Objective To investigate the serum levels of Thyroid stimulating hormone (TSH ) ,Thyroglobulin antibody (TgAb) and Peroxidase antibodies(TpoAb) in patients with different thyroid diseases and to explore the relationship between the 3 indexes with thyroid diseases .Methods 383 cases of thyroid diseases were divided into six groups ,simple adenoma of throid group(TA , n=30) ,nodular goiter group(NG ,n=59) ,papillary thyroid hyperplasia group(PTH ,n=36) ,nodular goiter with adenoma group (NG+ TA ,n=196) ,hashimoto′s thyroiditis(HT ,n=13) ,throid carcinoma group(TC ,n=49) .The relationship between concentra-tion of FT3 ,FT4 ,TSH ,TgAb ,TpoAb in serum and thyroid diseases incidence was analyzed .Results (1)The serum TSH concen-tration had statistically sinificance between group HT with group TA and NG ,group PTH and TA+NG group(P<0 .05) .Despite the concentration of serum TSH in TC group was in a high level near to the upper limit ,there was no statistically significance ver-sus other groups .(2)In group HT and TC ,the increased rate of TSH and positive rate of TgAb and TpoAb were significantly high-er than in group BT (P<0 .05) .(3)The double positive rate of TgAb and TpoAb ,the single positive rate of TpoAb in group HT and TC were higher than those in group BT (P<0 .05) .Conclusion There was a close correlation between serum TSH ,TgAb , TpoAb concentration and thyroid disease ,especially closely associated with HT and TC .Raised TSH and TpoAb positive have im-portant reference value in diagnosis of TC .

Objective: To observe the effect of Trifoliumpratense Leguminosae extract (TLE) on mouse allogenetic skin transplantation. Methods: Recipient BALB/c was divided into physiologic saline (PS) group and TLE group, full-thickness skins were transplanted through back to back method from donor C57BL/6. The allogenetic transplanted skin growth condition was observed. The proliferation of lymphocytes of recipient mice in vitro were detected by CFDA-SE stain and mixed lymphocyte reaction respectively. Results: The allogenetic transplanted skin injected with TLE 25g/kg per day by vena caudalis growed better than that in PS group. The proliferation of lymphocyte in TLE group was smaller than that in PS group. Conclusion: TLE maybe participate in the regulation of mouse immune system and induce its tolerance to the allogenetic transplanted skin.

Objective: To summarize the experience of valve replacement for multiple valve insufficiency in patients with giant left ventricle and the operative indication. Methods: Multiple valvular operations were performed in 62 patients with giant left ventricle between 1991 and 2002. Combined mitral and aortic valve replacement was performed in 56, tricuspid valve annuloplasty in 43, left atrium placation surgery in 12, and mitral valve replacement in 5. Results: The early postoperative complication and mortality rate were 45.2% and 17.7%, respectively .The late mortality rate was 6.5%. The main factors influencing the early surgical results were preoperative severe left ventricular enlargement (ESD ≥6.0cmand EDD ≥8.0cm) and systolic dysfunction (EF ≤0 40 and FS ≤0 25), perioperative ventricular fibrillation, postoperative low cardiac output and multiple organal failure. The main factors affecting long term survival were postoperative severe ventricular arrhythmia and left ventricular enlargement with depressed systolic performance. Conclusion: The keys to improve the early and late results of multiple valve replacement in these patients with giant left ventricle are the choice of optimum surgical timing, the proper management of the high risk factors mentioned above during perioperative and follow up periods.

Objective: The aim of this study is to compare the clinical data and result between transcatheter closure and surgical repair for the treatments of secundum ASD in patients above 50 years old, and explore the indications for these two methods. Methods: From January 1998 to December 2003, 53 patients with surgical repair and 42 patients with transcatheter closure were enlisted according to the diagnosis of ASD. The ages of all of cases were above 50 years old. The interventional approach was administrated with Amplatzer device. The surgical approach mended the defect directly or with autologous pericardium. These patients were followed up by echocardiography (Echo). The clinical data including the diameter of the right ventricle (RVD), the pulmonic flow velocity, the pulmonary pressure and the tricuspid valve regurgitation. Results: In surgery group, surgical mortality was 1 9% (1/53). Cerebral embolism occurred in 4 (7 5%) patients. Pericardial effusion and other complications occurred in 24.5%. All 42 patients with ASD were effectively closed with Amplatzer occlude. One occluder displaced and moved into pulmonary artery on the fourth day after the treatment. The short term effective rate was 97 6% in transcatheter closure group. The diameter of ASD showed by Echo was significantly less in patients treated with transcatheter closure than that in surgical repair group. The hospitalization time was significantly less in patients treated with transcatheter closure. The follow up data recorded decreased load of right ventricle, the decreased diameter of right ventricle as well as the relief of pulmonary artery hypertension. Conclusion: The data suggested that of surgical approach of ASD has a wider indication for patients in different stages of the disease, whereas surgical morbidity may increase in elderly patients due to their pre existed diseases. However, the transcatheter closure for ASD is feasible for patients with smaller defects.

AIM: To investigate the potential of murine epidermal stem cell (ESC) differentiation after seeded in a biodegradable carrier and implanted subcutaneously into syngeneic recipient mice. METHODS: ES cells were induced in vitro to differentiate into ESCs. After stained with a fluorescent dye Hoechst 33342, these ESCs were seeded into a polyglycolic acid (PGA) net containing collagen gel, functioning as a cell carrier, and implanted subcutaneously into 129/J mice, which were syngeneic to these stem cells. RESULTS: The ESCs kept alive in the implant when observed under a fluorescent microscopy 3 weeks or longer after implantation, and could differentiate into hair follicle - like structure,glandular structure, and gave rise to additional structures displaying features resembling native dermis. No apparent rejection or severe side effects were observed at least 10 weeks post- implantation. CONCLUSION: It is feasible to use these ESCs as seed cells in the study to fabricate dermal equivalent having the potential to develop dermal appendages.

Objective To study the epidemiological tendency and influencing factors for major chronic diseases in the elderly in Changsha,and to provide the scientific basis for the prevention and control strategies for the aged people.Methods Multi-stage randomized cluster sampling method was used in selecting 3135 persons aged 65 and over in Changsha.Using unified questionnaire and face to face asking method to investigate the prevalence of chronic diseases and its influencing factors.Results 95.7％ of questionnaires were valid (3000/3135).The total prevalence rate of chronic disease was 86.33％ in patients aged from 65-96 (74.83±6.63) years,with 85.49％ (1332) in males,and 87.23％ (1258) infemales(x2=1.93,P=0.164).Most of them had 1-3 kinds of chronic diseases,in 1 patient with 13 kinds of chronic diseases at the most.The most common chronic diseases among the elderly were hypertension,heart diseases,osteoarthritis,diabetes mellitus,benign prostatic hyperplasia,and fatty liver.Multivariate logistic regression suggested that age,marital status,smoking,quality of sleep were common influencing factors for hypertension,heart diseases and diabetes mellitus.Conclusions The prevalence of chronic diseases is high and the influencing factors are ubiquitous among the elderly in Changsha community.Community health education should be carried out to improve the effect of prevention and control of chronic diseases.

Objective To investigate the expression and significance of trefoil factor 3 (TFF3) and stromal cell de-rived factor-1 (SDF-1) in papillary thyroid carcinoma (PTC) and adjacent tissues, and to provide the basis for clinical diagno-sis and prognosis evaluation. Methods The expressions of TFF3 and SDF-1 proteins in PTC and adjacent tissues were de-tected by immunohistochemical SP method. The relationship between expressions of TFF3, SDF-1 and clinicopathological features was analyzed. Results (1) The positive rate and the expression level of TFF3 protein were significantly higher in PTC than those in adjacent tissues, which were higher in patients with lymph node metastasis than those in patients without lymph nodes metastasis, and were higher in PTC patients of stageⅢ/Ⅳthan those in patients of stageⅠ/Ⅱ(P＜0.05). The strong positive rate of TFF3 protein in stageⅢ/Ⅳof PTC patients was higher than that in stageⅠ/Ⅱ(P＜0.01). (2) The posi-tive rate and the expression level of SDF-1 protein were significantly higher in PTC than those in adjacent tissues, which were higher in patients with lymph node metastasis than those in patients without lymph nodes metastasis, and were higher in PTC patients of stageⅢ/Ⅳthan those in patients of stageⅠ/Ⅱ, and were significantly higher in patients over 45 years old than those of patients≤45 years old (P＜0.05). (3) There was a positive correlation between expression levels of TFF3 and SDF-1 proteins in PTC (r=0.266,P＜0.05). Conclusion The higher expressions of TFF3 and SDF-1 in PTC were closely correlated with carcinogenesis and progression, which may play a significant value in judging the malignant degree and pro-gression of PTC.

Objective:To investigate the occurrence and influencing factors of perioperative complications after robotic gynecologic surgery.Methods:The clinical data and occurrence of perioperative complications in 1 000 cases robotic surgery completed in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Results:(1) Clinical data: the average age of the patients was (50.2±10.4) years old, and the average body mass index (BMI) was (24.4±3.6) kg/m 2. Among 1 000 cases, 811 cases of them were malignant tumors, including 405 cases of cervical cancer, 279 cases of endometrial carcinoma, 112 cases of epithelial ovarian cancer (EOC), 15 cases of vulvar cancer; 189 cases of them were benign diseases, including 43 cases of uterine prolapse, 57 cases hysterectomy of uterine leiomyoma and adenomyosis of the uterus ≥12 weeks, 84 cases myomectomy of uterine leiomyoma, and 5 cases of fallopian tubal ligation requiring anastomosis. Surgical methods: in patients with malignant tumors, cervical cancer, hysterectomy plus salpingectomy or salpingo-oophorectomy for stage Ⅰa1, and radical hysterectomy plus pelvic lymphatic dissection plus salpingectomy or salpingo-oophorectomy for stage Ⅰa2-Ⅱb. Endometrial carcinoma, performed by staging surgery. Staging surgery for EOC with early stage and cytoreductive surgery with advanced EOC. Vulvar cancer, extensive vulvar resection plus inguinal lymphadenectomy. In patients with benign diseases, uterine prolapse, hysterectomy plus salpingectomy or salpingo-oophorectomy plus sacrocolpopexy. Uterine leiomyoma or adenomyosis with uterus ≥ 12 weeks, hysterectomy plus salpingectomy or salpingo-oophorectomy. Myomectomy for patients requiring uterine preservation with uterine leiomyoma. Tubal anastomosis for patients with fallopian tubal ligation. (2) Surgical complications: intraoperative complications occurred in 25 patients (2.5%, 25/1 000), including 11 patients with vascular laceration, 11 patients with ureteral injury, 2 patients with bladder injury, and 1 patient with intestinal injury. Postoperative complications occurred in 130 patients (13.0%, 130/1 000), including 66 cases of lower limb venous thrombosis, 20 cases of lymphatic cyst, 8 cases of hydronephrosis, 9 cases of ileus, 16 cases with infection, 6 cases with genital fistula, 4 cases with trocar site herniation and 1 case with subcutaneous emphysema. The incidence of intraoperative complications was 3.1% (25/811) in malignant tumors and no case in benign diseases, the incidence rate in malignant tumors was significantly higher than that in benign diseases ( χ2=4.778, P=0.029). The incidence rate in cervical cancer (4.2%, 17/405) and EOC (3.6%, 4/112) were significantly higher than those in endometrial carcinoma (1.4%, 4/279) and vulvar cancer (0/15; P<0.05). The incidence of postoperative complications was 15.2% (123/811) in malignant tumors and 3.7% (7/189) in benign diseases. The incidence rate in malignant tumors was significantly higher than that in benign diseases ( χ2=17.807, P<0.01), but there were no significant difference among different malignant tumors ( χ2=4.318, P=0.229). (3) The correlative factors affecting the occurrence of surgical complications: patient′s age, BMI, previous pelvic or abdominal surgery history, the nature of disease (malignant or benign), operation time, and comorbidities had a significant impact on the incidence of postoperative complications ( P<0.05). Multivariate logistic regression analysis showed that the patient′s age ≥40 years old, BMI ≥25 kg/m 2, previous pelvic or abdominal surgery history, malignant tumors and comorbidities were independent influential factors of the postoperative complications ( P<0.05). Conclusions:Perioperative complications vary according to the type of the surgery. The age, BMI, previous pelvic or abdominal surgery history, malignant tumors, and comorbidities are influential factors of postoperative complications.

Objective To investigate the effect of infiltrated mast cells on the biological characteristics of uterine carcinoma.Methods Twelve leiomyomas,ten uncertain malignant uterine leiomyomas,and seven uterine leiomyosarcomas were studied with light microscopy for the morphometry about their histological feature,mast cell particle and factor Ⅷ-related antigen(FⅧRAg);Cell apoptosis was measured by flow cytometry.The correlative analysis was carried out between the mast cell and others factors.Results Comparing with smooth muscle tumors of uncertain malignant potential(4209.9?273.0),the count of tumor cell was the highest in leiomyosarcoma(3557.6?346.3)(P

Objective To investigate the risk factors associated with gastroparesis syndrome after laparoscopic pancreatoduodenectomy which provide reference for clinical prevention.Methods Ninety cases of laparoscopic pancreatoduodenectomy admitted from August 2013 to December 2016 in Traditional Chinese Medicine Hospital of Guangdong Province were studied retrospectively,57 were male(63.3%),the average age was 54.6 years old.Twenty cases were diagnosed postoparative gastroparesis syndrome(22.2%).To screen out the risk factors,31 independent variables were analyzed by univariate analysis and logistic regression.Results Univariate analysis showed that malnutrition,hypoproteinemia,anemia,pylorus-preserving,extensive lymph nodes dissection,anxiety,high blood sugar before operation,delay of enteral nutrition,abdominal infection and postoperative high blood sugar were associated with postoperative gastroparesis(The value of OR were 3.143,3.587,2.852,2.889,3.231,7.071,2.889,5.359,6.000,6.263,P<0.05).Multivariate Logistic regression analysis showed that extensive lymph nodes dissection,anxiety,pylorus-preserving,abdominal infection,delay of enteral nutrition,hypoproteinemia,postoperative high blood sugar were risk factors of postoperative gastroparesis(The value of OR were 17.574,8.931,6.637,6.461,6.446,5.414,5.200;P<0.05).Conclusion Multiple risk factors can lead to gastroparesis after laparoscopic pancreatoduodenectomy,measures should be taken aimed at these risk factors during perioperative period.