Objective To investigate the prevalence of postpartum thyroiditis (PPT) in three different iodine intake areas, to explore the relationship between iodine intake and PPT. Methods Panshan, Zhangwu and Huanghua are three different iodine intake areas. The median urinary iodine concentration were 103 ?g/L,374 ?g/L and 614 ?g/L, respectively. One hundred and nineteen lactational women were investigated during the first year postpartum. Thyroid stimulating hormone(TSH), free thyroxine(FT_4), free triiodothyronine(FT_3 ), thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb) were determined with immulite method, and UI was determined by As-Ce 4+ catalytic spectrophotometry method. Results The prevalence of PPT is 11.8%, 10.1% of subclinical PPT, whereas 1.7% of clinical PPT. There was statistically significant difference in the frequency of PPT in three areas (Panshan 5.6%, Zhangwu 23.1% and Huanghua 6.8%, P

Objective To assess surgical strategies and its therapeutic effect on treating tumors invading of the great vessels. Methods 23 patients underwent tumor resection along with reconstruction of great vessels from Jan. 2001 to Dec. 2005 were retrospectively reviewed. Results 19 cases (82.6%) experienced radical resection along with reconstruction of great vessels, 4 cases (17.4%) underwent palliative resections. 20 cases (86.9%) were followed up by various imaging examination methods. 4 cases (17.4%) died perioperatively and 7 cases (30.4%) had complications in perioperative period. Up to Aug. 2005, the postoperative survival times in patients were from 1.5 to 59.0 months. 3 cases (15.0%,3/20) existed more than 48 months, 4 cases (20.0%,4/20) more than 36 months, 6 cases (30.0%,6/20) more than 24 months, 9 cases (45.0%,9/20) more than 12 months and 12 cases(55.0%,11/20)more than 6 months. No complications related to vascular graft occlusion and tumor recurrence next to grafts occurred in these patients. In 2 cases appeared partial thrombosis in grafts in perioperatively. Conclusion Combination of radical resection of tumor and reconstruction of great vessels could extend survival time and improve quality of life in selected patients with tumor invading thoracic and abdominal great vessels.

Objective To describe CT and MRI imaging findings of retinal hamartomas with tuberous sclerosis and evaluate their clinical value.Design Retrospective case series.Participants 7 patients of tuberous sclerosis complex(TSC) who have ocular lesions found with CT and MRI examination.Methods 7 patients with tuberous sclerosis were diagnosed by clinical data and head CT.The size,morphology,density and enhancing situation of the retinal lesions were observed with CT and MRI,as while as with direct or indirect fundoscopy.Main Outcome Measures CT and MRI features of ocular lesions.Results 7 cases displayed intracranial calcification and/or non-calcified tubercles,situating in subendyma(7 cases,accounting for 100%) by head CT.Orbital CT and MRI showed 4 cases (57.1%) of flat retinal hamartomas 3 cases(42.9%) of retinal lobular and nodular hamartomas,2 cases(28.6%) scattered calcification patches in hamartoma,and 2 cases(28.6%) of nanophthalmos.The lesions displayed unenhancement on contrast-enhanced MR images in 7 cases(100%).There was 1 case(14.3%) of progressive retinal astrocytic hamartoma.Conclusion The examination of CT and MRI may find the bigger retinal hamartomas,which can play a very important role at the diagnosis with the help of whole brain examination. For progressive retinal astrocytic hamartoma,systemic evaluation with CT and MRI can provide evidence for choosing appropriate thera- pies.

Objective To study the genetic susceptibility in patients with postpartum thyroiditis(PPT)by genotyping their human leukocyte antigen(HLA)-DP and -DQ alleles.Methods The polymerase chain reaction-sequence based typing(PCR-SBP)method was used to analyze the distribution of HLA-DPA1,HLA-DPB1,HLA-DQA1 and HLA-DQB1 alleles among 52 PPT patients(31 clinical patients,21 subclinical patients)and 82 healthy controls.Compare the allele frequencies between various patient groups and the control population.Results There was no significant difference between patient group and control group.Conclusion Perhaps PPT is not associated with HLA-DP and HLA-DQ alleles.

The article reviews the change of thyroid function in the women during pregnancy and the development of fetal thyroid function and introduces the principles of treating pregnancy with hyperthyroidism or hypothyroidism.

Objective To assess the diagnostic value of delayed CT contrast enhancement patterns in hilar cholangiocarcinoma based on two phased dynamic incremental CT scanning. Methods Fifty two patients with suspected hilar tumor and bile duct obstruction underwent spiral CT scan. The scan time for one revolution of the X ray tube was 1 second. To elucidate the delay time for optimal imaging, all proved cholangiocarcinoma with delayed (6、8、10、15、20、30 minutes) post equilibrium phase contrast enhanced CT scans were acquired with unenhanced, dynamic contrast enhanced, and delayed images. Degree of delayed enhancement was compared with that of surrounding liver parenchyma. Results (1) 8～15 minutes after IV injection of contrast material was the delay time for optimal imaging. (2) Of 29 cholangiocarcinomas, the early CT showed hypoattenuating (lower than that of liver parenchyma) in 23 tumors, isoattenuating (equal to that of the liver) in 4 tumors, and hyperattenuating (higher than that of liver) in 2 tumors. The delayed CT scan showed isoattenuating in 8 tumors, hyperattenuating in 21 tumors, and no hypoattenuating. Most of delay imaging of hilar cholangiocarcinoma may appear hyperattenuating ( U=-4.307 3, P

To investigate the therapeutic effects of recombinant humanized anti-HER2 antibody (Herceptin) on Her-2/neu-overexpressing metastatic human breast cancer, 7 patients with Her-2/neu-overexpressing metastatic human breast cancer were involved in this study. The results indicated that the therapeutic effective rate was 71. 4%. CR. PR, SD. PI) were seen in 2. 3, 1, 1 cases, respectively. No side reactions were observed. The results revealed that the therapeutic effect of Herceptin is intimately linked to Her-2/neu expression of breast cancer.

Objective To describe CT and MRI imaging findings of retinal hamartomas with tuberous sclerosis and evaluate their clinical value. Design Retrospective case series. Participants 7 patients of tuberous sclerosis complex (TSC) who have ocular lesions found with CT and MRI examination. Methods 7 patients with tuberous sclerosis were diagnosed by clinical data and head CT. The size, morphology, density and enhancing situation of the retinal lesions were observed with CT and MR.I, as while as with direct or indi-rect fundoscopy. Main Outcome Measures CT and MRI features of ocular lesions. Results 7 cases displayed intraeranial calcification and/or non-calcified tubercles, situating in subendyrna (7 cases, accounting for 100%) by head CT. Orbital CT and MRI showed 4 cases (57.1%) of flat retinal hamartomas 3 cases (42.9%) 9f retinal lobular and nodular hamartomas, 2 cases(28.6%) scattered calcification patches in hamartoma, and 2 cases (28.6%) of nanophthalmos. The lesions displayed unenhancement on contrast-enhanced MR images in 7 cases(100%) . There was 1 case (14.3%) of progressive retinal astrocytic hamartoma. Conclusion The examination of CT and MRI may find the bigger retinal hamartomas, which can play a very important role at the diagnosis with the help of whole brain examination. For progressive retinal nstrocytic hamartoma,systemic evaluation with CT and MRI can provide evidence for choosing appropriate thera-pies. (Ophthalmol CHN, 2009, 18: 257-260)

Background:China is an area with high incidence of gastric cancer,studies have shown that serum pepsinogen (PG) and gastrin-17 (G-17)levels can be used for gastric cancer screening. Aims:To investigate the values of serum PG and G-17 levels in screening gastric precancerous lesion and gastric cancer. Methods:A total of 211 patients with gastroduodenal disease diagnosed by endoscopy and biopsy from March 2016 to October 2016 at the First Affiliated Hospital of Soochow University were enrolled,and 67 healthy subjects were served as controls. Serum levels of PGⅠ,PGⅡ,G-17 and Hp-IgG antibodies were determined by ELISA. Results:Compared with control group,PGⅠ level and PGR were significantly decreased in atrophic gastritis group (P < 0. 01);serum PGⅠ level and PGR were significantly decreased, and G-17 level was significantly increased in low grade intraepithelial neoplasia group,high grade intraepithelial neoplasia group and gastric cancer group (P < 0. 01). ROC curve showed that the best cutoff values of PGⅠ,PGR and G-17 for diagnosing gastric cancer and gastric precancerous lesion were 74. 74 ng/ mL (sensitivity 88. 3％,specificity 78. 0％), 6. 59 (sensitivity 87. 0％,specificity 73. 8％),13. 02 pmol/ L (sensitivity 54. 2％,specificity 84. 4％),respectively. PGR and G-17 were the independent predictors of gastric cancer and gastric precancerous lesion. The sensitivity and specificity of combined detection of PGⅠ,PGR and G-17 for diagnosing gastric precancerous lesion and gastric cancer were 89. 9％ and 84. 4％,respectively. Conclusions:Serum PGⅠ,PGR and G-17 may be used as indicators of gastric cancer and gastric precancerous lesion screening. PG combined with G-17 for diagnosing gastric cancer and gastric precancerous lesion is more sensitive and specific than using serum PG or G-17 alone.

Objective To analyze the clinical features and risk factors of recurrent acute pancreatitis (RAP).Methods From September 2012 to September 2014,the clinical data of 411 patients with primary acute pancreatitis (AP) were collected.From March to June 2016,patients were followed up.The clinical features of patients with RAP were analyzed.Univariate and multivariate regression analysis were performed to analyze the risk factors of RAP.Results Among the 411 patients with AP,those caused by biliary disease,hyperlipidemia,alcohol,other known causes and idiopathic AP were 265 cases (64.5％),61 cases (14.8％),19 cases (4.6％),21 cases (5.1％) and 45 cases (10.9％),respectively.In two weeks of AP onset,the recurrent rate of biliary AP in cholecystectomy group was 7.1％ (5/70),which was lower than that of non-cholecystectomy group (30.2％,42/139),and the difference was statistically significant (xz =14.218,P＜0.01).The results of univariate regression analysis suggested that gender,body mass index (BMI),complicated with diabetes,etiology,history of smoking,history of drinking and pancreatic necrosis were correlated with RAP (all P＜0.05).The results of multivariate regression analysis indicated that complicated with diabetes (odd ratios (OR) =3.417,95 ％ confidence interval (CI) 1.979 to 5.900,P＜0.01),hyperlipidemic pancreatitis (OR=2.247,95％CI 1.077 to 4.688,P=0.023),history of smoking (OR=4.023,95％CI 2.377 to 6.809,P＜0.01),complicated with pancreatic necrosis (OR=3.312,95％ CI 1.675 to 6.546,P＜0.01) were independent risk factors of RAP.Conclusions Hypertriglyceridemia,smoking,complicated with pancreatic necrosis and diabetes are independent risk factors of RAP.Patients with biliary AP should receive cholecystectomy as early as possible,which could reduce RAP.