Objective To investigate the diagnostic value of dual energy CT for small central cervical metastatic lymph nodes in patients with papillary thyroid cancer.Methods The data of 43 patients with thyroid papillary carcinoma confirmed by pathology were retrospectively analyzed.All of the patients underwent dual energy CT scan before operation.The short diameter,iodine concentration and normalized iodine concentration (NIC) of enhanced arterial and venous phases and the slope of the energy spectrum curve were analyzed between metastatic central cervical lymph nodes and non-metastatic lymph nodes.ROC curve was used to analyze the diagnosis efficacy of iodine concentration and NIC for metastatic lymph nodes of thyroid carcinoma.Results Totally there were 119 lymph nodes in 43 patients included 55 thyroid papillary carcinoma metastasis lymph nodes (metastasis group) and 64 non-metastatic lymph nodes (non-metastasis group).There was significant differences of the mean short diameter of the lymph nodes between the two groupos (t=-2.20,P=0.03).In arterial phase,the average iodine concentration of metastasis group and non-metastasis group were (2.93±1.62)mg/ml and (2.17±1.09)mg/ml;the NIC were 0.33±0.21 and 0.19 ± 0.12;and the slope of the energy spectrum curve were 0.79±0.43 and 0.63±0.37 respectively.In venous phase,the average iodine concentration of metastasis group and non-metastasis group were (2.68± 1.54) mg/ml and (2.17 ± 1.01) mg/ml;the NIC were 0.51 ± 0.18 and 0.43 ± 0.15;the slope of the energy spectrum curve were 0.54 ± 0.42 and 0.62 ± 0.39 respectively.The iodine concentration and NIC in both phases and the slope of spectrum curve in arterial phase had statistical differences between the metastasis and non-metastasis groups (all P＜0.05).ROC curve showed that the area under the curve (AUC) of iodine concentration and NIC in the diagnosis of metastatic lymph nodes were 0.62 and 0.73 in arterial phase,respectively.And the AUC of iodine concentration and NIC were 0.61 and 0.63 in venous phase,respectively.Conclusion There are differences of iodine concentration,NIC in arterial and venous phases and curve slope in arterial phase of dual-energy between malignant and benign central cervical lymph nodes in thyroid papillary carcinoma.Dual energy CT technology is helpful in identifying of metastatic from non-metastatic small central cervical lymph nodes.

Objective To study the role of P53 target gene TIGAR on proliferation ,migration and invasion of lung cancer cells . Methods siRNA was introduced to knock down TIGAR in A 549 cells .Proliferation was detected by CCK-8 .The ability of migra-tion and invasion was measured by and ,respectively .was used to evaluate the expression levels of related proteins .Results Knock-down of TIGAR reduced the proliferation rate (P< 0 .05) ,inhibited the ability of migration and invasion ,decreased expression levels of MMP-2 and MM P-9 .Conclusion TIGAR promotes proliferation ,migration and invasiveness of lung cancer cells .

Objective To analysis the cause of injury of traumatic optic neuropathy and explore the main factors affecting the prognosis of visual acuity. Methods We retrospectively collected clinical data of 104 cases (108) of traumat-ic optic neuropathy from January 2007 to December 2012 in the Renhe Hospital of Three Gorges University. We then ex-amined the cause of injury and analyzed risk factors for poor prognosis of visual acuity in traumatic optic neuropathy us-ing multivariate Logistic regression analysis. Results The mean age of patients was 33.6 ± 12.8 years and 95 cases (91.3%) were males. The injury was mainly caused by non-motor vehicle and motor vehicle accidents (84 cases, 80.8%). Most of the patients came to the hospital within 3 days after the injury (81 cases, 77.9%). Overall efficacy rate of treat-ment was 45.4%(49/108). The effective rate was 29.9%(20/67) for visual acuity without light perception and 70.7%(29/41) for visual acuity with light perception, respectively. Logistic regression analysis showed that the time to treatment≥24h, orbital hemorrhage or orbital fracture, ethmoid or sphenoid sinus bleeding and no light perception vision were an in-dependent prognostic factors. Conclusion Time to treatment time and severity of injury are the independent risk factors for poor visual prognosis of traumatic optic neuropathy whereas controlling these risk factors has important clinical signifi-cance to the treatment and prognosis of traumatic optic neuropathy.

The purpose of this study is to explore the feasibility of wheat germ agglutinin (WGA) modified liposome as a vehicle for ophthalmic administration. Liposome loaded with 5-carboxyfluorescein (FAM) was prepared by lipid film hydration method. WGA was thiolated and then conjugated to the surface of the liposome via polyethylene glycol linker to constitute the WGA-modified and FAM-loaded liposome (WGA-LS/FAM). The amount of thiol groups on each WGA molecule was determined, and the bioactivity of WGA was estimated after it was modified to the surface of liposome. The physical and chemical features of the WGA-modified liposome were characterized and the ocular bioadhesive performance was evaluated in rats. The result showed that each thiolated WGA molecule was conjugated with 1.32 thiol groups. WGA-LS/FAM had a mean size of (97.40 +/- 1.39) nm, with a polydispersity index of 0.23 +/- 0.01. The entrapment efficacy of FAM was about (2.95 +/- 0.21)%, and only 4% of FAM leaked out of the liposome in 24 h. Erythrocyte agglutination test indicated that after modification WGA preserved the binding activity to glycoprotein. The in vivo ocular elimination of WGA-LS/FAM fitted first-order kinetics, and the elimination rate was significantly slower than that of the unmodified liposome, demonstrating WGA-modified liposome is bioadhesive and suitable for ophthalmic administration.

Objective:To observe the effect of large pushing Tianheshui manipulation intervention on the body temperature of young rabbits with endotoxin-induced fever and discuss its antipyretic mechanism.Methods:Thirty-two young rabbits meeting the standards were selected from 40 ordinary young male New Zealand rabbits after being adapted for 7 d,and randomly divided into a normal group,a model group,a large pushing Tianheshui group,and an ibuprofen group according to the random number table method,with 8 rabbits in each group.Rabbits in the model group,the large pushing Tianheshui group,and the ibuprofen group were subjected to preparing the endotoxin-induced fever model by intravenous lipopolysaccharide from the marginal ear vein.Rabbits in the large pushing Tianheshui group received Tuina(Chinese therapeutic massage)manipulation intervention 1.5 h and 2.5 h after modeling,respectively.Rabbits in the ibuprofen group were intragastrically given ibuprofen suspension 1.5 h after modeling.The dynamic changes in body temperature were observed for the young rabbits after fever modeling.Enzyme-linked immunosorbent assay was used to determine the content changes in positive mediators of hypothalamic body temperature,including prostaglandin(PG)E2 and cyclic adenosine monophosphate(cAMP),as well as negative mediators of hypothalamic body temperature,including arginine vasopressin(AVP)and α-melanocyte stimulating hormone(α-MSH).Results:The body temperature of the young rabbits in the model group was significantly higher than that in the normal group at 0.5-4.0 h,5.0 h,and 5.5 h after modeling(P＜0.01),showing two obvious fever peaks in the model group at 1.5 h and 3.0 h after modeling,respectively,with the highest peak at 1.5 h.Compared with the model group,body temperatures of the large pushing Tianheshui group and the ibuprofen group decreased significantly after 0.5 h of intervention(P＜0.05).Compared with the normal group,the contents of PGE2 and cAMP were significantly increased(P＜0.05),and the contents of AVP and α-MSH were significantly decreased(P＜0.01)in the hypothalamus of the model group.Compared with the model group,the contents of PGE2 and cAMP were significantly decreased(P＜0.01),and the levels of AVP and α-MSH were significantly increased(P＜0.01)in the hypothalamus in the large pushing Tianheshui group and the ibuprofen group.There were no significant differences in the PGE2,cAMP,AVP,and α-MSH contents in the hypothalamus between the ibuprofen group and the large pushing Tianheshui group(P＞0.05).Conclusion:Large pushing Tianheshui manipulation has a significant antipyretic effect on endotoxin-induced fever in young rabbits.The mechanism may be related to inhibiting the positive regulators(PGE2 and cAMP)and promoting the negative regulators(AVP and α-MSH)of hypothalamic control of body temperature.

The competency oriented management theory and method, which was proved to be an effective management measure, have been put into practice in many areas including high education. This essay will probe into the possibility of introducing the competency oriented management theory into the education of undergraduate stomatology students, analyze and research its feasibility from a theoretical point of view by combing the features of stomatology students and the patterns of educating stomatology students. This essay proposes a new pattern of training elite students of stomatology major with competency as the orientation and summarizes the practical experiences in training such elite students.
Humans ; Oral Medicine ; Students

Background In recent years,some researches had been conducted on the pathologic changes of the secondary injury of perihematoma in animal experiments,but only a few studies had been done on the dynamic pathologic and ultrastructural changes of the perihematoma in ICH patients. The unique contribution of our study is to investigate the dynamic pathologic and ultrastructural changes of the perihematoma in ICH patients and provide significant insights into how the pathophysiology and ultrastructures changed after ICH.Methods The written informed consents were obtained from the ICH patients or their relatives. 30 patients (the supertentorial hemotoma volume＞30 mi and the cerebellar hemotoma volume ＞10 mi) were divided into 8 groups according to the time passed after ICH:＜6 h (6 patients), 6 ～ 12 h (7 patients), 12 ～24 h (5 patients), 24～48 h (3 patients), 48 ～72 h (3 patients), 3 ～4 days group (3 patients), 5 days group (2 patients) and 8 days group ( 1 patient) and subjected to craniotomy for hemotoma evacuation. During the operation for the hemotoma's evacuation, a small amount of tissues that must be removed, which located at 1 cm near the hematoma, were taken as experimental groups; And the same tissues of 7 patients (＜12 h), which were far from the hemotoma on the operational way, were taken as control group. The pathologic and ultrastructral changes were observed.Results The tissues of the control group were almost normal while the damages of the tissues from the experimental groups were slight in ＜6 h groups, more severe after 6h and got to the maximum between 24 ～48 h , recovered gradually after 72 h, became similar to the 6 ～ 12 h group on 5 th day, got better on 8 th day and resembled the 6 h group.Conclusions The injury of the perihematoma occurred in early stage, reached the peak level between 24 and 48 hours after ICH; which was consistent to the clinical nervous functional deficits in the ICH patients.

Objective:To investigate the prevalence of sarcopenia as defined by the third lumbar skeletal muscle index (L3-SMI) and explore its impact on drug therapy in patients with inflammatory bowel disease (IBD).Methods:The baseline abdominal CT images of 230 patients with IBD hospitalized in the First Hospital of Shanxi Medical University from December 2018 to December 2022 were retrospectively analyzed to obtain L3-SMI. The optimal cut-off value of L3-SMI to define sarcopenia was determined using receiver operating characteristic curve analysis. The IBD group included 164 cases of ulcerative colitis (UC) and 66 cases of Crohn's disease (CD), compared with 100 cases of the normal control. The clinical data and biochemical indicators, such as body mass index (BMI), albumin (ALB), pre-albumin (PA), disease activity and therapeutic drugs, were collected. Outcomes were followed up, including the optimization of baseline drug therapy, the initiation of additional biological agents or combined drug therapy. Multivariate logistic regression analysis was used to identify risk factors for the escalation of drug therapy, and the nomogram was constructed and evaluated for the prediction of drug regimen escalation in patients with IBD.Results:The prevalence of sarcopenia in the IBD population in this study was 39.6%, among whom 36.0% were with ulcerative colitis and 48.5% with Crohn's disease. The prevalence of malnutrition (BMI<18.5) in IBD patients was 18.7%, whereas 69.2% of patients with concurrent IBD and sarcopenia had a BMI≥18.5 . The median L3-SMI of IBD patients was significantly lower than that of normal controls (36.30 cm 2/m 2vs. 39.37 cm 2/m 2, P=0.004). Sarcopenia ( OR=3.33, 95% CI: 1.06 to 10.50, P=0.040) was associated with the escalation of drug therapy in patients with IBD. Based on the patient's age, presence or absence of sarcopenia, albumin and BMI, the nomogram prediction model was established, with the area under the curve (AUC) of 0.762 (95% CI: 0.691 to 0.834), showing good discriminating performance. The calibration curve and Hosmer-Lemeshow goodness-of-fit test demonstrated good consistency between the predicted and observed data ( χ2 =11.906, P=0.156). Decision curve analysis showed potential benefits of the prediction model in clinical settings. Conclusion:Sarcopenia is common in patients with IBD, which is related to the escalation of drug therapy in patients with IBD.

Patients in the intensive care unit (ICU) often need to have various catheters placed on their bodies due to their severe condition. In order to prevent the occurrence of unplanned extubation, patients' hands should be restrained appropriately. The current restraint gloves used in clinical practice have problems such as improper restraint, easy falling off of oxygen saturation monitoring probes, and pressure injury of hands. Therefore, department of critical care medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine designed a wrist restraint glove suitable for restless patients, and obtained the national utility model patent (ZL 2020 2 1612453.7). The device is composed of restraint gloves and restraint rings, which can not only restrain patients, but also continuously monitor the changes of blood oxygen saturation in patients with restfulness. This device is convenient to use, low cost, comfortable to wear, and can prevent the occurrence of device-related pressure injuries, which is suitable for clinical application.
Humans ; Wrist ; Intensive Care Units ; Critical Care ; Hand ; Upper Extremity ; Restraint, Physical