Purpose: To evaluate the diagnostic utility of detection of Cytokeratin 19 (CK19), b-100 protein and epithelial membrane antigen ( EMA) in thyroid papillary carcinoma, follicular carcinoma and papillary hyperplasia. Methods: 65 thyroid lesions were stained immunohistochemically for CK19, S-100 protein and EMA. Results: CK19, S-100 and EMA are negative in all papillary hyperplasia. CK19 expression was strong and diffuse in 100% of papillary carcinoma including the follicular variant of papillary carcinoma, and was positive in 22% of follicular carcinoma. S-100 and EMA were respectively present in 61% and 100% of classic papillary carcinoma, in 38% and 54% of follicular variant of papillary carcinoma and in 44% and 11 % of follicular carcinoma. Conclusions: Our observations suggest that the expression of CK19, in combination with S-100 and EMA expression, is helpful in the diagnosis of thyroid lesions. CK19 is a valuable marker in the distinction of papillary carcinomas from papillary hyperplasia.

Purpose　The aim is to optimize the liquid culture conditions of dihydropyrimidinase producing strain Pseudomonas putida 9801. Methods　Plackett-Burman design and spherical symmetric desig n were used.Results　Optimum conditions for dihydropyrimidinas e formation of Pseudomonas putida 9801 were defined:yeast extract 2.39%, Glu cose 1.81%,Uracil 0.06%,K2HPO4*3H2O 0.2%, MgCl2*6H2O 0.05%and NaCl 0 .3%,when the strain was cultured at 32℃ for 10 h,about 3.02 units/ml of hydanto inase was obtained. This value was quite consistent with the theory value(2.91 u nits/ml).Conclusion　The liquid culture conditions of dihydrop yrimidinase producing strain were optimized.

Objective To evaluate the long-term effects and safety of an intense pulsed light (IPL) in the treatment of epilation.Methods 159 patients received treatment with a non-coherent IPL because of unwanted facial and body hair.116 cases were followed up by means of phone call or letters.The average follow-up time was 38 months.Results Overall,36 (31.0％) patients were very satisfied,53 (45.7％) were satisfied and 27 (23.3％) remained unsatisfied with the outcome of lightassisted hair removal.The non-coherent intense pulsed light satisfactorily removed unwanted dark hair.Hair-free periods from weeks to years could be observed.Besides,the satisfaction was not related with the colour of the skin.Conclusions Hair removal by a non-coherent intense pulsed light is an effective and safe method for long-term epilation of unwanted hair.

BACKGROUND: Senile intertrochanteric fracture is characterized as aging, instability, more complications and high mortality, so choosing an appropriate internal fixation method is critical.OBJECTIVE: To compare the curative efficacy of proximal femoral nail anti-rotation and locking proximal femoral plate for senile osteoporotic patients with unstable intertrochanteric fractures.METHODS: Sixty elderly patients with unstable intertrochanteric fractures were enrolled, and the clinical data were collected. They were randomized into treatment and control groups (n=30 per group), and subjected to internal fixation using proximal femoral nail anti-rotation and locking proximal femoral plate, respectively. The operative indexes,functional recovery and complications were observed in the two groups RESULTS AND CONCLUSION: (1) The incision length, operation time, intraoperative blood loss and time of weight bearing in the treatment group were significantly less than those in the control group (P < 0.01). (2) Harris hip scores in the treatment group were significantly higher than those in the control group (P < 0.05). (3) The incidence of complications in the treatment group was obviously lower than that in the control group. (4) To conclude, the proximal femoral nail anti-rotation exhibits satisfactory treatment outcomes in the internal fixation of unstable intertrochanteric fractures.

With the technological progress and the unremitting efforts of spinal surgeons， minimally invasive lumbar spine surgery has developed rapidly in this century and has been widely recognized and used by patients and surgeons. However， there is a lack of standardized treatment guidelines for minimally invasive lumbar surgery. Varieties of surgical techniques and treatment strategies mainly rely on training and surgical experiences. This paper reviews the development of minimally invasive lumbar surgery and discusses the future challenges and technical direction in the development of minimally invasive lumbar surgery. We hope that more spinal surgeons can master minimally invasive spinal technology and make more patients benefit from it.

Objective To investigate the expression of HIF-1α and P-gp protein in pancreatic carcinoma and determine their clinicopathological significance and the correlation between the expression of HIF-1α, P-gp and the clinical prognosis. Method In samples from 74 cases of pancreatic carcinoma and 10 healthy individuals, the expression of HIF-1α and P-gp were detected by immunohistochemical method. Results The positive expression rate of HIF-1α and P-gp was 75.7% and 86.5%,respectively, which were remarkably higher than that in normal pancreatic tissue (P＜0.05). There was a positive correlation between the expression of HIF-1α and that of P-gp. The aberrant expression of HIF-1α and P-gp was associated with lymph node metastasis but not the location, size, clinical stages and nerve invasion of the tumor. Patients with high intensity of HIF-1α and P-gp expression showed a significantly lower median survival time than those with low intensity expression.Conclusions The expression of HIF-1α and P-gp is up-regulated in pancreatic carcinoma and there is a positive correlation between them. The expression of HIF-1α and P-gp might be related to the lymph node metastasis and poor prognosis.

Objective To investigate the relationship between various stages of chronic hepatitis B virus (HBV) infection and lipid metabolism and its influencing factors.Methods Seventy-two cases of chronic hepatitis B (CHB),40 cases of liver cirrhosis and 17 cases of hepatocellular carcinoma (HCC) were enrolled.One-way ANOVA analyses were used to compare age,gender,liver function,lipid metabolism,and HBV DNA levels of each group.Pearson correlation analysis was used to study the correlation between HBV DNA and lipid metabolism.Binary Logistic regression analyses were performed to explore the risk factors of cirrhosis and HCC in patients with CHB.Results Differences of age,alanine aminotransferase (ALT),albumin (Alb),triglyceride (TG),and cholesterol(CHO) among the three groups (CHB group,cirrhosis group and HCC group) were statistically significant (all P＜0.05).TG levels in cirrhosis and HCC groups were (-0.061± 0.234)lg mmol/L and (-0.061±0.253) lg mmol/L,respectively,which were both significantly lower than that of the CHB group (0.116±0.182) lg mmol/L (F=11.466,P=0.000).CHO level in cirrhosis group was (0.460±0.333) lg mmol/L,which was lower than that in CHB group (0.586±0.101) lg mmol/L (F=4.892,P=0.009).The HBV DNA levels inversely correlated with TG and CHO levels in CHB group (r=-0.266,P=0.024; r=-0.309,P=0.008,respectively).The HBV DNA levels of cirrhosis and HCC patients positively correlated with ALT levels (r=0.355,P =0.007).Old age (OR=1.096,95％CI:1.025-1.172),low Alb (OR=0.000,95％CI:0.000-0.000),and low levels of ALT (OR=0.128,95％CI:0.026-0.641) were risk factors for development of cirrhosis and HCC in CHB patients (all P＜0.05).Conclusions With the progression of liver injuries,TG and CHO levels are reduced.Further studies of correlation between risk factors for the development of cirrhosis and HCC and lipid metabolism in CHB patients are needed.

BACKGROUND:Thoracic spinal cord injury often leads to double lower limb paralysis. Paraplegia walking orthosis can improve lower limb dysfunction, improve the daily living activity, and regain the ability to stand and walk in patients with paraplegia. OBJECTIVE:To discuss the effects of paraplegia walking orthosis on muscle spasticity and recovery of function of the affected lower extremity in patients with thoracic spinal cord injury. METHODS:The 20 patients with thoracic spinal cord injury (T5-12), according to the damage plane by American Spinal Injury Association standard, were divided into complete damage group and incomplete damage group (n=10). Al patients were fitted out paraplegia walking orthosis. They received residual muscle strength training, sitting balance training, and transfer training prior to assembly, and then subjected to standing exercise within paralel bar, balance and transfer training, and walking aid devices training indoor and outdoor, and elbow crutch training on foot after the assembly. RESULTS AND CONCLUSION:Compared with pre-treatment, American Spinal Injury Association score increased at 12 weeks after treatment with paraplegia walking orthosis, and sensation did not obviously alter. Spasm worsened with prolonged course of disease in the complete damage group. At 12 weeks after treatment, American Spinal Injury Association score increased, sensation apparently improved, and the spasm did not change with time in the incomplete damage group. Activities of daily living (modified Barthel index, and functional independence evaluation) evidently improved in both groups. Compared with 2 weeks, the 10-m walking time was noticeably reduced and the 6-minute walking distance was prolonged at 12 weeks in both groups. These results confirm that paraplegia walking orthosis fitted out in patients with thoracic spinal cord injury significantly improves the patient’s motor function, activities of daily living and walking ability, and also has certain influence on muscle spasm control.

Objectives:To investigate the effects of intravenous LCT or MCT/LCT fat emulsions on the lipid mediators and pancreatic histological changes in ANP rats. Methods:Forty three male SD rats were randomized to groups as follow.Group A～C were without ANP, group A:normal controls, group B:normal rats having received lipid based TPN and group C:operation control(OC) group having received the glucose fluid.Group D～F were with ANP,glucose group,Intralipid group and Lipofundin group.The amylase and prostaglandins in serum were determined in group A.Pancreatic histological examinations were also performed.In group B～F,Amylases or prostaglandins in serum were determined at 4,48 and 72 h, and pancreatic histological examination and pathological scoring were also completed. Results:Intralipid had no effects on serum prostaglandins when it was infused to normal rats.In groups of ANP,intravenous fat emulsion increased the 6 keto PGF 1? ,and PGE 2 concentration in serum at 4 h.Pancreatic hemorrhagic and fat necrosis were significantly reduced in Lipofundin group. Conclusions:Intravenous fat emulsion does not worsen the damages to pancreas in ANP.MCT/LCT fat emulsion is more suitable for patients with ANP.

Objective To evaluate clinical and sexual outcomes in women with severe uterine prolapsed at child-bearing period undergoing laparoscopic high uterosacral ligament suspension combined with cervical amputation.Methods From November 2007 to March 2010,34 patients (≤50 years old) with severe uterine prolapse (prolapse group) who had already given birth and underwent laparoscopic high uterosacral ligament suspension combined with cervical amputation in Peking Union Medical College Hospital were enrolled in this retrospective study.All patients were defined as Pelvic Organ Prolapse Quantification (POP-Q) stage Ⅲ.Follow-up was performed at 1,6,and 12 months,and then annually.Anatomic failure was defined as ≥ 1 pelvic compartment classified as POP-Q ≥ stage Ⅱ.Sexual outcomes were assessed at baseline and 3-year follow-up according to validated Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).Thirty one age-matched women who underwent health examinations during the same time period were selected as a healthy control group.Results Mean age of women at prolapse group were (39 ±5) years and average surgery time were (51 ±8) minutes.No severe intraoperative complications occurred,including urethral twist,bladder and rectum injury,pelvic hemotoma.All patients were followed up for more than 3 years,the mean following up period was 40 months (36-64 months).Based on stage Ⅱ of POP-Q as recurrence criteria,the anatomical success and patient satisfaction rates were both 100％ (34/34).POP-Q point C and D measurements were significantly higher after surgery then those at preoperative values [C:(-5.4±0.6) cm versus (2.2 ±0.7) cm,D:(-6.7 ±0.4) cm versus (-4.0 ±0.7) cm; P ＜0.01 for all].Three years postoperatively,33 patients were sexually active.Among the 94％ (31/33) patients who answered the PISQ-12 questionnaire,there was significant improvement in post-and preoperative total PISQ-12 scores (38 versus 26,P ＜ 0.01) and in all three subscale PISQ-12 domains (P ＜ 0.01 for all).The postoperative PISQ-12 score was similar to that of the control group (38 ± 6 versus 37 ± 3,P ＞ 0.05).Conclusion Laparoscopic high uterosacral ligament suspension combined with cervical amputation conferred satisfying long-term anatomic and sexual function outcomes in women at child-bearing age.