To investigate the risk of papillary thyroid carcinoma (PTC) in patients with nontoxic multinodular goiter (MNG) compared to that in patients with solitary nodule (SN).From Jan 2006 to Dec 2011,761 patients underwent thyroid surgery were included in the retrospective study.According to pathology,patients were subdivided into two groups,MNG and SN.Preoperative thyroid profiles were correlated with patients' postoperative diagnoses.In whole group,the risk of PTC was significantly lower in MNG than in SN (7.09％ vs 15.58％,P =0.000 9).In patients with nontoxic multinodular goiter,the risk of PTC was lower compared to that of those with SN.

Objective To investigate the therapeutic effects of thrombolytic drug infusion via carotid artery on experimental central retinal artery occlusion (CRAO), and observe the changes of fibrinolytic activity in the systemic circulation. Methods To dissolve the thrombi in 15 cats (30 eyes) with CRAO established by laser irradiating a branch of central retinal artery after intravenous injection of photochemical drugs, urokinase (UK) was directly infused via carotid artery in 5 cats (10 eyes) in group A or intravenously injected in 5 cats (10 eyes) in group B, and isotonic saline solution was intravenously injected in 5 cats (10 eyes) in group C respectively. The patency of the artery was evaluated by fundus fluorescein angiography. Moreover, the changes of fibrinolitic activity in the blood were observed by blood biochemical examination. Results Four hours after UK infusion, the complete repatency proportion was 80% (5 cats 8 eys) in group A, and 50% (4 cats 5 eyes) in group B. There was significant difference between the two groups. Besides, after the infusion, the indexes of coagulation, fibrinolysis, and anti-fibrinolysis in group A were better than those in group B and C (P

Objective To investigate the therapeutic effects of thrombolysis infusion via microcatheter on the treatment of central retinal artery occlusion(CRAO). Methods Urokinase (UK) was directly infused via ophthalmic artery (OA) by microcatheter (6 patients) or via intravenous (7 patients) to dissolve the thrombus. The patency of the artery was evaluated by fundus fluorescein angiography (FFA), and the effect of fibrinolytic activity on the systemic changes was observed by blood biochemical examination simultaneously. Results In 6 patients in the microcatheter group, 5 had completely and 1 had partly reopened OA on the morrow of UK infusion with the patency rate of 83.33%, while in 7 patients in vein group, 3 completely reopened, 2 partly reopened and 2 obstructed OA were found with the patency rate of 42.86%. The difference between the two groups was significant. No obvious change of index of blood coagulation system was found in catheter group, which had great disparity compared with the vein group. Conclusion Urokinase infusion via microcatheter in CRAO has better therapeutic impact and smaller effect on systemic action.

Objective To understand the guidance significance of sputum smear on the sputum culture by comparing the micro-scopic detection results of sputum smear with the sputum culture results in 227 cases.Methods 227 cases of sputum specimen were collected for observing the character and smear staining by microscopy.These specimens were divided into the class A,B,C and D according to the standards and simultaneously conducted the culture.The relationship between smear and culture was analyzed.Reˉ sults Among 227 cases of sputum specimen,158 cases were qualified and accounted for 69.60%,and 69 cases were unqualified and accounted for 30.40%.Potential pathogens were detected in 128 cases,the positive detection rate was 56.39%,the positive detec-tion rate of qualified sputum specimens was 70.39% and which of unqualified sputum specimens was 28.00%.The coincidence rate of qualified sputum specimen smear results and the culture results was 72.78%.The positive rate of cytophagic bacteria in the qual-ified sputum specimens was 11.72%,in which 14 cases of cytophagic bacteria were the qualified class A sputum specimens with the positive rate of 16.67% and 5 cases of cytophagic bacteria were the class B sputum specimens with the positive rate of 6.76 %. Conclusion The sputum smear microscopic detection can provide the important information for the diagnosis and treatment of re-spiratory infections and the sputum smear has the important guiding significance for sputum culture.

The PBL Teaching Method has implemented in the department of gynecology and obstetrics of Fudan University since 2004.This new method cultivates the students'ability to ask and answer the questions to collaborate,to comiderate problems conpletely and the ability to consult information and solve problems quickly.Teachers and department should improve the teaching and manage level.

Objective To observe the glucose profile in type 2 diabetic gastroparesis.Methods 31 patients diagnosed with type 2 diabetes were enrolled into this study for measurement of gastric emptying of solids and continuous glucose monitoring to observe blood glucose 1evels for 72 hours on a balanced diet;the results were compared with 7 subjects with norinal glucose regulation.Results 58.1%of 31 type 2 diabetic patients were found to have delayed gastric emptying of solids.The average glucose level was lower after breakfast[(7.82±1.42)mmol/L vs(9.35±2.28)mmol/L,P<0.01]in the patients with gastroparesis than in those without.Maximal blood glucose level after breakfast[(10.21±2.17)mmol/L vs (12.24±2.82)mmol/L,P<0.01]was lower in the patients with gastroparesis but it reached the peak at a similar time.Two hour AUC was also lower after breakfast in the patients with gastroparesis[(877.62±Post-prandial glucose levelin type 2 diabetic patients with gastroparesis tends to be lower than those without.

Objective To study the binding performance of 99Tcm labeled anti-human prostatic specific membrane antigen (PSMA) monoclonal antibody J591 (99Tcm-J591) and prostate cancer cells in vitro,the biodistribution and SPECT imaging of 99Tcm-J591 in nude mice bearing human prostate cancer in vivo.Methods The monoclonal antibody J591 was labeled with 99Tcm by improved Schwarz method.Labeled antibody was purified by Sephadex G-50.The labeling efficiency and radiochemical purity were measured by paper chromatography and trichloroacetic acid method.The binding performance of J591 and prostate cancer cells was measured by flow cytometry in vitro.The nude mice bearing PSMA-positive C4-2 prostate carcinoma xenografts served as experiment group,mice bearing PSMA-negative PC3 tumors served as control group.6.2-8.5 MBq of 99Tcm-J591 (25 μg) was intravenously injected into mice.Gamma imaging was performed 2,6,12 and 24 h after injection,T/NT was calculated by ROI technique.After scanned 12 h post injection,4 mice of the experiment group and 5 mice of the control group were sacrificed and the tracer in vivo biodistribution was measured by gamma-counting,and the ％ ID/g was calculated.Two-sample t test was carried out to validate significant difference of ％ID/g between two groups.Results The labeling efficiency and radiochemieal purity of 99Tcm-J591 were (78.9±6.2)％ and (92.3±5.1)％,respectively,and the specific activity of 99Tcm-J591 was 68.7 MBq/mg.The antibody J591 and 99Tcm-J591 could strongly combine with PSMA-positive C4-2 cells in vitro,and didn't combine with PSMA-negative PC3 cells in vitro.SPECT imaging results showed that radioactive concentration was obvious in tumor 6 h post injection,the concentration scope became large and the tumor image was clear 12 h post injection.T/NT was 1.9±1.1 at 2 h,4.3±1.8 at 6 h,5.6±2.7 at 12 h,1.4±0.6 at 24 h,respectively.In the control group,no radioactivity concentration was found in tumor,and T/NT was less than 2.The biodistribution results showed that ％ID/g of tumor tissue was 20.1±5.2 in the experiment group and 5.8±2.6 in the control group,and there was significant difference (t=5.37,P＜0.001).No significant tracer uptake occurred in other tissues and organs between the two groups (all t＜ 1.98,all P＞0.05).Conclusion The immunoactivity,characteristics of biodistribution and tumor targeting property of monoclonal antibody J591 show promising future and potential values in diagnosis and therapy of prostate cancer.

Objective To investigate the clinical efficiency of perforator pedicled propeller flaps for soft-tissue coverage of the lower leg and foot defects.Methods From July 2007 to December 2011,twentyfive cases with soft-tissue defects of the lower leg and foot were cured by using the perforator propeller flaps.The origins of the perforator were 18 cases from peroneal artery,six cases from posterior tibial artery and 1 case from dorsal foot artery.The minimum of the flap scale was 4-9 cm,and the maximum was 10-33 cm.Results All cases were followed-up from 1 to 26 months.All the flap pedicles were smooth with a satisfied appearance.The donor sites were sutured directly in 9 cases and cured with skin-grafting in 16 cases.Three cases suffered from vein congestion,two cases were cured by incisions in the distal parts of the flaps,one flap had necrosis of the distal 1/3 part and was cured by skin-grafting.Conclusion The perforator pedicled propeller flap is a simple,safe and useful flap.It has more advantages than other pedicled flaps for softtissue coverage of the lower leg and foot defects.

Objective To investigate the feasibility of a single-stage operation in the treatment of traumatic osteomyelitis with flap and vancomycin-impreganted artificial bone. Methods Forty-one cases using one single-stage operation in the treatment of traumatic osteomyelitis with flap and vancomycin-impreganted artificial bone were cured, osteomyelitis recurred in 2 cases, and was cured after debridement and vancomycin-impreganted artificial bone plantation again. 1 case occurred nonunion and was cured by autogenous nonvascular iliac bone transplantation. Results All cases were followed from 4 months to 2 years, the average fracture cured time was 5.3 months(3-9 months), and the average wound cured time was 3.7 weeks. The soft tissue defect was cured in one stage, the osteomyelitis of all cases was cured at last. Conclusion It is feasible that one single-stage operation treated the traumatic osteomyelitis with flap and vancomycin-impreganted artificial bone.

Objective To evaluate the validity of percutaneous radiofrequency ablation(RFA)combined with percutaneous ethanol injection(PEI) with different style in rabbit liver in vivo.Methods Twenty-four New Zealand white rabbits were included in this study and divided into four groups.Group A:RFA before PEI(n=6),RFA (1 cm mono-electrode,maintain 3 minutes RFA) before PEI 1.5 ml; Group B:PEI before RFA (n=6),PEI 1.5 ml before RFA (1 cm mono-electrode,maintain 3 minutes RFA); Group C:RFA (1 cm mono-electrode,maintain 3 minutes RFA) only (n =6);Group D:PEI (1.5 ml) only(n=6).To analyze the resistance,current and energy requirement per unit of each group including RFA.To observe the size,shape,isoperimetric ratio and volume of coagulated necrosis of each group by enhanced CT.Results The longest diameter and the shortest diameter of group B[respectirely,(24.1±4.4) mmand (21.45±4.0) mm] were significantly larger than group C [respectirely,(12.4 ± 1.6) mm and (11.1 ± 1.4) mm] and group D[respectirely,(7.7 ± 2.3) mm and (5.1 ± 1.5) mm] (P＜0.01).The height diameter and volume of coagulated necrosis of group B [respectirely,(20.3± 4.9) mm3 and (5879 ± 2607) mm3] were significantly larger than the other 3 groups [(14.8± 2.7) mm3 and (3130±1250) mm3,(10.7±1.6) mm3 and (767±173) mm3,(6.7± 1.0) mm3 and (146±83) mm3] in A,C,and a group (P＜0.01).Isoperimetric ratios of ablation zone in group B was the most highest.There were no statistically significant between each group (P＞0.05).The resistance of group B were significantly larger than group A and group C (P＜0.01).The current of group B were significantly lower than group A and group C (P＜0.05).The energy requirement per unit of group A and group B were significantly lower than group C (P＜0.01).Conclusion The volume of coagulated necrosis of group PEI-RFA was significantly larger than the other 3 groups.The energy requirement per unit of group PEI-RFA were the lowest in each group.The isoperimetric ratio of group PEI-RFA was the most highest.