Objective:To investigate the iodine content distribution of drinking water in Jiangsu Province.Methods:In 2017, the iodine content in drinking water of residents in townships (streets, hereinafter referred to as townships) of Jiangsu Province was investigated. Administrative villages (neighborhood committees, hereinafter referred to as administrative villages) of Jiangsu Province were selected as units for the investigation of townships with the median water iodine greater than 10 μg/L. Delimitation criteria: the median iodine content of water < 40 μg/L was iodine deficiency area, 40-100 μg/L was suitable iodine area, and > 100 μg/L was high iodine area.Results:A total of 1 285 townships were surveyed in 101 counties (cities, districts) in 13 cities, and the median water iodine in townships was 7.28 μg/L. Among them, there were 875 townships with median water iodine < 10 μg/L, accounting for 68.09%; 315 townships 10-< 40 μg/L, accounting for 24.51%; 56 townships 40-100 μg/L, accounting for 4.36%; 39 townships > 100 μg/L, accounting for 3.04%. The water iodine survey at the administrative village level was conducted in 5 864 administrative villages in 410 townships in 6 cities. Among them, 769 administrative villages with median water iodine < 10 μg/L, accounting for 13.11%; 3 558 administrative villages 10 - < 40 μg/L, accounting for 60.68%; 613 administrative villages 40 - 100 μg/L, accounting for 10.45%; and 924 administrative villages > 100 μg/L, accounting for 15.76%.Conclusion:According to the water iodine, there are iodine deficiency, suitable iodine and high iodine areas in Jiangsu Province, mainly in iodine deficiency areas.

OBJECTIVE: To evaluate the capability and limitation of magnetic resonance image(MRI)for Lumbar zygapophyseal joint cartilage through comparing pig lumbar zygapophyseal joint cartilage acquired from multiple MRI sequences of a 1.5 Tesla MR and gross specimens. METHODS: Six fresh lumbar spines from adult pigs were sagittaly scanned by Siemens 1.5 Tesla MR. The scan sequences included fast spin echo T1-weighted imaging (FSE T1WI), fast spin echo T2-weighted imaging (FSE T2 weighted T2WI), fat saturation proton density-weighted imaging (FS PDWI), 3-dimensional fast low angle shot imaging (3D-FLASH), and water excitation 3-dimensional fast low angle shot imaging (WE 3D-FLASH). Each scan sequence acquired images from the same layer. The signal-noise ratio (SNR) for articular cartilage, contrast-noise ratio (CNR) for cartilage versus bone cortex, cartilage versus bone marrow, and cartilage versus saline were calculated. Right after the scanning, the lumbar spines were snap-frozen, incised sagittally along the midline lumbar zypapophyseal joints, and photographed to compare the gross specimens with corresponding MRIs. The thickness of sagittal midline center of 6 pairs of lumbar(L₃/L₄) zypapophyseal joint cartilage was measured by vernier caliper. The thickness of the back ventral articular cartilage was added and then compared with corresponding MR images. RESULTS: 3D-FLASH (FA 20°) and WE 3D-FLASH (FA 20°) sequences had significant advantages compared with other sequences in imaging lumbar zypapophyseal joint cartilage, and were mostly close to the real thickness.(1) Comparison of the 4 flip angle (FA 10°, FA 20°, FA 30°, and FA 40°) 3D-FLASH sequences:The highest cartilage SNR and best CNR of cartilage versus bone cortex were both found in the 3D-FLASH(FA 20°) sequence, which was significantly different from the other three 3D-FLASH sequences.The satisfactory CNR of cartilage versus bone marrow, cartilage versus saline were found more in the 3D-FLASH(FA 20°) sequence. (2) Comparison of the 4 flip angle(FA 10°, FA 20°, FA 30°, and FA 40°) WE 3D-FLASH sequences: the highest cartilage SNR,best CNR of cartilage versus bone cortex,and best CNR of cartilage versus bone marrow were found in the WE 3D-FLASH (FA 20°) sequence, which was significantly different from the other three 3D-FLASH sequences. The CNR of cartilage versus saline was found more satisfactory in the WE 3D-FLASH (FA 20°) sequence. (3) The highest cartilage SNR and best CNR of cartilage versus bone cortex were both found in the 3D-FLASH (FA 20°) sequence, which was significantly different from those in the PDWI, FSE T1WI,and FSE T2WI sequences (P<0.05), but with no significance (P>0.05) in the WE 3D-FLASH (FA 20°) sequence. The highest CNR of cartilage versus bone marrow was seen in WE 3D-FLASH (FA 20°) sequence. It was statistically significant compared with that in FS PDWI,FSE T1WI, and T2WI sequences respectively, but the difference was not significant compared with 3D-FLASH (FA 20°) sequence (P>0.05). Both the FS PDWI and T2WI sequences displayed ideal CNR of cartilage versus saline, with no significant difference (P>0.05). The lower SNR of cartilage versus saline was shown in 3D-FLASH (FA 20°) and WE 3D-FLASH (FA 20°) sequence, and the difference was not significant (P>0.05). However, they were significantly different compared with FS PDWI and T2WI sequences (P<0.05). (4) WE 3D-FLASH (FA 20°) and 3D-FLASH (FA 20°) sequences were relatively better than the FS PDWI when comparing the thickness of articular cartilage, which was significantly different from the FS PDWI sequence (P<0.05). CONCLUSION The 3D-FLASH sequence and derived WE 3D-FLASH sequence have better definition of cartilage images and are mostly close to the real thickness, which possibly are the optimal scanning sequences for lumbar zypapophyseal joint articular cartilage MR imaging.
Animals ; Cartilage, Articular ; anatomy & histology ; Imaging, Three-Dimensional ; Lumbar Vertebrae ; anatomy & histology ; Magnetic Resonance Imaging ; methods ; Swine ; Zygapophyseal Joint ; anatomy & histology

Objective: To analyze the features of magnetic resonance imaging (MRI) of patients with high-voltage electrical burns in limbs at early stage. Methods: Thirty-eight patients with high-voltage electrical burns, conforming to the study criteria, were hospitalized in our unit from March 2013 to August 2016. T₁ weighted imaging (T₁WI), T₂WI, fat-suppression T₂WI plain scan, and fat-suppression T₁WI enhanced scan of MRI were performed in 78 limbs, including 56 upper limbs and 22 lower limbs at post injury hour 72. The MRI signal characteristics of electrical burns in skin and subcutaneous tissue, skeletal muscle, tendon, joint ligament, and skeleton of limbs were analyzed. " Sandwich-like" necrosis and injury in skeletal muscle, injuries of tendon, joint ligament, and skeleton were observed. MRI signal characteristics of amputated upper limbs and salvaged limbs were also analyzed. All patients underwent surgery within 24 h after MRI examination, and the muscle vitality was judged during operation. Muscle tissue without reaction to electrical stimulation which was completely necrotic as shown by MRI, muscle tissue with weak reaction to electrical stimulation which was injured with blood supply as shown by MRI, and muscle tissue with edema as shown by MRI were collected, and then the pathological characteristics of muscle tissue were observed with HE staining. Results: (1) The defect area of patients at entrance of current was bigger than that at exit. The skin and subcutaneous tissue extensively unevenly thickened. T₂WI manifested hyperintensity, and T₁WI manifested isointensity, while fat-suppression enhanced T₁WI manifested uneven enhancement. Zonal effusion was seen in the region of serious subcutaneous edema. (2) For complete necrosis of skeletal muscle, T₂WI manifested hypointense, isointensity, or slight hyperintensity, and T₁WI manifested isointensity, slight hyperintensity, or mixed signal of isointensity and slight hyperintensity, while fat-suppression enhanced T₁WI manifested most no enhancement area with clear boundary. The MRI signals of injured skeletal muscle could be divided into two types. Type Ⅰ signal was for partial necrotic muscle adjacent to the completely necrotic zone. T₂WI manifested uneven hyperintensity or slight hyperintensity, with unclear boundary. T₁WI manifested isointensity or slight hyperintensity. Fat-suppression enhanced T₁WI manifested significant banding or laciness enhancement. Type Ⅱ signal was for deep muscle tissue far from the complete necrotic zone. T₂WI manifested hyperintensity, and T₁WI manifested isointensity or main isointensity mixed with hyperintensity, while fat-suppression enhanced T₁WI manifested uneven moderate or slight enhancement. Normal muscle signal, type Ⅰ signal, and type Ⅱ signal were all mixed with necrotic signal, showing " sandwich-like" change. For skeletal muscle edema, T₂WI manifested slight hyperintensity and unclear boundary, and T₁WI manifested hypointense, while fat-suppression enhanced T₁WI manifested no obvious enhancement. (3) For complete necrosis of tendon, T₂WI manifested isointensity or slight hyperintensity, and T₁WI manifested isointensity, while fat-suppression enhanced T₁WI manifested no enhancement. For tendon injury, T₂WI manifested isointensity, and T₁WI manifested isointensity or hypointense, while fat-suppression enhanced T₁WI manifested slight enhancement. (4) Severe injury of wrist joint were manifested as complete necrosis of soft tissue around joint. T₂WI manifested slight hyperintensity or isointensity, and T₁WI manifested isointensity, while fat-suppression enhanced T₁WI manifested no enhancement or slightly uneven enhancement. For completely destroyed wrist joints, the structures were not clear from outside to inside. T₂WI manifested slight hyperintensity or isointensity, and T₁WI manifested hypointense or isointensity, while fat-suppression enhanced T₁WI manifested no enhancement. For elbow injury, T₂WI manifested hyperintensity, and T₁WI manifested isointensity or hypointense, while fat-suppression enhanced T₁WI manifested uneven enhancement. For knee injury, T₂WI manifested hyperintensity, and T₁WI manifested hypointense, while fat-suppression enhanced T₁WI manifested slight enhancement. (5) For bone edema, T₂WI manifested isointensity, while fat-suppression T₂WI manifested slight hyperintensity. T₁WI manifested isointensity, and fat-suppression enhanced T₁WI manifested patchy enhancement. (6) MRI of amputated upper limbs showed necrosis signals, type Ⅰ signals, type Ⅱ signals, and mixed signals of type Ⅰ and type Ⅱ in skeletal muscle. The necrosis signal and type Ⅰ signal area of the distal end were more than 50% greater than those of the lesion. The scope of the ecological tissue was large and the boundary was not clear. There were diffuse injuries in both anterior and posterior muscles, and the ulnar and radial artery pulsation disappeared in the upper limbs. The MRI of salvaged limbs were type Ⅰ signal, type Ⅱ signal, mixed signals of type Ⅰ and type Ⅱ, and local necrosis signals of skeletal muscle. The type Ⅰ signal was the main type, and the distal end showed type Ⅱ signal. (7) For completely necrotic skeletal muscle as shown by MRI, surgical exploration showed loss of muscle viability, and pathological examination showed complete necrosis of striated muscle tissue. For injury area of skeletal muscle as shown by MRI, surgical exploration showed interecological muscle with activity worse than mormal muscle, and pathological examination showed normal muscle cells and muscle fiber mixed with necrotic striated muscle cells having karyopyknosis, with different degree of injury. For edema area of skeletal muscle as shown by MRI, surgical exploration showed swelling skeletal muscle and normal muscle vitality, and pathological examination showed striated muscle interstitial edema with a large number of inflammatory cells infiltration. The manifestions of MRI were consistent with the results of surgical exploration and pathological examination. Conclusions Skeletal muscle complete necrosis, injury, and edema could be preferably differentiated by MRI, and the definite scope and depth of electrical injury, the injury of skin, tendon, joint ligament, and bone could also be displayed well on MRI. It can provide objective imaging basis for the diagnosis of high-voltage electrical burns in limbs at early stage, the establishment of clinical operation plan, and the judgment of intraoperative tissue vitality.

Objective:To evaluate the inflammatory factors effects of early endoscopic therapy for elderly patients with acute biliary pancreatitis (ABP) and its clinical efficacys.Methods:206 elderly patients with ABP admitted from Jan. 2010 to Dec. 2019 were divided into observation group (102 cases) and the control group (104 cases) according to treatment method. The observation group received endoscopic retrograde cholangiopancreatography (ERCP) , endoscopic sphincterotomy (EST) and endoscopic naso-biliary drainage (ENBD) , while the control group received conventional treatment. Clinical symptoms, changes of inflammatory factors, complications and prognosis were observed in each group.Results:CRP, SAA, IL-6, IL-8 and TNF-a after treatment were significantly lowered than those before treatment ( P<0.05) . In addition, the levels of CRP, SAA, IL-6, IL-8 and TNF-a in the observation group were significantly lower than those in the control group ( P<0.05) . The time to abdominal pain extinction, time to fever cessation, hospital stay in observation group were (3.92±1.54) , (3.63±1.41) , and (14.35±2.46) d, significantly less than those in the control group [ (5.81±1.72) , (5.45±2.13) , (19.37±3.12) d, P<0.05]. APACHE Ⅱ score of the observation group was (10.02±2.67) point after treatment, significantly lower than that in the control group [ (12.35±3.62) point, t=4.42, P<0.05]. The incidence of complications in the observation group was 10.78% after treatment, significantly lower than that in the control group [ (24.03%) , χ2=6.27, P< 0.05]. The mortality in the observation group was 1.96%, lower than 4.81% in the control group, with no statistical significance. Conclusion:Early endoscopic therapy is safe and highly effective for elderly patients with ABP, with the advantages of shorter hospital stay, quicker subsided inflammation, and lower incidence of complications.

【Objective】 To explore the effects of early application of erythropoietin (EPO) in patients with anemia after renal transplantation. 【Methods】 Patients who underwent renal transplantation in the First Affiliated Hospital of Soochow University were retrospectively analyzed. According to whether EPO was applied after operation, the patients were divided into EPO group and routine group. Patients with delayed renal function recovery were excluded, and the remaining patients were further analyzed. The general, laboratory and follow-up data of the two groups were compared, and adverse drug reactions were observed. 【Results】 The hemoglobin (P=0.026), red blood cell count (P=0.038) and hematocrit (P=0.011) in EPO group were higher than those in the routine group 2 weeks after operation, while the postoperative serum creatinine level was lower (P=0.001). Since the first week after operation, the reticulocyte count in EPO group was significantly higher than that in routine group (P<0.01). There was a negative correlation between hemoglobin and serum creatinine in EPO group at week 1 (r=-0.375, P=0.010) and week 2 (r=-0.386, P=0.008). During the treatment, 6 patients showed transient elevation of serum potassium, which returned to normal after symptomatic treatment, and no obvious adverse drug reactions were observed. 【Conclusion】 Continuous application of erythropoietin in the early stage after renal transplantation can significantly improve anemia in renal transplant patients and promote the recovery of renal function.

To examine the expression of vasohibin-1, metastasis-associated in colon cancer-1 (MACC1) and KAI1 proteins in serous ovarian cancer and their clinical significance.
 Methods: In 124 specimens of serous ovarian cancer (serous ovarian cancer group) and 30 specimens of ovarian serous cystadenoma (ovarian serous cystadenoma group), the expression of vasohibin-1, MACC1 and KAI1 protiens were detected by immunohistochemistry ElivisionTM method.
 Results: In the serous ovarian cancer group, the positive rates of vasohibin-1 and MACC1 proteins were 48.4% and 58.1%, respectively, which were both higher than those in the ovarian serous cystadenoma group (10.0% and 13.3%, respectively); while the positive rate of KAI1 protein in the serous ovarian cancer group was 33.9%, which was lower than that in the ovarian serous cystadenoma group (86.7%), there were significant differences between the 2 groups (all P<0.05). In the serous ovarian cancer group, the expression of the 3 proteins were closely related to the pathological grade, Federation International of Gynecology and Obstetrics (FIGO) stage and pelvic lymph node metastasis (all P<0.05). The KAI1 protein was negatively correlated with the levels of vasohibin-1 and MACC1 (r=-0.500, -0.600, respectively, both P<0.01); while there was a positive correlation between the vasohibin-1 and the MACC1 (r=0.518, P<0.01). Kaplan-Meier survival analysis showed that the over-expression of vasohibin-1, MACC1 and the low-expression of KAI1 protein were related to the survival rates (all P<0.05). Multi-factor analysis showed that the expression of vasohibin-1, KAI1 protein and the FIGO stage were independent prognosis factors for radical operation of serous ovarian cancer (RR=2.185, 3.893, 0.413; 95% CI=1.263-3.779, 2.190-6.921, 0.251-0.681; all P<0.05).
 Conclusion: The up-regulation of vasohibin-1, MACC1 and down-regulation of KAI1 in serous ovarian cancer are related to the tumor differentiation, clinical stage, metastasis and prognosis. Combined detection of these indexes is useful in predicting the progression and prognosis of serous ovarian cancer.
Carcinoma, Ovarian Epithelial ; Cell Cycle Proteins ; Colonic Neoplasms ; Female ; Humans ; Kangai-1 Protein ; Neoplasm Staging ; Ovarian Neoplasms ; Prognosis ; Trans-Activators ; Transcription Factors