Objective To investigate the pathogenistic, clinical and pathologic characteristics and treatment in elder patients with thyroid carcinoma(TC). Methods The clinical and pathologic manifestation, the treatment and prognosis of forty elder patients with thyroid carcinoma were analysed. Results The incidence of TC in elder patients was 14.2% in all of the thyroid carcinomas in the same period. The clinical course was longer and the neoplasm was bigger. A majority of the pathology was follicular adenocarcinoma(35%), followed by adenocarcinoma, undifferentiated carcinoma and pipallary adenocarcinoma. Surgerical management was the primary therapy. 17 cases underwent redical thyroidectomy with neck dissection, 13 total thyroidectomy or subtotal thyroidectomy, 4 palliative resection. Isotopic or radiotherapy as an adjuvant therapy was done if necessary. Five year survival rat was 52.0%, mortality was 45.0% in follow up period. Conclusions The main causes of the poorer prognosis of elder patients with thyroid carcinoma are follows: ① the malignant degree of the tumor is higher; ② the reaction for the tumor in elder patients is duller. So it is important to pay attention to elder patients with thyroid nodule, and an operation should be done as quick as possible.

BACKGROUND:Perioperative treatment of emergency liver transplantation for acute hepatic failure is extremely different from common liver transplantation, due to complex conditions, high risk, several complications, and high mortality. OBJECTIVE:To summarize the experience of emergency liver transplantation for acute hepatic failure during the perioperative period, and to increase the success rate in treatment of acute hepatic failure. METHODS:A retrospective analysis was undertaken on the clinical data of 38 cases undergone emergency liver transplantation for acute hepatic failure. There were 21 male and 17 female, who aged 15-69 years. Among them, 23 cases had hepatitis B virus (including 2 cases with hepatitis B and C virus), 7 cases had Wilsons disease, 3 cases had mushroom poisoning, 2 cases had unknown liver damage, 1 case had Tripterygium wilfordi poisoning, 1 case had decompensation after partial liver resection due to trauma, and 1 case had liver transplantation from corpse. RESULTS AND CONCLUSION:The survival time of the involve patients was 13-1 740 days, and the median survival time was 634 days. Perioperative survival rate was 76%, 1-year survival rate was 63%, and 2-year survival rate was 58%. During the perioperation nine cases died of brain edema and intracranial hypertension, renal failure, severe pulmonary infection, multiple organ failure, coagulation disorders (intracranial hemorrhage, upper digestive tract hemorrhage), acute respiratory distress syndrome and primary graft non-function. At present, emergency liver transplantation is stil the most effective way for acute liver failure. Hemorrhage, infection and rejection are the leading causes of the death. Each perioperative treatment is of great significance for the success of liver transplantation and long-term survival.

Neurofeedback, as an alternative treatment method of behavioral medicine, is a technique which translates the electroencephalogram (EEG) signals to styles as sounds or animation to help people understand their own physical status and learn to enhance or suppress certain EEG signals to regulate their own brain functions after several repeated trainings. This paper develops a neurofeedback system on the foundation of brain-computer interface technique. The EEG features are extracted through real-time signal process and then translated to feedback information. Two feedback screens are designed for relaxation training and attention training individually. The veracity and feasibility of the neurofeedback system are validated through system simulation and preliminary experiment.
Brain-Computer Interfaces ; Electroencephalography ; Female ; Humans ; Neurofeedback

Objective To evaluate the role of calcium/calmodulin-dependent protein kinase Ⅱ (CaMK Ⅱ) in the neuronal damage induced by lidocaine.Methods SH-SY5Y cells were seeded in 96-well plates (100 μl/hole) with a density of 5 × 105/ml and randomly divided into 4 groups (n =63 each):normal culture group (C group),CaMK Ⅱ inhibitor KN93 (K group),lidocaine group (L group) and KN93 + lidocaine group (KL group).KN93 (final concentration 1 μmol/L) was added to the culture medium and the cells were then cultured for 24 h in group K.Lidocaine (final concentration 10 mmol/L) was added to the culture medium and the cells were then cultured for 24 h in group L.KN93 (final concentration 1 μmol/L) and lidocaine (final concentration 10 mmol/L) were added to the culture medium and the cells were then cultured for 24 h in group KL.The cell morphology was examined with microscope after 24 h of incubation.The viability of cells was measured by MTT assay before incubation and at 1,6,12 and 24 h of incubation.The apoptosis in the cells was assessed by flow cytometry.The apoptotic rate was calculated.Results Compared with C and K groups,the cell viability was significantly decreased and the apoptotic rate was increased in L and KL groups (P ＜ 0.05).The cell viability was significantly higher and the apoptotic rate was lower in group KL than in group L (P ＜ 0.05).There was no significant difference in the cell viability and apoptotic rate between C group and K group (P ＞ 0.05).The pathological changes were obviousin group L and significantly reduced in group KL.Conclusion CaMK Ⅱ is involved in the neuronal damage induced by lidocaine.

Objective To investigate the effects of dexmedetomidine on perioperative cellular immune function and micro-metastasis in blood circulation in patients undergoing radical operation for colon cancer.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 38-69 yr,weighing 45-67 kg,undergoing radical operation for colon cancer,were randomly divided into 2 groups (n =30 each) ∶ dexmedetomidine group (D group) and control group (C group).Anesthesia was induced with midazolam,cisatracurium and sufentanil,and maintained with propofol,remifentanil and sevoflurane.After tracheal intubation,a loading dose of dexmedetomidine 1 μg/kg was injected intravenously,followed by infusion at 0.5μg· kg-1 · h-1 until the end of operation in D group.The equal volume of normal saline was administered in C group.Venous blood samples were obtained at 5 min before induction of anesthesia (T0),1 h after beginning of operation (T1),the end of operation (T2) and 24 h after the end of operation (T3) for determination of the levels of T lymphocyte subsets (CD3+,CD4+,CD8+) and NK cells by flow cytometry.CD4+/CD8+ ratio was calculated.Cytokeratin 20 (CK20) expression in circulation was detected by RT-PCR at T0 and T3 and the positive rate was calculated.Results Compared with the baseline value at T0,the levels of CD3+ and CD4+,CD4+/CD8+ ratio and level of NK cells were significantly decreased at T2 and T3 in group C,and the levels of CD3+ and CD4+ were significantly decreased at T2 and T3 in group D (P ＜ 0.05).The levels of CD3+,CD4+ and NK cells at T2 and T3 were significantly higher and positive rate at T3 was significantly lower in group D than in group C (P ＜ 0.05).Conclusion Dexmedetomidine can improve the cellular immune function and decrease the probability of micro-metastasis in blood circulation in patients undergoing radical operation for colon cancer.

Objective To observe the expression of calcium/calmodulin dependent protein kinase Ⅱ (CaMK Ⅱ) in the spinal cord of the rats followed lidocaine hydrochloride intrathecal injection.Methods 48 male SD rats weight(230 ± 20) g,after intrathecal indwelling catheter,were randomly divided into four groups (n =12,8 rats for behavioral detection and 4 rats for western blotting):normal group (C group),sham group (S group),DMSO group (D group),10％ lidocaine group (L group).Mechanical withdrawal threshold(MWT) and thermal withdrawal latency(TWL) were detected before and after 2 h,4 h,8 h,12 h,1 d,2 d,3 d,4 d and 5 d with drug treatment.Intumescentia lumbalis of the spinal cord were collected to measure the expression of CaMK Ⅱ with western blotting after drug treatment for 12 h.Results The based MWT of the rats in C,S and D group were (11.2 ± 3.1) g,(11.8 ± 2.2) g and (11.4 ± 2.4) g respectively.There were no differences among the every time points (n=8,P＞0.05).The MWT of the rats in L group significantly increased at 2 h,4 h,8 h,12 h,1 d,2 d,3 d and 4 d after treatment with lidocaine hydrochloride,and the data were (22.0 ± 6.6) g,(22.2 ± 5.3) g,(20.5 ±5.8)g,(18.5 ±4.3)g,(16.7 ±3.2)g,(15.2 ±3.1)g,(15.5 ±3.5)g,(13.7 ±2.4)g respectively (n=8,P＜0.01).TWL had no difference among the rats in C,S,and D group(n=8,P＞0.05).The TWL of the rats in L group significantly increased at 2 h,4 h,8 h,12 h,1 d,2 d and 3 d after treatment with lidocaine hydrochloride(n =8,P＜ 0.01).The expression of CaMK Ⅱ of the rats in C group,S group,D group and L group were 0.17 ± 0.03,0.16 ± 0.03,0.19 ± 0.05,0.42 ± 0.11,and significantly upregulated in L goup (n =4,P ＜ 0.01).Conclusion Lidocaine hydrochloride intrathecal injection can increase the expression of the CaMK Ⅱ in the spinal cord of the rats.Those indicate that CaMK Ⅱ may be involved with the nerve damage induced by lidocaine hydrochloride.

Objective To evaluate the role of T?type calcium channels in up?regulation of spinal Ca2+∕calmodulin?dependent protein kinase Ⅱ ( CaMKⅡ) expression in rats with neuropathic pain. Meth?ods Forty?eight male Sprague?Dawley rats, weighing 230-270 g, in which intrathecal catheters were suc?cessfully implanted, were divided into 4 groups ( n=12 each) using a random number table: sham opera?tion group (group S), neuropathic pain group (group NP), normal saline group (group NS), and T?type calcium channel blocker mibefradil group ( group M ) . The model of neuropathic pain was established by chronic compression of the dorsal root ganglion ( DRG) . Normal saline 20μl and mibefradil 200μg ( dilu?ted to 20μl in normal saline) were injected intrathecally at 5 days after compression of the DRG in NS and M groups, respectively. Before intrathecal catheter implantation ( T1 ) , before compression of the DRG ( T2 ) , at 5 days after compression of the DRG and before intrathecal administration ( T3 ) , and at 30, 60, 120 and 240 min after intrathecal administration ( T4?7 ) , the mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured. The rats were sacrificed after the last measure?ment of the pain threshold at T7 , and the lumbar enlargement segments of the spinal cord were harvested for determination of CaMKⅡ expression by Western blot. Results Compared with group S, the MWT was significantly decreased, and TWL was significantly shortened at T3?7 , and the expression of spinal CaMKⅡ was significantly up?regulated in NP and M groups (P<0.05). Compared with group NP, the MWT wassignificantly increased, and TWL was significantly prolonged at T4?6, and the expression of spinal CaMKⅡwas significantly down?regulated in group M (P<0.05), and no significant change was found in the parame?ters mentioned above in group NS (P>0.05). Conclusion T?type calcium channels are opened, the intra?cellular free calcium ion concentrations are increased, and activated spinal CaMKⅡ is involved in the de?velopment of neuropathic pain in rats.

Objective To compare the anesthetic efficacy of ketamine and sevoflurane for foreskin ligation in the pediatric patients.Methods A total of 120 pediatric patients,aged 2-6 yr,weighing 10-18 kg,scheduled for elective foreskin ligation,were equally and randomly divided into ketamine group (group K) and sevoflurance group (group S).In group K,atropine 0.25 mg/kg and ketamine 2 mg/kgwere injected intravenously,and foreskin ligation was performed after loss of eyelash reflex.In group S,8％ sevoflurance was inhaled using the tidal volume technique,the concentration inhaled was adjusted to 4％ after loss of eyelash reflex,and then foreskin ligation was performed.The occurrence of crying before and during anesthesia induction,induction time,emergence time,occurrence of agitation during emergence from anesthesia and duration of agitation were recorded.Results Compared with group K,the rate of crying was significantly decreased,the emergence time was shortened (P＜0.05),and no significant difference was found in the induction time,incidence of agitation during emergence from anesthesia,and duration of agitation in group S (P＞0.05).Conclusion Sevoflurance provides better anesthetic efficacy than ketamine when applied for foreskin ligation in the pediatric patients.

5 mm) had a significant influence on the frequency and distribution of cervical lymph node metastasis. The local recurrent rate in palpable lymph node group was significantly higher than the non-palpable lymph node group. Conclusions Careful palpation, B type ultrasonography, exploratory operation and frozen section are very important factors to heighten diagnosis of PTMC. We believe that PTMC could be divided into two subsets: with the former of non-aggressive behaviors treated by conservative surgery, and the later of a potentially aggressive clinical course treated by a more aggressive procedure.

Objective To evaluate the effects of sevoflurane on the expression of heparanase ( HPA) and fascin in lung carcinoma cells of mice. Methods Mouse LLC cells were inoculated in the culture plate. After being cultured for 24 h, the cells were equally and randomly divided into 4 groups using a random number table: control group ( group CC) , 1% sevoflurane group ( group Sev1 ) , 2% sevoflurane group ( group Sev2 ) , and 3% sevoflurane group ( group Sev3 ) . Cells in Sev1-3 groups were exposed to 1%, 2% and 3% sevoflurane, respectively, for 4 h, while cells in group CC were not exposed to sevoflurane, and all the cells were then cultured for another 24 h in an incubator. The invasion of cells was determined by Transwell invasion assay, and the invaded cells were counted. The migration of cells was determined by wound healing assay, and cell migration rates were calculated. The expression of HPA and fascin in cells was detected by Western blot. Results Compared with group CC, the number of invaded cells and cell migration rates were gradually decreased, and the expression of HPA and fascin was gradually down?regulated with increasing concentrations of sevoflurane in Sev1-3 groups. Conclusion The mechanism through which sevoflurane inhibits the metastasis of mouse lung carcinoma cells is associated with down?regulated expression of HPA and fascin.