Effects of nurse-led multidisciplinary cooperative nutrition intervention on nutritional indicator of patients with stroke / 重庆医学

Objective To explore the impact of nurse-led multidisciplinary collaborative nutrition inter-vention on the nutritional indicators in the patients with stroke.Methods A total of 100 patients with stroke admitted in this hospital from January to December 2020 were selected as the study subjects and divided into the observation group and control group by the propensity score matching,50 cases in each group.The control group was given the traditional nutrition intervention,and the observation group was given the nurse-led mul-tidisciplinary cooperative nutrition intervention.The blood,nutritional and biochemical indicators,physique monitoring indicators and nutritional risk indicators were compared between the two groups.Results The levels of total protein(TP),albumin(ALB),hemoglobin(Hb),prealbumin(PAB),body mass index(BMI),upper arm muscle circumference(AMC)and triceps skin fold thickness(TSF)on 21 d after admission in both groups were increased compared with those on 2,15 d after admission,and which on 15 d after admission were higher than those on 2 d after admission(P＜0.05),moreover the above indicators levels on 15,21 d after ad-mission in the observation group were higher than those in the control group,and the differences were statisti-cally significant(P＜0.05).Body mass index(BMI),upper arm circumference(AMC)and triceps skinfold thickness(TSF)in both groups on 21 d of admission were higher than those on 2,15 d of admission(P＜0.05).The nutritional risk screening 2002(NRS2002)score on 21 d after admission in the two groups were decreased compared with those on 2,15 d after admission,while which on 15 d after admission was decreased compared with that on 2 d after admission,moreover the NRS2002 score on 15,21 d after admission in the ob-servation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Giving the nurse-led multidisciplinary cooperative nutrition intervention could im-prove the blood nutritional and biochemical indicators and physique monitoring indicators,and reduce the nu-tritional risk of the patients with stroke.

The role of PTTG1 in colonic inflammation by regulating intestinal epithelial cells pyroptosis / 实用医学杂志

Objective To investigate whether the pituitary tumor transformation gene 1(PTTG 1)plays a role in colitis by regulating intestinal epithelial cells pyroptosis.Methods Ten PTTG 1 wild-type(WT)mice and Ten PTTG 1 knockout(KO)mice were randomly divided into 4 groups of 5 each,respectively PTTG1 WT control and experimental group,PTTG1 KO control and experimental group.The mice in the experimental group were given 3%dextran sodium sulfate(DSS)for 6 days to induce acute colitis,and the control group was given sterile double distilled water(ddH2O).The disease activity index of the respective group of mice was observed and recorded.Mouse colonic tissue were collected,and the expression levels of NLRP3,ASC,and GSDMD were determined by immuno-histochemistry and western blot.In HCoEpiC,PTTG1 expression was knocked down using shRNA,and the cells were subsequently treated with TNF-α to induce inflammation.Then,the expression of GSDMD was detected.Results The expression of PTTG1 was decreased in colonic mucosal tissue in mice with acute colitis(P<0.01).Compared with WT mice,the colitis was significantly aggravated in PTTG1 KO mice after 3%DSS treatment.The expression of pyroptosis-related proteins was significantly up-regulated in the colon mucosal tissues of PTTG1 KO experimental mice(P<0.05).After knocking down the expression of PTTG1 in HCoEpiC and TNF-α treatment,the expression levels of GSDMD were significantly up-regulated(P<0.05).Conclusion PTTG1 reduced pyroptosis in intestinal epithelial cells(IECs),while PTTG1 loss can enhance IEC pyroptosis,aggravating colonic inflammation.

Application of strontium polyphosphate with both radiopaque and osteogenic functions in calcium phosphate cement / 中国组织工程研究

BACKGROUND:Our previous studies found that adding barium sulfate could improve the mechanical and radiopaque properties of calcium phosphate cement.However,with the degradation of calcium phosphate,the remaining radiopaque agent is difficult to degrade,and the space-occupying and osteoclast effects at the implantation site affect the bone repair process.Therefore,it is necessary to develop a new biodegradable radiopaque material. OBJECTIVE:To discuss the radiopaque ability of bioactive degradable material strontium polyphosphate(SrPP)and its impact on the physicochemical properties and osteogenic effect of calcium phosphate cement. METHODS:(1)Calcium phosphate cement(CPC),starch modified calcium phosphate cement(CPS)and starch modified calcium phosphate cement(20%SrPP-CPN)containing SrPP(20%mass fraction of bone cement powder)were prepared respectively,and the physicochemical properties of the three groups of bone cements were characterized.(2)The three groups of bone cement extracts were co-cultured with rat bone marrow mesenchymal stem cells,respectively,to detect cell proliferation,energy metabolism,and osteogenic differentiation.(3)Bone defects with a diameter of 5 mm were made on each side of the top of the skull of 24 SD rats,and they were randomly divided into control group(without any intervention),CPC group,CPS group,and 20%SrPP-CPN group for intervention,with 6 rats in each group.Relevant tests were performed after 4 and 12 weeks of intervention. RESULTS AND CONCLUSION:(1)Compared with the other two groups of bone cement,20%SrPP-CPN had enhanced radiopaque ability,increased compressive strength and degradation rate,and prolonged curing time,and 20%SrPP-CPN could release Sr2+ stably during degradation.(2)CCK-8 assay showed that 20%SrPP-CPN did not affect the proliferation of bone marrow mesenchymal stem cells.Cell starvation test(serum-free culture)showed that 20%SrPP-CPN could promote the proliferation of bone marrow mesenchymal stem cells compared with the other two groups of bone cement.Compared with the other two groups of bone cements,20%SrPP-CPN increased adenosine triphosphate concentration in bone marrow mesenchymal stem cells.Alkaline phosphatase and alizarin red staining showed that 20%SrPP-CPN could promote osteogenic differentiation of bone marrow mesenchymal stem cells compared with the other two groups of bone cement.(3)In the rat skull defect experiment,Micro-CT scanning and histological observation(hematoxylin-eosin and Masson stainings)showed that bone cement in 20%SrPP-CPN group was significantly degraded compared with that in CPC and CPS groups,and a large number of new bone tissues were dispersed in degraded bone cement.Immunohistochemical staining showed that Runx2 protein expression was increased in 20%SrPP-CPN group compared with CPC group and CPS group(P＜0.01).(4)These results show that 20%SrPP-CPN has good radiopaque ability and osteogenic properties.

Prognostic value of baseline 18F-FDG PET/CT metabolic parameters in locally advanced cervical cancer after concurrent chemoradiotherapy / 中华核医学与分子影像杂志

Objective:To explore the prognostic value of baseline 18F-FDG PET/CT metabolic parameters in locally advanced cervical cancer (LACC) after concurrent chemoradiotherapy (CCRT). Methods:From September 2015 to October 2021, the clinical data of 180 LACC patients (age: 22-76 years) who underwent 18F-FDG PET/CT before CCRT at Affiliated Cancer Hospital of Shandong First Medical University were analyzed retrospectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUV max, and SUV mean were computed by using the margin threshold of 42%SUV max. The optimal threshold for predicting progression-free survival (PFS) was obtained by ROC curve analysis. The Kaplan-Meier method was applied for survival analysis, and the log-rank test was applied to compare the survival rate between groups. Multivariate Cox proportional hazard regression was used to analyze progression for PFS. Results:The median follow-up was 19.1 months, and 54 patients (30.0%, 54/180) suffered from disease progression. ROC curve analysis showed that the optimal cut-off value of MTV was 31.145 ml, with the AUC of 0.641. Para-aortic lymph node (PALN) metastasis had the highest AUC value (0.589) among the clinical factors, followed by International Federation of Gynecology and Obstetrics (FIGO) stage (0.581). The 1-year PFS rates of patients with MTV<31.145 ml ( n=88) and MTV≥31.145 ml ( n=92) were 80.68% and 59.78%, respectively ( χ2=13.72, P<0.001). Multivariate Cox analysis demonstrated that pathological type (hazard ratio ( HR)=3.075, 95% CI: 1.370-6.901, P=0.006), FIGO stage ( HR=1.955, 95% CI: 1.031-3.707, P=0.040), PALN metastasis ( HR=2.136, 95% CI: 1.202-3.796, P=0.010) and MTV ( HR=2.449, 95% CI: 1.341-4.471, P=0.004) were the significant predictors for PFS. Conclusions:Pathological type, FIGO stage, PALN metastasis and MTV are independent prognostic risk factors for PFS. MTV as the baseline 18F-FDG PET/CT metabolic parameter, can realize prognostic stratification analysis.

Dihydroartemisinin attenuates ischemia/reperfusion-induced renal tubular senescence by activating autophagy / 中国天然药物

Acute kidney injury (AKI) is an important factor for the occurrence and development of CKD. The protective effect of dihydroartemisinin on AKI and and reported mechanism have not been reported. In this study, we used two animal models including ischemia-reperfusion and UUO, as well as a high-glucose-stimulated HK-2 cell model, to evaluate the protective effect of dihydroartemisinin on premature senescence of renal tubular epithelial cells in vitro and in vivo. We demonstrated that dihydroartemisinin improved renal aging and renal injury by activating autophagy. In addition, we found that co-treatment with chloroquine, an autophagy inhibitor, abolished the anti-renal aging effect of dihydroartemisinin in vitro. These findings suggested that activation of autophagy/elimination of senescent cell might be a useful strategy to prevent AKI/UUO induced renal tubular senescence and fibrosis.

CT radiomics model for predicting progression-free survival of locally advanced cervical cancer after concurrent chemoradiotherapy / 中华放射肿瘤学杂志

Objective:To construct machine learning models based on CT imaging and clinical parameters for predicting progression-free survival (PFS) of locally advanced cervical cancer (LACC) patients after concurrent chemoradiotherapy (CCRT).Methods:Clinical data of 167 LACC patients treated with CCRT at Shandong Cancer Hospital from September 2015 to October 2021 were retrospectively analyzed. All patients were randomly divided into the training and validation cohorts according to the ratio of 7 vs. 3. Clinical features were selected by univariate and multivariate Cox proportional hazards model ( P<0.1). Radiomics models and nomograms were constructed by radiomics features which were selected by least absolute shrinkage and selection operator (LASSO) Cox regression model to predict the 1-, 3- and 5-year PFS. Combined models and nomogram models were developed by selected clinical and radiomics features. The Kaplan Meier-curve, receiver operating characteristic (ROC) curve, C-index and calibration curve were used to evaluate the model performance. Results:A total of 1 409 radiomics features were extracted based on the region of interest (ROI) in CT images. CT radiomics models showed better performance for predicting 1-, 3-and 5-year PFS than the clinical model in the training and validation cohorts. The combined model displayed the optimal performance in predicting 1-, 3-and 5-year PFS in the training cohort [area under the curve (AUC): 0.760, 0.648, 0.661, C-index: 0.740, 0.667, 0.709] and verification cohort (AUC: 0.763, 0.677, 0.648, C-index: 0.748, 0.668, 0.678).Conclusions:Combined model constructed based on CT radiomics and clinical features yield better prediction performance than that based on radiomics or clinical features alone. As an objective image analysis approach, it possesses high prediction efficiency for PFS of LACC patients after CCRT, which can provide reference for clinical decision-making.

Efficacy and Safety of Platinum-Based Chemotherapy for Ovarian Cancer During Pregnancy: A Systematic Review and Meta-Analysis.

INTRODUCTION: Based on the available data on ovarian cancer during pregnancy, we performed a review and meta-analysis to evaluate the efficacy and safety of platinum-based chemotherapy against ovarian cancer during pregnancy. METHODS: We systematically searched three databases including the PubMed, Embase, and Cochrane Library databases for articles published from January 1986 to December 2020 using the following terms: "ovarian tumors OR ovarian carcinoma OR adnexal masses OR ovarian cancer" AND "pregnancy" AND "chemotherapy." Two authors (Yaping Pei and Yuanfeng Gou) independently searched the literature and extracted data from each eligible study. The outcome measures were overall survival (OS) and progression-free survival (PFS). The OS and PFS of all patients were estimated by Kaplan-Meier survival curves and log-rank tests. RESULTS: A total of 43 studies including 55 cases of ovarian cancer during pregnancy were selected. Forty-eight patients were comprehensively staged using the International Federation of Gynecology and Obstetrics (FIGO) staging system. Twenty-six of the 48 patients (54.17%) were diagnosed with early-stage disease, while the remaining had advanced stages (II, III, and IV). The mean age at diagnosis was 29.31 years. The majority of patients in this meta-analysis were diagnosed at a mean gestational age of 16.05 weeks. The mean GA at chemotherapy administration was 17.42 weeks. Overall, 55 women gave birth to 56 newborns, including a pair of twins. At the end of follow-up (median 10 months, range 0-73 months), all the children were healthy, except for one child who died 5 days after delivery due to a congenital abnormality. During 2-204 months of follow-up, there were five cases of recurrence, with no evidence of recurrence in the remaining cases. Unfortunately, one patient died 29 months after diagnosis. Neither median overall survival nor median progression-free survival was obtained. CONCLUSION: Platinum-based chemotherapy may be a good choice for pregnant women with ovarian cancer who want to continue their pregnancy.

Application of PET/CT radiomics in the treatment of non-small-cell lung cancer / 中华放射医学与防护杂志

Primary lung cancer is the first malignant tumor in our country and in the world with an increasing mortality trend, which seriously endangers the human health. By digging the deep relationship between high-dimensional imaging features and pathophysiological features, radiomics can establish a predictive model to distinguish pathological types, tumor stages, distant metastases and survival, guide individualized diagnosis and treatment strategies, and improve prognosis. PET/CT has higher diagnostic accuracy and specificity by reflecting tumor tissue metabolism. This article reviews the application of PET/CT radiomics in the treatment of non-small-cell lung cancer (NSCLC).

Application of the in-basket test in head nurse competence evaluation / 中华医院管理杂志

Objective:To evaluate the competence of head nurses by using the in-basket test for establishing a hierarchical training system for these nurses.Methods:A set of in-basket test was independently designed to evaluate the head nurses of a tertiary hospital in September 2021.Fourteen competency indicators, including positive initiative, coordination and communication ability, and leadership, problem solving ability, motivation, empowerment, attention to quality and order, etc, were selected to analyze the answers of the in-basket test and score their competency level. The measures were described by Mean±SD and M(IQR), and the counts were described by rates and percentages. The rank sum test and multiple linear regression were used to analyze the influencing factors of competency scoring of head nurses. Results:A total of 133 head nurses were tested, with a total competency scoring of 30.0(5.5). The highest indicators were talent cultivation 3.0(2.0), positive initiative 3.0(1.0), coordination and communication ability 3.0(1.0), while those with lower scores were empowerment 1.0(1.0) and motivation 1.5(1.5). The rank sum test analysis showed that age, position, job position character and working seniority were the influencing factors of competency score( P<0.05). The multiple linear regression analysis showed that, working seniorities of 16-20 years( β=0.583, P=0.013), 21-25 years( β=0.732, P=0.008), 26-30 years( β=0.632, P=0.026) were the influencing factors of competency score of head nurses. Conclusions:The in-basket test is practical to evaluate the competence of head nurses as a basis for their targeted training in the future.

Clinical course and risk factors for mortality of COVID-19 patients with pre-existing cirrhosis: A multicenter cohort study

BackgroundPatients with pre-existing cirrhosis are considered at increased risk of severe coronavirus disease 2019 (COVID-19) but the clinical course in these patients has not yet been reported. This study aimed to provide a detailed report of the clinical characteristics and outcomes among COVID-19 patients with pre-existing cirrhosis. MethodsIn this retrospective, multicenter cohort study, we consecutively included all adult inpatients with laboratory-confirmed COVID-19 and pre-existing cirrhosis that had been discharged or had died by 24 March 2020 from 16 designated hospitals in China. Demographic, clinical, laboratory and radiographic findings on admission, treatment, complications during hospitalization and clinical outcomes were collected and compared between survivors and non-survivors. FindingsTwenty-one patients were included consecutively in this study, of whom 16 were cured and 5 died in hospital. Seventeen patients had compensated cirrhosis and hepatitis B virus infection was the most common etiology. Lymphocyte and platelet counts were lower, and direct bilirubin levels were higher in patients who died than those who survived (p= 0{middle dot}040, 0{middle dot}032, and 0{middle dot}006, respectively). Acute respiratory distress syndrome and secondary infection were both the most frequently observed complications. Only one patient developed acute on chronic liver failure. Of the 5 non-survivors, all patients developed acute respiratory distress syndrome and 2 patients progressed to multiple organ dysfunction syndrome. InterpretationLower lymphocyte and platelet counts, and higher direct bilirubin level might represent poor prognostic indicators in SARS-CoV-2-infected patients with pre-existing cirrhosis.

β-arrestin-2 inhibits autophagy by up-regulating PI3K/Akt signal to alleviate liver ischemia-reperfusion injury in mice / 器官移植

Objective To verify whether β-arrestin-2 inhibits autophagy by up-regulating PI3K/Akt signal to protect the liver from ischemia-reperfusion injury (IRI) in mice. Methods Twelve β-arrestin-2 knockout (KO) and twelve wild-type (WT) C57BL/6 mice were randomly divided into the KO+sham group, KO+IRI group, WT+sham group and WT+IRI group, six mice in each group. The mouse models with 70% liver IRI were established or sham operation was performed. Relevant experiments were carried out at 6 h after liver reperfusion or operation. The expression levels of apoptosis signal protein cleaved Caspase-3, proliferation signal protein Ki-67 and the PI3K/Akt signal protein p-Akt were detected by immunohistochemical staining. Results Immunohistochemical staining demonstrated that compared with the corresponding sham group, the positive cell count for cleaved Caspase-3, Ki-67 and p-Akt in liver tissues of mice was significantly increased in the KO+IRI and WT+IRI groups (all P < 0.01). Compared with the WT+IRI group, the positive cell count for cleaved Caspase-3 in liver tissues of mice was significantly increased, whereas the positive cell count forKi-67 and p-Akt was significantly decreased in the KO+IRI group (both P < 0.05). Conclusions β-arrestin-2 can mitigate the liver cell apoptosis and promote the repair of injury after IRI in mice. Moreover, β-arrestin-2 inhibits autophagy by up-regulating the PI3K/Akt signal to alleviate liver IRI in mice.

The value of ultrasound in assessment of the factors influencing on the early insufficient flow of central venous catheter in dialysis patients / 中华超声影像学杂志

Objective:To evaluate the value of ultrasonography in evaluating the influential factors of early insufficient flow after central venous catheter placement in dialysis patients.Methods:Three hundred and twenty seven hemodialysis patients who underwent central venous catheterization at the Affiliated Hospital of Chengde Medical College from May 2016 to June 2019 were selected. According to the catheter flow, the patients were divided into the low catheter flow group(43 cases) and the normal catheter flow group(284 cases). The distribution variance of clinical features(age, gender, blood pressure) were compared and whether some ultrasonic parameters(position of catheter tip, left ventricular ejection fraction, left atrial end-systolic diameter, left ventricular end-diastolic diameter, distance from the catheter tip to superior vena cava beyond right atrial opening) had influence on the insufficient catheter flow in the early stage between the two groups were analyzed.Results:The differences of left ventricular ejection fraction, left atrial end-systolic diameter and position of catheter tip between the two groups were statistically different( P<0.05). However, univariate and multivariate analyses showed that there were significant differences in catheter tip approaches and touches the wall of right atrium( OR=5.393, 95% CI=2.039-14.263, P=0.001), increased left atrial end-systolic diameter( OR=0.321, 95% CI=0.124-0.827, P=0.019), left ventricular ejection fraction in critical range( OR=2.953, 95% CI=1.113-7.835, P=0.030) and decreased left ventricular ejection fraction( OR=5.828, 95% CI=1.869-18.174, P=0.002) were the independent risk factors of early insufficient catheter flow. Conclusions:Insufficient catheter flow after central venous catheterization is related to catheter position, left atrial end-systolic diameter and left ventricular ejection fraction. Ultrasonography evaluation is a primary method to observe the position of the catheter tip in dialysis patients and diagnose the early insufficient catheter flow after central venous catheterization.

The values of Rockall, Blatchford and AIMS65 scoring systems in the diagnosis and treatment of patients with acute upper gastrointestinal bleeding / 天津医药

prognosis of patients with acute upper gastrointestinal bleeding (AUGIB). Methods A total of 130 patients with AUGIB in our hospital were enrolled in this study from August 2014 to August 2016 . Three kinds of scoring systems including Rockall, Blatchford and AIMS65 were used to evaluate the risk classification of the patients. Patients were followed up for 2 months. The incidence rates of re-bleeding and death within 2 months after admission were observed. Data of prognosis in patients with AUGIB were compared between the three scoring systems in the prognosis of patients with AUGIB, including the risk classification and the prediction accuracy of re-bleeding and death. Results There were no significant differences in the re-bleeding rate and fatality rate between the groups divided by Rockall and Blatchford scoring systems ( P>0.05). According to the grouping results of AIMS65 scoring system, the re-bleeding rate of low-risk group was lower than that in high risk group (1.45%vs. 13.11%, P=0.01), but there was no significant difference in fatality rate between the two groups (P>0.05). The values of area under the curve (AUC) of predicting re-bleeding rates by using Rockall, Blatchford and AIMS65 scoring systems were 0.6258, 0.6910, and 0.7241, and the values of AUC of predicting fatality rates were 0.7031, 0.7969, and 0.7031 by using receiver operating characteristic curve (ROC) analysis. There were no significant differences between them (P>0.05). The values of AUC of predicting re-bleeding rates by using the risk grading calculation by Rockall, Blatchford and AIMS65 scoring systems were 0.6189, 0.6139 and 0.7254 (P>0.05). But the values of AUC of predicting fatality rates were 0.6211, 0.6641 and 0.7695 (P<0.01). Conclusion The operation method of AIMS65 scoring system is simple and convenient, which is applicable to a wide range of patients with AUGIB. In the prediction of re-bleeding and mortality, AIMS65 scoring system has high accuracy and stability, which is worthy of promoting in clinical application.

Effects of Kangguzengsheng Capsules-containing serum on the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells / 中国组织工程研究

BACKGROUND: Our previous studies have found that the Kangguzengsheng Capsules can promote fracture healing.OBJECTIVE: To explore the influence of Kangguzengsheng Capsules-containing serum on the proliferation andosteogenic differentiation of bone marrow mesenchymal stem cells.METHODS: Forty Sprague-Dawley rats were randomly divided into four groups. The capsule powder was resolved into1 mL natural saline and intragastrically administered into rats according to 1.16 g/100 g, 3.48 g/100 g, 10.44 g/100 g in low,medium and high dose groups. Rats in control group were given equal volume of natural saline. After consecutiveadministration for 12 days, blood samples from the abdominal aorta were collected and serum samples were isolated andpreserved until use. Bone marrow mesenchymal stem cells were isolated and purified by the whole marrow adhesion method,and identified by flow cytometry. Harvested cells were divided into four groups and cultured in the osteogenic culture mediumcontaining different kinds of serum samples as described above. MTT method was adopted to test the cell proliferation at 24,48 and 72 hours of culture. Alkaline phosphatase activity in cells was detected at 7 and 14 days of culture. Alkalinephosphatase staining was performed at 7 days of culture, and alizarin red staining performed at 14 days of culture.RESULTS AND CONCLUSION: Compared with the blank control group, bone marrow mesenchymal stem cells showedno significant changes in the proliferative ability and alkaline phosphatase activity in the low dose group, but these twoindices were significantly increased in the high and medium dose groups at 48 and 72 hours of culture or at 7 and 14days of culture, respectively (P < 0.05). Cells positive for alkaline phosphatase and alizarin red staining were observed inthe low, medium and high dose groups, and the cell staining was most remarkable in the high dose group. To conclude,Kangguzengsheng Capsules-containing serum can promote the proliferation and osteogenic differentiation of bonemarrow mesenchymal stem cells.

The value of correction of ultrasound elastography strain rate ratio in BI-RADS grading of breast hyperplasia with fibroadenoma and breast cancer / 重庆医学

Objective To investigate the value of correction of ultrasound elastography strain rate ratio in BI-RADS grading of breast hyperplasia with fibroadenoma and breast cancer.Methods The data of 120 cases of hyperplasia of mammary gland hyperplasia with fibroadenoma and 120 cases of breast cancer confirmed by operation or biopsy in this hospital from January 2012 to October 2016 were analyzed retrospectively.The boundary,shape,echogenicity,aspect ratio,calcification,blood flow distribution,resistance index,BI-RADS grade,ultrasonic elastography strain ratio were analyzed.The value of correction of ultrasound elastography strain rate in breast hyperplasia with fibroadenoma and breast cancer BI-RADS grading ratio were investigated.Results There were significant differences in boundary,rear echo,aspect ratio,calcification,ultrasonic elastography strain ratio between breast hyperplasia with fibroadenoma and breast cancer (P＜0.05);There was no significant difference between the two groups about morphology and internal echo (P＞0.05);Breast hyperplasia with fibroadenoma were mainly 0-Ⅰ in blood flow distribution,RI＜ 0.7,breast cancer showed Ⅱ-Ⅲ,RI≥0.7,the difference was statistically significant (P＜0.05).Ultrasound elastography strain rate ratio improved the diagnose accordance rate of two groups after BI-RADS' classification correction.Conclusion Hyperplasia of mammary glands with fibroadenoma and breast cancer have overlapping ultrasound features.Ultrasound elastography strain rate ratio can improve the diagnose accordance rate of two groups after BI-RADS' classification correction,which has certain clinical value.

Characteristics of deceleration capacity and Tp-e/QT value in different age groups of patients with diabetic autonomic neuropathy / 中国糖尿病杂志

Objective To investigate characteristics of deceleration capacity (DC) and Tp-e/QT value in different age groups of patients with diabetic autonomic neuropathy, and to analyze their influencing factors. Methods A total of 487 subjects were enrolled in this study, and divided into three groups:patients with diabetic autonomic neuropathy (DM+CAN group,n=287), normal glucose tolerance patients with diabetic autonomic neuropathy (CAN group,n=130) and healthy controls (NC group,n=150).Then the DM+CAN group were further divided into three subgroups according to age tertiles:the lowest tertile group (35.0~47.2 years old,n=91),the middle tertile group (47.3~59.6 years old,n=116)and the highest tertile group (59.7~72.0 years old,n=80).All subjects were underwent 24-hour dynamic electrocardiogram recordings.DC and Tp-e/QT values were calculated,and then the correlation between DC and Tp-e/QT with other indicators was analyzed. Results The levels of WC,SBP,BMI,FPG,HbA1c,FIns and HOMA-IR were higher in DM+CAN group than in CAN group and in NC group (P0.05).DC increased [(2.90±0.47) vs (4.22±0.41) vs (4.97±0.35) ms],and the Tp-e/QT decreased [(0.23±0.05) vs (0.18±0.03) vs (0.12±0.02)] from the highest tertile group to the lowest tertile group,(P<0.05 or P<0.01),and the pairwise comparisons were statistically significant (P<0.05 or P<0.01).Multiple stepwise regression analysis showed that age,DM duration,WC,FPG,HbA1c,complicated with hypertension and coronary heart disease (CHD) were risk factors for DC and Tp-e/QT values (P<0.05). Conclusion Together with the increased age,DC level is reduced and Tp-e/QT value increased in patients with diabetic autonomic neuropathy.Dynamic electrocardiogram should be considered in patients with advanced age,long DM duration,high level of WC,FPG,HbA1c,and complicated with hypertension and CHD,in order to prevent the occurrence of cardiovascular events effectively.

Ultrasound elasticity imaging correction and biopsy diagnosis value in BI-RADS 4 breast mass / 中国肿瘤临床

Objective:To compare the diagnostic value of strain ratio correction in ultrasound elasticity imaging and ultrasound-guided percutaneous biopsy for the diagnosis of breast imaging reporting and data system (BI-RADS) 4 breast mass. Methods:From January 2014 to June 2016 in the Affiliated Hospital of Chengde Medical College, 120 patients with breast tumor resection and preoperative BI-RADS4 of all the masses were included in this study. The diagnostic value of contrast ultrasound elastography strain ratio correction and biopsy in ultrasound-guided percutaneous biopsy was evaluated with pathology as the gold standard. Results:In the 120 cases of grade BI-RADS4 mass by ultrasound elastography after correction, 46 cases were graded BI-RADS4 without changing;59 cases were downgraded to BI-RADS3, and 15 cases were upgraded to BI-RADS5. The pathology, ultrasonic elastography strain ratio correction, biopsy diagnostic sensitivity, specificity, and accuracy were 90.7%, 81.8%, 85.5%, 88.8%, 98.5%, and 95.0%, respectively. A significant difference was found between ultrasonic elastography strain ratio correction and ultrasound-guided biopsy for the diagnosis of breast malignant mass (P0.05). Conclusion:Ultrasound-guided puncture biopsy is highly valuable in qualitative diagnosis of BI-RADS4 breast mass. After the pathological diagnosis, ultrasound elastography strain ratio has certain clinical value in BI-RADS4 guided biopsy and correction of mass classification.

Hepatitis C patients serum HCV-RNA copy number and AFP-L3 percentage correlation analysis / 国际检验医学杂志

Objective To investigate the HCV patients with HCV‐RNA and AFP different plastid percentage (AFP‐L3/AFP) correlation ,analysis of liver cirrhosis to liver cancer caused by hepatitis c in the process of the development of HCV‐RNA and AFP‐L3/AFP change characteristics .Methods Collected clinical confirmed simple HCV patients 80 cases ,including 44 patients with cir‐rhosis of the liver and 36 cases of HCV liver cancer group and liver cirrhosis group were followed up at 3 ,6 months ,follow‐up re‐sults are divided into transfer of liver cancer group and treatment group ,in addition to choose 60 cases of healthy people as control group .Using case‐control study .Between different groups of HCV‐RNA and AFP‐L3/AFP compared by t test .Results The liver cirrhosis group average HCV‐RNA ,AFP‐L3/AFP for 7 .15 × 103 copy/mL ,44 .3% ,compared with the control group 400 copy/mL ,1 .1% ,the difference was statistically significant(P< 0 .05) .Liver cirrhosis group average HCV‐RNA ,AFP‐L3/AFP for 8 .33 × 109 copy/mL ,3 .35% ,and HCV liver cancer group (5 .71 × 107 copy/mL ,94 .33% ) ,the difference was statistically signifi‐cant(P<0 .05) .3 months follow‐up of patients with liver cirrhosis have 4 cases for the development of liver cancer ,8 cases after 6 months for the development of liver cancer .Conclusion The patients with cirrhosis caused by hepatitis c virus (HCV) should be combined ,dynamic detection of HCV RNA and AFP‐L3/AFP ,in order to early discover the liver cancer .

The Medical Ethics in Chinese Traditional Medical Culture / 中国医学伦理学

This paper analyzed the thoughts of Chinese traditional medical ethics through discussing the four aspects: philanthropy and salvation, incorruptibility and uphold justice, proficient in medicine, scholarly and re-fined. It proposed that moral cultivation is very important, which is the basic premise of medical profession.

Assessment of risk factors for patients with anatomical left ventricular aneurysm post acute ST-elevation myocardial infarction by use of multiple-risk-factor assessment models / 中华心血管病杂志

<p><b>OBJECTIVE</b>To set up the multiple risk factors model of patients with anatomical left ventricular aneurysm (LVA) post acute ST-elevation myocardial infarction (STEMI) and quantitatively assess the pathopoiesis of all the factors.</p><p><b>METHODS</b>A total of 518 consecutive inpatients with acute STEMI hospitalized from June 2010 to December 2013 in our hospital were enrolled in this study, patients were divided into two groups: LVA group (n = 106, 20.5%) and non-LVA group (n = 412, 79.5%). All demographic and clinical data were collected by cardiologists. Finally, all of the risk factors for anatomical LVA in the acute STEMI patients were quantitatively analyzed by a binary logistic regression model.</p><p><b>RESULTS</b>The multiple risk factors logistic regression model was set up for the anatomical LVA in patients with acute STEMI. Anterior wall myocardial infarction, occlusion of the left anterior descending branch, two or three vessels stenosis, high systolic blood pressure, sinus tachycardia and white blood cell count over 10 000 per microliter were all independent risk factors of the LVA in acute STEMI, with the odds ratio (OR) 18.21, 21.56, 4.22, 7.16, 1.98 and 1.57, respectively (all P < 0.05) . However, first medical contact less than 12 hours (OR = 0.60), collateral circulation of the coronary arteries(OR = 0.53), primary percutanous coronary intervention(OR = 0.23) and venous thrombolysis(OR = 0.12) were all protecting factors of the LVA in acute STEMI patients (all P < 0.05).</p><p><b>CONCLUSION</b>Anterior wall STEMI, occlusion of the left anterior descending branch, two or three vessels stenosis, high systolic blood pressure, sinus tachycardia and white blood cell count over 10 000 per microlitre are independent risk factors of the LVA in acute STEMI patients. However, first medical contact less than twelve hours, collateral circulation of the coronary arteries, together with the primary percutanous coronary intervention and venous thrombolysis are protective factors of the LVA in patients with acute STEMI. It is important for cardiologists to assess the risks of LVA and make emergent and suitable efforts to reduce the risk of developing LVA in STEMI patients.</p>