[Summary] We investigated a 12-year-old girl with elevated serum FT3 , FT4 , and TSH levels. The sequence of thyroid hormone receptorβ( TRβ) exons revealed a CCT→ACT transition mutation at nucleotide 453 site within exon10,whichresultedinthesubstitutionofcytosinetoadenosinein(P453T). Pituitarymagneticresonanceimage showed a pituitary micoradenoma. The patient underwent transsphenoidal pituitary adenomectomy. Pathological results exhibited positive TSH-β, GH, prolactin, ACTH, and α-HCG staining for the tumor. This is the first case report with thyroid hormone resistance syndrome and thyrotropin-secreting adenoma.

Electric Stimulation ; Humans ; Hypoglossal Nerve ; Sleep Apnea, Obstructive ; therapy

ObjectiveTo study the therapeutic effect and feasibility of endoscopic thyroidectomy via breast areola approach. MethodEndoscopic thyroidectomy via breast areola approach was performed in 62 patients, including 16 cases of adenoma, 43 cases of nodular goiter, and 3 cases of thyroid carcinoma.ResultsEndoscopic thyroidectomy was succeeded in 62 patients, 2 cases of cutaneous emphysema, 1 case of light skin bum which diameter was 0.5 cm, 1 case of transient hoarse voice,and 1 case of puncture sinus tract bleeding. There was no converted to open surgery,no hypercapnia, no damage of recurrent laryngeal nerve or parathyriod glands. ConclusionEndoscopic thyroidectomy via breast areola approach is safe and effective,and has good cosmetic results.

[Objective] To evaluate the clinical effect of acusector infrared and pressed needle on spondylopathy.[Method] Randomly divide the patients into treatment group 1 with acusector infrared and pressed needle,and control group 2 with acusector and infrared.[Result] In treatment group,8 cases were cured,32 better,5 not cured,and total effective rate 88.89%; for group 2,they were 2,28,15 and 66.67% respectively.There’s marked difference between them.[Conclusion] Acusector infrared and pressed needle are better in treating spondylopathy.

Objective To evaluate the clinical value and experience of endoscopic thyroidectomy.Methods Thyroidectomy with endoscopic instruments through chest-wall approach was done for 52 patients who had thyroid adenoma nodular goiter or thyroid cancer.We observed the results and complications of these operations.Results All 52 cases of operation were successful with no conversion.There was no nerve damage or postoperative hemorrhage.Average operation duration was (100 ± 22) min.The mean time of hospitalization after operation was (3 ± 0.5) d.Conclusion With the advantages of minimal and hidden incision,sooner recovery and satisfactory cosmetic effect,the endoscopic thyroidectomy will prevail in selected cases in the future.

This article systematically introduced the development of Smart Healthcare mode in Hangzhou. From the aspects of connotation, pattern, characteristics and the change of medical treatment mode, the authors pointed out that the development of Smart Healthcare must follow such principles as satisfaction of the people, enhanced inter-departmental synergy, government-guided social participation, and full involvement of medical workers.

OBJECTIVETo investigate the reconstruction of 1/4 defect on upper-lip vermilion with a lower-lip vermilion compound tissue flap pedicled at oral commissure.

METHORDSAt the first stage, the lower lip mucosal flap pedicled by inferior labial artery was transposed to reconstruct the defect on upper lip vermilion and tubercle. The defect at the donor site was closed directly. At the second stage, the flap pedicle was cut off and revised.

RESULTS6 patients were treated with satisfactory aesthetic results. All the flaps survived completely. The oral commissure kept normal with no obvious scar at the donor sites.

CONCLUSIONSThe modified crosslip vermilion flap pedicled at oral commissure has the advantages of avoiding inconvenience in feeding, speaking and cleaning. The procedure is simple with available blood supply. Both aesthetic and functional results are satisfactory.

Arteries ; Esthetics ; Humans ; Lip ; surgery ; Mouth Mucosa ; transplantation ; Surgical Flaps ; blood supply ; Transplant Donor Site ; surgery

Objective To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on emergence agitation in children under?went general anesthesia with sevoflurane. Methods Sixty children aged 3?6 years underwent adenoidectomy and tonsillectomy were selected and randomly divided into two groups:TEAS(group T,n=30)and control(group C,n=30). After venous induction,the general anesthesia was main?tained with sevoflurane. Group T received continuous TEAS at point hegu and neiguan after anesthesia induction till the end of operation. Control group were not given TEAS. The change of the blood flow dynamics in the process of anesthesia,the time of extubation,awaking time and the time in PACU were recorded. The emergence agitation,postoperative nausea and vomitting and respiratory depression were observed. Results There were no significant differences in gender,age,weight,anesthesia time,and operative time between the two groups (P>0.05 ). There was no significant difference in extubation time,awaking time and time in PACU between the two groups(P>0.05). The mean arterial pressure and heart rate in group T were lower than those in group C at the time of extubation and in PACU(P<0.05). The emergence agitation scale in group T was lower than in group C(P<0.01). There was no significant difference in incidence rate of PONV and respiratory depression between two groups. Conclusion TEAS can reduce emergence agitation in children with sevoflurane?induced general anesthesia,but not prolong extubation time,awaking time and time in PACU. In addition,it does not increase the incidence of respiratory depression.

Objective To investigate the relationship between promoter methylation of RASSF1A gene and laryngeal squamous cell carcinoma.Methods A methylation-specific PCR was performed to detect the promoter methylation of RASSF1A gene in 48 tumor tissues,48 corresponding normal tissues and 48 normal blood plasma.The expression of RASSF1A protein was determined by means of Western blotting.Results The methylation in RASSF1A gene was detected in 34(70.83%) tumor tissue samples,11(22.92%) corresponding normal tissue samples and 6(12.50%) blood plasma samples,respectively.The methylation degree of tumor tissue was higher than that of corresponding normal tissues and normal blood plasma(P

Objective To establish the allele-specific real-time polymerase chain reaction (ASPCR) for detection of neonatal hyperbilirubinemia related gene SLCO1B1 A388G polymorphism and apply this assay to identify the clinical samples.Methods According to SLCO1B1 A388G polymorphism loci,specific primers were designed and the assay was established.Wide type plasmid and mutant plasmid were constructed.Fifty clinical samples were selected,including 30 samples of neonatal hyperbilirubinemia that had been diagnosed with SLCO1B1 A388G mutant and 20 samples of healthy newborns without SLCO1B1 A388G mutant were selected as the controls.Wide type plasmid,mutant plasmid and clinical samples were tested by specific and non-specific primers.A388G polymorphism was determined by difference in Ct (cycle threshold) between specific and non-specific primers.Then,the accuracy,sensitivity and specificity of assay were evaluated.Results The difference in Ct (cycle threshold) between specific and non-specific primers that amplified equivalent wide type template was 13.97 ±0.75.The assay could correctly distinguish the wide type and mutant plasmid.Probit regression analysis showed the sensitivity of the assay could reach to 5.28 copies/μL.For clinical samples,the Ct values of the samples with A388G mutation was less than 37.75 and showed positive results,while the samples without A388G mutation did not show any amplification nor Ct values were larger than 37.75,which showed negative results.Conclusions ASPCR is a fast,simple and effective method for SLCO1B1 A388G polymorphism detection of the clinical simples.It can be used for large sample screening for neonatal hyperbilirubinemia gene loci.