0.05),however there was marked difference in diameter( P

Objective To explore the value of biopsy of lymph nodes alongside of internal jugular vein in surgery for papillary thyroid carcinoma(PTC) patients at CN 0 stage.Methods Clinical data of 103 PTC patients with operation at CN 0 stage were retrospectively analyzed.The lymph node ratio alongside of internal jugular vein was counted,and factors,such as gender,age,tumor size,capsular foreign invasion were analyzed.Results Of all 103 cases of papillary thyroid carcinoma at CN 0 stage,32 cases had lymph node metastasis alongside of internal jugular vein(31.1％).Meanwhile 31 cases had the thyroid capsule invasion,and 21 cases had lymph node metastasis alongside of internal jugular vein(67.7％).The rest 72 cases had no the thyroid capsule invasion,and 11 cases had lymph node metastasis alongside of internal jugular vein(15.3％),the difference was statistically significance(x2 =27.85,P ＜ 0.05).Conclusion Routine biopsy of lymph nodes alongside of internal jugular vein is necessary of papillary thyroid carcinoma patients at CN 0 stage.Whether the thyroid capsule is invased which is important factors affecting lymph node metastasis alongside of internal jugular vein.

The occurrence of iliac vein compression syndrome(IVCS) has the anatomic factor.IVCS has no specific symptoms and signs.The diagnosis of IVCS is mainly made by venography, intravascular pressure measurement, intravascular ultrasound, Doppler ultrasound,magnetic resonance venography, and CT.Before the occurrence of acute iliofemoral thrombosis,the treatment of IVCS is conservative therapy.The purpose of surgical intervention is to resolve the obstruction and keep the blood flow. The surgery of occluded iliac veins secondary to IVCS is now to be replaced by endovascular reconstruction. IVCS can be treated correctly before the occurrence of iliofemoral thrombosis and its sequelae can be reduced greatly, if the diagnosis of IVCS can be made as early as possible,and the degree of the stenosis of the iliac vein,the characteristics of its hemorheology and hemodynamics can be understood in time.

Objective In the present study we examined the roles of three proinflammatory cytokines, i.e. tumor necrosis factor-?(TNF-?), interleukin 1?(IL-1?), and IL-8 in the early phase of APTE, and analyze the impact of these cytokines on the systemic circulation. Methods APTE was induced in 7 anesthetized dogs by injecting the thrombus of own blood into the right jugular vein. Seven animals receiving only warm sterile saline served as controls. Arterial serum samples were collected regularly (0h, 0.5h, 1h, 2h, 4h, 6h) and cytokine levels could be measured by radio-immunity assay. Results Introduction of clots into the pulmonary circulation caused significant increase in the mean pulmonary arterial pressure(from 99.1?5.7 to 66.8?15.3mmHg, P

10% was found in 5 patients (16%). Mesothelial hyperplasia was found to be significantly higher in patients with PTE than that in the control group (P

The intramedullary expand self-locking nail(IESN) is a new type of solid small diameter nail consisting of the dynamic and the static types, designed on the basis of the CAIN. The mechanical experiments showed that its stiffness to resist the bending and twisting momentum was simillar to the Russell -Taylor's nail. The static nail was stable enough to prevent axial displacements of the fractured segments. The main characteristics of the IESN are as follows: 1) It is being able to be inserted without reaming the medullary cavity and without X- ray guidance; 2) a higher limit value to resist fatique and 3) no stress concentration on IESN.

Objective To explore the significance of carbon nanoparticles in routine central lymph node dissection of papillary thyroid microcarcinoma (PTMC).Methods 272 cases of PTMC admitted from 2013 to 2015 were retrospectively analyzed and they were divided into two groups,the experimental group who were given carbon nanoparticles during surgery (136 cases) and the control group (136 cases) without carbon nanoparticles.The total number of central lymph nodes,number of transfer,and the black dye lymph node number and transfer number in the experimental group were recorded.The total number of lymph nodes,and number of transfer in the control group were recorded.The metastasis rate of the two groups were analyzed.The number of parathyroid mistakenly cut and hypocalcemia cases of the two groups were counted.Parathyroid function was observed by determination of Ca2+ and PTH in blood.The incidence of recurrent laryngeal nerve (RLN) injury of the two groups was compared.Results The total number of central lymph nodes was 1216 and the transfer number was 481 in the experimental group,higher than those of the control group.The positive lymph node rate of the two groups was 39.6％ and 25.9％ respectively,and the difference was statistically significant.The mumber of patients with central lymph node metastasis was 63 and 42 respectively for the experimental group and the control group,and the transfer rate was 46.3％ and 30.8％ respectively.The difference was statistically significant.The rate of parathyroid mistakenly cut was 2.6％(7/261) and 14.7％ (28/193) respectively for the experimental group and the control group,and the difference was statistically significant.The difference of Ca2+ and PTH value at 3h,6h,and 12h after surgery between the two group was statistically significant.No RLN injury occured.5 cases in the experimental and 8 cases in the control group had temporary RLN injury.The difference was not statistically significant.Conclusions The application of carbon nanoparticles in PTMC surgery can help to improve the thoroughness of central lymph node dissection and to protect parathyroid function.However,its benefits to protect the recurrent laryngeal is uncertain.

BACKGROUND: A discussion is ongoing whether the elderly patients with femoral neck fractures should be treated with a non-cemented or a cemented hemiarthroplasty.OBJECTIVE: To evaluated the results of cemented hemiarthroplasty for femoral neck fractures in the patients older than 85 years with high-risk clinical problems and functional outcomes.METHODS: Thirty-two patients with femoral neck fractures were treated with cemented bipolar hemiarthroplasty. X-ray examination after operation was done at 1, 3 and 6 months and annually in all patients. The mean follow-up period was 2 to 5 years.RESULTS AND CONCLUSION: Medical complications occurred in five patients (16%) and four patients (25%) died within the follow-up period. Dislocation occurred in one patient (3%). None of the patients had heterotopic ossification. The mean Harris-hip score was 84. Cemented hemiarthroplasty can provide stability, security and good outcomes for the treatment of femoral neck fractures in elderly patients.

Objective To compare open reduction and cannulated screws combined with ascending branch of lateral femoral circumflex artery iliac bone flap with closed reduction and cannulated screw fixation for the treatment of displaced femoral neck fracture in young adults.Methods From January 1992 to January 2007,totally 204 cases of displaced femoral neck fracture were treated.Group A:one hundred and three cases were treated with open reduction and 2 cannulated screw fixation,covered by the vascular pedicled iliac bone flap with ascending branch of lateral femoral circumflex artery.Garden classification:type Ⅲ.68 cases,type Ⅳ:35 cases.Group B:one hundred and one cases,treated with closed reduction and three cannulated screw fixation.Garden classification:type Ⅲ in 62 cases and type Ⅳ in 39 cases.Results Two groups were followed up for 5-15 years.The healing time of group A was (73 ±21.2) days,including 4 cases of nonunion fracture (3.9％) and 5 cases of femoral head avascular necrosis occurred (4.9％) ; The healing time of group B was (89 ± 12.5) days,including 12 cases of nonunion fracture (11.9％) and 18 cases of femoral head avascular necrosis occurred (17.8％).The healing time,the rate of nonunion of fracture and the rate of femoral head necrosis were significantly different of these 2 groups.Conclusion The treatment of open reduction and 2 cannulated screw fixation,covered by the vascular pedicled iliac bone flap with ascending branch in young adults can effectively prevent nonunion of fractures and osteonecrosis of the femoral head.

Objective To determine the clinical characteristics of hospitalized patients who died of pulmonary thromboembolism (PTE) confirmed by autopsy. Methods The medical and autopsy records of 36 cases of autopsy proven fatal PTE in General Hospital of PLA from 1982 to 2001were reviewed. Cases of tumor embolism, fat embolism, and amniotic fluid embolism were excluded from the study. Results Six patients [16 7% (95% confidence interval, 6 4% to 32 8%)] were diagnosed as PTE prior to death. The diagnosis of PTE was significantly lower in patients with COPD or coronary artery disease. No risk factors were noted in only 4 patients (13 9%). Only a minority of patients had pleuritic pain or hemoptysis(8 3% and 11 1% respectively), while a significantly larger proportion of patients (25%, P