Most epidemiological investigations and basic studies have demonstrated that estrogen has neuroprotective effects,and the application of estrogen in cerebrovascular disease has a positive attitude.However,large clinical trials of the application of estrogen have indicated that harms outweigh benefits,and even have the risks of stroke.This article reviews the related studies about the neuroprotective effects of estrogen from the positive and negative aspects.

Objective To discuss the noticeable problems in the radiological diagnosis of thoracic sarcoidosis through retrospective analysis of misdiagnosis. Methods Imaging examinations of 32 misdiagnosed cases with thoracic sarcoidosis including chest radiography, CT, and their clinical data were reviewed. The final diagnosis was made by pathology (9 cases) and clinical therapy (23 cases). Results Enlarged thoracic lymph nodes were detected in all cases. 23 of them presented mediastinal lymph node enlargement associated with bilateral hilar lymph node enlargement, 5 of them had mediastinal lymph node enlargement and unilateral hilar lymph node enlargement, and 4 of them had mediastinal lymph node enlargement without hilar lymph node enlargement. In these cases, 24 had pulmonary abnormalities. 19 of them showed multiple pulmonary nodes, 4 of them had patchy pulmonary shadows, and another 1 had pulmonary fibrosis. Pleural lesions included 2 hydrothorax and 1 multiple pleural nodes, and all of pleural lesions were associated with multiple pulmonary nodes. Conclusion When the radiological findings of thoracic sarcoidosis are atypical, the diagnosis is difficult and must combine with the clinical findings, or the outcome of the treatment.

OBJECTIVE:To investigate the utilization of antineoplastic drugs and adjuvant drugs in our hospital. METHODS: By a retrospective review, the consumption quantity, consumption sum, and constituent ratio of antineoplastic drugs and adjuvant drugs used in our hospital from 2005 to 2008 were analyzed statistically. RESULTS: The consumption of antineoplastic drugs and assistant drugs had dominated the front places from 2005 to 2008, representing 25.91%, 28.16%, 31.16% and 33.00%, respectively of the total western drugs in terms of consumption sum, assuming a year-on-year increase tendency over the 4 years. Injections took a higher proportion, making up for 75.40%, 79.80%, 80.50% and 78.12%, respectively over the 4 years. The application of antineoplastic drugs and assistant drugs from domestic manufacturers assumed a predominant place. CONCLUSION: It is still necessary to standardize the use of antineoplastic drugs and assistant drugs in our hospital so as to ensure their safety, effectiveness and economy in clinical medication.

OBJECTIVEThis study aimed to evaluate the success and survival rate of endodontically treated premolars restored by ceramic onlays by comparing restored by quartz fiber posts and metal ceramic crowns.

METHODSNinety-four patients with 126 endodontically treated premolars were enrolled in this study and divided into 4 groups according to the remaining axial walls and restorative methods. The observation time was 36 months. The success and survival rates of the restorations, as well as causes of failures, were analyzed.

RESULTSAt the final follow-up, the success and survival rates of the mild defect endodontically treated premolars were restored by quartz fiber posts and the crowns were at 96.3% and 98.1%; the success and survival rates of the severe defect premolars restored by quartz fiber posts and crowns were at 88.5% and 96.2%. The success and survival rates of the mild defect premolars restored by cast ceramic onlays were both at 96.6%, the success and survival rates of the severe defect premolars restored by cast ceramic onlays were at 94.1% and 100%, respectively. The success and survival rates of the different groups were no significant difference (P>0.05).

CONCLUSIONBased on the results and within the limits of this study, cast ceramic onlays is a very reliable method to restore endodontically treated premolars.

Objectives:To introduce a new calibration protocol for clinical reference dosimetry of high energy electron beams published by Radiation Therapy Task Group 51, American Association of Physicists in Medicine. Methods:According to the new protocol, measuring the absorbed dose of 5, 6, 7, 9, 10 and 12 MeV Electrons produced by the Siemens M6740 accelerator of our hospital with the help of the Capintec-192 electrometer and PR 06C chamber. Results:For 7-12 MeV, the discrepancies vary from -0.1% to 0.7% between TG 51 and TG 21, and from -0.3% to 0.4% between TG 51 and JJG1026 91. For 5 and 6 MeV, there are 1.7% and 1.5% discrepancies between TG 51 and TG 21, and -1.6% and 1.7% between TG 51 and JJG1026 91. Conclusions:The new protocol is more accurate and convenient because of its precise rationale and concise formulae.

Objective To study the infection condition of AmpC ? lactamases producing strains for reasonable use of antibiotics in clinic. Methods Adopting modified three dimensional extract test was adopted to detect enterobacteriaceae strains, and 12 antibiotics were determined by the antimicrobial disk diffusion susceptibility tests in specimen collected from 233 senile infectious patients. Results The total isolating rate of AmpC ? lactamases producing enterobacteriaceae strains in senile patients was 8 6%. The incidence of AmpC ? lactamases producing strains was found most often in E.cloacae. The AmpC ? lactamases producing strains were susceptive to imipenem and there the resistance rates to imipenem were 100 0%. The resistance rates to cefepime were 85%～100% to the third generation cephalosporins and aztreonam Conclusions The drug resistance of AmpC ? lactamases producing enterobacteriaceae is very serious. It is important to surveillance and control drug resistance of AmpC producing strains.

ObjectiveTo observe the effects of chemotherapy on mitochondria ultrarnicrostructure and stereological characteristic of mucinous cystadenocarcinoma (MC) and serous cystadenocarcinoma (SC) and to investigate clinical significance and possible mechanism of chemotherapy on two cystadenocarcinoma.MethodsThe ultramicrostructure changes of mitochondrion were observed with electronic microscope and the stereological changes and its interrelation of volume density (Vv), surface density (Sv) and ratio of surface density(Rsv,μm-1)of mitochondria of the cells in ovarian carcinoma were studied and compared with the normal control. ResultsElectron microscope reveals that the mitochondria swelling and cristae disorganizing were seen in ovarian carcinoma.The Vv(0.072±0.059)and Sv(0.057±0.040)of MC mitochondria were decreased markedly(P =0.004 and P =0.029, respectively), while its Rsv (0.891 ±0.400) μm-1 increased obviously (P =0.015); but the Vv and Sv of mitochondria of the SC cells were increased markedly (0.267±0.12,P =0.001 and 0.122±0.057,P =0.003,respectively).After chemotherapy,cancer cells mitochondrion Sv elevated significantly (0.060±0.037, P = 0.053), showing a similar MC mitochondria of variability. Conclusion Therearedifferentcharacteristicsintheultramicrostructureandstereologicalcharacteristicinthe mitochondria of two types ovarian carcinoma. Effects of chemotherapy may be associated with the ameliorate of construction and function of ovary cells.

Objective To explore the value of salivary glands ultrasonography in diagnosis of Sj(o)gren's syndrome (SS).Methods Ninety-two patients with symptoms of xerophthalmia or xerostomia were enrolled,and 42 of them were divided to the SS group and the others to non-SS group.The bilateral parotid and submandibular gland of all patients were examined with ultrasonography,then the ultrasonographic features of bilateral salivary glands were obtained.The imaging features of salivary glands were evaluated by a semi-quantitative scoring system.The differences of ultrasonography scores between SS group and non-SS group were compared.The value of semi-quantitative scoring system in diagnosis of SS was analyzed.Results Salivary gland ultrasonic manifestations of 38 patients (38/50,76.00％) in non-SS group were normal,whose ultrasonographic scores were 0.Whereas the ultrasound of 32 patients (32/42,76.19％) were abnormalities in SS group,whose ultrasonographic scores were ≥1.Ultrasonographic scores in SS group were higher than that of non-SS group (P＜0.001).The area under the ROC curve of ultrasound score in diagnosis of SS was 0.805 (P＜0.001,95％ confidence interval was [0.711,0.899]).When the cutoff value of the scores was 2,the sensitivity and specificity were 59.5 ％,and 92.0％.Conclusion The ultrasonographic scoring of salivary glands can provide a semi-quantitative index for inhomogeneity of the salivary glands,which has significant value in the diagnosis of SS.

Purpose To evaluate the value of acoustic radiation force impulse (ARFI) imaging in the diagnosis of SjOgren's syndrome (SS).Materials and Methods Sixty-four cases of outpatients or inpatients with xerophthalmia or xerostomia in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Nanchang University from September 2015 to April 2016 were collected.According to American-European Consensus Group criteria of 2002,the subjects were divided into SS group (n=38) and nonSS group (n=26).The bilateral parotid gland and submandibular gland were examined by ARFI imaging,and the shear wave velocity (SWV) value was obtained.The differences in SWV values between the left and right sides of the parotid gland or submandi-bular gland and between the SS group and the non-SS group were analyzed.Results ① The SWV values between two sides of parotid glands or submandibular gland in SS group or non-SS group showed no significant differences (P＞0.05).The difference of SWV between the two groups was statistically significant (P＜0.05).② According to the ARFI imaging of parotid gland,the optimal cutoffvalue,sensitivity,specificity,Youden index and ROC area under the curve were 1.99 m/s,86.3％,80.8％,0.671 and 0.879,respectively.③ According to the ARFI imaging of submandibular glands,the optimal cutoff value,sensitivity,specificity,Youden index and ROC area under the curve were 2.13 m/s,79.5％,80.8％,0.603 and 0.878,respectively.Conclusion The ARFI imaging can provide the SWV value of salivary glands to quantify the elasticity of salivary glands in SS,which has great value in the diagnosis of SS.

10.3969/j.issn.2095-4344.2013.25.013