Objective To provide patients with clear understanding of their conditions and treatment plans,in order to solve the problems of asymmetric information and trust crisis between doctors and patients.Methods Three-dimension (3D)visualization doctor-patient communication platform for department of orthopedics was constructed.Dynamic display of anatomical structure of the joint,common diseases,treatment plans and surgical procedures was realized.Six functions were built into the platform including positioning,reset,paint brush,highlighting,screenshot and dual screen contrast,which were easy to be explained to the patients.Results The platform had the advantages of convenient operation,clear and visualized picture and lively animation effects of surgery simulation.Conclusions This platform enables the doctors and patients to communicate more conveniently,therefore significantly improve the doctor-patient relationship.

Objective To investigate the risk factors of central lymph node metastasis and significance of prophylactic central lymph node dissection for clinical N0 (cN0) patients with papillary thyroid carcinoma (PTC).Methods The clinical data of 315 patients with cN0 PTC in Department of General surgery,the Second Affiliated Hospital of Dalian Medical University from Jan.2012 to Jan.2014 were analyzed retrospectively.Results (Iumor size,infiltration of thyroid capsule,and tumor number were associated with central lymph node metastasis in patients with cN0 PTC(P＜0.05),and the high risk factors of central lymph node metastasis were infiltration of thyroid capsule and multiple lesions (P＜0.05);()The overall complication rate was 3.17％ (10/315),the rate of transient recurrent laryngeal nerve paralysis was 0.63％ (2/315),and the rate of transient hypoparathyroidism was 2.54％ (8/315).All patients with complications recovered after treatment.No patient developed permanent recurrent laryngeal nerve paralysis or hypoparathyroidism;()The follow-up time was 6 to 30 months,and 2 cases were lost.No patient developed local tumor recurrence,distant metastasis,or death.Conclusions The high risk factors of central lymph node metastasis in patients with cN0 PTC were infiltration of thyroid capsule and multiple lesions.No patient developed local tumor recurrence,distant metastasis,or death.It is preferable and necessary to perform prophylactic central lymph node dissection in patients with cN0 PTC.

Aim To investigate the modulation effects of NaHS on arterial vasodilatation functions of renal hy-pertensive rats .Methods Two-kidney , one-c lip ( 2K1C ) renovascular hypertension was induced .Rats were randomly divided into four group:sham group , two-kidney one-clip model ( 2K1C ) group, 2KIC +NaSH( H2 S donor ) group, PPG group.The systolic blood pressure ( SBP ) was measured before the opera-tion and each week after the operation .The carotid ar-tery was collected for morphometric parameters ( outer radius, wall thickness, the radio of wall thickness to outer radius) and the tension of the carotid artery was observed with the isolated artery ring technique .Immu-nohistochemistry was used to determine the protein ex-pression of eNOS , ET-1 protein in carotid artery .Re-sults The blood pressure of 2K1C group and PPG group was higher than that of sham group ( P<0.05) . Compared with 2K1C group,the blood pressure and the rat arteria carotis communis of the radio of wall thick-ness to outer radius of 2K1C+NaHS group decreased significantly , while the relaxation of carotid artery to ACh in NaHS group increased .According to the immu-nohistochemistry results , eNOS expression was upregu-lated while ET-1 was downregulated in 2K1C +NaHS group as compared with 2K1C group.Conclusions Chronical administration of NaHS can decrease blood pressure in renovasocular hypertensive rats .The anti-hypertensive effect of H 2 S maybe associated with im-provement of the arterial functions .

Objective To study the expression of Gli1 protein and vascular endothelial growth factor (VEGF)-C in papillary thyroid carcinoma and their relationship with cervical lymph node metastasis.Methods The expression of Gli1 protein and VEGF-C were investigated by immunohistochemical EnVision method in 67 cases of papillary thyroid carcinoma and 32 cases of nodular goiter pathological specimen tissues.Nascent microvascular and micro-lymphatic of all pathological speimen tissues were examined by immunohistochemical monoclonal antibody CD34 and D2-40 staining assay respectively,and the microvascular density (MVD) and micro-lymphatic vessel density (MLVD) were calculated.The relationship between the positive expression of Gli1 protein and MVD,between the positive expression of VEGF-C and MLVD,and their relationship with cervical lymph node metastasis were analyzed.Results The positive rates of Gli1 protein,VEGF-C and MVD,MLVD were significantly higher in papillary thyroid carcinoma than those in nodular goiter [67.16％(45/67) vs.43.75％(14/32),70.15％(47/67) vs.31.25％(10/32),23.14 ± 2.06 vs.2.14 ± 0.31,13.36 ± 1.32 vs.3.53 ± 0.65,P ＜ 0.05].The positive expression of Gli1 protein was related to the patient' s age and the tumor size (P ＜ 0.05),while the positive expression of VEGF-C was not related to the patient' s age and the tumor size (P ＞ 0.05).The positive expression of Gli1 protein and VEGFC were significantly higher in TNM stage Ⅲ-Ⅳ of papillary thyroid carcinoma than those in TNM stage Ⅰ-Ⅱ (P ＜ 0.01) and also was significantly higher with cervical lymph node metastasis than without cervical lymph node metastasis (P ＜ 0.01).MVD and MLVD were significantly higher with cervical lymph node metastasis than without cervical lymph node metastasis (P ＜ 0.05).The positive expression of Gli1 protein was positively correlated with MVD (r =0.784,P＜ 0.01),the positive expression of VEGF-C was positively correlated with MLVD (r =0.529,P ＜ 0.01),the positive expression of Gli 1 protein was positively correlated with the positive expression of VEGF-C (r =0.586,P ＜0.01).Conclusions Gli1 protein which may participate in the formation of nascent microvascular is abnormally activated by the Hedgehog signaling pathway to express,VEGF-C which may be participate in the formation of nascent micro-lymphatic is mediated and started by the MAPK signaling pathways to express.Expressions of Gli1 protein is positively correlated with expressions of VEGF-C,therefore the Hedgehog signaling pathway may be associated with the MAPK signal pathway.Suppressing nascent microvascular and micro-lymphatic may become new target to blockingup papillary thyroid carcinoma cervical lymph node metastasis.

Objective To investigate the expression of CD90,IGF1R in hepatocellular carcinoma.Methods CD90,IGF1R expression were detected by SP immunohistochemical staining in 36 cases of hepatocellular carcinoma,20 cases of normal liver tissue biopsied from patients of chronic cholecystitis undergoing cholecystectomy. Results The positive rate of CD90 (63.89％,23/36),IGF1R (52.78％,19/36) in hepatocellular carcinoma significantly increased (P ＜ 0.05 ); The positive rate of CD90 was higher in UICC Ⅲ - Ⅳ stage group (79.17％ ) than in UICC stage Ⅰ - Ⅱ group (33.33％,P ＜0.05) ;The positive rate of CD90 was higher in low differentiated group (76.92％ ) than in well-differentiated group (56.52％,P ＜0.05).The positive rate of IGF1R was higher in UICC Ⅲ - Ⅳ stage group (70.83％ ) than in UICC stage Ⅰ - Ⅱ group ( 16.67％,P ＜ 0.05 ). The positive rate of IGF1R was higher in low differentiated group (84.62％) than in well-differentiated group (37.38％,P ＜ 0.05 ).The expression of IGF1R was positively correlated with that of CD90 (P ＜ 0.05 ).The median survival of CD90+ patients (85 days) was shorter than CD90- patients ( 505 days ) ( P ＜ 0.05 ).The median survival of IGF1 R + patients (100 days) was shorter than IGF1 R- patients (408 days,P ＜ 0.05). Conclusions CD90 or IGF1R expression correlates positively with the progression of HCC.

The clinical significance of a myeloperoxidase (MPO) gene polymorphism and inducible nitric oxide synthase (iNOS) expression in cirrhotic patients with hepatopulmonary syndrome (HPS) was explored. Enrolled subjects were divided into three groups according to their disease/health conditions: the HPS group (cirrhotic patients with HPS; n=63), the non-HPS group (cirrhotic patients without HPS; n=182), and the control group (healthy subjects without liver disease; n=35). The distribution of the MPO -463 G/A genotype and its relationship with iNOS expression in a typical cell block from ascitic fluid were detected by immunohistochemistry and polymerase chain reaction-restricted fragment length polymorphism analysis (PCR-RFLP). In the HPS group, the partial pressure of oxygen in blood and ascitic fluid was significantly decreased (8.95+/-1.58 kPa and 6.81+/-0.95 kPa, respectively; both P<0.01), while the partial pressure of carbon dioxide significantly increased (4.62+/-0.20 kPa and 5.92+/-0.45 kPa, respectively; P<0.01). MPO and iNOS levels were significantly increased in the HPS group as compared with the non-HPS group. These increases were even more remarkable in ascitic fluid (41.36+/-11.62 and 13.23+/-4.81 mug/L; 10.27+/- 3.20 and 4.95+/-1.12 mug/L) than in blood (16.66+/-5.24 and 4.87+/-1.73 mug/L; 5.79+/-2.31 and 2.35+/-0.84 mug/L). The distribution of the MPO genotypes GG, GA, and AA were 76.2%, 22.2% and 1.6% in the HPS group, and 57.7%, 37.9% and 4.4% in the non-HPS group (P<0.05). The expression of iNOS was significantly higher in patients with the G alleles (G/G and G/A) (61.54%, 48/78) than in patients with A alleles (G/A and A/A) (38.46%, 30/78) (P<0.01). It was suggested that the expression levels of iNOS and MPO were correlated with HPS-induced hypoxemia. The MPO-463 G/A mutation might be a protective factor that prevents the development of HPS. The MPO might be involved in the regulation of iNOS expression. In humans, MPO pathways, the iNOS/NO system, and their interaction might have an impact on the occurrence and development of HPS.

Objective To evaluate the effects of mini-open anterior lumbar interbody fusion (ALIF) in the treatment of recurrent lumbar disc herniation (RLDH).Methods From February 2001 to February 2012,20 patients of RLDH who underwent mini-open ALIF were retrospectively analyzed.There were 8 male and 12 female with an average age of 53.1±5.9 years (range,44-68 years).The SynFrame retractor system and SynFix-LR interbody cage were used in operation.The operative time,intraoperative blood loss,blood drainage of 24 hours postoperatively and hospital stay were recorded.In addition,visual analogue scale (VAS)and Oswestry disability index (ODI) of pre-operation,2 days,3,6 and 12 months postoperatively were evaluated.Results All patients were followed up for 12-110 (average,45.6±29.6) months,postoperative VAS score and ODI percent decreased significantly comparing with that of pre-operation (P＜0.05).However,no remarkable difference (P＞0.05) was found among that of 2 days,3,6,12 months postoperatively.Average VAS score was 7.7±0.7 before operation and 1.7±0.9 at 12-month follow-up.Average ODI percent was 80.6％±3.9％ before operation and 6.6％± 1.3％ at 12-month follow-up.Intraoperative blood loss was 90-220 ml (average,126.0±40.3 ml) and postoperative blood drainage at 48 h was 35-63 ml (average,47.5±7.6 ml).Hospital stay was 4-11 days (average,6.7± 1.8 days).All patients had achieved solid fusion after 6 months' follow-up.All these implants were in good places without displacement or hardware failure.Conclusion Mini-open ALIF can result in fewer invasions,significantly relieve symptoms and improve patients' function in the treatment of RLDH.Moreover,it can increase fusion rate with fewer complications,which can obtain a satisfactory short-or mid-term effect.

Actins ; metabolism ; Aged ; Antigens, Neoplasm ; metabolism ; Carbonic Anhydrase IX ; Carbonic Anhydrases ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Keratin-7 ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Male ; Nephrectomy ; methods ; Vimentin ; metabolism

Objective To evaluate the efficacy of L?Arabinose for bowel preparation before colonos?copy. Methods A total of 170 patients who underwent colonoscopy were randomized into 2 groups. The ex?perimental group (n=85) used L?Arabinose for bowel preparation, while the control group (n=85) used polyethylene glycol electrolyte solution ( PEG?ELS ) . The degree of comfort, adverse effects, and the visibility during colonoscopy were observed. Results Premedication of L?Arabinose for bowel preparation yielded to more comfort ( U=-4?349,P=0?000) , less adverse effects (χ2=29?27,P=0?000) , and similar visibility during colonoscopy ( U=-0?875,P=0?381) compared with PEG?ELS. Conclusion L?Arabinose is safe, comfortable, and effective for bowel preparation before colonoscopy.