Objective To discuss the value of contrast-enhanced ultrasound and color Doppler in diagnosing esoph-ageal varices( EV) among patients suffering from portal hypertension. Methods The control group consisted of twenty nine patients without EV. Sixty patients with EV diagnosed by endoscopy were divided into two groups equal in number according to grade of EV. One being mild,the other was moderate to severe. All patients underwent color Doppler flow imaging and contrast-enhanced ultrasound, and the dynamic angiography data were collected. Time-in-tensity curves were drawn by software. The quantitative parameters including arrival time of hepatic artery ( HAAT) ,hepatic vein ( HVAT) and portal vein ( PVAT) ,damping index ( DI) of hepatic vein and portal vein ve-locity( PVV) were compared. Results The difference of PV-HV, PV-HA, PVV, DI showed statistically signifi-cant among the three groups(F=72.63,14.97,6.71,13.74,P<0.01). A comparison of the control and moderate to severe group among the above four parameters was statistically significant (P<0.01). PV-HV, PV-HA, DI in moderate to severe group showed statistically significant compared with mild group (P<0.01),however there exis-ted no significant difference grouping PVV between the two groups. Mild group contrasted to the control group,the differences of PV-HA were statistically significant (P<0.01), whereas PV-HV, DI, PVV displayed no significant difference. Conclusion Contrast-enhanced ultrasound and color Doppler are helpful in diagnosing EV,which is ex-pected to become a new noninvasive method.

Icarrin is the main monomer extracted and purified from Epimedium koreanum Nakai. Using dependentcell lines and LDH release assay,the synergistic effects of icarrin on inducing IL-2, 3, 6 and enhancing NK,LAK cell activity were studied. Results showed that icarrin can induce tonsil mononuclear cells to produce IL-2, IL-3,and IL-6 in collaboration with PHA in a dose-dependent manner. IL-2 and IL-6 peaked at 48h after reaction,and IL-3 peaked at 72h. Icarrin enhanced NK and LAK cell activity dose-dependentlylthe LAK activitypeaked on the 5th day. These results suggested that icarrin may be an effective BRM agent

Objective To investigate the effect of salvia mihiorrhiza on spinal cord ischemia reperfusion injury after surgical treatment in patients with cervical canal stenosis. Methods Retrospective analysis of 64 cases had cervical canal stenosis in the last 5 years in our hospital. Sixty-four cases were randomly divided into the salvia mihiorrhiza group(31 cases)and the control group(33 cases). The therapeutic effect was assessed using JOA grade system. Results In the salvia mihiorrhiza group,the JOA average score was 8. 8 ±2. 6 before surgical treatment, after two weeks of surgical treatment it was 13. 7 ± 2. 4. The JOA improvement ratio was (61. 5 ± 2. 9) % . In the control group,the JOA average score was 9. 1 ±2. 2 before surgical treatment,after two weeks of surgical treatment it was 13. 4 ± 2. 3. The JOA improvement ratio was (60. 5 ± 2.2)% .The JOA improvement ratio in the salvia mihiorrhiza group was significantly higher than that in the control group (P < 0. 05) . Conclusions Salvia mihiorrhiza has protective effect on spinal cord ischemia reperfusion injury.

Objective: To investigate the influence of Icarrin(ICA) on transforming growth factor ?2(TGF?2) expression by PG cells and the mechanisms of reversion of TGF?2 mediated immunosuppression by ICA.Methods: Cell proliferation and cytotoxici- ty were assayed by MTT assay. mRNA level of TGF?2 and perforin was detected by RT-PCR assay. assay.Expression of TGF?2 and IL- 2R? was analysed by folw cytometry assay. Results: ICA could inhibit the protein and mRNA expression of TGF?2 in PG cells. It could also reverse the supressed cytotoxicity of LAK, CD3AK cells by TGF?2. The IL-2R? expression on LAK and perforin gene transcription and proliferation of CD3AK inhibited by TGF?2 were also partly recovered. Conclusion: The anti-anti-tumor activity of ICA is at least partly due to its capability of inhibiting TGF?2 expression in tumor cells and restoring the cytotoxicity of immunocompetent cells inhibited by TGF?2.

Objective To explore the effect of perioperative continuous use of aspirin on bleeding in laparoscopic anterior resection for rectal cancer (RC) in patients taking low dose aspirin.Methods The prospective study was conducted.The clinicopathological data of 96 RC patients taking low dose aspirin who were admitted to the Shengjing Hospital of China Medical University from September 2014 to September 2016 were collected.All the 96 patients were divided into the aspirin group (perioperative continuous use of aspirin) and non-aspirin group (discontinuation of aspirin at 7 days preoperatively and taking aspirin at 3 days postoperatively)by random number table.Laparoscopic anterior resection for RC was applied to patients by the same team of doctors.Observation indicators:(1) comparison of surgical and postoperative situations between the 2 groups;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative survival of patients up to January 2017.Measurement data with normal distribution were represented as (x)±s.Comparisons between groups were evaluated with the t test.Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Comparison of ordinal data was analyzed using the nonparametric test.Results All the 96 patients were enrolled into the study,including 50 in the aspirin group and 46 in the non-aspirin group.(1) Comparison of surgical and postoperative situations between the 2 groups:96patients underwent successful laparoscopic anterior resection for RC,including 1 with conversion to open surgery and 95 undergoing laparoscopic anterior resection for RC,without perioperative death,postoperative blood transfusion and rcoperation.Cases with conversion to open surgery,operation time,volume of intraoperative blood loss,decreasing value of postoperative hemoglobin (Hb),time to anal exsufflation,peritoneal drainage volume from 1-3 days postoperatively,cases with postoperative hematoehezia,cardio-cerebrovascular complications and overall complications (including postoperative hematochezia and cardio-cerebrovascular complications),duration of hospital stay,hospital expenses,cases in stage Ⅰ,Ⅱ and Ⅲ of postoperative TNM stage,postoperative coagulation indexes of platelet,prothrombin time,international normalized ratio,prothrombin activity,activated partial thromboplastin time,thrombin time and fibrinogen were 0,(112± 18) minutes,(39± 18) mL,(4.3±2.8)g/L,(57±24)hours,(22±9)mL/d,6,0,10,(8.6±2.5)days,(6 739±481)yuan,11,35,4,(236±80) × 109/L,(12.7± 1.1) seconds,1.00±0.08,101％ ± 15％,(28 ±4) seconds,(15.5 ± 1.9) seconds,(3.2±1.0)g/L in the aspirin group and 1,(118±16)minutes,(38±22)mL,(3.5±3.0)g/L,(55±29)hours,(20±8)mL/d,4,1,8,(9.1±2.3)days,(6606±510)yuan,5,36,5,(211±49)×109/L,(12.5±0.7)seconds,1.00±0.06,103％±11％,(29±3)seconds,(15.3±1.7)seconds,(3.1±0.7)g/L in the non-aspirin group,respectively,with no statistically significant difference between the 2 groups (t =-1.737,0.204,1.416,0.380,1.365,x2=0.038,0.107,t=-1.082,1.322,Z=-1.370,t=1.850,0.978,0.872,-0.712,-1.291,0.311,0.585,P＞0.05).Ten patients with postoperative hematochezia in the 2 groups were cured,without special treatment.One patient in the non-aspirin group was complicated with deep venous thrombosis and then was cured by single anticoagulant drug.Two and 2 patients in the aspirin group were respectively complicated with urinary retention and urinary tract infection.One,1 and 1 patients in the non-aspirin group were respectively complicated with inflammatory intestinal obstruction,urinary retention and urinary tract infection,and then were cured by conservative treatment.(2) Follow-up situations:of 96 patients,95 were followed-up for 4-27 months,with a median time of 13 months.During the follow-up,3 patients died and 92 had survival.Conclusion The perioperative continuous use of aspirin cannot increase risk of bleeding in laparoscopic anterior resection for RC in patients taking low dose aspirin.

Objective To construct the assessment index system for general nursing goals management based on the performance structure theory. Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system, and SPSS17.0 was used to do data statistics and reliability analysis. Results The assessment index system for general nursing goals management was constructed which contained 6 level-Ⅰindicators such as nursing quality, nursing safety, nursing service, teaching and training, the contribution of department and the communication skills and 22 level- Ⅱ indicators. The department monthly examination scores calculation method and feedback mechanism were also established. The expert positive coefficients were 97.6%and 98.8%respectively, the authority coefficients were 0.85 and 0.86, the importance and feasibility mean scores of every index were 3.86-4.98 and 3.98-4.88, and coefficients of variation were 0.03-0.27 and 0.05-0.25 in 2 rounds of enquiry. The importance of level-Ⅰor level-Ⅱ indicators and operability coordination coefficients were 0.10-0.36, the significance test showed P<0.05. Conclusions The design of each dimension of the index system gives full consideration to 3 dimensions of performance: task-adaptive-relationship. Representative of key indicators is strong. The Delphi method used in building is scientific and the results are reliable. The maneuverability of calculate Method is strong, easy to quantify. The feedback mechanism has a strong incentive by combining the assessment results closely with the individual interests. The establishment of the index system can provide scientific and objective basis for the full implementation of the general nursing goals management.

All elements and refinements had been built in ontology with protégé 4.1, which can be used to record over 20 classic Chinese medicine books in related author, publisher, storage site, edition, form and arrangement of lines in calligraphy, and etc. It also realized the graphical display based on ontology. It gave brief analysis on elements which had been used or without using. Studies showed that Web Ontology Language (OWL) can express all elements of TCM literatures clearly. This study indicated that element refinements should be considered to add in the amendment of ISO International Standards application for further improvement.

Objective To investigate the protective effect of transection of cervical sympathetic trunk (TCST)on the fetal brain in rats with pregnancy-induced hypertension(PIH).Methods Thirty-two pregnant Wistar rats were randomly divided into 4 groups(n=8 each):A control group;B PIH group;C TCST+PIH group and D sham operation+PIH group,PIH was produced by L-NAME 12.5 mg?100g~(-1) given subcutaneously from 14~(th)-20~(th) day of gestation.In group A normal saline was given instead of L-NAME.In group C TCST was performed on the 14~(th) day of gestation and L-NAME was injected asin group B.In group D the cervical sympathetic trunk was only exposed but not cut.Caesarean section was performed and fetus was taken on the 21~(st) day of gestation.The ultrastructure of fetal brain was examined.The content of ATP,ADP and AMP in the fetal brain and the Na~+-K~+-ATPase and Ca~(2+)-ATPase activity in neuronal plasmalemma were determined.Results The ultrastructure of the fetal brain was almost normal in group A and C,but was seriously damaged in group B and D.The ATP and adenylic acid content in the brain tissue and the Na~+-K~+-ATPase and Ca~(2+)-ATPase activity in neuronal plasmalemma were significantly lower in group B and D than in group A and C.Conclusion TCST has protective effect on the fetal brain in rats with PIH by improving energy supply and enhancing pump function of neuron.

Objective: To investigate the association between frailty and type 2 diabetes mellitus (T2DM) using a bidirectional two-sample Mendelian randomization (MR) analysis, so as to provide the evidence for the prevention and control of frailty and T2DM. Methods: Frailty status was assessed using the Fried Frailty Score (FFS), with aggregated data sourced from 386 565 European samples in the UK Biobank. The T2DM data were obtained from the summary results of genome-wide analysis published by the Diabetes Genetics Replication and Meta-analysis Consortium, excluding the UK Biobank data, including 455 313 European samples. Eligible single nucleotide polymorphism site were selected from the FFS and T2DM summary data as instrumental variables. The bidirectional MR analysis was performed using the inverse-variance weighted method. The heterogeneity was assessed using the modified Cochran Q test. The horizontal pleiotropy of instrumental variables was examined using MR-Egger regression. The robustness of the results was evaluated using the leave-one-out method. The bias was tested using funnel plot. Results: The forward MR analysis revealed a statistically significant association between increased FFS and an increased risk of T2DM (OR=2.280, 95%CI: 1.169-4.447). The reverse MR analysis showed a statistically significant association between T2DM and increased FFS (β=0.026, 95%CI: 0.012-0.041). Both bidirectional MR results were robust, with no horizontal pleiotropy of the instrumental variables was found (all P>0.5); and the funnel plots did not show significant basis. Conclusion The study found a bidirectional causal association between frailty and T2DM.

Objective To study the MRI manitestation of juvemle acute pure cartilage fracture of the knee joint.Methods The MRI changes of cartilage,subcartilage low signal line and subcartilage bone were analysed retrospectively in 26 juvenile patients with acute pure cartilage fracture confirmed by arthroscopy.Sagittal and coronal MRI scanning were performed in 26 patients.Using fast low angle shot fat saturation T_1-weighted image(FLASH-FS-T_1WI)sequences,spin echo T_1-weighted image(SE-T_1WI)and fast imaging with steady-state precession three dimensional fat saturation T_2-weighted image(FISP-3D-FS- T_2WI)sequences in sagittal plane,SE-T_1WI and multi echo data image combination T_2-weighted imaging (MEDIC or ME-T_2WI)in coronal plane.Using ME-T_2WI sequence,axial plane MRI scanning in 5 patients.Results Twenty-seven sites of 26 patients include 8 patella,7 femoral medial condyle, 11 femoral lateral condyle and 1 tibial plateau.Three types pure cartilage fracture were observed,totally defect of the cartilage in 7 sites(include 3 patella,2 femoral medial condyle,1 femoral lateral condyle and 1 tibial plateau),fissuring fracture in 3 sites(include 2 femoral medial and 1 femoral lateral condyles), superficial defect of the cartilage in 17 sites(include 5 patella,3 femoral medial and 9 femoral lateral condyle).Corpus liberum was found in 21 patients'knee joints by arthroscopy,but only 3 cases by MRI. Bone bruise was detected,and subcartilage low signal lines were normal.Conclusion Using FLASH-FS- T_1WI,SE-T_1WI,FISP-3D-FS-T_2WI and ME-T_2WI sequences,sagittal and coronal MRI scanning in femoral and tibial plateau pure cartilage fractures,and using ME-T_2WI sequence axial scanning in patella r cartilage fractures may show the position,extension and types of the acute pure cartilage fracture of the knee joint. MRI is the hest non-invasive method for studying cartilage fracture.