Objective To investigate the application value of acoustic radiation force impulse imaging (ARFI) in differential diagnosis of small solid thyroid nodules coexisting with Hashimoto's thyroiditis (HT).Methods A total of 136 patients with 155 small solid nodules (≤1 cm in diameter) confirmed by pathology were included.The small solid nodules were divided into HT group and normal group.All patients underwent virtual tissue imaging (VTI) and virtual touch tissue quantification (VTQ).The stiffness of small solid thyroid nodules in two groups was respectively scored based on VTI images,and the area ratios of nodules in VTI images to gray scale images were calculated.Taking pathological diagnosis as the gold standard,the ROC curve were performed to explore the optimal points and efficacy of area ratio and shear wave velocity (SWV) in the diagnosis of malignant nodules in two groups respectively.Results Regarding VTI score≥4 as the diagnostic standard of malignant nodules,the sensitivity of HT group and normal group in diagnosis of malignant nodules had significant difference (64.29％[27/42] vs 81.69％[58/71],P＜0.05).In two groups,the area ratio and SWV of malignant nodules were significantly higher than those of benign nodules (all P＜0.05).The area ratio and SWV of thyroid benign nodules and malignant nodules had no significantly difference between two groups (all P＞0.05).Taking 1.41 as the cutoff point of area ratio,the sensitivity and specificity in diagnosis of malignant nodules in HT group were 85.7％ and 88.9％.Taking 2.87 m/s as the cutoff point of SWV,sensitivity and specificity in diagnosis of malignant nodules in HT group were 85.7％ and 94.4％.Taking 1.40 as the cutoff point of area ratio,the sensitivity and specificity in diagnosis of malignant nodules in normal group were 91.5％ and 95.8％.Taking 2.67 m/s as the cutoff point of SWV,the sensitivity and specificity in diagnosis of malignant nodules in normal group were 88.7％ and 95.8％.Conclusion ARFI technology can evalu-ate the hardness of the small solid thyroid nodules through the intuitive VTI images and objective SWV values in HT,which is helpful in diagnosis of malignant nodules in HT backgroud.

Spinal cord injury is one of the important field of neuroscience, and neural tract tracing techniques are important research tools. The neural fiber types in the spinal cord are complex, and there are some difference in structures between human beings and animals. This article reviewed different types of neural fibers closely related with spinal cord injury and regeneration, the difference between human beings and animals, and the application of neural tract tracing techniques in the study of spinal cord injury and regeneration.

Cone-Beam Computed Tomography ; Humans ; Pediatric Dentistry ; Root Canal Preparation ; Subcutaneous Emphysema ; diagnostic imaging

It is imperative to apply information technology in the area of management of clinical research so as to ensure the quality of clinical trials and to improve management efficiency.In this study,the based analysis method was the quality function deployment (QFD).This methodology is used to analysis the clinical trials management information system on a hospital directly under the Ministry of Health.It ensured user participation,lay a solid foundation for software engineers on system design.

Objective To investigate the serum level of calcium-binding protein A9(S100A9)in patients with rheumatoid arthritis and explore its potential clinical significance. Methods The serum level of S100A9 was measured by ELISA in 79 rheumatoid arthritis (RA) patients and 20 healthy controls (HC). The correlation of S100A9 level and relevant clinical parameters were analyzed. Results The serum level of S100A9 was significantly increase in RA patients than those in HC. The serum level of S100A9 was higher in high disease activity than that in moderate and low disease activity in the RA group. There was a positive correlation in serum S100A9 level and DAS28 score,Rheumatoid factor,tender joint count and swollen joint count. Conclusion The serum level of S100A9 increases in RA patients and correlates with RA activity.

With a reflection on the grand quantitative analysis in previous historical investigations, microhistory came into being in Italy in the 1960s and the 70s. Microhistory is, in principle, the intensive historical investigation of a relatively well defined smaller object. Notwithstanding, it still has the ambition to draw a larger picture of the history. Microhistory is also characterized by its preference to the exceptional individuals or phenomena, its "narrative" style and the delicate way it deals with historical sources. Essentially, microhistory endeavors to bring the individual's role, the concrete life as well as the diversity and complexity of history to the historical writing. At first, microhistory did not have intersection with the medical history. Nevertheless, the history of medicine echoes microhistory in bringing the concrete and vivid life beings to history. Mainly due to this similarity, historical surveys on medicine from the perspective of microhistory are increasing and gradually develop into a remarkable trend in the international historical academy from the 1980s onwards. As the microhistory is rising and its influence is expanding, the microhistorical approach has been practiced to a certain extent in the historical writings on medicine in China. Concentrating on an individual person, a single event, a particular drug or a specific concept, there already have some studies conduct intensive historical investigation on a small scale. A small part of these researches, for example, those of Chang Che-Chia, Li Shang-jen and etc. could be regarded as perfect examples of microhistory. However, no relevant research is carried out explicitly under the heading of microhistory, instead, they are the offspring of the "new history". Besides, most of these researches could not be regarded as real microhistories, strictly speaking. They do not practice microhistory consciously and they have a long way to go to improve the delicacy of the analysis, to reinforce the narrative style and to grasp the social context of the individual or the event (the link between micro and macro levels). Nevertheless, these studies anyway indicate the invisible influence of microhistory and have paved a way for the future microhistorical investigations on medicine. We believe that microhistory is an undercurrent about to emerge in the field of Chinese medical history. It is the right time to advocate and promote the self-conscious microhistorical investigation, promptly and strongly, while updating the ideas and methods of it to make it a dominant trend rather than an undercurrent in the studies of Chinese medical history. Its rise would not only display the value and significance of microhistory in a better way, but also would help medical history to realize its core idea of history of life, therefore to propel our inquiry into Chinese medical history.
China ; *Historiography ; *History of Medicine

Objective:It has been demonstrated that anesthetics exposure may lead to neurocognitive impairment in developing brain of animal models.However,for the limitation that the animal models can-not fully mimic the dose and duration in clinical settings especially for dental general anesthesia,the cli-nical significance of anesthetics exposure on developing central nervous system remains undetermined. Therefore,we conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia comparing to that before surgery.We conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia compared with that before surgery.Methods:Thirty two patients,ASA Ⅰ, who were exposed to dental general anesthesia in Department of Pediatric Dentistry Peking University School and Hospital of Stomatology,aged 4 to 6.5 years,were enrolled in this prospective study.Patients with severe learning difficulties or communication disorders were excluded.Written and informed consent was obtained from each patients’family which was fully explained of the purpose and method of study. Their intelligence quotients were evaluated with the Chinese Wechsler young children scale of intelligence (Urban version)before and 2 weeks after dental anesthesia.They were treated by experienced pediatric dentists and the sevoflurane,propofol and nitrous oxide were used for general anesthesia by anesthetist. Articaine hydrochloride and epinephrine tartrate injections were used for their pulp treatment or extrac-tion.The examiners and scorers for IQ had technical training in the test administration.All the patients were tested by the same examiner and with standardized guide language.Each subtest was scored accor-ding to the tool review.Verbal IQ and performance IQ consisted of relevant 5 subtests and full scale IQ. Statistical analyses were performed by SPSS 18.0.All the scores of subtests and 3 types of IQ were ex-pressed as x-±s.Paired two-tailed t test was applied and P<0.05 was accepted as statistically signifi-
cant.Results:The results of intelligent assessment from 28 subjects were collected.The anesthetic time was (163.4 ±32.6)min and the number of treated teeth was 12.1 ±2.3,mean age (4.60 ±0.41 ) years;age range=4.04 to 5.44 years.Among the patients,there were 13 girls and 15 boys.There was no significant difference in gender distribution.The postoperative full IQ (128.46 ±10.85 )was higher than that before surgery (124.64 ±11.46,P=0.017).We found that the elevation of performance IQ, to a large extent,contributed to this change in full IQ (P=0.007).Correspondingly,there was no sta-tistical difference in the verbal IQ,which was 119.68 ±11.74 to 120.21 ±15.61 (P=0.854).Con-clusion:Dental general anesthesia has no negative effect on the intelligence of preschool children,who were treated under general anesthesia by sevoflurane,propofol and nitrous oxide for 2 to 4 hours.The full IQ and performance IQ were slightly enhanced after treatment which can be explained by the memory effect.

Objective To observe the intervention effects of Xintongfang on the expression of P-selectin (PS), P-selectin glycoprotein ligand-1 (PSGL-1), platelet-leukocyte aggregates (PLA) and platelet-monocyte aggregates (PMA) in patients of coronary heart disease with carotid artery plaque. Methods Sixty patients were randomly divided into Xintongfang group and the control group, with 30 cases in each group. Xintongfang group was given Xintongfang, the control group was given aspirin and atorvastatin calcium for two months. The expression of PS, PSGL-1, PLA and PMA were tested by flow cytometry before and after treatment. Results The expression of PS, PSGL-1, PLA and PMA in two groups were reduced (P<0.01). Xintongfang group had more obvious effects on the expression of PLA and PMA than the control group (P<0.05). Conclusion Xintongfang can reduce the degree of inflammatory in patients of coronary heart disease with carotid artery plaque by inhibiting platelet-leukocyte interaction.

OBJECTIVE:To systematically review the effect of organic cation transporter 2 [(OCT2)808G>T] gene polymor-phism on the metformin hydrochloride pharmacokinetics in vivo,and to provide evidence-based reference for clinical medication. METHODS:Retrieved from PubMed,EMBase,Foreign Medical Journey Service,CJFD,VIP database and Wanfang database,re-lated studies about the effect of (OCT2)808G>T gene polymorphism on the metformin hydrochloride pharmacokinetics in vivo were collected,and Meta-analysis was performed by using Rev Man 5.1 statistics software. RESULTS:A total of 5 retrospective studies were included,involving 172 patients. The result of gene type was type GT,type TT and type GG. Results of Meta-analysis showed,compared with type GT volunteers,type TT could prolong the half-time period of metformin hydrochloride;compared with type TT,type GG could increase the peak concentration. However,(OCT2)808G>T gene polymorphism had no effects on the renal clearance rate,creatinine clearance rate and area under the drug-time curve. CONCLUSIONS:(OCT2)808G>T gene poly-morphism has certain effect on the half-time period and peak concentration of metformin hydrochloride in vivo of health volunteer, and has no effect on the renal clearance rate,creatinine clearance rate and area under the drug-time curve. Due to the limit of re-search methodological quality,large-scale and high quality studies are required for further validation of the conclusions.

Peer review anti assessment includes the evaluation of expert and index system in two parts.The current status of anti-assessment study mainly focused on expert,much of the index system anti-assessment study reports.As can be seen from the status,the anti-assessment system not yet formed and the application is rare.In urgent need of further research to improve our peer-reviewed scientific research.