Objective To analysis the progress in prevention and control of iodine deficiency disorders (IDD) in Dalian and to provide a scientific basis for further prevention and control of the disease.Methods From 2006 to 2010,5 or 9 townships were randomly sampled from each county in Dalian,4 villages were sampled from each selected townships and 15 or 8 households were sampled from each selected villages for collecting salt samples and salt iodine level was determined by direct titration method.Sixty daytime urine samples from pregnant women,breast feeding women,infants and young children were collected,respectively,every year to detect urinary iodine level.From 2007 to 2009,2 to 11 counties were sampled and from each selected county one school was sampled to collect 100 daytime urine samples of children aged 8-10 and iodine content was determined.From 2006 to 2009,2 to 5 counties were sampled,from each selected county 2 to 5 schools were sampled and 100 children aged 8 to 10 in each selected school were sampled to detect intelligence quotient level and the thyroid volume.Results From 2006 to 2010,16 012 copies of households' edible salt samples were monitored; the average iodine content was ranged 29.68-31.51 mg/kg,the rate of qualified iodized salt in household ranged from 97.24％ to 98.42％.A total of 1398 copies of urine samples of pregnant women,486 breast feeding women,473 infants and 502 young children were monitored,and the median value of urinary iodine was 129.3-189.6,114.6-190.6,148.5-298.5 and 144.4-187.3 μg/L,respectively.A total of 1657 urine samples were monitored,1264 intelligence quotient level and 1197 thyroid volume of school-age children were determined,the median urinary iodine,thyroid goiter rate and intelligence quotient level was 217.9-266.7 μg/L,0-3.29％ and 110.4-117.2 μg/L,respectively.Conclusions From 2006 to 2010,the city's households qualified iodized salt coverage rate has reached the national standard for elimination of iodine deficiency disorders.The iodine nutrition of key population and school-age children has reached adequate level,the thyroid goiter rate is less than 5％,and the level of intelligence quotient has increased every year.But the iodine nutrition of breast feeding women in 2009 and 2010,pregnant women in 2010 is inadequate,so iodine nutrition surveillance and health education in pregnant and breast feeding women need to be strengthened in the future.

Objective To assess intraplaque hemorrhage before carotid artery stenting (CAS)by use of 3D-MPRAGE and DWI sequence.Methods Thirty-two symptomatic patients who had carotid artery plaque suspected by color Doppler ultrasonography and prepared for CAS underwent 3.0T carotid high-resolution MR scans,including regular sequence,T1-weighted gradient echo three-di-mensional magnetization prepared (3D-MPRAGE ) sequence,diffusion-weighted imaging (DWI ) sequences.According to 3D-MPRAGE sequence hemorrhage and non-hemorrhage groups were divided,and measured the mean ADC values of the two groups, hemorrhage and non-hemorrhage part in the hemorrhage group.Meanwhile preoperative cerebral hemorrhage group underwent brain DWI scans.Independent samples t-test analysis was utilized by SPSS V20.0 statistical software.Results High-resolution MRI dis-played 40 plaques,fourteen hemorrhagic plaques showed by 3D-MPRAGE sequence.The mean ADC values of hemorrhage and no-hemorrhage group were(1 233.5±283.5)× 10 -6 mm2/s,(1 688.9 ± 449.6)× 10 -6 mm2/s respectively,the difference of both was significant (t=3.43,P <0.05).The mean ADC values of hemorrhage and non-hemorrhage parts in the hemorrhage group mean ADC values were (934.0 ± 387.9)× 10-6 mm2/s,(1 313.9 ± 295.0)× 10-6 mm2/s respectively;the difference of both was statistically significant (t=2.92,P < 0.05 ).The difference of mean ADC values between non-hemorrhage part in the hemorrhage group and hemorrhage group was statistically significant (t=2.80,P <0.05).Conclusion 3D-MPRAGE and DWI sequences can be evaluated intraplaque hemorrhage before CAS,and provided a reliable basis for timely clinical interventions to prevent stroke.

Objective:To acquire potential HBsAb sequences,we have analyzed the BCR CDR3 repertoire of the peripheral blood with HBsAb titer higher than 10 000 mU/ml,which could provide a data basis for follow-up study.Methods:Genomic DNA of pe-ripheral blood mononuclear cells was extracted from samples with HBsAb titer higher than 10 000 mU/ml.We have adopted Illumina Solexa high-throughput sequencing technology of the Adaptive Biotechnologies ImmunoSEQ platform to acquire sequence data.IMGT/High V-QUEST was used to preliminary analyze our sequence data,including usage of IGHV,IGHJ and IGHD gene subgroups,IGHV-J matching,distribution of CDR3 amino acid (AA) length and usage of total CDR3 AA.And these sequences were compared with the HBsAb sequences from NCBI database.Results:Experimental samples have highly selected gene subgroups IGHV3,IGHV4,IGHJ4, IGHJ6,IGHD3,IGHD6,and IGHV3-J4 pairing,IGHV3-J6 pairing.The AA length distributions of CDR3 region were normal distribution with the length of 14/15 AA as the midline.In the regard to amino acid usage in CDR3 region, each sample prior used Alanine, Tyrosine,Glycine,Alanine,Aspartic acid and Serine.The amino acid usages of 107,108,109,113,114 positions were diversified but 105,106,115,116,117 positions taking conservative amino acids usages.We have found 48 unique sequences that have same IGHV, IGHJ and CDR3 AA length with the HBsAb sequences from NCBI database.Conclusion:There were almost the same characteristics of BCR CDR3 repertoire of the peripheral blood with HBsAb titer higher than 10 000 mU/ml.The 48 unique sequences provided a solid data basis for the follow-up study.

Objective To investigate the management of external iliac artery mycotic hemorrhage after kidney transplantation. Methods A case of external iliac artery mycotic hemorrhage after kidney transplantation managed by the use of hypogastric artery autograft was reported with review of the literature.The massive blooding occurred 3 times after kidney transplantation in a male patient 25 years of age on the 22nd,24th and 38th day after transplantation.The blooding amounted to 800 ml,2500 ml and 3800 ml respectively.The blood loss was replaced and prompt surgical exploration was carried out with the blooding site at the anastomosis sutured up on the 1st and 2nd episode of bleeding.On the 3rd occurrence of bleeding, the diseased external iliac artery segment, about 2cm in length, was resected and the gap was replaced by a 3cm long hypogastric artery autograft. Results The blood flow through the repaired external iliac artery and the blood supply to the lower extremity was adequate.Periodic hemodialysis had been restored and the patient waited for reimplantation. Conclusions External iliac artery mycotic hemorrhage after kidney transplantation is a serious and fatal complication.Simple arterial repair is usually noneffective.Resection of the diseased mycotic segment of the external iliac artery with repairing of the gap with a hypogastric artery autograft is rational,feasible and simple.The procedure is highly recommended.

Comprehensive biochemistry experiment,which is interlocked and has difficulties in a certain degree,requires considerable knowledge,multiple techniques and long time.In order to ensure the smooth progress of the experiment,biochemistry and molecular biology department of Hebei medical university has taken following measures in teaching preparation and teaching implementation:building a specialized laboratory;performing collective lesson preparation and pre-experiments;technical teaching;teaching with multimedia equipments;students submitting experimental preparatory reports before class and then completing the experiments in groups.These measures achieved the intended purpose of setting up a comprehensive experiment.

Objective To evaluate the changes in cholinergic anti-inflammatory pathway in hippocampi global in aged rats with cerebral ischemia/reperfusion (I/R ) injury .Methods One hundred and twenty male Sprague-Dawley rats , aged 18-22 months ,weighing 450-600 g ,were randomly divided into 2 groups ( n= 60 each):sham operation group (group S) and global cerebral I/R group (group I/R) .The animals were anesthetized with intraperitoneal 10% chloral hydrate 0.4 ml/100 g .Global cerebral I/R was induced by 4-vessel occlusion method described by Pulsinelli .Fifteen rats were sacrificed at 1 ,3 ,5 and 7 days of reperfusion ,and brains were removed for determination of neuronal apoptosis and expression of α7 nicotinic acetylcholine receptor (α7nAChR ) , choline acetyltransferase (ChAT ) ,tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) in the hippocampal CA1 region .The apoptosis rate was calculated .Results Compared with group S ,the apoptosis rate was increased and the expression of α7nAChR ,ChAT ,TNF-αand IL-1βwas up-regulated in group I/R ( P<0.05 or 0.01 ) . The expression of α7nAChR and ChAT was up-regulated gradually during reperfusion and peaked at 5 day of reperfusion ( P< 0.05 ) .Conclusion Global cerebral I/R injury can activate cholinergic anti-inflammatory pathway in aged rat hippocampi ,and the activation of this pathway is the endogenous mechanism of inhibition of excessive inflammatory responses in brain tissues .

Objective To evaluate the diagnostic value of cerebrospinal lactate for the diagnosis of bacterial meningitis in patients post-neurosurgical operation (PNBM) with blood-contaminated cerebrospinal fluid (CSF). Methods A prospective observational study was conducted. 101 patients underwent neurosurgical operation and clinically suspected PNBM admitted to neurosurgical intensive care unit (NSICU) of the First Affiliated Hospital of Sun Yat-sen University from October 2015 to December 2016 were enrolled. Based on red blood cell quantitative test in CSF, the patients were divided into blood-contaminated and non blood-contaminated CSF groups. According to the PNBM diagnostic criteria of 2008 Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN), all patients were divided into PNBM group and non-PNBM group. The biochemical indexes levels in CSF were compared among the groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic power of CSF lactate for PNBM in blood-contaminated patients.Results A total of 101 suspected PNBM patients were enrolled. In 77 blood-contaminated CSF patients, 39 patients were diagnosed as PNBM (account for 50.6%); in 24 non-blood-contaminated patients, 12 patients were diagnosed as PNBM (account for 50.0%). ① In non-PNBM patients, the lactate level in blood-contaminated CSF was significantly higher than that of non-blood-contaminated CSF (mmol/L: 3.5±1.3 vs. 2.3±1.1,P < 0.01). In PNBM patients, there was no significant difference in lactate level between blood-contaminated CSF and non blood-contaminated CSF (mmol/L: 6.8±2.1 vs. 6.9±2.5,P > 0.05). ② In both blood-contaminated and non blood-contaminated CSF, white blood cell (WBC), protein and lactate levels in PNBM group were significantly higher than those in non-PNBM group [WBC (×106/L): 660.0 (67.5, 1105.0) vs. 41.0 (15.0, 142.5) in blood-contaminated CSF,168.0 (86.5, 269.5) vs. 34.5 (7.0, 83.5) in non-blood-contaminated CSF; protein (mg/L): 4757.8 (2995.2, 10219.8) vs. 1292.8 (924.2, 1936.2) in blood-contaminated CSF, 39247.3 (14900.6, 62552.2) vs. 1441.6 (977.3, 2963.9) in non blood-contaminated CSF; lactate (mmol/L): 6.8±2.1 vs. 3.5±1.3 in blood-contaminated CSF, 6.9±2.5 vs. 2.3±1.1 in non blood-contaminated CSF, allP < 0.05], and glucose and CSF glucose/blood glucose ratio in PNBM group were significantly lower than those in non-PNBM group [glucose (mmol/L): 2.5±1.2 vs. 4.4±1.6 in blood-contaminated CSF, 1.9±1.4 vs. 3.4±0.9 in non blood-contaminated CSF; CSF glucose/blood glucose ratio: 0.28±0.15 vs. 0.46±0.16 in blood-contaminated CSF, 0.24±0.16 vs. 0.45±0.11 in non blood-contaminated CSF, allP < 0.01]. ③ It was shown by ROC curve analysis that CSF lactate level was a good diagnostic parameter for PNBM both in blood-contaminated and non blood-contaminated CSF, and the area under ROC curve (AUC) was 0.91 and 0.97, respectively. When the cutoff value of lactate in non blood-contaminated CSF was 3.35 mmol/L, the sensitivity was 100%, and the specificity was 91.7%. When the cutoff value of lactate in blood-contaminated CSF was 4.15 mmol/L, the sensitivity was 92.3%, and the specificity was 71.1%, and the combination of CSF lactate and glucose achieved better diagnostic specificity (AUC = 0.96, sensitivity was 97.4%, specificity was 84.2%).Conclusions Blood in CSF led to the elevation of CSF lactate as compared with that in non-blood-contaminated CSF of patients with PNBM. CSF lactate was still a good diagnostic parameter for PNBM both in blood-contaminated patients, and the combination of CSF lactate and glucose achieved better diagnostic specificity.

Objective To obtain scientific data for control of iodine deficiency disorders(IDD) by reviewing the surveillance information of school children intelligence quotient(IQ) after the implementation of universal salt iodization. Methods One thousand five hundred and eighty children were selected from 11 primary school in Dalian city of Liaoning province during 2006 to 2009. IQ was measured by Combined Raven Test-C2(CRT-C2) in China. Groups of IQ were classified as outstanding(≥ 130), excellent (120- 129), above average (110- 119), average (90 - 109), below average(80 - 89), margin(70 - 79), low(≤69). Urinary samples of children were collected randomly. Urinary iodine were determined by As-Ce catalytic spectrophotometry. The growth characteristics of IQ were analyzed according to surveillance year and born year. Results The average IQ of children aged 8-10 were 110.4 ± 14.0,112.5 ± 12.4,117.2 ± 11.4,116.2 ± 12.6, respectively, increased year by year from 2006 to 2009. Its average annual increase from 2007 to 2009 were 2.1,3.4,1,9 compared with the IQ in 2006 respectively. The medians of urinary iodine were 224.7,266.7,222.1 μg/L from the year 2007 to 2009, respectively, which were all between 200 - 300 μg/L and can be classified as more than adequate level. The average IQ of children born during the year of 1994 to 2000 were 106.7 ± 13.0,108.1 ± 13.9,108.5 ± 13.4,111.3 ± 14.3,113.6 ± 12.5,115.3 ± 12.3,119.8 ± 11.2, respectively. Its average annual increase from 1995 - 2000 were 1.4,0.9,1.5,1.7,1.7,2.2 compared with the IQ born in 1994 respectively. The ratio of IQ in margin group and low group were all below 2% ; the ratio was increasing in excellent group and outstanding group and decreasing in average group and below average group significantly year after year(x2 = 52.471,34.329,66.483,11.148, all P<0.01). Conclusions Universal salt iodization improves IQ scores. IQ index should be brought into the surveillance project and put in use in IDD control.

Objective　To explore the risk factors and causes affecting the operative mortality in esophagectomy patients with esophageal can cer. Methods　1400 cases with a curative esophagectomy for neopl asm of esophagus hospitalized from Mar,1973 to June, 2000 were reviewed. There w ere 31 died within 30 d or during hospitalization after esophagectomy as a group , and 1 369 survival cases, after operation, as another group. Sixteen factors t hat may influence the operational mortality were selected. A multi-variate anal ysis of these individual variables was performed by the computer′s logistic reg ression model. Results　The operative mortality was 2.2%(31/1400 ). The causes of death included respiratory complication 17 cases (including res piratory failure caused by pneumonia or atelectasis), 15 cases, and adult respir atory distress syndrome (ARDS) 2 cases, the mortality was 54.8% in the death gro up), anastomotic leak 11 cases (34.5%), Chylothorax 2 cases (6.5%) and postopera tive digestive tract hemorrhage 1 case (3.2%). The results showed that the major risk factors that affected operative mortality in cases with esophageal cancer were history of long-herm heavy smoking, duration of operation and the year of operational (P<0.05). Conclusion　To minimize operative mort ality of esophagectomy, some means must be noticed, including the reinforcemen t of the perioperative care, the improvement of anastomotic methods and surgical skill, reduing operative time as p ossible, disposing pulmonary complications in time and using respirator if neces sary.

Objective To investigate the therapeutic method of metabolic acidosis in long-term sur- vival patients undergoing simultaneous pancreas and kidney transplantation.Methods A 45-year-old fe- male patient,who had undergone simultaneous pancreas and kidney transplantation(due to diabetic ne- phropathy and uremia)with bladder drainage 2 years before,developed severe metabolic acidosis,and thus underwent surgical conversion from bladder to ileal drainage.The procedure was as follows.The stoma of duo- denocystostomy was isolated and resected.The site of cystostomy was closed in two layers.The graft duode- num was then anastomosed to a loop of the recipient's ileum,which was proximal 40 cm from the ileocecum in a side-to-side manner.Results The metabolic acidosis resolved postoperatively.The patient received conventional immunosuppressants.The hospital stay was 30d.Follow-up of 4 years showed normal pancreas and kidney functions.Conclusions Conversion from bladder to ileal drainage is safe and effective for metabolic acidosis related to the exocrine secretions of bladder drained pancreas graft in simultaneous pancre- as and kidney transplant recipients.