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In Lijiang City, as a typical example, 93 soil samples were collected from the study area, and soil pH； organic matter； and heavy metals arsenic （As）, mercury （Hg）, copper （Cu）, zinc （Zn）, lead （Pb）, cadmium （Cd）, and chromium （Cr） were determined. We explored the sources of heavy metals in the study area by means of Positive Definite Matrix Factorization （PMF） modeling and analyzed the impact of influencing factors by combining seven heavy metals with 13 influencing factors in a GeoDetector. The results showed that the mean values of soil heavy metals ω （As）, ω （Hg）, ω （Cu）, ω （Zn）, ω （Pb）, ω （Cd）, and ω （Cr） in the study area were 17.55, 0.19, 86.75, 164.84, 28.95, 0.39, and 167.87 mg·kg -1 , respectively, which were greater than the background values of soils in Yunnan Province （except for As and Pb）. Regarding spatial distribution, the high values of Cu and Cr content were mainly concentrated in Yulong Naxi Autonomous County； the high value areas of As, Hg, Pb, and Cd were mainly concentrated in Ninglang Yi Autonomous County； and the high value of Zn content was mainly concentrated in Huaping County. Correlation analysis and PMF modeling revealed that the main sources of heavy metals As and Hg in the study area were industrial sources, Zn was from transportation pollution sources, Cr and Cu were from natural sources, and Cd and Pb were from agricultural sources. Further, the factor detector of the GeoDetector found that soil pH and organic matter （OC） had strong explanatory power for the content of seven heavy metals, and the interaction detector found that the results following the interaction of different influencing factors were nonlinear enhancement or two-factor enhancement, in which the interaction of OC and pH was the dominant factor for the spatial differentiation of heavy metals. This provides an important scientific basis for the protection of the soil environmental health and sustainable development in Lijiang City.

A farmland area in Zhaotong City was taken as the research object， and the method of point-to-point collaborative sampling was used to collect farmland soil and vegetables in Zhaotong and test the content of six heavy metals， namely As， Pb， Cu， Zn， Cd， and Cr. The geo-accumulation index and potential ecological risk index were used to evaluate the heavy metal pollution of soil. The health risk model was used to evaluate the risk to the human body imposed by vegetables. The results showed that Cu， Zn， Pb， Cd， and Cr pollution existed in the research area. Compared with the risk screening value of farmland， the over-standard rates were 34.35%， 6.87%， 2.29%， 80.15%， and 6.11%， respectively； Pb， Cd， and Cr were found in vegetables. Compared with the pollutant limit in food， the over-standard rates were 6.87%， 15.27%， and 36.64%， respectively. According to the soil pollution evaluation， Cd in the soil showed a strong ecological risk， and other heavy metals in the soil showed a mild ecological risk. The human health risk evaluation model showed that both non-carcinogenic risk and carcinogenic risk were out of the acceptable range and had a greater influence on children. Correlation analysis showed that As in the soil had an antagonistic effect on Cu and Zn absorption by vegetables， whereas Cr in the soil could promote Cu and Zn absorption by vegetables.

Background & Problems: Efficient handover is essential to ensuring high levels of caring quality and patient safety. In our psychiatric acute ward, it was noticed that there were many valueless tasks being performed during the nursing handover process that negatively affected efficiency., Purpose: To apply lean management principles to improve the nursing handover process in the psychiatric acute ward., Resolution: In order to find the rightful solution, our task team analyzed the problem using the Value Chart of Lean Management and detected that the handover process was slowed down by motion, waiting, and defects. According to the rules of lean management, group discussion, decision making, and the cost-benefit matrix, we proposed improvement solutions including visual stocktaking, adjusting handover patterns, switching the handover location, and systematizing nursing handover procedures., Results: The time required for stocktaking was shortened from 5 to 2 minutes (60% improvement). The waiting time was shortened from 114 to 49.6 minutes (56.6% improvement). The efficiency of the handover process increased from 66% to 90%., Conclusions: Applying lean management principles helped detect critical problems and reduce waste, which enhanced efficiency, improved handover, and helped maximize nursing value and benefit in an increasingly complex environment.

Objective: To explore the lymphocytic clonal expansion in adult patients with Epstein-Barr virus-associated lymphoproliferative diseases (EBV+LPD), and to investigate the experimental methods for EBV+LPD cells so as to provide a more objective measure for the diagnosis, classification and prognosis in the early stage of this disease., Methods: Peripheral blood samples from 5 patients with EBV+LPD, 4 patients with adult infectious mononucleosis(IM) as negative control and 3 patients with acute NK-cell leukemia(ANKL) as positive control were collected. Prior to immunochemotherapy, viral loads and clonality were analysed by flow cytometry (FCM), T cell receptor gene rearrangement (TCR) was detected by real-time polymerase chain reaction (RT-PCR), and diversity of EB virus terminal repeat (EBV-TR) was detected by Southern blot., Results: FCM showed only 1 case with clonal TCRVβ in 5 patients with EBV+LPD, TCR clonal expansion could be detected both in patients with IM(4 of 4) and 4 patients with EBV+LPD(4 of 5), Out of patients with EBV+LPD, 1 patient displayed a monoclonal band and 2 patients showed oligoclonal bands when detecting EBV-TR by southen blot., Conclusion: Detecting the diversity of EBV-TR by Southern blot may be the most objective way to reflex clonal transformation of EBV+LPD, which is of great benefit to the diagnosis, classification and prognosis in the early stage of this disease.

Objective: To screen and verify differentially expressed genes in prostate cancer., Methods: Using DNA microarray, we screened differentially expressed genes in prostate cancer tissue and its adjacent tissue followed by verification by PCR., Results: A total of 1 444 genes were found to be differentially expressed (differentiation ≥ 1.5-fold; P≤ 0.05) in the prostate cancer tissue, of which 769 (53%) were up-regulated and 675 (47%) down-regulated. Fifty percent of the differentially expressed genes showed a 1.5- to 2-fold differentiation, including 396 up-regulated and 182 down-regulated ones. Additionally, 308 up-regulated and 334 down-regulated genes exhibited a >2- to 5-fold, 46 up-regulated and 78 down-regulated genes a > 5- to 10-fold, and 19 up-regulated and 81 down-regulated genes a > 10-fold differentiation. Verification by subjecting 15 most significantly up-regulated and another 15 most markedly down-regulated genes to quantitative real-time PCR (qRT-PCR) showed that most of the genes had a transcriptional profile similar to that in the microarray data, with a Pearson correction coefficient of 0.83 between the microarray data and qRT-PCR results. Totally, 10 significantly differentially expressed genes were identified., Conclusion: DNA microarray analysis provides reliable information on differentially expressed genes in prostate cancer and benign tissues. The 10 significantly differentially expressed genes verified by qRT-PCR could possibly become new bio-markers and specific molecules for tumor identification.

In order to obtain the candidate strains of deodorizing microorganism, three optimization strains with relatively higher deodorizing capacity were isolated from landfill leachate, which were given the labels of CC3, CC7, CC13 and CC16. According to the results of morphological observation, physiological and biochemical tests, 16S rDNA sequence homology analysis, the strains CC3, CC7, CC13 and CC16 were identified as Pediococcus acidilactici, Bacillus megaterium, Lactobacillus acidophilus and Alcaligenes faecalis respectively. When the strains CC7, CC13 and CC16 were mixed with the inoculation rate was 1:1.5:0.5, the removal rates of ammonia and hydrogen sulfide were 83.56% and 70.25%. The optimal conditions of deodorizing by single factor test were deodorization time of 60 hours, sausage of 5%, temperature of 30 degrees C, initial pH of 6.5.

Objective: To establish a near-infrared qualitative analysis model to identify the authenticity of Polygonum multiflo- rum and distinguish processed products Polygoni Multiflori Radix., Method: The NIR spectra were peformed on over 30 batches of P. multiflorum and Polygoni Multiflori Radix samples and the adulterants Cynanchum bungei, Pteroxygonum giraldii, Polygonum cillinerve to establish the qualitative discriminant model and the conformity test model of Polygonum multifiorum , and cluster analysis was used to analyze the samples from different origins., Result: The model is able to identify correctly P. multiflorum with its counterfeit, and distinguish between P. multiflorum and Polygoni multiflori Radix., Conclusion: Near-infrared spectroscopy can be applied in the identification of P. multiflorum, which could be used to screen Chinese herbal medicine preliminarily.

Objective: To compare the continuous positive airway pressure (CPAP) of automatic titration with that of manual titration., Methods: A total of 58 patients with obstructive sleep apnea and hypopnea syndrome (OSAHS) diagnosed by overnight polysomnography at sleep center of First Affiliated Hospital, Guangzhou Medical University were studied between December 2010 and December 2012. Manual titration was performed under full polysmnography and auto-titration at home for 3-7 nights., Results: There were 52 males and 6 females with an age range of (48 ± 11) years. CPAP pressure titrated by automatic device (10.0 ± 2.2) cm H2O (1 cm H2O = 0.098 kPa) was significantly higher than that titrated manually (7.5 ± 1.5) cm H2O (P = 0.000). Apnea-hyponea index decreased significantly from (54.0 ± 21.0) events/h pre-treatment to (3.8 ± 2.5) events/h post-treatment under manual titration (P < 0.01)., Conclusions: CPAP pressure titrated by automatic device is usually higher than that titrated manually. Manual titration should be performed if a patient can not tolerate the CPAP pressure titrated by an automatic device.

Objective: To establish a method for the determination of eighteen elements (Be, Al, Cr, Mn, Ni, Cu, As, Se, Mo, Ag, Cd, Sn, Sb, Ba, Dy, Hg, Tl and Pb) in Serratulae Chinensis Radix by inductively coupled plasma-mass spectrography (ICP-MS)., Methods: After microwave digestion, 18 elements in the samples were determined by ICP-MS and the method was validated., Results: A good linearity of calibration curves was obtained, the mean recovery met the analytical requirement., Conclusion: This method is simple, accurate and effective. It provides basis for the research of Serratulae Chinensis Radix.

Objective: To explore the prevalence of central sleep apnea in different age groups of children with sleep apnea-hypopnea (SAH)., Methods: A total of 431 children with SAH diagnosed by overnight polysomnography at our Sleep Center were retrospectively studied. They were divided into 3 groups based on their ages: toddler group (1 - < 3 years old), preschool group (3 - < 6 years old) and school group (6 - < 13 years old). The relationship between age and different types of apnea-hyponea index (AHI) was analyzed. And the prevalence of central sleep apnea and sleep structure were compared between the groups., Results: A negative correlation existed between age and central sleep apnea index (r = -0.322, P < 0.01). However, there was no correlation between age and obstructive apnea index (P > 0.05). AHI was similar in different age groups, but the medians of central sleep apnea index for toddler, preschool and school groups were 2.35, 1.50 and 0.90 events/h respectively (all P < 0.01). Sleep structure was similar between the groups (P > 0.05)., Conclusions: Central sleep apnea is common in children with sleep disordered breathing. The younger their ages, a higher prevalence of central sleep apnea.

Objective: To explore the relationship between occupational factors and the incidence of bladder cancer., Methods: The present research was based on a hospital-based case-control study. The cases were frequency matched. The non-conditional Logistic regression was used to calculate the odds ratio (OR) of each occupation., Results: The OR of business and administration professionals, male electricians and electronic workers were 3.88 and 7.40; the OR of janitors and helpers was 0.21; the OR of handcrafted and printing clerks was 0.71, but there was no significant difference., Conclusion: Business and administration professionals, male electricians and electronic workers tend to have bladder cancer. The occupation of janitors and helpers has a protective effect on bladder cancer while the occupation of printing clerks shows no statistical significance on bladder cancer.

Objective: To study the contents of cadmium in Cortex Ilicis Rotundae and provide evidence for establishing the detection limit of cadmium in its quality standard., Methods: ICP-MS was used to determine the contents of cadmium in 18 batches of Ilex L., Results: The contents of cadmium in 10 batches of Cortex Ilex Rotunda ranged from 3.4 to 10.4 mg/kg,and the contents of cadmium in Ilex asprella and Ilex pubescents were more than 0.3 mg/kg., Conclusion: The contents of cadmium of Cortex Ilicis Rotundae, Ilex asprella and Ilex pubescents have particular characterise, and this study provides a basic for the analysis of cadmium in Cortex Ilicis Rotundace and other plants of this genus.

Objective: To explore the relationship between smoking and bladder cancer in China., Methods: A multicenter case-control study was conducted from September 2005 to June 2008. A total of 432 bladder cancer patients, matched with 392 control cases, received a questionnaire including the type of exposure (active vs. passive smoking), the age of beginning and/or quitting smoking, smoking amount and time and depth of smoke inhalation., Results: Both active smoking and passive smoking increased the incidence of bladder cancer (P < 0.05). Bladder cancer risk increased 1.89 times in active smokers and 1.88 times in passive smokers compared to non-smokers (P < 0.05). Smoke amount and time were significantly correlated with bladder cancer risk (P < 0.05). But the age of beginning smoking did not affect the bladder cancer risk (P > 0.05). Inhaling smoke into mouth or throat was also a risk factor for bladder cancer (P < 0.05)., Conclusion: There is a strong association between smoking and bladder cancer. Active and passive smoking, smoke amount and time, and the depth of smoke inhalation are risk factors for bladder cancer. The best way of preventing bladder cancer is never smoking.

Objective: To investigate the expression of CD147 in prostate cancer and discuss its diagnostic value in prostate cancer., Methods: The method of immunohistochemical SP was employed to detect the expression of CD147 in 101 cases of prostate cancer, 90 cases of benign prostatic hyperplasia, 36 cases of normal prostate and 15 cases of embryonic prostate by so as to evaluate its clinical significance in the histological classification and prognosis of prostate cancer., Results: The CD147 expression was positively expressed in 67/101 (66.3%) of prostate cancer, 21/90 (23.3%) of benign prostatic hypertrophy, 2/36 (5.6%) of normal prostate and 0/15 (0.0) of embryonic prostate respectively. A positive expression of CD147 was dramatically associated with TNM stage (P < 0.001), the depth of prostatic capsule invasion (P = 0.002) and histological grade (P = 0.006)., Conclusions: The detection of CD147 is helpful to raise the early diagnosis rate of prostate cancer. It will become a tumor marker of reflecting the malignant degree and predicting the prognosis of prostate cancer.

Objective: To investigate the value of special fluorescence spectrum in the early diagnosis of bladder cancer., Methods: Hematoporphyrin monomethyl ether (HMME) of the concentrations of 10, 100, and 200 microg/ml, as photosensitizer, was added into the sample vessels of bladder cancer tissue to be incubated for 1 - 3 h. A detecting system consisting of solid state ultraviolet laser with the wavelength of 355 nm was used to measure the fluorescence spectrum., Results: The laser-induced auto-fluorescence (LIAF) of the bladder cancer tissue had characteristic double peaks at 445 - 490 nm. There was a remarkable characteristic peak, drug peak, located at 628.25 nm in the laser-induced drug-fluorescence (LIDF) of the bladder cancer tissue soaked by HMME., Conclusion: Photosentisizer raise the sensitivity and specificity of fluorescence spectrum in diagnosis of bladder cancer. Stable, and with high strength and visible drug peak, the LIDF is may help improve the early diagnosis of bladder cancer.

Background & Objective: Regional lymph node metastasis plays an important role in the prognosis of esophageal carcinoma. However, the range of lymph node dissection is still controversial. This study was to investigate the regulations of lymph node metastasis of thoracic esophageal carcinoma in the mediastinum and upper abdomen, and explore the rational lymphadenectomy with Ivor-Lewis procedure., Methods: A total of 1 412 thoracic esophageal carcinoma patients underwent radical esophagectomy and mediastinal and abdominal lymphadenectomy by Ivor-Lewis procedure from 1990 to 2005 at Yangzhong People's Hospital; 517 of them underwent right para-trachea triangle field lymphadenectomy through the right pleural apical approach. The regulations of regional lymph node metastasis were analyzed., Results: Of the 1,412 patients, 323 (22.88%) had postoperative complications, 2 (0.14%) died during hospitalization, and 547 (38.74%) had lymph node metastasis. The lymph node metastasis rates were 32.30% in the right para-trachea triangle, 18.43% in the upper mediastinum, 5.31% in the lower mediastinum, and 17.28% in the upper abdomen(P<0.001). Of the 13 916 resected lymph nodes, 2 662 (19.13%) were positive; the metastasis degree (positive lymph nodes/resected lymph modes) were 23.83% in the right para-trachea triangle, 18.92% in the upper mediastinum, 21.07% in the lower mediastinum, and 17.20% in the upper abdomen. For those patients with the cancer focuses in the upper, middle and lower segments of the esophagus, the lymph node metastasis rates were 40.59%, 36.97% and 44.35% (P=0.093), respectively, while the lymph node metastasis degree in these 3 fields were 19.60%, 18.35%, and 21.82%, respectively. Both the lymph node metastasis rate and degree were significantly higher in the patients at advanced stage than in the patients at early stage (46.56% vs. 7.75%, 21.82% vs. 4.01%, P<0.001)., Conclusions: Regional lymph node metastasis, especially in the right para-trachea triangle and upper mediastinum, is a key factor for thoracic esophageal carcinoma. Ivor-Lewis esophagectomy with two-field lymph node dissection is a safe operation for thoracic esophageal carcinoma, and may increase the chances of complete resection.

Objective: To establish a method for content determination of indirubin and indigo in Baphicacanthus cusia (Nees) Bremek., Method: HPLC was used with C18 column, methanol-water (75:25) as mobile phase and detecting wavelength 289 nm., Results: The range linear curve was 3.875 approximately 23.25 microg/ml (indirubin), 3.05 approximately 18.3 microg/ml (indigo). The average recovery was 96.9%, RSD =3.5%, n =5 (indirubin); 96.9% RSD = 2.8%, n = 5 (indigo)., Conclusion: The method is proper for the quality control of Baphicacanthus cusia (Nees) Bremek.

An assessment of the current state of pollution from polychlorinated biphenyls (PCBs) and PCBs spatial character in sediments are represented. The sources of PCBs and relative factors are also analyzed. Songhua River and Dalian Bay in Northeast, Baoding in Hebei Province, Ya-er Lake in Wuhan City, Pearl River and Taiwan Province in Southeast of China have relatively high level of PCBs, while most other regions have lower average concentrations of PCBs. Serious pollution of PCBs is found in some locations, most of which are harbors, industrial areas, the places where improper disposal of and leakage from PCB containers taken place Point source pollution is the common pattern of contamination, influenced primarily by local geographic, economic, management and historical factors, with Pearl River/Estuary as an example.

Background: Propofol's greatest attributes are its pharmacokinetic properties which result in a rapid, clear emergency and lack of cumulative effects even after prolonged administration. It is a drug of popular choice for the maintenance of general anesthesia. The laryngeal mask airway (LMA), originally described by Dr. Brain is now a good alternative as the airway management technique. Because of its high success rate in securing a clinically acceptable airway in anesthetized patients, LMA has been proposed as a practical airway and conveyer for general anesthesia. This study was designed to observe and evaluate the feasibility of propofol infusion combined with N2O for maintenance of anesthesia, with a LMA as airway and conveyer during general anesthesia., Methods: Sixty patients, ASA class I-II, aged 15-59 years, were selected for this study. They were scheduled for upper-limb orthopedic surgeries in supine position. No patient was premedicated. Intraoperative monitoring included electrocardiography, pulse oximetry, end-tidal carbon dioxide and automatic non-invasive blood pressure. The agents for induction of anesthesia included atropine 0.01 mg/kg, atracurium 5 mg, fentanyl 2-3 micrograms/kg, 2% lidocaine 1.5-2 mg/kg, propofol 2 mg/kg, and succinylcholine 1-1.5 mg/kg, all of which were given intravenously in sequence. After that laryngeal mask airway (LMA) was inserted. The position of LMA was confirmed by even undulation of chest wall and breathing sound. Anesthesia was then maintained with nitrous oxide in 40% oxygen and continuous propofol infusion. The pumping rate was set to start at 6 mg/kg/h. Muscle relaxation was achieved by intravenous tracrium given intermittently. All patients were mechanically ventilated with a ventilator incorporated to the anesthesia machine. The ventilator was set to give a tidal volume of 8 ml/kg at a rate of 12-14/min. At the end of the operation, the propofol infusion and nitrous oxide were simultaneously discontinued. The effect of muscle relaxant was antagonized by atropine 1.0 mg and neostigmine 2.5 mg intravenously. The LMA was removed while the patient was awake and able to open mouth at request. They were followed 24 h postoperatively for inquiring intraoperative awareness and other complaints., Results: No patient was noted to experience awareness during the intraoperative period. Regarding LMA insertion, success in the first attempt was seen in 55 patients (90.2%). Success in the second attempt was seen in 5 patients (8.2%). Failure was encountered in one patient (1.6%). The average time of emergence was 92 +/- 3.4 min. The average rate of speed of propofol infusion was 6.29 +/- 0.97 mg/kg/h., Conclusions: The combination of propofol infusion and N2O with laryngeal mask as airway and recovery was a good alternative in administration of general anesthesia.

Allergic reactions are often unpredictable, sudden in onset and may be potentially lethal. Clinical manifestations are confined to skin (rash, urticaria, angioedema), respiratory tract (laryngeal edema, bronchospasm) and cardiovascular system (hypotension, bradycardia, dysrhythymia). Because cardiovascular collapse is the most common life-threatening clinical feature, immediate and proper treatment is necessary. We have experienced two cases of intraoperative anaphylatic shock between September 1988 and April 1989. The precipitating factors were of nonanesthetic origin (case 1 was probably due to cephalothin and case 2 was due to dextran 40). Both cases manifestated with hypotension, bradycardia, cutaneous rash and urticaria. Recovery was smooth and without sequela after volume expansion and sympathomimetic drug. We discuss these two cases with a brief review.