The vulnerable carotid atherosclerosis plaque is an important risk factor for ischemic stroke.However,there are no objective diagnostic criteria for the vulnerability of carotid atherosclerosis plaque in clinical practice now.This article reviews the progress in the diagnosis of vulnerable plaque from the aspects of ultrasound,CT,MRL cerebral angiography,and biochemical indexes.

Patients with nonvalvular atrial fibrillation are the high-risk population of ischemic stroke.Anticoagulation therapy is mainly used to prevent the occurrence of stroke in clinical practice.However,there are some difficulties in the conventional administration of oral anticoagulant warfarin because of some restrictions.There are a number of novel oral anticoagulants with promising data for the prevention of stroke in nonvalvular atrial fibrillation,such as direct thrombin inhibitor and coagulant factor X a inhibitor.

Objective To explore the relation between thyroid nodular and thyroid calcification .Methods The clinical data of 430 cases with nodular goiter admitted from January 2011 to December 2013 were reviewed.All cases were performed ultrasonography and pathologic examination .Results Of 430 cases,there was thyroid carcinoma in 49 cases(11.4%),including microcalcification in 30 cases(61.2%) and macrocalcification in 3 cases(6.1%);benign lesion in 381 cases(88.6%),including microcalcification in 24 cases(6.3%) and macrocalcification in 39 cases(10.2%).The difference was remarkable (P=0.000).There was remarkable difference in malignant calci-fied nodules ratio between the patients with microcalcification and macrocalcification (55.6%vs 7.1%,P=0.000), between the patients aged 45 years below and above(48.8%vs 22.6%,P=0.007),between the patients with solita-ry and multiple nodules(45.0%vs 16.7%,P=0.005).But there was no statistic difference in malignant calcified nodules ratio between the male and female groups (24.2% vs.39.7%,P=0.130).Conclusion Microcalcification is a highly specific sign to predict thyroid carcinoma in ultrasonography exam .Positive intervention will be performed immediately when calcification appears in thyroid nodules .

Objective To investigate the clinical features of early postoperative inflammtory small bowel obstruction,and discuss its diagnosis,treatment and preventive measures.Methods The clinical data of 68 cases of early postoperative inflammatory small bowel obstruction were analyzed retrospectively.Results Within the 68 cases,65 cases were cured by non-operative treatment including gastrointestinal decompression,anti-inflammatory drugs,somatostatin,total parenteral nutrition(TPN) and traditional Chinese medicine.The mean time from the onset of symptoms to the recovery of bowel function was 14 days.Three cases were cured by transferring to operation.One case of them was transferred to operation for strangulated intestinal obstruction during the period of conservative treatment.One case underwent oper.ion because the patient didn t recover after 4 weeks expectant treatment.One case underwent operation for the impatience with the conservative treatment of both the doctors and the patient.Conclusion Non-operative therapy should be the first choice for the treatment of early postoperative inflammatory small bowel obstruction,and its therapeutical effect was well-accepted.

Objective To explore the effect of separate management of income and expenditure (SMIE) on standard community healthcare services. Methods Health management records of 137 community health service ( CHS) institutions in Beijing during 2006 and 2009 were retrospectively analyzed. Paired t test was used to compare annual healthcare services at urban and rural areas before or after SMIE was adopted. Results The standard community healthcare services was reduced from 1 081 965. 53 to 971 793. 98 at urban areas and from 157 492. 23 to 149 305. 25 at rural areas (P >0. 05). Urban healthcare center-based standard services was decreased from 59. 94% to 52. 14% (P < 0. 05 ); while out-hospital services were increased from 13. 50% to 18. 88% (P<0. 05). In urban areas,standard services for women healthcare, chronic disease profiling, health education and information management were significantly increased (I <0. 05). However,Temporary observation and endemic disease prevention and treatment were the main job of rural healthcare. Conclusions SMIE in CHS institutions could accommodate to the need of health management, supporting policies should be further improved.

0.05). There was statistically significant difference in morbidity rate between the groups (2.1% vs 9.3%, P=0.037). Conclusions: Percutaneous and surgical treatment of pyogenic liver abscesses are both effective, nevertheless percutaneous drainage carries lower morbidity and should be the first-line treatment.

Purpose To evaluate the expression of miR-21 in the tissues and cell lines of hepatocellular carcinoma,and to try to find its possible target genes.Methods The expression profile of miR-21 was detected in hepatocellular carcinoma tissues and cell lines.Mter miR-21 inhibitor was used,the alterations in the vitality and invasion of hepatocellular carcinoma cells were observed.The possible target gene of miR-21 was predicted by bioinformatics analysis.The influence of miR-21 inhibitors on the target gene activity was evaluated by dual luciferase reporting gene system.Results The expression level of miR-21 was significantly higher in hepatocellular carcinoma tissues than that in the adjacent ones (P ＜0.05).The expression level of miR-21 in hepatocellular carcinoma cells was significantly higher than that in the hepatic cells (P ＜0.01).After inhibiting miR-21,the viability and invasion ability of hepatocellular carcinoma cells were decreased (P ＜ 0.01).The expression level of programmed cell death 4 (PDCD4) in hepatocellular carcinoma tissues was significantly lower than that in the adjacent tissues (P ＜ 0.01).Its expression level in hepatocellular carcinoma cells was significantly lower than that in the hepatic cells (P ＜ 0.01).After interfering with PDCD4,the vitality and invasion ability of liver cancer cells were increased (P ＜ 0.05).Dual luciferase reporter gene assay indicated that by inhibiting miR-21,the expression level of PDCD4 was up-regulated (P ＜ 0.01).The vitality and invasion ability of liver cancer cells were reduced (P ＜ 0.001).Conclusion MiR-21 can regulate the growth and invasion of liver cancer cells through targeting PDCD4.

Objectiye To investigate the clinical application value of emergency therapeutic encoscopic retrograde cholangio-pancreatography (ERCP) on acute biliary-pancreatic diseases.Methods Duodenoscope was applied on the emergency treatment for 103 patients of acute biliary-pancreatic diseases from March 2007 to May 2010. According to patients' conditions, the examination of ERCP,endoscopic nasobiliary drainage (ENBD) and endoscopic sphincterotomy (EST) were carried out. The papilla sphincter was slivered by needle knife under the circumstances of the stone incarceration in the papilla,then calculus was removed by net basket. ENBD or endoscopic retrograde biliary drainage (ERBD)was placed according to the state of an illness. Statistical analysis was made by SPSS 13.0 software with a 2 × 2 table analysis, Comparison of ratio were determined with x2 test, a value less than 0. 05 was considered as significant. Results Of 103 cases, the success rate of endoscopic treatment was 97. 1% ( 100/103 ).Among 100 cases, 25cases (24. 3% ) were treated with ERCP and ENBD/ERBD; 12 cases (11.7%) were treated with ERCP, needle knife fenestration and ENBD; 67 cases (65. 1% ) were treated with ERCP,EST, calculus removal and ENBD; 8 cases (7. 8% ) were treated with ERCP, EST and ERBD. Of 100 cases one (1.0%) suffered from postoperative hemorrhage of duodenal papilla, which was cured by endoscopic hemostasis. Compared with selective cases those undergoing emergency ERCP often needed two stage procedures (P = 0. 010), but there are no statistical differences between two groups in success rate (P = 0. 122). Conclusions Emergency ERCP are safe and effective in acute biliary-pancreatic diseases.

Digital polymerase chain reaction ( PCR) has been experiencing a rapid development during the past few years. Comparing with the traditional real-time quantitative PCR ( RT-qPCR) , using the same primer and probe, the accuracy for the absolute quantification of target gene is significantly improved. The development of digital PCR is directly related to the development of microfluidics. The integrated fluid circuit is an early combination of the microfluidics and digital PCR, which has a complicated fabrication process with high cost. Recently, researchers are trying to apply the droplet microfluidics in digital PCR, and the droplet microfluidic chip is able to generate millions of droplets within a short time. Each of these droplets containing no more than one target gene is a reaction chamber during the amplification process. After amplification, each droplet is tested to achieve the absolute quantification of the target gene. This paper reviews the recent progresses of droplet digital PCR, and the applications of droplet digital PCR in biological, medical and environmental fields.

Objective: To explore the antagonistic effect of quercetin on fine particulate matter (PM2.5)-induced embryonic developmental toxicity in vitro.Methods: PM2.5 was collected on glass fiber filters by PM2.5 samplers during the heating period of Dec.2015 to Mar.2016 in an area of Haidian District, Beijing City.The sampled filters were cut into 1 cm×3 cm pieces followed by sonication.The PM2.5 suspension was filtered into a 10 cm glass dish through 8 layers of sterile carbasus and stored at-80 ℃ until freeze drying.Frozen PM2.5 suspension was dried by vacuum freeze-drying.In vitro post-implantation whole embryo culture was used in this study.Pregnant rats with 9.5 gestation days (GD) were killed by cervical dislocation and the uteri were removed into sterile Hank's solution.The embryos with intact yolk sacs and ecto placental cones were induced by PM2.5, and then subjected to intervention of quercetin at the doses of 0.1 μmol/L, 0.5 μmol/L, 1.0 μmol/L and 5.0 μmol/L, respectively.At the end of the 48 h culture period, the cultures were terminated, and all embryos were removed from the culture bottles and placed in prewarmed Hank's solution for evaluation.Morphological evaluation of the embryos was conducted under a stereomicroscope using the morphologic scoring system by Brown and Fabro.The mitochondrial reactive oxygen species (ROS) level was detected by FACSCalibur flow cyto-metry using MitoSOXTM Red staining.Results: An obvious antagonistic effect was achieved through querce-tin at the dose of 1.0 μmol/L, which could result in an increase of visceral yolk sac (VYS) diameter, crown-rump length and head length, somite number, and the differentiation of visceral yolk sac vascular vessels.The scores of allantois, flexion, heart, hind brain, midbrain, forebrain, auditory system, visual system, olfactory system, branchialarch, maxillary process, forelimb bud and hindlimb bud also revealed a significant increase and the relative mitochondrial ROS level of embryonic cells was significantly decreased when compared with PM2.5 group.Although quercetin at the doses of 0.1 μmol/L, 0.5 μmol/L, 5.0 μmol/L also exhibited protective effects against PM2.5-induced embryonic developmental toxicity, the protective effect was weaker when compared with the dose of 1.0 μmol/L.Conclusion: Quercetin at proper dose may be of great benefit for the development of embryos exposed to PM2.5 in the uterus of the rats.Quercetin provides an effective strategy for the prevention of PM2.5-induced embryonic developmental toxicity.Clearance of mitochondrial ROS may be one of its mechanisms.