Objective To analyze the clinical and pathological characteristics of thyroid nodules.Methods A retrospective analysis of the clinical data of 2843 Han patients with thyroid nodules from January 2009 to June 2011 in Henan province was performed.Results The most high-risk of thyroid nodule resided in the group aged 45-54.The main pathological manifestation was simple nodular goiter.The rate of preoperative misdiagnosis was 2.4％.22.1％ of the patients with thyroid nodules showed abnormal thyroid function,which was mainly as subclinical thyroid dysfunction.The positive rate of thyroid peroxidase antibody (TPOAb) in patients with thyroid nodule was 19.8％ while that of thyroid globulin antibody (TgAb) was 20.0％.Among all 2843 subjects,the prevalence of differentiated thyroid carcinoma (DTC) was 28.8％,and the incidence of DTC was accompanied by raised TSH levels.The prevalence of DTC exceeded 40％ in patients aged between 25 to 34 as well as more than 74 years old.The prevalence of DTC was up to 33.8％ in TgAb positive patients.There was no difference in TPOAb levels between DTC patients and non DTC patients (P =0.406),but the TgAb level in patients with DTC was significantly higher than that of non DTC patients (P =0.033).Conclusion Thyroid nodule patients aged 25-34 or older than 74 formed high-risk groups of DTC.The serum TSH level and TgAb level were positively correlated with the risk of DTC.

Objective To review the clinical features,etiology and differential diagnosis of hypopituitarism.Methods The clinical data of 260 patients with hypopituitarism admitted to our hospital during 2007 to 2011 were retrospectively analyzed.Results In 260 patients 96 were males and 164 were females,the average age of female patients was significantly higher than that of males[ (44 ± 16) vs.(32 ± 20) years; t =3.821,P =0.001 ].Patients under 20 years accounted for the highest proportion in male cases (38/96,39.6％) ; while patients aged 40 - 60 years were the highest proportion for female cases (86/164,52.4％).Pituitary tumor and postoperative damage was the most common cause for hypopituitarism accounting for 36.2％ (94/260),followed by Sheehan syndrome (86/260,33.1％).The most common manifestation of hypopituitarism was anemia (102 eases) ; 26 cases presented all pituitary function failure.The causes leading to hypopituitarism usually showed specific manifestations in imaging examinations.The overall misdiagnosis rate was 40.4％ (105/260)in this series,while that of etiological diagnosis was 25.4％ (66/260).Conclusions This study suggests that hypopituitarism caused by different causes can be diagnosed by disease history,clinical manifestations and pituitary imaging examination.

ObjectiveTo investigate the protective effect of combination of triptolide and irbesartan on the podocytes in a type 2 diabetic(T2DM) rat model,and evaluate its mechanism.Methods T2DM rats were induced by fed with high-sucrose-high-fat diet combined with a low dose of streptozocin.The rats were randomly divided into 5 groups:normal control group ( NC,n =10),diabetes group ( DM,n =11),triptolide treatment group (DT,n =12),irbesartan treatment group (DI,n =12) and triptolide combined with irbesartan treatment group (DTI,n =13). Ultrastructure of podocytes was observed by electronic microscopy and urinary albumin (UAL) excretion by ELISA was determined after 8 weeks.The expression of nephrin and bone morphogenetic protein-7(BMP-7), connective tissue growth factor (CTGF),transforming growth factor (TGF)β1 mRNA and proteins were detected by immunohistochemistry,real-time PCR and Western blot. Results Increased UAL was significantly attenuated in all treatment groups.Compared to NC group,UAL in DM group was increased significantly (0.45 ± 0.09 vs 6.36 ± 0.87,P ＜ 0.01 ),while decreased in triptolide or irbesartan alone treatment group (2.48 ± 0.37 and 2.68 ±0.42,both P ＜ 0.01 ).Compared with those in control groups,kidney expression of nephrin,BMP-7 mRNA and proteins were downregulated while CTGF, TGFβ1 mRNA and proteins were significantly upregulated in T2DM rats. Triptolide or irbesartan each alone moderately ameliorated albuminuria and podocyte damage.However,their combined usage showed a dramatic therapeutic synergism,manifested by prevention of progressive albuminuria,restoration of the glomerular filtration barrier,reversal of the decline in slit diaphragm proteins,reduction expression of CTGF,TGFβ1,and upregulation of BMP-7.Conclusion Our findings show that triptolide can increase the efficacy of irbesartan,leading to a more effective prevention of kidney disease in T2DM rat model,which may through upregulation of BMP-7 and inhibition the overexpression of CTGF and TGFβ1.

Objective To study the effect of continous subcutaneous insulin infusion (CSII) and mutiple subcutaneous insulin infusion (MSII) on type 2 diabetes mellitus during perioperation. Methods One hundred and eighty surgical patients complicated with Type 2 diabetes were randomly divided into two groups,98 cases in the CSII group (treated with CSII of novolin R) and 82 cases in the MSII group (treated with MSII of novolin R and no-volin N). Blood glucose level,the time to reach normal blood glucose level, the average dosage of insulin, the inci-dence of hypoglycemic,infection rate of incisions and inpatient days were measured in two groups before and after treatment. Results The level of fasting blood glucose after treatment in the CSII group (4.8 mmol/L (SD: 1.6)) was significantly lower than that of the MSII group (6.4 mmol/L(SD :2.1)) (t = 7.74,P < 0.05), and 2-h glucose in the CSII group (7.6 mmol/L(SD :2.3)) was significantly lower than that of the MSII group (9.3 mmol/L(SD: 2.4)) (t = 7.72, P < 0.05). The time to reach normal blood glucose level in the CSII group (4.1 days (SD: 2.9)) was shorter than that of MSII group (6.9 days (SD :2.0)) (t=2.81, P < 0.05). The average dosage of insulin in the CSII group (40.7 U(SD: 10.3)) was lower than that of the MSII group (63.2 U (SD: 17.0)) (t=3.57, P <0.05). The incidence of hypoglycemic in the CSII group (3.05%) was lower than that of the MSII group (9.20%) (χ~2 = 4.92,P < 0.05). The infection rate of incisions in the CSII group (0.0%) was lower than that of the MSII group (10.9%) (χ~2 =4.18, P < 0.05). The inpatient days in the CSII group (15.3 days (SD :7.2)) was shorter than that of the MSII group (22.5 days (SD :9.7)) (t = 3.12, P < 0.05). Conclusions Compared to multiple sub-cutaneous insulin infusion, continuous subcutaneous insulin infusion is more effective in controlling blood glucose, hypoglycemic and incision infection, thus is recommend to perioperative patients complicated with type 2 diabetes mellitus.

Curcumin has been reported to possess antitumor activity with low toxicity. However, the clinical application of curcumin has been significantly limited by its instability and poor metabolic property. In order to overcome these limitations and discover novel small molecules with potential antitumor activity, 29 curcumin mimics were synthesized, which were confirmed by 1H NMR and HR-MS, and their cytotoxic property was evaluated against five human cancer cell lines in vitro. Compounds 16, 18 and 19 exhibited good cytotoxic property, their IC50 value were even below 5 micromol x L(-1) to some cancer cell lines, 5-9 times better than curcumin.

Objective To assess the efficacy of methylprednisolone (MP)pulse therapy in treatment of Hashimoto thyroiditis(HT) complicated with goiter.Methods 30 patients with HT complicated with goiter participated in the study and received MP pulse therapy.The patients had to be euthyroid for at least 3 months before the date of inclusion with plasma concentrations of thyroid hormones within their reference range.The goiter was still obvious and had no improvement.A dose of 250 mg MP was administered intravenously for seven consecutive days,and then treated with oral prednisone 10 mg,three times per day for 6 weeks with the dosage in each week gradually reduced at 5 mg to none.Ultrasonic was used to measure thyroid size before and after MP treatment.Results The treatment was successful at the end of the trial in all of the 30 patients receiving MP.The thyroid size from length,breadth,thickness to isthmus obviously decreased (P ＜ 0.05).The length of the left lobe was (57.42 ± 12.87) mm and (46.37 ± 7.67) mm (t =4.58) before and after treatment; The breadth of the left lobe was(26.68 ±7.71) mm and(22.21 ±6.09) mm(t =4.56) before and after treatment; The thickness of the left lobe was (27.18 ± 6.60) mm and (21.14 ± 5.67) mm(t =7.28) before and after treatment.The length of the right lobe was(58.17 ± 12.32)mm and(49.73 ±9.35) mm(t =3.84) before and after treatment; The breadth of the right lobe was (26.14 ± 7.37)mm and (23.00 ± 6.68) mm(t =3.29) before and after treatment ; The thickness of the right lobe was(27.57 ± 6.42)mm and(22.00 ±5.55)(t =5.88)before and after treatment.The isthmus before and after treatment was(9.94 ±4.15)mm and(6.19 ±2.57)mm(t =6.09).The recurrence rate was 17％ (5/30) after one year.Conclusions MP pulse therapy is an effective treatment for HT complicated with goiter.The recurrence rate is low.

Objective To investigate the cardiovascular risk factors in perimenopausal women and evaluate the risk for cardiovascular disease. Methods A total of 692 perimenopausal women permanent residents in a community of Zhengzhou from September, 2014 to May, 2015 were selected using multi-stage random sampling. Their age, blood pressure, body weight, smoking history, history of diabetes and fast-ing blood glucose, blood lipid and other information were collected. They were assessed with The National 10-Year Risk Assessment for Ischemic Cardiovascular Disease (ICVD). Results Prevalence of the cardiovascular risk factors screened for were as follow:hypertension 14.3%, dyslipidemia 32.1%, overweight or obesity 59.2%, type 2 diabetes mellitus 7.9%, smoking 0.6%. The absolute risk for ICVD in the next 10 years averaged as (2.01 ± 3.04)%, and increased with age. The incidence of high blood pressure, high total cholesterol, smoking, as well as the level of risk for ICVD were different among various age groups. Conclusion The cardiovascular factors are not controlled ideal-ly in the perimenopausal women, and result in high risk of cardiovascular disease, which need a set of intervention as their risk stratification.

Objective To compare the clinical effect of arthroscopic single-row and suture-bridge double-row fixation of full-thickness rotator cuff tear.Methods A retrospective study was conducted on 40 patients with full-thickness rotator cuff tear treated by single-row and suture-bridge double-row fixation between May 2010 and May 2012.Single-row rotator cuff repair was performed in 18 patients and doublerow repair in 22 patients.The two techniques were compared in aspects of complications,recovery time to daily life,time to achieve satisfaction score,re-tear rate,pre-and post-operative VAS,University of California at Los Angeles Shoulder Scores (UCLA),and American Shoulder and Elbow Surgeons (ASES).Results Mean period of follow-up was 15.6 months (range,13-24 months).Both treatment were effective in improving VAS,UCLA,and ASES,but the differences were insignificant (P ＞ 0.05).Recovery time to daily life,time to achieve satisfaction score,and large rotator cuff re-tear rate were 69.2 ± 16.6)d,(196.4 ±24.6)d,and 4/5 respectively in single-row fixation,with significant differences from (54.1 ± 13.3)d,(165.0 ±20.6)d,and 1/8 in suture-bridge double-row fixation (P ＜0.05).Conclusion Both treatments are effective for rotator cuff reconstruction,but suture-bridge double-row fixation provides earlier recovery to daily life,shorter time to achieve satisfaction score,and lower incidence of large rotator cuff retear.

Objective To explore the association between body mass index and blood pressure , blood glucose, blood lipids and the 10-year risk of ischemic cardiovascular disease (ICVD) among the middle-aged population and to provide theoretical evidence to prevent cardiovascular disease among overweight and obese mid-dle-aged population in the community. Methods A total of 1,628 middle-aged residents having health examina-tions in Hangdong and Nanguan Community Health Service Center in Guancheng District of Zhenghzou City from September 2014 to September 2015 were selected as subjects and were divided into three groups: normal group , overweight group, and obesity group according the size of the body mass index. The relationship among BMI , blood pressure, blood glucose, blood lipids and the 10-year risk of ICVD was explored. Results The preva-lence of overweight and obesity in the population was 47.97% and 15.72% respectively. There was significant dif-ference in body mass index , systolic blood pressure , fasting blood glucose , blood lipids and the distribution of the 10-year risk for ICVD (all P < 0.05). The incidence of hypertension, hyperglycosemia and hyperlipidemia increased with the increase of BMI (all P < 0.05). Multivariate logistic regression analysis showed that over-weight and obesity were independent risk factors of hypertension , hyperglycosemia and hyperlipidemia (OR =2.144, 1.911, 2.028). Conclusions The prevalence of overweight and obesity among middle-aged population is high in Guancheng District of Zhengzhou City. Overweight and obesity co-exit with other cardiovascular risk factors. Normal BMI is important to reduce the level of risk for CVD and the 10-year risk of ICVD.

Objective To evaluate transcather arterial chemoembolization (TACE) with hydroxycamptothecin combined with hepatectomy in treatment of primary liver cancer.Methods 64 primary liver cancer cases admitted and treated in Shanxi Provincial Cancer Hospital were divided into two groups with 32 cases in each.The control group were treated by surgery only and in the study group patients received TACE and hepatectomy.Results 0.5-year and 1-year recurrence rate in the study group were respectively 9.38％ and 28.13％,significantly lower than those in the control group.There was no significant difference in the 2-year recurrence rate between the two groups.0.5-year,1-year and 2-year survival rate in the study group were respectively 93.75％,84.38％ and 65.63％,significantly better than those in the control group.The AST and ALT were respectively (86 ±42)U/L,(96 ±55)U/L which were lower than those in the control group.The ALB and TBiL were respectively (32 ± 10) g/L and (24 ± 9) μmol/L,which were not significantly different with the control group.Conlunsion Hydroxycamptothecinbased TACE combined with hepatectomy is better than hepatectomy only for the treatment of primary liver cancer.