"Quality evaluation through identification"(QECI)is a theory that summarizes the essence of quality identification experience about traditional Chinese medicine(TCM).As an important component of the current quality evaluation system of TCM,the theory provides theoretical guidance for controlling and evaluating TCM's quality.Identifying based on human senses,traditional appearance identification relies on experience,which is subjective,difficult to quantify,and poorly repeatable.Modern measurement tools and biomimetic technology can quantify appearance characters(shape,color,smell,taste)of TCM.Then associate the results with content of active ingredients or biological effects.Make use of the visualization,quantifiability,portability,and repeatability of modern scientific means and screen feasible and controllable quality control indicators,which can be applied to quality evaluation and control of TCM's production and processing in each stage.The origin,connotation,modern research progress,and application value of QECI are reviewed,aiming to provide reference for addressing the shortcomings of traditional appearance evaluation,expanding the application scope of QECI,and promoting the construction of TCM's quality evaluation system.

Objective:To compare the efficacy of internal fixation and external fixation in the treatment of pelvic fractures.Methods:A retrospective case control study was conducted to analyze the data of 66 patients with anterior pelvic ring fracture treated from December 2015 to December 2017 at First People's Hospital of Lianyungang, including 36 males and 30 females, with an average age of 42.7 years (range, 19 to 63 years). There were 36 patients with Tile type B fractures and 30 with Tile type C fractures. Minimally invasive percutaneous internal fixation through the anterior inferior iliac spine was performed in 33 patients (internal fixation group) and external fixator was employed in another 33 patients (external fixation group). The two groups were compared in terms of the operation time, intraoperative blood loss, fracture healing time, fracture reduction assessment with Matta criteria, Majeed score and surgical complications.Results:All patients were followed up for 9-24 months (mean, 14.5 months). The operation time was (33.7±3.6)minutes in internal fixation group , and (24.5±3.5)minutes in external fixation group ( P<0.05). Intraoperative blood loss was (25.8±3.3)ml in internal fixation group and (21.8±4.3)ml in external fixation group ( P<0.05). The fractures were healed acceptably, with the healing time of (13.8±1.6)weeks in internal fixation group and (21.7±1.9)weeks in external fixation group ( P< 0.05). According to the Matta criteria, internal fixation group showed excellent results in 17 patients, good in 14, fair in 2 and poor in 0, with the excellent and good rate of 94%; external fixation group showed excellent results in 14 patients, good in 12, fair in 6 and poor in 1 , with the excellent and good rate of 79% ( P>0.05). For Majeed function score, the results in internal fixation group were excellent in 18 patients, good in 13, fair in 2 and poor in 0, with the excellent and good of 94%; the results in external fixation group were excellent in 14 patients, good in 12, fair in 7 and poor in 0, with the excellent and good of 79% ( P>0.05). After operation, frequent urinary occurred in one patient, unilateral femoral nerve partial paralysis in one, nail cap stimulation in two and incisional redness, swelling and exudation in one in internal fixation group. In external fixation group, there were 5 patients with nail rod exudation. Conclusion:Compared with the external fixator, the internal fixation for pelvic fractures is less invasive and more reliable, can accelerate fracture healing without interfering with the patient's daily life, and can be used as the final fixation.

Objective To investigate the expression and clinical significance of lactate dehydrogenase A (LDHA) in breast cancer.Methods Tissue samples of 76 breast cancers and corresponding paired adjacent normal tissues were collected and made into tissue micrcarrays (TMAs).Immunohistochemistry (IHC) analysis was performed to detect the expression of LDHA and further analyzed the correlation of LDHA expression and clinicopathological variables and prognosis of breast cancers.Results LDHA was frequently upregulated in breast cancer tissues compared to the normal breast tissues (P ＜ 0.05).High LDHA expression was associated with distant metastasis (P ＜ 0.05) and worse patient prognosis (P ＜ 0.05).Conclusions LDHA is closely related to the occurrence and clinical progress of breast cancers.LDHA might be a potential novel molecular marker for diagnosis,prognosis and therapy in breast cancers.

Objective:To investigate the prognostic value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) before radiation in pancreatic cancer patients underwent radiation therapy. Methods:Clinical data of 61 patients with pathologically confirmed pancreatic cancer were retrospectirely analyzed. Query index values for each patient were clinically tested through electronic medical records. Overall survival (OS) data were collected through electronic medical records or telephone follow-up. Survival curves were compared using Kaplan-Meier methodology and log-rank test. Cox regression methodolo-gy was used for univariate analysis. Results:Using log-rank test and univariate regression analysis, we found that patients with lower NLR, PLR, CA19-9, increased PNI, and lower TNM-staging lived longer than those with increased NLR, PLR, CA19-9, lower PNI, and high-er TNM-staging, and that the difference was statistically significant. Through multivariate analysis, we found that NLR (P=0.029, OR 2.344, 95%CI:1.090-5.041) and PNI (P=0.026, OR 0.477, 95%CI:0.248-0.917) were independent predictors of OS in patients with pan-creatic cancer. Conclusion:NLR, PLR, and PNI are simple, effective, and reliable indicators for evaluating the prognosis of pancreatic cancer.

Objective To analyze the morphological features of smokers' lung on MDCT scan,measure the CT volumetric parameters,and explore the correlation with pulmonary functional test(PFT) indexes.Methods 59 smokers were enrolled,in which 14 were chronic obstructive pulmonary disease(COPD) patients,and 39 non-smokers were chosen as control group.All subjects underwent inspiratory and expiratory phase MDCT scan and PFT.Eleven pulmonary CT features caused by smoking among three groups were analyzed and compared.The emphysema index (EI 95) and mean lung density (MLD) were measured.The correlation between above mentioned parameters and PFT indexes were analyzed.Results ①Among three groups,significant differences were found for the score and incidence of entrilobular emphysema,paraseptal emphysema and brochiectasis or bronchial wall thickness(P＜0.01).②In COPD patients,paraseptal emphysema and DLCO/VA,brochiectasis or bronchial wall thickness and DLCO SB(％P),DLCO/VA(％P),as well as EI and MEF25％ (％P),DLCO SB(％P),DLCO/VA (％P)were negatively related.In smokers without COPD,there were negative correlation between centrilobular emphysema and FEV1/FVC,MEF25％ (％ P),MEF5％ (％ P),DLCO SB (％ P),DLCO/VA (％ P),paraseptal emphysema and DLCO SB(％P),DLCO/VA(％P),brochiectasis or bronchial wall thickness and DLCO/VA(％P),as well as EI and FEV1/FVC,MEF5％ (％P),and MLD and FEV1 (％ P),MEF25％ (％ P)were positively related.Conclusion MDCT can be used to analyze smokers' pulmonary morphology,and the morphological features and volumetric parameters are good predictions for pulmonary function.

Objective To investigate the impact of quantitative measurement for lung volume using iterative model reconstruction (IMR),hybrid iterative reconstruction (iDose4 )and filtered back projection (FBP),and to compare the image noise between different reconstruction methods.Methods 70 subjects were performed with low-dose chest CT scan (Philips Brilliance 256 iCT),and the original data were reconstructed with IMR (algorithm:Routine,SharpPlus,Soft Tissue,level:1 - 3 ),iDose4 and FBP respectively.We set less than -950 HU as emphysema threshold,calculated the total lung volume (TLV),total emphysema volume (TEV),emphysema index (EI)and objective image noise (OIN),and then compared the quantitative parameters and OIN between different groups.Results All parameters showed a significantly statistical difference (P =0.000)except TLV (P =1.000).The TEV and EI are significant higher in IMR-S group than in other groups.The OIN in IMR-S-L1 group was the highest,and the FBP group was the second-highest.OIN in iDose4 group was lower than that in IMR-S groups but higher than that in IMR-R and IMR-ST group.Conclusion SharpPlus algorithm of IMR will affect the quantitative measurement of lung volume under low-radiation-dose condition,and the OIN in IMR-S groups is obvious.Therefore SharpPlus algorithm is not recommended for quantitative analysis of lung volume.The Routine and Soft Tissue algorithm will not affect the quantitative measurement,and can distinctly reduce the OIN compared with idose4 and FBP.

Objective To explore the application value of quantitative assessment of emphysema using CT in CT subjective evaluation of normal population,and compare the quantitative parameters of emphysema among groups.Methods A total of 1 231 volunteers with negative results of subjective assessment in low dose CT screening were included in this study.The threshold of emphysema was set at -950 HU,and the total lung volume(TLV),total emphysema volume(TEV),emphysema index(EI)and 15th percentile lung density(PD15)were quantified.The presence of emphysema was defined by an EI higher than or equal to 5%.The volunteers were divided into different groups by gender and age,and the quantitative parameters were compared among different groups.Results A total of 102 cases of emphysema were detected in 1 231 volunteers,with a detection rate of 8.29%,with 76 male volunteers,accounting for 9.93%,and 26 female volunteers,accounting for 5.58%,respectively.There were statistically significant differences in TLV,TEV, EI and PD15 between genders and age groups,with TLV,TEV,EI higher and PD15 lower in male(P<0.001)and with TEV and EI higher in older than 60 years old group(P<0.001).Conclusion Quantitative assessment of emphysema using CT exhibites relatively high clinical value in CT subjective evaluation of normal population.There are statistically significant differences in the quantitative parameters of emphysema among different groups.

Objective To evaluate the value of CT perfusion imaging (CTP)for solitary pulmonary nodule (SPN)by Meta-analysis.Methods Literatures about SPN diagnosed by CTP were filtered.PubMed,EMBASE,CNKI,VIP and WANFANG databases were searched for the relevant articles.The retrieved studies were screened according to the criteria for diagnostic research published by the cochrane methods group on screening and diagnosis.The quality of the articles was accessed and the basic data in the articles was extracted.Review Manager 5.3 software was used to compare the blood volume (BV)among different nodules,to perform heterogeneity test and analyze publication bias.Results A total of 1 7 studies with 877 lesions were included in the study.The random effect model was used for the existence of heterogeneity.The result showed the BV value of malignant SPN was higher than that of benign ones.Conclusion The result indicates that there exists significant difference in BV between malignant and benign SPN.The BV value,as one of the hemodynamic parameters of CTP,can be used as the diagnostic basis of SPN.

Objective To assess the CT image quality of the pure ground glass nodule(pGGN)in chest phantom by using different field of view(FOV)and matrix.Methods CT(Philips Brilliance 128 spiral CT)scans were performed on chest phantom containing 9 artificial pGGNs(diameter≥5 mm)in 3 different FOV (50 mm,150 mm,300 mm ),and were reconstructed in 2 different matrix(512×512, 1 024×1 024),standard kernel.Recorded the CT values and standard deviations (SD)of the nodules and surrounding regions in different FOV and matrix,and calculated the mean standard deviation(MSD),contrast noise ratio (CNR)and signal noise ratio (SNR),then compared the difference among them.Two radiologists assessed the image quality of the pGGNs in blind method respectively,then evaluated the coherence between them using Kappa testing.Results The coherence of 2 observers was substantial or almost perfect.No significant differences were found on MSD,CNR and SNR in different FOV (P value>0.05)when matrix was kept,whereas the visibility of the nodules improved with the FOV changing smaller.And there were significant differences all on MSD,CNR and SNR by using different matrix when FOV was kept.The MSD increased and the CNR,SNR decreased in high-resolution group.The visibility of the pGGNs was not improved obviously in high-resolution group.Conclusion The image quality of the pGGN(diameter≥5 mm)won’t be changed by using smaller FOV when matrix is kept ,but the visibility will be improved with the FOV changing smaller.When FOV is kept,the MSD increased and the CNR,SNR reduced in high-resolution group,but the visibility will not be improved obviously compare to the standard resolution group.

OBJECTIVETo investigate the mechanism of miR-133a in reversing neonatal rat cardiomyocyte hypertrophy induced by phenylephrine.

METHODSA miR-133a precursor cDNA was used to construct an adenovirus vector, which was transfected into 293 cells to harvest miR-133a-containing virus. Neonatal rat cardiac myocytes treated by phenylephrine were exposed to miR-133a adenovirus, and the changes in cell area was measured; the expression levels of miR-133a and Acta1, Actc1, Actb, Myh6, Myh7, and BNP mRNAs were detected by quantitative RT-PCR.

RESULTSPhenylephrine treatment increased the area of cardiomyocytes by more than 3 folds and significantly enhanced the expression levels of Acta1, Actc1, Actb, Myh6, Myh7 and BNP mRNAs. All these changes were obviously reverse by miR-133a treatment.

CONCLUSIONmiR-133a is an important regulator of phenylephrine-induced cardiomyocyte hypertrophy and negatively regulates this process.

Adenoviridae ; Animals ; Cells, Cultured ; Genetic Vectors ; Hypertrophy ; MicroRNAs ; genetics ; Myocytes, Cardiac ; cytology ; pathology ; Phenylephrine ; adverse effects ; RNA, Messenger ; Rats ; Transfection