Objective To observe the effects of baicalin on forms of hepatic tissue, liver apoptosis, mRNA expressions of iNOS, NF-κB and protein expression of Caspase-3 in rats with ischemia reperfusion injury; To discuss its mechanism of action.Methods The rat models of liver ischemia reperfusion were performed according to the Pringle's method. Rats were randomly divided into sham-operation group, model group and baicalin group. Sham-operation group and model group were given normal saline for gavage, while baicalin group was given baicalin for gavage. Morphological characteristic was observed by HE staining. Hepatocyte apoptosis was determined by TUNEL. The mRNA expressions of iNOS and NF-κB were determined by RT-PCR. The protein expression of Caspase-3 was determined by Western blot.Results Compared with the sham-operation group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the model group increased, as well as liver apoptosis rate (P<0.05,P<0.01); compared with the model group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the baicalin group decreased, as well as liver apoptosis rate (P<0.05), and the hepatic lesion significantly improved in the baicalin group.Conclusion Baicalin can restrain Caspase-3 induced apoptosis by reducing the expressions of iNOS and NF-κB, with a purpose to realize the hepatoprotective effect for liver of rats with ischemia reperfusion injury.

Objective To observe the curative effect of modified Shenghua Decoction on promoting uterine instauration after cesarean section. Methods A total of 300 parturient cases receiving cesarean section were evenly randomized into observation group and control group. After cesarean section, patients of observation group were given modified Shenghua Decoction orally, and those of the control group were given intramuscular injection of oxytocin. The observation indexes included uterine retraction, the amount of lochia, and ultrasound examination for uterine instauration. Results (1) In the observation group, uterine contraction 72, 120 h after cesarean section was better than that of the control group, and the difference was statistically significant ( P<0.05). ( 2) Lochia stopping occurred in 137 ( 91.33%) cases of observation group and in 109 ( 72.67%) cases of control group within 42 days after cesarean section. The duration of lochia in observation group was shorter than that in the control group ( P<0.05). ( 3) Five days after cesarean section, the sum of length, anteroposterior dimension, and transverse diameter of the uterus in the observation group was less than the control group, but the difference was insignificant (P>0.05). Forty-two days after cesarean section, the sum of the three uterine diameters in the ob-servation group significantly differed from that of the control group (P<0.05). (4) Forty-two days after cesarean section, the incidence of uterine cavity effusion was 6.67%in the observation group, and was 17.33% in the con-trol group, the difference being statistically significant (P<0.05). Conclusion The modified Shenghua Decoction has certain curative effect on promoting uterine instauration after cesarean section.

Objective To explore histopathological features of the atypical hyperplastie thyroid epithelial cells (TEC) in Hashimoto's thyroiditis (HT), and to investigate its association with papillary thyroid carcinoma (PTC). Methods Thirty cases of HT with atypical hyperplastie TEC and 50 cases of PTC were selected from archives, the comparatively normal follicles around thyroid adenoma and in HT served as eontroi group. The morphological changes in HT were observed and the expressions of CK19. PCNA, Bcl-2 were detected by Max-Vision immunohistochemistry techniques. The results were analyzed by Chi-square test. Results The atypical hyperplastic TEC in HT showed some PTC-like features such as crowded cells, nucleus enlargement and ground glass appearance in the nucleus. As compared to the control, CKI9, PCNA and Bcl-2 were positively expressed in both atypical hyperplastic TEC in HT and PTC cells (P<0.05). Conclusion The atypical hyperplastic TEC in HT showed some morphological and immunological features of PTC, with the PTC specific marker CK19 expression,suggesting that the atypical hyperplastic TEC in HT may link HT with PTC, leading to malignant transformation,which should be closely watched.

Objective To evaluate the expression of CD47 and calreticulin and their relationships with clini-copathologic features,prognosis in infiltrating ductal breast carcinomas.Methods The expression of CD47 and calret-iculin was evaluated in 128 cases with infiltrating ductal breast carcinomas by means of immunohistochemistry,and the relationship between CD47 and other clinicopathologic factors as well as prognosis were analyzed.Results The expression level of CD47 in cancer nest was 81/128,which was lower than 106/128 in its adjacent normal epithelium (χ2 =12.400,P<0.05),but calreticulin expression was 50/128 and was higher in cancer nest(χ2 =21.510,P<0.05 ).In addition,the expression level of calreticulin had certain difference in different molecular subtype (χ2 =21.510,P<0.05),and an increased expression in Basal-like and Her-(2 +)/ER(-)subtypes.The expression level of CD47 was associated with tumor sizes,histological tumor grade and lymph node involvement(χ2 =11.400, 4.732,5.432,all P<0.05),and the expression level of calreticulin was associated with histological tumor grade and distant metastasis(χ2 =10.810,6.770,all P<0.05).The 5 -year survival rate of patients performed following-up was 68.37%.Univariate analysis indicated the survival rate in 5 years of high level CD47,calreticulin expression was higher than that of low level CD47,calreticulin expression(χ2 =5.231,13.069,all P<0.05).Conclusion The expression of CD47,calreticulin is associated with index of dysprognosis and survival rate in 5 years,so combined CD47 and calreticulin detect may be of prognostic value in patients with breast caner.

Objectives To assess if visual analogue scale(VAS) or Likert scale was relatively more suitable when measuring self-reported clinical outcomes for apoplexy spastic-paralysis patients.Methods Nineteen questions were made from the serf-evaluating instrument based on patient reported outcomes for apoplexy spasticparalysis patients developed previously in cross-sectional study.104 patients answered the questions by both continuous and discrete visual analogue scale(VAS),while other 110 patients by both five-point Likert scales and Likert-typo scales.Cronbach'sαfor internal consistency reliability,spearman for correlation,and exploratory factor analysis for construct validity were applied.Results Except for emotional domain,the α coefficients of physical domain,social domain and overall score with continuous and discrete VAS are higher than that with five-point Likert scales and Likert-type scales.Internal consistency reliability was stronger for VAS.lntraclass correlation coefficients were above 0.4 mostly for each item with its domain,and VAS may produce the higher correlation.For VAS,there were three factors in the exploratory factor analysis,which confirmed the domain hypotheses of physical,mental and social functions,but for the Likert scales,the result was undesiable.Conclusion The more accurate for the response options,the better for the performance.When the patient can complete the measurement without the help of others,VAS seems better suited.

Objective To observe the clinical parameters, self-management, and compliance in peritoneal dialysis (PD) patients before and during Spring Festival, and to describe holiday syndrome in PD patients.Methods We prospectively observed PD patients with regular follow-up in our center before Chinese Spring Festival (January 8-February 7, 2016) and during Chinese Spring Festival (February 8-March 8, 2016).Demographic and clinical characteristics, self-management, and compliance with its influencing factors were collected by face-to-face method in outpatient care.Results Totally 130 PD patients were enrolled.The average age was (58.5±15.4) years, and women accounted for 53.1％.The primary diagnosis was diabetic kidney disease (32.3％), followed by primary glomerulonephritis (26.2％).Fourteen patients (10.8％) received automated peritoneal dialysis (APD), and most of the remaining patients chose continuous ambulatory peritoneal dialysis (CAPD,73.8％), with a median dialysis age of 34 months.During the 4-week followed-up, the appetite was stable, while the serum phosphate and pre-albumin increased [(1.5±0.4)mmol/L vs.(1.6±0.4)mmol/L, P=0.025;325.3 (272.2,355.1)mmol/L vs.326.0(284.2,376.5)mmol/L, P<0.01, respectively].No difference was observed in edema, dyspnea, and nighttime lying flat.However, the weight elevated significantly [(61.3±13.9)kg vs.(63.4±13.0)kg, P=0.002], with the median peritoneal ultrafiltration volume increased from 783.3 ml to 900.0 ml (P=0.005).During the holiday, the incidences of dialysis-related infections were unchanged, while the incidences of digestive system comorbidities increased significantly (5.4％ vs.13.8％, P=0.021).As for the compliance, 8 patients reduced their PD cycles during the holiday, which was more frequent than before holiday (P=0.018).One patient changed his PD pattern, and 6 patients did not follow the medication orders.Demographic characteristics such as gender, age, and marriage conditions were not associated with the compliance.Conclusions Holiday syndrome remarkably affects PD patient''s volume load, metabolism, and compliance.Poor self-management of PD patients during holidays needs further concern.

Objective To investigate the quality of the chronic kidney information found on websites. Methods Three search engines were searched for relevant chronic kidney websites. The independent raters use HON code(The Health On Net Code of Conduct for medical and health Web sites, HON code) and DISCERN instrument to evaluate the chronic kidney websites in Chinese. Results A total of 18 websites were included into our study.The overall mean quality of HON code was 3.6±1.6.The overall mean quality of DISCERN instrument was 32.3 ± 10.8. In the research site, the number of sites built by nonprofits accounted for only 5.6%(1/18). Conclusions The information quality on chronic kidney found online was of poor.The main reason is health websites contain lots of advertisement,and it is rare that non-profit websites can provide medical information which is suitable for general public,the overall reliability is poor,Chinese health websites need to put efforts on developing the quality of health information.

Objective:To evaluate the efficacy and safety of of rivaroxaban for different doses in the treatment of isolated distal deep vein thrombosis.Methods:The clinical data of 853 patients of isolated distal deep vein thrombosis attending Nanjing Drum Tower Hospital from Jan 2018 to Dec 2020 was retrospectively analyzed.Results:Thrombotic recurrence rate increased with increasing follow-up in the standard and low dose groups, and it was significantly lower in the standard dose group than in the low dose group (HR=0.44, 95% CI: 0.25-0.78, P=0.005) with most thrombosis occurring within the first year of follow-up. There was no statistical difference between the two groups in terms of major bleeding events (HR=1.70,95%CI 0.56-5.14, P=0.530) and the incidence of clinically relevant non-major bleeding events was significantly higher in the standard dose group than in the low dose group (HR=2.36, 95%CI 1.26-4.44, P=0.020). Subgroup analysis on anticoagulation duration found when anticoagulation duration was longer than 1.5 months, the risk of thrombosis was lower in the standard dose group than the low dose group (1.5-3 months:HR=0.11, 95%CI 0.01-0.87, >3 months: HR=0.19, 95%CI 0.04-0.95), there was an interaction between anticoagulation duration and dose ( P=0.007). Conclusions:Based on the risk of thrombosis recurrence and bleeding events, the standard dose of rivaroxaban (20 mg qd) is recommended for patients with isolated distal deep vein thrombosis, and the anticoagulant duration should be maintained for 1.5 months or more.

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound in breast precancerous lesions . Methods Retrospectively analyzed the contrast-enhanced ultrasound model and angiographic predictive model of 465 cases of the A prospective multicenter study of breast nodules contrast-enhanced ultrasound" that led the Sichuan Provincial People′s Hospital from January 2016 to April 2017 ,which included 69 cases of breast precancerous lesions and 396 other types benign lesions ,and the sensitivity ,specificity and accuracy of the diagnosis of breast precancerous lesions were calculated . Results The sensitivity of ultrasound predictive model for the diagnosis of precancerous lesions was 60 .9％ and AUC was 0 .681 . Precancerous lesions mainly showed non-concentricity , increased homogeneity , and increased lesions;other types of benign lesions mainly showed non-centripetal ,high uniformity enhancement and lesion size unchanged . Conclusions Contrast-enhanced ultrasound shows a potential value in the differential diagnosis of precancerous lesions and other types of benign lesions ,that can help clinicians to take early intervention measures for breast precancerous lesions ,but there are still many problems to be solved .

BACKGROUNDCurrently there is a trend towards reducing radiation dose while maintaining image quality during computer tomography (CT) examination. This results from the concerns about radiation exposure from CT and the potential increase in the incidence of radiation induced carcinogenesis. This study aimed to investigate the lowest radiation dose for maintaining good image quality in adult chest scanning using GE CT equipment.

METHODSSeventy-two adult patients were examined by Gemstone Spectral CT. They were randomly divided into six groups. We set up a different value of noise index (NI) when evaluating each group every other number from 13.0 to 23.0. The original images were acquired with a slice of 5 mm thickness. For each group, several image series were reconstructed using different levels of adaptive statistical iterative reconstruction (ASIR) (30%, 50%, and 70%). We got a total of 18 image sequences of different combinations of NI and ASIR percentage. On one hand, quantitative indicators, such as CT value and standard deviation (SD), were assessed at the region of interest. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The volume CT dose index (CTDI) and dose length product (DLP) were recorded. On the other hand, two radiologists with ≥ 5 years of experience blindly reviewed the subjective image quality using the standards we had previously set.

RESULTSThe different combinations of noise index and ASIR were assessed. There was no significant difference in CT values among the 18 image sequences. The SD value was reduced with the noise index's reduction or ASIR's increase. There was a trend towards gradually lower SNR and CNR with an NI increase. The CTDI and DLP were diminishing as the NI increased. The scores from subjective image quality evaluation were reduced in all groups as the ASIR increased.

CONCLUSIONSIncreasing NI can reduce radiation dose. With the premise of maintaining the same image quality, using a suitable percentage of ASIR can increase the value of NI. To assure image quality, we concluded that when the NI was set at 17.0 and ASIR was 50%, the image quality could be optimal for not only satisfying the requirements of clinical diagnosis, but also achieving the purpose of low-dose scanning.

Adult ; Aged ; Aged, 80 and over ; Algorithms ; Female ; Humans ; Male ; Middle Aged ; Radiation Dosage ; Radiography, Thoracic ; methods ; Tomography, X-Ray Computed ; methods