Objective To analyze the iodine nutritional status among pregnant women,breasffeeding women,0-2 years old infants,8-10 years old children,18-45 years old women and men in both urban and rural areas of Xiamen 3 years after promotion of new standard iodized salt.Methods The Huli and Xiang'an were selected as the urban and rural study sites in Xiamen City,from March 2015 to March 2016.Each study site was further divided into five geographic locations (east,south,west,north and center).In each location,one township was randomly selected.In each town,2 tap water samples,60 salt samples of residents,and urine samples of 40 children aged from 8-10 years old,20 pregnant women,12 breastfeeding women,0-2 years old infants,18-45 years old women and men were collected to determine the iodine level.The water iodine and urinary iodine were detected by arsenic cerium catalytic spectrophotometry;salt iodine was detected by direct titration.Results The medians of salt iodine in urban and rural were 23.0 and 25.3 μg/L,respectively.The coverage rates of iodized salt in urban and rural area were 99.3％ (298/300) and 94.0％ (282/300),respectively.The consumption rates of qualified iodized salt were 93.7％ (281/300) and 90.7％ (272/300),respectively.The medians of tap water iodine in urban and rural were 4.1 and 4.4 μg/L,respectively.In urban and rural areas,the medians of urinary iodine of pregnant women were 167.6 and 119.6 μg/L,respectively.The medians of urinary iodine of breastfeeding women were 121.6 and 101.2 μg/L,respectively.The medians of urinary iodine of infants were 165.9 and 110.5 μg/L,respectively.The medians of urinary iodine of children were 208.9 and 167.2 μg/L,respectively.The medians of urinary iodine of women aged 18-45 were 132.5 and 154.5 μg/L,respectively.The medians of urinary iodine of men aged 18-45 were 131.7 and 154.5 μg/L,respectively.Conclusions After 3 year promotion of new standard iodized salt,the iodine status of pregnant women in urban,breastfeeding women,0-2 years old infants,children aged 8 to 10 and adults aged 18 to 45 is adequate,but the pregnant women in rural has showed iodine deficiency.So surveillance and health education should be continuously strengthened in the future.Scientific salt iodization should continue to ensure the amount of iodine intake.

Objective This study aims to analyze the prevalence, distribution, and risk factors of abnormal glucose metabolism in urban and rural adult hypertension patients in Zhengzhou. Methods The study was conducted on permanent residents aged 18 years and over (with at least 6 months of residence) in urban and rural areas of Zhengzhou. The survey subjects were chosen by the multi‐stage sampling method. Basic information regarding the height, weight, waist circumference, and blood pressure of 6 798 people who met the standards of admission and discharge were obtained through an on‐site questionnaire survey and physical examination. Blood samples were collected and blood glucose and lipid levels were detected. Results There were 1 985 patients with hypertension, with a prevalence rate of 29.20% and the standardized prevalence rate was 26.53%. Blood samples were collected from 1 936 hypertensive patients (55.8±13.6 years), of whom 903 were male (46.64%) and 1 033 female (53.36%). Among 1 050 patients (54.24%) with abnormal glucose metabolism, the impaired fasting glucose rate was 4.44%, the decreased glucose tolerance rate was 22.21%, and the diabetes rate was 27.56%. Blood samples were collected from 4 748 non‐hypertensive patients and 1 123 patients (23.65%) with abnormal glucose metabolism. The prevalence of abnormal glucose metabolism in hypertensive patients was significantly higher than that in non‐hypertensive patients, and the difference was statistically significant (χ2=586.264, P<0.001). The prevalence rate of abnormal glucose metabolism in hypertensive patients was higher in females, 58.57%, than in males, 49.28% (χ2=16.743, P<0.001). Urban patients showed a higher abnormal glucose metabolism, 57.68%, than rural patients did, 51.67% (χ2=6.984, P<0.001), and the prevalence of abnormal glucose metabolism in hypertensive patients showed a significant upward trend with an increase in age. Patients with central obesity, abnormal blood lipids, family diabetes history, non‐smokers, and non‐drinkers showed a higher prevalence of abnormal glucose metabolism, and the differences were statistically significant (P<0.05). The prevalence of abnormal glucose metabolism increased with age and body mass index, and decreased with increase in education level, with differences being statistically significant (P<0.001). Multivariate logistic regression analysis showed that age, obesity, centripetal obesity, dyslipidemia, and family history of diabetes were the main risk factors for abnormal glucose metabolism in patients with hypertension. Conclusions There is a relatively high prevalence of abnormal glucose metabolism in hypertension patients among the urban and rural residents of Zhengzhou. In the management of hypertension, the detection and intervention for reducing abnormal glucose metabolism should be strengthened and related risk factors must be prevented. The age for health management objectives among hypertension and diabetes patients should be further reduced.

Objective To investigate the clinical characteristics of paraneoplastic syndrome with prominent osteoarticular involvement. Methods The clinical materials of 20 patients with paraneoplastic syndrome with prominent osteoarticular involvement were collected. The characteristics of clinical manifest-ations, laboratory tests and imagines were analyzed. Results Among the 20 patients, 16 were male and 4 were female, with a mean age of 44.5 years and a median course of 6 months. Ten cases were associated with hematological tumor and 10 cases were associated with solid tumor. Eleven cases presented as peripheral arthritis (7 cases of polyarthritis, 4 cases of oligoarthritis/monoarthritis), 5 cases presented with hypertrophic osteoarthropathy (HOA) and 4 cases presented with tumor-induced osteomalacia (TIO). Three cases were acute lymphocytic leukemia, 2 cases were multiple myeloma, 1 case was lymphoma, and 1 case was bone tumor in polyarthritis. Four oligoarthritis cases were all associated with acute lymphocytic leukemia. All 5 cases of HOA were associated with lung cancer. All 4 cases of TIO were associated with tumor of mesenchymal tissue. Extra-articular manifestations presented in 14 cases and inflammatory markers increased in 15 cases. anti-cyclic cirullinated peptide (anti-CCP) antibodies was low titer positive in only 1 case and other parameters including rheumatoid factor (RF), anti-CCP antibodies, antinuclear antibodies spectrum (ANAs) and human leukocyte antigen (HLA)-B27 were negative. Multiple bone imaging abnormalities appeared in 15 cases. Conclusion Osteoarticular manifestations may be the first symptom of malignancy and difficult to diagnose. It is necessary to be highly aware of potential malignancy.

Objective The aim of this study was to investigate the mechanism of sanguinarine(SANG)on the inhibitory pro-liferation in ovarian cancer SKOV3 cells. Methods CCK-8 assay was used to detect proliferation of SKOV3 cells. Flow cytometry was used to detect the effect of SANG on apoptosis in SKOV3 cells. The spectrophotometer was used to detect the production of reac-tive oxygen species(ROS)by SANG. The mouse ovarian cancer xenograft model was used to detect the inhibitory effect of SANG on tumor growth. Results SANG promoted apoptosis in SKOV3 cells in a dose-and time-dependent manner. The SANG-induced ap-optosis was associated with the production of ROS,Activated the c-Jun-N-terminal kinase( JNK) and nuclear factor-κB( NF-κB)signaling pathways. In mouse model of ovarian cancer xenografts,after intravenous injection of mice with SANG,SANG was signifi-cantly inhibited the growth of ovarian cancer xenografts when compared to the control group. SANG also significantly induced apoptosis in ovarian cancer xenografts. Conclusion SANG can significantly inhibit the proliferation of ovarian cancer SKOV3 cells,induce ap-optosis,increase the production of ROS,and inhibit the growth of ovarian cancer.

Objective To summarize the gene mutation,treatment and prognosis of neonatal congenital hyperinsulinism (CHI) cases.Method The gene mutation and treatment of newborn infants who were admitted to the neonatal center of Beijing Children's Hospital between February 2015 and February 2018 with confirmed CHI diagnosis and whole exome sequencing (WES) results were retrospectively summarized.Result Totally 8 infants (5 boys and 3girls) were included.The onset age was (13.2±6.1) h (2 h ～ 2 d).The main clinical presentations were inactivity,seizures and poor feeding.Among the 8 patients,3 were positively responded to diazoxide,5 were negative and then been treated by octreotide.Among these 5 cases,3 were positively responded to octreotide (with stable blood glucose level after discharged home and till 6 months of age) and 2 were negative to both diazoxide and octreotide (1 had partial pancreatectomy afterwards but still had 1～2 episodes pf hypoglycemia till 6 months post-operational periods,another 1 died with unknown detail information soon after the parents quit further medical intervention).All 8 cases had heterozygous gene mutations.7 out of the 8 cases were ABCC8 gene (encoding islet beta-cell potassium channel protein sulfonylurea receptor protein SUR1) mutation on different sites including c.4414G＞A,c.221G＞A,c.1773C＞G,c.4352T＞C,c.2924-9C＞T,c.4198+ 1G＞T,c.2509C＞T,c.2331G＞A,c.4316A＞G and c.47G＞C.Among these 7 cases,3 were complicated heterozygous mutations with completely no response to diazoxide (2 out of the 3 were positively responded to octreotide,1 out of the 3 was negative to octreotide)and the other 4 were simple heterozygous mutations (2 out of the 4 were positively responded to diazoxide,1 out of the 4 was negative to diazoxide but positive to octreotide,and 1 out of the 4 was negative to both diazoxide and octreotide).1 out of the 8 cases was heterozygous GLUD1 gene mutation at c.1388A＞T site and had positive therapeutic responses to diazoxide.All 5 out of the 8 cases with negative therapeutic response to diazoxide had ABCC8 gene mutation.Conclusion ABCC8 gene encoding islet beta-cellpotassium channel protein sulfonylurea receptor protein SUR1 is the most common gene to have mutation io CHI.Mutations at multiple sites of this gene may cause CHI.Various therapeutic responses to medications might be related to different types of gene mutation.

To evaluate right atrial ( RA ) structure and function of different left ventricular geometry in patients with obstructive sleep apnea syndrome ( OSAS ) by real‐time three‐dimensional echocardiography ( RT‐3DE) . Methods One hundred and ninety‐nine patients with habitual snoring were diagnosed as OSAS by polysomnography with apnea hypopnea index ≥ 5/h . Fifty gender ,age matching healthy people were selected as control group . Blood pressure and general clinical characteristics were collected and echocardiography was performed next morning . On the basis of left ventricular mass index , relative wall thickness ,left ventricular end‐diastolic diameter ,patients were divided into 6 groups :normal geometry ( NG) ,concentric remodeling ( CR) ,eccentric non dilated hypertrophy ( ND‐EH ) ,concentric non dilated hypertrophy ( ND‐CH ) ,eccentric dilated hypertrophy ( D‐EH ) ,and concentric dilated hypertrophy ( D‐CH) .Full volume images at apical four‐chamber view were collected . Right atrial volume‐time curve , RA maximum volume ( RAVmax ) , RA minimum volume ( RAVmin ) , RA pre‐contraction volume ( RAVpre‐a) were analyzed with QLab workstation . Following parameters including RA total emptying volume ( RA TotEV ) , RA total emptying fraction ( RA TotEF ) , RA passive emptying volume ( RA PassEV ) ,RA passive emptying fraction ( RA PassEF) ,RA active emptying volume ( RA ActEV ) ,RA active emptying fraction ( RA ActEF) were calculated . All structural parameters were corrected by BSA . Results①RA structural parameters :compared with control and NG groups ,RAVmax ,RAVmin ,RAVmin/BSA , RAVpre‐a and RAVpre‐a/BSA were increased in ND‐EH ,ND‐CH and D‐( CH+ EH) groups ( P ＜0 .05) . Compared with control ,NG and CR groups ,RAVpre‐a and RAVpre‐a/BSA were increased in ND‐EH ,ND‐CH and D‐( CH + EH ) groups , RAVmax , RAVmax/BSA , RAVmin , RAVmin/BSA , RAVpre‐a and RAVpre‐a/BSA were increased in ND‐CH and D‐( CH+EH ) groups( P ＜0 .05) . Compared with control , NG ,CR and ND‐EH groups ,RAVmax ,RAVmax/BSA ,RAVpre‐a and RAVpre‐a/BSA were increased in ND‐CH ,D‐( CH+EH) groups ,RAVmin and RAVmin/BSA were increased in D‐( CH+ EH ) group ( P ＜0 .05) . Compared with control ,NG ,CR ,ND‐EH and ND‐CH groups ,RAVpre‐a and RAVpre‐a/BSA were increased in D‐( CH + EH ) group ( P ＜ 0 .05 ) . ② RA reservoir function parameters :compared with control ,NG and CR groups ,RA TotEV was increased in ND‐CH and D‐( CH+ EH ) groups ( P ＜0 .05 ) . Compared with control ,NG ,CR and ND‐EH groups ,RA TotEV was increased in D‐( CH + EH ) group ( P＜0 .05) . ③ RA conduit function parameters :compared with control ,NG and CR groups ,RA PassEF was decreased in ND‐EH ,ND‐CH and D‐( CH + EH ) groups ,RA PassEV was decreased in ND‐CH and D‐( CH+EH) groups( P ＜0 .05) . Compared with control ,NG ,CR and ND‐EH groups ,RA PassEV was decreased in D‐( CH+EH) group ,RA PassEF was decreased in ND‐CH and D‐( CH+ EH ) groups ( P ＜0 .05) . ④ RA pump function parameters :compared with control ,NG and CR groups ,RA ActEF were increased in ND‐CH and D‐( CH+EH) groups ( P ＜0 .05 ) ; Compared with control ,NG ,CR and ND‐EH groups ,RA ActEV was increased in ND‐CH and D‐( CH+EH) groups ( P ＜0 .05) . Conclusions Different left ventricular geometric patterns have different RA structure and function in OSAS ,patients with ND‐CH and D‐( CH + EH ) have worse RA structure and function . T he results of this study suggested that the clinical need to pay attention to the RA structure and function of OSAS patients with dilated LV H .

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Tyrosine phosphatase SHP2 is a promising drug target in cancer immunotherapy due to its bidirectional role in both tumor growth promotion and T-cell inactivation. Its allosteric inhibitor SHP099 is known to inhibit cancer cell growth both and . However, whether SHP099-mediated SHP2 inhibition retards tumor growth anti-tumor immunity remains elusive. To address this, a CT-26 colon cancer xenograft model was established in mice since this cell line is insensitive to SHP099. Consequently, SHP099 minimally affected CT-26 tumor growth in immuno-deficient nude mice, but significantly decreased the tumor burden in CT-26 tumor-bearing mice with intact immune system. SHP099 augmented anti-tumor immunity, as shown by the elevated proportion of CD8IFN- T cells and the upregulation of cytotoxic T-cell related genes including , which decreased the tumor load. In addition, tumor growth in mice with SHP2-deficient T-cells was markedly slowed down because of enhanced anti-tumor responses. Finally, the combination of SHP099 and anti-PD-1 antibody showed a higher therapeutic efficacy than either monotherapy in controlling tumor growth in two colon cancer xenograft models, indicating that these agents complement each other. Our study suggests that SHP2 inhibitor SHP099 is a promising candidate drug for cancer immunotherapy.

Objective To strengthen the system of drug supply chain collaborative service platform in drug supply, decrease drug inventory backlog, and improve the outpatient pharmacy management capacity in outpatient pharmacy.Methods Failure mode and effects analysis (FMEA) method was used to discover the potential risks in the drug supply chain collaborative service platform and formulate the corresponding improvement measures.Results The number of drug-receiving errors dropped from 137times to 32times and the risk reduction rate was 76.64％after improving the procurement process of the supply chain service platform, which significantly reduced the risk of contracting errors.Conclusion FMEA method could help to figure out the loopholes and hidden dangers of the pharmacy system, which made the outpatient pharmacy more reasonable and accurate by constantly improving the measures of the drug supply chain collaborative service platform.

Objective: To explore the clinical feasibility and effectiveness of novel preoperative evaluating tool to achieve accurate and quantitative evaluation of renal vascular anatomy for retroperitoneoscopic radical nephrectomy (RLRN). Methods: Two-hundred and fifty one consecutive patients who underwent RLRN for renal tumours from September 2016 to March 2018 were enrolled prospectively, including 154 males (61.4%) and 97 females (38.6%), aged 26 to 84 years with the mean age of 58.7 and mean BMI of 25.8 kg/m². The tumors were all isolated with the mean size of 5.4 cm. According to presence or absence of vascular correlation events (VCE) and nephrectomy times under endoscope (NTE), all the cases were divided into two groups: the common group (VCE, NTE <60 min) and the difficult group (no VCE, NTE ≥60 min). With the help of preoperative three-dimensional reconstruction, the specific and crucial arteriovenous anatomical features were recorded, which consist of side, count, spatial configuration and density of the vessel to be processed. After univariable analysis, multivariable analysis with logistic regression was performed for the selected risk factors. Individualized reno-vasculature evaluation for nephrectomy were established, when the value of risk factors were assigned separately according to its correlation and clinical practice. Results: There was no statistical significance between common group and difficult group in the aspects of gender, age, BMI, maximum diameter of the tumor, R. E.N.A.L. score and PADUA score. There were statistical significance between common group and difficult group in the aspects of N (number of total vessels), D (vascular anomalies density), C (3D conformation), S (sides) of pending renal vessels (χ²=125.700, 102.014, 97.090, 12.603, P<0.05). The correlation of N, D, C were closely related (standardized regression coefficient were 0.742, 0.664, 0.324, P<0.05), but S was not significant (P>0.05). SIREN was preliminarily established as a preoperative evaluating tool to achieve accurate and quantitative evaluation of renal vascular anatomy. Of the 5 components of SIREN, N, D were scored on 1 to 3 points, C was scored on 0 to 3 points, E was scored on 0 to 1 point, and S was not scored but showed in terms of L or R. All of these constitute the assessment content with a full score of 10 points except S suffixed by L or R instead of scores. There was a statistically significant difference during low (2-3 points), middle (4-6 points), and high (7-10 points) groups (χ²=126.927, P<0.05) according to the comparisons between low and middle, low and high, as well as middle and high (χ²=90.997, 7.195, 91.679, P<0.05). Conclusions In virtue of the renal vascular scoring system named after SIREN by 3d reconstructing, the spatial structure information of the renal vascular system can be obtained accurately and expressed directly before operation, the difficulty of vascular treatment can be predicted, the preoperative planning can be optimized, and the accurate quantitative evaluation of renal vascular anatomical structure can be achieved to further improve the surgical safety and efficiency.