Objective To explore the effect of cosmetics on patients who have facial telangiectasis. Methods We treated 252 cases of facial and nasal telangiectasis with Vbeam laser machine made in USA. The wavelength is 595 nm. We chose proper pulse width and energy output according to the vascular diameter. The handle shaft should focus on the treatment locations when we treated the patients. The skin eruption turned grey and the telangiectasis disappeared after laser irradiation. The stellate telangiectasis and nasal telangiectasis could be cured after 1～7 times of laser irradiation. The puactate or filamentous telangiectasis and erythema, heliotrope patchy telangiecatasis could be cured after 1～3 times. The treatment interval was 1～2 months. Results All of the 252 cases of facial telangiectasis were cured. The cure rate was 100 %. The skin reaction to the laser irradiation was slight. 30 % of the patients showed hyperpigmentation, which could disappear spontaneously after 1～6 months. In addition, we found patients' faces become more smooth and less wrinkles. Conclusion Satisfied effects are archieved in facial telangiectasis with Vbeam laser machine. This treatment has no scar and no recurrence with only slight skin reaction. And the skin becomes smooth and less wrinkles. Therefore, it is a good choice to treat facial telangiectasis with Vbeam laser irradiation.

Background and purpose: Neck lymph node metastasis, most of which presents in central neck compartment, is common in patients with papillary thyroid carcinoma (PTC). The objective of this study was to investigate the relationship between the number of dissected central neck lymph nodes and clinical outcome after radioactive iodine (RAI) ablation in pN1a PTC with no more than 5 lymph nodes involvement. Methods: A total of 167 PTC patients who had 1-5 proven metastatic lymph nodes according to postoperative pathological diagnosis were retrospectively analyzed, all of whom underwent total or near total thyroidectomy and central lymph node dissection. After a median follow-up period of 26 months, the clinical outcome of each patient was evaluated as excellent response (ER), indeterminate response (IDR), bio-chemical incomplete response (BIR), or structural incomplete response (SIR) according to the new American Thyroid As-sociation guidelines. The accumulative ER rate (ERn) was calculated in patients with different numbers of dissected lymph nodes (ERn was defined as the proportion of patients who achieved ER with the dissected lymph node number of ≤n). The relationship between the number of dissected central neck lymph nodes and ERn were investigated. Results: As the increase in the number of dissected central neck lymph nodes,there was also an overall increase in ERn, especially when n rose from 1 to 10. The values of ER1, ER5, ER10 and ER30 were 25.0%, 66.7%, 74.7% and 79.1%, respectively. Besides, the proportion of patients who achieved ER was higher in those with 10 or more dissected lymph nodes than in those with less than 10 (85.7% vs 73.3%, P=0.05). In the multivariate logistic regression analysis, both the dissected central lymph node number of ≥10 (OR=2.720, 95%CI: 1.052-7.033, P=0.039) and the level of preablation stimulated thyroglobulin (OR=0.955, 95%CI: 0.926-0.984, P=0.003) were shown to contribute independently to ER. Conclusion: As the increas-ing number of dissected central neck lymph nodes, the percentage of pN1a PTC patients that achieved ER after RAI ablation generally rises. In pN1a PTC patients with no more than 5 lymph nodes involvement, a central compartment dissection with 10 or more lymph nodes might help them achieve ER after RAI ablation.

Objective To study wt-p53 gene's influence on the proliferation of keloid fibroblasts in vitro. Methods wt-p53 gene was transfected into keloid fibroblasts by adenovirus vector. wt-p53 mRNA was analyzed by RT-PCR; wt-p53 protein was evaluated by indirectiy immunofluorescence; The ability of proliferation of keloid fibroblasts was analyzed by cell growing curves; The cell cycle of KFB was checked by FCAS. Results The expression of wt-p53 mRNA and protein was obviously higher in the fibroblasts of the experimental group than those of control group; the rate of G_0~G_1 in cell cycle was higher in the fibroblasts of the experimental group than those of control group; at the same time, the rate of G_2~M was lower in fibroblasts of the experimental group than those of control group (P

Antigens, CD20 ; metabolism ; Carcinoma in Situ ; classification ; diagnosis ; metabolism ; pathology ; Diagnosis, Differential ; Humans ; Hyaluronan Receptors ; metabolism ; Hyperplasia ; Precancerous Conditions ; diagnosis ; metabolism ; pathology ; Tumor Suppressor Protein p53 ; metabolism ; Urinary Bladder ; metabolism ; pathology ; Urinary Bladder Neoplasms ; classification ; diagnosis ; metabolism ; pathology ; Urothelium ; metabolism ; pathology

Objective To observe the curative effect of head hypothermia combined with mouse nerve growth factor in the treatment of neonatal moderately severe hypoxic ischemic encephalopathy (HIE).Methods 50 cases of severe HIE were randomly divided into observation group and control group,with 25 cases in each group.Both two groups were given the conventional treatment.The observation group was given head hypothermia treatment in 6 hours after born,to maintain the nasopharyngeal temperature (34.0 ±0.5)℃,anal temperature (35.5 ±0.5)℃,72 hours continuously.At 96 hours after the birth,the nerve growth factor was given.The control group did not give the head mild hypothermia treatment.At 96 hours after birth,the nerve growth factor (methods,dosage and treatment were the same as the observation group)was treated with nutrition and brain nerve.After treatment,the improvements of heart rate,muscle tension,convulsions and disturbance of consciousness were observed in two groups.After 3 days,2 weeks and 4 weeks,the neonatal behavioral neurological assay (NBNA),1 and 3 months after birth,the outfit cranial MRI plain scan and brainstem auditory evoked potential (BAEP)were evaluated.Results NBNA scores of the two groups were compared in 3 days,2 weeks and 4 weeks after birth,the differences were statistically significant (t=2.53, 2.89,3.23,all P<0.05).In the observation group,the abnormal brain MRI was significantly less than the control group,the difference was statistically significant (χ2 =24.125,P<0.05).In the observation group,the number of abnormal auditory evoked potential was significantly less than that of the control group,the difference was statistically significant (χ2 =21.312,P<0.01 ).Conclusion Head hypothermia combined with mouse nerve growth factor therapy for the treatment of neonatal moderately severe HIE has protective effect,it can improve the treatment efficacy, reduce the long-term neurological sequelae,and without adverse reaction.

OBJECTIVE:To regulate the management of operation drug and promote medication security. METHODS:Based on the relevant principles in the standard of JCI,the practice about establishment of operation pharmacy in our hospital was intro-duced,and it were stated from two aspects which included working mode and effects. RESULTS:The working mode were format-ed by definiting the duties and working flow of pharmacist,anesthetist and liaison man. The establishment of operation pharmacy, which brought operation drugs into the unified management system of our hospital,saved manpower and improved work efficien-cy,refined the management of drugs in all aspects,improved the management of drug safety level,strengthened drug expiration date management,implemented the reporting of adverse drug reactions(event)and collecting of medication(potential)errors. The established mode conformed to the relative standard of JCI including preparation,grant,storage and collection of ADR of drug. CONCLUSIONS:The established drug management of operation pharmacy promotes standardized administration of surgery drug, which guarantees the drug use safety of patients.

Background and purpose:This study aimed to investigate the relationship between lymph node metastatic rate (LR) and response to radioiodine therapy in patients with papillary thyroid carcinoma (PTC).Methods:A total number of 143 PTC patients after radioiodine therapy were included and classified into 4 groups [Ⅰ(0%-10%),Ⅱ(>10%-25%),Ⅲ(>25%-50%),Ⅳ(>50%)] according to the lymph node metastatic rate, and the responses to initial radioiodine therapy after a median follow-up period of 20.7 months were evaluated. They were classiifed into 4 groups [excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR), and struc-tural incomplete response (SIR)] according to the guideline proposed by 2015 American Thyroid Association. One-Way analysis of variance,χ2 test and Kruskal-Wallis test were used to evaluate the differences in basic clinicopathological features and clinical responses among the 4 groups. The ROC curve was analyzed to evaluate the clinical value of lymph node metastatic rate for predicting ER and optimal cut-off point.Results:There were no signiifcant differences in gender and T-stage among 4 groups (P>0.05). However,Ⅰ group was signiifcantly older than the other 3 groups (P=0.001). With the increase of lymph node metastatic rate, the number of ER cases decreased, while cases of BIR and SIR generally increased. Compared with the other 3 groups, less cases of ER (27.8%), while more BIR (27.8%) or SIR (11.1%) were observed in groupⅣ (H=18.816,P=0.000). Cut-off value of lymph node involved rate was 52.27%, with a better speciifcity of predicting ER. Area under the ROC curve was 0.668.Conclusion:The higher lymph node metastatic rate in patients with PTC, the worse clinical outcome it could be. A cut-off value of lymph node metastatic rate 52.27% is a speciifc independent predictor for the clinical outcome in PTC patients treated with radioiodine therapy.

Objective To evaluate the distribution and drug resistance of bacteria causing neonatal infectious pneumonia in Jiaxing,and to provide a therapy for clinical doctor to make a correct diagnosis,choose reasonable anti-biotics and avoid abuse of antibiotics.Methods Took expectoration from trachea in condition of asepsis to conduct culture and perform drug-sensitive test from 3025 cases.Results Totally 1 156 strains of aerobic bacteria were iso-lated.875 strains were gram negative bacilli(75.7%),269 strains were gram positive cocci(23.3%),and 12 strains were fungi(1.0%).Klebsiella pneumoiae,Escherichia coil,Acinetobacter baumanni,Enterobacter cloacae were com-mon in gram negative bacilli( respectively 178 cases,151 cases,87 cases,113 cases) .The proportion of the Staphylo-coccus aureus was the largest in gram positive cocci(245 cases) .The results showed that gram-negative bacilli were resistant to cefazolin, ampicillin, piperacillin and sensitive to meropenem, imipenem, piperacillin-tazuobatanna and cefoperazone-sulbactam.The drug resistance was severe of ESBL-positive.Staphylococcus aureus was resistant to penicillin, ampicillin, erythrocin, clindamycin and sensitive to linezolid, vancomycin, nitrofurantoin.Conclusion Gram-negative bacilli are the main bacteria in neonatals with infectious pneumonia.The drug resistance is severe.It is important to make a standard management and isolation.

It is to difficult to diagnose and treat hepatobiliary surgical diseases since its diverse clinical manifestations,which increases the difficulty of clinical internship.Taking clinical cases as teaching material,case-based learning was combined with teaching theme and was conducted by means of discussion and question and answer between teachers and students.Students can know about concepts or theories related to teaching theme.Case-based learning in internship can consolidate basic knowledge of hepatobiliary surgery,cultivate clinical scientific thinking and is helpful in analyzing and resolving problems of hepatobiliary surgical diseases.

Objective To evaluated the role of wt-P53 protein in telomerase regulation in keloid fibroblasts(KFBs). Methods The fibroblasts were derived from human keloid tissue which was proved by pathological diagnosis. KFBs were divided into 2 groups, the transfection group and the untransfection group. wt-p53 gene was transfected into the fibroblasts by adenovirus vectors in the transfection group. The KFBs untransfected with wt-p53 gene served as control (untransfection group). After 48 hours of transfection, the expression of wt-P53 protein was analyzed by both Western blotting and immunofluorescence method, respectively. The telomerase activity was evaluated by TRAP-ELISA after 1-7 days of transfection.Results All the KFBs from 2 groups expressed wt-P53 protein. But the expression level of wt-P53 protein in the transfection group was significantly higher than that in the untransfection group. At the same time of high expression of wt-P53 protein, the telomerase activity of KFBs in transfection group was significantly lower than that in the untransfection group( P＜0.05). Conclusion High level expression of wt-P53 protein can transiently inhibit the telomerase activity of KFBs.