Objective-To-explore-the-feasibility-and-safety-of-endoscopic-total-thyroidectomy-via-chest-wall-approach-.-Methods-Endoscopic-total-thyroidectomy-via-chest-wall-approach-was-performed-in-20-patients-with-nodular-goiter-from-January-2008-to-December-2012.Subcutaneous-operative-space-was-created-through-an-unilateral-areola-incision-,-through-which-laparoscope-and-surgical-instruments-were-introduced-.The-neck-suture-suspension-technique-was-used-to-reveal-the-thyroid-gland-.By-using-an-ultrasonic-scalpel-,-the-thyroid-was-separated-and-removed-completely-.-Results-All-the-operations-were-successfully-completed-without-conversions-to-open-surgery-.The-operation-time-was-90-180-min-(mean,-120-min).The-blood-loss-was-15-40-ml-(mean,-20-ml).The-postoperative-hospital-stay-ranged-from-4-to-7-days-(mean,-5.8-days).There-was-1-case-of-temporary-hoarseness.No-severe-hemorrhage-,-wound-infection-,-or-subcutaneous-effusion-was-found-.-Conclusion-Endoscopic-total-thyroidectomy-via-chest-wall-approach-is-a-safe-and-feasible-procedure-.

Objective To study the selective tumoricidal effect of adenovirus (Ad)-mediated fusion gene system driven by kinase domain-containing (KDR) promoter on human stomach adenocarcinoma SCG7901 cells, and to observe its apoptosis induction effect. Methods Both the AdEasy-KDR-CDglyTK cells with KDR-expressing SCG7901 cells and non KDR-expressing HepG2 cells were reconstructed, and then they were treated with the pro-drugs 5-FC and/or GCV at different concentrations. The killing effects of the transfection on the cells were evaluated. Flow cytometry was employed to determine the cell cycle distribution, and Hooechest/PI stain and electron microscopy performed to observe the pathological changes of cells. Results The green fluorescent protein (GFP) was observed in 95% of the infected SCG7901 and HepG2 cells when the multiple of infection (MOI) of the Ads was 100. No significant difference on the growth feature was found among the transfected SCG7901, HepG2 and untransfected SCG7901 and HepG2 cells. The infected cells exhibited different sensitivities to the two pro-drugs: SCG7901 cells infected with rAd were highly sensitive to the pro-drugs, while the infected HepG2 cells were not (P

Objective To evaluate the effect of rediological intervention on thrombotic membranous obstructive Budd-Chiari syndrome(TMOB-CS) .Methods Seventeen cases of TMOB-CS were treated with mutliple stent inplantation to press the thrombus with PTA.Results The inferior vena cave(IVC) pressure declined from(29.4?3.13)cm H 2 O to (3.45?3.20)cm H 2 O after the multiple stent inplantation.There was no severe complication such as pulmonary thrombembolism occurrence in this series.All the patients had been followedup for 3 to 40 months and showed good results.Conclusion Multiple stent inplantation pressing the thrombus with PTA can be used to treat the patients with TMOB-CS.

Objective To prevent the occurrence of violence in the emergency department,to reduce the damage to medical personnel,and to maintain the normal medical order in emergency department.Methods A retrospective analysis of medical incidents of violence in the emergency department has been made.A root cause analysis (RCA) group has been established to explore the root cause of the incident and to make the violence emergency preplan of emergency department.Results Medical personnel have been trained according to the plan.It has improved the awareness of health care workers.The incidence of violent injury incidents decreased.Conclusions The establishment and training of emergency preplan can improve the awareness and prevention ability of emergency medical staff to violence injury.The safety of medical staff in emergency department can be guaranteed.

AIM: To investigate the relationship between p21 WAF1gene polymorphisms and protein expression in breast carcinoma. METHODS: Polymerase chain reaction single-strand conformation polymorphisms technique (PCR-SSCP) and immunohistochemical assay of S-P immunostaining technique were used to study polymorphisms of p21 WAF1 and protein expression respectively on the specimen of paraffin-embedded tissues in 100 cases of breast carcinomas and 40 benign breast diseases as control. RESULTS: Two p21 WAF1 gene polymorphisms were found in 18% (18/100) of breast carcinomas and 5% (2/40) of control samples. The difference between the two groups was statistically significant (?2=3 94, P

Objective To evaluate the feasibility, safety, and outcome of hepatectomy by hand-assisted laparoscopic surgery (Lapdisc system) in patients with hepatic hemangioma. Methods Eight patients with hepatic hemangioma underwent hand-assisted laparoscopic hepatectomy. Procedures included introduction of Lapdisc system, isolation of the liver from the ligments, occlusion of the hepatic porta, dissection of the hepatic parenchyma by harmonic scaple and removal of the samples. ResultsIn all patients, the hand-assisted laparoscopic hepatectomy were successfully performed. The operation time was(196.3?81.2)min. Blood loss was (307.5?224.7)ml, and postoperative hospital stay was (7.9?2.9)d. There was no significant postoperative complication such as bile leakage, bleeding or infection. ConclusionsLapdisc system could be safely used for hepatectomy in cases of hepatic hemangioma.

Objective To evaluate the utility of modified Z-stent in treatment for Budd-Chiarisyndrome (BCS). Methods A retrospective study was used in twelve BCS patients treated in twohospitals. The Doppler examination was carried out in all patients preoperatively, so as to confirm thenature of the lesion and chose correct type of endovascular modified Z-stent. Under DSA monitoring formembranotomy and dilation of the inferior vena cava(IVC), after that, insert the marked modified Z-stent to IVC correctly, and put the non-stent part to hepatic vein orifice. The cavography and hepaticvenography should confirm the position of the Z-stent. All of 12 patients with membranous obstructionof the IVC(MOVC) or segmental obstruction of the IVC (SOVC)were underwent modified Z-stentplacement. Results The IVC pressure (IVCP) before smd after membranotomy (dilation) were 27.33± 4.12cmH2O and 18.67 ± 5.07cmH2O (P＜0.01). Comparing with dilation and putting stent group,the IVCP decreased from 18.67 ± 5.07cmH2O to 11.42 ± 2.11 cmH2O ( P ＜ 0.01 ). The modffied Z-stent could avoid hepatic vein orifice getting compression and resist the retraction of IVC throughly infollowing-up period of 2.5 years. Conclusion s The endovascular treatment of BCS with modified Z-stent is more effective and safer to prevent thrombosis. Further study will be required to observe theirlong term effects.

Objective To probe the value of ultrasound in detection of malignant foci among multiple thyroid nodules. Methods Ultrasonograms of 83 patients with pathologically confirmed thyroid cancer combined with benign nodules were analyzed.Results Among 83 patients of thyroid carcinoma, 89 malignant and 87 benign nodules were detected with ultrasound. Significant differences of two-dimensional ultrasounic signs including low echoes, border fuzzy, micro-calcification and rear echo attenuation were found bteween malignant and benign nodules (P<0.01). There were significant differences in the grade Ⅱ, Ⅲ blood flow between malignant and benign ones (P<0.01). Of 89 malignant nodules, small thyroid carcinoma with diameter ≤1 cm accounted for 52.81% (47/89), and ultrasound diagnostic rate of all cancer nodules was 67.42% (60/89).Conclusion Ultrasounic characteristics including low echoes, border fuzzy, micro-calcification, rear echo attenuation and internal rich blood flow contribute to differentiate the thyroid microcarcinoma from multinodules.In particular, the microcarcinoma should not be ignored.

Objective To investigate the common chromosome abnormalities in the patients with multiple myeloma and the relationships of cytogenetic abnormalities and clinical features. Methods The interphase fluorescence in situ hybridization (I-FISH) analysis method was designed to detect RB1-/13q14-and 14q32 rearrangements in 49 MM patients. The statistic value of its effect on clinical features were determined. Results FISH disclosed 14q32 translocations in 26 of the 40 (53.1%) patients. 25 out of the 49 (51.02 %) cases were found with deletion of chromosome 13q14 included del(RB1) in 9 (18.4 %) and del(13q14.3) in 18 (36.7 %). 13q14 deletion and 14q32 translocation were simultaneously observed in 18 (36.7 %) cases. Spearman correlation analysis were found associated of 14q32 rearrangement with the percentage of plasma cells in bone marrow (r=0.316, P=0.27). Conclusion The frequency of 13q14 deletion and 14q32 gene translocation in multiple myeloma are high. There is a significant correlation between the presence of 14q32 translocations and chromosome 13 abnormalities in MM patients. The percentage of 14q32 translocation in plasma cells was increased significantly. The 14q32 translocation is an independent prognostic factor.

Soil water is one of the most important components in hydrological cycle. The stable hydrogen and oxygen isotopes in soil water have been increasingly used in the ecological, environment and hydrological research. In view of different techniques for extracting soil water, there is significant difference in theδD andδ18 O composition. This paper presents a method for analyzing hydrogen and oxygen isotopes in soil water by using elemental analyzer and isotope ratio mass spectrometry with accelerated solvent extraction for sample pretreatment. The conditions are: extraction solvent: dichloromethane, temperature: 100 ℃, pressure of 10. 3 MPa, static time:10 min. The samples were extracted three times, and with cycle values of four, four and three, respectively. Comparing with the added water, the deuterium and oxygen isotope values in the extracted soil water enrich 2. 12‰-4. 58‰ and 0. 17‰-0. 93‰, respectively. The reproducibility of replicate extractions of soil water is around ±0. 89‰ for δD and ±0. 37‰ for δ18 O.