[Objective]To analyze the clinical and biological characteristics of suspected malignant thyroid nodules associated with Hashimoto thyroiditis .To summarize different characteristics of benign and malignant nodules,diagnosis and treatment of suspected malignant nodules associated with Hashimoto's thy-roiditis. [Methods]Surgical y and pathological y confirmed, 58 cases of suspected malignant thyroid nodules associated with Hashimoto's thyroiditis were retro-spectively analyzed with clinical and pathological data. The differences of gender, age, number of nodules, calcification, and thyroid hormone and thyroid an-tibodies levels between malignant and benign nodules were compared from January 2009 to December 2011 .[Results] The average age of malignant thyroid nodules coexisting with HT group was significantly lower than that of benign nodules coexisting with HT group( P<0.05). The proportion of nodular calcifi-cation in malignant thyroid nodules coexisting with HT group was significantly higher than that in benign nodules coexisting with HT group( P<0.05). Pre-operative TSH and anti-TG levels in malignant thyroid nodules coexisting with HT group were significantly higher than that in benign nodules coexisting with HT group. Preoperative FT3, FT4, anti-TPO levels, sex ratio and number of lesions between the two groups were not statistical y significant. [Conclu-sions] The key point of preoperative diagnosis:patients of malignant thyroid nodules coexisting with HT are associated with youth, calcified nodules, elevated serum TSH and anti-TG levels.

Objective To evaluate the effect of limited arthroscopic debridement under local anesthesia for knee osteoarthritis. Methods A retrospective analysis was made including a total of 63 patients (77 knees ) with knee osteoarthritis.There were 11 male and 52 female,with an average age of 56.5 years old(range from 38~71 years old).The limited arthroscopic debridement included removal of loose bodies hyperplastic synovum,degenerated cartilage and the injured meniscus.The average follow-up period was 2.1 years (from 6 month to 4 year).Outcomes were assessed by JOA knee function score and rate of satisfactory. Results During the follow-up,the patients showed significant improvement of knee function score from 41 point to 78 point.Clinical outcomes of 77 knees were excellent in 31 knee,good in 28 knee,fair in 12 knee,poor in 6 knee.The rate of good and excellent results was 76.6%. Conclusions Limited arthroscopic debridement under local anesthesia for knee osteoarthritis is a relative simple and effective method.It could alleviate pain and improve function of the paticents.

Objective In this study,we aim to investigate and evaluate the application of peer education on the teaching of medical graduate students and to evaluate the teaching effect,in order to provide the basis for subsequent practice reform.Methods 49 graduate students majoring Internal Medicine-Pulmonology were randomly divided into traditional teaching(24) and peer education groups (25).We chose the primary culture technology of rat distal pulmonary arterial smooth muscle cells to be the teaching contents.For the traditional teaching group,we used the mode of class lecture giving and experimental skills learning under the assistance of the teachers; while in the peer education group,students benefited from the combination of class lecture given by the teacher and the seniors fixed teaching in which seniors help younger students.We selected the experimental operating time,cell purity and the practicing time to reach a standard culture as the evaluation indexes by filling a follow up questionnaire.The SPSS 13.0 was applied to the related data forx2 or t test.Results In the traditional teaching group,the average time to reach three times of standard culture was(3.2 ± 0.5) hour,which was(2.3 ± 0.4) hour in the peer education group.The cell purity was 80.1 ± 3.6％ in the traditional teaching group,while(85.4 ± 5.9)％ in the peer education group.The average practicing time was(6.3 ± 1.0) in the traditional teaching group,while(4.9 ± 0.6) in the peer education group.The peer education group master the teaching content better than the traditional teaching group (P=0.00).95.8％(23/24)of the students in the peer-education group considered the teaching contents simple,which was statistically higher(P=0.00) than traditional group (62.5％,15/24).Meanwhile,95.8％ (23/24)of the students in the peer-education group considered the teaching methods easy to accept,which was also statistically higher(P=0.02) than traditional group(70.8％,17/24).The difference was statistically significant (P=0.02).Conclusion The application effect of peer education is good and there is high degree of acceptance among the students.Besides,peer education accords with the medical postgraduate experiment teaching rules,and can cultivate medical graduate students' spirit of cooperation and communication ability in the process of implementation.

Objective To summarize the 18F-FDG PET/CT findings of LCH in children,and explore its value in the diagnosis of LCH.Methods PET/CT imaging and clinical data of 13 patients (6 males,7 females;average age (3.0±2.3) years) with LCH confirmed by histology before treatment from August 2011 to December 2015 in Xin Hua Hospital were retrospectively analyzed.Results All 13 patients have different degrees of bone destruction with increased metabolism,the common lesion sites were craniofacial bone,spine,limb long bones,ribs/chest/shoulder blade and pelvic bone.Lymph node lesions which manifested lymph node enlargement with increased metabolism were found in 10 cases,and the SUVmax was 4.0±1.3.Diffuse FDG uptake in spleen was found in 10 cases.There were 4 cases with liver lesions,3 with lung lesions,1 with high metabolic nodules in muscle,1 with orbital lesions and 1 with intraspinal high metabolic nodules.Conclusion 18F-FDG PET/CT could display the distribution and activity of LCH,and plays an important role in the diagnosis and systemic evaluation of LCH.

OBJECTIVETo explore the curative effect and adverse reactions of a convenient expiratory positive airway pressure device(EPAPD) in treatment of obstructive sleep apnea/hypopnea syndrome(OSAHS). METHODS74 subjects with OSAHS were treated by EPAPD. Polysomnography(PSG) and Epworth sleepiness scores(ESS) were performed and evaluated before, within 1 week and after 3 months using the EPAPD. The index of PSG and ESS were compared at different time. The adverse reactions were also observed at the same time.RESULTS Compared to baseline, the AHI, LSaO2, ESS were significantly improved both within 1 week and after 3 months(AHI:F=73.62,P=0.00; LSaO2:F=12.65,P=0.00; ESS:F=61.49,P=0.00). The improvement of AHI between different OSAHS groups(divided by the severity of AHI in baseline) was significantly different(within 1 week:F=15.39,P=0.00; after 3 months:F=12.60,P=0.00). There was also significant difference between different hypoxia groups which were divided by the severity of LSaO2 in baseline(within 1 week:F=3.80,P=0.03; after 3 months:F=3.27,P=0.04). Meanwhile, the ESS was significantly improved in different sleepiness groups(divided by the ESS score in baseline) within 1 week(F=6.17,P=0.00). The device-related adverse events were reported by 44.59%(33/74). There were not serious adverse reaction happened. The major adverse reactions were throat and nose dry, nasal obstruction, and nose discomfort.CONCLUSION The EPAPD is an effective, convenient device in treating OSAHS. Meanwhile, the device related adverse reactions are slight. It may be more efficient for serious OSAHS patients than mild ones.

OBJECTIVE: To investigate the effect of Millettia pulchra extracts on tumor necrosis factor ? (TNF-?), prostaglandin E2(PGE2) and nitric oxide (NO) in pleuritis model rats. METHODS: 56 Wistar male rats were randomly divided into control group, model group, dexamethasone (DEX) group, water extract of M.pulchra (TYLS) group (high dose and low dose) and total flavonoids of M.pulchra(FYLS) group (high dose and low dose). After preoperational intragastric administration for 7 days, the pleuritis model was induced by injecting carrageenan into pleural cavity in 30 minutes after the last medication. The amounts of pleurorrhea, leucocyte, TNF-?,PGE2 and NO in the pleurorrhea were measured at 8 hours after modeling. RESULTS: As compared with the model group, in TYLS and FYLS group the pleurorrhea volume, leukocyte amount, contents of TNF-? and PGE2 reduced markedly, but the synthesis of NO had little change.CONCLUSION:M.pulchra Extracts show a marked inhibitive effect on pleuritis. Their anti-inflammation effects may be related to inhibiting the increase of TNF-? and the infiltration and transmigration of leucocytes, but not associate with the synthesis of NO.

Objective To investigate the effects of tagged fluid and substraction in CT virtual colonoscopy (CTVC) on the conspicuity of polyps and to confirm the optimal attenuation value and the optimal viewing window. Methods Polyps measured 3-10 mm were created in fresh porcine colon in vitro and submerged in saline and mixed with positive contrast medium for the CT values of 200 HU, 400 Hu, 600 HU, and 800 HU. Polyps were measured before and after substraction and compared with those in the control group. The effects of different viewing windows and different attenuation values on the measurement and conspicuity of polyps were analyzed. Results The optimal attenuation value of tagged fluid was 800 HU and the optimal viewing window was colon (-150 HU, 1 500 HU) and bone (500 HU, 2 500 HU). Conclusion The combination of tagged fluid and CT substraction can improve the conspicuity of small polyps covered by colonic fluid.

BACKGROUND: There still is rarely report about the effect of glycosylphosphatidilinoditol-specific phospholipase D (GPI-PLD) on the adhesion function of leukemic cells through screening Medline and CNKI databases.OBJECTIVE: To observe the effect of GPI-PLD on the adhesion function of bone marrow mononuclear cells separated from myeloid leukemia patients, and to investigate the related mechanism. DESIGN, TIME AND SETTING: This study addressing cytology in vitro was conducted at the Hematological Laboratory of Xiangya Hospital from January to June 2004.MATERIALS: Bone marrow was collected from myeloid leukemia patients at the Department of Hematology, Xiangya Hospital, China.METHODS: The GPI-PLD activity of bone marrow mononuclear cells separated from myeloid leukemia patients was measured by using GPI-anchored placental alkaline phosphatase as substrate and Triton-X114 partition. By use of 1,10-phenanthroline, the activity of GPI-PLD was inhibited, the experiment was divided into 2 groups: treatment group adding phenanthroline to achieve a final concentration of 1 mmol/L, while control group adding the same amount of phosphate buffered saline. The adhesion rate to the fibronectin and CD24 expression of these cells were measured by MTT and immunohistochemical method, respectively.MAIN OUTCOME MEASURES: GPI-PLD activity of myeloid leukemic cells, cell adhesion rate, CD24 expression were all measured. RESULTS: The GPI-PLD activity of bone marrow mononuclear cells separated from myeloid leukemia patients was inhibited significantly after these cells were treated by 1 mmol/L 1,10-phenanthroline for 5 hours compared with control groups [(5.40±2.96)%, (42.08±7.21)%, P < 0.01]. At the same time, the adhesion rate of these cells were increased after the GPI-PLD activity was inhibited [(61.19±29.14)%, (49.78±26.73)%, P < 0.01], and the CD24 expression was also up-regulated [(18.5±11.14)%, (16.02±9.68), P < 0.01].CONCLUSION: The adhesion rate of bone marrow mononuclear cells separated from myeloid leukemia patients can be promoted by inhibiting GPI-PLD activity. At the same time, the CD24 expression of GPI-anchored proteins on bone marrow mononuclear cells is improved.

Objective To evaluate the curative effects of intravenous methylprednisolone (IVMP) during the conservative management for patients with indirect optic nerve injury (ONI),and to analyze the benefits of visual evoked potential (VEP) monitoring in prognosis assessment.Methods Among the 253 patients with cranial-facial injury,108 sufferred from optic nerve injury including 89 cases without optic nerve decompression treatment.These 89 patients were randomly divided into:group A,in which patients were given methylprednisolone intravenously for 7 days; and group B,in which patients without methylprednisolone treatment.The extent of and time required for eyesight recovery were recorded.VEP measurement was carried out in all cases.Results No differences in gender,age and BMI (Body Mass Index,all P ＞ 0.05) were observed.The incidence of ONI was higher in patients with motorcycle accident than that in those with car accident (P ＜0.01).In the motorcycle accidents,casualties wearing a helmet had lower incidence of ONI (P ＜ 0.01).Patients treated with methylprednisolone had a shorter recovery time (P ＜ 0.01) from blindness,however there was no difference in long-term outcome between group A and B.In patients with visual improvement in the “ non-extinguished” group,the amplitude and latency of the P wave of VEP were markedly ameliorated after the treatments (P ＜ 0.01).Conclusions Most of the ONI casualties in our study were resulted from motorcycle accidents,and wearing a helmet is an effective protection measure.The intravenous methylprednisolone (IVMP) showed no effect on improving the prognosis in patients with conservative treatment.The IVMP shortened the recovery time at the expense of increase in risk of complications.VEP examination is beneficial in prognosis assessment for non-operative ONI patients.The improvement of the amplitude and latency of P wave has close correlations with patients'visual recovery.

Objective To explore new method to improve the teaching effects of complete denture prosthetics.Methods Totally 49 students were divided into 6 groups randomly.Lecture-based learning (LBL) combined with problem-based learning (PBL) methods were tried in complete denture prosthetics teaching.LBL teaching was made up of 18 class hours,in which teachers' teaching in the form of lecture was given priority to and introduction to basic theory of complete denture was focused on.PBL teaching was made up of 6 class hours in the form of small class ； the teaching plan ' new dentures of uncle Wang' compiled by the teaching and research section was taken as the blueprint；students searched for the references and discussed on the upcoming problems,relevant reasons and processing methods for wearing new dentures ； students made the final report.The effects were estimated by denture prosthodontics examination and PBL teaching feedback form.Data were described by percentage.Results 93.88％ students passed the exam,67.35％ students got good results.Feedback showed that 77.55％ students hold a positive attitude to PBL teaching.Conclusion Combining LBL with PBL in complete denture prosthetics teaching can achieve satisfactory results.