Objective:To compare the diagnostic value of conventional fine needle aspiration biopsy(C-FNAB) and Ultrasound-guided FNAB(USFNAB) for thyroid nodules by Meta-analysis.Methods: PubMed and CNKI database were searched for English and Chinese language articles related to FNAB diagnosis for thyroid nodules.The literatures were assessed and screened according to the Standards for Reporting of Diagnostic Accuracy(STARD).Data were pooled by Metadisc software.Results: A total of 8 810 specimens were included in conventional FANA group and the pooled sensitivity,specificity,and the AUC of weighted summary receiver operating characteristic(SROC) curve were 84.9%,76.3% and 0.919 4,respectively;2 393 specimens were included in US-FNAB group and the above numbers were 84.0%,80.8% and 0.935 6,respectively.Conclusion: FNAB has high accuracy in diagnosing thyroid nodules;the accuracy of ultrasound-guided FNAB is higher than conventional FNAB.

OBJECTIVE:To systematically review the procalcitonin(PCT)-guided therapy in patients with sepsis. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CJFD,Wanfang Datebase,related trails about PCT-guided therapy(test group)versus conventional treatment group(control group)in the treatment of sepsis were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 5 studies were enrolled,involving 826 patients. Results of Meta-analysis showed,use time of antibiotics in test group was significantly shorter than control group, with statistical significance [MD=-2.52,95%CI(-3.07,-1.98,P<0.001];there were no significant differences in the mortality rate [OR=1.14,95%CI(0.83,1.56),P=0.42],ICU treatment days [MD=-0.22,95%CI(-1.40,0.96),P=0.72] and total hospi-talization [MD=-1.81,95%CI(-4.37,0.76),P=0.17]. CONCLUSIONS:PCT-guided therapy can effectively reduce the use of antibiotics and shorten treatment time in the treatment of patients with sepsis.It can be considered as inflammatory markers for guid-ing rational use of antibiotics in clinic.

Objective: To observe the effect of different caesalpinia sappan extract on the Mice thymus tissue, peripheral T-cell proliferation and the production of INF-?. Methods: To make preparation of different caesalpinia sappan extract and give them to the mice, weighing the mice thymus and calculating the thymus index 7 days later. The MTT method was used to measure the proliferation ability of T-cells of the mouse spleen. A double antibody sandwich ELISA was used to detect INF-? content in T-cells culture supernatant. Results: The different caesalpinia sappan extract not only have clear inhibitory effect on the weight of thymus but also have inhibitory effect on the proliferation of T-cells and the production of INF-?. The inhibitory effect of caesalpinia sappan ethanol extract and n-butanol extract on the T-cells is much stronger.

Objective To observe the clinical efficacy of interferon by aerosol inhalation as a part of treat-ment of hand,foot and mouth disease of children.Methods The clinical data of 240 children with hand foot and mouth disease were collected,and they were divided into group A (control group)and group B (interferon treatment group)according to the order of admission.The recovery time on body temperature,rashes on the hands and feet, mouth pain,the average hospitalization time and total efficacy rate were compared.Results Group B was superior to group A in the following aspects,it took shorter time to get recovery of mouth pain,rashes on hands and feet,the aver-age hospitalization time.The recovery time for mouth pain of group A was (60.5 ±22.1 )h,which of group B was (52.8 ±19.5)h.The time for rashes on hand and foot recovery of group A was (72.3 ±25.4)h,which of group B was (54.7 ±22.5)h.The average hospitalization time of group A was (124.8 ±42.4)h,which of group was B (108.2 ±36.7)h,and the differences were statistically significant (t =2.45,2.38,2.16,P =0.018,0.015,0.032). The total effective rate of group B was 93%,which was higher than 85.3% of group A,and the difference was statistically significant (χ2 =6.012,P =0.012).Conclusion Interferon by aerosol inhalation as a part treatment of hand -foot -and -mouth disease of children (ordinary type)can increase the efficacy rate,shorten course of the disease,accelerate comprehensive rehabilitation of patients.

In most non-excitable cells,the store-operated calcium channel (SOCC) in the plasma membrane is the major calcium entry pathway.SOCC plays an important role in calcium signals that control many cancer cellular processes such as adhesion,secretion,movement,gene expression,proliferation,division and apoptosis.Stromal interaction molecule 1 (STIM1) and Orail are the two important parts of SOCC.So overexpression or suppression expression of STIM1/Orail can regulate SOCC activity and biological characteristics of cancer cells.However,SOCC plays a contradictory role in cancer cells,which can both promote tumor progression and inhibit tumor progression.SOCC is expected to become a new target for the treatment of tumors,but its complicated mechanism needs to consider both types of tumor cells and the external stimulators of tumor cells.

Objective To study the surgical treatment strategy for elderly(aged at 80 years or over)colorectal cancer patients.Methods There were 65 cases of colorectal cancer undergoing Surgical treatment in Beijing Cancer Hospital from 1999 to 2006,and results were analyzed retrospectively.Results In this group of patients.the postoperative morbidity was 53.8%,but anastomotic leakage rate was only 3.9%,operative mortality was 1.5%.Postoperative 1-,3-and 5-year survival rate was 78.92%,27.79%,and 16.32%respectively.Kaplan-meier analysis and Cox regression analysis showed that:the TNM stage of the tumor and preoperative hemoglobin and WBC level were independent prognostic factors,but patients' age,gender,preoperative serum level of CEA and albumin,tumor differentiation,tumor size were not independent prognosis factors.Conclusion Elderly CRC patients have a higher risk of surgical treatment.But with the improvement of perioperative management,the anastomotic fistula and mortality rate were not increased significantly and the result is satisfactory.

Education, Nursing, Continuing ; General Surgery ; education ; Humans ; Physicians

Objective:To examine whether the thyroxine treatment can affect the serum lipid levels in patients with subclinical hypothyroidism by Meta analysis.Methods:Pubmed and China National Knowledge Infrastructure(CNKI)were searched for randomized controlled trials reporting the effectiveness of thyroxine treatment on serum lipid levels in subclinical hypothyroidism patients from January 1980 to September 2006;hand-search was also performed.The included trails were analyzed by RevMan4.2 software.Results:Six studies were finally included and five of them found thyroxine to be significantly more effective than placebo in improving the serum lipid disorders;one of them found thyroxine had no obvious effect.The pooled effect sizes(95%CI)of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),apoprotein A(ApoA),apoprotein B(ApoB)and lipoprotein a(Lp(a))were -0.39(-0.71, -0.07),-0.02(-0.07,0.04),-0.02(-0.06,0.03),-0.22(-0.31,-0.12),-0.08(-0.11,-0.06),-0.05(-0.08, -0.02),and -0.38(-2.41,1.64),respectively.The analysis results showed that thyroxine treatment was significantly effective on serum levels of TC,LDL-C,ApoA,and ApoB,but not on TG,HDL-C,or Lp(a).Conclusion:This Meta-analysis demonstrates that thyroxine treatment can improve thyroid function and lipid metabolism in patients with subclinical hypothyroidism,reducing the prevalence of artherosclerosis and coronary heart disease.

Objective To explore the relationship between resveratrol and Notch 1 signalling pathway in podocytes.Methods Interference RNA (RNAi) and doxycycline (Dox) were used to inhibit the Sirtuin (SIRT) 1 expression in the wild-type and inducible SIRT1 shRNA (CAGGS) podocytes respectively.Recombinant mouse delta-like ligand 4 (DLL4) was used to activate Notch1 signalling.The message RNA of SIRT1,Notch1 downstream gene Hes1 and Hey2,as well as the key enzymes of Notch1 signalling pathway were detected by using real-time PCR.Western blotting was used to detect intracellular domain of Notch 1 (ICD1),SIRT1,and metalloprotease (ADAM) 10 and components of γ-secretase complex protein expression.Results In WT murine podoytes,resveratrol up-regulated ICD1 protein production,as well as the mRNA of Hes1 and Hey2 in a dose-dependent manner.Treatment with resveratrol resulted Nicastrin mRNA and protein increase in podocytes (P ＜0.05),as well as inhibit ADAM10 expression (P ＜ 0.05),but all these changes were prevented after the use of SIRT1 RNAi(P ＜ 0.05).DLL4 up-regulated the expression of mRNA of Hes1 and Hey2,as well as ICD1 protein production in a dose-dependent manner.Treatment with doxycycline resulted decrease of SIRT1 gene and protein expression in CAGGS podocytes after 24 h and 48 h respectively(P ＜ 0.05),which weakend the role of DLL4 significantly(P ＜ 0.05).Conclusion Resveratrol induces Nicastrin expression,as well as activation of Notch1 signalling pathway in a SIRT1-dependent manner.

Objective To research the acute adverse effects of air pollution on the risk of stroke in the air pollution exposed people.Methods Daily counts of strokes occurrence (2004-2007) were obtained from the population-based stroke registry in one district of Shanghai.Air pollution data was obtained from the Shanghai Environmental Monitoring Center.A semi-parametric generalized additive model was used to study the acute effects of air pollution on stroke occurrence after controlling for long-term and seasonal trends,weather variables,and day of the week.Results The relative risks of stroke occurrence for per 10 ?g/m3 increase of PM10,SO2 and NO2 were 1.02 (95%CI:1.01-1.03),1.05 (95%CI:1.04-1.06) and 1.09 (95%CI:1.08-1.10),respectively.Conclusion The study has provided a new evidence for the association between air pollution and risk of stroke occurrence.