Objective To discuss the clinical value of ultrasonic elastography for thyroid nodules,and compared with pathology.Methods 77 patients with 105 thyroid lesions were analyzed.Tissue stiffness on elastography was scored from one(greatest elastics train)to five (no strain).Results On elastography:scores 1 and 2 were found in 75％ benign lesions.Scores 3 to 5 were found in 97.4％ malignant lesions.There were statistically difference in the scores of elastography between the benign and malignant lesions (P ＜0.01).Conclusions The ultrasonic elastography had positive significance in differentiating benign and malignant thyroid nodules.If the score of elastography is more than or equal to 3,the thyroid nodule is highprobablely malignant.

Epidermal growth factor receptor (EGFR) is a classic protein tyrosine kinase receptor, which plays an important role in cell proliferation, survival, adhesion, differentiation and apoptosis. Abnormality of EGFR and its signaling are closely associated with tumor initiation and development. Many environmental physical and chemical agents can interfere with EGFR and its signal transduction pathways via affecting its phosphorylation, conformation and function, or distribution on cell membrane, finally influencing gene expression and cell fate. This review focuses on the recent progress of above aspects for further understanding of epigenetic mechanisms of cellular stress and carcinogenesis related with environmental agents.
Carcinogens ; Environmental Exposure ; adverse effects ; Environmental Pollutants ; adverse effects ; Humans ; Phosphorylation ; Receptor, Epidermal Growth Factor ; drug effects ; metabolism ; Signal Transduction ; drug effects

Objective To discuss the reoperation method for recurrent pituitary apoplexy after the successful initial transnasal-sphenoidal surgery.Methods Twenty-one patients with pituitary apoplexy were found recurrence after previous tumor resection via transsphenoidal surgery in 9 months to 5 years.In the reoperation,transsphenoidal approach would be still used.The anterior wall of sphenoid sinus and the sellar floor were located accurately,and then the remnants of them were removed as large as possible to expand the range of bone window.Next,the intrasellar hematoma was cleared away gently,and the residual tumor was removed progressively and thoroughly to make sure the sellar diaphragm subsiding fully and finally removed the whole tumor.Results Most of recurrent tumors were found to be of soft texture with rich blood supply,and 17 cases were still apoplexy.In 18 cases of the 21 patients,total resection was achieved.However,for the other 3 cases with tumor aggressive growth,only massive resection was achieved,and underwent stereotactic radiosurgery postoperatively.Postoperative clinical symptoms were alleviated in 15 cases,whose hormones were also decreased.Temporary diabetes insipidus and hypopituitarism appeared in 5 and 3 cases respectively,but all of these postoperative complications were relieved after symptomatic treatment.Two cases of intraoperative cerebrospinal fluid leakage were resolved by packing the cavity with muscle and fat flaps.All cases were followed up for 3 months- 5 years,residual tumor enlarged in only 1 case of massive resection,which umderwent transsphenoidal surgery for the third time,no other cases recurred.Conclusion Operation via the transsphenoidal approach of recurrent pituitary apoplexy after successful initial transsphenoidal surgery could achieve high total resection rate.While the accurate locating,full expansion of the saddle bone window,and repeatedly scraping the apoplexy tumor to get a full subsidence for the sellar diaphragm,are the key points to remove tumors totally as well as to improve the symptoms.

AlM: To describe the expression of hypoxia-inducible factor-1α ( HlF-1α) and erythropoietin ( EPO ) in rats' corneal and evaluate its potential effect on corneal neovascularization ( CNV) growth.
METHODS:The young SD rats (3mo) was chosen and randomly divided into 2 groups, which were experimental group and normal control group. CNV model was established by alkali burn, and the length and area of CNV was observed everyday after operation by slit lamp. After that, the expression of HlF-1α and EPO was measured by SABC and RT-PCR methods at 1, 3, 5, 7, and 14d after alkali burn. The data was analyzed by SPSS 20. 0.
RESULTS:The area of CNV was increasing at 1, 3, 5, 7, and 14d after alkali burn, and the peak point appear at 7d. The growth speed was decreased after 14d. SABC method told us that no HlF-1αand very tiny amount EPO was detected at normal rats' corneal. The expression of the two factors increased at 1d after alkali burn in corneal epithelium and endoderm. The results of RT - PCR showed that a few amounts of HlF-1α and EPO mRNA were detected at normal group. The expression of the two factors was increased at 3d after alkali burn, and the peak value was found at 7d, however, it was decreased at 14d. Statistical difference was found at different time (P<0. 05).
CONCLUSlON: HlF- 1α and EPO is closely related to CNV.

Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

Objective To investigate the acute effect of dialysate calcium concentration on calcium balance and blood pressure(BP) of maintenance hemodialysis(MHD) patients with normal serum tCa,and to provide scien- tific basis for individualized calcium concentration dialysate formula.Methods For 4 weeks,dialysate with different calcium concentrations as DCa 1.25,DCa 1.5 and DCa 1.75 was used in 15 stable MHD patients.Arterial blood pressure was measured before and after each dialysis session,and every 30 minutes during hemodialysis session.Serum total calcium and ionized calcium were assessed before and after each dialysis session with different calcium concen- trations dialysate.Results With the DCa 1.2.5,BP,serum tCa and iCa decreased as compared with pre-dialysis val- ues(P

The OPG/RANKL/RANK system plays an important role in osteoclastogenesis and represents a great progress in bone biology. RANKL, which expresses on the surface of osteoblast/stromal cells and activated T cells, binds to RANK on the osteoclastic precursors or mature osteoclasts, and promotes osteoclastogenesis and bone resorption. While osteoprotegerin (OPG), which is expressed by osteoblasts/stromal cells, strongly inhibits bone resorption by binding to its ligand RANKL and thereby blocks the interaction between BANKL and RANK. A number of cytokines and hormones exert their effects on bone metabolism by regulating the OPG/RANKL ratio in the bone marrow microenvironment. RANK is also expressed on mammary epithelial cells and RANKL expression in these cells is induced by pregnancy hormones, RANKL and RANK are essential for the formation of the lactating mammary gland and the transmission of maternal calcium to neonates in mammalian species. Modulation of these systems provides a unique opportunity to develop novel therapeutics to inhibit bone loss in osteoporosis, rheumatoid arthritis, and bone metastasis of cancer. Further research should be focused on the cooperation of OPG/RANKL/RANK system with other signal pathways and the interactions among bone remodeling, immune system and endocrinology system. Currently, the development of OPG analogues or compounds which may stimulate OPG expression is becoming an attractive industry which may be profitable to both patients and manufacturers.
Animals ; Bone Resorption ; immunology ; metabolism ; Humans ; Osteoclasts ; cytology ; metabolism ; pathology ; Osteogenesis ; drug effects ; genetics ; immunology ; Osteoprotegerin ; metabolism ; physiology ; RANK Ligand ; metabolism ; physiology ; Receptor Activator of Nuclear Factor-kappa B ; metabolism ; pharmacology ; physiology ; T-Lymphocytes ; drug effects ; immunology

Functional analysis of new genes is playing a central role in postgenomic era. Here we reviewed several main strategies including bioinformatics, gene transduction, antisense technology, certain gene silence induced by RNA interference (RNAi), transgene and gene knockout and artificial chromosome transduction.
Animals ; Computational Biology ; methods ; Genes ; physiology ; Humans ; Transduction, Genetic ; methods

OBJECTIVETo evaluate the accuracy of continuous glucose monitoring system (CGMS) during oral glucose tolerance test (OGTT) in the detection of blood glucose changes in glucose stress condition.

METHODSForty-nine out-patients with fasting plasma glucose of 3.9-11.0 mmol/L underwent continuous blood glucose monitoring using CGMS for 3 days, and OGTT was conducted on the third day. The venous blood glucose was measured at 0, 30, 60, 90, and 120 min after oral glucose intake, and the accuracy of CGMS during OGTT was evaluated.

RESULTSThe correlation indices between CGMS values and the venous blood glucose values during the entire OGTT and in phases of stable, rapidly rising and falling glucose levels were 0.928, 0.901, 0.924 and 0.902, respectively (P<0.001). Clarke error-grid analysis showed that more than 95% of the measured results fell into the A and B zones.

CONCLUSIONCGMS values show good consistency with venous blood glucose values measured during OGTT. CGMS is accurate in detection of rapidly changing blood glucose during OGTT.

Adult ; Aged ; Blood Glucose ; analysis ; Blood Glucose Self-Monitoring ; methods ; Female ; Glucose Tolerance Test ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; methods ; Young Adult

Biomarkers ; blood ; Child ; Chorionic Gonadotropin ; blood ; Follicle Stimulating Hormone ; blood ; Growth Disorders ; etiology ; Humans ; Klinefelter Syndrome ; complications ; diagnosis ; genetics ; Magnetic Resonance Imaging ; Male ; Mediastinal Neoplasms ; complications ; diagnosis ; surgery ; Puberty, Precocious ; diagnosis ; etiology ; Teratoma ; complications ; diagnosis ; surgery ; Testis ; pathology