PurposeTo evaluate the value of combined employment of thyroid imaging-reporting and data system (TI-RADS) and ultrasound elastography (UE) in the differentiation of benign and malignant thyroid nodules.Materials and Methods The clinical data of 174 patients with 232 thyroid nodules confirmed surgically or pathologically with puncture biopsy were retrospectively analyzed. All nodules were examined by ultrasound and UE. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS, UE and the combination of the two methods were calculated respectively, and the receiver operating characteristic curve (ROC) was drawn to evaluate the value of each of the three methods in differentiating benign and malignant thyroid nodules by comparison of area under curve (AUC).Results The diagnostic sensitivity, specificity and accuracy of UE (number of benign nodules: 155, number of malignant nodules: 77) were 88.9%, 91.8% and 90.9%, respectively; those of TI-RADS (number of benign nodules: 153, number of malignant nodules: 79) were 76.4%, 85.0% and 82.3%, respectively. The values measured by UE were significantly higher than those by TI-RADS (χ2=3.920 and 7.446,P<0.05). The sensitivity, specificity and accuracy measured by the combined use of the two methods (number of benign nodules: 155, number of malignant nodules: 77) were 93.0%, 93.7% and 93.5%, respectively, which were higher than either of the methods, and the difference was statistically significant (χ2=7.725, 6.450 and 13.728,P<0.05). The areas under the curve (AUC) were 0.833 and 0.812 respectively for UE and TI-RADS; the AUC for the combination of the two methods was 0.914, which had significantly higher diagnosis accuracy than that by any single method, and the difference was statistically significant (Z=1.95 and 2.55,P<0.05). Conclusion Compared with gray scale ultrasound, the combination of TI-RADS and UE has higher diagnostic sensitivity and accuracy for excluding malignancy in diagnose of thyroid nodules.

Because of the population aging,the increase of the stroke patients and the need for rehabilitation,the treatment only in the rehabilitation department of the hospital is far from the satisfaction of people's demands of the service of rehabilitation.It is important to extend the community-based rehabilitation.Compared with the rehabilitation in hospitals,it is more economy,efficiency and convenience for stroke patients in community-based rehabilitation services,and further improve the rehabilitation effect of stroke patients.

Objective To investigate the correlation between serum insulin-like growth factor-1(IGF-1)level and the 131Ⅰahsorbante of thyroid nodule in patients with struma nadosa,to search for simpler and safer methods for differentiating thyroid nodule.Methods Detecting the 131Ⅰ absorbance of thyroid nodule by radioisotope scanning.then the patients were divided into warm and cold nodule groups,and the normal control group was also set up;the levels of IGF-1,FT3,FT4,sTSH were detected in serum of patients with struma nadosa by radio immunoassay,then the correlation between these data and the 131Ⅰabsorbance of thyroid nodule was analyzed.Results In the patients with warnl nodule,the level of serum IGF-1,FT3,FT4 and the 131Ⅰ absorbance of thyroid nodule[(315.86±22.74)μg/L,(9.95±5.62),(67.27±27.31)ng/L,0.64±0.17]were increased obviously when compared with the control group [(256.13±39.85)μg/L,(2.80±1.30),(13.51±5.50)ng/L,0.35±0.15],but the sTSH[(0.35±0.03)mU/L]went down significantly than the control group[(2.71±1.17)mU/L],the difference being statistically significant(P＜0.01).In the patients with cold nodule,the level of serum IGF-1,FT3,FT4,sTSH[(263.17±30.23)μg/L,(2.89±0.98),(14.23±2.84)ng/L,(2.81±0.42)mU/L] had no significant difference compared with the control group(P＞0.05).The level of serum IGF-1 was positively correlated with the 131Ⅰ absorbance of thyroid nodule(r＝0.835,P＜0.01),but negtively correlated with sTSH(r＝-0.326,P＜0.05)in the patients with warm nodule.Conclusion The level of sernm IGF-1 is closely correlated with the 131Ⅰ absorbance of thyroid nodule in patients with struma nadosa.

In traditional clinical application, Coptidis Rhizome and Evodiae Fructus have been combined to treat various stomach heat and cold syndromes, gastritis, gastric ulcer and the like. With the application of modem instruments and the development of molecular pharmacologic theory, their chemical constituents and pharmacological effects have been sufficiently studied. In this paper, literatures from Pubmed were adopted, with particular emphasis on findings of international counterparts and studies on compatibility of main chemical components in Coptidis Rhizoma and Evodiae Fructus, in order to elaborate on the scientific comparability of Coptidis Rhizoma and Evodiae Fructus through chemical analysis, and pharmacological and biopharmaceutics studies and introduce the future development trend of the studies.
Animals ; Drug Interactions ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Evodia ; chemistry ; Fruit ; chemistry ; Humans ; Ranunculaceae ; chemistry ; Rhizome ; chemistry

Objective To explore the effect of obstructive sleep apnea syndrome (OSAS), OSAS-like intermittent hypoxia (IH)on the expression levels of P-YAP and YAP in A549 lung cancer cell lines. Methods A549 cells were treated with IH exposure ( exposed to 5%O2 for 300 seconds and 21%O2 for 300 seconds) for 1, 3 and 6 h (IH1, IH3, IH6) or normoxia exposure (N group). Quantificational real-time PCR was used to measure the mRNA expression levels of YAP. Western blot assay was used to detect the protein expression levels of YAP and P-YAP. Results The mRNA expression levels of YAP were significantly increased with the increase of IH exposure time points in IH1 (2.50±0.18), IH3 (4.07±0.25) and IH6 (9.18 ± 0.58) groups than those in N group (1.00 ± 0.01) (all P<0.05). The protein expression levels of YAP were significantly increased with the increase of IH exposure time points in IH1, IH3 and IH6 groups than those in N group. The protein expression levels of P-YAP were significantly decreased with the increase of IH exposure time points in IH 1, IH3 and IH6 groups than those in N group. Conclusion YAP cell signaling plays an important role in the process of OSAS-like IH induced tumor development.

This study established a population pharmacokinetics-pharmacodynamics model of clopidogrel in patients with acute coronary syndrome. Fifty-nine patients were enrolled. The plasma concentration of clopidogrel active metabolite and vasodilator stimulated phosphoprotein platelet reactivity index (VASP-PRI) were selected as the pharmacokinetics index and the pharmacodynamics index, respectively. The covariates including demographic characteristics, laboratory indexes, combined medication, complications and genetic polymorphisms of related enzymes were screened for their influence on the pharmacokinetic and pharmacodynamics parameters. Population pharmacokinetic and pharmacodynamics data analysis was performed using NONMEM software. The general linear model and the indirectly effect model-turnover model for pharmacokinetic and pharmacodynamic analysis were selected as the basic model, respectively. The population typical values of K12, CL/F, V/F, EC50, K(in), and E(max) were 0.259 h(-1), 179 L x h(-1), 632 L, 1.57 ng x mL(-1), 4.29 and 0.664, respectively. CYP2C19 was the covariate in the final pharmacokinetic model, and the model was to design a prior dosage regimen.

Objective: To study the pharmacokinetics of diclofenac sodium microemulsions in human. Methods: According to the crossover design, each volunteer was orally given diclofenac sodium microemulsion and diclofenac sodium tablet. The serum concentrations were determined by RP-HPLC with UV-detector. The concentration-time data were analyzed using 3P87 Pharmacokinetic Program and the pharmacokinetics parameters were compared by paired t-test. Results: It was found that diclofenac sodium in serum was linear within the range of 50-8 000 μg/L. The minimum detection concentration was 30 μg/L. The mean rate of recovery was (100.55±1.56)%. After a single oral dose, AUC0～∞ were 5.563，7.891 μg*h/ml, MRT 5.489， 5.387 h for dispersible diclofenac sodium microemulsion and tablet respectively. Conclusion: Absorption progress of diclofenac sodium microemulsion in human may be special.

Objective: To investigate the expression of chemokine like factor 2 (CKLF2) mRNA in the rat myocardium after myocardial infarction(MI).Methods: In a rat model of MI, the myocardium surrounding the infarcted area was used for RNA preparation at different time points. After RT, competitive polymerase chain reaction amplification was performed to assess the expression of rCKLF2 mRNA. SAS Kruskal Wallis test was used for statistical comparisons. Results: The gene expression of rCKLF2 at mRNA level was significantly increased in the myocardium surrounding the infarcted area 3 days, 1 week, 2 weeks after infarction.Conclusion: It is possible that CKLF2 contributes to the pathophysiological process and needs to be further investigated.

Abstract: Objective　To analyze the serotype distribution, drug resistance rate and drug resistance gene carrying of Streptococcus pneumoniae isolates in hospitalized patients, and evaluate the coverage of the vaccine to the serotype of Streptococcus pneumoniae in this area, so as to provide reference for the rational use of antibiotics in clinic. Methods　A total of 150 strains of non-repetitive Streptococcus pneumoniae isolated from inpatients from January 2015 to December 2019 were collected for serotyping and antimicrobial sensitivity test. The carrying rates of pbp2b, ermB and tetM were detected by PCR. Results　The PCR classification rate of 150 strains of Streptococcus pneumoniae was 93.1%, and the classification rate of capsular swelling test was 100%, and a total of 19 serotypes were divided, mainly 19F and 6B. Children's serotypes were predominantly 19F, 6B, and 15A; adult serotypes were predominantly 19F, 14, and 23F. The coverage rates of the PCV7, PCV10, PCV13 and PPV23 vaccines were 36.8%, 42.1%, 57.9% and 68.4%, respectively. Strains with serotypes of 19F, 6B, 3, and 23F had higher rates of resistance to antimicrobials. The sensitivity of Streptococcus pneumoniae to penicillin was greater than 96.0%. Antimicrobials with significant differences in resistance rates between invasive and non-invasive strains were penicillin, moxifloxacin, and levofloxacin. The percentage of strains carrying both ermB and tetM resistance genes was 96.0%, and the concordance rate between pbp2b, ermB and tetM resistance genes and the resistance phenotype was >98.0%. A total of 10 multi-resistance combinations were detected, with a multi-resistance rate of 62.6%, and the multi-drug resistance pattern of Streptococcus pneumoniae was mainly concentrated in the 19F and 6B serotypes. Conclusion　There are significant age differences in the serotypes of Streptococcus pneumoniae in this area. The vaccine currently used has low coverage in this region and therefore offer limited protection to the population. The drug resistance rates of Streptococcus pneumoniae varied significantly among serotypes. Erythromycin and tetracycline are not recommended for clinical treatment of Streptococcus pneumoniae. Penicillin can still be used as the first choice for clinical treatment of Streptococcus pneumoniae infection.