Objective To evaluate the diagnostic value of ~(99)Tc~m-methoxyisobutylisonitrile (MIBI) SPECT scintigraphy combined Iocalizable CT in the localization of ectopic parathyroid glands in hyperparathyroidism.Methods Retrospective data of surgery,pathology and imaging were collected from 28 patients with hyperfunctioning ectopic parathyroid glands.All cases underwent CT studies.Twenty-five patients had ~(99)Tc~m-MIBI planar imaging first:SPECT scintigraphy combined localizable CT was performed for the patients with abnormal radionuclide foci immediately.The fusion images obtained after reconstruction showed the exact location of the ectopic foci.Operative histopathologic results were regarded as "gold standards".Presuming 4 parathyroid glands as normal findings,findings confirmed by operation and pathology were regarded as positive,otherwise negative.The results of CT and radionuclide imaging were compared by X~2-test of four-foId table.Results Twenty-eight ectopic parathyroid glands were found in 28 patients,all pathologically confirmed as adenomss.CT found 22 foci,of which 17 were true positive,5 false positive,11 false negative,and 79 true negative.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT found 23 foci,no false positive,2 false negative,and 75 true negative.The results showed that the sensitivities were 61% (17/28),92%(23/25),specificities 94%(79/84),100%(75/75),accuracies 86%(96/112),98% (98/100),positive predictive values 77%(17/22),100%(23/23),and negative predictive values 88% (79190),97%(75/77),respectively,for CT and radionuclide imaging.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT was therefore significantly higher than CT in sensitivity(X~2=6.98,P＜0.01),specificity (X~2=4.61,P＜0.05),accuracy (X~2=10.30,P＜0.01),positive predictive value(X~2=5.88,P＜0.05) and negative predictive value (X~2=5.36,P＜0.05).Conclusion ~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT is superior to CT alone in the localization of ectopic parathyroid glands in hyperparathyroidism,but false negative can be found in some patients.

Objective To investigate the geographical distribution of excessive iodine in drinking water and to demarc aI|e the excessive iodine regions in Hebei Province.Methods In 173 counties of Hebei Province, town was surveyed as an elementary unit.Five villages were sampled according to the direction of east,west, south,north,center in every town.If the water sources were more than 5 in a village,water was sampled according to the direction ofeast,west, south,north, center, respectively;If the water sources were less than 5 in a village, all were sampled:If the village used water of cental supply,only one sample wag collected.Arsenic-cerium catalysis was used to determine the iodine concentration of drinking water.Results Two thousands and forty-nine towns were investigated and 19 352 water samples were determined in Hebei Province.One hundred and seventy- two towns were confirmed to be excessive iodine areas,where the range of water iodine Wag 0.1～2840.4μg/L The water 8amDle with 18 358 had a water iodine median less than 150.0μg/L The areas with water iodine median less than 150.0μg/L,in between 150.0μg/L and less than 300.0μg/L,and equal to or more than 300.0 μg/L accounted for 94.86%,2.92%and 2.22%,respectively.There were 110 towns with water iodine median being between 150.0μg/L and iess than 300.0 μg/L and 62 towns with water iodine median equal to or more than 300 gμ/L.Exeessive iodine towns distributed in 33 counties of 6 cities involving 5 854 960 residents in'Hebei Provmce. MOBt of the water sources with excessive iodine Cangzhou were deep wells and there was a positive correlation between we depth and water iodine concentration (r=0.430,P<0.01), while they were shallow wells in Handan, Xingtai.Hengshui,and no correlation was found between well depth and water iodine concentration(r=-0.060,-0.119.-0.121,P>0.05).Conclusions Six cities have excessive iodine water resotlrees in Hebei Province, mostly in Handan.xingtai,Hengshui and Cangzhou Cities,which all are low-lying land.The water with excessive iodine is hypogene,and the towns with excessive iodine water distributein patchy or spot pattern.

Objective To investigate the iodine nutritional level and thyroid function of pregnant and lactating women in rural areas of Jilin province. Methods The investigation sites were selected from rural areas of three towns (Baoshan, Mingcheng and Yantongshan of Panshi county, Jilin province) in 2009. The pregnant and lactating women were selected as subjects in these three towns. The blood samples were collected and the thyroid function (including serum TT3, TT4, FT3, FT4) were measured with chemiluminescence, and serum thyroglobulin antibodies(TgAb), thyromicrosome antibody(TMAb), and thyroglobulin(Tg) were measured with radioimmunoassay (RIA). The urine samples were collected three times within one month and were measured for iodine concentration by As-Ce catalytic spectrophotometry method. Results In the pregnant women, serum TT3 was higher than that of healthy pregnant women, accounted for 14.3%(8/56), while serum TT4, TT3, FT4 were lower than those of healthy pregnant women, accounted for 3.6%(2/56),5.4% (3/56), and 1.8%(1/56), respectively. In the lactating women,serum TT3 was higher than that of healthy lactating women, accounted for 3.6%(2/56), while serum TT4, FT4 were lower than those of healthy lactating women, accounted for 1.8%(1/56), respectively. Five per cent to 20% of the pregnant and lactating women had higher TgAb and TMAb. Conclusions Existing salt iodine level is appropriate for pregnant women and lactating women, but there was a tendency towards hypothyroid in some women. Routine monitoring of urinary iodine and thyroid function should be carried out among pregnant and lactating women.

Objective To investigate the effect of exogenous kallikrein on apoptosis of the neurons aroundthe cerebralinfarctareain rats. Methods Thirty rats wjth cerebral infarction induced by middle cerebral artery occlusion(MCAO)were assigned randomly into 3 groups(n=10),namely the blank control group,saline group,and pAdCMV-HTK group.In the pAdCMV-HTK group,kallikrein gene was delivered into the cerebral ischemie lesion via a replication-defective adenovims using stereotaetic injection technique, and the expression of exogenous kallikrein was detected immunohistoehemically.TUNEL staining was performed to evaluate the neuronal apoptosis around the infarct area,and RT-PCR used to detect the mRNA expressions ofbcl-2,bax and caspase-3 in the brain tissues. Results At 24 h aftertreatment there were some HTK expressed cells found in group C and peal(at 72 h after treatment.While compare with group B and group C,there existed significant difference(112±6.1,68±4.2,59±3.9,P<0.05).At 72 h after treatment,the NSS of group C was significantly lower than that ofgruop B and A(6.70±0.16,8.13±0.16,7.93±0.20,P<0.05);7 days after the treatment,the difference was more significant(5.14±0.18,7.82±0.14,7.91±0.10,P<0.01).Apoptotic cells were mostly seen around the infarct area.The ratsinpAdCMV-HTK group showed significantly reduced number of cells positive for TUNEL staining as compared to those in the saline and blank control groups at 3 days(10.1±0.9,16.7±1.1,and 20.4±0.8,respectively)and 7 days after the treatment(15.2±1.2,33.6±1.3,and 28.8±1.7,respectively)(P<0.05).The mRNA levels ofbc1-2.bax and caspasc-3 were elevated in all the groups at 24 h,peaked at 72 h,and decreased gradually till 7 days alter the treatment.Compared with those in the other two groups，bcl-2 mRNA level in the pAdCMV-HTK group increased slightly P>0.05) while bax and caspase-3 mRNA levels decreased markedly(P<0.05) 72 h and 7 days after the treatment.Conclusion Kallikrein can inhibit neuronal apoptosis around the cerebral infarct and improve the neurological fimction of rats following cerebral infarction probably by reducing the expressions of such apoptotic factors as bax and caspase-3.

Objective To investigate the effects ofkallikrein gene transfer on microvascularproliferation around the cerebral infarct and on the recovery of regional cerebral blood flow (rCBF)following ischemia/reperfusion injury in rats. Methods The rats with cerebral ischemia/reperfusioninjury induced by middle cerebral artery occlusion (MCAO) were randomly assigned into blank controlgroup, saline group, and pAdCMV-HTK treatment group and received corresponding injections into thetissues around the infarct area. Each group was divided into 3 subgroups (n=10) for observation at 12, 24and 72 h after the treatment. The neurological deficits of the rats before and after the treatment wereevaluated using neurological severity scores (NSS), and the expressions of exogenous human tissuekallikrein (HTK) and vascular endothelial growth factor (VEGF) in the brain tissues were detectedimmunohistochemically. TIC staining was performed to measure the changes in the infarct size.14C-iodoantipyrine tracing technique was used to define the rCBF in the rats. Results Compared tothe blank control group, the cerebral infarct size was significantly reduced in pAdCMV-HTK group 24 hafter the treatment, and was further reduced at 72 h (P<0.05). At 24 h after the treatment, the NSS inpAdCMV-HTK group was significantly lower than that in the blank euntrol and saline groups (P<0.05),and was further reduced at 72 h (P<0.01). After MCAO, the VEGF-positive cells were found mostly inthe cortex and the white matter around the infarct area. The expression of VEGF in pAdCMV-HTK groupwas markedly higher than that in the other two groups at 12, 24, and 72 h after the treatment (P<0.05). Inall the 3 groups, the rCBF around the infarct was slightly decreased as compared to that in thecontralateral hemisphere, pAdCMV-HTK slightly increased the rCBF 12 h after the injection (P>0.05),and significant increase in the rCBF occurred 24 h and 72 h after the injection (P<0.05). ConclusionKallikrein gene transfer following cerebral ischemia/reperfusion injury promotes vascular proliferationaround the infarct and increases the rCBF to reduce the infarct volume and attenuate neurological deficitsin rats.

AIM To establish an HPLC method for the simultaneous content determination of seven constituents in Gnaphalium affine D.Don.METHODS The analysis of 80％ methanol of G.affine was performed on a 30 ℃ Atlantis (C) T3 column (4.6 mm× 250 mm,5 μm),with the mobile phase comprising of acetonitrile-formic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 288 nm.RESULTS Seven constituents showed good linear relationships within their own ranges (R2 ≥0.999 8),whose average recoveries were 98.58％-103.8％ with the RSDs of 0.88％-1.74％.CONCLUSION This accurate,stable and reproducible method can be used for the quality control of G.affine.

Objective To investigate the expression changes of myeloid-related protein-8 (MRP-8) and myeloid-related protein-14 (MRP-14) in children with Kawasaki disease (KD) and to obtain laboratory diagnostic serum markers and new targets for its drug therapy.Methods A total of 46 patients with KD(KD group) were enrolled from Jul.2009 to Dec.2010 and divided into the coronary artery dilatation(CAD) group(n =15) and the normal coronary artery group(n =31) ;Meanwhile,25 febrile patients with acute respiratory tract infection but without disease in the circulatory,blood,immune systems formed the non-KD febrile group.Twenty healthy children from the out-patient department formed the healthy control group.Peripheral venous blood was collected in the acute and subacute stage of KD.Levels of MRP-8/MRP-14 were detected with enzyme-linked immunosorbnent assay (ELISA).Gene expressions of MRP-8,MRP-14 in leukocytes were analyzed by semi-quantitative reverse transcription-polymerase chain reaction(RTPCR).Results The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in the leukocytes in the out-patient acute and subacute stage of KD were significantly higher than those in the non-KD febrile group and the healthy control group(all P ＜ 0.05) ;There was no significant difference between non-KD febrile group and healthy control group (P ＞ 0.05).The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in leukocyte in actue stage of KD were significantly higher than those in subacute stage(all P ＜ 0.001).The serum levels of MRP-8/MRP-14 as well as mRNA expressions of MRP-8 and MRP-14 in the acute and the subacute stage of CAD group were significantly higher than those in the normal coronary artery group(P ＜ 0.05).Conclusions MRP-8/MRP-14 may probably play a role in the pathogenesis of KD and can be used as a diagnostic indicator for KD;MRP-8/MRP-14 may be involved in the formation of coronary artery lesion and can be used as an effective predictor for the coronary artery lesion.

Objeetive As to the high incidence of arteriovenous fistula(AVF) stenosis,surgical operation will result in the exhaustion of vascular resources in patients,while percutaneous transluminal angioplasty(PTA) can maintain vascular resources for ostomy.However,there is still no clear definition between the choices of PTA and surgical resection.The aim of this study was to compare the efficacy of PTA and surgical resection followed by reconstruction for the treatment of arteriovenous fistula stenosis in order to find appropriate treatment.Methods Retrospective analysis had been done on 46 hemodialysis patients with arteriovenous fistula stenosis in Nanjing BenQ hospital from January 2015 to March 2017,which included 22 cases treated with PTA (PTA group) and 24 cases treated with surgical operation (operation group).Comparison was made in general clinical situation,patency rate at six months after surgery,over patency time and adverse reactions to surgery between the two groups.Results The number of stenoses in PTA group was bigger than that in operation group and the difference was of statistic significance (2.78±1.43 vs 1.67±0.71,P＜0.05).There was no significant difference in patency rate between the two groups (P =0.828).There were 57 venous stenoses in PTA group,among which 12 stenoses were anastomotic (21.05％) with 79.3％ average stenosis degree and 43 stenoses were at venous outflow tract of fistula (75.44％) with 84.26 average stenosis degree.In PTA group,3 patients had hematoma brachial puncture position and recovered by self-absorption without special treatment.In operation group,1 patient had mild blood oozing and recovered after treatment;4 patients recovered gradually from mild swelling on the back of the hand of the operation side.No difference was found in adverse reactions between two groups (P＞0.05).Conclusion PTA treatment is preferred for multiple stenoses(n ≥ 3),which ensures better preservation of vascular resources at a comparable patency rate.

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.