Purpose There is no agreement for contrast enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant thyroid nodules. This paper aims to evaluate the diagnostic value of the conventional and contrast-enhanced ultrasonography in the diagnosis of thyroid nodule by meta analysis. Materials and Methods Literature search was performed in PubMed, CNKI and Wanfang databases to identify relevant English and Chinese literatures by using pathological results as the gold standard from January 1990 to September 2014. The quality of each selected study was evaluated by QUADAS. The pooled weighted sensitivity, specificity and the corresponding 95% CI were calculated. Summary receiver operating characteristic curves (SROC), area under curve (AUC) and the Q* index were also calculated. Results A total of 14 literatures (1970 nodules) were included, the pooled weighted sensitivity and specificity of conventional ultrasonography were 0.74 and 0.70; those of contrast-enhanced ultrasonography were 0.86 and 0.82. The AUC by using the two methods were 0.84 and 0.93, respectively, and the Q* index were 0.77 and 0.86, respectively. Conclusion In the diagnosis of thyroid nodule, the accuracy of contrast-enhanced ultrasonography is better than conventional ultrasound; however, both of them have high clinical value in the diagnosis of thyroid nodule, thus they are helpful in avoidance of unnecessary surgical treatment in patients with thyroid disease.

AIM:To investigate the immune depressive effect on the reactive T cells and to explore the immunologic injury mechanism of beta cells of islet in type 1 diabetes mellitus(DM-1).METHODS:pAd5/PD-L1-GPI adenovirus vector with target gene was constructed and transfected into NIT cells which are known as a mouse insuloma cell line.The highly expressed membrane protein of PD-L1-GPI was confirmed by Western blotting.The peripheral blood non-adherence lymph leukocytes and target cells were cultured to detect lymph leukocyte proliferation and the T cell function.The level of IL-2,TNF-? and IFN-? were detected in the cell culture fluid.RESULTS:Compared with the control group,the NIT cells modified with PD-L1-GPI inhibited the sensitized lymph leukocyte proliferation effectively and down-regulated the level of some cytokine secretions such as IL-2,IFN-? and TNF-?(P

Auditory Cortex ; metabolism ; Humans ; Magnetic Resonance Spectroscopy

Objective To evaluate the effect of double stapling technique for sphincter preservation operation in mediate-low rectal carcinoma.Methods The resection through double stapling technique for sphincter preservation approach was performed on 30 patients with mediate-low rectal carcinoma from January 2004 to November 2007.The distance between the anal verge and the lower margin of the tumor was 4～8cm(averaged 6.5 cm),including 22 patients in Dukes A stage,6 Dukes B and 2 Dukes C.Results Fecal continences were preserved successfully in all patients.2 cases had got anastomotic narrowing(6.6%) after operation.At a median follow-up of 46 months,two patients had local recurrences(6.6%).There was no urinary dysfunction in this series.Conclusion Double stapling technique for sphinceter preservation operation was feasible and safe,provide a original operative style for mediate-low rectal carcinoma.

Objective To evaluate the effect of procaine on prevention of skin slap necrosis after modified radical mastectomy in breast cancer.Methods 106 breast cancer patients were randomly divided into treatment and control groups.In the treatment group,procaine(1% 100ml diluted in 300ml mormal saline,42℃)were compressed under the skin flap in operation,the control group received same amount of normal salin instead.The rates and sizes of skin flap necrosis were obeserved and compared.Results There were 13 cases suffured from skin flap necrosis among 106 breast cancer cases who received surgery operation.The rate of the flap necrosis in treatment group was5.76%(3/52),and the control group was 18.51%(10/54),there was significant difference(P

Objective To evaluate the clinical value of real-time 3 dimensional echocardiography (RT-3DE) for measurement of right ventricular function in the repaired tetralogy of Fallot (TOF) compared to cine magnetic resonance imaging (c-MRI).Methods Thirty-seven randomly selected patients with repaired TOF from Jan.2000 to Jun.2007 in Children's Hospital,Fudan University underwent both RT-3DE and c-MRI for the data of right ventricular enddiastolic volume (RVEDV),right ventricular end-systolic volume (RVESV),right ventricular ejection fraction (RVEF),which were compared to evaluate the reproducibility and correlation of two ways on right ventricular function.Results All the patients completed both RT-3DE and c-MRI on the same day.The correlation for RVEDV,RVESV,RVEF measured by 2 methods was high (r =0.933,0.943,0.911,P =0.000,0.000,0.105),and it showed that consistency existed in RVEF,as difference was only (1.2 ± 4.5) ％.Comparison with c-MRI,RVEDV and RVESV measured by RT-3DE was underestimated,in which difference was (-17.4 ± 16.9) mL,(-9.3 ± 10.5) mL.Conclusions RVEF with RT-3DE can be assessed with acceptable accuracy,but it is not so good for RVEDV and RVESV.Further study needs to be performed to make sure the value of RT-3DE on the assessment of right ventricular function in repaired TOF.

Objective To summarize the experience in the treatment of Marfan syndrome of pregnancy complicated with acute type A aortic dissection.Methods Three women with Marfan syndrome of pregnancy complicated with acute type A aortic dissection were treated.The average age was 28.6 (25-31) years,and the average gestational age was 36.5 (32-38) weeks.At first caesarean operation were performed under general anesthesia.Bentall + Sun' s operation was performed under deep hypothermic circulatory.After operation,the mother and fetus were followed up.Results Three women and their fetus were safe.The average extracorporeal circulation time,aorta clamp time and circulatory arrest time were 265 (210-280) min,135 (120-160) min and 26.5 (20-29) min,respectively.After a mean follow-up of 2.0 (1.0-2.5) years,3 patients were living well.CT angiogram detected normal aortic,with no signs of distal dilation.Three fetus were normal in development and neurocognitive function.Conclusion Methods of surgical repair and fetal delivery should be chosen based on aortic pathological changes and gestational age to maximize the safety of the mother and fetus.

Objective To compare the assessment results of Loewenstein occupational therapy cognitive assessment (LOTCA) and mini-mental state examination(MMSE) in stroke patients,and to analyze the correlation between the two assessments and to explore the applicable values of LOTCA in assessing vascular cognitive function impairment (VCI).Methods According to the diagnostic standard of cognitive impairment with MMSE,thirty stroke patients with cognitive impairment were selected as cognitive impairment group,thirty stroke patients without markedly cognitive impairment as stroke control group,and thirty normal subjects served as normal control group.All the subjects' age,gender and level of education were matched in the three groups. All the subjects were assessed with LOTCA and MMSE.ResultsThe total scores of LOTCA had high positive correlation with the total scores of MMSE in cognitive impairment group ( r =0.934,P ＜ 0.01 ),the correlations were also found between every sub-items of LOTCA and those of MMSE (P ＜ 0.01 ).The total scores and the scores of sub-items of LOTCA in cognitive impairment group were significantly lower than those in stroke control group and were those in normal control group(P ＜ 0.01 ),particularly lower scores in LOTCA sub-items of thinking operations,orientation,visuomotor organization.The scores of sub-items of LOTCA,including thinking operations,visuo-motor organization,attention,orientation,spatial perception were all significantly lower in stroke control group than those in normal control group(P ＜0.01 ),especially in thinking operations and visuo-motor organization sub-items.Conclusions Correlations were found between LOTCA and MMSE.Compared to MMSE,LOTCA could detect vascular cognitive function impairment earlier and is much more comprehensive,so it is suitable to assess vascular cognitive impairment patients with no dementia.

Objective To investigate the correlation between the frustration tolerance and personality of medical college students and to discuss its promoting strategies.Methods Totally 460 college students were selected randomly.Questionnaire of frustration tolerance and scale of Eysenck personality inventory(EPQ) were used and the measurement data were compared with correlation analysis and regression analysis of SPSS 13.0.Results Correlation was significant between frustration tolerance (total score and 6 inducing factors) and personality (EPQ factors) of college students ； personality (EPQ factors)of students could predict their frustration tolerance and corresponding t value was -4.85,P ＜ 0.01 (psychoticism),6.93,P ＜ 0.01 (extraversion),-11.15,P ＜ 0.01 (neuroticism).Conclusions Personality of college students are greatly influenced by their frustration tolerance.Targeted anti-frustration ability training should be conducted according to the different personality characteristics.

Objective To investigate the relation between polymorphism of NOS3 G894T and susceptibility of cancer .Methods Literatures under the inclusion and exclusion criteria about relation between polymorphism of NOS 3 G894T and susceptibility of cancer were collected by computer -based retrieval and manual retrieval .The pools ORs with 95% CI were calculated to assess the association strength between polymorphism of NOS 3 G894T and cancer risk by Meta methods .Sensitivity and publication bias were evaluated .Results 19 literatures with 7679 cases of cancer and 8180 cases as control group were included .The pooled result indica-ted that no significant association between its polymorphism and cancer (ORT versus G=1 .030 ,95% CI=0 .964 -1 .101 ;ORTT versus GG=1 .056 ,95% CI=0 .895-1 .245 ;ORTG versus GG=1 .045 ,95% CI=0 .977-1 .119 ;ORTT/TG versus GG=1 .047 , 95% CI=0 .981-1 .117 ;ORTT versus TG/GG=1 .005 ,95% CI=0 .900-1 .123) .No significant association was observed in sub-group analysis based on ethnicity ,cancer type ,and source of control group .Conclusion There was no relationship between NOS3 G894T polymorphism and cancer susceptibility .