Objective To explore central lymph node metastasis (CLNM) of cN0 papillary thyroid carcinoma(PTC).Methods We evaluate the clinical data of 245 patients with cN0 unilateral TPC undergoing total thyroidectomy and bilateral central lymph node dissection.Results Central lymph node metastasis of cN0 TPC was 36.8％ (91/245),significantly related to gender(x2 =5.626,P =0.018),age (x2 =6.255,P =0.012),tumor size (x2 =20.063,P ＜ 0.001) and capsule invasion (x2 =15.024,P ＜ 0.001).The central lymph node metastasis was 51.7％ (60/116) in 116 patients with tumor size ＞ 1 cm,and the contralateral CLNM was 22.4％ (26/116) which was related to capsule invasion (x2 =9.737,P =0.002) and delphian LNM(x2 =10.982,P =0.001) There were 6 cases (2.4％) suffering from temporary unilateral recurrent laryngeal nerve injury.96 cases (39.2％) suffered from temporary hypoparathyroidism and 3 cases (1.2％) from permanent hypoparathyroidism.The median follow-up time was 40 months.6 cases were found regional lymph node recurrence on the ipsilateral side.Tumor size ＞ 1 cm was significantly related with recurrence (P =0.008),as CLNM with higher recurrence rate (P =0.001).Conclusions CLNM is common in cN0 PTC patients,and central lymph node metastases increase the risk of recurrence.Prophylactic bilateral central lymph node dissection is suggested for tumor size ＞ 1 cm cases.

We have established adriamycin(ADR) nephropathy model, the expression of cyclophilin(CyP)mRNA was measured with RT PCR, and its relationship with the levels of total protein, albumin, cholesterol, 24 hour urine protein, BUN, and creatinine were determined.After four weeks,the levels of urine protein in ADR nephropathy animals were higher than 100mg/24h, whereas the levels in the control animals were lower than 6mg/24h. It was showed that the expression of CyP gene of kidney tissue in ADR nephropathy rats was significantly higher than that of the control animals. Meanwhile, it was found that there was negative correlation was found between the expression of Cyp gene and the levels of total protein and albumin,but positive correlation between the expression of CyP gene and the levels of 24 hour urine protein and cholesterol,and the expression of CyP gene had no correlation with the levels of BUN and creatinine. Our results suggested that the high levels of Cyp mRNA expression might contribute to renel tissue damage in ADR nephropathy,and it might reflect the degree of severity and prognosis in ADR nephropathy.

Objective To study the clinical significance of recognizing Zuckerkandl tubercle (ZT) during thyroid surgery. Methods One hundred and sixty-one patients (218 sides) having underwent thyroid lobectomy or thyroidectomy were retrospectively analyzed. The presence of ZT, the position and size of ZT, and the relationship between ZT and recurrent laryngeal nerve (RLN), superior parathyroid (SP) were observed. Results In 218 sides, 179 sides (82.1%) found ZT, with right side in 93 cases and left side in 86 cases. The main relationship between ZT and RLN was A type, accounting for 90.5%(162/179). There were no statistical differences in ZT grade and the relationship type between ZT and RLN between left side and right side (P>0.05). There was negative correlation in ZT grade and the relationship type between ZT and RLN (r=-0.269, P<0.01). In right side, 92.3%(72/78) of SP located on the top of ZT at 10-11 o′clock position;in left side, 94.6%(70/74) of SP located on the top of ZT at 1-2 o′clock position. Conclusions ZT is an important anatomical mark in the thyroid surgery, which helps to identify and protect the RLN and SP, so as to reduce surgical complications.

Objective To evaluate the effect of 5? reductase inhibitor on vascularity of benign prostatic hyperplasia (BPH). Methods Sixty male adult rats were randomly divided into 4 groups (15 per group): normal control, BPH control group, the group of 5? reductase inhibitor treatment during hyperplasia and the group of treatment after hyperplasia. Immunohistochemistry combined with computer assisted image analysis system were performed to examine the expression of factor Ⅷ related antigen, PCNA and VEGF in the prostatic tissue for all rats. Results The microvessel density(MVD) and the expressions of PCNA and VEGF were much less in treatment during hyperplasia and treatment after hyperplusia than that in BPH control group( P

Objective To study the effect of extracellular matrix(ECM)of xenogenic femoral fascia which is a tissue-engineering material in repair of renal trauma.Methods Twenty-four experiment dogs were divided into 3 groups:group 1(n=10),the kidneys were repaired using ECM of xenogenic femoral fascia;group 2(n=10),the kidneys were repaired using self-omentum;group 3(n=4),xenogenic femoral fascia was used as repair materials.The animals were sacrificed separately at 1,2 weeks and 1,2,4 months after renal repair operations in group 1,2.In group 3,the animals were sacrificed separately at 2 weeks and 2 months after renal repair operations.The examinations of blood routine were performed before and after operations immediately,blood creatinine and serum renin were measured before operations and before death.The creatinine clearances of affected and contralateral normal kidneys were evaluated before death and the local areas of renal repair were studied by light and scan electron microscopy.Results In group 1,bleeding stopped rapidly and completely after the entire patch was sutured,only mild adhesions to surrounding tissues were found in various times after operations.As time passed,the repair patch was replaced by smooth neocapsule just like a normal one.In group 2,the bleeding volume in the operations was larger than the other 2 groups.It was diffieult tO separate the kidneys from the surrounding tissues.The wounds gradually contracted because of the scar forming.In group 3,there were severe immunological reactions in the patchs.Conclusion ECM of xenogenic femoral fascia is an ideal tissue-enginee rjng material for renal repair.

Objective: To study the effect of extracellula matrix of xenogenic femoral fascia in repair of renal trauma. Methods: Twelve adult dogs were used and randomly assigned to 6 groups, and the animals were sacrificed separately in 1 and 2 weeks 1,2,4 and 8 months after renal repair operations. The examinations of blood and urine routine, blood urea nitrogen and creatinine, electrolyte and serum renin were performed before and after operations at various times. The creatinine clearances of affected and contralateral normal kidneys were evaluated before death and the local areas of renal repair were studied by light and electron microscopy. Results: Bleeding was stopped completely after the entire patch was sutured, and only mild adhesions to around tissues were found in various times after operations. As time passed, the repair patch was replaced by smooth neocapsule like normal renal capsule. Conclusion: Extracellula matrix of xenogenic femoral fascia might be an ideal tissue-engineering material for renal repair.

Objective To investigate cortactin expression in malignant colorectal tissues and corresponding adjacent non-cancerous colon tissues,precancerous lesions (adenomatous polyps) and the relationship between the expression of cortactin and cell division in colorectal cancer cells.Methods The expression of cortactin was detected by immunohistochemistry in colorectal cancer,colorectal adenomatous polyp (precancerous lesions) and colorectal tissues adjacent to adenocarcinomas (normal tissues).Kaplan-Meier method was employed to compare the survival between the groups.Cortactin expression and cell division were detected by Western blot and immunofluorescence in SW-620 colon cancer cells treated with cortactin siRNA.Results The positive expression rate of cortactin was significantly higher in colorectal cancer tissues than in adenomatous polyp tissues and pericarcinomatous normal tissues.Overexpression of cortactin in colorectal cancer tissues was correlated with poor differentiation (P ＜ 0.01),lymph node metastasis (P =0.006),and TNM stage (P =0.022).The 5 year survival rate of the group of negative/weak positive expression of eortactin was significantly higher than the group of strong positive expression of cortactin.CTTN gene amplification in colorectal cancer tissues was obvious.Cortactin siRNA induction caused a lower cortactin protein expression in colorectal cancer cells.Conclusions It is suggested that the excessive expression of cortactin contributes to the growth of cancer cells in colorectal cancer.

Objective To present our experience of dealing with complete penile amputation.Methods Two cases of penile complete amputation were reported.The first case was a 34-year-old man,suffered amputation of the penis approximately 2.5 cm distal from the pubic area with a sharp knife.3.5hours later,the patient was transferred to our hospital.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavernosum to the corresponding proximal segment.One dorssl artery,two dorsal veins,and dorsal nerve were anastomosed under a 10 × microscope with interrupted 9-0 nylon nonabsorbable sutures.The second case was a 25-year-old man,presented to the emergency room 15 hours after distal penile amputation,which had 2 wounds as a result of self-mutilation caused by psychiatric problems.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavemosum to the corresponding proximal segment using 4-0 polyglactic acid sutures.Results In the first case,the tourniquet was released after replantation,and the distal penis appeared to revascularize,as noted by the gradual increase in redness and size.An arterial pulse was detected,and the superficial penile veins displayed normal turgor,and no bleeding was found.On postoperative day 3,the penile skin started to necrotize.On day 12,the necrotic skin was superficially debrided,and a fistula was observed in the corresponding urethral segment.Two weeks later,the fistula was sutured with 4-0 interrupted synthetic absorbable suture,and a transposition flap to embed the whole injured penis shaft was created from the proximal scrotal skin.The glans was exposed.Two months after the second operation,the embedded penis was released from the scrotum.After follow-up of two years,the patient had glans re-epithelialization with normal voiding,sensation,and erections.In the second case,the glans was still pink,but the penile skin started to necrotize on postoperative day 3.On day 14,serious infections were noted,the necrotic skin was superficially debrided,and the amputated penis was relieved.Conclusions Prompt diagnosis and early treatment are essential to avoid the potential complications of ischemic necrosis and autoamputation.Venous outflow is a critical factor for success of replantation.Microsurgical reanastomosing of the dorsal penile vein,penile arteries,and dorsal nerves can be identified as the standard method for penile replantation.The bipedicled scrotal flap can provide adequate skin cover for penis defects.

Objective To evaluate the clinical results of minimally invasive plate osteosynthesis (MIPO) in treatment of complex fractures of the distal femur. Methads From July 2005 to December 2006, 41 patients with complex distal femur fractures induced by high energy trauma were treated with MIPO plus locking compression plate(LCP). There were 31 males and 10 females, at average age of 38 years(17-65 years). According to the AO/OTA fracture classification system, there were 11 patients with type A3 fractures, 22 with type C2 and 8 with type C3. There were 16 patients with open fractures. The clinical result was evaluated by using function examination and radiographic assessment. Results All patients were followed up for average 8 months(2-18 months), which showed fracture healing, with mean healing time of 13 weeks(7. 16 weeks). There was only 1 patient with superficial infection but no fixation failure or implant breakage were found. The average knee range of motion was 110°(45°-135°). Hospital for special surgery knee rating scale(HSS) showed excellent or good results in 36 patients (88%). No patient with greater than 5°difference in either varus or valgus was detected when compared 2 days after operation with latest follow-up. Conclusion In treatment of complex distal femur frac-tures, MIPO plus LCP have advantages of minor trauma, stable fLxation, slight interference on soft tis-sues, early fracture healing and few complications.

Objective To quantitatively analyze the fund theses published in the Journal of Practical Radiology(JPR)and Chinese Journal of Radiology(CJR)in order to detect effective approaches to the improvement of the journal quality and academic level of the JPR.Methods The number of funds-supported theses published,the ratio of fund theses,grade,regional,source of institutions and publication time-lag distribution of the fund theses were statistically analyzed by using bibliometrics in the two journals in 2013.Re-sults Six hundred and eighteen theses were published in JPR in 2013,the total number of fund theses were 137(accounted for 22.2% of total articles),the ratio of fund theses were 0.22,the provincial and municipal fund theses accounted for 59.2%.All fund theses were from 23 regions and 82 institutions throughout the country.The average of publication time-lag was 235.6 days.Three hundred and thirteen theses were published in CJR in 2013,the total number of fund theses were 97(accounted for 31.0% of total articles),the ratio of fund theses were 0.31,the provincial and municipal fund theses accounted for 32.0%.All fund theses were from 18 regions and 70 institutions throughout the country.The average of publication time-lag was 228.4 days.Conclusion JPR has its own superi-ority,meanwhile,it also has a significant disparity and insufficiency comparing to CJR.In order to further promote the quality conno-tations and the academic level of JPR,efforts should be made on subject selection and planning,initiative collection of manuscripts, priority publishment to excellent manuscripts,shortening publication time-lag,etc.Additionally,a database of core authors and ex-perts should be established.