Protection of Informed Consent Rights for Subjects in Drug Clinical Trials / 中国医学伦理学

The right to informed consent is the basic right of subjects in drug clinical trials. International treaties and domestic laws have successively formed a basic right protection framework, while there are still some problems such as imperfect legal norms and incomplete practical operations. To meet future challenges, it is necessary to further improve legislation, standardize notification procedures, improve notification content, expand dynamic notification methods, and strengthen ethical review, so as to build a standardized and modern system for protecting the right to informed consent of subjects.

Effects of adriamycin resistance cell-derived exosomes on the proliferation and migration of osteosarcoma cells through drug resistance transmission / 中华骨科杂志

Objective:To explore the relationship and underlying mechanism between exosomes derived from doxorubicin-resistant osteosarcoma cells and MDR1 and miRNAs. Methods:MG63 and U2OS cell lines were selected to construct doxorubicin-resistant strains, and the 50% inhibitory concentration (half maximal inhibitory concentration, IC 50) of drug-resistant and sensitive strains was detected by MTT, and fluorescence staining was performed at intervals of 15 min between 15 and 120 min to detect the change of fluorescence intensity. RT-PCR and Western Blot were used to detect the expression levels of MDR1 P-gp to verify the drug resistance of osteosarcoma cells. Exosomes were identified by particle size analysis and Western Bolt detection. The endocytosis of PKH26-labeled exosomes from doxorubicin-resistant cells was observed, and the proliferation level and migration of exosomes from doxorubicin-resistant cells co-cultured with osteosarcoma cells were detected by MTT assay and cell scratch assay. The differential expression levels of miRNAs in osteosarcoma-sensitive and drug-resistant cells were verified by sequencing and bioinformatics analysis and RT-PCR assay. Tumor growth, serum exosome identification and mRNA expression level of miR-21-5p in tumor-bearing nude mice between normal osteosarcoma cell group and drug-resistant group, drug-resistant+normal exosome group, drug-resistant+drug-resistant+drug-resistant exosome group were observed. MDR1 expression level in tumor tissue was detected by RT-PCR, Western Blot and immunohistochemistry. Results:The IC 50 of two adriamycin resistant strains were 2.21 vs. 11.81 μg/ml and 0.93 vs. 11.81 μg/ml, respectively, and the fluorescence intensity decreased faster than that of normal strains. The relative mRNA expression levels of MDR1 in two cell lines were normal 1.12±0.16, 1.02±0.11 and drug-resistant 2.15±0.10, 2.127±0.12, respectively. The relative protein expression of P-gp was normal 0.92±0.11, 0.73±0.10 and drug-resistant 0.46±0.03, 0.30±0.04, the differences were statistically significant ( P<0.05). Drug-resistant exosomes can enter osteosarcoma cells through endocytosis and concentrate in the cytoplasm when co-cultured with normal strains. Osteosarcoma cells were co-cultured with drug-resistant exosomes at 2, 4, 6, and 8 μg/ml adriamycin, respectively. Compared with normal group, the proliferation level in drug-resistant group was significantly increased. Compared with the normal cell group 35.95±3.92, 6.72±3.55 and the normal exosome group 51.22±5.55, 19.31±1.93, the drug-resistant cell group 54.20±9.32, 19.24±2.88 and drug-resistant exosome group 76.40±5.41, 30.26±4.87, all had significantly higher cell mobility, the difference was statistically significant ( P<0.05). Exosome sequencing and biogenic analysis of 10 highly upregated miRNAs to validate mRNA expression differences between normal and drug-resistant strains by RT-PCR, showing a significant increase in miR-21-5p expression level of drug-resistant strains (5.89±0.26 vs. 0.99±0.06; 1.05±0.07 vs. 8.80±0.93, P<0.05), the difference was statistically significant ( P<0.05). In MG63 and U2OS, the normal cell group and drug-resistant cell group, and the normal exosome group and drug-resistant exosome group were compared, the tumor volume and the terminal tumor weight of nude mice were increased to varying degrees. MRNA relative expression levels of miR-21-5p in serum exosomes of nude mice after drug intervention were 0.86±0.07 and 0.86±0.05 in normal cell group, respectively. The values were 1.13±0.12, 1.14±0.12 in drug-resistant cell group, 0.71±0.05, 0.75±0.03 in normal exosome group, and 0.90±0.07, 0.93±0.04 in drug-resistant exosome group. Compared with normal and drug-resistant strains, the expression levels of normal and drug-resistant exosome groups were increased, with statistical significance ( P<0.05). Conclusion:The exosomes of drug-resistant cells in osteosarcoma could enhance the proliferation level and migration ability of cells through intercellular transfer of MDR1 and miRNAs. The expression of MDR1 and miR-21-5p in drug-resistant cells and tumor-forming nude mouse serum and tumor tissues were up-regulated which suggested that it might be involved in regulating the drug resistance process of osteosarcoma.

Comprehensive therapy for advanced unresectable hepatocellular carcinoma / 中华普通外科杂志

Objective:To investigate the efficacy and safety of comprehensive therapy in the treatment of advanced unresectable hepatocellular carcinoma.Methods:Clinical data of 34 patients with primary liver cancer admitted to Peking Union Medical College Hospital from Nov 2018 to Dec 2020 initially evaluated as unresectable were treated firstly by combined therapy and then underwent reevaluation for further management.Results:A total of 34 patients completed the integrative treatment, and no serious adverse events occurred. Among them, 6 patients were evaluated as partial remission, and underwent successful tumor resection, tumors in 7 patients were stable, and 21 patients suffered from disease progression.Conclusion:After comprehensive therapy, unresectable tumors in some patients could reduce and be rendered resection.

Research progress on population adaptation to temperature / 环境与职业医学

Temperature is an environmental factor closely related to human daily life. Global climate change has led to an increase in the frequency and intensity of extreme meteorological events and climate anomalies. The associated adverse health also attracted public attention. Recently, with the processes of climate change and urbanization, epidemiological evidence pointing to a temporal change of population susceptibility to heat and/or cold over time has emerged. This paper summarized the definition of adaptation and then reviewed the studies on temporal change in temperature-related health risks at home and abroad, exploring whether the adaptation to temperature confirmed among different . Next, the research progress of influencing factors of adaptation. Finally, the common analytical methods of adaptation were reviewed. We also put forward an outlook based on the limitations of current exploratory studies. Rational identification of adaptation to temperature is of important scientific significance for the evaluation and prediction of the health effect of future climate.

Influencing factors of community hospice care service needs of the elderly based on structural equation model / 中华健康管理学杂志

Objective:To analyze the influencing factors of community hospice care service needs of the elderly based on structural equation model.Methods:A multi-stage sampling method was used to survey 564 elderly people from 40 community health service centers in four districts of Chaoyang District in Beijing from September to November 2020 with a self-designed questionnaire. The survey content included three dimensions: tendency characteristics (population characteristics, health beliefs), enabling resources and demand factors. The chi-square test and rank sum test were used to analyze the influencing factors of the community hospice care needs of the elderly. At the same time, based on Anderson theory, structural equation model was used to analyze the action path and effect size of the influencing factors.Results:Registered residence, occupation, understanding of community elderly care services, recognition of community medical convenience, recognition of community health services in reducing family burden, recognition of community health services in improving their own health, understanding of community hospice care services, mean monthly income of their families, degree of income satisfaction, self-paid medical expenses of the previous year, living status, acceptance of community medical expenses, satisfaction with the number of community medical staff, self-assessment of health status, whether the elderly was ill in the last two weeks and the number of chronic diseases and etc affected the needs of the elderly for community hospice care services (all P<0.05). In the three dimensions of Anderson model, enabling resources had a direct effect, and could also be affected by demand factors indirectly, the total effect value was 0.404; demand factors had direct impact, and the effect value was 0.193; propensity characteristics exerted impact indirectly through enabling resources and demand factors, and the total effect value was 0.176. Among them, the acceptance of community health service fees in the enabling resource dimension has the greatest impact (FL=0.535), the number of chronic disease in the demand factor dimension had the greatest impact (FL=1.018), and the recognition of community health service in reducing family burden in the propensity characteristic dimension had the greatest impact (FL=0.612) (all P<0.05). Conclusions:There are various factors and action paths that affect the needs of community hospice care services for the elderly. Among them, the acceptance of community health service fees, the number of chronic disease, and the recognition of community health service in reducing family burden have a greater impact.

Evaluation of the performance of systems for whole blood C-reactive protein detection: a multi-center study / 中华检验医学杂志

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.

Expert consensus on standardized TORCH laboratory detection and clinical application / 中华检验医学杂志

TORCH, which is considered as a series of pathogens, including the Toxoplasma gondii, Rubella virus, Cytomegalovirus or Herpes simplex virus, often infects the pregnant women to induce the the fetus or newborn infection by transplacental infection or exposure to contaminated genital tract secretions at delivery. Increasing evidence have been confirmed that the infection of TORCH may cause the miscarriage, premature birth, malformed fetus, stillbirth, intrauterine growth retardation, neonatal multiple organ dysfunction and other adverse pregnancy outcomes. For most TORCH-infections cases may lacking the effective treatments during pregnancy, and it is important to achieve the effacing monitoring of TORCH infections before and during pregnancy. The laboratory testing of TORCH has the great significance. However, the consensus opinions still need to improve the the standardization of TORCH testing process and the correct interpretation. Based on the characteristics of the TORCH detection method, this article gives a consensus opinion on the standardized detection and clinical application of TORCH from the laboratory perspective according to the characteristics and types of infection of different pathogens.

Research progress of fluorescence imaging in neural localization / 中华核医学与分子影像杂志

The difficulty of neural localization during operation often leads to the increased risk of nerve injury,which results in neurological dysfunction,so how to accurately locate the nerves in surgeries,such as operations for patients with recurrent parotid tumors and prostate surgery,has become one of the key factors for the success of the operation.There are many methods to locate nerves in real time during operation,among which fluorescence imaging has attracted more and more attention due to its unique advantages of high sensitivity,easy to use,low cost and no radiation.In this article,the related research progresses of fluorescence imaging in neural localization are reviewed.

Expression and clinical significance of lncRNA H19 and lncRNA MEG3 in serum of patients with gastric cancer / 中国医师杂志

Objective:To investigate the expression and clinical significance of long non-coding RNA (lncRNA) H19 and lncRNA maternally expressed gene 3 (MEG3) in the serum of patients with gastric cancer (GC).Methods:A total of 87 GC patients admitted to the First People′s Hospital of Suqian (July 2017 to August 2018) were selected as the GC group, 51 patients with benign tumors as the benign tumor group, and 40 healthy people with physical examination as the healthy control group. The expression levels of lncRNA H19 and lncRNA MEG3 in serum were measured; the relationship between the expression levels of the two and clinicopathological features and prognosis of patients with GC was analyzed.Results:The levels of serum lncRNA H19 in healthy control group, benign tumor group and GC group were gradually increased, and lncRNA MEG3 level was gradually decreased ( P<0.05); the serum lncRNA H19 level in GC group was related to tumor invasion depth, tumor node metastasis (TNM) stage and lymph node metastasis. The level of lncRNA MEG3 was related to the degree of differentiation, TNM stage and lymph node metastasis ( P<0.05). Among the 87 GC patients , 63 patients were followed up for 13-32 months with an average of (23.54±4.18)months. Kaplan Meier survival curve showed that the overall survival rate of high serum lncRNA H19 group and low serum lncRNA MEG3 level group was significantly lower than that of low serum lncRNA H19 level group and high serum lncRNA H19 level group. Multivariate Cox regression analysis showed that lncRNA H19 ( HR=3.442, 95% CI=0.089-23.421) was an independent prognostic factor for GC patients, and lncRNA MEG3 ( HR=4.386, 95% CI=0.934-20.596) was a protective factor ( P<0.05); receiver operating characteristic (ROC) curve showed that the sensitivity, specificity and accuracy of serum lncRNA H19+ lncRNA MEG3 [area under curve (AUC)=0.922, 95% CI=0.861-0.962] were higher than those of serum lncRNA H19 (AUC=0.840, 95% CI=0.771-0.904) and lncRNA MEG3 (AUC=0.830, 95% CI=0.753-0.890). Conclusions:The level of serum lncRNA H19 in GC patients is significantly increased, and the level of lncRNA MEG3 is significantly reduced, which is closely related to tumor occurrence, development and prognosis. Combined detection of the two can enhance the diagnostic value of GC.

Research progress of fluorescence imaging in neural localization / 中华核医学与分子影像杂志

The difficulty of neural localization during operation often leads to the increased risk of nerve injury, which results in neurological dysfunction, so how to accurately locate the nerves in surgeries, such as operations for patients with recurrent parotid tumors and prostate surgery, has become one of the key factors for the success of the operation. There are many methods to locate nerves in real time during operation, among which fluorescence imaging has attracted more and more attention due to its unique advantages of high sensitivity, easy to use, low cost and no radiation. In this article, the related research progresses of fluorescence imaging in neural localization are reviewed.

Roles of signaling molecules in biofilm formation / 生物工程学报

Bacterial biofilm refers to a tunicate-like biological group composed of polysaccharide, protein and nucleic acid secreted by bacteria on the surface of the mucous membrane or biological material. The biofilm formation is a major cause of chronic infections. Bacteria could produce some secondary metabolites during the growth and reproduction. Some of them act as signaling molecules allowing bacteria to communicate and regulate many important physiological behaviors at multiple-cell level, such as bioluminescence, biofilm formation, motility and lifestyles. Usually, these signal molecules play an important role in the formation of bacterial biofilm. We review here the effects of related signal molecules of Quorum Sensing, cyclic diguanylate, Two-Component Systems and sRNA on the biofilm formation. Focusing on these regulation mechanism of signal molecules in the process of biofilm formation is necessary for the prevention and treatment of some chronic diseases.

The application of digital surgical template in bimaxillary orthognathic surgery / 中华整形外科杂志

Objective@#To investigate the feasibility and accuracy using digital surgical guide to position the jaws in bimaxillary orthognathic surgery.@*Methods@#16 patients with dento-maxillofacial deformity were included from January to December 2018 in Nanjing Stomatological Hospital. There were 10 males and 6 females, all of which were skeletal Ⅲ deformity. The mean age was 21.3 years old (16 to 28 years). They were divided into digital guide (group A) and traditional model surgery (group B) according to the treatment sequence. All patients underwent both Lefort Ⅰ osteotomy and bilateral ascending sagittal split. Virtual surgery was performed and digital three-dimensional surgical template was printed before surgery in group A. During the operation, digital surgical templates were used to position maxilla and mandible. The accuracy was evaluated by generating color distribution map of deviation grade, which was imaging fusion of virtual surgical jaw position and actual surgical jaw position to measure the deviation distance of each marker point one week after surgery. The deviations between the preoperative design and the actual operation were compared with the t-test respectively in group A and group B, and the independent sample t test was chosen to compared the accuracy of reduction between the two groups in sagittal, horizontal, and vertical directions.@*Results@#All 16 patients had primary healing. The maximum deviation of the patients in group A was at U6. The deviation direction was vertical, and the deviation distance was (1.67±0.32) mm. In group A, the deviation distances of all marker points in the sagittal, horizontal and vertical directions were (0.55±0.26) mm (t=2.985, P=0.205), (0.62±0.20) mm (t=2.672, P=0.193) and (1.07±0.62) mm (t=5.122, P=0.823), respectively. The result in group B was (0.63±0.28) mm(t=3.397, P=0.307), (0.71±0.42) mm (t=4.438, P=0.541) and (1.82±0.36) mm (t=1.115, P=0.021) in these directions. There was no significant difference between two groups in the sagittal (t=4.704, P=0.763) and lateral (t=4.008, P=0.615) directions, and the difference in the vertical (t=1.432, P=0.037) direction was statistically significant.@*Conclusions@#The digital guides were feasible to position jaws accurately in orthognathic surgery.

Instant rehabilitation of Brown Ⅱ maxilla defects with 3D printed prosthesis: a clinical preliminary study / 中华整形外科杂志

Objective@#To assess feasibility and clinical effect of 3D printed prosthesis in instant rehabitation of Brown Ⅱ maxilla defect.@*Methods@#Five patients with maxillary primary tumor or malignant tumor involving maxillary bone admitted from August 2016 to April 2017 were treated.Before surgery, surgical guide template and prosthesis was designed and created with digital surgery technique. Surgery was performed under guidance of surgical template and checked with surgical navigation. Prosthesis was also placed to repair Brown Ⅱ maxilla defect instantly in surgery.Two weeks after surgery, CBCT examination was taken and compared to the pre-operative CBCT images to evaluate deviation and assess precision of surgery. One month after surgery, 3D photograph was taken to compare intercommissural width, differences of bilateral lip height and maximum distance between healthy and affected sides of lip, nasolabial angles, skewed degree of mouth corner, volume variation and superficial area variation of the lip before and after insertion of prosthesis. All data ware analyzed with SPSS 21.0 using the Mann-Whitney U test for non parametric test.@*Results@#Prosthesis was inserted during 20 minutes in all 5 included patients with good occlusion. The suture was removed two weeks after surgery.The wound healed well without infection. 5 patients had no recurrence of tumor during follow-up.Maximum deviation between actual and virtual surgery was(3.75±0.87) mm, minimum deviation was 0 mm, and average deviation was(0.35±0.08) mm.The difference of bilateral lip height was(2.66±1.52) mm and(0.46±0.49) mm before and after insertion of prosthesis(P=0.016). The skewed degree of mouth corner was(3.43±1.70)°and(1.98±1.24)°before and after insertion of prosthesis(P=0.047). The maximum distance between healthy and affected sides of lip were(5.75±3.66) mm and(2.19±1.14) mm before and after insertion of prosthesis(P=0.009). The above differences were statistically significant.No significant differences were found between nasolabial angles and intercommissural width (P=0.251, 0.251). Volume variation before and after insertion of prosthesis was(5.54±2.50) cm3and superficial area variation was (66.42±21.18) cm2.@*Conclusions@#3D printed prosthesis can instantly repair Brown Ⅱ maxilla defect, retain facial appearance and dentition and obtain good effect.

Experimental Study on Anaphylactoid Reactions of Hydroxyethyl Starch 40 Sodium Chloride Injection / 中国比较医学杂志

Objective To evaluate the sensitizations of Hydroxyethyl Starch 40 Sodium Chloride Injection . Methods Active systemic anaphylaxis ( ASA) test, internal sensitive index ' s determination and screening and Passive Cutaneous Anaphylaxis ( PCA) test are carried out .Observe the allergy safety of the samples .Results We use guinea pigs to carry on ASA test and PCA test with Hydroxyethyl Starch 40 Sodium Chloride Injection from 45 batches of 3 companies and no changes have occurred .Measuring and comparing the sensitive index of HIS ,IgG, IgM and IgE in plasma, IgM and IgE are not obvious variation;HIS and IgG positive group and negative group and sample groups are different .Conclusions It is suggestion that Hydroxyethyl Starch 40 Sodium Chloride Injection safety evaluation should include allergic reactions , HIS and IgG sensitive index monitoring in clinical application of hydroxyethyl starch .

Protective effect of Zheng Chaihu Yin on paracetamol induced acute liver injury of mice / 中国药理学与毒理学杂志

OBJECTIVE To explore the effect of aqueous extract of Zheng Chaihu Yin(ZCH)on paracetamol(acetaminophen,APAP)-induced hepatotoxicity. METHODS Male ICR mice were divided into three scenarios randomly:the single treatment dose of ZCH,multiple treatment or pretreatment dose of ZCH. Each scenario had a up control group and an APAP model group,while single treatment dose of ZCH group had a ZCH group at the same time. The dose of APAP and ZCH was 500 mg·kg-1 and 36 g · kg- 1,respectively. 24 h after the last administration,plasma and liver samples were prepared. Ultra- performance liquid chromatography/quadrupole- time- of- flight mass spectrometry (UPLC-Q-TOF-MS)based metabolomics profiling was used to examine changes in plasma after expo?sure to ZCH,APAP or co-exposure to ZCH and APAP. Glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminas (GOT) values were determined by a biochemical auto analyzer in plasma. Histopathologic changes in the liver were observed and the area was calculated after HE staining. The data were analyzed with SPSS16.0 statistical software and the results were compared with the test between the two groups to find biomarkers. Also,SIMCA software was used for partial least squares-discriminant analysis (PLS-DA) pattern recognition. RESULTS Compared to control group, APAP dosing alone caused an increase in plasma transaminases and alterations in multiple metabolic pathways. Compared to APAP group,decrease in plasma transaminases was noted when ZCH was administered after or prior to APAP. Histopathologic results showed that in the single treatment group, multiple treatment group and pretreatment group,ZCH could alleviate the liver damage induced by APAP from (32.3 ± 12.0)% to (14.2 ± 9.9)%,(8.6 ± 7.9)% to (5.2 ± 1.7)% and (32.5 ± 10.0)% to (5.2 ± 6.4)%(P<0.05). Similarly,the PLS-DA of the LC-MS data showed that the groups dosed with APAP alone were the most distinct from controls,while animals dosed with ZCH prior to or after APAP treatment were located near control group. Metabolic spectrum results showed that ZCH could restore the changes in endogenous substances including lipid metabolism,amino acid metabolism,sugar metabolism and energy metabolism induced by APAP to normal. CONCLUSION ZCH water-extraction plays major roles in the regulation of metabolism on APAP-induced liver injury. These studies demonstrate that UPLC-Q-TOF-MS-based metabolomic analysis can be sensitively and accurately predict the initiation and progres?sion of liver injury and greatly contribute to a better understanding of the hepatoprotective effects of ZCH in a clinical environment.

Development and application of modified military water tank / 医疗卫生装备

Objective To improve the existing military water tank to prevent water pollution.Methods The modified water tank was composed of a lip,body,a floating ring filled with foam materials,a zipper,multi faucets,drain valve,rack and etc.The zipper on the top of the tank could close down the tank,the faucets at the lower part realized water supply,and the drain valve at the bottom discharged residual water.Results The dust,small animals and etc were prevented from going into the tank with the consumed water decreased,and the tank was easy to clean.Conclusion The tank contributes to military water supply at field conditions,and is worthy promoting practically.

Determination of perchlorate in food by ultra performance liquid chromatography-tandem mass spectrometry / 中国食品卫生杂志

Objective To establish a method for the determination of perchlorate in food by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).Methods The perchlorate residue in spices and condiments was extracted with water,that in vegetables and fruits was extracted with acetonitrile-water (1∶ 1,V/V),and that in meat,poultry,eggs,milk and aquatic products was extracted with acetonitrile-water (2∶ 1,V/V).The supernatant was cleaned up with C18 SPE (3 ml,200 mg),and the detection was carried out by UPLC-MS/MS with internal standardmethod for quantification.Results The calibration curve was linear in the concentration range of 0.3-20.0 pg/L (R2 ≥0.999),the recovery was in the range of 82.6％-108.6％,the relative standard deviation (RSD) was in the range of 1.0％-9.9％,and the limit of detection was 2.0 μg/kg for milk,and 10.0 μg/kg for other food.Conclusion The method was simple,accurate and highly sensitive,and suitable for the determination of perchlorate in food.

Analysis of capabilities of microscopic examinations of Plasmodium in Dongxihu District,Wuhan City / 中国血吸虫病防治杂志

Objective To investigate and analyze the capabilities of Plasmodium microscopic examinations in medical and health organizations in Dongxihu District,Wuhan City,so as to provide evidences for achieving the standard of malaria elimina?tion and malaria control in the future. Methods The basic information of the laboratorians and the hardware facilities in 15 mi?croscopic examination stations of Plasmodium were collected and analyzed from 2010 to 2015. Meanwhile,the quality of mak?ing,dyeing,cleanliness of all the negatives blood smears were evaluated,and all the positive smears were re?checked in the dis?trict during the period above mentioned. Results Totally,there were 28 laboratorians and 9 qualified microscopes in 15 micros?copy stations in Dongxihu District. The age of the laboratorians in the first?level and third?level organizations was mainly from 40 to 50 years old,but the age of those in the second?level organizations was from 20 to 30 years old. The years for microscopic ex?amination working of most of the laboratorians in the first?level and third?level organizations were more than 15 years,while the working years of those in the second?level organizations were mainly less than 10 years. The education level of the laboratorians in the first?level organization was mainly(50.00%)junior college,while the education levels of those in the second and third or?ganizations were mainly bachelor. From 2010 to 2015,8 561 blood smears were produced and 539 of them were reviewed,the co?incidence rates of review were all 100%,and the average qualified rates of making,dyeing,and cleanliness of the negative blood smears were 82.08%,79.92%and 83.33%,respectively. All the rates mentioned above in 2015 were higher than those in 2010(χ2=26.45,16.85,13.93,all P<0.01). Conclusion The capability of microscopic examinations of Plasmodium has improved obviously in Dongxihu District,but the human resources construction and hardware input in this district should be im?proved,meanwhile,the check on the quality control of microscopic examinations of Plasmodium should be continued,so as to guarantee the sustainable and healthy development of malaria control work in this district.

A clinical study on retrieval of retained capsules by double balloon enteroscopy / 中华消化内镜杂志

Objective To evaluate the effectiveness and safety of double balloon enteroscopy( DBE) in retrieval of retained capsule and identify the factors associated with successful retrieval. Methods A total of 23 consecutive retention cases who received retrieval of retained capsules by DBE from January 2010 to December 2013 were reviewed. They were assigned to success group and failure group. The differences in insertion route, insertion depth, lesion location between the two groups were analyzed. Results Fifteen cases of all 23 retention cases were successfully retrieved and the success rate was 65?2%. There was no significant difference in the mean entrapped period of CE between the two groups [20?0(15?0,57?0)d VS 21?0(16?0,240?0) d,P=0?525]. DBE via oral route exhibited remarkable higher success rate than anal route [ 71?4%( 15/21) VS 0/5, P=0?007] . Compared with ileum, it was easier to take out CE located at jejunum( 8/8 VS 7/13, P=0?046 ) and the insertion depth was significantly less in the success group [(167?3±33?8)cm VS (258?3±23?9) cm, P=0?041]. Whether the capsule was in pelvic cavity shown by x?ray film before the surgery was irrelevant to the successful rate(9/14 VS 5/6,P=0?613) and insertion depth of the DBE on access to the capsule[(132?0±68?6) cm VS (200?0±40?3) cm, P=0?376],or to the actual location of the capsule. Conclusion Peroral DBE is an effective method for removal of retained CE and the success rate isn′t relevant to the entrapped period. Retained CE locates in ileum and jejunum is more difficult to be taken out than in duodenum.

Analysis of perfluoroalkyl substances and their precursors in eighteen market milk / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the level of perfluoroalkyl substances (PFASs) and their precursors in 18 market milk samples of China.</p><p><b>METHOD</b>The 18 milk samples were selected in 8 provinces of China, including Ningxia, Neimeng, Beijing, Tianjin, Hebei, Shanxi, Chongqing, and Guangdong. 8 PFASs and 11 PFAS precursors were measured by ultra-high performance liquid chromatography-tandem quadruple mass spectrometry (UPLC-MS/MS). The dietary exposure assessment was made.</p><p><b>RESULTS</b>Three PFASs were detected in milk samples which were PFOA, PFUdA, and PFOS. The numbers of detected samples were 5, 12, and 14, respectively. Their concentration ranges were < Limit of determination (LOD)-431.94 pg/ml, < LOD -15.95 pg/ml and < LOD -126.98 pg/ml, respectively. Three PFAS precursors were also found above the detection limits, namely, 4:2 FTS, 6:2 FTS, and 6:2 diPAP. Only one sample was detected 4:2 FTS at the concentration of 3.75 pg/ml. The detected samples of 6:2 FTS and 6:2 diPAP were 12 and 3. Their concentration ranges were < LOD -2.49 pg/ml and < LOD -24.56 pg/ml, respectively. The ranges estimated daily intake of PFOA and PFOS of the detected samples were 2.49 × 10⁻³-405.89 × 10⁻³ ng · kg⁻¹ · d⁻¹ and 36.10 × 10⁻³-119.32 × 10⁻³ ng · kg⁻¹ · d⁻¹.</p><p><b>CONCLUSION</b>Our results suggested that there were different contamination levels of PFASs and their precursors in the 18 market milk produced from different regions in china. The estimated daily intake of PFASs from the milk in our study were far below the tolerable daily intake set by European Union (PFOS: 150 ng · kg⁻¹ · d⁻¹, PFOA: 1 500 ng · kg⁻¹ · d⁻¹).</p>