ABCC8,KCNJ11,and GLUD1 gene mutations were investigated in a male patient with congenital hyperinsulinism and his parents were also investigated.A 1484 G＞A mutation was found in the 10th exon of ABCC8 gene in the patient,which leads to amino acid substitution at the 495 residue of the sulphonylurea receptor SUR1 protein.The patient's father also carried the same heterozygous inactive mutation,while the genotype of the mother was normal,indicating that the gene mutation of the patient was paternally inherited.According to that mutation,it is deduced that the patient may suffer from the focal type of congenital hyperinsulinism.

Objective To discuss the effect of the quality control circle(QCC)activities in reducing the incidence of cold in reflux-enema of children.Methods The QCC team was built,reducing the incidence of cold in reflux-enema of children was named as the theme,to grasp the present situation,set the goal,fix the methods and carry out countermeasures.Results Through the development of QCC,making the standards of reflux-enema,the incidence rate of cold reduced from 25.0％(7/28) down to 3.6％(1/28),the nurses' abilities of technical operation and communication improved significantly.Conclusions Application of QCC in reflux-enema of children is practical.It can effectively improve the nurses' awareness of participating in the implementation management and nursing management system.By making the standardization of reflux-enema,nurses can improve the quality and effect of the reflux-enema and ensure the quality and safety of nursing.

Objective To explore imaging features of Zinner syndrome.Methods Eight male patients with clinically diagnosed Zinner syndrome performed abdominal and pelvic CT and /or MRI scan.The radiological data was studied retrospectively.Results Eight cases showed seminal vesicle cyst with ipsilateral renal agenesis on CT and/or MR imaging ( left side, n =5; right side, n =3).The maximal diameter of seminal vesicle cysts varied from 4.2 to 7.0 cm, and appeared as oval cystic lesion with irregular contour or tube-like dilatation , which appeared low density on CT image and hypo-or hyperintensity on T 1 WI and hyperintensity on T 2 WI.Bladder compression was found in 6 cases.Fuild-fuild level in the cysts was seen in 2 cases.Remnants of ureter structure were seen in only 1 case.There was no other accompanying abnormality of urinary system.Conclusions Zinner syndrome presents with characteristic imaging features , and the key issue is differential diagnosis of seminal vesicle cysts.

Objective By analyzing the epidemiological characteristics and trends of brucellosis in Ji'nan City,to provide a scientific basis for further prevention and control of the disease.Methods Serum samples of suspected brucellosis patients were collected from every county (city,district) of Ji'nan City from 2008 to 2014,and these samples were screened by Rose-bengal plate agglutination test (RBPT).Then positive samples were confirmed by Standard tube agglutination test (SAT),and experimental data and results were analyzed by statistics.Results Totally 2713 serum samples of suspected brucellosis patients were tested,and 200 were positive by SAT.Temporal distribution:the serum antibody positive specimens were detected each month throughout the year,and the results showed clear seasonal prevalence by concentrating from March to September (82.07％,151/184).Population distribution:the serum antibody positive rate of males was higher than that of females,the ratio was 2.08:1.00,and the cases were found among 15 to 75 years old,while concentrated from 30 to 65 (67.00％,134/200).Spatial distribution:except Huaiyin District,positive samples were detected in all other 10 counties (cities,districts) of Ji'nan City,most of them (92.5％,185/200) in Shanghe,Zhangqiu,Changqing,Shizhong and Licheng counties (cities,districts).Conclusions Brucellosis epidemic in Ji'nan is serious,and cases have occurred mostly in spring,summer and autumn.It is recommended that health propaganda and education should be strengthened in order to enhance selfprotection awareness of the exposed population,and then improve the physical examination for early discovery,early reporting and early treatment.At the same time,it is important to cooperate with the Department of Livestock to prevent and control brucellosis.

Objective To explore the potential value of serum lipoxin A4 (LXA4) in monitoring bacterial load and anti-tuberculosis treatment progression in patients with pulmonary tuberculosis (PTB). Methods From January 2021 to January 2022, forty patients with active PTB, who were admitted to Shaanxi Provincial Tuberculosis Prevention and Control Hospital, were selected as the active PTB group, 38 patients with latent tuberculosis infection (LTBI) were selected as the LTBI group, and 28 healthy volunteers who underwent physical examination in our hospital during the same period were included as the healthy control group. The active PTB patients received a 2-month standard anti-tuberculosis chemotherapy, while the other two groups were untreated. Fasting venous blood was drawn from the three groups at enrollment (baseline), after 2 months of treatment, and upon the completion of 6 months of treatment in the active PTB group to measure serum LXA4 levels using enzyme-linked immunosorbent assay (ELISA). The relationship between serum LXA4 level and clinical manifestations, bacterial load, chest imaging manifestations, and treatment progress was analyzed. Results At baseline, serum LXA4 levels in the active PTB group, LTBI group, and healthy control group were [397.72 (210.68, 573.00)], [178.18 (108.17, 271.87)], and [131.06 (76.24, 166.04)] pg/mL, respectively. The levels in the active PTB and LTBI groups were significantly higher than those in the healthy control group, with statistical significance (P<0.01). According to the grading of acid-fast bacilli (AFB) sputum smears at diagnosis, baseline serum LXA4 level increased in the active PTB group with AFB sputum smear grade (P<0.001), and there was a positive correlation between serum LXA4 level and sputum smear grade (rs=0.209, P=0.003). After 6 months of treatment, the serum LXA4 level in the active PTB group was lower than the baseline value (P=0.002). The serum LXA4 level can predict treatment progress, with a baseline sensitivity of 55.0% (22/40), and after 6 months of treatment, 8 patients (20.0%) still showed positive serum LXA4 levels. Conclusions Serum LXA4 may be a useful biomarker for monitoring the progression of PTB treatment.

Chemokines are small cytokines with chemotactic activity, they are involved in regulating immune responses and inflammatory responses. In the development of tumors, chemokines are multi-functional mediators that not only affect the infiltration of immune cells into the tumor, but also have an important impact on tumor growth, angiogenesis, invasion, and metastasis. Besides, they are important targets of tumor therapy. Here we review chemokines involved in the regulation of signaling pathways, analyze the mechanism of chemokines in the development of breast cancer, summarize the chemokines targeted drugs for breast cancer in recent years and make a prospect about the role of chemokines in anti-breast cancer therapy.

Objective:To construct an intelligent performance measurement system of gastrointestinal endoscopy and to analyze its value for endoscopic quality improvement.Methods:The intelligent gastrointestinal endoscopy performance measurement system was developed by using the deep convolutional neural network (DCNN) and deep reinforcement learning, based on the Digital Imaging and Communications in Medicine. Images were acquired of patients undergoing gastrointestinal endoscopy at Digestive Endoscopy Center of Renmin Hospital of Wuhan University from December 2016 to October 2018. The system applied cecum recognition model (DCNN1), images in vitro and in vivo recognition model (DCNN2), and identification model at 26 gastric sites (DCNN3) to monitor indices such as cecal intubation rate, colonoscopic withdrawal time, gastroscopic inspection time, and gastroscopic coverage. Images of 83 gastroscopies and 205 colonoscopies acquired at Digestive Endoscopy Center of Renmin Hospital of Wuhan University from March to November 2019 were randomly selected to examine the effectiveness of the system. Results:The intelligent gastrointestinal endoscopy performance measurement system consisted of quality analysis of both gastroscopy and colonoscopy, including all indices, and could be generated automatically at any time. The accuracy for cecal intubation rate, colonoscopic withdrawal time, gastroscopic inspection time, and gastroscopic coverage were 92.5% (172/186), 91.7% (188/205), 100.0% (83/83), 89.3% (1 928/2 158), respectively.Conclusion:The intelligent performance measurement system for gastrointestinal endoscopy can be recommended for the quality control of gastrointestinal endoscopy, from which endoscopists can get feedback and improve the quality of gastrointestinal endoscopy.

cerebral infarction as compare with patients at Grade 1-2 in both vascular locations, whereas the risk was not significantly increased in patients at Grade 3-4 in only one vascular location. Conclusions The simple method of assessing the degree of arterial atherosclerosis can be used to evaluate carotid artery and lower-extremity artery atherosclerosis in patients with type 2 diabetes. Patients with plaques or stenosis in both vascular locations were with a significantly increased risk of coronary heart disease or cerebral infarction if they were evaluated concurrently.

Objective To observe the corrosion reaction and disinfection effect of the two different chlorine disinfectants toward the surgical instruments, to prevent the corrosion of instruments and the professional infection risk of cleaning staffs during washing the infectious disease-contaminated medical instruments manually in the primary hospitals. Methods The surgical instruments were soaked in the diluted chlorine effervescent tablets and the diluted chlorine disinfection powder, respectively. The corrosion of the two disinfectants to the equipment at different times was observed. The bloody surgical instruments were soaked in the diluted chlorine effervescent tablets and the chlorine disinfection powder for 4 hrs, respectively. The instruments' surfaces status was observed,and the bacterial reproduction status after soaking the instruments in the diluted liquid for 48 hrs was monitored.Results The diluted liquid of effervescent chlorine tablets had corrosion reaction after only 5- 10 minutes,but the diluted liquid of chlorine disinfection powder had no corrosion reaction after 48 hours. The dilution liquid of effervescent tablets and the dilution liquid of disinfection powder had a significant statistic difference in the rate of instruments corrosion. The bloody instruments' surface had difference after immersed for 4 hrs,and the pass rates of bacteria monitor was 100% after 48 hrs of immersion. Conclusions For the primary hospitals without cleansing and disinfection equipments,using the chlorine disinfection powder to soak the medical instruments before cleaning the infectious disease-contaminated medical instruments manually not only has no equipment corrosion but also achieves the disinfection effect.