Objective To investigate the expressions of RTN4 and TG2 in papillary thyroid cancer tissues and their clinical pathological significance.Methods A total of 40 samples of papillary thyroid cancer tissues and 20 samples of para‐carcinoma tissues were collected from the Department of Pathology ,Renmin Hospital of Wuhan University ,China.The expression levels of RTN4 and TG2 were detected by means of immunohistochemical staining and their relationship with clinicopathological charac‐teristics of papillary thyroid carcinoma was analyzed.SPSS 13.0 soft package was used for one‐way analysis of variance and SNK test of the average absorbance and the average positive area rate (α=0.05).Bivariate correlation analysis of the positive area rate of the expressions of RTN4 and TG2 was conducted (α=0.05).Results ①The expression levels of RTN4 and TG2 were much higher in the papillary thyroid carcinoma tissues than those in the para‐carcinoma tissues (P<0.05). ② The expres‐sion levels of RTN4 and TG2 were significantly higher in lymph node metastasis group than those in the group without lymph node metastasis (P<0.05).The positive expression rates of RTN4 and TG2 were much higher in clinical stage Ⅰand Ⅱ groups than those in clinical stage Ⅲ and Ⅳ groups (P<0.05).They were significantly increased in low differentiation group than in high or moderate differentiation group (P< 0.05).The expressions of RTN4 and TG2 were not statistically associated with tumor size ,age and sex (P>0.05). ③The positive correlation was found between the expressions of RTN4 and TG2 in papilla‐ry thyroid carcinoma tissues (r=0.587 ,P<0.05).Conclusion ① The expressions of RTN4 and TG2 were up‐regulated in pa‐pillary thyroid carcinoma tissues ,which is related with over‐proliferation and increase of apoptosis resistance of cancer cells. ②RTN4 and TG2 play an important role in the proliferation and metastasis of papillary thyroid carcinoma. ③ RTN4 and TG2 may play a synergistic role in the development of papillary thyroid carcinoma.

Objective To study the value of hysteroscopy and laparoscopy in the diagnosis and treatment of the complication of intrauterine device (IUD). Methods 55 patients with IUD complications who had previous (1～12) times of unsuccessful operations were performed by hysteroscopy and laparoscopy. The results were retrospectively analyzed. Results 45 abnormal IUD of deformed or broken or remained in uterus were successfully taken out under hysteroscope, and 1 case converted into open operation. 9 ectopic IUD in abdominal and pelvic cavity were successfully taken out under laparoscope. No operative complication occurred. Conclusions Hysteroscopic and laparoscopic operations have the advantages of clear diagnosis, higher successful rate and minimal invasion for the diagnosis and treatment of IUD complications. Abnormal IUD and ectopic IUD out of uterine cavity had better choose hysteroscopic and laparoscopic operations.

Objective To evaluate the short-term and long-term efficacy of conservative laparoscopic surgery combine with goserelin in treatment of severe ovarian endometriosis.Methods From January 2004 to December 2008,206 patients with severe ovarian endometriosis underwent laparoscopy surgery in Nanjing Drum Tower Hospital,Affiliated Nanjing University Medical School were enrolled in this retrospective study.According to the revised classification American Fertility Society (r-AFS), 123( 123/206,59.7％ ) cases were at stage Ⅲ and 83 ( 83/206,40.3％ ) patients were at stage Ⅳ.Among 138 cases presented pelvic pain.All the patients underwent laparoscopic cystectomy,of which 117 patients with childbearing preserving underwent hysteroscopy and hydrotubation examination,including 7 cases with bilateral salpingectomy,2 cases with bilateral tubal obstruction and 108 cases with normal reproduction.After surgery,all cases were administered by goserelin treatment at dose of 3.6 mg per 28 days for 3 to 6 months.At 1 to 5 years following up,pelvic pain,pregnancy and recurrence were observed,those factors associated with pregnancy rate and endometriosis recurrence were analyzed.Results (1)Pelvic pain:complete remission rate of pelvic pain was 76.1％ ( 105/138 ) at 1 to 5 years after surgery.(2) Pregnancy:total pregnancy rate was 70.4％ (76/108),spontaneous pregnancy rate was 68.8％ (66/96) and pregnant rate of in vitro fertilization and embryo transfer (IVF-ET) was 10/12.Pregnancy rate at 1 year was 57.3％( 55/96 ) and accounting for 83.3％ ( 55/66 ) in all pregnant womon.Live birth rates of spontaneous pregnant and IVF-ET were 86.4％ ( 57/66 ) and 9/10,respectively.( 3 ) Recurrence:the total recurrence rate was 8.3％ ( 17/206 ) at 1 to 5 years.The recurrence rates and the cumulative recurrence rates were 3.9％(8/206) and 3.9％ (8/206) at the first year after operation,2.0％ (3/149)and 6.7％ ( 10/149 )at the second year,1.0％ (1/99) and 8.0％ (8/99) at the third year,10.9％ (5/46)and 17.4％ (8/46) at the fourth year,0 and 2/18 at the fifth year,respectively.Conclusion It was suggested that conservative laparoscopic surgery combined with goserelin in treatment of stage Ⅲ or Ⅳ ovarian endometriosis could reduce the recurrence risk of severe ovarian endometriosis and improve the pregnant rate of endometriosisassociated infertility.

Objective To analyze the content of polycyclic aromatic hydrocarbons (PAHs) in mainstream smoke of 20 brands of Chinese cigarette. Methods Mainstream smoke of 20 brands of Chinese cigarettes were collected by ASM51 smoking machine. Both tar and nicotine were analysed in the same time. Nine kinds of PAHs, fluoranthene, pyrene, benzo(a)anthracene, chrysene, benzo(a)pyrene, benzo(b)fluoranthene, benzo(k)fluoranthene, benzo(g, h, j)perylene and dibenzo(a, h)anthracene, in mainstream smoke from each brand were determined with HPLC. Results Total PAHs ranged from 404.1 to 1 085 ng per cigarette with an average of 714.8 ng per cigarette. Non-carcinogenic PAHs accounted for 93% of total PAHs. Carcinogenic PAHs ranged from 49.4 to 117.7 ng per cigarette, averaging 89.4 ng per cigarette. Content of tar, not nicotine, was significantly related to either total PAHs or carcinogenic PAHs. Conclusion Significant correlation between tar and PAHs suggests that tar may be a predictor of carcinogenic PAHs in mainstream smoke of Chinese cigarettes and a parameter to assess the impact of Chinese cigarettes on health.

Ojective To evalute the efficacy of the procedure for prolapse and hemorrhoids (PPH) in the treatment of patients with severe hemorrhoids (grade Ⅲ～Ⅳ?) Methods 60 cases of hemorrhoids at the third or fourth degree were operated on by PPH. Results The mean operation time was 9 minutes and mean hospitalization time was 2.5 days. Postoperative bleeding was noted in 8 cases (13.3%) at the 1 st and 7 th day after operation, which was cured by conservative methods. 24 patients had no annal spasm following the procedure. Follow-up period lasting for 1-7 months showed no complications Conclusions PPH is a safe and effective treatment for hemorrhoids at the third or fourth degree with the advantages of shorter hsopitaliztion time and quicker recovery.

Objective:To investigate the infusion methods of postoperative enteral nutrition in patients with gastric cancer.Methods:86 patients with gastric cancer received radical operationin our hospital from January 2014 and December 2015 were enrolled for the study and randomly divided into continuous infusion group and periodic infusion group,each group with 43 cases.Patients in continuous infusion group were given postoperative continuous enteral nutrition for 24 h in one day,while cases in periodic infusion group were given postoperative continuous enteral nutrition for 15-17 h in one day.Results of enteral nutrition,physical indicators including upper arm skinfold,diameter of midpoint of upper arm and grip strength,nutritional indexes including total protein (TP),hemoglobin (Hb),albumin (AIb),prealbumin (PA) and transferrin(TF),immune indicators including immunoglobulin G(IgG),immunoglobulin M (IgM),immunoglobulin A (IgA),CD4+,CD8+ and CD4+/CD8+were compared between two groups before and after operation.Results:Intolerance of enteral nutrition occurred in 1 case(2.3％) of continuous infusion group and 3 cases(7.0％) of periodic infusiongroup,and there was no significant difference between them (P＞0.05).Time of transition to full enteral nutrition and taking off the tube to self-feeding incontinuous infusion group were significantly smaller than that in periodic infusion group (P＜0.05).There were no significant difference in baseline data,physical indicators,nutritional indexes and immune indicators between them before operation (P＞0.05).PA level at 5 d,10 d after operation in continuous infusion group were significantly higher than that in periodic infusion group (P＜0.05),and there were no significant difference in physical indicators,other nutritional indexes and immune indicators between them after operation(P＞0.05).Conclusion:Compared with periodic infusion,continuous infusion method could shorten the time of transition to full enteral nutrition and taking off the tube to self-feeding in patients after radical operation of gastric cancer,and had more significant effect of improvement of nutritional status,worthy of clinical popularization and application.

Objective To evaluate the possible correlation between anxiety state and serum angiontensin Ⅱ levels in patients with vitiligo.Methods Sixty patients with progressive vitiligo and 30 normal human controls were included in this study.Self-rating anxiety scale (SAS) was used to evaluate the anxiety state,and enzyme linked immunosorbent assay was performed to determine the serum level of angiontensin Ⅱ,in these subjects.Results SAS score was significantly increased in patients compared with the controls (46.13 ±11.72 vs.36.73 ± 12.59,t =3.50,P ＜ 0.01),and 48.3％ of the patients were affected by anxiety.The SAS score and prevalence of anxiety were statistically higher in female than in male patients (t =2.47,x2 =4.58,both P ＜ 0.05),in unmarried than in married patients (t =2.59,P ＜ 0.01; x2 =6.17,P ＜ 0.05),in patients with lesions on exposed areas than in those with lesions on unexposed areas (t =3.60,P ＜ 0.01; x2 =5.84,P ＜0.05).In patients affected by anxiety,the level of serum angiontensin Ⅱ was significantly elevated compared with patients without anxiety (63.83 ± 10.92 vs.40.74 ± 8.70 ng/L,t =9.09,P ＜ 0.01 ).Conclusions Patients with vitiligo are usually affected by anxiety.The serum level of angiontensin Ⅱ is closely correlated with anxiety state in patients with vitiligo as well as with the development of vitiligo,and may have an impact on the initiation and progression of vitiligo.

Objective To quantify the temporal changes in the volume of blood flow to the skin of the forearm and lower leg during static maximum inspiratory breath-holding of different durations.Methods Blood flow to the skin of the forearm and lower leg were continuously measured with laser Doppler flowmetry in 12 healthy subjects.They were randomly selected to hold their breath for 10,20 or 40 seconds,or as long as possible.The volume of skin blood flow,the onset latency and the recovery latency were measured before,during and after the breath holding.Results Blood flow decreased significantly during each breath-hold with any durations.The magnitude of the decrease and its latencies were similar with all the durations.The average volume of skin blood flow and it's minimum value during each breath-hold were significantly lower in the forearms than in the lower legs.However,the average onset latency (4.41 ±0.44 s) and the average recovery latency (5.95 ±0.59 s) in the forearms were significantly shorter than in the lower legs (4.83 ± 0.70 s for onset and 7.33 ± 0.91 s for recovery).Conclusion The volume of skin blood flow decreases during a static maximum inspiratory breath-hold,and the magnitude of the increase is not related to the duration of the breath-hold.The generalized increase in skin sympathetic vasoconstrictor activity during a static breath-hold is greater in the forearm than in the lower leg.

Objective To evaluate the efficacy of different doses of dexmedetomidine mixed with ropivacaine for brachial plexus block.Methods One hundred and twenty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 20-60 yr,weighing 40-70 kg,scheduled for upper extremity surgery under brachial plexus block,were randomly divided into 6 groups (n =20 each):ropivacaine group (group R) and different doses of dexmedetomidine groups (groups RD1-5).Brachial plexus block was performed using the interscalene approach.In group R,interscalene brachial plexus block was performed using 0.5 ％ ropivacaine 25 ml (single injection).In groups RD1.5,interscalene brachial plexus block was induced with a mixture (25 ml) of dexmedetomidine 0.25,0.50,0.75,1.00,1.25μg/kg and 0.5 ％ ropivacaine,respectively.The onset time and duration of sensory and motor block were recorded.The adverse effects such as adverse cardiovascular events,excessive sedation,and pneumothorax were also recorded.Results Compared with group R,the onset time was significantly shortened,and the duration of block was prolonged (P ＜ 0.05).Compared with groups RD1 and RD2,the onset time was significantly shortened,and the duration of block was prolonged in groups RD3 5 (P ＜ 0.05).There was no significant difference in the parameters mentioned above between groups RD1 and RD2 or among groups RD3,RD4 and RD5 (P ＞ 0.05).Some patients developed bradycardia,hypotension or excessive sedation in groups RD4 and RD5,while no adverse effects were observed in the other groups.Conclusion Dexmedetomidine 0.75 μg/kg mixed with 0.5 ％ ropivacaine 25 ml can be safely and effectively used for brachial plexus block in patients.

Objective To investigate the preventive effect of low molecular weight heparin or tranexamic acid in the rabbits with hypercoagulation induced by impact injury and intravenous infusion of the endotoxin. Methods Combination of impact injury and endotoxin was created by strike on rabbit chest with type BIM-Ⅱ biological impact machine and injection of endotoxin via vein.Thirty-two male New Zealand rabbits were divided into four groups in a completely random design as follows:impact injury combined with endotoxin without treatment group(control group),treatment with low molecular weight heparin(L group),treatment with tranexamic acid(TA group),and treatment with low molecular weight heparin and tranexamie acid(L+TA group).The changes of interleukin-1β(IL-1β)and interleukin-6(IL-6)were observed by using the enzyme-linked immunosorbent assay;changes of antithrombin-Ⅲ(AT-Ⅲ)activity,tissue factor(TF)and tissue factor pathway inhibitors(TFPI)were detected by the chromogenic substrate method chromozym P:the content of fibrinogen was observed by coagulation analyzer.The lung and kidney were removed from the experimental animals at 24 hours post impact injury forhistopathologic observation. Results In the control group,the activity of AT-Ⅲ was decreased obviously.while the content of fibrinogen and the activity of TF and TFPl were increased,with formation of the thrombosis in the kidney after injection of PLS.Compared with control group,the activity of TF and the content of IL-1β and IL-6 were reduced but the TFPI was increased in the L group,which resulted in a decrease of TF/TFPI ratio.with decrease of formation of the micro-thrombosis in the organs.The content of IL-1β and IL-6 in the TA group were reduced,which was still higher than that in tIle L group.In the TA group.the activity of IF and TFPI Was lower than that in the L group and control group,with higher TF/TFPI ratio than the L group.The frequency of thrombosis increased in pulmonary artery and other important organs.The content of IL-1β and IL-6 in the L+TA group wag lower than that in the L group.In the L+TA group.the activity ofTF was lower than that inthe L group and control group,but the activity of TFPI was higher than that in the L group and control group.with lower TF/TFPI ratio than the L group.There found no increase of thrombus in the pulmonary arterial and other important organs. Conclusions Besides anticoagulation function,the low molecular weight heparin can inhibit the inflanunation reaction,reduce the release of TF and attenuate the coagulation reaction.On the basis of treatment with low molecular weight heparin,application of the tranexamic acid will not lead to the formation of thrombus,but the only use of the tranexamic acid would have the contrary results.The rtsults of the study provide a theoretical and experimental basis for clinical diagnosis and prevention of hypercoagulation induced by injury and infection.