OBJECTIVE: To discuss the role of the central lymph node dissection in the treatment of papillary thyroid carcinoma. METHOD: Collect 136 patients who underwent thyroidectomy with papillary thyroid carcinoma in our hospital in 2011-2012,all are conducted with lymph node dissection in the central area as well as resection of primary lesion. Functionl lateral neck lymph node dissection were used for patients with clinical lateral neck lymph node metastasis. RESULT: In 136 patients, 56. 6%(77/136) of the central lymph node metastasis were detected. Positive rate was 47. 5% in 101 cN0 patients and 82. 9% in 35 cN1 patients. CONCLUSION In the case of not increasing risk of surgery, resection of thyroid cancer primary lesion the central lymph node at the same time is a surgical procedure to be recommended.
Carcinoma ; pathology ; surgery ; Carcinoma, Papillary ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Neck ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy

Objective To evaluate the effectiveness of melformin sustained release tablets in treatment of patients with abnormal glucose tolerance. Methods 78 cases with abnormal glucose tolerances were selected and divided into two groups. Patients in treatment group took melformin sustained release tablets, while patients in control group took normal therapy. The impaired glucose tolerance (IGT) and body mass index (BMI) were observed and compared. Results The blood glucose level of OGTT 2 h in treatment group was (7.61±1.04)mmol/L, while it was only (9.96±1.08) mmol/L in control group. The BMI of treatment group was 23.71±3.41, while it was 29.53±3.72 in control group. The glycosylated hemoglobin was (5.79±0.41)%, while it was (6.23±0.52)%in control group. The fasting blood glucose in treatment group was (5.34±0.39)mmol/L and in control group was (8.16±0.48)mmol/L. The differences of those indicators between two groups were signiifcant. Conclusion Melformin gains excellent clinical effects in treating patients with abnormal glucose tolerance. It can adjust blood glucose, improve glucose tolerance, and decrease blood glucose level of OGTT 2 h and BMI effectively.

Objective To construct a database for the genetic polymorphism of 19 STR loci in Han population from Hainan province. To investigate the application of 19 STR loci in the paternity testing. Methods The genotypes of 462 unrelated individuals in Hainan were detected with GoldeneyeTM 20A PCR Amplification Kit. 19-STR database was acquired, analyzed and evaluated in 283 paternity testing cases. Results No deviations of allele frequency from Hardy-Weinberg equilibrium expectations were found for Chi-square test (P>0.05). Observed heterozygosity (Hobs) varied between 0.603 and 0.914, total discrimination power (TDP) of 19 STR loci was more than 0.999999999999999, cumulative probability of exclusion (CPE) for triplet cases was 0.999999994. In all 283 paternity testing cases, triplets and duos were 170 and 113 respectively; there were 36 (12.7%) excluded cases comparing to 247 confirmed cases (87.3%). 14 mutation events were observed, and all were one-step mutation. Conclusion 14 out of 19 loci showed highly polymorphic in Han population from Hainan, and 19 STR system has high cumulative probability of exclusion and can meet the needs of paternity test of the local region. But mutation should be paid special attention to.

BACKGROUND:In the past 20 years, cholecystokinin in clinical application and nerve repair has been extensively studied. OBJECTIVE:To explore the role of cholecystokinin in nerve repair and its possible mechanism of action. METHODS:Relevant research results were retrospectively analyzed at the celland organ levels through retrieving recent literatures concerning the biological characteristics of cholecystokinin and its biological role in the nervous system. Then, we summarized the effect of cholecystokinin after nerve injury and its possible RESULTS AND CONCLUSION:Cholecystokinin and its receptors are widely distributed in the body, and under physiological and pathological conditions, their roles were complex and diverse. However, studies addressing the neuroprotective effect of cholecystokinin are not sufficient, most of which are limited to phenomenon observation. Neuroprotective mechanism of cholecystokinin is stil worthy of further studies, which can provide the basis for the clinical application.

Objcctive To detect the telomerase activity in rat hepatic oval cells, and to explore the relationship between telomerase expression and the proliferation and differentiation of oval cells. Methods The 2-acetamidofluorene/partial bepatectomy (2-AAF/PH) rat model was used to induce the proliferation of oval cells. Oval cells were isolated by modified collagenase perfusion and gradient centrifugation. Electron microscope exami-nation and immunofluorescence were adopted to identify oval cells. Immunohistochemistry, RT-PCR and fluores-cence quantitative PCR were used to detect the expression of telomerase in oval cells. All the data collected were analyzed by t test. Results The proliferatiun of oval cells was successfully induced by 2-AAF/PH rat model. Freshly isolated oval cells showed a large and ovoid nuclei, a small proportion of cytomplasm and a cobblestone appearance. When viewed by electron microscopy, there were few and immature organelles, and the nucleus/ cytoplasm ratio was high. Immunofluorescence staining showed that oval cells expressed OV-6, alpha-fetoprotein, cytokeratin-19, albumin and c-kit. Telomerase reverse transcriptase (TERT) was located in the nuclei of oval cells which were around the portal areas. As oval cells differentiated into small hepatocytes, the number of TERT-positive cells decreased significantly. The expression level of TERT mRNA in normal rat liver tissue was 2.27 times higher than that in LE-6 oval cells; the expression level of TERT mRNA in the isolated oval cells was 1.26 times higher than that in LE-6 oval cells. The telomerase activity decreased gradually (from △A=1.05, 1.15 to △A=0.25, 0.45) as the increase of oval cells passage (from passage 24 to passage 40) (t=17.74, 12.38, P<0.05). Conclusions Oval cells have telomerase activity. Telomerase may be indispensable for maintaining the proliferative and multi-directional differentiation abilities of oval cells.

Objective: To evaluate the predictive value of plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) on short term prognosis in patients with acute coronary syndrome (ACS). Methods: Plasma NT-proBNP levels were measured in ACS patients within 24 h after admission with ELISA method. The 600 ACS patients were divided into two groups: event group （n=108）and no-event group （n=492）according to occurrence of cardiovascular events（including cardiac death, cardiac shock and heart failure）, The NT-proBNP levels were compared between two groups. Single factor and multiple factor Logistic regression analyses were used to evaluate if NT-proBNP was an independent predictor for short term prognosis. Results: The plasma NT-proBNP levels of event group were significantly higher than those of no-event group [1361.2 (965.3, 2088.6) pmol/L vs.605.7 (274.5, 1177.8) pmol/L, p<0.01]. Multiple factor Logistic regression analyses demonstrated that plasma NT-proBNP was an independent predictor for short term prognosis (OR=1.000, p<0.01) in ACS patients. Conclusion: Plasma NT-proBNP was an independent predictor for short term prognosis in ACS patients.

BACKGROUND:Cholecystokinin as an endogenous neuroprotective factor in the nervous system has garnered increasing attention. Findings from previous animal studies show that cholecystokinin can effectively promote the regeneration of the injured peripheral nerve. On this basis, further clinical trials wil be performed to observe whether local application of cholecystokinin at nerve anastomosis can promote peripheral nerve regeneration.
METHODS/DESIGN:As a prospective randomized controled trial, this study wil enrol 100 patients with complete rupture of the peroneal nerve, who wil be randomly divided into two groups: after nerve suture and partial gelatin sponge infiltration at nerve anastomosis, the patients wil be treated with 8 nmol/kg cholecystokinin (treatment group) or saline (control group). At 6, 12, 24 weeks after treatment, common peroneal nerve conduction velocity and electromyography and nerve fiber morphology wil be detected; the clinical efficacy at the last folow-up wil be assessed; and al adverse events during the folow-up wil be recorded to assess the therapeutic efficacy and safety.
DISCUSSION:In this study, cholecystokinin as an inducing agent for nerve growth factor synthesis wil be observed and studied, with a view to providing a new idea for seeking peripheral nerve therapy.
ETHICAL APPROVAL: The study protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Putian University (approval No. 2014116). Written informed consent wil be obtained from patients before treatment.

Objective To establish and identify the induced pluripotent stem cell(iPSC) line reprogrammed from human umbilical cord mesenchymal cells(HuMSCs).Methods HuMSCs were cultured by adhesion method,and OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 were transfected into HuMSCs with lentiviral victor to reprogramme HuMSCs into iPSC.Morphological observation,pluripotency genes (SOX2,TDGF1,THY-1,OCT4,REX1 and TERF1) expression,alkaline phosphatase detection,karyotype analysis,embryonic stem cells (ESC) specific proteins (NANOG,OCT4,SSEA-4,TRA-1-81) immunofluorescence staining,differentiated into teratomas in vivo(inject the iPSC into SCID mice) and embryniod bodies in vitro were performed to exam the pluripotency of the iPSC.Results Four days after being infected by lentivirus,the HuMSCs became round-shape; 10 days after infection,some embryonic stem(ESC)-like colonies appeared.Fourteen days after infection,picked up the regularly shaped colonies and cultured several passages.About 1.25％ HuMSCs were reprogrammed into iPSC.The iPSC presented clone-like growth like ESC.All the cells were positive to alkaline phosphatase staining and expressed the pluripotency genes.The iPSC also expressed the ESC specific proteins,and karyotype analysis showed normal chromosome caryotype (46,XY).Furthermore,the iPSC could form embryoid bodies in vitro,expressed alpha fetoprotein(AFP),smooth muscle actin(SMA) and β-tubulin.The iPSC could alsoform teratomas in vivo.Conclusion OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 can reprogram HuMSCs into iPSC efficiently.

Objective To investigate the predictive value of pregnancy-associated plasmaprotein-A (PAPP-A) and GRACE risk score for death and nonfatal myocardial infarction (combined endpoint) in AMI patients.Methods All AMI patients hospitalized in our department during July 2011 to July 2015 were included consecutively in this prospective study.Plasma PAPP-A were measured at admission.GRACE risk score was acquired with the application of GRACE risk score calculator.Patients were followed up for at least 1 year for any nonfatal myocardial infarction or MACE.Kaplan Meier survival study was analysed according to PAPP-A and GRACE score risk stratification respectively.A cutoff value of 3.0 ng/ml of PAPP-A was chosen from pilot work in this cohort.Results A total of 220 patients were enrolled in the study.The death and nonfatal myocardial infarction during follow-up were significantly higher in patients with PAPP-A≥3.0 ng/ml compared to patients with PAPP-A<3.0 ng/ml (15.7% vs.6.0%, log-rank χ2=5.684, P=0.017).The area under ROC curve of PAPP-A was 0.796(95%CI 0.696-0.896, P<0.01) and the ROC curve of PAPP-A GRACE risk stratification was 0.715 (95%CI 0.567-0.863,P<0.01).Subgroup analysis showed that death and nonfatal myocardial infarction during follow-up was significantly higher in patients with PAPP-A≥3.0 ng/ml compared to patients with PAPP-A<3.0 ng/ml in intermediate and low risk group by GRACE risk stratifcation (log-rank χ2=14.63,P<0.001).Conclusions PAPP-A could predict mortality and nonfatal myocardial infarction in patients with AMI.PAPP-A combined with GRACE risk score can better predict outcome than GRACE risk score alone in intermediate and low risk patients by GRACE risk stratifcation.

To explore immune intervention effects of the combined use of cycloporin A (CsA) and 1, 25-dihydroxyvitamin D3[1,25(OH)2D3] at low doses on experimental autoimmune thyroiditis (EAT), porcine thyroglobulin (pTG) was injected into a CBA mouse at the dose of 100 micrograms on day 0 and day 14 to establish the model of EAT. The immune prevention group from day 0 to day 28, and treatment group from day 10 to day 38 were daily administered CsA (10 mg/kg) intragastrically and/or 1,25(OH)2D3 (0.2 microgram/kg) i.p. After immunized by pTG, the mice were sacrificed on day 28 and day 38 to examine their thyroid gland pathologically, and to check the levels of serum porcine thyroglobulin antibodies (pTGAb), porcine thyromicrosomal antibodies (pTMAb). The incidences of EAT in the immune prevention group and treatment group, with administration of low dose of CsA and 1,25(OH)2D3, were decreased respectively by 44.44% and 37.50%. Those of severe disease in the two groups were decreased respectively by 71.43% and 60.32%. The levels of serum pTGAb and pTMAb in the immune prevention group were lower than those of the positive control group. It was concluded that combined use of CsA and 1,25(OH)2D3 at low doses could effectively prevent EAT with a synergic effect.
Animals ; Antibodies ; blood ; Calcitriol ; therapeutic use ; Cyclosporine ; therapeutic use ; Drug Synergism ; Female ; Mice ; Mice, Inbred CBA ; Thyroglobulin ; immunology ; Thyroiditis, Autoimmune ; drug therapy ; immunology ; prevention & control