[The status and health risk assessment of dietary fipronil contamination among 20 provinces of China]

Objective: To understand the status and health risk assessment of dietary fipronil contamination among 20 provinces of China. Methods: A total of 13 kinds of dietary samples in Chinese total diet study include cereals, legumes, potatoes, meats, eggs, aquatics, dairies, vegetables, fruits, sugars, beverages and water, alcohols, condiments and their corresponding products. Among them, condiments were used in the preparation of 12 other sample categories; thus, the actual mixed dietary samples of each province covered 12 groups. A total of 240 mixed dietary samples were collected from 20 provinces in China from 2009 to 2013. After the sample extraction and cleanup, dietary samples were analyzed for the residues of fipronil and its metabolites to obtain the contamination levels of fipronil residues using liquid chromatography-high resolution mass spectrometry. The dietary intake of adult residents was estimated based on food consumption of general population of China. Results: Among the 240 dietary samples, the detection rate of fipronil was 10.4% (25 samples), and the detection rates of fipronil metabolites, i.e. fipronil desulfinyl, fipronil sulfone and fipronil sulfide were 20.4% (49 samples), 40.0% (96 samples) and 8.8% (21 samples), respectively. According to the dietary exposure analysis, the average lower and upper dietary exposure levels of fipronil residues in adult residents of China were 11.34 and 12.35 ng·kg(-1)·d(-1), accounting for 5.7% and 6.2% of acceptable daily intake (ADI), respectively. The highest adult dietary intake of fipronil residues was found in Hunan province, with a value of 72.98 ng·kg(-1)·d(-1), accounting for 36.5% of ADI. Vegetables were the main dietary source of fipronil residues, which contributed to 71.0% of the total intake dose. Conclusion: Fipronil residues were detected in varying degrees in dietary samples, yet the health risk caused by the dietary intake of adult residents among 20 provinces of China is low.

[Three cases report of juvenile dermatomyositis with positive anti-melanoma differentiation associated gene 5 (MDA5) antibody and severe interstitial lung disease and literature review]

Objective: To report the clinical features of anti-MDA5 antibody positive juvenile dermatomyositis (JDM) complicated with severe interstitial lung disease (ILD). Methods: The clinical data of three patients, who was admitted to the Department of Rheumatology and Immunology, Children's Hospital of the Capital Institute of Pediatrics from September 2016 to July 2017, with anti-melanoma differentiation associated gene 5 (MDA5) antibody positive JDM complicated with ILD were retrospectively extracted and analyzed. Meanwhile, PubMed database, CNKI, Wanfang database and China Biology Medicine disc (from their establishment to February 2019) with the key words "juvenile dermatomyositis" "interstitial lung disease" , and "anti-MAD5 antibody" both in English and Chinese were searched. Results: There were 2 females and 1 male (P1-P3), aged from 10 years 3 months to13 years 4 months, the time from onset to diagnosis were 2 months, 4 months and 10 months. All presented with rash. One of them had decreased muscle strength, and two had decreased activity tolerance. Creatine kinase was 588, 915 and 74 U/L, and serum ferritin were 1 792, >2 000 and 195.4 μg/L. All three patients had positive anti-MDA5 antibodies. At the time of diagnosis, all of them had ILD, pneumothorax and mediastinal emphysema, but had no respiratory symptoms. All three patients received oral methylprednisolone and cyclophosphamide pulse therapy, while human immunoglobulin was given only to P1 and P2. P1 developed rapid progressive pulmonary interstitial disease (RPILD) and died of respiratory failure after 2 months. While P2 and P3 were followed up for 1 to 2 years, who had complete remission, as anti-MDA5 antibody turned to negative and ILD improved significantly. Ten related reports in literature were retrieved, without reported Chinese cases, and most cases initiated with rash and very likely complicated with arthritis. Some of them were more likely to have ILD rather than muscle weakness. It also showed that Japanese JDM children had higher rate of positive anti-MDA5 antibody than patients from the U.S. and U.K., and are more susceptible to ILD and RPILD. The mortality rate of patients with RPILD is extremely high. Conclusions: The cases of JDM with positive anti-MDA5 antibody mainly presented with rash and mild muscle weakness, and could be complicated with ILD, pneumothorax and mediastinal emphysema without respiratory symptoms at early stage. Anti-MDA5 antibody titer is related to disease activity and can turn to negative after treatment.

[Health literacy level and influence factors of occupational population in one province]

Objective: To understand health literacy (HL) status of occupational population in work place and provide the basis of developing for HL standards and specific intervention strategies. Methods: Being selected by stratified cluster sampling, 3507 employees in 13 companies wthin Hebei Province were investigated by questionnaire. Results: The survey was conducted with 3507 questionnaires, the valid rate was about 97.83%. There were a total of 2629 men (76.62%) and 802 women (23.38%) . The overall level of HL was 32.24%. Health literacy level (HLL) of three aspects are: basic knowledge and concepts 52.03%, healthy life-style and behavior 26.00%, and health related skills 40.25%, the HL rate of six health issues as scientific view of health, prevention of communicable diseases, prevention of chronic diseases, safety and first aid, basic medical care and health information are 61.59%, 28.62%, 21.95%, 75.20%, 32.99% and 49.17% respectively. The group aged 25-34 had the highest HLL (43.95%) ; the higher culture degree, the higher the level of health literacy (P<0.05) . The HLL of the occupational population in Hebei province was 32.24%, which was close to the HLL of the national occupational population, but higher than that of general population in Hebei province and in the whole country. Conclusions: The HLL of the occupational population in Hebei province which was close to the HLL of the national occupational population. HLL of basic knowledge and concepts is higher than that of healthy life-style and behavior and health related skills, the health literacy rate of prevention of communicable diseases and chronic diseases were low. Age, culture degree and type of industry are important influence factors.

[Clinical significance of low-dose CT performed for three consecutive years in diagnosis of lung nodules in coal mine workers with 20 working years]

Objective: To investigate the clinical significance of low-dose CT (LDCT) in coal mine workers with relatively long working years. Methods: A total of 907 coal mine workers with ≥20 working years were enrolled, among whom there were 863 male and 44 female workers with a mean age of 49.5 years. Digital radiography (DR) was performed for these workers in 2013, and LDCT was performed for three consecutive years from 2014 to 2016. Results: A total of 32 workers were found to have lung nodules by DR in 2013, while in 2014, 269 workers were found to have non-calcified lung nodules by LDCT, and there was a significant difference in the number of workers with lung nodules (χ(2)=233.73, P<0.005) . There was also a significant difference in the detection rate of nodules between the workers with different working years of dust exposure (χ(2)=6.648, P=0.00) . The male workers had a significantly higher detection rate of nodules than the female workers (χ(2)=5.690, P=0.017) . There was no significant difference in the number of nodules between workers with different types of work (χ(2)=16.985, P=0.05) . There were 443 lung nodules in total, among which 71.56% were solid nodules and 55.75% had a size of ≤4mm; malignant nodules were confirmed by surgery in 6 (0.66%) of the 907 workers after baseline LDCT. LDCT reexamination in 2015 and 2016 found new nodules in 8 workers and enlarged nodules in 3 workers, and there was no significant change in the number of nodules with a size of ≤4 mm. Conclusions: It is necessary to perform high-risk population screening for coal mine workers by LDCT. The follow-up strategies for nodules with a size of ≤4mm are the same as those for negative results; annual reexamination is recommended for nodules with a size of >4-8 mm, and clinical treatment should be considered for nodules with a size of >8 mm.

Performance of fast-ion loss diagnostic on EAST

The scintillator-based detector for fast-ion loss measurements has been installed on EAST. To obtain high temporal resolution for fast-ion loss diagnostics, fast photomultiplier tube systems have been developed which can supply the complementary measurements to the previous image system with good energy and pitch resolution by using a CCD camera. By applying the rotatable platform, the prompt losses of beam-ions can be measured in normal and reverse magnetic field. The thick-target bremsstrahlung occurring in the stainless steel shield with energetic electrons can produce X-rays, which will strike on the scintillator based detector. To understand this interference on fast-ion loss signals, the effects of energetic electrons on the scintillator-based detector are studied, including runaway electrons in the plasma ramping-up phase and fast electrons accelerated by the lower hybrid wave.

[Glabridin reduces lipopolysaccharide-induced lung injury in rats by inhibiting p38 mitogen activated protein kinase/extracellular regulated protein kinases signaling pathway]

Objective: To investigate whether glabridin has a beneficial effect on lipopolysaccharide (LPS) induced acute respiratory distress syndrome (ARDS) in rats, and to explore the possible underlying mechanisms. Methods: Thirty-two Wistar rats were randomly assigned into control group, model group (LPS group), glabridin group (GLA group), and ulinastatin group (UTI group), with 8 rats in each group. ARDS rat model was reproduced by intraperitoneal injection of LPS (10 mg/kg). The rats in the control group received an equal volume of normal saline at the same times. The rats in GLA group were gavaged by glabridin (30 mg/kg). The rats in UTI group were injected ulinastatin (20 000 U/kg). Animals were sacrificed 12 hours after LPS challenge. Plasma and lung tissue samples were collected. Histopathological evaluation, lung wet/dry (W/D)ratio, tumor necrosis factor-α (TNF-α), interleukin-18 (IL-18), malondialdehyde (MDA), nitric oxide (NO) and superoxide dismutase(SOD)were analyzed. Immunohistochemical method was used to detect the protein expression of p38MAPK and ERK. Western blot method was used to detect the changes of p38 mitogen activated protein kinase (p-p38MAPK) and phosphorylated extracellular regulated protein kinases (pERK) protein expression in lung tissues. Result: In the control groups, lung tissue showed a normal structure and clear pulmonary alveoli under a light microscope. In the model group, ARDS characters such as extensive thickening of the alveolar wall, significant infiltration of inflammatory cells, demolished structure of pulmonary alveoli, and hemorrhage were found. In the GLA and UTI treatment group, these pathological changes in lung were markedly alleviated compare with LPS-induced ARDS group. Compared with control groups, lung W/D ratio, TNF-α and IL-18 in plasma, and lung MDA, NO levels in lung homogenates of the LPS group were increased significantly, while the lung SOD levels of the LPS group were decreased. Compared with the LPS group, lung W/D ratio, TNF-α and IL-18 in plasma , and lung MDA, NO levels in lung homogenates of the GLA group and UTI group were decreased significantly, while the lung SOD levels of the GLA and ulinastatin groups were increased [TNF-α(μg/L): 51.7±10.3 vs 105.7±30.5, IL-18(μg/L): 37.9±13.9 vs 49.2±14.5, MDA (nmol/mgprot): 2.87±0.62 vs 3.81±0.42, NO(μmol/L): 18.96±0.79 vs 28.58±2.51, SOD(U/mgprot): 115.5±15.2 vs 75.9±14.0, all P<0.05]. Immunohistochemistry showed that the positive expressions of p38MAPK and ERK in cytoplasm and nucleus of the glabridin and ulinastatin treatment group were significantly lower than those of the model group. Western blot showed that compared with the control group, the p-p38MAPK and pERK protein expression in LPS group were significantly increased. And the glabridin and ulinastatin inhibited the protein expressions compared with model group. Conclusion: Traditional Chinese medicine glabridin significantly ameliorated the lung injury induced by LPS in rats via reducing inflammation which caused by the inhibition of p38MAPK and ERK signaling pathway and antioxidant effect.

[Application of occupational hazard risk index model in occupational health risk assessment in a decorative coating manufacturing enterprises]

Objective: To evaluate the occupational health risk of decorative coating manufacturing enterprises and to explore the applicability of occupational hazard risk index model in the health risk assessment, so as to provide basis for the health management of enterprises. Methods: A decorative coating manufacturing enterprise in Hebei Province was chosen as research object, following the types of occupational hazards and contact patterns, the occupational hazard risk index model was used to evaluate occupational health risk factors of occupational hazards in the key positions of the decorative coating manufacturing enterprise, and measured with workplace test results and occupational health examination. Results: The positions of oily painters, water-borne painters, filling workers and packers who contacted noise were moderate harm. And positions of color workers who contacted chromic acid salts, oily painters who contacted butyl acetate were mild harm. Other positions were harmless. The abnormal rate of contacting noise in physical examination results was 6.25%, and the abnormality was not checked by other risk factors. Conclusion: The occupational hazard risk index model can be used in the occupational health risk assessment of decorative coating manufacturing enterprises, and noise was the key harzard among occupational harzards in this enterprise.

[Eperythrozoonosis complicated with hemophagocytic syndrome: report of four cases and review of literature]

Objective: To analyze the clinical characteristics of eperythrozoonosis complicated with hemophagocytic syndrome (HPS) in 4 children. Methods: Four patients diagnosed with eperythrozoonosis complicated with HPS in the Children's Hospital Affiliated Capital Institute of Pediatrics during the period from June 2014 to July 2016 were enrolled. The clinical manifestations, laboratory examination data and therapeutic strategies were analyzed. A literature search (search terms included 'eperythrozoonosis' and 'hemophagocytic syndrome') was conducted using CNKI, Wanfang database, Chinese biomedical literature database and PubMed to include recently published studies (searched from the database establishment to January 2017). Results: Four patients were included in the study. One was boy and the other three were girls. The age range of the 4 patients was between 9 months and 17 years (9 months, 2 years and 17 years, 11 months respectively). All the patients presented with recurrent high fever. During the course of fever, 3 patients presented with rash, and 2 patients presented with joint pain and swelling, which mimicked systemic juvenile idiopathic arthritis. Only 1 patient had the contact history of infectious disease. All patients had normal or decreased white blood cell count ((0.80-13.12)×10⁹/L), suffered from varied degrees of anemia and showed the increased C reactive protein (13.0-84.7 mg/L) anderythrocyte sedimentation rate (13-72 mm/1 h). Examination of peripheral blood smears confirmed eperythrozoonosis. After fever continued about 1 month, all the 4 patients rapidly progressed. Among the 4 patients, 1 patient died for giving up further therapy, and the other 3 patients completely recovered after treatment, including azithromycin for the treatment of eperythrozoonosis, and high-dose intravenous methylprednisolone pulse therapy and human immunoglobulin for the treatment of HPS. For the disease not satisfactory, the hemophagocytic lymphohistiocytosis-2004 (HLH-2004) protocol is given. After the hospitalization of 1 to 2 months, the conditions improved and the children were discharged from hospital. Three patients were followed up for 8 months to 2 years, and their conditions were stable. In the PubMed database, no report was found. Nine cases of children with eperythrozoonosis were found in CNKI, Wanfang database and Chinese biomedical literature database, and 1 case was complicated with HPS. These findings, taken together our report, provided the data of 5 children with eperythrozoonosis complicated with HPS (4 cases were younger than 2 years old). A patient had contact history of infectious disease. Five patientss showed fever of unknown origin. All the patients had severe eperythrozoonosis, and 2 cases at younger age died. Conclusions: Children with eperythrozoonosis often present with the protracted fever of unknown origin, and clinical manifestations mimic those of juvenile idiopathic arthritis (systemic type). The patients with eperythrozoonosis of mild-to-moderate disease severity may have a good prognosis. Children with severe eperythrozoonosis, especially those HPS cases with early onset before 2 years old, may have high risk of mortality. Once the patient's condition aggravates in the course of fever, HPS should be highly suspected. For the patients with eperythrozoonosis complicated with HPS, early diagnosis and the combination of anti-infection with the treatment of HPS are crucial for a good prognosis. For the treatment of HPS, HLH-2004 protocol is recommended.

[Experts consensus on the management of the right heart function in critically ill patients]

To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle. (2) Right heart function management is a key step of the hemodynamic therapy in critically ill patients. (3) Fluid resuscitation means the process of fluid therapy through rapid adjustment of intravascular volume aiming to improve tissue perfusion. Reversed fluid resuscitation means reducing volume. (4) The right ventricle afterload should be taken into consideration when using stroke volume variation (SVV) or pulse pressure variation (PPV) to assess fluid responsiveness.(5)Volume overload alone could lead to septal displacement and damage the diastolic function of the left ventricle. (6) The Starling curve of the right ventricle is not the same as the one applied to the left ventricle,the judgement of the different states for the right ventricle is the key of volume management. (7) The alteration of right heart function has its own characteristics, volume assessment and adjustment is an important part of the treatment of right ventricular dysfunction (8) Right ventricular enlargement is the prerequisite for increased cardiac output during reversed fluid resuscitation; Nonetheless, right heart enlargement does not mandate reversed fluid resuscitation.(9)Increased pulmonary vascular resistance induced by a variety of factors could affect right heart function by obstructing the blood flow. (10) When pulmonary hypertension was detected in clinical scenario, the differentiation of critical care-related pulmonary hypertension should be a priority. (11) Attention should be paid to the change of right heart function before and after implementation of mechanical ventilation and adjustment of ventilator parameter. (12) The pulmonary arterial pressure should be monitored timingly when dealing with critical care-related pulmonary hypertension accompanied with circulatory failure.(13) The elevation of pulmonary aterial pressure should be taken into account in critical patients with acute right heart dysfunction. (14) Prone position ventilation is an important measure to reduce pulmonary vascular resistance when treating acute respiratory distress syndrome patients accompanied with acute cor pulmonale. (15) Attention should be paid to right ventricle-pulmonary artery coupling during the management of right heart function. (16) Right ventricular diastolic function is more prone to be affected in critically ill patients, the application of critical ultrasound is more conducive to quantitative assessment of right ventricular diastolic function. (17) As one of the parameters to assess the filling pressure of right heart, central venous pressure can be used to assess right heart diastolic function. (18). The early and prominent manifestation of non-focal cardiac tamponade is right ventricular diastolic involvement, the elevated right atrial pressure should be noticed. (19) The effect of increased intrathoracic pressure on right heart diastolic function should be valued. (20) Ttricuspid annular plane systolic excursion (TAPSE) is an important parameter that reflects right ventricular systolic function, and it is recommended as a general indicator of critically ill patient. (21) Circulation management with right heart protection as the core strategy is the key point of the treatment of acute respiratory distress syndrome. (22) Right heart function involvement after cardiac surgery is very common and should be highly valued. (23) Right ventricular dysfunction should not be considered as a routine excuse for maintaining higher central venous pressure. (24) When left ventricular dilation, attention should be paid to the effect of left ventricle on right ventricular diastolic function. (25) The impact of left ventricular function should be excluded when the contractility of the right ventricle is decreased. (26) When the right heart load increases acutely, the shunt between the left and right heart should be monitored. (27) Attention should be paid to the increase of central venous pressure caused by right ventricular dysfunction and its influence on microcirculation blood flow. (28) When the vasoactive drugs was used to reduce the pressure of pulmonary circulation, different effects on pulmonary and systemic circulation should be evaluated. (29) Right atrial pressure is an important factor affecting venous return. Attention should be paid to the influence of the pressure composition of the right atrium on the venous return. (30) Attention should be paid to the role of the right ventricle in the acute pulmonary edema. (31) Monitoring the difference between the mean systemic filling pressure and the right atrial pressure is helpful to determine whether the infusion increases the venous return. (32) Venous return resistance is often considered to be a insignificant factor that affects venous return, but attention should be paid to the effect of the specific pathophysiological status, such as intrathoracic hypertension, intra-abdominal hypertension and so on. Consensus can promote right heart function management in critically ill patients, optimize hemodynamic therapy, and even affect prognosis.

Upgraded flowing liquid lithium limiter for improving Li coverage uniformity and erosion resistance in EAST device

We report on design and technology improvements for a flowing liquid lithium (FLiLi) limiter inserted into auxiliary heated discharges in the experimental advanced superconducting tokamak device. In order to enhance Li coverage uniformity and erosion resistance, a new liquid Li distributor with homogenous channels was implemented. In addition, two independent electromagnetic pumps and a new horizontal capillary structure contributed to an improvement in the observed Li flow uniformity (from 30% in the previous FLiLi design to >80% in this FLiLi design). To improve limiter surface erosion resistance, hot isostatic press technology was applied, which improved the thermal contact between thin stainless steel protective layers covering the Cu heat sink. The thickness of the stainless steel layer was increased from 0.1 mm to 0.5 mm, which also helped macroscopic erosion resilience. Despite the high auxiliary heating power up to 4.5 MW, no Li bursts were recorded from FLiLi, underscoring the improved performance of this new design.

FAMLF is a target of miR-181b in Burkitt lymphoma

Burkitt lymphoma (BL) is a highly malignant non-Hodgkin's lymphoma that is closely related to the abnormal expression of genes. Familial acute myelogenous leukemia related factor (FAMLF; GenBank accession No. EF413001.1) is a novel gene that was cloned by our research group, and miR-181b is located in the intron of the FAMLF gene. To verify the role of miR-181b and FAMLF in BL, RNAhybrid software was used to predict target site of miR-181b on FAMLF and real-time quantitative PCR (RQ-PCR) was used to detect expression of miR-181b and FAMLF in BL patients, Raji cells and unaffected individuals. miR-181b was then transfected into Raji and CA46 cell lines and FAMLF expression was examined by RQ-PCR and western blotting. Further, Raji cells viability and proliferation were detected by MTT and clone formation, and Raji cell cycle and apoptosis were detected by flow cytometry. The results showed that miR-181b can bind to bases 21–42 of the FAMLF 5′ untranslated region (UTR), FAMLF was highly expressed and miR-181b was lowly expressed in BL patients compared with unaffected individuals. FAMLF expression was significantly and inversely correlated to miR-181b expression, and miR-181b negatively regulated FAMLF at posttranscriptional and translational levels. A dual-luciferase reporter gene assay identified that the 5′ UTR of FAMLF mRNA contained putative binding sites for miR-181b. Down-regulation of FAMLF by miR-181b arrested cell cycle, inhibited cell viability and proliferation in a BL cell line model. Our findings explain a new mechanism of BL pathogenesis and may also have implications in the therapy of FAMLF-overexpressing BL.

[Application of means of surfaces with nonhomogeneity in estimating the incidence of pneumoconiosis]

Objective: To investigate the value of means of surfaces with nonhomogeneity (MSN) in esti-mating the incidence of pneumoconiosis. Methods: Based on the principal component analysis, all counties (districts) of Hebei Province, China, were divided into three categories according to the degree of pneumoconiosis hazards and the MSN model was used to estimate the incidence rate of pneumoconiosis and the number of pneu-moconiosis cases using the data of the incidence of pneumoconiosis in 2010. Results: With reference to the appli-cation requirements of the MSN model, results of the principal component analysis, and expert experience, the 172 counties (districts) in Hebei Province were divided into three categories with mild, moderate, and severe pneumoconiosis hazards. There were 74, 61, and 49 counties in the above categories, respectively, and 12, 12, and 25 counties were selected from them, respectively. The estimated number of pneumoconiosis cases in Hebei Province was 2105, and the incidence rate was 261.5 per hundred thousand, with a standard error of esti-mation of 389.9 per hundred thousand. Conclusion: The MSN model provides a new thought and method for es-timating the number of pneumoconiosis cases.

[Clinical characteristics and prognosis in 12 patients with adult T cell leukemia/lymphoma confirmed by HTLV-1 provirus gene detection]

Objective: To analyze the clinical characteristics and prognosis of adult T cell leukemia/lymphoma (ATLL). Methods: Peripheral blood samples from patients who were suspected as ATLL from March, 2013 to July, 2015, were collected for HTLV-1 provirus genes detection in genomic DNA extraction by PCR. Cases showing positive results were confirmed as ATLL. Clinical and laboratory characteristics, therapeutic outcomes and survival evaluation were collected. Results: 12 out of 23 suspected patients were confirmedly diagnosed as ATLL through HTLV-1 provirus genes detection by PCR. Eight patients were male and four patients were female. Median age was 51 (range 28-66) years old. All of those patients came from coastal cities of Fujian province where a HTLV-1 epidemic area locates. In the subtype classification of these 12 ATLL, 11 patients were classified as acute type and one case as lymphoma type ATLL. As one of the clinical characteristics of ATLL, ' flower cells ', with typical or atypical morphology had been observed in a high rate (81.8%). Clinical symptom such as hepatomegaly, splenomegaly and lymphadenectasis were detected in most of patients, and hypercalcemia and elevated LDH were also noted commonly. The ATLL cells immunophenotype were typical, and the major subtype was CD4+ CD8- type. Confection of hepatitis B virus was detected in a high rate (54.5%). Ten patients received chemotherapy, and 2 cases in complete remission after chemotherapy received allogeneic hematopoietic stem cell transplantation. At the end of the follow-up, 7 cases died, 4 cases survived, 1 case was lost, and the median survival was 2.8 (0.9-10.8) months. We found a case had HTLV-1 provirus negative after transplantation. Conclusion: In the coastal area of Fujian Province, ATLL is not rare. Characteristics of those ATLL are typical. But prognosis is still unsatisfactory.

[Effect of occupational lead exposure on the blood pressure of lead-exposed workers]

Objective: To investigate the effect of occupational lead exposure on blood pressure and pro-vide supportive evidence of health protection on lead - exposed workers. Methods: 612 workers (452 lead - ex-posed workers, 160 workers as control) were recruited in the battery factory. The blood lead concentration and blood pressure were detected by occupational health examination and biological monitoring. The relationship of blood lead concentration and blood pressure wasanalyzed. Results: The blood lead concentration in the exposed group (249.84±137.74) μg/L was higher than that of the control group (117.25±70.15) μg/L, and the differ-ence was statistically significant (P<0.01) . The difference of abnormal blood pressure and diastolic pressure among the exposed and the control group was statistically significant (P<0.05) . The abnormal blood pressure rate, systolic pressure rate and diastolic pressure rate in the 400~726 μg/L group was higher than that of the 6~199 μg/L and 200~399 μg/L group, and the difference was statistically significant (P<0.01) . Multiple lin-ear regression analysis showed that the influencing factors of the systolic pressure followed by sex, age, length of service and blood lead concentration, diastolic pressure followed by sex, age, smoke and blood lead concen-tration. Conclusion: These findings suggest that long - term occupational lead exposure may result in the in-crease of blood lead concentration.

First results from solid state neutral particle analyzer on experimental advanced superconducting tokamak

Full function integrated, compact solid state neutral particle analyzers (ssNPA) based on absolute extreme ultraviolet silicon photodiode have been successfully implemented on the experimental advanced superconducting tokamak to measure energetic particle. The ssNPA system has been operated in advanced current mode with fast temporal and spatial resolution capabilities, with both active and passive charge exchange measurements. It is found that the ssNPA flux signals are increased substantially with neutral beam injection (NBI). The horizontal active array responds to modulated NBI beam promptly, while weaker change is presented on passive array. Compared to near-perpendicular beam, near-tangential beam brings more passive ssNPA flux and a broader profile, while no clear difference is observed on active ssNPA flux and its profile. Significantly enhanced intensities on some ssNPA channels have been observed during ion cyclotron resonant heating.

Measurement of the deuterium Balmer series line emission on EAST

Volume recombination plays an important role towards plasma detachment for magnetically confined fusion devices. High quantum number states of the Balmer series of deuterium are used to study recombination. On EAST (Experimental Advanced Superconducting Tokamak), two visible spectroscopic measurements are applied for the upper/lower divertor with 13 channels, respectively. Both systems are coupled with Princeton Instruments ProEM EMCCD 1024B camera: one is equipped on an Acton SP2750 spectrometer, which has a high spectral resolution ∼0.0049 nm with 2400 gr/mm grating to measure the D_α(H_α) spectral line and with 1200 gr/mm grating to measure deuterium molecular Fulcher band emissions and another is equipped on IsoPlane SCT320 using 600 gr/mm to measure high-n Balmer series emission lines, allowing us to study volume recombination on EAST and to obtain the related line averaged plasma parameters (T_e, n_e) during EAST detached phases. This paper will present the details of the measurements and the characteristics of deuterium Balmer series line emissions during density ramp-up L-mode USN plasma on EAST.

[Application of principal component analysis in comprehensive indicator screening for pneumoconiosis in different regions]

Objective: To investigate the application of principal component analysis in comprehensive indicator screening for pneumoconiosis in different regions. Methods: A principal component analysis was performed for the data of 11 factors associated with the prediction of pneumoconiosis hazard and collected in the investigation on occupational health status conducted in 172 counties (districts) in Hebei, China. The degree of pneumoconiosis hazard in different regions was obtained and intuitively presented by GIS. Results: The eigenvalues of 5 principal components of pneumoconiosis were 4.103, 2.341, 0.981, 0.943, and 0.726, respectively, and the contribution values were 37.299%, 21.286%, 8.919%, 8.572%, and 6.596%, respectively. According to the comprehensive value of principal components, GIS Natural Breaks was used to divide the degree of pneumoconiosis hazard in 172 counties (districts) in Hebei into mild, moderate, and severe grades. Of all the counties, 46 had severe pneumoconiosis hazard, 69 had moderate pneumoconiosis hazard, and 57 had mild pneumoconiosis hazard, and the ranges of the score of principal components were 0.30-1.15, -0.24 to 0.27, and -0.69 to -0.25, respectively. Conclusion: Principal component analysis can optimize the comprehensive indicators for the evaluation of regional pneumoconiosis. The comprehensive score of principal components can quantify and intuitively show the degree of pneumoconiosis hazard in different regions. Tangshan, Chengde, Shijiazhuang, and Handan have the most severe pneumoconiosis hazard.

[Application of benchmark dose on renal injury in people chronically exposed to lead]

Objective: To screen sensitive indicators of renal injury in lead workers using benchmark dose method. Methods: Of the 486 subjects,116 did not occupationally contact to lead as a control. The blood lead was considered as exposure biomarker, while Uβ₂-MG and UNAG as effect biomarkers for renal injury. The BMD and BMDL of blood lead were estimated at the 10% benchmark response using BMDS Version 2.6. Results: There was statistical rise in blood lead between the lead group and control group (P<0.05) ; and the blood lead level was divided into four groups by quarterback spacing method, among which UNAG was statistically different (P<0.05) . There was an increased prevalence of abnormal rates of Uβ₂-MG and UNAG with increasing blood lead concentration (P<0.05) , after trend chi-square test. BMD and BMDL of UNAG and Uβ₂-MG were 602.784/431.838 μg/L and 130.398/100.981 μg/L caculated by Log-Probit model, respectively. Conclusions: Occupational lead exposure may cause kidney damage, and UNAG could be as a more sensitive marker for monitoring early renal injury than Uβ₂-MG.

[Determination of perfluorosulfonate and perfluorocarboxylate precursors in eggs by ultra-highperformance liquid chromatography-mass spectrometry]

OBJECTIVE

To develop a method for the determination of 11 perfluorosulfonate and perfluorocarboxylate precursors in eggs using ultra-high performance liquid chromatography-tandem quadruple mass spectrometry (UPLC-MS/MS).

METHODS

The target compounds of egg were extracted with 100 mmol/L NaOH-acetonitrile /water(90∶10, V/V) by ultrasonic. Then the extract was purified by solid phase extraction (Waters Oasis(@) WAX 6cc) and then eluted with 9% NH4OH in methanol. The target compounds were separated on a Waters ACQUITY(TM) BEH (18)C column (50 mm × 2.1 mm, 1.7 μm) and detected by negative electrospray ionization (ESI(-)) mass spectrometry in multiple reaction monitoring mode (MRM). All compounds were quantified with internal standards. The accuracy, precision and the limits of detection and quantification of the method were evaluated. Then we detected 7 different egg samples from the market.

RESULTS

The average recoveries for the eleven precursors at 3 levels were 74.09%-116.82% and the relative standard deviations were 2.37%-13.62%. The limits of detection (LOD) of the method were in the range of 0.06-1.50 pg/g (wet weight) and the limits of quantification (LOQ) were in the range of 0.15-3.00 pg/g (wet weight). And 5 target compounds were detected in the 7 market samples. 6:2 fluorotelomer sulfonate (6:2 FTS) was detected in all of samples with the concentrations of 1.67-3.11 pg/g. 6:2 fluorotelomer unsaturated acid (FHUEA) and 6:2 disubstituted polyfluoroalkyl phosphate ester (6:2 diPAP) were detected in 6 samples and the concentrations were<LOD-5.11 pg/g and 3.78-9.16 pg/g, respectively. And the concentrations of 8:2 fluorotelomer sulfonate (8:2 FTS) and N-methyl perfluorooctane sulfonamidoacetic acid (N-Me FOSAA) founded in the same sample were 105.78, and 4.95 pg/g, respectively.

CONCLUSION

This method was simple, rapid, and suitable for determination of perfluorosulfonate and perfluorocarboxylate precursors in eggs with high accuracy and sensitivity. It could also be applied to human burden studies of these precursors.

Effect of CYP1A1 and GSTM1 genetic polymorphisms on bone tumor susceptibility

Tumor gene polymorphisms are often associated with individual susceptibility to genetic diseases. Cytochrome P4501A1 (CYP1A1) and glutathione S-transferase mu 1 (GSTM1) gene polymorphisms are closely related to the susceptibility of the body to chemical carcinogens in the environment. Therefore, we explored the relationship between CYP1A1 and GSTM1 gene polymorphisms and susceptibility to bone tumors. Multiplex-polymerase chain reaction (PCR), allelic-specific PCR, and PCR-restriction fragment length polymorphism techniques were used to analyze CYP1A1 and GSTM1 gene polymorphisms in 52 bone tumor patients and 100 healthy subjects. The allelic variation frequency of the CYP1A1 gene at exon 7 (Ile 462 Val) in bone tumor patients was 0.462, which was significantly higher than that in the normal controls (0.223). The frequency of the absence of the GSTM1 homozygous genotype in the patients (0.65) was also markedly higher than that in the control group (0.41). Subjects with CYP1A1 Val/Val homozygous mutations and absence of the GSTM1 homozygous genotype were at markedly increased risk of developing bone tumors [ORs 4.15 (95%CI: 1.268-13.30) and 2.35 (95%CI: 1.15-4.85), respectively]. The OR for the combined effect of the CYP1A1 and GSTM1 gene polymorphisms was 8.55 (95%CI: 1.75-41.50). CYP1A1 and GSTM1 polymorphisms are genetic risk factors in patients with bone tumors, and the allelic variation of these genes increases the risk of bone tumor occurrence.

Hepatitis C virus-related mixed cryoglobulinemic endocapillary proliferative glomerulonephritis and B-cell non-Hodgkin lymphoma: a case report and literature review

OBJECTIVE

Chronic HCV (hepatitis C virus) infection is recognized as the major cause of mixed cryoglobulinemia. Cryoglobulins continually precipitate and form deposits on the vascular endothelium of small to medium-sized blood vessels, which may progress to vasculitic syndrome.

CASE REPORT

A 44-year-old female patient with chronic HCV infection presented with purpuras, edema and proteinuria. Her renal findings included microscopic hematuria, moderate proteinuria and endocapillary proliferative glomerulonephritis (EnPGN) on renal biopsy. Serum cryoglobulins comprised mixed monoclonal cryoglobulins characterized by IgM kappa. The serum protein electrophoresis revealed a monoclonal M protein (9.0%). CD19 and CD20-positive B-cell oligo-monoclonal expansion in the bone marrow was revealed. Rapid relief of the clinical symptoms, the disappearance of proteinuria and a sharp decrease in the HCV viral load were observed in our case after one year of interferon therapy.

CONCLUSIONS

HCV infection-associated extrahepatic manifestations are diverse, which may lead to misdiagnosis. This is the first report of HCV-associated cryoglobulinemic EnPGN and B-NHL, which rapidly responded to interferon.

New steady-state quiescent high-confinement plasma in an experimental advanced superconducting tokamak

A critical challenge facing the basic long-pulse high-confinement operation scenario (H mode) for ITER is to control a magnetohydrodynamic (MHD) instability, known as the edge localized mode (ELM), which leads to cyclical high peak heat and particle fluxes at the plasma facing components. A breakthrough is made in the Experimental Advanced Superconducting Tokamak in achieving a new steady-state H mode without the presence of ELMs for a duration exceeding hundreds of energy confinement times, by using a novel technique of continuous real-time injection of a lithium (Li) aerosol into the edge plasma. The steady-state ELM-free H mode is accompanied by a strong edge coherent MHD mode (ECM) at a frequency of 35-40 kHz with a poloidal wavelength of 10.2 cm in the ion diamagnetic drift direction, providing continuous heat and particle exhaust, thus preventing the transient heat deposition on plasma facing components and impurity accumulation in the confined plasma. It is truly remarkable that Li injection appears to promote the growth of the ECM, owing to the increase in Li concentration and hence collisionality at the edge, as predicted by GYRO simulations. This new steady-state ELM-free H-mode regime, enabled by real-time Li injection, may open a new avenue for next-step fusion development.

A flowing liquid lithium limiter for the Experimental Advanced Superconducting Tokamak

A program involving the extensive and systematic use of lithium (Li) as a "first," or plasma-facing, surface in Tokamak fusion research devices located at Institute of Plasma Physics, Chinese Academy of Sciences, was started in 2009. Many remarkable results have been obtained by the application of Li coatings in Experimental Advanced Superconducting Tokamak (EAST) and liquid Li limiters in the HT-7 Tokamak-both located at the institute. In furtherance of the lithium program, a flowing liquid lithium (FLiLi) limiter system has been designed and manufactured for EAST. The design of the FLiLi limiter is based on the concept of a thin flowing film which was previously tested in HT-7. Exploiting the capabilities of the existing material and plasma evaluation system on EAST, the limiter will be pre-wetted with Li and mechanically translated to the edge of EAST during plasma discharges. The limiter will employ a novel electro-magnetic pump which is designed to drive liquid Li flow from a collector at the bottom of limiter into a distributor at its top, and thus supply a continuously flowing liquid Li film to the wetted plasma-facing surface. This paper focuses on the major design elements of the FLiLi limiter. In addition, a simulation of incoming heat flux has shown that the distribution of heat flux on the limiter surface is acceptable for a future test of power extraction on EAST.