There has been existing problems such as teaching method and test pattern in construction of medicine mathematical statistic curriculum in the medicine colleges. In combination with the teaching practice and the theory pondered,the article has elaborated several views to medicine mathematical statistic educational reform.

Objective To explore the diagnostic value of conventional ultrasound(US) and contrast enhanced ultrasound(CEUS) in predicting extrathyroidal extension of papillary thyroid cancer(PTC).Methods Eighty-five PTCs in 75 patients were selected for thyroid surgery underwent ultrasound and contrast-enhanced ultrasound.The degrees of contact between PTCs and capsule were observed by US and CEUS respectively(0,0-25％,25％-50％,≥50％),and the diagnostic efficiency in different degree of contact (＞0 ％,≥25 ％,≥50％) as preoperative diagnostic criteria were analyzed.The diagnostic efficiency between US and CEUS in predicting extrathyroidal extension of PTC were compared.Results Of the 85 PTCs,extrathyroidal extension was presented in 57 (67.06％) based on pathologic results.When the degree of contact (＞ 0 ％,＜ 25 ％,25 ％-50 ％,≥ 50 ％) was gradually increased,the incidence of extrathyroidal extension of the thyroid cancer was also gradually risen (P ＜0.001).Comparing the sensitivity,accuracy,odds ratio,and Az value of three groups(＞0％,≥25％,≥50％),it showed that the general diagnostic efficiency between two groups(＞0％,≥25％) was similar by US and CEUS.However,the sensitivity and accuracy of ＞0％ contact with the adjacent capsule were markedly higher than those of the other two groups(P ＜0.001).Selecting ＞0％ contact with the adjacent capsule as preoperative criteria,the Az value of CEUS was markedly higher than that of US (Z =2.208,P =0.027).Conclusions The preoperative imaging feature of more than 0％ contact with the adjacent capsule is more sensitive and accurate degree in predicting extrathyroidal extension of PTC.Compared with US,CEUS may serve as a better useful tool to predict extrathyroidal extension of PTC.

Objective To analyze the clinical features of the hospitalized children with laboratory-confirmed influenza in Suzhou. Methods The demographic information, laboratory test results, clinical features, treatments and outcomes of the hospitalized children with laboratoryconfirmed influenza were collected retrospectively. The data were analyzed using chi square test,Cochran-Armitage trend test. Results Four hundred and eighty hospitalized children were diagnosed with laboratory-confirmed influenza during the period of 2005 to 2009. Among these cases, 414 were subtype A and 66 were subtype B. The positive rate was 2.66%. Four hundred and nineteen cases (87.29 %) were ≤ 5 years old. Most of the cases developed during winter (from December to April the next year) and summer (from July to August). The age and sex distribution didn't vary from year to year (x2=9. 7768,x2 = 8. 7573; both P＞0.05). The mean disease course was (16.22± 9.41)days, and the mean hospitalization duration was (7.89 ±2.97) days. The percentages of patients with symptoms of fever, dyspnea and diarrhea or requiring oxygen treatment decreased with age (Z =4. 9430, Z=2. 1021, Z=3. 2073 and Z=2. 3277, respectively; all P＜0.05). The percentages of cases with concomitant pneumonia and upper respiratory infection also decreased with age (Z =-3. 8762 and Z=-3. 5095, respectively; both P＜0.01). Fifteen point five percent (60/387 cases)of the cases were co-infected with pneumococcus and 15. 0% (72/480 cases) were co-infected with respiratory syncytial virus (RSV). The level of C-reactive protein was significantly higher in cases with bacterial co-infection than those with viral co-infection (Z= -3.1290, P ＜ 0. 01 ).Conclusions Hospitalized children with influenza are more common in winter and summer in Shuzhou.Many patients are co-infected with pneumococcus or RSV. The symptoms are more severe in younger children.

Objective: To investigate the expression and clinical significance of long-chain non-coding RNA brain cytoplasmic RNA 1 (BCYRN1) in serum of patients with non-small cell lung cancer. Methods: 74 patients with non-small cell lung cancer (NSCLC) diagnosed and treated in our hospital were selected as the experimental group, and 50 healthy subjects were selected as the control group. The expression of BCYRN1 in serum of NSCLC and control group was detected by real-time quantitative polymerase chain reaction (qRT-PCR). The patients′ clinical pathology data were collected and followed up. To analyze the relationship between the expression of serum BCYRN1 and clinicopathological parameters of NSCLC patients, and the relationship between BCYRN1 expression in the diagnosis and prediction of NSCLC prognosis. Results: The relative expression of BCYRN1 in serum of NSCLC patients was 2.84±0.95, which was significantly higher than that of healthy controls (1.16±0.50) (P<0.05). The level of serum BCYRN1 in patients with NSCLC with tumor size >3 cm was significantly higher than that in patients with tumor size ≤3 cm (P<0.05). The level of BCYRN1 in patients with tumor node metastasis (TNM) Ⅲ+ Ⅳ was significantly higher than that in patients with stage Ⅰ+ Ⅱ (P<0.05). Patients with low differentiation and positive lymph node metastasis had higher serum BCYRN1 than those with moderate to high grade and lymph node metastasis (P<0.05). The receiver operating characteristic (ROC) curve analysis showed that the area under the curve was 0.847 (95% CI: 0.772-0.922, P=0.000), and the sensitivity and specificity were 68.9% and 88.0%, respectively. The median progression free survival (PFS) (15 vs 21 months) and overall survival (OS) (19 vs 28 months) of patients with high and low expression of BCYRN1 were statistically significant (P<0.05). High expression of BCYRN1 was an independent risk factor for overall survival in patients with NSCLC. Conclusions BCYRN1 is highly expressed in the serum of NSCLC patients, and high expression of BCYRN1 is closely related to the poor prognosis of patients with NSCLC. It can be used as a novel biomarker and diagnostic target for NSCLC.

Protein A and protein G are two well-defined immunoglobulin (Ig)-binding proteins (IBPs), which show affinity for specific sites on Ig of mammalian hosts. Protein A and protein G contained several highly homologous IgG-binding domains which had been demonstrated to have function to bind to IgG. Whether combinations of Ig-binding domains of various IBPs could produce useful novel binding properties remains interesting. We constructed a combinatorial phage library which displayed randomly-rearranged A, B, C, D and E domains of protein A, B2 and B3 domains of protein G. Four rounds molecular evolution of this library directed by all four human IgG subclasses respectively generated a common arrangement of D-C respectively which didn't exist in SpA. The dynamic loss of control phages and increase of the phages displaying two or more binding domains, especially the selective enrichment of D-C and strict selection of its linking peptides demonstrated the efficient molecular evolutions and the significance of the selected D-C arrangement. The phage binding assays confirmed that D-C possessed a binding advantage with four human IgG subclasses compared to SpA. In this work, a novel combination of Ig-binding domains, D-C, was obtained and presented the novel Ig binding properties which provided a novel candidate molecule for the purification, production and detection of IgG antibodies and a new approach for the further study of structures and functions of IBPs.
Amino Acid Sequence ; Antibody Specificity ; Bacterial Proteins ; immunology ; metabolism ; Binding Sites ; Binding, Competitive ; Evolution, Molecular ; Immunoglobulin G ; immunology ; metabolism ; Molecular Sequence Data ; Peptide Library ; Sequence Alignment ; Staphylococcal Protein A ; immunology ; metabolism

Objective To study the enhanced performance of contrast-enhanced ultrasouond( CEUS) parametric imaging , and to explore the diagnostic value of CEUS parametric imaging in predicting extracapsular invasion and cervical lymph node metastasis of papillary thyroid cancer( PTC) . Methods One hundred and fifty-eight PTCs in 136 patients pathologically proven papillary thyroid carcinoma between January 2016 and January 2017 were enrolled in this study . According to the pathological results of extracapsular invasion and cervical lymph node metastasis respectively ,the PTCs were grouped into the negative group and the positive group . The parametric imaging features of the two groups were summarized to explore the risk factors of extracapsular invasion and cervical lymph node metastasis of PTCs respectively . Results The parametric imaging suggested that centripetal enhancement had a significant effect on extracapsular invasion ( P =0 .001) . While there was no difference in the perfusion start time of extracapsular invasion between the negative and positive group ( P > 0 .05 ) . Besides , there was no statistical significance in the perfusion start time and perfusion pattern of cervical lymph node metastasis between the negative and positive group (all P >0 .05) .Conclusions The parametric imaging features help predicting extracapsular invasion in PTCs . And the ones with centripetal enhancement patterns are more often with extracapsular invasion .

OBJECTIVETo explore whether there were differences between the results of automatic titration and the results of manual titration for positive airway pressure treatment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and its influencing factors, the results might provide a theoretical basis for the rational use of two pressure titration methods.

METHODSSixty one patients with OSAHS were included in this study. All patients underwent a manual titration and an automatic titration within one week. The clinical informations, polysomnography data, and the results of both two titration of all patients were obtained for analysis.

RESULTSThe overall apnea/hypopnea index was (63.1 ± 17.7)/h, with a range of 14.9/h to 110.4/h. The treatment pressure of manual titration was (8.4 ± 2.1) cmH(2)O, which was significantly lower than the treatment pressure of automatic titration, (11.5 ± 2.7) cmH(2)O (t = -9.797, P < 0.001). After using a ΔP of 3 cmH(2)O for the cutoff value (ΔP was defined as the difference of automatic titration and manual titration), it was found that the pressure of automatic titration was significantly higher in patients with a ΔP > 3 cmH(2)O than in patients with a ΔP ≤ 3 cmH(2)O, which was (13.3 ± 2.3) cmH(2)O vs (10.0 ± 2.0) cmH(2)O (t = -6.159, P < 0.001). However, there were no differences for the pressure of manual titration between these two groups, which was (8.6 ± 2.4) cmH(2)O vs (8.3 ± 2.0)cmH(2)O (P > 0.05). There was no significant difference in age, body mass index, neck circumference, abdomen circumference, apnea hypopnea index, and arterial oxygen saturation between these two groups.

CONCLUSIONSThe treatment pressure of automatic titration is usually higher than that of manual titration. For patients with a high treatment pressure which is derived from automatic titration, a suggestion about manual titration could be given to decrease the potential treatment pressure of continuous positive airway pressure, which may be helpful in improving the comfortableness and the compliance of this treatment.

Body Mass Index ; Continuous Positive Airway Pressure ; methods ; Humans ; Oximetry ; Patient Compliance ; Polysomnography ; Pressure ; Sleep Apnea, Obstructive ; therapy