Objective To study the renal pathology and expression of vascular endothelial growth factor (VEGF) in rats with hypothyroidism caused by iodine deficiency.Methods The rats were randomly grouped into test group and normal group,and the test group was further randomly divided into model group and L-T4 group.Observation were made when the hypothyroid model was formed after maneuvering for 21 days and the medication had been taken for 56 days.The observed data included the morphogy of the kidney,serum TT3,TT4,TSH,blood urea nitrogen (BUN),serum creatinine (SCr),and VEGF expression.Results (1) After medication for 56 days,compared to normal group,BUN and SCr levels in L-T4 and model groups showed apparently increasing [BUN (5.55 ± 0.50,5.80 ± 0.66 vs 5.00 ± 0.24) mmol/L,P＜0.05 ; SCr (26.83 ± 0.75,27.0 ± 3.41 vs 22.5 ± 2.07) μmol/L,P＜0.05],and L-T4 group showed slightly lowered BUN and SCr levels compared with model group (P＞0.05).(2) By 21 days,in the model group there was moderate mesangial hyperplasia involving focal glomeruli.By 56th day of medication,entire glomeruli showed moderate mesangial hyperplasia with lessened number of dilated capillaries in the model group.However,in the L-T4 treated group,mesangial hyperplasia was much less and capillaries though dilated appeared wholesome,as compared with the model group.(3) By 21th day,the IODA value of VEGF in the model group was higher than that in the normal control (44.64 ± 14.99 vs 29.05 ± 9.14,P＜0.01).After medication for 56 days,there was no significant difference in the IODA value of three groups.Conclusions The characteristics of renal pathology in rats with hypothyroidism caused by iodine deficiency consist of mesangial hyperplasia and loss of glomerular capillaries.The expression of VEGF is raised early in the course of renal damage,but lowered thereafter.L-T4 can not reverse the sustained kidney damage and impaired renal function.

Objective : To evaluate the quality of neonatal inherited metabolic diseases screening in Chaoyang District, Beijing Municipality from 2012 to 2021, so as to provide insights into improvements in the screening quality and efficiency of neonatal inherited metabolic diseases. Methods: Data pertaining to screening of neonatal inherited metabolic disease in Chaoyang District from 2012 to 2021 were captured from Beijing Center for Neonatal Disease Screening. The percentage of screening, eligible rate of blood smears collection, re-examination rate of suspected cases, and definitive diagnosis of congenital hypothyroidism (CH), phenylketonuria (PKU) and congenital adrenal hyperplasia (CAH) were analyzed to evaluate the quality of neonatal inherited metabolic diseases screening in Chaoyang District. Results: There were 484 002 live neonates in Chaoyang District from 2012 to 2021, and 481 395 neonates were screened for inherited metabolic diseases, with a screening rate of 99.46% and 99.71% eligible rate of blood smears collection. A total of 4 305 suspected positive cases were screened, including 4 148 cases recalled for re-examinations, with a 96.35% re-examination rate of suspected cases, and the re-examination rates of CH, PKU and CAH were 96.37%, 96.79% and 95.65%, respectively. Totally 482 neonates were definitively diagnosed with inherited metabolic diseases, with an overall incidence rate of 1/999, and the incidence rates of CH (307 cases), hyperthyrotropinemia (103 cases), PKU (66 cases) and CAH (6 cases) were 1/1 568, 1/4 674, 1/7 294 and 1/20 233, respectively. Conclusions The screening rate and re-examination rate of neonatal inherited metabolic diseases was both more than 95% in Chaoyang District from 2012 to 2021. Improving the management of neonatal inherited metabolic diseases screening and the recall of suspected cases is required.

Objective To explore the efficacy and safety of anxiety, depression, insomnia and other psychological and physical symptoms after trazodone treated in patients with alcohol dependence. Methods 100 patients whose met the inclusion and exclusion criteria were divided into trazodone group and the placebo group with a randomized, double-blind, placebo-controlled method. Each of the patients was oral trazodone, or placebo 3 times a day, each time a course of treatment was 8 weeks. Hamilton Anxiety Scale ( HAM A) , Hamilton Depression Rating Scale(HAMD) , Pittsburgh Sleep Quality Index(PSQI) , side effects scale (TESS) score and the necessary examinations were used to assess. Survey the re-drink situation after 1 year. Results 81 patients completed treatment, 19 patients were discharged or lost due to early treatment failure loss. In Trazodone group (41 cases) , the HAMA, HAMD and PSQI score before treatment and after treatment, total scores decreased gradually after 2 weeks of the three score and comfort dose group (40 cases) were the difference was statistically significant (P< 0. 05 ) ;recovery drink rate of trazodone group was significantly lower than the placebo group (24.4% vs 55. 0% , P<0. 05) after 1 year. After treatment, the side effects scale score difference was not statistically significant (P> 0. 05 ). Conclusion Improve trazodone treat alcohol dependence withdrawal anxiety, depression and insomnia effectively. Found no adverse drug reactions and the safety is high. Reduce the recovery drink.

Objective To evaluate the long-term clinical efficacy and toxicities of combined intracavitary hyperthermia and radiotherapy fur locally advanced uterine cervical cancer. Methods 310 patients with locally advanced uterine cervical cancer were assigned into intracavitary hyperthermia + radiotherapy group(TRT, 181 patients) and external-beam radiotherapy + traditional intracavitary radiation group (RT,129 patients). The external-beam radiotherapy were given with 60Co γ-my or 6-8 MV X-ray in traditional fractionation. In TRT group,radiotherapy was 40 Gy using the anterior-posterior pelvic fields and additional 20-25 Gy using the lateral fields. Hyperthermia was delivered by the 915 MHz microwave hyperthermia device within 15-60 min after external radiotherapy for 10-12 times(40 min each time,1-2 times per week). The temperature of tumor surface was 46-47℃. In the RT group, the external-beam radiotherapy of 40 Gy was delivered using the anterior-posterior pelvic fields. The intracavity radiotherapy of radium was delivered before 1989 ,with 50 mg radium in the vagina and 30 mg in uterine cavity for 24 hours ,weekly for 3 times to a total dose of 7200 mg·h. After 1989,intraeavity radiotherapy of 192Ir was delivered to a total dose of 30-36 Gy to point A in 5-6 Gy fractions,2 fractions per week. Results The 5-year survival of patients in TRT group and RT group was 67.4% versus 52.1% for stage Ⅱ disease (χ2=7.55,P=0.006), and 60.0% vemus32.3% forstage Ⅲ (χ2=7.06,P=0.007) . The 10-year survival was46.5% versus42.6% for stage Ⅱ (χ2=3.90,P=0.058), and 43.7% versus 20.6% for stage Ⅲ(χ2=17.28,P=0.000). Cox regression analysis showed that the tumor stage(P=0.023) and intracavitary hyperthermia( P=0.019) were prognostic factors. According to the RTOG criteria, the rate of mild to moderate late side effects of rectum and bladder in TRT and RT group was 17.7% and 33.1%, respectively (χ2=9.18, P=0.002). Rectovaginal fistula was developed in5 patients(3.9% ) in RT group and I patient (0.6%) in TRT group(χ2= 4.38,P=0.036). Conclusions The long-term survival of patients with stage Ⅲ uterine cervical cancer is better of TRT group than RT group. The TRT is well tolerated and the late toxicity rate is obviously low. It is necessary to carry out large randomized clinical trials to confirm these outcomes.

Objective:To analyze the effect of modified Banxia Baizhu Tianma Decoction combined with Nimodipine on cognitive dysfunction and changes on cerebral blood flows of the patients with chronic cerebral insufficiency (CCCI).Methods:A total of 91 patients with CCCI who received treatment in our hospital from March 2019 to March 2020 were selected and divided into the treatment group ( n=46) and the control group ( n=45), according to random number table method. The control group was treated with Nimodipine oral treatment, and the treatment group was treated with modified Banxia Baizhu Tianma Decoction on the basis of the control group treatment. Both groups were treated for 2 weeks. The Traditional Chinese Medicine (TCM) syndrome scores were performed before and after treatment, and transcranial Doppler ultrasound was used to detect the average blood flow of bilateral vertebral arteries (VA), basilar arteries (BA), internal carotid arteries (ICA) and middle cerebral arteries (MCA). The whole blood viscosity high shear (HS), whole blood low shear (LS), plasma viscosity (PV), fibrinogen (FIB) and hematocrit (HCT) were detected by automatic blood rheometerusing. The Montreal Cognitive Assessment Scale (MoCA) was used to assess the degree of cognitive impairment and evaluate the clinical efficacy. Results:The total effective rate was 91.3% (42/46) in the treatment group and 73.3% (33/45) in the control group, with a statistically significant difference between the two groups ( χ2=5.07, P=0.024). The scores of dizziness, headache, forgetfulness, insomnia and total scores in the treatment group were significantly lower than those in the control group after treatment ( t values were 8.59, 7.79, 3.92, 4.11, 5.01, all Ps<0.01), and the MoCA score (25.13±2.16 vs. 23.88±2.70; t=2.44, P=0.017) in the treatment group significantly higher than that in the control group. After treatment, VA [(35.49±4.08) cm/s vs. (32.17±4.25) cm/s, t=3.80], BA [(36.99±3.79) cm/s vs. (33.76±4.12) cm/s, t=3.89], ICA [(62.49±5.07) cm/s vs. (58.91±5.31) cm/s, t=3.29], MCA [(70.09±5.04) cm/s vs. (67.12±5.85) cm/s, t=2.60] in the treatment group was significantly higher than those in the control group ( P<0.01). After treatment, the levels of HS, LS, PV, Fg, and HCT in the treatment group were significantly lower than those in the control group ( t values were 2.37, 4.35, 2.23, 2.42, 2.20, P<0.05 or P<0.01). Conclusion:Modified Banxia Baizhu Tianma Decoction combined with Nimodipine tablets can relieve the clinical symptoms of CCCI patients, improve blood flow velocity, blood rheology level and cognitive function, and improve clinical efficacy.

Immune checkpoint inhibitor (ICI) has been emerged as a major breakthrough in tumor immunotherapy, but its unique mechanism of action has also led to a number of immune-related adverse events (irAE). Type 1 diabetes mellitus (T1DM) is one of the rarest irAEs. This paper reports a case of advanced malignant liver tumor-induced T1DM who received second-line anti-PD-1 therapy and showed initial symptoms of hyperosmolar coma and hyperglycemia. In addition, the relevant literature at home and abroad was collected and reviewed, and the clinical characteristics of T1DM induced by anti-PD-1 therapy were summarized with a view to achieve early detection, diagnosis and treatment.

Objective To explore the pathogens and clinical characterization of hand,foot and mouth disease (HFMD)in Huzhou city from 2013 to 2014. Methods All 253 specimens included 208 stool specimens and 45 throat swabs,and clinical data from 208 children cases with hand,foot and mouth diseases (HFMD)were collected. Preliminary de-tection for all of the specimens was performed by one-step triple real-time RT-PCR assay. Results Real-time RT-PCR assay indicated that the positive rate of Enterovirus(EV)from 208 cases was 83.17%(173/208),and the percent-ages of EV71,CoxA16 and other's EV subtypes in 173 enteroviruses were 55.49%,13.29%and 31.21%,respectively. These results were not significant differences between male and female children. EV71 from children with HFMD was predominant strain below 5 old years (≤5),and other's EV subtypes were predominant strains over 5 years (>5). Of fever with herpes was main clinical symptom in patients with HFMD,and EV71 was primary enterovirus induced many clinical features, such as fever with herpes or vomiting or neurological symptoms and so on. Additionally, detection rate of EV in stool specimens was significant higher than that in throat swabs. Conclusion EV71 and other's EV sub-types are predominant strains, CoxA16 strains have a downtrend in patients with HFMD in Huzhou city, so that the medical workers should improve the ability of surveillance to EV,EV71 and CoxA16 in order to make better for control and prevention of the HFMD diseases.

This article reports the prenatal diagnosis of 22q11.2 deletion syndrome (22q11.2 DS) in two consecutive pregnancies of a woman. Echocardiography on the first fetus at 24 +4 gestational weeks identified the right aortic arch, and right-sided ductus arteriosus with aberrant left subclavian artery. Subsequently, an amniocentesis was performed, and chromosomal microarray analysis (CMA) of amniotic fluid revealed a 2.181 Mb heterozygous microdeletion of 22q11.21, which indicated the presence of 22q11.2 DS in the fetus. After genetic counseling, the pregnant woman decided to terminate the pregnancy and declined genetic testing. During her second pregnancy, ultrasound at 21 +5 weeks detected interrupted aortic arch type B with aberrant left subclavian artery, ventricular septal defect, and enlarged posterior fossa in the fetus and further CMA of amniotic fluid indicated fetal 22q11.2 DS. CMA was performed on peripheral blood of the woman, which found the same deletion on 22q11.21. The woman had nasal sounds and velopharyngeal insufficiency with normal phenotype. Following the genetic counseling regarding the risk of recurrence, the pregnant woman opted to terminate the pregnancy and was suggested to undergo preimplantation genetic diagnosis in future pregnancies. One year after the second pregnancy termination, the woman's father developed heart failure at the age of 53 and was also found to have nasal sounds. Low-depth whole genome copy number variation sequencing in venous blood confirmed 22q11.2 DS in her father. For those with a prenatal diagnosis of 22q11.2 DS, genetic testing of the fetal parents is recommended to help assess the risk of recurrence and facilitate genetic counseling.

Objective To compare the safety and efficacy of SpyGlass DS system laser lithotripsy and conventional fractional treatment under endoscopic retrograde cholangiopancreatography(ERCP)in treatment of large calculus of common bile duct.Method 38 patients with large calculus of common bile duct(>2 cm)during ERCP from November 2021 to October 2023 were selected and divided into experimental group(n=18)and control group(n=20).The experimental group was treated with SpyGlass DS system combined with laser lithotripsy.The patients in the control group were treated with split treatment(the first biliary stent was placed,and the calculus of common bile duct were removed under conventional ERCP again 3 months later).The success rate of stone clearance and the incidence of complications after ERCP were compared between the two groups.Magnetic resonance cholangiopancreatography(MRCP)was performed 3 months after surgery to determine whether there were residual calculus of common bile duct.Results The surgical time of the experimental group was longer than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the stone clearance rate and the incidence of short-term complications between the two groups(P>0.05).The incidence of long-term complications in the experimental group was lower than that in the control group,but the difference was not statistically significant(P=0.090).Conclusion SpyGlass DS guided laser lithotripsy is effective and safe for the treatment of large calculus of common bile duct,with a low recurrence rate.

Background: Molecular markers associated with disease progression and prognosis of ulcerative colitis (UC) are still lacking in clinic. Aims: To investigate the expression and clinical significance of vanin 1 (VNN1) in intestinal mucosal tissue, serum and stool in patients with UC. Methods: A total of 100 UC patients and 100 healthy volunteers from Dec. 2018 to Jan. 2020 at the People's Hospital of Xinjiang Uygur Autonomous Region were recruited, and colonoscopy biopsy tissue samples, blood samples and stool samples were collected. PCR, Western blotting and immunohistochemistry were used to detect mRNA and protein expressions of VNN1 in intestinal mucosal tissue, respectively. The expression of VNN1 in serum and stool was determined by ELISA. Results: The mRNA and protein expressions of VNN1 in intestinal mucosal tissue in patients with UC were significantly higher than those in healthy controls (P<0.05). Immunohistochemistry results showed that VNN1 expression was significantly higher in intestinal mucosal tissue in patients with UC than in healthy controls (P<0.05). ELISA results showed that serum expression of VNN1 in patients with UC was significantly higher than that in healthy controls (P<0.05). There was no significant difference in expression of VNN1 in stool between patients with UC and healthy controls (P>0.05). Conclusions: The expressions of VNN1 in intestinal mucosal tissue and blood in UC patients are high, and can be used as a molecular marker of UC.