Objective To explore the rationality of correcting urinary iodine (UI) concentration by using urine specific gravity (U-SG).Methods Weighing method and refractometer method were used respectively to measure specific gravity of 10-30 g/L mass concentration of different inorganic salts (sodium chloride,sodium sulfate,ammonium biphosphate) and organic matters(urea,glucose,glycine) aqueous solution,and urine plus 10-30 g/L sodium chloride or urea.UI concentrations in urine samples of 27 pregnant women respectively were expressed by direct method,weighing method U-SG correction and refractometer method U-SG correction.One random urine sample was collected for six batches in different seasons from children aged 8-10 and pregnant women for determination of U-SG and UI concentration.UI concentration was determined by arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Results ①Measured by weighing method,specific gravity of inorganic salt (sodium chloride,sodium sulfate,ammonium biphosphate) aqueous solution was significantly greater than that of organic matters (urea,glucose,glycine) aqueous solution which had the same mass concentration.The specific gravity of 10 g/L sodium chloride aqueous solution was 1.008,and that of 30 g/L urea solution was 1.006.②Measured by weighing method,10 g/L sodium chloride was added to 3 urine samples separately.Accordingly the increases of USG were 0.006,0.008 and 0.007,respectively.Otherwise,the increases of U-SG were 0.003,0.002 and 0.004,respectively,when adding 10 g/L urea.~he median results of UI concentrations in urine samples from 27 pregnant women were 106.4,165.2 and 211.8 μg/L,respectively,expressing obtained by direct method,weighing method USG correction and refractometer method U-SG correction.④The determination results of six batches urine collected from children aged 8-10 in different seasons,the median results of U-SG measured by refractometer method were 1.019 0-1.021 2,the median UI concentration results obtained by direct method and refractometer method U-SG correction were 134.5-181.7 μg/L and 157.7-190.4 μg/L.The determination results of six batches urine samples of pregnant women in different seasons,the median results of U-SG measured by refractometer method were 1.013 4 -1.017 1,the median UI concentration results obtained by direct method and refractometer method U-SG correction were 96.2-138.9 μg/L and 135.2-181.6 μg/L.Conclusions The change of sodium chloride concentration in urine is the most important reason for the change of U-SG.In China,the main source of UI is the intake of edible iodized salt.Iodized salt intakes directly affect the U-SG and UI concentration.If the U-SG is used to correct the UI concentration,there will be a phenomena that the lower intake of iodized salt the lower U-SG.So the UI concentration was falsely increased significantly after correction.Conversely higher intakes of iodized salt caused higher U-SG.The UI concentration was falsely reduced significantly after correction.Therefore,U-SG cannot be used to correct the UI concentration.

Objective To analysis of the detection result of amniotic fluid chromosome which in NIPT high-risk pregnant women.Methods Amniotic fluid cells via amniotic cavity puncture were cultured and analyzed,the chromosome karyotypes were observed.Results The highest positive predictive value of NIPT was for trisomy 21(85.00%),then trisomy 18(75.00%),sex chromosome abnormalities(68.00%),other chromosome abnormalities(41.67%),trisomy 13 (25.00%).Conclusion The highest accuracy of NIPT was shown in detection of Down''s syndrome by NIPT.NIPT was screening test which is effective and noninvasive in prenatal diagnosis.Amniotic fluid Chromosomal karyotype analysis was the gold standard in the diagnosis of fetal chromosomal disease.

Objective To evaluate the clinical outcomes of internal fixation with extra-articular distal humerus locking compression plate (LCP) for the treatment of mid-distal humerus diaphyseal fracture.Methods From December 2012 to December 2016,a cohort of 22 patients with mid-distal humerus shaft fracture were treated by open reduction and internal fixation using extra-articular distal humerus LCP.They were 14 males and 8 females with an average age of 42.7 years (range,from 18 to 86 years).According to AO classification,there were 13 cases of type 12-A,7 cases of type 12-B,and 2 cases of type 12-C.The surgical time,intra-operative blood loss and hospital stay were recorded.The clinical outcomes were evaluated by the Mayo elbow performance score (MEPS) at the last follow-ups.Results Surgical time ranged from 46 to 95 minutes with an average of 57 minutes.The average blood loss was 220 mL (range,from 150 to 400 mL).The average hospital stay was 10.5 days (range,from 9 to 13 days).The mean follow-up was 23.8 months (range,from 6 to 48 months).Bone union was achieved in 21 cases after an average of 4.6 months (range,from 3 to 9 months),and one patient experienced bone non-union which was uneventfully healed after secondary auto platelet rich plasma (PRP) graft management.The average MEPS elbow performance score was 88.2,resulting in 16 excellent,4 fine and 2 fair cases (excellent and fine rate:90.9％).Conclusions Since extra-articular distal humerus LCP can provide stable internal fixation,facilitating early postoperative rehabilitation,it may be considered an effective alternative osteosynthesis for mid-distal comminuted humeral diaphyseal fractures.

Objective The subtypes of hepatocellular adenoma (HCA) were classified by immuno-histochemical study, and the clinicopathological characteristics of each subtype were analyzed. Methods From December 2003 to March 2018, 31 cases with HCA were retrieved from the archive files of the Depart-ment of Pathology, Peking Union Medical College Hospital, including 16 male patients and 15 female patients. The age ranged from 16 to 63 years. Hematoxylin and eosin ( HE) and immunohistochemical staining were performed with HCA samples. The subtypes were classified by immunohistochemical staining, and the clinicopathological characteristics of each subtype were analyzed. Results The HCA patients had no obvious and specific clinical symptoms, and most of them were diagnosed during the routine health checkup. All of the 31 patients were treated with surgery, and the complete resection was achieved in 26 cases. The adenomas were mainly in the right lobe of the liver (51. 6% , 16/31), and the solitary adenoma accounted for 54. 8% (17/31). 8 HCA were classified as H-HCA, 14 as I-HCA, 7 as β-HCA, and 2 as U-HCA by immunohistochemistry. H-HCA was characterized histologically by marked steatosis and lobulated contours, lacking L-FABP staining. I-HCA exhibited inflammatory infiltrate, telangiectasia, thickened arteries, more or less obvious ductular reaction, with the positive L-FABP/SAA/CRP staining. β-HCA all showed fibrous capsules, some of adenomas exhibited pseudoglandular structure and nodules in nodule. A strong homogeneous cytoplasmic overexpression of GS and nuclear β-catenin were observed in all β-HCA cases. The staining of SAA/CRP/GS was lacking in the U-HCA. Conclusions HCA is rare and difficult to diagnose in clinic. Final diagnosis relies on histological features, and immunohistochemical examinations need to be used for subtyping classification. Each of the four subtypes has characteristic pathological features.

Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.