Objective To study the value of CT scan in diagnosis and clinical therapy of thyroid diseases.Methods CT findings in 61 cases with various thyroid diseases confirmed pathologically were analyzed retrospectively.Results ① 9 patients were Hashimoto’s thyroiditis.Of them,5 cases were diffuse lesions and 4 localized at one enlarged lobe and 1 with calcification.② 28 cases with hyperplasia included 2 Graves disease of diffuse lesions with enlargement and 26 nodular hyperplasia.There were calcification in 8 and cystic change in 13.③ 24 cases of thyroid tumor included 14 thyroid adenomas with complete circumscribed enhanced ring around the lesion,10 of them were in company with cystic change and 4 with calcification.13 cases were single lesion and one case was mattiple lesions.10 thyroid carcinoma,3 cases were in company with cystic change and 7 with calcification.Metastasis of cervical lymph nodus was found by CT in 7 cases.Metastatic lymph nodes presented marked enhancement,cystic change and calcification.Conclusion CT scan both plain and contrast-enhanced are beneficial for the detection of thyroid diseases,and is also important for planning the management and predicting the prognosis of this disease.

AIM: To compare the ligustilide content in Siwu Decoction and its ingredient herb. METHODS: To extract with SFE-CO 2 and to determine ligustilide with HPLC. RESULTS: Of the content of ligustilide, the highest in single herb, next in the mixture of Angelicae Sinensis Radix and Lignstic Rhizoma, the lowest in Siwu Decoction. CONCLUSION: When Angelicane Sinensis Radix and Lignstic Rhizoma were in compound preparation, the content of ligustilide became lower obviously.

Objective: To explore the impact of ticagrelor on platelet aggregation in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention(PCI). Methods: A total of 98 ACS patients received PCI in our hospital from 2015-01 to 2015-12 were enrolled. The patients were randomly divided into 2 groups: Clopidogrel group, the patients received oral clopidogrel 300mg at first time and then maintained by 75mg/qd, n=48 and Ticagrelor group, the patients received oral ticagrelor 180mg at first time and then maintained by 90mg/bid, n=50. All patients were treated for 12 months.The level of vasodilator stimulated phosphoprotein (VASP) phosphorylation and platelet reactivity index (PRI) at pre-medication and 24h, 7 days and 1 month after PCI were detected; major adverse cardiovascular events (MACE) and bleeding events were recorded within 1 month after PCI, the incidence of platelet aggregation, MACE and bleeding events were compared between 2 groups.Results: The baseline information and PCI condition were similar between 2 groups, P>0.05. The overall average PRI was different between 2 groups, P<0.001 and PRI at each time point was different between 2 groups, P<0.001, different group and time point had interactive effect on PRI, P<0.001. Compared with Clopidogrel group, Ticagrelor group had the lower ratio of PRI≥50% at different time points after PCI, P<0.001. The incidence of MACE and bleeding event were similar between 2 groups within 1 month after PCI, P>0.05. Conclusion: Ticagrelor was superior toclopidogrel for anti-platelet aggregation in ACS patients after PCI, it didn't increase bleeding events.

BACKGROUND: Independent urination and defection functions do not exist in patients with paraplegia above T12 because the injury disrupts the connection to the brain.OBJECTIVE: To reconstruct urination and defecation functions in patients with paraplegia with vascularized intercostal nerve transfer to sacral nerve roots with selected interfascicular anastomosis.DESIGN: Self-control observation.SETFING: Department of Orthopedics, Changhai Hospital of the Second Military Medical University of Chinese PLA.PARTICIPANTS: We recruited 30 patients with traumatic paraplegia at T9-L2 who received treatment in the Department of Orthopedics,Changhai Hospital of the Second Military Medical University of Chinese PLA, from January 1990 to December 2000. Paraplegia plane at T9-T11was found in 17 cases and paraplegia plane at T12-L2 in 13 cases. All the cases had undergone vertebral lamina decompression and internal fixation, 24 of whom had an additional operation to remove the internal fixation.METHODS: Two normal vascularized intercoastal nerves and artery and vein (intercostals nerves were generally at ribs 7 and 8 or 9 and10)above the spinal cord injury site were harvested by cutting in at their distal ends at the midclavicular line and separating the proximal ends from the levatores costarum. The nerves were then transferred to the vertebral canal through a submuscular tunnel. A sural nerve segment that had been harvested and sheared into two segments was sutured to the intercostal nerves by epiperineurial neurorrhaphy and then to the S2-4nerve roots by interfascicular neurorrhaphy. For patients with spinal injury plane below T11, intercostal nerve or subcostal nerve among the 10th and 11th ribs were harvested from the incision of abnormal wall. The nerves were transferred to the lumbar part through the channel of lateral abdominal wall. The transplanted sural nerve was conrected to S2-4 nerve root of partial nerve tract cut alternatively and exposed from S1,2 plane posterior. Defecation function of the patients was evaluated at postoperative 1, 3, 6, 12 and 24 months and follow-up; urodynamic examination was performed before and after operation.patients.RESULTS: A total of 30 patients were followed up for 5 years on average,tion and defecation functions of the patients: 26 (86.6%) had recovered defecation and urination sensation, 23 (76.7%)regained the micturition reflex and uriesthesis; 19 (63%) had recovered function of the detrusor The postoperative maximum urine flow ratio, surplus urine volume, and the maximum systolic pressure of detrusor muscle were obviously improved as compared with those before operation [(12.0±3.0) vs (2.0±0.3) mL/s,(80±12) vs (150±30) mL, (11.76±3.43) vs (5.88±1.47) kPa, P ＜ 0.05]. Postoperative low compliance was found in 9 cases, and detrusor areflexia in 7cases. The number was both significantly decreased as compared with that of preoperative cases (26 and 27 respectively).CONCLUSION: Transfer of vascularized intercostal nerve to S2-4 nerve roots with selected interfascicular anastomosis can reconstruct partial urination and defecation functions, and sensation in buttock, perineal region and cunnus region in paraplegia.

Objective:To investigate the effect of catheterin-related antimicrobial peptides(CRAMP)on the damage of cardiac microvascular endothelial cells induced by high glucose.Methods:Adult mouse heart microvascular endothelial cells were isolated and cultured.A model of microvascular endothelial cell injury was established by high glucose culture.The endothelial cells were randomly divided into 4 groups as the following.In the control group, 27.5 mmol/L mannitol was given as isoosmotic control as compared with the high glucose group.In the high glucose group(HG group), cells were cultured with 33.3 mmol/L high glucose for 48 h, and then treated without CRAMP.In 0.15 mg/L CRAMP treatment group, cells were cultured with 33.3 mmol/L high glucose for 48 h, followed by 0.15 mg/L CRAMP treatmen for 24 h. In the 0.5 mg/L CRAMP treatment group, cells were cultured with 33.3 mmol/L high glucose treatment for 48 h, and then treated with 0.5 mg/L CRAMP for 24 h. Cell proliferation was examined by staining with CKK-8 cell counting kit.The secretion of inflammatory factors in microvascular endothelial cells was detected by ELISA kit.Reactive oxygen species assay kit detects the level of reactive oxygen species in cells.Cell apoptosis was detected by apoptosis kit.Tubule formation and tubule number were measured by cells cultured on the matrix glue membrane, then detected by microscopic observation.The nitric oxide(NO)test kit measures levels of NO.The expression of nitric oxide synthase(eNOS)was detected by western blotting.Results:The cell proliferation activity was significant lower in the HG group than in control group[(52.2±5.4)% vs.(100.0±7.3)%]. The cell proliferation activity was higher in the 0.15 and 0.5 mg/L CRAMP groups than in the HG group[(72.0±3.4)% vs.(52.2±5.4)%; and(84.2±5.8)% vs.(52.2±5.4)%( F=75.300, P<0.001)]. The expression of tumor necrosis factor-α was significantly higher in the HG group than in the control group and in 0.5 mg/L CRAMP group[HG group of(239.1±32.1)μg/L, the control of(22.1±3.7)μg/L, 0.5 mg/L CRAMP of(84.6±9.4)μg/L]( F=197.300, P<0.001). The level of reactive oxygen species was significantly higher in the HG group than in control group and in 0.5 mg/L CRAMP group[(20.8±2.4)in HG group, (4.8±1.7)in control group, (10.2±1.5)in CRAMP group]( F=105.700, P<0.001). The number of apoptotic cells was significantly higher in the HG group than in control group and in 0.5 mg/L CRAMP group[(21.2±3.1)% in HG group, (2.2±0.6)% in control group(9.5±1.2)% in CRAMP group]( F=141.900, P<0.001). The length and number of tubules were lower in the HG group than in control group and in CRAMP group[for the length: (87.8±9.1)μm in HG group, (337.0±37.2)μm in control group(206.5±16.3)μm in CRAMP group( F=160.800, P<0.001); for the number: (9.1±1.9)in HG group, (22.0±3.4)in control group, (16.8±2.2)]in CRAMP group( F=36.200, P<0.001)]. The level of NO was lower in the HG group than in control group and in CRAMP group[(0.25±0.05)in HG group, (1.05±0.16)in control group, (0.75±0.06)in CRAMP group( F=83.200, P<0.001)]. The protein expression and mRNA levels of endothelial nitric oxide synthase(eNOS)were lower in the HG group than in the control group and in CRAMP group[for eNOS protein: (0.07±0.03)in HG group, (0.81±0.05)in control group, (0.54±0.07)in CRAMP group, F=275.700, P<0.001; and for eNOS mRNA: (0.11±0.07)in HG group, (1.00±0.22)in control group, (0.57±0.12)in CRAMP group, F=50.600, P<0.001]. Conclusions:CRAMP protein can inhibit the damage of cardiac microvascular endothelial cells by increasing eNOS-mediated NO signal pathway.