Objective To observe the response of activated microglia/macrophages within and around the lesion site after rats' spinal cord injury treated with chitosan.Methods 35 adult female Wistar rats were randomly divided into the sham group (n=5), completely transection group (n=15) and chitosan treated group (n=15). The responses of activated microglia/macrophages on the 1st day, 3rd day, 7th day, and in the 2nd week and 4th week after surgery were examined by immunohistochemistry.Results Microglia/macrophages were fully activated and the number of these cells increased and got the highest level on the 3rd day post injury, then quickly decreased. In the chitosan treated animals, the microglia/macrophages were fully activated and the number increased to peak on the 7th day, then quickly decreased, there were still a few microglia/macrophages around the wound in the 2nd to 4th week after the treatment.Conclusion Microglia/macrophages could be recruited within and around the lesion area longer when treated by chitosan.

Objective To investigate the predictive value of symmetrical ambulatory arterial stiffness index (S-AASI) in detecting early renal impairment of patients with essential hypertension.Methods Totally 245 consecutive out-patients were confirmed with essential hypertension,and were divided into group A (56 cases),group B (64 cases),group C (72 cases),and group D (53 cases) according to the quartile of S-AASI.The combination testing of serum cystatin C,serum β2-microglobulin as well as urine microalbumin to creatinine ratio were implemented as laboratory diagnosis index of renal impairment in early stage and 109 essential hypertension patients were diagnosed with early renal impairment.The parameters were compared among 4 groups.Pearson correlation analysis and partial correlation analysis were performed to confirm the relationship between the markers of early renal impairment and S-AASI.The predictive value of S-AASI to detect early renal injury was evaluated by analyzing Receiver Operating Characteristic (ROC) curve.Results With the rising of S-AASI,age as well as 24 hours mean systolic blood pressure (24 h SBP),serum cystatin C,serum β2-microglobulin,urine microalbumin to creatinine ratio and the incidence rate of early renal injury went notably higher while estimated glomerular filtration rate (eGFR) decreased significantly.After controlling for age,correlation test showed S-AASI was positively correlated with24hSBP,serum cystatin C,serumβ2-microglobulin,urine microalbumin to creatinine ratio(r =0.392,0.627,0.514 and 0.643 respectively,P ＜ 0.05) and negatively correlated with eGFR(r =-0.312,P ＜ 0.05).The 24 hours mean diastolic blood pressure (24 h DBP) was uncorrelated with S-AASI.Area under ROC curve of S-AASI for diagnosis of hypertensive renal impairment was 0.885.The critical value of S-AA-SI was 0.17,the sensitivity,specificity,positive predictive value,and negative predictive value were 92.7％,65.2％,68.5％,and 91.7％,respectively.Conclusions When S-AASI was detected above 0.17,patients with hypertension had a higher risk of renal impairment.Higher S-AASI was correlated with worse early renal impairment laboratory indexes.The predictive accuracy of S-AASI for early hypertensive renal impairment was medium.

Objective To establish criteria for determination of sputum retention in elderly patients with non-ar-tificial airway. Methods Interview and Delphi methods were used to preliminarily determine clinical indication of sputum retentionand its classification through two-round expert consultation among 25 experts. Final criteria for de-termination of sputum retention were determined through experts group discussion. Results During the two rounds of consultation,all the questionnaires were collected,the experts' authority coefficients were 0.936 and 0.926 respec-tively,and the coordination coefficient of expert opinion was statistically significant.Criteria for determination of spu-tum retention included ineffective cough plus auscultation phlegm sound,with or without complaining of sputum,de-creased blood oxygen saturation,difficulty breathing and cyanosis. Conclusion Based on expert consultation and ar-gument,the criteria for determination of sputum retention can facilitate clinical nurses to detect sputum retention.

OBJECTIVE: To investigate the value of each single and combined applications of ultrasound thyroid imaging reporting and data system (TI-RADS), ultrasonic shear wave elastography in the diagnosis of thyroid microcarcinoma (TMC). METHOD: 323 patients with thyroid tiny nodules confirmed by surgery and pathology were analyzed prospectively. Then their TI-RADS and shear wave elastography features were summarized. SWE elasticity indices (mean, minimum and maximum value of interest) of nodules were measured. The surgical pathology results were regarded as the gold standard to calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS, shear wave elastography and their combination in the diagnosis of TMC. The receiver operating characteristic (ROC) curve of TI-RADS, shear wave elastography and combined application of both were drawn. The area under the ROC curve were calculated. Furthermore, the value of combined application of both examinations in the diagnosis of thyroid microcarcinoma (TMC) was investigated. RESULT: From 323 nodules,253 were thyroid carcinomas and 70 were benign. Areas under the ROC curves (AUC) of SWE parameters were 0. 648,0. 629 and 0. 605. For SWE, the optimal cut-off value according to ROC curve was SWE_max = 65.50 kPa and SWE_mean = 37.50 kPa. Generally, the sensitivity, specificity, accuracy, PPV and NPV were 88.14%, 82.86%, 87.00%, 94.89% and 65.91% for TI-RADS, and 49.01%, 74.29%, 54.49%, 87.32% and 28. 73% for SWE. There were statistically significant differences in the sensitivity, accuracy, PPV and no statistically significant differences in the specificity, and NPV. The sensitivity,specificity, accuracy, PPV and NPV were 95.26%, 67.14%, 89.16%, 91.29% and 79.66% for combined application of both. The area under the ROC curve of TI-RADS, shear wave elastography and their combination were 0.763, 0.616, 0.804. For nodules ≤ 5 mm, the sensitivity, specificity, accuracy, PPV and NPV were 91.67%, 66.67%, 87.07%, 92.44% and 64.29%. However, for nodules 5-10 mm,the sensitivity,specificity, accuracy, PPV and NPV were 98.50%, 67.44%, 90.91%, 90.34% and 93.55%. CONCLUSION The diagnose of TMC can be further improved by combined application of ultra-sonic TI-RADS and SWE.
Carcinoma ; complications ; Elasticity Imaging Techniques ; Humans ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; diagnosis

Objective To observe the treatment effects of trimetazidine on myocardial bridge. Methods A total of 76 patients with clinical symptoms, such as different degrees of chest tightness, palpitation, breath shortness, chest pain, were diagnosed as coronary myocardial bridge by coronary angiography, and were divided into two groups randomly. While control group (n=40) was given beta-blocker or (and) calcium antagonist as routine treatment. The treatment group (n=36) was given routine treatment and trimetazidine, 20 mg, three times daily. The mean follow-up period was 12 weeks. The episodes of chest pain per week, exercise tolerance, anxiety and depression scores, total ischemic burden in 24 h and walking distance in 6 min were observed in two groups of patients. Results The parameters of chest pain times per week, exercise tolerance, anxiety and depression scores, total ischemic burden in 24 h and walking distance in 6min were improved in treatment group compared with control group, and the symptoms were effectively relieved, the life quality of patients were improved. Conclusion The conventional treatment combined with trimetazidine is safe and effective, which can further improve myocardial energy metabolism and exercise tolerance, and enhance the clinical effect and the life quality of patients.

Disease bio-banks are an important strategic resource for medicine development. Such a bank with complete information and high information sharing enhances the competitiveness of medicine and promote the development of translational medicine. The present development of such banks is found with such setbacks as weak government leadership and standardization, as well as lack of a sharing mechanism. Therefore medical institutions should strengthen their standardization and informationization of disease bio-banks, which deserve sufficient government policy support and guidance. These efforts will help preserve our rich clinical resources, in addition to their integration and sharing for medicine advancement.

Objective To evaluate whether patients with BI‐RADS category 3 breast lesions can be managed safely by 1‐year follow‐ups using ultrasound elastography .Methods Data from 164 patients who underwent conventional B‐mode ultrasound and ultrasound‐based elasticity examinations from September 2009 to March 2014 ,and had BI‐RADS category 3 lesions that appear to be circumscribed and oval in shape with elasticity scores of 1 -2 ,were retrospectively reviewed .Results Of 331 BI‐RADS category 3 lesions that originally appeared circumscribed and oval in shape in 164 women ,the mean follow‐up period was 21 3. months (range ,12-48 months) ,and 330 (99 7.% ) were unchanged at follow‐up and considered probably benign .One lesion was upgraded to BI‐RADS category 4a ,and a subsequent biopsy pathologically confirmed it was a fibroadenoma .Conclusions BI‐RADS category 3 lesions with elasticity scores of 2 or lower can be reclassified as BI‐RADS category 2 lesions .A 1‐year follow‐up may be adequate for women undergoing screening ultrasonography ,which are found to have BI‐RADS category 3 lesions that appear to be circumscribed and oval in shape with elasticity scores of 1-2 .

Objective To design a worksheet generation software for satisfy the two CHEMCLIN ? 600 instruments (CC 600) and laboratory information system(LIS) data transmission needs in Daxing Hospital of Capital Medical University ,ensure consis‐tency and uniqueness of the test sample number .Methods Microsoft Visual Studio 2010 and DotNetBar for Windows Forms were used to develop a work table generation software .Results Work table generation software had good interface ,and the CC 600 sys‐tem interaction had the advantage of simple operation ,generation of working table was operating normally ,and data transmission with laboratory information system was correct .Conclusion The worksheet generation software solves CC 600 linking problem be‐tween different test batches ,gives full play to the detection performance of the two instruments ,clinical application effect is good .

Objective To establish a mouse model of orthotopic Lewis lung carcinoma using Matrigel, to evaluate the tumor growth and metastasis, and to provide a more stable mouse model of orthotopic lung cancer, which is more similar to human lung cancer.Methods Logarithmic phase of cultured Lewis lung cancer cells were suspended in Matrigel, vac-cinated into the left lung of inbred C57BL/6 mice.Five mice were killed on the 4th, 7th, 10th, 13th, and 16th days, re-spectively, and to observe the median survival, tumor formation rate, tumor growth, and metastasis.Pathological changes of the mouse lung, liver, kidney and spleen were examined.Results In 5 mice killed on the 7th postoperative day, small tumor nodules were observed on the lung in three mice and no tumor was visible by gross inspection in the other two mice, but small tumor nodules were observed under the microscope.For all the mice killed on the 10th postoperative day, tumors were visible to the naked eye on the lung of all the five mice.On the 13th day, orthotopic tumor was observed on the lung with bloody pleural effusion and pleural metastasis in all the five mice.On the 25th day, in addition to the pleural metasta-sis, one mouse had pericardial metastasis and renal metastasis.The survival periods of the 5 mice were 17 d, 20 d, 22 d, 22 d, and 25 d, respectively, with a median survival period of 21.2 d (17-25 d), and the tumor formation rate was 100%.Conclusions Mouse models of orthotopic Lewis lung carcinoma is successfully established using injection of tumor cells suspended in Matrigel.This model is more similar to the growth of human lung cancer, with good stability, high tumor formation rate and characteristics of distant metastasis, therefore, is worthy of further application.

Objective To investigate the expression change of renal NLR family pyrin domain containing-3 protein(NALP3) in-flammasome in the nephrotic syndrome(NS) patients with focal segmental glomerulosclerosis(FSGS) and its relation with the tubu-lointerstitial pathogenic injury degree ,expression of inflammatory factors and clinical biochemical indexes .Methods Immunohisto-chemistry was used to detect the expressions of NALP3/ASC/caspase-1 and their downstream effector molecule IL-1β,IL-18 in re-nal tubular epithelial cells .The tubulointerstitial injury score and the activated macrophages F4/80 in renal interstitium of the FSGS patients and NS patiens were evaluated .The serum creatinine ,urea ,total protein ,albumin ,24 h urine protein and estimated glomer-ular filtration rate(eGFR) were observed .The correlation of tubulointerstitial injury with NALP3/ASC/caspase-1 ,IL-1β,IL-18 were respectively analyzed .Results The expression of NALP3/ASC/caspase-1 ,IL-1β,IL-18 in the renal tissue of the FSGS pa-tients was significantly increased compared with that in the control group (P<0 .01) .NALP3/ASC/capspase-1 expression was pos-itively correlated with the expression of IL-1β,IL-18(P< 0 .01) .NALP3/ASC/caspase-1 ,IL-1β,IL-18 expression was positively correlated with renal tubulointerstitial injury and the F4/80 expression intensity(P<0 .01) .NALP3/ASC/caspase-1 ,IL-1β,IL-18 was significantly positively correlated with 24 h urine protein and Scr ,and negatively correlated with the eGFR (P<0 .05) ,but had no obvious correlation with plasma urea ,plasma total protein and albumin concentrations .Conclusion The NALP3 inflammasome might participate in the pathogenic mechanism of FSGS through the activation of its downstream inflammatory factor of IL-1β,IL-18 ,the more higher its expression degree ,the more severe the renal tissue injury ,whether which could be served as the warning in-dex needs the further clinical verification .