Objective To investigate the clinicopathological features ,diagnosis and differential diagnosis of primary leiomyo‐sarcoma of the thyroid gland .Methods The pathological characteristics and immunohistochemical features in a case of primary leio‐myosarcoma of the thyroid gland were analyzed and the relevant literatures were reviewed .Results Grossly ,the mass measured 5 .5 cm × 4 .0 cm × 3 .5 cm ,gray and yellow in cut surface and partial hard quality .Histologically ,the tumor was composed of spin‐dle cells ,arranging in bundles with obvious dysplasia ,nuclear mitosis was easily found .The tumor infiltrated thyroid follicles and in‐vaded surrounding tissues .The immunohistochemical study showed that Vimentin ,SMA ,Caldesmon and Actin were positive ,and CK ,CK8 ,EMA ,TTF‐1 ,P53 and LCA were negative .Conclusion Primary leiomyosarcoma of thyroid gland is extremely rare ,its diagnosis should be combined with clinical and imageologic data ,histological characteristics and immunohistochemistry .

Objective To discuss the feasibility on reducing the postoperative pulmonary complications ( PPC) incidence after thoracot-omy on chronic obstructive pulmonary disease ( COPD) though application of incentive spirometry ( IS) . Methods 62 patients with COPD concurrent thoracotomy were divided into control group and observation group,the control group was given routine nebulization,expectoration and other physical treatment;the observation group were given IS besides the conventional treatment. The incidence of PPC,prognosis,and the changes on pulmonary function were compared between these two groups. Results The incidence of PPC and mortality of observation group were significantly lower than those of control group,and the inspiratory capacity( IC) from 3~5 days was significantly higher than that of con-trol group. Conclusion Application of IS can reduce the PPC incidence after thoracotomy on COPD patients,and promote the recovery of pulmonary function.

Objective To study the influence of ammoniummeta vanadate on the histological structure of jejunum of rats. Methods One hundred and twelve healthy and clean SD rats were randomly divided into the high dosage (60 mg/L),the moderate dosage(40 mg/L),the low dosage(20 mg/L) and the control group(distilled water),28 in each group,the males and females in the same number,the administration was conducted through drinking water,for 8 consecutive weeks. In the 4th and 8th weeks,the length of jejunum villus,the depth of jejunum gland and the thickness of jejunum wall were measured,the ratio of villus length and gland depth were counted and the pathological examination was done. Results With the increase of ammoniummeta vanadate,the weight of SD rats,the jejunum villus length,the depth of the jejunum gland,the wall thickness had showed a downward trend,the ratio of villus length and gland depth were significantly lower (P

Objective To understand the effect of vanadium to liver ultramicro structure in SD rats.Methods One hundred and fifty generaMevel SD rats of 2 months were randomly divided into control groups,30 in each,the males and females were equivalent,treated with ammonium metavanadate at doses of 0,10,20,40,60 mg/L through drinking water.After 2,6 and 10 weeks of treatment,6 rats from each group were weighed and the changes of ultramicro-structure in the liver were examined with electron microscope.Results As the increasing of dose,the increase in body weight showed a downward trend,but the coefficient of liver showed a increasing trend,the consistent performance was seen in male and female rat.After two weeks of exposure,the rats acted,ate and drank less,hair roughing and no shining,often getting together were seen.After 10 weeks,the rats had not the basic activities,the hair was disheveled and loose,some died,the structure of mitochondria and endoplasmic reticulum was normal in the 10,20,40 mg/L group,the number of endoplasmic reticulum increased,in 60 mg/L group,the rough endoplasmic reticulum vanished,the liver cytoplasm had a swelling phenomenon,the mitochondria reduced.Conclusion Vanadium have little effect on the liver cells of rats in low exposure level,but high level exposure may damage the liver cells in rats.

ObjectiveTo evaluate the effect of psychological and behavioral intervention combined with varenicline smoking cessation clinics and to analyze predictors of successful quitting.Methods Subjects were collected from quitters who went to receive consultation and intervention in “smoking and related diseases” clinic at Zhongshan Hospital,Fudan University from March 2009 to September 2010.Eligible subjects were screened and divided into strengthen follow-up group and control group.The 4 weeks continuous abstinence rate from week 9 through week 12 were observed logistic regression model and used to analyze the predictors of successful quitting.Results Subjects who are addicted to nicotine received strengthening psychological and behavioral intervention combined with varenicline in smoking cessation clinics.The total continuous cessation rate during the 9th-12th week was 52.3％,with 60.9％ (28/46) and 46.2％ (30/65) of strengthen follow-up group and control group respectively.The most frequent adverse effects were nausea 39.6％ (44/111),insomnia and abnormal dreams 17.1％ ( 19/111 ).Adverse effects were tolerable and withdraw symptoms were few.Preparation and medication time can be used as predictors of successful quitting.Conclusion The quit rate of varenicline therapy combining with strengthen intervention is high and strengthening psychological and behavioral intervention could increase the success rate more obviously,which is a good choice for cessation therapy in smoking cessation clinics.Better preparation and regular adequate treatment can improve quit rate.

Objective To evaluate the prognostic value of lateral lymphadenectomy for advanced lower rectal cancer. Methods A total of 96 consecutive patients who underwent total mesorectal excision and lateral lymphadenectomy for advanced lower rectal cancer were retrospectively evaluated by using therapeutic index. A product of the frequency of lymph node metastasis and the cancer-related 5-year survival rate. Results The incidences of lymph node metastasis in mesorectal area, superior rectal artery area, inferior mesenteric artery area and lateral area was 21%,13%.10%and 15%respectively.The 5-year survival rate of patients with metastasis to the mesorectal area, superior rectal artery area, inferior mesenteric artery area and lateral area was 35%,25%,20%and 36%respectively.The therapeutic indexes for total mesorectal excision and lateral lymphadenectomy were 7.4 and 5.4,which were much higher than that of lymphadenectomy of the superior rectal artery area(3.3)and inferior mesenteric artery area(2.0).Local recurrence occurred in 19%(18 out of 96 cases)patients with advanced lower rectal cancer. Local recurrence rate of patients with positive lateral lymph node metastasis was 64%(9 of 14 cases),whereas it was 11%(9 of 82 cases)in those without lateral lymph node metastasis. The difference between these two groups was statistically significant(x2=22.308,P=0.000).Kaplan-Meier survival analysis showed significant improvements in median survival(80.9±2.1)m,95%CI:76.7～85.1 m vs(38±6.7)m,(95%CI:24.8～51.2 m)for patients with negative lateral lymph node metastasis over patients with lateral lymph node metastasis(log-rank,P=0.000). Conclusion The current results indicate that lateral pelvic lymphadenectomy could significantly reduce loeal recurrence and effectively improve the survival of patients with advanced lower rectal cancer. Except for total mesorectal excision, lateral pelvic lymphadenectomy should be followed in the surgery of pailents with advanced low rectal cancer.

To analyze the data of 284 smoking patients visiting the clinic during January 2009 to December 2011.There were 273 males and 11 females with a mean age of 49 years and an average length of 26 years of smoking 24 cigarettes per day.The average volume fraction of exhaled carbon monoxide was 16 × 10-6.The average score of Fagerstrom test of nicotine dependence (FTND) was 5.The importance,confidence and preparation of quitting smoking were graded at an average of 8.5,6.7 and 7.6 respectively.Abstinence rate was 66.1％ at 1 month and 50.9％ at 3 months.A particular focus was placed upon those smokers with more serious nicotine dependence and longer smoking years.They knew much about the importance of smoking cessation,but there was a lack of confidence.Smoking cessation improves abstinence rate via behavioral counseling,psychotherapy and medication.We should strengthen publicity of smoking cessation and smoking cessation clinic to attract more patients with heightened confidence through treatment.

Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children's Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged (8.6 ± 4.5) years,the chief complaints were abdominal distention in 30 cases (100.00％),visible or audible air swallowing in 28 cases (93.33％),repetitive belching in 27 cases (90.00％),reduced appetite in 25 cases (83.33％),constipation in 22 cases (73.33％),psychological stresses in 15 cases (50.00％),recurrent abdominal pain syndrome in 10 cases(33.33％),chronic diarrhea in 3 cases(10.00％) and acute abdominal pain in 3 cases(10.00％).Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 (47-553)times of air swallowing were recorded.In the 30 patients,24 cases (80.00％) were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases(20.00％) were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichannel intraluminal impedance monitoring is a useful technology in the diagnosis of aerophagia children.

Adult ; Aged ; Female ; Humans ; Infratentorial Neoplasms ; diagnosis ; surgery ; Male ; Meningioma ; diagnosis ; surgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Supratentorial Neoplasms ; diagnosis ; surgery ; Treatment Outcome ; Young Adult

Objective:To evaluate the effectiveness of abdominal acupuncture plus the Confluent Points of the Eight Extraordinary Meridian in treating chronic pharyngitis. Methods:Thirty eligible subjects with chronic pharyngitis were given abdominal acupuncture plus needling Lieque (LU 7) and Zhaohai (KI 6), two out of the Confluent Points of the Eight Extraordinary Meridian, once a day, 10 sessions as a course, and the therapeutic efficacy was evaluated after a treatment course. Results:After a treatment course, of the 30 subjects, 21 were recovered, 5 showed markedly effective, 2 were improved, and 2 failed,the total effective rate was 93.3%. Conclusion:Abdominal acupuncture plus the Confluent Points of the Eight Extraordinary Meridian is effective in treating chronic pharyngitis, worth promoting in clinic.