Objective To investigate the epidemiological features and disease spectrum of inpatients with hepatitis C in recent years and to provide reference for the control of hepatitis C.Methods A retrospective study of demography,epidemiology,and laboratory examination was performed in 1 10 hospitalized patients with hepatitis C.Results Of the 1 10 patients,60 were male and 50 were female,with a male-to-female ratio of 1.2:1.The main transmission routes included blood product transfusion (33.6%),surgery (30.0%),intravenous drug use (14.5%),and sexual transmission (4.5%).The other 19 cases (17.4%)were of unknown transmission route.The annual numbers of cases from 2008 to 2011 were 16,18,32,and 44,respectively.The genotype proportions in patients were as follows:1b,60.7%(17/28);2a,28.6%(8/28);1b/2a mixed type,7.1%(2/28);3b,3.6%(1/28).Of all patients,13.6%(15/110)were found with a-cute hepatitis C,67.3% (74/110)with chronic hepatitis C,19.1% (21/110)with liver cirrhosis,and 10.9% (12/110)with decom-pensated cirrhosis.Conclusion The incidence of HCV infection has been increasing year by year.The major HCV genotypes are 1 b and 2a.Hepatitis C is apt to develop into liver cirrhosis.It is necessary to reinforce monitoring and to carry out specific epidemiological study a-mong the target population.

Objective To optimize prescription for double-layered Erhuang sustained-release suppository. Methods Amounts of PEG400, PEG4000, HPMC were selected as influence factors for L9(34) orthogonal experiment. A comprehensive assessment was conducted by setting the cumulative release degree at three different time points as index, and the inner and outer layers of double-layered Erhuang sustained-release suppository were optimized. Results The best prescription was the inner HPMC∶PEG4000∶PEG400=1.5∶10∶4;outer HPMC∶PEG4000∶PEG400=0.5∶10∶4. Conclusion Prescription for double-layered Erhuang sustained-release suppository has good forming property and a good sustained-release effect according to the optimized prescription, which has certain reference value for researches and development of TCM suppository.

Objective To evaluate the applicative value of ultrasound elastography in diagnosis of focal lesions in the parotid and submandibular glands.Methods 30 patients(30 lesions) were scanned by real-time ultrasound elastography and were analyzed in elastography evaluated criteria (5 score method).All the results were compared with the pathological types.Results The elastographic grades of most benign nodules were 1 - 3,while most of malignancy were 4 - 5.The elastographic grades of benign and malignant lesions were of significant difference statistically( P ＜0.01 ).If elastographic grade 4 or 5 were diagnosed as malignancies,the sensitivity,specificity and accuracy for diagnosing malignant l(e)sions in the parotid and submandibular glands were 72.73 ％,84.21 ％,80.00 ％,respectively.Conclusions Ultrasound elastography is useful in the differential diagnosis of focal lesions in the parotid and submandibular glands.

Objective To explore the clinical application value of virtual touch tissue quantification (VTQ) technique in Hashimoto's thyroiditis(HT).Methods Fifty-three patients with HT and 46 health subjects were examed by conventional ultrasonography and VTQ, their shear were velocity (Vs) was measured.A receiver-operating characteristie(ROC) curve was drew according to Vs which can obtain the value of optimal operating point for diagnosing HT.Results The 2D ultrasonic appearance of 53 cases HT were classified into five species, but there was no significant difference in the Vs (F = 0.424, P = 0.790).The area under the ROC curve was 0.976,which showed a high statistical significances(P = 0.000).ROC curve displayed that Vs of 2.53 m/s could be used to diagnose HT,the sensitivity and specificity were 87％and 100％ ,respectively.Fifty-three patients with HT were classified into three groups according to thyroid function, 10 patients with hyperthyroidism, 25 patients with hypothyroidism and 18 patients with euthyroidism.The Vs of HT among the three groups were no significant difference(P = 0.884), but their Vs were all obviously higher than that of normal thyroid Vs(P = 0.000).Conclusions VTQ technique can evaluate the hardness of thyroid and has some help for differential diagnosis of HT.

Objective To optimize the ethanol extraction technology ofLichong ShengsuiDecoction.Methods An L9(34) orthogonal test was used in the study. The extraction rates of calycosin glycoside, icariin, baohuosideⅠ, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, astragaloside, and ginsenoside Rd were set as indexes. The influence of ethanol concentration, extraction time, extraction temperature, and amount of ethanol on the yield of Lichong ShengsuiDecoction were detected by comprehensive scoring method.Results The optimal ethanol extraction technology forLichong ShengsuiDecoction was soaking for 2 h with ten times of 60% ethanol and then reflux extracting for two times; extraction time was 1.5 h each time at 80℃.ConclusionThe optimal extraction technology is efficient, stable and feasible, which can provides data for the further study ofLichong ShengsuiDecoction.

Ovarian cancer is a common malignant tumor in the female reproductive system,and its pathogenesis and regulato-ry mechanisms are extremely complex and still unclear.Fatty acid metabolism mainly involves the processes of fatty acid uptake,syn-thesis,and oxidation.Previous studies have shown that fatty acid metabolism plays a unique role in the occurrence and development of ovarian cancer.Therefore,this article reviews existing literature and delves into the correlation between fatty acid metabolism and ovarian cancer,aiming to provide new perspectives and reflections on the mechanism of fatty acid metabolism and targeted treatment of ovarian cancer.

OBJECTIVETo systematically review whether statins can reduce the risk of infection and infection-related mortality.

METHODSWe searched the Cochrane Library, MEDLINE, EMBASE, PubMed, Elsevier and CBM databases for randomized placebo-controlled trials of statins published by September 2013, and each trial enrolled at least 100 participants with follow-up for at least 4 weeks. Two reviewers independently assessed the quality of the included studies and extracted the relevant data for analysis using Stata 12.0 software.

RESULTSSixteen trails involving a total of 48973 patients were included in our meta-analysis. The results showed that statins significantly reduced the risk of infection (OR=0.93, 95% CI 0.89 to 0.98, P=0.004) compared to placebo but did not significantly lower infection-related mortality (OR=0.96, 95% CI 0.82 to 1.12, P=0.592).

CONCLUSIONStatins can significantly reduce the risk of infection but does not lower infection-related mortality.

Objective To explore the effect of micro-lectures withadvanced simulation man in improving the practical skills teaching of nursing students, so as to promote the students' post competency. Methods Totally the 186 nursing internswere divided into control group and observation group by random number method with 93 people in each group. The control group used the traditional teaching modein the teaching of practical skills.The observation group used the micro-lectures with high simulation teaching.Comparing the two groups of nursing students comprehensive assessment test simulation results in the theory, skills, scenarios, and nursing students the evaluation of the curriculum. Results The scores of the two groups were all above the qualification line, but the scores of the observation group were significantly higher than those of the control group (P<0.05). The theoretical examinations and the situation simulation comprehensive testswas(77.89 ± 7.79), (75.60 ± 7.92)points in control group, and (93.87 ± 3.90),(92.87 ± 4.08)points in observation group, there was significant difference between two groups (t=17.67, 18.70,all P=0.000). The curriculum evaluation results of improving learning initiative, active curriculum atmosphere, clear operation demonstration, exercise clinical thinking, improve the clinical interest were 81.72％(76/93), 72.04％(67/93), 93.55％(87/93), 60.22％(56/93), 67.74％(63/93)in control group, and 96.77％(90/93), 95.70％(89/93), 100.00％(93/93), 92.47％(86/93), 98.92％(92/93)in observation group, there was significant difference between two groups(χ2=20.39, P=0.016).Conclusions The effect is significant of micro-lectures combined with high simulation of human using in clinical skills teaching. Thismold can conducive to the cultivation of clinical thinking of nursing students, and improve clinical comprehensive ability, and promote the promotion of nursing students post competency.

Objective To explore the correlation between Galectin-3 ,c-Met , HBME-1 ,CK19 and lymph node metastasis of thyroid carcinoma ,and study the value of ultrasound combined with the markers in estimating prognosis . Methods From December 2015 to September 2016 ,46 patients with thyroid nodules (8 were benign and 38 were malignant) who undergone surgery in our hospital were screened out . Preoperative analysis of ultrasonic manifestations of cervical lymph nodes and the evaluation of lymph node had been done before surgery .Immunohistochemical test of Galectin-3 ,c-Met ,HBME-1 and CK19 by Maxvision one step method for postoperative paraffin wax block were performed . Pathology was the gold standard for the final determination of metastatic lymph nodes . Results Chi-square and prospective chi-square test results showed that ultrasound assessment of metastatic lymph nodes compared with the final pathological results were statistically significant ( P ＜ 0 .001) . The expressions of Galectin-3 and c-Met were statistically significant compared with the lymph node metastasis confirmed by pathology ( Galectin-3 :P ＝0 .005 ;c-Met : P ＜0 .001) . The expressions of HBME-1 and CK19 were not statistically significant ( HBME-1 : P ＝0 .162 ,CK19 : P ＝0 .154) . ROC curve results showed that the comparison of Galectin-3 and c-Met and ultrasound cut-off value had the highest diagnostic value ,the sensitivity was 92 .3% and the specificity was 80 .0% . Conclusions The expressions of Galectin-3 and c-Met are associated with lymph node metastasis of thyroid carcinoma ,but HBME-1 and CK19 are not . Ultrasound combined with the expression of the markers for lymph node metastasis is valuable in guiding the prognosis of patients .

This paper discusses the theoretical basis of traditional Chinese medicine （TCM） for the treatment of cancer-related fatigue （CRF） based on the principle of treating overstrain with warming in the Huangdi's Internal Classic 《黄帝内经》 and the role of hypothalamic-pituitary-adrenal （HPA） axis dysregulation in CRF， aiming to provide new ideas for the clinical treatment of CRF. In the pulsatile regulation of the HPA axis， cortisol， which is synthesized and released by the adrenal cortex， plays an essential role in the life activities. The abnormal circadian rhythm and reduced serum level of cortisol are major factors leading to CRF. Therefore， increasing the serum level and stimulating the biological activity of cortisol and restoring the normal function of HPA axis are important targets for the treatment of CRF and also the key to the TCM treatment of this disease. According to the TCM principle of treating overstrain with warming， we interpreted the etiology and clinical manifestations of overstrain and further explored the causes of CRF. It is believed that the depletion of Qi and blood， Yin and Yang， and fluid in the kidney， spleen， and liver is the key of the disease， which results in symptoms such as fatigue. Further， we elaborated on the theoretical connotation of warming and summarized the two main treatment principles of tonifying with warm-natured herbs and relieving fever with sweet- and warm-natured herbs. According to the different characteristics of the organs affected by pathogen， we proposed the treatment method of warming kidney to cultivate essence， warming stomach and nourishing spleen to replenish Qi， nourishing liver and tonifying blood to promote Qi movement， and relieving fever with sweet- and warm-natured herbs to alleviate fatigue. The warming method can elevate the serum level and invigorate the biological functions of cortisol in CRF patients， which provides a new theoretical basis for alleviating the symptoms and improving the quality of life of cancer patients in clinical practice.