The grading of evidence is an important factor in clinical decision-making. The current evidence grading system based on western medicine is limited in the clinical practice of traditional Chinese medicine （TCM）， therefore we propose the solutions to the development of grading system for TCM interventional evidence， following the international evidence grading standards， taking into considerations of the unique characteristics of TCM practice， based on the Grades of recommendation， assessment， development and evaluation （GARDE） evaluation system， and integrating with grading system regarding TCM classical literature and empirical evidence from modern famous doctors. The evidence from classical literature is suggested to be evaluated from three aspects including source of ancient medical records， comprehensive of treatment details， and the inheritance. The qualification of famous doctors， content integrity， and inheritance of experiences will be used to evaluate the evidence from famous doctors' experience. The multi-sourced evidence such as TCM classical literature， experience of modern famous doctors， and modern researches is mainly integrated in a qualitative way， and the overall level of evidence of TCM interventions will be graded consistently with the GRADE system based on modern research. The evidence from classical literature and modern famous doctors' experience will be assessed and considered as supplementary evidence， which will make the evaluation of clinical evidence more objectively and comprehensively， thereby guiding clinical practice further.

Objective To investigate the value of conventional ultrasound combined with contrast‐enhanced ultrasound in qualitative diagnosis of benign and malignant cervical lymph nodes (LNs) .Methods Totally 129 enlarged LNs in 112 cases were performed the 2‐dimensional ,color Doppler ultrasound ,and grey‐scale contrast‐enhanced ultrasound(CEUS)examinations .LNs were divided into the benign group and malignant group according to pathologic results .The aspect ratio ,eccentric medulla or medulla de‐fect ,echo type ,blood supply distribution ,contrast‐enhancement pattern and distribution equilibriuym of contrast agent were com‐pared between the two groups .Results The most of aspect ratio in the benign LNs group were ≥ 2 ,the cortex and medulla were uniform with symmetric increase and without microcalcification ,the blood supple was mainly the non‐blood flow type or hilar type , in contrast‐enhanced ultrasound ,the majority were the early hilar and medullar enhancement ,showing the centrifugally full filling ;the most of aspect ratio in the malignant LNs group were <2 ,medulla was eccentric or loss ,partial of LNs showed the increased parenchymal echo accompanied with cystic lesion and microcalcification ,the blood supply was mainly the peripheral and mixed types ,and the non‐hilar and medulla started enhancement pattern .The ultrasonographic parameters mentioned above were statisti‐cally different between the two groups ,in which the non‐hilar and medulla started enhancement patterns had the highest sensitivity and accuracy for diagnosing malignant LNs ,the positive predictive values of these parameters were higher ,whereas the negative predictive values were lower .Conclusion The conventional ultrasound combined with contrast‐enhanced ultrasonography has a higher practical value in qualitative diagnosis of cervical LNs ;the comprehensive judgment of multiple indicators can increase the differentiating ability for benign from malignant LNs .

Objective To investigate the value of high frequency color doppler ultrasound for screening thyroid diseases in physi-cal examination people .Methods The detectable information of thyroid diseases using high frequency color doppler ultrasound in 1 413 physical examination people was analyzed .Results A total of 588 cases of the 1 413 people were detected to have thyroid dis-eases with positive rate of 41 .61% ,and the detectable rate increased with aging .The positive rate of female (349 cases ,54 .96% ) was statistically higher than that of male(239 cases ,30 .72% ) .Within the 588 people ,111 cases were diagnosed as diffused thyroid diseases and 488 cases were diagnosed as thyroid nodules by high frequency color doppler ultrasound .Twenty cases were confirmed to have thyroid carcinoma by pathologic examination ,with 3 males and 17 females .Twelve lesions were less than 1 .0 cm in diameter and were diagnosed as microcarcinoma .The smallest lesion was 6 mm × 5 mm .Conclusion The high frequency color doppler ultra-sound was useful in screening for thyroid diseases ,especially for carcinoma ,and should be used as routine examination item .

The university test is important appraisal method of the higher education.It is also the effective appraisal means of examining the university students' innovative ability.University's test reform improves the education quality,and is the important link of raising innovative talented persons.The author discusses the necessity of university test reform,the problems existing in the current test and how to deepen the test reform and cultivate the students'innovative abilty.

The non-affiliated hospital’s teaching system in college includes teaching administration system, teaching operation system and teaching quality supervision and evaluation system. It is the significant step for the non-affiliated hospital to assume the clinic teaching duties that constructs the teaching system. The college and hospital should take measures to provide essential guarantee for constructing the teaching system.

Ascites ; therapy ; Humans ; Treatment Outcome ; Ultrafiltration ; instrumentation

OBJECTIVETo explore the effects of recombinant human growth hormone (rhGH) on the serum levels of cytokines in severely burned patients.

METHODSThirty-six burn patients were enrolled in the study and were randomly divided into 3 groups according to the rhGH dosage used, i.e. small (0.3 IU.kg(-1).d(-1), A), large (0.6 IU.kg(-1).d(-1), B) dose groups and control group (C, with normal saline). The rhGH was administered beginning from 3 postburn days (PBDs) and lasted for 20 days. The dynamic changes in the serum levels of TNFalpha, IL-6, IL-8 and LPS at different time points were observed.

RESULTSWhen compared with those in C group, the serum levels of TNFalpha, IL-6 in A, B groups were decreased, especially in B group with earlier decrease and bigger range (P < 0.01). Simultaneously, the serum LPS level was decreased accordingly with evident positive correlation with the change in those cytokines (r = 0.9723, P < 0.01). But there was no obvious difference in serum IL-8 level among A, B and C groups (P > 0.05).

CONCLUSIONrhGH might decrease the production of postburn inflammatory mediators, especially in higher dose in dose-dependent manner for some degree. The clinical application of rhGH might be a supplementary measure in preventing and ameliorating postburn SIRS and MODS in severely burned patients.

Adult ; Burns ; blood ; complications ; drug therapy ; Cytokines ; blood ; drug effects ; Dose-Response Relationship, Drug ; Female ; Human Growth Hormone ; pharmacology ; therapeutic use ; Humans ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Lipopolysaccharides ; blood ; Male ; Middle Aged ; Multiple Organ Failure ; etiology ; mortality ; Recombinant Proteins ; pharmacology ; therapeutic use ; Survival Rate ; Time Factors ; Tumor Necrosis Factor-alpha ; metabolism

Purpose: To investigate the antitumor efficacy of intra-tumoral administration of plasmid DNA expressing mIL-12 in murine H22 liver tumor models grafted subcutaneously. Methods: Plasmid encoding mIL12 was constructed and examined the expression of cytokine in the eukaryotic cell through enzyme-linked immunosorbent assay (ELISA). The proliferation assay of T lymphoblasts was performed for measuring the biological activity of expressed mIL12. After intra-tumoral administration of plasmid DNA, mean diameters of the tumor mass and survival time were measured in each murine models group. Lactic dehydrogenase ( LDH) assay was performed to examine whether or not treatment with different plasmid DNA could induce systemic cytolytic activity of lymphocytes against parental H22 cells. Histopathological analysis was operated after administration of plasmid DNA vectors in each murine model group. Results: Growth of liver tumor was significantly inhibited( F =4. 10, P =0. 03), and activity of CTL against H22 was enhanced in mIL12 gene therapy group as compared with the control group. In the focal treated with pDC511mIL12 plasmid DNA, inflammatory cell infiltration was more extensive and necrosis was more definite than control group at 1 month after DMA injection. Conclusions: Intra-tumoral administration of plasmid DNA encoding interleukin-12 could inhibit the growth of H22 liver tumor and induce the host antitumor immune response efficiently in the murine model.

Objective To improve the management of dyspepsia by evaluating the potential role of pretreatment gastric histology as predictive factors on the symptomatic response after Helicobacter pylori (H. pylori) eradication in patients with functional dyspepsia (FD).Methods 240 FD patients with H. pylori infection out of 920 consecutive patients receiving gastroendoscopy due to dyspepsia were investigated, including 190 patients enrolled as the therapy group and administered with anti-H. pylori triple therapy. In addition, 50 patients were enrolled as the control group, in which omeprazole was an alternative to the triple therapy. The course of therapy in both groups was 7 days. Pretreatment gastric histology was evaluated by the updated Sydney system. C~ 13 urea breath test was performed to evaluate the H. pylori eradication results one month (both therapy group and control group) and six months (therapy group) after therapy. For each patient, the baseline, month 1 and month 6 symptom scores were assessed by a questionnaire of dyspepsia, including 12 symptom items of dyspepsia with scoring of severity. The relationship between pretreatment gastric histology and good symptom responses after H. pylori eradication was then analyzed.Results Of 35.3% and 42.6% patients with successful H. pylori eradication in the therapy group had a good symptomatic response one month and six months after the triple therapy respectively, higher than those from the patients who failed H. pylori eradication (month 1:35.3% vs 12.2%, P

Objective To explore the possibility of using HBV as a gene delivery vector, and to test the anti-HBV effects by intracellular expression of antisense RNA. Methods Two parts of HBV genome were reversedly recombined back into overlength HBV genome, which can produce HBV particle, to express antisense RNA complementary to S or S promoter region respectively. HepG 2.2.15 cell lines were transfected with these constructs and the empty vector pMEP4, then positive clones were selected and mixed in respective groups with hygromycin in the culture medium. HBsAg and HBeAg, which exist in the culture medium, were tested by ELISA method and intracellular HBc related HBV DNA was examined by dot blot hybridization. The existence of recombinant HBV virion in the culture medium was examined by PCR. Results The mean inhibitory rates of HBsAg were (2.74?3.83)%、(66.54?4.45)%(P