Objective To evaluate the value of 2D ultrasound and elastic strain ratio (SR) in diagnosis of thyroid nodule by fine needle aspiration (FNA).Methods 196 thyroid nodules were analyzed retrospectively with 2D ultrasound,elastography and FNA results,pathology results as the golden standard.A receiver operating characteristic (ROC) curve was used to identify the best cut-off point of SR.The Logistic regression analysis was used to evaluate the variables effectiveness on age,nodule echo,calcification and SR.Tried to discuss how to use SR before or after US-FNA in diagnosis of thyroid nodule.Results The SR of the malignant nodules group was significantly different from the benign nodules group,and the best cut-off point was 0.5 with sensitivity 91.7％,specificity 90.2 ％ and accuracy 90.8 ％.The Logistic analysis results were SR,age,echo,calcification according to the odds ratio.SR can screened nodules without puncture necessary before FNA,and increase the FNA sensitivity,specificity and accuracy after FNA.Conclusions SR has good application value in diagnosis thyroid malignant tumor.SR can reduce unnecessary FNA and make a supplementary diagnosis of FNA.

[Objective]This study was designed to discover the expression of histamine H4 receptor in allergic rhinitis(AR)and its clinical significance.[Methods]Seventy-three patients with allergic rhinitis and 30 volunteers were recruited in our study.Western blot and Real-time fluorescent quantification PCR were used to detect the protein and mRNA expression of H4R on peripheral blood monocytes(PBMC).To analyze the relationship between the H4R and allergic rhinitis,the level of serum interleukin 4(IL-4)and interleukin 12(IL-12)were determined by enzyme linked immunosorbnent assay(ELISA)in the AR group.[Results]The protein and mRNA expression of H4R in the AR group were significantly higher than that in the NAR group.Person correlation analysis revealed that H4R was positively correlated with IL-4(r=0.71,P＜0.01)and negatively correlated with IL-12(r=-0.50,P＜0.01).The expression of H4R also had positive relationship with IL-4/IL-12 ratio(r=0.75,P＜0.01).[Conclusion]These results indicate that histamine H4 receptor is closely related with allergic rhinitis and is important in the pathogenesis of AR.The elevated expression of H4R in AR patients' PBMC may be closely correlated with Th1/Th2 balance.

[Abstract ] Objective At present, the majority of injectable tissue engineering bones or carrier stents are gel , whose surface area , intensity, and hardness cannot satisfy the requirements of the repair of complex and varied bone and cartilage defects .This paper evaluated the new injectable microspherical porous chitosan/biological properties of the hydroxyapatite ceramic scaffold . Methods Injectable porous chitosan /hydroxyapatite composite microspheres with mass fractions of 30%, 50%, and 70% were prepared respectively . The hydroxyapatite ceramic ball was obtained by sintering with liquid nitrogen freezing ( liquid nitrogen group ) or without liquid nitrogen pro-cessing ( non-liquid nitrogen group ) as a new carrier of bone tissue engineering scaffold material .The microstructure of the scaffold was observed and the porosity measured under the scanning electron microscope .The mechanical properties were determined through biome-chanical experiments.Human umbilical vein endothelial cells (HUVECs) were grown in the porous chitosan/hydroxyapatite ceramic scaf-fold followed by observation of the growth of the cells and validation of the biological fusion of the scaffold . Results No difference was observed with the naked eye in the ceramic scaffold of different mass fractions in the liquid nitrogen and non -liquid nitrogen groups . Scanning electron microscopy exhibited spherical shape , uniform size, and regular morphology of the ceramic scaffolds in both groups .A large number of irregular pores were seen in the surface of the microspherical ceramic scaffolds treated with liquid nitrogen but not in the surface of those not treated .With increased mass percentage of chitosan/hydroxyapatite , the internal pores were reduced and the interior structure compacted.In the liquid nitrogen group, the scaffold of 50%mass fraction had a significantly larger diameter ([0.48 ±0.11] mm), higher compression intensity ([1.75 ±0.14] MPa), and lower porosity ([79 ±2]%) than that of 30%mass fraction ([0.40 ± 0.08] mm, [1.21 ±0.12] MPa, and [87 ±1]%) (all P<0.05).Electron microscope scanning revealed well -grown HUVECs with multiple synapses in the porous tricalcium phosphate scaffold. C onclusion The porous chitosan /hydroxyapatite ceramic scaffold of 50%mass fraction treated with liquid nitrogen , with its strong mechanical intensity and high biological fusibility , can be used as a new carrier of bone tissue engineering scaffolds .

Objective To evaluate left ventricular diastolic and systolic function of the dogs during different status of acute myocardial ischemia with velocity vector imaging (VVI). Methods Six healthy mongrel dogs were enrolled. Home-made artery constrictor was placed in the proximal coronary artery after opening the chest of dogs to produced different grades of coronary artery stenosis. Mean of peak diastolic velocity (Em), peak strain rate of diastole (Esr), mean of peak systolic velocity (Sm), peak strain rate of systole (Ssr), ejection fraction (EF) and left ventricular pressure were measured. Results There was good linear correlation between Em and Esr by VVI and left ventricular end diastolic pressure (LVEDP) (r=-0.834, P＜0.001 and r=-0.703, P＜0.001, respectively). Em and LVEDP had better correlation than that between Esr and LVEDP (P=0.032). Sm, Ssr or EF had significant correlation with +dp/dt_(max) (r=0.883, P＜0.001, r=0.772, P＜0.001 and r=0.647, P＜0.001, respectively). Significant difference was observed for correlation coefficient between Em and Esr and EF (P＜0.001). Conclusion Em and Sm are sensitive echocardiography indexes to evaluate left ventricular diastolic and systolic function, and are better than EF, Esr and Ssr.

Objective To evaluate the effect of ulinastatin pretreatment on endoplasmic reticulum stress during myocardial injury in the patients undergoing mitral valve replacement (MVR) with cardiopulmonary bypass (CPB).Methods One hundred patients of both sexes,aged 35-64 yr,weighing 40-80 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective MVR with CPB,were divided into ulinastatin pretreatment group (UP group,n=50) and normal saline control group (NS group,n =50) using a random number table.Ulinastatin 0.5× 104 U/kg was intravenously infused over 1 h before skin incision,and administration was repeated every 4 h until the end of operation in group UP,while the equal volume of normal saline was given instead in group NS.Immediately after opening the right atrium (T0),at 30 min after aortic clamping (T1) and while suturing the right atrium (T2),blood samples were collected from the radial artery for measurement of the concentrations of plasma creatine kinase-MB and cardiac troponin T by enzyme-linked immunosorbent assay.Right auricle specimens were obtained after blood sampling at each time point for determination of the expression of glucose-regulated protein 78,CCAAT/enhancer-binding protein homologous protein and c-Jun N-terminal kinase protein and mRNA (by real-time polymerase chain reaction and Western blot,respectively) and apoptosis in cardiomyocytes (by TUNEL).The apoptosis rate was calculated.Results Compared with group NS,the plasma concentrations of creatine kinase-MB and cardiac troponin T at T1 and T2 and apoptosis rate at T2 were significantly decreased,and the expression of glucose-regulated protein 78,CCAAT/enhancer-binding protein homologous protein and c-Jun N-terminal kinase protein and mRNA was down-regulated at T1 and T2 in group UP (P＜0.05).Conclusion The mechanism by which ulinastatin pretreatment inhibits apoptosis in cardiomyocytes and attenuates myocardial injury is related to decrease in endoplasmic reticulum stress in the patients undergoing MVR with CPB.

BACKGROUND: Metal implants have been extensively applied in joint arthoplasty, but the stress shielding effect caused by its high elastic modulus results in a series of complications, such as bone resorption, bone atrophy and prosthesis loosening. Carbon fiber-reinforced polyetheretherketone (CF-PEEK) composites are anisotropic and exhibit more advantages used for prosthesis due to its low elastic modulus and high intensity.OBJECTIVE: To investigate the blood compatibility of CF-PEEK composites, and compare the biomechanical properties after arthroplasty between CF-PEEK composites and Co-Cr-Mo used for femoral head prosthesis. METHODS: (1) The blood compatibility of CF-PEEK composites was evaluated through hemolysis test. (2) Femoral samples from eight fresh cadavers were collected and randomly divided into two groups, followed by subjected to CF-PEEK and Co-Cr-Mo prosthesis replacement, respectively. The displacement between the prosthesis and bone was measured under loading 200, 400, 600, 800 and 1000 N, and the torsional strength after arthroplasty was detected.RESULTS AND CONCLUSION: (1) The hemolysis rate of the CF-PEEK composites was 3.23% < 5%, which was in line with the national standards for biological evaluation of medical devices. (2) The micromovement in distal prosthesis was significantly less than that of proximal prosthesis under different loads in both two groups (P < 0.05). (3) The torsion angle under different loads in the CF-PEEK group was significantly less than that in the Co-Cr-Mo group (P < 0.05), and the torsion stiffness in the CF-PEEK group was significantly higher than that in the Co-Cr-Mo group (P < 0.05). (4) To conclude,the CF-PEEK composites possess good blood compatibility and stability, which can be used as a prosthesis material.

Objective To explore the clinical significance of N-terminal pro-brain natriuretic peptide(NT-proBNP)in the evaluation of cardiac function in patients with severe burns. Methods A total of 78 patients with severe burns in intensive care unit(ICU)in our hospital were selected. Patients were divided into a heart failure group(n = 31)and a non-heart failure group(n = 47)according to the heart failure complication condition. The changes of NT-proBNP level in different time ,heart function index ,relevant index and mortality were compared between the two groups. Results The levels of NT-proBNP ,troponin(CTnT),creatine kinase(CK),creatine kinase isoenzyme (CK-MB),stroke volume index (SVI),cardiac index (CI) and central venous pressure (CVP),and the score of acute physiologic and chronic health conditions(APACHE II)in the heart failure group were shown to be significantly increased than those of the non-heart failure group (P < 0.05). The mean arterial pressure(MAP)in the heart failure group was significantly lower than the non-heart failure group(P < 0.05). Mortality rate in the heart failure group was shown to be significantly higher than the non-heart failure group (P < 0.05). Conclusion Heart failure is a common complication in patients with severe burns. The mortality rate in the population with heart failure is relatively high ,for which NT-proBNP can effectively assess the conditions and prognosis.

Objective To evaluate the effect of penehyclidine hydrochloride on Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway in the myocardium of pediatric patients undergoing radical correction of tetralogy of Fallot with cardiopulmonary bypass (CPB).Methods One hundred pediatric patients of both sexes,aged 5 months-3 yr,with body mass index of 13.9-16.0 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association classification Ⅱ or Ⅲ),with the left ventricular ejection fraction＞50％,scheduled for elective radical correction of tetralogy of Fallot with CPB,were divided into 2 groups (n =50 each) using a random number table:penehyclidine hydrochloride group (group P) and control group (group C).Penehyclidine hydrochloride was intravenously injected at a dose of O.04 mg/kg immediately after successful internal jugular vein puncture in group P,and the equal volume of normal saline was given instead at the same time in group C.Before anesthesia induction,at 10 min after induction,after re warming to 36 ℃,at 1 h after termination of CPB,at the end of surgery and at 24 h after surgery,venous blood samples were collected to detect the concentrations of tumor necrosis factor-alpha,interleukin-6 (IL-6),IL-8 and cardiac troponin T in plasma (by enzyme-linked immunosorbent assay).Myocardial specimens were obtained from the right auricular appendage after opening of pericardium and at 1 h after aortic unclamping for microscopic examination and for determination of activated NF-κB and TLR4 protein and mRNA expression (by Western blot and real-time polymerase chain reaction,respectively).Results Compared to group C,the concentrations of plasma tumor necrosis factor-alpha,IL-6,IL-8 and cardiac tropnin T were significantly decreased after re-warming to 36 ℃C,at 1 h after termination of CPB,at the end of surgery and at 24 h after surgery,the expression of activated NF-κB and TLR4 protein and mRNA was down-regulated at 1 h after aortic unclamping (P＜0.05),and the pathological changes of myocardium were significantly attenuated in group P.Conclusion The mechanism by which penehyclidine hydrochloride reduces inflammatory responses is related to inhibition of the activation of NF-κB/TLR4 signaling pathway in the myocardium of pediatric patients undergoing radical correction of tetralogy of Fallot with CPB.

Objective To determine the efficacy and safety of Chinese Medicine Jiaweidingchuan Soup in the treatment of asthma.MethodsPatients(n =32)with mild-to-moderate asthma were treated with Chinese Medicine Jiaweidingchuan Soup for 4 weeks.We measured the FVC、FEV1、PEF、IL-6 and IFN-? level.ResultsAfter treatment,the FVC、FEV1 and PEF values and the expression of IFN-? in patient with asthma increased significantly(P

Objective:To observe the effect of transdermal fentanyl combined with gabapentin for the treatment of malignant neu-ropathic pain (MNP). Methods:A total of 60 patients with MNP were randomly divided into two groups. A total of 30 cases in the con-trol group received transdermal fentanyl according to the dosages of opioid medicine that patients used. Such dosages were gradually in-creased until the pain relief visual analogue scale (VAS) fell below 3 or until the times of breakthrough pain became less than 3. For the combined group, gabapentin was co-administered with transdermal fentanyl, similar to the control group. Initially, 100 mg of gabapen-tin was administered thrice a day. This dosage was gradually increased until pain relief. However, gabapentin dosages were kept below 2,400 mg a day. VAS, quality of life (QOL), degree of pain relief, dosages of fentanyl and morphine, and side effects were evaluated be-fore treatment and at one, two, three, and four weeks after the treatment. Results:Both groups exhibited lower VAS after treatment (P<0.05), but the difference was observed to be more significant in the combined group than that in the control group (P<0.05). Both groups exhibited improved QOL (P<0.05), which was observed to be more significant in the combined group than in the control group (P<0.05). The effective rate was 96.7%in the combined group and 83.3%in the control group. The dosage of opioid medicine and the side effects in the combined group were less than those in the control group. Conclusion:Transdermal fentanyl combined with gabapen-tin is effective for the treatment of malignant neuropathic pain.