Objective To discuss the feasibility and value of routine clinical preoperative examination predicting benign and malignant thyroid nodules. Methods The clinical data of 1630 patients undergoing thyroidectomy for nodular thyroid disease were analyzed retrospectively.The relationship between pathological diagnosis and physical examination,ultrasonographic parameters,the results of laboratory test and nuclear medicine test were examined to build a risk prediction model.The sensitivity,specificity and accuracy of the formula were tested. Results In 387 cystic nodules 0.78％ were malignant; In 1243 solid nodules 17.2％ were malignant.Among the 1243 cases,characters significantly related to malignancy were:age younger than 40 years,solitary lobe involvement,hypoechoic nodule,irregular margins,solid nodule,microcalcification,macrocalcification,max diameter ≤ 2 cm. The prediction formula was: malignancy indicator =0.80 × age + 0.59 × solitary lobe + 0.72 × hypoechoic + 0.82 × irregular margin + 1.32 × solid nodule + 1.90 × microcalcification + 0.70 × macrocalcification + 0.71 × max diameter.The threshold limit value was 2.8,and the sensitivity,specificity and accuracy of which were 74.4％,80.4％ and 75.2％,respectively. Conclusions Benign and malignant thyroid nodules could be differentiated roughly with the combination of patients' general information and the results of routine examination before operation.

Objective To prepare active components from extract of Arca subcrenata Lischke and analyze its antioxidative activity.Methods The antioxidative component(P3)from Arca subcrenata Lischke was isolated by chromatography on Superdex-75 column followed by a Sephadex LH-20 column,and antioxidative activities were assayed using potassium ferricyanide and DPPH methods,respectively.The characters of this component were determined by ninhydrin reagent,anthrone reagent,Coomassie Brilliant Blue G250 reagent as well as thin-layer chromatography.Results and Conclusion A component with strong antioxidative activity was isolated and identified as glycosylated peptide.

Objective: To investigate the chemical constituents from the whole plant of Carpesium faberi. Methods: Compounds were isolated by various chromatographic techniques, including silica gel, ODS, sephadex LH-20, and semi-preparative HPLC, and their structures were identified by comparison of their experimental spectroscopic data with their reported data. Results: The phytochemistry investigation led to the isolation of 12 compounds, and their structures were elucidated as ent-kaurane-3β,16β,17-triol (1), 3-(hydroxy-acetyl)-1H-indole (2), 8,9,10-trihydroxythymol (3), 8-hydroxy-9,10-diisobutyryloxy-thymol (4), neryl-β-D- glucopyranoside (5), (3S)-linalyl-β-D-glucopyranoside (6), (1R,2S,4S,5R)-2,5-dihydroxy-p-menthane (7), luteolin (8), apigenin-7-O-β-D-glucopyranoside (9), medioresinol (10), pinoresinol (11), and a mixture of silybin and isosilybin (12). Conclusion: All compounds except compound 7 are not only isolated from this plant for the first time, but also from this genus for the first time.

Objective To determine the diagnostic value of double-phase enhancement and virtual endoscopy with multi-slice spiral CT (MSCT) on clinical staging of preoperative bladder cancer.Methods Seventy-five patients with bladder cancer diagnosed by fibercystoscope or operation. All of them were examined by double-phase enhancement and virtual endoscopy with MSCT. The images were analyzed and clinical staging were obtained. The findings of MSCT (71 cases)were compared with the post-operative histopathological results. Results There were 94 lesions to be found. The staging of MSCT: T1 26 cases,T2, 27 cases, T2b 13 cases, T3 12 cases, T4 16 cases. Histopathological results: pT1 28 cases, pT2a 24 cases, pT2b 14 cases, pT3 12 cases, pT4 16 cases. The sensitivity of preoperative staging on bladder cancer was 89.4 % (84/94) by double-phase enhancement of MSCT;the sensitivity of virtual endoscopy was 96.6% (84/87)for polyploidy tumors and 90. 9 % (10/11) for sessile lesions. When double-phase enhancement and virtual images were evaluated together, the sensitivity rate increased to 94.5%. When the tumors were confined within the bladder wall (≤T2b), the diagnostic accuracy of double-phase enhancement and virtual images was 91.2% (51/56). When the tumors had invaded the tissues and organs beyond the bladder wall (≥T3), the accuracy was 100% (28/28). Conclusion Double-phase enhancement and virtual endoscopy of MSCT is of great value in clinical staging of bladder cancer.

By using various chromatographic techniques,18 sesquiterpene lactones were isolated from the acetone extract of Carpesium faberi. Their structures were identified on the basis of comprehensive spectroscopic data, involving 2 carabrane sesquiterpenoids [carabrone(1), 4R-carabrol(2)], 3 eudesmane sesquiterpenoids [granilin(3), 3-epi-isotelekin(4), 1α-hydroxypinatifidin(5)], 8 guaiane sesquiterpenoids [4β,10α-dihydroxy-5α(H)-1,11(13)-guaidien-8α,12-olide(6), 8-epi-helenium lactone(7), 4-epi-isoinuviscolide(8), 9β,10β-epoxy-4α-hydroxy-1β-H,11α-H-guaian-8α,12-olide(9), 4α,10α-dihydroxy-1β(H),5β(H)-guaian-11-(13)-en-8α,12-olide(10), 4α-hydroxy-9β,10β-epoxy-11β-H,5α-H-guaian-11(13)-en-8α,12-olide(11), 4α-hydroxy-1β,5α,11α-H-guaian-9(10)-en-8α,12-olide(12), inuviscolide(13)], 1 pseudoguaiane sesquiterpenoid [(+)-confertin(14)], 3 germacrane sesquiterpenoids [madolin B(15), carabrolactone A(16),11(13)-dehydroivaxillin(17)], 1 xanthane sesquiterpenoid [tomentosin(18)]. Furthermore, the absolute configuration of 1 was confirmed by Cu-Kα X-ray crystallographic analysis,and the R-configuration of the chiral center at C-4 in 2 was established by the modified Mosher's method.The compounds 2-5, 7 and 9-15 were isolated from this plant for the first time, and compounds 4-5, 7, and 12-15 were isolated from this genus for the first time.In addition, the neurotrophic activity of compounds 1-3, 6 and 17 were evaluated by morphological observation and statistical analysis of cells differentiation, using rat pheochromocytoma(PC12)cells as a model system. However, all compounds were inactive.

Objective:To analyze the prevalence of epilepsy and its clinical features in patients with Alzheimer's disease(AD).Methods:Clinical data of patients with AD from a separate database of Tianjin Huanhu Hospital for dementia and degenerative diseases from January 2010 to January 2019 were retrospectively examined.The prevalence of AD combined with epilepsy was analyzed.The characteristics from neuropsychological assessment, clinical manifestations of epileptic attacks, electroencephalogic patterns and other features were analyzed and compared with those of AD patients without epilepsy.Results:Of 376 AD patients, 11.4% had epilepsy, with 4.0% showing non-induced seizures before AD diagnosis and 7.5% after AD diagnosis.The average age of AD patients at first onset of epilepsy was 59.8±19.9 years, and the average age of patients at initial diagnosis with AD was 62.8±6.6 years.The most common type was focal seizures(65.1%), and EEG showed mostly focal slow waves(69.8%)and focal epileptiform discharges(23.3%). The AD diagnosis for patients with epilepsy was 8 years earlier than those without epilepsy.Conclusions:Epilepsy has a high prevalence in AD patients, and seizures may be a risk factor for progression from cognitive impairment to AD.Early identification of seizures and cognitive impairment may have a positive effect on delaying the progression of dementia.

T site polymorphism is closely related to CHD and elevated serum triglyceride and total cholesterol.

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood

OBJECTIVETo evaluate the short- and medium-term efficacy, complications, and anti-coagulation therapies related to transcatheter closure (TCC) of coronary artery fistula (CAF) in children.

METHODSWe conducted a retrospective review of the medical records of 12 children with CAF who underwent TCC between January 2006 and January 2014, focusing on details such as preoperative, radiographic, and postoperative follow-up data, to record closure methods for CAF, anti-coagulation therapies, postoperative complications, and results of auxiliary examinations.

RESULTSAmong the 12 cases who underwent successful TCC and whose age was 1-158 months, four patients had proximal/medium-sized CAF, five had proximal/large CAF, and three had distal/medium-sized CAF. The mean period of postoperative follow-up was 3.5±2.4 years. Eleven patients took aspirin for 6 months post closure, and one took it for 18 months. Neither coronary thrombosis nor interventional complications were found. Left ventricular ejection fraction, cardiothoracic ratio, pulmonary artery pressure, and the diameters of coronary artery lesions decreased post TCC.

CONCLUSIONSTCC is feasible and safe in proximal and distal/medium-sized CAF patients. Postoperative anti-coagulation with aspirin may prevent short- and medium-term thrombosis, but treatment course and safety need to be investigated by further follow-ups.

Adolescent ; Cardiac Catheterization ; Child, Preschool ; Coronary Vessel Anomalies ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Vascular Fistula ; surgery

OBJECTIVETo define the effects of Astragalus membranaceus on the atrial dynamics and ANP secretion in the perfused beating rabbit atria.

METHODThe experiments have been done in isolated perfused beating rabbit atria. ANP was measured by radioimmunoassay in the atrial perfusate in real-time base.

RESULTA. membranaceus (2.0, 2.5, 3.0 g L(-1)) could increase atria stroke volume from (694.70 +/- 0.01) microL g(-1) (P<0.05) to (1,003.00 +/- 8.80) microL g(-1) (P<0.001); (1,120.00 +/- 17.71) microL g(-1) and (1,195.00 +/- 8.21) microL g(-1) (P<0.001), respectively, and its could difference increase atrial pulse pressure from (0.82 +/- 0.01) kPa to (0.86 +/- 0.01) kPa (P<0.01); (0.96 +/- 0.01) kPa (P<0.001) and (1.02 +/- 0.01) kPa (P<0.001), respectively; A. membranaceus obviously increased rabbit atrial dynamics with dose-dependent manner. Simultaneously, A. membranaceus inhibited ANP secretion. Nifedipine (1.0 micromol L(-1)), a L-type Ca2+ channel inhibitor, and KB-R 7943 (10.0 micromol L(-1)), an inhibitor of reversed Na+ -Ca2+ exchanger, blocked the effects of A. membranaceus-induced augmentation of atrial dynamics but failed to modulation the inhibition of A. membranaceus on ANP secretion.

CONCLUSIONA. membranaceus increases the atrial dynamics via Na+ -Ca2+ exchanger and L-type Ca2+ channel and negatively modulates ANP secretion in beating rabbit atria.

Animals ; Astragalus membranaceus ; chemistry ; Atrial Natriuretic Factor ; metabolism ; secretion ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Female ; Heart Atria ; drug effects ; metabolism ; secretion ; Male ; Myocardial Contraction ; drug effects ; Nifedipine ; pharmacology ; Rabbits ; Radioimmunoassay ; Thiourea ; analogs & derivatives ; pharmacology