Objective Previously, there was an argument on the surgery way of unilateral papillary thyroid microcarcinoma(PTMC).The purpose of this study was to investigate the predictive factors of occult thyroid carcinoma in unilateral thyroid papillary microcarcinoma, and to compare the surgical methods of unilateral thyroid papillary microcarcinoma.Methods We retrospective analyzed 327 cases of unilateral PTMC patients confirmed by preoperative color Doppler ultrasound examination from January 2014 to January 2016 in Department of Breast Surgery, First Affiliated Hospital of Harbin Medical University.According to the presence of occult cancer, patients were divided into unilateral glandular foci (n=278) and bilateral glandular foci(n=49);according to whether carry out the prevention of central lymph node dissection, patients were divided into lymph node dissection(n=117) and without lymph node dissection(n=210) to further analyze the predictive factors of contralateral gland occult cancer and postoperative complications of preventive central lymph node dissection.Results 55 cases had central lymph node metastasis in 117 cases with lymph node dissection, the metastasis rate was 47.0%.The multiple foci in the ipsilateral gland is a risk factor for the presence of occult foci in the contralateral gland (OR=4.924, 95%CI: 1.605~15.107).There was no significant difference in postoperative complications between lymph node dissection and without lymph node dissection(P>0.05).Conclusion multiple foci in the unilateral thyroid papillary thyroid microcarcinoma can help us to predict the contralateral gland occult cancer, and the central lymph node metastasis rate is higher, therefore, for the unilateral glands of multiple tumors in the papillary thyroid microcarcinoma, we recommended the total thyroidectomy+prophylactic central lymph node dissection surgery way.

Thyroidectomy is an effective treatment for thyroid diseases,especially thyroid malignancies.The postoperative phonological disturbances in patients with recurrent laryngeal nerve injury caused by vocal cord paralysis have been recognized.However,in clinical work,many patients in the absence of recurrent laryngeal nerve injury in the case of postoperative speech changes.With the development of modern electronic acoustics detection technology,the quality of postoperative recurrent laryngeal nerve injury patients with quantitative research,to explore and found that recurrent laryngeal nerve injury after thyroid surgery is not the voice of the factors.

Objective To evaluate the clinical application of computer-aided electromagnetic imaging navigation in nasal endoscopic surgery.Methods Twenty-two cases of nasal endoscopic surgery with intraoperative imaging navigation were retrospectively reviewed,including 16 cases of sinusitis with or without polyp;5 cases of nasal inverting papilloma; 1 case of maxillary capillary hemangioma.All cases were operated with computer-aided electromagentic imaging navigation and nasal endoscope.Results The preoperative preparing time would take 4-10 minutes.In 22 cases,the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1 mm.The optic nerve and other anatomical landmarks could be orientated accurately in intraoperative procedures.No complication occurred.Conclusions Nasal endoscope combined with computer-aided electromagnetic imaging navigation provides accurate anatomical localization of nasal cavity,sinuses and anterior skull base.It could improve the effectiveness and decrease surgical complications,especially in complicated cases.

Objective To observe the incidence and the rate of embolism in patients undergoing hysteroscopy procedures by using the transesophageal echocardiography (TEE), as well as the changes of respiratoric and haemodynamic variables. Methods Fourty ASA Ⅰ~Ⅱ patients undergoing hysteroscopy procedures under general anesthesia received intraoperative TEE monitoring. The systolic pulmonary artery pressure, the incidence of the venous gas embolism (VGE) and the eegmental wall motion abnormality (SWMAs) were observed. Results In the 40 patients, 38 patients received intravenous anesthesia hysteroscopic surgery, with the intraoperative TEE to monitor the intracardiac VGE. The degree of gas embolism was related with the perfusion and the usage of monopolar or bipolar diathermia (P<0.05). The systolic pulmonary artery pressure promoted and SWMAs were also observed. Conclusions The continue TEE monitor during hysteroscopy could detect the intracardiac gas embolism in time , contributing to early diagnosis and avoiding the occurrence of malignant arrhythmias or myocardial ischemic events.

Abstract: Objective To investigate the prevalence and pathogenic characteristics of Yersinia enterocolitica infection in children with diarrhea under 5 years of age in western Yunnan, and to provide a basis for the prevention and treatment of infectious diarrhea in children. Methods Feces were collected from under five-year-old children with diarrhea in the First Affiliated Hospital of Dali University from 2020 to 2021. Clinical information of the cases was also collected. Yersinia enterocolitica was isolated from the samples after cold enrichment on selective culture plates, and the pathogenic characteristics of Yersinia enterocolitica were analyzed by biological type and serotype and virulence gene detection. Results A total of 397 feces were collected. Seven strains of Yersinia enterocolitica were isolated in three samples, and the prevalence of Yersinia enterocolitica infection was 0.76% (3/397). Among the three positive samples, two Yersinia frederiksenii or Yersinia intermedia were isolated in specimen No. 212 , and five Yersinia enterocolitica were detected in specimens No. 24 and 226. Two Yersinia enterocolitica isolated from one sample were biological type 1A, and the virulence gene test results were ail-/ystA-/ ystB+ /yadA-/virF-, which were non-pathogenic Yersinia enterocolitica. Three Yersinia enterocolitica isolated from the other sample were biological type 3, serotype O∶3 (rfbc+), and virulence gene detection results were ail+/ystA+/ystB-/yadA+ /virF+, which were pathogenic Yersinia enterocolitica. While pathogenic Yersinia enterocolitica was detected from feces of children with diarrhea at 11 months of age with a infection rate of 0.50%(2/397). Conclusion Sporadic infection of pathogenic Yersinia enterocolitica was found in under five-year-old children in western Yunnan Province. It is necessary to strengthen the monitoring and research of Yersinia enterocolitica.

Objective:To establish a method to determine the content of bacterial endotoxin in iodixanol. Methods:The standard curve of kinetic turbidimetric method was established and the dilution ratio was optimized by interference test. Bacterial endotoxin in the samples was determined. Results:The dilution ratio of 1 ∶12 did not interfere with the test. The recovery rate of bacterial endotox-in was 50%-200%. Conclusion:The kinetic turbidimetric method is suitable for the determination of bacterial endotoxin in iodixanol.

Objective A comparability analysis was performed between the various parameters of the self-developed dry-type blood cell analyzer with the reference instrument (Sysmex XT-1800i).Methods In line with the evaluation program of blood cells issued by ICSH,the detection results,six parameters as HCT,Hb,GRAN (granulocytes),LM (lymphatic and monocytes),WBC and PLT,were compared between the two instruments.Some indexes of the subject instrument such as precision,comparability,outlier points,bias,etc.were analyzed and compared so as to calculate the equation of linear regression and the expected bias intervals.Results The intra and inter CV of the subject instrument about six parameters were respectively less than 5％ and 6％,so it showed that the instrument had good precision.Correlation analysis showed that the classification results of HCT,Hb,GRAN and WBC had a good correlation (r =0.991,0.972,0.986,0.975,P ＜0.01),while that of LM and PLT were slightly lower (r =0.952,0.942,P ＜0.01) ; As to the medical decision level,HCT values were 14％ and 70％,WBC 0.5 × 109/L and 3 ×109/L,and PLT 10 × 109/L,50 × 109/L and 100 × 109/L,and the acceptable bias of these values all fell in the confidence intervals; the values of the rest items were slightly higher than the high value of the confidence interval of expected bias.Conclusions The subject instrument produces the same results in the test of its parameters as the reference instrument Sysmex XT-1800i and therefore the two instruments are comparable.The subject instrument is particularly suitable for field rapid detection.

Objective To investigate the changes of proteomics in serum of Sprague-Dawley(SD) rats after accumulated irradiation with 137Cs γ-rays.Methods A total of thirty mature SD rats were randomly divided into three groups:0.2 Gy group,2 Gy group and healthy control group.Rats were irradiated at a dose rate of 0.336 mGy/min for 10 d and 20 d continuously.Isobaric tags for relative and absolute quantitation (iTRAQ) was used to analyze the different protein expression in serum of irradiated rats.Gene Ontology,KEGG pathway and protein-protein interaction network analysis were conducted using softwares.Results In total,363 protein spots were identified.Twenty nine proteins were differentially expressed in both groups compared with control,of which 10 proteins were up-regulated and 19 proteins were down-regulated.Based on the information of GO categories,these differentially expressed proteins were mainly located in the cytoplasm and membrane concerning the function of binding and catalytic activity.Analysis with the PAJEK software demonstrated that 16 differentially expressed proteins could form a complicated interaction network where glutathione S-transferase P1 (GSTP1),phosphoglycerate kinase 1 (PGK1) and protein disulfide-isomerase (PDI) might be key nodes.Conclusions Accumulated irradiation can induce differentially expressed proteins in serum of irradiated rats.Analysis on functional roles of the screened proteins GSTP1,PGK1 and PDI may provide insight into further mechanistic investigations and underlying molecular biomarkers induced by accumulated irradiation.

Objective To study the operative strategy of congenital atlantoaxial dislocation(CAAD)-induced Chiari malformation and (or) syringomyelia. Methods The operation in reported 23cases of CAAD-induced Chiari malformation and (or) syringomyelia was composed with the transoral resection of odontoid process to achieve anterior decompression at first stage and occipito-cervical bone grafting fusion at second stage. Results MRI examination revealed the tonsils ascent and (or) syrinx reduction in 19 cases after first-stage operation. Compared with their preoperative manifestations, 14cases were obviously improved and 5 improved to some extent after operation, while 4 were unchanged. Conclusions CAAD is the main cause of tonsils descent and (or) syringomyelia in the series of patients. After anterior decompression by transoral resection of odontoid process, most patients will get recovered in tonsils descent and (or) syringomyelia reduction. The main aim of posterior operation is to reconstruct the stability of craniovertebral junction.

OBJECTIVETo research the influence of K(2)O composition in the raw material on leucite microcrystallization and to study the effect of leucite content on compressive strength of the dental glass ceramics reinforced by leucite microcrystallization.

METHODSThe raw materials with different K(2)O content were treated by a decided thermal treatment system. The products were analyzed by polaring microscope and X-ray diffractometer, and their compressive strength was also tested.

RESULTSThe microstructure of products from high K(2)O component was remarkably good, at microcrystal size of 0.8 micro m and the compressive strength was 206.6 MPa. A positive correlation was found between leucite volume and the compressive strength when leucite volume was less than 50% (Vol%).

CONCLUSIONSThe component of K(2)O has a great effect on the microstructure and the properties of the leucite-microcrystal-reinforced dental glass ceramics and the content of leucite microcrystals has a notable influence on the compressive strength of the dental glass ceramics.