Objective To evaluate the value of revised Geneva score, Daniel ECG score and age-adjusted D-dimer for predicting pulmonary embolism(PE).Methods A total of 91 cases suspected as pulmonary embolism were collected, and 52 cases were diagnosed as pulmonary embolism by computed tomographic pulmonary angiography(CTPA) results.Receiver operating characteristic(ROC) curves and diagnostic test evaluation indexes were used to evaluate the probability of PE predicted by the revised Geneva score,Daniel ECG score, age-adjusted D-dimer and combination of these two clinical scores and age-adjusted D-dimer.Results The confirmed PE was 21.4% with a low probability(revised Geneva score 0~3 points),55.4% in intermediate probability(4~10 points),85.7% in high probability(score≥11 points).The prevalence of PE was 33.3% with a low clinical probability (Daniel ECG score<2 points)and 70.7% with a high clinical probability(Daniel ECG score≥2 points).The sensitivity and specificity of age-adjusted D-dimer in predicting pulmonary embolism were 92.3%,69.2%.The area under curve of the ROC curve(AUC)in the revised Geneva score and Daniel ECG score has no significant difference(Z=0.979).The negative predictive value of the revised Geneva score, Daniel ECG score combined with D-dimer in pulmonary embolism were 100.0% and 87.5%.Conclusion All of revised Geneva score, Daniel ECG score and age-adjusted D-dimer have certain predictive value on pulmonary embolism , and the revised Geneva score combined with age-adjusted D-dimer can be more safely exclude pulmonary embolism.

Objective To detect the changes in DNA loads of human papillomavirus (HPV) type 6/11 in lesions of patients with condyloma accuminatum (CA) before and after 5-aminolevulinic acid photodynamic therapy (ALA-PDT).Methods After removal of warts by electrocautery,HPV6/11-positive patients with CA were divided into two groups:treatment group (32 cases) receiving two sessions of ALA-PDT with intervals of 7-10 days,and control group (29 cases) remaining untreated.Exfoliated cells were collected from the lesional sites of these patients before and 3 months after the first session of ALA-PDT,and fluorescence-based quantitative PCR was conducted to estimate the DNA loads of HPV 6/11 in these cells.Results Three months after the first session of ALA-PDT,89.7％ (26/29) of the patients in the treatment group and 68.4％ (13/19) in the control group became HPV DNA negative,with significant differences between the treatment group and control group in the DNA loads of HPV ((1.70 ± 7.86) × 105 vs.(1.27 ± 2.21) × 106 copies/ml,P ＜ 0.05).Conclusion ALA-PDT can reduce HPV DNA loads in lesions of CA in patients.

AIM:To discuss the changes of IL-17, IL-21 in glucocorticoid therapy of active thyroid associated ophthalmopathy (TAO) and analyze the relation with results.METHODS:The 67 patients (134 eyes) of TAO in our hospital, were divided into activity group(32 patients 64 eyes) and atypical activity group(35 patients 70 eyes) according clinical activity score (CAS) grading standard, and 30 cases of healthy as control group at the same time.The activity group were treated by glucocorticoid therapy treatment, and proceed the CAS scores before and after treatment, measured the degree of exophthalmus and width of palpebral fissure.At the same time, compared the expression level of IL-17 and IL-21 in all groups, and analyzed the correlation between the IL-17 and IL-21 and CAS score.RESULTS:Compared with control group, expressions of IL-17 and IL-21 in TAO patients were significantly higher (P<0.05).The expressions of IL-17 and IL-21 in active period TAO patients were higher than atypical activity (P<0.05).After glucocorticoid treatment, the expressions of IL-17 in active period TAO patients decreased significantly(P<0.05), and it was significantly positive correlation with CAS score (before treatment:r=0.8847,P=0.042;after treatment:r=0.8886,P=0.0439) the expression of IL-21 in active period TAO patients was significantly positive correlation with CAS score (before treatment:r=0.8893, P=0.0435;after treatment:r=0.8876,P=0.045).CONCLUSION:IL-17 and IL-21 is closely related to the TAO disease activity, and glucocorticoids impact treatment by reducing IL-17 and IL-21 in activity TAO, IL-17 and IL-21 can be used as one of indexes of predicted curative effect and condition in patients with TAO.

China ; Foundations ; Integrative Medicine ; Natural Science Disciplines

Humans ; Integrative Medicine ; Medicine ; Medicine, Chinese Traditional

This paper discussed the different ways on the pharmacology of traditional Chinese medicine teaching to cultivate students' autonomous learning ability, promoting independent learning through PBL teaching, enhancing students' ability to think independently and practical operation using heuristic teaching.Survey results showed this student-centered, teacher-led, student-teacher interaction style pharmacology teaching model could improve the quality of teaching of Pharmacology.

BACKGROUND:Current research has shown that tumor necrosis factorαstimulated gene 6 (TSG-6) has anti-inflammatory effect, and the scar formation can be inhibited by local injection of TSG-6 protein at the early stage of trauma. However, the mechanism of this effect is stil unclear. OBJECTIVE:To construct the lentiviral expression vector and shRNA vector for human TSG-6, with stable overexpression, transfection and interference, and to explore the effect of TSG-6 on proliferation and apoptosis of keloid fibroblast cel lines. METHODS:Human keloid fibroblast cel s were isolated from the keloid’s tissue by enzyme digestion and identified by immunocytochemistry assay. Lentiviral vectors pLVX-puro-TSG-6 and pLVX-shRNA1-TSG-6 were constructed and transfected into human keloid fibroblast, exclusively. Expression levels of TSG-6 mRNA and protein were detected by RT-PCR and western blot assay. MTT assay and flow cytometry were used to estimate the cel proliferation and apoptosis in each group after transfection. In addition, expression of Bcl-2, p53 and active-caspase-3 were detected by western blot assay in each group. RESULTS AND CONCLUSION:(1) Human keloid fibroblasts were separated successful y. Under the light microscope, cel s were spindle. Immunohistochemical staining for vimentin was performed in the fifth passage of cel s, with the positive rate of 100%. Cel s were negative for cytokeratin. (2) Recombinant lentiviral vectors and stably transfected cel lines were successful y established. TSG-6 gene expression was altered apparently. Compared with the control group, cel proliferation was delayed and apoptotic rate was noticeably increased in TSG-6 gene overexpression group. Cel proliferation increased and apoptotic rate decreased in the TSG-6 gene intervention group (P<0.05). (3) Western blot assay results demonstrated that Bcl-2 expression reduced, P53 and Active-caspase-3 expression significantly increased in the TSG-6 gene overexpression group (P<0.05). (4) These finding showed that TSG-6 could inhibit proliferation and induce apoptosis in keloid fibroblasts. Its mechanism may be associated with the down-regulation of Bcl-2 protein expression, up-regulation of P53 protein expression and increased Caspase-3 activity.

Radiation-induced cognitive impairment is hypothesized to occur because of dynamic interactions be -tween multiple cell types, including astrocytes, endothelial cells, microglia, neurons, and oligodendrocytes.Cur-rent researche indicates that radiation-induced changes include the decrease in hippocampus neurogenesis , altera-tions of neuronal functions , particularly synaptic plasticity , as well as the elevation of neuroinflammatory cytokines .

Objective To evaluate the value of mediastinoscopy in the diagnosis of undifferentiated mediastinal diseases. Methods A total of 35 mediastinoscopies were performed for patients with undifferentiated mediastinal disease from November 1999 to February 2002 and suspicious tissues at peritracheal,retrosternal,subcarinal,or bilateral hilar areas were obtaiued for pathological examination. Results Thirty four of 35 patients with undetermined mediastinal diseases had definite pathologic diagnosis.The diagnosis accuracy was 97%(34/35).Of the 34 patients,18 were diagnosed as malignant accounting for 52.9%.Sixteen of the 34 were diagnosed as benign,accounting for 47.1%.The diagnostic consistency of preoperation and postoperation was 47.1%(16/34).The misdiagnosis of preoperation was 52.9%(18/34).In this series,the benigns were apt to lead to misdiagnosis.10 of 16 patients with benign disease were diagnoscd as initially malignancies,representing 62.5%.In the entire group one patient had complications (2.9%).Yet no perioperative death occurred. Conclusions Mediastinoscopy is a valuable procedure which helps mede a correct diagnosis of mediastinal diseases.Given its safety and usefulness It is suggested that mediastinoscopy should be used routinely in the diagnosis of undifferentiated mediastinal diseases.

1.0 cm) by radiographic examinations, video-mediastinoscopy showed positive results in 30 cases, and negative in 14 cases, in which the surgical exploration found no evidence of metastasis to mediastinal lymph nodes. No postoperative complications and mortality were observed. Conclusions Video-mediastinoscopy offers clear operation field, high resolution, convenient application, safety and reliability. We suggest that it be adopted as a routine method in the diagnosis of mediastinal tumor and the staging of lung cancer.