Quality analysis of Codonopsis pilosula with different commodity specification grades / 中国药房

OBJECTIVE To study the quality of Codonopsis pilosula with different commodity specification grades， and to provide the data support for market transactions， scientific research and clinical use. METHODS According to the classification standard of commodity specification grades of C. pilosula， 17 batches of C. pilosula from different producing areas， origins and commodity specification grades were collected. The contents of tangshenoside Ⅰ， lobetyolin and atractylenolide Ⅲ were determined by HPLC. The contents of alcohol-soluble extracts were determined by hot dipping method stated in general rule 2201 of Chinese Pharmacopeia （part Ⅳ）. The contents of polysaccharide were determined by phenol-sulfuric acid method （calculated by D-glucose anhydrous）. RESULTS For cultivar of C. pilosula， four specifications and three commodity grades of C. pilosula all contained tangshenoside Ⅰ and lobetyolin； Radix C. pilosula from Shanxi of China and C. pilosula from Wenxian County of China， also contained atractylenolide Ⅲ. In terms of the contents of tangshenoside Ⅰ， lobetyolin and atractylenolide Ⅲ， the content of second class was equivalent to that of first class， even better than the first class， while the content of third class was lower than that of first class and second class； the content of tangshenoside Ⅰ was the highest among the two types of wild C. pilosula. The contents of alcohol-soluble extracts and polysaccharides in first class cultivated C. pilosula were higher than those of second class， and the second class was higher than the third class； wild C. pilosula had low content of alcohol-soluble extracts and polysaccharides. CONCLUSIONS The internal quality of C. pilosula is basically consistent with the classification standard of different commodity specification grades； the content of each indicator in first-class and second-class medicinal herb is high， making them high-quality medicinal herbs.

Mechanism of levosimendan on acute kidney injury after cardiopulmonary resuscitation in rats / 中华急诊医学杂志

Objective:To investigate the mechanism of levosimendan on acute kidney injury after cardiopulmonary resuscitation (CPR) in rats.Methods:Twenty-five healthy adult male SD rats were randomly divided into three groups: control group ( n=5), levosimendan group ( n=10) and experimental group ( n=10). A cardiac arrest-cardiopulmonary resuscitation model was established using smothering method in the experimental group and levosimendan group. The levosimendan group was treated with levosimandan during and after resuscitation, while the experimental group was given equivalent volume of saline solution during and after resuscitation, and the control group was only given equivalent volume of saline without performance of CPR. The rats in the three groups were sacrificed at 6 h after resuscitation. The serum and kidney tissue samples were collected. Serum biochemical indicators [serum creatinine (Scr), blood urea nitrogen (Bun), interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] were measured. HE staining and Paller score were used to identify the degree of kidney damage. Apoptosis was estimated by TUNEL staining. Western blot was used to detect the expression levels of phosphorylation of extracellular regulated protein kinases (p-ERK). One-way analysis of variance was used to compare the mean values of normally distributed measurement data between groups. Comparisons between groups were performed using the least significant difference t-test. Results:Scr (85.02±1.31) μmol/L, Bun (7.36±0.13) mmol/L, Paller score (7.3±0.2), IL-1β (302.20±17.35) pg/mL, IL-6 (564.60±23.24) pg/mL and TNF-α (1346±83.73) pg/mL in the experimental group were significantly higher than those of the control group [(15.94±0.96) μmol/L, (2.95±0.18) mmol/L, (0.7±0.2), (7.27±0.44) pg/mL, (51.30±2.87) pg/mL, and (10.39±0.52) pg/mL] (all P<0.01). Compared with the experimental group, Scr (63.88±2.01) μmol/L, Bun (5.45±0.47) mmol/L, paller score (4.8±0.2), IL-1β (78.61±3.66) pg/mL, IL-6 (297.90±13.64) pg/mL and TNF-α (276.2±20.18) pg/mL were significantly decreased in the levosimendan group (all P<0.01). TUNEL staining showed that levosimendan could improve the apoptosis of renal cells ( P<0.01). The expression of p-ERK protein in the levosimendan group was significantly higher than that in the experimental group ( P<0.01). Conclusions:Lovosimendan could attenuate acute kidney injury following cardiac arrest and cardiopulmonary resuscitation via suppression apoptosis. The mechanism of levosimendan protective effect might be associated with activation of ERK signaling pathway.

Familial dysalbuminemic hyperthyroxinemia: One case report and literature review / 中华内分泌代谢杂志

This article reported a patient with familial dysalbuminemic hyperthyroxinemia (FDH). A 38-year-old male occasionally found to have increased FT 4 level with normal FT 3 and TSH on routine physical examination was admitted to our hospital. Thyroid function was rechecked and found that the levels of TT 4, FT 4, rT 3 were increased, while TT 3, FT 3, TSH, TRAb, TPOAb and TGAb were normal. The patient had no other symptoms of thyrotoxicosis except occasional diarrhea. Gene sequencing revealed a heterozygous mutation of c. 653G>A (p.R218H) in exon 7 of albumin (ALB) gene, therefore the patient was confirmed as a case of FDH.

The diagnostic value of dual-phase enhanced spiral CT scanning in common benign and malignant garotid glands / 中国医师进修杂志

Objective:To evaluate the diagnostic value of dual-phase enhanced spiral CT scanning in common benign and malignant parotid gland tumors.Methods:Sixty-four cases of parotid tumors confirmed by operation and pathology in Zhejiang Quhua Hospital from January 2016 to January2019 were retrospectively analyzed. The morphological characteristics of benign and malignant parotid tumors and the enhancement characteristics of common parotid tumors were compared.Results:Among 64 parotid tumors, there were 50 cases (78.1%) of benign tumor, 26cases (52.0%) of pleomorphic adenoma, 17cases (34.0%) of adenolymphoma, 7 cases (14.0%) of other benign tumors, and the coincidence rate of dual-phase enhanced spiral CT scanning in diagnosis of benign parotid gland tumors was 88.0%(44/50). Fourteen cases (21.9%) had malignant tumor, 5 cases(5/14) had mucoepidermoid carcinoma, 9 cases had other malignant tumors, and the coincidence rate of dual-phase enhanced spiral CT scanning in diagnosis of malignant parotid gland tumors was 12/14. The total coincidence rate of dual-phase enhanced spiral CT scanning was 87.5%(56/64). The clear boundary and no lymphadenectasis were the characteristic of benign tumor, and fuzzy boundary and lymphadenectasis were the characteristic of malignant tumor. There were no significant differences between benign tumor and malignant tumor in outline and cystic change ( P>0.05). The arterial stage enhancement rate of adenolymphoma was higher than that of pleomorphic adenoma and mucoepidermoid carcinoma (2.78 ± 0.90 vs. 1.69 ± 0.32 and 1.97 ± 0.64), the parenchymal phaseenhancement rate was lower than that of pleomorphic adenoma and mucoepidermoid carcinoma (1.69 ± 0.56 vs. 2.13 ± 0.74 and 2.24 ± 0.50), and there were significant differences ( P<0.05). The clearance rate (CWR) of pleomorphic adenoma was lower than that of adenolymphoma and mucoepidermoid carcinoma(-0.20 ± 0.15 vs. 2.34 ± 0.37 and 0.19 ± 0.07), and the CWR of mucoepidermoid carcinoma was lower than that of adenolymphoma (0.19 ± 0.07 vs. 2.34 ± 0.37), and there were significant differences ( P<0.05). Conclusions:Thedual-phase enhanced spiral CT scanning in the diagnosis of common benign and malignant parotid gland tumors is of great value.

Biosafety evaluation of medical injectable carboxymethyl glycosaminoglycan gel / 国际生物医学工程杂志

Objective:To evaluate the biosafety of medical injectable carboxymethyl glycosaminoglycan gel.Methods:Ames test, chromosome aberration test in vitro and gene mutation test in vitro were used to detect the genotoxicity of the medical carboxymethyl glycosaminoglycan gel. The gel saline extract (50 ml/kg) was injected slowly through the marginal vein of the ear into Japanese big-eared rabbits. The body temperature was measured and the temperature rise was calculated. The gel saline extract (50 ml/kg) and normal saline (control) were injected intraperitoneally and intravenously into the Kunming mice, respectively. The toxicity response in mice was observed after injection, and bodyweight change was valued. The gel saline extract, normal saline and distilled water were added into the rabbit anti-clotting, to detect the rate of hemolysis.Results:Under active and inactive conditions, the number of spontaneous revertants of the 4 strains of gel saline extract group and gel DMSO extract group did not reach 2 times of that of the corresponding negative control group. The rate of chromosome aberration of the three dose groups were 0. There was no significant increase in the large colony mutation frequency, small colony mutation frequency and total mutation frequency in three dose groups (all P>0.05). After injection of gel saline extract for 24, 48 and 72 h, no toxic reaction was found in each group of mice. With the extension of time after injection, the body weight of mice in the sample group and the control group increased, but the difference was not statistically significant ( P>0.05). After injection of gel saline extract, the temperature rise of 3 Japanese big-eared rabbits were 0.0, 0.3 and 0.2 ℃ respectively. The results of hemolysis test showed that the hemolysis rate of the polycarboxymethyl glucosamine gel was 0.1%. Conclusions:No genetic toxicity changes were found in carboxymethyl glycosaminoglycan to induce gene mutation or chromosome damage in bacteria and cells, and no pyrogenicity, acute systemic toxicity and hemolysis were observed. These results indicate that thecarboxymethyl glycosaminoglycan gel has good biosafety.

Investigation on the prevalence of COPD in high-risk population in Suzhou and measures against cognitive misunderstanding / 公共卫生与预防医学

Objective To investigate the prevalence of COPD in high-risk population in Suzhou, and to explore the corresponding measures against cognitive misunderstanding. Methods From January 2017 to January 2020, a total of 4,800 residents from 4 COPD national monitoring points in Suzhou were selected using a multi-stage stratified cluster sampling method. Questionnaire surveys and lung function tests were conducted. The high-risk groups of COPD and their morbidity and COPD awareness were statistically analyzed. The influencing factors of COPD in Suzhou were analyzed by single factor analysis and multi-factor stepwise logistic regression analysis. Results A total of 4 747 residents were included in the analysis, including 4 249 people with high-risk COPD and 441 confirmed patients. Among them, 75.96% had basic knowledge, 52.15% understood the treatment knowledge, 49.89% understood the self-management, and 61.68% understood the lung rehabilitation training. Multivariate stepwise logistic regression analysis showed that age (OR=1.557, 95%CI=1.202~2.017), daily smoking (OR=2.062, 95%CI=1.673~2.541), cooking fuel being polluted (OR=1.526,95%CI=1.255~1.900), and occupational dust exposure>1 year (OR=1.474, 95%CI=1.196~1.816) were risk factors for COPD, while kitchen with smoke exhaust equipment (OR=0.601, 95%CI=0.465~0.777) and ethnic minorities (OR=0.642, 95%CI=0.508~0.812) were COPD protective factors (P<0.05). Conclusion The incidence of COPD in high-risk population aged ≥40 years in Suzhou area was higher, and the patients' cognitive level was lower. It is necessary to strengthen science popularization, improve health awareness, and reduce the related risk factors.

Effect of Monochromatic Energy Image Synthesized from Dual-layer Detector Spectral CT on Imaging of Inferior Vena Cava / 中国医学科学院学报

To evaluate the effect of monochromatic energy image on inferior vena cava imaging quality on dual-layer detector spectral CT. Totally 39 patients who were clinically suspected of abdominal disease and referred to perform contrast-enhanced computed tomography(CT)were prospectively enrolled and underwent abdominal examination using a single-source,dual-detector spectral CT.The delayed phase scan was performed 3 minutes after injection of 60 ml of iopamidol(320 mg/ml)at a rate of 3 ml/s.The raw images were reconstructed to obtain conventional mixed energy images and spectral based images(SBI).The 40,50,60,and 70 keV single energy images were obtained.The CT value,noise,and signal-to-noise(SNR)of inferior vena cava and the contrast-to-noise(CNR)of inferior vena cava relative to psoas major on conventional mixed energy images and the 40,50,60,70 keV single energy images were measured.The SNRs and CNRs on monoenergetic 40-70 keV images were compared with polychromatic 120 kVp images.ANOVA was used to compare the CT value,noise,SNR,and CNR among these five groups.The optimal monoenergetic image set was chosen. The differences in CT value,noise,SNR,CNR of inferior vena cava were statistically significant among five groups(all <0.05).The SNR and CNR in 40 keV group and 50 keV group were significantly higher than those in other groups(all <0.05).The SNR of 40 keV group was significantly higher than that of 50 keV group(=0.002).The CNR of 40 keV group was not statistical different compared with that of 50 keV group(=0.630). 40 keV is the optimal monoenergetic energy level for the inferior vena cava on dual-layer detector spectral CT and may be valuable for the diagnosis of inferior vena cava disease.

Application value of the two estimation methods in evaluating the radiation dose of adult chest CT / 中华放射医学与防护杂志

Objective@#To investigate the application value of CTDIvol and size-specific dose estimate(SSDE) in evaluating the radiation dose of adult chest CT.@*Methods@#A retrospective analysis was made on the CTDIvoland SSDE of 128 patients who underwent chest CT scanning in the First Affiliated Hospital of Zhejiang Chinese Medical University from March to April 2017 and all images are adequate for diagnosis. The subjects were divided into three groups according to body mass index (BMI): Group A, 38 cases with 16≤BMI<21.1 kg/m2; Group B, 53 cases with 21.1≤BMI<23.9 kg/m2; Group C, 37 cases with 23.9≤BMI<34.1 kg/m2. The diameters of anterior-posterior (AP) and left-right (LAT) of each patient were measured in the slice of nipple level, and CTDIvol, effective diameter (ED), conversion factor (fsize) and SSDE of each patient were recorded and calculated. Meanwhile, the differences between CTDIvol and SSDE in different BMI groups were compared.@*Results@#SSDE of each group was higher than CTDIvol, and increased by 50.13%, 42.83% and 33.68% in group A, B and C, respectively. There were significant differences in radiation dose between CTDIvol and SSDE in the three groups (t=-48.873, -57.001, -32.651, P<0.05). There were significant differences in ED, fsize, CTDIvol and SSDE among the three groups (F=51.456, 47.749, 113.916, 106.449, P<0.05).@*Conclusions@#SSDE can evaluate the radiation dose absorbed by patients with different body types in chest CT, while CTDIvol underestimated the radiation dose.The lower BMI, the greater the underestimated dose value, the more radiation dose absorbed.

Clinical value of 1. 5T dynamic enhanced MRI in the differential diagnosis of prostate cancer / 中国基层医药

Objective To analyze the clinical value of 1. 5T dynamic enhanced MRI in the differential diagnosis of prostate cancer. Methods A total of 298 patients with prostate disease admitted to Zhejiang Quhua Hospital from January 2017 to December 2017 were enrolled. All subjects underwent MRI(including T2WI,DWI, DCE),and the results of all subjects were observed. The pathological biopsy was used as the gold standard for diagnosis. The possibility of prostate cancer was evaluated. Results Among the 298 patients with prostate disease,there were 136 cases of prostate cancer,including 84 cases of peripheral prostate cancer,the detection rates of T2WI,DWI and DCE were all 100. 00％,52 cases of central gland prostate cancer,the detection rates of T2WI,DWI and DCE were 100. 00％,98. 08％,and 98. 08％,respectively. Among 298 patients with prostate disease,there were 162 cases of pre-existing adenitis,including 64 cases of peripheral prostatitis. The detection rates of T2WI,DWI and DCE were 98. 44％,100. 00％,96. 88％,respectively,98 cases of central glandular gland inflammation,the detection rates of T2WI,DWI,DCE were 97. 96％,100. 00％,98. 98％,respectively. Conclusion 1. 5T dynamic enhanced MRI can correctly detect prostate diseases,especially prostate cancer.

Application value of the two estimation methods in evaluating the radiation dose of adult chest CT / 中华放射医学与防护杂志

Objective To investigate the application value of CTDIvol and size-specific dose estimate( SSDE) in evaluating the radiation dose of adult chest CT. Methods A retrospective analysis was made on the CTDIvol and SSDE of 128 patients who underwent chest CT scanning in the First Affiliated Hospital of Zhejiang Chinese Medical University from March to April 2017 and all images are adequate for diagnosis. The subjects were divided into three groups according to body mass index ( BMI):Group A,38 cases with 16≤BMI<21. 1 kg/m2; Group B,53 cases with 21. 1≤BMI<23. 9 kg/m2; Group C,37 cases with 23. 9≤BMI<34. 1 kg/m2. The diameters of anterior-posterior (AP) and left-right (LAT) of each patient were measured in the slice of nipple level, and CTDIvol , effective diameter ( ED) , conversion factor ( fsize ) and SSDE of each patient were recorded and calculated. Meanwhile, the differences between CTDIvol and SSDE in different BMI groups were compared. Results SSDE of each group was higher than CTDIvol , and increased by 50. 13％, 42. 83％ and 33. 68％ in group A, B and C, respectively. There were significant differences in radiation dose between CTDIvol and SSDE in the three groups ( t=-48. 873,-57. 001, -32. 651, P<0. 05) . There were significant differences in ED, fsize , CTDIvol and SSDE among the three groups ( F=51. 456, 47. 749, 113. 916, 106. 449, P<0. 05) . Conclusions SSDE can evaluate the radiation dose absorbed by patients with different body types in chest CT, while CTDIvol underestimated the radiation dose. The lower BMI, the greater the underestimated dose value, the more radiation dose absorbed.

Study on DNA Barcode Identification Method of Saiga tatarica and Its Adulterants Based on CO Ⅰ Gene / 中国药房

OBJECTIVE:To investigate the feasibility of molecule identication of Saiga tatarica and its adulterants by using cytochrome C oxidase subunit Ⅰ (CO Ⅰ) gene.METHODS:A total of 7 horns and incomplete horns were collected from 4 areas.The extraction effect of DNA from bone plug and stratum corneum were investigated;PCR technology was used to amplify CO Ⅰ gene of samples using universal primer LCO Ⅰ 490,HCO2198;after gel electrophoresis,purification (750 bp strip) and sequencing,using CO Ⅰ gene as barcode alignment sequence,online comparison was conducted by using Blast software of NCBI database to determine specific species.RESULTS:The extraction of DNA from stratum corneum was better (DNA concentration was 15.7-22.6 ng/μL,the absorbance of 260 nm/280 nm was 1.73-4.72).Online comparison showed that the similarity of CO Ⅰ gene in all sampies reached 99％,mainly from the horns of saiga antelope,Tibetan antelope,gazelle,sheep and goats.CONCLUSIONS:DNA barcode technology based on CO Ⅰ gene can be used for the identification of S.tatarica and its adulterants.The technology can provide an accurate and objective method for the identification of horn medicinal materials.

Identification for the Characteristics of Common Decoction Pieces with Poor Quality and Analysis for the Lab-oratory Test Results / 中国药房

OBJECTIVE:To explore the relationship between several common traits-identify characteristics of decoction pieces and laboratory test results,and improve the efficiency and accuracy of line inspection work. METHODS:Combined with the Chi-nese Pharmacopoeia(2010 edition)standards and traditional inspection experience,and collected decoction pieces,the accuracy of traits-identification points were inferred and increased by the ways of TLC,contents,aggravated powder,sulfur dioxide residues , staining and extract. RESULTS:The majority of decoction pieces had the relationship between character identification points and laboratory test results and a small part didn’t. CONCLUSIONS:This study has cleared the identification accuracy of several com-mon decoction pieces,and other parts of the differential diagnosis needs further exploration.

Effect of A Chitosan Product on Scarring and Adhesion of Injured Nerve after Laminectomy / 中国康复理论与实践

@#Objective To investigate the effects of a chitosan product on scarring and adhesion after never injury in laminectomy in rats. Methods 48 male Sprague-Dawley rats were divided into group A and group B, and carried laminectomy of L4-5, and injured the right spinal nerve roots. The normal saline was smeared on the operation field in the group A, while the chitosan product was smeared in the group B. The adhesion was assessed with Rydell score 1 (groups A1/B1), 2 (groups A2/B2) and 4 (groups A3/B3) weeks after operation, while the spinal nerves were observed with HE staining and Masson staining, and the adhesion was assessed with Nussbaum score. The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were measured. Results The Rydell scores of adhesion was I grade in group A1, II grade in A2 and III grade in A3, while was 0 grade in B1, 0 grade in B2 and II grade in B3. The scar and adhesion contact more loosely in the group B than in the group A, and the Nussbaum score was less in the group B than in the group A at the same time (P<0.05). The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were in normal. Conclusion This chitosan product can prevent the formation of epidural scar and adhesion around the spinal and the nerve roots after laminectomy, with little toxicity and side effects.

Effect of A Chitosan Product on Scarring and Adhesion of Injured Nerve after Laminectomy / 中国康复理论与实践

Objective To investigate the effects of a chitosan product on scarring and adhesion after never injury in laminectomy in rats. Methods 48 male Sprague-Dawley rats were divided into group A and group B, and carried laminectomy of L4-5, and injured the right spinal nerve roots. The normal saline was smeared on the operation field in the group A, while the chitosan product was smeared in the group B. The adhesion was assessed with Rydell score 1 (groups A1/B1), 2 (groups A2/B2) and 4 (groups A3/B3) weeks after operation, while the spi-nal nerves were observed with HE staining and Masson staining, and the adhesion was assessed with Nussbaum score. The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were measured. Results The Rydell scores of adhe-sion was I grade in group A1, II grade in A2 and III grade in A3, while was 0 grade in B1, 0 grade in B2 and II grade in B3. The scar and ad-hesion contact more loosely in the group B than in the group A, and the Nussbaum score was less in the group B than in the group A at the same time (P<0.05). The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were in nor-mal. Conclusion This chitosan product can prevent the formation of epidural scar and adhesion around the spinal and the nerve roots after laminectomy, with little toxicity and side effects.

Epidemiological and etiological characteristics of hand-foot-mouth disease in Yongchuan District from 2009 to 2011 / 重庆医学

Objective To provide evidence for control and prevention of hand-foot-mouth disease(HFMD) ,we analyzed the epi-demiological and viral characteristics of HFMD in Yongchuan district from 2009 to 2012 .Methods We collected the clinical dates of HFMD cases from Diseases Infectious Department of the Yongchuan Affiliated Hospital of Chongqing Medical University during 2009 to 2012 ,and analyzed the epidemiological characteristics .Results There were 509 HFMD cases in recruitment ,including 2 se-vere cases(one was dead) .The peak incidence of HFMD occurred from May to July annually .Between 2011 and 2012 ,there was an-other peak incidence ,which occurred from November to December .Most of the patients were under 5 years-old .The number of male cases was larger than that of the female .The number of scattered children cases was larger than that of the nursery children .More cases were reported in rural area than in urban area .Coxsackie virus A16(Cox A16) and other enteroviruses were the predominant strains of HFMD ,however enterovirus 71(EV71) infected cases increased sharply between 2011and 2012 .Enterovirus 71(EV71) inflection is the main cause of severe and death of HFMD .Conclusion The prevalence of HFMD in Yongchuan district had signifi-cant seasonal ,sex and age-specific ,regional differences and etiological characteristics .It was very important to make practical man-agements to prevent occurrence of HFMD according to these epidemiological characteristics .

Spectral analysis of nearly 5 years of infectious diseases in a hospital of Chongqing city / 重庆医学

Objective To understand epidemic data and provide evidence for prevention and control of infectious diseases in Yongchuan area .Methods We collected the clinical materials of patients hospitalized during January 2008 to December 2012 ,and retrospectively analyzed the spectrum ,classification and epidemic tendency of infectious diseases in a hospital .Results A total of 4 632 patients were admitted to the department of infectious disease .The top two diseases were always hepatitis B virus infection related diseases and tuberculosis .Fatality mainly also appeared in end-stage liver diseases and tuberculosis .Morbidity of measles and mumps increased obviously in recent years .Hand-foot-mouth disease and influenza A(H1N1) were epidemic in this area .Conclusion The main infectious diseases in Yongchuan area are hepatitis B virus infection related diseases and tuberculosis ,which still are the important points for control and prevention .Also we should strengthen prevention of other infectious diseases such as hand-foot-mouth disease ,H1N1 and the mumps in order to decrease the occurrence of these infectious diseases .

The study on genotypes and drug resistance-mutations of HBV in chronic hepatitis B patients in Yongchuan area / 重庆医学

Objective To investigate the relationship among HBV genotypes ,nucleoside analogues drug resistance-mutations and the patients with chronic hepatitis B in Yongchuan area .Methods The gene chip was used to detect the nucleoside analogues drug resistance-mutations of 605 cases with chronic hepatitis B ,and the HBV-DNA level was analysised after the antiviral therapy .Re-sults Among 605 cases ,63 .1% genotype were genotype B ,116 cases(19 .17% ) were found to be resistance mutants .The major drug resistance-mutations was genotype B ,49 .14% drug resistance-mutations was Adefovir drug resistance-mutations ,and the re-sistance rate of genotype B with reverse transcriptase 236T mutation was 35 .09% .The resistance rate of genotype B Lamivudine drug resistance-mutations with reverse transcriptase 108M mutation was 34 .29% ,the virus replication between resistance and non-resistant virus were significant difference (P<0 .05) .Conclusion To monitor the hepatitis B patients with HBV resistance gene mutations is beneficial to detect the patients with drug resistance-mutations early ,which is important for selecting reasonable treat-ment methods in clinical practice .

Semi-quantitative dynamic contrast enhanced MRI in diagnosing of breast tumor / 中华放射学杂志

Objective To evaluate the semi-quantitative parameters of dynamic contrast enhanced MRI (DCE MRI) with double echo in the diagnosis of breast tumors.Methods Thirty eight patients suspected of breast tumour underwent DCE MRI with double echo examination by using 3.0 T whole-body MR scanner with a sixteen-channel phased-array breast coil.Semi-quantitation of both pharmacokinetic and perfusion parameters were performed including peak enhancement ratio (PER),time from contrast agent arrive to peak enhancement (Tmax),and maximum signal intensity loss (MSIL).The mean PER,Tmax and MSIL of the breast cancer,fibroma and other benign lesions were calculated.One-way ANOVA and receiver operating characteristic curve (ROC) analysis were used to compare the differences between malignant and benign lesions.Results The mean PER,Tmax and MSIL of the lesions were as follows:0.61 ± 0.09,(164.9 ± 20.5) s,and 0.31 ± 0.03 for breast cancers (n =20) ; 0.46 ± 0.07,(183.2 ± 13.7) s,and 0.17± 0.03 for fibromas (n =10) ; 0.23 ± 0.06,(139.4 ± 23.6) s,and 0.24 ± 0.07 other benign lesions (n =8),respectively.There were significant differences among 3 groups in all semi-quantitative parameters (F =4.319,4.154,4.752,respectively.P ＜ 0.05).The areas under the ROC curve of PER,Tmax and MSIL for the diagnosis of malignant lesions were 0.513,0.794 and 0.769,respectively.The sensitivity of PER,Tmax,and MSIL were 60.0％,80.0％ and 62.5％ and the specificity were,62.5％,75.0％ and 90.0％,respectively,with the maximum Youden'index as cut off value.When combining the 3 semi-quantitative parameters,the sensitivity,specificity and accuracy for differential diagnosis of breast tumors were 95.0％ (19/20),83.3％ (15/18),and 89.4％ (34/38),respectively.Conclusion The semi-quantitation of pharmacokinetic parameters (PER,Tmax) and perfusion data (MSIL) can be simultaneously estimated in a dynamic contrast enhanced MRI with double echo in breast lesions.The Accuracy for differential diagnosis of breast tumors can be improved when judge by combination of PER,Tmax and MSIL.

Surgical treatment of differentiated thyroid carcinoma / 中国基层医药

Objective To summary the experience in surgical treatment of differentiated thyroid carcinoma (DTC).Methods The clinical data and follow-up results of 110 cases of DTC were retrospectively analyzed.Results 110 patients received operation and TSH suppress therapy.Histologic examination after operation revealed that papillary thyroid carcinoma(PTC) 88 cases(80%) ,follicular thyroid carcinoma 22 cases(20%) ,cervical lymph node metastasis were found in 22 cases(20%).The operation procedure consists of excision of the suffered lobe,isthmus and greater partial of the opposite lobe 59 cases(along with functional cervical dissection 12 cases) ;excision cf the sufferedlobe,isthmus 29 cases(along with functional cervical dissection 7 cases) ;excision of the suffered lobe,isthmus greater partial of the opposite lobe 18 cases(along with functional cervical dissection 5 cases) ;total thyroidectomy and bilateral cervical dissection 2 cases;total thyroidectomy and bilateral cervical dissection with postoperative 131I therapy,1 cases with metastasis to lung.98 cases 10-year survival rate was 91.8%.Conclusion Differentiated thyroid carcinoma has a good prognosis,a proper surgical procedure is the key point to get a good outcome.

Operative treatment on 14 cases with tumors closed to hepatic hilar / 中国基层医药

Objective To sum up operative experience and prevention of complications while resecting the hepatic hilar tumor. Methods 14 cases with hepatic hilar tumor were analyzed in respect of operative method,complications, experience and prevention of complications. Results Some peri-operative complications happened. such as massive hemorrhage in 2 cases,billiary fistula in 1 case,hepatic failure in 1 case and tumor remained at resection edge in 1 case. No patients died during the operation. Conclusion The resection of hepatic hilar tumor is very difficult and risky,safety of surgery can be improved by paying attention to pre-operative evaluation and preparation,as well as carefulness during operation.