Construction of a quantitative diagnosis model for predicting the nature of thyroid nodules based on multi-modality ultrasound images / 中华超声影像学杂志

Objective:To construct a quantitatively diagnostic nomogram model by analyzing the clinical information of patients and the features of multi-modality ultrasound images of thyroid lesions, so as to preoperatively predict the malignant probability of suspicious thyroid nodules and provide effective references for clinical decision-making.Methods:A total of 933 patients, 1 121 thyroid nodules of C-TIRADS 3-5 categories, who underwent surgery in the Second Affiliated Hospital of Harbin Medical University from September 1, 2020 to June 10, 2021 were collected. The nodules were randomly divided into training ( n=897) and test groups ( n=224) in 8∶2 ratio. Finally, the diagnostic performance was evaluated by area under the curve (AUC). Results:①After preliminary screening by univariate analysis, multivariate analysis showed that age, echogenicity, orientation, echogenic foci, margin, posterior features, and elastic score were significantly correlated with benign and malignant nodules (all P<0.001), and the difference of halo between benign and malignant nodules was also statistically significant ( P=0.012). ②The AUC of nomogram was up to 0.903(95% CI=0.862-0.944) in the test set, and 0.889(95% CI=0.832-0.946) and 0.960(95% CI=0.925-0.994) in nodules with maximum diameter of ≤10 mm and of >10 mm respectively, which showed high diagnostic performance. Conclusions:The nomogram model could accurately differentiate malignant from benign thyroid nodules preoperatively, with the highest diagnostic performance for the nodules with maximum diameter of >10 mm, and effectively avoid the unnecessary fine-needle biopsy and surgical operation.

Effects of Head-down Tilt on Nerve Conduction in Rhesus Monkeys / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Few studies have focused on peripheral nerve conduction during exposure to microgravity. The -6° head-down tilt (HDT) comprises an experimental model used to simulate the space flight environment. This study investigated nerve conduction characteristics of rhesus monkeys before and after prolonged exposure to HDT.</p><p><b>METHODS</b>Six rhesus monkeys (3-4 years old) were tilted backward 6° from the horizontal. Nerve conduction studies (NCSs) were performed on the median, ulnar, tibial, and fibular motor nerves. Analysis of variance with a randomized block design was conducted to compare the differences in the NCS before and 7, 21, and 42 days after the -6° HDT.</p><p><b>RESULTS</b>The proximal amplitude of the CMAP of the median nerve was significantly decreased at 21 and 42 days of HDT compared with the amplitude before HDT (4.38 ± 2.83 vs. 8.40 ± 2.66 mV, F = 4.85, P = 0.013 and 3.30 ± 2.70 vs. 8.40 ± 2.66 mV, F = 5.93, P = 0.004, respectively). The distal amplitude of the CMAP of the median nerve was significantly decreased at 7, 21, and 42 days of HDT compared with the amplitude before HDT (7.28 ± 1.27 vs. 10.25 ± 3.40 mV, F = 4.03, P = 0.039; 5.05 ± 2.01 vs. 10.25 ± 3.40 mV, F = 6.25, P = 0.04; and 3.95 ± 2.79 vs. 10.25 ± 3.40 mV, F = 7.35, P = 0.01; respectively). The proximal amplitude of the CMAP of the tibial nerve was significantly decreased at 42 days of HDT compared with the amplitude before HDT (6.14 ± 1.94 vs. 11.87 ± 3.19 mV, F = 5.02, P = 0.039).</p><p><b>CONCLUSIONS</b>This study demonstrates that the compound muscle action potential amplitudes of nerves are decreased under simulated microgravity in rhesus monkeys. Moreover, rhesus monkeys exposed to HDT might be served as an experimental model for the study of NCS under microgravity.</p>

Value of serum procalcitonin for the guidance of antibiotic therapy in children with lower respiratory tract infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the value of serum procalcitonin (PCT) for the guidance of antibiotic therapy in children with lower respiratory tract infection (LRTI).</p><p><b>METHODS</b>A prospective randomized controlled study was conducted in 396 children with LRTI who visited Weifang Maternity and Child Care Hospital. The participants were randomly assigned into a PCT group in which the antibiotic therapy was guided by serum PCT level and a control group in which the standard therapy was given according to clinical guidance. Afterwards, a subgroup analysis was performed according to whether the patient was diagnosed with community-acquired pneumonia (CAP). After 14-day treatment, antibiotic prescription rate, duration of antibiotic treatment, and side events were compared between the groups.</p><p><b>RESULTS</b>A total of 396 cases were recruited and equally assigned into the PCT group and the control group, among whom the numbers of the children with CAP were 125 and 123, respectively. The mean duration of antibiotic treatment was significantly shorter in the PCT group than in the control group (P<0.05). The subgroup analysis showed that the duration of antibiotic treatment in both CAP and non-CAP PCT subgroups was significantly shorter than in the control subgroups (P<0.05), however, the antibiotic prescription rate in the non-CAP PCT subgroup was significantly higher than that in the non-CAP control subgroup (P<0.05). There were no differences in the rate and duration of side events from antibiotic therapy, hospitalization rate, the length of hospital stay, and safety between the PCT and control groups.</p><p><b>CONCLISOPNS</b>Serum PCT-based guidelines on antibiotic use can shorten the duration of antibiotic therapy in children with LRTI.</p>

Clinical application of ultrasound-guided radiofrequency ablation for primary hepatocellular carcinoma near the liver surface / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the value of ultrasound-guided percutaneous radiofrequency ablation (RFA) in designing the indication, treatment protocol and operational skills for patients with primary hepatocellular carcinoma (HCC) near the liver surface.</p><p><b>METHODS</b>Sixty-one HCC patients with 69 lesions, confirmed by clinical examination and pathology, underwent percutaneous radiofrequency ablation. The study included 40 cases of liver function Child-Pugh grade A and 21 cases of grade B. The average size of tumors was (3.8 ± 1.2) cm, tumor diameter ≥ 4 cm accounted for 39.1% (27/69 lesions), and the average age was 58.2 years (range, 35-76 years). Taking comprehensive measures, such as intraperitoneal injection of saline adjacent to the tumor before RFA, increasing the puncture sites on the surface of tumor to avoid overlapping of the central portion of tumor, repeated ablation of the needle track to reduce needle tract metastasis, avoid vertical puncture, and other additional measures, to improve the inactivation of tumors adjacent to the liver surface. Enhanced CT/MRI was performed to evaluate the curative effect at 1, 3, 6 and 24 months after the treatment.</p><p><b>RESULTS</b>The inactivation rate of tumor was 98.6% (68/69 lesions) and local recurrence rate was 5.8%(4/69) after RFA. The tumor-related marker AFP was 1 000-1 500 ng/ml before and reduced to (98.5 ± 42.5) ng/ml after radiofrequency ablation, among them returned to normal in 13 cases (21.3%). Since the ablation area was rather small, the level of serum alanine aminotransferase was elevated only to (148.5 ± 38.5) U/ml at one week after RFA and returned to normal at (1.8 ± 0.6) week after RFA. No patient experienced severe liver dysfunction. The local HCC recurrent rate after RFA was 5.8%(4/69 lesions) and intrahepatic heterotopic recurrence rate was 24.6% (15/61). The 20-61 months follow-up showed that the 1-, 2- and 3-year survival rate was 83.6%, 57.3% and 44.2%, respectively.</p><p><b>CONCLUSIONS</b>Ultrasound-guided percutaneous radiofrequency ablation provides an effective minimally invasive treatment for primary HCC near the liver surface. Taking some additional measures such as intraperitoneal injection of saline, increase of percutaneous puncture sites, and avoiding vertical needle puncture, may reduce complications and improve the therapeutic outcome. RFA is one of effective and minimally invasive treatment and causing less liver damage for primary HCC near the liver surface.</p>

The clinical value of real-time ocntrastenhanced ultrasound in differential diagnosis of low echo benign and malignant lesions in fatty liver / 实用肿瘤学杂志

Objective To summarize the characteristics of low echo lesions by ultrasound findings in fat-ty liver,using real -time contrast -enhanced ultrasonography ( CEUS) for differential diagnosis .Methods The study was examed in 128 cases low echo lesions of fatty liver by using CEUS ,the malignant and the highly suspec-ted malignant and part of the benign lesions (in all the 52 cases)were punctured by ultrasound guided biopsy ,the rest of the 76 cases was confirmed benign by clinical comprehensive diagnosis ,were compared to the characteris-tics about ultrasound and contrast -enhanced ultrasound image and reviewed regular follow -up.We calculated the sensitivity,specificity,youden index and the area under the ROC curve by contrast -enhanced ultrasonography and ultrasound and apply for Kappa test for reliability analysis to contrast -enhanced ultrasonography and ultra-sound.Results There were 23 malignant lesions and 105 benign lesions in total of 128 patients.The sensitivity, specificity,youden index and the area under the ROC curve by contrast -enhanced ultrasonography and ultra-sound were 95.65%,98.10%,93.75% and 87.00%,91.43%,84.43%respectively.Compared contrast -en-hanced ultrasound examination diagnosis of low echo lesions in fatty liver with the clinical diagnosis performed good reliability(Kappa=0.922,P=0.045).Conclusion We should pay attention to low echo lesions in the fatty liver.contrast-enhanced ultrasound can effectively identify low echo lesions in the fatty liver ,and identify benign and malignant lesions in the liver ,and improve obviously the accuracy of diagnosis ,and reduce the misdi-agnosis rate.

Treatment of serious burst thoracolumbar fracture with posterior pedicle screw fixation, transpedicular bone grafting and vertebral canaloplasty / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical results of posterior pedicle screw fixation, transpedicular bone grafting and vertebral canaloplasty with ilium autografting in treating serious burst thoracolumbar fracture.</p><p><b>METHODS</b>From March 2004 to March 2008,10 patients with serious burst thoracolumbar fracture, including 7 males and 3 females with age for 24-58 years (mean 41 years)were treated by posterior pedicle screw fixation, transpedicular bone grafting and total laminectomy with preservation of spinal process and vertebral canaloplasty with ilium autografting. The operative effects were assessed according to Frankel classification and radiologic results.</p><p><b>RESULTS</b>All patients were followed up from 1 to 4 years. There was no loosening or broken in instrumentation. The anterior edge height of the fractured vertebrae body was restored from (21.00 +/- 12.00)% to (95.00 +/- 4.20)%, and the posterior edge height of the fractured vertebrae body was restored from (70.00 +/- 15.00)% to (96.00 +/- 3.20)% postoperatively, which both demonstrated improvement compared with preoperative instance (P < 0.01). The Cobb angle was restored from (32.80 +/- 8.20) degrees to (4.20 +/- 1.60) degrees which also demonstrated improvement compared with the preoperative Cobb angle (P < 0.01). At least one grade recovery was observed in all cases except one patient with preoperative Frankel A degree. The result of Denis classification, P1, had 4 cases, P2 had 4, P3 had 1, P4 had 1.</p><p><b>CONCLUSION</b>Posterior pedicle screw fixation, transpedicular bone grafting and vertebral canaloplasty can obtain satisfactory results treating serious burst thoracolumbar fractures. It is a feasible method with advantages of simple operation, good efficacy, preservation of structure of posterior column which should be applied clinically.</p>

Effect of Angelica sinensis polysaccharide-iron complex on iron deficiency anemia in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effects of Angelica sinensis polysaccharide-iron complex (APIC) on rats with iron deficiency anemia (IDA).</p><p><b>METHODS</b>The IDA rat model was established by adopting low-iron forage with a small amount of regular bloodletting. The rats were randomly divided into a model group, three AIPC groups (high, middle, and low dosage), an Angelica sinensis polysaccharide (ASP) group, a mixture group (ASP+FeCl(3)) and a positive control group (Niferex). Changes in hemoglobin (Hb), red blood cell count (RBC), hematocrit (HCT) and iron content of whole blood were observed.</p><p><b>RESULTS</b>There was a significant difference before and after administration in all treated groups and all indices were restored to near-normal levels in the APIC groups and the positive control group. There was a significant difference among the changes of the indices in all the APIC groups and those of the model group but not between those of the APIC groups and the positive control group. However, the recovery of the indices in the APIC groups was superior to that in the positive control group.</p><p><b>CONCLUSION</b>APIC not only has a superior therapeutic effect on IDA, but also has the effect of the ASP on supplementing blood and activating blood circulation. Hence, it may be used as a new iron-supplementing agent with a double therapeutic efficacy on blood supplementation for the treatment of IDA.</p>

Preliminary studies on physicochemical properties of Angelica sinensis polysaccharide-iron complex / 中国中药杂志

<p><b>OBJECTIVE</b>To study some physicochemical properties of Angelica sinensis polysaccharide-iron complex (APC).</p><p><b>METHOD</b>Based on the qualitatively identified reactions of iron (III), the qualitatively identified reactions of APC were found out by comparing hydroxide. The content of iron (III) in APC was determined with iodometry. The stability of APC under physiological pH conditions was judged by titrating APC with sodium hydroxide. The deoxidization of APC was tested with colorimetric analysis.</p><p><b>RESULT</b>APC showed the qualitatively identified reactions of iron (III). The content of iron (III) in APC ranged from 10% to 40%, and the water-solubility of APC was related to the content of iron (III). The complex was stable at physiological pH from 3 to 12, without precipitation and dissociation. At 37 degrees C, Fe (III) in the complex was completely reduced to Fe (III) by ascorbic acid in about 6 hours.</p><p><b>CONCLUSION</b>APC can be qualitatively identified by using the qualitatively identified reactions of iron (III). When its iron (III) content is within 20%-25%, APC has a better ability to dissolve in water. And the complex is stable under physiological pH conditions.</p>

Disruption of microfilament cytoskeleton induced by simulated microgravity increases the activity of COL1A1 promoter / 生理学报

It is well known that cytoskeleton system is the sensor of gravity in cells. Under microgravity condition, cytoskeleton is associated with the changes of cell shape, function, signaling and so on; but the relationship between cytoskeleton and gene expression is not fully understood. In present study, we discussed the effects of cell microfilament on the activity of collagen type I alpha 1 chain gene (COL1A1) promoter under microgravity simulated by clinostat and/or cytochalasin B as microfilament depolymerizer in the established EGFP-ROS cell line using the method of fluorescence semi-quantitative analysis and the fluorescent stain of microfilament. Compared with the normal control, the microfilament of ROS17/2.8 cell tended to disassemble, marginal distribution of fiber stress, and showed reducing stress fibers after spaceflight in Photon-M1 or clinorotation simulated microgravity, which suggested that microgravity destroyed the well-order cell cytoskeleton and induced a rearrangement. Treatment with suitable concentration of cytochalasin B in normal gravity induced disruption of microfilament, increased the activity of COL1A1 promoter and resulted in a dose-dependent increase of EGFP fluorescence. Therefore, a certain extent disruption of the microfilament system was associated with increased activity of the COL1A1 promoter. All above demonstrate that microfilament cytoskeleton system takes part in the regulation of COL1A1 promoter activity and plays an important role in the signaling of microgravity.

The Process of Mesenchymal Stem Cells and their Potential as Cardiac Therapeutics / 中国生物工程杂志

Bone marrow mesenchymal stem cells (MSCs), multipotent stem cells, can replicate as undifferentiated cells and have the potential to differentiate into different lineages of mesenchymal tissues, including bone, cartilage,endothelial, neural, smooth muscle, skeletal myoblasts, and cardiac myocyte cells. The ischemia-induced death of cardiomyocytes results in scar formation and reduced contractility of the ventricle. Several preclinical and clinical studies have supported the notion that MSCs therapy may be used for cardiac regeneration.When transplanted into the infracted heart, MSCs prevent deleterious remodeling and improve recovery, but the mechanism is not clear. In this work,we review evidence and new prospects that support the use of MSCs in cardiomyoplasty.