Objective To investigate the sonographic diagnostic value of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. Methods Ultrasonography of 22 cases with differentiated thyroid carcinoma and anaplastic thyroid carcinoma were observed with color doppler sonography.The shape,size,echo,boundary,microcalcifieation foci and blood stream distribution were studied,and contrasted with pathological diagnosis after operation.Lymphnode in cervical part and sulcus esophagus were examined.The characters of thyropathy according to the above sonographie features were judged. Results 16uhrasonography or before operation and biopsy,in which 9 were left,7 were right.6 cases were in both leaves.Ultrasound showed that 2 cases were poody differentiated thyroid carcinoma, 1 case was parathyroid carcinoma. 1 case was Hashimoto's thyroditis, and remainders were thyroid carcinoma. Conclusion Ultrasonography could enhance the detection rates and diagnose accordance rates of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma.

Objective To evaluate the effectiveness of clinical pathways for pediatric asthma.Methods The literatures on the application of clinical pathways for pediatric asthma were collected in the databases such as PubMed,Cochrane Library,Ovid,ScienceDirect,EBSCOhost,CNKI,Wanfang and CBM while a manual search was added.The search was performed from 1980 to 2014.Two reviewers independently screened references,extracted data and assessed the risk of bias.Data was pooled and analyzed by using Revman 5.2 version.Results Eleven studies involving 2 207 participants from nearly 1 048 relevant studies met the inclusion criteria.1 174 participants were in the clinical pathway group while the other 1 033 participants were in the control group.Meta-analysis result showed that patients with asthma in a clinical pathway had a shorter length of stay,less medical cost,reduced rate of emergency room visits,and improved health education.However,clinical pathway did not appear to reduce readmission.Conclusions Clinical pathway can significandy reduce the length of hospital stay,cost,rate of emergency room visits and improve health education.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.

BACKGROUND:Studies addressing coronary heart disease are largely dependent on the establishment of myocardial infarction animal models. It is very important that exploring a safe method with easy operation, less damage, long time survival and high survival rate for myocardial infarction animal model OBJECTIVE:To compare the pros and cons of two kinds of thoracotomy anterior descending coronary artery ligation to do myocardial infarction animal model. METHODS: Thirty healthy male New Zealand white rabbits were randomly divided into three groups: control, median sternotomy incision, and left sternal incision. The anterior descending coronary artery was ligated after thoracotomy. The operation time, amount of intraoperative bleeding, postoperative food intake, and recovery time of eating were monitored during the surgery and within 24 hours after the surgery. And myocardial enzyme indexes were also monitored within 24 hours after the surgery. Rabbits were detected with ultrasonic echocardiogram at 4 weeks. RESULTS AND CONCLUSION:Different levels of ST segment elevation appeared in median sternotomy and left sternal incision groups by echocardiogram. The success rate of modeling was 70% in median sternotomy incision group, and 80% in left sternal incision group. Within 24 hours post-surgery, the myocardial enzyme indexes in the two groups were significantly increased compared with before surgery (P < 0.05). At 4 weeks, the left ventricular ejection fraction and the left ventricular shortening fraction were significantly decreased when compared to before surgery (P< 0.05). The operation time was shorter, the amount of bleeding was less, the time of eating recovery was less and the amount of eating was much in median sternotomy group than in left sternal incision, with significant differences between he two groups (P < 0.05). The median sternotomy incision for the ligation of anterior descending coronary artery is better than the left sternal incision to establish myocardial infarction models.

Objective To assess the cognitive function of subjects with brain injury with Loewenstein occupational therapy cognitive assessment (LOTCA) and mini-mental status examination (MMSE). Methods Two groups of subjects participated in this study. One group consisted of 36 subjects with brain injury (patient group). They were 28 males and 8 females,aged 61.0?16.7 years old. The other group was made of 44 healthy subjects (control group),with 25 males and 19 females,aged 55.4?23.7 years old. All subjects were assessed using LOTCA and MMSE and the results of them were analyzed. Results There was high correlation between the total scores of LOTCA and those of MMSE ( r =0.892,P

Objective To observe the therapeutic effects of electrical stimulation of pelvic floor muscles on urinary incontinence (UI) in patients with incomplete spinal cord injury (ISCI). Methods Seven patients (5 males and 2 females; average age: 32.5 years; average duration after injury: 7.5 months) with ISCI were treated with ESPFM applied on rectum (for male) or vagina (for female) for 30～45 min,once a day, 5 days a week for (2～3) months. The rate of success on stopping using catheters and the frequency and amount of urination were observed during treatment. Results Catheters were taken out successfully from all patients 2～3 weeks after treatment. Five out of the 7 patients had more self-control of urination than incontinence after 8 weeks of treatment though there was no significant difference in the amount of the urination. Conclusion ESPFM might improve the function of urinary bladder in patients with incomplete spinal cord injury.

Objective To investigate the optimal time of termination of pregnancy for patients with hemolysis elevated liver enzymes and low platelet (HELLP) syndrome Methods 57 patients with HELLP syndrome admitted from October 1992 to September 2001 were enrolled According to the length from the time diagnoses confirmed to the time of delivery,patients were divided into 3 groups; group Ⅰ,within 24 hours, group Ⅱ,24 to 48 hours and group Ⅲ,over 48 hours Complications,maternal and perinatal mortality were analyzed retrospectively between different groups Results Maternal and perinatal mortality were 7% and 11% in group Ⅰ, 16% and 21% in group Ⅱ, 64% and 73% in group Ⅲ with significant differences between group Ⅲ and group Ⅰ or group Ⅲ and group Ⅱ ( P

Objective To develop the hypothesis ‘saturated or non-saturated cytotoxicity model' and explain the various phenomena of antibody mediated immunoresponses in recipients,including rejection and accommodation.Methods The imitating complement dependent cytotoxicity.The threshold set to identify as saturated or non-saturated cytotoxicity depends on antigen-antibody complex(R)whether or not above lethal number(D)in effective time.Feasibility of the hypothesis was examined through explaining various phenomena mediated by anti-donor antibodies,especially some contradictory phenomena.Results Hyperacute rejection,accelerated rejection and acute rejection could be well explained by saturated cytotoxicity.Accommodation of ABO imcompatible transplantion,de novo antibody induced injury,change of protein profile,and C4d deposition in graft could be well elucidated by the hypothesis.Conclusion The hypothesis saturated or nonsaturated cytotoxicity model' help to interpret and interconnect various phenomena of antibodies mediated immune response,such as rejection and accommodation.

BACKGROUND: Nowadays, angiotensin Ⅱ plays an important role in onset of diabetic nephropathy. Therefore, the nuclear factor-κB may have adjustive effects on angiotonin system of kidney tissue of diabetic rats. OBJECTIVE: To observe the relationship of activity of inhibitive nuclear factor-κB with angiotensin Ⅱ and its type 1 receptor mRNA expression of renal tissue of diabetic rats. DESIGN: Completely randomized group design, control experiment. MATERIALS: The experiment was conducted at the Experimental Animal Center, Sun Yat-sen University of Medical Sciences between March and April 2000. Fifty-one pure breed clean grade male Wistar rats were select ed. METHODS: ①Models were established in 39 rats. Streptozotocin dissolv ing in citric acid buffer (0.1 mmol/L,pH=4.5) were given to establish dia betic models with 60 mg/kg intraperitoneal injection. If the fasting blood glucose maintained above 13.9 mmol/L, the establishment of models was successful. The thirty-nine rats were randomly assigned into 3 groups: model group (n=17, without other interventional measure, feeding normally) and pyrrolidine dithiocar2. Bamate (PDTC) (active inhibitor of nuclear fac tor-κB) interventional group [n=22, PDTC at the dose of 20 mg/kg were given with intraperitoneal injection, twice a day]. Other 12 rats were as normal control group, did not make into diabetic models with normal breeding. ②After feeding for 18 weeks kidneys were got in every group. The activity of nuclear factor-κB was detected with electrophoretic mobility shift assay. The expression of type 1 receptor mRNA of angiotensin Ⅱ was measured with reverse transcription polymerase chain reaction (RT-PCR). Contents of angiotonin Ⅰ and angiotensin Ⅱ were tested with Radio Im munoassay (RIA). Activity of rennin was referred to that the result of the level of angiotonin Ⅰ at 37 ℃ water bath subduced to that at 4 ℃. ③Dif ference of measurement data was compared with single factor analysis of variance. After normal transformation, the non-normal distribution data were conducted with statistical disposal. MAIN OUTCOME MEASURES: Comparison of contents of angiotensin Ⅰ and Ⅱ, activities of rennin and nuclear factor-κB and expression of type 1 receptor mRNA of angiotensin Ⅱ in renal tissues of rats of each group. RESULTS: In the normal control group, model group and PDTC interven tional group 1, 6 and 13 rats were dropped out, respectively, so 11, 11 and 9 rats in each group were involved in the result analysis. ①Activity of nu clear factor-κB: It was higher significantly in the model group than that in the normal control group and PDTC interventional group (P ＜ 0.01 ). It was similar between the normal control group and the PDTC interventional group. ②Activity of rennin of renal tissue: It was similar among the 3 groups. ③Content of angiotonin Ⅰ of renal tissue: It was higher obviously in the model group that that in the normal control group and the PDTC interventional group (P ＜ 0.01 ). ④Content of angiotensin Ⅱ in renal tissue: It was similar between the model group and the normal control group. It was lower markedly in the PDTC interventional group than that in the model group and the normal control group (P ＜ 0.01 ). Expression of type 1 receptor mRNA of angiotensin Ⅱ: It was lower remarkably in the model group than that in the normal control group (P ＜ 0.01 ). It was lower dis tinctly in the PDTC interventional group than that in the model group and the normal control group (P ＜ 0.01 ). CONCLUSION: The increase of activity of nuclear factor-κB in renal tissue of diabetic rats can inhibit the activity of nuclear factor-κB, which will induce the reduction of the level of angiotensin Ⅱ and expression of type 1 receptor mRNA of angiotensin Ⅱ in renal tissue of diabetic rats.

Objective To investigate the correlation between the degree of liver fibrosis and Aspartate aminotransferase-to-Platelet Ratio Index ( APRI ) in children with biliary atresia ( BA ) , and evaluate the clinical significance of liver fibrosis in biliary atresia.Methods A total of 97 patients with diagnosed BA were recruited between January 2010 and June 2013.AST, PLT and APRI were determined one week before laparotomy.The severity of hepatic tibrosis was.Judged by Metavir system the correlation among AST, PLT, APRI and severity of liver fibrosis were evaluated, and their diagnostic value for degree of liver fibrosis was analyzed by ROC.Results Sera AST levels and PLT counts of BA patients were found to be positively(r=0.367, P<0.01) and negatively(r=-0.403, P<0.01) correlated with Metavir scores of liver fibrosis, respectively.There existed positive correlation between APRI and the severity of hepatic fibrosis (r=0.541, P<0.01).The area under ROC curve of APRI to diagnose none or mild fibrosis and moderately severe fibrosis was 0.78, with sensitivity of 77.9%and specificity of 62.1%at the optimal cut-off value of 0.75; the area under ROC curve of APRI to diagnose moderately severe fibrosis with liver cirrhosis arrived 0.85, with sensitivity of 75.0% and specificity of 89.4% at the optimal cut-off value of 1.77.The accuracy of none or mild fibrosis, moderate fibrosis and cirrhosis diagnosed by APRI were 73.2%, 64.9%, 87.6%, respectively.Conclusion APRI can be used as a non-invasive parameter to assess the severity of hepatic fibrosis with BA.