Objective: Thyroid nodules are common clinical thyroid disorders.The purpose of this study was to investigate the diagnostic value of the clinical characteristics and various parameters of malignant thyroid nodules and the sensitive indexes for their differentiation so as to improve the diagnosis of malignant thyroid nodules and avoid unnecessary procedures or operations.Methods: We retrospectively studied 600 cases of thyroid nodules treated by surgery from 2001 to 2008,divided them into a benign and a malignant group according to the pathological results,and analyzed by multivariate logistic regression the correlation between the nature of thyroid nodules and various factors.Results: Of the 600 cases of thyroid nodules,519(83.47%) were benign and 81(16.53%) were malignant.Clinical symptoms and signs,ultrasonography and CT were all useful in indicating malignancy,especially ultrasonography,whose specificity and diagnostic accuracy were 93.3% and 84.2%,respectively.Multivariate logistic regression analysis revealed a higher rate of malignancy in younger patients with solid or hard nodules,or accompanied with calcification or painless adenophyma in the neck.Conclusion: Clinical symptoms and signs,ultrosonography and CT are of significant value in the diagnosis of malignant thyroid nodules.

Objective To investigate clinical value of serum procalcition(PCT) in early diagnosis of nosocomial infection in severe cerebral injury.Methods 58 patients with severe cerebral injury needing ICU monitoring were enrolled.Levels of serum PCT and C-reactive protein(CRP) and white blood cell(WBC) and nosocomial infection when entering ICU or on days 3 were observed.Results There were not difference in level Serum PCT when entering ICU in infection group compared with non-infection group(P ＞ 0.05).Serum PCT increeassd remarkably when entering ICU on days 3 in infection group as compared with non-infection group,the difference was significant (t =5.44,P ＜ 0.01).There were not difference in CRP and WBC level when entering ICU or on days 3 (all P ＞ 0.05).Conclusion Detection of serum PCT helps diagnosis early nosocomial infection in patients with severe cerebral injury.It is suggested that antibiotics should be chosen early in patients with obviously increased PCT,control abuse of antibiotics contributes to reduce incidence of drug resistance and mortality.

Reactive oxygen species (ROS) caused oxidative stress plays an important role in the occurrence and development of atherosclerosis,and it is associated with the occurrence of ischemic cerebrovaseular diseases.This article reviews the mechanism of action of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in atherosclerosis and ischemic cerebrovascular disease,and the neuroprotective effects of NADPH oxidase inhibitors.

Objective To investigate the correlation between the NADPH oxidase p22phox-A930G polymorphism and hypertensive intracerebral hemorrhage in Chinese Han population in Shanghai area.Methods The patients with hypertensive intracerebral hemorrhage and normal controls were enrolled.The polymerase chain reaction and the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to detect the genotypes and alleles of NADPH oxidase p22phox-A930G.Results A total of 128 patients with hypertensive intracerebral hemorrhage and 151 healthy controls were enrolled.The levels of systolic blood pressure,diastolic blood pressure,glucose,and triacylglycerol,as well as the proportions of smoking and alcohol consumption in patients of the hypertensive intracerebral hemorrhage group were significantly higher than those of the control group (all P＜ 0.05).There were significant differences in AA,AG,and GG genotypes (42.2％,44.5％,and 13.3％ vs.63.6％,27.8％,and 8.6％,x2 =12.757,P =0.002) and in A and G allele (64.5％ and 35.5％ vs.77.5％ and 22.5％ ;x2 =8.734,P=0.001) frequencies between the hypertensive intracerebral hemorrhage group and the control group.Multivariatelogistic regression analysis showed that systolic blood pressure ≥ 140 mm Hg (1 mm Hg =0.133 kPa) (odds ratio [OR] 13.952,95％ confidence interval [CI] 7.242-26.879; P ＜ 0.001),apolipoprotein A ≥ 0.99 mmol/L (OR 3.139,95％ CI 1.012-9.733; P =0.048),and AG +GG genotype (OR 2.333,95％ CI 1.253-4.342; P=0.008) were the independent risk factors for hypertensive intracerebral hemorrhage.Conclusions Among the Chinese Han population in Shanghai area,the NADPH oxidase p22phox-A930G polymorphism is an independent risk factor for hypertensive intracerebral hemorrhage.

Animals ; Humans ; Rats ; Respiratory Distress Syndrome, Adult ; etiology ; therapy

The lipoprotein-associated phospholipase A2 (Lp-PLA2), a subtype of the phospholipase A2 superfamily, is produced primarily by macrophages and lymphocytes. Lp-PLA2specifically hydrolyzes oxidized phospholipids on oxidized low-density lipoprotein particles,resulting in production of lysophosphatidylcholine and oxidized fatty acids. Lp-PLA2 is expressed in atherosclerotic plaques and in macrophages within a fibrous cap of unstable plaque.Studies haw shown that the plasma Lp-PLA2 activity increases significantly in patients with ischemic stroke, and Lp-PLA2 may become an independent risk factor for predicting ischemic cerebrovascular events. The selective Lp-PLA2 inhibitor can reduce the inflammatory response,enhance the stability of plaques, and inhibit the formation of atherosclerotic plaques, and may become a new class of drugs for preventing the formation of atherosclerotic plaques.

Mechanical ventilation plays an important role in the treatment of preterm infants,especially respiratory problems.With improvement in both antenatal and neonatal care and therapeutic strategies,premature babies are surviving more than ever.However,the incidence of bronchpulmonary dysplasia remains high which affects the clihical outcomes of premature infants.Non-invasive respiratory support techniques have been used in attempts to decrease lung injury and the complications of preterm infants.This review will focus on various ventilation modalities for managing preterm infants with respiratory failure and lung protective ventilation strategies to minimize lung injury in preterm infants.

Objective To investigate the clinical characteristics of imflamatroy bowel disease (IBD) and the risk factors in developing eoloreetal cancers. Methods Five hundred and thirteen patients with IBD were consecutive collected from Jan. 1996 to Oct. 2007. The history database of these patients was established. The items including demography features, morbidity, diagnosis, the related risk factors, the treatment and outcomes were analyzed. Results Two hundred and forty two out of 513 patients were ulcerative colitis (UC). Of which 4 patients (1.65%) developed cancer and 4 (1.650%) were confirmed with precancer. But none of the 271 patients with Crohn's disease (CD) de-veloped cancer. The Logistic regression analysis showed that weight loss, complications and relapse might be the potential risk factors of the cancer. Conclusions In clinical, the probability that develope to cancer in patients with UC is higher than that in patients with CD. The main risk factors are frequent relapse, weight lost and complications.

Objective:To analyze and discuss the factors of seizure induced by imipenem/cilastatin.Method: The reports of seizure induced by imipenem/cilastatin from CBMDisc(1971-2006)and CHKD(1994-2006)were re- viewed and analyzed with Excel.Result:28 cases of seizure induced by imipenem/cilastatin were collected,including 20 men and 8 women with the principal primary respiratory infection with an average age of 66.5.Seizure occurred as early as 10 min.after the medication,and occurred latest in the fourth day of the medication.22 cases showed grand mal seizure and 6,partial seizure with a duration ranging from 20s to 30min and with a frequency of eight seizures.18 cases discontin- ued the administration,and 8 cases took lower daily dosage,in which some were given antiepileptic drugs or other adjunc- tive therapy,and 2 cases were not treated at all.All the cases recovered and were discharged from hospital except one who died from his circulation failure and respiration failure.The cause-effect relations of the relevance evaluation of seizures e- yoked by imipenem/cilastatin were as follows:1 sure case,26 probable cases,and 1 possible case.Conclusion:Seizure can be induced by imipenem/cilastatin,Owhich should be rationally used.More attention should be paid in clinic so as to ensure a safe medication.

Objective To study the clinical value of fat-suppression(FS)sequence and dynamic contrast-enhanced MRI in judging the nature of breast neoplasm.Methods Sixty patients with breast neoplasm(including malignant lesions in 40 cases and benign lesions in 20 cases)proved by histopathology were reviewed.All patients were undergone FS sequence and 30 cases underwent dynamic contrast-enhanced MRI examinations,time-signal curves were acquired.Results 22 malignant lesions in 20 cases and 46 benign lesions in 40 cases were found by FS.Dynamic contrast-enhanced MRI showed 18 malignant and 20 benign lesions.The malignant lesions had visible contrast-enhancement of administration of Gd-DTPA.Type Ⅲ curve was showed in 16 lesions(malignant in 14 and benign in 2),type Ⅱ in 5(malignant in 3 and benign in 2)and type Ⅰ in 17(malignant in 1 and benign in 16).There was significant difference between benign and malignant tumors on the type of time-signal curve(P