Objective To evaluate the value of 2D ultrasound and elastic strain ratio (SR) in diagnosis of thyroid nodule by fine needle aspiration (FNA).Methods 196 thyroid nodules were analyzed retrospectively with 2D ultrasound,elastography and FNA results,pathology results as the golden standard.A receiver operating characteristic (ROC) curve was used to identify the best cut-off point of SR.The Logistic regression analysis was used to evaluate the variables effectiveness on age,nodule echo,calcification and SR.Tried to discuss how to use SR before or after US-FNA in diagnosis of thyroid nodule.Results The SR of the malignant nodules group was significantly different from the benign nodules group,and the best cut-off point was 0.5 with sensitivity 91.7％,specificity 90.2 ％ and accuracy 90.8 ％.The Logistic analysis results were SR,age,echo,calcification according to the odds ratio.SR can screened nodules without puncture necessary before FNA,and increase the FNA sensitivity,specificity and accuracy after FNA.Conclusions SR has good application value in diagnosis thyroid malignant tumor.SR can reduce unnecessary FNA and make a supplementary diagnosis of FNA.

Objective To evaluate the efficacy and safety of recombinant adenovirus-p53 (rhAd-p53) combined with neoadjuvant chemotherapy in treatment of locally advanced cervical cancer.Methods Forty patients with stage Ⅰ R2-Ⅲ A locally advanced cervical cancer were randomly divided into 2 groups,gene therapy + neoadjuvant chemotherapy group (rhAd-p53+PVB group,n =20.They received one course of chemotherapy consisting of PVB.rhAd-p53 solution 1 ×1012 VP was injected intratumorally every three days for three circles since the 3rd day of PVB chemotherapy) and chemotherapy group (PVB group,n=20,the above course of chemotherapy was conducted).The volums of tumors was observed.Patients were monitored for adverse event.The expression of VEGF,p53 pertein and MVD in tumor tissue was detected by immunohistochemistry.Results The evaluation was performed three weeks after the completion of chemotherapy.The PVB group response rate (CR+PR) was 75 ％,while the effective rate was 95 ％ of the PVB combined with gene group.After using of the PVB chemotherapy,the tumor was shrunk by (11.42±2.78) cm2.However,the volums of tumor were significantly shrunk by (15.25±4.00) cm2 using the PVB combined with gene therapy,and P ＜ 0.05.The positive expression rate of VEGF,p53 protein and MVD were reduced respectively in PVB group and rhAd-p53 + PVB group with statistic significance.There were no additional adverse events by recombinant adenovirus-p53 combined with neoadjuvant chemotherapy.Conclusion A potentially gene therapeutic agent for cervical cancer treatment,intratumoral injection of rhAd-p53 is effective.

Objective To evaluate the value of elastic strain ratio (SR) in ultrasound guided fine needle aspiration (US-FNA) of thyroid nodule.Methods A total of 222 thyroid nodules from 216 patients were reviewed and analyzed by Logistic regression of clinical data,2D ultrasound,and SR.The odds ratios of variables in the equation were compared to assess various variables,especially of SR in the diagnosis.The sensitivity,specificity,and accuracy of the SR method,US-FNA method,and combined method were calculated.Results Three statistically significant features finally entered the Logistic regression model,followed by SR,echo,and age according to the odds ratio.The sensitivity,specificity,and accuracy of the SR method,US-FNA method and combined method were 85.4％,82.1％,83.3％ ; 91.5％,82.1％,85.6％ ; 97.6％,94.3％,95.5％ respectively.Conclusions SR＜0.5 is the most important risk factor in differential diagnosis of thyroid malignant nodules from benign nodules.SR raises the sensitivity,specificity,and accuracy of US-FNA method and plays an important role in diagnosing thyroid nodules via US-FNA.

To study the name of Wenyujin Rhizoma Concisum and Film Turmeric by literature research methods provide the basis for correct application of Cuba in modern clinical application. Wenyujin Rhizoma Concisum and Film Turmeric often called each other mutual generation and used as the same kind of medicine in the ancient prescriptions books. They were often recorded and stated as the same species of Curcumae Longae Rhizoma. Wenyujin Rhizoma Concisum and Curcumae Longae Rhizoma also often called each other mutual generation in the ancient prescriptions books and used as the same kind of medicine. Wenyujin Rhizoma Concisum was often recorded and stated under the Curcumae Longae Rhizoma articles in the ancient materia medica literatures. Ancient literatures on Wenyujin Rhizoma Concisum records were almost the same, the modern literatures on the records of the sources of Wenyujin Rhizoma Concisum were inconsistency. Inconsistency of Wenyujin Rhizoma Concisum source records in modern literatures was related to the changes of the modern records on source records about Curcumae Longae Rhizoma, Root-tuber of Aromatic Curcumae Longae Rhizoma and Zedoray. The author thinks that Wenyujin Rhizoma Concisum is the ancient Film Turmeric which referes to the same medicine as Curcumae Longae Rhizoma. The source of it just as the Curcumae Longae Rhizoma is not only one kind. Wenyujin Rhizoma Concisum and Curcumae Longae Rhizoma have been recorded as two medicines at the present, and the source of them simply referes to the original plant Curcuma wenyujin. When using ancient prescriptions, we need to understand the changes that Curcumae Longae Rhizoma and Wenyujin Rhizoma Concisum are the same in ancient but different today in order to choose medicine correctly in the clinical.
Curcuma ; Medicine, Chinese Traditional ; Rhizome ; Terminology as Topic

Along with the development of society and the rapid economic growth in the past decades,hypertension and other chronic diseases have become important reasons for people's poverty caused by illness in China.This study collected a total of 5857 people from 2010 to 2013 randomly from the database of the Medical Insurance Department (MID),including 3229 people in Hubei province and 2628 people in Guangdong province.One-way ANOVA was used to compare the total medical expense,out-of-pocket (OOP)expense and hospital stay between variables.A multiple linear regression analysis was done to identify possible risk factors of total medical expense.The results showed that the average total medical expense per capita was 5709.89 yuan,and the medical expense per capita was 7053.58 and 4555.97 yuan in Guangdong province and Hubei province,respectively.The medical expense of hypertensive inpatients decreased from 7222.32 yuan in 2012 to 4894.66 yuanin 2013.There were no significant differences in medical expenses between different genders of hypertensive patients (P＞0.05).People of different ages,provinces,medical insurances and medical institution levels showed significant differences in medical expenses.The government should increase the investment in chronic disease management and treatment in the central and western regions to narrow the gap with the eastern region.Medical insurance fund payment should be improved to ensure the fairness of the use of medical services in different medical insurances.And measures should be taken to encourage chronic patients to visit primary medical institutions to effectively reduce medical expenses.

Coix ; Epimedium ; Fatigue ; Humans ; Hypoxia ; Plant Leaves

OBJECTIVETo study the pathogen distribution and risk factors of nosocomial infections in neonates in the neonatal intensive care units (NICU).

METHODSThe clinical data of 145 neonates with nosocomial infection in the NICU were retrospectively reviewed.

RESULTSOf the 145 neonates, 41 (28.3%) were infected with Klebsiella pneumoniae, 39 (26.9%) with Escherichia coli, 10 (6.9%) with Staphylococcus epidermidis, and 55 (37.9%) with other pathogens. Logistic regression analysis showed that a gestational age of ≤32 weeks (OR=5.57), birth weigh of <1500 g (OR=6.95), hospitalization time (OR=1.23), mechanical ventilation (OR=14.12) and parenteral nutrition (OR=3.01) were major risk factors for nosocomial infections caused by Klebsiella pneumoniae. The five factors were also main risk factors for nosocomial infection caused by Escherichia coli, with the OR of 3.42, 6.73, 9.96, 0.55 and 2.13 respectively. Klebsiella pneumoniae and Escherichia coli were highly resistant to β-lactam antibiotics but were relatively sensitive to levofloxacin and meropenem.

CONCLUSIONSKlebsiella pneumoniae, Escherichia coli and Staphylococcus epidermidis are major pathogens of nosocomial infections in neonates in the NICU and they are resistant to β-lactam antibiotics. Mechanical ventilation and hospitalization time are the most important risk factors for nosocomial infections caused by Klebsiella pneumoniae and Escherichia coli respectively.

Bacteria ; isolation & purification ; Cross Infection ; drug therapy ; etiology ; microbiology ; Drug Resistance, Bacterial ; Escherichia coli ; isolation & purification ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Klebsiella pneumoniae ; isolation & purification ; Logistic Models ; Male ; Risk Factors ; Staphylococcus epidermidis ; isolation & purification

OBJECTIVETo investigate the protective effect and action mechanism of petroleum ether extracts from Saussurea involucrate on brain tissues of hypoxia rats under constant pressure and closed conditions.

METHODThe PESI dosage-dependent experiment for hypoxia rats was conducted under constant pressure and closed conditions by intraperitoneally injecting 125, 250, 500 mg x kg(-1) to finalize that the optimum dosage is the high dose of PESI. Afterwards, 90 Wistar rats were randomly divided into the hypoxic model group, the acetazolamide 250 mg x kg(-1) group and the PESI high dose group. Each group was further divided into three subgroups according to different hypoxia times, with 10 rats in each subgroup. Under the same hypoxia and administration conditions, the rats were sacrificed after 0, 3, 6 h respectively. Their brain samples were collected for common pathological observation and immunohistochemical staining of HIF-1alpha. Real-time RT-PCR was used to detect HIF-1alpha, EPO, HO-1 and Caspase-3 gene expressions. And the Western blot assay was adopted to detect HIF-1alpha protein expression.

RESULTThe brain tissues of the hypoxia model group were severely damaged with the increase in the hypoxia time. The acetazolamide group and the PESI high does group were damaged in a much lower degree. According to the gene expression and the Western blot assay, high dose of PESI could inhibit HIF-1alpha expression. According to the pure gene expression test, high dose of PESI could increase EPO and HO-1 mRNA expressions, but inhibit Caspase-3 mRNA expression.

CONCLUSIONPESI's protective mechanism for brain tissues of hypoxia rats under constant pressure and closed conditions may be related to its effects in inhibiting HIF-1alpha expression, increasing EPO expression and resisting cell apoptosis.

Alkanes ; chemistry ; Animals ; Brain ; cytology ; drug effects ; metabolism ; Caspase 3 ; genetics ; Cell Hypoxia ; drug effects ; Cytoprotection ; drug effects ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; Erythropoietin ; genetics ; Gene Expression Regulation, Enzymologic ; drug effects ; Heme Oxygenase-1 ; genetics ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Male ; Rats ; Rats, Wistar ; Saussurea ; chemistry

OBJECTIVETo study and compare the anti-inflammatory effect and molecular mechanism of artemisinin and dihydroartemisinin.

METHODMouse mononuclear macrophage RAW264.7 cells were stimulated to release inflammatory mediators such as TNF-alpha, IL-6 and NO, in order to assess the drugs' inhibitory effect on macrophage's release of above inflammatory mediators. The levels of TNF-alpha and IL-6 were determined by ELISA and the cytotoxicity was determined by MTT method. The protein expression of iNOS, COX-2 and beta-actin were tested by Western blot. The enzymatic activity of COX-2 was determined by colorimetric method.

RESULTDihydroartemisinin significantly inhibited LPS-induced release of TNF-alpha, IL-6 and NO from RAW264.7 in mice with the concentration range of 12.5 - 100 micromol x L(-1), and showed good dose dependence. Artemisinin only inhibited the IL-6 release to a certain extent.

CONCLUSIONDihydroartemisinin inhibits macrophages from releasing inflammatory factors TNF-alpha and IL-6 and inflammatory mediators NO by down-regulating iNOS protein. Artemisinin may help dihydroartemisinin to show its anti-inflammatory effect through metabolism.

Animals ; Anti-Inflammatory Agents ; pharmacology ; Artemisinins ; pharmacology ; Cell Line ; Gene Expression ; drug effects ; Inflammation Mediators ; immunology ; Interleukin-6 ; genetics ; immunology ; Macrophages ; drug effects ; immunology ; Mice ; Nitric Oxide ; immunology ; Tumor Necrosis Factor-alpha ; genetics ; immunology

OBJECTIVE: We aimed to do a meta-analysis of the existing literature to assess the accuracy of prostate cancer studies which use magnetic resonance spectroscopy (MRS) as a diagnostic tool. MATERIALS AND METHODS: Prospectively, independent, blind studies were selected from the Cochrane library, Pubmed, and other network databases. The criteria for inclusion and exclusion in this study referenced the criteria of diagnostic research published by the Cochrane center. The statistical analysis was adopted by using Meta-Test version 6.0. Using the homogeneity test, a statistical effect model was chosen to calculate different pooled weighted values of sensitivity, specificity, and the corresponding 95% confidence intervals (95% CI). The summary receiver operating characteristic (SROC) curves method was used to assess the results. RESULTS: We chose two cut-off values (0.75 and 0.86) as the diagnostic criteria for discriminating between benign and malignant. In the first diagnostic criterion, the pooled weighted sensitivity, specificity, and corresponding 95% CI (expressed as area under curve [AUC]) were 0.82 (0.73, 0.89), 0.68 (0.58, 0.76), and 83.4% (74.97, 91.83). In the second criterion, the pooled weighted sensitivity, specificity, and corresponding 95% CI were 0.64 (0.55, 0.72), 0.86 (0.79, 0.91) and 82.7% (68.73, 96.68). CONCLUSION: As a new method in the diagnostic of prostate cancer, MRS has a better applied value compared to other common modalities. Ultimately, large scale RCT (randomized controlled trial) randomized controlled trial studies are necessary to assess its clinical value.
Humans ; Magnetic Resonance Spectroscopy/*diagnostic use ; Male ; Prospective Studies ; Prostatic Neoplasms/*diagnosis/metabolism ; ROC Curve ; Sensitivity and Specificity