Objective To discuss the feasibility of endoscopic thyroidectomy via breast approach for papillary thyroid carcinoma.Methods From April 2009 to December 2013,clinical data of 90 papillary thyroid carcinoma cases undergoing endoscopic thyroidectomy was analyzed retrospectively.Results There was no conversion to open surgery,the mean operation time was 97 min,the mean intraoperative blood loss was 10 ml,the mean postoperative drainage volume was 65 ml,the mean hospital stay was 4.5 d,the mean lymph node number dissection of central compartment was 5.3.No obviously chest pain and numbness occurred.No skin flap ecchymosis,necrosis,effusion,and hematoma occurred.No hypocalcemia convulsions occurred.Transient hoarseness occurred in 3 cases which recovered within 1 to 2 months.Follow-up time ranged from 1 to 5 years,the median follow-up time was 41 months,with no tumor recurrence and lymph node enlargement.All patients were satisfied with the cosmetic results.Conclusions Endoscopic thyroidectomy via breast approach is a safe and feasible procedure in treating papillary thyroid carcinoma (cN0).

Lung cancer is one of the commonest of malignant tumor in the world.It is a major threat to human health in China with highest morbidity and mortality.Steady increase in incidence rates have been observed worldwide in the last few decades in young patients,but previous studies have provided conflicting data about the clinical characteristics and prognoses of young patients with lung cancer.Consequently,we have difficulty in comparing their results with each other,as the cutoff ages defining"young"were different in each study.Therefore,this article focuses on the clinical characteristics and the different results of researches for the young patients with primary lung cancer.

A lot of single species of bacteria was seperated from the pathological changes position of the liver in sick (or dead) soft-shelled turtle which was infected by septicae-uia. By identifying and the characteristic of physics and chemistry the six single culture strains of bacteria, preliminary showed that it was A. caviae in Aeromonas. Through examination ablut causing illness, it was proved that the A. caviae seperated and appraised was pathogenic bacteria of this infection septcaemia of soft-shelled turtle.

The Tongmai Yangxin pill (TMYX) has potential clinical effects on no-reflow (NR); however, the effective substances and mechanisms by which this occurs remain unclear. This study evaluates the cardioprotective effects and molecular mechanisms of TMYX against NR. We used a myocardial NR rat model (2 h after myocardial ischemia and 2 h after reperfusion) to confirm the effect and mechanism of action of TMYX in alleviating NR. In vitro studies in isolated coronary microvasculature of NR rats and in silico network pharmacology analyses were performed to reveal the underlying mechanisms of TMYX and determine the main components, targets, and pathways of TMYX, respectively. The experiment was approved by the Ethics Committee of Hunan University of Chinese Medicine (LLBH-202212160001). TMYX showed therapeutic effects on NR by improving cardiac structure and function, reducing NR, ischemic areas, and cardiomyocyte injury, and decreasing the content of cardiac troponin I (cTnI). Moreover, the mechanism of TMYX predicted by network pharmacology is related to the hypoxia inducible factor-1 (HIF-1), nuclear factor kappa-B (NF-κB), and tumor necrosis factor (TNF) signaling pathways. TMYX increased the expression of G protein-coupled estrogen receptor (GPER), phospho-extracellular signal-regulated kinase (p-ERK), and HIF-1α. In vitro, TMYX enhanced the diastolic function of coronary microvascular cells; however, this effect was inhibited by GPER inhibitor (G-15), eNOS inhibitor (L-NAME), and sGC inhibitor (ODQ). This study integrates pharmacology and experimental evaluation to reveal that TMYX activates HIF-1α/eNOS signaling pathway by upregulating GPER to relax coronary microvessels, thereby significantly alleviating NR.

Carcinosarcoma ; metabolism ; pathology ; radiotherapy ; surgery ; Follow-Up Studies ; Humans ; Keratins ; metabolism ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Parotid Gland ; pathology ; surgery ; Parotid Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Radiotherapy, Adjuvant ; Vimentin ; metabolism

Chronic Disease ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Gastritis ; diagnosis ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Reference Standards

Background:For patients with liver cirrhosis and acute decompensation(AD),it is of great clinical importance to predict short-term mortality at admission. It has been reported that CLIF-C OF,MELD and MELD-Na score can accurately predict the short-term mortality,but all these scoring systems are complicated and have limits in their application. Aims:To define a simple and objective scoring system -- simplified MELD score for short-term mortality prediction in HBV-related cirrhotic patients with AD. Methods:A total of 890 consecutive HBV-related cirrhotic patients with AD hospitalized during Jan. 2005 to Dec. 2010 at Shanghai Ren Ji Hospital were enrolled retrospectively. Clinical data and patients’outcome were collected,and simplified MELD score was calculated by using total bilirubin,international normalized ratio and creatinine values at admission. Patients were classified into different prognostic groups according to their 28-day mortalities and simplified MELD score. Kaplan-Meier survival curve was used to analyze the 1-year accumulate survival rate,and ROC curve was used to evaluate the performance of different scoring systems in predicting 28-day mortality. Results:Simplified MELD score at admission could classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups and different long-term prognostic groups;the score of low,moderate and high 28-day mortality group was 0-2,3 and 4-6,respectively,and the corresponding mortality was 5. 5% ,19. 8% and 48. 6% ,respectively. Simplified MELD score had the same good performance as compared with the CLIF-C OF,MELD and MELD-Na scores in predicting 28-day mortality,the area under ROC curve was 0. 828,0. 831,0. 828 and 0. 830,respectively. Conclusions:Simplified MELD score can accurately classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups at admission. It is convenient for using in clinical practice.

Objective To explore the application value of DOSE index score in the peitients with chronic obstructive pulmonary disease.Methods 122 cases of plateau COPD patients were followed up for 12 months,and we recorded and analyzed the patient's health and life.We also recorde FEV 1 and DOSE scores of the patients with COPD,and record the COPD risk events,including the number of respiratory failure and death,and the times of hospitalization,total such confinement,outpatient expenses,hospitalization expenses,mMRC,and scored in the number of exacerbations,etc.Results The DOSE index score was negatively correlated with FEV1％ pred (r=0.73,P ＜ 0.05) for 122 COPD patients,and were positively correlated with mMRC (r=085,P ＜ 0.01),the annual number of exacerbations (r=0.71,P ＜ 0.01),respiratory failure (r=0.65,P ＜ 0.01),heart failure (r=0.50,P ＜ 0.01),number of outpatient service (r=0.12,P＜0.01),hospitalization time (r=0.70,P＜0.01),the totalsuchconfinement (r=0.66,P＜0.01),outpatient expenses (r=0.13,P＞ 0.13),hospitalization expenses (r=0.65,P＜0.01).ROC curve was used to analyzed the cut-off point and curve area of COPD DOSE index.Conclusion The DOSE index is a simple COPD assessment tools,and is closely related to the prognosis of patients and health.

Objective To investigate the changes of antibrain-antibody (AB-Ab) in blood serum and the effect of AB-Ab on blood-brain barrier (BBB) and cerebral edema after the traumatic brain injury (TBI) in rabbits.Methods Forty-five New Zealand rabbits were randomly divided into control group (n =5),sham operation group (fenestration only without injury,n =15) and TBI group (severe lateral fluid percussion brain injury,n =15) according to the random number table.Sham and TBI animals were subdivided at postoperative 1,3,7 and 14 days.Level of AB-Ab,BBB permeability and brain water content were determined after operation.Results At each time point,serum AB-Ab level,BBB permeability and brain water content were higher in sham operation group and TBI group than in control group (P ＜0.05).At postoperative 3,7 and 14 days,serum AB-Ab level,BBB permeability and brain water content were higher in TBI group than in sham operation group (P ＜ 0.05).Conclusion Serum level of AB-Ab is significantly increased after TBI along with synchronous changes in BBB permeability and brain water content,indicating that AB-Ab may be associated with the increase of BBB permeability and brain edema.

Objective To observe the effect of simvastatin on bone metastasis of breast cancer in nude mice model.Methods Sixty mice were divided into three groups randomly with 20 in each group.Mice were inoculated with MDA-MB-231 cells into the left cardiac ventricle.After 7 days,mice were treated with either simvastatin,saline,or nothing twice per week for 19 days.The area of osteolytic metastases was subsequently measured in long bones of all mice using an image analysis system.After sacrifice,parathyroid hormone-related protein (PTHrP) concentrations in bone marrow from all mice were determined using a two-site immunoradiometric assay.Osteoclast number expressed per millimeter of tumor/bone interface was assessed using an OsteoMeasure System.Measured data were compared with analysis of variance,and P ＜ 0.05 for the difference was statistically significant.Results The area of osteolytic lesions was significantly lower in mice treated with simvastatin compared with mice receiving saline and no treatment (0.51 ±0.18 mm2 vs 2.13 ± 1.24 mm2 vs 2.29 ± 1.22 mm2 ; F =15.600,P =0.002 ; F =15.673,P =0.001).In addition,treatment with simvastatin decreased the concentrations of PTHrP in bone marrow plasma (0.98 ±0.20 pmol/L vs 2.11 ±0.31 pmoL/L vs 1.99 ± 0.29 pmol/L; F =61.469,P ＜ 0.001 ; F =58.274,P ＜ 0.001) and the osteoclast numbers per millimeter of tumor/bone interface (4.00 ± 1.73 vs 11.40 ±4.93 vs 10.91 ± 3.87 ; F =17.820,P =0.001 ; F =17.184,P =0.002) compared with controls.Conclusion Simvastatin may reduce the production of PTHrP of breast cancer cells,which suppresses the development of destructive bone lesions as well as the growth of breast cancer cells in bone.