Objective To investigate the biological characteristics of papillary thyroid carcinoma(PTC) and to discuss its surgical method.Methods 221 patients of PTC underwent total thyroidectomy and conventional central lymph node dissection from Jul.2009 to Feb.2011 in Department of Thyroid Surgery in the First Hospital of Jilin University.Their clinical data were retrospectively analyzed.Results There was no permanent iatrogenic injury of recurrent laryngeal nerve.Only one patient had permanent hypoparathyroidism.Postoperative pathological results showed that bilateral cancer was found in 69 cases(31.2％).Thyroid membrane invasion was found in 143 cases(64.7％),in which the invasion rate of bilateral cancer was 68.1％ (47/69).Central cervical lymph node metastasis was found in 95 cases(43％),in which central cervical lymph node metastasis rate of bilateral cancer was 46.4％ (32/69),central cervical lymph node metastasis rate of unilateral cancer was 41.5 ％ (63/152),central cervical lymph node metastasis rate of thyroid membrane invasion was 49.7％ (71/143).Thyroid membrane invasion or cervical lymph node metastasis rate in all cases was 75.6％ (167/221).There were 42 cases who were found with suspicious unilateral cancer before surgery but proved to have bilateral PTC by postoperative pathological diagnosis(60.9％).Conclusions Most PTC often occurs bilaterally and the ratio of central cervical lymph node metastasis is very high.We suggest that most patients with PTC should undergo total thyroidectomy,conventional central lymph node dissection,and combine with postoperative Ⅰ131 and hormonal treatment.

Objective To investigate the gamma glutamine carboxylase (GGCX ,rs6738645) genotype distribution in Chinese Han population and the correlation between GGCX (rs6738645) polymorphism and the warfarin stable dose in the patient after valve replacement .Methods The genotypes of 228 cases were detected by the Snapshot technology in order to explore the genotype and allele frequencies .The correlation between the gene polymorphism in 176 cases after valve replacement and the stable dose of warfa-rin was compared .Results In total of 228 research subjects ,the number of TT ,GT and GG genotype were 84(36 .84% ) ,122 (53 .51% ) and 22(9 .65% ) .The frequencies of T and G allele were 63 .60% and 36 .40% respectively ;in 176 patients after the valve replacement ,the maintenance stable dose of warfarin was lower in GG group than in the TT and GT groups ,the differences between the groups showed statistical significance (P<0 .01) .The PT value and INR value had no statistical difference among 3 genotype groups(P>0 .05) .Conclusion The GGCX(rs6738645) polymorphism in Chinese Han population may be the influencing factor of warfarin individual dose difference in the patients after valve replacement .

Objective To investigate the recent curative effect and adverse reactions of radiotherapy combined with temozolomide in non-small cell lung cancer (NSCLC) patients with brain metastases.MethodsThe clinical date of 51 NSCLC patients with brain metastases were retrospective analyzed in Department of Radiation Oncology of Affiliated Hospital of Hebei University.Patients were divided into experimental group (n=26) and control group (n=25) according to the different treatment methods.The experimental group underwent whole brain and local tumor radiotherapy plus temozolomide.The control group only received whole brain and local tumor radiotherapy.The recent curative effect and adverse reactions of the two groups were analyzed.Results The Karnofsky performance status score of patients in the experimental group was obviously improved than that in the control group (76.2±6.4 vs.72.8±5.3), with a significant difference (t=2.06, P=0.04).The total effective rate in the experimental group was higher than that in the control group (80.8% vs.64.0%), but there was no statistically significant difference (χ2=1.80, P=0.18).Compared with the control group, the incidences of nausea and vomiting (80.8% vs.28.0%) and bone marrow suppression (84.6% vs.24.0%) in the experimental group were significantly higher, with significant differences (χ2=14.33, P=0.00;χ2=18.91, P=0.00).There were similar incidences of headache (69.2% vs.60.1%), liver and kidney damage (73.1% vs.64.0%) in the two groups, with no significant differences (χ2=0.47, P=0.49;χ2=0.47, P=0.49).Conclusion Radiotherapy combined with temozolomide can improve the quality of life in NSCLC patients with brain metastases, which has controllable and tolerable adverse reactions.

Objective:To explore the application of standardized treatment process for early enteral nutrition combined with gastric retention after operation in patients with esophageal cancer.Methods:Using convenience sampling, 84 patients with gastric retention complicated by early enteral nutrition support after esophagectomy in Department of Thoracic Surgery, Third People′s Hospital of Dalian from July 2015 to June 2020 were selected as the subjects. They were divided into control group and experimental group according to admission time with 42 cases in each group. The control group received routine nursing, while the experimental group received early enteral nutrition and gastric retention standardized treatment process nursing. The differences between the two groups in nutritional status and immune indexes before and 7 days after operation, the standard feeding rate within 7 days after operation, incidence of postoperative complications and enteral nutrition-related complications, length of hospitalization time and hospitalization expenses were compared.Results:In the control group, 2 cases were lost to follow-up. There was no statistically significant difference in preoperative nutritional status and immune indexes between the two groups ( P<0.05); 7 days after operation, the body mass index, serum total protein, prealbumin, nitrogen balance, IgM, CD3, CD4, and CD4/CD8 of the experimental group were all higher than those of the control group, and the differences between the two groups were statistically significant ( t values were 2.228-5.332, P<0.05 or 0.01).The standard feeding rate within 7 days was (68.93±8.12)% in the experimental group and (51.19±6.96)% in the control group, respectively, and the difference between the two groups was statistically significant ( t value was -4.38, P<0.01). The incidence of postoperative nausea and vomiting, Ⅱ B healing, anastomotic fistula and aspiration was 2.38% (1/42), 2.38% (1/42) and 0 (0/42), 2.38% (1/42) in the experimental group and 15.00%(6/40), 7.50% (3/40) and 5.00% (2/40) and 10.00% (4/40) in the control group, respectively, and the differences were statistically significant ( χ2 values were 5.99 - 9.88, P< 0.05 or 0.01). The length of hospitalization time in the experimental group was (10.18±1.69) d, and the hospitalization cost was (53 268.46 ±3 651.56) yuan, both lower than (13.66 ± 2.18) d and (64 972.39 ± 4 029.81) yuan in the control group, and the difference was statistically significant ( t values were 2.14, 2.89, P< 0.05). Conclusions:The standardized treatment process of enteral nutrition combined with gastric retention can improve the feeding rate, nutritional index and immune index within 7 days after operation, reduce postoperative complications and incidence of enteral nutrition related complications, reduce the hospitalization time and reduce hospitalization expenses.

AIM:To investigate the effect of AG 490 on the expression of VEGF and HIF-1α, and the capacity of invasion in human erythroleukemia (HEL) cells.METHODS:The HEL cells were treated with AG490 at different con-centrations .The cell viability was detected by CCK-8 assay.The apoptosis was detected by Hoechst staining .The apoptosis and the cell cycle were analyzed by flow cytometry .The capacity of migration was evaluated by Transwell assay .The mRNA expression level of JAK2 was measured by RT-PCR.The protein levels of p-JAK2, VEGF and HIF-1αwere determined by Western blot.RESULTS:The HEL cell viabilities were 88%, 75%, 48%, 10%and 0.12%after treated with AG490 at 20, 40, 60, 80 and 100 μmol/L for 48 h, respectively.The results of Hoechst staining showed that brilliant blue cells in 80 μmol/L AG490 group was significantly increased compared with control group for 48 h.The apoptosis rate of 80μmol/L AG490 group was significantly increased compared with control group at 48 h after AG490 treatment.The number of membrane-permeating HEL cells in 20μmol/L AG490 group at 24 h after AG490 treatment was significantly lower than that in control group (P<0.05).The mRNA level of JAK2 decreased in a concentration-dependent manner after the HEL cells were treated with different concentrations of AG 490 for 48 h.The protein levels of p-JAK2, VEGF and HIF-1αwere lower in AG490 treatment groups than those in control group (P<0.05).CONCLUSION: AG490 inhibits the expression of VEGF and HIF-1αin HEL cells by inhibiting JAK2 pathway.

Objective To investigate the reasonable anticoagulant therapy for patients over sixty five years old in Yunnan-Guizhou plateau after heart biological valve replacement , and study the standard of reasonable anticoagulant therapy. Methods We collected the recent cases by retrospective way . Low-intensity anticoagulation standard INR (1.5~2.5) was used on 130 patients over sixty five years old. The warfarin dose and anticoagulation INR values in different surgery operation were compared when the patients reached the stable anticoagulation status. The frequency of INR values and warfarin dosage were studied. The differences between the patients with high risk factors and the ordinary patients without the high risk factors in INR values and warfarin dosage were investigated. Results The INR values and warfarin doses showed no significant difference (P > 0.05) in different operation groups when they reached stable anticoagulation status. The INR values was 1.94 ± 0.50 and the daily warfarin dose was (2.45 ± 0.82)mg/d. No significant differences in INR values and warfarin doses were found between the high-risk group and the general group (P>0.05) in steady-state. During follow-up, both the incidence rate of thrombosis and general bleeding were 0.77%. Conclusion The precent study showed that the low-intensity anticoagulation INR values (1.5~2.5) can be the standard of reasonable anticoagulation in Yunnan-Guizhou plateau after heart biological valve replacement with satisfactory anticoagulant effect.

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Objective To evaluate the effect of single-nucleotide polymorphisms at the miRNA binding site rs3660 in the 3'-untranslated region of the KRT81 gene (miR-SNPs) on the cancer risk and clinical prognosis of non-Hodgkin's lymphomas (NHL).Methods The single-nucleo-tide polymorphisms of rs3660 was genotyped with ligation detection reaction method.The association of rs3660 with NHL survival was calculated with log-rank test using Kaplan-Meier method.Multivariate survival analysis was performed using a Cox proportional hazards model.Results The rs3660 genotype distribution difference was not statistically significant between the case and control group (P =0.50).Patients carrying the rs3660 CG/CC genotype exhibited a significantly longer survival time than patients carrying the GG genotype (P =0.012).In addition,rs3660 was associated independently with the survival of NHL patients in multivariate analysis (RR=0.589,95％ CI:0.415-0.832,P =0.004).The association of this miR-SNP with NHL survival was further confirmed in the peripheral T cell lymphoma (PTCL) subtype.Conclusion Our results indicate that KRT81 rs3660 GG type is an independent prognostic marker in NHL.

Objective To compare the different doses of low-temperature plasma (LTP) on wound healing in BALB/c mice so as to discuss the effects of the optimal dose of low-temperature plasma dealing with wound in mice and the acting mechanism of wound healing.Methods Adoptatmospheric pressure plasma jet discharged by the dielectric barrier was used to treat mouse skin wound.According to the processing time, the wounds were divided into 10s, 20s, 30s, 40s and 50s experimental groups, while naturally healing wounds served as negative controls and the wounds dealt with recombinant human epidermal growth factor served as positive controls.We recorded the wound size every day, observed the histopathological changes, the expression level of type Ⅰ collagen by immunofluorescence, and analyzed the composition of low-temperature plasma jet.Results The wounds with plasma treatment time of 10s, 20s, 30s, and 40s showed significant daily improvement and almost complete closure at days 12, 10, 7, 13, respectively.However, the wounds with plasma treatment time of 50s remained unhealed atday 14.The wounds in positive control group all healed, and the wound healing effect in positive control group could be achieved in 30s group.HE staining and immunofluorescence staining assays showed the optimal result of epidermal cell regeneration, granulation tissue hyperplasia, and collagen deposition in histological aspect at day 7 in 30 s group.The low-temperature plasma jet contained highly reactive free radicals of nitrogen and oxygen, which play an important role in wound healing process.Conclusion Appropriate doses of cold plasma can accelerate wound healing whereas over-doses of plasma can suppress wound healing.The process of wound healing may be related to reactive oxygen and nitrogen species in LTP.

Objective To observe the prevalence of hyperuricemia(HUA)among obese children,and to ex-plore the association between uric acid(UA)levels and cardiometabolic risk factors,acanthosis nigricans and non - al-cohol fatty liver disease(NAFLD). Methods By using representative sampling method,1 753 obese children aged 6 -17 years old from 18 schools in 3 districts of Beijing(Xicheng,Haidian,Miyun)were selected to participate in the clini-cal examinations,including anthropometric measurements(height,weight)and blood pressure. Serum biochemical pa-rameters were assessed,including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high - densi-ty lipoprotein cholesterol(HDL - C),low - density lipoprotein cholesterol(LDL - C)and UA. Acanthosis nigricans and B - model ultrasonography of the liver were conducted. Results The prevalence of hypertension,impaired fasting glu-cose,dyslipidemia,acanthosis nigricans,and NAFLD among these 1 753 obese children was 33. 6%(589 cases), 66. 5%(1 156 cases),54. 3%(943 cases),23. 3%(408 cases),and 17. 0%(298 cases),respectively. The preva-lence of HUA was 40. 70%(714 / 1 753 cases),with 50. 17%(581 / 1 158 cases)in boys and 22. 34%(133 / 595 ca-ses)in girls. There was a significant increase in body mass index,systolic blood pressure,diastolic blood pressure, FPG,TG and LDL - C with the increase of UA,but there was a decrease in HLD - C with the increase of UA(all P ﹤0. 05). In boys,the adjusted odds ratios( OR)and 95% CI of the highest quartile of UA for hypertension,impaired fasting glucose,dyslipidemia,acanthosis nigricans,and NAFLD were 1. 16(0. 77 - 1. 74),1. 34(0. 90 - 1. 99),1. 29 (0. 89 - 1. 87),1. 89(1. 17 - 3. 04),and 1. 71(1. 03 - 2. 84),respectively;in girls,the adjusted OR and 95% CI of the highest quartile of UA for hypertension,impaired fas-ting glucose,dyslipidemia,acanthosis nigricans,and NAFLD was 0. 70(0. 40 - 1. 24),0. 60(0. 40 - 1. 00),1. 69(1. 04 - 2. 70),1. 67(0. 80 - 3. 49),and 1. 33(0. 48 - 3. 66),re-spectively. Conclusions The prevalence of HUA is relatively high in obese children and there is a strong association between UA and some car-diovascular metabolic disorders,acanthosis nigricans and NAFLD.