Objective To analyze the application value of region Ⅵ lymph node dissection in the lateral neck lymph node-negative(cN0 stage)papillary thyroid microcarcinoma (PTMC).Methods The clinical data of 18 PTMC patients in cN0 stage were collected,and all 18 patients underwent total thyroidectomy,homolateral lobe andisthmus total thyroidectomy and contralateral lobenear total thyroidectomy.The region Ⅵ lymph node dissection was performed on all cases.A long term follow-up was made.Results Six patients were found region Ⅵ lymph node metastasis while other 12 cases no.The time of follow-up was 0.5-6.0(3.5 ± 1.2)years.One patient with temporary recurrent laryngeal nerve palsy returned to normal within 3 months by symptomatic treatment.One patient was found region Ⅵ lymph node metastasis after 3 years treatment and other patients showed no lymph node metastasis.Conclusions There is a tendency for PTMC to occur region Ⅵ lymph node metastasis,it's necessary to perform prophylactic region Ⅵ lymph node dissection.It could decrease the complications and improve the prognosis.

The level of serum soluble interleukin 2 receptor(sIL-2R)was studied in 29chronic persistent hepatitis (CPH) patients and in 18 normal individuals.It was found that sIL-2R level was significantly higher in the CPH patients than that in normal individuals(P

Objective To investigate the expression of β-catenin and PCNA,and its relationship with clinical parameters and prognosis.Methods Tissue microarray technology and immunohistochemical method were used to detect the expression of β-catenin and PCNA in gastric carcinoma and normal tissue collected from January 2000 to December 2006.Data were analyzed by SPSS 19.0.Results The percentage of expression of β-catenin and PCNA in gastric carcinoma is 96.7％,99.2％,respectively,and higher than the normal gastric tissue (x2 =41.082,P =0;x2 =97.692,P =0).ROC curve was used to find that PCNA was better than β-catenin to discriminate gastric carcinoma from normal gastric tissue in sensitivity,specificity,coincidence rate(84.4％,87.5％,84.6％).The expression of β-catenin is related to lymph node metastasis in gastric cancer (x2 =6.107,P =0.04).The expression of PCNA is related to pathological type (x2 =9.71,P =0.02).The expression of β-catenin and PCNA in gastric carcinoma were positively correlated (r =0.24,P =0.005).Multivariate analysis showed that TNM staging and both positive β-catenin and PCNA were independent factors impacting on the overall survival rate of patient with gastric cancer.Conclusions The expression of β-catenin and PCNA in gastric carcinoma is signifrcandy high.PCNA is more important than β-catenin in discriminating gastric carcinoma from normal gastric tissue.Combined detection of the two kinds of protein have some clinical significance in predicting the prognosis of patients with early gastric cancer.

Objective To evaluate the therapeutic effects of gemcitabine regional artery perfusion combined with systemic chemotherapy for late-stage cancer of pancreas.Methods Thirteen cases of late-stage cancer of pancreas proven by operation and pathology were treated with 5-FU+MMC as a combined system chemotherapy, and use of gemcitabine for regional artery perfusion chemotherapy.Results Among the 13 patients who could be evaluated for therapeutic effect, four cases had partial response (PR), six cases had (SD), three cases were PD, and the effective rate of the clinical benifical-reflected evaluation was 76.9%, pain releive rate 75.0% the median survival time was 6.3 months. None of the patients have had serious toxious side-effects.Conclusions The gemcitabine regional artery perfusion combined with systemic chemotherapy can relieve the cancer pain of patients with late-stage cancer of pancreas, improve their general condition, increase the survival quality of life, prolong the survival time. The drug tolerance of the patients is good.

Objective To summaize the experience of application of direct digital radiography and electrohydraulic shockwave lithotripsy in treatment of residual bile duct stones.Methods A retrospective analysis of clinical records of 60 patients with residual bile duct stones treated in our hospital from 2003 to 2006 was made.Results In 59(95.9%) of 60 cases the stones were removed completely,including successful removal in one time of application of this method in 57 Patients(95.0 %),and 2 applications in 2 Patients ﹙3.3 %).One case with bile duct stone complicated with dile duct cancer was unsuccessful.The biggest stone was 3.5 cm?2.5 cm?2.0 cm.No serious complications occurred and changed to operation.The 59 cases were followed up for 6 mo to l yr,and all had a successful outcome.Conclusions The method of combination of direct digital radiography and electrohydraulic shockwave lithotripsy in treatment of postoperative residual bile duct stones after operation can facilitate removal of residual bile duct stones.The procedure is a safe way of treating residual stones.

Purpose Sustained attention dysfunction is a common symptom of patient with attention-deficit/hyperactivity disorder (ADHD).To reveal the neural mechanism of the abnormality of sustained attention of patients with ADHD,the cerebral blood flow (CBF) abnormalities in patients were studied by perfusion imaging.Materials and Methods Sixteen children with ADHD and twenty normal controls treated at the 401st Hospital of PLA from June 2013 to September 2015 underwent 3D arterial spin labeling (3D-ASL)scanning with GE 3.0T MRI scanner.The participants were performed four continuous sections of sustained attention to response task (SART) for 20 minutes in the scanner.Using SPM 8 toolkit,the local CBF values of both groups were compared in a voxel-wise manner,and their correlations with response time and target accuracy of SART were analyzed.Results When performing the SART,the patients with ADHD showed significantly inhibited trend of increasing CBF in the anterior cortex like dorsal cortex,medial prefrontal cortex,and motor area;however,they presented enhanced trend of increasing CBF in the posterior cortex such as posterior cingulate cortex and parietooccipital sulcus (P＜0.01);the change of CBF in the dorsal prefrontal cortex and that in the precentral and postcentral gyrus had significant correlation with response time of SART task and targeting ratio (dorsal prefrontal cortex:r=0.745,P＜0.001;r=0.591,P＜0.001;r=-0.521,P＜0.001.Precentral and postcentral gyrus:r=0.579,P＜0.001).Conclusion Patients with ADHD show different CBF redistribution between anterior and posterior cerebral cortex in performing SART,and the abnormal CBF shows significant correlations with behavioral metrics,which reflects the mechanism of sustained attention dysfunction of patients with ADHD.

Objective To explore the rationality of pancreaticojejunostomy and double purse embedded pancreaticogastrostomy in pancreaticoduodenectomy through comparing the short-term effects between pancreaticojejunostomy and double purse embedded pancreaticogastrostomy in pancreaticoduodenectomy.Methods A retrospective review was performed for 38 patients who were underwent pancreaticoduodenectomy at the second affiliated hospital of Kunming Medical University from January 2010 to December 2012.Results All 38 pancreaticoduodenectomy were performed successfully.The pancreatic fistula (0％),operationtime [(327.50±32.56) min],postoperative hospital days [(10.31 ±2.44) d] were found to be significantly lower in double purse embedded pancreaticogastrostomy group than those of pancreaticojejunostomy group [3/12,(425.83 ± 33.77) min,(14.33 ± 4.14) d],which has statistical significance(P＜0.05).Although the incidence of bile leakage,postoperative abdominal bleeding,delayed gastric emptying,infection of incision,infection of lung,intraoperative amount of bleeding are also lower than that of pancreaticojejunostomy group,which has no statistical significance.Conclusions Double purse embedded pancreaticogastrostomy is a digestive tract reconstruction which is safer and more reasonable than pancreaticojejunostomy.The former one is operated simply and the operation time is shorter.There are great advantages in the prevention of complications such as pancreatic fistula after pancreaticoduodenectomy.

Objective To evaluate the efficacy of X-ray guided choledochoscopy via T tube tunnel and interventional treatment of residual bile duct stones.Methods Cholangiography was performed in patients suspected of residual bile duct stone with choledochoscopy via the remaining T tube tunnel,and data of 45 patients who received endoscopically treatment for the residual bile duct stones and bile duct stricture were analyzed.Results Seven patients' with adhesive bile duct stenosis were resolved by repeat rinse and dilation,but the procedure failed in 2 cases of bile duct stricture caused by scar;seven cases of common bile duct stone combined with gradeHand Ⅲ multiple hepatic cholelith were removed within 1.5 h:six cases of hepatic bile duct narrowing with multiple cholelith were taken out in 1.0 hour;six cases of grade Ⅱ and Ⅲ multiple massive choledocholith were removed with lithotrity for over 2.0 h:six cases of grade Ⅱ-Ⅳ cholelith were eliminated within 1.5 h:six cases of hepatobiliary stone were removed successfully in 30 min.Stones in 3 cases of multiple stones with intrahepatie bile duct stenosis were not taken out due to bile duct stricture;stones in 2 cases of gradeⅡand Ⅲ multiple choledocholith were not removed for T tube tunnel bleeding.Conclusion X-ray guided choledochoscopy is convenient and effective to remove residue cholelith.

Preventing bioweapons is an important component of biosecurity,and the Biosecurity Law of the People's Republic of China has a chapter devoted to"Preventing Biological Terrorism and the Threat of Bioweapons".A good knowledge of the history plays a positive role in effective protection against bioweapons.This article analyzes history of bioweapons based on books and literature that have been published in order to provide reference for professionals in the sphere of biosecurity.

Objective:To investigate the prevalence of physical violence against children (PVAC)by parents and to explore possible related factors.Methods:In two primary schools in Liaoning Province,1164 parents of pupils in grade 1 to 6 were surveyed by a self-administered questionnaire anonymously to analyze situation about PVAC and related factors.PVAC was defined as having one or more following parent-to-child behaviors in the past three months:push,or shook a child;pinch,screw,or scratch a child;hit child's buttocks with hand;hit child's hand,foot,arm,leg or back with hand;hit child's buttocks with an object;hit child's face or head with hand;hit elsewhere (not buttocks)with an object;kicked a child with a foot or hit with a fist.Results:Of 1164 parents,53.1% reported that they had minor PVAC (51.0%)or/and severe PVAC (19.8%).Multivariate logistic regres-sion analysis indicated that following factors increased the risk of PVAC:child's male gender (OR =1.49),younger age of children (OR =1.38),poor school performance of children (OR =1.85 ),mother (OR =2.09),parents'childhood physical violence victimization experiences (OR =1.53),parents'supportive or tolerant attitudes towards corporal punishment (OR =3.15),parents'lower awareness of the harmfulness of physical violence against children (OR =2.31),and lower social economic status (OR =1.47).Conclusion:The PVAC by their parents may be com-mon in the present study.Parents'supportive or tolerant attitudes toward corporal punishment and low awareness of the harmfulness of physical violence is the main risk factors of PVAC.