To improve class teaching quality,we must concentrate on the leading factor: teacher,the key factor: design,and the subjective factor: students.

Objective To evaluate the clinical features and efficiency of surgical treatment in elderly patients with parathyroid tumor.Methods Clinical data of 12 cases (aged 60-83 years) was retrospectively analyzed.Their main complaints varies individually,including bone and muscle trouble in 9 patients,abdominal problem in 7 ones,and kidney stone in 6 ones.PTH level ranged from 78 to 2850 μg/L,and calcium level 2.6-4.5 mmol/L.Parathyroidectomy was carried out in 8 patients,while extended excision of suspected tissues in 6 ones.Intraoperative PTH determination was routinely performed.Results A drop by at least 50％ in PTH level was achieved in all cases after 10 minutes of tumor-bearing tissues excision.A much improvement of main complaints was shown in all cases about 1 week postoperatively.During the follow-up period from 18 to 48 months,both PTH and calcium levels were still in normal range in 9 patients,relapse was noticed in two cases 1 or 2 years after operation respectively.One patient died even after successful excision of parathyroid tumor.Conclusions PTH and calcium level determination is advised in elderly patients with suspected parathyroid tumor,and surgical treatment is generally safe and effective.

OBJECTIVE To study and evaluate the surgical management of cervical anastomotic stricture of the esophagus and its efficiency. METHODS Cervical anastomotic stricture resulted from colon by-pass for patients with esophagus stricture due to corosive in 5 cases,and gastric pull-up in 3 with esophagus carcinoma,one patient suffered serious esophagus stricture at its upper end because of previous radiation,and failed to the anastomoticplasty RESULTS All of them failed to respond to prior dilation. Anastomoticplasty was used in 6 of them,local flap,colon by-pass and jejunal free flap interposition was chosen based on the patient's situation. The operation got succeeded at its first time in seven patients,and at its second time in two cases. Normal oral feeding was restored in seven of them,and semiliguid feeding in the other two. CONCLUSION Surgical treatment is reliable in dealing with patients with problem of anastomotic stricture of the cervical esophagus.

OBJECTIVE To evaluate the clinical features of tumors primarily in the pterygopalatine fossa, and the efficiency of surgical management for these lesions. METHODS The clinical data of 7 cases with tumors primarily in the pterygopalatine fossa were retrospectively studied. Three of them were primary diseases, i.e. fibrous histiocytoma, neurofibroma and cholesteatoma. The other 4 cases were secondary tumors mainly located in pterygopalatine fossa. There were 1 case with epithelial-myoepithelial carcinoma, 1 case with adenoid cystic carcinoma , 1 case with recurrent inverted nasal papilloma, 1 case with recurrent malignant fibrous histiocytoma. Approaches to tumors in pterygopalatine fossa lesions included lateral rhinotomy, and transnasal or transantrum approaches under the nasal endoscope. RESULTS The patient suffered from adenoid cystic carcinoma developed local recurrence 4 months after operation, and extended resection of the recurrent tumor with laser was performed again. No further recurrence was found after following-up for 3 years. Neither local recurrence nor regional metastasis was found in the remaining 6 cases with a follow-up period of 2 to 4 years. The main complication was oronasal fistula. CONCLUSION CT scan or MRI is the main method to the early diagnosis of pterygopalatine fossa tumors. Lateral rhinotomy, endoscopic trasnnasal or transantrum approaches are feasible procedures to resect the tumors.

ObjectiveTo investigate the clinical effects and side-effect of mesenchymal stem cell(MSCs) transplantation on spinal cord injury(SCI),traumatic brain injury(TBI),multiple sclerosis(MS) or Parkinson's disease(PD).MethodsThe bone marrow(222～350 ml) of 11 patients with SCI(n=6),TBI(n=3),MS(n=1) or PD(n=1) were harvested from the patients' ilia and then MNCs were isolated.The MNCs were injected intravenously or into subarachnoid space by lumbar puncture.The neural function and side-effect were observed before and after MSCs transplantation and the patients were followed up.ResultsThe data demonstrated the improvement of sense and motor function in 5 patients with SCI,one had no improvement by 2 months following-up.These patients' sense and motor levels improved obviously.Their muscle strength of lower extremity increased,the muscular tone decreased and urinary bladder function improved.Changes in neurological deficits and improvements in function may appear within 2 days after transplantation,most of them within 2 weeks.There were significantly amelioration in 3 patients with TBI treated with MSCs transplantation,one of them could walk with cane independently after 3 months.One's PVS score elevated from 5 to 8 scales after transplantation.The tremor was alleviated after 1 week,and the muscular tone decreased,which lead to reduce the dose of Madopar after 3 months,in patient with PD.The patient with MS showed no improvement in short time.The side-effect included fever(7/11),headache(2/11) and abdominal dissension(1/11).1 patient feel numb in his legs while injection into subarachnoid,and appeared meningeal stimulation after injection.ConclusionThere were significantly clinical effects in treatment of SCI,TBI,MS,and PD with MSCs transplantation in short time,and with few side-effect. The long-term clinical effects need more observation with larger samples.

Objective:To investigate the value and influence factors of preoperative and intraoperative localization of ectopic hyperparathyroidism (EHPT).Methods:Results of 99mTc-sestamibi ( 99mTc-MIBI), neck ultrasound, contrast CT and intraoperative local venous parathyroid hormone (IOLVPTH) were retrospectively analyzed in 205 patients with primary hyperparathyroidism (PHPT) suspected of EHPT. Results:Incidence of EHPT was 16.6% (34 cases), and 36 ectopic lesions were detected. The proportion of EHPT in antero-superior mediastinum, intrathyroidal, in the retropharyngeal region, in carotid sheath, in the prevertebral region and intrapericardial were 44.1% (15 cases), 29.4% (10 cases), 11.8% (4 cases), 5.9% (2 cases), 5.9% (2 cases) and 2.9% (1 cases), respectively. Contrast CT was the most sensitive (86.1%, 31 lesions/36 lesions) for EHPT, followed by 99mTc-MIBI (66.7%, 24 lesions/36 lesions), IOLVPTH monitoring (61.8%, 21 lesions/34 lesions) and neck ultrasound (55.6%, 20 lesions/36 lesions). Contrast CT was most sensitive,100% in detecting deep-located EHPT lesions, whereas IOLVPTH had advantages in detecting intrathyroidal EHPT lesions, with a sensitivity of 100.0%.The combined use of 99mTc-MIBI and neck ultrasound showed a sensitivity of 77.8% in the localization of EHPT. Conclusions:Contrast CT is highly sensitive in the localization of EHPT. The combined use of preoperative imaging and IOLVPTH monitoring helps to higher localization for EHPT.

OBJECTIVETo evaluate the efficiency of (99)Tc(m)-sestamibi (MIBI) in the diagnosis of parathyroid diseases with primary hyperparathyroidism.

METHODSOne hundred and four cases with primary hyperparathyroidism underwent MIBI and parathyroidectomy between May 2010 to November 2013 were reviewed. With MIBI, single adenoma was found in 91 cases, two adenomas in 5 cases, carcinoma and hyperplasia in 3 cases respectively. Primary hyperparathyroidism was diagnosed based on the associated symptoms and signs in 93 patients, while it was indicated in 11 asymptomatic patients due to the presence of hypercalcemia in health examination. Parathroid hormone levels ranged from 98 to 2 800 ng/L, and serum calcium levels were between 2.56-4.23 mmol/L.

RESULTSThe sensitivity of MIBI for total diseased parntyroids was 84.0% (100/119), and that for parathyroid adenoma, parnthyroid carcinoma, atypical adenoma and primary parathyroid hyperplasia was 87.1% (88/101), 3/3, 2/2 and 7/13, respectively.

CONCLUSIONSMIBI is efficient in the diagnosis of parathyroid diseases with primary hyperparathyroidism. The size and cystic degeneration of parathroid disease are two common factors decreasing MIBI reliability, and thyroid nodule is additional source leading to false-positive results.

Adenoma ; Carcinoma ; Humans ; Hyperparathyroidism, Primary ; diagnosis ; Hyperplasia ; Parathyroid Glands ; Parathyroid Neoplasms ; Parathyroidectomy ; Radiopharmaceuticals ; Reproducibility of Results ; Technetium Tc 99m Sestamibi ; Thyroid Nodule

GLKs (GOLDEN 2-LIKEs) are a group of plant-specific transcription factors regulating the chloroplast biogenesis, differentiation and function maintains by triggering the expression of the photosynthesis-associated nuclear genes (PhANGs). The GLKs also play important roles in nutrient's accumulation in fruits, leaf senescence, immunity and abiotic stress response. The expression of GLK genes were affected by multiple hormones or environmental factors. Therefore, GLKs were considered as the key nodes of regulatory network in plant cells, and potential candidates to improve the photosynthetic capacity of crops. Since numerous researches of GLKs have been reported in plants, the biological function, molecular mechanism of GLKs genes and its applications in breeding were summarized and a GLK-mediated signaling network model was developed. This review may facilitate future research and application of GLKs.
Chloroplasts/genetics* ; Gene Expression Regulation, Plant ; Photosynthesis/genetics* ; Plant Breeding ; Transcription Factors/metabolism*

YABBY proteins are important transcription factors that regulate morphogenesis and organ development in plants. In order to study the YABBY of strawberry, bioinformatic technique were used to identify the YABBY gene families in Fragaria vesca (diploid) and Fragaria×ananassa (octoploid), and then analyze the sequence characters, phylogeny and collinearity of the family members. The RNA-seq data and the quantitative reverse transcription-polymerase chain reaction (qRT-PCR) technique were used to assay the expression patterns of the family members. A green fluorescent protein (GFP) was fused with FvYABBYs and transiently expressed in tobacco leaf cells for the subcellular localization. As the results, six FvYABBY genes and 26 FxaYABBY genes were identified from F. vesca and F.×ananassa, respectively. The FvYABBY genes were grouped into five clades, and five family members were orthologous with AtYABBY genes of Arabidopsis. In F. vesca, all of the FvYABBYs were basically not expressed not expressed in root and receptacle, while FvYABBY1, FvYABBY2, FvYABBY5 and FvYABBY6 were highly expressed in leaf, shoot, flower and achene. In F.×ananassa, FxaYABBY1, FxaYABBY2, FxaYABBY5 and FxaYABBY6 were expressed in achene, and all FxaYABBY were poorly or not expressed in receptacle. Additionally, under the abiotic stresses of low temperature, high salt and drought, the expression of FvYABBY1, FvYABBY3, FvYABBY4 and FvYABBY6 were down-regulated, FvYABBY5 was up-regulated, and FvYABBY2 was up-regulated and then down-regulated. In tobacco leaf cells, the subcellular localization of FvYABBY proteins were in the nucleus. These results provides a foundation for the functional researches of YABBY gene in strawberry.
Fragaria/genetics* ; Arabidopsis ; Biological Assay ; Cold Temperature ; Computational Biology

OBJECTIVETo assess the efficiency of carbon nanoparticle in guiding level VI lymphadenectomy and parathyroid preservation in thyroidectomy for carcinoma.

METHODSOne hundred and nine patients with well differentiated thyroid carcinoma, in whom thyroidectomy and bilateral lymphadenectomy for level VI were carried out at the same time, were prospectively studied. Fourty-five cases received carbon nanoparticle injecion in thyroid consistitued trial group, while sixty-four underwent conventional surgery as control group. The numbers of total dissected lymph nodes, metastasis lymph nodes, black-stained lymph nodes, detected parathyroids and mistakenly removed parathyroids were counted respectively. The PTH levels were measured at 1 d, 5 d and 30 d after surgery, respectively. Student's t test and Chi-square analysis were used for analyzing data.

RESULTSThe number of lymph node found in the trial group in level VI was checked out as (9.7 ± 1.7) each side, whereas that of the control group was (6.7 ± 1.9) each side. The discrepancy of two groups was statistical meaningful (t = 23.14, P < 0.001). The discrepancy of the rate of lymph node black-stained 90.5% (738/815), incidence of metastasis of the black-stained lymph nodes 45.9% (339/738) and that without black-staining 13.0% (10/77), was statistical meaningful (χ(2) = 30.91, P < 0.001). On average, the trial group showed (1.8 ± 0.9) parathyroid each side, and had 5.9% (5/84) of mistakenly removed incidence , on contrary, the control group showed (1.8 ± 1.0) parathyroid each side, and had 8.2% (11/134) of mistakenly removed incidence averagely as well. The discrepancy of two groups was statistical meaningful. In the trial group, the amount of PTH 1 d, 5 d and 30 d postoperatively were 7.30, 11.19 and 30.50 ng/L respectively, while that of the control group were 7.51, 10.90 and 28.30 ng/L respectively. The amount discrepancy between the two groups was not differences. No permanent recurrent nerve paralysis was found in both groups.

CONCLUSIONCarbon nanoparticle may improve the detected rate of metastasis lymph nodes, but may not be helpful to the prevention of postoperative hypoparathyrosim.

Carbon ; Carcinoma ; Humans ; Hypoparathyroidism ; prevention & control ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Nanoparticles ; Nanotubes, Carbon ; Parathyroid Glands ; Postoperative Period ; Staining and Labeling ; Thyroid Neoplasms ; therapy ; Thyroidectomy ; methods