ObjectiveTo investigate the diagnosis and treatment of occult thyroid carcinoma(OCT).MethodsRetrospective analysis on the clinical data of 34 cases of OCT was made. ResultsOnly 6 cases were preoperatively diagnosed as OCT. Total resection of the affected lobe and isthmus was performed on 16 cases with neck dissection in 14 cases. Subtotal thyroidectomy was performed on 18 cases. The occult cancer lesion was pathologically confirmed within ipsolateral lobe in all the 34 cases. Neck lymph node metastasis was found in 4 cases and local infiltration in 3 cases. The psammoma bodies in cancer lesion and adjacent normal gland were found in 15 cases. Thirty-one cases were followed up for an average of 9 years. One died of lung metastasis and two more of other unrelated diseases. Conclusion(1) The psammoma bodies in normal thyroid gland usually imply the existence of cancer. (2) Total thyroidectomy of a lobe or subtotal thyroidectomy was the therapy of choice. Local infiltration or neck lymph node metastasis necessitates additional neck dissection.

ObjectiveTo study the value of quantitive scoring methodby ultrasound in differential diagnosis of thyroid nodule.MethodsTotally 1 360 patients with thyroid carcinoma or nodular goiter were given preoperative ultrasound examination of thyroid. The features of thyroid nodule and their signiifcances in diagnosing thyroid carcinoma were evaluated by logistic regression analysis. Surgical pathology was taken as golden standard. Signiifcant feature was scored as 1 point, and insigniifcant feature was scored as 0 point. In two groups, the data were analyzed statistically.ResultsLow echo, obscure boundary, incomplete or no capsule, incomplete or no halo, aspect ratio≥1, internal lfow, posterior acoustic attenuation, no cystic echo, microcalciifcation and background Hashimoto′s thyroiditis showed correlation with malignancy. There were statistically significant difference between thyroid cancer and nodular goiter in thyroid nodules scores (χ2=802.08,P<0.05). Of 768 thyroid nodules with<6 points, 742 were benign and 24 were malignant. Of 60 thyroid nodules≥10 points, 2 were benign and 58 were malignant. Of 314 thyroid nodules with 8-9 points, 60 were benign and 254 were malignant. Of 368 thyroid nodules with 6-7 points, 155 benign and 213 were malignant.ConclusionsQuantitive scoring of thyroid nodule had clinic signiifcance in differential diagnosis. Thyroid nodule with>8 points accounted for the majority of malignancy and should be considered for surgery.

Objective To explore the relationship between the expression of CD44v6,P16 protein and the invasion and metastasis in gastric carcinoma and to investigate the correlation between the expression of CD44v6 and P16 protein.Methods Immunohistochemical methods were used to detect the expression of CD44v6 and P16 protein in 110 cases of gastric carcinoma.Results In 110 cases of gastric carcinoma,the expression of CD44v6 and P16 protein were 72.7%(80/110)and 47.3%(52/110)respectively. The high level expression of CD44v6 protein and low level expression of P16 protein were positively correlated with the TNM staging,serosa infiltration,lympho node and liver metastasis of gastric carcinoma(P

OBJECTIVE: To investigate the relation between the expression of tPA, MMP-2, MMP-9 and AEG-1 in the human brain tissue and the ethanol concentration under the acute alcohol poison, and to analyze the role of alcohol and trauma in the mechanism of death of subarachnoid hemorrhage. METHODS: Fifteen real cases were collected in this study. The brain tissues were researched by histological examination and the concentration of ethanol in heart blood were detected. The tPA, MMP-2, MMP-9 and AEG-1 in brainstem, brain and cerebellum were observed respectively by immunohistochemistry. RESULTS: In alcohol poisoning groups with or without trauma, the acute alcohol toxicity resulted in the swelling of brain tissues. The tPA, MMP-2, MMP-9 and AEG-1 of brainstem, brain and cerebellum showed high expression in alcohol victims, and the tPA in cerebellum showed no difference. The expression of the MMP-2, MMP-9 and AEG-1 showed good relation with the ethanol concentration in blood (P < 0.05, r > 0.6). CONCLUSION The expressions of tPA, MMP-2, MMP-9 and AEG-1 are significant higher in alcohol victims, and expressions of MMP-2 and MMP-9 and AEG-1 have positive correlation with the alcohol concentration. The alcohol has acute toxicity to brain cells.
Alcohol Drinking/adverse effects* ; Brain ; Cell Adhesion Molecules/metabolism* ; Craniocerebral Trauma/etiology* ; Death ; Ethanol/poisoning* ; Heart/drug effects* ; Humans ; Matrix Metalloproteinase 2/metabolism* ; Matrix Metalloproteinase 9/metabolism* ; Membrane Proteins ; RNA-Binding Proteins ; Subarachnoid Hemorrhage/complications*

Objective To investigate the effect of reinfusion of drained bile and pancreatic juice on the outcome of pancreaticoduodenectomy (PD).Methods The clinical data of 51 patients who received PD at the Affiliated Hospital of Binzhou Medical College from June 2005 to March 2009 were retrospectively analyzed.Nineteen patients received external drainage of bile and pancreatic juice ( ED group) and the other 32 patients received external drainage and intraintestinal administration of autologous bile and pancreatic juice (ID group).The daily volume of output of bile and pancreatic juice,intraoperative condition,tolerance of enteral nutrition,liver function and nutritional parameters of the 2 groups were detected.All data were analyzed by using chi-square test,Fisher exact test,independent t test,Mann-Whitney U test and one-way analysis of variance.Results The pulmonary infection rate of ID group was 3％ (1/32) after operation,which was significantly lower than 26％ (5/19) of the ED group (P ＜ 0.05).The output of pancreatic juice in the ID group was significantly lower than that in the ED group since postoperative day 4 ( t =7.143,9.244,8.808,7.915,6.461,14.097,15.038,P ＜ 0.05 ).There was no significant difference in the daily output of bile between the 2 groups.The incidence of diarrhea in the ID group was 9％ (3/32) after nutritional support,which was significantly lower than 37％ (7/19) of ED group (P＜0.05).The duration of achieving targeted enteral feeding in the ID was 3 days,which was significantly shorter than 4 days of the ED group ( U =145.000,P ＜ 0.05 ).The levels of total bilirubin ( TBil),direct bilirubin (DBil) and indirect bilirubin (IBil) were (261 ± 108 ),( 132 + 55 ) and ( 129 + 55 ) μmol/L in the ID group,and (239 ±92),( 12A ±46) and ( 116 ±46) μmol/L in the ED group before operation.The levels of TBil,DBil and IBil were (39 ± 19),(20 ± 10) and ( 19 +9) μmol/L in the ID group,and (55 ±22),(29 ± 12) and (26 ±11 ) μmol/L in the ED group at 12 days after nutritional support.There were significant differences in the decrease of TBil,DBil and IBil between the 2 groups ( t =7.324,8.437,5.827,P ＜ 0.05 ).The levels of serum prealbumin,retinol binding protein and transferrin were (0.261 ± 0.021 ) g/L,(34.3 ± 2.8 ) mg/L,(3.08 + 0.26 ) g/L in the ID group,and (0.263 ±0.021)g/L,(33.8 +3.5)mg/L and (3.10 +0.27)g/L in the ED group before operation.The levels of serum prealbumin,retinol binding protein and transferrin decreased significantly after operation,and then got increased 3 days after nutritional support.The levels of serum albumin,retinol binding protein and transferrin were (0.238 ±0.025)g/L,(30.7 ±2.0)mg/L,(2.78 ±0.19)g/L in the ID group,and (0.222 +0.025)g/L,(29.3 ±2.1)mg/L and (2.63 +0.21)g/L in the ED group at 12 days after nutritional support.The levels of serum albumin,retinol binding protein and transferrin in the ID group were significantly higher than those in the ED group (t=4.615,6.097,4.913,P＜0.05).Conclusion Reinfusion of external drained bile and pancreatic juice after PD could enhance the tolerance of patients in early enteral nutrition,reduce incidence of pneumonia,promote decrease of serum bilirubin and improve the nutritional status.

Glucagonoma is a kind of neuroendocrine tumor of the pancreas,which is rarely seen in clinical practice.Glucagonoma is characterized by necrolytic migratou erythema (NME),diabetes,anemia and body weight loss,and NME is the most characteristic clinical manifestation.The most important laboratory basis of glucagonoma is the levels of fasting plasma glucagon.Various imaging examinations are helpful for the localization of the tumor.Operation is the main method for the treatment of glucagonoma.A patient with glucagonoma was admitted to the Affiliated Hospital of Binzhou Medical College in December 2013,and the experiences in the diagnosis and treatment of glucagonoma were shared based on the data of this patient.

Objective To investigate the role and the mechanism of ppk1 gene (coding for polyphosphate kinase 1) in oxidative stress resistance in uropathogenic Escherichia coli (UPEC).MethodsMutant strains with ppk1-deletion (△pk1) and complemented strains (△pk1-C) were constructed based on the UPEC strain CFT073.A comparative analysis was conducted to analyze survival rates of CFT073, △pk1 and △pk1-C strains at different time points while they were under oxidative stress.Differences in protein expression between CFT073 and △pk1 strains were analyzed using mass spectrometric analysis.Differences between CFT073 and △pk1 strains in expression of katG and katE genes were analyzed using real-time quantitative RT-PCR.Results The survival rate of △pk1 strains was lower than that of CFT073 strains at every time point, while the survival rate of △pk1-C strains was basically the same as that of CFT073 strains.Gel image analysis and mass spectrometric analysis revealed that six proteins were down-regulated and one was up-regulated in △pk1 strains as compared with those in CFT073 strains.Expression of the catalase-coding genes katG and katE in △pk1 strains were respectively (20.5±8.2)% and (20.9±6.9)% of those in CFT073 strains (P<0.05).Conclusion The ppk1 gene plays an important role in oxidative stress resistance in UPEC by modulating the expression of catalase-coding genes katG and katE.

Objective To explore the prevention and treament of the complications for laparoscopic cholecys- teetomy(LC).Methods Clinical datas of 600 eases undergoing LC were collected and analyzed retrospectively.Re- suits Among all the cases,249 cases were diagnosed as cholecystolithiasis,284 cases as gallbladder and 67 cases as chronic cholecystitis.The mean duration of operation was 42min.Conversions to open cholecystectomy were needed in 18 cases(3%).Complications took place in 6 cases(0.5%),involving 2 cases of abdominal bleeding and 1 case of bile leakage.There was no bile duct injury and death.Conclusion Strictly-controlled indications,skilled performance and timely open exploration are very important to prevent and reduce the complications.

OBJECTIVETo compare the effectiveness and accuracy of the use of vacuum-assisted biopsy (VAB) versus wire localization (WL) in the diagnosis of non-palpable breast lesions (NPBL).

METHODSNinety-seven consecutive women with NPBL were randomized into VAB group and WL group. All specimens were identified by mammography. The patients were requested to score the cosmetic appearance of their breast after operation, and a numerical rating scale was used to measure pain on the first postoperative day. Underestimation rates for atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) were recorded if open surgical biopsy revealed DCIS and invasive cancer, respectively. Clear margins were also recorded in the two groups.

RESULTSVAB and WL located all the NPBL successfully. In the VAB group, the specimen volume was smaller than that of the WL group (2.3 cm(3) vs. 18.4 cm(3), P = 0.03). Underestimation rates of ADH and DCIS in the VAB group were 16.7% and 11.1%, respectively. The diagnostic accordance rate of VAB was 97.9%, the false negative rate was 2.1%, and there was no false positive case. The means of the numerical rating pain scale were different in both groups (1.7 for VAB vs. 2.5 for WL, P = 0.02). When cosmetic results were taken into account, 40 VAB patients had excellent outcomes and 8 good outcomes, compared with 25 excellent and 24 good for the WL group. There were better cosmetic outcomes with the VAB procedure (P < 0.05).

CONCLUSIONVAB is highly reliable and may avoid diagnostic open surgery in the majority of patients with benign lesions. However, because of the underestimation of histologic diagnosis and tumor margin involvement, VAB can not be used to completely substitute wire localization.

Adult ; Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; pathology ; Carcinoma in Situ ; diagnosis ; pathology ; Carcinoma, Ductal, Breast ; diagnosis ; pathology ; Diagnostic Errors ; Female ; Fibroadenoma ; diagnosis ; pathology ; Humans ; Hyperplasia ; Middle Aged ; Precancerous Conditions ; diagnosis ; pathology ; Stereotaxic Techniques ; instrumentation ; Vacuum

Paeonol is a major phenolic micromolecular component of Moutan cortex Radicis, a traditional Chinese Medicine. It has shown antitumor effects in previous studies; however, the underlying mechanisms remain unknown. This study investigated the mechanism by giving treatments of placebo, cyclophosphamide, paeonol of 150 and 300 mg/kg to 4 groups of mice bearing EMT6 breast cancer. Apoptosis in tumor cells were confirmed by morphology analysis, including hematoxylin, eosin staining and TUNEL staining. The results showed that the weight of EMT6 breast tumor was significantly reduced in the groups treated with both 150 and 300 mg/kg of paeonol. Immunohistochemical and Western blot results showed that the expression of Bcl-2 was down-regulated while the expression of Bax, caspase 8 and caspase 3 was up-regulated respectively. These results suggest that paeonol exhibits antitumor effects and the mechanism of the inhibition is via induction of apoptosis, regulation of Bcl-2 and Bax expression, and activation of caspase 8 and caspase 3.
Animals ; Apoptosis* ; Blotting, Western ; Breast Neoplasms* ; Caspase 3 ; Caspase 8 ; Cyclophosphamide ; Eosine Yellowish-(YS) ; Hematoxylin ; In Situ Nick-End Labeling ; Medicine, Chinese Traditional ; Mice* ; Phenol