Objective\ To introduce the speciality of pontine infaction in clinic and screenage.Method\ we made retrospective study on clinical data and image data of pontine infarction caused by BAD,and compared with the data of 31 patients with lacunar infarction in pontine.Result\ Clinical spetiality of BAD group:There are a few disturbance of consciousness,mainly the movement disturbance and dysarthria with ocular movement disturbance.Compared with the control group,there is difference between the two groups(P

Objective To evaluate the pattern of lateral cervical metastases and to investigate the risk factors for lateral cervical lymph node metastases in paoiuary thyroid carcinoma patients with clinical negative lateral neck lymph node.Methods 73 patients with paoiuary thyroid carcinoma who underwent prophylactic lateral neck dissections(level Ⅱ-Ⅵ or level Ⅱ-ⅣandⅥ) were reviewed retrospectively on their medical records paoiuary thyroid carcinoma.None of patients in this study had a clinically positive lymph node.Neck dissection specimens were obtained for histological analysis for node metastasis with respect to the individual neck levels.Results Occult metastases in lateral neck were observed in 12(16.4 ％)patients.9.6 ％,0,13.6 ％,9.6 ％,0,4.8 ％ and 42.4 ％ patients had histologically positive lymph nodes in levels Ⅱa,Ⅱb,Ⅲ,Ⅳ,Va,Vband Ⅵ respectively.In multivariate analysis,lymphatic metastases in level Ⅵ was associated with lateral neck metastasis(OR=7.3,P=0.020)in cN0 patients with paoiuary thyroid carcinoma.Conclusion Levels Ⅲ,Ⅱa and Ⅳwere the most common stages showing occult lymph node metastases.Prophylactic lateral neck dissections may be omitted in the treatment of cN0 PTC patients ff level Ⅵ lymphatic metastases are not found on histological exam.

Objective To probe into the effect of sitagliptin on blood glucose fluctuation of the patients with type 2 diabetes mellitus(T2DM) and poor control by insulin aspart 30.Methods Ninety cases of T2DM and poor control by insulin aspart 30 in affiliated Zhongshan hospital from January 1,2014 to December 31,2014 were selected and randomly divided into three groups:simply continuous subcutaneous insulin injection(CSII),acarbose combined CSII group(CSII + Aca) and sitagliptincombined CSII group (CSII + Sig),30 cases in each group.Three groups received the intensive treatment for 2 weeks,and72-h continuous glucose monitoring was performed on last 3 d.The 24 h mean blood glucose(24 hMBG),largest amplitude of glycemic fluctuation(LAGE),mean amplitude of glycemic excursion(MAGE) within 1 d,postprandial blood glucose spike(PGS),postprandial glucose peak time(△t),postprandial glucose excursion(PPGE) and total T were observed within 24 h.The difference of insulin dose(△ insulin),hypoglycemia incidence,glucose-target rate,blood glucose profiles were compared at the end of treatment.Results After two-week treatment,intraday blood glucose variation indicators(24 hMBG,LAGE and MAGE) and postprandial blood glucose variation indicators (PGS,△t,PPGE and total T) in the CSII+Sig and CSII+-Aca groups were significantly lower than those in the CSII group(P＜ 0.05),while the differences in blood glucose variation indicators between the CSII+Sig group and CSII+-Aca group were not statistical significant(P＞ 0.05).In the comparison after treatment,△ insulin,hypoglycemia incidence and glucose-target rate in the CSI + Sig group were lower(P＜0.05).Conclusion The combined application of short-term CSII and sitagliptin will achieve a better effect than the combination with acarbose,can smoothly and steadily reduces the blood glucose level,relieves the whole day glucose fluctuations,effectively reduces △ insulin,and has lower hypoglycemia occurrence rate.

Objective To evaluate if Ⅵ region lymph nodes metastasis status can be a reliable indicator in prediction of lateral lymph nodes metastasis in papillary thyroid carcinoma (PTC) with negative cervical lymph nodes (cN0).Methods Retrospectively reviewed the medical records from January 2003 to October 2011 of 73 patients with PTC who underwent prophylactic lateral neck dissection (Ⅱ-Ⅴ region or Ⅱ-Ⅳ region).The relationship between cervical lymph nodes metastasis and lateral lymph nodes metastasis was assessed.Results The rate of lateral lymph nodes metastasis was 16.4％(12/73).The rate of Ⅵ region lymph nodes metastasis was 42.5％(31/73).Multivariate analysis showed that Ⅵ region lymph nodes metastasis was the risk factor of lateral lymph nodes metastasis in cN0 patients with PTC(OR =7.3,P=0.020).Conclusion Ⅵ region lymph nodes metastasis status can be a reliable indicator of lateral lymph nodes metastasis in cN0 patients with PTC.

Objective To investigate the efficacy of enteral nutrition containing glutamine on improving blood lipids and immune parameters in elderly patients with gastrointestinal cancer.Methods 98 cases of elderly patients with gastrointestinal cancer were randomly divided into observation group(n=5 1)and control group (n=47).The control group was additionally given conventional enteral nutrition,and the observation group was additionally given enteral nutrition containing glutamine.The levels of albumin (ALB),tumor necrosis factor (TNF),indicators of cellular immunity,indicators of humoral immune function and blood lipid,before and after operation,were observed in the two groups.Results 9 days after operation,the levels of ALB and total cholesterol,per-centage of CD8 + cells were lower than those in the control group,and levels of TFN,IgA,triacylglycerol,low density lipoprotein cholesterin,percentage of CD4 + cells and CD4/CD8 ratio were higher than those in the control group,and have significant differ-ences (P <0.05).While,there was no statistically significant difference of the percentage of CD3 cells between the groups(P >0.05).Conclusion Enteral nutrition containing glutamine can significantly improve blood lipids and immune function in elderly pa-tients with gastrointestinal cancer,which may have important clinical research value and be worthy of further application.

In view of the evaluation of fundus image segmentation, a new evaluation method was proposed to make up insufficiency of the traditional evaluation method which only considers the overlap of pixels and neglects topology structure of the retinal vessel. Mathematical morphology and thinning algorithm were used to obtain the retinal vascular topology structure. Then three features of retinal vessel, including mutual information, correlation coefficient and ratio of nodes, were calculated. The features of the thinned images taken as topology structure of blood vessel were used to evaluate retinal image segmentation. The manually-labeled images and their eroded ones of STARE database were used in the experiment. The result showed that these features, including mutual information, correlation coefficient and ratio of nodes, could be used to evaluate the segmentation quality of retinal vessel on fundus image through topology structure, and the algorithm was simple. The method is of significance to the supplement of traditional segmentation evaluation of retinal vessel on fundus image.
Algorithms ; Databases, Factual ; Diagnostic Imaging ; methods ; Diagnostic Techniques, Ophthalmological ; Fundus Oculi ; Humans ; Image Processing, Computer-Assisted ; Retina ; Retinal Vessels ; anatomy & histology

Objective To report the clinical results and the advantages/disadvantages of anterolateral thigh flap (ALT) and forearm flap (FAF) in reconstruction of head and neck defect after cancer ablation. Methods 20 FAFs and 12 ALTs were performed to repair the head and neck tumor ablation defects. Of the 20 FAFs, 7 were used for repair of the through and through buccal defects, 4 for circumferential bypopharyngeal defects, 2 for plate defects, 1 for parotid area skin defect, 4 for floor of the mouth defects, and 2 for defect, of the base of the tongue, while of the 12 ALTs, 3 were used for repair of the defects of the base of the tongue, 4 for plate defects, and 5 for the floor of the mouth and/or lower gum defects. Survival of the flaps, function of the recipient site, and impact to the donor site were compared between these two groups to analyze the advantages/disadvantsges and key technique details of these two flaps. Results 19 FAFs totally survived. Vascular crisis occurred in 2 cases of FAF, of which 1 flap survived after conservative treatment, while the other 1 developed partial necrosis. All the 12 ALTs survived, without vascular crisis. 2 of the 14 planed ALTs were abandoned and replaced by FAFs, of which 1 because of absence of the perforating branch and the other 1 because of injury of the perforating branch. Secondary defects of the ALTs could be closed primarily, while secondary defects of the FAFs should be closed with skin grafts. Conlusion Both ALT and FAF can be performed with high survival rate. Each has its own advantages. Selection of the donor site deponds on situation of the defect and purpose of the reconstruction.

Objective:To evaluate the relationship between the mechanism of promoting wound healing by modified autologous blood transfusion and metastasis-associated lung adenocarcinoma transcript 1 ( MALAT1) in diabetic mice. Methods:Twenty SPF ICR mice, weighing 21-25 g, in which the diabetic model was successfully established, were divided into 2 groups ( n=10 each) using a random number table method: modified preservation group (group I) and ordinary preservation group (group O). Peripheral venous blood samples were collected and stored in the corresponding preservation solution for 7 days.The platelet aggregation rate, blood glucose, serum glycosylated hemoglobin (GHB) and phosphodiesterase (DPG) concentrations and WBC were measured.Autologous blood was transfused back immediately after the wound model was established.The percentage of wound healing area was calculated at 7, 10 and 14 days after autologous blood transfusion.The expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, β-actin, type Ⅰ collagen (Col Ⅰ), Col Ⅲ protein and mRNA and MALAT1 was determined by Western blot, immunohistochemistry and quantitative real-time polymerase chain reaction respectively, at 14 days after transfusion. Results:Compared with group O, the blood glucose, serum concentrations of GHB and DPG, and WBC were significantly decreased, platelet aggregation rate was increased, the percentage of wound healing area was increased, the positive staining rate of Col Ⅰ and Col Ⅲ was increased, and the expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, ColⅠ, Col Ⅲ and β-actin protein and mRNA and MALAT1 was up-regulated in group I ( P<0.05). Conclusion:The mechanism by which modified autologous blood transfusion promotes wound healing may be related to up-regulating MALAT1 expression in diabetic mice.

Purpose To assess the clinical application of non-contrast-enhanced MR angiography (NCE-MRA) using flow sensitive dephasing (FSD) prepared steady-state free precession (SSFP) for displaying hand arteries of patients with rheumatoid arthritis. Materials and Methods Twenty-two patients with rheumatoid arthritis were recruited in this study. All the patients undertook hand NCE-MRA and three-dimensional dynamic CE-MRA on a 1.5T MR scanner. The informed consent was obtained from each subject. Image quality was assessed independently by two experienced radiologists at three arterial segments (wrist arteries, palm arteries, andfinger arteries) with a four-point scale. Signal to noise ratio (SNR), contrast to noise ratio (CNR), and vessel sharpness were evaluated by a magnetic resonance physicist. The results and image quality were statistically compared between the two MRA techniques.Results Twenty-two patients of 24 hands successfully underwent NCE-MRA and CE-MRA scan. Among 72 vascular segments, 69 segments of NCE-MRA were diagnostic, which was higher than that of CE-MRA (96% vs 83%,P<0.05). Otherwise, the image quality, SNR, CNR and vessel sharpness of NCE-MRA were all superior to those of CE-MRA (P<0.05).Conclusion NCE-MRA using FSD-prepared SSFP allows clear depiction of the hand arterial tree, and the image quality is superior to that of dynamic CE-MRA. It is a potential tool for evaluating the disease of hand arteries.

ObjectiveTo compare the exposure, identification of parathyroid and postoperative complications between total thyroidectomy (TT) and subtotal/near total thyroidectomy (S/NT) for bilateral multiple thyroid nodules. MethodsA total of 278 cases were performed TT and S/NT randomly from Dec. 2006 to Dec.2009. The histology, identification of parathyroid and recurrent laryngeal nerves (RLN), and incidence of complications were compared between the 2 surgical procedures. The data were processed with t test or x2 test.Results227 cases were estimated to be benign preoperatively, among whom 28 cases ( 12.3％ ) were diagnosed as focal cancer by postoperative pathology. The identification rate of parathyroid was 96.5％ in TT group and 60.4％ in S/NT group (P＜0.05). The mean postoperative serum calcium level was 2.057 +0.016 mmol/L in TT group and 2. 15 + 0.019 mmol/L in S/NT group (P ＜ 0.05 ). The incidence rate of transient hypoparathyroidism (HPT) was 16.9％ in TT group and 5.7％ in S/NT group (P＜0.05). There was no statistical difference between the 2 groups in terms of the incidence rate of permanent HPT and transient recurrent laryngeal nerves (RLN) palsy ( P ＞ 0.05 ). The incidence rate of permanent HPT was higher in reoperation cases ( 11.1％ ) than in primary surgery cases (0.0％) in TT group ( P ＜0.05 ). ConclusionBased on the accurate technique under microscope field, TT is a safe surgical procedure for primary surgery with bilateral multiple thyroid nodules.