Objective To evaluate the image quality of dynamic three-dimensional contrast enhanced ultrasonography(3D-CEUS) in liver tumors.Methods Twenty-five patients were examed with 2D-CEUS and dynamic 3D-CEUS.Contrast-enhanced computed tomography or magnetic resonance imaging(CECT/MRI) were performed early or late.Two readers reviewed the images of both modalities and graded the images according to diagnostic criteria as follows:tumor blood fusion in arterial phase(unclear-score 0,moderate-score 1,clear-score 2),tumor boundry and relationship with periphery tissues (unclear score 0,moderate-score 1,clear-score 2).The concordance between the two modalities for showing liver tumors was evaluated by Kappa test.Results Twenty-three of 25 danymic 3D-CEUS were displayed successfully versus total objects in CECT/ MRI.Among them,for showing blood fusion,16 lesions scored 2,7 lesions scored 1,2 lesions scored 0 in danymic 3D-CEUS,meanwhile 18 lesions scored 2,7 lesions scored 1,0 lesion scored 0 in CECT/MRI,the Kappa value was 0.65.For showing tumor boundry and relationship with peripherytissues,16 lesions scored 2,7 lesions scored 1,2 lesions scored 0 in danymic 3D-CEUS,meanwhile 21 lesions scored 2,4 lesions scored 1,0 lesion scored 0 in CECT/MRI,the Kappa value was 0.52.Conclusions Danymic 3D-CEUS was shown to be useful for displaying tumor blood fusion,boundry and relationship with periphery tissues in single liver tuomor,the concordance between dynamic CEUS and CECT/MRI for single liver tuomor was fair.For huge liver tumor and multi-tumors,3D-CEUS can not give overall information.

Objective:To explore the correlation between serum cystatin C (Cys C)content and renal function in aged patients with benign prostatic hyperplasia (BPH).Methods:Clinical data of 237 aged BPH patients were retro-spectively analyzed.According to international prostate symptom score (IPSS),they were divided into mild group (n=25),moderate group (n=67)and severe group (n= 145);another 110 patients without prostatic hyperplasia were enrolled as normal control group in the same period.Levels of serum Cys C,blood urea nitrogen (BUN),ser-um creatinine (Scr),fasting blood glucose (FBG),blood lipids and prostate-specific antigen (PSA)were measured in all groups,and prostate volume (PV)was calculated.Results:Compared with normal control group,PV signifi-cantly rose [(18.94±4.62)ml vs.(40.09±12.72)ml],maximum urinary flow rate (Qmax)significantly reduced [(18.67±4.60)ml/s vs.(9.93±3.54)ml/s],and serum Cys C level significantly increased [(1.03±0.23)mg/L vs.(1.53±0.61)mg/L]in BPH group,P <0.01 all.Subgroup analysis indicated that serum Cys C levels in mild, moderate and severe group [(1.32±0.45)mg/L,(1.42±0.32)mg/L,(1.61 ±0.64)mg/L]were significantly higher than that of normal control group,P <0.01 all;and that of severe group was significantly higher than those of mild group and moderate group (P <0.01 or P <0.05).Pearson correlation analysis indicated that serum Cys C level was positively correlated with of age,SBP,DBP,FBG,BUN,Scr,PV and IPSS (r=0.179~0.580,P <0.05 or P <0.01),and inversely correlated with Qmax (r=-0.243,P <0.05)in BPH patients.Conclusion:Serum Cys C level significantly rise,and related with BPH degree,correlated with renal function in aged BPH patients,which can be used to predict renal function of these patients.

Objective To explore the effects of amlodipine,perindopril and valsartan on plasma adiponectin and retinol binding protein 4 in elderly patients with essential hypertension.Methods From March 2007 to July 2010,238 elderly patients with essential hypertension were selected and 193 cases completed this study.Patients were randomly divided into 3 groups:amlodipine group (n=68),perindoprilgroup (n=60) and valsartan group (n=65).Patients in each group were treated with amlodipine,perindopril and valsartan respectively for at least 12 weeks.The changes in blood pressure,heart rate,body height,body mass index (BMI),abdominal circumference,waist circumference (WC),levels of blood lipids,plasma adiponection and retinol binding protein 4 were observed before and after treatment.Results Compared with pre-treatment,systolic blood pressure in 3 groups were significantly decreased after treatment (all P＜0.01).There were no significant differences in blood pressure among 3 groups after treatment (all P＞0.05).Compared with pre treatment,plasma adiponectin level was significantly increased in perindopril group and valsartan group after treatment [(7.4±1.8) μg/L vs.(8.3± 1.8) μg/L,(7.5±1.7) μg/L vs.(8.4±1.9)μg/L,both P＜0.01].Plasma adiponectin level was higher in perindopril group and valsartan group than in amlodipine group after treatment [(8.3±1.8) μg/L vs.(7.6±1.8) μg/L,(8.4±1.9) μg/Lvs.(7.6±1.8) μg/L,both P＜0.05].Compared with pretreatment,plasma retinol binding protein 4 level in 3 groups were all decreased after treatment,and the decrements had significant differences in perindopril group and valsartan group (both P＜0.01) but had no difference in amlodipine group (P＞0.05).Plasma adiponectin retinol binding protein 4 levels were lower in perindopril group and valsartan group than in amlodipine group after treatment[(36.6± 14.2) μg/L vs.(42.7± 13.8) μg/L,(36.3±14.1) μg/L vs.(42.7±13.8) μg/L,respectively,both P＜0.01].Conclusions Perindopril and valsartan play important roles in cardiovascular protection beyond the antihypertensive effects by increasing plasma adiponection level and decreasing plasma retinol binding protein 4 level in elderly patients with hypertension.

This thesis mainly expounds the design ideas and the realization methods of medical statistics question database management system.Specifically speaking,the function modules,data structure and business processes of the system are designed based on the analysis of questions,test papers and the needs of system functions.We choose Visual Basic 6.0 to develop the system interface,establish the question database with Access 2003,and make use of Word 2003 to output documents.This system can achieve the separation of teaching and testing effectively which can make examinations more normal and scientific.

Objective To investigate the mental health status and related personality type of psychological clinic adoleScent in general hospital and provide data for psychology treatment and intervention.Methods 219 adolescence consulters in 2006 were tested by symptom checklist(SCL-90) and eysenck personality questionnaire(EPQ).The caseswere separatedthree age groups,A group(16～20 years old),B group(21～25 years old),C group(26～30 years old)and disposed by SPSS 13.0.Results All factor scores of SCL-90 in psychological clinic adolescents were higher than those of youth norm in China(P＜0.01).The scores of female consulters were significant higher than those of male in depression(P＜0.05).The incident rate of mild mental obstacle(factor score＞2)in 3 age groups were significant different.The incidence rate of B and C groups were higher A group(P＜0.01).The factor scores were positive associated with P in EPQ and negative associated with L in EPQ.The obsession score of SCL-90 was negative associated with E in EPQ.Conclusions The mental health status of psychological clinic adolescents was not as good as norm adolescents.In psychological consulting and psychological health service,measures in different age and different personality could help build up healthy personality and effectively promote the development of mental health.

Objective To explore the mechanisms of synergic action of commonly-used herb pair of Radix Sophorae Flavescentis (Kushen, KS) and Fructus Cnidii (Shechuangzi, SCZ) for the treatment of pruritus. Methods We predicted and analyzed the potential targets of KS and SCZ based on network pharmacology method, and then established Chinese herbs-compound skeletons-targets networks to reveal anti-pruritus targets, predicting targets, and the interaction of KS and SCZ, as well as the components of the herb pair. The RAW264.7 inflammatory cell model was established to observe the synergistic anti-inflammatory activity of KS and SCZ. Results KS and SCZ had possible synergic action on the pruritus-related targets such as histamine receptors, cannabinoid receptors and proteinase-activated receptor 2. Additionally, KS and SCZ probably had synergic regulation of inflammation-related pathway (Toll -like receptor signaling pathway , chemokine signaling and Fc epsilon RI signaling pathway) and nerve-related pathway(neurotrophin signaling pathway) during the treatment of pruritus. Flavones from KS and coumarin of SCZ had various synergistic anti-inflammatory activities(P<0.05), indicating that they played an important role in inhibiting pruritus induced by inflammation. Conclusion The method may reveal the molecular mechanism of KS and SCZ in inhibiting pruritus, which is important for the modernization of Chinese medicine and new drug development.

Objective To retrospectively analyze the relationship of the classification and risk stratification in senile hypertension with benign prostatic byperplasia (BPH).Methods Totally 376 male senior patients,including 233 senile hypertensive patients and 143 non-hypertensive patients as a control,were enrolled in this study.There were 35 cases of hypertension at level 1,82 cases at level 2,116 cases at level 3.Based on risk stratification of hypertension,there were 3 cases of low-risk,28 cases of medium risk,75 cases of high-risk,127 cases of very high risk.All candidates accepted the International Prostatic Symptom Score (IPSS) assessment before the treatment.Fasting blood glucose (FBG),total cholesterol (TC),triglycerides (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and prostate specific antigen (PSA) were determined.Body mass index (BMI) and prostate volume (PV) were calculated.Relationship of classification and risk stratification in hypertension with BPH were analyzed.Results The levels of systolic blood pressurc (SBP),diastolic blood pressure (DBP),body weight,BMI,FBG and TC were higher (t=3.883,2.498,2.161,3.399,2.200,2.370,P＜0.05 or P＜0.01),while serum HDL-C were lower (t=2.036,P＜0.05) in hypertensive patients than in control group.Compared with the control group,IPSS and PV was increased (t =3.432,3.381,both P＜0.01) in hypertension group.Risk rate of hypertensive patients with BPH was 2.03 times (95％CI:1.33-3.11,P＜0.01) as compared with control group.In hypertensive patients,PV and IPSS were higher in level 2 or 3 grade group than in level 1 group (F=6.890,7.576,all P＜0.01).PV and IPSS in high risk and very high risk groups were enhanced as compared with those in low-medium risk group (F=30.608,19.804,all P＜0.01).Pearson analysis showed that PV was positively correlated with SBP,FBG and TC(r=0.223,0.251,0.305,all P＜0.05),while negatively correlated with HDL-C(r =-0.235,P＜0.05).Similarly,IPSS was positively correlated with SBP,DBP and FBG (r=0.396,0.273,0.224,all P＜0.01),while negatively correlated with HDL-C (r =-0.288,P＜ 0.01).Conclusions High incidence of BPH appears in the elderly men with hypertension.The increased PV and IPSS coexist with conventional risk factors of essential hypertension.Development of BPH is closely related to higher blood pressure and risk stratifications of hypertension.

Objective:To explore the clinical characteristics of patients with pituitary thyrotropin-secreting adenoma and evaluate the effect of preoperative short-acting octreotide treatment on hyperthyroidism.Methods:A retrospective analysis was performed in 40 patients with pituitary thyrotropin adenoma diagnosed in Beijing Tiantan Hospital from January 2008 to January 2018. The general data, laboratory examinations and imaging findings were reviewed and analyzed. The clinical effect of preoperative octreotide on hyperthyroidism was evaluated.Results:The age of onset year of the 40 patients (male: female = 24∶16) was (30.5±5.1) years. Among them, 35 patients (87.5%) were with macroadenoma. The most common symptoms were thyroid hypermetabolism syndrome, followed by headache, dizziness, visual field damage and hypogonadism. The thyroid function of 30 patients (75%) recovered to normal within 3-5 days after the octreotide treatment. The total effective rate of the octreotide was 90.0%. The level of free thyroxine (FT 4) before treatment in patients with more than 10 times of effective cumulative dose was significantly higher than that in patients with less than 10 doses. Conclusions:Thyroid hypermetabolism syndrome and pituitary occupying effect are the most common clinical manifestations of thyrotropin-secreting adenoma. Preoperative octreotide treatment can effectively control hyperthyroidism. The level of FT 4 is a crucial factor affecting the efficacy of octreotide.

Objective To explore the theory of mind (TOM) between adolescent with schizophrenia and normal adolescent from hot TOM and cool TOM.Methods 37 adolescent schizophrenias and 25 normal adolescents were interviewed with the Chinese version of YONI task, Reading the Mind in the eyes test and series of tests,then analyzed with adolescent schizophrenias cognitive features.Results ① Compared with the control group (83.16± 10.07),the scores of YONI task in the adolescents with schizophrenia (74.30 ± 11.44) had statistically significant difference (t=-2.983,P＜0.05),mainly the statistically significant difference existed in the groups in cool and hot TOM.②The differences between positive subtype (69.85± 12.66) and negative subtype (78.18±8.92) in scores were significant(t=-2.104,P＜0.05),especially in the hot TOM.③In Reading the Mind in the eyes test,there was no statistically significant difference in scores(t=0.982,P＞0.05) between the control group (17.59±3.13) and the group of adolescents with schizophrenia(18.42±2.98).Conclusion The adolescents with schizophrenia damage in hot TOM and cool TOM.The adolescents with schizophrenia in positive subtype are worse than the negative subtype,especially in the hot TOM.

Objective To investigate the incidence and risk factors of acute kidney injury (AKI)in hepatitis B virus (HBV)related acute-on-chronic liver failure (ACLF)patients,and to explore the impact of AKI on the prognosis of ACLF.Methods The medical records of 227 patients who were diagnosed with HBV-related ACLF at the Department of Infectious Diseases in the First Affiliated Hospital of Nanchang University from January 2015 to August 2016 were retrospectively reviewed.Patients were divided into AKI group and non-AKI group based on the AKI criteria published by International Club of Ascites in 2015 .Demographic and clinical data were compared between groups.The AKI incidence and its impact on patients’prognosis were analyzed.The comparison of continuous variables was done by t test or rank-sum test.The comparison of categorical variables was done byχ2 test or Fisher exact test.AKI risk factors were analyzed by using logistic regression.Results There were 66 (29.1 %)cases were diagnosed with AKI among 227 ACLF patients,among which,45 patients (68.2%)were stage Ⅰ,14 (21 .2%) were stage Ⅱ and 7 (10.6%)were stage Ⅲ.Age,cirrhosis,concentrations of total bilirubin and albumin,international normalized ratio (INR),percentage of neutrophils,MELD scores and spontaneous peritonitis rate (SBP)were all statistically different between AKI group and non-AKI group (all P <0.05).The binary logistic regression analysis revealed that only INR (OR=3.132,P =0.001 )and SBP (OR=4.204,P =0.001 )were the independent risk factors of AKI.The optimal cut-off value for INR was 2.025 with AUROC of 0.609 (P =0.01),sensitivity of 59.1 % and specificity of 62.1 %.The 30-day mortality of AKI group was significantly higher than non-AKI group (χ2= 18.324,P < 0.01). Conclusions AKI is relatively common in patients with ACLF.The risk factors of AKI are INR and SBP. AKI has significant impact on the short-term survival rate of ACLF.Therefore,physicians should pay attention to patients with INR of ACLF at admissions and SBP during the management so as to prevent the occurrence of AKI and to reduce the fatality of ACLF.