Objective To explore the diagnostic value of ultrasound in thyroid nodular disease.Methods Eighty-seven patients with thyroid nodule in hospital from 2010-2011 were taken ultrasound examination,including 23 cases with benign nodules and 64 cases with malignant nodules.Univariate analysis and mutivariate Logistic regression analysis were taken to test the ultrasonic index (internal echo,boundary,size,shape,microcalcifications,and aspect ratio) for discovery of the best diagnostic ultrasonic index to identify benign and malignant nodules.Results The ultrasound in the patients with malignant thyroid nodules showed the hypoecho,unclear border,irregular shape,microcalcifications,low blood supply,the aspect ratio ＞ 1.The ultrasound in the patients with benign thyroid nodules showed high or equal echo,clear border,regular shape,high blood supply,and the aspect ratio≤ 1.The ultrasonic indices between two groups had statistically significant difference (P ＜ 0.05).The shape and microcalcifications were the best ultrasonic diagnostic index to indentify the benign and malignant nodules with an EXP(B) 20.12 and 19.14,respectively.Conclusions The ultrasound is helpful in the diagnosis of thyroid nodular disease and identification of benign and malignant thyroid nodules.The ultrasonic images are the basic data for the clinical diagnosis of thyroid nodules.

Objective To investigate the protective effects and molecular mechanism of peroxisome proliferate-activated receptor α(PPARα) activation on acute myocardial damage induced by isoproterenol (Iso) in rats. Methods Thirty male Wistar rats, weighting 160～180 g, were randomly divided into control group, Iso group, fenafibrate(FF) group(each n=10) according to physique quantity. Acute myocardial injury caused by Iso abdomen cavity injection induced ischemia was established and the protective effects of peroxisome proliferate-activated receptor α activation were accessed by the level of ereatine kinase(CK), lactic dehydrogenase(LDH) in serum as well as the activities of myoperoxidase(MPO) in myocardium, and the protein expressions of PPABα in myocardium by Western blot. Results The level of serum CK in control group, lso group and FF group, was (62.41±9.47),(101.71±11.05),(75.64±11.73)kU/L, respectively(F= 34.34, P<0.01). Whereas the level of serum CK in Iso group and FF group was higher than that in control group(P<0.01 or<0.05), the level of serum CK in FF group was lower than that in Iso group(P<0.01). The levels of LDH in these three groups were (5912.20±204.44), (6365.78±137.10), (6089.76±169.60) U/L, respectively(F= 17.54, P<0.01). Compared with the control group, the levels of LDH in Iso and Fir groups were significantly increased(P<0.01 or<0.05). But the level of LDH in FIr group was decreased compared with that in Iso group(P<0.01). The activities of myocardial MPO in these three groups were (1.95±0.10),(3.89±0.17),(2.49±0.19)U/g, espectively(F=391.68,P< 0.01). The activities of myocardial MPO in Iso and FF groups were higher than that in the control group (all P< 0.01), while the activities of myocardial MPO in FIr group were lower than that in lso group(P<0.01). The protein expressions of PPARα in myocardium of these three groups were 251.57±10.95,191.97±10.74,215.08±9.61, respectively(F=82.69, P<0.01). Conclusion PPARα activation by its actor FF can exert protective effects on the acute myocardial ischemia injury induced by lso in rats through inhibiting the release of inflammatory cell factors.

Objective To examine the impact of C-reactive protein (CRP) on the expression of interleukin-6 (IL-6), inflammatory cytokine, in cultured human pulmonary artery smooth muscle cells (hPASMCs) in order to find out the cause of pulmonary artery hypertension (PAH). Method The hPASMCs were cultured and stimulated by different concerntrations of CRP (5 - 200 μg/ml) for different lengths of time. The activity of nuclear factor-κB (NF-κB) was evaluated by electrophoretic gel mobility shift assay (EMSA). The expression of IL-6 mRNA and the level of IL-6 protein were measured by using real-time PCR and ELISA, respectively. Results CRP increased IL-6 production in hPASMCs in a dose-dependent manner. The increase in IL-6 at concerntration of 200 μg/mL in the CRP group was as high as 2.8times that in the control group. CRP also significantly induced the activation of NF-κB in hPASMCs. The effect of CRP on the inflammatory cytokine, IL-6, was inhibited by the specific FcγⅡa receptor antibody.Conclusions In vitro, CRP increases the production of IL-6 in hPASMCs mediated by FcγⅡa receptor and NF-κB translocation. These data offer important insights into the role of CRP in the pathogenesis of PAH.

Animal models of pulmonary artery hypertension (PAH),aiming to simulate human characteristics of the disease,have contributed extensively to understanding the pathophysiology of PAH and the investigation of experimental treatments.The classical models include monocrotaline models,chronic hypoxia model and so on,more new models were investigated in recent years.These animal models were not able to perfectly mimic human pathological characteristics of PAH because of the defect in different aspects.In this review,both typical and novel methods of PAH modeling were summarized and evaluated to provide a suitable guidance for the settlement of animal models which can meet human characteristics comprehensively.

Objective To compare the efficacy and safety of percutaneous nephrolithotomy ( PCNL) in modified supine Valdivia and traditional prone positions for the treatment of renal stones.Methods Clinical data of 80 consecutive patients with renal calculi who accepted PCNL from December 2012 to September 2014 were retrospectively reviewed.They were divided into modified supine Valdivia group ( n=44) and prone position group (n=36) according to the position during surgery.There was no significant difference between the 2 groups in age, sex, ASA class, stone location and size (P>0.05).Total operative time, ratio of multi-access, blood loss, perioperative complications and stone-free rate were compared between the 2 groups.Results All punctures were performed successfully.No case was converted to open surgery.No severe complications such as colon injury, pleura or peritoneum perforation, or death occurred intra-and post-operatively.In prone position, 1 patient was found to develop high intra-trachea pressure because of large stone burden and prolonged operative time (130 min).This procedure was stopped and the patient received the second session of PCNL 1 week later.The mean total operative time was significantly shorter in the modified supine than in the prone position ( 67.7 ±24.5 min versus 91.5 ±29.8 min, P<0.05).There were no significant differences in ratio of multi-access (14% versus 22%), mean blood loss (1.3 ±0.2 g/L versus 1.4 ±0.7 g/L), incidence of complications (18% versus 19%), and stone clearance rate ( 80% versus 86%) between the 2 groups ( P >0.05 ) .Conclusion PCNL in modified supine Valdivia is as safe and effective as that of prone position for the treatment of renal stones, but the former is more time-saving than the latter.

Objective To understand the direct medical expense for surgical patients with splenomegalic advanced schisto?somiasis and its influencing factors,so as to provide evidences for relevant departments to improve the rescue strategy of ad?vanced schistosomiasis. Methods The data about the expenses of patients with splenomegalic advanced schistosomiasis hospi?talized in Xiangyue Hospital affiliated to Hunan Institute of Schistosomiasis Control from January 2010 to August 2014 were col?lected,the hospitalization expense and hospital stays of the patients were analyzed,and the factors influencing the hospital ex?penses were analyzed by the univariate and multi?factor analyses. Results From January 2010 to August 2014,totally 249 cas?es were hospitalized in the hospital,their average hospital stays and hospital expenses were 28.92 d and 18 896.13 Yuan,and both of them were increased year by year. Among all the kinds of expenses,the constitution ratios of the medicine expenses were the highest,and those in the 5 years were all above 44%. The results of the univariate and multi?factor analyses showed that the hospital stays,the amount of intraoperative bleeding,liver function classification,postoperative complications,age,portal hy?pertensive gastropathy were the influencing factors of the hospital expenses. Conclusion Presently,the burden of the direct hospital expenses of the patients with splenomegalic advanced schistosomiasis is still heavy. The government should further im?prove the proportion of the compensation of medical assistance and perfect the medical aid scheme. Meanwhile ,the hospitals should strengthen the management and standardize medical behavior to reduce the hospitalization expenses of the patients.

12E7 Antigen ; Aged ; Antigens, CD ; metabolism ; Carcinoma, Transitional Cell ; pathology ; Carcinosarcoma ; pathology ; Cell Adhesion Molecules ; metabolism ; Cystectomy ; methods ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Nephrectomy ; Osteosarcoma ; metabolism ; pathology ; surgery ; Ureter ; surgery ; Ureteral Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo compare therapeutic effects of locking plates for the treatment of Neer 3-and 4-part proximal humerus fractures.

METHODSFrom January 2009 to June 2011, 64 patients with Neer 3-and 4-part proximal humerus fractures were treated with locked plate fixation. There were 39 patients in the 3-part group including 16 males and 23 females, with an average age of (55.12 +/- 12.52) years old; and 25 patients in the 4-part fractures group including 9 males and 16 females,with an average age of (57.92 +/- 13.14) years old. The American Shoulder and Elbow Surgeons score (ASES), visual analogue scale (VAS) and complications were documented for analysis before and after treatment.

RESULTSAll the patients had incision healing at the first stage. All the patients were followed up, and the duration ranged from 12 to 30 months, with a mean of 16.5 months. Comparably better shoulder function recovery was achieved in the 3-part fractures group with regard to the ASES (76.14 +/- 14.10 in the 3-part fractures group vs. 65.93 +/- 11.82 in the 4-part fractures group, P < 0.05). Moreover,a statistical difference (P < 0.05) was observed regarding the VAS pain score (2.12 +/- 1.63 in the 3-part fractures group vs. 3.90 +/- 2.21 in the 4-part fractures group). For the complications rate,no statistical difference was noted between 3-part fractures group and 4-part fractures group (20.51% vs. 36.00%).

CONCLUSIONThe clinical outcomes of the 3-part proximal humerus fractures is better than the 4-part fractures proximal humerus fractures treated with locking plate. Complex proximal humeral fractures treated with locking plates can be achieved a satisfactory outcome when attention is paid to anatomic reduction, stable fixation, proper screws and plate placement, and reasonable functional exercise postoperative.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To explore the clinical significance of serum cystatin C (Cys C) combined with brain natriuretic peptide(BNP)in more earlier,more accurate diagnosis of contrast-induced nephropathy(CIN)after coro-nary angiography or percutaneous coronary intervention .Methods 358 patients undergone coronary angiography or percutaneous coronary intervention were enrolled in this study , and the data were collected .The serum creatinine (Scr),Cys C and BNP were tested before operation .The serum Cys C and BNP were tested 8h,16h,24h after opera-tion.The serum Scr was tested 24h,48h,72h after operation.All patients were diagnosed and grouped with CIN by ser-um Scr.The results were compared between the CIN group and control group ,diagnosis efficiency of Cys C ,BNP and combine with them was analyzed .Results CIN occurred in 16 cases of 358 enrolled patients , the incidence was 4.47%.The levels of Scr increased beyond 24h after operation in the CIN group .The levels of serum Cys C and BNP had no significant difference at 8h after operation compared to preoperation (P>0.05),and significantly rosed at 16h and 24h after operation(P<0.01)than before in the two group,[16h Cys C:(1.63 ±0.49)mg/L vs(0.91 ±0.33) mg/L,24h Cys C:(3.45 ±0.83)mg/L vs(0.91 ±0.33)mg/L,16h BNP:(215.96 ±55.72)ng/L vs(102.40 ± 32.23)ng/L,24h BNP:(352.41 ±61.08)ng/L vs(102.40 ±32.23)ng/L,all P<0.01].The levels of serum Cys C and BNP had no significant difference at 8h after operation in CIN(P>0.05),and significantly rosed at 16h and 24h after operation in CIN( P<0.01)than the corresponding levels in the control group [16h Cys C:(1.63 ±0.49)mg/L vs(0.93 ±0.38)mg/L,24h Cys C:(3.45 ±0.83)mg/L vs(0.92 ±0.34)mg/L,16h BNP:(215.96 ±55.72)ng/L vs(149.32 ±43.74)ng/L,24h BNP:(352.41 ±61.08)ng/L vs(164.82 ±49.62)ng/L,all P<0.01].The diagno-sis efficiency of serum Cys C combined with BNP at 16h after operation had high degree of accuracy .Conclusion In this study,the serum Cys C and BNP are better biomarker for early diagnose of CIN ,witch can diagnose CIN earlier than Scr .Combine of the two biomarker can more earlier ,more accurate diagnose CIN .

To compare angiopoiesis ability of eutopic and ectopic endometrial tissue isolated from women with endometriosis and endometrium isolated from women without endometriosis (control), and to explore the inhibitory effects of medicated serum of Neiyi Recipe, a compound traditional Chinese herbal medicine.