OBJECTIVE: To explore the diagnostic value of the proposed thyroid imaging reporting and data system (TI-RADS) classification in thyroid nodules, and to investigate interobserver variability among different observers using TI-RADS classification for ultrasound. METHOD: We reviewed 667 thyroid nodules conventional ultrasound image data from 532 patients who were confirmed by Pathological diagnosis. Those ultrasound images were reviewed by 4 experienced sonographers who can independently assessed the sonographic characteristics and analyzed according to the TI-RADS classification. It is to assess the diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the TI-RADS classification. The multirater kappa statistics were used to assess the interobserver agreement among different observers. RESULT: The overall sensitivity, specificity, negative predictive value (NPV) and Accuracy were 94%, 79%, 97% and 81%, respectively. Positive predictive values (PPVs) for categories 4 and 5 were 55% and 92%. There was substantial interobserver agreement for categories 3, 4B and 5 (Kappa = 0.62, 95% CI, 0.58-0.65), and was moderate agreement for category 4A (Kappa = 0.57) and 4B(Kappa = 0.60). CONCLUSION The diagnostic criteria of TI-RADS for differentiating between benign and malignant thyroid nodules have a high diagnostic value. There was substantial interobserver agreement in different experienced sonographers. The TI-RADS diagnostic criteria have a high diagnostic value and has great practical value in making a proper and further treatment plan.
Humans ; Observer Variation ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Nodule ; classification ; diagnostic imaging ; Ultrasonography

ObjectiveTo investigate whether miR-25 targets KLF4 to regulate the growth of gastric cancer cells and lucidate the mechanism of miR-25 producing functional effects in gastric cancer cells. Methods The expression levels of miR-25 and KLF4 were detected by qRT-PCR in 35 pairs of gastric cancer tissues of patients. Target genes of miR-25 were predicted using Targetscan and verified though dual luciferase activity assay and west-ern blot. MTT assay and clone formation assay were detected after downregulated miR-25 and overexpressed KLF4 respectively. Results miR-25 was highly expressed in gastric cancer tissues with KLF4 downexpresstion. Downreg-ulated miR-25 and overexpressed KLF4 respectively can significantly reduce the proliferation of gastric cancer cells,the results were opposite when overexpression of KLF4. Conclusion miR-25 promotes gastric cancer cells proliferation by targeting KLF4.

BACKGROUND: Biomechanical changes of the trunk might be an important factor contributing to the pathogenesis and poor recovery of lumbar disc herniation.OBJECTIVE: To study the biomechanical changes of the trunk of patients with lumbar disc herniation by isokinetic test of the protruded lumbar disc.DESIGN: Non-randomized controlled retrospective study of concurrent patients.SETTING: Department of Rehabilitation Medicine, Changhai Hospital, Second Military Medical University of Chinese PLA.PARTICIPANTS: Thirty patients with lumbar disc herniation, admitted in the clinic of Department of Rehabilitation, Changhai Hospital affiliated to Second Military Medical University between February 2001 and January 2002, were enrolled in this study, with another 30 concurrent patients without lumbar disc herniation serving as the control group. Informed consent was obtained from all patients involved.METHODS: A Biodex Multi-joint Testing System was employed for measuring the peak torque(PT), peak torque to body weight(PT/BW), time to peak torque(TPT), torque at 0. 2 s(T@ 0. 2), total work(TW), average power(AP) and flexion to extension(F/E) ratio of the trunk muscles of the patients. The results were analyzed by t test using SPSS 9.0 software.MAIN OUTCOME MEASURES: Main outcome: isokinetic evaluation of the lumbar and dorsal flexors and extensors; secondary outcome: F/E ratio.RESULTS: The strength of the trunk flexors and extensors decreased significantly in patients with lumbar disc herniation at each testing speed of retraction, and the bursting strength and indices for work efficiency of the muscles also exhibited obvious changes. The flexors showed greater reduction in muscle strength than the extensors. The F/E ratios during isokinetic concentric contraction at 60°/s and 180°/s were 57.99 ±5.68 and 65.74 ± 8.12, respectively, in patients with lumbar disc herniation, in comparison with the ratios of 95.25 ±5. 18 and 83.03 ±7.61 in the control patients, showing significant difference between the two patient groups( P ＜ 0.01 ).CONCLUSION: Biomechanical changes of the trunk muscles of patients with lumbar disc herniation are definite, and proper rehabilitative treatment of these patients should consists of specific training protocols to restore the mechanical balance of the trunk and break the vicious cycle on the basis ofaccurate evaluation of such changes.

Objective To investigate the lung function testing performing in normal smokers,and urge smokers to stop smoking early. Methods Two hundred and one adult men did the pulmonary function testing by MINATO AS-505 portable spirometer, and analyzed the effect d different smoking degree on the pulmonary function. Results There was no relationship between lung volume index and smoking, smoking degree. Compared with nonsmokers, the indicants such as FEV1, MVV, FEV1/FVC had decreased, and the indexes of the small airway function (PEF, FEF25%-75%)had significantly dropped in the smokers. And the smokers especially long-term smokers, most indexes of the pulmonary functions and all indexes of the small airway function correlated with smoking index. Conclusion Although smokers do not show clinical symptoms, their lung functions have been reduced, especially small airway function.

Objective To improve the effects of health education(HE)and satisfaction degree on HE of inpatients by executing hierarchical full-responsibility nursing. Methods Fourteen wards were randomly chosen form the hospital and divided into the control group and the experimental group, each group having 7 wards. The control group carried out routine holistic nursing model, and the experimental group carried out a new hierarchical full-responsibility nursing system. Reforming nursing scheduling and diminishing the nursing unit to assure that the patients acquired the continous and stable nursing service when they were in hospital. The effect and the degree of satisfaction of HE were compared between two groups after 6 months. Results The effects of HE in the experimental group were significantly better than those in the control group, and the degree of satisfaction on HE in the experimental group was much higher than in the control group. Conclusions The hierarchical full-responsibility nursing system can give patients systematic and normalized HE. It can significantly improve the effects and the degree of satisfaction on HE.

Objective To study the clinical value of serum FL-6 detection in patients with Graves. Methods The level of IL-6 was detected in 75 Graves patients and controls with ELISA, the correlation between IL-6, other function parameter (T3, T4, etc.) and immune indicators (TRAb) were analyzed. Results The level of IL-6 in Graves patients was(1. 84 ±1. 58) ng/L, which was significantly higher than the healthy controls(l. 28 ±0.46)ng/L (t=2.55,P<0.05).IL-6 was positive correlation with T3(r =0. 55) ,T4(r =0. 40) ,FT4(r =0. 36) , FT3(r = 0. 35)and TRAb(r = 0. 47) (P <0. 05)and was negative correlation with TSH(r= -0. 58, P < 0. 05). Conclusions IL-6 can be used as a good index of immune derangement and thyroid function disorders in Grave patients.

Objective To explore the clinical characteristics,diagnosis and therapeutic strategies of acute appendicitis in pregnancy.Methods The clinical data of 45 cases with acute appendicitis in pregnancy,which had been diagnosed by surgeries in our hospital since Jan 2010 to Jun 2016,were retrospectively analysed.Results All patients had exhibited abdominal pain.Among them,15 patients(33.3％)had exhibited shifting pain in right lower quadrant,and 44 patients(97.8％)had abdominal tenderness.4 cases with appendiceal gangrene and 1 case with necrosis of the great omentum had been found during the surgeries.There were 5 patients had occurred complications after the surgeries,including 2 cases with poor wound healing,1 case with septic shock,1 case with inflammatory ileus and 1 case with incompletely adhesive ileus.Threatened abortion and threatened premature delivery were found in 11 patients(during 22+3 to 36+2 weeks gestation)after the surgeries.Finally,1 patient occurred abortion(25+3 weeks gestation)and 3 patients occurred premature delivery(during 28+4 to 30+4 weeks gestation).Conclusion Abdominal pain as the main clinical manifestations of the pregnancy with acute appendicitis,prone to severe complications.

Objective　To investigate the changes of free calcium distribution in hepatocytes after administration of phenylephedrine. Methods The changes of fluorescence intensity were observed by confocal laser scanning microscopy after administration of phenylephedrine alone or pretreated with phentolamine before phenylephedrine administration. Results　The fluorescence intensity increased rapidly after administration of phenylephedrine to hepatocytes. When liver cells were pretreated by phentolamine before phenylephedrine administration, the changes of fluorescence intensity not obvious. Meanwhile, the inconformity of the fluorescence intensity in hepatocytes suggested the existence of the second subarea of free calcium distribution. Conclusion　Ca2+ signal can be arisen by phenylephedrine via the α-receptor in hepatocytes in vitro. The distribution and dynamic changes of free calcium in hepatocytes display some characteristics.

Objective To study the application effect of multi-dimensional health education model in the outpatient department of gynecological painless surgery,and explore more standardized and more effective education method.Methods 2 639 patients were selected in Sir Run Run Shaw Hospital outpatient service of gynecological department from July 2010 to June 2011,and were randomly divided into the control group(1 302 cases) and the intervention group(1 337 cases).The control group adopted conventional health education,the intervention group adopted the multi-dimensional health education.Design form was used to analyze preoperative compliance of the two groups.Results The preoperative compliance of the intervention group was higher than those of the control group,the difference was statistically significant.Conclusions Multi-dimensional health education mode can improve the preoperative education compliance of patients in the outpatient service of department of gynecological painless surgery patients,reduce the rate of operation delay and anesthesia method alteration,reduce patient pain,increase peri-operative nursing quality of painless surgery.

AIM To establish a quantitative analysis of multi-components by single-marker (QAMS) method for the simultaneous content determination of four saikosaponins in Xiaozheng Pellets (Bupleuri Radix,Cyperi Rhi-zoma,Rhei Radix et Rhizoma,etc.).METHODS The analysis of 5％ ammonia-methanol extract of this drug was performed on a Waters Xbridge C18column (250 mm ×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-water flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 210 nm and 254 nm.With saikosaponin a as a internal standard,the relative correction factors of saikosaponins b1,b2 and c were calculated,followed by the determination of their contents.RESULTS Four saikosaponins showed good linear relationships within their own ranges (r ≥ 0.999 5),whose average recoveries were 98.08％-102.94％ with the RSDs of 0.85％-1.82％.The results obtained by QAMS approximated those obtained by external standard method.CONCLUSION This simple,precise and feasible method can be used for the quality control of Xiaozheng Pellets.