Objective: From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods: Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results: A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions: Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.目的： 基于癌症筛查实际供方角度，从工作人员主观感受及意愿层面评价癌症筛查项目的可持续性。 方法： 2014－2015年，基于城市癌症早诊早治项目，在16个省份项目点选取2013－2015年所有承担项目的医院、CDC和社区卫生服务中心，采用纸质问卷和网络调查开展访谈，对象包括宏观管理人员、具体项目管理人员和一线工作人员等。 结果： 最终完成访谈4 626份，访谈对象总体认为参加项目的最大收获在于社会价值感的提升（63.6%）、当地影响力（35.9%）及专业技能提升（30.6%）等；最大困难在于社会物质激励不够所致工作积极性低（30.9%）、信息采集口径不一致（28.3%）、部门间协调（24.4%）和机构间沟通衔接困难（23.5%）等。当单项筛查服务劳务补偿约50元时，工作人员会考虑加班工作。63.7%的受访者有长期筛查服务意愿，主要原因：可通过项目提升个人/团队在当地影响口碑（48.7%）、通过项目提升个人/团队专业技能（43.1%）等；无服务意愿者主要担心工作量超负荷（59.8%）、对日常工作的干扰（49.8%）等。 结论： 收获与困难相关结果提示，若要长期可持续性开展癌症筛查工作，建议加强项目内荣誉激励、对外宣传及专业能力建设，根据具体情况提高劳务补偿。服务意愿结果则提示，应从政府和领导层面加强信息化建设及机构/部门间协调，机构内应合理协调筛查项目与日常工作。.
Objective: A new ion exchange column technology was used to establish an efficient and sensitive method for the detection of inorganic arsenic. Methods: Based on the new As Specia Fast Column, the pretreatment methods, liquid phase separation and mass spectrometry determination conditions of inorganic arsenic in rice were optimized. Finally, arsenic compounds were separated by As Specia Fast Column and detected by liquid chromatography inductively coupled plasma mass spectrometry. The external standard method was used for quantitative analysis. The detection limit, precision and accuracy of the method were determined by measuring the content of arsenic compounds in rice samples and rice standard samples. At the same time, three Guangdong rice samples were selected as the experimental samples of this study, and 1 g of each sample was weighed and measured in parallel three times. The method was compared with the method of liquid chromatography-atomic fluorescence spectrometry (LC-AFS) and liquid chromatography-inductively coupled plasma mass spectrometry (LC-ICP-MS) in the national standard. Results: The inorganic arsenic in rice was extracted with 0.5% nitric acid solution at 65 ℃ for 15 h, and the pH was adjusted to alkaline. The mobile phase A (8 mmol/L HNO(3), 50 mmol/L NH(3)·H(2)O) and mobile phase B (40 mmol/L HNO(3), 80 mmol/L NH(3)·H(2)O) were used as the mobile phase gradient elution (93%) . Five arsenic compounds can reach baseline separation under the conditions of RF power of 1 500 W and atomization gas flow of 0.97 L/min. The detection limits ranged from 0.114 to 0.331 μg/L, and the inorganic arsenic content in rice samples ranged from 0.063 to 0.232 mg/kg. The results of determination of arsenic compounds in rice flour reference materials were all within the uncertainty range indicated by the standard. The recoveries were 86.7%~106.7%, and the precision was 1.9%-12.5%. Compared with national standards, the results of determination of arsenate in rice were relatively close (using this method, LC-AFS, LC-ICP-MS to detect the content of arsenate in rice samples 1 was 0.231, 0.226, 0.236 mg/kg, respectively). However, due to insufficient sensitivity, the national standard method is difficult to detect low levels of arsenic compounds (Arsenobetaine was not detected in rice sample 1). The method can detect the content of arsenobetaine in rice sample 1 was 0.023 mg/kg. Conclusion: The established method can meet the requirements of inorganic arsenic determination in rice, and it is more rapid and accurate than the current national standard. It can better monitor and evaluate the content of i-As in rice, and provide accurate data for comprehensively grasping and evaluating the safety of rice consumption of residents.目的： 采用新型离子交换柱技术建立高效、灵敏的无机砷的检测方法,并检测大米基质中的砷含量。 方法： 基于新型离子交换柱，对大米中无机砷分析的前处理方法、液相分离及质谱测定条件进行优化，最终砷形态化合物以新型离子交换柱分离，液相色谱-电感耦合等离子体质谱联用法进行检测。采用外标法定量，通过检测大米样品和大米标准样品中砷形态化合物含量，对方法的检出限、精密度和准确度进行评价。同时选取3种广东市售大米作为本研究的实验样品，每份称取试样1 g，平行测量3次，将本方法与国家标准中的液相色谱-原子荧光光谱法（LC-AFS）、液相色谱-电感耦合等离子体质谱法（LC-ICP-MS）进行比较。 结果： 经检测，在以0.5%硝酸溶液在65 ℃超声水浴条件下，对大米中无机砷萃取1.5 h，调节pH至碱性时，大米的平均提取效率最高（>93%）。以流动相A（8 mmol/L HNO(3)，50 mmol/L NH(3)·H(2)O）和流动相B（40 mmol/L HNO(3)，80 mmol/L NH(3)·H(2)O）为流动相梯度洗脱，在射频功率1 500 W，雾化气流量0.97 L/min的测定条件下，5种砷形态化合物能达到基线分离，检出限范围在0.114~0.331 μg/L，大米样品中无机砷含量为0.063~0.232 mg/kg，测定大米粉标准物质中砷形态化合物结果均在其标示的不确定范围内，加标回收率为86.7%~106.7%，测定精密度分别为1.9%~12.5%。与国家标准相比，大米中砷酸盐中的测定结果较为接近，采用本研究、LC-AFS、LC-ICP-MS检测大米样品1砷酸盐的含量分别为0.231、0.226、0.236 mg/kg，而国标方法由于灵敏度不足，难以检出低含量砷形态化合物（大米样品1中均未检出砷甜菜碱)。方法可检出大米样品1中的砷甜菜碱含量为0.023 mg/kg。 结论： 本研究建立的方法能满足大米中无机砷的测量需求，相比现行国标，能较大程度地缩短了检测时间和提高效率，同时也降低了方法检出限，提高了方法灵敏度。.
To compare the effect of radiotherapy (RT) combined with Antike capsule (AC) and RT alone in treating nasopharyngeal cancer (NPC) patients.Eighty-nine patients with pathologically confirmed NPC (stage II-IV) were randomly divided into two groups: group A (46 cases) were treated with RT, receiving 65-70 Gy/6.5-7 weeks to nasopharynx region and the same dosage to neck region, and AC was given in combination. Group B (43 cases) received the same RT alone. The total dosis of RT for complete remission (CR) of primary nasopharyngeal tumor and neck lymph nodes, the CR rate and the changes of peripheral NK cell, T lymphocyte subsets in the two groups were compared.The total dosis of RT for CR in group A and B were 41.6 +/- 8.9 Gy vs 50.7 +/- 9.2 Gy for primary nasopharyngeal tumor, P < 0.05 and 47.4 +/- 10.3 Gy vs 56.2 +/- 9.7 Gy for neck lymph nodes, P < 0.05. The CR rate of primary nasopharyngeal tumor in group A and B were 93.5% and 88.4% respectively, P < 0.05. The activity of NK cell as well as T3, T4 in peripheral blood increased significantly in the group A after treatment, P < 0.05, while in group B, T3, T4 lowered significantly, P < 0.05.RT combined with AC could be helpful in elevating and promoting the remission rate of primary tumor and neck lymph nodes, and AC has some effects in improving the immune function and general condition in NPC patients during RT.
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