1.Thyroid Imaging Reporting and Data System in Identifying Benign and Malignant Thyroid Nodules
Xueqin HOU ; Xue FAN ; Lingfei YANG ; Jian DONG ; Tao SONG
Chinese Journal of Medical Imaging 2015;(7):489-493
PurposeAs a main method to detect thyroid nodules, ultrasonography seems to have a rather low accuracy in differentiating benign and malignant ones. The present study aims to explore the diagnostic value of thyroid imaging reporting and data system (TI-RADS) in identifying benign and malignant thyroid nodules.Materials and Methods A total of 168 patients with thyroid nodules conifrmed pathologically (with 251 suspicious nodules) underwent ultrasonography and were further grouped into category 3-5 according to TI-RADS classiifcation standard. The results were retrospectively compared with histopathological ifndings. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of TI-RADS classiifcation in the diagnosis of benign and malignant thyroid nodules were calculated, and the differences in ultrasonic features between benign and malignant thyroid nodules were also compared.Results The surgical and pathological findings showed that 94 nodules were benign and 157 were sinister; TI-RADS regarded 93 nodules were benign and 185 were malignant. The difference of the two means of identification was significant (χ2=149.6,P<0.01). The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of TI-RADS were 91.2% (144/157), 85.1% (80/94), 89.3% (224/251), 91.2% (144/158) and 86.0% (80/93), respectively. The ultrasonic manifestations of benign and malignant nodules were signiifcantly different with regard to aspect ratio, echogenicity, shape, calciifcation inside the nodule (χ2=8.7-121.4,P<0.01).Conclusion TI-RADS classiifcation standards have a high accuracy in the differentiation of benign and malignant thyroid nodules as a means of ultrasound examination, and thus can serve as an important guiding method in clinical diagnosis and treatment.
2.Repairing sciatic nerve crush injury by transplantation of bone marrow mesenchymal stem cells
Guang YANG ; Weitian YIN ; Jinwei XUE ; Chunyu LI ; Dongyan FAN
Chinese Journal of Tissue Engineering Research 2008;12(25):4948-4951
BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) are conveniently cultured and separated in vitro because theirimmunogenicity is low. Therefore, BMSCs are suitable for cell transplantation. Research has shown that BMSCs are potential to repair neurological defect. OBJECTIVE: To determine whether in vitro cultured BMSCs can be transplanted to repair peripheral nerve injury or not, and to investigate its mechanisms. DESIGN, TIME AND SETTING: Randomized controlled animal study This study was performed in Department of Toxicology, Public Health College of Jilin University from March 2006 to March 2007.MATERIALS: Fifty healthy female Wistar rats aging 2 months and six 1-week-old female Wistar rats were used for extraction of BMSCs. Rabbit-anti-nerve growth factor (NGF) monoclonal antibody was provided by Santa Cruz Company. METHODS:BMSCs were separated and cultured with adherent method. In the 3rd generation, BMSCs were preiabeled with bromodeoxyuridine (BrdU) 48 hours before transplantation. Fifty healthy Wistar rats were selected to prepare sciatic nerve crush injury models with clamping method.Subsequently, rats were randomly divided into transplantation group and control group, with 25 rats in each group. Rats in the transplantation group underwent transplantation of BrdU-labeied BMSCs at nerve injured sites; while, the same volume DMEM was injected into rats in the control group. MAIN OUTCOME MEASURES: Injured nerve in the transplantation group suffered from anti-BrdU staining 1, 2, 4, and 6 weeks after surgery. Distal injured nerve in both groups suffered from NGF immunohistochemical staining 1, 2, 4, and 6 weeks after surgery. Image analysis system was adopted to analyze integrated absorbance of positive expression. Gait analysis was performed every week after surgery to measure sciatic nerve function index, and it was also adopted to measure regenerated nerve conduction velocity 6 weeks after surgery. Subsequently, amount and inner diameter of medullated nerve fibers were calculated after luxol fast blue staining, while wet weight of experimental-lateral gastrocnemius muscle and cross section area of muscle fiber were measured at the same time. RESULTS: Fifty rats were included in the final analysis. BrdU-labeled positive cells could be found at injured nerve in the transplantation group 1, 2, and 4 weeks after surgery. Integrated absorbance of NGF protein expression in the transplantation group was significantly higher than that in the control group 1 and 2 weeks after surgery (P < 0.01), but there were no significant differences between the two groups 4 and 6 weeks after surgery (P > 0.05). Sciatic nerve function index in the transplantation group superiorly recovered to that in the control group 3-6 weeks after surgery. Furthermore, 6 weeks after surgery, nerve conduction velocity, amount and diameter of medullated nerve fibers, wet weight and cross section area of gastrocnemius muscle in the transplantation group were significantly higher than those in the control group (P < 0.05-0.01). CONCLUSION: BMSCs can be transplantated into injuried nerve tissue, and promote the recovery of nerve function in the micro-enviroment, improve NGF expression in an early phase may be one of its mechanisms.
4.Improved analysis of related substances of cobamamide and the impurities research
Hongmiao YANG ; Haiming LIAO ; Xue REN ; Huihong FAN
Chinese Journal of Biochemical Pharmaceutics 2015;(6):157-160,164
Objective To improve the related substances analysis method of cobamamide.And to further research light degradation characteristics of cobamamide.Methods Determined the related substances of solid and aqueous solution of cobamamide after light degradation by high performance liquid chromatography(HPLC) conditions,which is Merck Hibar C18 column (4.6 mm ×250 mm, 5μm), 0.05 mol/L KH2PO4 solution:acetonitrile (90:10) -80% acetonitrile as mobile by gradient elution and detection wavelength 260 nm.And compared their light stability.The main three kinds of light degradation impurities were determinate from LC-MS.Results Gradient elution made the light degradation impurities separate better.The results of precision and reproducibility tests increased to RSD =0.2% (n=6) and RSD =8% (n=5) from RSD =3.8% (n =6) and RSD=38%(n=5). Cobamamide solution was very sensitive to light, the preparation should be strict dark operation.Two of the light degradation impurities were adenosine and hydroxycobalamin, with the relative response factor 2.5 and 0.7.Conclusion New method is specific, durable and reproducible, which can be used for quality control of cobamamide.
5.Improving doctor-patient relationship, enhancing the oral cavity medical service effect
Ming-cong YANG ; Xiao-ping FAN ; Xue-rong XIANG
Chinese Journal of Medical Education Research 2011;10(7):851-853
While the medicine pattern of biomedicine turn to biological-psychology-society, the medical trouble communication becomes more and more important in the medical service. Good medical trouble communication ability is the essential condition of doctor. As oral cavity clinicians, only by gasping the principle of communication can we appropriately utilize some skills of communication exchange,establish the good medical trouble relations with the patient and achieve the good treatment result finally.
6.Management of breakthrough cancerous pains: a literature view
Qianqian ZHAO ; Zhihui YANG ; Lili ZHANG ; Yingwei FAN ; Xue MI ; Zhongyi FAN
Modern Clinical Nursing 2016;15(12):64-68
7.To provide safer and better emergency service for elderly patients
Jin FAN ; Ming YIN ; Lining XU ; Yang SONG ; Ruihua CAO ; Xue YANG
Chinese Journal of Geriatrics 2016;35(12):1263-1266
8.Clinical significance and the expression of NT-proBNP and copeptin in patients with acute cerebral hemorrhage
Yongkai YANG ; Fan ZHANG ; Shaohua XUE ; Xiangzhong HE ; Wei GAO ; Dun LIU ; Xiaohui ZHOU
Chongqing Medicine 2015;(7):910-912
Objective To investigate the relationship of plasma concentration of NT-proBNP,copeptin and glasgow coma scale(GCS)scores,hematoma volumes in patients with acute cerebral hemorrhage.Methods 109 patients with acute cerebral hem-orrhage(the cerebral hemorrhage group)and 32 healthy individuals (the control group)admitted in our hospital from December 2011 to June 2013 were selected and detected for plasma NT-proBNP and copeptin.The levels of NT-proBNP,copeptin,glasgow co-ma scale(GCS)scores and hematoma volumes were compared between the two groups.Results The levels of plasma NT-proBNP and copeptin in the cerebral hemorrhage group were significantly higher than that in control group(P <0.05).The levels of plasma NT-proBNP and copeptin were significantly increased with the severity and the hematoma volume of the acute cerebral hemorrhage. The levels of NT-proBNP and copeptin are positively correlated with hematoma volumes(r=0.63,r=0.58,P <0.01)and negative-ly correlated with Glasgow Coma Scale(GCS)scores(r=-0.52,r=-0.46,P <0.01).Conclusion The levels of NT-proBNP and copeptin are positively correlated with hematoma volumes and negatively correlated with glasgow coma scale(GCS)scores.They are important clinical parameters to reflect the severity and hematoma volumes of the acute cerebral hemorrhage.
9.Effects of agmatine on excessive inflammatory reaction and proliferation of splenic cells in mice with trauma
Zheng LIU ; Fengyan HOU ; He JIN ; Ya XIAO ; Xia FAN ; Xue YANG ; Jun YAN ; Huaping LIANG
Chinese Critical Care Medicine 2015;(2):110-114
ObjectiveTo observe protective effects of agmatine (AGM) on inflammatory response and spleen immune function in mice with trauma.Methods Forty-eight adult male C57BL/6 mice were randomly divided into three groups (n= 16 each), including control group, model group (bilateral femoral fracture and removal of 35% of the total blood volume), and AGM group (trauma/hemorrhage & AGM 200 mg/kg). Eight mice in each group were sacrificed at 3 hours and 24 hours, respectively, after modeling, and blood samples and tissue homogenate of spleen and liver were collected. The contents of tumor necrosis factor-α (TNF-α), interleukins (IL-6, IL-1β) in serum and liver tissue were determined with enzyme linked immunosorbent assay (ELISA). Serum aspartate transaminase (AST), alanine aminotransferase (ALT) and lactic dehydrogenase (LDH) were determined with automatic biochemistry analyzer. Spleen proliferation response stimulated with concanavalin A (ConA) was evaluated with methyl thiazolyl tetrazolium colourimetry (MTT).γ-interferon (IFN-γ) and IL-2 releases were determined with ELISA.Results Compared with control group, 3 hours after trauma/hemorrhage, the levels of serum TNF-α, IL-6, and IL-1β in model group were significantly elevated [TNF-α (ng/L): 145.38±31.50 vs. 23.06±11.14, IL-6 (ng/L): 496.94±50.76 vs. 47.13±17.47, IL-1β (ng/L): 321.31±43.02 vs. 29.25±16.24,allP< 0.01]. It was found that AGM treatment could alleviate the increase in serum pro-inflammatory mediators induced by trauma/hemorrhage, such as TNF-α (ng/L:111.56±25.47 vs. 145.38±31.50), IL-6 (ng/L: 412.56±44.33 vs. 496.94±50.76), IL-1β (ng/L: 273.38±45.25 vs. 321.31±43.02,P< 0.05 orP< 0.01). Twenty-four hours after trauma/hemorrhage, serum pro-inflammatory mediators were recovered to the levels in control group. There was no significant difference in TNF-α and IL-6 levels at 3 hours after trauma/hemorrhage among groups. Compared with control group, the expressions of liver TNF-α and IL-6 in model group were increased at 24 hours following trauma [TNF-α (ng/mg): 32.93±4.90 vs. 26.58±2.33, IL-6 (ng/mg): 11.20±1.66 vs. 8.38±0.89,bothP< 0.01]. However, AGM inhibited the level of TNF-α (ng/mg:28.92±3.16 vs. 32.93±4.90) and IL-6 (ng/mg: 9.03±1.28 vs. 11.20±1.66) in the liver as induced by trauma/hemorrhage (P< 0.05 andP< 0.01). At 24 hours after modeling, model group and AGM group had distinctly higher serum AST, ALT, LDH levels than those of control group [AST (U/L): 405.9±31.2, 245.7±22.1 vs. 128.2±15.9; ALT (U/L): 92.1±6.3, 51.6±5.0 vs. 30.1±3.2; LDH (U/L): 606.7±36.3, 478.7±25.3 vs. 384.0±16.6, allP< 0.01]. Nevertheless,the increase in serum AST, ALT and LDH was alleviated in AGM group (allP< 0.01). Meantime, trauma/hemorrhage produced a noticeable depression of proliferation of splenic cells and IFN-γ and IL-2 release stimulated with ConA compared with control group [proliferation rate: (40.97±4.13)% vs. (89.99±7.76)%, IFN-γ(ng/L): 91.6±12.3 vs. 353.2±21.5,IL-2 (ng/L): 53.4±6.4 vs. 91.0±12.2,allP< 0.01]. In contrast, AGM notably restored the capacity of proliferation response of splenic cells [proliferation rate: (74.86±5.75)% vs. (40.97±4.13)%, P< 0.01],enhanced the release of IFN-γ and IL-2 stimulated with ConA [IFN-γ (ng/L): 327.8±23.6 vs. 91.6±12.3, IL-2 (ng/L): 74.8±10.4 vs. 53.4±6.4, bothP< 0.01].Conclusion AGM can dramatically alleviate spleen immunosuppression, excessive inflammation and organ damage induced by trauma/hemorrhage.
10.Effects of vacuum sealing drainage on oxygen partial pressure and wound healing in rabbits
Fan YANG ; Rui HU ; Xiangjun BAI ; Renjie LI ; Kun ZHANG ; Chengcheng XUE ; Bo LI
Chinese Journal of Emergency Medicine 2011;20(9):940-944
ObjectiveTo investigate the effect of vacuum sealing drainage (VSD) with different negative pressures on variation of oxygen partial pressure (PtO2 ) and wound healing in the rabbits.MethodsTwelve rabbit wound models were made and randomly (random number) divided into two groups, namely vacuum group ( n =6 )in which rabbits were treated with VSD by different negative pressures ( - 75 mmHg,- 125 mmHg,- 225 mmHg and - 350 mmHg) for 7 days, and routine treatment group ( n =6). At each interval of measurement, variation of PtO2 was measured by oxygen partial pressure admeasuring device, and area of VSD dressing and surface of wound were measured by vernier caliper, and growth of anaerobic bacteria was detected by bacterial culture, and morphological change and the course of wound healing were observed under by light microscope after HE tissue staining. Meanwhile anther two groups (n =6, in each) were set for comparing, including normal group, sham operation group. ResultsAverage PtO2 value of vacuum group was in the range of ( 1.87 +0. 19) kPa to ( 1.54 ±0. 21 ) kPa which was decreased gradually in 7 days under different negative pressures. Average PtO2 value of routine treatment group and normal group were ( 2. 82 ± 0. 37 ) kPa and ( 5.79 + 0. 50 ) kPa, respectively which weresignificant higher than that in vacuum group ( P < 0. 01 ). PtO2 was fell to 80. 94% of its original value after VSD for 5 seconds, and continued the downward trend with the increasing of negative pressure at the same interval of measuring. Area of VSD dressing significantly decreased to 65. 36% of its original area after VDS for5 minutes (P<0.01). Surface of wound was minimized to 62. 82% of its original area after VSD for 7 days ( P < 0. 01 ), and variations of those in - 350 mmHg group were significant greater than those in other groups ( P < 0. 01 ). There was no evidence of anaerobic bacteria growth in vacuum group during this experiment. ConclusionsPtO2 could be down-regulated by VSD significantly without growth of anaerobic bacteria, and minimization of VSD dressing at - 350 mmHg was significantly helpful to reduce the area of wound for promoting the healing.