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 set up the quality standard of Shenbai concentrated pills. Methods Radix Astragali, Radix Paeoniae Rubra and Rhizoma Imperatea in Shenbai concentrated pills were identified with the method of TLC. The concentration of salvianolic acid B was determined with the method of HPLC. Results For TLC, the chromatogram spots of Radix Astragali, Radix Paeoniae Rubra and Rhizoma Imperatea were well separated and without interference in their negative controls. Quantitative analysis of HPLC showed that the average recovery of salvianolic acid B was 99.74% (RSD=2.08%) with the RSD of precision, reproducibility and stability was 1.74%, 1.19% and 1.70%, respectively. Conclusions The methods set up by this study are easy, accurate and stable, and can be used as the quality control standard of Shenbai concentrated pills.

Seventeen physiological,biochemicaland morphological indexes consistently showed that Astragalus polysaccharide was able to enhance the myocardia contractility,attenuate the area of myocardial infarction, and reduce the degree of myocardial damage of myocardially infarcted dog heart in vivo.The mechanism might be related to the inhibition of Na+-Kr+ATPase activity & the anti-free-radical-damage action.

Objective Through the analysis of cases,to improve the cognition of clinicians on extracranial vas-cular embolism diseases(VED)in children.Methods The clinical information included incidence trend,thrombophi-lia,clinical features,treatment and prognosis of 29 children with VED,who were admitted from January 201 1 to Decem-ber 201 5 in Nanjing Children′s Hospital Affiliated to Nanjing Medical University,and retrospectively analyzed.Results The annual rate of VED increased from 0 to 1 .49 per 1 0 000 hospital admissions from January 201 1 to December 201 5.In 29 cases,there were 20 male and 9 female,with an average age of 6.03 years old (2 h -1 3.83 years old).In-fants accounted for >20%(6 /29 cases).The average age of the female,non infected group,rheumatic disease group and venous thrombosis group was higher than that of the male,the infection group,the non rheumatic disease group and the arterial embolization group,but there was no significant difference(all P >0.05).Thrombophilia were as follows:in-fection disease,heart disease,kidney disease syndrome,rheumatoid disease,tumor,and twins embolization syndrome. Risk factors included central venous line,immobility,dehydration,glucocorticoids use,etc.Heart disease was the leading cause of non thrombotic embolism,while other thrombophilic diseases resulted in thrombotic embolism.Pulmonary em-bolism was mainly seen in patients with severe pneumonia,especially mycoplasma pneumoniae pneumonia (MPP ).The older the age,the more typical clinical manifestations,and significantly elevated D dimer,fibrin/fibrinogen degradation products tips VED.Treatment depends on the degree of risk.Thirty -seven point five percent(3 /8 cases)of children with arterial embolism were less than 1 year old,and the mortality 25.00% (2 /8 cases)was significantly higher than that of venous thrombosis 1 7.65%(3 /1 7 cases)and 1 1 .76% (2 /1 7 cases).Conclusion Heart disease mainly cause arterial embolism and infection,while nephritic syndrome and rheumatic disease mainly cause venous embolism.Pulmona-ry embolism is mainly seen in children with severe pneumonia,especially MPP.The risk of arterial embolization is higher than that of venous embolism.

Objective To investigate the effect of self-designed closed negative pressure drainage combined with sponge dressings on refractory wounds.Methods Sixty patients with phase III-IV pressure ulcers were randomly divided into experiment group and control group in equal number.The self-designed closed negative pressure drainage combined with sponge dressing was applied in the experiment group and in the control group the conventional dressings were used.The two groups were compared in terms of hyperplasia of fresh granulation tissue,time for filling the defect and the healing time and the medical expense.Results Compared to the control group,the time for hyperplasia of fresh granulation tissue,the time for filling the defect and the healing time in the experiment group were all significantly shorter,and the medical expense of the experiment group was significantly less(all P<0.01). Conclusion The self-designed closed negative pressure drainage combined with sponge dressings in the treatment of phase III-IV refractory pressure ulcers may effectively shorten the healing time,improve the curative effects and reduce the economic burden of patients.

Objective To explore the clinical characteristics of treatment?resistant depression ( TRD) and of its relevance with thyroid hormones. Methods 43 patients with TRD and 48 patients with non?TRD were as?sessed with 17?item Hamilton depression scale ( HAMD?17) and Hamilton anxiety scale ( HAMA) . The serum lev?el of thyroid?stimulating hormone ( TSH) ,total triodothgronine ( TT3) ,total thyroxine ( TT4) ,free triodothgronine ( FT3) and free thyroxine ( FT4) were determined by radioimmunoassay. χ2 test and t test were used for statistic a?nalysis. The quantitative relation of FT3 level with TRD was analyzed and the value of FT3 level in TRD diagnosis was evaluated by ROC curve.Results Compared with non?TRD patients,the TRD patients showed a younger dis?ease onset age ((16.98±2.25)years vs (23.50±3.38)years) and a longer disease course ((10.14±6.47)years vs (5.48±4.15)years) for total disease course;(60.35±23.64)months vs (5.00±3.40)months for current disease course),and had shorter education years ((8.53±1.72)years vs (11.04±2.07)years) and higher HAMD total scores (19.09±1.59 vs 15.69±2.38) and behavior retarding factor scores (8.72±0.98 vs 4.98±1.63). In addition, the FT3 level of TRD patients was lower than that of non?TRD patients ((3.92±0.15)pmol/L vs (4.16±0.20) pmol/L).All the above differences between two groups were statistically significant (P<0.05). The logistic regres?sion analysis showed that the risk of suffering TRD increased by 1. 006?fold when FT3 level reduced 0. 1 pmol/L (OR=2.006,95%CI=(1.501,2.681). The area under ROC curve was 0.821 (P<0.001) with its 95% confidence interval of (0.734,0.907). Conclusion Compared with non?TRD patients,TRD patients have a longer disease course,a younger disease onset age, a lower education level, higher HAMD total scores, more severe retardation symptoms,and a lower FT3 level. The serum FT3 level has a high reference value in diagnosis of TRD.

Objective:To study the effects of soybean isoflavone (SI) on metabolism of lipids and lipoprotein (a) [Lp(a)] in ovariectomized rats . Methods:Senventy female Sprague- Dawley (SD) rats were randomly divided into 7 groups according to the levels of total cholesterol (TC) in serum: high-lipid (HF) group, estrogen (EG) group, low-dose SI (L-SI) group, middle-dose SI (M-SI) group, high-dose SI (H-SI) group, sham group and normal control (NC) group. One week after bilateral ovaries were extirpated, except sham and NC group, estrogen, different doses of SI or deionized water were fed i.g. for 12 w. Except NC group, the other groups were fed high fat diet. Body weights were weighed every week and blood and heart were collected at the end of experiment. The serum TC, triglyceride(TG), high or low density lipoprotein-cholesterol (HDL-C, LDL-C), Lp (a), and antioxidative enzymes activities were assayed. Results:After SI intervention, the levels of LDL-C in SI groups were significantly lower than in HF group but higher than in NC group. The levels of Lp (a) were also changed, but there was almost no effect on HDL-C. Persistent intervention with SI can reduce TC, TG , and protect cadiocyte’s actin filament andmitochondrial ultramicrostructure from damage as shown in HF group. The ultramicroscopic pictures in EG and H-SI group almost resembled NC group. Conclusion:Persistent intervention of high-dose SI can reduce the levels of LDL-C, TC, TG and protect the myocardiac damages due to high fat diet in ovariectomized rats.

Objective To explore the features of sustained attention in the patients with social anxiety disorder and their first degree relatives.Methods 60 cases of normal controls,58 cases of patients with social anxiety disorder and 68 cases of their first degree relatives were performed with continuous performance test.Results In reaction time task(a simple performance),all of CPT parameters in patient group (number of cancel (5.2±6.9),number of omission(6.7± 13.6),reaction time(421.0± 112.0) ms,variance coefficient(47.3±38.1) ％)were higher than those in the first degree relatives group(number of cancel (2.9± 3.3),number of omission (1.5±2.1),reaction time (342.0±47.0) ms,variance coefficient(28.9± 10.1) ％) and controlled group (number of cancel (2.8 ± 2.9),number of omission (1.3 ± 0.7),reaction time (329.0 ± 53.0) ms,variance coefficient (27.8± 9.7) ％),the differences were significant(P＜0.01),while all of CPT parameters in the first degree relatives were similar to those in controlled group(P＞0.05).In X task (a complex performance),the results of CPT in the first degree relatives were between the patients and the normal controls,and the differences were statistically significant(P＜0.05).Conclusion The anxiety disorder patients showed no sustained attention impairment in simple performance while in a complex performance there were some defects of sustained attention functions in the patients with social anxiety disorder and their first degree relatives.

Objective To explore a surgical treatment of skin defects on the thumb by reverse-flow island flaps on dorsal thumb web with dorsoulnar artery of thumb as a pedicle.Methods The origin,courses and distribution of dorsoulnar artery of thumb from 70 adult cadaveric hand specimens perfused by red latex were explored.Skin defects on the thumb of 8 cases were repaired with reverse-flow island flaps on dorsal thumb web.The cut areas of flaps vary from 4.5 cm × 3.0 cm to 7.5 cm × 4.0 cm.Results There were 4 types of the dorsoulnar artery of thumb basing on the origin and courses.Type Ⅰ was outside the first dorsal interosseous muscle type,which was the dorsoulnar artery of thumb mainly originated from the first dorsal metacarpal artery and cross through the surface of the first dosal interosseous muscle(42.9％).Type Ⅱ was under the first dorsal interosseous muscle type,which was from the thumb principal artery or deep branch of radial artery and run under the first dorsal interosseous muscle(41.4％).Type Ⅲ was mixed type from the anastomose point of above two arteries at the level of the first metacarpophalangeal joint(11.4％).Type Ⅳ was absence type (4.3％).Eight flaps fully survived.Excellent texture and satisfying appearance of the flaps as well as normal thumb web function were verified after 8 months' follow-up.Conclusion It is significant to determine the type of dorsoulnar artery of thumb to decide different operations due to the artery's considerable variation.The reverse-flow island flap on dorsal thumb is an ideal method to repair soft tissue defect on the thumb for its convenient operating and little effect in the donor area.

Objective To evaluate the effects of butorphanol pretreatment on myocardial damage induced by limb ischemia/reperfusion (I/R) in rats.Methods One hundred and eight male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 3 groups (n =36 each) using a random number table:sham operation group (group S),I/R group and butorphanol pretreatment group (group B).Limb ischemia was induced by occlusion of bilateral hind limbs for 2 h followed by reperfusion in I/R and B groups.At 10 min before ischemia,butorphanol 0.2 mg/kg was injected via the right jugular vein in group B,while the equal volume of normal saline was injected in group I/R.Six rats were chosen randomly before ischemia (baseline,T0) and at 2,6,12,24 and 48 h after reperfusion (T1-5) and blood samples were taken from the abdominal aorta for determination of the serum creatine kinase isoenzyme-MB (CK-MB) activity and cardiac troponin Ⅰ (cTnI) concentration.The animals were then sacrificed and myocardial specimens were obtained for determination of myocardial apoptosis (using TUNEL) and the expression of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated protein kinase (ERK) (using Western blot analysis).Apoptosis index was calculated.Results Compared with group S,the serum CK-MB and cTnI levels were significantly increased at T1-5,and the apoptosis index and expression of JNK and ERK were increased at T2-5 in group I/R (P ＜ 0.05).Compared with group I/R,the pathological changes of myocardium were significantly reduced at T4,the serum CK-MB and cTnI levels were decreased at T2-5,the apoptosis index was decreased at T4,5,the expression of ERK was up-regulated at T2-5,and the expression of JNK was down-regulated at T2-4 (P ＜ 0.05).Conclusion Butorphanol pretreatment can reduce apoptosis in myocardial cells through activating MAPK signal transduction pathway,up-regulating ERK expression and down-regulating JNK expression,thus attenuating myocardial damage induced by limb I/R in rats.