Objective In clinical practice,ultrasound-guided fine-needle aspiration biopsy (US-G FNAB) is the gold standard in diagnosing the pathological nature of undetermined thyroid nodules before operation.Re---sults of FNAB may vary substantially among operators with different skills.The aim of this study is to evaluate whether operator experience in US-G FNAB influences the rate of diagnostic procedures.Methods A total of 600 consecutive US-guided FNAB done by a single radiologist with 22-or 27-gauge needles from Feb.2008 to Apr.2012 were retrospectively analyzed.All specimens were prepared and fixed without the cytologist on site and were subsequently analyzed by 2 expert cytologists.The procedures were chronologically divided into 6 groups and further stratified according to the overall (A),solid nodules (B),mixed nodules (C),pure cystic nodules (D),acellular sample(E),heavily blood-stained sample(F),exclusively colloid material(G),incorrect slide fixation(H) and they were classified as diagnostic or no-diagnostic.Results The rate of no-diagnostic procedures for each group in learning curves were reported as:① Among A,34％ in group 1,15％ in group 2,18％in group 3,10％ in group 4,7％ in group 5,and 8％ in group 6.② Among B,4％ in group 1,1％ in group 2,0％ in group 3,0％ in group 4,0％ in group 5,and 0％ in group 6.② Among C,10％ in group 1,1％ in group 2,4％ in group 3,0％ in group 4,1％ in group 5,and 0％ in group 6.④ Among D,20％ in group 1,13％ in group 2,14％ in group 3,10％ in group 4,6％ in group 5,and 8％ in group 6.⑤ Among E,25％ in group 1,15％ in group 2,15％ in group 3,10％ in group 4,6％ in group 5,and 8％ in group 6.⑥ Among F,4％ in group 1,0％ in group 2,1％ in group 3,0％ in group 4,0％ in group 5,and 0％ in group 6.⑦ Among G,1％ in group 1,0％ in group 2,1％ in group 3,0％ in group 4,1％ in group 5,and 0％ in group 6.⑧ Among H,4％ in group 1,0％ in group 2,1％ in group 3,0％ in group 4,0％ in group 5,and 0％ in group 6.Among the 600 procedures,there were 2 cases of vertigo and 4 cases of moderate bleeding at the biopsy site,all of which resolved spontaneously.No major complications were recorded.Conclusions The rate of no-diagnostic US-guided FNAB is heavily dependent on the operator's experience.We estimate that at least 200 procedures are needed in order to achieve the levels of diagnostic accuracy reported in the literature.We therefore suggest operators to get specific training before routinely perform this procedure in clinical practice.

[ ABSTRACT] AIM: To investigate the role of anterior thalamic nucleus in trigeminal nerve electrostimulation ( TNS)-induced effects on seizures and hippocampal damage.METHODS: The rats were intraperitoneally injected with pilocarpine to induce chronic epilepsy, and then received sham treatment, TNS treatment and TNS treatment after stereotac-tic lesion to the anterior thalamic nucleus.The TNS treatment lasted for 1 month in each group.Another injection of pilo-carpine was conducted to induce seizures, and the severity and duration of seizures were quantitatively evaluated.TUNEL, Fluoro-Jade B ( FJB) and Nissl staining were applied to determine in situ apoptosis, neuronal degeneration and neuron loss in the hippocampal CA1 area respectively.RESULTS:Compared with TNS group, TNS treatment after stereotactic lesion to the anterior thalamic nucleus significantly increased the severity and duration of seizures (P<0.05), and the numbers of TUNEL positive cells, FJB positive cells and lost neurons in the hippocampal CA1 area (P<0.01).CONCLUSION:Anterior thalamic nucleus plays a role in TNS-induced reduction of seizures and hippocampal damage.The mechanisms might be due to the chronically activation of the cortex through anterior thalamic nucleus pathway induced by TNS, resulting in the down-regulation of neuronal excitatory susceptibility.

Objective To investigate the possible risk factors for prognosis of diffuse alveolar hemorrhage (DAH) in children and to improve the recognition of the disease.Methods The study included 62 DAH pediatric patients hospitalized from January, 2006 to January, 2016. Clinical data were retrospectively analyzed. According to the basic diseases, children were divided into immune associated DAH and non-immune associated DAH to explore the effect of early glucocorticoid treatment on the two groups of DAH. Based on the prognosis, the patients were divided into the death group and the survival group to analyze its related risk factors.Results Of the 62 patients, 20 were of immune associated DAH, 42 of non-immune associated DAH. There was no signiflcant difference of early treatment with glucocorticoid between the two groups (P>0.05). In our cohort, 30 patients died, the total mortality was 48.4% (30/62). Pediatric critical illness score may be the independent risk factor for DAH mortality.Conclusions DAH is an acute, life-threatening event, the lower the pediatric critical illness score, the higher risk of death.

A novel rapid method for detection of the illicit beta2-agonist additives in health foods and traditional Chinese patent medicines was developed with the desorption corona beam ionization mass spectrometry (DCBI-MS) technique. The DCBI conditions including temperature and sample volume were optimized according to the resulting mass spectra intensity. Matrix effect on 9 beta2-agonists additives was not significant in the proposed rapid determination procedure. All of the 9 target molecules were detected within 1 min. Quantification was achieved based on the typical fragment ion in MS2 spectra of each analyte. The method showed good linear coefficients in the range of 1-100 mg x L(-1) for all analytes. The relative deviation values were between 14.29% and 25.13%. Ten claimed antitussive and antiasthmatic health foods and traditional Chinese patent medicines from local pharmacies were analyzed. All of them were negative with the proposed DCBI-MS method. Without tedious sample pretreatments, the developed DCBI-MS is simple, rapid and sensitive for rapid qualification and semi-quantification of the illicit beta2-agonist additives in health foods and traditional Chinese patent medicines.

Objective To analyze the clinical feature and common etiology of diffuse alveolar hemorrhage (DAH) in children. Methods Clinical data from 138 children with initially diagnosed DAH were retrospectively analyzed. The etiology, diagnosis, treatment, and prognosis had been summarized. Results Among 138 children, 76 were male and 62 were female. The clinical features are pallor ( 130 cases, 94 . 2%), cough ( 86 cases, 62 . 3%), fever ( 74 cases, 53 . 6%), anhelation ( 67 cases, 48 . 6%), hemoptysis ( 59 cases, 42 . 8%) and dyspnea ( 43 cases, 31 . 2%). Chest imaging changes were mainly patch shadow and ground glass shadow. Moreover, the detection rate of hemosiderin cells in sputum, gastric juice and bronchoalveolar lavage lfuid was 90 . 8%( 79/87 ). The common underlying diseases that caused DAH were idiopathic pulmonary hemosiderosis ( 65 cases), hematological system disease ( 22 cases), vascular inlfammatory diseases ( 15 cases), infectious diseases ( 14 cases) and cardiovascular disease ( 5 cases). The mortality rate in acute phase of DHA was 23 . 2%( 32/138 ). Conclusions DHA is a life-threatening clinical emergency disease, its cause was complex and diverse, and the acute mortality rate is high. Glucocorticoid is the ifrst choice of treatment for majority of patients.

Objective This study is to investigate the changes in the NFATc 4/3 signaling pathway in rat hippocampus after whole brain radiation. Methods A total of 120 one?month?old male Sprague?Dawley rats were randomly divided into four groups to receive whole brain radiation using 4?MeV electron beams with doses of 0( control) ,2,10,and 20 Gy,respectively,in a single fraction. At 6 hours,12 hours,1 day,3 days,1 week,and 2 weeks after radiation,Western blot and real?time PCR were used to evaluate the changes in expression levels of CaN, NFATc 4/3, p?NFATc 4/3, and GSK?3β. Results There were no significant changes in the expression of NFATc 4/3 or p?NFATc 4/3 at 6 and 12 hours after whole brain radiation. At 1 day after radiation,compared with the control group,the expression of p?NFATc 4/3 in the radiation groups was significantly increased in a dose?dependent manner ( 2 Gy:P= 0. 014;10 Gy:P=0. 011;20 Gy:P=0. 000 );however, there was no significant difference in the expression of NFATc 4/3 between the radiation group and the control group. The expression of NFATc 4/3 was significantly decreased in the radiation groups than in the control group at day 3 ( 2 Gy:P=0. 040;10 Gy:P=0. 000;20 Gy:P=0. 000),1 week (2 Gy:P=0. 692;10 Gy:P=0. 032;20 Gy:P=0. 021),and 2 weeks (2 Gy:P=0. 001;10 Gy:P=0. 000;20 Gy:P=0. 000) after radiation,while there was no significant difference in the expression of p?NFATc 4/3 between any two groups. There were no time?or dose?dependent changes in expression of CaN or GSK?3β. Conclusions Ionization radiation has an inhibitory effect on the NFATc 4/3 signaling pathway in rat hippocampus. Combined with our previous results,this study suggests that radiation?induced cognitive dysfunction is associated with the NFATc 4/3 signaling pathway.

Objectives To analyze the clinical manifestation of pulmonary injury in children with systemic lupus erythematosus (SLE).Methods The clinical data of 8 SLE children with onset of respiratory symptoms as the first sign were retrospectively analyzed from January 2011 to December 2015.Results In these 8 children (4 females and 4 males) aged 6-15 years old.All of them presented cough,and 7 cases had fever,5 cases had anhelation,3 cases had hemoptysis,3 cases had stethalgia,3 cases had dyspnea and 3 cases had cyanosis.The types of pulmonary injury were pleural efthsion in 5 cases (62.5％),acute lupus pneurnonitis in 4 cases (50.0％),chronic interstitial pneumonia in 2 cases (25.0％),and pneumorrhagia in 2 cases (25.0％).In 7 children who performed chest high resolution CT examination,it showed that 5 cases had ground-glass shadow,5 cases had pleural effusion,5 cases had enlargement of mediastinum or lymph nodes,and 4 cases had segmental pulmonary consolidation.After treatment of the primary disease,the respiratory symptoms and pulmonary images were improved rapidly in 7 cases,and one case died of pneumorrhagia.Conclusion The clinical ministrations in SLE children with onset of respiratory symptoms as the first sign were not specific,and it was usually confused with respiratory infection.However,it usually had other organs involved and the chest imaging was more commonly showed groundglass shadow,segmental pulmonary consolidation,and pleural effusion.

Objective To discuss the possible reasons of contrast agent reflux during transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy),and in order to provide scientific evidences for reducing the contrast agent reflux.Methods The sonographic features of contrast reflux were observed in the images of 167 infertile patients who underwent TVS RT-3D-HyCoSy, and the association of the incidence rate of the reflux with tubal patency,the types of infertility,endometrial thickness,menstrual clean days,abnormal uterine cavity,the history of intrauterine operations,pelvic operations and ectopic pregnancies were analyzed.Results The incidence rate of the reflux during TVS RT-3D-HyCoSy was 41 .3%.The incidence rates of reflux in unilateral patency and bilateral obstruction were 4.929 and 9.21 5 times of that of bilateral patency respectively.The incidence rate of reflux in the secondary infertility cases was significantly higher than that of primary ones(P <0.05).Logistic regression analysis demonstrated that the reflux is associated with the tubal patency,the endometrial thickness and the history of intrauterine operations,and none of the other factors.Conclusions TVS RT-3D-HyCoSy could differentiate the images of reflux better;the proper timing of the contrast examination and avoiding the damage of endometrium would reduce the incidence of the reflux.

Objective To translate the Female Sexual Function Index(FSFI) into Chinese and establish its psychometric properties among ordinary Chinese people and diabetes patients.Methods A two-phase study design was applied.The Chinese version of FSFI was established by translation and back translation,then the reliability and validity of the FSFI were evaluated.Results The content validity coefficient of FSFI was 0.953.The test-retest reliability in each dimension had good correlations (r value was 0.817～0.922),with the highest correlation coefficient in vaginal lubrication dimension (0.922) and arousal dimension the minimum (0.817).In all samples (including diabetes and non diabetes) a reliability coefficients of the Cronbach alpha of each dimension was from 0.760 to 0.874.The Cronbach alpha of each dimension for the diabetic group was from 0.783 to 0.882,and from 0.757 to 0.865 in the non-diabetes group.Pearson correlation of each dimension was very good in total samples,the diabetes group,and the non-diabetes group.Conclusions The psychometric properties of the FSFI demonstrated satisfactory validity and reliability.The Chinese version of FSFI is a reliable and valid measure to evaluate the sexual function in Chinese women.

Aim To explore the effects of chrysin on endothelial dysfunction induced by acute high glucose.Methods ① The effects of chrysin on normal isolated aortic at contraction induced by PE and on endothelial dysfunction induced by high glucose were tested in the following medium: normal group,chrysin group;normal-glucose group: glucose 11mmol·L-1 in Krebs' solution;high-glucose group: glucose 44 mmol·L-1 in Krebs' solution;mannitol group: mannitol 33 mmol·L-1 in Krebs' solution and chrysin group: 44 mmol·L-1 Glu+chrysin 1.0 μmol·L-1 in Krebs' solution.② The effects of chrysin on HUVEC cell viability after incubated in high glucose were observed in the following groups: normal-glucose group: glucose 5.5 mmol·L-1 in culture solution;high-glucose group: glucose 33.3 mmol·L-1 in culture solution;mannitol group: mannitol 27.8 mmol·L-1 in culture solution and chrysin group: chrysin(25,50 μmol·L-1)in culture solution.And the NO release was also testd in these groups.Results ① Chrysin could induce vaso-dilation in a dose-dependent manner at normal glucose.The Emax was(58.94±9.61)％,and the EC50 value was 51.9 μmol·L-1.After incubating the aortic rings with high glucose(44 mmol·L-1)for 4 h,there were significant differences in ACh-induced vascular relaxation between the normal glucose group and the high glucose group.The Emax was(32.12±3.92)％and the EC50 value was 78.0 μmol·L-1 of high glucose group(P<0.01).The endothelium-independent relaxation induced by SNP was not significantly different between the two groups.And chrysin(1.0 μmol·L-1)could reverse the decline of ACh-induced vasorelaxation response induced by high glucose(44 mmol·L-1).The Emax was(70.7±3.87)％and the EC50 value was 0.852 μmol·L-1.② The cell viability of HUVEC was depressed after incubated in high glucose,and chrysin could reverse the decline in a concentration-dependent way.And chrysin in defferent concentrations could increase the cell NO release.Conclusion Chrysin could prevent the acute high glucose-induced vascular endothelial dysfunction and could increase the NO release.