微生态制剂对慢性肝衰竭患者肠道菌群的影响

目的探讨微生态调节剂双歧杆菌三联活菌对慢性肝衰竭患者肠道菌群的影响。方法根据治疗方法不同将46例慢性肝衰竭患者随机分为治疗组和对照组各23例,两组均给予慢性肝衰竭常规治疗,治疗组在上述基础上给予双歧杆菌三联活菌胶囊,210mg／粒,每次2粒,2次／d,疗程2周。观察治疗前后两组患者的肠道菌群菌落计数变化及血清总胆红素（TBiL）、凝血酶原时间（PT）变化。结果两组患者在实验前肠道菌群、TBiL、PT比较差异均无统计学意义（P〉0．05）。治疗2周后,对照组患者治疗前后肠道菌群无明显变化（P〉0．05）,TBiL、PT有所下降但不显著,治疗组患者的肠球菌、双歧杆菌、乳杆菌以及酵母样真菌的菌落数均较治疗前明显增加,TBiL、PT较前明显好转（P〈0．05）。结论口服双歧杆菌三联活菌制剂可以促进慢性肝衰竭患者肠道正常菌群的恢复及改善肝功能。     

加味补中益气汤促进肠道益生菌生长的实验研究

目的通过观察加味补中益气汤在小鼠肠道正常菌群失调过程中的调节作用,为临床治疗消化道疾病及新型生物制品和营养疗法提供依据,并为进一步开发补中益气汤提供理论依据。方法首先造成小鼠腹泻,肠道菌群功能紊乱,然后通过灌服加味补中益气汤进行治疗,并与正常组进行结果比较,评价加味补中益气汤对肠道菌群的调整功能。结果在造模后模型组与正常组差异存在显著性（P〈0．05）,经加味补中益气汤和整肠生治疗后的小鼠与正常组肠道益生菌差异无显著性（P〉0．05）。结论加味补中益气汤具有调节小鼠肠道益生菌的作用,使小鼠肠道益生菌数量有所增加。     

鱼油对断奶大鼠脏器指数及肠道菌群影响的研究

目的探讨鱼油对断奶大鼠脏器指数及肠道菌群的影响。方法选取（21±3）d日龄断奶SD大鼠96只,雌雄各半,随机分为2组,实验组饲喂添加0．5％鱼油的饲料,对照组饲喂正常饲料。分别于第7、14、21、28天处死各组大鼠12只,分别测定大鼠肝脏指数、胸腺指数及脾脏指数;应用梯度稀释法和培养法测定大鼠4种肠道正常菌群,即肠杆菌、双歧杆菌、乳酸杆菌、葡萄球菌。结果实验组第7天脾脏指数与对照组相比差异有显著性（P〈0．05）,第28天肝脏指数和胸腺指数与对照组相比差异有显著性（P〈0．05）;实验组第7、14和21天肠道内肠杆菌数量与对照组相比差异有显著性（P〈0．05）,第7天大鼠肠道内葡萄球菌数量与对照组相比差异有显著性（P〈0．05）,第14天大鼠肠道内葡萄球菌数量与对照组相比差异有非常显著性（P〈0．01）,实验组大鼠肠道内乳酸杆菌和双歧杆菌数量与对照组相比虽有所增高,但差异无显著性（P〉0．05）。结论鱼油可以明显提高断奶大鼠的脏器指数,并且可通过增加断奶大鼠肠道内双歧杆菌和乳酸杆菌数量,降低肠道内肠杆菌和葡萄球菌数量,进而调节断奶大鼠的肠内菌群,改善肠道内环境。     

双叉奶中合生元对改善肠道菌群功效的研究

目的 对双叉奶中合生元改善肠菌群的功效进行研究分析。方法 依卫生部《新增保健功能评价指标及程序的初步方案》,做动物及人体改善肠道菌群试验。结果 1．双叉奶中合生元对小鼠4种肠道菌群数量的影响：与对照组比较,各剂量组小鼠肠道内肠球菌、肠杆菌数量均无显著性差异（P＞0．05）;低剂量、高剂量组乳酸杆菌数量明显增加,有显著性差异（P＜0．05）,中剂量组乳酸杆菌数量增加显著,有非常显著性差异（P＞0．01）;低剂量、中剂量组双歧杆菌数量明显增加,有显著性差异（P＞0．05）。2．双叉奶中合生元对人体5种肠道菌群数量的影响：与饮用前相比,受试人群肠道内肠杆菌、肠球菌数量均无显著性差异（P＞0．05）;双歧杆菌、乳酸杆菌数量增加显著,有非常显著性差异（P＞0．01）。肠梭菌数量降低显著,有非常显著性差异（P＞0．01）。3．受试人群自觉症状观察：所有人无不良反应,可改善便秘、增加食欲、排气。结论 双叉能奶中合生元对小鼠、人体肠道菌群具改善作用。     

葛根素对冷激诱导的高血压小鼠的影响

目的：检测葛根素灌胃对冷激诱导的高血压小鼠的血压血脂及肾脏结构的影响。方法：小鼠分为正常对照组、冷激对照组、冷激葛根素饲喂组（2,5,10ms／kg bw3组）（n=12）。以寒冷刺激（4±2℃）建立小鼠高血压模型,每天定时灌胃葛根素治疗,对照组给予聚乙烯吡咯烷酮溶液。连续饲喂18d．检测各组小鼠血压、血脂含量,石蜡切片观察肾脏结构。结果：冷激对照组小鼠血压显著高于正常对照组（P〈0．01）,葛根素饲喂组血压显著低于冷激对照组（P〈0．05）。冷激对照组TG含量显著高于正常对照组（P〈0．01）,而冷激饲喂组TG含量明显降低（P〈0．05）;冷激饲喂组TC含量与冷激对照组相比有所降低但无统计学意义;2mg／kg BW葛根素组LDL-C显著低于冷激对照组（P〈0．01）,各组间HDL-C含量比较无统计学意义,但葛根素饲喂组HDL-C／LDL-C值显著高于冷激对照组。冷激对照组肾小管上皮细胞水肿,内腔极度缩小,肾小球明显胀大,肾小囊腔显著变窄,葛根素饲喂组肾小管水肿基本消失,内腔明显增大,肾小球、肾小囊结构趋于正常。结论：葛根素灌服具有降血压、降血脂、改善病变肾脏结构的作用。     

粒细胞集落刺激因子对小鼠内毒素性急性肝损伤的保护作用

目的观察粒细胞集落刺激因子对小鼠内毒素性急性肝损伤的作用,并对其机制进行初步探讨。方法昆明（KM）小鼠随机分为模型组、预防组和正常组,模型组小鼠腹腔注射内毒素（LPS）10mg／kg或30mg／kg,预防组于造模前1小时皮下注射重组人粒细胞集落刺激因子（rhG-CSF）500btg／kg,正常组注射等剂量的生理盐水,观察各组小鼠的存活率及造模后6h、24h小鼠肝脏组织病理变化,全自动生化分析仪检测血清丙氨酸氨基转移酶（ALT）和天门冬氨酸氨基转移酶（AsT）的水平,酶联免疫吸附试验（ELISA）检测血清肿瘤坏死因子（TNF—a）和白介素10（IL-10）的水平。结果预防组小鼠存活率与模型组相比无明显差异（80％VS66．7％,P〉0．05）;预防组肝组织损伤及肝功能酶学指标ALT和AST均好于模型组（P〈0．05）;预防组小鼠血清IL-10的表达水平在6小时点明显高于模型组（P〈0．05）,24小时点与模型组相比无明显差异（P〉0．05）,血清TNF-a表达水平与模型组相比差异无统计学意义（P〉0．05）。结论粒细胞集落刺激因子对小鼠内毒素性急性肝损伤具有保护作用,对小鼠的存活率无明显影响。     

复方树舌液对肠道微生态失调小鼠的调节作用

目的应用复方树舌液作为微生态调节剂对肠道微生态失调小鼠进行调节。方法用盐酸林可霉素造成菌群失调模型,用复方树舌液进行治疗,在治疗期间分别检测各组小鼠的肠道优势菌群、乙酸、内毒素含量及肝脏肠杆菌易位。结果小鼠肠道菌群失调得到恢复、小鼠肠道内乙酸含量增加、内毒素含量下降、易位至肝脏的肠杆菌数量减少,与自然恢复组相比,差异有统计学意义（P〈0.05）,树舌组优于丽珠肠乐组。结论复方树舌液作为益生元对小鼠肠道菌群失调具有调节作用。     

不同脂肪源对管角螺生长和体成分的影响

在基础配合饲料中添加（4％）不同脂肪源[鱼油、猪油、豆油、花生油、混合油I（鱼油：豆油=1：1）、混合油Ⅱ（鱼油：猪油：豆油：花生油=1：1：1：1）]配制成6组实验饲料,对体重（2．23±0．05）g的管角螺幼螺进行60d的饲养试验。结果表明,鱼油组摄食率（34．10g／d·ind·10^3）、增重率（64．33％）和特定生长率（0．79％）最高,与混合油I组没有显著差异（P〉0．05）,并显著高于其他各组（P〈0．05）,最低的为猪油组;肝体比没有显著差异（P〉0．05）,猪油组最高（1．33）,混合油I组最低（1．22）;饲料转化率和存活率没有显著差异（P〉0．05）;鱼油组粗蛋白含量（肌肉：18．35％;肝脏：17．55％）显著高于猪油组、豆油组、花生油组和混合油Ⅱ组,猪油组（2．96％）和鱼油组（2．86％）肝脏粗脂肪含量显著高于其他各组（P〈0．05）,水分和灰分没有显著差异（P〉0．05）;鱼油组EPA（肌肉：4．44％;肝脏：5．89％）和DHA（肌肉：4．53％;肝脏：5．65％）含量,n-3／n-6（肌肉：1．57;肝脏：1．69）均最高．与混合油I组没有显著差异（P〉0．05）。从人体健康和生产角度来说,以混合油I作为管角螺脂肪源不但可以得到较好的生长效果,还可以节约饲料成本。     

不同剂量甲泼尼龙对大鼠急性百草枯中毒肾脏的影响

目的：观察不同剂量甲泼尼龙治疗大鼠百草枯中毒肾脏损伤的疗效。方法：将120只Wistar大鼠随机分为五组,空白组,染毒组和干预组（根据甲泼尼龙剂量不同分为三组）,除空白组外,均予百草枯（22mg／kg）稀释后腹腔注射,2h后依照组别、体重注射甲泼尼龙,在第1、3、7天共3个时间点,按抽签法处死实验对象6只获取标本,观察肾功能和病理变化。结果：各组血尿素氮（P=0．001〈0．05）和肌酐（P=0．01〈0．05）差异有统计学意义,干预组中5mg／kg甲泼尼龙组同染毒组比较差异有统计学意义。不同时间点血尿素氮（P=0．007〈0．05）和肌酐（P=0．016〈0．05）差异有统计学意义,其中第七天明显低于第一、三天。病理评分各组（P=O．21〉0．05）差异无统计学意义。讨论：早期应用糖皮质激素治疗PQ中毒大鼠,可以显著减轻PQ中毒所致的肾损伤程度,改善肾功能,尤其小剂量改善显著,传统的大剂量糖皮质激素冲击治疗不值的推崇。     

苯并[a]芘对小鼠肝脏和肾脏中丙二醛和过氧化氢酶的影响

目的探讨苯并[a]芘（B（a）P）对小鼠肝脏和肾脏脂质过氧化及抗氧化能力的影响。方法采用B（a）P口腔灌胃连续染毒3 d后,取肝、肾组织作匀浆,采用TBA比色法测定鼠肝脏和肾脏内的丙二醛（MDA）的含量,钼酸铵比色法测定鼠肝脏和肾脏内的过氧化氢酶（CAT）的含量。结果肝中各剂量染毒组的MDA含量增加,其中5 mg/kg、10 mg/kg剂量组与油剂对照组比较差异有显著性（P〈0.05）。肾脏中各剂量染毒组的MDA含量均有所增加,其中10 mg/kg剂量组与对照组比较差异有显著性（P〈0.05）。肝脏中各剂量染毒组的CAT的含量低剂量增加高剂量减少,肾脏中各剂量染毒组的CAT的含量增加。结论B（a）P可引起MDA含量增加诱导小鼠肝肾的脂质过氧化损伤。     

Influence of depleted uranium on hepatic cholesterol metabolism in apolipoprotein E-deficient mice

Depleted uranium (DU) is uranium with a lower content of the fissile isotope U-235 than natural uranium. It is a radioelement and a waste product from the enrichment process of natural uranium. Because of its very high density, it is used in the civil industry and for military purposes. DU exposure can affect many vital systems in the human body, because in addition to being weakly radioactive, uranium is a toxic metal. It should be emphasized that, to be exposed to radiation from DU, you have to eat, drink, or breathe it, or get it on your skin. This particular study is focusing on the health effects of DU for the cholesterol metabolism. Previous studies on the same issue have shown that the cholesterol metabolism was modulated at molecular level in the liver of laboratory rodents contaminated for nine months with DU. However, this modulation was not correlated with some effects at organs or body levels. It was therefore decided to use a "pathological model" such as hypercholesterolemic apolipoprotein E-deficient laboratory mice in order to try to clarify the situation. The purpose of the present study is to assess the effects of a chronic ingestion (during 3 months) of a low level DU-supplemented water (20 mg L(-1)) on the above mentioned mice in order to determine a possible contamination effect. Afterwards the cholesterol metabolism was studied in the liver especially focused on the gene expressions of cholesterol-catabolising enzymes (CYP7A1, CYP27A1 and CYP7B1), as well as those of associated nuclear receptors (LXRα, FXR, PPARα, and SREBP 2). In addition, mRNA levels of other enzymes of interest were measured (ACAT 2, as well as HMGCoA Reductase and HMGCoA Synthase). The gene expression study was completed with SRB1 and LDLr, apolipoproteins A1 and B and membrane transporters ABC A1, ABC G5. The major effect induced by a low level of DU contamination in apo-E deficient mice was a decrease in hepatic gene expression of the enzyme CYP7B1 (-23%) and nuclear receptors LXRα (-24%), RXR (-32%), HNF4α (-21%) when compared to unexposed ones. These modifications on cholesterol metabolism did not lead to increased disturbances that are specific for apolipoprotein E-deficient mice, suggesting that chronic DU exposure did not worsen the pathology in this experimental model. In conclusion, the results of this study indicate that even for a sensitive pathologic model the exposure to a low dose of DU has no relevant impact. The results confirm the results of our first study carried out on healthy laboratory rodents where a sub-chronic contamination with low dose DU did not affect in vivo the metabolism of cholesterol.     

Transcriptomic effects of depleted uranium on acetylcholine and cholesterol metabolisms in Alzheimer's disease model

Some heavy metals, or aluminium, could participate in the development of Alzheimer disease (AD). Depleted uranium (DU), another heavy metal, modulates the cholinergic system and the cholesterol metabolism in the brain of rats, but without neurological disorders. The aim of this study was to determine what happens in organisms exposed to DU that will/are developing the AD. This study was thus performed on a transgenic mouse model for human amyloid precursor protein (APP), the Tg2576 strain. The possible effects of DU through drinking water (20 mg/L) over an 8-month period were analyzed on acetylcholine and cholesterol metabolisms at gene level in the cerebral cortex. The mRNA levels of choline acetyl transferase (ChAT) vesicular acetylcholine transporter (VAChT) and ATP-binding cassette transporter A1 (ABC A1) decreased in control Tg2576 mice in comparison with wild-type mice (respectively -89%, -86% and -44%, p < 0.05). Chronic exposure of Tg2576 mice to DU increased mRNA levels of ChAT (+189%, p < 0.05), VAChT (+120%, p < 0.05) and ABC A1 (+52%, p < 0.05) compared to control Tg2576 mice. Overall, these modifications of acetylcholine and cholesterol metabolisms did not lead to increased disturbances that are specific of AD, suggesting that chronic DU exposure did not worsen the pathology in this experimental model.     

Long term depleted uranium exposure in Gulf War I veterans does not cause elevated numbers of micronuclei in peripheral blood lymphocytes

Depleted uranium (DU) is a high density heavy metal that has been used in military munitions since the 1991 Gulf War. DU is weakly radioactive and chemically toxic. Long term exposure can cause adverse health effects. This study assessed genotoxic effects in DU exposed Gulf War I veterans as a function of uranium (U) body burden. Levels of urine U were used to categorize the cohort into low and high exposure groups. Exposure to DU occurred during friendly fire incidents in 1991 involving DU munitions resulting in inhalation and ingestion exposure to small particles of DU and soft tissue DU fragments from traumatic injuries. All of these Veterans are enrolled in a long term health surveillance program at the Baltimore Veterans Administration Medical Center. Blood was drawn from 35 exposed male veterans aged 36-59 years, then cultured and evaluated for micronuclei (MN) using the cytokinesis block method. The participants were divided into two exposure groups, low and high, based on their mean urine uranium (uU) concentrations. Poisson regression analyses with mean urine U concentrations, current smoking, X-rays in the past year and donor age as dependent variables revealed no significant relationships with MN frequencies. Our results indicate that on-going systemic exposure to DU occurring in Gulf War I Veterans with DU embedded fragments does not induce significant increases in MN in peripheral blood lymphocytes compared to MN frequencies in Veterans with normal U body burdens.     

Leukemic transformation of hematopoietic cells in mice internally exposed to depleted uranium

Depleted uranium (DU) is a dense heavy metal used in military applications. During military conflicts, US military personnel have been wounded by DU shrapnel. The health effects of embedded DU are unknown. Published data from our laboratory demonstrated that DU exposure in vitro can transform immortalized human osteoblast cells (HOS) to the tumorigenic phenotype. Results from our laboratory have also shown that DU is genotoxic and mutagenic in cultured human cells. Internalized DU could be a carcinogenic risk and concurrent alpha particle and heavy metal toxic effects complicate this potential risk. Anecdotal reports have suggested that DU can cause leukemia. To better assess this risk, we have developed an in vivo leukemogenesis model. This model involves using murine hematopoietic cells (FDC-P1) that are dependent on stimulation by granulocyte-macrophage colony stimulating factor (GM-CSF) or interleukin 3 (IL-3) and injected into mice to produce myeloid leukemia. Although immortalized, these cells are not tumorigenic on subcutaneous inoculation in mice. Intravenous injection of FDC-P1 cells into DU-implanted DBA/2 mice was followed by the development of leukemias in 76% of all mice implanted with DU pellets. In contrast, only 12% of control mice developed leukemia. Karyotypic analysis confirmed that the leukemias originated from FDC-P1 cells. The growth properties of leukemic cells from bone marrow, spleen, and lymph node were assessed and indicate that the FDC-P1 cells had become transformed in vivo. The kidney, spleen, bone marrow, muscle, and urine showed significant elevations in tissue uranium levels prior to induction of leukemia. These results demonstrated that a DU altered in vivo environment may be involved in the pathogenesis of DU induced leukemia in an animal model.     

Human Health Risk Assessment at a Depleted Uranium Site

Human health risk assessments for depleted uranium are common for Department of Defense (DOD) sites since the metal has various military uses. At a training and experimental site, DU was evaluated in soil in order to make decisions regarding cleanup and future use of the site. At this site, concentrations were found to be protective of human health; DU is less toxic than uranium. Other data important to this decision were the type of receptors likely to be exposed, the amount of time spent by the receptor on-site, the acceptable yearly radiation dose, and other non-radiation associated effects to the kidney. Total uranium concentrations in soil were calculated for the 90th percentile and the 50th percentile. The highest soil concentration used as an exposure point was 3500 ug/g (90th percentile). Short exposure timeframes contributed to the risk results.     

Neurotoxicity of depleted uranium

Depleted uranium (DU) is a byproduct of the enrichment process of uranium for its more radioactive isotopes to be used in nuclear energy. Because DU is pyrophoric and a dense metal with unique features when combined in alloys, it is used by the military in armor and ammunitions. There has been significant public concern regarding the use of DU by such armed forces, and it has been hypothesized to play a role in Gulf War syndrome. In light of experimental evidence from cell cultures, rats, and humans, there is justification for such concern. However, there are limited data on the neurotoxicity of DU. This review reports on uranium uses and its published health effects, with a major focus on in vitro and in vivo studies that escalate concerns that exposure to DU might be associated with neurotoxic health sequelae.     

In vivo effects of chronic contamination with depleted uranium on vitamin D3 metabolism in rat

The extensive use of depleted uranium (DU) in today's society results in the increase of the number of human population exposed to this radionuclide. The aim of this work was to investigate in vivo the effects of a chronic exposure to DU on vitamin D(3) metabolism, a hormone essential in mineral and bone homeostasis. The experiments were carried out in rats after a chronic contamination for 9 months by DU through drinking water at 40 mg/L (1 mg/rat/day). This dose corresponds to the double of highest concentration found naturally in Finland. In DU-exposed rats, the active vitamin D (1,25(OH)(2)D(3)) plasma level was significantly decreased. In kidney, a decreased gene expression was observed for cyp24a1, as well as for vdr and rxralpha, the principal regulators of CYP24A1. Similarly, mRNA levels of vitamin D target genes ecac1, cabp-d28k and ncx-1, involved in renal calcium transport were decreased in kidney. In the brain lower levels of messengers were observed for cyp27a1 as well as for lxrbeta, involved in its regulation. In conclusion, this study showed for the first time that DU affects both the vitamin D active form (1,25(OH)(2)D(3)) level and the vitamin D receptor expression, and consequently could modulate the expression of cyp24a1 and vitamin D target genes involved in calcium homeostasis.     

Depleted uranium-catalyzed oxidative DNA damage: absence of significant alpha particle decay

Depleted uranium (DU) is a dense heavy metal used primarily in military applications. Published data from our laboratory have demonstrated that DU exposure in vitro to immortalized human osteoblast cells (HOS) is both neoplastically transforming and genotoxic. DU possesses both a radiological (alpha particle) and a chemical (metal) component. Since DU has a low-specific activity in comparison to natural uranium, it is not considered to be a significant radiological hazard. In the current study we demonstrate that DU can generate oxidative DNA damage and can also catalyze reactions that induce hydroxyl radicals in the absence of significant alpha particle decay. Experiments were conducted under conditions in which chemical generation of hydroxyl radicals was calculated to exceed the radiolytic generation by one million-fold. The data showed that markers of oxidative DNA base damage, thymine glycol and 8-deoxyguanosine could be induced from DU-catalyzed reactions of hydrogen peroxide and ascorbate similarly to those occurring in the presence of iron catalysts. DU was 6-fold more efficient than iron at catalyzing the oxidation of ascorbate at pH 7. These data not only demonstrate that DU at pH 7 can induced oxidative DNA damage in the absence of significant alpha particle decay, but also suggest that DU can induce carcinogenic lesions, e.g. oxidative DNA lesions, through interaction with a cellular oxygen species.     

Uranium quantification in semen by inductively coupled plasma mass spectrometry

In this study we report uranium analysis for human semen samples. Uranium quantification was performed by inductively coupled plasma mass spectrometry. No additives, such as chymotrypsin or bovine serum albumin, were used for semen liquefaction, as they showed significant uranium content. For method validation we spiked 2 g aliquots of pooled control semen at three different levels of uranium: low at 5 pg/g, medium at 50 pg/g, and high at 1000 pg/g. The detection limit was determined to be 0.8 pg/g uranium in human semen. The data reproduced within 1.4–7% RSD and spike recoveries were 97–100%. The uranium level of the unspiked, pooled control semen was 2.9 pg/g of semen (n = 10). In addition six semen samples from a cohort of Veterans exposed to depleted uranium (DU) in the 1991 Gulf War were analyzed with no knowledge of their exposure history. Uranium levels in the Veterans’ semen samples ranged from undetectable (<0.8 pg/g) to 3350 pg/g. This wide concentration range for uranium in semen is consistent with known differences in current DU body burdens in these individuals, some of whom have retained embedded DU fragments.     

Depleted uranium exposure and health effects in Gulf War veterans

Health effects stemming from depleted uranium (DU) exposure in a cohort of Gulf War veterans who were in or on US Army vehicles hit by friendly fire involving DU munitions are being carefully monitored through the Baltimore Veterans Affairs (VA) DU Follow-Up Program initiated in 1993. DU exposure in this cohort has been directly measured using inductively coupled plasma-mass spectrometer (ICP-MS) isotopic analysis for DU in urine specimens. Soldiers with embedded DU fragments continue to excrete elevated concentrations of U in their urine, documenting ongoing systemic exposure to U released from their fragments. Biennial surveillance visits provide a detailed health assessment that includes basic clinical measures and surveillance for early changes in kidney function, an expected target organ for U. Tests also include measurements of genotoxicity and neuroendocrine, neurocognitive and reproductive function. With the exception of the elevated urine U excretion, no clinically significant expected U-related health effects have been identified to date. Subtle changes in renal function and genotoxicity markers in veterans with urine U concentrations greater than 0.1 microg(-1) creatinine, however, indicate the need for continued surveillance of these DU-exposed veterans.