Objective:To evaluate the predictive value of gait kinematic combined with total MRI burden for the risk of falls in patients with gait disorder in cerebral small vessel disease(CSVD)using logistic regression analysis and ROC curve. Method:Forty-three patients diagnosed with CSVD and presenting primarily with gait disorder at Rehabilitation Department of Gansu Province Hospital from March 1,2019 to March 30,2020 were selected.The statistical clinical data were collected,and according to the TUG test time,all patients were divided into a group with high risk of fall(high risk of falling,HRF,TUG≥15s)and a group of low risk of falls(low risk of falling,LRF,TUG＜15s).Logistic regression analysis and ROC curve were used to assess the predictive value of gait kinematic characteristic combined with total MRI burden for the risk of falls in CSVD patients. Result:A total of 43 patients were included with average age(71.07±8.17)years.Among them,there were 26 female(60.4％)and 30 hypertension patients(69.8％),After adjusting for age and TUG,the logistic regres-sion analysis showed that the step length(OR 0.821,95％CI 0.702-0.959,P=0.013)was an independent protec-tive factor against the risk of falls in CSVD patients,while the total MRI burden(OR 4.217,95％CI 1.444-12.317,P=0.009)was an independent risk factor for the falls in CSVD.The ROC curve analysis showed that the combination of step length and total MRI burden had a high predictive value for the risk of fall in CSVD patients with gait disorder(AUC=0.904),with a sensitivity of 82.6％and a specificity of 90％. Conclusion:Step length combined with total MRI burden has a high predictive value for the risk of falls in CSVD patients with gait disorder.

Objective: To study the clinical significance of serum calcitonin in the diagnosis and treatment of medullary thyroid carcinoma and to analyze its cost-benefit. Methods: One hundred and forty one patients with medullary thyroid carcinoma who undertook calcitonin test and frozen pathological examination were enrolled in this study from Oct 2012 to Mar 2018. Using the method of χ² test, the positive rate of calcitonin test and frozen pathological examination in diagnosis of medullary thyroid carcinoma(MTC) were compared. Firstly, we compared the correct checkout cost of calcitonin test and that of frozen pathological examination (total number of patients×cost of examination/the correctly detected number of patients) . Secondly, we calculated whether calcitonin test help patients save money(average cost of treatment in hospital for MTC×number of patients who were evaluated to be candidate for surgery-cost of calcitonin test×total number of patients)/total number of patients. Results: 139 patients were positive in calcitonin test among 141 patients, and the positive rate was 98.58%. 91 patients were positive in frozen pathological examination, and the positive rate was 64.54% (χ²=97.821, P<0.000 1) . Cost-benefit analysis showed that the correct checkout cost of calcitonin test and frozen pathological examination were 71.01 yuan and 426.10 yuan, also,1 371 938.64 yuan could be saved totally and 9 730.06 yuan could be saved per patient because of calcitonin test. Conclusion Serum calcitonin test had a significant effect on the diagnosis and treatment of medullary thyroid carcinoma and was economical and practical.

Objective To explore the applicability of the three commonly used CT examination decision rules in Chinese head injured children. Methods This prospective observational study included 1538 children and adolescents (aged < 18 years), who were treated at the Emergency Department of First Hospital of Shanxi Medical University after head injuries. The three clinical decision rules include the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE; UK); the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury, that was developed by the Pediatric Emergency Care Applied Research Network (PECARN; USA), and the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) rule. Diagnostic accuracy had been evaluated by using the rule-specific predictor variables to predict each rule-specific outcome measure in populations who met inclusion and exclusion criteria for each rule. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and ROC curve were referred to the diagnostic accuracy. Indicators were characterized by 95％ CI. Results Of the 1538 patients, CTs were obtained for 339 patients (22.04％). Forty-nine patients (3.19％) had positive CT results, 8 patients (0.52％) underwent neurosurgery, 2 patients (0.13％) died, and 1 patient (0.07％) may be missed. In this study, CHALICE was applied for 1394 children (90.70％; 95％ CI: 89.24％-92.15％), PECARN for 801 children (52.11％; 95％ CI: 49.62％-54.61％), and CATCH for 325 patients (21.15％; 95％CI: 19.10％-23.19％). The validation sensitivities of CHALICE, PECARN, and CATCH rules were 92.6％(74.2％-98.7％), 100％ (56.1％-100％), and 85.7％ (42.0％-99.2％), respectively; the specificities were 78.1％(75.7％-80.2％), 48.0％ (44.5％-51.5％) and 70.8％ (65.4％-75.6％); positive predictive value were 7.7％ (5.1％-11.3％), 0.9％ (0.4％-1.9％) and 6.1％ (2.5％-13.2％); and negative predictive value were 99.8％ (99.2％-100％), 99.1％ (98.1％-99.6％), and 99.6％ (97.2％-100％), respectively. Conclusions The clinical decision rules of CHALICE, PECARN and CATCH have high sensitivities. The specificity of PECARN rule is lower than those of CHALICE and CATCH rules. The above three clinical decision rules can be used for the decision of CT examination in Chinese children with head injury in practice.

PurposeThe restriction of strain ratio (SR) in the diagnosis of thyroid malignant tumor are caused mainly because of disadvantages including low sensitivity, in this research the authors used different calculation methods of strain ratio based on the size of tumors, to explore the clinical application value of them on the differentiation of benign and malignant thyroid nodules.Materials and Methods Data of 336 patients with thyroid nodule (340 nodules) who underwent elasticity imaging and ultrasound-guided fine-needle aspiration were retrospective analyzed, with the pathology combined follow up acted as golden standards, fixed surface area assay and true surface area assay of strain ratio were compared on the differential diagnosis of benign and malignant thyroid nodules with various size.Results Among 340 thyroid nodules, there were 91 small nodules and 249 big nodules. Pathological results showed that 36 of 91 small nodules and 104 of 249 big nodules were malignant, while the others were benign. The true surface area assay was significantly better for the diagnosis of smaller thyroid nodules with longitudinal diameter and transverse diameter<8 mm with higher consistency with pathology (χ2=20.89,P<0.01), and fixed surface area assay is more suitable of thyroid nodules with longitudinal diameter and transverse diameter>8mm (χ2=57.08,P<0.01). The sensitivity, specificity and consistency for the diagnosis of malignant nodules of true surface area assay were 57.10%, 83.00% and 72.30% (Kappa=0.413), which were 73.60%, 85.00% and 72.30% (Kappa=0.590) in the fixed surface area assay, and 85.00%, 85.50% and 85.30% (Kappa=0.699) in the selective usage of two methods according to the tumor size, respectively.Conclusion The sensitivity is highest when using the two methods selectively according to the nodule size, with a better consistence rate with pathological results as well.

Objective To observe the clinical efficacy and safety of 0.1% and 0.03% tacrolimus ointment in patients aged 18 to 65 years with atopic dermatitis (AD). Methods Treatment was given twice daily to all affected areas for 3 weeks in a multicentre, randomized, double blind, parallel, and vehicle-controlled study. Follow-up visits were scheduled on day 1(baseline), and 1, 2 and 3 weeks post-treatment. The therapeutic effect and safety were evaluated. Results A total of 211 adults with moderate to severe AD in 6 study centres were enrolled in the efficacy evaluation. The efficacy rates were 88.4%, 77.8% and 30.0% in patients treated with 0.1%, 0.03% tacrolimus ointment, and the vehicle, respectively (P

Objective: To investigate the role of nuclear factor ?B (Rel/NF-?B) in pathogenesis of atopic dermatitis(AD) and the effect of topical 0.1%(mass fraction) or 0.03%(mass fraction) tacrolimus ointment on expression of NF-?B in lesional AD skin. Methods: Immunohistochemistry has been employed to study the expression of NF-?B in normal skin and lesional AD skin before and after using topical tacrolimus ointment. Results: The expressions of NF-?Bp50 and NF-?Bp65 were scattering or negative in normal keratinocytes. NF-?Bp50 was overexpressed on nuclear of basal and suprabasal keratinocytes in 9 cases of AD, NF-?Bp65 was overexpressed in cytoplasm and perinuclear of basal and suprabasal keratinocytes. After using topical tacrolimus ointment for three weeks , nuclear NF-?Bp50 expressed on basal and suprabasal keratinocytes were lost and NF-?Bp50 was expressed sparsely on basal keratinocytes cytoplasm or nuclear. NF-?Bp65 was expressed sparsely on basal and suprabasal keratinocytes cytoplasm. Conclusion: These data suggest that increased NF-?B activity may represent the basis of initiation or maintenance of the skin inflammatory response in atopic dermatitis. Topical tacrolimus may directly or indirectly inhibit NF-?B nuclear expression in keratinocytes and inhibit skin innate immuno-inflammatory response in atopic dermatitis that related to NF-?B.

The effectiveness of rhIL-11 on thrombocytopenia induced by carboplatin in rhesus monkeys was investigated. Thrombocytopenia was induced in monkeys by i.v. administration of carboplatin at a dose of 15 mg/kg(-1)/d(-1) for three consecutive days. rhIL-11 (50 or 100 micro g/kg(-1)/d(-1)) or Neumega (100 micro g/kg(-1)/d(-1)) were administered s.c. for 14 days beginning one day following the final dose of carboplatin. The results showed that rhIL-11 significantly improved mean platelet nadirs and shortened the mean duration of platelet counts less than 50% of pre-treatment values. Administration of rhIL-11 also resulted in moderate increase of the reticulated platelet, leukocyte and reticulocyte counts in peripheral blood and megakaryocytic and erythroid progenitors in bone marrow. rhIL-11 did not enhance ADP-induced platelet aggregation. These results indicate that rhIL-11 has a potent thrombopoietic effect in vivo and could be an important agent to reduce the severity and duration of thrombocytopenia following chemotherapy.

Objective To study the relationship between apoptosis regulation and epidermal proliferation in psoriasis. Methods The expression of apoptosis molecule PDCD5 (programmed cell death 5) on psoriatic lesions was observed by direct immunofluorescence. The positive rates and the average of fluorescence intensity of PDCD5 were analyzed quantitatively with FACS and computer CELL Quest software. The expression of PDCD5 mRNA in psoriatic lesions was detected by RT-PCR. Results The expression of PDCD5 protein was obviously lower in psoriatic epidermal cells than that of the normal skin. The positive rate and the average fluorescence intensity of PDCD5 in psoriatic epidermal cells were notably lower than those of the normal skin (P

Objective: To study the hypoglycemic activity of polysaccharides from Tremella aurantialba mycelium (TMP). Methods: The anti-hyperglycemic effect of TMP was investigated in normal mice and diabetic rats induced by alloxan in comparison with phenformin and acarbose. Results: TMP not only decreased serum glucose level in normal mice, but also in diabetic rats. After i.g.TMP to hyperglycemic rats for 1w, the glucose and TG in serum were decreased obviously , but serum TC did not change remarkably. After i.g. 100 mg/(kg ?d) TMP to hyperglycemic rats for 23 d, liver glycogen and BLA did not change significantly, but serum glucose was reduced obviously compared with the control . Conclusion: TMP has obvious hypoglycemic activity and can reduce hyperlipemic complications.