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.

Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcomas, this sarcoma occurs rarely in the larynx. Herein, we describe an unusual case of ASPS occurring in the larynx. The patient was a 46-year-old woman who presented with a more than 2-year history of right pyriform fossa mass and progressive hoarseness for three months. The endoscopic examination of the larynx revealed a mass in the right pyriform fossa with smooth surface and well-defined margin. Computed tomography demonstrated a heterogeneous tumor in the right pyriform fossa, and involving the paralaryngeal space, measuring approximately 2.1 cm x 1.7 cm x 2.6 cm, which was resected via lateral neck approach. Histopathology and immunohistochemistry revealed an ASPS. To ours knowledge, this is the first reported case of ASPS arising in pyriform fossa.
Female ; Hoarseness ; Humans ; Immunohistochemistry ; Larynx ; pathology ; Middle Aged ; Sarcoma, Alveolar Soft Part ; pathology ; Tomography, X-Ray Computed

To study the method of preparing the composite skin composed of keratinocytes and acellular dermis, and to investigate the efficacy as well as its histological changes after being grafted on wounds of athymic mice. Compared with keratinocyte sheet grafting, the wounds grafted with composite skin had better healing rate, appearance and less wound contraction rate. Moreover, histological examination revealed fully differentiated epidermis, organized proliferated collagen fibres, and distinct reconstruction of epidermis-dermis junction in composite skin group, with absence of acute immuno-rejection response. As a new kind of skin substitutes, the composite skin can improve the quality of wound healing.

Objective:To analyze the clinical materials of 2 patients with lung cancer complicated with syndrome of inappropriate secretion of antidiuretic hormone (SIADH),and to improve the clinical awareness and management.Methods:One patient was treated with lung cancer chemotherapy alone for 7 courses.The other patient received the strictly limited for liquid intake and tolvaptan by oral against hyponatremia without chemotherapy.Results:With the relapsing and advancing of lung cancer,the hyponatremia and its relevant symptoms of the first patient were poorly relieved.While the level of serum sodium of the second patient returned to the normal level 3 d after administration of tolvaptan.Conclusion:About one-third of the patients with hyponatremia have SIADH.The etiological treatment and symptomatic therapy of hyponatremia should be given to the patients in clinical treatment.

The application of biological technology and the deepening of tumor research have effectively improved the level of tumor diagnosis, treatment and clinical outcome prediction. However, the specific mechanisms of tumorigenesis and development are still unclear, and tumor drug resistance has also become an urgent problem that needs to be solved to improve the clinical outcome of patients. Considerable studies have shown that the extrachromosomal DNA (ecDNA) can promote tumorigenesis, development and drug resistance. EcDNA is a looser, rounded form of DNA with unique genetic properties that carry specific genes and regulatory elements. This paper will discuss the biological characteristics, tumor-promoting mechanisms and drug resistance-facilitating of ecDNA.

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.

Aim To investigate the effects and possible mechanisms of kaemperol in the rats with chronic cere-bral ischemia.Methods Chronic cerebral hypoperfu-sion model was produced by permanent occlusion of bi-lateral common carotid arteries (2VO)in rats.After KAE treatment,the rats underwent Morris water maze and prehensile traction test.Neuronal morphology was observed using Nissl and HE staining.The activity of SOD and the content of MDA in brain tissue were de-termined.The DJ-1 protein expression was assayed by Western blot.Results Compared with 2VO model group,KAE significantly improved learning and memo-ry and the grasping ability.In addition,KAE signifi-cantly reduced brain tissue pathological injury induced by 2VO. Furthermore, KAE significantly increased SOD activity and enhanced antioxidant protein DJ-1 ex-pression in brain tissue.Conclusions KAE could sig-nificantly attenuate the cognitive impairment,limb bal-ance dysfunction and pathological injury in rats with chronic cerebral ischemia.The mechanism may be re-lated to improving the antioxidant system in vivo.

Abstract: Objective　This study aims to explore the prevalence and risk factors of metabolic syndrome (MS) among the adults in Hainan Province, and to provide scientific basis for MS prevention and control. Methods　A multi-stage cluster random sampling method was applied to select 3 690 permanent residents aged 18 years and above in Hainan Province. The survey was conducted by trained investigators using household appointments and centralized surveys. A questionnaire survey, physical measurement, and laboratory examination were conducted after the collection of blood samples. The processed samples were then tested by a quality-controlled laboratory. Finally, we analysed the prevalence of metabolic syndrome (MS) and its relationship with population characteristics and health-related behaviors. Results　The crude prevalence of MS in the population aged 18 and above in Hainan province was 19.46% and the standardized prevalence was 13.21%, with a higher rate in urban areas (22.21%) than in rural areas (18.13%). The prevalence of MS increased with age (P<0.001), and there were significant differences in MS prevalence among different marital and occupational statuses (P<0.01). Logistic regression results indicated that the age groups of 40-<50 years (OR=2.986, 95%CI:1.355-6.580), 50-<60 years (OR=3.739, 95%CI: 1.715-8.151), 60-<70 years (OR=3.890, 95%CI: 1.769-8.556), 70 years and above (OR=3.927, 95%CI: 1.758-8.771), technical, transportation and production personnel (OR=1.579, 95%CI: 1.033-2.412), retired (OR=1.788, 95%CI: 1.415-2.259), unemployed (OR=1.503, 95%CI: 1.044-2.165), smoking cessation (OR=1.582, 95%CI: 1.162-2.154), insufficient intake of fruits and vegetables (OR=1.196, 95%CI: 1.005-1.422), and insufficient physical activity (OR=1.437, 95%CI: 1.155-1.787) were all associated with the prevalence of MS. Among the investigated subjects, 30.22% of them had one abnormal component, with hyperglycemia being the highest (54.44%); 24.25% of them had two abnormal components, with "hyperglycemia + hypertension" being the highest (33.30%); and 19.46% had three or more components, with "overweight/obesity + hyperglycemia + hypertension" being the highest (24.79%). Conclusions　The prevalence of MS in Hainan Province is on the rise, and effective lifestyle intervention measures are needed to reduce the risk of MS.

Objective To explore the therapeutic effect of electroencephalograph(EEG)biofeedback on clinical symptoms and cognitive function of children with attention deficit hyperactivity disorder(ADHD).Methods Twenty children aged(10.4?2.2)years old who were diagnosed as ADHD according to American Diagnostic and Statistical Manual of mental disorders the 4th ed received EEG biofeedback treatment.The treatment was administered by Autogenic A620 machine,? wave(4-8 Hz)was suppressed and sensory motor rate wave was strengthened(12-15 Hz)at the same time.The treatment was total 40 times.Before and after treatment,Conner's Behavior Rating Scale-parent questionnaire was administered to assess the clinical symptoms,wechsler memory scale(WMS)to assess the long-term memory,short-term memory and instantaneous memory,number cancellation test and stroop test were used to assess the cognitive process speed and selective attention,and continuous performance test(CPT)was administered to assess the attention and impulsiveness.The children in healthy control group who compared with ADHD children by one to one came from the primary or middle school near the hospital,the age difference between ADHD child and healthy control group was within 6 months.All the measurements were administered to the healthy control group.Results After the EEG biofeedback treatment,the score of behavior factor in Conners Scale decreased significantly(P0.05).Conclusions Forty sessions EEG biofeedback can improve clinical symptoms,attention,memory,selective attention and cognitive process speed of ADHD children significantly,some indicators even become normal.

Obstructive sleep apnea-hypopnea syndrome(OSAHS) is a common sleep-related breathing disorder,which has a series of impact on the cardiovascular system.The dctection of some biochemical indicators plays an important role in predicting this kind of cardiovascular damage.The role of inflammatory predicting factors such as TNF-?,IL-6,CRP,IL-10,MMPs and ICAM-1 is reviewed in this paper.