BACKGROUND: Neonatal hypoxic ischemic encephalopahty(NHIE) is a common neonatal disease, which could cause cerebral palsy, inferior intelligence and convulsion. At present, usual examinations for this disease are CT.MRI and single photon emission computed tomography(SPECT), etc.OBJECTIVE: To investigate the character of SPECT image of NHIE, and compared with CT and MRI as well to provide a theoretical gist for function surveillance and early intervention of NHIE.DESIGN: An observatory comparative study based on NHIE patients and normal neouates as control.SETTING: Department of nuclear medicine in a medical university hospital.PARTICIPANTS: Thirty neonates hospitalized in the Department of Pediatrics, Affiliated Hospital of Jining Medical College between September 1998 and October 2000 were selected as observation group with 23 males and 7 females. Another 10 normal neonates including 7 males and 3 females were randomly selected from same period into control group.METHODS: SPECT brain blood perfusion was conducted in the subjects of two groups and the results were compared with that of CT and MRI.MAIN OUTCOME MEASURES: ① comparison of SPECT brain blood image features between NHIE and normal neonates; ② comparison of SPECT images and CT, MRI results. RESULTS: In 22 NHIE cases who received SPECT, CT and MRI simultaneously, mild group had 7 cases, and positive cases of SPECT, CT or MRI was 7, 3 or 5; moderate group had 10 cases, and positive cases of three methods was 10, 8 or 9; severe group had 5 cases, the all of them were positive in all three examinations. The total positive detectable rate of SPECT, CT or MRI was 100, 72.73% or 86. 36%. There was no significant difference of sensitivity between SPECT and MRI in mild group, while there was significant difference between SPECT and CT(x2 = 3.95, P ＜ 0.05);there was no significant difference among three methods in either moderate group or severe group(x2 =0. 83, P ＞ 0.05).CONCLUSION: SPECT brain blood perfusion image is a quite sensitive method for the surveillance of NHIE, which can provide imageological reference for the evaluation of its prognosis and early intervention.

Objective:To explore the effectiveness of clinical pathway (CP) and team-based learning (TBL) teaching method in standardized residency training of gynecology.Methods:The research included 40 residents as objects who took standardized training in gynecological rotation in Luohe Central Hospital from July 2017 to July 2019, and they were randomized into experimental group and control group. The combination of CP and TBL teaching method was used in the experimental group ( n=20), while the traditional teaching method was applied in the control group ( n=20). All residents were tested for the professional theory and clinical skill after training. After the training, a survey about the teaching satisfaction and the effectiveness of teaching methods was conducted for both groups. Statistical analysis was performed by SPSS 23.0 software. Results:The average scores of professional theory and clinical practice skills in the experimental group were (85.55±5.96) points and (89.90±6.40) points respectively, which were better than the average scores of the control group [(76.36±6.68) points and (75.50±4.81) points, respectively], and there were significant differences between two groups ( P<0.05). The results of the questionnaire survey showed that the experimental group residents had a higher degree of satisfaction and a higher evaluation of the teaching method than the control group. Conclusion:CP and TBL teaching is beneficial to improve the quality of standardized residency training of gynecology, and it is suggested to make wide popularization and application in the training.

Objective To investigate the establishment of a six-gene-edited pig-to-non-human primate kidney xenotransplantation model. Methods The kidney of humanized genetically-edited pig (GTKO/β4GalNT2KO/CMAHKO/hCD55/hCD46/hTBM) was transplanted into a cynomolgus monkey. The survival of the recipient and kidney condition after blood perfusion were observed. The parenchymal echo, blood flow changes, and size of the kidney were monitored on a regular basis. Routine blood test, kidney function test and electrolyte assessment were carried out. Dynamic changes of urine, feces and body mass were monitored. At the end of life, the transplant kidney, heart, liver, spleen, lung, and cecum were collected for pathological examination. Results The recipient died at postoperative 7 d. After blood flow was restored, the kidney was properly perfused, the organ was soft and the color was normal. At the end of the recipient's life, a slight amount of purulent secretion was attached to the ventral side of the kidney, with evident congestion and swelling, showing the appearance of "red kidney". Postoperatively, the echo of renal parenchyma was increased, blood flow was decreased, the cortex was gradually thickened, and a slight amount of effusion surrounded the kidney and abdominal cavity over time. In the recipient, the amount of peripheral red blood cells, hemoglobin, albumin, and platelets was progressively decreased, and serum creatinine level was increased to 308 μmol/L at postoperative 7 d, whereas the K⁺ concentration did not significantly change. Light yellow urine was discharged immediately after surgery, diet and drinking water were resumed within postoperative 3 h, and light yellow and normal-shape stool was discharged. The reddish urine was gradually restored to normal color within postoperative 1 d, which were consistent with the results of the routine urine test. A large amount of brown bloody stool was discharged twice in the morning of 2 d after surgery. Omeprazole was given for acid suppression, and the stool returned to normal at postoperative 4 d. The β₂-microglobulin level was increased to 0.75 mg/L at postoperative 7 d. The body mass was increased by 1.7 kg. Autopsy pathological examination showed interstitial edema and bleeding of the transplant kidney, a large amount of infiltration of lymphocytes and macrophages, infiltration of lymphocytes in the arteriole wall and arterial cavity, accompanied by arteritis changes, lymphocyte infiltration in the cecal stroma and congestion in the spleen tissues. No significant abnormal changes were observed in other organs. Conclusions The humanized genetically-edited pig-to-non-human primate kidney xenotransplantation model is successfully established, and postoperative survival of the recipient is 1 week.