Effectiveness evaluation of the Thyroid Imaging Report and Data System proposed by American Radiological Society (2017) (ACR-TIRADS) for differential diagnosis in thyroid nodules / 中华超声影像学杂志

Objective@#To evaluate the effect of the Thyroid Imaging Report and Data System proposed by American Radiological Society (ACR-TIRADS) for differential diagnosis in thyroid nodules, and compare ACR-TIRADS to the TIRADS proposed by Kwak et al.(K-TIRADS) and the ultrasound-based risk stratification system evaluated by American Thyroid Association (ATA-Risk Stratification).@*Methods@#The clinical data of 1 760 patients with 1 912 thyroid nodules from 8 hospitals in Jiangsu province were retrospectively analysed. All of them were categorized based on ultrasound-based risk stratification systems. The ROC curve was established to assess and compare the diagnostic value of the systems.@*Results@#The area under the ROC curve (AUC) of ACR-TIRADS was 0.830, with high sensitivity and negative predictive value (86.9% and 87.5%, respectively), and relatively low specificity and positive predictive value (64.1% and 62.9%, respectively). The sensitivity and specificity of K-TIRADS were up to 84.9% and 76.1%, respectively. The AUC of ATA-Risk Stratification was 0.852, with relatively high specificity (83.4%), and low sensitivity (79.4%). There were significant differences in the AUC among the three ultrasound-based risk stratification systems, of which K-TIRADS was the highest (P<0.001). There was no significant difference in sensitivity of ACR-TIRADS and K-TIRADS (P=0.137), but significantly higher than that of ATA-Risk Stratification (P<0.001). There were significant differences in the specificity among the three systems, of which ATA-Risk Stratification was the highest (P<0.001). In addition, there were 109 nodules (5.7%) couldn′t be classified based on ATA-Risk Stratification, with high malignancy rate of 31.2%.@*Conclusions@#The diagnostic efficiency of ACR-TIRADS is good, but lower than K-TIRADS and ATA-Risk Stratification. ACR-TIRADS has the highest sensitivity, and ATA-Risk Stratification has the highest specificity, while the overall diagnostic efficiency of K-TIRADS is the best.

Improvement Effects of 3 Kinds of Angiotensin Converting Enzyme Inhibitor on Ventricular Remodeling in Patients with Acute Myocardial Infarction / 中国药房

OBJECTIVE: To observe the improvement effects of angiotensin converting enzyme inhibitor (ACEI) fosinopril, perindopril and benazepril on ventricular remodeling in patients with acute myocardial infarction (AMI), and to evaluate its safety. METHODS: A total of 96 AMI patients selected from our hospital during Jan. 2014-Oct. 2016 were divided into group A, B, C according to random number table, with 32 cases in each group. All patients received symptomatic treatment, underwent percutaneous coronary intervention, and then given ACEI after blood vessels recanalization and keeping blood pressure stable. Group A was given Fosinopril sodium tablets 10 mg, qd; group B was given Perindopril tert-butylamine tablets 4 mg, qd; group C was given Benazepril hydrochloride tablets 10 mg, qd. All groups were treated for consecutive 6 months. Cardiac structure and function indexes (LVESD, LVEDD, IVSD, LVPWD, LVEF, CO), hemodynamic indexes (SBP, DBP, HR) and related lab indexes (FPG, TG, TC, HDL-C, LDL-C, AST, ALT, Scr, BUN) of 3 groups were observed before and after treatment. The occurrence of ADR was recorded. RESULTS: Before treatment, there was no statistical significance in cardiac structure and function indexes, hemodynamic indexes or related lab indexes among 3 groups (P＞0. 05). After treatment, the levels of LVESD, LVEDD, LVPWD, CO, HR, FPG, TG, TC and LDL-C in 3 groups were decreased significantly, while the levels of LVEF and SBP were increased significantly, with statistical significance (尸＜0. 05). There was no statistical significance in above indexes among 3 groups after treatment (P＞0. 05). After treatment, the level of Scr in group B was significantly increased and higher than group A and C, with statistical significance (P＜0. 05). There was no statistical significance in the levels of IVSD, DBP, HDL-C, AST, ALT or BUN among 3 groups before and after treatment as well as the level of Scr between group A and C (P＞ 0. 05). There was no statistical significance in the incidence of ADR among 3 groups(P＞0. 05). CONCLUSIONS: Fosinopril, perindopril and benazepril can significantly improve ventricular remodeling in AMI patients, narrowing the heart cavity, increasing systolic pressure, lowering heart rate, reducing the oxygen consumption of the ventricle, with similar effects. Perindopril may increase the level of Scr, so fosinopril and benazepril are safe and suitable for AMI patients with renal function disorder.

Comparison of diagnostic value of TIRADS, BSRTC, BRAFV600E mutation detection and their combined use in differentiating thyroid nodules / 中华内分泌代谢杂志

Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system (TIRADS), the Bethesda system for reporting thyroid cytopathology(BSRTC) and BRAFV600E detection, and their combined use in the differentiation between benign and malignant thyroid nodules. Methods One hundred and twenty eight patients with 128 thyroid nodules who were scheduled for ultrasound-guided fine-needle aspiration biopsy (FNAB) were recruited for the study. All of them underwent ultrasound, fine-needle aspiration cytology(FNAC) examination, and BRAFV600E detection. TIRADS and BSRTC systems were adopted to judge the ultrasound and FNAC results. The receiver operating characteristic curve was established to assess the diagnostic value of each method. Results The sensitivity, specificity, and AUC of TIRADS were 74. 3%, 84. 5%, and 0. 794, respectively. BSRTC had higher specificity(98. 3%) and equal sensitivity compared to TIRADS. The sensitivity, specificity, and AUC of BRAFV600E detection were the highest ones among the three methods. Combinations of different methods could increase the diagnostic sensitivity and accuracy. The combination of FNAC and BRAFV600E detection significantly increased the diagnostic efficiency(AUC=0. 984), with sensitivity 98. 6% and specificity 98. 3%. Conclusions The diagnostic value of BRAFV600E detection in the differentiation of benign and malignant thyroid nodules is better than both TIRADS and BSRTC, and the combination of FNAC and BRAFV600E detection reaches the best diagnostic efficiency.

Changes of serum levels of myeloperoxidase and lipoxin A 4 in patients with coronary heart disease and its significance / 心血管康复医学杂志

Objective:To observe changes of serum levels of myeloperoxidase (MPO) and lipoxin A4 (LXA4) in pa‐tients with coronary heart disease (CHD) and explore its clinical significance .Methods :A total of 120 CHD patients treated in our hospital from Jun 2013 to Sep 2014 were selected as CHD group ,another 40 healthy subjects were re‐garded as normal control group .According to CHD type ,patients were divided into stable angina pectoris (SAP) group (n=36) ,unstable angina pectoris (UAP) group (n=46) and myocardial infarction (MI) group (n=38) .Ac‐cording to plaque nature assessed by CT value ,patients were divided into calcified plaque group (n= 27) ,mixed plaque group (n=31) and non-calcified plaque group (n=62) .Levels of MPO and LXA4 and ratio of MPO/LXA4 were compared among all groups .Results:Compared with normal control group ,there were significant rise in MPO level [ (167.2 ± 20.4) U/L vs .(218.3 ± 32.5) U/L] and MPO/LXA4 [ (0.78 ± 0.08) vs .(1.34 ± 0.27)] ,and sig‐nificant reduction in LXA4 level [ (214.6 ± 31.3) nmol/L vs .(162.4 ± 22.4) nmol/L] in CHD group ,P<0.05 or<0.01 .Compared with SAP group ,there were significant rise in MPO level [ (180.4 ± 21.6) U/L vs .(230.3 ± 32.5) U/L vs .(238.6 ± 44.7) U/L] and MPO/LXA4 [ (0.97 ± 0.11) vs .(1.37 ± 0.23) vs .(1.62 ± 0.25)] ,and significant reduction in LXA4 level [ (184.7 ± 23.7) nmol/L vs .(156.3 ± 21.2) nmol/L vs .(148.4 ± 19.6) nmol/L] in UAP group and MI group ,and MPO/LXA4 of MI group was significantly higher than that of UAP group , P<0.05 or < 0.01 . Compared with calcified plaque group and mixed plaque group , there were significant rise in MPO level [(196.3 ± 27.2) U/L vs .(211.2 ± 24.6) U/L vs .(231.6 ± 26.5) U/L] and MPO/LXA4 [(1.13 ± 0.14) vs .(1.26 ± 0.16) vs .(1.51 ± 0.21)] ,and significant reduction in LXA4 level [ (174.3 ± 23.4) nmol/L vs .(167.4 ± 21.2) nmol/L vs .(154.6 ± 19.2) nmol/L] in calcified plaque group ,and MPO/LXA4 of mixed plaque group was significantly higher than that of calcified plaque group , P<0.05 or <0.01 .Conclusion:There exist significant ab‐normal levels of MPO and LXA4 in CHD patients ,ratio of MPO/LXA4 is more helpful for determining disease se‐verity and stability of atherosclerotic plaque .

Estimation of hospitalization rate of laboratory confirmed influenza cases in Jingzhou city, Hubei province, 2010-2012 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To estimate the hospitalization rate of severe acute respiratory infection (SARI) cases attributable to influenza in Jingzhou city, Hubei province from 2010 to 2012.</p><p><b>METHODS</b>SARI surveillance was conducted at four hospitals in Jingzhou city, Hubei province from 2010 to 2012. Inpatients meeting the SARI case definition and with informed consent were enrolled to collect their demographic information, clinical features, treatment, and disease outcomes, with their respiratory tract specimens collected for PCR test of influenza virus.</p><p><b>RESULTS</b>From April, 2010 to September, 2012, 19 679 SARI cases enrolled were residents of Jingzhou, and nasopharyngeal swab was collected from 18 412 (93.6%) cases of them to test influenza virus and 13.3% were positive for influenza. During the three consecutive 2010-2012 flu seasons, laboratory-confirmed influenza was associated with 102 per 100 000, 132 per 100 000 and 244 per 100 000, respectively. As for the hospitalization rate attributable to specific type/subtype of influenza virus, 48 per 100 000, 30 per 100 000 and 24 per 100 000 were attributable to A (H3N2), A (H1N1) pdm2009, and influenza B, respectively in 2010-2011 season; 42 per 100 000 [A (H3N2)] and 90 per 100 000 (influenza B) in 2011-2012 season; 90 per 100 000 [A (H3N2)] and one per 100 000 [influenza B] from April, 2010 to September, 2012. SARI hospitalization caused by influenza A or B occurred both mainly among children younger than five years old, with the peak in children aged 0.5 year old.</p><p><b>CONCLUSION</b>Influenza could cause a substantial number of hospitalizations and different viral type/subtype result in different hospitalizations over influenza seasons in Jingzhou city, Hubei province. Children less than five years old should be prioritized for influenza vaccination in China.</p>

Expression of mythl-CpG-binding protein-2 gene in developing rat brain / 北京大学学报(医学版)

Objective: To analyze the expression of mecp2 gene at mRNA and protein;Cerebral cortex level in the cerebral cortex of the normal Wistar rat throughout development. Methods: We chose the 15th day (E15), 17th day (E17), 19th day (E19) of embryo period, the day of birth (P0), the 7th day (P7), the 14th day (P14), the 28th day (P28) of postnatal period, and adulthood as analyzing time points. The expression of mecp2 gene at mRNA level was analyzed by real time PCR and Northern blot. The expression of MeCP2 protein was analyzed by Western blot. Results: There was one type of mecp2 mRNA transcript (approximately 10 kb) expressed in the cerebral cortex of the normal Wistar rat. The expression level of mecp2 mRNA varied subtly during the development. There was one type of MeCP2 protein (75 000) expressed in the cerebral cortex of the normal Wistar rat. The expression level of MeCP2 protein remained the lowest on E15, from E19 to adulthood the expression levels of MeCP2 protein increased dramatically compared with that on E15. From P7 to adulthood, the differences of expression between two time points were subtle. Conclusion: The expression level of MeCP2 protein increases as the neurons in the cerebral cortex of normal Wistar rat grow mature. This indicates that MeCP2 protein is very important to neuron's maturation, and probably has relationship with maintaining maturation state of neurons.

Neuroprotective effect of bFGF on cerebral diffuse axonal injuries of rats / 中国康复理论与实践

@#ObjectiveTo observe the neuroprotective effect of basic fibroblast growth factor(bFGF)on cerebral diffuse axonal injuries (DAI)of rats.Methods40 male SD rats were randomly divided into control group, DAI injury group, bFGF group and DAI saline group. According to the survival time of rats, DAI injury group were divided into five groups, the 6h, 12h, 24h, 72h and 7th day group, The changes of bFGF expression in cerebral cortex were detected by immunohistochemical method from 6h to 7d after DAI. Two hours before DAI, bFGF 10μl was injected into right ventricle in bFGF group. ResultsThe bFGF expression appeared at 6h after DAI, increased at 12h, reached the highest level at 72h, and kept in a high level at 7d.There were obvious differences between 72h group and other groups in DAI injury group (P<0.01),cerebral cortex neurons were obviously decreased by HE staining. In each time group,injured neurons were decreased in bFGF group combined with DAI injury group(P<0.05). ConclusionsbFGF has obvious neuroprotective effect on cerebral diffuse axonal injuries of rats.

Effects of Xintong Oral Solution on Cardiac Hemodynamics and Myocardial Oxygen Consumption in Dogs / 中成药

Objective: To investigate the effect of Xingtong Oral Solution on cardiac hemodynamics and myocardial oxygen consumption in dogs.Methods: The coronary blood flow and cardiac outpout were measured by electromagnetic flowmeter. The internal pressure of left ventricle was determined by carrier amplifier. And the blood oxygen content was also determined by oximeter. Results: Xintong Oral Solution can raise the internal pressure of left ventricle, enhance the work of left ventricle and reduce the peripheral resistance. Conclusion: Xintong Oral Solution can obviously reduce myocardial oxygen consumption and coronary resistance. It is also to give protection to myocardial ischemia.

Aspero saponins phospholipid preparation and absorption in rats' intestine in situ / 中成药

AIM: To prepare the asperosaponin—phospholipid compound to improve the bioavailability of asperosaponin in rat intestine in situ. METHODS: Ratio of asperosaponin to phospholipid was chosen as index to screen the optimal proportion based on the orthogonal design.Rat intestine perfusion was use to compare aspersaponin absorption under with and without phospholipid. RESULTS: Asperosaponin—phospholipid compound showed the markedly improvement in absorption capacity and absorption rate. CONCLUSION: The experiment recommends that asperosaponin in the combination with phospholipid is better than only used asperosaponin concerning bioavailability.