Sporadic parathyroid adenomas are the most common cause of primary hyperpamthyroidism,The molecular mechanisms underlying the pathogenesis of sporadic parathyroid adenomas are incompletely understood and early specifical diagnosis is lack.With the development of molecular biological technology,gene research in parathyroid adenoma has made great progress.This article reviewed the changes at the molecular level.

Objective To evaluate the outcomes of umbilical hernia repairing in adults.Methods Forty-nine cases of umbilical hernia admitted between 2003 and 2008 were analyzed retrospectively.Opera-tive techniques included traditional repair (n = 14),Kugel patch (n = 21) and mesh plug-patch (n = 14).Results The operative time of traditional repair was shorter than those for patients who underwent Kugel patch hernioplasty or mesh plug-patch hemiorrhaphy.But the pain was significantly higher.With a follow-up of 1 -6 years,whereas no recurrence was documented for the tension-free hemiorraphy,but a case recurred for traditional repair.Conclusion Tension-free hemiorraphy is a safe,efficacious and lower complications technique for the repair of umbilical hernia.

ASL-fMRI by measuring tissue blood flow, thus reflects the pathophysiology of organ blood flow dynamics and change, provides a new method for clinical and scientific research.With the improvement of MR image technology, technology as a MR perfusion imaging of arterial spin labeling method has been applied.It is non-invasive, repeatable high tissue contrast with a good advantage. Current clinical studies of renal ASL-fMRI is increasing. Includes renal transplantation, kidney tumors, acute kidney injury, patients with chronic renal dysfunction renal blood flow studies. Below reviews the progress of renal ASL-fMRI.

Objective To evaluate outpatient and inpatient medical services of hospitals in various regions of the whole country in 2009.Methods RSR was applied to perform the statistical analysis.Results The hospital outpatient and inpatient medical services in 31 provinces and municipalities (municipalities and autonomous regions) were divided into four grades.The hospital outpatient and inpatient medical services were excellent in Guangdong, Yunnan, Hebei, Jiangsu, Hubei, Shandong, Henan, Hunan, good in Guangxi, Liaoning, Heilongjiang, Shaanxi, Jiangxi, Anhui, Guizhou, Sichuan, Zhejiang, fair in Qinghai, Beijing, Fujian, Shanxi, Inner Mongolia, Gansu, Chongqing and Xinjiang,and poor in Hainan, Tianjin, Ningxia, Tibet, Shanghai, Jilin.Conclusion RSR is suit-able for the comprehensive evaluation of any material, scientifically reflecting the outpatient and inpatient medical services of hospitals in various regions of the whole country.

Objective To introduce the method of treating chronic mallet finger using Micro Arc bone Anchor, and investigate the feasibility of this method with the clinical effects.MethodFourteen chronic mallet fingers were treated with Micro Arc bone Anchors. During the operation, a "?" skin incision over the dorsum of the DIP joint was made to expose the extensor tendon and resect the scar tissue between the disrupted ends. Then the DIP joint was made at extending position was immobilized with a 1mm Kirschner wire and the ends of extensor tendon was sutured with horizontal mattress suture method. After that,the Micro Arc bone Anchor was sutured into the dorsal base of the distal phalanx,the suture thread attached the end of anchor was tied to the proximal end of the extensor tendon to reinforce the former suture. External fixation on the anterior face of forearm was applied to immobilize the wrist at 30?of extention and the metacarpophalangeal and interphalangeal joints and extending position for 3 w, and Kirschner wire fixation was taken out 6 w postoperatively. Functional exercises were performed after the Kirschner wires were removed.ResultAll the cases were followed up for 6 months to 1 year, and excellent results were obtained in 10 cases, good in 2, fair in 2 and poor in 1 according to Dargan's functional assessment system, with dysfunction of flexion in DIP joint in 1 case, and recurrence of abnormity in 1 case.The total rate of excellent and good results was 85.7%.ConclusionMicro Arc bone Anchor is a convenient and effective alternative for the treatment of chronic mallet finger deformity with many advantages such as the high suturing intensity,low recurrence rate of abnormity, convenient for operation and reliable effect.

OBJECTIVETo evaluate the clinical effects of minimal invasion and closed reduction with external fixation in treating elderly femoral intertrochanteric fracture.

METHODSFrom August 2007 and September 2013, 43 patients with elderly femoral intertrochanteric fracture were treated by minimal invasion and closed reduction with external fixation. There were 26 males and 17 females with an average age of 78 years old ranging from 68 to 92 years. Durations from injury to operation ranged from 1 to 8 days with an average of 3 days. According to AO classification, there were 22 cases with type A1, 15 with type A2, 6 with type A3. The time of bone healing were observed after operation and the clinical effects were evaluated by Harris scoring standard.

RESULTSAll patients were followed up from 10 to 18 months with an average of 13 months. The incisions obtained one-stage healing after removal of external fixation. All the fractures were healed and the mean healing time was 16 weeks (ranged, 12 to 18 weeks). Two patiens complicated with the thread needle loosening in the femoral trochanteric, 2 cases with the hip varus deformity and 1 case with the delayed union. No bone nonunion, external fixer breakage, blood vessel or nerve damage were found. According to the Harris scoring standard,the average Harris score of hip joint function was 85.89±7.36, and 18 cases got excellent results, 19 good.

CONCLUSIONMinimal invasion and closed reduction with external fixation can obtain satisfactory results in treating elderly femoral intertrochanteric fractures. It is a simple and effective method for elderly patients who cannot tolerate anesthesia and surgery trauma.

Aged ; Aged, 80 and over ; External Fixators ; Female ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures ; methods

Objective To investigate the clinical characteristics on diagnosis and treatment of renal tubercu- losis.Methods Clinical data of 82 patients with renal tuberculosis were retrospectively reviewed.Results All of the 18 cases who received medication recovered completely.64 cases undergoing surgery were pathologically diagnosed to have renal tuberculosis,of which 2 cases developed ureteral stump syndrome.Conclusion Urine PCR-TB-DNA re- mained the primary diagnostic method before operation.Computed tomography(CT)and magnetic resonance urogra- phy(MRU)could be used in diagnosis of renal tuberculosis.When the non-functioning kidney was resected,per- inephrit fat and the involved ureter should be concomitantly resected as much as possible.

AIM:To explore the clinical effect of capsule membrane phacoemulsification and capsular bag in phacoemulsification in treatment of hard nuclear cataract with high myopia.
METHODS:A total of 297 patients(322 eyes) with hard nucleus cataract(Ⅳ-Ⅴ grade nucleus) and high myopia were selected from Mar. 2014 to Mar. 2016 in our hospital. They were randomly divided into the observation group with 149 cases(162 eyes) and the control group with 148 cases(160 eyes). The observation group received capsule membrane phacoemulsification and the control group received capsular bag in phacoemulsification. The therapeutic effect and safety of patients in two groups were compared. The comparison of phacoemulsification time, energy parameters and corneal endothelial cell density used t-test, post-operative visual acuity and the occurrence of complications were tested by Chi-square test.
RESULTS: The harder the nucleus was, the longer the phacoemulsification time and higher the average phacoemulsification energy was, and the differences were statistically significant(P<0. 05). The phacoemulsification time and energy parameters of the observation group were significantly lower than that of the control group( P<0. 05 ). One month after operation, the postoperative visual acuity in two groups was significantly higher than the visual acuity at 1d after operation(P<0. 05). But there was no statistical significance on the visual acuity at 1mo after operation between two groups ( P> 0. 05 ). After operation, the density of corneal endothelial cell in two groups was significantly lower than the density before operation ( P < 0. 05 ). But there was no statistical significance on the density of corneal endothelial cell after operation between two groups ( P > 0. 05 ). The intraoperative complication rate of observation group was significantly lower than that of the control group ( P<0.05 ) , but there was no statistical significance on postoperative complication rate between two groups ( P>0. 05). CONCLUSION: For the treatment of hard nuclear cataract with high myopia, capsule membrane phacoemulsification and capsular bag in phacoemulsification have similar effect, but capsule membrane phacoemulsification has better safety.

0.05).While the diagnosis ratio of MP and LP with RT-PCR+IIF method were higher than any of other 3 methods significantly(Pa

AIM: IL-12 acts upon T lymphocytes and activates its receptor complexes of ?1/?2 ,and so IL-12 can regulate TH1/TH2 balance. Our study is aimed at IL-12-inducing apoptosis of T cells and expression and signal transduction of Fas/FasL during T cell apoptosis. METHODS: The apoptosis of T cells was detected by Annexin V staining cytometry and the expression of Fas/FasL under different inhibitors were detected by semi-quantitative PCR. RESULTS: IL-12 induced the human leukemic T cell line(TIB-152) and the human lymphoma T cell line(HTB-176) and the normal human T cells to undergo apoptosis. The FasL expression at 6 hours after treatment with IL-12 increased apparently, and reached the max at 24 hours, and FasL expression induced by IL-12 was inhibited by PKC inhibitor. But IL-12 did not influence Fas expression. CONCLUSIONS: IL-12 can induce T cells to undergo apoptosis which is characterized by early membrane changes, the inducing effect is correlated with the concentration of IL-12 and the maturation of T cells. FasL participates in the progression of T cell apoptosis as a apoptosis mediator, and the effect of IL-12 on FasL expression may be related with PKC pathway.