Objective To analyze clinical features of papillary thyroid microcarcinoma(PTMC) and to evaluate the diagnosis and treatment for PTMC.Methods The clinical data of 447 cases of PTMC receiving surgical treatment and confirmed by pathology were reviewed.Color Doppler ultrasonography was used to identify thyroid nodules and cervical lymph nodes,and frozen section was used to confirm the pathological diagnosis during operation.104 cases received unilateral lobectomy,22 cases received unilateral lobectomy plus isthmectomy,321 cases received total thyroidectomy,257 cases underwent central neck dissection,and 54 cases underwent lateral neck dissection(level Ⅵ included).All cases took levothyroxine to maintain low TSH level after operation,and were followed up through telephone or in out-patient clinic.Results Central compartment node metastasis was found in 144 patients,and lateral neck metastasis was found in 41 cN1 cases.The age,extra-capsular invasion and multifocal carcinoma were independent risk factors of PTMC.The number of positive nodes in level Ⅵ was positively correlated with the risk of lateral node metastasis.395 cases were followed-up successfully for 20 to 42 months,with the media follow-up of 32 months.During the follow-up,recurrence or metastasis was found in 15 cases,and no death happened.Conclusions PTMC has no specific symptoms,and was difficult to be diagnosed before operation.Physical examination and color Doppler ultrasonography should be used as routine examination.Thyroid lobectomy and total thyroidectomy plus central node dissection should be major surgical treatment for PTMC patients.Lateral neck dissection should be considered in all cN1 patients.

Eight-year program education is the heated topic in the field of medical education across the country.The system of eight-year program education can be discussed as a system,from the view of system philosophy.We analyzed beth internal relationships and external relationships connected to the system,so as to look upon the eight-year program education in its entirety.And then we discussed about the problems of epistemology and methodology on that basis.

It is inevitable for colleges and universities to reform their information literacy education course with the coming of education informationization time.The construction elements of MOOC-based flipped classroom for information literacy education course in colleges and universities were studied in aspects of teaching design, classroom activities, hardware, teachers literacy based on the analysis of its necessity and feasibility, and strategies were put forward for colleges and universities to construct their multi-mainstay plus multi-element flipped classroom for information literacy education course.

ObjectiveIn order to understand changes of immunological response under different psychic state. MethodsMice were divided into two groups,male and female group, 1: 2, were feeded together for together group, anther was that mice, male, were feeded solely for thesolely group. Male mice in two groups were immunized with sheep red blood cell(SRBC). Titer of antiboty against SRBC and IL -2 in serum wasdetected. Results The titer of antibody against SRBC in together group was higher than that in solely group. The concentration of IL - 2 was lowerin the solely group comparing with the together group. ConclusionIt was suggested that psyxhological status had impact on immune system.

Objective To evaluate the clinical value between peritoneal lavage cytology (PLC) and prognosis of gastric cancer. Methods The peritoneal lavage fluid of 60 gastric cancer patients and 12 noncancer patients were collected,different methods were used to examine the exfoliated cancer cells,and relationships between positive results and relative clinico-pathological parameters were evaluated.Results The positive rate of PLC was 31.8%,and was positively correlated with the degree of histologic differentiation of gastric cancer (P0.05). The postoperative one-year recurrence and survival rates of the positive and negative groups were significantly different(P

Objective:To investigate the effect of JAK2 V617F gene mutation status and burden on BCR-ABL-negative myeloproliferative neoplasms (MPN).Methods:Clinical data of 199 patients with MPN in Cangzhou Central Hospital in Hebei Province from September 2015 to January 2020 were retrospectively analyzed, and the correlations of JAK2 V617F gene mutation burden with clinicopathological features and prognostic score of MPN patients were analyzed.Results:Of the 199 BCR-ABL-negative MPN patients, 138 patients (69.4%) were positive for JAK2 V617F mutation; of these patients, 64 (88.9%) of 72 patients with polycythemia vera (PV) were mutation-positive, 54 (53.5%) of 101 patients with essential thrombocytosis (ET) were positive, 20 (80.0%) of 25 patients with myelofibrosis (MF) were mutation-positive, and 1 patient with hypereosinophilic syndrome (HES) was mutation-positive. About 55.1% (76/138) of patients had a high JAK2 V617F mutation burden. The mutation burden in PV group was the highest, MF was the second, and ET was the lowest; the mutation burdens in these three groups were (73.9±18.3)%, (59.9±25.2)% and (25.0±16.5)%, respectively. Mutation burden was positively correlated with the white blood cell counts of patients with PV, ET and MF ( r values were 0.626, 0.675 and 0.796, all P < 0.01). JAK2 V617F mutation burden was positively correlated with the prognostic scores of patients with PV and ET ( r values were 0.296 and 0.404, both P < 0.05). Conclusion:The JAK2 V617F mutation burden of BCR-ABL-negative MPN patients is related to clinicopathological factors, and the prognosis of patients with high JAK2 V617F mutation burden is poor.

? AlM: To evaluate the efficacy of the method of vitrectomy combined with posterior sclera reinforcement for retinal detachment due to macular hole in high myopia.
?METHODS:From January 2012 to December 2013, in 45 eyes of 45 high myopic patients with retinal detachment due to macular hole, 28 eyes were in group A of vitrectomy with posterior sclera reinforcement and 17 eyes were in group B of vitrectomy. Preoperative examinations included visual acuity, intraocular pressure, indirect ophthalmoscopy and OCT were performed. ln follow - up 6 to 12mo, postoperative examinations of visual acuity, OCT were performed and effects of retinal reattachment and macular hole closure were compared between the two groups.
?RESULTS: ( 1 ) Postoperative examinations: visual acuity was 1. 19±0. 39 in group A and 1. 51±0. 34 in group B. The differences were statistically significant(P<0. 05). (2) The retinal reattachment rate was 100% in group A and 88. 24% in group B. There was no statistical significance between them(P>0. 05). (3) The macular hole closure rate was 82% in group A and 53% in group B. The differences were statistically significant(P<0. 05).
? CONCLUSlON: The treatment of vitrectomy with posterior sclera reinforcement is safe and feasible, which could improve visual acuity and increase the rate of macular hole closure in treating retinal detachment due to macular hole in high myopia.

BackgroundThe research of corneal thickness after pars plana vitrectomy in DM patient plays an important role not only theoretically but clinically.Objective Present study was to evaluate the change in corneal thickness after pars plana vitrectomy.Methods A prospective coherent study was designed.Seventy-five eyes of 70 consecutive diabetic retinopathy(DR) patients were collected in Tianjin Medical University Eye Center.Pentacam was used to assess the central and periphery corneal thickness by the same investigator preoperatively and 7 days,1 and 3 months postoperatively,respectively.The thickness values from five corneal zone were obtained,including cornea vertex,the thinnest point of the cornea,periphery cornea near the scleral incision of 4 mm away to vertex of cornea on vertical and 240°,120°,60° meridian ( right eye) or 300°,120°,60° meidian ( left eye ).These results were compared and analyzed with ANOVA of repeated measurement data.Subgroup analysis was performed to evaluate the influence of different corneal positions,the use of conventional 20g or 23g transconjunctival sutureless vitrectomy(TSV) groups,surgery duration,gas or fluid endotamponde on corneal thickness.This study was approved by Ethic Committee of this hospital.Written informed consent was obtained from the subjects before any relative medical procedure.Results The mean corneal thickness was ( 639.9 ± 103.1 ),( 689.5 ± 119.3 ),( 666.5 ±113.7),( 650.8 ± 108.6 ) μm before operation,postperative 7 days,1 and 3 months respectively.As covariates appearing in the model,the corneal thickness change rates were revised as the parameters as following: diabeitc duration =13.0 and age =57.2.The revised corneal thickness was significant different among various time points( F=210.928,P=0.000) and different corneal zones(F=24.843,P=0.000) with the size order in turn P4＞P3＞P1＞P2＞P5.The corneal thickness change rates were less in 23g TSV group compared with conventional 20-g group (F =53.843,P =0.000) and BSS tamponade group compared with gas tamponade group ( F =5.288,P =0.022).But no significant difference was found in the revised corneal thickness among surgery duration ＜ 1 hour group,1-2 hour group and ＞2 hour group( F=1.233,P =0.293).ConclusionsVitrectomy is a safe procedure on the ground of cornea,but TSV and fluid endotamponade appear to be more beneficial to the protection of cornea.Pentacam could offer the reliable data in not only central cornea but also periphery cornea.

Adult ; Aged ; Agranulocytosis ; chemically induced ; Antineoplastic Agents, Alkylating ; administration & dosage ; adverse effects ; therapeutic use ; Brain Neoplasms ; secondary ; therapy ; Carcinoma, Non-Small-Cell Lung ; pathology ; Chemoradiotherapy ; Dacarbazine ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Dose-Response Relationship, Drug ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Remission Induction ; Survival Rate ; Vomiting ; chemically induced

OBJECTIVETo study the relationship between Chinese medical syndrome types and metabolomics of non-small cell lung cancer (NSCLC) patients.

METHODSTotally 120 NSCLC patients were assigned to asthenia syndrome group and sthenia syndrome group, 60 in each group. Meanwhile, 60 cases of benign pulmonary nodules in physical examinations were recruited as the control group. Tumor tissues or benign pulmonary nodules tissues were obtained by thoracoscope. Changes of their metabolites were observed using gas chromatography-mass spectrometry (GC-MS). Their differences were studied using principal component analysis (PCA) and partial least-squares discriminant analysis (PLS-DA). ROC curve analysis was performed in different metabolic compounds of sthenia and asthenia syndromes groups. The area under the curve (AUC) was calculated to evaluate the sensitivity of diagnosing syndrome types.

RESULTSCompared with the control group, difference existed in 16 compounds. Of them , contents of citric acid, pyruvic acid, alanine, choline phosphate, glycerol phosphate choline, linoleic acid, oleic acid, lactic acid, inositol were more in the two tumors group than in the control group. Difference existed in 10 compounds between the sthenia syndrome group and the asthenia syndrome group. Of them, citric acid, pyruvic acid, alanine, choline phosphate, glycerol phosphate choline, lactic acid, and inositol were more in the asthenia syndrome group than in the sthenia syndrome group. Contents of valine, glucose, and glutamine were more in the sthenia syndrome group than in the asthenia syndrome group. ROC curve analyses of different compounds indicated that AUC of lactic acid and glucose was more than 0.8 (P < 0.01); AUC of inositol, choline phosphate, and glycerol phosphate choline was more than 0.7 (P < 0.01); AUC of valine, citric acid, glutamine, alanine, and pyruvic acid was more than 0.6 (P < 0.05).

CONCLUSIONSThere existed certain correlation between CM syndrome types and metabolomics of lung cancer. Lactic acid, glucose, inositol, choline phosphate, glycerol phosphate choline, valine, citric acid, glutamine, alanine, pyruvic acid were sensitive diagnostic compounds, and the first four kinds were most sensitive compounds.

Asian Continental Ancestry Group ; Carcinoma, Non-Small-Cell Lung ; metabolism ; Gas Chromatography-Mass Spectrometry ; Humans ; Lactic Acid ; Least-Squares Analysis ; Metabolomics ; methods ; Principal Component Analysis ; Pyruvic Acid