At present,thyroid surgery is widely carried out during clinical practice.Because of preoperative or intraoperative misdiagnosis,nonstandard scope of operation,tumor recurrence and other factors,resulting in some cases needed to treat again.Due to the previous surgical scar adhesion and disordering of anatomical structure,the risk of injury of recurrent laryngeal nerve(RLN)increased manyfold.Intraoperative neuromointoring(IONM)is a technology for monitoring the functional integrity of the nervous system in state of dangerous by neural electrophysiological means.Better than the naked eye to identify and prompt the recurrent laryngeal nerve injury,to find the site of injury,IONM can significantly reduce the chance of transient RLN injury during thyroid reoperation as a sharp weapon to protect RLN.

Objective To evaluate the therapeutic effect and mechanism of specific inducible nitric oxide synthase(iNOS)aminoguanidine(AG)in rats with obstructive jaundice.Methods Forty male Wistar rats were divided randomly into four groups: normal control group, sham operation group, obstructive jaundice group and aminoguanidine therapeutic group.Each group had 10 rats.We assayed levels of liver function,hemobilirubin, endotoxin,lactic acid and malondialdehyde before and after therapy, and we also analyzed pathology of the liver and small intestine.Then we could explore the therapeutic effect of AG in rats with obstructive jaundice.Results The levels of endotoxin,lactic acid and malondialdehyde in blood increased progressively along with the pathological changes of the liver and small intestine.Each of the AG group parameters was significantly lower, and the pathological changes of liver and small intestine were improved.Conclusion AG could protect liver and small intestine by attenuating lipid peroxidative and endotoxemia,and provide a new way to cure obstructive jaundice.

Humans ; Molecular Targeted Therapy ; Thyroid Neoplasms ; therapy

Objective To investigate the therapeutic effect of frozen-thawed murine islets which were transplanted into diabetic rats after cultured with hyperbaric oxygenated rotary cell culture system (HORCCS). Methods The purified rat islets were divided into two groups: A. In vitro experiment groups (IvEG) : The rat islets in each subgroup were cultured in HORCCS or common medium for 30 days, then evaluated for the intracellular DNA and insulin contents of islets, and the viability and insulin secreting level of islets. B. Islet transplantation experimental groups (TxEG) : The frozen-thawed islets were cultured in HORCCS or common medium for 7 days, and then transplanted into the recipients. We observed the blood glucose level (BGL) and insulin secreting level in the recipients as well as the uhrastructure change of islets in TxEG. Results The viability and insulin secreting level of islets cultured with HORCCS at 14th day were much higher than those cultured with common medium (P <0.05). The blood glucose level in recipients transplanted with islets cultured with HORCCS recovered to normal value at the 2nd week and lasted for 8 weeks. All these recipients maintained the normal glucose tolerance curve. Electronic microscopy found microchannel outlets on the surface of the frozen-thawed islets cultured with HORCCS. Conclusions Frozen-thawed islets cultured with HORCCS could establish nutrient transmission microchannels, which were not only capable of oxygen and nutrients transmission, but also improving cryopreservation solution to diffuse inside the islet cells evenly and uniformly. So this method not only lessens islet damage from cryopreservation, but also improves the effect of transplantation.

Objective To investigate the effect of ulinastatin on the postoperative immune function of effective T-lymphocytes (Teff cells) and regulatory T-lymphocytes (Treg cells) in the peripheral blood in patients undergoing laparoscopic operation.Methods Forty ASA physical status Ⅰ or Ⅱ patients,aged 20-40 yr,weighing 45-65 kg,scheduled for elective laparoscopic operation for infertility,were equally and randomly divided into 2 groups using a random number table:control group (group C) and ulinastatin group (group U).At 15 min before induction of anesthesia,ulinastatin 200,000 U (in 100 ml of normal saline) was infused intravenously in group U,while the equal volume of normal saline was infused instead in group C.Anesthesia was induced with iv injection of fentanyl,propofol,and cisatracurium and maintained with iv infusion of propofol and sevoflurane.Before surgery (T0),at the end of surgery (T1) and on 1st and 3rd days after surgery (T2.3),venous blood samples were collected from the peripheral blood for determination of the expression of Teff cells (CD4 + CD25-) and Treg cells (CD4 + CD25+) and serum interferon-γ (IFN-γ) and transforming growth factor-β (TGF-β) concentrations (by ILISA).Teff/Treg and IFN-γ/TGF-β ratios were calculated.Results Compared with the baseline value at T0,the expression of Treg cells was significantly up-regulated,and Teff/Treg ratio was decreased at T2 and T3 in group C,and the expression of Teff cells was up-regulated at T3 (P ＜ 0.05 or 0.01),while no significant difference was found in the expression of Treg cells and Teff/Treg ratio at T3 in group U (P ＞ 0.05).Compared with group C,the expression of Teff cells was significantly up-regulated at T3,the expression of Treg cells was down-regulated and Teff/Treg ratio was increased at T2 and T3,the concentration of serum TGF-β was decreased and IFN-γ/TGF-β ratio was increased at T2 and T3 in group U (P ＜ 0.05 or 0.01).No significant changes were found in the serum IFN-γ and TGF-β concentrations and IFN-γ/TGF-β ratio at each time point in the two groups (P ＞ 0.05).Conclusion Ulinastatin can enhance the immune function of Teff cells in the peripheral blood and decrease the immune function of Treg cells,thus maintaining the balance of the postoperative cellular immune function in patients undergoing laparoscopic operation.

Objective:To explore the prognosis of posttraumatic stress disorder (PTSD) in flood survivors 13 years after they had been diagnosed with PTSD symptoms,and investigate the relationship between their personality traits and the prognosis of PTSD.Method:In this cross-sectional study,the survivors of Dongting Lake flood in 1998-1999 in Hunan in China,who were investigated and screened as PTSD symptoms positive in 2000 were selected as the target population,from which a sample of 200subjects was drawn using amulti-stage random sampling method.The Posttraumatic Stress Disorder Scale Civilian Version (PCL-C) was used to examine and re-screen the participants of PTSD symptoms in order to explore the prognosis of PTSD.Participants whose PCL-C scores were equal to 44 or higher were classified as the PTSD symptoms positive group,while those with PCL-C scores less than 44 were classified as the recovered group.Personality traits were then assessed,using the Revised Eysenck Personality Questionnaire Short Scale for Chinese (EPQ-RSC),in both the recovered group and the PTSD symptoms positive group.Finally,the multivariate logistic regression analysis was used to investigate the relationship between the prognosis of PTSD and personality traits.Results:Totally 200 subjects were eligible for this study and completed the questionnaires,but 16 of them had their questionnaires excluded from data analysis because they provided incomplete information.Thus,the response rate was 92.0％.According to the PCL-C's cut-off score,22 participants were still screened as PTSD symptoms positive and were classified as the PTSD symptoms positive group,whereas the other 162 participants were screened as PTSD symptoms negative and were classified as the recovered group.Compared with the recovered group,the EPQ-RSC extroversion scores for the PTSD symptoms positive group were significantly lower [(51.8 ± 10.7) vs.(45.1 ± 13.2),P ＜ 0.05] and their neuroticism scores were significantly higher [(46.5 ± 10.1) vs.(58.3 ± 12.2),P ＜ 0.05].The multivariate logistic regression analysis showed,after adjusting for the variables such as gender and age,that higher neuroticism (OR ＝ 3.63,95％ CI:1.05 -12.54) was a risk factor for the persistent PTSD symptoms in the flood survivors.Conclusions:It suggests that neuroticism is associated with prognosis of PTSD in flood survivors,those with higher neuroticism scores appear to have problems to recover from PTSD.

BACKGROUND:Low back pain in patients with hip osteoarthritis can be relieved to some extent after total hip arthroplasty, indicating the changes in limb line of force have obvious effects on low back pain. OBJECTIVE:To review and analysis the pathological base and biomechanics mechanism of hip-spine syndrome. METHODS: We retrieved PubMed database and China National Knowledge Infrastructure for related articles published from January 1976 to March 2015. The key words were “low back pain, hip-spine syndrome, hip osteoarthritis, total hip replacement, biomechanics, balance parameters” in English and Chinese, respectively. Repeated studies and unrelated articles were excluded. RESULTS AND CONCLUSION:A total of 145 articles were retrieved, and finaly 62 articles were enroled in result analysis. In the pathophysiology, tumor necrosis factor-α, interleukin-1β and matrix metaloproteinases play a significant role in the occurrence and development of hip-spine syndrome. As for the biological biomechanics, the spine-pelvic-lower limb balance compensatory process can be the main mechanical mechanism of hip-spine syndrome, and the balance parameters can provide a basis for the diagnosis, treatment and postoperative evaluation of hip-spine syndrome.

The 3T3-L1 preadipocytes were used as carriers in the investigation of total extract, n-butanol extract, CB-1 and CB-2 of Coreopsis tinctoria Nutt. on cell proliferation and differentiation. Three groups at different doses were set for each of the four extract regions of C. tinctoria Nutt., respectively. MTT assay was used to detect 3T3-L1cell proliferation by four extract regions of C. tinctoria Nutt. Oil Red O staining was used to analyze the formation and accumulation of cytoplasmic lipid during cell differentiation. The results showed that compared with the control group, there were significant inhibition on cell proliferation when thetotal extract of C. tinctoriaNutt. at 100 μg·mL-1, n-butanol extract at 0.5, 5, and 50 μg·mL-1, CB-1 and CB-2 at 50 μg·mL-1 (P< 0.01). N-butanol extract showed certain dose-dependent manner (r = -0.903). Oil Red O staining showed that compared with the control group, thetotal extract of C. tinctoria Nutt. at 1, 10, 100 μg·mL-1 can obviously inhibit cell differentiation, reduce the formation of cytoplasmic lipid (P< 0.01). N-butanol extract can inhibit cell differentiation in a dose-dependent manner (r= -0.779). CB-1 and CB-2 obviously inhibited cell differentiation at the concentration of 50 μg·mL-1 (P < 0.01). It was concluded that thetotal extract, n-butanol extract, CB-1 and CB-2 of C. tinctoria Nutt. can inhibit the proliferation and differentiation of 3T3-L1 preadipocytes and reduce the formation of cytoplasmic lipid.

Objective To elucidate the effect of clavulanic acid (CLA) in suppressing the antibiotic resistance of Helicobacter pylori (Hp) to metronidazole (MZ) and its mechanism. Methods All Hp strains were isolated from biopsy specimens taken endoscopically and random amplified polymorphic DNA assay (RAPD) was used to certificate the distinct origin of these strains. The minimum inhibitory concentration (MIC) of CLA and MZ aganst Hp were determined by using agar dilution procedure and Epailometer test (E-test). The effect of CLA on the morphology of Hp was examined by transmission electron microscopy. Fluorescein-C6-aminopenicillanic acid (FLU-C6-APA) competition assay was used to detect the binding between CLA and penicillin-binding proteins (PBPs). Results Eleven strains were isolated. In vitro CLA could decrease the MIC of MZ resistant(1.442±0.459 vs 0.376±0.288, P=0.0077), but not affect the MIC for MZ sensitive strains significantly (P>0.05). Exposure to CLA resulted in morphological changes of Hp, including cell wall disintegration and cell lysis. Furthermore, CLA inhibited the binding of FLU-C6-APA to PBPs(30.5-33.5×103). Conclusions CLA suppresses the antibiotic resistance of Hp to MZ through its binding with PBPs which results in the morphology changes of Hp.

Objective To investigate the value of individualized thyroid stimulating hormone (TSH) inhibition therapy in postoperative patients with differentiated thyroid carcinoma.Methods The medical record and follow-up data of the 556 patients with differentiated thyroid carcinoma after total or neartotal thyroidectomy were retrospectively reviewed.Patients were divided into two groups:Group A (304 cases) received TSH suppression therapy without risk assessment.Group B (252 cases) were given TSH suppression therapy in accord with risk assessment of both differentiated thyroid cancer recurrence risk stratification condition and the side effects of TSH suppression therapy risk stratification.Results The 3-year non-recurrence and (or) non-metastasis rate in group B was 99.2％ which was higher than 96.8％ in group A (P =0.044).The hospitalization rate caused by postoperative cardiovascular events or other morbidities in group B decreased 89％ than that in group A.Conclusions Individualized TSH suppression therapy can significantly decrease the recurrence and metastasis rate as well as concurrent morbidities caused by unnecessary TSH inhibition.