Objective To evaluate the ability of contrast-enhanced ultrasonography (CEUS ) compared to enhanced MRI scan in differential diagnosis of benign and malign tumor of orbit.Methods CEUS and enhanced MRI was performed in 74 patients with tumor of orbit.These patients were divided into two groups:benign and malignant tumor depended on histological diagnosis.The results were analysed with SonoLiver software.The coincidence rate of diagnosis and enhancement intensity among CEUS,MRI and CEUS+ MRI were compared and the quantitative parameters of CEUS were analysed.Results (1 )The diagnostic accordance rate of benign group by three methods were 90.0%,80.0% and 96.0% respectively, there was statistical difference for diagnostic coincidence rate between the MRI and CEUS+ MRI(P <0.05).The diagnostic accordance rate of malignant group by the above three methods were 75.0%,79.2%and 95.8% respectively,there was no statistical difference for diagnostic coincidence rate between the three methods(all P > 0.05 ).(2 )The enhancement intensity of CEUS was different between benign and malignant groups (P <0.05).There was no statistical difference between benign and malignant groups by MRI method (P >0.05).(3)The parameters of tumor imaging obtained time intensity curve(TIC):rise time (RT),half elution time and time to peaking (TTP)were significantly different between benign and malignant groups(P <0.05).While there was no significant difference of parameters as mean transit time (mTT)and arrived time (AT)(P >0.05).Conclusions CEUS had higher diagnostic accuracy than MRI in benign orbital tumor.The contrast enhancement intensity and time-intensity curves provide valuable diagnostic information for differential diagnosis of benign and malignant orbital tumor.

Objective Previons studies showed that,the gene of P16 is a kind of gene suppressing the cancer.its function once lose,the cell may change to cancer.Methods The expression of P16 has a closely relation with the malignant latent and evolve of the oesophagus cancer.ResulIs This research explored the relation between the P16 expression and the prognosis of oesophagus cancer,the results showed the positive rate of the expression of P16 is more low the rate ofexistence is more low,it in dicates the expression rate of P16 can reflect the prognosis of oesophagus cancer cell.Conclusion The expression of P16 missing or descending is closely rehted with the aggravate and evolve of oesophagus cancer,therefore the expression of P16 had a relation with the prognosis of oesophagus cancer.

This study firstly reviews the history and current situation of course construction, then combines closely with the objectives and the summary of current situation of the standardized residency training, and finally puts forward concrete countermeasures from the several angles, such as teaching objectives, teaching team development, teaching content and forms, as well as evaluation mechanism, advocating the promotion of problem-based learning (PBL), medical simulation teaching (MST), literature discussion and other teaching methods, encouraging the integration of humanities education and clinical guidelines into teaching, and adopting objective structured clinical examination + standardized patient (OSCE+SP) assessment method and conducting two-way assessment, so as to assist in the education development of the standardized residency training.

Objective To evaluate the ability of contrast-enhanced ultrasonography (CEUS)in differentiate reactive lymph node,metastatic lymph node and lymphoma.Methods In a prospective study CEUS was performed in 129 patients with cervical lymph node enlargement.The entire process were recorded and preserved in DICOM format.The results were registered with Sonoliver.The receiver operating characteristic curve (ROC curve)analysis was performed to find the corresponding cutoff values. The selected node was removed surgically and submitted for histology.Results Of all the nodes,26 were reactive nodes,85 were metastases and 1 8 were lymphoma.Enhancement pattern was the most accurate way to characterize lymph nodes.The enhancement pattern of reactive lymph nodes was homogeneous and most of them were enhanced by lymphatic type while the metastatic lymph nodes were inhomogeneously enhanced or weakly enhanced by peripheral type.Lymph node lymphoma usually had no fixed enhancement pattern. Arrive time (AT),rise time (RT),time to peak (TTP),mean transit time (mTT),maximum intensity (IMAX),under the curve (AUC),rising slope(Kup),semi descending slope(Kdown)and perfusion index (PI)were significantly different in the three groups(P <0.05).RT,TTP and mTT of reactive lymph nodes were the shortest,which had significant difference compared with those of metastatic lymph nodes and lymphoma (P < 0.05 ).Kup,Kdown,IMAX%,AUC,PI in the reactive lymph nodes were significantly decreased compared with the metastatic group (P <0.05),but there was no significant difference compared with those in lymphoma (P >0.05 ).When TTP≥ 7.74 s,mTT≥26.54 s,metastatic lymph nodes were considered.When RT≥4.62 s,TTP ≥ 7.74 s,mTT ≥ 28.32 s,reactive lymph nodes were not considered. Conclusions Dynamic contrast-enhanced ultrasound image and enhancement pattern can distinguish neck lymph nodes while the optimal cut-off point time of the time-intensity curve parameters can further contribute to the identification of lymph nodes.

Objective To investigate the characteristic of MRS in patients suffered diffuse axonal injury (DAI)in acute and suba-cute stage,and the correlation between MRS changes and the severity of disease.Methods We reported MRI and proton magnetic resonance spectroscopy studies of 3 6 head-inj ured patients in acute and subacute stage.Proton magnetic resonance spectra were ac-quired from the white matter and gray matter of bibateral frontal lobe that on conventional MRI appeared normal by using 2D MRSI at 3.0T MRI .30 volunteers as contronl were studied at the same time.Results In patient group,N-acetylaspartate/creatine ratios were (2.14±0.15)and (1.71±0.08)choline/creatine ratios were(1.35±0.13)and (1.03±0.08)for the white matter and the gray matter,respectivily.The brain N-acetylaspartate/creatine ratio was reduced and the choline/creatine ratio was increased in pa-tient group compared with the controls.The increase in the choline/creatine ratio was significant even in the moderate and severe in-j ured groups.Furthermore,there was a significantly correlation between the severity of head inj ury and the N-acetylaspartate/cho-line ratio,and changes in patients with metabolite ratios of the GCS score had a strong correlation.Conclusion We conclude that DAI patients with normal conventional imaging manifestations of the frontal lobe appear metabolite ratio change,suggesting the existence of local cerebral inj ury,and it has a strong correlation between the prognosis and MRS changes.MRS may provide an useful method that can tell us the severity of the brain inj ury in patients with DAI .

Objective To investigate the features of variation of sympathetic skin response(SSR)in depression patients and to clarify the correlation between SSR and the effect of antidepressant therapy in first episode depression.Methods The sample comprised 50 first visit patients,who fulfilled the ICD-10 criteria in a structured interview for depressive disorder.These 50 patients received antidepressant therapy for 6 weeks.Clinical response was defined as ≥50%reduction in total 17-item Hamilton depression rating scale(HAMD).Remission was defined as HAMD score ≤7 at week 6.SSR waveforms were classified into three patterns based on the amplitudes of positive and negative components:P pattern,N pattern and M pattern.Another 50 healthy subjects were involved in this study as controls.Results (1)SSR could be obtained in all normal subjects but couldn't be recorded in 5 of 50 patients whose HAMD scores>28.SSR waveforul patterns were analyzed in these 45 patients P pattern in 7 cases,N pattern 21,M pattern 17.(2)Depression patients had longer latency and lower amplitude than the controls(P<0.01).P pattern had shorter latency and higher amplitude than N pattern.There were no difference in age,course and HAMD scores among the patients with 3 different SSR patterns.(3)Nine of 21 patients of N pattern treated with fluoxetine were remitters.6 patients were clinical responders.These 15 patients had shorter latency and higher amplitude after treatment than that at the initial stage,but there were still differences in latency and amplitude compared with the controls.Conclusion There were significant damages on sympathetic function of depression patients.N pattern was the most SSR pattern among 45 patients recorded SSR.P pattern had shorter latency and higher amplitude than N pattern.SSR is a sensitive and feasible measure inder for neurocardiac electrophysiologic autonomic regulation examination,which could be used to measure clinical therapeutic efficacy for antideppressant in depression patients.

OBJECTIVETo investigate the mechanisms of Wuling mycelia powder on memory retrieval impairment in rats with chronic epilepsy.

METHODSD rats were randomly divided into four groups: the pentylenetetrazole-kindling group (the model control group), the low dose of Wuling mycelia powder (0.3 g x kg(-1), ig) group, the high dose of Wuling mycelia powder (0.6 g x kg(-1), ig) group and the blank control group. After being successfully trained in the 8-arm (4-arm baited) radial maze, the rats were intraperitoneally injected with a subconvulsive dose (35 mg x kg(-1)) of pentylenetetrazole (saline in control group) every 48 h for 12 times. Wuling mycelia powder were orally administered 30 min before every pentylenetetrazole injection. Memory retrieval was tested at the same maze. Phosphorylated CREB were analyzed by Western blot. Brain pathological sections were stained using HE, hippocampal nerve cells were observed under optical microscopes.

RESULTBoth of reference and working memory abilities of these chronic epilepsy rats were impaired as expressed in the 8-arm radial maze but reversed by Wuling mycelia powder to some extent. Chronic epilepsy caused a decreasing p-CREB in hippocampal nerve cells and injury in hippocampal CA1 region and CA3 region among rats. Wuling mycelia powder inhibited hippocampal p-CREB from decreasing and protected hippocampal nerve cells.

CONCLUSIONWuling mycelia powder could ameliorate memory impairment induced by epilepsia. Its mechanism may be related to the increase in p-CREB expression in brain and the protective effect on hippocampal nerve cells.

Animals ; Chronic Disease ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Epilepsy ; complications ; Hippocampus ; drug effects ; pathology ; Male ; Memory Disorders ; drug therapy ; Phosphorylation ; Rats ; Rats, Sprague-Dawley

Post stroke cognitive impairment (PSCI) is the most common complication in stroke patients, which seriously affects their quality of life. Early comprehensive treatment to intervene in mild cognitive impairment caused by stroke is of great significance in reducing and delaying the occurrence of dementia. This is a review on the latest treatment progress of PSCI.

Objective To provide a reference for differential diagnosis of thyroid microcarcinoma classified as TI-RADS 3-4 grade using contrast-enhanced ultrasound.Methods SonoLiver software was used to analyze the process of contrast-enhanced ultrasound of 112 thyroid small nodules classified as TI-RADS 3-4 grade.The dynamic vascular pattern curve(DVPC)and the time-intensity curve(TIC)were automatically acquired for summarization of the types and characteristics of the two curves.The relevant parameters such as the rise time(RT),time to peak(TTP),maximum intensity(IMAX%),mean transit time(mTT),area under curve(AUC)and perfusion index(PI)were acquired and calculated using the software.Receiver operating curve (ROC) analysis was used to achieve the cut-off value of these parameters for differential diagnosis.Results For thyroid microcarcinoma which TI-RADS assessment of grade 3-4,TIC showed as slow rise and slow drop wave or slow rise and fast drop wave,DVPC showed negative waveform or negative-positive bi-directional waveform.ROC analysis demonstrated that IMAX of 96.5%,AUC of 443.08 and PI of 47.64 were the best cut-off values for the differential diagnosis of benign and malignant nodules.When IMAX<96.5%,AUC<443.08,PI<47.64,the nodules were highly likely to be thyroid microcarcinoma.Conclusions The contrast-enhanced ultrasound parameters can provide effective reference for the differential diagnosis of thyroid carcinoma with grade 3-4 in TI-RADS classification.

Objective:This paper examines the access control mechanisms of a big data platform and explores its integration with the ChatGPT artificial intelligence platform for nursing management. The aim was to pilot a self-monitoring and follow-up big data platform for valve disease patients in the Northeastern region of China and assess its effectiveness, providing healthcare professionals with a more practical follow-up tool.Methods:Convenience sampling was used to select 32 patients who underwent mechanical valve replacement surgery or postoperative follow-up at the affiliated hospital of North Sichuan Medical College between January and October 2022 by a retrospective study, were taking oral warfarin anticoagulant therapy, and were willing to use the platform. Based on their platform usage data from November to December 2022, the 32 patients were divided into two groups according to their INR compliance rates: a high compliance group (16 patients) and a low compliance group (16 patients). Evaluate the operational effectiveness of the platform and its impact on patient anticoagulation efficacy based on its usage frequency and INR value compliance rate.Results:The number of login times and INR values written by patients in the high-standard-rate group were (11.31 ± 3.38) and (7.00 ± 1.63) times respectively, which were higher than those in the low-standard-rate group (9.44 ± 3.39) and (6.06 ± 1.88) times, the difference were not statistically significant (all P>0.05). The number of INR values written within the normal range and the number of occurrences of warning values by patients in the high-standard-rate group were (6.38 ± 1.50) and 1.00(0, 2.00) times, which were different than that in the low-standard-rate group (4.05 ± 1.57) and 2.00(2.00, 3.50) times, the differences were statistically significant ( t = 4.26, Z = - 2.22, P<0.05). Conclusions:The self-monitoring and follow-up big data platform for patients after artificial mechanical valve replacement equipped with ChatGPT can optimize and standardize the nursing follow-up workflow, improve nursing work efficiency, reduce the workload of medical staff. At the same time, it provides a better self-management platform for patients after artificial mechanical valve replacement. Assist patients in monitoring INR values and predicting possible changes in their condition, providing corresponding warnings and recommendations helps patients better participate in self-anticoagulation management, and improves the quality of life of patients.