Purpose To investigate the diagnostic value of dual energy CT spectrum curve combined with CT morphology in central lymph node metastasis of papillary thyroid carcinoma (PTC).Materials and Methods Thirty-one PTC patients who accepted dual energy CT double-phase enhanced scan before surgery were analyzed.Central lymph nodes with short diameter ＞ 5 mm were labelled using axial plus 3D positioning.Preoperative labelled lymph nodes were collected and marked during operation.The CT morphology of metastatic lymph nodes was analyzed.The spectrum curve slope (K) difference between metastatic and non-metastatic lymph nodes of arterial-phase and venous-phase primary lesion was compared.The critical K value and the diagnostic efficacy of K value combined with morphology were obtained according to receiver operating characteristic (ROC) curve.Results A total of 73 central lymph nodes were obtained from 31 patients,among which 51 were metastatic and 22 were non-metastatic.There was no significant difference in K value between metastatic and non-metastatic lymph nodes of arterial phase group (P＞0.05).While,there was a significant difference in K value between metastatic and non-metastatic lymph nodes of venous phase group (P＜0.05).For venous phase,the sensitivity and specificity of the K value in diagnosing central lymph node metastasis were 62.7％ and 59.1％,respectively,and combined with morphology,the sensitivity and specificity reached 76.5％ and 81.8％,respectively.Conclusion The K value of CT spectrum curve is of certain significance in predicting PTC central lymph node metastasis,and the K value combined with CT morphology can improve the accuracy of diagnosis.

OBJECTIVE: To observe the changes of endothelium-dependent dilation (EDD) of patients with congestive heart failure (CHF) before and after Kanli Decoction treatment. METHODS: Thirty-five CHF patients were treated with Kanli Decoction. We used color Doppler ultrasound to monitor the flow-mediated dilation (FMD), pulsatile index (PI), resistance index (RI), baseline blood flow (BF), ejection fraction (EF) before and after the treatment. RESULTS: FMD after treatment (9.26+/-3.19) were obviously higher than that before the treatment (7.06+/-2.58) (P<0.05), but BF, PI and RI were not improved. CONCLUSION: Applying color Doppler ultrasound into observation on EDD of patients suffering from CHF and treated by the Kanli Decoction shows that the CHF could be treated by traditional Chinese medicine.

10.3969/j.issn.2095-4344.2013.23.003

To improve the quality of personnel training,carry out the complementary ascendancy and resource sharing,grasp the law and optimize the program of practice teaching,we designed the undergraduate practice teaching of 9 disciplines including clinical medicine,biotechnology,pharmacy,etc.,formulated the practice teaching pattern named "two-stage & two-model",and carried out the practice teaching step by step. The results show that the profession level and overall quality of students have been improved.

Objective To compare the efficacy of small splint fixation and plaster fixation in treating distal radius fracture. Methods One hundred and four cases of type A2 distal radius fracture admitted from January of 2012 to May of 2013 were randomly divided into small splint fixation group and plaster fixation group. After reduction, patients in the two groups were fixed with small splint and plaster separately. Wrist function scores, 36-item Short Form ( SF-36) scores and roentgenographic scores were evaluated for the two groups at different time points. Results ( 1) Within 3 months of follow up, the improvement of wrist function in small splint fixation group was significantly superior to that in plaster fixation group (P<0.05), and the differences of wrist function scores were insignificant between the two groups with the prolongation of follow-up (P>0.05). (2) SF-36 scores of the two groups were gradually increased along with the follow up. After follow-up for one week, 2 weeks, one month and 3 months, the SF-36 scores in small splint fixation group were significantly higher than that in plaster fixation group ( P<0.05) , but there was no significant difference after 6 months ( P>0.05). ( 3) After follow up for one year, the excellent rate for roentgenographic scores was higher than 80% in both groups, and there was no significant difference between the two groups (P>0.05). Conclusion Both small splint fixation and plaster fixation have satisfacory efficacy in treating type A2 distal radius fracture. But during the therapeutic process, wrist function scores and life quality scores in the small splint fixation group were higher than those in the plaster fixation group.

BACKGROUND:The mechanical characteristics of intramedul ary and intramedul ary fixations for treating intertrochanteric fracture were hot research of finite element, but there was few comparative research on tension side and pressure side of proximal femur. In our study, we found that the distribution of the stress zone was important indication to researches on intertrochanteric fracture and internal fixation design. OBJECTIVE:To explore the effects of intramedul ary and extramedul ary fixations for treating intertrochanteric fracture on pressure side and tensile side of proximal femur. METHODS:CT scan and Mimics modeling of volunteer’s femur were conducted, and the model Evans type I intertrochanteric fracture was constructed and treated with proximal femoral nail antirotation and dynamic hip screw respectively. The stress condition of proximal femur in weight status was simulated. The Abaqus 6.13 was used for finite element analysis, and the tension side and pressure side of proximal femur in both fixations were also analyzed. RESULTS AND CONCLUSION:(1) The stresses of compressive side and tensile side in proximal femoral nail antirotation group were both less than that in dynamic hip screw group. The stress of proximal femur in proximal femoral nail antirotation group was more similar to that in physiological status. (2) These findings verified that for treating intertrochanteric fracture, intramedul ary fixation exerted better mechanical behavior than extramedul ary fixation. The protection of compressive side and tensile side of proximal femur had achieved by intramedul ary fixation.

Objective To analyze and compare two potency assay methods of protamine sulfate.Methods Heparin titration method was according to foreign pharmacopoeia,while biological assay method was according to China pharmacopoeia(2015).Results The absorbance at the end-point was stable at 0.10 mg/mL and 0.15 mg/mL test solutions.The relative standard deviations(RSDs)of potency results were all less than 5%.Three test solutions and volumes of the titrant had a good linear relationship(R2 =1.000).The results of titration method were significantly related to those of biological assay(P=0.013),with similar RSD(P>0.05).However,the potency of titration method were significantly lower than those of biological assay (P=0.045).Conclusion Heparin titration method is good-using,convenient,and need to be applied widely at home.

Purpose To assess the feasibility of dual-energy dual-source virtual noncontrast (VNC) CT in the diagnosis of laryngeal carcinoma,in order to reduce radiation hazard.Materials and Methods Forty-nine patients with clinically identified laryngeal carcinoma underwent conventional non-contrast (CNC) scan as well as arterial and venous dual-phase and dual-energy VNC scan.The VCN images of arterial and venous phase were obtained by using the dual-energy software.The mean CT value,signal-to-noise ratio (SNR),contrast noise ratio (CNR),lesion morphology,image quality and radiation dose were compared between the VNC and CNC images.Results The mean CT value,SNR,CNR and image quality scores of CNC were higher than those of VNC images of arterial and venous phase (P＜0.05).There was no significant difference in the image quality scores of VNC between the arterial and venous phase (P＞0.05).The image quality scores of VNC were all above 3,which could meet the diagnostic requirements.There was no significant difference in the shape,size,boundary and cystic necrosis of the lesions,invasion of the surrounding space,osteolytic destruction and size of the surrounding lymph node between the CNC and VNC image.The radiation dose of dual-phase dual-energy scan was 0.42 mSv,which was 18.3％ lower than that of the conventional three-phase scan.Conclusion For laryngeal carcinoma,the VNC images from the dual-energy CT scan can be used to reduce the radiation dose without affecting image quality and diagnosis accuracy,which has good clinical value.

OBJECTIVETo observe the effect of Spleen-invigorating Prescription (SIP) on dendritic cell function in patients with chronic hepatitis B.

METHODSA total of 60 patients with chronic HBV of Pi-deficiency syndrome type were enrolled and randomized to 2 groups, 30 in each group. Patients in the control group were given intramuscular injection with human interferon alpha 1b, 3 times a week, while those in the treated group were given orally with SIP twice a day, the therapy lasted for 6 months. Dendritic cells (DCs) were isolated from peripheral blood and cultured, then the expression of surface markers, HLA-DR, CD86, CD80, CD40, CD14 and CD11c were detected before and after treatment by flow cytometry, and the function of DCs was also evaluated by mixed lymphocyte reaction (MLR) determination once before treatment and once after treatment.

RESULTSThe expressions of DCs' surface CD86, CD80, CD40 and CD11c in the treated group were higher (P < 0.05, P < 0.01) and the changes of stimulating index, IFN-gamma and IL-12 were superior in the treated group to those in the control group (P < 0.05).

CONCLUSIONSSIP can significantly improve DC's function, so, one of mechanisms of SIP in improving clinical efficacy may be the regulation of immune function.

Adult ; Antiviral Agents ; therapeutic use ; B7-1 Antigen ; analysis ; B7-2 Antigen ; analysis ; Dendritic Cells ; cytology ; drug effects ; immunology ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Syndrome ; Yang Deficiency ; drug therapy ; Young Adult

Objective To investigate the characteristics of blood glucose fluctuation of continuous ambulatory peritoneal dialysis (CAPD) patients with end stage diabetic nephropathy(ESDN) attaining glycated hemoglobin standard. Methods The study recruited 17 patients with type 2 diabetes attaining glycated hemoglobin standard, and used continuous glucose monitoring system (CGMS) to monitor glycemic variation for 72 h. General information was collected and biochemical indexes were determined. Results The mean amplitude glycemic excur-sions (MAGE), standard deviation ,mean blood glucose levels, maximum of blood sugar, and the proportion of greater than 13.9 mmol/L in peritoneal dialysis patients were (8.36 ± 4.44) mmol/L, (3.38±1.08) mmol/L, (9.88±1.92) mmol/L, (17.95±13.11)%, which were significantly higher than those in normal. The mean amplitude glycemic excur-sions (MAGE), standard deviation ,mean blood glucose levels, maximum of blood sugar, and the proportion of greater than 13. 9 mmol/L in daytime were (8.25± 3.71) mmol/L, (2.83±0.89) mmol/L, (11.32±2.54) mmol/L, (16.61±3.86) mmol/L, (28.45±19.56)%, which were significantly higher than those in nighttime: (4.20±2.67) mmol/L, (1.34±0.89) mmol/L, (7.02±1.92) mmol/L, (9.61±2.77) mmol/L, (5.31±1.28)%, all P<0.05. The minimum and the proportion of less than 3.9 mmol/L between the two groups had no significant difference ( P>0.05). Besides, biochemical glycosylated hemoglobin was less than the calculated from CGMS: (5.88± 0.73)%vs. (7.85±1.20)%, t=4.76, P<0.01. Conclusions Peritoneal dialysis patients with ESDN have an increased glycemic fluctuation and a unsatisfied glycemic control, which is worse in daytime. Glycosylated hemoglobin is undervalued. Glycosylated hemoglobin should not be simply used on hemodialysis patients with ESDN to evaluate whether they have a good glycemic control. CGMS can better describe their blood sugar condition.