0.05). The expression of IL－ 1, IL－ 6, TNF－? in fibromatosis and the periosteum of CPT was higher than that in normal periosteum and traumatic pseudarthrosis (P

Background: Previous studies have demonstrated that ultrasonography is the recommended imaging modality for preoperative staging of papillary thyroid carcinomas (PTCs). However, only a few studies have kept watch on preoperative evaluation of capsular invasion (CI) or extracapsular extension (ECE) and cervical lymph node metastasis using preoperative ultrasonography. This study aimed to investigate the relationship between the CI or ECE and the cervical lymph node metastasis in PTCs using preoperative ultrasonography and postoperative pathology in Chinese patients. Methods: The data of preoperative ultrasonography and postoperative pathology of 166 patients who had a definitive diagnosis of PTCs from October 2011 to July 2014 at Xuanwu Hospital, Beijing were collected and reviewed. Preoperative ultrasonic parameters of thyroid nodules were compared with those of postoperative pathological diagnoses. All the patients were divided into bilateral PTCs group (n = 42, 78 nodules) and unilateral PTCs group (n = 124, 124 nodules), and the data of the nodule sizes, CI or ECE, and cervical lymph node metastasis by preoperative ultrasonography were compared between two groups. Results:Atotal of 202 nodules of 166 patients which were confirmed by preoperative ultrasonography and postoperative pathology were analyzed. Hypoechogenicity (n = 201, 99.5%) and irregular margins (n = 167, 82.7%) were the main ultrasonic characteristics of PTCs. A significant moderate agreement between preoperative ultrasonic examination and postoperative pathology for CI or ECE(κ=0.622,P<0.001)was observed. The diagnostic sensitivity was 92.0%, and specificity was 71.1%. In bilateral PTCs group, 81.0% had CI or ECE, and 61.9% had cervical lymph node metastasis. In unilateral PTCs group, 76.6% had CI or ECE, and 58.1% had cervical lymph node metastasis. There were no significant differences in the incidence of CI or ECE and cervical lymph node metastasis between two groups (all P > 0.05). Conclusions: Ultrasonography was proved to be a valuable method for preoperative diagnosis of PTCs. Hypoechogenicity and irregular margins were strongly associated with PTCs. CI or ECE in unilateral PTCs strongly implied the cervical lymph node metastasis. Therefore, the cervical lymph nodes should be carefully examined by ultrasonography in patients with PTCs.

Objective To study whether the warm ischemia-reperfusion injury can be alleviated if the hepatic glycogen content were increased before liver transplantation.Methods The male SD rats as donors and recipients were divided into groups A,B and C randomly.In group A,the rats were al- lowed access to solid and water ad libitum;In group B,the rats drank glucose liquor for 4 days prior to liver harvesting;In group C,the rats were intravenously injected with 50% glucose besides the protocol in group B 3-4 h prior to liver harvesting.According to the non-heart-beating time(the non- heart-beating time were set into 60,90,120 and 150 min),the rats in groups A,B and C were divided into 4 subgroups,and the orthotopic liver transplantation was performed and the hepatic glycogen and ATP contents were measured.The one-week survival rate and the serum levels of MDA and SOD in the recipients were determined after liver transplantation.Results The hepatic glycogen and ATP con- tents in groups B and C were more than those in group A significantly(P

Small intestinal neuroendocrine carcinoma is poorly differentiated,highly malignant,and originated from the diffuse neuroendocrine system.It diffusely expresses the general neuroendocrine differentiation markers.The disease can be manifested as carcinoid syndrome,but most of the patients were with occult onset and absence of specific clinical symptoms,which led to difficult diagnosis before operation.On June 18,2012,a patient with manifestation of recurrent vague abdominal pain received capsule endoscopy at the Northern Jiangsu People's Hospital.The capsule endoscope was retained in the distal small intestine,and malignant ileum lesion was revealed during the surgical exploration.Finally,poorly differentiated neuroendocrine carcinoma with abdominal wall metastases was identified by pathological examination.

Adenoma, Liver Cell ; metabolism ; pathology ; Adolescent ; Adult ; Child ; Diagnosis, Differential ; Female ; Focal Nodular Hyperplasia ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Liver ; chemistry ; pathology ; Liver Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; biosynthesis ; Young Adult

Objective:To investigate the efficacy of three different methods of digestive tract reconstruction after total gastrectomy.Methods:A total of 106 cases underwent the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch(group A,n=38) ,Roux-en-Y esophagojejunostomy with the J-type jejunal pouch(group B,n=31) ,and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch(group C,n=37) respectively.The clinical data were retrospectively studied.The digestive tract reconstruction time,the post-operative complication incidence rate,postprandial symptoms,food-intake quantity,weight,serum nutritional parameters and emptying time of the gastricsubstitute were compared respectively.Results:The reconstruction time was the shortest in group A,which was significantly shorter than that in group B(P0.05) ,Group A was significantly lower than group B and C in the incidence of roux stasis syndrome.The Visick score of group A were superior to those of group B and C in 6 and 12 months after operation.The food intake gain of group A and B were superior to that of group C 6 and 12 months after operation.There were no significant differences among 3 groups in the term of weight,Hb and ALB loss and prognosis nutritional index(PNI) 6 months postoperatively.Weight and ALB loss in group A and B were lower than those in group C 12 months postoperatively,but PNI was higher in group A and B than those in group C.Emptying time of the gastric substitute was prolonged both in group A and B 12 months postoperatively.Conclusion:The uncutted Roux-en-Y esophagojejunostomy may act as an adoptable method of digestive tract reconstruction after total gastrectomy for gastric cancer.

Objective To design and develop a kind of venipuncture auxiliary device to use in the absence of light condition or patients with poor vein condition, and validate its clinical effect. Methods A total of 70 patients with shock were divided into experimental group (venipuncture auxiliary device group with 37 cases) and control group (non-device group with 42 cases) by random digits table method. The one-time puncture success rate and operating time were compared between two groups. Results The one-time puncture success rate was 94.59%(35/37) in experimental group and 78.57%(33/42) in control group, and there was significant difference, χ2=4.214, P<0.05. The time of establishing a single vein passage was (73.63±29.35) s in experimental group and (107.61±45.94) s in control group, and there was significant difference, t=3.656, P<0.05. Conclusions The device is small in size, low cost, easy to carry, the screen is clear, is a rapid infusion with explore vascular equipment. It can guide nurses accurately on vascular puncture, fast, smooth and effective transfusion puncture process.

The article introduces the applic at ion of glucose clamp technique in the study of diabetes. The changes in insulin sensitivity, insulin secretion, metabolism of glucose, lipids and protein, etc. in euglycemic or hyperglycemic status in vivo can be investigated by glucose cla mp technique.

OBJECTIVETo study the correlation between lacunar cerebral infarction and level of serum uric acid in elderly male hypertension patients.

METHODSNinety-eight elderly male hypertension patients were enrolled in this study. They all underwent cerebral magnetic resonance imaging (MRI) scan, and their clinical and laboratory data were collected. The patients were divided into the 1st group (n = 32), the 2nd group (n = 32) and the 3rd group (n = 34) according to the level of serum uric acid.

RESULTSThe numbers of lacuner infarction, serum creatinine, urea and high density lipoprotein(HDL) were significantly diferrent from the other groups. The numbers of lacuner infarction were positively related with serum uric acid and urea. Multiple variant analysis showed that serum uric acid was the independent factor of the numbers of lacuner infarction.

CONCLUSIONThe elevated level of serum uric acid may contribute to the risk factors of lacuner infarction.

Aged, 80 and over ; Cerebral Infarction ; etiology ; Humans ; Hypertension ; blood ; complications ; Male ; Regression Analysis ; Risk Factors ; Uric Acid ; blood

OBJECTIVE: To analyze the clinical features of severe acute pancreatitis (SAP) in aged patients, and to explore the measures of its diagnosis and treatment. METHODS: The clinical data of 100 aged patients (55-85 years old) with SAP admitted from January 2003 to December 2005 were reviewed and compared with those of 221 non-aged SAP patients (11-54 years old) admitted at the same period. RESULTS: Totally 112 times of onset occurred in 100 aged patients, and the main causes for senile SAP were biliary diseases and hyperlipemia. Both acute physiology and chronic health evaluation II (APACHE II) and Ranson scores of the aged patients with SAP were higher than those of the control group (P<0.05); while there was no significant difference in Balthazar score between the two groups(P>0.05). The incidences of low serum calcium, low albumin and high aspartate aminotransferase (P<0.05), liver, kidney or brain impairment as well as the mortality were higher in the senile SAP group than those in the control group (P<0.05). CONCLUSIONS: Biliary disease and hyperlipemia are the main causes of senile SAP, which lacks characteristic clinical symptoms and is often associated with multiple complications such as infection and lung, gastrointestinal tract, liver, kidney, and brain impairment. Individualized differential treatment with integrated traditional Chinese and Western medicine based on stage classification is an effective approach.