The carotid plaque (CP) detachment can induce thrombosis, which may lead to cerebral vascular disease. In recent years,research of CP is mainly focused on qualitative and quantitative analysis of vulnerable plaque. Therefore, it is important to choose therapeutic method and opportunity according to the structure and stability of the plaque. This article reviews the progress in the diagnosis of plaque from the aspects of common ultrasound, contrast enhanced ultrasound, ultrasound real-time tissue elastography, intravascular unltrasound, digital subtraction angiography (DSA), comuted tomography angiography (CTA), magnetic resonance imaging (MRI) and optical coherence tomography (OCT). Common and all kinds of new ultrasonic technology can be used to evaluate the vulnerability of CP from different aspects.

Objcetive To evaluate the clinical significance of bone biochemical metabolic markers in osteoporosis( OP),and investigate the clinical application value of the determination.Methods BMD at various skeletal sites was measured by XR-36 dual energy X-ray absorptiometry for 65 patients.Enzyme linked immunosorbent assay (ELISA) were used to determine bone biochemical metabolic markers in sera of 65 patients with osteoporosis and 62healthy controls.Results The levels of serum TRACP5b and 25-OH-VD3/25-OH-VD2 in OP group were higher than that in control group( P ＜0.05),meanwhile the level of BGP,BAP and Ca were varying degrees higher than that in control group,but the level of P was lower than that in control group.Conclusion TRACP5b,BGP,BAP,VD3/2 and other bone metabolic markers can be used as indicators of early detection of osteoporosis,in order to provide valuable data for early treatment of osteoporosis.

OBJECTIVE:To investigate the effects of different operation methods on the residual amount of docetaxel. METH-ODS:60 Docetaxel injections were selected and divided into two groups,i.e. standard operation method was adopted in group A (30 injections),and clinical common operation method was used in group B(30 injections). Docetaxel injections were placed for 5,10 or 15 minutes respectively,and drained. Residual liquid was collected to calculate residual amount. The difference of residual amount,due to preparation method and standing time,were compared between two groups. RESULTS:After placing for 5,10 or 15 min,the volume and amount of residual liquid in group B were significantly higher than in group A(P<0.05). In same group, the volume and amount of residual liquid after placing for 10 and 15 min were all lower than that after placing for 5 min(P<0.05 or P<0.01);the volume and amount of residual liquid after placing for 15 min were lower than that after placing for 10 min(P<0.05). CONCLUSIONS:The standard operation of pharmacy dispensing staff is very important to reduce the residual amount of docetaxel,and guarantee safe,effective and sufficient medication. It is suggested that clinical staff should abide by standard opera-tion method.

Objective To investigate the clinical significance and relationship of preS1, HBV DNA and HBV-M. Methods PreS1 and HBV-M was detected by ELISA method,and HBV DNA was detected by PCR. Then the results were analyzed. Results In HBV patients,the positive rates of preS1 and HBV DNA had no statistically significant ,they had fine dependability. The detection rate of preS1 in HBeAg(+) group(80.3%) and HBeAg(+)group( 56.3% ) had statistically significant. In some patients,though HBeAg had become negative, HBV still replicated. In HBV DNA replicated patients(≥103 copies/ml) ,the detection rate of HBeAg and preS1 were 51.5% and 70.9% ,they had statistically significant. Conclusion HBV DNA and PreS1 had fine dependability,preSl could reflect the replication of HBV sensitively than HBeAg,it could be used as a reliable new marker of HBV replication in vivo.

Objective To observe the effect of Hydroxychloroquine (HCQ) on the apoptosis of peripheral blood mononuclear cells (PBMCs) of Systemic lupus erythematosus (SLE) patients and on the level of Th17 cells and IL-17.Methods The peripheral blood of 20 incipient SLE patients in active stage were taken,and PBMC were separated for cell culture.Using HCQ and Chlorambucil (CLB) as an intervention,and after cultured for 24 h and 48 h,the apoptosis of PBMC and the level of Th17 were tested using Flow cytometry (FCM),the supernatants were collected to test for the level of cytokine IL-17 by ELISA.One-way ANOVA was used and SNK-q was used in the comparison between every two groups.Results There was significant difference in the apoptosis rate of mononuclear cells between the HCQ and CLB group at 24 h [HCQ:(10.3±0.7)％,CLB:(8.5±1.1)％] and48 h [HCQ:(13.9±0.6)％,CLB:(11.8±0.8)％] (P＜0.05).There was significant difference between HCQ [24 h:(0.81±0.13)％,48 h:(0.73±0.45)％] and CLB group [24 h:(0.78±0.26)％,48 h:(0.68±0.20)％] in Th17 percentage (P＜0.05).The levels of IL-17 in the supematants of the HCQ group [24 h:(26.3±0.97)％,48 h:(24.2±0).91)％] and CLB group [24 h:(24.6±0.7)％,48 h:(22.6±1.1)％] were significandy different between the two groups(P＜0.05).Conclusion HCQ has apoptosis-induction effect on PBMC,and it can decrease the number of Th17 and IL-17 level in the PBMCs.

Objective To investigate the effect of serum of esophageal squamous cell carcinoma (ESCC) patients with blood stasis syndrome (BSS) on proliferation and cycle of EC9706 cells, and to explore the action of blood micro-environment of ESCC patient with BSS on EC9706 cells. Methods Human EC9706 cells were cultured in an incubator with RPMI-1640 medium containing fetal bovine serum ( FBS) , at 37℃ and under 5% saturated humidity for 24 h. After EC9706 cells were starved in serum-free medium for another 24h, the three experimental groups were treated with serum of ESCC patients with BSS, serum of ESCC patients with spleen-qi deficiency syndrome (SQDS), and serum from healthy volunteers, respectively. Cell proliferation was determined by methyl thiazolyl tetrazolium ( MTT) assay, EC9706 cell morphology was observed under light microscope, and cell cycle was measured by flow cytometer (FCM). Results The serum concentrations of ESCC patients with BSS and ESCC patients with SQDS for obtaining 50 percent cell proliferation rates ( PI50) were 71.1 μL/mL and 118 μL/mL, respectively. And the proliferation of EC9706 cells in the both groups all arrived to the peak values at culturing hour 48. The light microscopy results showed that the feature of EC9706 cells in both groups presented as spindle-like or polygon-like shape, and cell count in BSS group was larger than SQDS group. FCM assay results for EC9706 cell cycle showed that the percentage of G1-phase EC9706 was decreased and the percentage of S-phase EC9706 was increased in BSS group as compared with those in SQDS group ( P<0.05). Conclusion Serum micro -environment in ESCC patients with BSS is more beneficial to EC9706 cells proliferation than ESCC patients with SQDS, and the mechanism may be related to the regulation of cell cycle.

Objective:To investigate the clinical characteristics of postpartum pyomyoma.Methods:Clinical data of two patients with postpartum pyomyoma admitted to the Department of Obstetrics and Gynecology, Peking University First Hospital, between 2019 and 2020, were collected. Another 16 postpartum pyomyoma reported in China and foreign areas from 2000 to 2020 were reviewed.Results:Apart from three patients without reported gravidity and parity, 12 out of the remaining 15 patients were primiparous. The median maximum diameter of uterine fibroids in pregnancy was 10 cm (6-25 cm). Of the 18 patients, 12 had a history of intrauterine manipulation, 10 had anemia or severe postpartum hemorrhage, and four had other infections. All patients manifested as fever at first, and most were accompanied by abdominal pain. The onset time of 14 cases was within postpartum two weeks. CT, MRI, and ultrasound detection rate in diagnosing postpartum pyomyoma was 11/13, 3/6, and 1/8, respectively. Pus culture had the highest positive rate, with Escherichia coli as the most common pathogen. No death was reported, but 14 patients developed severe complications, including sepsis, septic shock, disseminated intravascular coagulation, rupture of pyomyoma, peritonitis, and incision infection. As failing in anti-infection medication, all patients received surgical treatment, which controlled infections. Three patients were conceived two years after the operation (16 months to two years). Conclusions:Pyomyoma should be considered once postpartum fever develops in patients complicated by uterine fibroids ≥10 cm in diameter during pregnancy, especially those with anemia, infection, or a history of intrauterine manipulation. Surgical treatment should be performed once pyomyoma is diagnosed.

Objective To summarize the clinical features of patients with ovarian tumor associated anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis,and to explore the influence of operation patterns on the prognosis.Methods The clinical data of ovarian tumors with anti-NMDAR encephalitis in the Third Affiliated Hospital of Sun Yat-sen University from January 2009 to December 2018 were collected,and the clinical characteristics,treatment and prognosis were analyzed.Results A total of 110 patients with ovarian tumors and anti-NMDAR encephalitis were collected.All patients were positive for anti-NMDAR antibodies in serum and/or cerebrospinal fluid.The age of onset ranged from 10 to 35 years (24.6 ±5.7).About 60.9％ patients'initial symptom was psychosis.The main clinical features were psychosis (97.3％),seizures (83.6％),conscious disturbance (72.7％),autonomic dysfunction (64.5％),dyskinesia (64.5％),central hypoventilation (54.5％) and impaired memory (31.8％).Most patients'symptoms were relieved after surgery and immunotherapy.Postoperative pathological results revealed that ovarian teratoma accounted for 97.8％ of the ovarian tumor.The prognosis of patients with surgery was better than the patients without surgery,with statistically significant difference (P ＜ 0.05).The prognosis of patients with adnexectomy was better than the patients with ovarian tumor excision,with statistically significant difference (P ＜ 0.05).Conclusions Anti-NMDAR encephalitis,with psycho-neurological symptoms as dominant manifestation,is usually associated with ovarian tumor.For young female patients with psychosis,clinicians should be alert to the possibility of anti-NMDAR encephalitis and screen for tumor.Patients with adnexectomy and immunotherapy can get a better prognosis.

Objective:To analyze the serology and molecular typing of Listeriamonocytogenes isolated from patients in Henan, and to explore the epidemic situation of listeriosis, construct the molecular traceability database of patient isolates, so as to provide laboratory basis for listeriosis traceability. Methods:From January 2015 to July 2020, 71 positive Listeriamonocytogenes cases were monitored in 16 sentinel hospitals in Henan. Eighty samples of positive cases were collected for detection, and 71 positive strains were obtained for molecular typing. According to the Entry-exit Inspection and Quarantine Industry Standard of China (SN/T 2521-2010) and the instructions for the use of diagnostic serum of Listeriamonocytogenes, 80 strains of Listeriamonocytogenes were serotyped, and PFGE cluster analysis was performed according to the User Manual of National Foodborne Disease Molecular Traceability Network. Results:A total of 71 positive listeriosis cases were detected, of which 38 cases were perinatal cases and 33 cases were non-perinatal cases. Among the 80 positive cases of listeriosis, 58.75% (47/80) were from perinatal cases, 20.00% (16/80) were from non-perinatal cases with underlying diseases, the proportion of>1 month-≤5 years old,>5-≤60 years old and >60 years old was 7.50% (6/80), 12.50% (10/80) and 1.25% (1/80), respectively, in non-perinatal age group. There were 5 types of specimens, 73.75% (59/80) were blood, 15.00% (12/80) were cerebrospinal fluid, and 3.75% (3/80) were stool, intrauterine swab and sputum. 80 strains of Listeriamonocytogenes were classified into three serotypes, Type 1/2b, Type 1/2a and Type 4b accounted for 61.25% (49/80), 35.00% (28/80) and 3.75% (3/80) respectively. The 71 strains of Listeriamonocytogenes were digested by AscⅠ, and 58 bands were obtained. Each band type included 1-4 strains, and the similarity was 60.8%-100%. GX6A16HA0005, GX6A16HA0011, GX6A16HA0030, GX6A16HA0023, GX6A16HA0029 and GX6A16HA0054 were dominant bands, including 4, 4, 4, 3, 2 and 2 strains respectively. Four strains of GX6A16HA0005 from 2016, 2018 and 2020 were isolated. One strain from 2016 and one strain from 2018 were from Puyang City. Four strains of GX6A16HA0011 were isolated from samples of 2016, 2018 and 2020, including two strains of 2020 from Luoyang City. Four strains of GX6A16HA0030 were isolated from 2018 samples from Luoyang City, Shangqiu City and Zhengzhou City, respectively. Three strains of GX6A16HA0023 were isolated from 2017 and 2018 samples, of which one strain from 2017 and one strain from 2018 were from Luoyang City. Two strains of GX6A16HA0029 were isolated from 2018 samples, from Kaifeng City and Puyang City respectively. Two strains of GX6A16HA0054 were isolated from 2020 from Pingdingshan City and Anyang City, respectively. The PFGE patterns of 4 strains with different serotypes were the same. Conclusion:Listeriosis cases in Henan are mainly found in patients during the perinatal period, and in elderly, new-born, and low immunity population. The infection type is mainly invasive infection; the serotypes of epidemic strains are 1/2a, 1/2b and 4b, and the results of PFGE typing of strains are diverse. There is a consistent phenomenon of cross-year or different regions in the same year, different time zones in the same year and the same region; phenotyping and genotyping or different genotyping techniques should be combined in the traceability analysis.

Objective:To study the effects of Empagliflozin on left ventricular function and the level of blood glucose and lipid in type 2 diabetes mellitus (T2DM) patients.Methods:A total of 120 patients with T2DM complicated with cardiac function impairment were selected from Chu Hsien-I Memorial Hospital, Tianjin Medical University from December 2020 to May 2021. The diabetic patients were randomly divided into the observation group (60 cases) and control group (60 cases) by random number table method. Patients in the observation group were treated with Empagliflozin, while the control group underwent original hypoglycemic treatment. After the treatment, 6 cases were eliminated and 114 cases were completed, with 57 cases in each group. The changes of echocardiographic left ventricular function related indexes such as E/ e', left atrial volume index (LAVI), tricuspid regurgitation speed, left ventricular ejection fraction (LVEF) and laboratory indexes in the two groups were observed before and after treatment. The laboratory indexes checked include fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL) and how density lipoprotein (HDL). Results:The E/ e', LAVI of the observation groups was significantly lower than that of the control group, and the differences were statistically significant (all P<0.05). There were no significant changes in tricuspid regurgitation speed, LVEF, TG, TC, LDL and HDL levels between the two groups after the treatment (all P>0.05). After the treatment, the levels of FBG and HbA1c in the two groups decreased, but there was no significant difference between the two groups (all P>0.05). Conclusions:Empagliflozin can effectively control the E/ e', LAVI of T2DM patients, and can early significant improvement of left ventricula diastolic function, which is very favorable for the patients. Along with good safety, Empagliflozin is suitable for clinical recommendation.