Objective To explore the incidence and possible risk factors of restless legs syndrome (RLS) in the maintenance hemodialysis patients.Methods A total of 375 maintenance hemodialysis patients were enrolled in this study from September 1 to 30 in 2012.The diagnosis and assessment of severity were based on the International Restless Leg Syndrome Study Group (IRLSSG) standard.The relevant laboratory parameters and dialysis indicators were collected,such as hemoglobin,serum ferritin,parathyroid hormone,blood flow and dialysis mode.The clinical data were analyzed by multivariate logistic regression method.Results The incidence of RLS was 13.3％ with the severity score of 18.69 ± 0.95.The logistic regression analysis showed that anuria (OR 0.292,95％ CI 0.114-0.750) and β2 microglobulin(OR 1.023,95％C1 1.003-1.044) were the risk factors for RLS in the maintenance hemodialysis patients,while hemoglobin,serum iron and parathyroid hormone were not correlated with RLS.Conclusions The incidence of RLS is high in the maintenance hemodialysis patients.The risk factors of RLS are anuria and β2 microglobulin.Therefore,the preservation of residual renal function and the improvement of dialysis adequacy,especially the removal of the middle molecular weight toxins,may reduce the occurrence of RLS and improve the quality of life in the hemodialysis patients.

Objective To investigate the effect and mechanism of mitomycin C in reducing hypertrophic scar in rat traumatic osteomyelitis model.Methods A total of 120 Wistar rats were divided into control group (Group A,n =40),traumatic osteomyelitis group (Group B,n =40),traumatic osteomyelitis treated with Mitomycin C group (Group C,n =40),according to the random number table.The model of traumatic osteomyelitis was produced by Staphylococcus aureus.Muscle tissues around the focus were harvested at 15 d and 30 d postinjury.HE staining was used to observe the changes of muscle tissue structure.Immunohistochemistry was used to detect expression of transforming growth factor (TGF)-β1.Masson staining was used for collagen deposition evaluation.Western blot was used for detection of levels of TGF-β1 and collagen Ⅰ.Results HE staining revealed consistent alignment of fibers within the muscle in Group A.Fibrosis with the muscle was observed in both Group B and C,but the degree of muscle fiber disorder was decreased in Group C compared to Group B.Either 15 d or β0 d after injury,expressions intensity of TGF-β1,collagen fraction volume,and activation levels of TGF-β1 as well as collagen Ⅰ were higher in Group B and C than Group A,and all parameters were decreased in Group C compared to Group B (all P ＜ 0.05).Conclusion Mitomycin C can reduce hypertrophic scar formation in traumatic osteomyelitis model,and the potential mechanism relates to downregulated TGF-β1 and collagen Ⅰ.

To compare the diagnostic value between the thyroid imaging reporting and data system ( TIRADS) and ultrasound ( US ) patterns of 2015 American Thyroid Association ( ATA ) guidelines in the differentiation of benign and malignant thyroid nodules. 639 patients in Jiangsu province who were scheduled for ultrasound-guided fine-needle aspiration biopsy or thyroidectomy were recruited for the retrospective study. All of them were categorized based on TIRADS and ultrasound patterns of ATA ( 2015 ) guidelines. The receiver operating characteristic curve was established to assess and compare the diagnostic value of the two models. Results:( 1 ) 639 patients with 847 thyroid nodules were included in this study, 510 females and 129 males. The mean age was (46. 77 ±12.98)yearsold. (2)818nodulescouldbeclassifiedaccordingtoTIRADS. ThemalignancyratesofTIRADS2,3, 4A, 4B, 5 were 0, 15. 9%, 49. 1%, 78. 8% ,and 100%, respectively. (3) Ultrasound patterns of ATA could be assigned to 793 nodules. The malignancy rates of nodules with very low, low, intermediate, high suspicion for malignancy were 6. 2%, 10. 3%, 24. 9% and 70. 1%, respectively. (4) Ultrasound patterns of ATA had higher specificity (77. 9%) compared to TIRADS. The sensitivity and area under curve of ultrasound patterns of ATA were lower than those of TIRADS, though, not significant. Ultrasound patterns of ATA(2015) guidelines may yield higher specificity in the differential diagnosis of benign and malignant thyroid nodules, while TIRADS classification may offer a relatively higher sensitivity and area under curve.

Objective: To evaluate the effect of the Thyroid Imaging Report and Data System proposed by American Radiological Society (ACR-TIRADS) for differential diagnosis in thyroid nodules, and compare ACR-TIRADS to the TIRADS proposed by Kwak et al.(K-TIRADS) and the ultrasound-based risk stratification system evaluated by American Thyroid Association (ATA-Risk Stratification). Methods: The clinical data of 1 760 patients with 1 912 thyroid nodules from 8 hospitals in Jiangsu province were retrospectively analysed. All of them were categorized based on ultrasound-based risk stratification systems. The ROC curve was established to assess and compare the diagnostic value of the systems. Results: The area under the ROC curve (AUC) of ACR-TIRADS was 0.830, with high sensitivity and negative predictive value (86.9% and 87.5%, respectively), and relatively low specificity and positive predictive value (64.1% and 62.9%, respectively). The sensitivity and specificity of K-TIRADS were up to 84.9% and 76.1%, respectively. The AUC of ATA-Risk Stratification was 0.852, with relatively high specificity (83.4%), and low sensitivity (79.4%). There were significant differences in the AUC among the three ultrasound-based risk stratification systems, of which K-TIRADS was the highest (P<0.001). There was no significant difference in sensitivity of ACR-TIRADS and K-TIRADS (P=0.137), but significantly higher than that of ATA-Risk Stratification (P<0.001). There were significant differences in the specificity among the three systems, of which ATA-Risk Stratification was the highest (P<0.001). In addition, there were 109 nodules (5.7%) couldn′t be classified based on ATA-Risk Stratification, with high malignancy rate of 31.2%. Conclusions The diagnostic efficiency of ACR-TIRADS is good, but lower than K-TIRADS and ATA-Risk Stratification. ACR-TIRADS has the highest sensitivity, and ATA-Risk Stratification has the highest specificity, while the overall diagnostic efficiency of K-TIRADS is the best.