Objective To discuss the diagnosis and surgical treatment of multiple endocrine neoplasia 2 (MEN2). Methods The clinical data of 28 MEN2 cases from Jun 1997 to Jun 2006 were retrospectively analyzed. Results There were 25 cases of MEN2a and 3 cases of MEN2b. Among the patients of MEN2a, 23 patients were from 7 families with mutation of codon 634, exon 11 of RET, 3 patients of MEN2b had mutation of codon 918, exon 16 of RET and no family history. Twenty-two cases of MEN2a had thyroid masses with elevated calcitonin level, in which 17 were pathologically diagnosed as medullary thyroid carcinoma (MTC) ,12 patients had pheochromocytomas. Among them, 5 were of multiple foci and 2 were malignant. Five patients presented hyperparathyroidism and 3 patients were asymptomatic without biochemical alterations. Three MEN2b patients had MTC and mucosal ganglioneuromatosis with Marfanoid, one patient had bilateral pheochromocytoma. Total thyroidectomy with bilateral dissection of regional lymph nodes was performed in 12 patients of MEN2a, and nodule enucleations was done in other 5 patients followed by persistent elevated calcitonin level. Nine MEN2a patients underwent pheochromocytoma enucleation including bilateral adrenal resection in 3 cases. Three MEN2b patients underwent total thyroidectomy with bilateral lymph node dissection. Conclusions MTC is the most often complications of MEN2. Germline mutation test helps to make early diagnosis. Radical total thyroidectomy in young patients may prevent MTC.

Objective To study the clinical characteristics of thyroid carcinoma in young females,in order to improve the diagnosis and treatment of this disease.Methods The clinical data of 74 consecutive young female patients with thyroid carcinoma treated in our hospital in the recent ten years were analysed.In most of the cases,there was no firm texture or fixation of the thyroid nodules to surrounding structures on physical examination before operation.Ultrasonography was performed in all patients and multiple thyroid nodules were found in 61 cases(82.43%).Thyroid scintiscans were performed in 43 cases,and thyroid nodules were found in 41 cases.The cold,cool and warm nodules were found in 14,18 and 9 cases,respectively,by scintiscans.Fine needle aspiration biopsy(FNAB) was performed in 11 cases,and in 2 cases were negative,1 case showed abnormal cell,3 cases were suspicious of carcinoma,and 5 cases were confirmed papillary carcinoma.Results Papillary carcinoma was found in 70 cases,follicular carcinoma in 3 cases and medullary carcinoma in 1 case by histological examination,and benign disease was also accompanied in most cases.Lymph node metastases was found in 28 cases(37.84%),and the rate of metastases was significantly different than that of older female patients(16.46%) at the same time.There were 2 cases who died 3 years after operation because of metastases.Conclusions The lymph node metastases were prevalent in young female patients with thyroid carcinoma.The texture and mobility of the nodules cannot be used to differentiate benign from malignant nodules.We should carefully analyze every nodule found on ultrasonography.For the solid nodules with diameter larger than 1.0cm,we suggest operation;for the non-solid nodules with diameter larger than 2.0cm,we prefer scintiscans and FNAB for diagnosis.

Objective To discuss the diagnosis and surgical treatment of multiple endocrine neoplasia 1 (MEN1). Methods The clinical data of MEN1 from 1974 to 2005 were retrospectively analyzed. Results There were 17 cases of MEN1 in our group. Among them, 11 cases were from 4 families. MEN1 gene mutation was detected in 14 cases admitted after 1997. There were 11 cases of pHPT, 6 cases of insulinoma, 8 cases of pituitary adenoma, 6 cases of adrenal adenoma, 2 cases of thymic carcinoid and 2 cases of collagenoma. Two patients had respectively 4 glands involved, 3 patients had 3, 7 patients had 2 kinds of gland involved respectively. Four patients had only one kind of gland involved. A 12 year old girl had no clinical symptom and biochemical change. Six patients presented with nephrolithasis, 6 patients had impaired pancreatic endocrine function. Subtotal parathyroidectomy was performed in 4 patients of pHPT, and one patient received parathyroid adenoma enucleation. Insulinomas were enucleated in 4 patients. Two patients underwent thymus tumor extirpation. Conclusions MEN1 varies in symptoms, even those from the same family. Cermline mutation test helps establish diagnosis. Operations should be aiming at tumor resection as well as the improvement of life quality.

ObjectiveTo modify the technique of whole small bowel transplantation in rats to improve the survival.MethodsOne hundred and six SD rats served as donors and recipients to establish a homogeneous and orthotopic model of small bowel transplantation without fistula.Anastomosis of aorta and vein was done with three- cuff technique,the vena mesenterica superior of recipient was done under a surgical microscope.End-to-end anastomosis was performed between donor proximal small intestine and receptor jejunum,and also between the remote and receptor ascending colon.Surviving more than 3 days after surgery was defined as the operation was successful.ResultsThe operation was successfully carried out in 48 cases with the survival rate of 90.6％ (48/53).The average warm ischemic time was 0 minute,and the average cold ischemic time was(30 ±2.48)min.The survival rate( ＞7 d) was 97.9％ (47/48).ConclusionsOn the basis of three-cuff technique,the survival of SBT was greatly improved.When the vena mesenterica superior of recipient was done under a surgical microscope,the surgical training time was shortened.

Objective To investigate the imaging and clinical features of Percheron artery infarction.Methods The clinical manifestations,imaging data,treatment,and prognosis of 10 patients with Percheron artery infarction were analyzed.Results All 10 patients had acute onset and had different degrees of consciousness disorders,including vertical gaze palsy (n =3),language disorder (n =3),limb weakness (n =6),and memory impairment (n =4).MRI showed bilateral thalamus infarction.Midbrain V-sign in one patient was observed.Cerebral angiography revealed that one patient had Percheron artery infarction.All 10 patients were improved and discharged,but left with varying degrees of sequelae.Conclusions Percheron artery infarction is rare in clinical practice.The diagnosis is mainly based on clinical manifestations and imaging examinations.Cerebral angiography can diagnose the disease.

Objective: To investigate the prospect of applying technology of ultra fine powder (UFP) to TCM powders for external use. Methods: The morphocytology between UFP of Cortex cinnamomi , compared with its common powder, was observed; physical parameters of the UFP particles and the penetrating amount of cinnamaldehyde, through rat skin in vitro was determined with an improved Franz diffuse cell. Results: The diameter of the UFP particles detected was small (D 50 =12.72?m). and a typical microscopic characters of Cortex cinnamomi powder was not observed. The Cortex cinnamomi UFP have good transdermal effects. There existed the linear relationship between penetrating amount of cinnamaldehyde and penetrating time. The highest penetrating rate (0.25mg/cm 2/h) was within the first hour in the beginning, and then the rate became lower and sustained. The accumulating transdermal amount of the UFP was 1.0mg/cm 2 totally in 8 hours. Conclusion: It indicated that UFP might have a fine respect, applied in cosmetic or drug preparations for external use.

AIM To investigate the anticonvulsive action of supercritical CO2 ethanol extract from Pinellia Pedatisecta Schott(SEE-CO2PP). METHODS The rat convulsive model was induced by penicillin localized injected in rat cortex. The effects of SEE-CO2PP on the latency of seizure and changes of convulsive behaviors were investigated. The latency of epileptiform discharge, and frequency and amplitude of highest wave in cortex and hippocampus were recorded by using RM6240C multichannel physiological signal collection and analysis recorder. At the same time, the contents of glutamic acid (Glu), aspartic acid (Asp), glycine (Gly) and γ-aminobutyric acid (GABA) in hippocampus were determined with high performance liquid chromatography. RESULTS SEE-CO2PP 15 and 30 g·kg-1, ig, prolonged the latent period of seizure and weakened the extent. SEE-CO2PP also prolonged the latent period of epileptiform discharge, reduced the frequency and decreased amplitude of the highest wave in both cortex and hippocampus. Moreover, SEE-CO2PP increased the content of GABA in hippocampus, but the levels of Gly,Asp and Glu had no obvious changes. CONCLUSION SEE-CO2PP inhibits the epileptiform discharge and convulsive behaviors of convulsive model rats, which suggests SEE-CO2PP has anticonvulsive action.

Objective To investigate the dosimetric differences between Utrecht applicator and ring applicator in three-dimensional (3D) conformal brachytherapy for locally advanced cervical cancer.Methods Twenty-five patients with locally advanced cervical cancer were treated with magnetic resonance imaging-guided 3D conformal brachytherapy.Utrecht applicator and ring applicator were used interchangeably for 96 cycles.Patients were divided into two groups according to the type of applicator.Each group received 48 cycles of treatment, in which ring applicator was first applied for 26 cycles and Utrecht applicator was first applied for 22 cycles.High-risk clinical target volume ( HR-CTV) , width, thickness, and D90 at the point A level, D2 cm3 of organs at risk (OARs), V7 Gy , W7 Gy,A, V7 Gy ,A, and W/T7 Gy were evaluated and analyzed using paired t-test.Results There were no significant differences in HR-CTV and the width, thickness, and D90 at the point A level between the Utrecht group and the ring group ( P=0.487;P=0.340;P=0.857;P=0.921);there were no significant differences in D2 cm3 values of bladder, rectum, sigmoid, and bowel between the two groups ( P=0.136;P=0.802;P=0.985;P=0.458);there were no significant differences in V7 Gy and T7 Gy,A between the two groups ( P=0.076;P=0.435) .The Utrecht group had a significantly larger W/T7 Gy,A than the ring group ( P=0.002 ) .Conclusions Utrecht applicator is appropriate for patients with relatively large width and width/thickness ratio of HR-CTV at the point A level.

Objective To investigate the effect of the optimal prescription of huiru yizeng on rats with hyperplasia of mammary gland and hyperprolactinemia. Methods Fifty-six female Wistar rats were randomly divided into 7 groups (n=8), including normal control group, model control group, sodium chloride group, bromocriptin group, rupi sanjie group, the original prescription group and optimizing prescription group. Rat model of mammary gland hyperplasia with hyperprolactinemia was replicated in 6 groups but not the normal control group. The successfully established experimental rats were given corresponding drugs by intragastric gavage. After 30 days, the levels of the estradiol, progesterone, and prolactin were detected, and the pathomrphology of glandular tissue was observed. Results Prolactin levels of model control group, the original prescription group and optimize prescription group were (69.47 ±6.08), (53.13 ±10.59), and (28.41 ±6.37) pg·mL-1, respectively . Compared with that in the model control group, the contents of prolactin in both the optimal prescription group and the original prescription group were reduced, but the optimal prescription group was better (P<0. 01). In the original prescription group, the lobules of mammary gland showed a few of hyperplasia, the individual alveoli and duct showed a slight hyperplasia, and a small amount of secretions was found in the duct. The degree of the hyperplasia was alleviated in the optimal prescription group similar to that observed in the normal control group, which showed that there was no hyperplasia in the lobules of mammary gland or no secretions in the duct. Conclusion The therapeutic effects of the optimal prescription are much better than the original prescription, which can effectively lower the level of prolactin, adjust the balance among the prolactin , estrogen and progesterone, and alleviate the pathological hyperplasia of mammary glands in the model rats.