Thyroid nodules are very common.Its etiological factors include hyperplasia,adenomas,cancer,cysts,and thyroiditis.Most of thyroid nodules are benign.The management of thyroid nodules whether thyroidectomy or observation is according to their nature.So,the key of the therapy is to identify that they are benign or malignant.We should comprehensive evaluate patients' history,physical examination,laboratory examination,and auxiliary examination for judging the nature of thyroid nodules and making decision in the choose of thyroidectomy or observation.

Objective To study the diagnosis and treatment of the inappropriate antidiuretic hormone secretion(SIADH) syndrome after cerebral injury. Methods A retrospective analysis was conducted on 12 patients suffered from SIADH after cerebral injury. The clinical features were similar to common hyponatremia, no specific manifestation. Most of the hyponatremia were detected by routine examination. The first of all,sodium losing in these patients with hyponatremia was routine supplied according the amont of true salt losing.If natremia was not raised or still more descended 2～3 days after treatment, and amount of supplying salt was correspond to that of natriuresis, SIADH should be considered,using restricting water therapy,substituted for salt supplement.furosemide plus albumin were the first choice for dehydration therapy. Results 24～48h after restricting water and natrium, 12 patient's natremia level was back up in different degree. Except for 2 death whose natremia was not corrected completely, 8 patient's natremia was corrected completely in 1 week, 1 patient's in 14 days, and 1 in 3 months after injury. Conclusions Diagnosis of SIADH is very difficult before treatment, but effective treatment can be obtained if we adopt correcting strategy. In these patients, the diagnosis of SIADH was confirmed with the course of treatment,we call it as therapeutic diagnosis.

Objective To provide an anatomic data of the lumbar isthmus, and to increase the fusion rate of the graft bone for spondylolisthesis treated with posterolateral spinal fusion and Steffee plate fixation. Methods The area and volume of the bone graft bed for posterolateral spinal fusion in the lumbar isthmus were studied on 30 dried specimens of adult lumbar spines from L 1 to L 5(a total of 150 lumbar vertebrae) with a vernier calipers, a goniometer and a graduate. Results The length of the superior edge of the isthmus gradually increased from L 1[(7.34? 1.15) mm] to L 5[(10.31? 1.89) mm], and that of its inferior edge progressively decreased from L 1[(6.63? 1.24) mm] to L 5 [( 4.73? 1.21) mm]. The superior edge of the isthmus was the thinnest at L 1[(1.85? 0.64)mm], and the thickness increased inferiorly from L 1[(6.57? 1.24) mm] to L 5[(7.57? 1.16) mm]. The medial and caudal inclination of the isthmus with respect to the pedicle gradually increased from L 1 (113.9?? 13.3? ) to L 5(119.1?? 13.5? ) medial inclination and from (101.2?? 9.5? ) at L 1 to (117.6?? 13.4? ) at L 5 caudal inclination, respectively. The length of the superior edge of the isthmus and the transverse diameter of the pedicle were positively correlated to the vertebral levels. The length of the inferior edge of the isthmus were negatively correlated to the vertebral levels. The dimensions of the graft bed area were postively correlated to dimensions of the graft bone volume. Conclusion The application of firm spinal internal fixation system with adequate graft bed area and adequate graft volume, the maintenance of close contact between the graft bed and the graft bone, and adequate period of postoperative stable contact of the graft in bed were the keys to enable reduction of the spondylolisthesis and to increase the fusion rate of posterolateral bone graft.

Objective: To observe the effect of static magnetic fields(SMF) on the proliferation of bone mesenchymal stem cells(MSC) in human. Methods: The MSC were obtained by using gradient centrifuge method, and then selected by the adhesive method. The third generation cells were irradiated by use of static magnetic fields at different intensities for 5 days(8 h/d). The method of MTT was employed to evaluate the level of proliferation. The parameters regarding the variation of the cell cycle were detected with the flow cytometry(FCM). Results: As compared to the control group, the proliferative rate of the MSC exposed to 0.05 mT SMF was significantly higher; there was no difference between the 0.10 mT group and control group; howere, cell proliferation was attenuated significantly when SMF intensity was 0.50 mT and 1.00 mT. No abnormal ploidy was found in any group. Conclusion: The effect of SMF on the proliferation of MSC is dependent on the magnetic intensity. 0.05 mT SMF can accerate the proliferation of MSC. 0.10 mT SMF have no effects on the growth of MSC. Wherease, 0.50 mT and 1.00 mT SMF can attenuate the growth of MSC.

Objective To construct a EGFP-labled recombinant plasmid of VEGF165 (vascular endothelial growth factor) gene, and to study the transfection and expression of VEGF165 eukaryotic expression plasmid in mesenchymal stem cells (MSCs). Methods pIRES2-EGFP-VEGF165 recombinant plasmid was constructed, which was then transfected into rat MSCs. ELISA and MTT were used to detect the expression level and biological activity of VEGF in the conditioned medium after transfection. Results There was a significant increase in VEGF protein in the MSCs after being transfected with pIRES2-EGFP-VEGF165. The conditioned medium after transfection showed the biological activity of stimulating the proliferation of endothelial cells. Conclusions The pIRES2-EGFP-VEGF165, a eukaryotic expression plasmid for VEGF165 gene, is constructed. High levels of VEGF protein expression can be obtained in the MSCs transfected with pIRES2-EGFP-VEGF165. The expressed protein has the biological activity of VEGF.

Objective To evaluate the possibility and efficiency of nanoparticles as a new vector in vascular endothelial growth factor (VEGF) gene transfection. Methods Nanoparticle-VEGF (Np/VEGF)complex was prepared with poly (D, L-lactide-co-glycolide) (PLGA) loading VEGF165 gene using the multiple emulsion (w/o/w) technique. The envelopment efficiency and size of the complex were determined. Rat myocardial cells were cultured in vitro, and the Np/VEGF was transfected into the cultured myocardial cells. Then RT-PCR and ELISA were used to evaluate whether the Np/VEGF increased the level of gene expression. Four New Zealand rabbits were used, the suspension of Np/VEGF was injected into myocardial tissue of rabbits after thoracotomy. 96h after the operation, the tissue sections of the implant sites were observed with transmission electron microscope (TEM) to determine the process of nanoparticles as vectors for gene transfer to cardiac myocytes. Results The envelopment efficiency and size of the Np/VEGF complex thus prepared were 1.87% and 25-300nm respectively. RT-PCR and ELISA showed that VEGF gene could be successfully transfected into myocardial cells by nanoparticle, and NP/VEGF significantly enhanced gene transfection efficiency, and it was more effective than plasmid. 96h after the operation, a great number of nanoparticles were observed in myocardial cytoplasm and nucleus with TEM, and many nanoparticles began to dissolve and degrade, suggesting that the DNA was released slowly from the nanoparticles localized in the cytoplasmic compartment, and was then transferred into the nucleus. Conclusions NP/VEGF can act as a vector to transfect VEGF gene in vitro and in vivo, it significantly enhanced gene transfection efficiency, and it was more effective than plasmid.

BACKGROUND: Minimally invasive percutaneous pedicle screw fixation possesses the advantages of less blood loss, less muscle and soft tissue dissection, and rapid recovery; however, accuracy of the screw positioning is the key to be successful.OBJECTIVE: To explore the application value of self-designed spinal localizer in the screw positioning for minimally invasive percutaneous pedicle screw fixation.METHODS: 428 patients with thoracolumber disorders were subjected to minimally invasive percutaneous pedicle screw fixation at the First Affiliated Hospital of University of South China, from March 2009 to March 2015, and randomly underwent the preoperative screw positioning by self-designed spinal localizer or one of traditional localizing methods (iliac crest, ribs, symptomatic vertebral appearance, skin marker, Kirscher wire, puncture needle localizations). The location accuracy, positioning time and radiographic times were compared among methods.RESULTS AND CONCLUSION: (1) Compared with the traditional localization methods, the self-designed spinal localizer was superior in accurate rate (P < 0.05), cost less positioning time (P < 0.05) and received less radiation (P < 0.05). (2) To conclude, the self-designed localizer exhibits a certain application value, which is an ideal method in preoperative localization for minimally invasive percutaneous pedicle screw fixation.

The article mainly presents the key problems in class III bio-safety lab,including air-flow distribution,pressure gradient of the room,and the stability of pressure.Scientific methods for solving all the problems are also considered,which offer the theory evidence for the design of negative pressure control system in class III bio-safety lab.Volatile blow control and heat exchanger are recommended to be used in the negative pressure control system in class III bio-safety lab for energy conservation.

ObjectiveTo compare the clinical characteristic and postoperative histopathological parameters in different prostate size and to assess the effect of prostate volume on histopathological outcomes in patients after laparoscopic radical prostatectomy. MethodsTwo hundred and sixteen patients from 2006 to 2011 who were proved prostatic carcinoma by biopsy and performed laparoscopic radical prostatectomy wewe retrospectively evaluated.All patients were divided into the small group ( ＜ 30 ml,103 cases),intermediate group(30 -60 ml,71 cases) and large group ( ＞60 ml,42 cases) according to prostate volume.Clinical variables included age,body mass index (BMI),preoperative PSA level,prostate volume,percentage of positive needles,clinical stage,and biopsy Gleason score (GS).Histopathological parameters included pathological GS,upgrading or not compared to biopsy GS,pathological stage and surgical margins status.Preoperative clinical variables and postoperative histopatholgogical parameters were compared among the 3 prostate groups. ResultsPatients with smaller prostates had lower PSA levels than those with intermediate and larger prostates (P =0.000).They also had worse histopathological outcomes such as pathological GS ( P =0.034 ),upgrading of GS ( P =0.037 ),and pathological stage ( P =0.025 ).35.0％ of patients in smaller prostate group had a positive surgical margin compare to 33.8％ and 19.0％ in intermediate and larger prostate groups,but there was no significant difference (P =0.152).ConclusionMen with smaller prostate may have more high-grade cancer and more advanced disease after laparoscopic radical prostatectomy.

Objective To determine relative risk factors for positive surgical margins in extraperitoneal laparoscopic radical prostatectomy(LRP). Methods From February 2004 to September 2007,33 patients(mean age 70 years old)with prostate cancers underwent extraperitoneal LRP.All patients were diagnosed by pathology preoperatively.Gleason score:3+3 14 cases(43%),3+4 11 cases(33%),4+3 6 cases(18%),4+4 2 cases(6%).Clinical stage:T1a-T1b 4 cases(12%),T1c 14 cases(43%),T2a-T2b 5 cases(15%),T2c10 cases(30%).Logistic regression analyses were performed. Results LRP was successfully performed on 31 cases.There were 2 cases converted to open surgery.Nine cases(27%)had PSMs.There were 6 cases(67%)and 4 cases(17%)of clinical stage T2c in PSM and negative surgical margin(NSM)groups respectively(P=0.010).There were 3 cases(33%)and 0(0)with high Gleason score(higher than 7)in PSM and NSM cases(P=0.015).There were 4 cases(44%)and 5 cases(21%)with t-PSA higher than 20dg/ml in PSM and NSM cases respectively(P=0.178).In these 9 cases,there were 4 cases(44%)positive with DRE.However there were 9 in the 24 NSM cases(38%)(P=0.509).Clinical stage T2c was independently positively correlated with PSM(OR=24.69).High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml were positively correlated with PSM. Conclusions Clinical stage is positively correlated with PSM.It is an independent factor.High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml mignt be the risk factors in predicting PSM and should be used together with clinical stage.Positive DRE findings may be also useful to predict PSM.