Objective To compare the efficacy of different thyroidectomy surgery on postoperative quality of life in elderly patients with thyroid cancer.Methods 56 patients with thyroid cancer in the hospital from August 2011 to October 2014 were selected,and they were divided into observation group and control group according to the different methods of treatment.Patients in the observation group accepted small incision improvement while the control group accepted conventional thyroidectomy.The operation time,intra -operative blood loss,intra -operative blood transfusion,postoperative drainage,length of hospitalization period,complications occurring,VAS pain score and SF -36 score 1 month after treatment in two groups were recorded for statistical analysis.Results In the observation group,the operation time,intra -operative blood loss,intra -operative blood transfusion,postoperative drainage,length of hospitalization period were obviously lower than these in the control group,the difference was statistically significant (t =3.568,2.139,6.368,3.716,3.569,all P <0.05).The VAS pain score and SF -36 score in the observation group of (2.02 ±0.25)points and (77.21 ±8.13)points were obviously higher than these in the control group of (2.61 ±0.29)points and (43.46 ±5.63)points,the difference was statistically significant (t =3.867,4.568,all P <0.05).The rates of postoperative complication in the control group and the observation group were respectively 16.0% (4 /25 )and 35.5% (11 /31 ),the difference was statistically significant (χ2 =0.035,P <0.05 ). Conclusion Small incision improvement has a better curative effect with fewer complications and can improve quality of life for patients with thyroid cancer,thus it's worth popularization and application in clinic.

Objective To investigate the value of SPECT imaging in the evaluation of rCBF improvement after bypass surgery in patients with moyamoya disease (MMD).Methods Retrospective analysis was conducted in 13 patients with MMD (5 children aged 3-8 years and 8 adults aged 45-55 years).The SPECT cerebral perfusion imaging data before and after operation were analyzed.Age matched subjects who underwent cerebral perfusion imaging for accidental headache (10 children,10 adults) were taken as control group.Two-sample t test or paired t test was used to compare rCBF of different groups.The brain DSA and MRI results during follow-up were taken as the reference of perfusion improvement.Results Based on visual judgment of SPECT,11/13 in MMD group showed significant improvement in the blood perfusion reduction area after surgery.The coincidence rates of SPECT-DSA and SPECT-MRI was 8/11 and 9/11,respectively.The rCBF of the control group and MMD group before surgery was (51.19±1.63) ml · 100 g-1 · min-1 and (38.83±2.22) ml · 100 g-1 · min-1 respectively (t=-18.465,P＜0.05).The rCBF of MMD group before and after surgery was significantly different ((38.83±2.22) ml · 100 g-1 · min-1 vs (45.03±2.63) ml · 100 g-1 · min-1,t=-11.707,P＜0.05).The rCBF of MMD group after surgery and the control group was significantly different (t =-8.313,P＜0.05).There was no significant difference of rCBF between the children and adults in the control group ((51.81±1.82) ml · 100 g-1 · min-1 vs (50.55±1.18) ml · 100 g-1 · min-1 ;t=0.081,P＞0.05).Conclusions Brain perfusion SPECT may effectively reflect the regional distribution and changes of blood flow in the ischemic tissue before and after MMD surgery.Thus it may be helpful in evaluation of the effect of surgical treatment.

Objective To investigate the satisfaction degree of students and teachers towards PBL teaching method and to provide a basis for continuing to carry out PBL teaching.Methods Anonymous questionnaires of PBL teaching method in teaching plan and procedure was conducted among 49students (2008 grade) and teachers.SPSS 13.0 software package was used to analyze the data and P ＜ 0.05 stands for statistically significant differences.Results Both students and teachers were satisfied.Teachers' evaluation scores of 17 projects were all higher than 4 points and students' evaluation scores of 13 projects were all higher than 4 points; scores for the rest projects were all higher than 3 points.Conclusions PBL teaching method combined with stomatology is effective and measures should be taken to strengthen the management of PBL teaching in stomatology.

The traditional discipline-centered curriculum design can neither keep up with developments of modern medical science nor reach requirements of the education reform in the new century.Since 2011,College of Stomatology in School of Medicine in Shanghai Jiao Tong University had developed ‘ disease oriented integrated curriculum system reform’ for students of long-term stomatology education.In view of the problems existing in the original curriculum system,the integrated curriculum system was set up by coalescing clinical medicine curriculum according to the related systems and oral medicine curriculum according to the developmental rules of diseases.Lectures were combined with discussion classes in the reform and performance appraisal system was changed from simplex judgments into comprehensive evaluations.At last,further considerations of promoting the reform based on the practice were proposed.

Objective To study the hygroscopicity of glucosamine sulfate powder.Methods Hygroscopic studies were conducted on glucosamine sulfate powder at 5℃ and 30℃ used gravimetric method,determined the equilibrium moisture content(EMC) and drew the moisture sorption isotherms.The experimental values were regressed using the BET model,calculated the monolayer moisture content.Results At 30℃,when water activity exceeded 0.43,samples agglomerated,browned and lose adsorbed water,EMC declined;At 5℃,the isotherm had typical ob-S shape,the EMC increased with water activity raising.At 30℃ and 5℃,the monolayer moisture content were 4.8633,5.5740g/100g respectively.Conclusion At 5,30℃ the appropriate aw for storage appeared to be below 0.3056,0.2784,respectively.

Objective To prepare and optimize fibrin-gel-coated vaneomycin alginate beads (FG-Vanco-AB)and investigate their possible use in treatment of osteomyelitis or prevention of infection.Methods Vancomycin alginate beads were produced by dropping vancomycin and alginate mixed liquor into calcium chloride solution.Beads including high vancomycin content were prepared and chosen by optimizing different concentrations of vancomycin solution and alginate solution.These beads were coated with fibrin gel formed by different concentrations of fibrin and the same concentration thrombin.The optimized beads were selected based on available release time,when vancomycin in medium could kill Staphylococcus aureus(ATCC25923). Results Higher content of vancomycin in bead resulted in increase of vancomycin concentration and alginate concentration in mixed liquid.The highest vancomycin content beads were prepared by 16%alginate and 50 mr/ml vancomycin,up to(27.36±0.90)%.The further results showed that vancomycin concentrations from beads coated with fibrin at 75 mg/ml and thrombin at 400 IU/ml could kill Staphylococcus aureus and remained above the breakpoint sensitivity for 19 days.Conclusion The available release time is prolonged,and the possibility of clinical use is conspicuously increased after vancomycin beads are optimized by adjusting the rate of mixed component and fibrin gel coat.

Objective:This study aimed to determine the function of herbs in preventing diarrhea after irinotecan chemotherapy and analyze the efficacy of the herbs based on UGT1A1*28 gene polymorphism. Methods:A total of 200 patients admitted to the De-partment of Synergistic Chinese and Western Medicine, Tianjin Medical University Cancer Institute and Hospital between October 2011 and May 2013 were randomly divided into the control (chemotherapy alone) and herb (chemotherapy combined with herbs) groups. All patients consented to UGT1A1*28 gene polymorphism detection prior to chemotherapy. Herbs were administered from 2 d prior to chemotherapy to 5 d post chemotherapy, with or without the regimen of fluorouracil, folinic acid, and irinotecan. Adverse reac-tions were recorded, and short-term effect was evaluated regularly. Results:A total of 144 patients had TA6/6 wild genotype, and anoth-er 56 patients had non-wild genotype (12 of the 56 cases were TA7/7 homozygous, and the other 44 cases were TA6/7 hybrid). A total of 58 patients experienced grades 2 to 4 diarrhea. A 14%decrease in the incidence of diarrhea was observed in the herb group compared with that of the control group (22%vs. 36%, P=0.029). In addition to diarrhea, grades 2 to 4 vomiting was significantly lower in the herb group than in the control group (15% vs. 27%, P=0.037). The overall response rate was 37.5%. No significant difference was found between the two groups (40% vs. 35%, P=0.465). The incidences of grades 2 to 4 diarrhea (22.9% vs. 44.6%, P=0.002) and grades 2 to 4 vomiting (23.2%vs. 16.7%, P=0.016) were lower in patients with the UGT1A1*28 wild genotype than in those with the non-wild genotype. However, in the herb group, the incidences of grades 2 to 4 diarrhea (22.2% vs. 21.9%, P=0.974) and vomiting (18.5% vs. 13.7%, P=0.777) were not significant between the non-wild-and wild-type groups. Conclusion:Herbs can effectively pre-vent the late diarrhea caused by irinotecan, which is also applicable in UGT1A1*28 non-wild genotype patients. Incidence of diarrhea was obviously higher in the cases with UGT1A1*28 non-wild type than in those with wild genotype. Hence, the UGT1A1*28 gene type should be detected prior to chemotherapy with irinotecan.

Objective To investigate radiological characteristics of the posterior tibial plateau fracture and operative treatments for the fracture.Methods Thirty-one cases of posterior tibial plateau fracture treated between February 2009 and February 2014 were enrolled.There were 19 men and 12 women aged 24-72 years (mean,42.5 years).Injury arose from traffic accidents (13 cases),falls from a height (9 cases),fall on the ground (5 cases),and crash (4 cases).Type Ⅴ in 15 cases and type Ⅵ in 15 cases were classified by the Schatzker classification.Meanwhile,all fractures were identified as three-column pattern.According to the X-ray and CT manifestations of fracture displacement,the cases with minor displacement were grouped as Group A (22 cases) and the cases with major displacement group as Group B (9 cases).Depending on the radiographic characteristics of fracture size and angle off fracture line,anterior approach for reduction and fixation was performed in Group A and combined anterolateral and posteromedial approaches in Group B.Radiographic and functional outcomes were evaluated using the Rasmussen score.Results All cases underwent one-stage surgery uneventfully.Operation time was 80-120 minutes (mean,98 minutes) in group A and was 110-165 minutes (mean,110 minutes) in Group B.Mean total operation time was 105 minutes.Period of follow-up was 6-48 months (mean,21.5 months).Rasmussen radiographic results showed total excellent to good rate of 84％ with 86％ in Group A and 78％ in Group B respectively.Rasmussen functional results showed total excellent to good rate of 87％ with 91％ in Group A and 78％ in Group B respectively.Conclusions Anterior approach or anterolateral approach combined with posteromedial approach for reduction and internal fixation is developed according the radiographic findings and degree of fracture displacement.Clinical outcome is good and associated intraarticular soft tissue injury can be managed concurrently.

Objective To explore a new technique to treat the benign stricture at hilar bile duct of plastic anastomosis, so as to obtain the theoretical basis and the feasibilities of practical application in treating the benign stricture at hilar bile duct with plastic anastomosis through the animal experiments. Methods 30 miniature pigs were randomly divided into three groups. Group A (control group):2 centimeters of the bile duct above the duodenum was isolated;Group B:The same separation of bile duct with group A, then making physical injury on it with the clamps and electric heat;Group C:Making bile duct injury model in group C as group B,and then monitoring of the diet, feces, urine, ALT, AST and bilirubin etc. When the bile duct stricture was formed, taking the plastic anastomosis operation in this group. After all the operations, we observed the diet, mental state and the color of the urine of animals in all the three groups, and tested ALT,AST,T-BIL and D-BIL levels on the pre- and post-day and every 7 days after surgery respectively. After three months of the surgery,we executed all the pigs,picked up part of the liver tissue,then preserved them by liquid nitrogen for pathological examination. Results From the day before operative-day to the 30 days after operation, there was no significant change in ALT, AST, T-BIL and D-BIL in group A,while the relative indicators of group B and C had obvious changes ( <0.05) . The indicators of group B were significantly increased 21 days after surgery, compared with pre-operation and 14 days after operation respectively ( <0.05) . In group C, the indicators were significantly declined 14 to 21 days after the plastic anastomosis compared with pre-operation (<0.05) . Conclusions Treating benign stricture at hilar bile duct of miniature pigs by plastic anastomosis is feasible and practicable. This study provides an experimental basis for clinical application of plastic anastomosis in treatment of benign stricture at hilar bile duct.

Objective To investigate the expression and clinical significance of β2 microglobin (β2-MG)protien and vascular endothelial growth factor (VEGF) protien in diffuse large B-cell lymphoma (DLBCL).Methods The expressions of VEGF protien and β2-MG protien were evaluated in 49 DLBCL patients which started the initial treatment by luminex suspension array.Results Among 49 DLBCL patients,expression of β2-MG protein was high in 37 cases and the expression of VEGF protein was high in 23 cases.The expression of VEGF protien and β2-MG protien were not related with gender,age,B symptoms,clinical stage and lactic acid (LDH).There was positive correlation between the high expression of β2-MG protien and chemotherapy (P =0.037).There was relevant trend between the higher expression of VEGF protien (P =0.067).Conclusion The expressions of VEGF protien and β2-MG protien are detected in DLBCL,both proteins may be the potencial markers of DLBCL and therapeutic targets for DLBCL.