Twenty four female patients underwent thyroidectomy between June 2015 and August 2016,among whom 11 cases were pathologically diagnosed as nodular goiter (NG group),and 13 cases were diagnosed as nodular goiter complicated with Hashimoto's thyroiditis (NG + HT group);meanwhile,17 female patients with Hashimoto's thyroiditis (HT group) and 20 healthy females (control group) were also recruited in the study.The expression of micro RNA(miR)-125b was evaluated by quantitative real-time PCR(qRT-PCR),the expression level of tumor necrosis factor α (TNF-α) was analyzed by Western blotting in thyroid nodules and adjacent thyroid tissue in NG and NG + HT groups.Serum expression of miR123b was detected in all 4 groups.qRT-PCR results showed that the expression of miR-125b was down regulated by 0.55 fold in thyroid nodules of NG + HT group compared to NG group (t =2.873,P ＜ 0.01).The serum expression levels of miR-125b in control group,NG group,HT group and NG + HT group were 1.00,1.06,0.92 and 0.79,respectively,the expression level in NG + HT group was significantly lower than that of control group (q =4.717,P ＜ 0.01).Western blot showed that the expression of TNF-α in thyroid nodules of NG + HT group was significantly higher than those in nodules of NG group and adjacent thyroid tissues of both groups.The results suggest that miR-125b might serve as a promising diagnostic biomarker of Hashimoto's thyroiditis in patients with nodular goiter.

Disruption of blood supply to the femoral head and subsequent hypoxia are implicated in the pathogenesis of osteonecrosis of the femoral head(ONFH),which frequently leads to the progressive collapse of the femoral head,thus causing degenerative arthritis of the hip joint.But the pathophysiology of osteonecrosis of the femoral head has not been completely elucidated.It is accepted that steroids and alcohol intake are two most common causes of ONFH.Now many theories have been proposed to decipher the etiology and pathogenesis of ONFH,including abnormal lipid metabolism,elevated intraosseous pressure,intravascular coagulation,second collision theory,etc.The purpose of this review is to summarize the etiology and pathogenesis of osteonecrosis of the femoral head.

[Objective]To investgate the expression of vascular endothelial growth factor in osteonecrosis of the femoral head during the repairing with biodegradable strontium-doped calcium polyphosphate in glucocorticoid-induced rabbits.[Method]Twenty mg/kg methylprednisolone was injected into right gluteus medius muscle at intervals of 24 hours for three times in 21 adult male Japanese white rabbits.Three rabbits were killed randomly at 2 weeks after methylpednisolone injection,both the femora and humeri were histologically examined for the presence of osteonecrosis. The remaining 18 animals with a total of 36 cylindrical 2.5?5 mm femoral head defects were created following the trapdoor procedure. Eighteen animals with femoral head bone defects were randomly divided into three groups. Group A:the defects filled with strontium-doped calcium polyphosphat,Group B:the defects filled with calcium polyphosphate and Group C:the defects filled with autologous cancellous bone alone. Roentgenographic and histological examinations were performed postoperatively. Finally,immunohistochemical analysis using monoclonal antibodies anti-VEGF was performed.[Result]No hip joint dislocation occurred. In Group A,the results of VEGF expression had a significantly difference from those in the other groups 12 weeks after operation. Most of the biodegradable strontium-doped calcium polyphosphate was resorbed and was largely replaced by newly formed trabecular bone at 12 weeks. While in Group B,a major part of defect were repaired. New formed trabecular bone in the defect was very thin. In Group C,morsellized cancellous bone was completely surrounded by fibrous and newly formed trabecular bone. [Conclusion]VEGF expression in the defect of osteonecrosis of the femoral head during the repairing with biodegradable strontium-doped calcium polyphosphate may play a role in stimulating vascular invasion and granulation tissue formation.This may be an important step toward facilitating the resorption in the osteonecrosis,thus impooring the repairing proceduce of femoral head defect.

Objective To explore the magnetic resonance spectroscopy characteristics of prefrontal white matter in bipolar Ⅱ disorder and its relation with executive function.Methods Thirty bipolar Ⅱ disorder patients and twenty healthy controls were evaluated with Multi-Voxel proton magnetic resonance spectroscopy (1H-MRS)scans on prefrontal white matter to assess the N-acetyl-aspartate (NAA),Choline (Cho),Creatine (Cr) and myoinositol (MI),and then the ratios of NAA/Cr,Cho/Cr,MI/Cr,NAA/Cho and NAA/Cho + Cr were calculated.All subjects were assessed for executive function using the Wisconsin Card Sorting Test (WCST).Results NAA/Cr in right prefrontal white matter(1.43 ± 0.26) and NAA/Cr,NAA/Cho,NAA/Cho + Cr in left prefrontal white matter (separatelyl.40 ± 0.29,1.13 (1.53,0.24),0.62 ± 0.12) were lower than healthy controls (separately 1.58 ±0.18,1.59,0.23,1.30 (0.53 ± 0.29),0.71 ± 0.08) (P ＜ 0.05).The correct trials and the number of categories of WCST in Bipolar Ⅱ disorder (separately 26.97 ± 8.97,3(6,3)) were less than in healthy controls(separately 36.35±4.85,5 (3,2)),and perseverative errors and random errors were more in patients (separately 12.77 ±5.73,7 (21,5)) than healthy controls (separately 7.35 ± 3.01,4 (13,2)).NAA/Cho and NAA/Cho + Cr in left prefrontal white matter were positively correlated with correct trials,number of categories,and negatively related with perseverative errors (P＜0.05).Conclusions Bilateral prefrontal white matter fiber damage occurs to bipolar Ⅱ disorder.And left prefrontal white matter fiber damage in bipolar Ⅱ disorder may lead to executive impairment.

Config and modify open source software such as Nagios、 MRTG and Awstats, make it more suitable and stable for our network environment. Construct server monitor、 service monitor、 network monitor and website statistics system by using open source software. Besides, we construct network resource management system via ASP and database technology.Finish the network and service monitoring and management system based on B/S architecture. This system can keep close watch on the status of servers and services running on servers, and ensure all of the servers and services normal running, and provide the basic information service for policy-making body and other research institute.

Objective To investigate the effect of enteral nutrition support on prognosis in patients with severe acute stroke.Methods Ninety-eight cases of severe acute stroke were divided into nutrition supported group(50 cases) and control group(48 cases) randomly.All patients were treated by conventional therapy.Nutrition supported group received high energy nutrition diet and control group received common liquid diet by nasal feeding.The levels of hemoglobin,serum albumin,neurologic impairment score (NIHSS)and the incidence rates of complications were assessed at the 1st,10 th and 21st day after admission.Results Hemoglobin was (122.5 ± 2.4),(106.4 ± 2.8) g/L and serum albumin was (36.5 ± 4.7),(34.2 ± 5.1) g/L at the 21st day after admission in nutrition supported group and control group,and there was significant difference between two groups (P < 0.05).The complication rate in control group was higher than that in nutrition supported group (P< 0.05).NIHSS score was(8.45 ± 3.02) scores in nutrition supported group and (10.24 ± 2.57)scores in control group at the 21st day after admission,and there was significant difference between two groups (P <0.05).Conclusion Early enteral nutrition support can significantly improve nutritional status and decrease the incidence rates of complications in patients with severe acute stroke,and it is helpful for clinical prognosis.

Background:Recently,the American Society for Gastrointestinal Endoscopy published the PIVI( Preservation and Incorporation of Valuable Endoscopic Innovations)initiative regarding to the“predict,resect,and discard”strategy on diminutive(≤5 mm)colorectal polyps. The low prevalence of adenoma with advanced histology( containing ≥25%villous component,or high-grade intraepithelial neoplasia,or submucosal invasive carcinoma)in diminutive polyps would provide high confidence for endoscopists to adopt the strategy. Aims:To investigate the prevalence of adenoma with advanced histology in diminutive colorectal polyps. Methods:Data of diameter,location and morphology of colorectal polyps were collected prospectively from patients undergoing colonoscopy at Digestive Endoscopy Centre,Shanghai Ren Ji Hospital from Jan. 2013 to Jun. 2013. The polyps were resected,placed in a unique specimen vial,and sent for histological evaluation. Results:A total of 1 986 colorectal polyps were enrolled in the study,including 900(45. 3%) diminutive polyps(≤5 mm),521(26. 2%)small polyps(6-9 mm)and 565(28. 4%)large polyps(≥10 mm). Prevalence of adenoma with advanced histology in diminutive polyps was significantly lower than those in small and large polyps(1. 1% vs. 8. 4% and 43. 7%,P<0. 05),and was not correlated with the location and morphology of diminutive polyps. Submucosal invasive carcinoma was found in 4. 6% of large polyps,0. 4% of small polyps,and 0% of diminutive polyps. Conclusions:The very low prevalence of adenoma with advanced histology and absence of submucosal invasive carcinoma in diminutive colorectal polyps favours the potential practice of“predict,resect,and discard”strategy in the patient population studied.

Objective To summarize the progress of research on the influence of nutrition support on quality adjusted life year (QALY) in elderly patients with nutritional risk, and to evaluate the feasibility of QALY as an outcome indicator.Methods Literature in Chinese, English and Japanese relating to the feasibility of QALY and cost-utility in evaluating the influence of nutrition support on the outcomes of patients with nutritional risk published from 1980 to 2013 were searched in Wanfang, China National Knowledge Infrastructure,PubMed, Nature databases.The methodological quality of randomized controlled trials was assessed using Jadad scale combined with Schulz allocation concealment, and the quality of cohort studies with Newcastle-Ottawa scale.Results Totally 10 articles were fotnd, in which 8 were selected, including 6 randomized controlled trial and 2 cohort studies, covering 1 130 patients;the other 2 were excluded for not conforming to inclusion criteria.Four of the 6 randomized controlled trial indicate that QALY is higher and all-cost is lower in the treatment group compared with the control group (or cost-utility is higher in the treatment group).The 2 cohort studies indicate that total parenteral nutrition support at home could improve the QALY of malnourished patients and could save cost compared with nutrition support at hospital when necessary.Conclusions Nutrition support for patients with nutritional risk can improve prognosis, reduce cost, and increase QALY.More large-scale, high-quality randomized controlled trials are needed to evaluate the effect of nutrition support on the QALY of elderly patients with nutritional risk.

Objective To study the effects of psychological rehabilitation in the treatment of paraplegic patients with spinal cord injury (SCI).Methods A hundred paraplegic spinal fracture survivors were divided into a research group and a control group with 50 cases in each.Systematic rehabilitation was given to the patients in the control group,while this was combined with individualized psychological rehabilitation protocols for the patients in the research group.The daily treatment lasted 10 weeks,6 days a week.All of the patients were assessed with the Barthel index (BI),a functional independence measure (FIM),the Hamilton depression scale (HAMD) and the Hamilton anxiety scale (HAMA) pre-treatment and post-treatment.Results Before the intervention there was no significant difference between the 2 groups in any of the assessments.After ten weeks the average BI,FIM,HAMD and HAMA results in the research group were significantly better than those pre-treatment and also significantly better than those in the control group.Conclusions Psychological rehabilitation can distinctly improve the functioning and psychological state of paraplegic patients after SCI.

ObjectiveTo evaluate left ventricular (LV) function and dyssynchrony in patients with dilated cardiomyopathy (DCM) and complete left bundle branch block (CLBBB) by three-dimensional speckle tracking imaging(3D STI).Methods3D STI was performed and analyzed using TomTec 4-D LV analysis 3.0 software in 37 DCM patients with CLBBB and 25 healthy volunteers.The global 3D,longitudinal,circumferential,radial strains were measured.LV dyssynchrony was evaluated by the standard deviation of time to peak from 3D strain of 16 segments related to the heart cycle(3D-SDI).ResultsIn control group,uniformity in the average value of 3D strain was observed between apical,mid-ventricular and basal levels (P ＞ 0.05).Global 3D,longitudinal,radial and circumferential strains had excellent correlations with LV ejection fraction ( r =- 0.92,- 0.84,- 0.78 and 0.81,respectively,P ＜0.01).Compared with control group,global 3D,longitudinal,radial and circumferential strains were significantly lower in DCM patients ( P ＜0.01 for all).3D-SDI in DCM patients with CLBBB was significantly longer than that of volunteers ( P ＜0.01).3D-SDI increased with worsening LV systolic function regardless of QRS duration (P ＜0.05).ConclusionsWhen image quality is optimal,3D STI represents a promising novel technique for assessment of global LV function and dyssynchrony.