ObjectiveTo observe the effects ofYushen Zhuyun Prescription on ovarian morphology and sex hormone of rats with decreased ovarian reservation (DOR) induced by tripterygium glycosides; To explore its mechanism of action.Methods Tripterygium glycosides solution was used to establish DOR model rats by gastric gavage. 48 female SD rats were randomly divided into blank group, model group, positive medicine group andYushen Zhuyun Prescription low-, medium- and high-dose groups.Yushen ZhuyunPrescription groups were given the low, medium, high dosagesYushen Zhuyun Prescription liquid; positive medicine group were given estradiol valerate liquid; model group and blank control group were given normal saline with the same amount, by gavage 2 times per day for 14 consecutive days. The general condition of the rats was observed; ovarian was weighed and the viscera index was calculated; ovarian morphology was observed by HE staining; the levels of serum estradiol (E2), follicle stimulating hormone (FSH) and testosterone (T) were detected by radioimmunoassay; the levels of inhibin B (INHB) and anti Mullerian hormone (AMH) were detected by ELISA.Results Compared with the blank group, ovarian tissue atrophied; the number of follicles was reduced; ovarian index and the level of E2, INHB and AMH decreased; the levels of FSH and LH increased in the model group (P<0.01). Compared with the model group, ovarian tissue morphology improved significantly; the number of follicle and corpus luteum increased; follicular atresia was reduced; ovarian index and the levels of E2, INHB, and AMH increased; the levels of FSH and LH decreased in Yushen Zhuyun Prescription high-dose group (P<0.01). INHB and AMH had significant correlation (P<0.01). ConclusionYushen Zhuyun Prescription can regulate hormone levels, promote the growth and secretion of follicle, and inhibit follicular atresia, thereby improve ovarian reserve function.

Objective To evaluate the prevalence,anatomic features of right superior septal artery (RSSA) with 256-slice MSCT.Methods A retrospective analysis of coronary artery computed tomography angiography with 256-slice CT was performed in 1 646 consecutive patients.Multi-planar reconstruction (MPR),maximum intensity projection (MIP) images on coronal and sagittal planes,and three-dimensional volume rendering (VR) reconstruction images were obtained and used for the evaluation of the anatomic features of the RSSA.The images were transferred to EBW4.52 workstation to trace the vessel and to analyze the origin,diameter,and length of the RSSA.Student's t test was performed to compare the differences in the length and diameter of the RSSA between patients with different coronary artery distribution dominant types,different genders.Analysis of variance (ANOVA) was used to compare the differences in the length and diameter of the RSSA among patients with and without coronary artery stenosis.Results The RSSA was present in 130 (7.9％) of 1 646 patients.The origin of RSSA was from the proximal portion of the right coronary artery in 104 patients,from the right sinus of valsalva in 26 patients.The artery co-existed with the conus artery in 22(16.9％) of 130 patients.The mean length of RSSA was (31.7±15.6) mm (range from 8.9 to 70.7 mm),and the mean diameter was (1.0±0.4) mm (range from 0.2 to 2.5 mm).The average length and diameter of RSSA in men were (33.5±15.7) and (1.0±0.4) mm,respectively; The average length and diameter of RSSA in women were (24.5 ± 13.0) and (0.9 ±0.4) mm,respectively.There was a significant difference in RSSA length between men and women (t=2.718,P=0.007),but there was no significant difference in the RSSA diameter between men and women (t=1.134,P=0.259).There was no significant differencein RSSA length and diameter between different coronary artery distribution dominant types (t=-0.219 and-0.080 respectively,P＞ 0.05).In the patients with left anterior descending artery (LAD) and right coronary artery (RCA) stenosis,the mean length and diameter of RSSA were (38.9±17.9),(1.1 ±0.4) mm,respectively.In the patients without LAD and RCA stenosis,the mean length and diameter of RSSA were (28.9±14.4),(0.9± 0.4) mm,respectively.Patients with coronary artery stenosis tended to have longer RSSAs in comparison to those without coronary artery stenosis (P＜0.05).Conclusions RSSA variantions can evaluated with a cardiac 256-slice MSCT scan.The recognition of this vessel is useful for physians dealing with diagnosis and treatment of coronary artery disease.

Objective To determine the measurement consistency of diffusion coefficient D, perfusion fraction f and pseudodiffusion coefficient D*in rectal cancers based on different ROIs. Methods Forty-three patients with histologically proven rectal cancers were examined using echo-planar DW-MRI with eight b values (0 to 1 000 s/mm2). Intravoxel incoherent motion parameters were measured on intravoxel
incoherent motion map that contained the largest tumor cross-section, according to two distinct ROI protocols:freehand outline ROI and semi-automatic tumor center ROI. The two protocols were compared for differences in IVIM parameters and the interclass correlation coefficient (ICC) were also calculated. intra-and inter-observer variability using paired t test and Bland-Altman plot. Results The IVIM parameters(D, f and D*) obtained by ROIs for outlined and center analysis were (1.08 ± 0.24) × 10-3mm2/s, (0.16 ± 0.06), (26.59 ± 19.54) × 10-3mm2/s and (1.06 ± 0.27) × 10-3mm2/s, (0.17 ± 0.07), (30.79 ± 20.85) × 10-3mm2/s, respectively. No significant differences were observed between the means of the IVIM parameters (D, f, D*) calculated by the two methods (t=1.113,-0.259,-1.660;P=0.272, 0.797,0.104, respectively),and the relative ICC were 0.863, 0.469, 0.663, respectively. The intra-observer 95% limits of consistency of IVIM parameters were (-0.012—0.038) × 10-3mm2/s, (-0.003—0.007), (-0.923—1.166) × 10-3mm2/s with ROI outline tumor, respectively;(-0.024—0.044)×10-3mm2/s, (-0.005—0.015), (-1.670—4.195)×10-3mm2/s with center ROI, respectively. The inter-observer 95% limits of consistency of perfusion parameters were (-0.047—0.009) × 10-3mm2/s, (-0.015—0.009), (-7.206—3.190) × 10-3mm2/s with ROI outlined tumor, respectively;(-0.068—0.048) × 10-3mm2/s, (-0.005—0.041), (-17.657—0.779) × 10-3mm2/s with center ROI, respectively. Conclusions There was no statistically significant difference between the outlined ROI and tumor center ROI analysis of rectal cancers' IVIM parameters. The tumor analysis by outlined ROI protocol appropriately improves intra-and inter-observer consistency and can provide more reproducible and stable results.

Objective To investigate the incidence of surgical site infection(SSI)following clean incision breast surgery under non-local anesthesia,and evaluate risk factors for SSI.Methods Clinical data of 3 327 patients who underwent clean incision breast surgery under non-local anesthesia in 22 hospitals in Fujian Province were surveyed retrospectively,SSI and risk factors were analyzed.Results Among 3 327 patients,1 502(45.19%)were with malignant tumors,the average dura-tion of surgery were (101.18 ±8.04)minutes;a total of 24 cases of SSI occurred,incidence of SSI was 0.72%;253 (7.60%)patients received pre-operative antimicrobial prophylaxis,62.66% used antimicrobial agents within 0.5-2 hours before surgery.The main pathogenic bacteria was Staphylococcus aureus .Univariate and logistic regression analysis re-vealed that malignant tumor,diabetes mellitus,and use of immunosuppressants were all risk factors for SSI (all P <0.05). Conclusion SSI following clean incision breast surgery under non-local anesthesia is well controlled,risk factors for SSI should be evaluated before operation,comprehensive preventive measures should be taken to reduce the incidence of SSI.

Objective To develop and validate a ultrasonographic (US)imaging agent with targeted microbubbles that attaches to chemokine receptor 2 (CCR2)and to compare the US single obtained from targeted microbubble with that from control microbubble in murine breast tumor model.Methods The microbubble which carried CCR2 antibody (MBCCR2 )and isotype-macthed immunoglobulin G-labled control microbubble (MBcontrol ) were prepared. The microbubble size and distribution were assessed by AccuSizer780.Binding specificities of targeted microbubble compared with control microbubble were tested with murine microvascular endothelial cells (bEnd.3 ).Orthotopic breast tumor model was estabished in BALB/c mice with mouse breast cancer 4T1 cell.In vivo imaging signals of contrast material-enhanced ultrasound by use these two different types of microbubble which were injected respectively into each mouse at random order and 30 min interval.Tumor tissue was stained for CCR2 and CD3 1 .Results Automatic Particle Sizer showed size uniform of two kinds of microbubbles,and narrow distribution of particle size (mean diameter of about 1 -2 μm),which were not significantly different (P >0.05).Adhension to bEnd. 3 endothelial cells was significantly higher (P < 0.001 )for MBCCR2 (mean,9.50 ± 1 .5 1 )than that for MBcontrol (mean,0.01 ±0.01).Imaging signal in the murine tumor model was significantly higher for MBCCR2 [mean,(6.76±0.26)dB]than that for MBcontrol [mean,(1 .06 ±0.62)dB,P <0.001 ].Immunofluorescence confirmed expression of CCR2 on tumor vasculature.Conclusions The targeted microbubbles with CCR2 monoclonal antibody had been successfully prepared,which precisely targeted to CCR2 of tumor angiogenesis in the murine breast cancer xenograft tumor models in vivo.These results suggest that the targeted microbubbles as a kind of ultrasound molecular imaging agent with a better specificity can be used for both evaluating tumor neovascularization and monitoring therapeutic effect of anti-angiogenesis.

Objective To investigate the discriminant analysis model of gray-scale ultrasound (GSUS),contrast-enhanced ultrasound (CEUS) and the combination of them in the differential diagnosis of benign and malignant thyroid lesions and the diagnostic values.Methods Ultrasound images of 211 thyroid lesions confirmed by pathology were synthetically reviewed by scoring 5 GSUS indicators including shape (X1),orientation (X2),interior echogenicity (X3),halo sign (X4),and microcalcification (X5),as well as 6 CEUS indicators including relative arrival time of microbubhles in the periphery (X6) and interior (X7),peak periphery (X8) and interior (X9)echogenicity,peripheral ring-enhancement (X10),homogeneity of enhancement (X11).The diagnostic models with their values of GSUS,CEUS and the combination of them were explored by discriminant analysis.Results The discriminant analysis function of GSUS in the diagnosis of thyroid benign and malignant lesions was g1 (X) =0.715 X1+0.276X2 + 1.028X3 +1.197X4 +0.923X5-2.202 with the diagnostic value 86.3％,the discriminant analysis function of CEUS was g2(X) =-0.392X6 +0.541X7-0.117X8 +0.562X9 + 1.173X10 +2.200X11-1.956 with the diagnostic value 89.1％,and the discriminant analysis function of the combination of GSUS and CEUS was g3 (X) =0.418X1 + 0.173X2 + 0.626X3 + 0.558X4 + 0.183X5-0.476X6 + 0.474X7-0.071X8 + 0.399X9 + 0.985X10 +1.639X11-2.530 with the diagnostic value 91.0％.Conclusions GSUS and CEUS were valuable in the differential diagnosis of benign and malignant thyroid lesions,and the combination of GSUS and CEUS was most valuable.

Objective To investigate the therapeutic effect of acupoint application combined with Daqinglong Decoction (DD) for children asthma with the syndrome of exterior cold and interior heat. Methods One hundred and five children with mild and moderate persistent asthma were evenly randomized into combination group, DD group and Montelukast group. The three groups were separately given acupoint application combined with oral use of DD, oral use of DD, oral use of Montelukast, respectively. The treatment for the three groups lasted for 12 weeks. The scores of traditional Chinese medical syndromes in the three groups were recorded before and after treatment. The control of asthmatic symptoms, acute asthmatic attack frequency, and the course of disease were evaluated at the end of follow-up week 12. Results (1) At the end of treatment week 4 and 16, the syndrome scores were obviously decreased in the three groups (P<0.05 compared with those before treatment). At the end of treatment week 4, the decrease of syndrome scores in the combination group was superior to that in DD group (P<0.05), but did not differ from that in Montelukast group (P>0.05) . At the end of follow-up week 12, the decrease of syndrome scores in the combination group was superior to that in DD group and Montelukast group (P<0.05). (2) The effect of the combination group on controlling the asthmatic symptoms was superior to that of the other two groups ( P<0.01). ( 3) The combination group had lower acute asthmatic attack frequency and shorter disease course than DD group and Montelukast group ( P<0.01). Conclusion Acupoint application combined with oral use of Daqinglong Decoction is effective for children asthma with the syndrome of exterior cold and interior heat by relieving symptoms, enhancing the control of asthma, reducing acute asthmatic attack frequency and shortening disease course.

BACKGROUND:Constructing animaI model of intervertebraI disc degeneration which more faithfully mimics the pathologic hallmarks of human intervertebral disc degeneration can be a beneficial assistance for further intervertebraI disc degeneration therapy.However,there is not an accepted optimal model for intervertebral disc degeneration study OBJECTIVE:To compare the rabbit model of degenerative intervertebral disc constructed by anulus puncture and anulus incision.METHODS:Totally 32 New Zealand white rabbits were randomly divided into the anulus puncture group and annulus incision group.Intervertebral disc of L_(3-6) 6was exposed by extro-peritoneal approach,and the discs were injured by puncturing the anulus or cutting the anulus The deep and direction were controlled.Pathological change of intervertebral disc was checked with MRI and histopathological examination at weeks 2,4,12,and 20 after operation.RESULTS AND CONCLUSION:At week 4 after operation.the area of nucleus gelatinosus was deflated with enlarged anulus fibrosus,T_2-weighted image(T_2WI)declined,blurred,and the height of intervertebral space was also decreased,the grade of T2 value in the anulus puncture group was lower than that of the annulus incision group(P＜0 05):with time prolonged,T2 scores increased,and the intervertebraI space narrowed.which reached a peak at week 20 after operation.The differences had no significance.The histological sections demonstrated that the cell content in nucleus pulposus was increased gradually.The rabbit model of intervertebraI disc degeneration can be successfully constructed by the methods of anulus puncture and annulus incision.The degeneration of incision modelis more severe than that of puncture model.Anulus puncture method can faithfully mimic intervertebral disc degeneration after damage in human being.

Standardized patient(SP) is the core element of medical student evaluation system and completes the contents and tasks of objective structured clinical skills examination(OSCE).Its training level directly affects the accuracy and science of the evaluation system.By training and management,SP can be applied in interrogation,physical and other exams for undergraduate,graduate,continuing education students.It has been recognized apparently that the application of SP meets the target of cultivating innovative medical talents and plays a key role in practice evaluation and appraisal system.SP is the useful supplement for the cmrent clinical teaching methods and means.