Taking three Chinese databases (CNKI,WANFANG and VIP) as data sources,the paper retrieves documents about Clinical Pathway (CP) dated from 2000 to 2009 and dated from 2010 to 2015 as well as respectively performing the clustering analysis and strategic coordinate analysis of high-frequency keywords on dereplicated document set,summarizes the study hotspots of documents about CP in China.

Objective To explore the applied value of thyroid imaging reporting and data system (TI-RADS) strati?fication in diagnosing thyroid nodules in patients with different ages.Methods A total of 527 patients with thyroid nod?ules (aged 26-65) were divided into four groups:aged 26-35 group, aged 36-45 group, aged 46-55 group and aged 56-65 group. TI-RADS was used to evaluate patients in four groups. The results of TI-RADS were compared with the pathologic di?agnostic analysis. Results For the low aged groups (aged 26-35 group and aged 36-45 group), the positive predictive val?ue, the negative predictive value and accuracy rate were more than 90%. With regard to the patients aged 46-55, the positive and negative predictive values and accuracy rate were 81.5%, 87.5%, and 81.9%, respectively. The positive and negative predictive values, accuracy rate were 76.6%,88.8%and 77.9%for patients aged 56-65 group. The diagnostic rate of TI-RADS in patients with thyroid lesions was lower in aged 56-65 group than that of other groups. Conclusion TI-RADS method is affected by age. The diagnostic rate is lower in the high age group than that of the low age group.

Objective:To investigate the correlation between the CTLA-4 expression in the peripheral blood CD4+ and CD8+T cells in the patients with glioma and glioma WHO classification and operation,and to clarify the clinical significances of CTLA-4.Methods:60 patients with glioma from our hospital were selected as glioma group, and 46 healthy volunteers were used as control group.Then the CTLA-4 expression levels in the peripheral blood CD4+ and CD8+T cells of the subj ects in glioma group and control group were detected by fluorescence-activated cell sorting (FACS)and the relationship between CTLA-4 and glioma WHO classification and surgery was analyzed. Results:The CTLA-4 expression levels in CD4+ and CD8+T cells in peripheral blood of the patients in glioma group were higher than those in control group (P<0.01).The CTLA-4 expression level in the patients with gradeⅣ glioma was the highest, the expression level of the patients with grade Ⅳ glioma was higher than that of the patients with grade Ⅲ glioma (P<0.01),and the expression level of grade Ⅲ the patients with was higher than that of the patients with grade Ⅱ (P<0.01).The expression level of CTLA 4 in CD4+ and CD8+T cells of the patients with glioma after operation was lower than before operation (P<0.01 ). Conclusion:The CTLA-4 expression levels in the peripheral blood CD4+ and CD8+T cells are increased with the increasing of malignancy degree of the patients with glioma,and it has a promotion role in the occurrence of development of glioma.

Objective To study microcirculation of acute pancreatitis(AP)in vivo with confocal la-ser endoscopy(CLE).Methods Thirty-two SD rats were randomly divided into 2 groups，I.e.control(n=8)and experiment group(n=24).In the control group，pancreas were identified，the blood was collectedfrom the inferior vena cava,0.5％uranin was administered at 4 ml/kg intravenously,and the pancreas were observed through CLE.In the experiment group,AP model was established by ligation of the end of common bile duct.The abdomen was opened to observe the pancreas at 12 h(n=8)，24 h(n=8)and 48 h(n=8)， uranin was administered intravenously，and the pancreatic tissue was observed through CLE.Pancreatic tis- sue in each group was sent for pathological study.Results Both healthy and affected pancreatic microcircu- lation can be viewed through CLE.The number of red blood cells can be counted within certain period of time cross-sectionally.In 12 h group，the construction of pancreatic acini was normal，and the flow of red blood cells could be seen in the capillary，but quite slow.In 24 h group，the structure was vague，but there were still normal pancreatic acini less visible capillaries and less and slower red blood cells flow were ob- served.In 48 h group，some pancreatic acini were not visible，normal pancreatic acinar structure and micro- circulation could not be observed，neither could red blood cells.Insulin tissue，white blood cells and micro- thrombosis could not be observed through CLE.ConclusionCLE is distinctly valuable for pancreatic mi- crocirculation study，especially for AP microcirculation in vivo.However，color developing agents and image processing techniques should be improved to ensure better images and better application.

BackgroundCycloplegia is well accepted for the first refraction estimate in childhood.Yet no good evidence is offered in terms of which cyclopegia is preferable for the different ages and refractive status in children. ObjectiveThis study aimed to compare the effectiveness of cycloplegia between 1％ cyclopentolate and 1％ atropine sulphate before optometry in ametropia children. Methods This was a prospective clinical trail.The self matched-pairs control randomly observation was designed.One hundred and sixty eyes of 80 children of 4-9 years old with refractive error were recruited in this study.1％ cyclopentolate eye drops were topically administered once per 5 minutes for 3 times and 1％optometry was performed 45 minutes after eye dropping.Three days after that,1％ atropine then was used 3 times per day for consecutive 3 days and again the refractive diopter was obtained.The differences of the results in autorefraction,retinoscope and residual accommodation were compared between 1％ cyclopentolate and 1％atropine eye drops.This trail was approved by the Ethic Committee and written informed consent was obtained from each custodian. Results The autorefraction values were ( 0.55 ±3.52 ) D and ( 2.22 ±3.52) D before and after the administration of 1％ atropine with the difference value( 1.66± 1.62) D (t =13.02,P =0.00 ).The autorefraction value was( 1.74±3.46 ) D after dropping of 1％ cyclopentolate and the difference value from that of 1％ atropine was (0.48 ± 0.46) D ( t =13.08,P =0.00 ).The cy(e)lplegic autorefractions of atropine and cyclopentolate have strong correlation ( R2 =0.98,P =0.000 ).The residual accommodation values were ( 0.32± 0.44 )D and(0.05±0.41 ) D after dropping of 1％ cyclopentolate and 1％ atropine with the difference( 0.27±0.55 ) D ( t =4.56,P =0.00 ).The difference value of refractive diopter was (0.31 ± 0.37 )D in myopic group,(0.56±0.48 )D in moderate hypermetropic group and(0.59±0.50)D in high myopic group,and that of myopic group was significantly lower than the moderate hypermetropic group ( t =- 3.14,P =0.00 ).No significant difference was found in the autorefraction difference between 4-6 years group and 7 -9 years group [ ( 0.61 ±0.53 ) D vs ( 0.49 ±0.39 ) D ] ( t =1.21,P=0.23 ).The hidden value because of accommodation had weak correlation with the difference value between atopine and cyclopentolate(r=0.43,P=0.00). ConclusionsBoth 1％ atropine and 1％ cyclopentolate have the cycloplegic effects.This study suggestes that 1％ atropine should be used for the optometry of hypermetropia children.

Humans ; Intestines ; Stomach Neoplasms/complications*

ObjectiveTo study the protective effects of tert-butylhydroquinone(tBHQ) on sodium arsenite (NaAsO2)-induced cytotoxicity and oxidative injuries. Methods Chang liver cells were pretreated with tBHQ[0(control), 5, 25 μmol/L]for 24 h, and then co-treated with tBHQ(5 μmol/L) together with NaAsO2[0(control),30, 40, 50, 60 μmol/L] for another 24 h, and Alamar blue reduction rates were used to evaluate cell viability,the results were expressed as the relative ratio of Alamar blue reduction rates between the experimental group and the control group. On the other hand, Chang liver cells were pretreated with tBHQ[0(control), 5, 25 μmol/L] for24 h,and then co-treated with tBHQ(5 μmol/L) together with NaAsO2[0(control), 40, 50 μmol/L] for another 24 h,and the levels of cellular reactive oxygen species(ROS) were detected by staining cells with 2',7'-dichlorofluorescin diacetate(DCFH-DA), the results were expressed as the relative ratio of mean fluorescence intensity between the experimental group and the control group. ResultsCell viability decreased dramatically by treatment with NaAsO2(30, 40, 50, 60 μmol/L), while relieved to some extent by pretreatment with 5, 25 μmol/L tBHQ, the main effects of NaAsO2 and tBHQ, as well as their interaction were all statistically significant(F =566.57, 55.09, 14.50,all P ＜ 0.05) ; the cell viability of NaAsO2(30, 40, 50, 60 μmol/L) pretreated with tBHQ(5, 25 mol/L) were 0.75 ±0.02, 0.70 ± 0.04, 0.59 ± 0.03, 0.43 ± 0.03 and 0.75 ± 0.02, 0.73 ± 0.03, 0.65 ± 0.02, 0.50 ± 0.02, respectively,all significantly higher than corresponding NaAsO2 alone groups(0.70 ± 0.03, 0.64 ± 0.03, 0.43 ± 0.03, 0.33 ±0.01, all P ＜ 0.05), the cell viability of NaAsO2(50, 60 μmol/L) pretreated with 25 μmol/L tBHQ was higher than corresponding 5 μmol/L tBHQ pretreatment groups(all P ＜ 0.05). On the other hand, 40, 50 μmol/L of NaAsO2 significantly induced hepatocellular ROS generation, while tBHQ(5, 25 μ mol/L) pretreatment significantly decreased NaAsO2-induced intracellular ROS levels, the main effects of NaAsO2 and tBHQ, as well as their interaction were all statistically significant (F =181.78, 60.55, 4.93, all P ＜ 0.05) ; the ROS levels of NaAsO2(40, 50 μ mol/L) pretreated with tBHQ(5, 25 μmol/L) were 1.87 ± 0.09, 1.80 ± 0.07 and 1.36 ± 0.11, 1.44 ± 0.12,all significantly decreased than corresponding NaAsO2 alone groups(2.30 ± 0.18, 2.18 ± 0.17, all P ＜ 0.05),the ROS levels of NaAsO2(40, 50 μmol/L) pretreated with 25 μmol/L tBHQ decreased than corresponding 5 μmol/L tBHQ pretreatment groups (all P ＜ 0.05). ConclusiontBHQ has a certain antagonism on arsenic induced cytotoxicity and oxidative injuries.

Objective:To investigate the effect of GTPBP4 silencing by RNA interference on the radiosensitivity of esphageal cancer EC9706 cells line.Methods:The expression data of GTPBP4 in esophageal cancer tissues was obtained from public Gene Expression Omnibus (GEO) database. Recombinant plasmid-mediated RNA interference (RNAi) was employed to transfect the esophageal cancer EC9706 cell to evaluate the influence of GTPBP4 silencing on the proliferation, apoptosis and radiosensitivity of esphageal cancer EC9706 cells. The expression levels of GTPBP4 mRNA and protein and apoptosis-associated proteins of Bax, cleaved caspase-9, cleaved caspase-3 and Bcl-2 were determined by qRT-PCR and Western blot. The cell proliferation was determined by MTT assay. The changes in cell apoptosis were detected AnnexinⅤ-FITC/PI double staining flow cytometry. The variations in radiosensitivity after radiation exposure were assessed by clone formation assay.Results:The expression level of GTPBP4 in the esophageal cancer tissues was significantly higher than that in the normal adjacent esophageal tissues ( P<0.001). qRT-PCR and Western blot demonstrated that the expression levels of GTPBP4 mRNA and protein in the GTPBP4-siRNA group were significantly lower than those in the blank and negative control groups (both P<0.001), suggesting that the plasmid was successfully transfected into the EC9706 cells. MTT assay indicated that the EC9706 cell proliferation rate was significantly inhibited ( P<0.001). Flow cytometry found that the apoptosis rate was significantly increased in the GTPBP4-siRNA group ( P<0.001). After GTPBP4 gene interference combined with radiotherapy, the cell sensitivity enhancement ratio was 1.716. The apoptosis rate of EC9706 cells was significantly increased in the GTPBP4-siRNA group ( P<0.001). The expression levels of apoptosis-associated proteins including cleaved caspase-9, cleaved caspase-3 and Bax were significantly up-regulated, whereas that of Bcl-2 was significantly down-regulated in the EC9706 cells in the GTPBP4-siRNA group ( P<0.001, P=0.001, P=0.001 and P=0.005). Conclusions:GTPBP4 gene is highly expressed in human esophageal cancer tissues. RNAi technology can effectively inhibit the expression of GTPBP4 gene in the EC9706 cells, thereby suppressing cell proliferation, inducing cell apoptosis and enhancing the radiosensitivity of cells.

ObjectiveTo observe the efficacy and safety of dihydroergotoxine in the treatment of acute ischemic stroke. Methods30 patients with acute ischemic stroke were randomly given dihydroergotoxine 0.6 mg(group 1), 1.5 mg (group 2) or Danshen injection 40 ml (group 3) respectively each day for 14 days,each for 10 cases. ResultsBefore and after treatment, the Scandinavian stroke scores of the three groups were increased(P<0.05). There was no significant difference(P>0.05) between the scores of group 1 and the group 3, but the scores of group 2 was higher than that of the group 3 and group 1(P<0.05). The common side-effect of both dihydroergotoxine groups were nausea, vomit, headache, palpitation and transient hypotention, which was more frequently apeared in group of 1.5 mg. ConclusionDihydroergotoxine and Danshen injection are all useful in the treatment of acute ischemic stroke. It is more efficient using higher dose of dihydroergotoxine. But as the dose going on, there will be more side-effect.

Antibodies, Monoclonal, Murine-Derived ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangioendothelioma ; metabolism ; pathology ; surgery ; Hemangioendothelioma, Epithelioid ; metabolism ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sarcoma ; metabolism ; pathology ; surgery ; Thigh ; Vimentin ; metabolism ; von Willebrand Factor ; metabolism