Effect of different thrombus risk assessment tools in obstetric inpatients / 中国实用护理杂志

Objective:To compare the application value of Caprini thrombosis risk assessment scale and Shanghai venous thrombosis risk factor scale in predicting venous thromboembolism in hospitalized maternal patients.Methods:This was a case-control study. A total of 67 pregnant women complicated with venous thromboembolism in the Obstetrics Department of Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2010 to September 2021 were retrospectively analyzed. And 144 pregnant women without venous thromboembolism in the same period were selected. Two venous thrombosis risk assessment tools were used to evaluate the pregnant women, and the predictive effectiveness and accuracy of the two assessment tools were compared.Results:The effects of the two risk assessment tools for venous thrombosis were different before and after delivery with statistical difference ( Z=8.15, 5.97, both P<0.01), but the Shanghai venous thrombosis risk factor scale (83.9%, 67.3%) was superior to Caprini thrombosis risk assessment scale (52.1%, 45.0%) in the accuracy of prenatal and postnatal prediction. The area under receiver operating characteristic curve showed that the Shanghai venous thrombosis risk factor rating scale (0.863) was significantly superior to the Caprini thrombosis risk assessment scale (0.748) after delivery. Conclusions:The Shanghai venous thrombosis risk factor scale is more valuable than the Caprini thrombosis risk assessment scale in the early risk identification of venous thromboembolism in pregnant women.

Neural Circuit Mechanisms Involved in Animals' Detection of and Response to Visual Threats / 神经科学通报·英文版

Evading or escaping from predators is one of the most crucial issues for survival across the animal kingdom. The timely detection of predators and the initiation of appropriate fight-or-flight responses are innate capabilities of the nervous system. Here we review recent progress in our understanding of innate visually-triggered defensive behaviors and the underlying neural circuit mechanisms, and a comparison among vinegar flies, zebrafish, and mice is included. This overview covers the anatomical and functional aspects of the neural circuits involved in this process, including visual threat processing and identification, the selection of appropriate behavioral responses, and the initiation of these innate defensive behaviors. The emphasis of this review is on the early stages of this pathway, namely, threat identification from complex visual inputs and how behavioral choices are influenced by differences in visual threats. We also briefly cover how the innate defensive response is processed centrally. Based on these summaries, we discuss coding strategies for visual threats and propose a common prototypical pathway for rapid innate defensive responses.

Mechanistic analysis for the origin of diverse diterpenes in Tripterygium wilfordii

Tripterygium wilfordii is a valuable medicinal plant rich in biologically active diterpenoids, but there are few studies on the origins of these diterpenoids in its secondary metabolism. Here, we identified three regions containing tandemly duplicated diterpene synthase genes on chromosomes (Chr) 17 and 21 of T. wilfordii and obtained 11 diterpene synthases with different functions. We further revealed that these diterpene synthases underwent duplication and rearrangement at approximately 2.3-23.7 million years ago (MYA) by whole-genome triplication (WGT), transposon mediation, and tandem duplication, followed by functional divergence. We first demonstrated that four key amino acids in the sequences of TwCPS3, TwCPS5, and TwCPS6 were altered during evolution, leading to their functional divergence and the formation of diterpene secondary metabolites. Then, we demonstrated that the functional divergence of three TwKSLs was driven by mutations in two key amino acids. Finally, we discovered the mechanisms of evolution and pseudogenization of miltiradiene synthases in T. wilfordii and elucidated that the new function in TwMS1/2 from the terpene synthase (TPS)-b subfamily was caused by progressive changes in multiple amino acids after the WGT event. Our results provide key evidence for the formation of diverse diterpenoids during the evolution of secondary metabolites in T. wilfordii.

Research progress of exercise rehabilitation in women with perimenopausal syndrom / 中国实用护理杂志

Perimenopausal syndrome is a common uncomfortable symptom in women during the perimenopausal period, with a high incidence, a long duration, and adverse effects on physical and psychological, patients bear a heavy burden of symptoms, and increase the risk of adverse events in the elderly stage, increase the social medical burden. With the development of sports rehabilitation research, more and more attention has been paid to the effect of exercise on human health. This paper reviews the studies on exercise rehabilitation in women with perimenopausal syndrome, including exercise forms, exercise intensity, exercise time and exercise effect, in order to provide basis for the relevant research and practice.

Effect of isopentenyl pyrophosphate translocation on the biosynthesis of triptolide / 生物工程学报

Triptolide has wide clinical applications due to its anti-inflammatory, anti-tumor and immunosuppressive activities. In this study, we investigated the effect of blocking isopentenyl pyrophosphate (IPP) translocation on the biosynthesis of triptolide by exogenously adding D,L-glyceraldehyde (DLG) to the suspension cells of Ttripterygium wilfordii at different stages (7 d, 14 d). Subsequently, the cell viability, biomass accumulation, triptolide contents, as well as the profiles of the key enzyme genes involved in the upstream pathway of triptolide biosynthesis, were analyzed. The results showed that IPP translocation is involved in the biosynthesis of triptolide. IPP is mainly translocated from the plastid (containing the MEP pathway) to the cytoplasm (containing the MVA pathway) in the early stage of the culture, but reversed in the late stage. Blocking the translocation of IPP affected the expression of key enzyme genes involved in the upstream pathway of triptolide, which in turn affected the accumulation of triptolide. Understanding the characteristics and mechanism of IPP translocation provides a theoretical basis for further promoting triptolide biosynthesis through synthetic biology.

The effects of using a walking support band on the gait of stroke survivors / 中华物理医学与康复杂志

Objective:To evaluate the effect of using a walking support band on the gait of stroke survivors.Methods:Sixty stroke survivors were randomly divided into a walking support band group ( n=20), an ankle foot orthosis (AFO) group ( n=20) and a conventional rehabilitation group ( n=20). All three groups received conventional rehabilitation therapy, while the AFO group members were additionally provided with an ankle-foot orthosis and the walking support band group members received training wearing a walking support band. Before and after 4 weeks of treatment, all three groups were evaluated using three-dimensional gait analysis. Results:A total of 57 patients finished the study. After the interventions, the average step speed, frequency and step length of the three groups had all increased significantly, while the average stride width, the percentage of double stance phase, unaffected and affected side stance phase, and the ratio between unaffected and affected side stance phase had all decreased significantly. After the intervention, the average step speed, frequency and length of the AFO and walking support band groups had increased significantly compared with the conventional rehabilitation group, while the average stride width of the AFO group, and the stride width, the percentage of double stance phase and unaffected side stance phase of the walking support band group had decreased significantly. After the treatment, the average percentages of double stance phase and unaffected side stance phase of the walking support band group had decreased significantly more than in the AFO group.Conclusions:A walking support band can significantly improve the abnormal gait of stroke survivors and is superior to an ankle-foot orthosis when combined with conventional rehabilitation therapy.

Analysis of risk factors of lymph node metastasis of superficial esophageal cancer and its clinical application / 中华消化杂志

Objective To investigate the risk factors of lymph node metastasis (LNM) in patients with superficial esophageal cancer (SEC) and to evaluate its clinical application.Methods From January 2010 to December 2016,769 SEC patients,who received surgery in the First Affiliated Hospital of Nanjing Medical University,were enrolled,and their clinical data were retrospectively analyzed.Chisquare test and logistic regression analysis were performed for statistical analysis.The sensitivity,specificity,and overall positive accuracy of pathological type and depth of invasion before operation were evaluated.Results The rate of LNM in patients with SEC was 15.34％ (118/769).There were significant differences in alcohol consumption,maximum tumor diameter,histological type,differentiation degree,depth of invasion and vascular invasion between patients with LNM (118 cases) and patients withoutLNM (651 cases) (x2=5.66,13.71,40.65,20.04,36.70 and 61.51;all P＜0.05).The results of multivariate analysis showed that maximum tumor diameter＞2 cm(odd ratio (OR) 1.76,95％ confidence interval (CI) 1.12 to 2.77),poor differentiation(OR 1.92,95％CI 1.23 to 3.01),submucosal invasion(OR 2.67,95％CI 1.28 to 5.56) and vascular invasion (OR 5.28,95％CI 2.75 to 10.13) were independent risk factors of LNM in patients with SEC.The tumor location was significantly correlated with the site of LNM (x2=107.05,P＜0.01).The sensitivity and specificity of preoperative assessment of LNM were 58 ％ (51/88) and 59 ％ (301/510),respectively.The overall positive accuracy of histological type before operation was 66.7％ (440/660).The overall positive accuracy of depth of invasion evaluated by endoscopic ultrasound before operation was 27.9％ (19/68).Conclusion Endoscopic treatment is recommended for SEC patients with maximum tumor diameter ≤ 2 cm,high ormoderate degree of differentiation,tumor confined to the mucosal layer and without vascular metastasis for the relatively low risk of LNM.

Molecular cloning and functional identification of sterol C24-methyltransferase gene from

Sterol C24-methyltransferase (SMT) plays multiple important roles in plant growth and development. SMT1, which belongs to the family of transferases and transforms cycloartenol into 24-methylene cycloartenol, is involved in the biosynthesis of 24-methyl sterols. Here, we report the cloning and characterization of a cDNA encoding a sterol C24-methyltransferase from().(GenBank access number KU885950) is a 1530 bp cDNA with a 1041 bp open reading frame predicted to encode a 346-amino acid, 38.62 kDa protein. The polypeptide encoded by thecDNA was expressed and purified as a recombinant protein from() and showed SMT activity. The expression ofwas highly up-regulated incell suspension cultures treated with methyl jasmonate (MeJA). Tissue expression pattern analysis showed higher expression in the phellem layer compared to the other four organs (leaf, stem, xylem and phloem), which is about ten times that of the lowest expression in leaf. The results are meaningful for the study of sterol biosynthesis ofand will further lay the foundations for the research in regulating both the content of other main compounds and growth and development of

Robot-assisted gait training improves the walking ability of hemiplegic patients / 中华物理医学与康复杂志

Objective To evaluate the effect of robot-assisted gait training on the walking ability of hemiplegic patients.Methods Sixty hemiplegic patients were randomly divided into a control group and a treatment group,each of 30.Both groups were given traditional rehabilitation and drug therapy.The control group was additionally provided with the traditional gait training,while the treatment group additionally received robot-assisted gait training.The gait training lasted 30 minutes a day,5 days per week.Before and after 8 weeks of training,the time parameters,phase parameters,the joint angles of the lower limbs,and the peak ground reaction forces of both groups were evaluated using a three-dimensional gait analysis system.Results After the intervention,the walking velocity,stride frequency and stride length had increased in the treatment group,while stride width had decreased.Significant improvement was observed in the treatment group in terms of the percentage of swing phase on the paretic side,the percentage of stance phase on the paretic side,the single support time ratio,the percentage of double support phase,the range of motion of the hip and knee joints,and the peak vertical and forward ground reaction force as a percentage of body weight.The improvements were significantly greater than those observed in the control group.Conclusions Compared with traditional walking training,robot-assisted gait training can be more effective in improving the walking ability of hemiplegic patients.

Prokaryotic expression of Staphylococcus aureus Clumping factor B and evaluation of the antiserum-mediated opsonic activity / 生物工程学报

Staphylococcus aureus is a major cause of hospital-acquired infection. Because the bacteria are very easy to become resistant to antibiotics, vaccination is a main method against S. aureus infection. Clumping factor B (ClfB) is an adhesion molecule essential for S. aureus to colonize in the host mucosa and is regarded as an important target antigen. In this study, we successfully used Escherichia coli to express a segment encoding the N1-N3 regions of ClfB protein (Truncated-ClfB) cloned from S. aureus. The protein was purified by affinity and ion exchange chromatographies and gel filtration. Rabbits were immunized three times with purified Truncated-ClfB. After that, blood was collected to prepare serum which were then used for measurement of antibody level. Phagocytosis of S. aureus opsonized by the serum was determined by a flow cytometry. Results show that the serum IgG titer reached 1:640 000. Phagocytosed S. aureus by polymorphonuclear leukocytes were significantly more when the bacteria were opsonized by the serum from Truncated-ClfB immunized rabbits than those from no immunized group (P < 0.01). Therefore, the results indicated that Truncated-ClfB could be a promising vaccine candidate against S. aureus infection.

Correlation between the expression level of coiled-coil domain-containing protein 80 and obesity / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the relationship between expression of coiled-coil domain-containing protein 80(CCDC80) and obesity in serum and adipose tissues.</p><p><b>METHODS</b>A cross-sectional survey was conducted in a hospital in Tangshan in September 2010. 100 people including 78 healthy people and 22 with type-2 diabetes were recruited. Another 36 female patients with benign tumor of Obstetrics and Gynecology were also recruited. Demographic characteristics and serum samples were collected from all subjects, basic biochemical indicators were tested. All subjects were divided into 'Normal Weight' and 'Overweight and Obese' according to their BMI (BMI <24.0 kg/m(2); BMI≥24 kg/m(2)). Serum CCDC80 of the 100 subjects was detected by ELISA. Visceral and subcutaneous fat were derived from the other 36 female subjects, and Real-time PCR was used to detect CCDC80 mRNA expression in adipose tissues. Pearson correlation and multiple linear regression were used to analyze the correlation between serum or adipose CCDC80 expression and waist, BMI, and other biochemical indicators.</p><p><b>RESULTS</b>The age of 100 subjects was (52.9±8.4) years old. 44% of them were women (44 cases) and 56% of them were men (56 cases). After dividing them into three groups according to their BMI, covariance analysis were conducted, and age and gender were adjusted. The HDL-C level was significantly different among three groups (F = 10.73, P < 0.001): 'Overweight and obese combined with diabetes' group ((0.90±0.06) mmol/L)< 'Overweight and obese' group ((1.14±0.04) mmol/L) < 'Normal weight' group ((1.28±0.05) mmol/L). The adjusted expression of serum CCDC80 of the 100 subjects was (5.84±0.16) pg/ml, (5.81±0.98) pg/ml among men and (5.97±0.89) pg/ml among women, and there was no significant difference (t = -0.812, P = 0.419) between genders. ANOVA revealed that there was no significant differences of the expression of serum CCDC80 among three groups (F = 1.06, P = 0.351), 'Normal weight' group was (5.84±0.16) pg/ml, 'overweight and obese' group was (6.11±0.14) pg/ml, and 'Overweight and obese combined with diabetes' group was (5.84±0.19) pg/ml. The analysis showed that FBG had a negative correlation with serum CCDC80 (R(b) = -0.223, P = 0.026). Multivariate linear regression had a similar result, with 1 mmol/L increase of serum FBG, serum CCDC80 decreases for 0.24 pg/ml (β = -0.24, 95% CI: -0.21--0.02). There was also a negative correlation between serum CCDC80 and FBG in overweight and obese people (R(a) = -0.368, P = 0.013). Besides, CCDC80 mRNA was detected in both subcutaneous and visceral adipose tissue of 36 cases, the expression level was 0.06±0.02 for subcutaneous fat, was 0.05±0.04 for visceral fat, and the expression in visceral fat was lower (0.05±0.03) than that in subcutaneous fat (0.06±0.03) (t = 2.50, P = 0.025) among overweight and obese group. There was a negative correlation between waist and visceral CCDC80 mRNA expression (r = -0.472, P = 0.035).</p><p><b>CONCLUSION</b>This study suggested that CCDC80 may be involved in energy and insulin metabolism, and plays a protective role in obesity and diabetes.</p>

Novel technique of virtual touch tissue imaging quantification shear wave elastography in differential diagnosis of thyroid nodules:initial experience / 中华医学超声杂志（电子版）

Objective To evaluate diagnostic value of the novel virtual touch tissue imaging quantification (VTIQ) technique of acoustic radiation force impulse (ARFI) shear wave elastography in the differential diagnosis between benign and malignant thyroid lesions. Methods From June to July 2014, the imaging data of 82 thyroid lesions in 75 patients proven by fine needle aspiration cytology (FNAC) biopsy on conventional ultrasound and VTIQ were retrospectively analyzed. The thyroid nodules were examined by conventional ultrasound firstly and then the lesions were classified by thyroid imaging report and data system (TI-RADS). The maximum, minimum, median and average of shear wave velocity (SWV) values were obtained from multiple SWV measurement under the VTIQ speed mode. The region of interest (ROI) was determined according to the VTIQ quality mode after the patients holding the breath. According to the FNAC cytology results, ROC curve were plotted to determine the most accurate SWV value and the cut-off value for differential diagnosis. Results According to the FNAC results, grading≥5 level was set as the positive results and FNAC<5 level as the negative results. There were 28 positive nodules and 54 negative nodules in 82 thyroid nodules. The positive rates of TI-RADS classification were consistent with the theoretical results. The SWVmax, SWVmin, SWVmedian, and SWVmean on VTIQ of negative and positive thyroid nodules were (3.2±0.6), (2.2±0.4), (2.7±0.4), (2.6±0.4) m/s, and (4.6±1.7), (3.1±0.8), (3.5±1.0), (3.6±1.1) m/s. There were significant differences between positive and negative thyroid nodules in SWVmax, SWVmin, SWVmedian, and SWVmean on VTIQ (t=3.53, 3.68, 3.32, 3.81, all P<0.01). Based on the area under curve of ROC, the SWVmean value in the nodule was the best value in comparison with other SWV values. The cut-off value of VTIQ mean was 2.9 m/s. According to ROC curve analysis, the sensitivity, specificity and Youden index for VTIQ were 70.6%, 88.5%, 0.59, respectively. Conclusion The study proved that VTIQ elastography technique plays an important role in differential diagnosis of thyroid nodules and the VTIQ SWVmean is the best parameter for differential diagnosis.

The analysis of current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou, Jiaxing and Shaoxing in Zhejiang province / 中华老年医学杂志

Objective From October 2010 to explore the current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou,Jiaxing and Shaoxing in Zhejiang province.Methods To April 2011,10 644 geriatric patients aged 60 years and over were included,and related questionnaire survey,physical examination and laboratory examination were carried out.The situation of hypertension control and influencing factors were analyzed.Results The control rate of hypertension was 38.6％,and its standardized rate was 27.6％.It showed that female,inhabited city,high level of education degree and regular exercise were positively correlated with hypertension control,while age,smoking,high salt diet and abdominal obesity were negatively correlated with hypertension control,and standardized treatment had a close relationship with hypertension control.Conclusions The situations of hypertensive control among geriatric patients in Hangzhou,Jiaxing,Shaoxing in Zhejiang province are still unsatisfactory.Strengthening standardization management measures for improving the control rate of hypertension is needed and has actual value.

Effect of shenqifuzheng injection on CX3CR1 in colonic mucosa of patients with ulcerative colitis / 重庆医学

Objective To observe the clinical efficacy of shenqifuzheng injection combined with sulfasalazine (SASP) in the treatment of ulcerative colitis (UC) ,and to evaluate the effect of CX3CR1 on colonic mucosa of UC in treatment with shenqifuzheng injection .Methods Fifty‐one patients with active mild to moderate UC were collected during the period from January 2012 to June 2014 in the second people′s hospital of Lianyungang ,which randomly divided into experimental group and control group ,and setting up health group of 15 cases .Experimental group were treated with shenqifuzheng injection combined with SASP ,control group were only with SASP ,health group were no‐treatment control .The modified Mayo scoring results and the expression of CX3CR1 on co‐lonic mucosa of the same lesion site were observed before and two weeks after treatment separately .Results The total positive rate of CX3CR1 on colonic mucosa in patients with ulcerative colitis was 88 .37% before treatment ,The total positive rate of CX3CR1 on colonic mucosa in health group was 20 .00% ,There was significant difference between two groups (Z= -2 .689 ,P<0 .01) .Two weeks after treatment ,the expression of CX3CR1 on colonic mucosa and the modified Mayo scoring results in the experimental group were significantly lower than those in the control group (P<0 .05) .The clinical comprehensive efficacy of the experimental group was significantly better than the control group (Z= -2 .085 ,P<0 .05) .Conclusion Combination of shenqifuzheng injection and SASP is more effective than using SASP alone in the treatment of UC .Shenqifuzheng injection may play important role in the treatment of UC by inhibiting the expression of CX3CR1 on colonic mucosa .

Prospective validation of the thyroid imaging reporting and data system on thyroid nodules / 中华医学超声杂志（电子版）

Objective To prospectively validate the feasibility and usefulness of the thyroid imaging reporting and data system (TI-RADS) suggested by Kwak. Methods According to the TI-RADS published in Radiology by Kwak et al in 2011, the TI-RADS score of 810 thyroid nodules in 415 patients whose pathologic diagnoses were available were categorized . According to TI-RADS and pathologic results, receiver operating characteristic (ROC) curve was plotted, and the probability of malignancy in each category was calculated. Results Eight hundred and ten pathologically proven thyroid nodules included 649 benign and 161 malignant lesions. Among them, 11 nodules were categorized as TI-RADS 2 (all benign nodules);370 nodules were categorized as TI-RADS 3 (368 benign nodules and 2 malignant nodules);150 nodules were categorized as TI-RADS 4a (143 benign nodules and 7 malignant nodules);116 nodules were categorized as TI-RADS 4b (87 benign nodules and 29 malignant nodules); 146 nodules were categorized as TI-RADS 4c (39 benign nodules and 107 malignant nodules);17 nodules were categorized as TI-RADS 5 (1 benign nodules and 16 malignant nodules). The area under the curve of TI-RADS was 0.89, and the probability of malignancy in nodules with a classiifcation of TI-RADS 2, 3, 4a, 4b, 4c and 5 was 0, 0.5%, 4.6%, 25.0%, 73.0%and 94.0%, respectively. Conclusions The TI-RADS suggested by Kwak has great diagnostic value in diagnosing thyroid nodules. The actual probability of malignancy conforms with the theoretical risk of malignancy.

Community-based hypertension management for elderly patients / 中华全科医师杂志

Using the method of stratified random cluster sampling,8 996 elderly hypertensive patients in community were selected in the study.Patients entered the community-based hypertension program receiving stratified management,individualized treatment and health education.After 3 years of intervention,the disease awareness rate,treatment compliance rate and hypertensive control rate were increased from 68.30％,55.40％ and 38.60％ to 98.90％,86.70％ and 77.80％,respectively (P ＜0.05).The systolic and diastolic pressure,body mass index,triglyceride levels and other hypertensionrelated indicators were improved significantly,the number of individuals with obesity/overweight,smoking and drinking were decreased and those with regular exercise increased (all P ＜ 0.05).The results indicate that community-based comprehensive hypertension management is effective for hypertension control for elderly patients in community.

Extreme lateral lumbar disc herniation after pedicle screw fixation and interbody fusion cage:lumbar stability at long-tem follow-up / 中国组织工程研究

BACKGROUND:Extreme lateral lumbar disc herniation is a rare type of lumbar disc herniation, there are a variety of treatment methods, but the therapeutic efficacy and recurrence rate are controversial. OBJECTIVE:To investigate the availability of lumbar pedicle screw fixation combined with interbody fusion cage for treating extreme lateral lumbar disc herniation. METHODWe retrospectively analyzed 19 patients with extreme lateral lumbar disc herniation after treatment with lumbar pedicle screw fixation combining with interbody fusion cage from March 2006 to January 2009. The outcomes were evaluated depending on VAS scoring standard and Macnab scoring standard, lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after lumbar pedicle screw fixation combined with interbody fusion cage depending on literature search. RESULTS AND CONCLUSION:Al the 19 patients were fol owed up for 13 months to 3 years, the leg and lumbar pain of al the patients were relieved to varying degrees. Preoperative VAS score was 7.3±1.28 points and postoperative VAS score was 2.1±0.8 points, showing significant difference between two groups (P<0.05). The excellent and good rate was up to 95%with 15 excellent results, 3 good results and 1 acceptable result depending on Macnab evaluation standard. There was no pedicle screw loosening, broken, non-fusion phenomenon. Al the lumbar interbody fusions were good. No one occurred secondary lumbar spinal stenosis. Experimental findings indicate that, lumbar pedicle screw fixation combined with interbody fusion cage for extremely lateral lumbar disc herniation, is characterized as fast symptom relief, strong fixation and good lumbar stability.

Training general practitioners in hypertension management with expert-guided network tracing system / 中华全科医师杂志

Objective To evaluate the application of “expert-guided network tracking system” in training community general practitioner for hypertension management.Methods Total 855 general practitioners (GPs) from 20 community health service centers in Hangzhou,Jiaxing and Shaoxing of Zhejiang province were divided into two groups: 430 GPs from 10 community health centers received training for hypertension management using “ expert-guided networking tracking system” (intervention group) in December 2008 and 425 GPs from another 10 health centers received conventional training (control group).Questionnaire surveys about the knowledge and skill of hypertension management were conducted before and 3 y after training.Results The awareness rates of knowledge about hypertension prevention and control,non-drug therapy and drug therapy increased from 37.0％ (159/430),45.6％ (196/430),42.8％ (184/430) to 66.8％ (284/425),81.4％ (346/425),77.6％ (330/425),respectively and the accuracy of case analysis increased from 38.4％ (490/1290) to 73.3％ (946/1290) (P ＜0.01) after training in intervention group.Meanwhile the knowledge and case management abilities in control group were also improved after conventional training,but the degree was significantly lower than that in the intervention group.Conclusions “Expert-guided networking tracking system” can significantly improve the knowledge and skills for hypertension management in community general practitioners.

Value of virtual touch tissue imaging in the differential diagnosis of benign and malignant thyroid nodules / 中华超声影像学杂志

Objective To explore the value of virtual touch tissue imaging (VTI) of acoustic radiation force impulse (ARFI) elastography in the differential diagnosis of benign and malignant thyroid nodules.Methods VTI features of 77 histologically proven thyroid nodules in 74 patients were analyzed and the VTI features were divided into 6 grades.The higher grade represented higher tissue stiffness.Differences in VTI grade between benign and malignant lesions were analyzed by receiver operator characteristic (ROC) curve,and the sensitivity,specificity and accuracy were calculated.Results 77 pathologically proven thyroid nodules included 61 benign and 16 malignant lesions.VTI images classification included 0 in grade Ⅰ,1 ingrade Ⅱ,1 in grade Ⅲ,9 in grade Ⅳ,3 in grade Ⅴ and 2 in grade Ⅵ for malignant diseases ; and included 18 in grade Ⅰ,28 in grade Ⅱ,10 in grade Ⅲ,1 in grade Ⅳ,2 in grade Ⅴ and 2 in grade Ⅵ for benign diseases.The best diagnostic point of VTI-grade was grade Ⅳ.When VTI-grade Ⅳ or greater was used as the diagnostic criterium for malignancy,the sensitivity,specificity and accuracy rate in differentiation between benign and malignant thyroid nodules were 87.50％,91.80％ and 90.9(％ respectively.Conclusions VTI is useful in the differential diagnosis between benign and malignant thyroid nodules.

Imaging features of intraductal papillary neoplasm of bile duct (IPN-B) on baseline ultrasound and contrast-enhanced ultrasound / 中华超声影像学杂志

Objective To investigate the features of intraductal papillary neoplasm of the bile duct (IPN-B) on baseline ultrasound and contrast-enhanced ultrasound (CEUS).Methods A retrospective analysis of the baseline ultrasound and CEUS in nine pathologically proven IPN-B lesions in eight patients.CEUS was performed with low mechanical index and continuous real-time imaging technique and the contrast agent of SonoVue.Results On conventional ultrasound,5 lesions were appeared as expansion of bile duct type,whose main features were cauliflower shape tumor (n =1) or papillary nodes (n =3) in expanded bile duct with rare blood supply;the other 3 lesions were appeared as complex cystic type,which contained cystic and solid components in the lesions.Many tiny anechoic areas were observed inside the solid lesions.Two lesions were rich in blood supply and another one was rare.All were communicated with adjacent slightly dilated bile duct.On CEUS,solid components of eight lesions appeared homogeneous (n =5) or heterogeneous (n =3) hyper-enhancement in the arterial phase and declined into hypo-enhancement in the portal and late phases.One lesion,on the contrary,was invisible on both conventional ultrasound and CEUS.Conclusions Understanding the ultrasound features of IPN-B is mandatory because of its low preoperative diagnosis rate on CEUS.IPN-B should be taken into consideration when cauliflower shape tumors or papillary nodules in expanded bile duct,as well as hyper-enhancement in the arterial phase and hypo-enhancement in the portal and late phases on CEUS,were demonstrated.