Objective To explore the relationship between the features of thyroid carcinoma and its metas tasis to cervical lymph nodes(MCLN) with conventional and contrast-enhanced ultrasound imaging.Methods Totally 89 thyroid carcinoma nodules were used in this study.The pathology of those samples was confirmed by surgical pathology at the First Affiliated Hospital of Shanxi Medical University from Sep 1,2014 to Oct 30,2015.The samples were divided into two groups based on the surgical pathology report:the group with MCLN (49) and the group without MCLN (40).Using the pathology report as gold standard,we analyzed the conventional ultra sound features,contrast-enhanced ultrasound enhancement pattern as well as the quantitative parameters.Results ① There was statistically significant difference in tumor size,contact of the tumor with capsule or not,microcalcification of the tumor,as well as echo texture of the thyroid carcinoma nodules between the groups (P＜0.05).②) There was statistically significant difference in peak intensity (PI) between the two groups (P＜0.05).Conclusion There is a positive correlation between cervical lymph nodes metastasis and tumor size,with or without contact with fibrous capsule,with or without microcalcification,the internal echo as well as PI.

Objective To explore the clinical characteristics of autoimmune disease with dual seropositive antibodies of leucine-rich glioma inactivated 1(LGI1)and contactin-associated protein 2(Caspr2).Methods The clinical data of seven patients with dual seropositive LGI1 and Caspr2 antibodies who were admitted to the Neurology Department of Peking Union Medical College Hospital from July 2014 to December 2017 were retrospectively analyzed.Results Central,peripheral and autonomic nervous systems were all involved in the seven cases;100%(7/7)presented with insomnia,myokymia,neuropahic pain and hyperhydrosis;71%(5/7)showed memory decline or psychiatric and behavioral symptoms;57%(4/7)had urinary hesitation or constipation;and 43%(3/7)had seizure.Electromyography showed 100%(6/6) of the patients had prolonged afterdischarges following normal M waves and/or abnormal spontaneous firing.Electroencephalography revealed slow waves or basic rhythm slowing in 71%(5/7)of patients.Electrocardiography showed sinus tachycardia,axis deviation,and prolonged QT intervals in 71%(5/7)of patients.One patient died from arrhythmia before immunotherapy.One died from pulmonary infection after immunotherapy.Improvement with immunotherapy was documented in the other five cases.No relapse was noted during the 1-2-year follow-up.Conclusions Autoimmune disease with dual seropositive antibodies of LGI1 and Caspr2 can diffusely affect the central,peripheral,and autonomic nervous systems.The possibility of this disease should be considered in patients with acute and subacute onset of neuropsychiatric symptoms,especially in patients with accompanying insomnia,myokymia,and hyperhydrosis.
Autoantibodies ; blood ; Autoimmune Diseases ; immunology ; Humans ; Membrane Proteins ; immunology ; Nerve Tissue Proteins ; immunology ; Proteins ; immunology ; Retrospective Studies

Objective Lipid metabolism disorders caused by cell foam plays an important role in atherosclerosis,but wheth-er it is involved in the development and progression of silicosis has not yet been elucidated. This study aimed to investigate the effect of free silica(SiO2) in inducing foam cell formation of NR8383 alveolar macrophages in rats. Methods NR8383 cells were cultured in vitro by the routine method (the control group) or in 50 μg/mL SiO2 (the SiO2group), 50 μg/mL ox-LDL (the ox-LDL group), or 50 μg/ml SiO2and ox-LDL (the model group), all for 36 hours. The survival rate of the cells was calculated with the cell proliferation and cytotoxicity assay (MTS),the lipid deposition observed by oil red O staining,the levels of total cholesterol (TC), free cholesterol (FC) and cholesterol esters(CE) measured by ELISA,and the mRNA and protein expressions of PPARγ and CD36 in the cells determined by RT-PCR and Western blot, respectively. Results Compared with the control group,the cells treated with ox-LDL showed a significantly increased survival rate, which reached the peak at 50 μg/mL ([1.501±0.201]%) (P<0.05). Foam cells were observed in the SiO2,ox-LDL and model groups,but most significantly in the model group. In comparison with the ox-LDL group,the model group exhibited remarkable increases in TC([14.195±2.260] vs[35.764±4. 226] μg/mg,P<0.05),FC([7.722±0.690] vs[10.049±0.698] μg/mg,P<0.05),CE([6.473±1.707] vs[25.715±4.243] μg/mg,P<0.05),and CE/TC (45.057% vs 71.642%, P<0.05). Conclusion Free SiO2promotes the lipid metabolism disorder in macrophages and enhances the foaming of the cells,in which PPARγ and CD36 may play an important role of regulation.

The HA gene of H9N2 influenza virus (A/chicken/Hunan/04.14 (H9N2)) was amplified and sequenced. The RNA was synthesized by in vitro transcription. The RNA transcription solutions were diluted to 10⁹ copies/μL using the RNA storage solution. The aliquoted RNA solutions were used to evaluate the homogeneity and stability. The results were determined by the average value obtained from four independent laboratories. Furthermore, the fluorescence quantitative RT-PCR method was also developed to verify the detection accuracy of clinical samples. The detection limit of this method is approximately 10 copies. Taken together, the RNA transcription solution established in our study can used as positive standard reference for rapid detection of H9N2 influenza virus.

Objective: To explore the relationship between plasma levels of soluble ST2 (sST2), galectin-3 (Gal-3) and clinical prognosis of ventricular septal myectomy in patients with obstructive hypertrophic cardiomyopathy (HOCM). Methods: A total of 200 consecutive HOCM patients received modified Morrow surgery in our hospital from 2011-03 to 2016-02 were studied. According to plasma levels of sST2, patients were divided into 3 groups: Low sST2 group (sST2<9.05 ng/ml), Middle sST2 group (sST2 9.05-16.74 ng/ml) and High sST2 group (sST2>16.74 ng/ml); based on plasma levels of Gal-3, patients were divided into another 3 groups: Low Gal-3 group (Gal-3<6.19 ng/ml), Middle group (Gal-3 6.19-8.22 ng/ml) and High Gal-3 group (Gal-3>8.22 ng/ml); in addition, Control group, n=42 volunteers without heart disease. Plasma levels of sST2 and Gal-3 were measured by ELISA, compared between Control group and HOCM group (n=42 patients with matched gender and age to Control group). The predictive value of sST2 and Gal-3 on major endpoint events including all cause death or cardiovascular hospitalization were assessed by Cox regression analysis.Results: Compared with Control group, plasma levels of sST2 and Gal-3 were increased in HOCM patients, P<0.01. The patients were followed-up for the average of 26 months, Kaplan-meier survival analysis showed that the incidences of composite endpoint event were similar at different levels of sST2 and Gal-3 (log-rank P=0.06 and P=0.68). Cox regression analysis indicated that either sST2 or Gal-3 could not independently predict the endpoint events, both P>0.05, while age was an independent risk factor for composite endpoint event occurrence (HR=1.06, 95% CI 1.02-1.11, P<0.01). Conclusion: Plasma levels of sST2 and Gal-3 were not related to clinical prognosis of ventricular septal myectomy in HOCM patients even they had increased sST2 and Gal-3; while advanced age was the independent predictor for endpoint event occurrence.

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.

To investigate the long-term efficacy of endolymphatic sac mastoid drainage for Ménière disease.Data from 26 patients diagnosed with MD strictly meeting the criteria issued by " Guideline of diagnosis and treatment of Meniere disease(2017)" from 2006 to 2015 were analyzed in this study.Endolymphatic sac mastoid shunt surgery was performed for each patient.The therapeutic effect was evaluated against the " Guideline of diagnosis and treatment of Meniere disease(2017)".Vertigo control and auditory function were measured after at least two years follow up.In 26 cases,16 cases were male and 10 cases were femaleThe age ranged from 24 to 71 years old,with an average of 52.04 years.The disease duration ranged from 1 to 32 years.22 cases were diagnosed as unilateral Ménière disease,and bilateral involvement was identified in 4 cases,thus a total of 30 ears were included.According to the preoperative staging of hearing,there were 0 cases in stage one,5 cases in stage two,16 in stage three and 9 cases in stage four.15 cases(57.7%)achieved class A vertigo conrol(complete control),9 cases(34.6%)class B(substantial control)and 2 cases(7.7%)class D(no control).The severity of vertigo and its impact on daily life were improved in 24 cases(92.3%)with a score of 0 point,and 2 cases(7.7%)scored 2 points.Post-operative hearing was improved in 3 cases(11.5%),unchanged in 16 cases(61.6%)and worsened in 7 cases(26.9%).After operation,tinnitus disappeared in 5 cases(19.2%),reduced in 13 case(50%)and unchanged in 8 cases(30.8%).Endolymphatic sac mastoid drainage was an effective and safe management for intractable Ménière disease patients with pre-operative residual hearing.The occurrence of complication was unsual.The patients who are in stage four could gain benifits from the surgery.
Adult ; Aged ; Drainage ; Endolymphatic Sac ; Female ; Follow-Up Studies ; Humans ; Male ; Mastoid ; Meniere Disease ; therapy ; Middle Aged ; Vertigo ; Young Adult

Objective To investigate the characteristic sonographic and pathological features of breast ductal carcinoma in situ (DCIS) without microcalcifications on mammography (MG).Methods Forty cases of DCIS without microcalcifications on MG were retrospectively reviewed.The 40 lesions were classified into mass and non-mass groups according to their sonographic findings.The pathological subtypes and nuclear grades of these cases were also analyzed.Fisher exact test was used to compare the differences of the sonographic accuracy rate,sonographic microcalcification rate,pathological nuclear grade and subtype rate between mass and non-mass groups.Results No abnormal finding was found in sixteen cases (40.0％)on MG and only one case (2.5％) on ultrasonography (US),respectively.The most common sonographic feature of DCIS without microcalcifications on MG were masses (75.0％,30/40),and other sonographic findings were round/oval and irregular shape,microlobulated margin,heterogeneous hypoechogenicity and isoechogenicity,and posterior acoustic feature.Ductal dilatations and heterogeneous isoechogenicity were present in most non-mass lesions of DCIS without microcalcifications on MG (22.5％,9/40).The ultrasonographic microcalcifications were found in 5 cases of DCIS without microcalcifications on MG.The common pathological features of DCIS without microcalcifications on MG were medium-low nuclear grade (85.0％,34/40) and noncomedo (87.5％,35/40).The difference of US accuracy rate in mass and non-mass groups was statistically significant [73.3％ (22/30) vs 33.3％ (3/9),P=0.047].The differences of US microcalcification rate,pathological subtype and nuclear grade were not significant (P=1.000,0.070).Conclusions The mass appearance and medium-low nuclear grade were most common sonographic findings and pathological features of DCIS without microcalcifications on MG.Ultrasonography should be an helpful tool for improving the diagnostic sensitivity ofmammography in breast DCIS.

A switch thrombin aptamer sensor was constructed based on the host-guest competition mode ofβ-cyclodextrin (β-CD ) . The aptamer that modified with ferrocene ( Fc ) at its terminal was fixed on the surface of the gold electrode via the host-guest recognization with β-CD. When thrombin was present, the configuration of aptamer transformed from vertical linear to "G-quadruplex" and far away from the electrode surface, which resulted in a decrease in the redox current of the aptamer probe and produce "Signal-off"effect. On the basis of this, a high sensitive detection of thrombin was made. The detection result indicated that the thrombin concentration had a consideration linear response to the signal of aptasensor between 5 . 0 × 10-13-5. 0 × 10-9 mol/L, and as low as 2. 0 × 10-13 mol/L thrombin had been detected. This method for thrombin detection showed a higher specificity compared to other protein molecules. Besides, the sensor was constructed easily and possessed excellent regeneration, which provided a significant platform for highly efficient real-time detection of thrombin in biological serum samples.

Objective To investigate the morphological features of colorectal sessile serrated adenoma/polyp (SSA/P) by white light endoscopy (WLE) and narrow band imaging (NBI). Methods A retrospective analysis was made on the morphological characteristics of SSA/P from January 2014 to March 2017, and compared with HP. Results There were 50 cases of SSA/P from 41 patients and 50 cases of HP from 43 patients. SSA/P located in the right colon was more than HP, but the difference was no statistical significance (16 cases vs 14 cases,P > 0.05). SSA/P have 11 cases of Type Is, 21 cases of Type IIa, 16 cases of Type IIb, 2 cases of Type LST, HP have 17 cases of Type Is, 25 cases of Type IIa, 8 cases of Type IIb, there was no significant difference (P > 0.05); SSA/P has more mucus than HP (37 cases vs 11 cases, P < 0.05). In NBI: The proportion of SSA/P with a red mucus cap, indistinctive borders, irregular shape, black dots inside the crypts, Cloud-like surface, Type II-O pit pattern and varicose microvascular vessels were higher than that of HP (P < 0.05). In the differential prediction of SSA/P and HP: Black dots inside the crypts (OR^ : 14.2; 95%CI: 5.8 ~ 34.7) with higher sensitivity, the sensitivity, specificity and accuracy respectively were 80.0%, 78.0%, 79.0%; Type II-O pit pattern (OR^ : 56.0; 95%CI: 17.7 ~ 177.6) with higher specificity, the sensitivity, specificity and accuracy respectively were: 70.0%, 96.0%, 83.0%; Red mucus cap (OR^ : 9.3; 95%CI: 3.8 ~ 22.8) with high specificity, the sensitivity, specificity and accuracy respectively were 64.0%, 80.0%, 74.0%; Cloud-like surface (OR^ : 16.9; 95%CI: 5.7 ~ 50.7) with high specificity and low sensitivity, the sensitivity, specificity and accuracy respectively were: 52.0%, 94.0%, 73.0%. Combining the black dots inside the crypts and Type II-O pit pattern with other endoscopic features of SSA/P could improve the sensitivity and the accuracy in diagnosis prediction. Conclusion The study has confirmed that SSA/P has unique endoscopic features compared with HP in NBI mode. Observing the morphological characteristics of SSA/P with NBI could achieve the purpose of identifying SSA/P and HP. The black dots inside the crypts and Type II-O pit pattern respectively have higher sensitivity and specificity in diagnosis prediction of SSA/P, so we recommend to combine the two indicators with others endoscopic features of SSA/P to identify SSA/P and HP to achieve the purpose of screening SSA/P in colonoscope examination.