Objective To explore the clinical feature,diagnosis,treatment and prognosis of Hashimoto′s thyroiditis(HT) combined with hyperthyroidism in children.Methods The clinical features of 56 children with HT combined with hyperthyroidism,including clinical features,complications,thyroid hormone,thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),the detection of ultrasonic imaging and fine needle aspiration biopsies,diagnosis,treatment and prognosis were analyzed.Results The proportion of men to women was 16 in all 56 children,and the mean age at diagnosis was(9.95?2.09) years.The percentage of positive TGAb and TPOAb were 93% and 98%,respectively in all the 56 children.One child was diagnosed as HT combined with hyperthyroidism coexistent and myasthenia gravis type Ⅰ.The duration of hyperthyroidism ranged from 3 to 24 months.There were 14 children who had hypothyrodism and 8 children were euthyroid in all the 56 children.Conclusions Children with HT hyperthyroidism are more frequent in young females.TGAb and TPOAb are important markers for the diagnosis of HT.Pharmacotherapy is the first choice to treat HT hyperthyroidism.Hyperthyroidism is a clinical process of HT,and the percentage of children with hypothyrodism is increasing along with the development of disease.

Objective To explore the possible role of B7 family cell surface costimulatory molecules and their receptors in immunopathogenesis in children with asthma.Methods Forty children with acute exacerbation of asthma and 36 cases of age-matched healthy children were enrolled in the study.Interferon(IFN-?),IFN-? and lipopolysaccharide(LPS),phorbol 12-myristate 13-acetate and ionomycin or zero were used to stimulate peripheral blood mononuclear cells,flow cytometry was used to detect B7-1 and B7-2,B7H1,B7DC and B7H expression on CD14+ cells;CD4+ cells were separated by immune beads and stimulated by phorbol-12-myristate-13-acetate and ionomycin and fluorescence quantitative polymerase chain reaction was used to detect CD28,cytotoxic lymphocyte associated antigen-4(CTLA-4),programmed death-1(PD-1)and inducible costimulator(ICOS) mRNA expression.Results 1.The levels of B7-1 and B7-2 expression in children with asthma were higher than those of healthy control group [B7-1:(6.68?3.97)% vs(1.74?0.69)%;B7-2:(10.87?5.99)% vs(1.58?0.75)% Pa

Objective To investigate the relationship between the imbalance of suppressors of cytokine signaling 1(SOCS1)/SOCS3 and abnormal activation of monocytes/ macrophages in children with acute-phase asthma, and explore the molecular mechanism of chronic inflammatory process on airway.Methods The present study enrolled 20 asthmatic children and 20 age-matched normal children. Dual-color flow cytometric analysis was performal to detect the percentage of CD_ 80 、CD_ 86 expressing on CD_ 14 ~+ cell. Reverse transcriptase-polymerase chain reaction and real-time PCR were used to analyze SOCS1,SOCS3 expression in monocytes/ macrophages.Results The proportions of CD_ 80 ,CD_ 86 expressed on CD_ 14 ~+ cell in children with asthma were significantly higher than those in control subjects(CD_ 80 :7.0% vs 1.70%),(CD_ 86 :11.37% vs 2.03%),all P

Objective To find out the situation of Kashin-Beck disease and it's dynamic changes in Yan'an city, and provide basis for decision-making on prevention and control of the disease. Methods In accordance with the national monitoring program on Kaschin-Beck disease, 21 villages were selected from 6counties in Yan'an, clinical and X-ray inspection of 7 to 13 year-old children were made according to historical illness information from 2006 to 2008. Clinical monitoring on Kashin-Beck disease was made in 2008 for people over 16 years old from 5 villages in 5 counties. Results One thousand and one hundred eighty children were found positive with the illness from 2006 to 2008, with 7 cases of grade Ⅰ , the detection rate was 0.59%(7/1180).One thousand and one hundred sixty-two people were taken X-ray photo on right hand, with no positive case found.In 2008, 1444 adults were taken clinical examination, the detection of grade Ⅰ and over were 160 cases, the detection rate was 11.08%(160/1444), mainly in the age of 36 years[93.75%(150/160)]. Conclusion KashinBeck disease in Yan'an city is in stable condition, but surveillance and preventing measures are stilled needed.

Objective To explore the method of clinical application and the final result of the com- pound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels.Methods Basing on the anatomic basis that the nutrient vessels of saphenous nerve-great saphenous vein have the same deriva- tion as the branches of the muscle,bone and skin.Eight cases of the tissue defects of ankles and feet were re- paired by the flap.Results Seven cases were survived completely except the distal partly necrosis in one case.The calcaneal defects of one case were repaired by the iliac graft after two weeks of the operation.Follow up from 3 monthes to one year,the texture,appearance and function of the multiflap were good.Conclusion The compound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels has the ad- vantages as follow:the reliable blood supply,avoidance of sacrificing the major arteries,reconstruction of sen- sation and simply procedure.Besides,the defects of soft tissue and bone can be repaired on one operation.

The thrombin is a neurotoxic agent,which plays an important role in the course of brain edema and brain injury following intracerebral hemorrhage.This article reviews the neurotoxicity mechanisms of thrombin in intracerebral hemorrhage.

OBJECTIVETo investigate the mechanisms of Kebimin decoction (KD) in treating allergic rhinitis (AR).

METHODSSixty patients with AR were randomly divided into two groups, patients in the treated group (TG) were treated with KD, those in the control group (CG) were given Xinfang rhinitis capsule. The serum levels of adhesion molecule (sICAM-1, P-selectin), Th1 cytokines, including interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), and Th2 cytokines (IL-4 and IL-5) were determined by enzyme-linked immunosorbent assay (ELISA) before and after treatment, and compared with those in 30 healthy subjects as control.

RESULTSThe serum levels of adhesion molecule and Th2 cytokines were higher and Th1 cytokines were lower in AR patients than those in healthy control (P < 0.01). After treatment, these indexes were restored significantly (P < 0.01) in the treated group, but no significant change was found in the control group.

CONCLUSIONKD has definite effect in treating allergic rhinitis by inhibiting production of adhesion molecule and regulating the levels of Th1/Th2 cytokines to correct the imbalanced Th1/Th2 cytokines network.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Interleukin-5 ; blood ; Male ; Middle Aged ; P-Selectin ; blood ; Phytotherapy ; Rhinitis, Allergic, Perennial ; drug therapy ; metabolism ; Th1 Cells ; metabolism ; Th2 Cells ; metabolism

OBJECTIVETo compare the therapy efficiency of immediate implanting breast reconstruction after skin sparing mastectomy and modified radical mastectomy in breast cancer.

METHODSThis study retrospectively analyzed 530 female patients with early breast cancer operated in the department of General Surgery, Beijing Chaoyang Hospital, from Jan. 2004 to Dec. 2008, including 91 patients operated with skin sparing mastectomy and immediate implanting breast reconstruction and 439 patients with modified radical mastectomy. The follow up ended in Mar. 2010. By comparing complications, local recurrence, distant metastases and mortality rates between the two groups, the research was done to evaluate the therapy efficiency.

RESULTSIn the group of immediate implanting reconstruction, 84 patients completed follow up with the median follow-up time of 35 months (14 - 72 months) while the local recurring rate was 2.4%, distant metastasis rate was 8.3% and mortality rate was 6.0%. In the group of modified radical mastectomy, 398 patients completed follow up with the median follow-up time of 36 months (12 - 74 months) while the local recurring rate was 3.3%, distant metastasis rate was 9.5% and mortality rate was 6.5%. Therefore there was no obvious statistic difference between the two groups in local recurring rate, distant metastasis rate and mortality rate (P > 0.05). Evaluation of aesthetic results was done in the 84 patients after immediate implanting reconstruction for 12 months which was 93% as good or excellent by surgeons while 87% by patients. Surgeons and patients were both satisfied with the breast appearance.

CONCLUSIONFor patients with early stage breast cancer, combining standard postoperative therapy, skin sparing mastectomy and immediate implanting reconstruction could achieve the same effect as the traditional modified radical mastectomy, while reconstruction would bring about better appearance and higher quality of life.

Adult ; Breast Implantation ; Breast Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; methods ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism.

METHODSFrom 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment.

RESULTSAll patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P < 0.05).

CONCLUSIONBone setting manipulation is a good method for treating supination-eversion ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary

Adult ; Ankle Injuries ; physiopathology ; therapy ; Ankle Joint ; physiology ; Case-Control Studies ; Female ; Fractures, Bone ; physiopathology ; therapy ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Supination

OBJECTIVETo investigate the surgical methods, indications and effects of postmastectomy breast reconstruction in 67 consecutive patients.

METHODSFrom July 2002 to October 2005, 67 patients received postmastectomy breast reconstructions. Immediate breast reconstructions were performed using full-size implants in 38 cases, Becker expandable implants in 16 cases, unilateral pedicled transverse rectus of abdominis musculocutaneous (TRAM) in 2 cases. Delayed breast reconstruction were carried out in 6 cases with unilateral pedicled TRAM flaps, 4 cases with extended latissimus dorsi musculocutaneous flap (ELDF), one case with Becker expandable implant.

RESULTSOf the patients, more than 90% were satisfied with the results. Minor complications were recorded in 5 patients, including small local skin necrosis, partial necrosis of nipple-areola complex preserved and seroma formation.

CONCLUSIONSFull-size implant breast reconstruction is ideal for slender, small-breast women undergoing immediate breast reconstruction after skin-sparing mastectomy, but not suitable for delayed breast reconstruction. Expandable implants can be used for immediate breast reconstruction in patients with large breast or those who received modified mastectomy and also can be used for delayed breast reconstruction in patients with well-preserved skin and muscle. TRAM or ELDF flap for breast reconstruction is a useful procedure with advantages of autologous tissue and excellent results, both are suitable for immediate and delayed breast reconstruction.

Adult ; Breast Implantation ; Breast Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; methods ; Mastectomy, Radical ; Middle Aged ; Retrospective Studies ; Surgical Flaps ; Time Factors ; Transplantation, Autologous