Objective To explore the influence of ROI size on the diagnostic performance of shear wave elstography (SWE) of breast masses.Methods A total of 225 consecutive patients with 239 solid breast masses underwent SWE before surgery,and then quantitative SWE parameters,including the maximum stiffness (Emax),mean stiffness (Emean),ratio of stiffness of the mass to stiffness of surrounding fat (Eratio) and standard deviation (SD),were measured by two methods,one method was using larger ROI to include the largest part of a mass,and the other was placing fixed ROI=2 mm over the stiffest part of the lesion to measure.The diagnostic performance of the two methods were evaluated by ROC curve,and the cut-off value,sensitivity and specificity of each SWE parameter were obtained.Results There were no statistically significant differences between the performance of Emax,Emean and SD from the two different methods (all P＞ 0.05),the performance of Eratio of the two methods showed significant difference (P=0.046).The significantly higher specificity of Emax and Emean in the larger ROI were found,and the significantly higher sensitivity of SD and Eratio in the ROI=2 mm was found.Furthermore,the diagnostic performance of combination of SWE and BI-RADS were not greatly affected by the ROI size,the difference had no statistical significance (all P＞0.05).Conclusion The ROI size only affects the diagnostic performance of Eratio,and donot affect the diagnostic performance of the quantitative SWE parameters (Emax,Emean,SD) and combination of SWE and BI-RADS.

Objective To study the influence of resolving phlegm and relaxing bowels decoction(Huatan Tongfu decoction)on plasma tissue type plasminogen activator(t-PA),plasminogen activator inhibitor(PAI)and homocysteine(Hcy)in patients with acute cerebral infarction. Methods With randomized and controlled clinical research,78 inpatients from 2010 to 2012 in Traditional Chinese Medicine(TCM)Department of Beijing Chaoyang Hospital,Capital Medical University were chosen,including 40 patients in observation group and 38 patients in control group. The patients in control and observation groups were treated by conventional treatment,and additionally the patients in observation group received Huatan Tongfu decoction(ingredients:Trichosanthis 30 g,Arisaema with bile 6 g,Magnolia bark 10 g,Fried rice sprout 15 g),and the rhubarb decoction was made alone,each 20 mL decoction containing crude drug 6 g. 1-4 days after the beginning of the study,the two decoctions were mixed,and the patients took the lukewarm mixture orally twice daily(once 1/2 the dosage);5-12 days after the start of the study, the patients took 200 mL lukewarm mixed decoction daily,being divided into 2 times to administer,and according to the patient defecation situation,the dosage of rhubarb decoction was adjusted individually,the therapeutic course being 12 days. The t-PA,PAI and Hcy were detected before treatment and on the 7th day after treatment. TCM syndrome scores(phlegm syndrome,fire-heat syndrome and sthenic-fu syndrome)were recorded before and on the 12th day after treatment,and the scores of National Institute of Health Stroke Scale(NIHSS)were recorded at the same time. Results Before treatment,the differences in t-PA,PAI,Hcy levels and NIHSS score and phlegm syndrome,fire-heat syndrome and sthenic-fu syndrome scores were not statistically significant;all the indicators improved significantly after treatment compared with those before treatment,and the changes in observation group were more remarkable〔t-PA(mg/L):13.03±2.15 vs. 12.95±2.16,PAI(mg/L):23.64±9.07 vs. 26.81±10.00, Hcy(μmol/L):9.13±1.15 vs. 11.52±3.17,phlegm syndrome:9.16±1.71 vs. 11.17±2.89,fire-heat syndrome:7.51±1.59 vs. 8.81±2.26, sthenic-fu syndrome:0.61±0.87 vs. 1.19±1.14, NIHSS score:5.70±3.16 vs. 5.90±2.97〕. Conclusion The mechanism of Huatan Tongfu decoction in treatment of patients with acute cerebral infarction accompanied by TCM syndromes of phlegm heat and sthenic-fu may be related to the reduction of plasma PAI and Hcy levels,protection of vascular endothelium and promotion of fibrinolysis,thereby the decoction can improve the clinical efficacy.

Objective To analyze the correlation between health quotient and quality of life by investigated and studied the relationship between the two. Methods One hundred and ninty three caregivers of cancer patients were investigated by the general situation questionnaire, Health Quotient Questionnaire and Health Survey Short Form (SF-36). Results Different age, gender, education, marriage status, income, occupation, whether suffering from chronic diseases, physical examination frequency, care time and care relationship had a significant differences on quality of life of caregivers ( t/F=7.618-21.043, P < 0.05 or 0.01); the dimension scores of health quotient of caregivers were self-care (4.87±1.65) points, health knowledge (4.53±1.50) points, life style (4.47±1.65) points, state of mind (4.66± 1.87) points, life skills (4.73±1.78) points, were all on the alert value;caregiver′s level influenced by age, income, education level, occupation, whether suffering from chronic diseases and other factors (F=5.227-11.143, P<0.05);the dimension of health quotientand quality of life of caregivers were significantly correlated (r=0.506-0.771, P<0.01). Conclusions The status on quality of life and health quotient of caregivers are poor, and there is a positive correlation between the two, the level of health quotient is higher, the quality of life is better. Therefore, as for improving the quality of nursing care, clinical nursing staff should pay more attention to improve their health quotient level so as to improve the quality of life better.

0.05).2.5 mg/kg and 5.0 mg/kg avermetine groups can increased the activity of LDH,GS,CK in cerebrum,and decreased the activity of CaN in cerebrum,compared with control group(P0.05).Conclusion Avermectine may cause the toxic effect in rat nervous system through creating the nerve metabolism enzyme activity.

OBJECTIVE:To investigate the complexation of clonazepam with hydroxypropyl-?-cyclodextrin(HP-?-CD)in aqueous solutions.METHODS:The complexation of clonazepam with(HP-?-CD),the inclusion molar ratio of host and guest molecules and thermodynamic parameters were detected using phase solubility method,equimolar series method,UV absorption spectroscopy etc.RESULTS:The solubility of clonazepam increased linearly with the increase of(HP-?-CD)level in aqueous solutions at different temperatures(25℃,35℃and45℃)and in buffers at different pH values(4.0,6.0and7.0),the phase solubility diagram was classified as type AL.CONCLUSIONS:Under the above research condition,the incl_ usion complexes of clonazepam with(HP-?-CD)can be formed spontaneously at a molar ratio of1∶1.

AIM:To evaluate the clinical effects of femto-LASIK using new Ziemer LDV Z6 femtosecond laser machine (Z6).
METHODS: Two - hundred cases ( 400 eyes ) was randomly separated into two groups: Group A included 200 eyes which corneal flaps were made by Z6, and Group B included rest of 200 eyes which corneal flaps were examined by a traditional Ziemer LDV CrystalLine femtosecond laser machine (CrystalLine). Visual acuity, slit lamp, refraction, Sim-K average, intraocular pressure (IOP), non-invasive tear break-up time (NIAvg-BUT), operation difficulty and complications were compared between two groups preoperatively and postoperatively.RESULTS:There was no significant differences between two groups in visual acuity, refraction, Sim-K average, IOP and NIAvg - BUT either preoperatively or 6mo postoperatively (P>0. 05). Although there were significant differences in operation difficulty and complications were found between two groups ( P< 0. 05 ), there was no serious complication in any group. Furthermore, a clear demarcation line could be observed in the cornea of Group A postoperatively.
CONCLUSION:More careful and strict requirements are needed when using the new Z6 femtosecond laser for corneal flaps.

Objective To investigate effects of Naoxintong drip pill (NDP) in activating blood and removing blood-stasis and on myocardial and cerebral ischemia. Methods The in-vivo effect of NDP on thrombosis, aggregation of platelets, blood viscosity, microcirculation, acute myocardial and cerebral ischmia and the focal cerebral-infarction were observed for study the pharmacodyamic effect of NDP. Results NDP could significantly inhibit the formation of thrombosis and maximal aggregation rate of platelets, and decrease viscosity in whole blood and plasma in rats with blood stasis. It could also promote auricular microcirculation, prolong the survival time of mice with cerebral ischemia, improve the electrocardiogram of ischemic rats, reduce the focal cerebral-infarction area and improve behavior disorder. Conclusion NDP possesses actions of activating blood and removing blood-stasis and improving myocardial and cerebral ischemia and focal cerebral-infarction.

The problems to offer HIS course in plateau medical colleges and universities were pointed out and corresponding reform measures were put forward in view of the requirement for medical professionals in the 21stcentury information society and the current situation in HIS course teaching.

Objective To explore the association between acute ischemic stroke and albumin to creatinine ratio (ACR).Methods A case-control study.During January to December in 2013, 127 acute ischemic stroke patients as case group and 150 controls who were similar with case group in age and gender were recruited in Tianjin Union Medicine Center . According to diabetes , hypertension , cardiovascular diseases and patients without these three diseases , case group was divided into A1, B1, C1 and D1 subgroups, control group was divided into A2, B2, C2 and D2 subgroups in the same way.The first morning urine from participants were collected .Urinary albumin concentration was tested by nephelometry , urinary creatinine was examined by using enzymic method , ACR were calculated(≥30 mg/g as the cutoff value). Then difference of ACR between case and control group was compared , the cutoff value of albuminuria for ischemic stroke patients was analyzed by ROC , and the risk factor of ischemic stroke were analyzed by logistic regression analysis.Results The prevalence of albuminuria in ischemic stroke patients was 38.58%(49).According to analysis of covariance, after adjustment for age, gender, cardiac-disease, diabetes, hypertension, lnACR in case group was significantly higher than control group (3.18 mg/g vs 2.78 mg/g, t=2.13 P=0.03), especially D1 was significantly higher than D2 subgroup (3.01 mg/g vs 2.51 mg/g,t=5.56,P=0.009) .If 19.82 mg/g from ROC analysis was used as the cut-off value, the sensitivity and specificity are 68.5% and 61.7%.The odds ratio ( OR ) of ACR >19.82 mg/g was about 2-fold when compared with ACR<19.82 mg/g adjusted for stroke risk factors , and the OR value is 2.43 in comparison of patients without diabetes , hypertension and cardiovascular diseases .Conclusions Urinary albumin excretion is the independent risk factor of ischemic stroke .The increased urinary albumin has important clinical significance to predict the risk of ischemic stroke for the patients without diabetes , hypertension and cardiovascular diseases.

Objective To express the antigen gene Ts21 of Trichinella spiralis, purify the recombinant protein and test its antigenicity. Methods T. spiralis gene Ts21 was sub-cloned into the prokaryotic expression vector pMAL-c2X and the recombinant pMAL-c2X-Ts21 was constructed. The recombinant plasmid was transformed into E. coli TB1 strain and induced by IPTG. The expression products were purified by MBP-binding affinity chromatography. The antigenicity of the recombinant protein was examined by SDS-PAGE and Western blotting. Mice were immunized with the recombinant protein, the titer of the immune sera was detected by ELISA. The distribution of Ts21 protein in muscle larvae was observed by IFA. Results The molecular weight of the expressed fusion protein was about Mr 63 500 and the expression level peaked at 4 h post-incubation. The portion of the fusion protein accounted for 18.2% of all the protein by thin-layer gel optical scanning. Western blotting demonstrated that the recombinant protein was recognized by sera from mice infected by T. spiralis (T1) and T. nelsoni (T7) as well as sera of patients with trichinellosis, but not by sera from mice in-fected with T. nativa (T2), T. britovi (T3) and T. pseudospiralis (T4). The recombinant protein did not react with sera from patients with ancylostomiasis, cysticercosis and schistosomiasis, but cross-reacted with sera from patients with parag-onimiasis, clonorchiasis and echinococcosis. High titers of antibodies were produced in mice immunized with the recom-binant protein. IFA showed that the Ts21 protein was mainly distributed in the cuticle of muscle larvae. Conclusion The Ts21 antigen gene of T. spiralis has been expressed and the recombinant protein shows antigenicity.