Objective To explore the value of high frequency ultrasonography for the early diagnosis of hyperuricemia in patients with joint disease.Methods Ninety-eight patients with hyperuricemia and 100 healthy persons,according to with or without history of acute gout attack,were divided into symptomatic group,asymptomatic group and control group,whose first metatarsophalangeal joint,ankle and knee were examined by high frequency ultrasonography.Chi-square test was used for statistical analysis.Results ① The joint lesions detection rate in the symptomatic group,asymptomatic group and the control group was 57％ (13/23),16％ (12/75),0 (0/100) respectively.There was statistical significant difference between the symptomatic group and the asymptomatic group (x2=9.69,P＜0.05).② The symptomatic group had 29 joint involvement (29/138),including 25 at the first metatarsophalangeal joint,3 at the ankle and one at the knee joint.The asymptomatic group had 14 joints involved (14/450),which were all located at the first metatarsophalangeal joint.③ The sonographic appearance of the two groups of arthropathy were synovial thickening,effusion,crystal deposition andbone erosion.The symptoms group presented as tophi,and increased synovial blood flow.Conclusion Patients with asymptomatic hyperuricemia may have joint diseases.The joint disease detection rate of the symptomatic group is higher than that of the asymptomatic group.High frequency ultrasonography can be used a conventional imaging method for the screening of patients with hyperuricemia joint disease.The focus of the screening of asymptomatic patients is the first metatarsophalangeal joint.The focus of the screening of symptomatic patients is the first metatarsophalangeal joint and the joints that were attacked in the past history.

Objective To study the risk factors of lymph node metastasis in the central neck compartment of thyroid carcinoma,and to explore the reasonable range of lymph node dissection in central neck dissection for clinically node-negative papillary thyroid microcarcinoma patients.Methods From Dec.2015 to Dec.2016,a total of 200 patients with CN0 papillary thyroid carcinoma were randomly divided into two groups according to the registration number:unilateral central neck dissection group and bilateral central neck dissection group in Department of Thyroid Surgery,Fujian Medical University Union Hospital.The risk factors of lymph node metastasis and value of bilateral central neck dissection were analyzed.Results The risk factors of lymph node metastasis in the central papillary thyroid carcinoma were ≥0.7 cm in diameter and older than 45 years in age and gender in male.Further analysis found that contralateral central lymph node metastasis occurred in patients with tumor diameter ≥0.5 cm.The positive rate was 22％.The number of lymph nodes detected in the unilateral and bilateral central areas was 9.53±6.04 and 12.19±7.18,P=0.035,respectively.The positive numbers of lymph nodes were 1.17±1.47 and 2.11±2.75,P=0,022 respectively.Conclusion In patients with tumor diameter ≥0.5 cm,bilateral central neck dissection is conducive to improving the thoroughness of tumor dissection and does not increase the risk of complications.

Objective To assess the clinical significance of reverse trendelenburg position in preventing postoperative nausea and vomiting(PONV)in thyroid surgery.Methods 110 patients with papillary thyroid carcinoma(PTC) admitted from Feb.2013 to Mar.2014 were prospectively divided into experimental group and the control group according to whether reserve trendelenburg position was adopted.Univariate and multivariate method were used to analyze relations between PONV and surgical position,gender,age,body mass index,hypertension,surgical time,ASA classification,anesthesia,and motion sickness.Results Of the 110 cases of PTC,the incidence of PONV was 16.28％ (7/43) in the experimental group while it was 37.31％ (25/67) in the control group.The difference had statistical significance(P ＜ 0.05).Statistical analysis showed that PONV was related to patients'gender,surgical position,surgical time,and motion sickness,while only surgical position and motion sickness was the independent risk factors.Conclusion Reverse trendelenburg position surgery can help to prevent PONV and promote recovery.

Objective To assess clinical significance of the right side lymph node dissection behind recurrent laryngeal nerve (RLN) in papillary thyroid carcinoma (PTC).Methods Clinical data of 111 cases of PTC adimitted in our hospital (Department of Vascular and Thyroid Surgery,the Union Hospital of Fujian Medical University) from Feb.2013 to Mar.2014 were retrospectively analyzed.Central lymph node metastasis was analyzed.Univariate and multivariate analysis were made to analyze relations between the right side lymph node (Ⅵ b2) metastasis behind RLN and gender,age,tumor size,capsule infiltration and so on.Results Among 111 cases of PTC,71 had central lymph node metastasis (63.96％).Total metastasis number of the right side lymph node behind recurrent laryngeal nerve (Ⅵ b2) was 2.720±2.037,and the transfer rate was 27.03％ (30/111) (P＜0.05),all lower than those of Ⅵ bl.The one-way ANOVA results showed that metastasis of the right side lymph node behind RLN (Ⅵ b2) was related with age,lateral neck dissection,and Ⅵ b1 lymph node metastasis (P＜0.05) while Ⅵ bl lymph node metastasis was the only independent risk factor for metastasis of the right side lymph node behind RLN(Ⅵ b2) in PTC.Conclusion For patients with right PTC,the metastasis rate of Ⅵ b2 is high,thus dissection of this area is favorable and can accurately reflect lymph node metastasis and further to guide tumor staging and postoperative treatment.

Objective To understand the primary structure and potential antigenic epitopes of antigen Pf332(Ag332) of P.falciparum iso late FCC1/HN.Methods　Based on the published Pf332 gene sequence , nine pairs of primers were designed for the PCR amplification of the Pf332 gen e fragments from genomic DNA of P.falciparum isolate FCC1/HN. The amplified gene fragments were subcloned into pMD-18T vectors and sequenced. The sequences were aligned using DNAstar software to obtain the full-length sequence of the gene Pf332. The primary structure and sequence homology of Ag332 were analyzed by SAPS, Tmpred, SingalP and Blastn programs. Three fragments, R0, R1 and R2, cor responding to nt#9595-10083, nt#10339-10767 and nt#10855-11247 of Pf332 gene were subcloned into the eukaryotic expression vector pcDNA3-S separately. The Balb/c mice were immunized with pcDNA3-S-R0, pcDNA3-S-R1 and pcDNA3- S-R2 separately, and the expressions of the recombinant proteins were detected by immunohistochemistry assay. The protective immune responses elicited by DNA I mmunization were analyzed by ELISA and parasite growth inhibition tests in vitro .Results　Nine Pf332 gene fragments were specifically amplif ied, subcloned into pMD-18T vectors and sequenced. Pf332 gene of the P.falci parum isolate FCC1/HN was 16,377 bp in length, encoding a protein of 5,458 ami no acids, about 615.28kDa. The Ag332 contains 17 regions of highly degenerated Glu-rich repeats, with 30.18% Glu in total amino acids of Ag332. Ag332 of P.falciparum isolate FCC1/HN and 3D7 exhibited 94.55 % homology in amino acid residues. The results of immunohischemistry assay showed that R0, R1 and R2 were expressed in mice muscle tissue. The amount of IgG antibody of the groups immu nized with pcDNA3-S-R0, pcDNA3-S-R1 and pcDNA3-S-R2 were higher than those of blank and pcDNA3 groups (P＜0.05). The result of parasite growth inhibition test showed that the immunized sera at 1∶5 dilution of groups of pcDNA3-S-R0, pcDNA3-S-R1 and pcDNA3-S-R2 had an incomplete inhibitor y effect on P.falciparum growth. Conclusion　The antigen Pf332 is an large protein containing highly degenerated Glu-rich repeats. Pf332 gene fragments, R1 and R2 encoding potent antigenic epitope repeats.

OBJECTIVETo study application of needlescopic assisted hemithyroidectomy and central neck dissection using bilateral breast approach.

METHODSTotally 145 cases of papillary thyroid cancer patients received endoscopic hemithyroidectomy in Fujian Medical University Union Hospital were randomized to needle assisted endoscopic group (NE group, n=81) and conventional endoscopic group (CE group, n=64). The average age of the patients was 35.9 years and 11 patients were male.All patients underwent hemithyroidectomy and central neck dissection through bilateral breast approach, the NE group additional used the MiniLap-assisted intraoperation.The operative time, postoperative complications and cosmetic results were analyzed by t-test and χ(2) test.

RESULTSThe operation time of thyroid gland in NE and CE Group was (42±7) min and (31±7) min(t=9.082, P=0.000), respectively. The operation time of central neck dissection was (33±6) min and (26±3) min (t=9.050, P=0.000), respectively.There were 4 cases occurs transient recurrent laryngeal nerve paralysis in CE group and no case occur in NE group(χ(2)=5.206, P=0.036). There was no significant different in other postoperative complications and cosmetic results.

CONCLUSIONSHemithyroidectomy and central neck dissection using bilateral breast approach and needlescopic assisted technique isa safe and reliable approach, with high cosmetic effect. Application needle assistive devices can shorten the operation time while no significant increase trauma in patients, it will makes endoscopic thyroid surgery easier to promote.

Adult ; Breast ; Carcinoma ; surgery ; Carcinoma, Papillary ; Endoscopy ; instrumentation ; Female ; Humans ; Male ; Neck Dissection ; Needles ; Operative Time ; Postoperative Complications ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods

The incidence of papillary thyroid carcinoma is growing rapidly.Especially in young patients,the patients have high demand for better cosmetic effect and less psychological trauma.The application of laparoscope technique in papillary thyroid carcinoma surgery should meet the needs of patients.The development of needle assisted technique make it easy to access the neck potential fascial spaces,and provide the basic instrument for laparoscope modified neck dissection.The application of needle assisted techniques mainly include suture suspension and V type needle retractor,MiniLap,3 mm laparoscopic apparatus.Indications of this procedure is very important,and it is necessary to make full use of the "critical points","mark lines" and "fascia layers" to precise positioning in the operation.Furthermore,the levels of dissection must be determined based on the pattern of cervical lymph node metastasis in differentiated thyroid carcinoma,that will make the surgical procedures more safety.

The incidence of papillary thyroid carcinoma is growing rapidly.Especially in young patients,the patients have high demand for better cosmetic effect and less psychological trauma.The application of laparoscope technique in papillary thyroid carcinoma surgery should meet the needs of patients.The development of needle assisted technique make it easy to access the neck potential fascial spaces,and provide the basic instrument for laparoscope modified neck dissection.The application of needle assisted techniques mainly include suture suspension and V type needle retractor,MiniLap,3 mm laparoscopic apparatus.Indications of this procedure is very important,and it is necessary to make full use of the "critical points","mark lines" and "fascia layers" to precise positioning in the operation.Furthermore,the levels of dissection must be determined based on the pattern of cervical lymph node metastasis in differentiated thyroid carcinoma,that will make the surgical procedures more safety.

Objective To explore the significance of parathyroid hormone (PTH) measurement in drainage liquid after thyroid surgery,and to evaluate its relationship with parathyroid glands in situ.Methods Form Dec.2013 to Aug.2014,166 patients who underwent unilateral thyroidectomy were chosen as the research object.According to the number of parathyroid reserved in situ,patients were divided into group A0,group A1 and group A2.The levels of blood PTH and serum calcium were measured before and after operation,and postoperative PTH in drainage liquid was measured.Results The levels of postoperative blood PTH and serum calcium were lower than those before operation(P＜0.05).The difference of PTH level in drainage liquid in each group had statistical significance(P＜0.05).The level of drainage liquid PTH was highest in group A2,following group A1,and finally group A0.We found a positive correlation between the number of parathyroid glands protected in situ and the level of drainage liquid PTH.Conclusion Drainage liquid PTH measurement can be used to determine whether parathyroid gland is reserved in situ and its secretion function.

The adhesive protein secreted by marine sessile animals can resist the resistance of water and exert stickiness under the humid environment. It has become a candidate for the development of high-performance materials in the field of biomedicine and bionics. Barnacles are as one of the marine macrofoulers that can be firmly attached to the underwater substrate materials with different surface characteristics through its cement proteins. To date, the adhesion process of barnacle has been understood in-depth, but the specific underwater adhesion mechanism has not been elucidated and needs further exploration. This review first presented an overview of barnacle and its adhesion process, followed by summarizing the advances of barnacle adhesive protein, its production methods, and applications. Moreover, challenges and future perspectives were prospected.
Animals ; Thoracica/metabolism* ; Proteins/metabolism* ; Adhesives/metabolism*