ObjectiveTo investigate the cause of clinically missed diagnosis of thyroid microcarcinoma(TMC) and the management. Methods Clinical diagnostic and therapeutic data of 110 cases with TMC operated and confirmed by pathology from Jan. 1985 to Dec. 2000 were analysed. Results Diagnostic positive rates by ultrasonography and freezing section were respectively 58%(15/26) and 66 7%(14/21) in 26 cases diagnosed preoperatively. Diagnostic positive rate of freezing section was 80%(24/30) in 30 cases discovered intraoperatively. Through postoperative pathologic exam,54 cases were confirmed as TMC that was not discovered in 19 cases by intraoperative freezing section.Total or near total thyroidectomy was only performed on 35 cases,lobectomy of one or both lobes on other cases. Follow up rate was 80 1% with time ranging from 6 months to 15 years. One case recurred without mortality.Conclusion The clinical diagnosis of TMC is often difficult to establish. Careful palpation, ultrasonography with fine needle aspiratiou cytology before operation, and thorough exploration of the suspected nodules in operation will help to heighten the diagnostic rate. Total or near total lobectomy fulfils the eradication of TMC.

With the development and clinical use of the molecular targeted drugs and individualized treatment,cancer research has been focused on gene targeting diagnosis and treatment.Especially for the epidermal growth factor receptor (EGFR) signaling pathway-related genes,DNA replication-related genes,spindle apparatus format-related genes,cell metabolism-related genes and other molecular targeted detection and treatment,the polymorphism of targeting genes/molecules determines the clinical efficiency of the therapies.

Objective To investigate the effects of Qibai Pingfei Capsules(QPC) on the expression of monoamine neurotransmitters of 5-hydroxytryptamine receptor(5-HT) and dopamine(DA) receptors of DA1 and DA5 in the rats with chronic obstructive pulmonary disease (COPD) accompanied with depression, and to explore the possible therapeutic mechanism. Methods Ninety male Wistar rats were randomly divided into 6 groups, namely normal group, COPD depression group, QPC group, Venlafaxine group, and QPC plus Venlafaxine group. The rat model of COPD accompanied with depression was established by compound methods of smoking, food deprivation, water deprivation, forced swimming, shaking, and clipping tail. And then the effects of QPC on the lung function and the general characteristics were observed. Furthermore, the mRNA level of 5-HT1AR was determined by real-time quantitative reverse transcription PCR(RT-qPCR), and protein levels of DA-1 and DA-5 in rat hippocampus were assayed by Western blot analysis. Results Compared with the normal group, forced expiratory volume in 0.3 second(FEV0.3), the forced volume capacity(FVC) and FEV0.3/ FVC in the COPD depression group were significantly reduced (P < 0.01). Compared with the COPD depression group, the values mentioned above were restored to different extents in the groups of QPC, Venlafaxine, and QPC plus Venlafaxine(P<0.01). Compared with the normal group, the expression levels of 5-HT1AR mRNA, and DA-1 and DA-5 protein in the COPD depression group were significantly down-regulated, and their levels were also slightly decreased in the treatment groups(P<0.05). Compared with the COPD depression group, the expression levels were up-regulated to various degrees in all of the treatment groups (P < 0.05). Conclusion QPC can increase the mRNA levels of 5-HT1AR and protein levels of DA-1 and DA-5 in the hippocampus of COPD with depression.

Objective To explore the preliminarily clinical value of strain rate parameters using velocity vector imaging (VVI) evaluating left ventricular regional endocardial systolic function in patients with coronary artery heart disease (CAD).Methods A total of eight six inner subjects who were suspected as CAD was enrolled in the study.Patients with the vascular stenosis rate ≥ 50％ were defined as the CAD group,patients with the vascular stenosis rate ＜ 50％ were defined as the coronary atherosclerosis group,and patients with the completely normal angiographic results were included in the control group,according to the results of angiography.The left ventricular endocardial systolic strain rate parameters of VVI were obtained in standard long axis views (apical two,three,and four-chamber view) and short axis views (at the level of the mitral valve,papillary muscles,and apex).The strain rate parameters were global longitudinal endocardial systolic strain rate in the apical two,three,and four-chamber views (A2-GLSRs,A3-GLSRs,and A4-GLSRs),global radial endocardial systolic strain rate in short axis view of the mitral valve level,papillary muscles,and apex (MV-GRSRs,PM-GRSRs,and AP-GRSRs),and global circumferential endocardial systolic strain rate in short axis view of the mitral valve level,papillary muscles,and apex (MV-GCSRs,PM-GCSRs,and AP-GCSRs).The parametric differences were compared among three groups.Results All the subjects included in the present study had normal left ventricular ejection fraction (LVEF) and there was no significant difference in LVEF across three groups.Compared to other groups,the control group had significantly higher E/A ratio.The LV endocardial systolic strain rate parameters were all significantly reduced in the CAD group compared to the control group and the coronary atherosclerosis group (all P ＜ 0.05).Compared to the control group[(-1.37 ± 0.25)/s],the coronary atherosclerosis group [(-1.12 ± 0.42)/s] had significantly lower MV-GCSRs (P ＜0.01).Conclusions VVI is useful for quantitative assessment of the left ventricular systolic function in CAD.MV-GCSRs might have the potential to predict early left ventricle (LV) systolic dysfunction in subjects with coronary artery stenosis ＜ 50％.

Objective To discuss teaching methods of TCM lectures for students of Western medicine in colleges and universities.Methods Totally 36 studens majoring in Western medicine from Capital Medical University were involved in the study. The first questionnaire survey showed the interest of those students. According to the students' response, the topics for the lectures were determined. The purpose for the second questionnaire was to investigate the teaching outcomes. Results The recovery rate for the first questionnaire was 100%, and the effective rate was also 100%. Students showed interest in the course of Introduction of TCM Health Maintenance, with few different ideas. The recovery rate for the second questionnaire was 88.89%, and the effective rate was also 88.89%. Students were relatively satisfied with lecture teaching, with few different ideas.Conclusion Lecture teaching can promote students' interest and teaching quality.

Objective To explore clinical characteristics of severe pre-eclampsia and eclampsia complicated with reversible posterior leukoencephalopathy syndrome(RPLS).Methods Clinical data of 31 cases of severe pre-eclampsia and eclampsia complicated with RPLS were studied retrospectively.ResulIs These 31 cases with RPLS accounted for 48% of those with eclampsia,.and all presented with hypertension,headache and disturbalice of vision,24 cases with seizure episodes,19 cases with nausea and vomiting and 13 with continuous dysphoria after seizure.Neuroradiologic findings showed edema predominantly in the bilateral posterior cerebral white matter,especially in occipital-parietal lobe,with low density lesions in CT and long T1 and T2 signals in brain MRI. Conclusions Severe pre-eclampsia and eclampsia tended to complicate with RPLS,presenting severe hypertension,headache,disturbance of vision and recurrent seizure as major clinical manifestations.

Objective To investigate the effect of atorvastatin and rosuvastatin on endothelial function in diabetics with coronary heart disease. Methods A total of 73 consecutive diabetics with coronary heart disease who were not receiving statins were randomized to receive atorvastatin 20 mg/d or rosuvastatin 10 mg/d. The levels of lipids, high-sensitivity C-reactive protein(hs-CRP), monoxide nitrogen(NO), endothelin-1 (ET-1) and endothclium-dependent relaxing function(EDF) were assessed before and after 3 months of the treatment. Results The treatment with statins significantly improved endothelial function in diabetics with coronary heart disease. For both rosuvastatin group and atorvastatin group in pro-treatment versus post-treatment, EDF was higher[(5.2±2.4)% vs. (7.9±3.1)%, P=0.008; (5.0±2.8)% vs. (7.6±3.6)%, P=0.024, respectively], NO was also higher((46.6±14.5) μmmol/L vs. (73.3±18.5) μmmol/L; (51.7±14.0) μmmol/L vs. (79.8±16.0) μmmol/L,both P<0.001], ET-1 was lower[(108.2±29.6) pg/L vs. (77.5±26.4) pg/L, P =0.005;(117.1±34.5) pg/L vs. (80.7±28.2) pg/L, P= 0.003, respectively],and hs-CRP was lower[3.17(1.33～6.32) mg/Lvs. 1.39(0.81～2.58) mg/L, P=0.006; 3.43(1.51～7.02) mg/L vs. 1.63(0.69～3.11) mg/L, P = 0.001, respectively]. There were no differences in these between rosuvastatin group and atorvastatin group. Significant negative correlation existed between EDF and hs-CRP. Conclusions A 3 months treatment with either atorvastatin 20 mg/d or rosuvastatin 10 mg/d is effective in improving endothelial function in diabetics with coronary heart disease.

Objective To study the role of photoallergens and contact allergens in the pathogenesis of chronic actinic dermatitis (CAD).Methods Ba sed on the standard procedures of photopatch test recommended by the British Pho todermatology Group (BPG) and the routine procedures of patch test,photopatch a nd patch tests were performed on 56 patients with CAD,42 patients with polymorp hous light eruption (PLE) and 25 patients with chronic eczema on scalp and face by standard photopatch test series recommended by the International Contact Derm atitis Research Group (ICDRG) and home-made standard series of contact allerge ns.A set of ten Philips TL20W/09N tubes was used as the source of irradiation.Results In the 56 CAD patients,the positive rates were 46.43 %,57.14 % and 32.14% for photopatch test,patch test and both tests,respectively,which appea red to be significantly higher than those in the patients with PLE.Positive pa tch reactions were found in 65% of the patients with chronic eczema,which was s imilar to that of CAD.And the frequency of the positive allergens in chronic ec zema was the same as that in CAD,in which fragrance mixture (FM) ranked the fir st,followed by balsam of Peru (BOP),cobalt chloride,nickel sulphate.In CAD,FM and BOP were the most common allergens and photoallergens,which accounted fo r 44% and 32% of the positive reactions in patch tests,15.38% and 17.95% in pho topatch tests,respectively.Conclusions Both photoallergens and contact aller gens may play important roles in the pathogenesis of CAD.Allergens positive in patch tests and photopatch tests and related compounds which can cause cross-r eactivity with the above allergens should be avoided by the patients with CAD.

Objective To compare the short-term efficacies of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity and type 2 diabetes mellitus,and to investigate the relationship between the body weight loss and the decrease of glucose of the 2 treatment methods.Methods The clinical data of 40 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Changhai Hospital of the Second Military Medical University from January 2010 to December 2011 were retrospectively analyzed.There were 14 patients treated by LAGB (LAGB group) and 26 by LSG (LSG group).The body weight loss and the decrease of glucose at postoperative year 1 of the 2 groups were compared.The differences in the body weight and glucose before and after operation within groups were compared using the paired t test,and the differences in the body weight and glucose between the 2 groups were compared using the multiple analysis of variance.The correlation between the body weight loss and the decrease of glucose was analyzed using the linear regression analysis.Results Laparoscopic surgery was successfully done without conversion to open surgery or intraoperative complications.The operation time and volume of blood loss were (69 ± 16)minutes and (31 ± 14)mL in the LAGB group,(120 ± 15) minutes and (148 ± 48) mL in the LSG group.Complications including postoperative malnutrition,electrolyte disturbance,delayed gastric emptying,bleeding,anastomotic leakage did not occurr in the 2 groups.Two patients were complicated with abdominal incision fat liquefaction,and were cured by symptomatic treatment.(1) The body weight,body mass index (BMI) and waistline had a decrease trend.The body weight,BMI and waistline in the LAGB group were decreased from (117 ± 28)kg,(40 ± 8)kg/m2 and (118 ± 15) cm before operation to (94 ± 28) kg,(33 ± 8) kg/m2 and (92 ± 15) cm at postoperative week 48.The body weight,BMI and waistline in the LSG group were decreased from (119 ± 25)kg,(42 ± 6)kg/m2 and (123 ± 14)cm before operation to (74± 16)kg,(26± 4)kg/m2 and (86 ± 13)cm at postoperative week 48.The EWL had an increase trend in the 2 groups.The EWL in the LAGB group was increased from 7％ ± 2％ at postoperative week 1 to 53％± 24％ at postoperative week 48,and the EWL in the LSG group was increased from 11％ ± 4％ at postoperative week 1 to 90％ ± 20％ at postoperative week 48.There were significant differences in the changes of body weight,BMI,waistline and EWL between the 2 groups (F =60.660,74.490,57.650,90.020,P ＜ 0.05).(2) The levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LAGB group were decreased from 8.1％± 0.8％,(8.4±0.6)mmol/L,(21±8)μmol/L,7.9 ±2.9,(1.68±0.50)mmol/L,(6.0±1.1)mmol/L (4.1 ± 0.8) mmol/L,(1.09 ±0.15)mmol/L to 6.4％ ±0.8％,(6.3 ±0.3) mmol/L,(10 ± 3) μmol/L,2.7 ±0.9,(1.04 ± 0.09) mmol/L,(4.3 ± 0.8) mmol/L,(2.3 ± 0.4) mmol/L,(1.22 ± 0.09) mmol/L at postoperative week 48 ; the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LSG group were changed from 7.9％ ± 1.0％,(9.0±1.0)mmol/L,(21 ±9) μ mol/L,8.5 ±3.5,(2.09 ± 0.70) mmol/L,(6.0 ± 1.2)mmol/L,(3.9 ± 1.1) mmol/L,(1.06 ± 0.21) mmol/L before operation to 5.1％ ± 0.8％,(5.2 ± 0.4) mmol/L,(4 ± 1)μmol/L,0.9±0.2,(1.22±0.17)mmol/L,(4.2±0.8)mmol/L,(2.3 ±0.6)mmol/L,(1.30±0.13)mmol/L at postoperative week 48.There was a decrease trend of the glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,trigluceride,total cholesterol and low density lipoprotein and a increase trend of the high density lipoprotein in the 2 groups.There were significant differences in the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein between the 2 groups (F =57.650,74.270,36.750,42.960,10.870,30.650,32.560,11.490,P ＜0.05).The levels of glucose of the LAGB group at postoperative month 1 and 3 were influenced by BMI (b =0.543,0.753,P ＜ 0.05),while the levels of glucose of the LAGB group did not be influenced by BMI at postoperative month 6 and year 1 (b =0.130,0.222,P ＞0.05).The levels of glucose of the LSG group did not be influenced by BMI at postoperative month 1,3,6 and year 1 (b =0.185,0.035,0.212,0.126,P ＞0.05).Conclusions The efficacy of LSG is superior to LAGB for the treatment of obesity combined with type 2 diabetes mellitus.The efficacy of LAGB is correlated with the change of body weight,while the efficacy of LSG does not correlated with the change of body weight.

Objective:To investigate the behavior of tobacco use among migrants in construction sites and explore the associated factors .Methods: A total of 652 migrants in 10 construction sites were selected in Xi’ an and Tongchuan .Chi-square and logistic regression were used to analyze the influencing factors of tobacco use.Results:The average age of the migrants in the construction site was (38.23 ± 10.61), and males occupied 82.7%(535/647) of the total.The current smoking rate of the migrants was 55.8%(364/652), with 64.3%(344/535) in males and 14.3%(16/112) in females.82.5%(329/399) smokers wanted to quit smoke , however only 52.7%(210/399) had tried quitting smoking in action, and 8.8%(35/399) quitted smoking successfully .Multivariable regression indicated that the migrants who were at lower age , and sick within 2 weeks, had perceived not difficult to stop smoking and who disagree with the benefits of smoking were more likely to try to quit smoking .Conclusion:Migrants in construction sites show their characteristics of old age , low level of health literacy , male-domination , high smoking rate and high intention of quitting smoking .Tobacco control projects should be implemented in construction sites to promote the translation of smoking quitting intention into action .