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OBJECTIVE: To explore the incidence of ischemic stroke after the onset of type 2 diabetes, and further analyze the risk factors, so as to provide a basis for further research. METHODS: The data were obtained from the database of the Beijing Urban Employee Basic Medical Insurance Database. The study used a prospective design to describe the incidence of ischemic stroke in patients with type 2 diabetes. In our study, these patients were followed up for seven years. Multivariate Logistic regression models were used to analyze the risk factors of ischemic stroke in patients with type 2 diabetes. RESULTS: A total of 185 813 newly diagnosed type 2 diabetes patients were enrolled, with an average age of (58.5±13.2) years, and 49.0% of them were males. A total of 10 393 patients with newly diagnosed ischemic stroke occurred in 7 years, with a cumulative incidence of 5.6% and an incidence density of 8.1/1 000 person-years. Ischemic stroke occurred in all age groups in patients with type 2 diabetes. The cumulative incidence was 1.5% (95%CI: 1.3%-1.6%) in group ≤44 years old, 3.6% (95%CI: 3.4%-3.7%) in group 45-54 years old, 5.4% (95%CI: 5.2%-5.5%) in group 55-64 years old, and 9.2% (95%CI: 9.0%-9.4%) in group ≥65 years old, and the cumulative incidence increased with age (P < 0.05). Cumulative incidence rate of the males (6.8%, 95%CI: 6.7%-7.0%) was higher than the females (4.4%, 95%CI: 4.3%-4.6%). Among the patients < 80 years old, the cumulative incidence rate of the males was higher than that of the females in all the age groups. In the patients ≥80 years of age, the cumulative incidence was higher in the females (9.2%) than in the males (7.9%). Further analysis revealed that complications, such as coronary heart disease (OR=3.18, 95%CI: 2.72-3.72), heart failure (OR=1.53, 95%CI: 1.32-1.79) and kidney failure (OR=1.45, 95%CI: 1.20-1.75) were associated with ischemic stroke in the patients with type 2 diabetes. CONCLUSION: The incidence level of ischemic stroke in patients with type 2 diabetes is high. It is necessary to strengthen the management of risk factors in elderly patients, screen the complications of type 2 diabetes as early as possible, and take active preventive and control measures.

Based on Yichang health big data platform, 850 608 patients from September 2018 to September 2019 were included in this study. According to the date of birth, the participants were divided into early childhood famine exposure group, fetal famine exposure group and non-famine exposure group. The incidence of adult herpes zoster (HZ) in Yichang city was analyzed, and the correlation between early life famine exposure and adult HZ was analyzed. In 2019, the crude incidence rate of adult HZ in Yichang was 6.83‰. The crude incidence rate of adult HZ in females (7.26‰) was higher than that in males (6.40‰). Compared with the non-famine exposure group, fetal famine exposure was associated with the incidence of adult HZ (基于宜昌健康大数据平台，纳入2018年9月至2019年9月期间的850 608例就诊患者为研究对象，根据出生日期将研究对象分为儿童早期饥荒暴露组、胎儿期饥荒暴露组和非饥荒暴露组，分析宜昌市成人带状疱疹（HZ）发病情况并分析生命早期饥荒暴露与成年HZ的相关性。2019年宜昌市城区成年HZ粗发病率6.83‰，女性（7.26‰）高于男性（6.40‰）。与非饥荒暴露组相比，胎儿期饥荒暴露与成年HZ发病相关（

OBJECTIVE: To explore the prevalence and related factors of osteoarthritis in patients with type 2 diabetes mellitus, and provided a scientific basis for the prevention of the comorbidity. METHODS: The data were obtained from the database of all designated medical institutions in Beijing from 2015 to 2017. Data of the adult patients with type 2 diabetes mellitus were collected for descriptive analysis, and a Logistic regression model was used to explore the related factors of osteoarthritis in the patients with type 2 diabetes mellitus. RESULTS: A total of 1 046 264 diagnosed type 2 diabetes mellitus adult patients were included in our study, with an average age of 63.07 years, and 50.78% were males. Among the patients with type 2 diabetes mellitus, there were 341 561 cases with osteoarthritis, and the prevalence of osteoarthritis was 32.65%. The prevalence of females (38.05%) was higher than that of males (27.41%), and the difference was statistically significant (P < 0.05). Osteoarthritis occurred in all age groups among the patients with type 2 diabetes mellitus, with the highest prevalence of osteoarthritis in the age group of 65-69 years (36.76%), and the lowest prevalence in the age group ≤44 years (14.3%). Before the age of 70, the prevalence increased with age. Further analysis of related factors for osteoarthritis in the patients with type 2 diabetes mellitus showed that female (OR=1.62, 95%CI: 1.61-1.63), age (OR=1.01, 95%CI: 1.01-1.01), had other comorbidities (OR=1.19, 95%CI: 1.18-1.21), used hypoglycemic drugs (OR=0.79, 95%CI: 0.78-0.80), having the cardiovascular disease (OR=1.13, 95%CI: 1.11-1.15), having cerebrovascular disease (OR=1.25, 95%CI: 1.23-1.28), and having nephropathy (OR=1.61, 95%CI: 1.51-1.71) were associated with the osteoarthritis in the type 2 diabetic mellitus patients. CONCLUSION: Our study revealed that the prevalence of osteoarthritis in patients with type 2 diabetes mellitus is high in Beijing area. Health education and disease monitoring should be strengthened in middle-aged and elderly patients. Screening for comorbidities should be carried out as soon as possible, with the focus on menopausal women.

OBJECTIVE: To validate five-year risk prediction models for stroke in a contemporary rural Northern Chinese population. METHODS: Totally 6 483 rural adults aged 40 to 79 years without cardiovascular diseases were enrolled at baseline between June and August 2010, and followed up through January 2017. Expected prediction risk using the China-PAR (prediction for atherosclerotic cardiovascular disease risk in China) stroke risk equations were compared with the new Framingham stroke risk profile (FSRP). The recalibrated models were applied by adjusting the five-year baseline survival rate and the mean score to our rural northern Chinese population, while keeping other coefficient parameters the same as the original models. Kaplan-Meier analysis was used to obtain the observed event (nonfatal or fatal stroke) rate for the five years, and the expected-observed ratios were calculated to evaluate overestimation or underestimation in the cohort. The models were assessed by discrimination C statistic, calibration χ(2), and calibration charts and plots for illustration as well. RESULTS: Over an average of (5.83 ± 1.14) years of the follow-up in this validation cohort with 6 483 rural Chinese participants, 438 subjects deve-loped a first stroke event. Recalibrated China-PAR stroke risk equations and FSRP well-performed for predicting five-year stroke risk in men, and had C statistics of 0.709 (95%CI, 0.675 - 0.743) and 0.721 (95%CI, 0.688 - 0.754), with calibration χ(2) values being 5.7 (P = 0.770) and 13.6 (P = 0.137), respectively. However, both China-PAR and FSRP overestimated stroke events by 11.6% and 30.0% in women, and had C statistics of 0.713 (95%CI, 0.684-0.743) and 0.710 (95%CI, 0.679-0.740), respectively. Calibration χ(2) values in women were 12.5 (P = 0.188) for China-PAR and 24.0 (P = 0.004) for FSRP. In addition, the calibration charts and plots illustrated good agreement between the observations and the predictions only in the China-PAR stroke risk equations, especially for men. CONCLUSION: In this validation cohort of rural northern Chinese adults, the China-PAR models had better performance of five-year stroke risk prediction than the FSRP, indicating that recalibrated China-PAR stroke risk equations might be appropriate tools for risk assessment and primary prevention of stroke in China.

To estimate the potential health benefit of screening strategies for cardiovascular diseases primary prevention in a rural northern Chinese population.A total of 6 221 adults aged 40-74 years old, from rural Beijing, China and free from cardiovascular diseases at baseline were included. The following screening strategies were compared: Strategy 1, the strategy based on numbers of risk factors recommended by the Chinese Guideline for Prevention of Cardiovascular Diseases in people aged 40-74; Strategy 2, screening people aged 40-74 based on the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) risk prediction model; Strategy 3, screening people aged 50-74 using the China-PAR risk prediction model. Participates who were classified into medium- or high-risk by the corresponding strategies would be introduced to lifestyle intervention, while high risk population would take medication in addition. Markov model was used to compare the potential health benefits within 10 years in each scenario, which applied the parameters from this rural northern Chinese cohort, published literatures, meta-analyses and systematic reviews, clinical trials and other cohort studies of Chinese population. Quality-adjusted life year (QALY) gained, cardiovascular diseases (CVD) events/deaths could be prevented and number needed to be screened (NNS) per QALY gained/per CVD event prevented/per CVD death prevented were calculated to compare the effectiveness. One-way sensitivity analysis concerning uncertainty of cardiovascular disease incidence rate and probabilistic sensitivity analysis about the uncertainty of hazard ratios were conducted.Compared with non-screening strategy, the potential health benefits of each strategy were: Strategy 1 would gain QALY of 498 (95%CI: 103-894) and prevent 298 (95%CI: 155-441) CVD events; Strategy 2 would gain QALY of 691 (95%CI: 233-1 149) and prevent CVD events of 374 (95%CI: 181-567); Strategy 3 would gain QALY of 654 (95%CI: 199-1 108) and prevent CVD events of 346 (95%CI: 154-538). Screening strategy based on ChinaPAR risk prediction model (strategy 2 or 3) would be generally better in terms of QALY gained, CVD events/deaths prevented and NNS than the strategy based on numbers of CVD risk factors (all P0.05 except NNS per QALY gained and NNS per CVD event prevented in 40-74 years). Similar benefits were obtained for the strategy 2 and 3. The results were consistent in the sensitivity analyses on the parameters of incidence rates and hazard ratios.Screening people to target increased risks of cardiovascular diseases in this rural northern Chinese population is necessary. Screening strategy based on China-PAR risk prediction model could gain more health benefits than that based on numbers of CVD risk factors.

To validate five-year risk prediction models for atherosclerotic cardiovascular disease (ASCVD) in a contemporary rural Northern Chinese population.Totally 6 489 rural adults aged 40 to 79 years without clinical ASCVD were enrolled at baseline between June and August 2010, and followed up through January 2017. Expected prediction risk using the China-PAR (prediction for ASCVD risk in China) model was compared with the pooled cohort equations (PCE) reported in the American College of Cardiology/American Heart Association guideline. Kaplan-Meier analysis was used to obtain the observed ASCVD event (including nonfatal myocardial infarction, coronary heart disease death, nonfatal or fatal stroke) rate at 5 years, and the expected-observed ratios were calculated to eva-luate overestimation or underestimation in the cohort. The participants in the cohort were divided into 4 categories (5.0%, 5.0%-7.4%, 7.5%-9.9%, and ≥10.0%) for comparisons based on ASCVD prediction risk. The models were assessed by discrimination C statistic, calibration χOver an average 5.82 years of follow-up in this validation cohort with 6 489 rural Chinese participants, 955 subjects developed a first ASCVD event. Recalibrated China-PAR model overestimated ASCVD events by 22.2% in men and 33.1% in women, while the overestimations were much higher for recalibrated PCE as 67.3% in men and 53.1% in women. Gender-specific China-PAR model had C statistics of 0.696 (95%CI, 0.669-0.723) for men and 0.709 (95%CI, 0.690-0.728) for women, which were similar to those of 0.702 (95%CI, 0.675-0.730) for men and 0.714 (95%CI, 0.695-0.733) for women in the PCE. Calibration χIn this validation cohort of rural Northern Chinese adults, the China-PAR model had better performance of five-year ASCVD risk prediction than the PCE, indicating that recalibrated China-PAR model might be an appropriate tool for risk assessment and primary prevention of ASCVD in China.

Pulmonary hypertension (PH) is an increasingly recognized complication of systemic lupus erythematosus (SLE). To develop a more comprehensive understanding of the clinical and pathological characteristics of pulmonary hypertension associated with systemic lupus erythematosus (PH/SLE) in the Chinese population, a systematic review of the literature up to 2012 was conducted. Six hundred and forty-two Chinese PH/SLE cases from 22 studies were identified as well documented and further analyzed. Transthoracic echocardiography (TTE), X-ray, electrocardiogram and right heart catheterization (RHC) were performed to diagnose PH in SLE patients. The mean age of subjects was 35.5 years, the male to female ratio was 1:14, and the mean duration of SLE when PH was diagnosed was 10.7 years. The prevalence of PH in SLE was 2.8–23.3 %. Symptoms were usually nonspecific, and the observed clinical characteristics include Raynaud’s phenomenon (41.4 %), serous effusion (27.7 %), positive RNP (51.5 %) and positive ACL (46.6 %). Gold standard RHC is strongly recommended, especially for those who had resting pulmonary arterial systolic pressure >30 mmHg on TTE with the aforementioned clinical characteristics. Corticosteroids, immunosuppressants and vasodilators were the most common medications employed in treatment. Early identification and standard PH treatment with intensive SLE treatment can improve the prognosis.

The effect of dietary amino acid taurine on the liver function of chronic hepatitis patients was investigated. The 24 chronic hepatitis patients with 2–5 times over normal activities of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) were selected and equally divided into taurine treatment and control groups. In taurine treatment group, each patient took 2 g taurine 3 times a day for three months, and then stopped treatment for 1 month. Patients taking placebo without taurine for 4 months served as a control group. ALT and AST activities and levels of cholesterol, triglyceride and thiobarbituric acid relative substances of serum plasma in the taurine group were all decreased at the end of three month treatment. The study suggested that dietary amino acid taurine may ameliorate liver injury for chronic hepatitis patients.

To evaluate the effect of autolyzed antigen-extracted allogenic bone ("AAA" bone) graft combined with autogenic red bone marrow on bone defects, 58 cases with benign bone tumor(66 long bones) were treated with curettage operation, and the post-curettage bone defects were filled with the complex of "AAA" bone combined with autogenic red bone marrow. Forty two cases(49 bones) were followed up by taking X-ray radiography every 2 months in a period of 1-3 years. The result showed that 49 bones all got bony healing within 9 months(6 months in average). It is suggested that "AAA" bone combined with autogenic red bone marrow may be an ideal material for bone defect repairing.

To study the effects of tea polyphenols (TP) on bulbi conjunctiva microcirculation (BCM) and antioxidation in aircrew and find out the proper antioxidant for the health protection of aircrew.Fourty healthy aircrew were divided into TP group (TP 600 mg/d.po) and control group (placebo) randomly. The effects of TP on microcirculation and antioxidation in aircrew were tested after 20 days.Red blood cell (RBC) superoxide dismutase (SOD) activity and GSH-PX (Whole blood glutathione peroxidase)/MDA (serum malondialdehyde) ratio in TP group were significantly higher than those in control (P0.01), and serum MDA level was significantly decreased after TP administration (P0.05). The numbers of capillaries and blood flow in micrangium were significantly increased, RBC aggregation, ischemia area and A (arteriole)/V (venule) ratio were remarkably decreased in TP group (P0.01). The total integral value of microcirculation in TP group was significantly reduced in comparison with that in the control group.TP can significantly increase the antioxidative ability of aircrew, decrease the BCM disturbance and improve the microcirculatory function.

Sixty chronic active hepatitis patients complicated with hyperbilirubinemia (total bilirubin171 mumol/L) were treated with combined treatment of Ganyan IV and Western medicine. The curative effect was compared with that treated with Western medicine alone as control (56 cases). Result showed that the effect of combined therapy group was much better than that of the control in eliminating the jaundice, descending the alanine transaminase (ALT) and improving the reversed A/G ratio (P0.05-0.001). In experimental studies, Ganyan IV was applied to the mice with acute liver damage formed by CCl4. It also showed significant effect on reducing total bilirubin and elevating the serum albumin statistically as compared with control (P0.05 = 0.01). In addition Ganyan IV could accellerating the bile excretion of normal as well as of liver damaged rats significantly. It was concluded that the Ganyan IV has the effects of treating jaundice, descending transaminase, elevating serum albumin and improving A/G ratio.

The effect of essential hypertension at baseline on the development of NIDDM within 6 years was investigated in 465 Chinese nondiabetics with or without hypertension. The age, sex adjusted 6 year incidence of NIDDM in hypertensive group (BP18.7 +/- 12. okPa (140/90 mmHg) or treated with antihypertensives) at baseline was significantly higher than that in normotensive group (44.6%, n = 325, P0.05) at baseline. Multivariate regression analysis showed the hypertensive group had higher risk of worsening to diabetes compared with normotensives (OR: 1.82, 95% Ci: 1.03-3.21, P0.05) after the adjustment for two other important risk factors for NIDDM, the fasting plasma glucose and BMI. Further more the increasement of SBP by 20 mmHg at baseline significantly increase the risk for NIDDM in the followup period in the blood-lowering-drug-free group (OR: 1.54, 95% Ci: 1.05-2.24, P0.05). Thus it confirmed that hypertension at baseline was an independent predictor for NIDDM. In addition, our observation showed that some antihypertensive drugs appears also to play an unfavorable role in the occurrence of NIDDM.

Based on the survey of the prevalence of NIDDM in 110 660 people aged 25-74 in 1986, the incidence of NIDDM was investigated in 1990 in 36 471 people (M/F 18,801:17,670) who had normal glucose tolerance and/or plasma glucose concentration less than 6.7 mmol/L 2-hour after breakfast (carbohydrate 80 g) four years ago in Daqing, Heilongjiang province, northeast China. 103 male and 88 female diabetics were diagnosed among the 36 471 subjects from June 1986 to June 1990. This result showed that the annual incidence of NIDDM in this area is 131/100,000 (137 in males, 125 in females), and is 130/100,000 standardized to the 1982's chinese population (95% confidence interval, 94-168/100,000). We may estimate that there would be 754 thousand new diabetics per year in 25-74 years old Chinese if the total population were 1.3 billion in China in the 21st century.

This study shows that the social correlates of suicide rates in the USA and Taiwan are quite different, and that Durkheim's theory of suicide does not appear to be valid in Taiwan. By contrast, homicide rates in both nations do share some common social correlates, including divorce rates and crime rates.

1,048 cases (1,360 eyes) of corneal disease during 1982 to 1987 with complete records were analyzed. It was found that the ratio of incidences between male and female was about 2:1, and the age was predominantly (66.5%) from 21 to 50 years. The leading blinding corneal disease was herpes simplex keratitis, and bacterial and mycotic infections were mostly associated with trauma. The pathogenesis of marginal keratitis was mainly an autoimmune process, and the high incidence (43.9%) of punctate superficial keratitis was surprising. Corneal disease due to vitamin A deficiency still occurred occasionally in children. The findings indicated that most corneal blindness was preventable through hygienic measures and promotion of general health.

A series of 50 patients with cancer of the maxillary sinus treated by either preoperative or postoperative radiation from February, 1958 to June, 1974 is presented. In the postoperative group the patients were either free from recurrence, of if there was recurrence, the tumor was less than 0.5 cm in diameter. In the preoperative group, 23 of 36 patients survived for more than five years (64%). In the postoperative group, 4 of 14 patients survived for more than five years (26%). There is an obvious superiority in the preoperative radiation group. The surgical complication rate in the preoperative group was 29% as compared to 14% in the postoperative group. Although the incidence of complications in the preoperative group is higher, we believe it is worth attempting in clinical practice because of the more favourable survival rates.

One thousand three hundred seventy-nine nasopharyngeal carcinoma (NPC) patients were treated from March 1958 to December 1978. Twenty-two percent had stage I or II and 78% Stage III or IV had lesions. Two hundred twenty-Kv radiographs were used before 1960; and telecobalt was used from 1961 to 1978. Factors influencing the 5-year survival rate favorably are youth of patient, being female, pathologic condition (poorly differentiated carcinoma, 45.1% versus adenocarcinoma, 13%), stage (Stage I, 86%, Stage II, 59.5%; Stage III, 45.8%; Stage IV, 29.2%), decade admitted for treatment in the past (31% in the 1950s, 48.6% in the 1970s), total dose delivered to the nasopharynx (40 to 49 Gy, 46%; 70 to 79 Gy, 54.1%; 90 Gy or more, 64%) and prophylactic radiation to the neck regions (with prophylactic irradiation, 53.8%, without prophylactic irradiation, 23%). This implies that prophylactic radiation of the neck is crucial even without positive clinical metastasis. For those who have a residual tumor in the primary site when 70 Gy has been delivered, the total dose may be boosted to more than 90 Gy with the cone-down technique or on basis of adding 20 Gy to the dose at which the primary lesion disappeared grossly. The common postirradiation complications are: radiation myelitis, trismus, and otitis media. Because disease recurred in some patients after the fifth year, NPC patients should be followed for at least 10 years.

12 patients with double primary cancers in the larynx and lung were treated from 1958 to 1984. The incidence is 1.2% (12/943) of laryngeal carcinomas, 1.3% (12/904) of multiple primary cancers, 1.4% (12/873) of double primary cancers and 39% (12/31) of double primary cancers related to laryngeal cancers. There were 9 male and 3 female. 11 of the first primary cancers occurred in the larynx and only one in the lung. All were proved to be squamous cell carcinoma. In the 11 patients whose second primaries occurred in the lung, 4 were proved to be squamous cell carcinoma, one adenocarcinoma, one oat cell carcinoma, one poorly differentiated carcinoma and one cancer unclassified. Of 10 patients in whom both the first and the second primary cancer were treated, 6 survived for more than 2 years, 4 for 3 years and one for 5 years after the second treatment. It seems that double primary cancers of the larynx and lung could yield favorable results.

It is generally known that a close relationship exists between Epstein-Barr Virus (EBV) and nasopharyngeal carcinoma (NPC). Recently, patients with early lesions of NPC have been detected in the general population by use of serologic mass survey. Using the double-blind method, we have studied the diagnostic value of the four EBV antibody titers, VCA-IgA, VCA-IgG, EA-IgA and EA-IgG, in four groups of subjects, each consisting of 50 persons: patients with nasopharyngeal carcinoma (NPC group), patients with cancers other than NPC in the head and neck regions (HNC group), patients with cancers outside of head and neck regions (OC group) and normal individuals (NS group). The results of these four antibodies were evaluated both singularly and together by multivariate sequential discrimination. Taking 1:10 as the criterion of being positive, in the NPC group, the positive rate of VCA-IgA is 88%, the VCA-IgG rate is 100%, the EA-IgA rate is 48% and the EA-IgG rate is 74%. In the non-NPC group, the positive rates of VCA-IgA are as high as 86%-92%, but those of the other antibodies are as low as 0-42%. The positive rates and the geometric mean titers of these four antibodies were all elevated as compared with those in the three non-NPC groups. These differences are statistically significant. VCA-IgG is unimportant in the diagnosis of NPC because of its low specificity. By treating the antibody titers of VCA-IgA, VCA-IgG, EA-IgA and EA-IgG with sequential discrimination, the correlation rate between the serology and pathology of NPC is 88% and the false positive rate is 7.3%.

13 patients with extra-medullary plasma cell tumor treated by radiotherapy in a Cancer Hospital from March 1958 to December 1983 are reported. The tumor occurred more frequently in the head and neck, particularly in the upper respiratory tract and oral cavity. Grossly, the majority of the tumor showed dark reddish polypoid masses with the surface bled easily. A misdiagnosis of polyp or hemangioma was usually made. The tumor is sensitive to radiotherapy. In the patients with recurrence or metastasis, retreatment is still effective, at least, palliative. The 5 year survival rate was 70%. A dose of 4,000-6,000 rad in 4-6 weeks is advised for the primary tumor.

This paper presents 1379 patients with nasopharyngeal carcinoma treated in our hospital from March 1958 to December 1978. The stage I and II lesions comprised 22% and stage III and IV lesions, 78%. 220 KV X-ray was used before 1960 and 60Co was predominant from 1961 through 1978. The overall 5 year survival rate was 41.4% (571/1379). Young adults and female patients gave better results. The 5 year survival rate was, according to pathological type, 45.1% for poorly differentiated squamous cell carcinoma and 13% for adenocarcinoma; according to clinical stage, 85.7% for stage I lesion, 59.5% for stage II, 45.8% and 29.2% for stages III and IV; according to period of treatment, 31.3% in the sixties and 48.6% in the seventies; according to tumor dose at the primary focus, 48.2% for 40-49 Gy, 55.6% for 60-69 Gy and 67.3% for 90 Gy or more; according to with or without prophylactic radiation in the neck region, 53.8% for the former and 23% for the latter. It implies that prophylactic radiation of the neck is necessary regardless of the presence of cervical lymph node metastasis or not. For those who had residual tumor at 70 Gy, the total dose may be boosted to more than 90 Gy with the cone down technic or the dose, at which the primary lesion disappears grossly, is added with 20 Gy. The common complications are radiation myelitis, trismus and otitis media. As in certain patients, the lesion would still recur 5 years after radiotherapy, the authors believe that the nasopharyngeal cancer patients should be followed for ten years at least.

The CSF fluoride level of individuals drinking water with normal fluoride content and of patients with endemic fluorosis were studied. For the purpose of studying the relationship between the dynamic equilibrium of the CSF fluoride and other body fluids, urine and blood fluoride were examined simultaneously. Fluoride was revealed in every CSF sample of the control group and its mean value was lower than that of the blood. The CSF fluoride concentration of patients with fluorosis was slightly higher than that of the control group, although there was no statistically significant difference. The results suggests that fluoride is a normal component of CSF. In severe cases of fluorosis or breakdown of the blood-brain in some diseases of the central nervous system, the CSF fluoride value might be increased.

A multiple-hole needle for biopsy was designed. Use of needle diagnoses were obtained for 420 cases. Some of these were not diagnosed previously with other biopsy methods. This report describes biopsy procedure with case presentation, showing the advantage of this technique. The overall rate of successful diagnosis by biopsy method is 90.2%, and the rate of success in the thoracic cavity is 81.6%. Only 3 pneumothoraxes developed in 125 cases of thorax puncture using the multiple-hole needle.