Value Of Anteroposterior-To-Transverse Ratio in Ultrasonic Diagnosis of Thyroid Nodule in Different Locations.

PURPOSE: To investigate the value of anteroposterior-to-transverse ratio (ATR) and the effect on features of nodules in ultrasound (US) diagnosis of thyroid nodules in different locations.  Methods: The nodules were divided into three groups according to the different nodule location: isthmus group; upper and lower poles of bilobed thyroid group; and the middle of the bilobed thyroid group. The diameters of the nodules were recorded, and ATR of the nodule was calculated on the transverse and longitudinal sections. The transverse and the longitudinal sections of ATR of thyroid nodules in different groups were compared.  Result: The transverse section of ATR was significantly different among the three groups (p = 0.001). In addition, there are significant differences in many US features among three groups, including nodule composition, thyroid parenchyma, morphology, echogenicity, shape, calcifications, vascularity, nodule ACR TI-RADS and histopathologic (all p < 0.05). In the group of upper and lower poles of bilobed thyroid, significant difference was found between the transverse and the longitudinal section of ATR (p = 0.019). The cut-off values of transverse section and longitudinal section of ATR were 0.967 and 0.750, respectively.  Conclusion: The transverse section of ATR at different location of thyroid may be a predictor for malignancy with clinical diagnostic significance.

Automatic quantitative measurement of left atrial pressure using mitral regurgitation spectrum: clinical study on comparison with floating catheter.

INTRODUCTION: To explore how to measure LAPEq accurately and quantitatively, that is, the left atrial pressure (LAP) measured and calculated by equation method using mitral regurgitation spectrum. METHODS: The mitral regurgitation spectrum, pulmonary arteriolar wedge pressure (PAWP) and invasive arterial systolic pressure of radial artery of 28 patients were collected simultaneously, including 3 patients with rheumatic heart disease, 15 patients with mitral valve prolapse and 10 patients with coronary artery bypass grafting, patients with moderate or above aortic stenosis were excluded. LAPBp (Doppler sphygmomanometer method), LAPEq (Equation method) and LAPC (Catheter method) were measured synchronously, and the measurement results of the three methods were compared and analyzed. A special intelligent Doppler spectrum analysis software was self-designed to accurately measure LAPEq. This study had been approved by the ethics committee of the Northern Theater General Hospital (K-2019-17), and applied for clinical trial (No. Chictr 190023812). RESULTS: It was found that there was no significant statistical difference between the measurement results of LAPC and LAPEq (t = 0.954, P = 0.348), and significant correlation between the two methods [r = 0.908(0.844, 0.964), P < 0.001]. Although the measurement results of LAPC and LAPBP are consistent in the condition of non-severe eccentric mitral regurgitation, there are significant differences in the overall case and weak correlation between the two methods [r = 0.210, (-0.101, 0.510), P = 0.090]. In MVP patients with P1 or P3 prolapse, the peak pressure difference of MR was underestimated due to the serious eccentricity of MR, which affected the accuracy of LAPBP measurement. CONCLUSIONS: It was shown that there is a good correlation between LAPEq and LAPC, which verifies that the non-invasive and direct quantitative measurement of left atrial pressure based on mitral regurgitation spectrum is feasible and has a good application prospect.

Calculation of left ventricular diastolic time constant (Tau) in dogs with aortic regurgitation using continuous-wave Doppler spectra.

OBJECTIVE: To investigate a new noninvasive method for calculating left ventricular diastolic time constant (Tau) through a continuous-wave aortic regurgitation Doppler spectrum. METHODS: According to ultrasound guidance, twenty-four animal models (beagles) of aortic regurgitation and acute ischemic left ventricular diastolic dysfunction were created. The left ventricular diastolic function was manipulated with dobutamine or esmolol and fifty-nine hemodynamic stages were achieved. Raw audio signals of the continuous-wave Doppler spectra were collected, and new aortic regurgitation Doppler spectra were built after reprocessing by a personal computer. The updating time of the spectral line was 0.3 ms. The new Doppler spectra contour line was automated using MATLAB (MATrix LABoratory, MathWorks, Natick, MA, USA), and two time intervals, (t2-t1) and (t3-t1) were measured on the ascending branch of the aortic regurgitation Doppler spectrum. Then, the two time intervals were substituted into Bai's equations, and Doppler-derived Tau (Tau-D) was resolved and compared with catheter-derived Tau (Tau-c). RESULTS: There is no significant difference between Tau-D and Tau-c (45.95 ± 16.90 ms and 46.81 ± 17.31 ms, respectively; P > 0.05). Correlation analysis between Tau-c and Tau-D suggested a strong positive relationship ( r = 0.97, P = 0.000). A Bland-Altman plot of Tau-c and Tau-D revealed fair agreement. CONCLUSIONS: This new calculation method is simple, convenient, and shows a strong positive relationship and fair agreement with the catheter method.

Effect of moxibustion on clinical symptoms, peripheral inflammatory indexes and T lymphocyte subsets in COVID-19 patients / 中国针灸

OBJECTIVE@#To explore the therapeutic effect and the mechanism of the adjuvant treatment with moxibustion on coronavirus disease 2019 (COVID-19).@*METHODS@#A total of 95 patients with COVID-19 were randomly divided into a moxibustion group (45 cases) and a basic treatment group (50 cases). The routine treatment of western medicine was applied in the patients of both groups. In the moxibustion group, on the base of the treatment of western medicine, moxibustion was applied to Dazhui (GV 14), Feishu (BL 13), Qihai (CV 6) and Zusanli (ST 36), once daily and consecutively for 14 days. At the end of treatment courses, clinical symptom scores for cough, asthmatic breathing, chest oppression and short breath, as well as their remission rates were compared between the two groups before and after treatment. Before and after treatment, the white blood cell (WBC) count, the levels of c-reactive protein (CRP) and interleukin-6 (IL-6) and the absolute number of T lymphocyte subsets, i.e. , and of the peripheral blood were compared in the patients between the two groups. The principal component analysis was adopted to analyze the common data extracted from the above 10 clinical indexes variables and comprehensively evaluate the differences in the therapeutic effect of two regimens.@*RESULTS@#The clinical symptom scores were all decreased after treatment in both of the moxibustion group and the basic treatment group as compared with those before treatment (@*CONCLUSION@#On the base of the routine treatment with western medicine, moxibustion therapy supplemented relieves the clinical symptoms, reduces the levels of inflammatory indexes, i.e. IL-6 and CRP as well as improves the absolute number of peripheral T lymphocyte subsets. The clinical therapeutic effect of such regimen with moxibustion supplemented is significantly better than the simple routine treatment of western medicine.

[Value of ultrasound shear wave elasticity imaging in diagnosis of Hashimoto's thyroiditis].

OBJECTIVE: To investigate the correlation between Young's modulus of the thyroid tissue measured by in shear wave elastography (SWE) and the clinical manifestations of Hashimoto's thyroiditis in different stages. METHODS: A total of 104 patients with the clinical diagnosis of Hashimoto's thyroiditis were enrolled in this study, including 26 with hyperthyroidism, 29 with normal thyroid function, 27 with subclinical hypothyroidism, 22 with clinical hypothyroidism, with 50 healthy volunteers serving as the healthy control group. All the subjects underwent SWE to obtain the Young's modulus value of the thyroid tissue. Univariate analysis of variance was used to compare the Young's modulus among the groups, and Pearson correlation analysis was used to analyze the correlation between the Young's modulus of the thyroid tissue and serum levels of thyroid microsomal antibody (TMAb) and thyroid globulin antibody (TGAb). RESULTS: In the 4 groups of patients, the Young's modulus increased significantly in the order of hyperthyroidism group, normal thyroid function group, subclinical hypothyroidism group and clinical hypothyroidism group (F=60.983, P<0.01). The Young's modulus was significantly lower in hyperthyroidism group than in the other 3 groups (P<0.05), and was significantly lower in normal thyroid function group than in subclinical hypothyroidism group and clinical hypothyroidism group (P<0.05). CONCLUSION: The Young's modulus of the thyroid tissue measured by shear wave elastography is related with the clinical manifestations of Hashimoto's thyroiditis in different stages, but the relevance needs to be further confirmed by multi-center, randomized, controlled studies involving a larger sample size.

The evaluation of reasonable application of CRRT in ICU / 中国药学杂志

OBJECTIVE: To evaluate the status of application of continuous renal replacement therapy (CRRT) in patients in the intensive care unit (ICU). METHODS: The clinical data of 171 ICU patients who had indications for CRRT in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2014 were retrospective analyzed. The patients were divided into non-CRRT group (n=23) and CRRT group (n=148) which was composed of continuous veno-venous hemofiltration (CVVH) group (n=66) and non-CVVH group (n=82). Among the 148 CRRT patients, 83 had improvement, 46 had no improvement, and 19 died. Among the 66 CVVH patients, 39 had improvement, and 27 had no improvement. The indications of the 171 patients and several aspects of the CRRT group including anticoagulation regimen, catheterization program, replacement fluid, and CRRT pipe flushing were statistically analyzed. And the correlations between the clinical data, CRRT mode, and efficacy were evaluated. RESULTS: The rate of rational indications of 171 patients was 86.55%, meanwhile the rates of the reasonability of anticoagulation method, catheterization program, replacement fluid, and CRRT pipe flushing of the CRRT group were 84.76%, 66.89%, 100%, and 100%, respectively. Single factor analysis showed that the levels of BUN (P=0.035) and creatinine (P=0.007) at baseline and the urine output on the third day (P=0.034) had statistically significant difference among the CVVH group, non-CVVH group, and non-CRRT group. There were also significant differences in the survival rate (P=0.01) and prognosis of survivals (P=0.007) in CRRT group among different catheterization programs. Multivariate analysis indicated that there was significant correlation between the lengh of stay in ICU [P=0.005, OR: 0.734, 95% CI(0. 592, 0.910)], catheterization program [P=0.016, OR: 5.302, 95%CI(1.369, 20.527)] and prognosis. CONCLUSION: The indications, anticoagulation method, and catheterization program of the CRRT group were partially unreasonable in the 171 patients in our study, and the unreasonability rates were 13.45%, 15.24%, and 33.11%, respectively. Clinical pharmacists should focus on the drug regimens and individual monitoring of ICU patients in the process of CRRT, considering their pathophysiological characteristics and complexity of medical therapeutic schemes.

CorreIation of retinaI vein occIusion with bIood Iipids and carotid artery changes / 国际眼科杂志(Guoji Yanke Zazhi)

· AlM: To investigate the correlation of retinal vein occlusion ( RVO ) with blood lipids and carotid artery changes. · METHODS: Forty cases ( 40 eyes ) with RVO who presented to Eye Hospital of Xinxiang Medical University between May 2013 and April 2014 were selected as the research objects. Proceeded blood lipids and color doppler ultrasonography examination, including total cholesterol ( TC ) , triglycerides ( TG ) , high -density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol ( LDL-C ) , common carotid artery intima-media thickness, carotid plaques, internal carotid artery blood flow mechanics parameters were detected.Thirty eyes ( 30 cases ) were enrolled as control underwent above examinations. ·RESULTS:TC, TG, LDL-C of RVO group was obviously higher than those of the control group ( P0.05 ) . There were also no statistical difference between ipsilateral and contralateral carotid artery measured value of control group (P>0.05).There were no differences in age, sex between RVO group and control group (P>0.05). · CONCLUSlON: Lipid metabolism disorder, carotid artery changes is closely related to the pathogenesis of RVO.

Design of acetylcholinesterase inhibitor for Alzheimer's disease therapy: from multi-binding site inhibitors to multi-target directed ligands / 药学学报

Alzheimer's disease (AD) is a complex neurodegenerative disorder which seriously causes the dementia in elderly people and afflicts millions of people worldwide. Drug discovery for Alzheimer's disease therapy has been a hot research area and a big challenge, in which development of acetylcholinesterase (AChE) inhibitors design was the most active and some AChE inhibitors are commercially available for AD medication already. However, practical using of commercial AChE inhibitors showed their limited usefulness and related adverse effects. Thus, it is extremely urgent to find novel AChE inhibitors with higher potency and less adverse effects. Based on the accurate crystallographic studies about AChE, strategies for multi-binding site AChE inhibitors have been formed, followed by design of the multi-target directed ligands. In this review, the structures and binding modes of commercial AChE inhibitors were briefly discussed, together with the development of AChE inhibitor design for AD therapy: from multi-binding site inhibitors to multi-target directed ligands.

[Related factor analysis of brachial-ankle pulse wave velocity in patients with obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To explore the related factors for the measurement of arterial stiffness by brachial-ankle pulse wave velocity (baPWV) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: The blood pressure and baPWV in 76 patients with OSAHS confirmed by polysomnography (PSG) were measured. Clinical data were collected, and the carotid and extremity arteries were examined by ultrasound. Arterial intima thickening, atherosclerotic plaque formation and calcification, and the morphological changes of the arterial wall were evaluated. The related factors for baPWV in patients with OSAHS were analyzed. RESULTS: The baPWV was significantly higher in the severe OSAHS group as compared to the low-moderate group (P < 0.01), as classified according to the apnea hypopnea index and the lowest oxygen saturation. Multiple regression analysis showed that the baPWV of patients with OSAHS was related to age, oxygen desaturation index and systolic blood pressure (F = 1.726 - 5.574, P < 0.05). CONCLUSIONS: Our study showed that with OSAHS exacerbations, the baPWV value increased. The baPWV of patients with OSAHS was related to age, oxygen desaturation index and systolic blood pressure. The abnormal changes of baPWV were present earlier than the morphological changes of atherosclerosis for OSAHS patients.

[Effect of obstructive sleep apnea hypopnea syndrome on arterial stiffness].

OBJECTIVE: To assess the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on brachial-ankle pulse wave velocity (b-aPWV) in untreated diagnosed patients. METHODS: This study involved 24 consecutive male patients with newly diagnosed untreated OSAHS (aged 39.13±8.31 years) and 22 normal male individuals (aged 39.59±10.86 years) matched for age and body mass index. Carotid and extremities ultrasound were performed in all the subjects, and none of them had atherosclerosis, arterial calcification, or aneurysm. No subject had a history of hypertension, coronary heart disease or stroke. All the subjects underwent arterial stiffness evaluation by means of b-aPWV measurements. RESULTS: The b-aPWV in OSAHS patients was significantly higher than that in normal subjects (1346.86±123.48 vs 1237.91±84.46, P<0.01), and the rate of positive b-aPWV in OSAHS patients was significantly higher (13/24 vs 1/22, P<0.01). CONCLUSION: The value and positive rate of b-aPWV in OSAHS patients are higher than those in normal people, suggesting increased arterial stiffness in OSAHS patients.

[Influence of microwave ablation and surgical resection of small primary hepatocellular carcinoma on hematogenous dissemination of tumor cells].

OBJECTIVE: To study the influence of percutaneous microwave ablation (PMA) and surgical resection for patients with small primary hepatocellular carcinoma (PHC) on dissemination of tumor cells in peripheral blood determined by AFP mRNA. METHODS: Forty patients with small PHC (The maximal diameter < or = 5 cm) confirmed histologically were included in this study. All the patients had single tumor nodule only without metastasis. Of the 40 patients, 19 were treated by PMA and 21 by surgical resection. Blood samples were collected and tested immediately before treatment, 30 min after the mass ablated/resected, 1 d and 7 d later by RTD-Nested-RT-PCR for AFP mRNA. The CD3, CD4, CD8 and CD4/CD8 in blood, and hepatic function were tested at the same time points as well. RESULTS: After treatment, ALT and AST in peripheral blood increased in both groups, but more intensely in the surgical group. The CD3, CD4 and CD4/CD8 in peripheral blood decreased at 30 min, 1 day and 7 days after surgical resection, and the lowest value was at 30 min after surgery. The immune function was kept at the same level as pre-treatment in the PMA group. AFP mRNA copies in blood could be detected in 27 of 40 patients (67.5%) in two groups before treatment, and the copy number was increased after treatment. There was no significant difference between the two groups. The patients were followed up for 1 - 16 months. AFP mRNA copies in blood could be detected persistently in the 4 patients with extrahepatic metastasis or liver recurrence. CONCLUSION: Surgical resection and microwave ablation may cause PHC cells dissemination into the blood circulation in patients with small PHC, and there was no difference between the two treatment groups. The cellular immune function in peripheral blood is decreased after surgical resection, but is maintained at the same level as pre-treatment in the PMA group. The impairment of liver function is less severe after PMA treatment than surgical resection. PMA may provide certain value for clinical management of small hepatocellular carcinoma.

The Development of Rapid PCR / 中国生物工程杂志

Polymerase chain reaction (PCR) is one of the common techniques in molecular biology, which can amplify nucleic acids through the cycle of denaturation, annealing and extension. Based on the principle of common PCR, rapid PCR is to realize the amplification of nucleic acids in less time without affecting the specificity, sensitivity and fidelity of the reaction. A lot of research work in this field has been going on in recent years. This article will make a review of the development of rapid PCR with emphases on the improvement of DNA polymerase, the choice of additives and the improvement of thermocyclers.