Objective:To explore the feasibility of using Hirsch index(H index) to evaluate the performance of academic papers published by medical talents.Methods:67 medical talents of Wuxi People′s Hospital Affiliated to Nanjing Medical University were enrolled in the study. The numbers of papers published and citations of these talents which have been included by PubMed, Chinese Citation Database, CNKI, Wanfang, and Baidu Scholar. The H value of these talents was calculated according to the list method proposed by Rousseau R. The H index was compared with the traditional evaluation indexes of scientific research performance, such as the number of papers published, the total number of citations and the average number of citations. Pearson test was used to explore the correlation between H index and traditional evaluation index.Results:The H value of 67 talents ranged from 1 to 14. Pearson test showed that the H index was significantly correlated with the total number of papers, the total number of citations and the average number of citations at the level of 0.01, and their Pearson value was 0.746, 0.932, and 0.648 respectively.Conclusions:As a new scientific research performance evaluation system, the H index is recommended in the evaluation of medical personnel, but it needs further and sustained optimization in terms of database inclusion timespan, research work timespan, and authors ranking limit among others.

Objective To investigate the involvement of VEGFR-3 signaling pathway in lymphatic metastasis of thyroid cancer. Methods The expression of VEGFR-3 mRNA in thyroid carcinoma and normal thyroid tissue was detected by RT-PCR. The expression of VEGFR-3 mRNA and the lymphatic vessel density (LVD) in thyroid carcinoma and normal thyroid tissue was measured by immunohistochemical staining. Results All thyroid cancer samples expressed VEGFR-3 and the expression rate of VEGFR-3 in thyroid carcinoma was significantly higher than that in the normal thyroid group ( P ＜ 0. 05 ). LVD in thyroid cancer was significantly higher than that in normal control. LVD with lymph nodes metastasis ( N + ) was significantly higher than that without lymph node metastasis (NO) (P ＜ 0. 05). Conclusions There is upregulatin of VEGFR-3 expression in thyroid carcinoma. The higher the expression of VEGFR-3, the severer of lymph node metastasis. VEGFR-3 receptor-mediated signal transduction pathway might be an important factor of thyroid cancer lymph node metastasis.

Smoking is closely related to respiratory diseases, cardiovascular and cerebrovascular diseases, and is one of the biggest public health problems in society today. It is imperative to control smoking in a large scale. The primary task is to understand the internal mechanism of smoking, so as to guide and intervene smoking cessation. In recent years, studies have revealed changes of brain function and structure caused by nicotine. These findings greatly enriched that researches on the mechanism of tobacco addiction are the keys to the formation of tobacco addiction. The progresses of brain structure, function, network and degree centrality of long-term smokers were reviewed in this article.

Objective: To assess the value of T2WI maximum tumor level histogram in differentiating pleomorphic adenoma from malignant tumors of parotid gland. Methods: MRI of 64 patients with parotid tumors, including 41 cases of pleomorphic adenomas and 23 cases of malignant tumors confirmed by pathology were analyzed retrospectively. Mazda software was used to select ROIs in the maximum tumor level image on axial T2WI. Gray histogram analysis was carried out to obtain 9 characteristic parameters, including mean, variance, kurtosis, skewness, first percentile (perc 1%), tenth percentile (perc 10%), fiftieth percentile (perc 50%), ninetieth percentile (perc 90%) and ninety-ninth percentile (perc 99%). Statistical analysis was performed to compare the characteristic parameters of histogram between pleomorphic adenoma and malignant tumors. ROC curve was drawn to evaluate the effectiveness of the characteristic parameters of histogram in tumors differentiating. Results: Among 9 characteristic parameters of histogram, perc 1% and perc 10% had statistical differences between pleomorphic adenoma and malignant tumors (both P<0.05). Both of perc 1% and perc 10% of pleomorphic adenoma were significantly higher than those of malignant tumors. ROC curve analysis showed that perc 10% was the most effective parameter for differential diagnosis. The AUC was 0.70 (P=0.01), and the optimal critical value was 76.00. The sensitivity and specificity was 66.70% and 60.00%, respectively. Besides, the AUC, optimal critical value, sensitivity and specificity of perc 1% was 0.67 (P=0.04), 46.50, 63.90% and 60.00%, respectively. Conclusion: T2WI maximum tumor level histogram can be used as an important method to differentiate pleomorphic adenoma from malignant tumors of parotid gland before operation, which can provide valuable references for clinic.

Objective To explore the interleukin (IL)-6,IL-10 and T cell subsets levels in bronchoalveolar lavage fluid(BALF) of children with refractory mycoplasma pneumonia.Methods A total of 53 children with refractory mycoplasma pneumonia were selected as the observation group,30 children with bronchial foreign body in our hospital were chosen as controls during the same period.ABC-double antibody sandwich ELISA method was used to detect IL-6,IL-10 levels and the CD3 +,CD4 + and CD8 + T levels were measured by means of flow cytometry in BALF.Results The IL-6 and IL-10 levels in BALF of children in the observation group were (63.25 ± 18.61) ng/ml,(31.83 ± 8.33) ng/ml respectively,and they were significantly higher than those of the controls[(30.51 ± 1.34) ng/ml,(11.01 ± 2.91) ng/ml] (P ＜ 0.05,respectively).The percentage of CD3 +,CD4 +,CD8 + T cells and the ratio of CD4 +/CD8 + T cells in BALF of the observation group were (48.47 ± 2.88)％,(21.16 ± 6.29)％,(23.04 ± 4.63)％,0.94 ± 0.33,respectively,and they were significantly lower than those of the controls [(64.24 ± 3.06) ％,(34.34 ± 7.59) ％,(26.71 ±5.29)％,1.56-±0.67] (P＜0.05,respectively).Conclusion The IL-6,IL-10 levels in BALF of children with refractory mycoplasma pneumonia significantly increased,suggesting that cell-mediated immunity play an important role in the pathogenesis of refractory mycoplasma pneumonia.

Aim To investigate the effects of midazolam on porcine isolated coronary artery rings pre-contracted by potassium chloride(KCl)and the possible mechanism.Methods The vessel tension recorder system was used.Isotonic tension of porcine isolated coronary artery rings precontracted by KCl(30 mmol·L-1)was recorded.The vasorelaxing action of midazolam and effects of various drugs were observed in the rings.Results Midazolam(3×10-6～1×10-4 mol·L-1)respectively concentration-dependently reduced the contraction induced by KCl,and there was significant difference between the rings with intact and denude endothelium(P<0.05).On KCl-induced precontraction,midazolam′s relaxation was depressed by L-NAME and the blend of L-NAME and L-Arg(P<0.05),but was not affected by Indo,L-Arg and 1400W.The contraction was not prevented by pretreatment with the inhibitor of Na+/Ca2+ exchanger(KB-R7943).The inhibitor of KATP(Gli)restrained the diastolic function of midazolam(P<0.05),while the inhibitor of BKCa(TEA),Kir(BaCl2),KV(4-AP)had no obvious effect.Conclusions Midazolam produces remarkable vasodilatation on KCl pre-contracted porcine isolated coronary artery rings.Its relaxtion effect is via concentration-dependent and endothelium-dependent mechanisms and relevant to the production of NO.Na+/Ca2+ exchanger is not involved midazolam′s vasodilatation on KCl pre-contracted porcine coronary artery rings.The relaxant mechanism of midazolam may be concerned with KATP.The Kir,BKCa and KV may be not involved.

Objective To detect serum levels of thyroid hormones in patients with thyroid nodules (TN), and investi-gate their relationship with the nature of TN. Methods A total of 245 patients with TN were recruited in the study. Accord-ing to levels of thyroid antibodies and postoperative pathological results, all patients were divided into nodular goiter (NG) group, thyroid adenoma (TA) group and thyroid cancer (TC) group. TC group was further classified as the TC with increased level of thyroid antibodies (TC-AB+group) and the TC with normal level of thyroid antibodies (TC-AB-group). The serum levels of free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH) were detected for all patients before operation, and differences of thyroid hormones were analyzed between different groups. Results The serum level of TSH was signifi-cantly higher in TC group than that of NG group and TA group (P<0.05). The serum level of FT3 was significantly lower in TC-AB+group than that of NG group and TC-AB-group. The serum level of FT4 was significantly lower in TC-AB+group than that of NG group, and the serum TSH level was significantly higher than that of other groups (P<0.05). Conclusion The increased serum levels of TSH were found in some patients with TC, which may partly attribute to their coexistence with autoimmune thyroiditis and subsequent hypothyroidism. The increased serum TSH level may not be the inherent characteris-tics of TC.

Objective To investigate the clinical significance of piatelet activity in patients with chronic cor Dulmonale.Methods PAC-1 and CD62p was measured with flow cytometry in whole blood samples from 40 patients and 30 normal controls.The pulmonary arterial pressure was detected through Doppler echocardiography.The arterial partial pressure of oxygen and the carbon dioxide were also analyzed.Results PAC-1 and CD62p increased significantiy (P<0.01).Conclusion Platelet activity is positively related to pulmonary artrial systolic pressure,CO2 partial pressure,and negatively related to O2 partial pressure.

Objective To explore the responses of antigen-specific T cells stimulated by hepatitis B virus(HBV)-specific proteins in chronic hepatitis B patients accepting antiviral therapy. Methods Seventeen patients with chronic hepatitis B (CHB) accepting antiviral therapy were included in this study. The peripheral blood monocular cell ( PBMC) were separated from the whole blood collected at the three different time of before and one and three months after accepting antiviral therapy. ELISPOT assay was used to detect the frequency and strength of secreting IFN-γ cells of PBMC stimulated by HBsAg, HBcAg and HBeAg. HBV virus loading, HBsAg, HBeAg, ALT and AST in serum were detected at the same time. Results After three months therapy, ALT, TBiL were improved in all patients, and HBV DNA level were dropped and undetectable in 11 cases. The rates of T cell response in patients to HBV specific proteins were 64. 7% , 76. 5% and 82. 4% at the time of before and one and three months after accepting antiviral therapy, respectively. The frequency of responses of antigen-specific T cells stimulated by HBcAg was higher than that stimulated by HBsAg or HBeAg, and the frequency was enhanced after antiviral therapy. The average response magnitude was expressed as spot forming cells (SFC) per million input cells. SFC of T cell responses to HBcAg was also higher than to HBsAg or HBeAg. There was no significant difference in SFC of T cell responses to HBsAg or HBeAg at the time of before and after antiviral therapy, but there were significant difference in SFC of T cell responses to HBcAg at the time of before and after antiviral therapy. SFC of T cell responses to HBcAg was negatively associated with HBV DNA, and no associated with level of ALT in serum. Conclusion The responses of antigen-specific T cells were improved in CHB patients accepting antiviral therapy which associated with the decrease of HBV DNA. It suggested to investigate HBV specific T cell responses was important.

BACKGROUND: Spinocerebel ar ataxia is a common neurodegenerative disease characterized by slowly progressive movement incoordination of the limbs. It responds badly to common medication. OBJECTIVE: To observe the clinical effect of autologous bone marrow mesenchymal stem cells and al ogeneic umbilical cord mesenchymal stem cells tranfusion in the treatment of spinocerebel ar ataxia. METHODS: A total of 27 spinocerebel ar ataxia patients treated with mesenchymal stem cells treatment were included for comprehensive statistical analysis. Among these patients, six patients received autologous bone marrow mesenchymal stem cells lumbar puncture treatment and 21 patients received al ogeneic umbilical cord mesenchymal stem cells lumbar puncture treatment combined with intravenous infusion. The neurologic function of the patients in the two groups was evaluated with International Cooperative Ataxia Rating Scale before and after treatment. RESULTS AND CONCLUSION: There was no obvious adverse effect in the 27 spinocerebel ar ataxia patients during, before or after mesenchymal stem cells treatment. The effect of autologous bone marrow mesenchymal stem cells in six patents was not significant; for the other 21 patients treated with al ogeneic umbilical cord mesenchymal stem cells transfusion, the subjective symptoms of the patients were improved, and the International Cooperative Ataxia Rating Scale scores were decreased significantly at 3 months after treatment when compared with those before treatment (P < 0.05). The results suggest that umbilical cord mesenchymal stem cells treatment is safe and able to ameliorate the clinical symptoms and improve life quality of spinocerebel ar ataxia patients to some extent.