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Objective: Autologous peripheral blood stem cells (PBSC) derived from bone marrow can promote liver regeneration and improve the liver function of patients, but there are few studies on its effect on the long-term outcomes in patients with decompensated cirrhosis. Based on previous work, this study observed the clinical outcomes of PBSC treatment in patients with decompensated cirrhosis for 10 years, in order to provide more data support for the safety and efficacy of stem cells in clinical applications. Methods: Data of patients with decompensated liver cirrhosis who completed PBSC treatment in the Department of Gastroenterology of the First Affiliated Hospital of Air Force Military Medical University from August 2005 to February 2012 were included. The follow-up endpoint was death or liver transplantation, and patients who did not reach the follow-up endpoint were followed-up for at least 10 years. The patients with decompensated liver cirrhosis who met the conditions for PBSC treatment but did not receive PBSC treatment in our hospital during the same period were used as controls. Results: A total of 287 cases with decompensated liver cirrhosis had completed PBSC treatment, and 90 cases were lost to follow-up within 10 years after surgery. A total of 151 cases with complete survival follow-up data were included in the control group. There were no statistically significant differences in baseline information such as gender, age, etiological composition and liver function score between the two groups. The 10-year survival rate was higher in PBSC than control group (37.56% vs. 26.49%, P<0.05). Cholinesterase, albumin, international normalized ratio, Child-Turcotte-Pugh score, model for end-stage liver disease score, and other indicators were gradually recovered within 3 months to 1 year after PBSC treatment, and stabilized at a more desirable level in the long-term after follow-up for up to 10 years. There was no statistically significant difference in the incidence of liver cancer between the two groups (25.22% vs.31.85%, P=0.267). The age of onset of hepatocellular carcinoma was later in PBSC than control group [(56.66±7.21) years vs. (52.69±8.42) years, P<0.05]. Conclusions: This long-term observational follow-up study of more than ten years confirms that PBSC treatment can bring long-term benefits to patients with decompensated cirrhosis, with good long-term safety, thus providing more data support on the safety and efficacy of stem cells for clinical applications.
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End Stage Liver Disease , Follow-Up Studies , Humans , Liver Cirrhosis/drug therapy , Middle Aged , Peripheral Blood Stem Cells , Severity of Illness Index , Treatment OutcomeABSTRACT
Objective:To understand the prevalence of tea-drinking-borne fluorosis in Inner Mongolia Autonomous Region, and to provide a data basis for formulation of prevention and control measures.Methods:All administrative villages of 53 banners (counties) in 10 leagues (cities) of Inner Mongolia Autonomous Region were investigated for tea-drinking-borne fluorosis. The basic information and demographic information of each administrative village were collected, and 10 households were selected from each administrative village to investigate the basic information of family members and the drinking situation of brick tea, and collect household brick tea samples to determine the fluorine content. The prevalence of dental fluorosis in children aged 8 to 12 and skeletal fluorosis in adults over 16 years in the administrative villages were investigated.Results:There were 39 banners (counties) in Inner Mongolia Autonomous Region that had the habit of drinking brick tea, people who habitually drink brick tea a lot accounted for 70.22% of the total population (4.278 5 million/6.092 8 million). The per capita annual consumption of brick tea was 1.00 kg and the per capita daily intake of brick tea fluoride was 0.68 mg. A total of 24 282 brick tea samples were collected, and the samples with fluorine content exceeding the standard accounted for 74.77% (18 155/24 282). Except that the fluorine content of black brick tea was lower than the national health standard (300 mg/kg), other varieties of brick tea exceeded the standard. A total of 97 295 children aged 8 to 12 years were examined, and 6 558 cases of dental fluorosis were detected. The detection rate of dental fluorosis was 6.74%. Among them, 3 623 cases were very mild, 2 440 cases were mild, 489 cases were moderate and 6 cases were severe. There were significant differences in the detection rates of dental fluorosis in children of different regions and ages (χ 2 = 6 803.76, 30.82, P < 0.05). A total of 115 251 adults over 16 years old were examined, and 1 691 cases of skeletal fluorosis were detected. The detection rate of adult skeletal fluorosis was 1.47%; among them, 1 043 cases were mild, 481 cases were moderate and 167 cases were severe. There were statistically significant differences in the detection rates of skeletal fluorosis among adults of different regions and ages (χ 2 = 3 584.26, 562.67, P < 0.05). Conclusions:The fluoride content of brick tea consumed by residents in Inner Mongolia Autonomous Region seriously exceeds the standard. Moderate and severe patients with dental fluorosis in children aged 8 to 12 years and skeletal fluorosis in adults over 16 years old have been detected. The prevention and treatment of tea-drinking-borne fluorosis in Inner Mongolia Autonomous Region should be continuously strengthened.
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Objective:To understand the change trend of people's condition in tea drinking endemic fluorosis area of Inner Mongolia Autonomous Region, and to provide scientific basis for formulating prevention and control strategies.Methods:From 2009 to 2018, a cross-sectional survey was conducted in 30 villages of 6 banners (counties) of drinking tea type of endemic fluorosis of Inner Mongolia Autonomous Region. The tea drinking habits of residents were investigated. Ten families were selected from each monitoring village to collect brick tea samples, and the fluorine content in brick tea was detected for health risk assessment. In each monitoring village, one water sample was collected from each drinking water source. Fluoride ion selective electrode method was used to detect fluorine in tea and water. The prevalence of dental fluorosis in children aged 8-12 years old was examined and the X-ray examination and analysis were carried out for all the permanent residents aged 36-45 years and living in the local area for more than 5 years.Results:From 2009 to 2018, a total of 3 000 brick tea samples were collected. The geometric mean value of tea fluorine was 522.01 mg/kg, and the annual per capita consumption of brick tea by permanent residents was 2.52 kg. The average daily intake of fluorine in brick tea was 4.11 mg. According to the standard of "Total Fluoride Intake of Population" (WS/T 87-2016), there were 6 years of risk quotient > 1 in 10 years, while according to the World Health Organization (WHO) recommend standard, there were 5 years of risk quotient > 1. From 2012 to 2018, 210 water samples were detected, and the geometric mean value of fluorine in water was 0.90 mg/L, and the qualified rate was 84.76% (178/210). A total of 5 384 children aged 8-12 years old were examined and 1 562 dental fluorosis patients were detected. The total detection rate of dental fluorosis in children was 29.01% (1 562/5 384), and the dental fluorosis index was 0.62 (very mild). A total of 1 890 adults aged 36 to 45 years old were examined by X-ray. The detection rate of skeletal fluorosis was 18.10% (342/1 890). There were 77 patients with moderate and severe skeletal fluorosis.Conclusions:The brick tea fluorine content of residents in Inner Mongolia Autonomous Region is high, and there are health risks. The dental fluorosis of children aged 8-12 years old is very mild, and there are still moderate and severe skeletal fluorosis patients in adults. Therefore, it is necessary to strengthen the supervision of brick tea market and strengthen health education for residents.
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Objective:To understand the current situation of water improvement and the prevalence of dental fluorosis in children aged 8 to 12 in drinking-water-type endemic fluorosis (referred to as drinking-water-type fluorosis) areas in Inner Mongolia Autonomous Region (referred to as Inner Mongolia), and to evaluate the effectiveness of prevention and control measures, and provide a basis for timely adjustment of prevention and control strategies.Methods:In 2019, a cross-sectional survey was conducted to investigate the situation of water improvement and water fluoride content in all villages of 85 drinking-water-type fluorosis banners (counties) in Inner Mongolia, and all the children aged 8 to 12 were examined for dental fluorosis.Results:Among the 9 623 disease affected villages in the region, the water improvement projects were completed in 8 547 villages, and the water improvement rate was 88.82%. There were 7 145 water improvement villages whose water fluoride content met the national drinking water hygiene standard, which accounted for 83.60% (7 145/8 547) of the total villages with water improvement projects. A total of 118 857 children aged 8 to 12 were examined, and 9 123 cases of dental fluorosis were detected. The detection rate of dental fluorosis was 7.68%, which was lower than the upper limit of the dental fluorosis detection rate of fluorosis area standards (30%).Conclusions:The accomplishment rate of water improvement projects in drinking-water-type fluorosis areas of Inner Mongolia is high, and the condition of children's dental fluorosis has been effectively controlled. However, it is still necessary to strengthen the water quality monitoring, improve the qualified rate of water improvement projects, and effectively implement various comprehensive prevention and control measures.
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Objective:To investigate the distribution of arsenic content in drinking water of residents in Inner Mongolia Autonomous Region, and to provide a scientific basis for formulation of detailed prevention and control measures for endemic arsenic poisoning.Methods:From 2017 to 2019, water arsenic survey was carried out in all natural villages in 103 banners (counties, districts) of 12 leagues (cities) in Inner Mongolia Autonomous Region, and drinking water samples were collected according to different water supply modes (engineering water supply, physical and chemical water purification, decentralized water supply). Among them, engineering water supply: one factory water sample was collected from each water modification project in dry season and wet season; and one terminal water sample was collected in historical arsenism area/high arsenic exposed villages covered by the project. Physical and chemical water purification: one water sample was collected from each household. Decentralized water supply: in historical arsenism area/high arsenic exposed villages, one water sample was collected from each household; in the villages with historical qualified water arsenic, one household was selected according to the five directions of east, south, west, north and middle, and one water sample was collected from each household. The content of arsenic in water was detected by atomic fluorescence spectrometry and a distribution map of water samples with excessive arsenic was drawn using ArcGIS 10.2 software.Results:A total of 90 455 water samples were collected, including 31 617 water samples for engineering water supply, 2 702 water samples for physical and chemical water purification, and 56 136 water samples for decentralized water supply. The medians of water arsenic content of engineering water supply, physical and chemical water purification, and decentralized water supply were 1.00, 1.00 and 0.50 μg/L, respectively, and the differences among different water supply modes were statistically significant (χ 2 = 1 147.831, P < 0.05). A total of 486 water samples with excessive arsenic were detected, the detection rate was 0.54% (486/90 455). The detection rates of water samples with excessive arsenic in engineering water supply and decentralized water supply were 1.48% (469/31 617) and 0.03% (17/56 136), the detection rate of water samples with excessive arsenic in engineering water supply was higher than that in decentralized water supply (χ 2 = 775.401, P < 0.05); there was no water samples with excessive arsenic in physical and chemical water purification. The top three areas with the detection rates of water samples with excessive arsenic were Bayannaoer [15.38% (343/2 230)], Hohhot [2.00% (86/4 293)], and Ordos [0.85% (50/5 848)]. ArcGIS 10.2 software showed that the water samples with excessive arsenic were mainly distributed in the western region in the shape of focal and block, and only existed sporadically in the eastern region. Conclusions:The detection rate of water samples with excessive arsenic in engineering water supply in Inner Mongolia Autonomous Region is high, the water samples with excessive arsenic are mainly distributed in the western region in the shape of focal and block, and sporadically in the eastern region. The management and supervision of engineering water supply should be strengthened, in areas where the water arsenic exceeds the standard, we should take physical and chemical water purification measures, such as change water sources, increase water purification equipment, and improve water purification technology to reduce arsenic hazards, so as to ensure that residents can drink qualified water.
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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.
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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.
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Objective:To explore the effect and mechanism of esculentoside on lipopolysaccharide-induced mastitis in mice. Method:Female BALB/c mice were randomly divided into control group, model group, dexamethasone group (DEX, 5.0 mg·kg-1) and esculentoside group (50, 25, 12.5 mg·kg-1). The mastitis model of postpartum female mice (BALB/c) induced by lipopolysaccharide (LPS) was used to analyze the pathological conditions of breast tissue and the activity of recombinant myeloperoxidase（MPO）, factor content and oxidative stress level. Western blot was used to evaluate the effect of esculentoside on Toll-like receptor4 (TLR4)/nuclear transcription factor (NF-κB) signaling pathway proteins. Result:Compared with the normal group, the breast tissue of the model group had typical mastitis changes, such as hyperemia and congestion, the level of MPO increased, and the expression levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) increased significantly (P<0.01). Compared with LPS model group, esculentoside groups could significantly improve the inflammatory damage of mammary gland tissue, reduce the secretion of neutrophils and the activity of MPO, the expression levels of pro-inflammatory factors TNF-α, IL-1β and IL-6 were also significantly down-regulated, the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were increased, while the level of malondialdehyde (MDA) was decreased, and the activation of TLR4/NF-κB signaling pathway was inhibited by esculentoside（P<0.05，P<0.01）. Conclusion:Esculentoside have a protective effect on lipopolysaccharide-induced mastitis in mice, which may be related to the inhibition of TLR4/NF-κB signaling pathway protein expression.
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Objective:To assess the diagnostic and prognostic value of lymphocyte subtyping for invasive candidiasis infection (ICI) in critically ill patients with non-neutropenic sepsis.Methods:A prospective observational cohort study was performed at Peking Union Medical College Hospital (PUMCH), 377 patients with non-neutropenic sepsis admitted to Department of Critical Care Medicine from January 2017 to November 2019 were enrolled. There were 9.0% (34/377) patients diagnosed as ICI. Vital signs, supportive care therapy and microbiological specimens were collected. Peripheral blood lymphocyte subtypes, serum globulin, complements, inflammatory factors such as interleukin(IL)-6, IL-8, IL-10 and tumor necrosis factor were detected within 24 hours after sepsis was diagnosed. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value and prognostic significance of immunological indicators for ICI. Multiple logistic regression was used to analyze the independent risk factors for ICI. Kaplan-Meier analysis was used to analyze survival.Results:The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 17.0 (13.0, 21.0) in all 377 patients. The sequential organ failure score (SOFA) was 11.0 (8.0, 13.0), and the 28-day mortality rate was 27.6% (104/377). Peripheral blood CD8 +absolute T lymphocyte count≤177 cells/μl, CD28 +CD8 +T-cell count≤81 cells/μl and 1, 3-β-D-glucan (BDG) ≥88.20 ng/L were closely correlated with the diagnosis of ICI (AUC=0.793,95 %CI 0.749-0.833, P<0.000 1;AUC=0.892,95 %CI 0.856-0.921, P<0.000 1;AUC=0.761, 95 %CI 0.715-0.803, P<0.000 1, respectively), with sensitivity of diagnosis 94.12%, 100.00%, and 88.24%; the specificity of diagnosis 81.34%, 62.39%, 63.56% respectively. Multivariate logistic regression analysis identified CD8 +T-cell count≤139 cells/μl ( OR=7.463, 95 %CI 1.300-42.831, P=0.024) and CD28 +CD8 +T-cell counts≤52 cells/μl ( OR=57.494, 95 %CI 3.986-829.359, P=0.003) as independent risk factors for higher mortality. Kaplan-Meier survival analysis suggested that CD8 +T-cell count ≤139 cells/μl ( P=0.0159) and CD28 +CD8 +T-cell count≤52 cells/μl ( P=0.000 1) were associated with higher mortality within 28 days (68.8%, 91.7%). Conclusions:Low CD28 +CD8 +T cell count in peripheral blood is closely related to the development and clinical outcome of ICI in sepsis patients, which could be used as an effective indicator for the diagnosis and prognosis prediction of ICI.
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Inner Mongolia is a region where drinking-water-type endemic fluorosis is seriously prevalent.Huge sums of manpower and financial resources have been invested by Inner Mongolia government in prevention and control of drinking-water-type endemic fluorosis since 1980s,from which some remarkable achievements have been made.However,the current prevention and control work is still difficult due to the wide distribution and complex geological and geomorphological conditions of the drinking-water-type endemic fluorosis.After recent investigation of the disease area conditions,the author has grasped the actual problems in the disease area and the prevention and control work,and pondered the corresponding prevention and control countermeasures.The results are summarized to provide some ideas for prevention and control of endemic fluorosis.
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BACKGROUND@#At present, there is no available delirium translated assessment method for 3.3 million Tibetans. This study aimed to provide a method for delirium assessment for Tibetan patients speaking this language by validating a translation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).@*METHODS@#The study was conducted between July 2018 and November 2018. Patients were screened for delirium by a neurologist using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Patients were subsequently screened by two nurses using Tibetan translations of the CAM-ICU. With DSM-IV criterion as the reference standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the validity of the CAM-ICU criterion. Interrater reliability was determined by comparing the CAM-ICU ratings of nurse 1 vs. nurse 2 using the κ coefficient.@*RESULTS@#Ninety-six patients were assessed independently by two nurses and one neurologist. According to DSM-IV standard, 42 out of 96 (43.8%) patients developed delirium. The sensitivities of Tibetan CAM-ICU were 90.5% for nurse 1 and 92.9% for nurse 2, respectively. Their specificities were 85.2% and 90.7%, respectively. The PPV were 82.6% for nurse 1 and 88.6% for nurse 2. Their NPV were 92.0% and 94.2%, respectively. The Tibetan CAM-ICU was done with good interrater reliability between nurse 1 and nurse 2 (κ = 0.91, P < 0.001).@*CONCLUSION@#The Tibetan CAM-ICU shows good validity and might be incorporated into clinical practice in Tibetan Intensive Care Units. CLINICAL TRAIL REGISTRY:: www.chictr.org.cn (No. ChiCTR1800018231).
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Background:@#At present, there is no available delirium translated assessment method for 3.3 million Tibetans. This study aimed to provide a method for delirium assessment for Tibetan patients speaking this language by validating a translation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).@*Methods:@#The study was conducted between July 2018 and November 2018. Patients were screened for delirium by a neurologist using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Patients were subsequently screened by two nurses using Tibetan translations of the CAM-ICU. With DSM-IV criterion as the reference standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the validity of the CAM-ICU criterion. Interrater reliability was determined by comparing the CAM-ICU ratings of nurse 1 vs. nurse 2 using the κ coefficient.@*Results:@#Ninety-six patients were assessed independently by two nurses and one neurologist. According to DSM-IV standard, 42 out of 96 (43.8%) patients developed delirium. The sensitivities of Tibetan CAM-ICU were 90.5% for nurse 1 and 92.9% for nurse 2, respectively. Their specificities were 85.2% and 90.7%, respectively. The PPV were 82.6% for nurse 1 and 88.6% for nurse 2. Their NPV were 92.0% and 94.2%, respectively. The Tibetan CAM-ICU was done with good interrater reliability between nurse 1 and nurse 2 (κ= 0.91, P < 0.001).@*Conclusion:@#The Tibetan CAM-ICU shows good validity and might be incorporated into clinical practice in Tibetan Intensive Care Units.@*Clinical Trail Registry:@#www.chictr.org.cn (No. ChiCTR1800018231)
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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.
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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.
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<p><b>Background</b>Recent studies have indicated that autophagy is involved in sepsis-induced myocardial dysfunction. This study aimed to investigate the change of autophagy in cecal ligation and puncture (CLP)-induced myocardium dysfunction and its relationship with mammalian target of rapamycin (mTOR) pathway.</p><p><b>Methods</b>Totally, 12 rats were randomly divided into CLP group or sham-operated (SHAM) group. Cardiac tissues were harvested 18 h after CLP or sham operation. Pathology was detected by hematoxylin and eosin staining, cardiac functions by echocardiography, distribution of microtubule-associated protein light chain 3 type II (LC3II) by immunohistochemical staining, and autophagic vacuoles by transmission electron microscopy. Moreover, phosphorylation of mTOR (p-mTOR), phosphorylation of S6 kinase-1 (PS6K1), and LC3II and p62 expression were measured by western blotting. Pearson's correlation coefficient was used to analyze the correlation of two parameters.</p><p><b>Results</b>The results by pathology and echocardiography revealed that there was obvious myocardial injury in CLP rats (left ventricle ejection fraction: SHAM 0.76 ± 0.06 vs. CLP 0.59 ± 0.11, P < 0.01; fractional shortening: SHAM 0.51 ± 0.09 vs. CLP 0.37 ± 0.06, P < 0.05). We also found that the autophagy process was elevated by CLP, the ratio of LC3II/LC3I was increased (P < 0.05) while the expression of p62 was decreased (P < 0.05) in the CLP rats, and there were also more autophagosomes and autolysosomes in the CLP rats. Furthermore, the mTOR pathway in CLP myocardium was inhibited when compared with the sham-operated rats; p-mTOR (P < 0.01) and PS6K1 (P < 0.05) were both significantly suppressed following CLP challenge. Interestingly, we found that the mTOR pathway was closely correlated with the autophagy processes. In our study, while p-mTOR in the myocardium was significantly correlated with p62 (r = 0.66, P = 0.02), PS6K1 was significantly positively correlated with p62 (r = 0.70, P = 0.01) and negatively correlated with LC3II (r = -0.71, P = 0.01).</p><p><b>Conclusions</b>The autophagy process in the myocardium was accelerated in CLP rats, which was closely correlated with the inhibition of the mTOR pathway.</p>
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Animals , Autophagy , Physiology , Cecum , Wounds and Injuries , Echocardiography , Immunohistochemistry , Ligation , Male , Microscopy, Electron, Transmission , Myocardium , Metabolism , Rats , Rats, Wistar , Sepsis , Metabolism , TOR Serine-Threonine Kinases , MetabolismABSTRACT
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.
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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.
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Objective: To explore application of 24h ambulatory blood pressure monitoring (ABPM) in aged patients with hypertension. Methods: A total of 223 aged patients with hypertension treated in our hospital from Feb 2013 to Feb 2015 were selected. According to age, patients were divided into young age group (60～79 years, n=137) and advanced age group (≥80 years, n=86). Another 80 normotensive aged people undergoing physical examination in our hospital simultaneously were regarded as healthy control group. The 24h systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) were measured and compared between three groups. Results: Ambulatory blood pressure: compared with healthy control group, there were significant rise in 24h mean blood pressure (BP) [24hSBP: (117. 63±11. 53) mmHg vs. (132. 04±11. 23) mmHg vs. (144. 26±12. 87) mmHg], daytime BP [dSBP: (119. 85±13. 20) mmHg vs. (134. 26±13. 52) mmHg vs. (146. 83±10. 64) mmHg]and nighttime BP [nSBP: (115. 48±9. 74) mmHg vs. (128. 76±10. 85) mmHg vs. (141. 67±13. 42) mmHg]in young age group and advanced age group (P＜0. 05 or＜0. 01). Compared with young age group, there were significant reductions in 24h DBP, dDBP and nDBP, and significant rise in 24h SBP, dSBP, nSBP, 24h PP, dPP and nPP in advanced age group (P＜0. 05 or ＜0. 01). Conclusion: The 24h ABPM can effectively display the blood pressure abnormal fluctuations in aged patients with hypertension, and the higher age is, the greater blood pressure abnormal fluctuation is.
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Objective To evaluate the effect of continuous veno venous hemofiltration (CVVH) on neutrophil gelatinase associated lipocalin (NGAL) in critically ill patients with acute kidney injury (AKI).Methods Critically ill patients with AKI who needed CVVH and admitted to Department of Critical Care Medicine of Peking Union Medical College Hospital were enrolled prospectively from January 2015 to June 2015.AN69 membrane filters were used for CVVH.Prefilter,postfilter,and plasma NGAL measurements were taken at 10 mins,4 hours and 8 hours (T 10 min,T 4 h,T 8 h) after CVVH.The influence of membrane filter and volume management on NGAL level was analyzed.Results Forty patients were recruited.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 22.9±7.0.The sequential organ failure score (SOFA) was 12.1±2.9,and ICU mortality was 27.5％.During CVVH,there were no significant differences in NGAL levels between prefilter [T 10 min:39.3 (24.8,62.4)μg/min;T 4 h:(45.1±23.2)μg/min;and T 8 h:(45.5±22.4)μg/min] and postfilter [T 10 min:33.5 (25.1,60.7)μg/min;T 4 h:(44.2±24.3)μg/min,and T 8 h:(45.9±22.4)μg/min] (P＞ 0.05 for all).Compared with the survival group[310.0(162.0,588.0) μg/L],plasma NGAL level in T 10 min [684.0(270.0,944.0) μg/L] was significantly higher in death group (P=0.033).After fluid balance correction,T 4 h [603.4(484.8,620.2) μg/L] and T 8 h [590.2(475.9,749.4) μg/L] plasma NGAL levels in death group were significantly higher than those in the survival group [T4 h:419.5 (227.5,552.4)μg/L;T 8 h:400.7(196.1,517.4) μg/L] with statistical significance (P＜0.01 for both).Conclusions During CVVH,AN69 membrane filter does not have significant effect on plasma NGAL level in critically ill patients with AKI.After volume balance correction,plasma NGAL level could be used as an effective indicator in these patients.
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<p><b>BACKGROUND</b>Triggering receptor expressed on myeloid cell-1 (TREM-1) may play a vital role in mammalian target of rapamycin (mTOR) modulation of CD8+ T-cell differentiation through the transcription factors T-box expressed in T-cells and eomesodermin during the immune response to invasive pulmonary aspergillosis (IPA). This study aimed to investigate whether the mTOR signaling pathway modulates the proliferation and differentiation of CD8+ T-cells during the immune response to IPA and the role TREM-1 plays in this process.</p><p><b>METHODS</b>Cyclophosphamide (CTX) was injected intraperitoneally, and Aspergillus fumigatus spore suspension was inoculated intranasally to establish the immunosuppressed IPA mouse model. After inoculation, rapamycin (2 mg.kg-1.d-1) or interleukin (IL)-12 (5 μg/kg every other day) was given for 7 days. The number of CD8+ effector memory T-cells (Tem), expression of interferon (IFN)-γ, mTOR, and ribosomal protein S6 kinase (S6K), and the levels of IL-6, IL-10, galactomannan (GM), and soluble TREM-1 (sTREM-1) were measured.</p><p><b>RESULTS</b>Viable A. fumigatus was cultured from the lung tissue of the inoculated mice. Histological examination indicated greater inflammation, hemorrhage, and lung tissue injury in both IPA and CTX + IPA mice groups. The expression of mTOR and S6K was significantly increased in the CTX + IPA + IL-12 group compared with the control, IPA (P = 0.01; P= 0.001), and CTX + IPA (P = 0.034; P= 0.032) groups, but significantly decreased in the CTX + IPA + RAPA group (P < 0.001). Compared with the CTX + IPA group, the proportion of Tem, expression of IFN-γ, and the level of sTREM-1 were significantly higher after IL-12 treatment (P = 0.024, P= 0.032, and P= 0.017, respectively), and the opposite results were observed when the mTOR pathway was blocked by rapamycin (P < 0.001). Compared with the CTX + IPA and CTX + IPA + RAPA groups, IL-12 treatment increased IL-6 and downregulated IL-10 as well as GM, which strengthened the immune response to the IPA infection.</p><p><b>CONCLUSIONS</b>mTOR modulates CD8+ T-cell differentiation during the immune response to IPA. TREM-1 may play a vital role in signal transduction between mTOR and the downstream immune response.</p>