ObjectiveTo probe into the ultrasonic(US) predictive value for metastasis of the cervical lateral lymph node(LNM) with the preoperative ultrasonic examination in thyroid papillary microcarcinoma (PTMC),then,to further evaluate the significance of the preoperative ultrasonic score (US) for predicting metastasis of the cervical lateral lymph node.Methods From May 2004 to May 2011,165 patients diagnosed as PTMC (the ultrasonic imaging of lymph node showed no lateral LNM) were retrospectively analyzed and the US and final pathological data from the cases were collected to determine the relevant factors and different scores.ResultsThere were significant differences(P ＜ 0.05 )among US characteristics of microcalcification,no well-defined margin,tumor located at the upper pole,the perimeter of the tumor contacted with the adjacent capsule of thyroid being ＞25 ％ and the presence of the cervical lateral lymph nodes metastasis in PTMC between the metastatic group and the non-metastatic group.The total scores of the ultrasonic ≥2.5 was the delimitation value,its sensitivity was 86.2％ and its specificity was 89.7％.ConclusionsThe ultrasonic score has definite value in the differential diagnosis for the metastasis of the cervical lateral node in the patients of no lateral LNM,when the ultrasonic score is larger than 2.5,the possibility of the cervical lateral lymph node metastasis should be noticed.

Objective To observe the changes of serum ferritin (SF)in neonates with mechanical ventilation and its clinical significance in the ventilation-induced lung injury (VILI). Methods The study was carried out in 36 neonates with mechanical ventilation and 31 neonates without mechanical ventilation in neonate intensive care unit(NICU).SF level in venous blood was measured on 1,24,48,72 hours after mechanical ventilation and 24 hours after mechanical ventilation removal by radioimmunoassay (RIA ).SF level of non-mechanical ventilation group were determined at the same time. Results SF levels in mechanical ventilation groups were significantly higher than those of control group (P

Objective:To investigate the alteration of retinal perfusion in aquaporin-4 antibody (AQP4-ab) positive neuromyelitis optica spectrum disorders (NMOSD) patients by optical coherence tomography angiography (OCTA).Methods:A case-control study. Forty-eight AQP4-ab positive NMOSD patients (96 eyes) and 20 age and gender matched healthy controls (40 eyes) were recruited from September 2015 to August 2017 at the Eye & ENT Hospital of Fudan University. Patients of both eyes were included in the groups. The patients were further divided into 4 subgroups (0 ON, 1 ON, 2 ON, 3+ ON group) according to the number of episodes of ON (0, 1, 2, or 3+) with respect to 30、22、31、13 eyes. 0 ON group had no history of ON episodes; 1 ON group, 2 ON group, and 3+ ON group had ON episodes 1, 2, ≥3 times, respectively. All patients underwent complete ophthalmological examinations including BCVA, visual field and OCTA examination. The BCVA was recorded for each eye using metric notation from the Snellen chart, and then converted to the logarithm of the minimum angle of resolution. The central visual field was assessed using a Humphrey Field Analyzer 750 and the mean deviation (MD) was determined. OCTA scans of the optic disc (4.5 mm × 4.5 mm) and macula (6 mm × 6 mm) were acquired. Radial peripapillary capillary (RPC) vessel density, superficial capillary plexus vessel density (SVD), the thickness of ganglion cell and inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) were determined. The generalized estimating equations was performed to compare the difference of BCVA, MD, pRNFL thickness, GCIPL thickness, RPC vessel density and SVD among the groups and the correlations between retinal perfusion and retinal structure, visual function were analyzed.Results:The RPC vessel density and SVD were significant lower in the 0 ON group compared with healthy group (Wald χ2=7.190, 10.134; P<0.01), however, the BCVA, pRNFL and GCIPL thickness were not significant difference between the two groups (Wald χ2=2.308, 1.020, 2.558; P>0.05). The BCVA, visual field MD, RPC vessel density, SVD, pRNFL and GCIPL were significant lower in 1 ON, 2 ON and 3+ ON groups compared with healthy group and 0 ON group (Wald χ2=12.390, 11.346, 38.860, 18.040, 45.418, 26.608; P<0.001 ), but the parameters had no significant difference among the three groups ( P>0.05). The RPC vessel density was significantly correlated with pRNFL thickness ( β=0.372, standard error=0.018, P<0.001), and the SVD was significantly correlated with GCIPL thickness ( β=0.115, standard error=0.204, P<0.001). The MD and BCVA was significantly correlated with peripapillary vessel density after adjustment for other variables (BCVA: β=0.025, standard error=0.005, P=0.000; visual field MD: β=0.737, standard error=0.185, P=0.000). Conclusions:Subclinical primary retinal vasculopathy may occur in NMOSD prior to ON attack, the ON attack may further impair visual function, retinal structure and perfusion, however, the extent of injure is not relevant with the increase of ON attack. The peripapillary vessel density might be a sensitive predictor of visual outcomes in NMOSD patients.

Objective To establish an early diagnostic test for tuberculous meningitis (TBM) with good sensitivity and specificity. Methods Twenty-five patients with a clinical diagnosis of TBM and 49 controls, including 27 patients with other infectious diseases of central nervous system and 22 patients with noninfectious neurological diseases, were enrolled in our research. We simultaneously detected antimycobacterium bovis BCG IgG secreting cells in both cerebral spinal fluid (CSF) and peripheral blood (PBL)by enzyme linked immunospot assay(ELISPOT),repeated insertion sequence IS6110 specific for mycobacterium tuberculosis in CSF by PCR and anti-BCG IgG titre in both CSF and PBL by enzyme linked immunosorbent assay(ELISA).Results The sensitivity of ELISPOT was 84.0%,much higher than that of PCR(75.0%)and ELISA(52.3%).The specificities of the three tests were 91.8%,93.7%and 91.8%respectively.The numbers of CSF cells secreting anti-BCG IgG tested by ELISPOT were even higher in the early phase of TBM, but declined along with the disease progressing(t=-3.183,P=0.008),which allowed an early diagnosis to be made. Conclusion ELISPOT technique is proved to be the most valuable test for the early diagnosis of TBM.

Adenoma, Pleomorphic ; surgery ; Humans ; Parotid Neoplasms ; surgery

Objective To observe the influence of early postoperative feeding in the healing of intestinal anastomosis in rabbits,and to clarify preliminarily the relationships between early postoperative feeding after gastrointestinal surgery and gastrointestinal anastomotic fistula formation and healing time in rabbits.Methods 48 rabbits were randomly divided into experimental group and control group, then they were treated with gastrointestinal anastomosis.The rabbits in experimental group were fed with liquid diet 24 h after operation,and the rabbits in control group were fed nothing after operation and supplied by total parenteral nutrition.Two rabbits of each group were selected for exploratory laparotomy on the 3rd,5th,7th,10th and 15th day after operation,and the healing rate of anastomosis,the anastomotic bursting pressure,the anastomotic breaking strength,and the hychoxyproline level of anastomosis were observed.Results The healing rate of anastomosis in control group was 91.6%(22/24), and the healing rate of anastomosis in experimental group was 95.8%(23/24),there was no significant difference between two groups(P>0.05).The anastomotic bursting pressures of the rabbits in two groups were decreased remarkably at the 72nd hour after operation,which was the lowest point,and they were increased remarkably on the 5th day after operation,but the anastomic bursting pressure in experimental group was a little lower than that in control group,and it reached the peak on the 7th day after operation in control group. On the 10th day after operation,the anastomic bursting pressure in control group was a little lower than that on the 7th day after operation,but the anastomic bursting pressure in experimental group reached the peak.There were no significant differences of anastomic bursting pressure at different time points between two groups(P>0.05).The anastomotic breaking strength had no significant difference between two groups at the 72nd hour after operation,both of them reached the lowest points,however the anastomtic breaking strengths in two groups were increased remarkably on the 10th day after operation,and reached the peaks.but there were no significant differences of anastomic breaking strength at different time points between two groups (P>0.05 ). The hychoxyproline level of anastomosis:in experimental group was a little lower than that in control group at the 72tnd hour after operation,and both of them reached the peaks on the 7th day after operation;but there were no significant differences of hychoxyproline levels of anastomosis at different time points between two groups(P>0.05).Conclusion Early postoperative feeding can not cause the increase of anasmotic healing time and the incidence rate of gastrointestinal anastomotic fistula.

Objective Learning and memory function is the form of brain higher nervous activity .Hippocampus is the main parts responsible for learning and memory function .Once damaged , it will seriously affect the quality of life in patients .The purpose of this paper was to observe the effects of neonatal repeated intermittent sevoflurane inhalation on learning-memory function and Tau protein , p-Tau protein in brain hippocampus in juvenile and adult rats . Methods Twenty-four healthy SD rats ( n=24 ) were randomly di-vided into juvenile sevoflurane inhalation group ( n=6) , juvenile con-trol group ( n=6);adult sevoflurane inhalation group ( n=6) , and adult control group ( n=6) .Rats in juvenile sevoflurane inhalation group and adult sevoflurane inhalation group inhaled 2.6%sevoflurane at the postnatal 7th day, 14th day, 21th day ( P7,P14,P21) for 2 hours.Rats in juvenile control group and adult control group inhaled the carrier gas (1L/min Air+1L/min O2) at the same time for 2 hours.During P31~37, Morris water maze test was conducted in juvenile sevoflurane inhalation group and juvenile control group to detect the behavior.During P91~97, Morris water maze test was conducted in adult sevoflurane inhalation group and adult control group to detect the behavior .Then hippocampi were taken out to detect the expression levels of Tau protein and p -Tau protein. Results ( 1) Comparison of escape latency at the same time ① Juvenile period: no statistical difference between sevoflurane inhalation group (52.04±41.90,29.77±14.23, 19.87±5.71,22.74±13.73,21.91±9.07) and control group (47.82±8.06,25.26±12.53,23.79±9.49, 20.00±10.10, 14.03±7.55) had (P>0.05).② Adult period: no statistical difference between sevoflurane inhalation group (42.00± 14.12, 26.87±16.93, 19.80±13.76, 15.06±8.45, 8.66±4.82) and control group (41.97±25.66,22.88±10.04,15.88±5.20,9.26± 3.98,11.33±6.05 (P>0.05).(2) Comparison of spatial probe test results:no statistical difference in the swimming times from original area,swimmingresidencetime,swimmingdistanceandspeedbetweengroups(P>0.05).(3)Tauproteinexpressiondetection ①Juvenile period:In the hippocampal CA1 region, CA3 region, DG region, the expression level of Tau in the sevoflurane inhalation group (0.237±0.015, 0.324±0.024,0.226±0.019) was higher than the control group (0.185±0.024,0.232±0.040, 0.184±0.018) (P>0.01).②Adult peroid:no statistically significant difference between sevoflurane inhalation group and control group (P>0.05). (4)p-Tau(Ser396)proteinexpressiondetection ①Juvenileperiod:nostatisticallysignificantdifferencebetweensevofluraneinhala-tion group and control group ( P>0.05) .②Adult period:The expression level in the hippocampal CA3 region of sevoflurane inhalation group (0.170±0.005) was higher than control group (0.158±0.011) (P<0.05), but in the CA1 and DG regions there was no statisti-cally significant difference (P>0.05). Conclusion Neonatal repeated intermittent sevoflurane inhalation has done no harm to learn-ing and memory function of juvenile and adult rats , however , it can result in the significant increase of hippocampal Tau protein expres-sion level in juvenile rats and the increase of hippocampal p-Tau protein expression level in adult rats .

Objective To evaluate the efficacy and safety of somatostatin and ileus tube for adhesive bowel obstruction.Methods From January 2008 to February 2010,ninety-one patients diagnosed with adhesive bowel obstruction were enrolled in the study.Patients were randomly divided into four groups:somatostatin + ileus tube group ( group A,n =22 ),somatostatin + nasogastric tube group (group B,n=19),ileus tube group (group C,n=23),and nasogastric tube group (group D,n =27).All cases received conventional treatment,including fasting,maintaining electrolyte and acid-base balance,enteral and parenteral nutrition support and antibiotics; Groups A and B received somatostatin 0.6 mg/day,groups B and D received nasogastric tube decompression.ANOVA analysis and x2 test were used to compare the variables.Results Group A had a quick recovery of flatus and stool compared with group D,[ (4.5 ±1.9) vs.(7.8 ± 1.7) d] (F =28.715,P =0.000).Abdominal pain and abdominal distension recovered faster [ (3.6 ± 1.5) vs.(8.4 ± 2.2) day ] in group A compared with group D ( F =23.857,P =0.000).Less amount of gastric drainage were observed in somatostatin-treatment groups [ group A vs.C:(632 ±102) ml/d vs.(1020±148) ml/d; group B vs.D:(410±86) ml/d vs.(590±97) ml/d] (F=11.687,P =0.000;F=10.399,P =0.000).The rate of laparotomy in group A was O,which was significantly less than the 22％ in group D ( x2 =5.571,P =0.018 ).Conclusions The high improvement rate in abdominal symptoms suggested the efficacy of somatostatin and ileus tube in patients with small bowel obstruction.The application of somatostatin combined with ileus tube improves the symptoms of adhesive intestinal obstruction and decreases the rate of laparotomy.

Objective To assess the reliability and validity of the Tree-Drawing Test in medical college students.Methods The study randomly selected 312 aged 19 to 23-year-old medical students to take part in TreeDrawing Test.In addition,a total of 275 college students were selected to receive re-test,30 days late and Pearson correlation coefficient of two tests were calculated.The three raters were invited to assess 30 trees painting score,analyzing the Kendall coefficient of concordance between the scores to verify raters' reliability; parts of students also participated in the 16PF test,SAS,SDS test,analyzing the correlation coefficient between the various test results,in order to assess the effectiveness of the Tree-Drawing Test.Results The re-test reliability in different time was 0.570-0.733 and 0.341-0.713 (P＜0.05),the raters' reliability was 0.491 ～ 0.626(P＜0.05),there are some correlations between Tree-Drawing Test and 16PF,SAS,SDS.Conclusion The Tree-Drawing Test has good reliability and validity; it can be applied to the detection of college students' psychological assessment and psychological problems.