Objective: To investigate the feasibility and advantages of supraclavicular approaching thyroidectomy for benign thyroid diseases. Methods: From February 2004 to December 2007, 64 cases of thyroidectomies were performed via the lateral cervical supraclavicular incision, and were selected as experimental group, of whom, there were 37 cases of thyroid adenomas and 27 cases of nodular thyroid goiters, respectively. At the same time period, 63 cases of consecutive thyroidectomies through the conventional anterior neck incision were selected as a control group, of whom, there were 39 cases of thyroid adenomas and 24 cases of nodular thyroid goiters, respectively. Results: All the operations in two groups were successfully accomplished. In the experimental group, there were 9 subtotal thyroidetomies, 40 subtotal lobectomies and 15 nodulectomies. While in the control group, there were 8 total thyroidetomies, 37 subtotal lobectomies and 18 nodulectomies. The statistical analysis between the two groups was carried out in terms of tumor size, operative time-consuming, blood loss, postoperative drain volume, time for return of motion and postoperative complications. There were no injuries of laryngeal recurrent nerve, superior laryngeal nerve and parathyroid glands. Two cases of postoperative complications in the experimental group and 3 in the control group were observed, respectively, the statistical differences were not significant between the two groups. Conclusion: The supraclavicular incision for thryoidectomy for benign thyroid diseases is a feasible and safe technique with a satisfactory cosmetic result. It is accessible to the treatment of bilateral thyroid diseases and can facilitate the detection of lymphatic metastases.

Objective:To evaluate the role of miR-124 in breast cancer and its underlying mechanism. Methods:Quantitative re-verse transcription-polymerase chain reaction (qRT-PCR) was employed to quantify the expression level of miR-124 in the breast can-cer cell lines and matched tissues of 52 patients. Cell proliferation, invasion, and migration of MDA-MB-231 and T-47D were deter-mined by miR-124 overexpression in vitro. Luciferase vectors (pMIR-SP1 3'UTR) were also constructed. The predicted target gene of miR-124 was identified via luciferase activation assay. The mRNA and protein expression of SP1 was detected via qRT-PCR and West-ern blot, respectively. Results:MiR-124 was decreased in breast cancer tissues and cell lines. This result is correlated with metastatic capacity, TMN stages, and prognosis in breast cancer tissues. In breast cancer cell lines, ectopic overexpression of miR-124 inhibited cell proliferation, invasion, and migration in vitro. MiR-124 mimics significantly inhibited luciferase activation (P<0.05) in HEK293 cells and could significantly decrease the mRNA (P<0.05) and protein expression levels of SP1 in MDA-MB-231 and T-47D cells. Con-clusion:MiR-124 could be inhibited in breast cancer. The low miR-124 expression is associated with poor prognosis. In addition, miR-124 could inhibit cell proliferation, invasion, and migration by targeting SP1. These findings confirm that miR-124 downregulation may be a key mechanism for breast cancer carcinogenesis.

Objective To study the clinical value of plasma BNP level in evaluation cardiac function of children with left-to-right shunt congenital heart disease.Methods 32 children with left-to-right shunt congenital heart disease were selected as the observation group.Then according to the heart load capacity,the observation group children were further divided into right ventricular group(14 cases) and left ventricular group(18 cases).20 cases of normal children were selected as the control group.Then plasma BNP level was determined by ELISA and the left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter(LVEDD),right ventricular end diastolic diameter(RVEDD),pulmonary blood flow/systemic blood flow ratio (Qp/Qs) and left heart Tei indices were determined by echocardiography.Results In the right ventricular group,the BNP level was (360.21 ± 56.78) ng/L,LVEDD was (35.71 ± 6.98) mm,RVEDD was (25.04 ± 5.52) mm,Qp/Qs was (1.74 ± 0.24) and left heart Tei index was (0.34 ±0.12).And in the left ventricular group,the BNP level was (384.57 ±55.18) ng/L,LVEDD was (45.27 ±7.26)mm,RVEDD was (12.34 ±2.18)mm,Qp/Qs was (1.78 ±0.19) and left heart Tei index was (0.36 ±0.11),which were significantly higher than those in the control group (F =307.00,18.92,84.24,91.47,3.44,all P ＜ 0.05).LVEF of the observation group had no obvious difference compared with the control group (F =1.51,P ＞0.05).The plasma BNP level of the right ventricular group was positively correlated with RVEDD,Qp/Qs and left heart Tei index (r =0.634,0.721,0.647,all P ＜ 0.05).The plasma BNP level of the left ventricular group was positively correlated with LVEDD,Qp/Qs and left heart Tei index(r =0.547,0.794,0.745,all P ＜ 0.05).There was no correlation between the plasma BNP level and LVEF of the observation group.Conclusion The plasma BNP level can help evaluation the early cardiac function of children with left-to-right shunt congenital heart disease,and combined with echocardiography can accurately reflect the early cardiac function of the left-to-right shunt congenital heart disease,which can provide basis for the clinical diagnosis and treatment.

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Objective To observe the near future curative effect and toxicity of the combination of weekly dose of cisplatin in the treatment of elderly patients with esophageal cancer intensity-modulated radiotherapy observa-tion.Methods 60 patients with locally advanced esophageal cancer patients aged by method randomly were divided into synchronous chemotherapy group( CRT group) and 30 cases of radiotherapy alone group( RT group) 30 cases,the two groups using 6MV-X ray intensity modulated radiotherapy,radiotherapy dose:DT 60 Gy/30/6 week.The CRT treated group was given cisplatin 20-25mg/m2 in the radiotherapy of second day,1 times per week,a total of 6 times. Results Radiotherapy and chemotherapy, radiotherapy group recent effective rate were 80.0% and 63.3%, the difference was statistically significant(χ2 =5.934,P<0.05),P< 0.05).The main toxicity was myelosuppres-sion,radiation esophagitis,basically I and II,no statistically significant difference between the two groups(P>0.05). Conclusion Intensity modulated radiotherapy combined with weekly dose of cisplatin in the treatment of elderly patients with esophageal cancer significant short-term effect,less adverse reactions,patient tolerance is good,which is worth the clinical promotion.

Objective To study the clinical efficacy of computer-assisted stereotactic brain transplantation of human retinal pigment epithelium (hRPE) cells into the patients with Parkinson disease (PD). Methods Under the guidance of computed X-ray tomography and magnetic resonance imaging image mergence, 4 × 106 hRPE cells were transplanted into the putamen and ventriculus laterlis of 17 cases of PD by stereotactic surgery. The transplantation sites were contralateral to the side of main symptoms and signs. The curative efficacy were observed at the 7th day, 1st month, and 3rd month after the transplantation. Results The contralateral symptoms were ameliorated continuously after the transplantation. Three months after the surgery, the total effective rate of cell transplantation was 88. 2 %, and 82. 4 % of the cases got significant improvement. The cases that got ipsilateral improvement soon after the surgery gave a total effective rate as high as 88. 2 % at the 3rd month during follow-up period, and 64. 7% among these cases improved significantly. Only a minority of cases had transient dizziness and hemiparesis, but the duration was short. Conclusion The therapy, computer-assisted stereotactic transplantation of hRPE ceils in the treatment of PD, is safe and efficient.

Objective To explore the most effective route of mesenchymal stem cell transplantation (MSCs) in D-galactosamine (D-gal) induced porcine model with acute liver failure (ALF) and the potential mechanism.Methods BA-MA mini-pigs with D-gal-induced ALF were transplanted with porcine mesenchymal stem cells (MSCs) through four routes:intraportal injection (InP),peripheral intravenous injection (PV),hepatic intra-arterial injection (AH) and intrahepatic injection (IH).The survival time was recorded.The blood samples before and after MSC transplantation were collected for detecting liver function.Liver histology was interpreted and scored.Hepatic apoptosis and regeneration were detected by Terminal Deoxynucleotidyl Transferase dUTP Nick End Labeling (TUNEL) assay and Ki-67 assay.The protein expression of cleaved caspase-3,survivin,AKT and ERK were analyzed by Western blot.Results The average survival time in each group was (10.7 ±1.6) days (InP),(6.0 ±0.9) days (AH),(4.7 ±1.4) days (PV),(4.3 ± 0.8) days (IH) when compared with D-gal group [(3.8 ± 0.8) days].The histopathological scores revealed a significantly decrease in InP group (3.17 ± 1.04,P ＜0.05) and AH group (8.17 ± 0.76,P ＜ 0.05) when compared with that in D-gal group (11.50 ± 1.32).The apoptosis rate in InP group (25.0 ± 3.4％,P ＜ 0.05) and AH group (40.5 ± 1.0％,P ＜ 0.05) was lower than that in D-gal group (70.6 ± 8.5％).The expression of active caspase-3 was inhibited,while the expression of survivin,AKT and ERK was elevated in InP group.Conclusions The intraportal injection was superior to other pathways for MSCs transplantation.Intraportal MSC transplantation could improve liver function,inhibit cell apoptosis,promote cell proliferation and prolong the survival in porcine ALF model.

Objective To systematically evaluate the relationship between atherosclerotic renal artery stenosis (ARAS) and cor‐onary artery disease (CAD) and peripheral arterial disease (PAD) .Methods We gathered all case‐control studies about the correla‐tion of ARAS with CAD and PAD in the following databases:Cochrane library ,PubMed ,EMBASE ,Web of science until April , 2014 .Two reviewers extracted all relevant datas from the screened documents independently according to exclusion and inclusion criteria ,RevMan 5 .2 software were used to conduct Meta‐analysis .Results Fourteen trials were included .Meta‐analysis showed that :the OR (95% CI)of CAD with 1 vascular lesions ,2 vascular lesions ,3 vascular lesions and left main stenosis ,PAD and ARAS were 0 .70(0 .59-0 .82) ,1 .28(1 .10 -1 .48) ,2 .09(1 .69 -2 .59) ,1 .82(1 .40 -2 .36) ,3 .68(2 .21 -6 .10) with statistical signifi‐cance (P<0 .05) .Conclusion CAD with 2 vascular lesions ,3 vascular lesions and left main stenosis ,PAD were connected with ARAS ,CAD with 1 vascular lesions has little relationship with ARAS .

Objective: To study the change rule of polysaccharide content in different processed products of polygonatum from Shaanxi. Methods:The content of polysaccharides was determined by UV spectrophotometry at the wavelength of 580nm after colored by 0. 2% anthranone-sulfuric acid solution. Results: The content of polysaccharide was significantly different among different pro-cessed products of polygonatum, and that in the raw slices was the highest followed by alcohol evaporate slices, while that in the steamed samples was the lowest. Furthermore, the extract and the content in the different processed samples of polygonatum showed a similar regularity. Conclusion:The results of the research can provide reference for the quality control and processing methods of po-lygonatum slices from Shannxi.

Objective To investigate the feasibility and technique in laparoscopic cholecystectomy and exploration of common bile duct (CBD) in patients who have previous subtotal gastrectomy.Methods From January 2001 to October 2010,22 patients who had a history of subtotal gastrectomy received laparoscopic cholecystectomy and CBD exploration in our hospital.In addition,these patients received cholangioscopic lithotomy,electrohydraulic lithotripsy,T-tube drainage,or primary suturing of the CBD wound.Results The procedures were completed successfully in 18 patients.In 4 patients,conversion to laparotomy was necessary because of multiple stones in a stenosed CBD (n=1),severely congested CBD wall with edema (n=1),CBD carcinoma associated with impacted stones (n=1) or Mirzzi syndrome (n =1).T tube drainage was employed in 16 patients,and primary suturing in 2 patients at the end of the operation.There was no hemorrhage,biliary leakage or abdominal infection.At a mean follow-up of 13 (range 3 to 60) months there was no residual stone,biliary stenosis or cholangitis.In 3 patients Stone recurred,and another 3 patients were lost to follow-up.Conclusions A history of subtotal gastrectomy is not a contradiction to laparoscopic cholecystectomy and CBD exploration.With choledocoscopy,surgery can be safe and feasible even for patients with previous gastectomy.