OBJECTIVE:To optimize the formula of piribedil hydrochloride orally disintegrating tablets and to investigate their related indexes.METHODS:Taking the contents of crospovidone(PVP XL)(disintegrating agent),amylum pregelatinisatum(loading agent) and Gum Acacia(glidant) as factors,the disintegrating time(td),the wet time(t) and the suspend stability(?A) as the evaluate indexes to carry on the orthogonal experimental to optimize the formula.The dissolution curve of the optimized formula was drawn.RESULTS:The optimized formula for the piribedil hydrochloride orally disintegrating tablets were as follows:the contents of crospovidone(PVP XL),amylum pregelatinisatum and Gum Acacia were 15%,20%,and 15% respectively.The prepared orally disintegrating tablets disintegrated completely within 30s and dissolved basically within 2min.CONCLUSION:The prepared preparation can meet the related standards specified of China Pharmacopeia.

Objective To improve diagnosis effectiveness for patients with multiple endocrine neoplasia(MEN).Methods 68 patients with MEN were reviewed in this paper.The diagnosis,clnical features and principle of treatment were discussed.Results (1)MEN-Ⅰ 22.05%,MEN-Ⅱ 36.86%,MEN-Ⅲ 8.82% MEN-Ⅰ\,Ⅱ 33.72%.(2)The cases in female were more than male and ten years earlier than male.(3)Endocrinophathies involred in order were thyroid,adrenal medulla,parathroid and islet.Conclusion It is important that more than one endocrinopathy be examined in doubtful cases.

Objective To observe the expressions of Slug, BRAF V600E and STIP1 proteins in papillary thyroid carcinoma (PTC), and to explore their correlation with capsular invasion and regional lymph node metastasis. Methods Slug, BRAF V600E and STIP1 expressions in 107 cases of differentiated PTC were examined by immunohistochemical staining. The expressions of three proteins and clinicopathological data were statistically analyzed. Results Positive rates of Slug, BRAF V600E and STIP1 in PTC were 65.4 % (70/107), 61.7 % (66/107) and 66.4 % (71/107), respectively, and overexpression of Slug, BRAF V600E and STIP1 was significantly associated with capsular invasion and regional lymph node metastasis in PTC (P< 0.05). There are a significant correlation between expression of Slug and BRAF V600E in PTC (r= 0.235, P< 0.05). Conclusion Overexpression of Slug, BRAF V600E and STIP1 proteins is associated with capsular invasion and regional lymph node metastasis in PTC, which maybe useful for predicting regional lymph node metastasis and prognostic evaluation.

Objectives To explore the clinical application of deceleration capacity of rate (DC), acceleration capacity of rate (AC) and heart rate variability (HRV) in children with precardial distress of unknown origin. Methods A total of 56 children with precardial distress of unknown origin and 63 healthy children aged 6 to 17 years were examined by 24 h dynamic elec-trocardiogram, and the indexes of DC and HRV were compared between these two groups. Results DC value of children with precardial distress is less than that of the control group (P<0.05), AC value is greater than that of the control group (P<0.05), and heat rate (HR) is greater than that of the control group (P<0.05). No statistical differences were observed in the indexes of HRV between the two groups. The indexes of DC show a signiifcant positive correlation with HRV in children with precardial distress(r=0.27~0.40, P<0.05), while appear a negative relation with HR (r=-0.46, P=0.000). In contrast, the indexes of AC show a signiifcant negative correlation with HRV (r=-0.57~-0.34, P<0.05), and appears a positive relation with HR(r=0.61, P=0.000). HR value is higher in male children less than 12 years old with precardial distress than that of age-matched males in control group, and RMSSD is lower than the latter. DC value of male children more than 12 years with precardial distress is lower than that of age-matched males in control group, while AC value is higher than that of the latter;DC value is signiifcant lower in fe-male children more than 12 yeares with precardial distress than that of age-matched females in the control group (P<0.05). Con-clusions The activity of vagus nerve in children with precardial distress of unknown origin is decreased. DC value is signiifcantly lower than that of control group, and shows correlation with indexes of HRV. There is no signiifcant difference in DC and HRV value between male and female children with precardial distress. DC value is lower in children aged 12 or older with precardial distress than that of age-matched children in the control group, which indicates adolescents are vulnerable to autonomic nerve functional disorder.

Background Age-related macular degeneration (AMD) is a heritable,progressive degenerative disorder that triggers central visual impairment.Research demonstrated that the single nucleotide polymorphisms (SNPs) of vascular endothelial growth factor 1 (VEGFR1) gene is associated with AMD in different population.However,the results varied among diversified ethnic origin composition and distinct regions.Objective This study was to investigate the associations between the SNPs of VEGFR1 genetic variants along with smoking exposure and the risk of AMD in Hui and Han ethnics in the Ningxia population in China.Methods A case-control study was conducted.Four hundreds and thirty-two AMD patients including 325 Han ethnic patients and 107 Hui ethnic patients were recruited from March 2011 to June 2015,and 906 ethnicity-and gender-matched age-related cataract patients were contemporaneously recruited as control group,including 698 Han ethnic patients and 208 Hui ethnic patients.Periphery blood sample of 5 ml was collected from the subjects and genomic DNA was prepared.Eight tagging SNPs loci were acquired to cover rs2281827,rs3936415,rs7337610,rs7981680,rs9554320,rs9554322,rs9582036 and rs9943922,and the genotypes of SNPs were detected by using MassARRAYTM time-of-flight mass spectrometry system.Chi-square test and multi-factor Logistic regression analysis were utilized to estimate the discrepancy of allele frequency and genotype distribution in Hui and Han AMD patients.Moreover,the correlation of AMD with smoking and age statue were further analyzed.This study protocol complied with Helsinki Declaration and was approved by Ethic Committee of Ningxia Eye Hospital.Written informed consent was obtained before any relevant medical examination.Results There were significant differences in the age between AMD group and control group in both Han and Hui ethnicity (Han:P =0.000;Hui:P =0.009).The smoking exposure was significantly different between AMD group and control group in Han ethnicity (P =0.000),and smoking was the independent risk factor of AMD disease in Han ethnicity of N ingxia region (odds ratio [OR] =2.622,95％ confidence interval [CI]:1.899-3.619).The allele frequencies of SNPs were not significantly different in the AMD patients between Han and Hui ethnicity (all at P＞0.05).However,the allele frequencies and genotype distribution of rs7337610 and rs9554322 SNPs were significantly different between the AMD group and control group in both Han and Hui ethnicity (all at P=0.00).The genotype distribution of rs9582036 and rs9943922 SNPs was significantly different between the AMD group and control group in Han ethnicity (P=0.02,0.00).Allelic G of rs7337610 was the protective factor of AMD disease in Han and Hui ethnieity (OR=0.354,95％ CI:0.288-0.435;OR=0.446,95％ CI:0.315-0.632),while allelic C of rs9554322 was the risk factor of AMD disease in Han and Hui ethnicity (OR=1.671,95％ C1:1.234-2.262;OR=3.661,95％ CI:2.156-6.218).Allelic A of rs9582036 was the risk factor of AMD disease in Han ethnicity (OR =1.477,95％ CI:1.124-1.940).Conclusions Smoking is the independent risk component for Han population with AMD.Of the eight SNPs tagged,the genotypes and alleles of rs9554322 and rs7337610 seems to confer susceptibility to AMD in both Han and Hui ethnicity,the genotypes and alleles of rs9582036 and rs9943922 confer susceptibility to AMD in only Han ethnicity.

Objective:To explore the feasibility of artificial intelligence ultrasound to diagnose of biliary atresia (BA) based on deep learning.Methods:A total of 531 gallbladder ultrasound images in 177 cases of BA patients (BA group) and 585 gallbladder ultrasound images in 195 cases of Non-BA patients (Non-BA group) were collected in Hunan Children′s Hospital from September 2018 to October 2020. For the BA and Non-BA groups, all images were divided into training set and test set according to the ratio of 2∶1. The Mask R-CNN model was trained by training samples, and then the model was tested, according to patient and image as a unit respectively, to evaluate the gallbladder organ detection rate and the diagnostic accuracy of BA. In addition, the images of the test set were randomly numbered.Four sonographers were invited to interpret the images to calculate the diagnostic accuracy individually. Last, the diagnostic accuracy of the Mask R-CNN model was compared with that of sonographers.Results:In terms of the automatic detection of gallbladder organs, the detection rate in both BA and Non-BA group reached 100%, but there were 17 false alarms in 372 test images, with a false alarm rate of 4.57%. In terms of the diagnostic rate of gallbladders, when taking patient as a unit, the total diagnostic accuracy of the model in the test set was 95.97%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.005). It was slightly higher than that of sonographer with senior professional title in our hospital (91.94%), but the difference was not statistically significant ( P=0.183). When taking picture as a unit, the total diagnostic accuracy of the model was 97.04%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.001). It was slightly higher than that of sonographer with senior professional title in our hospital (94.09%), but the difference was not statistically significant ( P=0.05). Conclusions:The artificial intelligence technology based on Mask R-CNN can automatically and accurately detect gallbladder organs and diagnose BA, which is worthy of further study.

Objective To explore the clinical significance of Slug expression in papillary thyroid carci-noma(PTC). Methods Employed Ventana immunohistochemistry assay to determine the expression of Slug in 107 cases of PTC and para-tumorous normal tissue. The relationship with Slug expression in PTC and clinico-pathology data were also analyzed. Results Expression of Slug in PTC (65.4%, 70/107)and para-tumorous nor-mal tissue (14.0%,15/107)were statistically different (P < 0.001). Overexpression of Slug in PTC was signifi-cantly associated with capsular invasion and lymph node metastasis (P < 0.05). Conclusion Overexpression of Slug in PTC is associated with capsular invasion and lymph node metastasis , these may suggest some clinical significance of Slug expression in PTC in predicting lymph node metastasis and prognosis.

Objective To systemically evaluate the accuracy of CT and MR estimating whole liver volume with evidence based medicine methods.Method Published papers about whole liver volume estimation with CT or MR modality were searched in Cochrane library,MEDLINE,EMBASE,CMBdisc(China biology medicine disc) for English and Chinese abstracts.Inclusion criteria were formulated according to validity criteria for diagnostic research published by the Cochrane collaboration.Heterogeneity test of extracted data of Eligible papers was performed first to determine the appropriate statistical model used to pool the result.Finally,sensitivity and publish bias analysis was performed.Result Seventeen articles with 37 studies including 351 patients met the inclusion criteria.There was no heterogeneity between included studies (I2 =0％,Q =5.85,P =1).Fixed effect model was selected for the meta analysis and there was no statistically significant difference between true and radiological estimated whole liver volume (WMD =21.61 mL,95％ confidence interval:-6.33-49.57 mL,z =1.51,P =0.13).Sensitivity analysis revealed the result was robust which was not affected by excluding any of the included studies.Funnel plot and publish bias analysis showed no publish bias (t =-1.55,P=0.13).Conclusion CT and MR volume estimation is accurate for liver volume measurement,which provides important information for preoperative evaluation,postoperative monitoring and follow-up studies of other hepatic pathologies.aximum benefit to patients.

Objective To assess the role of pelvic ultrasound examination in discriminating between normal girls,isolated premature thelarche/pubarche /menarche and central precocious puberty (CPP).Methods Eighty-four isolated premature thelarche/pubarche /menarche cases,47 CPP cases,and 177 normal girls aged 0-10 years were recruited.All diagnoses were confirmed by the gonadotropin-releasing hormone-stimulation test.All subjects underwent pelvic ultrasound examination for the measurement of length,width,thickness,and volume of the uterine body,uterine cervix,and ovary,and the number of follicles with diameter≥ 4 mm.The groups were subdivided by age intervals when the difference in ultrasound measurements between CPP,isolated premature thelarche/pubarche/menarche,and normal girls were analyzed.Results 1) Differentiation between CPP and normal girls:for the 6-8 years,there were 11 variables elevated in CPP as compared to the normal girls.Uterine cervix thickness was the most efficient parameter as judged by the largest value of area under the ROC curve (0.958).The best cut-off,sensitivity,and specificity was 0.73 cm,93.30％,and 85.70％ respectively;for the 8-10 years,uterine body volume was the best parameter among the 10 elevated variables as judged by the largest area under the ROC curve (0.869),3.23 cm3 was the best cut-off limit with a sensitivity of 84.21％ and a specificity of 52.11％.2) Differentiation between isolated premature thelarche/pubarche/menarche and normal girls:for the 0-6 years,ovary thickness was the best variable as judged by the largest area under the ROC curve (0.806),0.98cm was the best cut-off limit with a sensitivity of 76.46％ and a specificity of 84.85 ％ ;for the 6-8 years,ovary width was the best variable among the 8 valuable variables for its largest area under the ROC curve (0.843),1.39 cm was the best cut-off limit with a sensitivity of 85.71％ and a specificity of 73.81％ respectively;for the 8-10 years,uterine cervix thickness was the best variable among the 5 valuable variables for its largest area under ROC curve (0.841),0.75 cm was the best cut-off limit with a sensitivity of 90.48％ and a specificity of 64.21％.3) Differentiation between CPP and isolated premature thelarche/ pubarche/menarche cases:for the 6-8 years,uterine cervix length and width were potential parameters.Uterine cervix length was the best variable for its largest area under the ROC curve(0.764),and 1.49 cm was the best cut-off limit,the corresponding sensitivity and specificity was 93.33％ and 55.17％ respectively;for the 8-10 years,3 variables could be used,among which uterine cervix length was the best variable for its largest area under the ROC curve (0.893),1.88 cm was the best cut-off limit with a sensitivity of 100％ and a specificity of 71.43％.Condusions Pelvic ultrasound examination is a valuable tool for the diagnosis and differentiation between CPP,isolated premature thelarche/pubarche /menarche and normal girls.

Objective To reveal the role of inhibitor of nuclear factor kappa B kinase alpha (IKKα) in renal inflammation after renal ischemia-reperfusion (IR) injury and its potential associated mechanism.Methods Ischemia-reperfusion injury models were induced in a total of 24 healthy C57BL/6 male mice.Renal function and histological changes were estimated.The expression and site of IKKα,p52,RelB,IL-10 and IL-18 were determined by immunohistochemistry and Western blotting.After the short hairpin RNA(shRNA)targeting IKKα was injected into renal parenchyma,renal function and protein expressions of IKKα,p52,RelB,IL-10,IL-18 were detected.Results Compared with sham-operated group[Scr(7.30±0.13) μmol/L,BUN (8.39± 0.30) mmol/L],levels of Scr [(29.80± 2.10)μmol/L,(27.00±3.40) μmol/L,(23.00±3.70) μmol/L] and BUN [(9.47±3.50) mmol/L,(11.68 ±4.30)mmol/L,(13.12±2.10) mmol/L] were higher on day 1,3,7 and the injury of kidney was serious in IR injury group.Immunohistochemical expression of both IL-18 and IL-10 were increased.Markedly increased IKKα,p52 and RelB protein expression were noted in experiments from day 1 to day 7 during kidney recovery period,with a peak on day 3 and then decreasing toward baseline after day 7.Compared with IR injury group,low-expression of IKKα by injection of shRNA up-regulated the expression of IL-18 and down-regulated the expression of IKKα,p52,RelB and IL-10.Conclusions The NF-κB pathway is activated and IKKα expression is up-regulated during the kidney ischemiareperfusion injury,low-expression of IKKα may block inflammation resolution via down-regulation of alternative NF-κB pathway family members of both p52 and RelB.