Objective To discuss the feasibility of endoscopic thyroidectomy via breast approach for papillary thyroid carcinoma.Methods From April 2009 to December 2013,clinical data of 90 papillary thyroid carcinoma cases undergoing endoscopic thyroidectomy was analyzed retrospectively.Results There was no conversion to open surgery,the mean operation time was 97 min,the mean intraoperative blood loss was 10 ml,the mean postoperative drainage volume was 65 ml,the mean hospital stay was 4.5 d,the mean lymph node number dissection of central compartment was 5.3.No obviously chest pain and numbness occurred.No skin flap ecchymosis,necrosis,effusion,and hematoma occurred.No hypocalcemia convulsions occurred.Transient hoarseness occurred in 3 cases which recovered within 1 to 2 months.Follow-up time ranged from 1 to 5 years,the median follow-up time was 41 months,with no tumor recurrence and lymph node enlargement.All patients were satisfied with the cosmetic results.Conclusions Endoscopic thyroidectomy via breast approach is a safe and feasible procedure in treating papillary thyroid carcinoma (cN0).

A lot of single species of bacteria was seperated from the pathological changes position of the liver in sick (or dead) soft-shelled turtle which was infected by septicae-uia. By identifying and the characteristic of physics and chemistry the six single culture strains of bacteria, preliminary showed that it was A. caviae in Aeromonas. Through examination ablut causing illness, it was proved that the A. caviae seperated and appraised was pathogenic bacteria of this infection septcaemia of soft-shelled turtle.

Lung cancer is one of the commonest of malignant tumor in the world.It is a major threat to human health in China with highest morbidity and mortality.Steady increase in incidence rates have been observed worldwide in the last few decades in young patients,but previous studies have provided conflicting data about the clinical characteristics and prognoses of young patients with lung cancer.Consequently,we have difficulty in comparing their results with each other,as the cutoff ages defining"young"were different in each study.Therefore,this article focuses on the clinical characteristics and the different results of researches for the young patients with primary lung cancer.

The Tongmai Yangxin pill (TMYX) has potential clinical effects on no-reflow (NR); however, the effective substances and mechanisms by which this occurs remain unclear. This study evaluates the cardioprotective effects and molecular mechanisms of TMYX against NR. We used a myocardial NR rat model (2 h after myocardial ischemia and 2 h after reperfusion) to confirm the effect and mechanism of action of TMYX in alleviating NR. In vitro studies in isolated coronary microvasculature of NR rats and in silico network pharmacology analyses were performed to reveal the underlying mechanisms of TMYX and determine the main components, targets, and pathways of TMYX, respectively. The experiment was approved by the Ethics Committee of Hunan University of Chinese Medicine (LLBH-202212160001). TMYX showed therapeutic effects on NR by improving cardiac structure and function, reducing NR, ischemic areas, and cardiomyocyte injury, and decreasing the content of cardiac troponin I (cTnI). Moreover, the mechanism of TMYX predicted by network pharmacology is related to the hypoxia inducible factor-1 (HIF-1), nuclear factor kappa-B (NF-κB), and tumor necrosis factor (TNF) signaling pathways. TMYX increased the expression of G protein-coupled estrogen receptor (GPER), phospho-extracellular signal-regulated kinase (p-ERK), and HIF-1α. In vitro, TMYX enhanced the diastolic function of coronary microvascular cells; however, this effect was inhibited by GPER inhibitor (G-15), eNOS inhibitor (L-NAME), and sGC inhibitor (ODQ). This study integrates pharmacology and experimental evaluation to reveal that TMYX activates HIF-1α/eNOS signaling pathway by upregulating GPER to relax coronary microvessels, thereby significantly alleviating NR.

Carcinosarcoma ; metabolism ; pathology ; radiotherapy ; surgery ; Follow-Up Studies ; Humans ; Keratins ; metabolism ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Parotid Gland ; pathology ; surgery ; Parotid Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Radiotherapy, Adjuvant ; Vimentin ; metabolism

Objective To investigate the effect of trastuzumab for injection on apoptosis and the expression of related genes in locally advanced breast cancer and related indexes.Methods 166 patients with locally advanced breast cancer were selected and divided into two groups, 83 cases in the control group treated with neoadjuvant chemotherapy before operation, 83 cases in the experimental group received trastuzumab for injection on the basis of the control group, serum tumor marker levels, tumor cell apoptosis index and proliferation activity, Bcl-2, Bax gene expression levels, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group(78.32%)was lower than the experimental group(90.36%), with significant difference (P<0.05).Compared with the control group, serum levels of CA153,CA125,CEA,TSGF were lower in the experimental group after chemotherapy, levels of apoptosis index(AI) in tumor tissue was higher, levels of S-phase fraction (SPF), proliferation index ( PI) were lower after treatment, Bcl-2 gene in tumor tissue expression level was lower, Bax gene expression level was higher after treatment, all with significant difference (P<0.05).There was no significant difference in the incidence of adverse reactions between two groups. Conclusion The trastuzumab for injection treatment can significantly improve the total remission rate of patients with locally advanced breast cancer , reduce the levels of serum tumor markers, can down-regulate the expression of apoptosis related gene Bcl-2, up-regulate the expression of Bax gene, promote the apoptosis of tumor cells.

Objective To probe into the feasibility of establishing a uniform reimbursement plan for hospitalization expenses under NRCMS in Nanjing city. Methods Hospitalization expenses in 2005 for peasants under NRCMS from the sour suburb districts and county in Nanjing were sampled. Based on this study, a reimbursement ratio was designed for such peasants as classified by "grades, sections and accumulated reimbursement". Results A uniform NVRMS reimbursement plan for hospitalization expenses may not be practical for all peasants in Nanjing. Yet such a plan of relative uniformity is worthy of experimenting as follows: no minimum for reimbursement;within the same expense range, reimbursement ratio may be measured and fixed accordingly among districts and county in the city, ranging 20%-70%;a uniform ceiling and reimbursement range are recommended. Conclusions A uniform city-wide plan requires by-step and planned implementations. With support from government finance, fund-raising gaps among these areas can be narrowed gradually, cutting back differences in their reimbursement plans in the end.

AIM: To explore the mechanism of myocardium protection after ischemia/reperfusion (I/R) injury by preconditioning with ischemia in human. METHODS: Thirty - six patients underwent valve replacement were divided into ischemic preconditioning group (IP group, 20 cases) and non -ischemic preconditioning group (control group, 16 cases) according to whether they were given single cycle reperfusion before cardioplegia or not. Serum levels of interleukin -8 and 10 were measured with ELISA. Expressions of myocardial Bel -2 and caspase -3 were analyzed. RESULTS: The inflammatory factors IL - 8 and IL - 10 increased to the highest level in serum at 6 h after declamping and recovered to normal level on 5 d after declamping. On 6 h, 1 d and 2 d after declamping, serum level of IL -8 was significantly lower in IP group than that in control group ( P < 0.05 ) , but serum level of IL -10 was higher in IP group (P < 0.05 ). Expression of myocardial Bel - 2 and caspase - 3 increased in both groups after reperfusion, and Bel - 2 was lower in the control group than that in IP group while the level of caspase - 3 was higher (P < 0.05). Expression of myocardial Bel - 2 had positive correlation with IL - 10 and negative correlation with IL - 8.CONCLUSION: Ischemic preconditioning has the effect of protection of human myocardial cells after ischemia/reperfusion injury through decreasing systemic inflammatory response following ischemia reperfusion injury.

Objective To evaluate the efficiency and the timing of continuous blood purification(CBP) in patients with multiple or-gan dysfunction syndrome(MODS) and acute renal failure(ARF) following cardiac surgery. Methods From November,2003 to July,2007,thirty-one patients with MODS and ARF following cardiac surgery were treated with CBP. They were divided into two groups, alive group ( group A) and dead group ( group B). Clinical data of the two groups were reviewed. Before CBP, duration of extracorporeal circulation, du-ated. Mean arterial pressure (MAP), heart rate (HR), oxygenic index (PaO2/FiO2), white blood cell count (WBC), platelet count (PLT) and renal function (blood urea nitrogen, BUN, ercatinine, Cr) were observed before and after CBP. Results The number of im-paired organs of patients in group B was significantly more than that in group A before CBP ( P＜0.05). MODS scores ( 12.9±3.2 vs 6.9 ±2.3, P＜0.05) and APACHE Ⅱ scores (26.3±10.4 vs 17.2±5.1, P＜0.05)of group B were significantly higher than those of group A before CBP. After treatment of CBP for 24 hours, APACHE Ⅱ scores and MODS scores only significantly decreased in group A (P＜0.05 ). After treatment of CBP, Cr and BUN significantly reduced, while MAP and PaO2/FiO2 increased, in all patients, but HR was signif-icantly lower than that before CBP in group A (P＜0.05). The duration of ARF (34.67±32.79 hours vs 13.05±14.09 hours,P＜cantly higher than those of group A. Conclusion MODS scores and APACHE II scores can be used to evaluate the severity of patients with MODS and ARF after cardiac surgery. CBP is an effective treatment for these patients. It is suggested that early CBP therapy is important for reducing the chances of the multiple organ dysfunction syndrome and mortality of these patients.

Inner fistula by abdomino-back anastomosis of cephalic vein to radial artery was erformed in 86 patients with hemodialysis (test group) and end-to side arteriovenous anastomosis was performed in 85 cases (control group).There were no significant differences in postoperative anastomotic blood flow and vascular complications between two groups (P ＞ 0.05);however the average time consuming for operation in test group was shorter than that in control group (36 min vs.75 min,P ＜ 0.01).The minimally invasive abdomino-back anastomosis is a desired arteriovenous fistula method for hemodialysis patients.