Objective To evaluate the diagnostic value of gray-scale ultrasonography (GSU) combined with contrast-enhanced ultrasonography (CEUS) and real-time elastography imaging (EI) in solid thyroid nodules.Methods A total of 124 solid nodules were collected from Xuanwu Hospital of Capital Medical University from September 2011 to November 2014, including 49 benign nodules and 75 malignant nodules conifrmed by surgical pathology. The data of multimodal imaging were retrospectively analyzed and compared with the pathological results. The parameters among the groups were compared byχ2 test. Four diagnostic models including the statistically signiifcant independent variables were established accord to different combinations of routine ultrasound examination. The binary Logistic regression equation using the pathological results as the dependent variable Y and the ultrasound features of thyroid nodules as independent variableX was established for calculating the area under the receiver operator curve (ROC) and multiple regression analysis furthermore.Results There were statistically significant differences in aspect ratio, margin condition, echo type, CEUS features, elastic imaging score and elastic strain rate of benign and malignant thyroid nodules(χ2=13.966, 7.106, 24.215, 17.250 and 27.158,P<0.05).The four Logistic regression models were statistically signiifcant (χ2=5.37, 5.37, 8.155, 8.155, allP<0.05). By using modelⅠ,Ⅱ,Ⅲ andⅣ, the diagnostic sensitivity, speciifcity and accuracy of malignant nodules were (73.8%, 75.9%, 79.7%, 83.3%), (67.5%, 70.7%, 85.2%, 86.7%), and (71.8%, 74.2% 81.8%, 84.4%) respectively. The area under the ROC of logistic equation predicted values were (0.778, 0.809, 0.875 and 0.898, allP<0.01). Multivariate categorical analysis showed that aspect ratio, margin condition and the elastic strain rate ratio (χ2=13.73, 7.541 and 11.461, allP<0.05) of thyroid nodules were effective diagnostic indicators. Conclusions Our study indicated that CEUS and EI could be helpful modality for GSU to improve the diagnostic accuracy of thyroid nodules. The combined application of multi mode ultrasound examination has a high diagnostic value.

Objective To assess the diagnostic value of contrast enhanced ultrasound (CEUS),elastography and their combined use in diagnosing thyroid nodules of thyroid imaging reporting and data system (TI-RADS) 4. Methods From November 2011 to August 2016, 159 TI-RADS 4 nodules diagnosed by conventional ultrasound were prospectively enrolled and examined by CEUS and elastography before surgery. Multivariate logistic regression models were established for CEUS and CEUS combined with elastography to diagnose thyroid malignancy. The diagnostic performances of CEUS, elastography and their combined use were evaluated with the receiver operating characteristic (ROC) curve. The sensitivity,specificity, accuracy, positive predictive value, negative predictive value and omission diagnostic rate of CEUS, elastography and their combined use were compared by Chi-square test. Results The CEUS features significantly predicting malignancy were heterogeneous enhancement, hypoenhancement, without or incomplete ring-enhancement and later time to peak than the surrounding parenchyma (χ2=24.378, 69.194,29.434 and 7.375, all P < 0.01). Furthermore, the multivariate logistic regression for CEUS combined with elastography showed that heterogeneous enhancement, ring enhancement and elasticity score were the independent predictors of thyroid malignancy. The area under the ROC curve of CEUS combined with elastography was (0.921±0.023) which was higher than that of CEUS and elatography (0.88±0.029 and 0.80±0.038, respectively; both P < 0.05). Moreover, the sensitivity, accuracy and negative predictive value of CEUS combined with elastography were 92.1%, 86.2% and 84.6%, respectively. The omission diagnostic rate of CEUS combined with elastography (7.9%) was reduced. And the diagnostic accuracy of CEUS combined with elastography was significantly higher than that of CEUS and elastography (P < 0.05). While the diagnostic accuracy of CEUS was close to the elastography, the difference was not statistically significant (P > 0.05). Conclusion The diagnostic value of CEUS combined with elastography was remarkably significant in the differential diagnosis of TI-RADS 4 nodules.

To evaluate the effect of Hexue mingmu tablets on traumatic hyphema caused by blunt ocular trauma.
●METHODS: Totally 150 patients of traumatic hyphema were divided into seven types by using ultrasound biomicroscopy combining with anterior segment abnormalities, each type was randomly classified as trial group and control group. The trial group was administered Hexue mingmu tablets, control group was treated by hemocoagulase.
●RESULTS: The absorbing time of trial group was shorter than that of the control group. And there was statistical significance between the two groups (P<0. 05).
● CONCLUSlON: Hexue mingmu tablets is an effective medicine to treat traumatic hyphema. Ultrasound biomicroscopy can be used as a routine examination method in traumatic hyphema.

Objective To develop an early-warning indicator system of brucellosis outbreak. Methods The methods of literature review and expert discussion were used to formulate the initiatory framework and indicators, and then Delphi method was used to filter indicators, discuss the boundary of indicators and determine the weighting coefficient. Results The average length of service provided by experts who engaged in prevention and control of brucellosis was (25.10 ± 8.80) years and the positive coefficient of the consultant experts of the two-round results were 95% and 68%, respectively. Kendall coefficients were 0.35, 0.54 and X2R value were 81.31 and 285.27, respectively and P value was all less than 0.01. Five first-level indicators(the host animal, high-risk groups,social environment, index case and the level of previous disease) and 13 secondary indicators were selected to develop the early-warning indicator system of brucellosis outbreak. The weight coefficients of the five first-level indicators were 0.21, 0.22, 0.17, 0.21 and 0.19, respectively. Conclusions The early-waming indicator system of brucellosis outbreak is initially established. We propose to develop the early-warning programs according to local conditions and the indicator system.

In order to clarify the chemical constituents in Qiliqiangxin capsule, a rapid ultra-performance liquid chromatography/orthogonal acceleration time-of-flight mass spectrometry (UPLC-Q-TOF/MS(E)) method was established. Forty peaks were identified on line using this method. The herbal sources of these peaks were assigned. The results implied that triterpenoid saponins, flavonoid glycosides, C21-steroids and phenolic acids were included in the main components of Qiliqiangxin capsule. The method is simple and rapid for elucidation of the constituents of Qiliqiangxin capsule and the results are useful for the quality control of Qiliqiangxin capsule.

Objective To systemically evaluate the effects of combined Chinese and western medicine in improving endometrial receptivity. Methods A search for relevant articles ran on the CNKI, WanFang, VIP, PubMed, EMBASE and Cochrane library. The randomized controlled trails of combined Chinese and western medicine therapy versus western medicine alone for improving endometrial receptivity were retieved The Revman 5.3 software was used for Meta-analysis according to Cochrane system evaluation method. Results A total of 7 randomized controlled trails involving 499 patients were included. There was statistically significant difference in the growth of clinical pregnancy rate [RR=1.78, 95％ CI (1.41, 2.26)], the increase of patients with endometrial thickness [MD=1.42, 95％ CI(1.27, 1.58)], the raise of the proportion with type A endometrium [RR=1.25, 95％ CI (1.07, 1.45)], the reduction of the patients with endometrial PI [SMD=-1.41, 95％ CI (-2.18,-0.64)]. There was no statistically significant difference in the reduction of endometrial RI [SMD=-1.11, 95％ CI (-2.52,0.30)]. Conclusions The therapy integrated Chinese and western medicine for endometrial receptivity is better than simple western medicine. But there is less literature on the high quality, suggesting that the methodology of clinical research should be further improved in the future.

Glucocorticoids/urine* ; Humans ; Hydrocortisone ; Marathon Running ; Saliva/chemistry* ; alpha-Amylases/analysis*

ObjectiveThe mechanism that affects the infiltration of immune cells in pancreatic cancer has not yet been clarified. This study aims to investigate the lncRNA mRNA regulatory pathways that affect immune infiltration in pancreatic cancer.MethodsTCGA and GEO gene expression data were used to screen common differential lncRNAs. We perform survival analysis, target gene prediction, GO, KEGG enrichment analysis, immune infiltration analysis, gene set enrichment analysis (GSEA) on the selected differential lncRNAs to identify the relevant pathways of immune infiltration.ResultsThe pancreatic cancer patients with high expression of ADAMTS9 AS1 have a higher survival rate when compared to patients with low expression (P=0.010). The combined analysis of TCGA and GSE86436 revealed the difference and survival-related ADAMTS9 AS1. The functional prediction of ADAMTS9 AS1 was related to immunity. Using the TIMER database, the lncRNA affected the infiltration of immune cells in pancreatic cancer tissues. The clinical analysis was demonstrated that the ADAMTS9 AS1 was related to pathological grade. The target gene SEMA3G was screened by co-expression analysis using the IMMPORT database and TIMER database. Lastly, GSEA analysis of ADAMTS9-AS1 showed that the lncRNA was also related to tumor metabolism.ConclusionThese results indicate that ADAMTS9-AS1-SEMA3G is associated with the prognosis and immune invasion level of pancreatic cancer, which can provide a theoretical basis for subsequent genetic verification experiments and immune research.

Objective To explore the influence of lack of parental accompaniment, physical abuse and neglect in childhood on the psychological distress of college entrant students. Methods In a comprehensive university in Sichuan Province, 8367 freshmen were surveyed using the 6-item Kessler psychological distress (K6) scale and a questionnaire for lack of parental accompany, physical abuse and neglect in childhood. The students were divided into rural group and urban group for data analysis. Results The months of lack of maternal and/or paternal accompaniment were more in rural group than that in urban group (P<0.05). In rural group, female (standardizedβ’=0.139, P<0.001), neglect (standardizedβ’=0.237, P<0.001) and physical abuse (standardized β’=0.076, P<0.001) were associated with K6 scale. In urban group, female (standardizedβ’=0.091, P<0.001), lack of paternal accompaniment (standardizedβ’=0.050, P<0.001), ne? glect (standardized β’=0.169, P<0.001) and physical abuse (standardized β’=0.095, P<0.001) related with K6 scale. Conclusions Neglect and physical abuse are independent risk factors to freshmen both from rural and urban areas. Lack of paternal accompaniment in childhood is a risk factor only in urban freshmen. Further research should select more rep?resentative samples and also include more factors which may interact with the loss of parental accompaniment such as pa?rental divorce and conditions regarding so calledleft-behindchildren in rural area.

Objective To assess the effect of anemia on long-term outcomes in patients with acute coronary syndrome(ACS) undergoing pereutaneous coronary intervention(PCI). Methods In 3136 patients presenting with ACS,636 patients were anemic. The clinical features, mortality and major cardiocerebral events including non-fatal acute myocardial infaret,revascularization and non-fatal cerebral stroke were compared in patients with or without anemia. The average follow-up period was 550 days. Results Anemic patients were older and had a higher percentage of comorbidities compared with nonanemic cohorts. Compared with nonanemic patients, anemic patients had higher mortality (4.7% versus 1.5% ,P <0. 001) and a higher major adverse end point events,including nonfatalmyocardial infarction, stroke and revaseularization (14.2% versus 11.0%, P = 0.032). After adjustment for comorbidities, anemia was associated with a higher risk of mortality after percutaneous coronary intervention (adjusted hazard rate ratioRR2. 166 ;95% CI 1. 298-3. 612 ;P =0.003). Conclusion Anemia before PCI is an independent factor for predicting the long-term mortality of ACS.