Objective To explore the causes of congenital hypothyroidism by single photon emission computed tomography(SPECT) thyroid imaging.Methods Nineteen cases with congenital hypothyroidism were collected,and SPECT thyroid imaging was performed 15 minutes late after injected 99m TcO_ 4- 18.5-37.0 MBq.Results Five cases were found with normal glands,1 case with enlarged thyroid, 2 cases with enlarged thyroid and increased radiation,4 cases with ectopic thyroid,4 with a hypogenetic thyroid,and the last 3 cases showed no thyroid imaging.Conclusions The causes of congenital hypothyroidism can be found by SPECT thyroid imaging,which is important to the diagnosis of congenital hypothyroidism combined with detection of T_3,T_4,TSH.

Objective To evaluate the diagnostic value of 99mTc-dimercaptosuccinate acid(DMSA) renal cortical scintigraphy for the identification of distinguishing between upper urinary infection(UUTI) and lower upper urinary infection(LUTI).Methods Two hundred and seventy-five children (111 males,164 females)ranging from 44 days to 15 years old,presented with urinary tract infection underwent 99mTc-DMSA renal cortical scintigraphy.The images were scored as normal (indicating LUTI) and abnormal (indicating acute pyelonephritis or renal scarring).Results Of 275 children with UTI,95 cases had normal images diagnosed as LUTI,41 males,54 females;and 180 cases had abnormal images,70 males,110 females.One hundred and seventy-four cases were diagnosed as acute pyelonephritis,6 cases were diagnosed as renal cortical scars,56 cases were single renal involved and 118 cases were both renal involved,and 22 cases repeatedly underwent renal cortical scanning after therapy.Sixteen of 18 cases with acute pyelonephritis completely recovered normal or obviously ameliorated after 0.5 to 2.0 years,2 cases did not show any improvement after 0.5 to 1.5 years,4 cases with renal scarring,and showed little change on repeated images after 1.0 to 1.5 years.Conclusions The 99mTc-DMSA renal scintigraphy is very useful in differentiating the children with urinary tract infection.It also can be used to determine the extension,degree and nature of UUTI,and might play an important role in the treatment and follow-up observation in children with UUTI.

Objective　To understand the overall under-reporting of cause of death monitoring in Hainan Province, and to provide a scientific basis for evaluating the data from death registration report and health planning in Hainan. Methods　Multi-stage cluster random sampling was used, all towns/streets in cities and counties of the province were ranked from highest to lowest in terms of crude death rate, divided into high, medium and low levels (the number of each level was basically the same), and one was randomly selected from each level. A total of three towns/streets were used as survey areas, and all households in the area were survey households. Death information of resident population during 2018-2020 was collected and compared with routine surveillance data for the same period. The under-reporting rate was calculated, and comparison between groups was performed by chi-square. Results　A total of 12 583 death cases were investigated from 2018 to 2020, and the average mortality was 621.48/105. 4 809 cases were missed with the total under-reporting rate of 38.22%. The under-reporting rate from 2018 to 2020 were 39.75%, 39.99% and 34.77% (χ2=30.404, P<0.01) respectively. The under-reporting rate in eastern and central and western areas were 30.33%, 30.10% and 60.15% (χ2=931.901, P<0.01) respectively. The negative rate were different in different years old group (χ2=14.834, P<0.05). Of the 4 809 under-reported cases, as many as 93.49% died at home, and the composition of deaths in hospitals was about 10 times higher in the center than in the east and west, and the proportion of those who died in hospital in central areas was about 10 times higher than in eastern and central areas. Conclusions　More than half of the cities and counties in Hainan Province have improved the completeness of cause of death surveillance data. The under-reporting rate in age group <5 years are still high, and regular under-reporting investigations are still needed to strengthen the reporting and management of death information.

Mild cognitive impairment caused by craniocerebral trauma is the key points and difficulties in judicial authentication. This article has comparative analysis of each mode of event-related potential (classical Oddball, Eriksen flanker task and so on), which can provide a more objective method for such craniocerebral trauma cases in clinical forensic judicial authentication.
Cognitive Dysfunction ; Craniocerebral Trauma ; Evoked Potentials ; Forensic Sciences ; Humans

Objective To explore the incidence and distribution features of neonatal phenylketonuria(PKU) and congenital hypothyroidism(CH) in Lianyungang area.Methods The heel blood samples dried on filter paper was collected from newborns after 72 hours.As the screening indicators,PKU was detected through serum phenylalanine concentration(Phe) detection by Guthrie′s bacterial inhibition assay and CH was detected through serum thyroid stimulating hormone(TSH) levels detection by time-resolved fluorometry(TRFIA) or enzyme linked immunosorbent assay(ELISA).Results Sixty-four children with CH were diagnosed and the rate of CH was 1∶2423,41 patients were examined by thyroid gland nuclein kinescope picture,among which there were 23 patients whose thyroid glands were unusal.These patients lived in 45 towns(streets),which had no difference between men and women,city and country side.A couple of twins were screened for CH;15 cases of PKU was detected with an incidence of 1∶10 339.These patients′ parents were neither consanguineous marriage nor dominance hereditary family history.Their physical and mental development were similar to the same age children after interventive treatment.Conclusions The distribution of CH and PKU is diffuse in Lianyungang.Neonatal screening is the only valid means to find patients with CH and PKU.

ObjectiveTo analyze the risk factors of nosocomial infection of patients with spinal cord injury.MethodsRetrospective surveys of nosocomial infection including risk factors, pathogen analysis and drug sensitivity tests were carried out for 88 cases with spinal cord injury in our hospital from 1996 to 2002.ResultsIt showed that the rate of nosocomial infection was 90.91% with 46.59% of urinary tract infection and 32.95% of respiratory tract infection. Nosocomial infection was closely related with such factors as the disease of spinal cord, the use of antibiotics, invasive operation, age and disturbance of disease.ConclusionReducing risk factors and using antibiotics reasonably are effective measures to reduce nosocomial infection of patients with spinal cord injury.

Objective To assess the outcomes of modified spiral ileal orthotopic neobladder.Methods From January 1998 to January 2008, 32 patients (all male) underwent radical cystectomy and spiral ileal orthotopic substitution for muscle invasive bladder cancer. A segment of 40 to 45 cm ileal loop was isolated, detubularized, and reconfigured in spiral shape to form a pouch. Bilateral ureters were reimplanted by inserting the 1 cm distal segment into the pouch to form a Split-Cuff nipple.The bottom of the pouch was opened and anastomosed with the urethra (4 stitches). Results There were no perioperative deaths. The mean operative time was 281.2±48.7 min. Blood loss was 545.4±181.9 ml. Twenty cases required a blood transfusion, the mean volume of intraoprative blood transfusion was 430.8±235.9 ml. The average hospital stays were 26.8±9. 7 days. Rate of daytime continence was 93. 7% (30/32) while nighttime continence was 81.3% (26/32). Urodynamic studies were carried out in 23 cases 6 months after surgery. Neobladder capacity at first desire to urinate was 315.0± 33.4 ml(270-420 ml). The maximum neobladder capacity was 490. 3±39.7 ml(350-600 ml).The maximum flow rate (Qmax) was 16.5 ± 5.9 ml/s. Full resting pressure was 22. 5 ± 11.8 cm H2O. Peak voiding pressure was 78.3 ± 14.7 cm H2O. After mean 58. 4 months' follow up (range 22 to 132), 4 cases died of metastasis of bladder cancer. Conclusion Modified spiral ileal orthotopic neobladder is a reasonable option for treating invasive bladder cancer.

BACKGROUND:DCLK1 is a transmembrane microtubule-associated kinase in neurons after mitotic division, which may be the intestinal cancer stem cel marker. OBJECTIVE:To observe the expression and pathological significance of DCLK1 and Ki67 in colorectal cancer. METHODS: Expression of Ki67 and DCLK1 in 150 cases of colorectal cancer tissues was detected by immunohistochemical method in contrast to normal colorectal mucosa, para-carcinoma tissue, and adenoma tissue. RESULTS AND CONCLUSION:The expression rates of DCLK1 and Ki67 were 36.7% and 34.7% in cancer tissues, respectively, both of which were significantly higher than those in normal colorectal mucosa and adenoma. The expression of DCLK1 was associated with the location, depth of invasion, lymph node metastasis (P < 0.05), while the expression of Ki67 was just associated with the depth of invasion (P < 0.05). There was a negative correlation between the expression of DCLK1 and Ki67 (r=-0.460,P=0.000). The count of DCLK1+/Ki67-cels was about 2.01% in colorectal cancer tissues, and these cels mainly distributed at the bottom of intestinal mucosa base and common duct wal. DCLK1+/Ki67- cels were oval, the nuclei were large and deep-stained with prominent nucleolus, and there was rare nuclear fission and less cytoplasm. From the aspects of cel number, location, and cel morphology, DCLK1+/Ki67- cels are in line with the characteristics of cancer stem cels; therefore, DCLK1+/Ki67-can be used as a cancer stem cel marker of colorectal cancer.

Objective To evaluate the effect of rapamycin on proliferation and cell cycle of human bladder cancer cell line 5637. Methods Total?ly 5637 cells were maintained in RPMI 1640 containing 10%fetal bovine serum,100 U/mL penicillin and 100μg/mL streptomycin for adherent cul?ture. Cells were grown at 37℃in a 5%CO2 incubator. The 5637 cells were treated with various concentrations of rapamycin solution(50 nmol/L, 100 nmol/L,200 nmol/L,and 400 nmol/L). The control group was daily treated with single RPMI 1640 without medication. The growth repression rate for 5637 cells was evaluated by MTT. Flow cytometry was used to investigate the effect of rapamycin of different concentrations on cell cycle of 5637 cells. Results Compared to the control group,rapamycin can inhibit the proliferation of 5637 cells in a concentration and time dependent manner. Rapamycin inhibited 5637 cells at G0/G1 thus inhibiting cell proliferation but not inducing apoptosis. Conclusion Rapamycin inhibited growth of 5637 bladder carcinoma cells and arrested cell cycle at G0/G1,indicating that mammalian target of rapamycin may play an important role in proliferation of 5637 cells and act as a new tumor therapeutic target in patients with bladder cancer.

Objective To investigate the characteristics of CD8+ stem memory T cells (CD8+Tscm) in patients with chronic HIV-1 infection before and after antiretroviral therapy (ART) and to analyze their associations with progression of HIV-1 infection.Methods Thirty-six patients with chronic HIV-1 infection and 20 healthy subjects were enrolled in this study.Flow cytometry was performed to detect the percentages and absolute numbers of CD8+Tscm in patients with chronic HIV-1 infection before and after antiretroviral therapy (ART) as well as in healthy subjects.Correlation analysis was used to demonstrate the relationships between CD8+Tscm and markers for progression of HIV-1 infection (CD4+T cell count, HIV-1 viral load and level of activated T cells).Results The percentages and the absolute numbers of CD8+Tscm in patients with chronic HIV-1 infection had no significant change before and after ART.They were respectively positively correlated with the percentages and the absolute numbers of CD4+Tscm.The percentage of CD8+Tscm was proportional to the percentage of CD8+ central memory T cells (CD8+Tcm), but was inversely proportional to the percentage of CD8+ effector memory T cells (CD8+Tem).In addition, the percentages of CD8+Tscm in patients with HIV-1 infection were negatively correlated with the viral loads before ART.Conclusion CD8+Tscm are responsible for maintaining the homeostasis of other CD8+T cell subsets.CD8+Tscm play an important role in inhibiting viral replication.