Purpose:Occult carcinoma of thyroid ( OCT) is difficult to differentiate from benign thyroid nodules because it is small ( < 1 cm),often asymptomatic,shares similar ultrasonographic characteristics.The aim of this study was to retrospectively review the ultrasound diagnosis and pitfalls of ultrasound in OCT.Materials and Methods: The ultrasonography in 37 cases suspected of OCT were reviewed,analyzed and compared with histopathology.Results: 30/37 (81.1% ) cases (38 nodules) confirmed of OCT were found solid,hypoechogenic nodules in 97.4%,with irregular margins ( 33/38,86.8% ),longitudinal-to-transverse ratio = 1 ( 17/38,44.4% ),minute calcification (19/38,50.0%),decreased flow (36/38,94.7%),and resistance index < 0.7( 30/37,81.1%).7/37 (19.0%) cases of misdiag-nosis included 3 chronic lymphocytic thyroiditis with nodules,2 nodular goiter and 2 collagen nodules.They all had overlapping ultrasonographic features.Conclusion: Those ultrasonographic features were of certain value in OCT.

Objective To explore the administration of Dexmedetomidine combined with remifentanil for sedation and analgesia of ICU patients with hypertensive cerebral hemorrhage after operation.Methods A total of 60 patients with hypertensive cerebral hemorrhage treated with hematoma removal under craniotomy were selected from May 2013 to June 2015.The patients were randomly (random number) divided into the Dexmedetomidine combined with remifentanil group (D + R, n =30), and Midazolam combined with remifentanil group (M + R, n =30).The blood pressure, respiration rate, oxygen saturation, heart rate, ICP (intracranial pressure), Ramsay sedation scores, and IL-1, and TNF-α levels were recorded after sedation and analgesia in ICU, and 6 h, 24 h, 48 h after operation (T0-T3).Results Compared with M +R group, the MAP, RR, HR, ICP, IL-1β, TNF-α, rate of reoperation for check bleeding, and mortality were significantly decreased in D + R group (P ＜ 0.05), and Ramsay sedation score was significantly increased at the same time (P ＜ 0.05) without excessive sedation and analgesia noticed.Conclusions Dexmedetomidine combined with remifentanil exhibits significant benefit in many respects including control of great fluctuations of blood pressure and intracranial pressure after craniotomy, reduce the production and release of inflammatory mediators, reduce the occurrence of rebleeding after operation.It shows good controllability and safety, it is an optimal method producing sedation and analgesia in ICU patients with hypertensive cerebral hemorrhage after operation.

Objective To investigate the sensitivity of the real-time fluorescence PCR technique and the bacterial culture for detecting the colonization of group B Streptococcus(GBS)in late pregnant women.Methods 2 specimens were collected from preg-nant women genital tract-rectal secretions swabs,one specimen for conducting the bacterial culture and another for conducting the real-time PCR technique to detect genital GBS.The accuracy and rapidness were compared between the two methods.308 cases of pregnant women were divided into the GBS positive group and the GBS negative group according to the detection results of the real time real-time fluorescence PCR technique.The relation between the occurrence of premature rupture of membranes with GBS was investigated by the comparative analysis.Results Among 308 pregnant women with GBS detection,18 cases were positive by the ordinary bacterial culture with the positive rate of 5.8%(18/308),while 28 cases were positive by the real-time fluorescent PCR with the positive rate of 9.4%(29/308).In the GBS positive group detected by PCR,the premature rupture of membranes occurred in 9 cases with the positive rate of 31%,while in the GBS negative group detected by PCR,which occurred in 33 cases with the pos-itive rate of 11.83%.Conclusion This survey shows that the positive detection rate of the real-time fluorescent PCR technique is significantly higher than that of the bacterial culture method,the application of this detection technique for detecting GBS provides the basis for rapidly diagnosing GBS and conducting the prophylactic use of antibacterial drugs more accurately and more effectively.

Pancreatic neuroendocrine neoplasms (pNENs) are rare tumors with malignant potential.The pNENs could be classified into functional or nonfunctional according to associated clinical symptoms.Magnetic resonance imaging (MRI) is helpful for preoperative diagnosis of nonfunctional pNENs.The clinical data of 22 patients with nonfunctional pNENs who were admitted to the Chinese PLA General Hospital from March 2010 to February 2014 were analyzed retrospectively.Nonfunctional pNENs were characterized by moderate to marked,consistent or progressive enhancement with capsule-like enhancement on dynamic contrast MRI,which is very important for the diagnosis and differential diagnosis of pNENs.

Objective To identify the therapeutic effect and safety of mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope for the treatment of staghorn stone.Methods The clinical data of 116 patients with staghorn calculi who underwent mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope were retrospectively analyzed.Of the 116 patients,63 cases were men,53 cases were women .Age ranged from 2 5 to 6 7 years .The diameter ofcalculi ranged from 4 6 to 9 8 (mean =4 6 )mm .There were 63 large complete staghorn renal calculi in these patients.Results All procedures were performed successfully using a single lithotripsy tract.The mean surgical time was (125.4 ±30.0)minutes.The initial stone -free rate was 81.03%(94 /116).Twenty -two cases had several residual calculi from 12 to 25mm.Post -procedure complications included hemorrhage in 9 patients,fever(>38.5 ℃)in four patients,and reactive pleural effusion in one patient. Blood loss requiring transfusion,sepsis,adjacent organ injury and kidney loss were not observed.Conclusion Mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope has good therapeutic effect in treating renal staghorn calculi,since the technique in treating the renal staghorn calculi makes the operation period shorter,the rate of stone -free higher,the operation wounds smaller,the rate of complication lower,the rate of surrounding organ injury less.

BackgroundThe effects of extremely low frequency electromagnetic fields (ELF-EMFs) on public health have attracted wide attentions.The association of the thermal effect of ELF-EMFs with cancer and ocular tissue damage has been of concern.However,the pathological changes of scleral tissue after exposure to ELF-EMFs as well as the relationship between these changes and myopia are still poorly understood.ObjectiveThe present study was to investigate the molecular pathological changes of human fetal scleral fibroblasts (HFSFs) after exposure to ELF-EMFs in vitro and to explore the possible mechanism in the occurrence and development of myopia.MethodsHFSFs were cultured and passaged and then exposed to 50 Hz electromagnetic fields,and HFSFs that did not receive the irradiation of ELF-EMFs were used as the control group.The expression of collagen type Ⅰ (COL1A1 ) mRNA and matrix metalloproteinase-2 (MMP-2) mRNA in cultured HFSFs were detected by real-time qualitative polymerase chain reaction (real-time PCR) under different magnetic field intensites (0,0.1,0.2,0.5,1.0 mT) and different exposure time (0,6,12,24,36,48 hours).Cell proliferation assay of HFSFs was detected by the cell counting kit 8 ( CCK8 ) assay.The expression levels of COL1 A1 and MMP-2 proteins in HFSFs were further confirmed by immunofluorescence staining.Results The expression of COL1A1 mRNA was significantly down-regulated under the exposure of 0.2 mT ELF-EMFs for 6 hours,in comparison with the control group;moreover,it decreased in parallel with the increased of flux density (0.099±0.008 vs.0.050±0.004) (P =0.009 ).The expression of MMP-2mRNA was up-regulated conspicuously after exposure to 0.1 mT ELF-EMFs for 24 hours,and it increased with exposure time in comparison with the control group ( 0.009 ±0.001 vs.0.018±0.003 ) ( P =0.038 ).Proliferation of HFSFs (A450) was inhibited following the exposure to 0.2 mT ELF-EMFs for 24 hours in comparison with the control group (P =0.009 ).The expression of COL1 A1 in the experimental group was decreased,compared with the control group,but the expression of MMP-2 was increased.ConclusionsELF-EMFs inhibit the proliferation of HFSFs and expression of COL1 A1 in HFSFs,which might be one of the reasons for the development of myopia.

Baizi Yangxin tablets are common Chinese medicine used for the treatment of heart palpitations, insomnia and irritable forgetful. To evaluate the total amount of heavy metals evaluation, artificial gastric juice was used as juice samples and the extracted soluble heavy metals were extracted by microwave digestion technology. An analytical method of bionic extraction microwave digestion with inductively coupled plasma mass spectrometry ( ICP-MS ) was established for the determination of trace metals, such as Co, Cr, Cu, Ba, Cd, Mn, Ni, Pb, Hg, Sr and Zn, in 18 batches of Baizi Yangxin tablets. The correlation coefficient of linear regression equation for different elements ranged from 0. 9989 to 1. 0000, the detection limit was 0. 19-5. 6 μg / L, and the repeatability of the method was less than 6. 2% , the precision of the RSD value was less than 5. 6% , and the recovery rate was 87. 7% -101. 9% . According to “the standard of the heavy metal in the standard of import and export of medicinal plants and preparations”, the contents of Cd, Cu and Pb in the 18 batches were not exceed the standard, but the Hg content (7. 68 mg / kg) exceeded the standard value. The bionic extraction-ICP-MS method provide a reference basis for the safety of the proprietary Chinese medicine's study.

AIM: To observe the synergetic analgesic effects of low dose of haloperidol, a dopamine antagonist and under-threshold dose of morphine on mice induced by thermal and acetic acid, and to analyze the major mechanism of their synergetic actions. METHODS: To examine the analgesic synergetic effect of haloperidol (0.315 mg/kg, 0.625 mg/kg, 1.25 mg/kg, ip respectively), morphine (3.125 mg/kg, 6.25 mg/kg, 12.5 mg/kg ip, respectively) or combining effect of haloperidol (0.3125 mg/kg) with morphine (3.125 mg/kg) on mice, we compared the change of pain threshold stimulated by thermal, latent period of twisting, the number of times of twisting by acetic acid, and we also estimated the antagonistic effect of d -amphetamine (10 mg/kg) and naloxone (5 mg/kg) on haloperidol and morphine group. RESULTS: Combination of haloperidol with morphine significantly enhanced pain threshold of mice induced by thermal, prolonged latent period of twisting and decreased the number of times of twisting. Naloxone markedly antagonized the combination of analgesic action of haloperidol and morphine and not d -amphetamine. CONCLUSION: Combination of haloperidol with morphine have synergetic analgesic effect and morphine is the dominant factor.

Objective Preoperative autologous blood donation(PABD) can reduce the demand of allogeneic blood transfusion and its safety in obstetrical application has been proved.The article aimed to explore the effects of PABD on reducing allogeneic blood transfusion in pregnant women with placenta previa and the optimal PABD volume for implanted placenta.Methods Retrospective analysis were made on 156 cases with placenta previa hospitalized in our hospital from January 2015 to April 2016, including 78 cases with placenta implantation.According to the volume of PABD, the cases were classified into no PABD group, 300~400mL PABD group, and 600ml PABD group.Data of postpartum hemorrhage volume and allogeneic blood transfusion after delivery were collected to analyze the effectiveness of PABD in reducing the need for allogeneic blood transfusion during pregnancy.Results The hemorrhage volume during the delivery of all 156 patients with placenta previa was 230-5670mL (median 985ml), the rate of severe postpartum hemorrhage (PPH) was 49.4% (77/156), and the rate of allogeneic blood transfusion was 33.3% (52/156).In patients who had no PABD, the rate of allogeneic blood transfusion was 48.2% (40/83).However, this rate dropped down to 16.4% in PABD patients (12/73)(χ2=17.624,P<0.001).The rate of allogeneic blood transfusion in patients was different according to the situation of placenta planting, 43.3% in patients with no placenta plantingand 53.8% in patients with placenta planting.600ml autologous blood could meet all the needs for blood transfusion if there was no placenta implantation.300-400mL PABD could meet the needs of more than 80% patients.11.2%-13.3% of ABD patients might need allogeneic blood transfusion in addition to autologous blood.However, the amount of allogeneic RBC and FFP per capita reduced.Conclusion Patients with placenta previa is in high risk of PPH and PABD can improve their medical safety by reducing the rate and volume of the allogeneic blood transfusion.The strategy of 300-400mL PABD during pregnancy are recommended if there is no contraindication.

Objective To examine the expressions of AQP1 and VEGF in human hepatitis B associated hepatocellular c arcinoma and to investigate its relationship with the occurrence and development of hepatocellularcarcinoma. Methods AQP1 and VEGF expressionsin the cancer tissues and AQP1 and VEGF levels in the serum were detected in 62 cases of hepatocellula carcinomaby immunohistochemistry and ELISA , respectively. Results The expressions of AQP1 and VEGF in the liver cancers were significantly higher than in the normal tissues (P<0.01). The higher expression was related to pathologic type,degrees of differentiation and lymph node metastasis, but not related to sex, age and TNM stages. In the serum of liver cancer, the concentrations of AQP1 and VEGF were significantly higher than those in the control group. Conclusion High expressions of AQP1 and VEGF in the patients with liver cancer may be correlated to the occurrence and development of liver cancer. Plasma levels ofAQP1 and VEGF may be more meaningful for the evaluation of clinical prognosis.