRNA and different levels of arsenic exposure,and skin lesion induced by arsenic were analyzed. Results ①The results showed that there was a dose-effect relationship between the prevalence of hyperkeratosis, pigment abnormity and arsenic exposure (χ2= 14.597, 12.825, P < 0.05); ②With increasing of arsenic exposure, RXRα mRNA expression in blood decreased firstly and then increased (F = 8.312, P < 0.05), which were significantly different statistically from those of control [(1.20 ±0.53)×10-3]and low dose groups[(0.92 ± 0.49)×10-3,P<0.05];RXRα expression was significantly higher in high dose group[(1.40 ± 0.45)×10-3]than those of middle and low dose groups [(1.12 ± 0.58,0.92 ± 0.49)×10-3,P<0.05]; ③The RXRα mRNA expression in people with different level of skin damage (hyper keratosis and pigment abnormity)were statistically significant(F=4.206,4.389, P< 0.05); degree Ⅲ[(1.98 ± 0.38) × 10-3] hyperkeratosis patients compared with degree Ⅰ [(1.11 ± 0.52) × 10-3] and degree Ⅱ [(1.13 ± 0.42) × 10-3], RXRα mRNA expression was significantly different (P < 0.05), degree Ⅱ and higher degrees [(1.61 ± 0.54) × 10 -3] pigment abnormity patients compared with control [(1.15 ± 0.52)×10-3],RXRα mRNA expression was significantly different (P < 0.05). Conclusions Chronic arsenic exposure has an effect on RXRα mRNA expression in blood. There is a relationship between abnormal expression of RXRα mRNA and skin lesion induced by arsenic.

Pelvic Floor Ultrasound in Diagnosis of Female Stress Urinary Incontinence by Measuring Angle Parameters / 中国医学影像学杂志

Purpose To investigate the diagnostic criteria and value of angle parameters in female stress urinary incontinence (SUI),and to provide an objective basis for clinical diagnosis of SUI.Materials and Methods In retrospective analysis,138 patients with SUI diagnosed by clinic from December 2014 to December 2016 were selected as the study group,while 100 normal females receiving the routine medical examination were selected as the control group.All subjects in both groups were examined by pelvic floor ultrasound to observe the urethral inclination angle,urethral rotation angle (URA) and posterior urethrovesical angle (PUVA) to obtain the standard in diagnosis of female SUI.30 SUI patients from January to February 2017 were prospectively analyzed,and the above results were verified to evaluate their value in the diagnosis of SUI.Results There was no significant difference in age,body mass index,gravidity and parity history and resting state PUVA between the two groups (P＞0.05).There was significant difference in the resting state urethral inclination angle,Valsalva urethral inclination angle,PUVA and URA between the two groups (P＜0.05).The receiver operating characteristic curve was used to find the cut-off value of SUI:urethral inclination angle in resting state ＜14.5°,urethral inclination angle in Valsalva state ＞32.5 °,and URA ＞49.5 °,PUVA ＞154.5 °,with their sensitivity of 62％,73％,67％ and 57％,respectively;the specificity of 61％,84％,82％ and 70％,respectively;and the area under the curve of 0.633,0.809,0.768 and 0.658,respectively.By verification,when the urethral inclination angle was 14.5° in the resting state,the coincidence rate of the diagnosis of SUI was 63％;when the urethral inclination angle of Valsalva was 32.5°,83％;when the URA was 49.5°,77％;when the PUVA was 154.5 °,60％.Conclusion Pelvic floor ultrasound can clearly observe angle parameters of females,the determination of the cut-off value of ultrasound is helpful for clinical diagnosis and evaluation of SUI,and the urethral inclination angle in Valsalva state and URA are of high diagnostic value in the diagnosis of female SUI,providing an objective basis for clinical diagnosis of SUI.

Expression and significance of Heat shock proteins 70 and Heat shock proteins 90 mRNA of residents exposed to arsenic via drinking water / 中华地方病学杂志

Objective Through measuring and analyzing blood Heat shock proteins (HSP) 70 and HSP90 mRNA expression of different levels of arsenic exposure population,to explore the relationship between HSP70 and HSP90 mRNA expression and endemic arsenic poisoning.Methods The study subjects included a total of 226 residents exposed to arsenic via drinking water from two townships in the city of Bayannur (Shengfeng Township and Hangjinhouqishahai Township Wuyuan County) in Inner Mongolia Autonomous Region in 2011.The residents were divided into four groups according to drinking water arsenic concentration:control group (drinking water arsenic concentration ＜ 10 μg/L),low exposure group (drinking water arsenic concentration 10-＜ 100 μg/L),middleexposure group (drinking water arsenic concentration 100-＜ 200 μg/L),and high exposure group (drinking water arsenic concentration ≥200 μg/L).Epidemiological investigation was carried out.Real-time PCR technology was used to detect the expression levels of blood HSP70 and HSP90 mRNA.And the relationships between the expression of HSP70 and HSP90 mRNA and water arsenic and urinary arsenic levels were analyzed.Results ①With the increase of arsenic concentration,the expression level of HSP70 mRNA increased first and then decreased.The HSP70 mRNA in the blood of high exposure group [2.44 × 10-3 (1.72 × 10-3)] and middle exposure group [3.01 × 10-3 (1.95 × 10-3)] were significantly different from that in the control group [2.27 × 10-3 (1.09 × 10-3),P ＜ 0.05].There was significant difference between the middle exposure group [3.01 × 10-3 (1.95 × 10-3)] and the low and high exposure groups [2.38 × 10-3 (1.55 × 10-3),2.44 × 10-3 (1.72 × 10-3),P ＜ 0.05].The expression of HSP70 mRNA in blood of male [2.71 × 10-3 (1.90 × 10-3)] was slightly higher than that of female [2.34 × 10-3 (1.35 × 10-3),t =2.523,P ＜ 0.05].② With the increase of arsenic concentration,the expression level of HSP90 mRNA increased first and then decreased.The expression of HSP90 mRNA in the middle exposure group [1.29 × 10-2(1.04 × 10-2)] was significantly different from that in the control group [1.04 × 10-2 (0.83 × 10-2),P ＜ 0.05].The differences of HSP90 mRNA between the high exposure group [1.19 × 10-2 (0.88 × 10-2)] and the low and middle exposure groups [1.23 × 10-2 (0.68 × 10-2),1.29 × 10-2 (1.04 × 10-2)] were statistically significant (P ＜ 0.05).③The relative expression of HSP70 mRNA showed a U-shaped regression relationship with the level of urinary arsenic exposure (R2 =0.031,P ＜ 0.05),and the expression of HSP90 mRNA was also correlated with urinary arsenic and nail arsenic (R2 =0.049,0.036,P ＜ 0.05).Conclusion Chronic arsenic exposure affects blood HSP70 and HSP90 mRNA expression.

Impact of Arsenic methylation of population exposed to chronic arsenic through drinking water / 中华地方病学杂志

Objective To investigate the arsenic methylation level of people chronically exposed to different levels of arsenic in drinking water.Methods A cluster sampling method was used to select 874 cases that had drank different concentration arsenic-contaminated water from arsenic endemic area in Bayannaoer City.They were divided into four groups according to arsenic exposure level:control (≤ 10 μg/L),low (＞ 10-50 μg/L),medium (＞ 50-200 μg/L) and high groups (＞ 200 μg/L),146,155,224,349 cases,respectively.The content of arsenic in drinking water and the arsenic species in urine were analyzed by inductively coupled plasma mass spectrometry (ICPMSS) and the results were expressed as median.Results The inorganic arsenic (iAs),monomethylarsonic acid (MMA),dimethylarsinic acid (DMA),and total-arsenic (tAs) in urine of low,medium and high groups increased following increasing of arsenic exposure level (x2 =605.08,609.96,615.83,628.64,all P ＜ 0.017) and iAs％,MMA％ and MMA/DMA significantly increased following increasing of arsenic exposure level (x2 =112.30,56.60,86.47,all P ＜ 0.017).DMA％,PMI and SMI significantly decreased following increasing of arsenic exposure level (x2 =125.80,112.30,86.47,all P ＜ 0.017).In the four groups,iAs％ of female were 11.39％,12.28％,13.47％ and 17.58％,they were significantly lower than those of male's (15.52％,16.19％,17.45％,21.86％,Z =-4.22,-3.79,-4.60,-6.71,all P ＜ 0.05);and DMA％ were 76.95％,74.05％,72.76％,and 68.64％ in the four groups respectively,and the PMI of female were 0.89,0.88,0.87,and 0.82,both DMA％ and PMI were significantly higher than those of male in each group (71.17％,69.39％,67.36％,61.29％,0.84,0.84,0.83,0.78,Z =-4.00,-3.34,-5.50,-7.24,-4.22,-3.79,-4.60,-6.71,all P ＜ 0.05).In control group,arsenic metabolites levels of people were not significantly different in the three age groups (all P ＞ 0.05).Compared to the ≤30 age group,the MMA,DMA and tAs of 31-45 age group increased and DMA,DMA％,PMI of ≥46 age group increased while iAs％ decreased in high group (μg/L:72.71 vs 109.13,307.90 vs 419.50,505.59 vs 684.60,307.90 vs 418.26;64.31％ vs 68.45％,0.79 vs 0.83,20.71％ vs 17.35％,x2 =10.72,10.24,8.20,10.24,9.89,20.96,20.96,all P ＜ 0.017).Compared to the 31-45 age group,DMA％ and PMI of ≥46 age group increased while iAs％ decreased (64.91％ vs 68.45％,0.80 vs 0.83,20.14％ vs 17.35％,x2 =9.89,20.96,20.96,all P ＜ 0.017).Conclusion There is a significant dose response relationship between arsenic metabolites and arsenic exposure level,and arsenic methylation is related to gender and age.

Expression and significance of thyroid hormone receptors mRNA of residents exposed to arsenic via drinking water / 中华地方病学杂志

Objective To detect thyroid hormone receptors (TRs) mRNA expression of subjects exposed to different levels of arsenic,to further study the endocrine disturbing effect of arsenic.Methods Molecular epidemiological method was used,in drinking water type of endemic arsenic poisoning areas,which were divided into control (＜ 10 μg/L),low (10-＜ 100 μg/L),medium (100-＜ 200 μg/L) and high (≥200 μg/L) dose groups based on the drinking water arsenic concentrations.According to the gender stratification,a total of 273 (control,low,medium and high dose groups were 58,49,66,100,respectively) residents were chosen.To carry out the questionnaire,urine arsenic determination,electrocardiographic examination.Real-time PCR was used to detect blood TRs mRNA expression.Results TRα mRNA relative expression levels in the control,low,medium and high dose groups were (12.2 ± 5.7) × 10-4,(12.2 ± 5.0) × 10-4,(12.3 ± 5.4) × 10-4,(12.2 ± 4.3) × 10-4,respectively,the differences were not statistically significant (F =0.109,P ＞ 0.05).TRβ mRNA relative expression levels were all low,the control,low,medium and high dose groups were (5.7 ± 4.1) × 10-6,(8.6 ± 7.6) × 10-6,(6.3 ± 4.2) × 10-6 and (6.2 ± 3.8) ×10~,respectively,the differences were statistically significant (F =2.938,P ＜ 0.05).The levels of TRβ mRNA relative expression changed with increased content of arsenic in water and urine trends in inverse U-shaped curves (R2 =0.035,0.067,all P ＜ 0.05).TRβ mRNA relative expression in low dose group was higher than that in control group,the difference was statistically significant (P ＜ 0.05);TRβ mRNA relative expression in high dose group was lower than that in low dose group,the difference was statistically significant (P ＜ 0.05).Arsenic induced arrhythmia which most displayed sinus bradycardia;the prevalence of arrhythmia in the control,low,medium and high dose groups were 12.1％ (7/58),10.2％ (5/49),13.6％ (9/66),19.4％ (19/98),respectively,the differences were not statistically significant (x2 =2.877,P＞ 0.05).Heart rate was positively associated with the level of TRβ mRNA relative expression in lg value (r =0.218,P ＜ 0.05).Conclusion Chronic arsenic exposure can disturb TRβ mRNA expression;there is a possible relationship between TRβ mRNA abnormal expression and arrhythmia caused by arsenic.

The efficacy of trans-cranial magnetic stimulation for relieving post-stroke depression：A meta-analysis / 中华物理医学与康复杂志

Objective To assess the effectiveness of repeated trans-cranial magnetic stimulation ( rTMS) in relieving post-stroke depression ( PSD). Methods PubMed, Embase, the Cochrane library, Web of Science, CNKI, WANFANG, and VIP were searched for reports of randomized, controlled trials of rTMS treatment of PSD published before June 2015. Crude standardized mean differences ( SMDs) and odds ratios with 95% confidence in-tervals ( CIs) were calculated for depression intensity and effectiveness rate after treatment using random or fixed effects models. Results Twenty-four studies involving 856 rTMS-treated patients and 802 control patients were in-cluded in the meta-analysis. The results showed that compared with the control group, PSD patients showed significant reductions in depression after rTMS treatment ( SMD=-1.36;95% CI-1.6 to-1.12;P≤0.05) . The total effective-ness rate in the treated group was 85% with a reduction in NIHSS score ( SMD=-0.82;95% CI-1.2 to-0.44;P≤0.05) . Subgroup analysis showed that neither the frequency of rTMS stimulation, the site stimulated, nor time after stroke had a significant influence on the effectiveness of rTMS. Additionally, a few studies reported adverse reactions after rTMS. Conclusion rTMS appears to be a safe and effective therapy for PSD. Further well-controlled trials may elucidate the mechanism underlying the placebo effects of the sham rTMS observed among PSD patients.