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.

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 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.

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 investigate the clinical significance of a new method,axis-line-distance technique(ALDT),in scoliosis measurement.Methods Thirty cases with idiopathic scoliosis were measured on two separate occasions by six observers with the Cobb technique and the ALDT on PACS workstation.The interval time between two measurement occasions were three weeks.The data were analyzed statistically with the paired-sample t-test.Results(1)Concerning intraobserver variance in two measurement occasions,the minimum variance,the maximum variance and the average variance were 0, 24.00?,5.71??1.54?for Cobb technique and 0,12.00 mm,(1.95?0.58)mm for ALDT.There were significant measurement differences for four observers with Cobb method 39.00??10.69?versus 36.50?? 10.63?,31.73??10.96?versus 37.30??9.65?,32.03??7.49?versus 27.86??9.00?,29.77??8.87? versus 34.20??7.26?,all P0.05].(2)Concerning interobserver variances in six observers,the average measurement variance was 5.07??0.35?for Cobb method,and(2.32?0.26)mm for ALDT. There were significant measurement differences for every observer using with Cobb method(36.63??10.30? versus 33.27??10.10?,39.00?10.69?versus 31.73??10.96?,32.03??7.49~ versus 29.78?? 8.87?,36.63??10.30?versus 39.00??10.69?versus 32.03??7.48?,39.00??10.69?versus 32.03?? 7.49?,all P

Objective To evaluate the effect of clopidogrel premedication on in-hospital major adverse cardiovascular and cerebral events (MACCE) and bleeding outcomes before coronary artery bypass graft surgery (CABG). Method A total of 2021 patients who underwent CABG from July 2003 to September 2005 were divided into either clopidogrel ( n = 479) or no clopidogrel (1542) group before CABG. Patients with clopidogrel administration ( n = 479) were subdivided into < 5 d ( n = 154) ,5～7d(n = 183)and >7d(n = 142) group according to timing of clopidogrel withdrawal before surgery. In-hospital MACCE and perioperative bleeding outcomes were analyzed among groups. Results Patients who took clopidogrel before surgery had nonsignificantly rates of bleeding and in-hospital MACCE compared with those patients not administered clopidogrel. No differences were found about the incidence of total bleeding,minor bleeding,transfusions of red blood cells,fresh frozen plasma,whole blood and in-hosptial MACCE among three subgroups.The < 5 d group had higher incidence of major bleeding and more platelets transfusions than 5 ～ 7 d [47.8% vs. 31.9%,P < 0.017; (0.08 ±0.38) U vs. (0.00±0.00) U,P <0.017,respectively]and >7 d group [47.8% vs. 20.3%,P <0.017; (0.08±0.38) U vs. (0.00±0.00) U,P <0.017,respectively). However,there were no significant differences between 5 ～ 7 d and > 7 d group ( P > 0.05). Conclusions Gopidogrel administration before CABG does not increase the incidence of in-hospital MACCE events. However,the perioperative risk of bleeding will rise if the patients withhold clopidogrel less than five days before surgery.