Objective To evaluate the value of ultrasound in diagnosing ductal carcinoma in situ (DCIS). Methods The sonographic characteristics of 12 DCIS which were confirmed by pathology were analyzed retrospectively. Results The ultrasound image of DCIS could be divided into four types;the solid mass nodule, mammary dysplasia, mix mass nodule, the dilated duct type. Micro calcification had high incidence rate. Ultrasonic diagnosis accordance rate was 50.0 %. On molybdenum target mammograms, the tumor appeared as a cluster of calcified spots in 8 cases, and the accuracy rate of diagnosis of was 66.7 %.Conclusion There are no typical characters of DCIS in ultrasound image. However, some characteristics are suggestive and can help to differentiate them from the benign tumors, such as small nodule, irregular shape,obscure boundary, and microcalcification. When sonography combine with molybdenum target mammography,the accuracy rate of diagnosis will be improved.

Herpes simplex virus type Ⅰ(HSV-1) is a common pathogen, and human is the only natural host of it.Following a period of lytic replication in epithelial cells, HSV-1 enters axon terminals of sensory neurons and then travels via retrograde transport to the sensory ganglia where latency can be established.Upon the stimulation of some stressors, the latent virus can reactivate, leading to recurrent diseases.Therefore, to clarify the mechanism of HSV-1 latent infection and stress-induced reactivation will offer new insights into the prevention, treatment and control of HSV-1 infection.In this review, we describes the mechanisms underlying HSV-1 latent infection and stress-induced reactivation.

Objective To establish a suitable evaluation index system to track implementation effect of clinical research program.Methods Delphi method was used to creat the evaluation index system.The weighted average method was adopted to determine the weight of each index.Results After two rounds of expert consultation,twenty seven evaluation indices were selected,including three first-class indices,eight second-class indices and sixteen third-class indices,and the weight of each index was determined.Conclusions The evaluation index system reflects the purpose of tracking clinical research to a certain extent.This index system is simple and easy to be used.

Nutrition therapy is considered as the basis for prevention and management of chronic kidney disease (CKD), throughout the three-tier prevention strategies of CKD. The primary objective is to delay the disease progression, correct metabolic disorders, and improve the outcomes of CKD. Low protein diet has been recognized as an important therapeutic measure in CKD, but the quantity, quality and source of protein are always the points of contention. Recently, both domestic and foreign guidelines have been updated on the amount of protein intake. In addition to quantity, attention has been paid to the type and diversity of proteins. With the rise of plant-based food consumption and the concept of vegetarian diet, the scientific community began to review the benefits of plant protein again, and a plant-based diet is recommend extensively. Whether the plant-based dietary pattern is also suitable for CKD patients who need a low-protein diet, and whether it could meet the nutritional needs of CKD patients are hot topics, this article reviews the recent progress of these research hotspots.

Objective:To investigate the turnover intention and its influencing factors in rural general practitioners in southwest Shandong province.Methods:In May 2020, a survey with self-designed questionnaire was conducted among 2 805 rural general practitioners in southwest Shandong province selected by multi-stage sampling method. Pearson chi square test (χ2) and binary logistic regression were used to analyze the factors influencing the turnover intention of rural general practitioners.Results:A total of 2 805 questionnaires were sent out, 2 693 were collected and 2 272 were valid, with an effective rate of 84.4%. Among 2 272 participants, 1 076 (47.4%) had medium to high level turnover intention. Binary logistic regression showed that part-time job ( OR=1.443, 95% CI: 1.105-1.884, P<0.01), average monthly night shifts ≥20 times ( OR=1.340, 95% CI: 1.106-1.623, P<0.01), daily working time ≥13 hours ( OR=1.358, 95% CI: 1.107-1.666, P<0.01), insomnia ( OR=2.075, 95% CI: 1.755-2.454, P<0.01), feeling depressed at work ( OR=2.987, 95% CI: 2.516-3.546, P<0.01), degree of emotional exhaustion ( OR=3.801, 95% CI: 3.188-4.533, P<0.01) and degree of de-personalization tendencies ( OR=2.493, 95% CI: 2.086-2.981, P<0.01) were the significant factors influencing the turnover intention of rural general practitioners. Conclusions:Rural general practitioners in southwest Shandong have a high-level turnover intention, part-time jobs, average number of night shift per month, working time, insomnia, depression and job burnout are the main factors affecting the turnover intention. Necessary measures should be taken by relevant departments to enhance the stability of rural general practitioners.

Objective To investigate the impact of secreted frizzled-related protein 1 (SFRP 1) gene polymorphisms and gene-smoking interactions on the risk of large artery atherosclerotic (LAA) stroke.Methods Two hundred and sixty-four patients diagnosed with LAA stroke and 228 healthy controls were enrolled from the Department of Neurology,Affiliated Hospital of Qingdao University from August 2016 to June 2017.The methods of polymerase chain reaction-restriction fragment length polymorphism,combined with DNA sequencing,were used to detect the three single nucleotide polymorphisms (SNPs:rs7832767,rs1127379,rs3242) in the SFRP 1 gene.Logistic regression was applied to analyze associations between SNPs and LAA stroke.Cross analysis of additive model was used to evaluate gene-smoking interactions.Results The genotype TT/CT and allele T of rs7832767 in case group were in higher frequency than that in controls (54.9％ (145/264) vs 37.7％ (86/228),OR =2.123,95％ CI 1.482-3.041,P ＜0.01;33.9％ (179/528) vs 20.0％ (91/456),OR=2.057,95％ CI 1.536-2.755,P＜ 0.01).However,the frequencies of genotypes and alleles in other SNPs (rs1127379,rs3242) showed no significant differences between cases and controls.Multivariate Logistic regression analysis showed that TT/CT genotype was a risk factor for LAA stroke (OR =1.649,95％ CI 1.066-2.550.P =0.025).Moreover.SFRP 1 gene was not related to the distribution of cerebralvascular stenosis in LAA stroke patients.Additive model analysis showed significant interactions between rs7832767 and smoking (relative excess risk of interaction =2.442,95％ CI 0.281-4.603).Smokers with T allele of rs7832767 showed significantly increased risk of LAA stroke (OR =3.252,95％ CI 1.629-6.491,P =0.001).Whereas,no significant interaction was detected between rs3242 or rs1127379 and smoking.Conclusion The T allele of rs7832767 within SFRP 1 gene may be a risk factor of LAA stroke,and the interactions between rs7832767 and smoking can significantly increase the risk of LAA stroke.

Objective:To compare the value of 3 methods (threshold method, visual method and CT method) based on 18F-FDG PET-CT for qualitative diagnosis of solitary pulmonary nodules (SPN). Methods:The clinical characteristics, pathological results, CT signs and maximum standardized uptake value (SUV max) of 226 SPN patients who underwent 18F-FDG PET-CT and met lung imaging reporting and data system (Lung-RADS1.1) grading criteria grade 2-4 in Shanxi Province Cancer Hospital from January 2015 to January 2019 were retrospectively analyzed, and the diagnostic efficacy of threshold method (according to SUV max), visual method [according to the degree of fluorodeoxyglucose (FDG) uptake in the mediastinum or liver blood pool] and CT method (according to Lung-RADS1.1 grading criteria) for SPN were compared by using receiver operating characteristic (ROC) curve. The highest diagnostic accuracy of CT method and the highest diagnostic accuracy of threshold method and visual method were combined as PET-CT comprehensive diagnosis method, and the diagnostic efficiency of which was compared with the other methods. Results:Among the 226 patients with SPN, 174 cases were malignant and 52 cases were benign in pathology. ROC curve analysis showed that the area under the curve (AUC) of CT method 2 (defined Lung-RADS1.1 grade 4A and below as benign, grade 4B and above as malignant) in CT methods for qualitative diagnosis of SPN was 0.622, the sensitivity was 87.93%, and the accuracy was 76.11%, the diagnostic efficiency was higher than method 2. The AUC of the threshold method 1 (defined solid nodules that SUV max≥2.5 and ground-glass nodules that SUV max≥1.14 as malignant, the others as benign) in threshold methods for qualitative diagnosis of SPN was 0.675, the sensitivity was 85.06%, and the accuracy was 76.99%, the diagnostic efficiency was higher than other methods in the threshold methods and visual methods. The AUC of PET-CT comprehensive diagnosis method (combination of CT method 2 and threshold method 1) for qualitative diagnosis of SPN was 0.652, the sensitivity was 97.70%, and the accuracy was 82.74%, the diagnostic efficiency was higher than other methods. Conclusions:There is no significant difference among threshold method, visual method and CT method based on 18F-FDG PET-CT in qualitative diagnosis of SPN. The diagnostic efficiency of combining CT method with threshold method is significantly improved.