Objective The widely use of ultrasound elastography has increased the detection rate of breast cancer.It has great advantage of differential diagnosis of breast tumor.Our study is to evaluate and compare the value of the quantitative ultrasound elastography parameters of AR ( area ratio) , ESR ( entire strain ratio) , LSR ( locolized strain ratio) , EFLR( entire fat to lesion ratio) and LFLR( locolized fat to lesion ratio) in the differential diagnosis of breast tumor. Methods 110 patients with 113 breast tumors were collected from Nanjing General Hospital of Nanjing Military Region between January 2015 and January 2016 who underwent breast exami-nation.The tumors were divided into two groups according to patholo-gy which acts as gold standard:benign group with 59 lesions and ma-lignant group with 54 lesions.Participants underwent quantitative ul-trasound elastography parameters examination.AR、ESR、LSR、EFLR、LFLR were compared between benign group and malignant group and ROC curve was drawn.Conventional ultrasound and ultrasound elastography parameter are combined to differentiate the benign or malignant lesion.Calculate the various parameters on the accuracy、susceptibility、specificity、positive likelihood ratio、negative likeli-hood ratio of the diagnosis of benign and malignant lesions, and determine the quantitative parameter with the highest accuracy. Results The mean value of AR、ESR、LSR、EFLR and LFLR of malignant lesions were all significantly greater than that of benign le-sions (P=0.000).Compared with the conventional ultrasound, AR、ESR、LSR、EFLR and LFLR have higher AUC in the differentia-tion of benign and malignant breast lesions;AUC of AR and ESR are higher than conventional ultrasound、LSR、EFLR and LFLR( P<0.000).Compared with conventional ultrasound(1.523) alone, conventional ultrasound combined separately with AR、ESR、EFLR and LFLR have higher positive likelihood ratio(11.581、8.272、3.482、2.458、2.100) in the differentiation of benign and malignant breast lesions, so as accuracy、susceptibility、specificity(P<0.000).The AUC of conventional ultrasound combined separately with AR and ESR[0.940(0.890~0.990)、0.941(0.891~0.990)] were higher than conventional ultrasound and conventional ultrasound com-bined separately with LSR、EFLR、LFLR[0.669(0.669~0.768)、0.837(0.759~0.915)、0.763(0.673~0.852)、0.787(0.701~0.874)],so as accuracy、susceptibility、specificity and positive likelihood ratio(P<0.000). Conclusion Quantitative ultrasound elastography may be helpful in differentiation of benign and malignant breast lesions, especially combining conventional ultrasound with AR and ESR, which were superior to combining with the other parameters and provide a more objective and credible basis to differenti-ate benign and malignant breast tumors with conventional ultrasound.

BACKGROUND: Now, the current study has not yet confirmed two treatment methods of the proximal femoral nail antirotation and total hip arthroplasty for treating intertrochanteric fractures in the elderly, which method has more advantages, and there is no clear conclusion at present. OBJECTIVE: To systematical y compare the repair effect of proximal femoral nail antirotation and total hip arthroplasty for treatment of intertrochanteric fractures in the elderly. METHODS: We searched the related literatures from 2011 to 2015 on Wanfang database, PubMed, MEDLINE and Embase database by computer. We retrieved the journals in China by hand and col ected randomized control ed trials on proximal femoral nail antirotation and total hip arthroplasty in the treatment of intertrochanteric fractures in the elderly. Intraoperative blood loss, operation time, hospitalization time, ambulation time after operation, and Harris score were selected as evaluation indexes. Data were analyzed using RevMan 5.2 software. RESULTS AND CONCLUSION: Final y, 7 Chinese literatures were included, with 811 patients. The results of meta analysis showed that the hospitalization time and ambulation time after operation were significantly shorter in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01), which reduced the pain of patients. Operation time and intraoperative blood loss were poorer in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01). No significant difference in Harris hip score was detected between the two groups (P > 0.05). These results confirmed that the internal fixation of proximal femoral nail antirotation in minimal y invasive therapy when reducing operation time and blood loss has a certain advantage. The total hip arthroplasty can make the recovery of hip function earlier, al ow early weight-bearing walking, reduce the patients’ bedridden time and reduce the complications in bed. Thus, the clinicians in the practical work should choose the appropriate therapy with considering the patient’s condition, damage degree, fracture type, and financial capability.

BACKGROUND:Current research data have shown that patients with epilepsy are often accompanied by complications such as cognitive impairment. Recent studies have demonstrated that melatonin has an inhibitory effect on epilepsy, but its underlying mechanism is unknown. OBJECTIVE: To investigate the effects of melatonin on the cognitive function and GluR2 expression in the hippocampus of rat models of epilepsy, and further study the mechanism of melatonin against epilepsy. METHODS: Rat models of chronic epilepsy were established by intraperitoneal injection of lithium chloride-pilocarpine, and intraperitonealy injected with sufficient amount of physiological saline and melatonin respectively. Control group was set for observation. RESULTS AND CONCLUSION:At 4 and 6 weeks after modeling, the GluR2 expression level in the hippocampus of rats in the epilepsy + melatonin group was significantly higher than that in the epilepsy group (P < 0.05); the GluR2 expression level in the synaptic membrane of hippocampal CA1 region of rats in the control and epilepsy + melatonin groups was significantly higher than that in the epilepsy group (P < 0.05). At 4 days after modeling, compared with epilepsy group and epilepsy + physiological saline group, the escape latency, operation time, active avoidance latency, passive avoidance latency of rats in the epilepsy + melatonin group were significantly decreased (P< 0.05), the correct rate and active avoidance number were significantly increased (P < 0.05). These results demonstrate that melatonin can improve the cognitive function of rat models of epilepsy by up-regulating the expression of GluR2 in the synaptic membrane of hippocampal CA1 region.

A special collision unit was used in the experiment by which the distal ends of the fore legs of young rabbits were struck repeatedly on the right aspect. In another group of young rabbits, deep branches of the artery of the right fore legs were ligated and severed. X-Ray examination was made before the two groups of rabbits were killed.Roentgenogram demonstrated: Growth plate of the right fore leg showed wave-like growth, thickened or thinned in the collision group; no difference showed between 2 fore legs in vessel group.Histological demonstrations1. Collision group: 1) Chondrocytcs of articular surface decreased, degenerated and disappeared. 2) Trabecula of the cpiphysis and metaphysis atrophied; osteoblasts and ostcocytcs decreased and degenerated. 3) Growth plate thickened, some arranged wave-like; chondrocytes increased and degenerated. 4) Fibrous tissues and cartilage increased in the mctaphysis. 5) Perichondral ring thickened.2. Vessel group: Similar to the collision group except fibrous and cartilage proliferation in the epiphysis and no arrangement disorder in the growth plate.

OBJECTIVETo compare the difference in clinical efficacy on chronic obstructive pulmonary disease (COPD) at stable stage in the patients among the combined therapy of cutting method and western medication (combined therapy), simple cutting method and simple western medication.

METHODSOne hundred and twenty cases of COPD were randomized into three groups, 40 cases in each one. In the cutting method group, for excessive phlegm pattern/syndrome, Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1) and Yuji (LU 10) were selected as the main acupoints, and Lieque (LU 7) and Pianli (LI 6) were as the supplementary acupoints. For the pattern/syndrome of failure to consolidate kidney primary, Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4) and Yuji (LU 10) were selected as main acupoints, and Jueyinshu (BL 14) and Zusanli (ST 36) were as the supplementary acupoint. Three acupoints were selected alternatively in each treatment and the cutting method was applied once every 10 days. Three treatments made one session. Two sessions of treatment were required. In the western medication group, salbutamol sulfate aerosol, one press (200 μg/press) was used each night, as well as salmeterol xinafoate and fluticasone propionate powder for inhalation, one inhalation each night. The treatment of 1 month made one session. Two sessions were required. In the combined therapy group, the cutting method and western medication were applied in combination. The results of clinical symptom score, lung function test, arterial blood gas analysis, degree of inflation as well as clinical efficacy were observed before and after treatment in each group.

RESULTSExcept the degree of lung inflation, the clinical symptom score, indices of lung function test, partial pressure of arterial blood gas (PaO2) and partial pressure of carbon dioxide (PaCO2) were all obviously improved after treatment as compared with those before treatment in each group (all P<0.05). They were apparently improved after treatment in the combined therapy group and the cutting method group as compared with those in the western medication group (all P<0.05). The total effective rate was 77.5% (31/40) in the combined therapy group and was 75.0% (30/40) in the cutting method group, both better than 60.0% (24/40) in the western medication group (both P<0.05).

CONCLUSIONThe simple cutting method based on syndrome differentiation and the combined therapy with western medication achieve the superior efficacy on COPD at stable stage as compared with the simple western medication. The effect mechanism is possibly related to the improvement of bronchial airway function through constant acupoint stimulation.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Albuterol ; administration & dosage ; analogs & derivatives ; Androstadienes ; administration & dosage ; Combined Modality Therapy ; Female ; Fluticasone ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; physiopathology ; therapy ; Salmeterol Xinafoate ; Treatment Outcome

Objective To determine the main components of SZ herbal disinfectant and to observe its inactivation efficiency on microorganism in suspension. Methods The spectrophotometer examination, neutralizer screening trial, bacteria count trial, phage plaque count trial and cells infection test had been used to determine contents of ursolic acid in SZ herbal disinfectant and the disinfection efficacy. Results The ursolic acid contents in original SZ disinfectant reached 436.43 ?g/ml and decreased by 8.07% after a year of deposit. Treated by disinfectant for 5 min and 1∶5 dilution solution for 10 min, the Staphylococcus aureus (SA) and Escherichia coli (EC) in suspension could be killed with the efficiency of 100%. Treated with SZ disinfectant and the dilution solution (1∶50) respectively, the Candida albicans could be killed with the efficiency of 90.97% and 51.10%. Treated with the dilution solution for 3 min, the f2 bacteriophage and PV could be reduced by 100% and 9.00 log. Conclusion With the main component of ursolic acid, the SZ herbal disinfectant is a kind of natural disinfectant. It has a satisfactory inactivation efficacy on bacterial vegetative form and virus.

OBJECTIVE:To provide reference for lung cancer therapy in the filed of TCM and offer guidance for pharmacy work. METHODS:266 lung cancer prescriptions were collected from the department of TCM of our hospital during Jan. to Dec. in 2014,in-vestigated and analyzed in respects of patient’s age,the number of TCM ingredient,the weight and number of dose,cost,drug catego-ries,the frequency of each ingredient use. RESULTS:The high-risk population of lung cancer were over 40 years old group;the num-ber of TCM ingredient were from 16 to 20;the weight of dose was from 200 g to 300 g;the average number of dose was 10.01 with 53.79 yuan in average. Top 3 TCM were tonics (16.5%),TCM for relieving cough,reducing phlegm and preventing asthma (13.5%),TCM for clearing heat(11.5%). Fritillaria thunbergii,Morus alba,Citrus reticulate and Tetrastigma hemsleyanum took up the front place in the list of frequency. CONCLUSIONS:TCM for relieving cough,reducing phlegm and preventing asthma(13.5%) and TCM for clearing heat are frequently used in TCM prescription for lung cancer;all of them are easily damaged by worms,mildew, rot and extensive diffusion of oil. The management should be strengthened.

Objective To investigate the role of p38MAPK in the differentiation of murine osteoblasts, and to observe the expressions of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG). Methods The calvarial osteoblasts of newborn BALB/c mice were cultured in MEM medium containing 10% NCS. Raloxifene (10~(-7) mol/L) and 17β-estradiol (10~(-8) mol/L) were added respectively when cells reached 70%-80% confluence combined with or without 5 μmol/L SB202190, an inhibitor of p38MAPK. The osteoblasts alkaline phosphatase activity assays were performed 72 hours later using PNPP method, and mRNA levels of alkaliphosphatase (ALP), OPG and RANKL were determined by RT-PCR. Results 17β-estradiol and raloxifene increased ALP activity and ALP mRNA level in osteoblasts in vitro which were blocked by p38MAPK inhibitor.The mRNA levels of RANKL and OPG were up-regulated by 17β-estradiol and raloxifene while the ratio of OPG/RANKL kept constant. SB202190 (5 μmol/L) inhibited the highly expressed RANKL and OPG in osteoblasts, and obviously decreased the ratio of OPG/RANKL. Conclusions p38MAPK inhibition blocked the differentiation of osteoblasts and decreased the up-regulated OPG and RANKL expressions in osteoblasts significantly (P<0.05).

Objective To investigate the suppression to 2-glycoprotein-1-specific B cell response by human recombinant 2-glycoprotein-1 domain Ⅰ dimer(rh?2-GP1-DⅠ2) in rh?2-GP1 immunized mice.Methods The effects of treatment using rh?2-GP1-DⅠ2 on titer and ratio of anti-?2-GP1 were analyzed by solid phase ELISA.The number of splenic ?2-GP1-specific antibody-forming cells(AFC) was counted by ELISPOT.Results The levels of anti-?2-GP1 from rh?2-GP1 immunized mice treated with rh?2-GP1-DⅠ2 were significantly decreased compared with those in negative controls(P

Objective To evaluate the influencing factors for hypocalcemia after total thyroidectomy in thyroid carcinoma.Methods 650 patients with thyroid carcinoma undergoing total thyroidectomy from Jun.2009 to Dec.2011 were followed up and analyzed retrospectively.The relativity between persistent hypocalcemia and the following criteria were studied:age, sex, primary tumor stage, initial thyroid treatment, neck dissection cen-tral compartment dissection, inadvertent parathyroidectomy, and thyroid caspsular dissection.χ2test was used to analyze the statistical correlation between hypocalcemia after total thyroidectomy and the other clinical factors. Multiple logistic regression analysis was used to identify the multivariate correlation of clinical factors and hypocal-cemia after total thyroidectomy. Results Persistent hypocalcemia was found in 112 out of 650 patients (17.2%).Advanced stage(OR=2.121,95%CI 1.140-3.947,P=0.018),bilateral central compartment dis-section(OR=1.852,95% CI 1.199 -2.863,P =0.006),failure to use thyroid caspsular dissection(OR =2.307,95%CI 1.208-4.405,P=0.011)and IPE(OR=1.580,95%CI 1.029-2.427,P=0.037)were inde-pendent predictive factors for hypocalcemia after total thyroidectomy.Conclusions It has high incidence of persis-tent hypocalcemia in patients with andvanced-stage thyroid carcinoma after going total thyroidectomy.Thyroid caspsular dissection method, proper indications for bilateral central compartment dissection, and reducing IPE can help to reduce the incidence of persistent hypocalcemia and improve the life quality of patients after going thyroidectomy.