Objective The increased use of high-resolution ultrasound (US) for thyroid disease has markedly increased the detection rate of nonpalpable thyroid nodules .The objective of this study was to investigate the diagnostic value of conventional ultrasonography, ultrasonic elastography(UE) and combined application of both in the differential diagnosis of thyroid nodules. Methods A retrospective analysis was made on 105 patients with 160 histologically proved thyroid nodules from September 2014 and August 2015 in our hospital.The receiver operating characteristic ( ROC) curve analysis was made on Thyroid Imaging Repor-ting and Data System ( TI-RADS) score, elastography score and the score of combined application.The area under curve ( AUC) was calculated and compared to select the best cut-off value in order to work out the respective diagnostic efficacy of 3 methods and Kappa consistence check with pathologic results . Results In ROC curve analysis, AUC of combination score(0.930, 95%CI:0.890-0.969) was higher than those of TI-RADS score(0.855, 95%CI:0.794-0.915) and elasticity score(0.845, 95%CI:0.780-0.909), and the difference was statistically significant (Z=2.20, 2.03, P<0.05) .Taking TI-RADS score≥4, elastography score≥3, and combination score≥7 as the limitation to diagnose ma-lignant thyroid nodules, the specificity and PPV of combination score(94.3%, 95%CI:0.867-0.979;91.7%, 95%CI:0.809-0.969) were higher than those of TI-RADS score(78.4%, 95%CI:0.681-0.862;84.7%, 95%CI:0.692-0.886) and e-lasticity score(81.8%, 95%CI:0.719-0.889;78.7%,95%CI:0.674-0.870).Kappa value of combination score(0.718, 95%CI:0.610-0.826) was higher than that of TI-RADS score(0.586, 95%CI:0.461-0.711) and elasticity score(0.635, 95%CI:0.515-0.755). Conclusion Conventional ultrasonography and UE are mutual complementation, and the application of conventional ultrasonography combined with UE has higher value than single examination in the differential diagnosis of thyroid nodules.

Objective The extensive use of high-resolution thyroid ultrasonography has markedly improved the detection rate of thyroid nodules ( TNs) .However, the ultrasonographic features of benign and malignant TNs usually overlap and have yet to be de-fined.This study aimed to investigate the ultrasonographic features and risk factors of malignant TNs by comparing their ultrasonograph-ic manifestations with those of benign TNs. Methods A total of 119 TNs (63 benign and 56 malignant) in 64 patients were includ-ed in this retrospective study.The gender, age, location of the TNs, and other variables were subjected to univariate analysis, the risk factors of malignant TNs were screened by multivariate logistic regression analysis, and the predictive value of the logistic regression model was assessed using the ROC curve. Results Multivariate logistic regression analysis indicated that the risk factors of malig-nant TNs in ultrasonography were irregular shape (OR:6.166, 95%CI:1.681-22.617), micro calcification (OR:3.593, 95%CI:1.800-7.169), and A/T ratio≥1 (OR:17.577, 95%CI:1.739-166.468).ROC curve analysis showed the area under the curve (AUC) to be 0.922 (95%CI:0.868-0.976). Conclusion Such ultrasonographic manifestations as irregular shape, micro-calcification, and A/T ratio≥1 are valuable in identifying the nature of TNs.

Objective To study the relationship between activity and virulence of secretory acid proteinase and extracellular phosphlipase of different Candida albicans isolated from various specimens.Methods 190 strains of Candida albicans were isolated from various specimens(sputum,blood,thrush,wound,secretion of vaginitis) of patients with Candida albicans infection in hospital.Milk-plate medium and egg-yolk medium were used respectively to test the activities of secretory acid proteinase and extracellular phosphlipase of Candida albicans.The suspension of two forms of Candida albicans(5?106CFU?mL-1) were injected to vein of tail in mice respectively in virulence test.The mortality and mean survival time of mice were observed in 1 month.The virulence was appreciated with the mean survival time of mice.Results All of 190 strains,the positive detectable rates of secretory acid proteinase and extracellular phosphlipase were 83.68% and 85.26%,respectively.Animal experimental results showed the activities of secretory acid proteinase and extracellular phospolipase in hyphal forms were significantly higher than that in spore form(P

Although children with differentiated thyroid cancer ( DTC) are in a high proportion of cure, due to the absence of the standard management of the evaluation, treatment and follow-up of children with thyroid neoplasia, the aggressive therapy including total thyroidectomy followed by radioactive iodine ( RAI) ablation with iodine-131 ( 131 I) could not be ignored. For the majority of children, total or near-total thyroidectomy is recommended. Central neck dissection is recommended for children with malignant cytology and clinical evidence of gross extrathyroidal invasion and/or loco-regional metastasis on pre-operative. Selective use of 131 I in children with DTC was based on pre-and post-operative staging. Multi-disciplinary collaborative management is needed to improve their outcomes and to minimize adverse effects as far as possible.

Objective To evaluate the relationship between the level of AMP-activated protein kinase (AMPK) in hippocampus and cognitive dysfunction after splenectomy in aged rats.Methods Sixty-three male aged Sprague-Dawley rats,weighing 480-550 g,were randomly divided into 3 groups (n =21 each):control group (group C),anesthesia group (group A),and surgery group (group S).Morris water maze (MWM) test was performed to evaluate the spatial learning and memory ability before surgery and at 1,3 and 7 days after surgery.The escape latency and swimming distance were recorded.Seven rats were chosen after MWM test was performed at 1,3 and 7 days after surgery and sacrificed.Their hippocampi were removed for detection of the expression of AMPK and phosphorylated (p-AMPK) (by Western blot).Results Compared with the baseline,the escape latency and swimming distance were significantly prolonged at 1 and 3 days after surgery in group S (P ＜ 0.05).Compared with group C,the escape latency and swimming distance were significantly prolonged at 1 and 3 days after surgery,the expression of AMPK was up-regulated at 1,3 and 7 days after surgery,and the expression of p-AMPK was up-regulated at 1 and 3 days after surgery in group S (P ＜ 0.05),and no significant changes were found in the indices mentioned above in group A (P ＞ 0.05).Conclusion Increased AMPK level in hippocampus is the regulatory mechanism of the body adapting to the development of cognitive dysfunction after splenectomy in aged rats.

Objective To evaluate the role of AMP?activated protein kinase ( AMPK) in neuronal apoptosis in the hippocampus of aged mice during cerebral ischemia?reperfusion ( I∕R ) . Methods Seventy?two male C57∕BL6 mice, aged 18-20 months, weighing 34-36 g, were randomly divided into 3 groups ( n=24 each ) using a random number table: sham operation group ( S group ) , I∕R group and AMPK inhibitor compound C group ( CC group) . The cerebral ischemia was produced by 15 min transient occlusion of bilateral common carotid arteries followed by reperfusion. In group CC, compound C 20 mg∕kg was injected intraperitoneally immediately after occlusion, while the equal volume of normal saline was given in I∕R group. At 48 h of reperfusion, the mice were sacrificed, and the brains were immediately harvested for examination of pathologic changes in hippocampal CA1 region and for determination of neuronal apoptosis ( using TUNEL) and expression of phosphor?AMPKα ( p?AMPKα) and caspase?3 ( by Western blot) . Results In I∕R and CC groups, the examination showed the pathologic changes in hippocampal CA1 region, the disordered arrangement of pyramidal cells and the nucleus condensation. Compared with S group, the neuronal apoptotic rate was significantly increased, and the expression of p?AMPK and caspase?3 was up?regulated at 48 h of reperfusion in I∕R and CC groups. Compared with I∕R group, the expression of p?AMPK was significantly down?regulated, and no significant change was found in the neuronal apoptotic rate and caspase?3 expression in CC group. Conclusion AMPK is not involved in neuronal apoptosis in the hippocampus of aged mice during cerebral I∕R.

Objective To solve the agglomeration problem in the former process, dry granulation technology was used to prepare the granules of Lianhua Qingwen Capsules. Methods Complexity and granule yield coefficient were set as inspection indexes. The optimum subsidiary material and its amount were optimized. The parameters of dry granulation technology were optimized by orthogonal test. Then, granule yield, angle of repose, and bulk density were compared with those of wet granulation technology. Results Starch was set as subsidiary material. The optimum technology is roll pressure of 12 MPa, rotation speed of 5 r/min, and feed speed of 10 r/min. The yield of granules prepared by dry granulation technology was significantly higher than that of wet granulation technology. Conclusion The dry granulation technology can effectively improve the agglomeration of the granulation process of Lianhua Qingwen Capsules, and was suitable for granulating process of Lianhua Qingwen Capsules.

Objective To investigate the expression and prognostic value of Ikaros6 in adult T-cell acute lymphoblastic leukemia(T-ALL) patients.Methods The RNA was extracted from mononuclear cells of bone marrow in 74 adult T-ALL patients.The expression of Ikaros6 was examined by reverse transcription-PCR,and the results were confirmed by sequencing.Clinical features and prognosis were analyzed based on clinical data.Results In 74 T-ALL patients,the incidence rate of Ikaros6 was 21.6 ％ (16/74).Extramedullary infiltrations were occurred often (x2 =4.084,P =0.043),had higher WBC (103.15 × 109/L vs 15.60×109/L,t =0.214,P =0.831),more severe anemia (75.95 g/L vs 107.00 g/L,t =1.504,P =0.142) and lower platelet count (26.0×109/L vs 67.0×109/L,t =1.421,P =0.164) in patients with Ikaros6 positive.Meanwhile Ikaros6-positive patients had inferior survival and were increased risk of relapse as compared with the Ikaros6-negative patients.Conclusions The incidence of Ikaros6 is high in adult T-ALL patients.Ikaros6-positive patients are more likely to have extramedullary infiltration and higher WBC,meanwhile they had inferior survival and increased risk of relapse.Thus Ikaros6 may be served as a valuable factor for risk stratification and prognosis evaluation in adult T-ALL patients.

Objective To explore the qualitative evaluation of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant thyroid nodules (TNs).Methods Totally 110 outpatients with 132 TNs underwent CEUS were enrolled in this study in Jinling Hospitall Medical School of Nanjing University (Nanjing General Hospital of Nanjing Military).Nanjing General Hospital of Nanjing Military All the nodules underwent ultrasound guided fine needle aspiration biopsy (FNAB).113 TNs were histologically diagnosed,the characteristics of enhancement for each noudle were scored.The characteristicsof enhancement between benign and malignant TNs were compared by chi-square test.The receiver operating characteristic (ROC) curve analysis were conducted to determine the diagnostic values of thyroid CEUS.Results Contrast-enhanced patterns were significantly different between benign and malignant TNs in the degree,homogeneity of enhancement,enhanced ring and boundary,shape and size of the enhanced lesions (x2=23.85,P ＜ 0.001;x2=7.43,P=0.04;x2=34.54,P ＜ 0.001;x2=25.7,P ＜ 0.001;x2=53.10,P ＜ 0.001;x2=22.78,P ＜ 0.001;x2=30.90,P ＜ 0.001).Contrast-enhanced patterns were not significantly different between benign and malignant TNs in the process and completeness of enhancement.Malignant lesions had concentric (79.5％),inhomogeneous (89.0％) and low (71.1％) enhanced with irregular (79.5％) and unclear (64.4％) boundary and bigger size (63.0％).The typical CEUS feature of benign nodules was peripheral ring hyperenhancement (34.7％).According to ROC curve,the cut off value was 3.5 points.The area under the ROC curve (AUC) for CEUS was 0.862 (95％CI:0.797-0.927).The sensitivity,specificity and accuracy for CEUS were 80.8％,79.6％,80.3％ respectively.Conclusion The pattem of CEUS may assist in differential diagnosis of benign and malignant TNs.

Multiplex reverse transcription-polymerase chain reaction (M-RT-PCR) has been proved to possess great clinical potential for simultaneous screening of 29 chromosomal translocations in acute leukemia. To evaluate the clinical value of M-RT-PCR in hematologic malignancies, bone marrow samples from 90 patients with various hematologic malignancies, including 25 acute myelogenous leukemia (AML), 22 acute lymphoblastic leukemia (ALL), 27 chronic myelogenous leukemia (CML), 4 myeloproliferative diseases (MPD), 3 chronic lymphoblastic leukemia (CLL), 3 non-Hodgkin's lymphoma (NHL), 3 myelodysplastic syndrome (MDS), 2 multiple myeloma (MM) and 1 malignant histocytosis (MH) were subjected to both M-RT-PCR and chromosome karyotypic analysis. Some of cases were subjected to follow-up examination of M-RT-PCR during the period of clinical complete remission (CR) for detection of minimal residual leukemia. In our hand, 12 of 29 chromosomal translocation transcripts including TEL/PDGFR, DEK/CAN, MLL/AF6, AML1/ETO, MLL/AF9, BCR/ABL, MLL/MLL, PML/RARu, TLS/ERG, E2A/HLF, EVI1 and HOXI1 were detected in 57 cases (63.3 %) of the 90 samples, which were in consistence with the results of karyotypic analysis. Furthermore, M-RT-PCR had also shown good clinical relevance when used as an approach to detect minimal residual leukemia. We concluded that M-RT-PCR could be used as an efficient and fast diagnostic tool not only in the initial diagnosis of hematologic malignancies but also in subsequent monitor of minimal residual leukemia.