Objective To investigate the clinical-pathological feature of careinoma showing thymus-like dif- ferentiation(CASTLE) of the thyroid. Methods The clinical data, histopathologie changes and immunohistoche- mical findings were studied in 1 case of carcinoma showing thymus-like differentiation of the thyroid with review of the related literature. Results The age of the patient was 38 years old. The clinical manifestation displayed a pain- less mass in the thyroid. On ultrasound the tumor appeared hypoechoic. Histologically the tumor cells were arranged in nests and islands accompanied by desmoplasfie strorna. The architecture thus showed a superficial resemblance to the lobulation seen in thymic carcinomas. The tumor was characterized by squamoid or syheytial-appearing cells with lightly eosinophilic cytoplasm. Nuciec were oval, pale to versicular, and had small distinct nudeoli. Immunohistoche- mically the tumor cells were positive for CK, CD5, CD117 but neyative for TG, Calcitonin, SYN, NSE, TTF- 1, EBV. Conclusion CASTLE is a very rate a carcinoma thyroid with architectural resemblance to thymic epithelial tumors. The immunophenolype of CASTLE is identical with that of thymie carcinoma.

Objective To explore the medication rules of national TCM masters’ treatment for phymatosis. Methods The prescriptions for phymatosis of national TCM masters were collected to build a database. The methods of association rules with apriori algorithm and complex system entropy cluster were used to achieve frequency of individual herbs, frequency of medicine combinations, association rules of herbs and core medicine combinations. Results In the prescriptions for phymatosis, Chinese medicinal herbs with the highest frequency were Astragali Radix, Pinelliae Rhizoma, Poria, Herba Oldenlandiae, Rehmanniae Radix Exsiccata, and so on. Medicine combinations with the highest frequencywere Atractylodis Macrocephalae Rhizoma-Poria, Citri Reticulatae Pericarpium-Poria, Atractylodis Macrocephalae Rhizoma-Codonopsis Radix, and Poria-Codonopsis Radix. The medicine association rules of confidence coefficient 1 were Sparganii Rhizoma→Curcumae Rhizoma, and Moutan Cortex, Persicae Semen→Paeoniae Radix Rubra. The new prescriptions composited by “Curcumae Rhizoma, Sparganii Rhizoma, Manis Squama, Prunella Spica, Dipsacus Asperoides”, or “Paridis Rhizoma, Adenophorae Radix, Gleditsiae Spina, Sargassum, Laminariae Thallus”. Conclusions Chinese medicinal herbs used in the prescriptions of national TCM masters for the treatment of phymatosis were often with the actions of invigorating the spleen and benefiting qi, clearing away heat and toxic material, and promoting blood circulation to remove blood stasis, which were complied with the medication rule of treating both the incidental and fundamental aspects in TCM.

Objective To study the protective effect of rose (Rosae Rugosae Flos) essential oil on acute myocardial infarction in mice, and explore its mechanism. Methods The model of acute myocardial ischemia in mice was established by intraperitoneal injection of isopropyl adrenaline. The myocardial tissue pathological changes and the degree of myocardial injury in mice were observed by HE staining and TTC staining. Activities of super oxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in myocardial tissue of mice were determined, and activities of creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) in serum of mice were determined as well. Results HE staining results showed that rose essential oil group (160, 80, and 40 mg/kg) can significantly improve myocardial tissue pathological injury in mice; TTC staining results showed rose essential oil (160, 80, and 40 mg/kg) can significantly reduce the myocardial ischemia areas in mice. Compared with model group, SOD and GSH-Px in the myocardial tissue of mice significantly increased (P < 0.05, 0.01), while enzyme activity of serum LDH and CK-MB significantly reduced in rose essential oil group (P < 0.05, 0.01). Conclusion Rose essential oil has certain protective effect on acute myocardial infarction injury and its mechanism may be associated with inhibiting oxidative damage, enhancing activities of anti-oxidant enzymes, and reducing the lipid peroxidation damage.

Objective To understand websites of public hospitals in China.Methods Website search and appraisal were called into play to analyze the percentage and present conditions of websites built by public hospitals in Shanghai,Hubei Province and Gansu Province.Rusults The study found websites in less than 55％ of the public hospitals in these three areas.Those websites in operation provide instant information on hospitals and medical services,yet their online service functions are less satisfactory and website levels vary sharply.Conclusion The authors recommend the Chinese government encourage public hospitals to build websites and enhance their online services.

Objective This study is undertaken to evaluate the changes of serum cytokine levels in different stages of collagen induced arthritis(CIA)rats,to search for the specific proteins related with rheuma- toid arthritis(RA)pathogenesis and inflammation,and to explore the mechanism of RA pathogenesis.Methods Rat cytokine antibody array coated with 19 specific cytokine antibodies was used to examine serum samples at peak and late stage of CIA rats,and were compared to normal cytokine levels.At the same time,ELISA assay for serum TNF-?production was used to verify the array results.Results Among the target cytokines,10 up- regulating cytokines were kept in high expression in different phases of disease,while 1 showed significant change only at the peak of disease.There was no downregnlating cytokines in the results.Serum TNF-?assay results were consistent to the array results.Conclusion Cytokines show different expression in CIA at differ- ent stages,and specific cytokines can be used as the candidates to further study of the RA pathogenesis.This study also provides molecular makers for early diagnosis.

Corresponding author: SONG Guang yao Human umbilical venous endothelial cells (HUVEC) were incubated with free fatty acids (FFAs) of various degrees of saturation. C18:1 and C18:2 inhibited the synthesis of nitric oxide (NO) and endothelin (ET) in HUVEC, and ET synthesis was inhibited much more than NO synthesis, and C18:0 increased ET synthesis in HUVEC, suggesting that the effects of FFAs on HUVEC were related to their degree of saturation.

ITS2 sequence was used as a barcode to identify Viticis Fructus and its adulterants. The study collected 46 samples include Viticis Fructus and its adulterants. The sequences were obtained by extracting DNA, amplification, sequencing bi-direstionlly, and then assembling with CodonCode Aligner. To identify Viticis Fructus and its adulterants, the study used the methods of computing the genetic distances by Kimura 2-Parameter (K2P) model and constructing the Neighbor-joining (NJ) phylogenetic trees using MEGA5.0. The results showed that the maximum inter-specific K2P distance of Viticis Fructus was less than the minimum inter-specific K2P distance of Viticis Fructus and its adulterants and the NJ tree indicated that the Viticis Fructus and its adulterants could be distinguished clearly. Therefore, using ITS2 barcode can distinguished Viticis Fructus and its adulterants accurately.

Objective: To assess the implementation effects of clinical pathways, compared with usual care, among patients with stroke. Methods:Two investigators independently searched PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database and Wanfang Database for studies published before December 2014. Jadad methodological approach was applied to assess the quality of included studies and RevMan software (version 5.2.7) was used for meta-analysis. Results: A total of 11 RCTs involving 913 patients were included in this meta-analysis. The overall results showed that a shorter average length of stay [MD = -2.92; 95% CI (-4.06, -1.78); P < 0.001] and a lower inpatient expenditures [SMD = -1.64; 95% CI (-1.80, -1.48); P < 0.001] in clinical pathways group comparing with the usual care group. The higher score of patient satisfaction was also seen in clinical pathways group. Conclusion: clinical pathways may reduce the average length of stay, reduce the inpatient expenditures, increase patient satisfaction and improve the quality of care in stroke management.
Stroke

Objective: To assess the implementation effects of clinical pathways, compared with usual care, among patients with stroke. Methods:Two investigators independently searched PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database and Wanfang Database for studies published before December 2014. Jadad methodological approach was applied to assess the quality of included studies and RevMan software (version 5.2.7) was used for meta-analysis. Results: A total of 11 RCTs involving 913 patients were included in this meta-analysis. The overall results showed that a shorter average length of stay [MD = -2.92; 95% CI (-4.06, -1.78); P < 0.001] and a lower inpatient expenditures [SMD = -1.64; 95% CI (-1.80, -1.48); P < 0.001] in clinical pathways group comparing with the usual care group. The higher score of patient satisfaction was also seen in clinical pathways group. Conclusion: clinical pathways may reduce the average length of stay, reduce the inpatient expenditures, increase patient satisfaction and improve the quality of care in stroke management.

Objective To investigate therapeutic effect of the low dose clomiphene treatment of idiopathic oligoasthenospermia and effect on sperm epididymal protein level 4.Methods183 cases of idiopathic oligoasthenospermia were divided into three groups, vitamin group of 61 patients were given vitamin E,clomiphene group(61 cases)treated with low dose clomiphene, combined group of 61 patients were given low dose clomiphene and vitamin E, lasted for 12 weeks.Semen volume, sperm density, sperm motility, sperm survival rate and sperm reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), human epididymis protein 4 (HE4), follicle stimulating hormone, luteinizing hormone, testosterone concentration were observed before and after treatment.After treatment, the patients were followed up for 1 year, the observation of the natural pregnancy rate after treatment.ResultsSperm density, sperm survival rate and sperm and a A+B grade sperm in the clomiphene group were significantly higher comparedwith the vitamin group (P< 0.05), sperm density, sperm survival rate and sperm and a A+B grade sperm in the combined group were significantly increasedcompared with clomiphene group and vitamin group (P< 0.05),levels of HE4 after treatment was significantly lower compared with before treatment (P< 0.05), And the difference between the three groups were statistically significant (P< 0.05).Follicle stimulating hormone, luteinizing hormone, testosterone in clomiphene group and combined group after treatment, were significantly increased compared with before treatment (P< 0.05), and the combined group had no statistically difference compared with clomiphene group.The pregnancy rate in 1 year of vitamin group, clomiphene group and combined group were 24.59%, 42.62% and 62.29% (P< 0.05).ConclusionClomiphene treatment of idiopathic asthenospermia is better than vitamin E, the combination of the two has a synergistic effect.