The vulnerable carotid atherosclerosis plaque is an important risk factor for ischemic stroke.However,there are no objective diagnostic criteria for the vulnerability of carotid atherosclerosis plaque in clinical practice now.This article reviews the progress in the diagnosis of vulnerable plaque from the aspects of ultrasound,CT,MRL cerebral angiography,and biochemical indexes.

Patients with nonvalvular atrial fibrillation are the high-risk population of ischemic stroke.Anticoagulation therapy is mainly used to prevent the occurrence of stroke in clinical practice.However,there are some difficulties in the conventional administration of oral anticoagulant warfarin because of some restrictions.There are a number of novel oral anticoagulants with promising data for the prevention of stroke in nonvalvular atrial fibrillation,such as direct thrombin inhibitor and coagulant factor X a inhibitor.

Objective To explore the relation between thyroid nodular and thyroid calcification .Methods The clinical data of 430 cases with nodular goiter admitted from January 2011 to December 2013 were reviewed.All cases were performed ultrasonography and pathologic examination .Results Of 430 cases,there was thyroid carcinoma in 49 cases(11.4%),including microcalcification in 30 cases(61.2%) and macrocalcification in 3 cases(6.1%);benign lesion in 381 cases(88.6%),including microcalcification in 24 cases(6.3%) and macrocalcification in 39 cases(10.2%).The difference was remarkable (P=0.000).There was remarkable difference in malignant calci-fied nodules ratio between the patients with microcalcification and macrocalcification (55.6%vs 7.1%,P=0.000), between the patients aged 45 years below and above(48.8%vs 22.6%,P=0.007),between the patients with solita-ry and multiple nodules(45.0%vs 16.7%,P=0.005).But there was no statistic difference in malignant calcified nodules ratio between the male and female groups (24.2% vs.39.7%,P=0.130).Conclusion Microcalcification is a highly specific sign to predict thyroid carcinoma in ultrasonography exam .Positive intervention will be performed immediately when calcification appears in thyroid nodules .

Objective To investigate the clinical features of early postoperative inflammtory small bowel obstruction,and discuss its diagnosis,treatment and preventive measures.Methods The clinical data of 68 cases of early postoperative inflammatory small bowel obstruction were analyzed retrospectively.Results Within the 68 cases,65 cases were cured by non-operative treatment including gastrointestinal decompression,anti-inflammatory drugs,somatostatin,total parenteral nutrition(TPN) and traditional Chinese medicine.The mean time from the onset of symptoms to the recovery of bowel function was 14 days.Three cases were cured by transferring to operation.One case of them was transferred to operation for strangulated intestinal obstruction during the period of conservative treatment.One case underwent oper.ion because the patient didn t recover after 4 weeks expectant treatment.One case underwent operation for the impatience with the conservative treatment of both the doctors and the patient.Conclusion Non-operative therapy should be the first choice for the treatment of early postoperative inflammatory small bowel obstruction,and its therapeutical effect was well-accepted.

0.05). There was statistically significant difference in morbidity rate between the groups (2.1% vs 9.3%, P=0.037). Conclusions: Percutaneous and surgical treatment of pyogenic liver abscesses are both effective, nevertheless percutaneous drainage carries lower morbidity and should be the first-line treatment.

Objective To explore the effect of separate management of income and expenditure (SMIE) on standard community healthcare services. Methods Health management records of 137 community health service ( CHS) institutions in Beijing during 2006 and 2009 were retrospectively analyzed. Paired t test was used to compare annual healthcare services at urban and rural areas before or after SMIE was adopted. Results The standard community healthcare services was reduced from 1 081 965. 53 to 971 793. 98 at urban areas and from 157 492. 23 to 149 305. 25 at rural areas (P >0. 05). Urban healthcare center-based standard services was decreased from 59. 94% to 52. 14% (P < 0. 05 ); while out-hospital services were increased from 13. 50% to 18. 88% (P<0. 05). In urban areas,standard services for women healthcare, chronic disease profiling, health education and information management were significantly increased (I <0. 05). However,Temporary observation and endemic disease prevention and treatment were the main job of rural healthcare. Conclusions SMIE in CHS institutions could accommodate to the need of health management, supporting policies should be further improved.

Objective To explore the potential pathogenesis of Yersinia pestis and provide new clues for vaccine development through comparative proteomic analysis of wild-type and pCD1 cured strain of Yersinia pestis 201.Methods Differentially expressed proteins at 26℃ and 37℃ were separated and identified using two-dimensional electrophoresis coupled with mass spectrometry .Results A total of 24 differently expressed proteins were successfully identified from the samples of bacteria grown at 26℃ and 25 proteins at 37℃.Among these, 7 proteins were encoded by pCD 1 plasmid. Conclusion Through comparative proteomic research, we have found that the abundance of several proteins can be dramatically changed when the large plasmid pCD 1 is missing,suggesting that the plasmid can regulate the expression of many genes located in the chromosome .

Rheumatoid arthritis (RA), as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does not have a clear understanding of the etiology and pathogenesis of RA. Xinfeng Capsule, a patent Chinese herbal medicine, has been used in the treatment of RA in recent years. Despite its reported clinical efficacy, there are no large-sample, multicenter, randomized trials that support the use of Xinfeng Capsule for RA. Therefore, we designed a randomized, double-blind, multicenter, placebo-controlled trial to assess the efficacy and safety of Xinfeng Capsule in the treatment of RA.

objective To investigate the effects of different sections of receptor associated protein (RAP) on the expression and distribution of TRPC6,synaptopodin and podocalyxin in passive Heymann nephritis(PHN). Methods Male Sprague-Dawley rats were injected with three kinds of antisera (anti-RAP full-length serum,anti-RAP N-terminal serum and anti-RAP C-terminal serum)to establish three kinds of PHN models.The control group was injected with normal rabbit serum.The quatitation of 24 h urinary protein,serum albumin and creatinine were taken before injection and one week after PHN model successfully induced.The histopathologic changes of renal tissues were observed by light microscopy.The expression and distribution of TRPC6,synaptopodin and podocalyxin in glomerular podocytes were observed by laser scanning confocal microscopy and analyzed by fluorescence quantitative software after indirect immunofluorescence double staining.Results The quantities of 24 h urinary protein in the three model groups were significantly higher than those of themselves before injection and control groups (P<0.01,respectively).The values of serum albumin and creatinine were not significantly different before and after injection (P>0.05).The expression of TRPC6 in podocytes was higher in the PHN model groups than that of control group.Fluorescence intensity of TRPC6 in RAP full-length group was stronger than that in RAP N-terminal or C-terminal groups.The expressions of synaptopodin and podocalyxin distributed along the glomerular basement membrane as spot,discontinuous short line and defect of some segments,and were lower in three PHN groups than those of control group.Fluorescence intensity of synaptopodin and podocalyxin among three PHN groups had no differences. Conclusions RAP full-length and N-terminal or C-terminal parts can increase the expression of podocyte TRPC6,but decrease the expressions of synaptopodin and podocalyxin,and alter their distribution,which may be associated with the proteinuria,however,their role in the PHN pathogenesis needs further study.

Objective: To investigate the diagnostic value of serum SCC, NSE, CEA, and CYFRA21-1 for lung cancer patients.Methods" The levels of SCC, NSE, CEA, and CYFRA21-1 were detected by electrochemoluminescence immuno-assay in 132 lung cancer patients, 48 patients with benign lung diseases and 92 healthy people.Results: The levels of NSE, CEA, and CYFRA21-1 in patients with lung cancer were higher than those in patients with benign lung diseases and in.normal controls.The level of SCC in patients with lung cancer was higher than that in normal controls.The levels of CEA and CYFRA21-1 in patients with benign lung disease were higher than those in normal controls.Patients with adenocarci-noma had the highest level of GEA and patients with small cell lung cancer had the highest level of NSE.Patients with squamous cell carcinoma had the highest levels of SCC and CYFRA21-1.The sensitivity sequence of the tumor markers in lung cancer was: NSE>CEA>CYFRA21-1>SCC.CEA showed the highest sensitivity of about 58.8% in adenocarcinoma.CYFRA21-1 showed the highest sensitivity of about 71.4% in squamous cell carcinoma.NSE showed the highest sensitivi-ty of about 50% in small cell lung cancer.ROC curves showed that the under-curve area of NSE, CEA, and CYFRA21-1was 0.928±0.034, 0.957±0.026, and 0.964±0.023, respectively.The combination of NSE, CEA, and CYFRA21-1 presented with the highest sensitivity (75.6%) and good specificity (90.7%) for the diagnosis of lung cancer.The combination of SCC, NSE, and CEA detection presented with the highest sensitivity (73.5%) for the diagnosis of adenocarcinoma.The combina-tion of NSE, CEA, and CYFRA21-1 showed the highest sensitivity (87.5%) for the diagnosis of squamous call carcinoma.The combination of SCC, NSE, and CYFRA2.1-1 showed the highest sensitivity (75.0%) for the diagnosis of small cell lung cancer.Conclusion: The assay of SCC, NSE, CEA and CYFRA21-1 is useful for the diagnosis of lung cancer and the ex-pression of the four tumor markers is closely correlated with pathological types.The suitable combination of tumor markers is helpful for differential diagnosis of lung cencar.