Objective To investigate the ultrasonic features and pathological basis of follicular variant of papillary thyroid carcinoma (FVPTC). Methods Ultrasonic presentation of 30 patients with FVPTC conifrmed by surgery and pathology from the Seventh People′s Hospital of Shaoxing during March 2002 and December 2012 were analyzed retrospectively and compared with pathological results. Results Ultrasonic presentation of 30 FVPTC cases could be classiifed into three types:(1) Six cases (20%, 6/30) of typeⅠ, with typical sonographic features of papillary thyroid carcinoma:nodules with irregular shape, unclear boundary, and very low echo inside, microcalciifcation could be seen. (2) Fourteen cases (47%,14/30) of typeⅡ, presented as clearer iso-echoic or hypo-echoic nodules, with irregular shape, angled and lobular edge, rare microcalciifcation. (3) Ten cases (33%, 10/30) of typeⅢ, presented as adenoma-like features, nodule with clear boundary and regular edge, uniform medium echo inside. The microscopic structure characteristics could be divided into three categories:6 cases of typeⅠ, lesions were featured with no obvious capsule, irregular shape and inifltrative growth;14 cases of type Ⅱ, lesions with irregular shape, which invading the capsule with partial protrusion and peripheral small satellite lesions;10 cases of typeⅢ, lesions with more complete envelope, more regular shape with no signiifcant or lower level and smaller extent invasion of the capsule. Differences in morphology, boundary, aspect ratio, internal echo, presentation of microcalciifcations between the encapsulated type (typeⅡ,Ⅲ) and non-encapsulated type (typeⅠ) FVPTC were statistically signiifcant (Fisher′s exact test, all P<0.05). While the difference in lymph nodes involvement between them was not statistically signiifcant (Fisher′s exact test, both P>0.05). Conclusion Ultrasonic presentation of FVPTC show characteristics of both follicular tumor and papillary carcinoma, and the ultrasonic presentations are closely related to the pathological subtypes.

Objective To evaluate the effect of schistosomiasis control in Yizhou City,Guangxi Zhuang Autonomous Re?gion,from 2011 to 2014,so as to provide the evidence for formulating the further prevention and control strategy. Methods The schistosomiasis surveillance data were collected and analyzed in Yizhou City from 2011 to 2014. Results From 2011 to 2014,770.38 hm2 was surveyed for the Oncomelania hupensis snails,and two snail infested sites were found,while no infected snails were found. Totally 3 524 residents were tested by ELISA for Schistosoma japonicum infection,and 38 cases were posi?tive. The positive rate of 2013 was significantly higher than those of other three years( χ2 = 15.08,P < 0.05). Totally 432 rats and 28 dogs were dissected and 1 697 cattle were examined by the stool test,but no positive cases were found. Conclusions The indicators of schistosomiasis surveillance are basically stable in Yizhou City.

[Objective]To evaluate the efficacy of Shenmai injection combined with psychotherapy in chemotherapy of non-small cell lung cancer.[Method]79 cases of advanced non-small cell lung cancer were randomly divided into two groups,40 cases in observation group with Shenmai injection combined with chemotherapy and psychotherapy,39 cases in control group with chemotherapy alone.The Karnofsky scores,therapeutic efficacy,one year survival rate and incidence of myelosuppression were evaluated.[Result] The two groups were significantly different in Karnofsky scores,therapeutic efficacy and one year survival rate.The improvement and stability rate of Karnofsky scores and that of therapeutic efficacy were 75.0% and 70.0% in observation group,with 46.2% and 46.2% in control group,respectively.One year survival rate was 47.5% in observation group and 25.6% in control group,respectively.The incidence of myelosuppression had significant differences in the two groups,with grade 2～4 leucopenia 32.5% in observation group and 53.8% in control group(P=0.032),with grade 2～3 thrombocytopenia 30.0% in observation group and 46.2% in control group(P=0.032).[Conclusion] Combination treatment in observation group was superior to the treatment in control group,with a higher Karnofsky scores,more effective therapy,a higher one year survival rate and a lower incidence of myelosuppression.The treatment of Shenmai injection combind with chemotherapy could reduce toxicity and enhance therapeutic efficacy.

AIM:To make a evaluation of high-dose Senmai(Radix Ginseng Rubra, Radix Ophiopogonis, Fructus schisandrae.)(HD-SM)in treating patients with advanced cancer.METHODS:32 patients with advanced cancer were assigned to treatment group. And 28 cases were assigned to the control group. The treatment group received chemotherapy and HD-SM, the control group received chemotherapy and the routine supporting treatment (except HD-SM). The toxicity and effect of all patients were observed, and the value of HD-SM was assessed.RESULTS:All cases in treatment group received 4 chemotherapy courses according to plan. The toxicities were tolerable, and the effect was satisfactory. All cases in the control group were only performed 1 course of treatmeur.CONCLUSION:HD-SM can decrease the effect of chemotherapy and reduce chemotherapeutic toxicities, and it is a very effective supporting treatment in chemotherapy.

Objective To retrospectively demonstrate risk factors for mortality in multiple trauma patients with acute respiratory distress syndrome(ARDS).Method This wes a retrospective cohort stuay regarding multi-ple trauma as a single cause for intensive care unit admission.Patients identified multiple trauma with ARDS en-rolled in prospectively maintained database between May 2003 and April 2008 were observed,and 23 items of po-tential risk factors of impacting mortality were calculated by univariate and multivariate logistic analyses in order to find distinctive items in these multiple trauma patients.Information on patients demographics characteristics,treat-ment procedures and injury severity were collected at the time of EICU admission.The criteria used for ARDS met definition of the guideline(2006)of Chinese medical association.The commonly accepted definition of multiple injuries was consistent with both several injury sites(generated from two or more than two anatomic sites)and in-jury in one anatomic site at least threatening life.Severity of injury was quantified by injury severity seore and the simplified acute physiology score and chronic health evaluation score (APACHE Ⅱ)in EICU admission.We in-cluded adult patients(age≥18 years),those with an EICU length of stay longer than 48 hours,and those accept-ing mechanical ventilation more than 24 hours.Patients who were readmitted to EICU by virtue of non-traffic injury or transferred to EICU from other hospitals after long-term treatment were excluded.Mortality was assessed at the 28th clay after trauma.Results There were 269 multiple trauma patients with posttranmatic ARDS admitted to ICU during the study period,the unadjusted odds ratio(OR)and 95% confidence intervals(CI)of mortality were associated with six risk factors(APACHE Ⅱ score,duration of tratuna factor,pulmonary contusion,aspiration of gastric contents,sepsis and duration of mechanical ventilation)out of 23 items.The adjusted Odds Ratios(ORs) with 95% CI were denoted with respect to surviving beyond 96 hours ICU admission(APACHE Ⅱ score,duration of trauma factor,aspiration of gastric contents),APACHE Ⅱ score beyond 20 ICU admission(duration of trauma factor,scpsis,duration of mechanical ventilation)and mechanical ventilation beyond 7 days ICU admission(dura-tion of trauma factor and sepsis).Conclusions Impact of pulmonary contusion and APACHE Ⅱ score contribut-ing to prediction of mortality may exist in prophase after multiple trauma.Sepsis is still a vital risk factor referring to systemic inflammatory response syndrome,infection,and secondary multiple organs dysthnetion.Aspiration of gastric contents could lead to incremental mortality due to scvere ventilation associated pneumonia.Duration of trauma factor determined degree of injury and outcomes,longer duration generally manifested higher mortality.Long-standing mechanical ventilation should be constrained on account of occurring severe refractory complications.

Objective To study the expression of tansforming growth factor(TGF)-?1 and mRNA in the renal tubules of Streptozotocin(STZ)-induced diabetic nephropathy rats.Methods SD rats were randomly divided into two groups: normal control and diabetic nephropathy.Diabetes was induced by intraperitoneal injection of STZ.And the diabetic rats were randomly divided into four groups: model group,irbesartan treatment group,Haikunshenxi low and high dose group.Twenty-four-hour urine volume and urinary protein excretion were examined at week 4,8,and 12 respectively.All the rats were sacrificed at week 12,and body weight,kidney weight,and serum excretion,serum creatinine,blood urea nitrogen were examined.The expression of TGF-?1and mRNA in rat renal tissue were detected respectively by immunohistochemistry and in situ hybridization.The graphic analysis system and SPSS 11.5 statistics software were used to treat the results.Results The expression of TGF-?1and mRNA in the Haikunshenxi group was depressed greatly(P

AIM: To study the effect of TGF-? 1 and TN F-? antisense PS-ODNS on ex vivo expansion of hematopoietic stem/progenitor cell s (HSPC). METHODS: CD 34 + cells were purified from fres h umbilical cord blood by immunomagnetic beads, and mononuclear cells were purifi ed from bone marrow by Ficoll-hypaque . The effects of TGF-? 1 and /or TNF-? an tisense PS-ODNS on ex vivo expansion of CD 34 + cells、CFU-GEMM、CFU-G M、CFU-E and BFU-E were detected by using liquid and semi-solid culture systems . RESULTS: TGF-? 1 antisense PS-ODNS cooperated with cytokines increased the number of CD 34 + cells,CFU-GEMM,CFU-GM,CFU-E and BFU-E , which was as 4,2.6,2.7,1.8,2.1 times as that of the control (the cytokine s combination), respectively. TNF-? antisense PS-ODNS cooperated with cytokines respectively increased the number of CD 34 + cells, CFU-GEMM, CFU-GM, CF U-E and BFU-E by 4, 2 9, 2 6, 1 7, 1 8 times as that of the control. The ab ove two antisense PS-ODNS cooperated with cytokines could respectively increased the number of CD 34 + cells, CFU-GEMM, CFU-GM, CFU-E and BFU-E by 5 3,2 1, 2 7, 1 9, 1 8 times as that of the control. CONCLUSION: I nhibition of endogenous TGF-? 1 and TNF-? by antisense PS-ODNS will be one of the effective methods to expand HSPC ex vivo.

Objective To investigate the immune response of IL-10 to Schistosoma japonicum infection in the early infectioin model and SEA immunization model of the IGTP~(-/-) and IRG-47~(-/-) mice.Methods In the early infection model,the IGTP knock out (IGTP~(-/-)) mice,IRG-47 knock out (IRG-47~(-/-)) mice and wild-type (WT) C57BL/6J mice were exposed to 300 S.japonicum cercariae via the pinna and sacrificed on day 7 post-infection.Each mouse pinna section was stained with hematoxylin-eosin (HE) to detect the pathological lesions,and the culture supernatant of pinna was used to test the levels of Th1/Th2 cytokines by indirect ELISA.In the SEA immunization model,IGTP~(-/-) IRG-47~(-/-) and WT mice were immunized with SEA twice and sacrificed in 3 weeks after the initial immunization.SEA-specific IgG antibody in sera was detected by indirect ELISA;the levels of Th1/Th2 cytokines were tested in culture supernatant of splenocytes by indirect ELISA;the proportions of CD4~+ T cells,CD8~+ T cells,B cells,Th1 and Th2 cells in the spleen were assayed by FACS.Results Although no obvious differences on the pathology of pinna were observed among the three mouse groups,the level of IL-10 in the culture supernatant of pinna of IRG-47~(-/-) mice was lower than that of IGTP~(-/-) mice in 7 days after the exposure.Following SEA immunization,the level of SEA-specific IgG antibody in sera of IGTP~(-/-) mice was lower than that in WT mice,the level of IL-10 in the culture supernatant of splenocytes of IRG-47~(-/-) mice was higher than that of IGTP~(-/-) and WT mice with the stimulation of SEA.However,the proportion of Th2 cells in the spleen of IRG47~(-/-) mice was the lowest among the three mouse groups.Conclusions SEA is the stimulus of IRG-47 deficiency mice to defend Schistosoma japanicum infection and promote the host to produce a protective response,and IL-10 may play an important role in immune regulation in this process.

Objective To analyze the incidence of BK virus (BKV) infection after kidney transplantation in our center and to evaluate the efficacy and safety of conversion treatment with Mizoribine (MZR) on BKV infection after kidney transplantation.Methods The information of recipients who received BK virus screening in hospital or outpatient during 2015-02 to 2016-12 in our center was retrospectively analyzed.The recipients positive for BKV were divided into experiment group (given conversion treatment with MZR) and control group (not given MZR conversion) according to the inclusion criteria.The negative rate of BKV,AR,hyperuricemia and the function of renal allograft during the conversion treatment with MZR were observed.Results 182 recipients accepted BKV screening during 2015-02 to 2016-12 and 68 cases were positive.The positive rate of BKV was 38.5 ％.The positive rate of peripheral blood specimens and midstream urine specimens was 7.1％ and 36.8％ respectively.Twelve recipients were positive for BKV in both peripheral blood specimens and midstream urine specimens.There were 27 recipients in experiment group and 36 cases in control group.Fourteen recipients positive for BKV became negative after MZR conversion in experiment group and the negative rate was up to 51.9％.The mean time of negative rate was 3.2 ± 2.7 (1-10) months after MZR conversion.During the conversion treatment with MZR,AR occurred in 1 case and was reversed by the impact therapy with Thymoglobulin in experiment group.The value of serum uric acid was maintained stable before and after MZR conversion under the action of uric-acidlowering drug.The renal function was kept stable in both experiment group and control group after renal transplantation.No deaths and renal allograft failure cases occurred in both groups during the research period.The 2-year survival rate for patients and kidneys was both 100％.Conclusion The incidence of BKV infection after kidney transplantation was high and the treatment scheme of MZR conversion was safe and effective.

Objective To investigate the relationship between different topographic locations and neurological deteriorations (ND) in patients with acute new isolated pontine infarction.Methods One hundred sixty-eight patients with acute new isolated pontine infarction during arch 2012 to March 2016 were identified by diffusion weighted imaging (DWI) for retrospective review.Patients were divided into two groups according to their clinical symptoms:patients with ND and patients without ND.According to neuroimaging of DWI,the topographic location of pontine infarction was divided into three types:The upper,middle,and lower ones,and the correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were explored by statistical tests.Results Of 168 patients,26.8％ (45/168) were diagnosed with ND,and 73.2％ (123/168) were diagnosed without ND.Univariate analysis showed that there were differences in female ratio [62.2％ (28/45) vs 41.5％ (51/ 123)],smoking ratio [13.3％ (6/45) vs 26.0％ (32/123)],mean length of hospital stay [(22.83 ± 7.12)d vs (19.31 ± 7.65)d],ratio of worse short-term clinical outcomes [77.8％ (35/45) vs 33.3％ (41/123)],and ratio of lower pontine infarction [55.6％ (25/45) vs 26.0％ (32/123)] between two groups (P ＜ 0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND (OR =1.953,95％ CI:1.092-3.535,P =0.029).Conclusions Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.