Objective To investigate the protective effect of bicyclol tablets on drug-induced hepatic injury in patients with severe psoriasis.Methods One hundred and six patients with severe psoriasis and drug-induced hepatic injury were enrolled in this study,and randomly divided into 2 groups:bicyclol group (53 cases) treated with oral bicyclol tablets (25 mg thrice a day) for 8 weeks,diammonium glycyrrhizinate group (53 cases) treated with diammonium glycyrrhizinate capsules (150 mg thrice a day) for 8 weeks.Serum biochemical indices of hepatic function were measured before and after treatment,therapeutic efficacy was evaluated,and adverse reactions were observed and recorded after treatment.Intergroup and intragroup differences in these parameters were assessed.Results During the treatment,3 patients were lost to follow up.After treatment,serum biochemical indices of hepatic function markedly improved in both the bicyclol group (52 cases) and diammonium glycyrrhizinate group (51 cases) (both P ＜ 0.01),and the bicyclol group showed a better treatment response than the diammonium glycyrrhizinate group (P ＜ 0.01).The marked response rate was 71.15％ and 47.06％ (P ＜ 0.05),and the response rate was 84.62％ and 66.67％ (P ＜ 0.05),respectively,in the bicyclol group and diammonium glycyrrhizinate group.No adverse reactions related to tested drugs were observed in either of the two groups.Conclusion Bicyclol can attenuate antipsoriatic drug-induced hepatic injury with good safety.

Objective To assess the diagnostic value of Logistic model in differentiating between malignant and benign ovarian lesions. Methods Thirty-five indexes of clinical and ultrasound data were recorded in 601 ovarian lesions confirmed by surgical pathology. The Logistic model was developed on a training set( n - 400) and tested on a test set( n = 201). Results Variable selection resulted in a set of 10 variables for the models: personal history of ovarian cancer, maximal diameter of the lesion, maximal diameter of the solid component, multilocular-solid tumor, solid tumor, ascites, flow within papillation, irregular walls, very strong intratumoral blood flow (i. e. color score 4) and acoustic shadows. Test set area under the receiver-operating characteristics curve was 0.963 with a sensitivity 93.9% and a specificity 93. 1 %. Conclusions Logistic model can accurately separate malignant from benign ovarian masses.

Objective To evaluate the clinical efficacy of Yangyin Yiqi mixture and western medicine in the treatment of oral lichen planus(OLP)and its effect on the levels of interferon -γ(IFN -γ)and interleukine -10 (IL -10)in serum and saliva.Methods Sixty patients with OLP were randomly divided into control group(n =30) and treatment group(n =30).The control group was treated with triamcinolone acetonide and lidocaine,local injec-tion.The treatment group was treated with Yangyin Yiqi mixture on the basis of the control group.The treatment lasted two months.After treatment,the clinical efficacy,objective indicators score,levels of IFN -γand IL -10 in serum and saliva,adverse reactions were compared between the two groups.Results The overall response rate of the treatment group (86.67%)was significantly higher than that of the control group (63.33%)(χ2 =11.64,P <0.01).After treatment,the two groups'objective index score significantly reduced(t =8.52,12.51,all P <0.01),and the treat-ment group's objective indicators rating was significantly lower than the control group (t =4.38,P <0.05).After treatment,the levels of IFN -γin serum and saliva were (25.39 ±1.29)pg/mL and (12.76 ±1.28)pg/mL,which were significantly increased in the treatment group (t =10.35,8.15,all P <0.01),so did the control group (P <0.05).And the levels of IL -10 in serum and saliva were (27.54 ±1.82)pg/mL and (9.92 ±0.86)pg/mL,and the levels were significantly decreased in the two groups after treatment (t =8.76,9.39,all P <0.01,t =4.65,4.94,all P <0.05).And levels of IFN -γin serum and saliva of the treatment group were significantly higher than those of the control group (t =4.68,4.32,all P <0.05),and levels of IL -10 in serum and saliva of the treatment group were significantly lower than those of the control group (t =5.41,5.25,all P <0.05).During treatment,there were no sig-nificant adverse reactions.Conclusion Yangyin Yiqi mixture combined with western medicine has definitive clinical efficacy in the treatment of OLP.It can significantly increase the level of IFN -γand reduce the level of IL -10 in serum and saliva in patients,so provide theory value for treatment of OLP.

Personnel training marks a key assurance for the healthy and sustainable development of healthcare sector and healthcare institutions in China, rendering it critical importance to include personnel training into performance appraisal. The authors analyzed the connotation and orientation of personnel training index assessment in the performance appraisal at tertiary public hospitals in the country, sorted out the assessment details to be optimized. On such basis, the authors recommended on optimal assessment methodology, combining the gradual improvement of medical personnel training assessment indexes and interval range assessment. These efforts aim at providing references for further improving the scientificity, standardization, homogeneity, as well as vertical and horizontal comparability and operability of personnel training index assessment.

In this study, hollow fiber membrane extraction combined with ambient ionization mass spectrometry ( AMS) was developed for the simultaneous determination of 7 perfluorinated compounds ( PFCs) in aqueous solution, including perfluoroheptanoic acid ( PFHpA ) , perfluorooctanoic acid ( PFOA ) , perfluorooctane sulfonate acid ( PFOS ) , perfluorononanoic acid ( PFNA ) , perfluorodecanoic acid ( PFDA ) , perfluoroundecanoic acid ( PFUdA) , and perfluorododecanoic acid ( PFDoA) . PFCs were detected in negative ion mode using selective reaction monitoring ( SRM) mode. The extraction time and the pH value of extraction solution were optimized. 13 C4-PFOS and 13 C4-PFOA were used as internal standards for quantitative analysis. The method showed good linearity with correlation coefficient values ( r2 ) greater than 0. 991 for the seven target PFCs. With the exception of PFHpA, the limit of detection ( LOD) for other six PFCs was within ranges from 0. 8 to 2. 7 ng/L while the limit of quantitative (LOQ) was from 2. 7 ng/L to 8. 9 ng/L. The enrichment factor of five PFCs was more than two hundred. The developed method was applied to detect the seven PFCs in tap water and Pearl River water, and they were all not detected. The recoveries were within the ranges of 88. 5%-108. 3% and 94. 2%-116. 7% when 40 ng/L and 400 ng/L PFCs were spiked into tap water, respectively. In terms of the Pearl River water, the recoveries were within the ranges of 75. 0%-102. 6% and 81. 2%-97. 6% when 40 ng/L and 400 ng/L PFCs were spiked, respectively.

Objective To investigate the effect of songling xuemaikang(SL-xmk)pretreatment on the expression of matrix metalloproteinase-9(MMP-9)after focal cerebral ischemia-reperfusion in rats.Methods A total of 45 male Sprague-Dawley rats were randomly allocated into SL-xmk pretreatment,sham operation,and normal saline control group.Preventive gavage was per-formed for 8 weeks in rats using SL-xmk(937.50 mg/kg)suspension in the SLxmk pretreatment group(n = 15);the preventive gavage was performed in rats using the equal volume of normal saline in the sham operation(n = 15)and normal saline control(n = 15)groups.At the end of the pretreatment process,a model of middle cerebral artery occlusion(MCAO)in rats was induced by suture method for 2 hours and reperfusion for 24 hours.The effects of SL-xmk pretreatment on the neurologic deficit scores after transient MCAO,brain water content,and infarct volume in rats were observed.Immunohistochemical staining was used to detect the MMP-9 immunoreactive positive cells in ischemic brain tissue.Results The neurologjc deficit scores(1.21 ± 0.25 vs.2.37 ± 0.35,P = 0.000),the brain water content (76.24% ± 7.09% vs.88.78% ± 6.57%,P = 0.000),the percentage of infarct volume (22.62% ±2.17% vs.27.84% ±3.43%,P =0.000),and the numbers of MMP-9 positive cells(16.20 ± 2.17/mm vs.20.60 ± 2.71/mm,P = 0.000)were all significantly lower than those in the control group.Conclusions SL-xmk pretreatment may significantly inhibit the expression of MMP-9 in the brain tissue of focal cerebral ischemia-reperfusion rats and reduce brain water content and infarct volume.

ObjectiveTo evaluate the diagnostic value of “taller-than-wide sign” of thyroid malignancy in transverse and longitudinal plane using ultrasound.Methods708 thyroid lesions including 302 benign nodules and 406 malignant nodules ( 390 papillary carcinomas,12 medullary carcinomas,4 follicular carcinomas) that were diagnosed at surgery were included in this study.The sensitivity and specificity of “taller-than-wide sign” in transverse (A/TC ≥ 1 ) and longitudinal plane (A/TL ≥ 1 ) were evaluated using ultrasound.All thyroid malignant lesions were divided into three groups according to size of the nodules:group A≤1 cm; group B≤2 cm,group C＞2 cm.The sensitivity of each group was also evaluated.ResultsThe constituent ratio of “taller-than-wide sign” between benign and malignant nodules was significantly different (P＜0.001 ).The differences of sensitivity of A/TL ≥ 1 and A/TC ≥ 1 among three groups were also found( P ＜0.001),and the sensitivity of A/Tc≥1 was higher than A/TL≥1.ConclusionsA/TC≥1 found by ultrasound contributes to differentiate the thyroid carcinoma from benign nodules.For a large thyroid lesion,other indicators are needed to diagnose thyroid carcinoma.

Objective To study the relationship of three-dimensional power Doppler ultrasonographic parameters and endocrine profile in different symptoms of patients with polycystic ovary syndrome(PCOS).Methods One hundred and forty nine women with PCOS were divided into two groups,which included obese PCOS(OB-PCOS) group and non-obese PCOS (NOB-PCOS) group.The ultrasonic parameters such as follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,vascularization index(Ⅵ),flow index(FI),vascularization flow index(VFI) were measured and compared.Serum levels of luteinizing hormone (LH),follicle stimulating hormone (FSH),progesterone (P),estradiol (E2),testosterone(T),prolactin (PRL),sex hormone binding globulin (SHBG),free androgen index (FAI),fasting plasma glucose (FPG),fasting insulin (FINS),homeostasis model assessment-IR(HOMA-IR) were also measured and compared.The correlation of the ultrasonic parameters and hormonal factors were analyzed.Results The follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,FI and VFI,FINS,HOMA-IR,FAI of OB-PCOS were significantly higher than those of NOB-PCOS (P ＜0.01 or 0.05),the FSH,SHBG were significantly lower than those of NOB-PCOS (P ＜0.05 or 0.01).In OB-PCOS group,the follicle number was significantly associated with FSH(r =0.771,P ＜0.01).The ovarian volume,stromal volume,FI and VFI were significantly associated with HOMA-IR(r =0.412,0.842,0.389,0.415,P ＜0.05 or 0.01),FI was significantly associated with FAI (r =0.812,P ＜0.01).In NOB-PCOS group,the follicle number,ovarian volume were significantly associated with FAI(r =0.472,0.552,P ＜0.05)..Conclusions There are some different characters in ultrasonography and endocrine parameters between obese and non-obese PCOS patients.

Objective To assess prenatal heart disease screening program by ultrasound. Methods A total of 11 544 second-trimester screening scans were performed before 24 weeks′ gestation on 11 410 women between February 2004 and May 2007 in Obstetrics and Gynecology Hospital of Fudan University. Fetal heart screening was based on four-chamber and outflow tract views( left ventricular outflow + three vessel view). The sensitivity and specificity of different views were evaluated. Follow-up data of newborns was obstained. Results (1) Among 11 544 cases, 48 cases of congenital heart disease (CHD) were diagnosed in utero. Six cases were false negative, and 2 cases were false positive. The incidence of CHD was 0.47% (54/11 544). (2) Thirty-three CHDs were detected based on the four-chamber view, including 18 ventricular septal defect (9 with conotroncal anomalies),6 anomalous atrioventricle valve, 9 disproportion of left/right ventricle. The sensitivity of the four-chamber view alone was 61.11% (33/54), and the specificity was 99. 98% ( 11 488/11 490). Fifteen CHDs were detected based on the left ventricular outflow and three vessel views, including 1 pulmonary atresia, 3 pulmonary valve stenosis, 2 transposition of the great arteries ( TGA ), 1 pulmonary stanosis with TGA, 6 tetralogy of Fallot, and 2 pulmonary stenosis. The sensitivity of the combination of the four-chamber and outflow tract views was 88. 89% (48/54), and the specificity was 99. 98% (11 488/11 490). (3)Of 48 CHDs,11 cases were eceompanied by other malformations. Eleven cases were performed amniocentesis, amony whom 5 cases were trisemy 21. Conclusion The screening program based on four-chamber and outflow tract views shows good sensitivity and excellent specificity. Our prenatal heart screening program is clinically feasible.

Objective:To study the role of Jagged1 and Notch signaling pathway played in the differentiation and proliferation of RAW 264.7 cells.Methods: RAW 264.7 cells were divided into three groups to culture:The control group:RAW 264.7 cells were threated with culture and RANKL.The Jagged1 group:RAW 264.7 cells were threated with recombinant protein Jagged 1 besides the control group.The DAPT group:RAW 264.7 cells were threated with DAPT besides the Jagged 1 group.The mRNA expression of osteoclast markers(TRAP,CK,CTR) and Notch key target genes (HES-1 and HEY-1) were measured by real-time PCR.The formation of osteoclast , bone resorption , Notch expression and proliferation of RAW 264.7 cells were detected by TRAP staining , scanning electron microscope ,immunofluorescence and cell counting kit-8 ( CCK-8 ).Results: TRAP, CK, CTR , HES-1 and HEY-1 mRNA expression were significantly higher than the control group and DAPT group in Jadded 1 group ( P<0.05 ).TRAP+cell count ,osteolytic area was significantly increased in Jagged 1 group compared with control and DAPT group , and no significant difference observed between the last two groups.Immunofluorescence results showed high expression of N ICD in cell membrane and cytoplasm in all groups and additionally expressed in nucleus in Jadded 1 group.Cell proliferation was inhibited in Jagged 1 group also ( P<0.05 ).Conclusion:Jagged1 promotes RAW264.7 cells osteoclast differentiation and inhibits proliferation by activating Notch signaling pathway .