Objective To ascertain and evaluate the quality of radiological protection in rural and urban primary health care institutions . Methods Questionnaires were designed to investigate the protection levels in diagnostic radiology in primary health care institutions in six cities in 2013 and to evaluate the results by using the technique for order preference by similarity to an ideal solution ( TOPSIS) combined with the rank sum ratio ( RSR) method.Results The six cities and an integrated case ( all the data of the six prefecture-level citys were merged as one for comprasion ) were ranked based on the comprehensive assessment.The order from good to bad was Suzhou , Dalian, Yichang, integrated case, Shaoxing, Quzhou and Heihe.The results were divided into three grades , with Suzhou, Dalian at best grade, Yichang, integrated case, Shaoxing, Quzhou at middle grade, and Heihe at poor grade. Conclusions The quality of protection in radiation diagnosis varied considerably .Suzhou ranked the first and Heihe ranked the last .The study suggests that efforts should be focused on the management of key cities and indicators to upgrade whole protection level in radiation diagnosis .

Objective To investigate the activation of matrix metalloproteinase (MMP)9 by acute arterial injury and the involved signaling mechanism in murine femoral artery. Methods In the C57BL/6 mice femoral artery denudation injury were performed. Total protein and membrane protein extracts were prepared from targeted arteries. The MMP 9 activity was measured by zymography assay, the expressions of MMP 9 antigen and protein kinase C (PKC) isoforms were measured by Western blot. Seventy-two hours after mice fed with PKCβ inhibitor (ruboxistaurin), the denudation injury triggered MMP 9 activation was reassessed. Results Within 4-24 hours after denudation injury, MMP 9 activity in femoral arteries was significantly increased, with a peak induction of (99.3±9.5) times the sham control (F=51.49,P＜0.01) at 8 h. MMP 9 antigen increased in parallel with MMP 9 activity. Within 15-120 minutes after denudation injury, there was a significant induction of PKCβⅡ in membrane fraction of femoral arteries, with a maximum induction of (7.50±0.60) times the sham control (F=207.06,P＜0.01)at 30 min. Injury-induced MMP 9 activation was significantly inhibited by ruboxistaurin. Conclusions MMP 9 activation is, at least in part, mediated by PKCβ in acute arterial denudation injury, it highlights the new target for therapeutic intervention to suppress the over-activation of MMP 9, which plays a critical role in restenosis.

Objective To establish the HPLC fingerprints of Radix Glycyrrhizae. Methods The RP-HPLC method was used, Zorbax SB C_ 18 column (250 mm?4.6 mm, 5 ?m) was employed; the acetonitrile-1.2% acetic acid (gradient elution) was used as mobile phase, analytic time was 70 min, and detective wavelength was at 254 nm. Results The HPLC fingerprints of Radix Glycyrrhizae were set up. The result showed that 38 peaks were common in different sources. The results of method validation met technical standard of fingerprints. Conclusion The method is stable and reliable with a good reproducibility and provides a reference standard for the quality control of Radix Glycyrrhizae.

Clinical data and treatment of a patient with late-onset glutaric acidemia type Ⅱ who was admitted to the Department of Pediatric Intensive Care Unit (PICU) of Shenzhen Children′s Hospital were retrospectively analyzed.The patient is a female with the clinical manifestations of aggravated progressive proximal muscle weakness, accompanied by vomiting, abdominal pain and liver enlargement.A marked increase of transaminase, bilirubin and creatine kinase was detected, and hyperammonemia, hypoglycemia and metabolic acidosis were also observed in the patient.Blood amino acids and acylcarnitines spectra showed increased levels of various acylcarnitines.The muscle biopsy study suggested lipid storage myopathy (LSM), and the genetic test identified a homozygous mutation in the electron transfer flavoprotein dehydrogenase (ETFDH) gene.After treatment with Vitamin B 2, carnitine, coenzyme Q10 and plasma exchange, the motivate ability and biochemical parameters of the patient returned to normal.For patients with aggravated progressive proximal muscle weakness, hepatic dysfunction and increased serum creatine kinase levels, late-onset glutaric acidemia type Ⅱ should be considered.The key to early diagnosis and treatment of the disease is to improve the knowledge of it.

Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) at different frequencies on behavioral and psychological symptoms and cognitive function in patients with Alzheimer's disease.Methods Seventy-two patients were randomly divided into a high frequency group,a low frequency group and a control group (n =24 for each),and given 10 Hz,1 Hz or sham rTMS over the left and right dorsolateral prefrontal cortex at an intensity was 80％ of each patient's movement threshold.The stimulation was for 30 min a day,five days a week.During the 4 weeks of treatment,risperidone was used at a fixed dose of 1 mg per day for all patients.Before and after the treatment,all 3 groups were assessed using the behavioral pathology in Alzheimer's disease rating scale (BEHAVE-AD) and the mini-mental state examination (MMSE).Results Two weeks after the treatment,the average BEHAVE-AD score of the high frequency group had decreased significantly from (16.75±6.26) to (13.84± 6.10),significantly lower than the low frequency and the control groups' averages.Two weeks later,the average BEHAVE-AD scores of the 3 groups were significantly lower than before the treatment,but the decrease of the high frequency group was of significantly greater compared to the other 2 groups.Four weeks after the treatment the average MMSE score of the high frequency group was significantly better than before the treatment (P＜0.01),and better than the low frequency and the control group's averages.The effectiveness rates of the high frequency group,the low frequency group and the control group were 88％,58％ and 54％ respectively,all significantly different.Conclusion High frequency (10 Hz) rTMS combined with risperidone can improve the behavioral and psychological symptoms and cognitive function of AD patients,while low frequency (1Hz) rTMS does not have obvious effects.

Objective:To study the clinical efficacy of adjuvant therapy with thymosin alpha -1 in patients with severe peritoneal cavity infection(sIAI),and to explore its effect to celluar immune function and T-like receptor.Methods: A total of 60 patients with sIAI,who received treatment in the intensive care unit of our hospital in January 2012-December 2014,were divided into observation group and control group.Cases in control croup received routine treatment ,and cases in observation group received routine treatment besides thymosin alpha-1.T-lymphocyte subsets were determined by flow cytometry and expression of Toll-like receptor (TLR)2 and TLR4 in the peripheral blood mononuclear cells were determined by real time PCR before treatment and in the 2nd week after treatment.The scores of acute physiology and chronic health evaluation ( APACHE)Ⅱscore and gastrointestinal function were recorded before treatment and in the 2nd week after treatment.The rate of systemic inflammatory response syndrome (MODS),the rate of death in hospital stays,intestinal function recovery and hospital stays in both groups were compared .Results: (1) CD3+,CD4+and CD4+/CD8+of cases in observation group significantly increased ( P<0.01 ) , and CD8+significantly decreased ( P<0.01 ) compared with those in control group.(2) The expression levels of TLR2 and TLR4 mRNA in PBMCs of cases in observation group significantly decreased compared with those in control croup (P<0.01).(3)The scores of APACHEⅡ and gastrointestinal function in observation group significantly decreased compared with those in control group ( P<0.01 ) .( 4 ) The recovery of intestinal function , vanishment of SIRS,hospital stays and the rate of MODS in observation group significantly decreased compared with those in control group (P<0.01), the rate of death in hospital stays had the trend of reduction with no statistic significance (P>0.05).Conclusion:Adjuvant therapy with thymosin alpha-1 in patients with sIAI has good clinical efficacy ,and can improve the cellular immune function ,decrease the expression of Toll-like receptor.

Background Orbital tumor has complex histological types and it is difficult for clinical differential diagnosis.Therefore, it is badly in need of a new diagnostic technology to distinguish its benign and malignancy.Objective This study aimed to analyze and compare the characteristics of contrast ultrasound image between benign and malignant orbital neoplasms and evaluate the diagnostic value of contrast ultrasound to orbital tumor.Methods The clinical data of 24 patients with malignant orbital neoplasms and 51 patients with benign orbital neoplasms were retrospectively analyzed in Taihe Hospital of Hubei University of Medicine from September 2010 to September 2013.Contrast ultrasound examination was carried out on all the patients using MyLab Twice color ultrasonic device under the informed consent.SonoVue solution of 2.0 ml was intravenously injected and then the state and dynamic graphs of orbital tumors were collected.According to the classification of enhanced levels and patterns,the imaging features of orbital neoplasms were evaluated, and time-intensity curve (TIC) and dynamic vascular pattern (DVP) curve were obtained with SonoLiver software.The general ultrasonic signs and contrast ultrasonic characteristics between benign and malignant neoplasms were compared.Results Hyper-enhanced lesions were found in 62.5％ (15/24) and 27.5％ (14/51) ,and iso-intensity lesions were found in 20.8％ (5/24) and 49.0％(25/51) in the malignant orbital neoplasm patients and benign ones, respectively, with a significant difference in enhanced types between them (x2 =26.40,P＜0.01).Based on the enhanced mode, heterogeneity enhancement lesions were found in 75.0％ (18/24) and 25.5％ (13/51), and hemogeneity enhancement lesions were seen in 25.0％(6/24) and 47.1％ (24/51) in the malignant orbital neoplasm patients and benign ones, respectively, showing a significant differnee between them (x2 =30.40, P ＜ 0.01).The 58.3％ patients showed rapid rising and sharp descending TIC curves,and 75.0％ patients showed the biphasic wave DVP curves in the malignant lesions;while in the benign lesions,the TIC curves of 78.7％ patients were quick lift and slow dessend, and the DVP curves of 74.5 ％patients appeared to be positive phasic wave.These curve features were significantly different between the malignant lesions and benign ones (TIC:Z=-3.130,P=0.002;DVP:Z =-4.730,P =0.000).Conclusions Contrastultrasound examination shows that different tissue-derived orbital neoplasms have varied enhanced modes and types.Contrast-ultrasound examination is helpful for the differential diagnosis of orbital neoplasms.

Objective To evaluate the ability of contrast-enhanced ultrasonography (CEUS ) compared to enhanced MRI scan in differential diagnosis of benign and malign tumor of orbit.Methods CEUS and enhanced MRI was performed in 74 patients with tumor of orbit.These patients were divided into two groups:benign and malignant tumor depended on histological diagnosis.The results were analysed with SonoLiver software.The coincidence rate of diagnosis and enhancement intensity among CEUS,MRI and CEUS+ MRI were compared and the quantitative parameters of CEUS were analysed.Results (1 )The diagnostic accordance rate of benign group by three methods were 90.0%,80.0% and 96.0% respectively, there was statistical difference for diagnostic coincidence rate between the MRI and CEUS+ MRI(P <0.05).The diagnostic accordance rate of malignant group by the above three methods were 75.0%,79.2%and 95.8% respectively,there was no statistical difference for diagnostic coincidence rate between the three methods(all P > 0.05 ).(2 )The enhancement intensity of CEUS was different between benign and malignant groups (P <0.05).There was no statistical difference between benign and malignant groups by MRI method (P >0.05).(3)The parameters of tumor imaging obtained time intensity curve(TIC):rise time (RT),half elution time and time to peaking (TTP)were significantly different between benign and malignant groups(P <0.05).While there was no significant difference of parameters as mean transit time (mTT)and arrived time (AT)(P >0.05).Conclusions CEUS had higher diagnostic accuracy than MRI in benign orbital tumor.The contrast enhancement intensity and time-intensity curves provide valuable diagnostic information for differential diagnosis of benign and malignant orbital tumor.

Objective To investigate the coagulant function of Thrombomodulin-Protein C-EPCR System in rats with hemorrhagic shock in virto study.Methods In this study,30 rats were divided into three groups,with each group 10 rats:control group,the sham shock group,hemorrhagic shock group.Hemorrhagic shock model was subjected to computer-controlled arterial hemorrhage to 40 mm Hg for 60 min The rat blood serum samples were obtained from rats in sham shock group and shock group after maintaining 3 hours,and fetal bovine serum (FBS) was used as control group.Then medium contained fore-mentioned serums cultured with SV40-transformed aortic rat endothelial cells for 6 hours,12 hours and 18hours.The messenger RNA (mRNA) expression of thrombmodulin (TM),Endothelial cell protein C receptor in the SV40-transformed aortic rat endothelial cells which were treated with serums were detected by reverse-transcription polymerase chain reaction.Results Compared to control group,SVARECs were incubated for 6hrs with shock serum,the mRNA expression of TF,TM and t-PA was significantly higher,and continued elevating at the time of 18 hours (P ＜ 0.01).Conclusions Serums from hemorrhagic shock rats upregulate TMmRNA EPCRmRNA expression on the endothelial cells surface.It is suggested that Thrombomodulin-Protein C-EPCR System pay a key role of anticoagulation,the protection of endothelial function.

Objective To investigate the mechanism of myocardial ischemia and reperfusion-induced acute lung injury (ALl) and protective effect of ischemic postconditioning.Methods Forty SD rats were allocated to sham group,myocardial ischemia/reperfusion group (reperfusion group),ischemic postconditioning group (postconditioning group),and ischemic postconditioning + phosphatase and tensin homolog deleted on chromosome ten (PTEN) inhibiting group (inhibitor group) according to the random number table,with 10 rats per group.Myocardial ischemia/reperfusion was induced by left anterior descending coronary artery occlusion.Postconditioning was performed within 1 minute before reperfusion consisting of 3 10 s cycles of reperfusion followed by 10 s occlusion.Lung was immediately removed 120 minutes after reperfusion for HE stain,immunohistochemical detection of inflammatory factors and apoptosis factors,TUNEL assay of cell apoptosis,and Western blot of protein kinase B (Akt),phospho-Akt (p-Akt),glycogen synthase kinase-3β (GSK-3β),and phospho-GSK-3β (p-GSK-3β).Results Down-regulated B-cell lymphoma-2 (Bcl-2) and IL-10 and up-regulated Bcl-2 associated X protein (Bax),cysteinyl aspartate specific proteinase-3 (Caspase-3),IL-6 as well as IL-8 were observed in other 3 groups compared with sham group (P ＜0.01).Moreover,down-regulated Bax,Caspase-3,IL-6,IL-8 as well as TUNEL and up-regulated Bcl-2 as well as IL-10 were observed in reperfusion group compared to postconditioning group and tensor group (P ＜ 0.01).No statistical differences were found among the four groups in levels of Akt,p-Akt,and GSK-3β,but level of p-GSK-3β was significantly down-regulated in reperfusion group compared to other 3 groups(P ＜ 0.01).Conclusion Development of ALI may relate to down-regulation of p-GSK-3β evoked directly by the release of inflammation factors in early period of myocardial ischemia/reperfusion and ischemic postconditioning may attenuate the condition.