Objective To review the experience on screening,diagnosis and treatment for neonatal congenital hypothyroidism (CH)in Xuancheng City,Anhui Province.MethodsFrom Jan 2008 to Dec 2014,peripheral blood samples from the heel were collected among 83787 neonates and the blood samples were sent to the screening center to test the level of thyroid stimulating hormone (TSH).Neonates with abnormal level of TSH were admitted to our hospital for further TSH and free tetraiodothyronine (FT4 )tests. Neonates with CH diagnosis were given standard treatments of levothyroxine and their thyroid function, physical and intelligence development were evaluated on a routine basis.Results Among the 106 neonates with abnormal TSH level ,68 were diagnosed CH.The prevalence of CH in Xuancheng City was 0.8 ‰.All 68 patients with CH received levothyroxine treatment and 6 cases were lost during follow-up.44 patients received physical examination and their bone ages were normal. 53 patients received intelligence assessment.Only 1 of them was diagnosed of mental retardation, and 3 with suspicious mental retardation.Conclusion Neonatal screening is necessary for the early diagnosis and treatment of CH. Neonates with CH can have normal physical and mental development if they receive standard treatment as early as possible and followed up regularly.

Objective To study the change of the hyaluronic acid (HA),laminin (LN) and col- lagen type IV (C_(?)) within the renal grafts and in serum during acute rejection and to investigate their relationship.Methods Male Wistar and Sprague-Dawley rats were used as donors and recipients,re- spectively.Rat orthotopic kidney transplantation was performed according to a modification of the method decribed by Biota.Experimental rats were randomly divided into 4 groups,homotransplanta- tion rats treated with cyclosporine,isotransplantation,pseudooperation and controls.Animals were subsequently killed at defined time points for determination of the extracellular matrix (ECM) parame- ters (HA,LN and C_(?)) within the graft and in serum by radioimmunoassay.Results Significant increases in HA,LN and C_(?) levels within the renal grafts were found in the rejection group as compared with the non-rejection groups.Serum levels of HA,LN and C_(?) were also significantly elevated in the rejection group at diagnosis of rejection.Serum HA,LN and C_(?) levels were correla- ted with those within the renal grafts.Histologic examination revealed that 4 cases developed acute re- jection in homotransplantation rats treaded with cyclosporine,17 cases in controls.HA,LN and C_(?) levels within the renal grafts were correlated with acute rejection Banff scores.There was correlation between serum levels of HA,LN and C_(?) and acute rejection Banff scores (P＜0.01).Conclusion HA,LN and C_(?) play an important role in the pathogenesis of acut allograft rejection.In addition, serum levels of HA,LN and C_(?) may be a sensitive marker of acute rejection in the postoperative period of renal transplantation.

Background:Clinical features and outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze characteristics and prognosis of patients with HFmrEF.Methods:PubMed,Embase,and Web of Science were searched for cohort studies up to April 23,2019.Clinical features and multivariate adjusted hazard ratios (HRs) of endpoints of short-term all-cause mortality (SAM),long-term all-cause mortality (LAM),long-term cardiovascular death (LCD) and long-term HF rehospitalization (LHR) among patients with HFmrEF and HF with preserved ejection fraction (HFpEF),HF with reduced ejection fraction (HFrEF) were well addressed.The primary outcome was LAM.Results:Totally 19 studies were included in this study with 164,678 patients enrolled.The follow-up time of LAM was 3.6 ± 2.5 years.HRs of LAM,SAM,LCD,LHR indicated that the risks of patients with HFmrEF were higher than HFpEF patients but lower than HFrEF patients,as for LAM,HFmrEF:HFpEF (reference) HR:1.07,95％ confidence interval (CI):1.00-1.15 (I2=63％,P =0.0005);HFmrEF:HFrEF (reference) HR:0.80,95％ CI:0.73-0.88 (I2=70％,P ＜ 0.0001).However,HFmrEF patients had the lowest rate in LAM (30.94％),SAM (2.73％),LCD (17.45％),LHR (26.36％) compared with the other two groups.Conclusions:This systematic review and meta-analysis compared features and prognosis between patients with HFmrEF and HFpEF,HFrEF by HRs.There appeared a special "separation phenomenon" showing rates of endpoints were inconsistent with their hazards in patients with HFmrEF compared with HFpEF patients.

Objective To study the clinical values of positron emission tomography(PET)in pre-term and term newborn infants through observing neonatal brain by 18F-fluorodeoxyglucose(18F-FDG)PET.Methods The brain by 18F-FDG PET in 11 term and 7 pre-term newborn infants after administration of 0.1 mCi /kg 18F-FDG were observed.There were 11 males and 7 females,who were normal by brain computed tomography or magnetic resonance imaging.Results The brain 18F-FDG PET image in pre-term and term newborn infants was relatively high in thalamus,and relatively low in cerebral cortex,whereas the total brain was different with adults.Especially in the area of cerebral cortex,the uptake of glucose was relatively higher,and the structure of brain 18F-FDG image was more clear in term infants than that in pre-term infants.Conclusion Neonatal brain picture by 18F-FDG PET is a new tool for predicting the brain function,and its clinical values need further investigating.

Objective To explore the changes of positron emission tomography(PET)in newborn infants with HIE through 18F-fluorodeoxyglucose(18F-FDG)and it's significance.Methods Eleven healthy newborn infants and 8 newborn infants with HIE were selected.Among the healthy newborns,7 cases were male and 4 cases were female,and the mean birth-weight was(3 350?620)g,the gestational age was(37.9?1.3)weeks.Among the HIE neonates,5 cases were male and 3 cases were female,and the mean birth weight was(3 180?390)g,the gestational age was(37.1?2.4)weeks.There were no significant differences of sex and gestational age between the 2 groups.The examination time was form 3 to 21 d,and the mean age was(8.7?3.9)d.PET of the children in 2 groups were observed after 0.1 mCi/kg 18F-FDG injected 30 min.Results The brain 18F-FDG PET image in newborn infants was relatively high in thalamus,and relatively low in cerebral cortex,whereas the total brain was different with that of the adults,and that was not as clear as that of adults.Especially in the area of cerebral cortex,the uptake of glucose was relatively higher.The structure of brain 18F-FDG image was significantly changed in newborn infants with HIE,especially increased in the areas of peripheral ventricle and hypophloeodal cerebral white matter,and there was a remarkably bilateral asymmetry.Conclusions Neonatal brain picture by 18F-FDG PET is a new tool for predicting the brain function,and its clinical values need further investigating.

Objective To explore the association of sedentary behavior and time with risk of metabolic syndrome (MS).Methods A total of 10 149 subjects were recruited from local residents aged ≥40 years old in Jiashan County by cluster-random sampling method.The data including physical activity,job,sedentary time,and sleep,etc.were collected.Height and body weight,waist circumference,blood pressure,blood glucose,blood lipid,etc.were determined.Logistic regression was used for correlation analysis.Results The prevalence of MS was 28.64％ in local residents over 40 years old in Jiashan.The rate of sedentary behavior in all subjects was 67.57％,with 3 h sedentary time on average.Compared with non-MS group,the rates of sedentary behavior and sedentary time were significantly higher in MS group (P＜0.01).Multivariate logistic regression analysis showed that sedentary behavior was independently associated with an increased risk of MS after adjustment for age,sex,body mass index (BMI),smoking,drinking,and sedentary time(OR=1.16,95％ CI 1.03-1.30,P=0.017).Increased sedentary time was associated with higher risks of hypertension,type 2 diabetes mellitus,and dyslipidemia (P ＜ 0.05 or P ＜ 0.01).Sedentary time ≥ 5 h/d independently increased the risk of MS (OR =1.15,95％ CI 1.01-1.31,P =0.034).Conclusions There is a high prevalence of MS in adults over 40 years old living in the eastern coastal rural area.MS and its related diseases are closely associated with sedentary behavior and its duration.

ObjectiveTo explore the regulation of claudin-4 expression in endometrial adenocarcinoma cell lines by progesterone.Methods Ishikawa cells were treated with various concentrations of megestrol acetate (MA:2,5,10,15,20 mg/L).After cultured for 24,48 and 72 hours,cells growth were measured by methyl thiazolyl tetrazolium (MTT).The group of Ishikawa cells incubated with MA at the 50％ inhibitory concentration ( IC50 ) was selected for cell apoptosis assay by using transmission electron microscopy and flow cytometry method.Real-time PCR and western blot were used for detecting the mRNA and protein expression levels of claudin-4.The localization of claudin-4 was examined by immunofluorescent staining.Results The inhibitory effects of megestrol acetate on the growth of Ishikawa cells were dosedependent and time-dependent.IC50 of MA on Ishikawa cells was 15 mg/L after incubated for 72 hours.After MA treatment,Ishikawa cells showed shrinkage,nuclear chromatin condensation,fractures of nuclear membrane and endoplasmic reticulum expansion,even round apoptotic bodies were found.The apoptosis rate of cells before MA treatment was (0.076 ±0.024)％,and the rate was (3.934 ±0.816)％ by MA treated for 72 hours,in which there were signicant difference( P ＜ 0.05 ).The relative quantification of claudin-4 mRNA and protein of the cells before MA treatment were 0.64 ± 0.20 and 0.94 ± 0.18,while they were 0.47 -0.15 and 0.62 ±0.15 after MA treated.The expression of claudin-4 was significantly decreased after MA treatment ( P ＜ 0.05 ).The localization of claudin-4 transferred from cytomembrane to cytoplasm and nucleus after MA treatment.Conclusions MA could inhibite the growth of Ishikawa cells,in which the mechanism may be decrease the expression of claudin-4 and the apoptosis of cells.The distribution change of claudin-4 may be related to the anti-cancer effect of progesterone.

OBJECTIVETo investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).

METHODSFifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated.

RESULTSThe long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4 ± 8.6 minutes, and the mean radiation exposure time 18.9 ± 6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.

CONCLUSIONSUsing the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies

Objective: To investigate the degree and influencing factors of glycosylated hemoglobin ( HbA1c ) control among patients with type 2 diabetes ( T2DM ) living in rural communities of Zhejiang Province, so as to provide the reference for optimizing the management of diabetes patients in rural communities. Methods: Permanent adult patients with T2DM that were registered and received standardized management in all communities of Jiashan County and Suichang County, and 6 communities of Yongkang City, Zhejiang Province in 2016 were recruited, and their demographic characteristics were captured from the health record system and chronic disease management system. The height, body weight, waist circumstance and blood pressure were measured, and HbA1c and blood lipid parameters were detected. The degree of HbA1c control ( <7% ) was analyzed, and its influencing factors were identified using a multivariable logistic regression model. Results: A total of 10 339 patients with T2DM were enrolled, including 4 520 men ( 43.72% ) and 5 819 women ( 56.28% ), with a mean age of ( 63.54±9.78 ) years and the mean course of diabetes of ( 6.36±4.73 ) years. The rate of HbA1c control was 47.89%. Multivariable logistic regression analysis showed that males ( OR=1.123, 95%CI: 1.024-1.233 ), region ( Suichang, OR=2.413, 95%CI: 2.106-2.765; Yongkang, OR=2.460, 95%CI: 2.188-2.767 ), course of disease ( 5-9 years, OR=1.724, 95%CI: 1.504-1.977; 10 years and longer, OR=2.881, 95%CI: 2.477-3.351 ), use of hypoglycemic drugs ( OR=1.203, 95%CI: 1.089-1.329 ), development of chronic complications ( OR=1.190, 95%CI: 1.027-1.379 ), uncontrolled blood pressure ( OR=1.140, 95%CI: 1.030-1.261 ), uncontrolled blood lipid ( OR=1.258, 95%CI: 1.104-1.433 ), and smoking ( OR=1.318, 95%CI: 1.165-1.491 ) were statistically associated with HbA1c control among T2DM patients. Conclusion The rate of HbA1c control was 47.89% among T2DM patients in rural communities of Zhejiang Province. HbA1c control should be given a high priority among men living in low-economic-level regions with long course of disease, use of hypoglycemic drugs, chronic complications, smoking, uncontrolled blood pressure and lipid.

Objective To investigate the role of nucleosome in the pathogenesis of systemic lupus erythematosus (SLE). Methods BALB/c mice were immunized with nucleosome, and then serum dsDNA and ANA autoantibodies were detected by ELISA. Kidney specimens were observed by immunofluorescence and histological examination. Results High titers of IgG dsDNA and ANA autoantibodies in sera of BALB/c mice were observed at the 14th day after immunization with nucleosome. Nephritis and immune complex deposition in renal glomeruli were observed at the 35th day. Conclusion Nucleosome could induce SLE-like disease in BALB/c mice, and may play a critical role in the pathogenesis of SLE.