Object To investigate clinical features,surgical strategy and prognostic factors of bone metastasis from thyroid cancer.Methods A total of 46 patients with bone metastasis from thyroid cancer,who had undergone surgical treatment from January 1999 to July 2011 and had complete follow-up data,were enrolled in this retrospective study.There were 20 males and 26 females,aged from 40 to 87 years (average,56.87 years).Forty two (91.3％) cases of metastatic lesion located in axial skeleton,while 4 (8.7％) in limbs.The tumor histology type was well-differentiated in 35 patients and poorly differentiated in 11 cases.Nineteen patients (41.3％) had an isolated metastatic bone lesion,while other 27 patients (58.7％) had multiple lesions.Kaplan-Meier survival curve and Cox regression model were performed to identify prognostic factors among 19 factors including gender,age,tumor subtype,number of bone metastasis,site of bone metastasis,visceral metastasis,skeletal-related events,timing of metastasis,whether metastatic lesion was detected when thyroid cancer was diagnosed,whether thyroid surgery was performed,whether 131Ⅰ therapy was performed,whether chemotherapy or radiotherapy were performed,preoperative general condition (good or poor),surgical type (excisional surgery or palliative surgery),characteristics of metastatic lesion (osteolytic or mixed),intraoperative blood loss,whether measures were applied to prevent intraoperative bleeding,perioperative complications and long-term complications.Results Excisional surgery was performed in 36 patients (78.3％),while palliative surgery in other 10 patients (21.7％).The average amount of blood loss was 2603.26ml.The postoperative 5-year survival rate and 10-year survival rate were 37.3％ and 12.4％,respectively.Univariate analysis showed the significant prognostic factors include tumor subtype,number of bone metastasis,whether 131Ⅰ therapy was performed,and preoperative general condition (good or poor).Multivariate analysis showed the independent prognostic factors were number of bone metastasis (solitary or multiple) and whether 131Ⅰ therapy was performed.Conclusion For patients with bone metastasis from thyroid cancer,the prognostic factors are useful for determining indications for operation and improving treatment outcome.

Objective To investigate incidence,risk factors and the prevention strategy of local recurrence 6 months after surgery for metastatic bone tumors.Methods Data of 797 patients who had undergone operations for metastatic bone tumors from March 1997 to March 2012 were retrospectively analyzed.Sixty-three patients (7.9％) who had local recurrence 6 months after operation were enrolled in the recurrence group,including 40 males and 23 females,and the average age at the time of operation was 55.21 years.Seven hundred thirty-four patients were enrolled in the non-recurrence group,including 432 males and 302 females,with an average age of 56.49 years.The risk factors for local recurrence 6 months after operation for metastatic bone tumors were statistically analyzed.Results The statistical analysis showed the risk factors for local tumor recurrence 6 months after surgery for metastatic bone tumors included preoperative general condition (10.9％ vs 6.2％),the rate of progress of the primary tumor (10.1％ vs 6.1％),site of bone metastasis (9.1％ vs 3.9％),surgical method (11.4％ vs 6.4％),whether local radiotherapy was performed preoperatively (28.0％ vs 6.6％),whether local radiotherapy was performed postoperatively (8.7％ vs 2.8％),whether sensitive systemic therapy was performed preoperatively (12.2％ vs 6.1％),whether sensitive systemic therapy was performed postoperatively (10.3％ vs 5.6％) and whether local therapy was performed in primary tumor site (10.1％ vs 5.8％).Multivariate analysis showed the independent risk factors included preoperative general condition (OR=0.534),rate of progress of the primary tumor (OR=2.164),site of bone metastasis (OR=2.906),whether local radiotherapy was performed preoperatively (OR=3.184),whether sensitive systemic therapy was performed preoperatively (OR=2.344) and whether sensitive systemic therapy was performed postoperatively (OR =0.468).Conclusion When the patients has following conditions:poor preoperative general condition,fast progressive primary tumor,metastatic tumor in the axial skeleton,application of local radiotherapy preoperatively,and application of sensitive systemic therapy,the surgical treatment should be chosen cautiously.

Objective To study the curative effect and adverse reactions in patients with chronic nephritis by two treatment methods.Methods 1 00 cases with chronic nephritis were randomly divided into alone western medicine group(control group)50 cases and traditional Chinese combination western medicine group(treatment group)50cases,The index of efficacy,urinary protein of 24h,serum albumin(Alb),serum creatinine(Scr),blood urea nitrogen (BUN)were observed.Results The total effective rate 78.0%in treatment group was significantly higher than 52.0%in control group(x2=3.841,P＜0.05);Three sub-types showed no significant efficacy difference(x2=1.841,P＞0.05);The contents of urine protein,BUN,Scr levels after treatment were lower than before treatment in two groups(t=2.231,2.245,2.311,all P＜0.05).The content of Alb after treatment was higher than before treatment(t=2.241,P＜0.05);The contents of urinary protein,BUN,Scr,Alb after treatment were significantly different in two groups(t=2.241,2.285,2.301,2.295,all P＜0.05);The adverse reactions in 2 cases(2.4%)in treatment group were significantly lower than 8 patients(16.0%)in control group(x2=6.941,P＜0.01).Conclusion Traditional Chinese and western medicine could delay progression and obtain better clinical results in patients with chronic nephritis.

Adolescent ; Adult ; Aged ; Child ; Female ; Foreign Bodies ; diagnostic imaging ; Head ; Humans ; Male ; Middle Aged ; Neck ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Young Adult

Legal clinic education originating in the United States, aims at educating students on legal practical skills, and plays an positive role in cultivating students' ability of integrating theory with practice and training their various practical vocational skills. The present Chinese training mode of health law specialty does not perform very well in training students' practical ability, while legal clinic education can better make up for some deficiencies. Therefore, this paper learns from the experience of American universities in their legal clinic education, such as the particular division of specialties, the development of outside-school clinics, taking pre-training seriously, and the unique evaluation mechanism. Correspondingly, we explore to construct a set of reasonable legal clinic education system in health law specialty, including the orientation of legal clinics, the double training system inside and outside school, the construction of teaching staff and the establishment of evaluation mechanism.

Objective:To investigate the correlation between ultrasonic elasticity score ,elasticity coefficient and autoimmune thyroid function in patients with HT ( hashimoto thyroiditis ) .Methods: Used GE LOGIQ3 type Color Doppler Ultrasound Diagnostic System to acquire satisfactory elastosonography from 216 patients with HT,and evaluated the elasticity score and elasticity coefficient;to detecte the thyroid function and the titer of Thyroid peroxidase antibody ( TPOAb ) , Thyroid globulin antibody ( TgAb ) by chemiluminescence ,respectively investigated the correlation between ultrasonic elasticity score , elasticity coefficient and autoimmune thyroid function.Results:Serum Thyroid stimulating hormone (TSH),TGA and TPO in 216 patients with HT increased significantly , TgAb and elastic coefficient were positively correlated , r=0.54 , P<0.01;TgAb and elasticity score were positively correlated , r=0.496 ,P<0.01;TPOAb and elastic coefficient were positively correlated ,r=0.77 ,P<0.01 ,TPOAb and elasticity score were positively correlated,r=0.73,P<0.01.Conclusion: Real-time ultrasound elastography in combination with measurement of autoimmune thyroid function was helpful to diagnosis of HT .

Objective:To analyze and summarize the commonalities and patterns in acupoint selection for moxibustion treatment of asthma. Methods: Data retrieval was conducted using ‘moxibustion’ and ‘asthma’ as the keywords through China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP). Excel 2010 was used to establish the major acupoint database for moxibustion prescriptions in treatment of asthma; data mining methods including association patterns and clustering were adopted to analyze the characteristics and patterns in acupoint selection for moxibustion treatment of asthma. Results: A total of 161 moxibustion prescriptions were recruited. The most commonly used acupoint was Feishu (BL 13), the most commonly used meridian was the Bladder Meridian of Foot Taiyang, and the most commonly treated region was the back. The association rule analysis showed that Feishu (BL 13)-Dazhui (GV 14)-Fengmen (BL 12) had the most significant correlation, and the clustering analysis discovered 5 effective acupoint clusters. Conclusion: In moxibustion treatment of asthma, topical acupoints Feishu (BL 13), Dazhui (GV 14) and Fengmen (BL 12) can be selected, along with the acupoints from the Bladder Meridian of Foot Taiyang and the back.

BACKGROUND: Is the inhibition of the hematopoietic stem progenitor cell (HSPC) proliferation and differentiation after human cytomegalovirus (HCMV) infection associated with abnormal expression of infected cell proliferated gene?OBJECTIVE: To observe the HOXB6-mRNA expression in the process of proliferation and differentiation of HCMV-infected HSPC into colony-forming unit granulocyte-macrophage (CFU-GM) and colony-forming unit erythroid (CFU-E).DESIGN: A controlled observation.SETTING: Laboratory for Molecular Biology, Affiliated Hospital of Luzhou Medical College, Lanzhou, Gansu Province, China.MATERIALS: All cord blood (CB) specimens were provided by the Obstetrics Department of Affiliated Hospital of Luzhon Medical College. They were collected from the umbilical vein of normal term neonates delivered spontaneously. All neonate mothers were healthy and HBS-Ag-negative. HCMV-IgM antibody revealed by routine ELUSA and HCMV-DNA checked by PCR were undetectable. Written informed consent for the laboratory measurements was obtained from each neonate mother, and the protocol was approved by the hospital's Ethics Committee. HCMV-AD169 strains were obtained from the Institute of Virology, Chinese Academy of Preventive Medicine. All-trans retinoic acid (ATRA, lot No. 20010126) was provided by Chongqing Huapont Pharm. Co., Ltd., China.METHODS: This study was performed at the Laboratory of Molecular Biology (state-level), Affiliated Hospital of Luzhou Medical College of Luzhou Medical College from April 2006 to April 2007. Cord blood mononuclear cells were separated for HSPC culture. According to different interventions, the study consisted of 4 groups. Control group: no HCMV virus solution was added and equal volume of culture medium was added instead. HCMV group: 105 PFU/mL HCMV-AD169 virus solution was added to the culture system. ATRA group: ATRA was added into the cultivation system at the final concentration of 60 μ mol/L. HCMV+ATRA group: ATRA was added into the HCMV group, and its final concentration was also 60 μ mol/L.MAIN OUTCOME MEASURES: In each group, cells were harvested on days 3,7 and 12. HOXB6 mRNA expression levels in CFU-GM and CFU-E were detected by real-time fluorescent-based quantification PCR.RESULTS: In the control group, both CFU-E and CFU-GM expressed HOXB6-mRNA. The HOXB6 mRNA expression was increased as a function of time. The HOXB6-mRNA expressed by CFU-E reached its peak level on day 12, while that expressed by CFU-GM reached its peak level on day 7. Compared to control group, the expression levels of CFU-E and CFU-GM HOXB6-mRNA genes in normal cord blood were significantly lower in the HCMV group (P＜0.05)and significantly higher in the ATRA group (P＜0.05) at each time point after HCMV infection. Furthermore, the expression levels were significantly higher in the ATRA+HCMV group than in the HCMV group at each time point(P＜0.05-0.01).CONCLUSION: HOXB6-mRNA expression is stable and lasting in the proliferation and differentiation of HSPC into CFU-GM and CFU-E. HCMV could down regulate HOXB6 gene expression, and ATRA could up regulate HOXB6 gene expression.

The binding mechanism between pefloxacin mesylate (PM) and transferrin (Tf) was explored using spectral experiment combined with molecular modeling techniques. The binding parameters and thermodynamic functions of PM-Tf solution system were measured at different temperatures. The effect of PM on molecular conformation of Tf was investigated and the interaction mechanism was also discussed. The results showed that dynamic quenching mechanism occurs with PM binding to Tf. The value of binding distances (r) is low, which indicates the occurrence of energy transfer. The drug had conformational effect on Tf, which resulted in changes of hydrophobic environment of the binding domain in Tf. According to the obtained thermodynamic parameters, the main interaction force between PM and Tf is attributed to hydrophobic bonding. The results of molecular modeling revealed that hydrophobic and hydrogen bonds are main binding forces in the PM-Tf system. These results were in accordance with spectral experiments. The research results have given a better theoretical reference for the study of pharmacological mechanism between protein and quinolone.

Objective To compare the effects of equivalent dose sufentanil,remifentanil or fentanyl on hemodynamic and cardiac output in the elderly patients during induction of general anesthesia.Methods Ninety elderly patients(ASA Ⅰ ～ Ⅱ) undergoing elective abdominal surgery under general anesthesia were randomly divided into sufentanil group(group S),remifentanil group(group R) and fentanyl group(group F),30 patients in each group.Patients in group S,group R and group F received sufentanil 0.2μg/kg,remifentanil 2μg/kg and fentanyl 2μg/kg Ⅳ,respectively,using an blind method before intubation.SBP,DBP,MAP,HR,CO,CI and SVR were recorded before of anesthesia (T0),immediately after induction (T1),1,3 minutes after tracheal intubation (T2,T3).Changes of SBP and HR during observation were also recorded.Results The MAP and HR in three groups at T1 were significantly lower than those at T0 and decreased significantly in group R than those in group F and S(P ＜0.05).The MAP and HR in group F significantly increased at T1 than T0.The MAP and HR in group R were significantly decreased after tracheal intubation.Compared with the baseline,the MAP and HR in group S at T1,T2,remained unchanged.In group R,there were two patients whose HR were under 50 bpm.In group F,the MAP at T1,T2 were significantly higher than those at T.In group S,there were no significant changes in CO,CI,SVR which were all within normal range (P ＞ 0.05).Conclusion Both sufentanil and remifentanil effectively inhibit the stress response during induction of general anesthesia.At the same time,sufentanil has better hemodynamic stability.