Objective To investigate the effects of leflunomide(A771726) on the apoptosis of the rat glomerular mesangial cells and its possible mechanism .Methods The cultured rat glomerular mesangial cells were divided into the normal control group (adding DMEM culture solution containing 5% fetal calf serum) ,A771726 group(adding 50 A771726 on the basis of control group , making it a concentration as 50 μg/mL) ,LY294002 group (adding LY294002 on the basis of normal control group ,making its final concentration as 2 μg/mL) and the LY294002+A771726 group(first adding 2μg/mL LY294002 to interfere the mesangial cells for 2 h ,then adding A771726 50μg/mL) .After 48 h intervention ,its influence on mesangial cell apoptosis in each group were measured by flow cytometry .The expression of mTOR was measured by immunofluorescence .The expression of Caspase‐3 was measured by Western‐blot .Results Compared with the normal control group ,the apoptosis rate of rat glomerular mesangial cells in the A771726 group ,LY294002 group and LY294002+A771726 group were significantly increased ,the expression of mTOR was decreased ,the expression of Caspase‐3 was increased;compared with the A771726 group ,the apoptosis rates of rat glomerular mesangial cells in the LY294002 group and LY294002+ A771726 group were significantly increased ,the expression of mTOR was significantly de‐creased ,the expression of Caspase‐3 was significantly increased;compared with the LY294002 group ,the apoptosis rate of rat glo‐merular mesangial cells in the LY294002+ A771726 group was significantly increased ,the expression of mTOR was significantly decreased ,while the expression of Caspase‐3 was significantly increased .Conclusion Leflunomide may induce the rat mesangial cells apoptosis through down - regulating the PI3K/Akt/mTOR signaling pathway ,moreover ,leflunomide may synergize with LY294002 to induce rat mesangial cells apoptosis .

Objective To explore the MSCT and MRI characteristics of hydrosalpinx.Methods The CT and MRI findings of 28 patients with hydrosalpinx confirmed by surgery and pathology were retrospectively studied.Before operation,the plain and contrast enhanced CT in 25 patients and the plain and contrast enhanced MRI in 3 had been carried out.Results 1 9 patients with unilateral hydrosalpinx (12 on the left and 7 on the right side)and 9 patients with bilateral hydrosalpinx were found.Both CT and MRI images showed the cystic mass with different forms in annex area,including botuliform changes in 1 6 patients,beaded form in 9,polycystic changes in 8 and retort-like changes in 4.The low density as water on plain CT,and the low signal on T1 WI and high signal on T2 WI were showed.The cystic walls were significantly enhanced without nodules.If there is septum,mild enhancement was also found.14 patients with chronic salpingitis,2 with fascial thickening,3 with uterine fibroid and 1 7 with pelvic fluid.Conclusion CT and MRI findings of hydrosalpinx are characteristic.

Objective To explore the value of ultrasound-guided core needle biopsy (CNB) in diagnosis of thyroid nodules.Methods The clinical data of 395 patients with thyroid nodules who underwent ultrasound-guided CNB were retrospectively analyzed,and the results of CNB pathology of 278 patients who endured surgery were compared with postoperative wax pathology results.Results All patients completed CNB successfully and satisfaction rate for tissue samples was 100％.Local hematoma occurred in one case and relieved by conservative therapy.The CNB pathology results of 278 cases of patients were as follows:92 cases were malignancy,including 91 cases of papillary thyroid carcinoma,lcase of medullary thyroid carcinoma; 182 cases were benign,including lcase of parathyroid adenoma,48 cases of adenoma,and 133 cases of nodular goitre and other nodular affection.In 278 patients who underwent surgery,the CNB pathology results in 273 cases,including 90 malignancy cases and 183 benign cases,were consistent with postoperative wax pathology results and false positive occurred in 1 cases,ambiguous occurred in 4 cases.So the accuracy,sensibility,specificity,missed diagnosis rate,and misdiagnosis rate of ultrasound-guided CNB for differential diagnosis of thyroid malignant nodules from benign nodules were 98.20％ (273/278),95.79％ (91/95),99.45％ (182/183),4.21％ (4/95) and 0.55％ (1/183).Conclusion Ultrasound-guided CNB has important value on differential diagnosis of thyroid nodules.It is safe and effective.

Objective To discuss the influence factors on the quality of Potassium dehydroandrograpolide succinate for injection,and to optimize its production process.Methods The related substances were taken as the estimated standards and the orthogonal experimental method for determining the best production process was adopted.Results The water temperature and pH value had a significant effect on the related substances.The best production process was:dispensing water temperature at 40℃,pH at 6.4 and filling time being 2 h.Conclusion The optimized production process was quality control and reasonable,which can be used in industrial production.

ObjectiveTo study the diagnostic value of sonographic “Leopard pattern” sign in breast hyperplasia.MethodsTwo hundred and twenty-three female patients in Beijing Friendship Hospital from October 2012 to April 2013 were choosen. All the cases were diagnosed as mammary gland hyperplasia clinically, and their breast ultrasound images show the breast imaging-reporting and data system (BI-RADS) grad was 0 or 1. These patients were divided into 3 groups according to their age, Group A: 20 to 35 age (36 cases), Group B: 36 to 50 age (102 cases), and Group C: order than 50 year-old (85 cases). The pathological diagnosis were obtained by ultrasound guided breast biopsy. With pathological diagnosis as the gold standard and “Leopard sign” as ultrasound diagnostic criteria, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. The consistency between the ultrasonic and the pathological diagnosis were analyzed by Kappa statistical test.ResultThe diagnostic consistency test of the total sample of 223 cases: in terms of the ultrasonic Leopard sign” for the diagnosis of breast hyperplasia, the sensitivity was 69% (59/85),the specificity was 46% (64/138), the accuracy was 55% (123/223), the positive predictive value was 44% (59/133), the negative predictive value was 71% (64/90), the consistency was poor (Kappa=0.14,P<0.05). Group A:the sensitivity was 90% (18/20), the specificity was 50% (8/16),the accuracy was 72% (26/36), the positive predictive value was 69% (18/26), the negative predictive value was 80% (8/10), the consistency was good (Kappa=0.42, P<0.05);Group B:the sensitivity was 70% (33/47), the specificity was 49% (27/55),the accuracy was 59% (60/102), the positive predictive value was 54% (33/61), the negative predictive value was 66% (27/41), the consistency was poor (Kappa=0.19,P<0.05); Group C: the sensitivity was 44% (8/18), the specificity was 43% (29/67), the accuracy was 44% (37/85), the positive predictive value was 17% (8/46), the negative predictive value was 74% (29/39), the consistency was poor (Kappa=0.08,P<0.05).Conclusion“Leopard pattern” sign is not suitable as an independent standard in diagnosing breast hyperplasia disease.

OBJECTIVE:To investigate the condition of ESBLs produced by E.coli isolated from urinary tract and the drug resistance of ESBLs-producing E.coli.METHODS:The identification of bacteria was performed using ATB-Expression analysator(France);the susceptibility test was performed using K-B method,and ESBLs were detected using disc diffusion confirmatory test.RESULTS:The detection rate of ESBLs-producing E.coli was 31.8%.All(100%)of the 107 strains of ESBLs-producing E.coli were sensitive to imipenem,however,in which different degree of resistance to other antibiotics was noted.The resistance rate was significantly higher in ESBLs-producing strains than in non-ESBLs-producing strains.CON-CLUSION:In view of the high antibiotic resistance of ESBLs-producing E.coli,great importance should be attached to the detection of the ESBLs.Antibiotics should be used rationally based on the results of susceptibility test.

OBJECTIVE To investigate the drug resistance of ESBLs-producing Escherichia coli in community-acquired urinary tract infection for guiding the clinical drug-using.METHODS ATB-Expression analysis system was used for identification of bacteria,extra-susceptibility tests were detected by K-B method.RESULTS Totally 104 E.coli strains were detected,the isolation rate of ESBLs-producing E.coli was 13.5%,the resistant rates of E.coli were up to 70% to ampicillin,piperacillin and Co-trimoxazole,the resistant rate was up to 55% to ciprofloxacin and levofloxacin,and the susceptible rate was 100% to imipenem.CONCLUSIONS The E.coli is a main pathogen in community-acquired urinary tract infection,Its drug resistance is extremely severe.To enhance detecting drug resistance of pathogenic bacteria is of important significance for guiding the clinical rational drug-using and reducing drug-resistant strains.

OBJECTIVE To investigate the distribution and drug resistance status of extended-spectrum ?-lactamases producing(ESBLs) Klebsiella pneumoniae and to provide the basis for clinic anti-infective treatment.METHODS To use ATB-expression analyzer to identify the microbe.The drug susceptibility was tested with the K-B method and the ESBLs producing strains detected by diffusion confirmed test.RESULTS Among 137 strains of identified K.pneumoniae,34.3% of them(47 strains)produced ESBLs,and most had been shown in geriatrics ward.The drug resistance rate of ESBLs producing K.pneumoniae was higher than that in non-producing ESBLs one.So imipenem should be considered to be a preferred antibiotic when used on K.pneumoniae seriously infected cases.CONCLUSIONS The drug resistance of K.pneumoniae is a serious problem,we should pay attention on the status of ESBLs distribution,based on the susceptibility to choose the reasonable antibacterial to avoid the producing ESBLs bacteria spread out.

OBJECTIVE To investigate the drug resistance of ESBLs-producing Escherichia coli and Klebsiella pneumoniae in local nosocomial infection,for guiding the clinical drug resistance. METHODS ATB analysis system was used for identification of bacteria,extra-susceptibility tests were detected by K-B method. RESULTS The isolation rate of ESBLs-producing E. coli and the K. pneumoniae was 29.9% and 30.8%,respectively. The drug susceptibility was indicated the resistance rate of ESBLs producing strains to antibacterial agents except imipenem was higher than that of non-ESBLs producing strains. CONCLUSIONS Detecting drug resistance of ESBLs producing strains is of important significance for guiding the clinical rational use of antibacterials and controling the epidemics.

A cross-sectional study was conducted on 1 052 patients with coronary heart disease (CHD) who visited 10 community health service centers in Chaoyang and Haidian districts of Beijing from March 2019 to September 2019. Basic information, medical history, cardiovascular risk factors, β-blocker use, height, weight, blood pressure level and resting heart rate were collected by face-to-face interview;biochemical tests and on-site physical examination were performed;and the influencing factors of heart rate control were analyzed by logistic regression. There were 563 males (53.5%) and 489 females(46.5%),with a mean age of (66.7±9.5) years. The rate of β-blockers use was 43.6% (459/1 052). The average resting heart rate was (70±8)/min, and only 14.5% (153/ 1 052) patients had the heart rate under control. The resting heart rate control rate in patients with β-blockers use was 17.9% (82/459), higher than that of those without β-blockers use [12.0% (71/593), χ 2=7.23, P=0.007]. Moderate leisure activities were beneficial to the control of resting heart rate ( OR=2.14, 95% CI: 1.26-3.62). The study shows that β-blockers use and resting heart rate control in CHD patients in Beijing community health institutions were both at low levels, and the resting heart rate was not well controlled even in patients taking beta-blockers.