Objective:To explore the diagnostic value of C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology in the differential diagnosis of thyroid nodules.Methods:A total of 237 thyroid nodules patients (237 thyroid nodules)with ultrasound examination and definitive pathologic results in Henan Cancer Hospital from April to September 2020 were retrospectively analyzed. The nodules were diagnosed according to C-TIRADS guidelines, and then by S-Detect technology combined with C-TIRADS guidelines. The ROC curve was plotted with the pathological results as the gold standard, and the area under the ROC curve, sensitivity, specificity and accuracy of the diagnosis results between the two groups were compared.Results:Among the 237 thyroid nodules, 105 were benign and 132 were malignant.The area under the ROC curve of C-TIRADS diagnosis alone and C-TIRADS diagnosis combined with artificial intelligence were 0.869 and 0.942 respectively, the difference between the two groups was statistically significant (χ 2=36.11, P<0.001); When Category 4A was used as the cutoff value of benign and malignant differential diagnosis, the specificity and accuracy of C-TIRADS classification of artificial intelligence-assisted diagnosis was significantly higher than that of C-TIRADS alone, and the difference was statistically significant(83.81% vs 47.62%, 90.72% vs 75.53%, all P<0.05). Conclusions:C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology has a high efficiency in the diagnosis of thyroid nodules and can improve the specificity and accuracy of thyroid nodules diagnosis and reduce unnecessary biopsy.

Objective:To investigate the mechanism for intraperitoneal injection of sapylin to enhance the anti-tumoral immune functions of peritoneal macrophages.Methods:72 cases of patients with early or middle stage gastrointestinal cancer were peritoneally injected saline or sapylin, 48 h or 24 h before operation. The peritoneal macrophages(PM?) was harvested during their operations. The number of the PM? was counted. The phagocytosis, the enzyme activity of LDH and ACP,and the NO secretion were analyzed. Using human gastric cancer cell line MKN1 as target cells, the anti-tumoral cytotoxicity of the PM? was observed.The greater omentum was harvested,both the number and the size of the omental milky spots were measured.Results:I.p. injection of sapylin significantly increased the number, the phagocytosis, the enzyme activities,NO secretion and anti-tumoral cytotoxicity of the PM?, as well as the number and the size of omental milky spots.Conclusion:By activating omental milky spots, intraperitoneal injection of sapylin increased the number and enhanced the immune function of PM?, the activated PM? showed enhancement of anti-tumoral cytotoxicity.

Objective:To explore the mechanisms of the inhalation of atomized 1.0% anti-IL-1βand TNF-αimmunoglobulin yolk ( IgY) on treating guinea pigs with allergic asthma induced by the inhalation of aerosolized ovalbumin ( OVA).Methods:Healthy guinea pigs were randomly divided into the normal controls ( group C ) , the allergic asthma model group ( group M )-treated by the inhalation of atomized ovalbumin ( OVA ) , the inhalation of atomized 1.0% anti-IL-1βand TNF-αimmunoglobulin yolk ( IgY ) treatment group (group Z1)-treated asthma model guinea pigs by the inhalation of atomized 1.0% anti-IL-1βand TNF-αIgY,and positive control the inhalation of atomized budesonide treatment group (group Z2)-treated asthma model guinea pigs by the inhalation of atomized budesonide.The blood was gotten by cardiac puncture and the bronchoalveolar lavage fluid ( BALF ) was collected by bron-choalveolar lavage at 2 h,4 h,8 h and 24 h after the last time atomization.The inflammatory cells in the peripheral blood ( PB) were counted by methylene blue and eosin staining.Cytokine concentrations of IL-1β,IL-4,IL-6,IL-8,IL-13,IL-16,TNF-α,TGF-β1 and IgE in the plasma and bronchoalveolar lavage fluid (BALF) were measured using an enzyme-linked immunosorbent assay (ELISA).Results:In PB,eosinophils was decreased from 2 h to 8 h in group Z1 compared to group M.In plasma,the levels of IL-1βat 4 h and 24 h,IL-16 at 2 h,4 h and 24 h,TGF-β1 from 4 h to 24 h and IgE at 24 h,as well as the levels of IL-1βand TNF-αfrom 2 h to 8 h,IL-4,IL-6,IL-8 and IL-13 from 4 h to 24 h,IL-16 at 8 h,and TGF-β1 and IgE from 4 h to 8 h,especially the level of IL-1βand TNF-αstarting at 2 h,in BALF were significantly reduced in group Z 1 compared to group M ( P<0.05 ).The levels of IL-1βand TNF-αwere positively cor-related with that of IL-4,IL-6,IL-8,IL-13,IL-16,TGF-β1 and IgE (P<0.05).Conclusion: The inhalation of aerosolized anti-IL-1βand TNF-αIgY effectively alleviates inflammatory responses in guinea pigs with allergic asthma induced by aerosolized OVA inhalation may be due to the significant decrease in the levels of various allergic inflammatory cytokines .

Purpose To study the expression of Ech1 in hepatocarcinoma and its clinical significance, and to explore the relationship between subcellular location of Ech1 and malignant biologic behaviour of hepatocarcinoma. Methods Immunohistochemical analysis was used to detect Ech1 expression in the 20 cases of normal liver tissue and the 30 cases of hepatocarcinoma. Subcellular location of Ech1 in Hca-F and FEch1-down cell was observed with subcellular protein extraction. Results The expression of Ech1 in primary hepa-tocarcinoma was increased compared to that of normal liver tissues ( P<0. 05 ) , while there was no significant difference between the expression of Ech1 with the age, AFP, and with or without liver cirrhosis or hepatitis virus in hepatocarcinoma (P>0. 05). Ech1 was found expressed almost at the same location although the expression level one is normal and the other is downregulation. Ech1 expres-sion was found in cytosol, membrane fraction, and its expression was higher in cytosol than other fractions both in Hca-F cell and Ech1 downregulated Hca-F cell. Conclusions The expression of Ech1 in primary hepatocarcinoma was increased, which may indicate that Ech1 is a critical factor in the development of primary hepatocarcinoma, but the subcellular location of Ech1 has not much contribution to that.

OBJECTIVETo investigate the distribution and drug sensitivity of pathogenic bacteria isolated from patients with nosocomial infection in intensive care unit.

METHODSThe clinical data were collected from 229 hospitalized patients with nosocomial infection in intensive care unit from 2009 to 2011.

RESULTSGram-negative bacteria were the main pathogens (68.25%) in the intensive care unit. From 2009 to 2011, the annual isolation rate of multidrug-resistant baumannii showed a significant reduction with time (39.13%, 18.18%, and 15%, respectively, P<0.05), while the prevalence of multidrug-resistant Pseudomonas aeruginosa, ESBLs-producing Escherichia coli and Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus, coagulase-negative staphylococci methicillin-resistant strains showed no significant changes in the 3 years (P>0.05). The overall sensitivity of gram-negative bacilli to the antimicrobial agents tended to increase with time. The Gram-negative bacilli remained highly sensitive to carbapenems, tigecycline, amikacin and piperacillin/tazobactam; the Gram-positive bacilli were highly sensitive to vancomycin, quinoline Nupu Ting/dalfopristin, linezolid, and tigecycline with sensitivity rates all reaching 100%.

CONCLUSIONAdherence to the principles of antibiotic use and effective monitoring and preventive measures are encouraged to reduce antibiotic resistance rates of the bacteria and the incidences of hospital infection.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cross Infection ; epidemiology ; microbiology ; Drug Resistance, Multiple, Bacterial ; Female ; Gram-Negative Bacteria ; drug effects ; Gram-Positive Bacteria ; drug effects ; Humans ; Intensive Care Units ; Microbial Sensitivity Tests ; Middle Aged ; Prospective Studies ; Young Adult

Aim To observe the adhesive process of the human gastric cancer cell line MKN1,and study the expression of integrin ?1;to investigate the mechanism of the inhibition of the adhesion process of MKN1 cells by destran sulfate(DS).Methods The MKN1 cells were cultured with DS or PBS,then stained with immunofluorescent cytochemistry and observed in fixed or living conditions with confocal laser scanning microscope.RT-PCR was used to analyze the cDNA expression of MKN1 cells.Results MKN1 cells adhered to culture dishes by the process of forming filopodia,changed into a flat shape,and then adhered to other cells to form a cell-monolayer.Integrin ?1 was intensively expressed in the cell membrane,where integrin ?1 formed clusters.DS inhibted the expression of integrin ?1 in cell membrane,and decreased the area of integrin ?1 clusters.DS-treated cells also tended to maintain a round shape by contracting the filopodia.In DS-containing culture dishes,some cells kept floating 4 hours after seeding.DS decreased the level of the cDNA expression of the adhered cells to 74% and of the floating cells to 38% of that of the cells in un-treated group,respectively.Conclusion The inhibition of the adhesion of MKN1 cells by DS was related to the suppression of the expression of integrin ?1.

Objective To prepare a novel loaded NdFeB and Fe3O4 liquid-solid phase inversion poly (polylactic-co-glycolic acid,PLGA) in situ implant (PLGA 60％ NdFeB-20％ Fe3O4) for ultrasound-guided intratumoral injection,and to investigate its intensity of magnetism and therapeutic efficiency of nude mice bearing MDA-MB-231 breast cancer.Methods PLGA-60 ％ NdFeB-20 ％ Fe3O4 in situ implant was prepared.The microstructure of PLGA-60 ％ NdFeB-20 ％ Fe3O4 was tested with scanning electron microscope (SEM).Magnetometer was used to qualify the intensity of magnetism.For the in vitro assay,60 μl solid PLGA-60％ NdFeB-20％ Fe3O4 implant was put in the center of the electromagnetic induction heating coil.Infrared thermal video of the tubes was simultaneously recorded.The size of 2 cm × 2 cm× 2 cm fresh ex vivo bovine liver was prepared,and then 60 μl PLGA-60％ NdFeB-20％ Fe3O4 was injected into it.Similarly,ex vivo bovine liver was heated by the above intermittent time for 1,2,3,4 minutes,respectively,and the ablation volume was calculated.Finally,nude mice were equally divided into treatment group and control group.Mice in treatment group were discontinuously heated for 3 min after being injected with the above mentioned implant,while CEUS was performed before and after heating to observe the blood perfusion in the tumor.One nude mouse was executed on the next day in each group,then pathological sections and HE staining of tumor tissue were taken,whereas the growth of the remaining nude mice were observed daily.Results SEM showed the implant with rough and porous surface.The magnetism increased with the volume of material.The tube and bovine liver experiments showed that the PLGA-60 ％ NdFeB-20％ Fe3O4 generated heat efficiently.The bovine liver ablation experiment showed that the range of ablation of 60 μl PLGA-60 ％ NdFeB-20％ Fe3O4 implant reached (2.34±0.25)cm3 after 3 min heating.In vivo experiments showed that the tumor tissue began to form a scab on the 2nd day,and the scab began to desquamate on the 20th day.CEUS showed the original predominant enhancement disappeared significantly after the treatment.HE staining proved that cancer cells had coagulative necrosis,whereas tumors in control group became bigger.Conclusion PLGA-60％ NdFeB-20％ Fe3O4 in situ implant can produce obvious thermal effect under high frequency alternating magnetic field,therefore can be effectively ablated with nude mice MDA-MB-231 breast cancer during time interval heating.

Objective Based on the establishment of flight nurses′competency standard indexes and core knowledge system in the early stage,key points of the training examination were set up for Chinese flight nurses.Rationality and effectiveness of the key points were investigated,providing theoretical support for the subsequent training and examination of Chinese flight nurses.Methods Fifteen experts from different areas were consulted by letter in two rounds using the methods of literature analysis,expert interviews,Delphi, analytic hierarchy process.Data were analyzed by Excel 2010 and SPSS 16.0 software.Results In the two rounds of questionnaires,the positive coefficient of experts was 100%,the authority coefficient of experts was above 0.77,the test of the coordination coefficient of experts was P <0.05.Finally six key points of the training examination of Chinese flight nurses were established.Conclusions In light of the excellent and mature standards of flight nurses′training examination in western developed countries and combined with the actual requirement of Chinese air evacuation,the related key points of the training examination of flight nurses are set up and the items with experts′high recognition and low recognition are summarized and analyzed in depth, providing a reference and a theoretical basis for further revision and improvement of flight nurses′training examination standards.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.