ObjectiveTo investigate the cause of clinically missed diagnosis of thyroid microcarcinoma(TMC) and the management. Methods Clinical diagnostic and therapeutic data of 110 cases with TMC operated and confirmed by pathology from Jan. 1985 to Dec. 2000 were analysed. Results Diagnostic positive rates by ultrasonography and freezing section were respectively 58%(15/26) and 66 7%(14/21) in 26 cases diagnosed preoperatively. Diagnostic positive rate of freezing section was 80%(24/30) in 30 cases discovered intraoperatively. Through postoperative pathologic exam,54 cases were confirmed as TMC that was not discovered in 19 cases by intraoperative freezing section.Total or near total thyroidectomy was only performed on 35 cases,lobectomy of one or both lobes on other cases. Follow up rate was 80 1% with time ranging from 6 months to 15 years. One case recurred without mortality.Conclusion The clinical diagnosis of TMC is often difficult to establish. Careful palpation, ultrasonography with fine needle aspiratiou cytology before operation, and thorough exploration of the suspected nodules in operation will help to heighten the diagnostic rate. Total or near total lobectomy fulfils the eradication of TMC.

From October 1978 through 1983, 225 rectal cancer patients were randomized into R+S group (115 patients) and S only group (110 patients). The radiation dose of pre-operative radiotherapy was 30～45Gy/3～4.5 wks. Radical or palliative resection was done after a rest of 2～4 weeks. The lymphatic metastasis and local recurrence rates of the R+S group (20.6% and 27.8%) were lower than those of the S only group(32.7% and 41.8%)(P

Objective To discuss the value of percutaneous compression plate (PCCP) in treating intertrochanteric fractures. Methods A retrospective study was done on 57 patients with intertrochanteric fractures treated by PCCP from January 2008 to January 2009 to evaluate the operative effect.Results All the fractures were healed in 11-15 weeks after the operation, with no incision infection, hematoma, internal fixation failure or fracture collapse. Two surgical incisions were for 2 cm, with no blood transfusion found in any patient. According to Harris score, the postoperative excellent rate reached 92.6%. Conclusion PCCP can attain similar effect wiht DHS and now is the choice of treatment in treating intertrochanteric fracture in the elderly patients.

Objective To compare the early result of endovascular repair and conventional open repair for abdominal aortic aneurysm. Methods We analyzed the clinical data of 34 patients with infrarenal AAA. Among them, 15 patients were treated with endovascular repair ( EVR group), 19 with conventional open repair ( COR group). Pre-operative status, intra-operative variables, post-operative outcomes and laboratory findings of the two groups were compared. Results Blood loss and blood transfusion in EVR group were significantly less than COR group (P =0.005, P =0.015). The median fasting period and post-operative hospital stay were shorter in EVR group (P

Hearts from eight adult dogs were perfused through both coronary arteries with methylmethacrylate. Small specimens cut out from the left ventricular wall were eroded in 50% HCL for 5-7 days. The replicas were studied under the SEM (S-450). The main results were outlined as follows: The subendocardial capillary plexus composed of varied shapes and orientation of meshes was present. The capillary network of the myocardial layers was consisted of many parallel capillaries and between them a variety of models of anastomoses, such as "H" "K" and "8" modes etc, were observed. In our findings, it was demonstrated that the arteriole and venule were distributed between the myocardial bundles and their direction was often perpendicular to the myocardial bundles. The postcapillary venules were poured into venule by the "ginger or turnip root" arrangement. The replicas of the Thebesian veins were proved in our specimens. The A-V shunting was not observed.

Objective To optimize the matrix formula of propranolol hydrochloride gels. Methods On the basis of single factor experiment, central composite design-response surface method was used to optimize the formula. Addition levels of glycerol (A), PEG-400 (B) and HPMC (C) were evaluated as the independent variables.Eight-hour accumulative penetration amount per unit area measured by HPLC was used as the index. Quadratic polynomial was used to estimate the relationship between the index and the independent variables, and to delineate response surface and overlay contour plots in order to select the optimal formulations.Finally, predicted responses were verified. Results The optimized formula consisted of 18.53% glycerol, 8.54% PEG-400 and 2.35% HPMC.The quadratic polynomial regression model of 8-h accumulative penetration amount per unit area:R1=-7 415. 69+306. 10A+167. 47B+4 820. 59C-8. 26A2-9. 81B2-1 025. 75C2 , and the cumulative transmittance was 49.6%. Conclusion A credible model is established by using central composite design-response surface method and the formula of propranolol hydrochloride gels is optimized and the gel is stable and controllable.

The vascular architecture of the adult man testis was examined by using thevascular casting method combined with scanning electron microscopy.The circuitousmain branches of testicular artery ran radially from testicular porta towards testicu-lar free border in tunica vasculosa.The test(?)cular surface veins were accompaniedby the main branches of testicular artery and they converged from testicular circum-ference circuitously towards testicular porta.There were centripetal artery andvein as well as centrifugal artery and vein in the septula testis.The intertubularblood vessels and the peritubular capillary plexus were contained in the testicularlobules.The latter was made up of two capillary layers.The outer layer was capil-lary network interwined in fine capillaries.The inner layer was coarse capillarycircles.The interstitial capillary plexus was situated in interstitial tissue between theseminiferous tubules and compose of capillaries arising from the origin of someperitubular capillaries.

Objective To explore the compare of complete and incomplete radical debridement for thoracolumbar spinal tuberculosis.Methods Data of 296 patients with spinal tuberculosis from January 2000 to January 2011 were retrospectively analyzed.All patients were divided into two groups according to completeness of debridement:complete debridement group (group A) and incomplete debridement group (group B).There were 162 cases in group A including 86 males and 76 females,with an average age of 38.74± 17.26 years.There were 134 cases in group B including 73 males and 61 females,with an average age of 35.64± 18.21 years.All paticnts had undergone anterior debridement,focal graft implantation,anterior or posterior deformity correction,and internal fixation.Regular follow-up was required in the two groups.Results Residual sclerotic walls (36.54％),multipie cavities (34.62％),affected bony bridges (13.46％),sequestmm (3.37％),abscess (7.21％) and other lesionses (4.81％) were found in the group B.The first three factors were made up 84.62％ of the total.The mean follow-up time was 76.13±8.32 months in the group A and 79.24±5.49 months in the group B.The symptoms,C-reactive protein and erythrocyte sedimentation rate were improved more obviously in group A than those in group B.Six months after operation,tuberculosis healing rate in group A and group B was 29.01％ (47 patients) and 4.48％ (6 patients),respectively.The mean healing time was 4.36± 1.27 months in the group A and 9.15±2.53 months in the group B,with significant differences.The mean the time of chemotherapy was 5.21± 1.38 months in the group A and (10.45±2.15) months in the group B,with significant differences.Reoperation rate in group A and group B was 0.62％ (1/162) and 4.48％ (6/134),respectively.Conclusion Sclerotic bone,multiple cavities,and bony bridges are parts of foci in spinal tuberculosis.Clearing tuberculous foci with sclerotic bone,multiple cavities,and bony bridges can increase the curative effect,shorten the time of chemotherapy and reduce the side effects of drug,thus early resumption can be achieved.

Objective To investigate the expression characteristics of epidermal growth factor-like domain 7 ( egfl 7 ) in arteriosclerosis obliterans ( ASO) tissues and abdominal aortic aneurysm ( AAA ) tissues, and it's role in atherosclerosis (AS).Methods In this study, 8 normal artery, 11 lower extremity ASO and 34 AAA samples were collected.Immunohistochemistry and in situ hybridization were performed in artery sections to investigate the expression characteristics of egfl 7 at protein and mRNA levels.The relative quantitative detection of egfl 7 mRNA was detected by qRT-PCR.The effect of egfl 7 was examined by RNA interference.Results In ASO and AAA samples, the expression of egfl 7 protein was mainly in the tunica media; The expression site of egfl 7 mRNA was the same as that of egfl 7 protein.Compared with normal artery samples, the expression of egfl 7 mRNA was significantly upregulated in the early stage of ASO samples and AAA samples (325 ± 120 vs.100 ± 36, P ＜ 0.01, 216 ± 133 vs.100 ± 36, P ＜ 0.05 ).Compared with the control group, the proliferative ability of smooth muscle cells was significantly down regulated after egfl 7 interference (0.85 ± 0.05 vs.1.34 ± 0.04, P ＜ 0.01).Conclusions egfl 7 might be a gene that regulates the pathogenic process of atherosclerosis through promoting vascular smooth muscle cell proliferation.