Objective To determine the relationship between plasma cytokeratin polypeptide 19 (CK 19) level and prognosis of patients with first occurrence of papillary thyroid carcinoma (PTC).Methods This prospective trial enrolled 60 patients with PTC.The plasma CK19 level was determined by ELISA and the other clinical data were collected on admission.All patients were followed up for 12 months.The patients were divided into recurrence group (27 patients) and non-recurrence group (33 patients) according to the results of follow-up.Results Single factor analysis showed that age,female,history of smoking,Graves disease,occupational exposure,the level of thyroid peroxidase antibody,thyroglobulin antibody,triglyceride and CK19 between two groups had significant difference (P ＜ 0.05).Multiple factors analysis showed that female,history of smoking,occupational exposure,the level of thyroid peroxidase antibody,thyroglobulin antibody and CK19 were independent risk factors for recurrence (P =0.01).The recurrence rate of CK19 ≥4.12 μg/L patients was 79.31％ (23/29),significantly higher than that in CK19 ＜4.12 μg/L patients [12.90％ (4/31)] (x2 =5.17,P ＜ 0.05).The recurrence rate of CK19 ≥ 4.12 μ g/L was significantly higher than that in CK19 ＜4.12 μ g/L (x2 =4.11,P ＜ 0.05).Conclusions The plasma CK19 level is an independent risk factor for recurrence of PTC patients.It can be used as a significant independent predictor for recurrence of PTC patients.

BACKGROUND:Advancement in bioengineering based upon tissue engineering techniques may offer the possibility of repairing degenerative intervertebral disc.
OBJECTIVE:To summarize the research progress in the scaffolds of tissue engineered intervertebral disc.
METHODS:A computer-based retrieval was performed to search manuscripts describing tissue engineered intervertebral disc scaffolds published between January 1st, 1900 and December 31st, 2012 in PubMed database with the key words of“tissue engineering, intervertebral disc, scaffold”in English.
RESULTS AND CONCLUSION:Scaffold is an important part of tissue-engineered research. There are three kinds of materials for intervertebral disc scaffolds:natural biomaterials, synthetic materials, and composite materials. A variety of scaffold materials have their own advantages and disadvantages. Up to now, none of these scaffold materials is accepted as the most suitable one. The selection of scaffold materials is stil to be further studied. The study and development of nanoscale biomaterials is an inevitable trend. Otherwise, with the help of bionics, improving scaffolds is also an inexorable trend in progress of simulating human intervertebral disc. Furthermore, injectable scaffold is also an research hot spot, and the selection range of injectable scaffold materials mainly focuses on chitosan, typeⅡcolagen,hyaluronic acid,fibrin,elastin,and alginate.C urrently, studies on chitosan as a scaffold material are relatively more.

Objective To discuss the reasons,surgical procedures and prognosis of multiple-operations for intra-and extrahepatic cholangiolithiasis.Methods The retrospective cohort study was adopted.The clinical data of 85 patients with intra-and extrahepatic cholangiolithiasis who underwent multiple-operations at the Second Affiliated Hospital of Anhui Medical University from January 2006 to January 2015 were collected.Individualized operations were determined according to the distribution of stones and liver functional reserve,including stones removal by incising bile duct and external biliary drainage,Roux-en-Y hepaticojejunostomy and hepatolobectomy or segmental hepatectomy.The treatment followed the principles as complete removal of stones,complete resection of lesions,correction of stenosis and adequate drainage.Bile was extracted during operation for bacilli culture.Patients received the postoperative symptomatic treatments,including anti-inflammation,hemostasis,liver protection,acid inhibition and nutritional support.The observation indicators included reoperation reasons,operation method,operation time,volume of intraoperative blood loss and transfusion,hepatic inflow occlusion,stone clearance rate,postoperative complications and treatments,bacilli culture of bile,results of pathological examination and duration of hospital stay,results of follow-up.The follow-up using outpatient examination and telephone interview was performed to detect postoperative living conditions and results of abdominal ultrasound once every 3 or 6 months in patients without stone residue and once every 1 month in patients with stone residue from postoperative week 6 to December 2015.Measurement data with normal distribution and with skewed distribution were represented as x ± s and M (range),respectively.Results (1) Reasons of reoperation:85 patients had stone residue or recurrence,including 7 combined with stenosis of bilioenteric anastomosis,5 with secondary malignant biliary tumors and 2 with gastrointestinal stromal tumor invading intrahepatic bile duct.(2) Intraoperative status of reoperation:of 85 patients,25 received partial hepatectomy + stones removal by incising common bile duct + choledochoscopy exploration + T-tube drainage,21 received partial hepatectomy + stones removal by incising common bile duct + choledochoscopy exploration + Roux-en-Y hepaticojejunostomy,13 received stones removal by incising common bile duct + choledochoscopy exploration + T-tube drainage,8 received stones removal by incising common bile duct + choledochoscopy exploration + Roux-en-Y hepaticojejunostomy,5 received partial hepatectomy + removal of former bilioenteric anastomosis + choledochoscopy exploration + T-tube drainage,4 received former intestinal Y-loop resection + stones removal by choledochoscopy + Roux-en-Y hepaticojejunostomy,3 received stones removal by incising intrahepatic bile duct + choledochoscopy exploration + T-tube drainage,3 received partial hepatectomy + residual gallbladder resection + stones removal by incising common bile duct + choledochoscopy exploration + Roux-en-Y hepaticojejunostomy,2 received partial hepatectomy + residual gallbladder resection + stones removal by incising common bile duct + choledochoscopy exploration + T-tube drainage and 1 received residual gallbladder resection + removal of former bilioenteric anastomosis + choledochoscopy exploration + Roux-en-Y hepaticojejunostomy.Operation time and volume of intraoperative blood loss of the 85 patients were (259 ± 66) minutes and (180 ± 142) mL,respectively.Seven patients underwent intraoperative blood transfusion and 17 underwent first hepatic hilum occlusion.ALl the 85 patients received intraoperative choledochoscopy exploration.The immediate and final stone clearance rates were 62.4％ (53/85) and 87.0％ (67/77).(3) Postoperative status of reoperations:of 85 patients,45 had postoperative complications.Sixteen patients with incision infection were improved by wound drainage and dressing,anti-infection and supporting treatments without other treatments.Ten patients with pleural effusion were out of hospital after effective anti-infection and nutritional support treatments.Eight patients with biliary fistula were discharged from hospital after abdominal drainage.Six patients with incision infection combined with pleural effusion were discharged from hospital after wound drainage and dressing,anti-infection and nutritional support treatments.Among 5 patients with bile duct bleeding,1 was self-healing,1 underwent reoperation and 3 were improved by conservative treatment.The bacilli culture of bile in 68 patients was positive,and bacteria mainly consisted of Escherichia coli,Enterobacter cloacae,Pseudomonas aeruginosa and Klebsiella pneumoniae.Of 85 patients,78,5 and 2 patients were respectively confirmed with hepatolithiasis,bile duct cell adenocarcinoma combined with stone recurrence and choledocholithiasis combined with interstitialoma by pathological examination.Duration of hospital stay was (21 ±8)days.(4) Results of follow-up:77 patients were followed up for a median time of 32 months (range,6-108 months) with an overall follow-up rate of 90.6％ (77/85).During follow-up,50 patients had good survival,27 had poor survival including 11 with stone residue,9 with stone recurrence and 7 with bile duct canceration,and 7 died of no operation of secondary tumors.Conclusions Stone residue and recurrence are the main reasons for reoperation.The individualized surgical methods are determined according to preoperative stone distribution,with or without atrophy of liver lobe,with or without canceration and condition of liver function,which can increase the stone clerance rate,reduce the stone residue and recurrence rates and avoid reoperation.

It is important to pay more attention to students’ basic skills training and their comprehensive abilities cultivating in microbiology experiment teaching. Explorations and reforms in enforcing the students’ base and cultivating their abilities were carried out in order to improve teaching quality and train specialized talents with high quality.

A case of multilocular solitary cyst of the kidney containing approximately 5000 ml. of fluid has been reported along with a literatural review.
Bone Cysts* ; Kidney*

Objective By means of analyzing the antihypertensive use of hypertension patients of Guiyang in 2013 and impact factors for basic drug use,to evaluate the impacts of the essential medicines list in place in Guiyang to hypertension patients in communities in Guiyang.Methods 969 hypertension patients were surveyed with structured questionnaire of stratified random sampling at 6 community health centers in Guiyang city.Results Hypertension patients in communities averaged 1.4 types of antihypertensive,and the essential medicines used accounted for 39.8％of all the antihypertensive.The distribution differences of the ratio of essential medicines use are significant interms of age,gender,and household annual income.Use ratio of non-essential medicines of the 55～64 age group and 65～74 age group are 3.48 times and 0.47 times over that of the 75 and above age group.For hypertension patients of low income and medium income,their probable use of non-essential medicines is 2.05 and 2.87 times that of high income households.Conclusion As the use ratio of hypertension patients in Guiyang is relatively low,and the factors for it are age and household income,focused intervention is recommended for the 65～74 age group and low-income households,for the purpose of high use ratio of essential medicines of such people.

The purpose of this study is to know the present situation of head louse infestation among the students in Yongyang-gun, Kyongsangbuk-to From May 11 to June 20, 1984, a total of 5,937 students in 23 primary and 3 middle schools were examined to identify the adult worms of head louse and/or their nits on the hair. The results are as follows: The overall infestation rate was 44.5 percent and the rates ranged from 19.6 percent to 88.6 percent by each school. In primary schools, the rate was 53.0 percent and in middle schools, 27.1 percent. The school boys' rate was 33.2 percent and the school girls' 55.6 percent, and the difference was statistically significant (p<0.001). The rates were different by grades in middle schools. The rates were different by areas (Myons) (p<0.001). The adult worms collected from the students were Pediculus humanus var. capitis.
parasitology ; arthropod ; head louse ; Pediculus humanus capitis ; epidemiology

A portable glucose meter based on PIC microcomputer with data storage, analysis and historical data curve display functions, is presented. The concentration of blood glucose is detected with a glucose oxidase electrode. Test records may be stored and historic data can be displayed on the LCD with a fitting curve.
Blood Glucose Self-Monitoring ; instrumentation ; Computer-Aided Design

OBJECTIVETo research the change of concentration of the amino acid neurotransmitters in the striatum focal cerebral ischemia in rat and the effect of Acorus tatarinowii Schott, one of inducing resuscitation drugs, for 4 of amino acid neurotransmitters.

METHODSTwenty four rats were divided into four groups (n = 6): control group, cerebral ischemia group, sham operation group and Acorns tatarinowii Schott treated group. Rats were established into models of cerebral ischemia by occluding bilateral thread cork method. Formation sampling were performed in a striatum area using microdialysis and the detection of biological sample including aspartic acid, glutamic acid, glycine and gamma-aminobutyric acid by high performance liquid chromatography (HPLC) electrochemical detector system.

RESULTSCompared with the control, the all contents of 4 kinds of the amino acids were significantly increased during cerebral ischemia (P < 0.01). Compared with the cerebral ischemia group, the contents of aspartic acid, glutamic acid that were excitatory amino acids were remarkably decreased in the striatum for Acorus tatarinowii Schott treated group (P < 0.01), It was no significant influence on gamma-aminobutyric acid and glycine that belonged to inhibitory amino acid in a nascent condition but with a elevating in the later period of microdialysis.

CONCLUSIONAcorus tatarinowii Schott can enter the cerebral parenchyma through blood brain barrier and cut down glutamic acid,aspartic acid increased during cerebral ischemia. As a result, the neurotoxicity attributed to the excitatory amino acid has been released in excessive amounts declined so as to avoid the secondary impairment of neurons caused by excitatory amino acids pernicious effects after ischemia. It may be one of the protective mechanism of drugs for inducing resuscitation resembling EAA receptor antagonists to ischemi brain.

Acorus ; chemistry ; Animals ; Brain Ischemia ; metabolism ; Corpus Striatum ; metabolism ; Disease Models, Animal ; Excitatory Amino Acids ; metabolism ; Male ; Neurotransmitter Agents ; metabolism ; Rats ; Rats, Sprague-Dawley

Objectives:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) and identify the risk factors for death.Methods:The clinical data of 60 patients undergoing ECPR admitted to our hospital and Hangzhou First People's Hospital from September 2014 to September 2019 were retrospectively analyzed. The patients were divided into the survival group and the death group. The clinical data of the two groups were compared to explore the risk factors related to death. COX regression analysis was used to identify the risk factors for death.Results:Sixty patients undergoing ECPR were included in our study, of them, 16 (26.7%) cases were out-of-hospital cardiac arrest (OHCA) and 44 (73.3%) cases were in-hospital cardiac arrest (IHCA). The mortality of OHCA patients was higher than that of IHCA patients (87.5% vs. 56.89%, P < 0.05), and the duration from CPR to ECMO installation in the death group was longer than that in the survival group [(105.4±105.1) min vs. (53.0±28.5) min, P < 0.05]. Compared with the survival group, patients in the death group had higher troponin and glutamic oxalacetic transaminase and lower PH and lactate ( P < 0.05). The median survival time of the 60 patients was 42 days. Out-of-hospital cardiac arrest, high SOFA score before ECMO, high-dose norepinephrine, pulmonary infection during ECMO support and long ECMO support time were independent predictors of patients’ death. Conclusions:Risk factors associated with patients’ death undergoing ECPR are out-of-hospital cardiac arrest, high SOFA score before ECMO, high-dose norepinephrine, long duration from CPR to ECMO installation, pulmonary infection during ECMO support and long ECMO support time.