Uremia caused secondary hyperparathyroidism is one of the common and serious complications caused by uremia. Surgery treatment is effective. Total parathyroidectomy plus forearm transplantation is more commonly used because of exact outcomes and easy monitoring. It is necessary to be fully prepared be-fore operation,particularly to clarify the location of parathyroid gland. Yet each surgical method has its re-lapse rate.

ObjectiveTo understand the detections of influenza A (H1N1) in 2009,and haemagglutinin (HA) gene mutations and the comparisons with standard strains.MethodsThe nasopharyngeal swabs from patients with influenza-like illness (ILI) in National Influenza Sentinel Surveillance Hospital and the outbreak epidemic area were collected.The virus typing and A (H1N1) viruses were tested by real time-polymerase chain reaction (RT-PCR).Then the pathogens were isolated with MDCK cells,the virus titer was determined with hemagglutination test and the virus typing was identified with hemagglutination inhibition test (HA1).The RT-PCR products of HA1 gene of virulent strains were sequenced and then analyzed through bioinformatics.Results A total of 996 pharyngeal swab specimens were tested,and nucleic acid positive cases included 337 A (H1N1) subtype,1 seasonal A (H1N1) subtype,67 A (H3N2) subtype,and 12 B type.The positive rate of nucleic acid detection of influenza was 41.87％ and that of A (H1N1) was 33.84％.Thirty-six influenza A (H1N1) virus strains were isolated,and 10 of them were successfully sequenced and several amino acid mutations were identified.There were 6 amino acid mutations found compared with vaccine strain A/California/07/2009 (H1N1),and 1 site was in area B of epitope.Conclusions A (H1N1) is absolute predominant among isolated strains in 2009.HA gene of virulent strains is mutated compared with vaccine strain provided by World Health Organization,which shows that the area B of epitope changes,while the key amino acid position 222 doesn't change.

Objective To evaluate the consistency of hemoglobin (Hb) as an diagnostic index for iron deficiency anemia (IDA) in pregnant women with serum ferritin (SF) and free erythrocyte protoporphyrin (FEP).Methods Hb,SF and FEP were assayed for 506 pregnant women with various gestational weeks for the diagnosis of IDA with Hb

Objective To define the expression of Shh/Gli1,the key elements of Hedgehog signaling pathway in papillary thyroid carcinoma(PTC) and to explore the relationship between the expression of Shh/Gli1 and clinical significance.Methods The expression of Shh and Gli1 was examined in 142 cases of PTC tissues and adjacent tumor thyroid tissues as control by immunohistochemistry.The relationship between the expression of Shh/Gli1 and clinical characteristics of PTC patients was analyzed.Results The positive rate of the cytoplasm Shh expression and the nuclear Gli1 expression was 64.1% and 47.9% ,respectively.Significant difference was found between normal thyroid tissues and PTC.The research showed that the expression of Shh/Gli1 was related to the tumor size,clinical stages and lymph node metastasis,Shh was more significantly related to the tumor size(P ＜0.01) and Gli1 was more significantly related to the lymph node metastasis (P ＜ 0.01).Conclusions Varying expression of the main ligand Shh and transcription factor Gli1 in Hedgehog signaling pathway was found in PTC.The expression of Shh/Gli1 was related to the tumor size,clinical stage and lymph node metastasis,indicating that the aberrant activation of Shh signaling pathway plays some roles in PTC.Shh/Gli1 may be indicators for prognosis and ideal targets for therapy against PTC.

Objective To approach the guide of ultrasound-guided minimally invasive biopsy technique in diagnosis and treatment of thyroid diseases. Methods One hundred and seventeen cases (a total of 131 nodules, nodules 0. 5-1.5 cm in diameter, with an average diameter of approximately 0. 8 cm) with thyroid nodules , under Ultrasound-guided minimally invasive biopsy techniques from October 2008 to July 2009 were analyzed. Result One hundred and seventeen cases of patients with biopsy derived satisfaction were not ap-parent discomfort and complications after biopsy. Across 59 cases of surgical treatment in patients with biop-sy, and preoperative biopsy and postoperative pathologic is not fully consistent in only two cases, 58 patients without surgical treatment, who is combined with symptoms, palpation, serum thyroxine and color Doppler ultrasound and other laboratory examinations, and regularly review treated with symptomatic treatment, the symptoms, and color Doppler ultrasound imaging were much better under the treatment. 8 cases of patients in 117 cases of minimally invasive biopsy have cervical lymph node biopsy at the same time, biopsy patholo-gy and postoperative results are consistent with postoperative pathologic (7 cases of metastatic carcinoma, 1 case of reactive hyperplasia), accuracy was 100%. Conclusion Uhrasound-guided minimally invasive bi-opsy technique have important guiding for diagnosis and treatment of thyroid diseases, consistent with the high rate of clinical, especially for the preoperative diagnosis of small nodules, to avoid unnecessary over-treatment, can also reduce the misdiagnosis of thyroid cancer. While this technology is simple, safe and ac-curate, which have clinical value in the thyroid surgery.

Objective To investigate the effect of optimizing protocol activity on the cardiac function in patients with hypertension.Methods One hundred and one patients with mild and moderate hypertension in Navy General Hospital were enrolled in the study.The patients took regular exercise(6 min walking activity and treadmill test),Echocardiogram was performed 24 h after 6 min walking activity and treadmill test.The cardiac function related parameters were obtained through M-mode,2DE,pulse Doppler and DTI detection to compare the effect of 6 min walking activity and treadmill test on cardiac function.Results The results showed that in the male hypertensive patients,EF and E/E' after treadmill test were superior to those after 6 min walking activity (EF:(59.33±4.46)% vs.(56.05±4.57)%;E/E':(4.12±1.66)vs.(4.95±1.79)),the differences were statistically significant(P=0.02,0.01),while among the female hypertensive patients,there were no significant differences in cardiac function(P>0.05).Conclusion Appropriate activity can improve the cardiac function in male hypertensive patients.EF and E/E' after the treadmill test performed better than those after the 6 min walking activity,while its influence on female hypertensive patients was not significant.

Objective To discuss the effective factors and metastasis rules of cervical lymph node of papillary thyroid microcarcinoma,aimed to provide references for indications and range of lymph node dissection.Methods Reviewed the clinical information and pathological material of primary treatment of 1 180 cases of papillary thyroid microcarcinoma patients in China-Japan Union Hospital of Jilin University from June 2008 to December 2011 by retrospective analysis,futher summared cervical lymph node metastasis rules and effective factors.Results The lymph node metastasis rate of 1 180 patients with papillary thyroid microcarcinoma was 29.6％,which of these of the central and lateral region were 26.4％ and 15.2％.Central region lymph nodes metastasis rates in male and female were respectively 44.9％,21.8％ (P ＜ 0.05),and were 39.8％,9.0％ in lateral region (P ＜ 0,01).Lymph node metastasis rates of patients whose age ≤45years old and ＞45 years old were 30.3％,17.9％ (P ＜0.05).The lymph mode metastasis rate which diameter of tumour(D) ≤0.5 cm or 0.5 cm ＜ D ≤ 1 cm in central region were 20.2％,33.2％ (P ＜ 0.05).The lymph node metastasis rate of single and more nidi respectively were 15.7％,45.0％ in central region.The lymph node metastasis rate of tumors invasion or not were 44.4％ and 14.2％ in central region (P ＜0.05).The metastasis rates were 45.5％ and 4.3％ in the lateral region when the lymph node infringe or not in central region.Conclusions Lymph node metastasis happens relatively more common in papillary thyroid microcarcinoma patients with the factors such as male,young age,multiple nidi,long diameter of tumor and invasion of tumor envelope.So when doctors establish the indications and range of lymph node dissection,it's need to pay attention to the high risk factors seriously which effect lymph node metastasis of papillary thyroid carcinoma,and establish the lymph node dissection strategy individually.

One patient confirmed as pituitary carcinoma by histopathology was retrospectively analyzed according to the great changes of tumor invasive growth in imaging examine and clinical characters. Clinically,pituitary carcinoma quickly grows,and the growth character of tumor is helpful in the diagnosis. Moreover,the treatment for pituitary carcinoma is different from pituitary adenoma.The rapid progress of pituitary adenoma indicates the possibility of primary carcinoma.More experience should be accumulated for the diagnosis and treatment of the disease.

Objective To evaluate the diagnostic significance of blood cells and electrolyte in preoperative diagnosis and surgical treatment of Cushing's disease (CD).Methods 116 csses of CD and 21 cases of adrenocortical adenoma (ACA) patients pathologically proven adrenocorticotropic hormone (ACTH) adenoma from Jan.2003 to Dec.2010 were enrolled into the study.They were given transsphenoidal surgery (TSS) and laparoscopic resection of adrenal adenoma (LRAA).Patients were divided into remission group ( group A),non-remission group (group B) and ACA group (group C) according to the remission criteria of CD.The preoperative and postoperative level of blood cells and electrolyte were determined.Results TSS treatment improved the abnormal level of blood cells and electrolyte in patients with CD.Group A had significant change in preoperative and postoperative level of blood cells and electrolyte,while group B and group C didn't.Conclusions Compared with the endocrine examination items which need huge expense and harsh conditions,the change of blood cells and electrolyte level is more superior in assessing diagnostic and cruative effects on CD patients.

ObjectiveTo investigate the effect of simvastatin on severe complications and prognosis of subarachnoid heamorrhage (SAH).Methods98 cases with SAH were randomly divided into the treatment groups and control group (finally, there were 32 cases in treatment group, 48 cases in control group). Patients in treatment group were given simvastatin 20 mg/day, and those in control group were treated with routine therapy. The incidences of cerebral vasospasm, hydrocephalus, rebleeding and mortality between the two groups were compared.ResultsThe incidence of hydrocephalus of treatment group was 3.13%; that of control group was 18.7%, there was a significantly difference between two groups (P<0.05). There were no significant differences for incidences of cerebral vasospasm, rebleeding and mortality between two groups (P>0.05).ConclusionSimvastatin can reduce the occurrence of hydrocephalus after SAH.