Objective To evaluate the features of the encapsulated papillary thyroid carcinoma (EPTC) by ultrasound and histopathology.Methods The EPTC were classified into the following two types based on the shape,characteristics of the border,size of the nodule,echogenicity,a hypoechoic halo and microcalcification by ultrasound features:papillary carcinoma (PC) type and follicular tumor (FT) type.Results Of all the 33 cases,21 cases were PC type and 12 cases were FT type.The histopathological result of PC type was papillary carcinoma.PC type had a jagged border,an irregular tumor shape with marked hypoechogenicity by ultrasound.PC type were composed of papillae by histopathology,completely surrounded by a fibrous capsule with tumor cells having the nuclear features of papillary thyroid carcinoma,densely interstitial fibrosis and microcalcification;FT type had a smooth border,a regular shape (spherical to oval),isoechogenicity and a hypoechoic halo by ultrasound.FT type were completely or significantly composed of follicles by histopathology,completely surrounded by a fibrous capsule with tumor cells having the nuclear features of papillary thyroid carcinoma.Hypoechoic halo were more frequently observed in FT type than in PC type.The nodule size of FT type(1.8-7.0 cm)was larger than that of PC type(0.8-5.2 cm).Fine and multiple strong echoes were characteristically present only in PC type.Conclusion The EPTC have characteristic features that are similar to those of the benign follicular thyroid tumor by ultrasound.

Objective To study the use of nursing outcome classification (NOC)in the specialized gerontology nursing, so as to make the basis for popularizing the NOC.Methods 293 elderly inpatients were taken care by the specialized gerontology nursing while the NOC was used to determine the nursing outcome, the nursing measures and aims were amended constantly according to the outcome and the doctors would be suggested to adjust their diagnosis and treat schemes.Results The adverse event of nursing in observation group was less than that of control group(2.5% vs 17.3%,χ2=17.86,P<0.01). the diagnosis, measures and their NOC knowledge of nursing and skills were improved significantly(P<0.01).Conclusions The application of NOC in gerontology nursing is helpful to use nursing procedures to promote the level of nursing qualities and their professional competency in specialized gerontology nursing.

Objective:To analyze the expression of LETM2 in KYSE150 and ECA109 cell lines and its effect on the proliferation, migra-tion, and invasion of esophageal squamous cell carcinoma (ESCC). Methods:The expression level of the LETM2 protein in 90 paired hu-man ESCC tissues and matched adjacent normal tissues was determined through immunohistochemistry. The expression level of LETM2 in ESCC cell lines was detected by real-time PCR and Western blot. The expression levels of LETM2 in KYSE150 and ECA109 cell lines were knocked down using lentivirus. MTT assays were performed to examine the effect of LETM2 on the proliferation of ESCC cells. Colony formation assay was used to detect the colony formation ability. Flow cytometry was performed to analyze the cell cycle. The effect of LETM2 depletion on the migration and invasion of ESCC cells was determined by Transwell assay. Results:LETM2 expres-sion was frequently upregulated in the ESCC tissues than in the adjacent normal tissues. The suppressed exogenous expression of LETM2 led to the inhibition of cell proliferation and colony formation. However, cell migration and invasion were not affected. The re-sults on the cell cycle distribution revealed that LETM2 knockdown acts as a negative regulator of the cell cycle at the G1 to S phase transition. Conclusion:LETM2 acts as a tumor-driven gene in the development and progression of ESCC. This finding suggests that LETM2 can be used as an efficient prognosis biomarker and a potential therapeutic target for ESCC.

OBJECTIVETo investigate the outcome of in vitro fertilization and embryo transfer (IVF-ET) in couples with the husband positive for chronic infection of hepatitis B virus (HBV).

METHODSThis study involved 102 infertile couples receiving IVF-ET with the husbands(but not the wives) positive for hepatitis B surface antigen (HBsAg), and another 204 couples negative for HBsAg receiving the treatment served as the control group. The cumulative embryo score, fertilization rate, cleavage rate, rate of good quality embryos, implantation rate, clinical pregnancy rate, first trimester and late miscarriage rates, delivery rate, and neonatal malformation rate were recorded and compared between the two groups.

RESULTSBetween the HBsAg-positive and the control groups, the cumulative embryo score (52.8-/+18.7 vs 55.4-/+16.9), insemination rate (66.9% vs 66.1%), cleavage rate (97.6% vs 97.2%), rate of good quality embryos (34.0% vs 37.1%), implantation rate (40.9% vs 34.6%), clinical pregnancy rate (56.9% vs 50%), first trimester miscarriage rate (6.9% vs 5.9%) and late pregnancy miscarriage rate (8.6% vs 4.9%), delivery rate (40.2% vs 43.6%) and neonatal malformation rate (0 vs 0) were all similar (P>0.05;).

CONCLUSIONChronic HBV infection in the husband might not affect the outcome of IVF-ET treatment.

Case-Control Studies ; Embryo Transfer ; Female ; Fertilization in Vitro ; Hepatitis B Surface Antigens ; blood ; Hepatitis B, Chronic ; physiopathology ; Humans ; Male ; Pregnancy ; Pregnancy Outcome

BACKGROUNDConventional computed tomography angiography (CTA) is time consuming, user-dependent and has poor image quality in skull base region. This study assessed the feasibility of a new method, dual energy CTA for depicting the cerebral artery.

METHODSPhantom scan was done with head CTA sequences on dual source CT and 64 spiral CT for radiation dose calculation. Dual energy CTA was done with dual source CT on 36 patients who were suspected of having cerebral vascular disease. Three series axial images in 0.75 mm thick, 0.4 mm increment were acquired, which were named with 80 kV, 140 kV and merged images; 80 kV and 140 kV images were transferred into dual energy software, and maximum intensity projection (MIP) image was generated quickly by dual energy bone remove (DEBR group); merged images were transferred into In Space software to acquire MIP image through manual conventional bone remove (CoBR group). Post processing time and reading time were compared. Image qualities of the two groups were compared, mainly focusing on skull base segments of internal carotid artery and bone subtraction. ANOVA and SNK tests were applied for radiation dose comparison. Student's t test and Wilcoxon rank sum test were applied for assessing differences between data for significance. Cohen's kappa was used for interobserver agreement.

RESULTSRadiation dose of phantom scan showed dual energy CTA was between digital bone subtraction and conventional CTA. The post processing time and reading time were much shorter in DEBR than CoBR, and image quality in skull base was much higher in DEBR than CoBR (P < 0.01). There was no significant difference for suprasellar vessels between two groups (P > 0.5). Interobserver agreement for all vessel segments was excellent (kappa = 0.97).

CONCLUSIONSDual energy CTA is a reliable, new modality for depicting cerebral artery, overcoming the limitation of conventional CTA in the skull base region. It can save much time in post processing and reading than conventional CTA.

Adolescent ; Adult ; Aged ; Angiography ; methods ; Cerebral Arteries ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Radiographic Image Interpretation, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; methods ; Young Adult

Twin pregnancy with mosaic partial hydatidiform mole (PHM) and survival of two healthy fetuses following in vitro fertilization and embryos transfer (IVF-ET) is a rare situation and is considered a challenge for management. A 32-year-old Chinese woman conceived twin pregnancy following IVF-ET. At 22 weeks' gestation, an additional intrauterine echogenic mass with features of PHM were shown by successive ultrasound examinations. At 35 weeks' gestation, two live male infants and two placentas were delivered by caesarean section (CS). Histologic examination of the abnormal placenta confirmed mosaic PHM. Genetic study showed the abnormal placental mosaicism (expressed in molar-69XXY and normal vili-46XY), co-existing with a hypospadia new-born (46XY) in one amniotic sac. However, the other one was normal. Serial serum β-hCG levels showed a declining trend and serum β-human chorionic gonadotropin (hCG) were undetectable at 6 months after delivery. The case demonstrated that it is possible to prolonged gestation by PHM under close surveillance during the entire pregnancy.
Adult ; Female ; Fertilization in Vitro ; Humans ; Hydatidiform Mole ; genetics ; Infant, Newborn ; Male ; Mosaicism ; Placenta ; metabolism ; pathology ; Pregnancy ; Pregnancy, Twin ; genetics

BACKGROUNDMutations in fumarylacetoacetate hydrolase (FAH) gene can lead to tyrosinemia type 1 (HT1), a relatively rare autosomal recessive disorder. To date, no molecular genetic defects of HT1 in China have been described. We investigated a Chinese family with a HT1 child to identify mutations in FAH.

METHODSDNA sequencing was used for mutations screening in FAH gene. Real-time polymerase chain reaction (PCR) was performed to determine the FAH gene expression level. To confirm the presence of degradation by the nonsense-mediated mRNA decay pathway (NMD), the fragments containing R237X mutations were analyzed by primer introduced restriction analysis-polymerase chain reaction (PIRA-PCR) and cDNA sequencing. Finally, the effects of the mutations reported in this study were predicted by online softwares.

RESULTSA boy aged 3 years and 8 months was diagnosed clinically with HT1 based on his manifestations and biochemical abnormalities. Screening of FAH gene revealed two heterozygous mutations R237X and L375P transmitted from his mother and father respectively. In this pedigree, the amount of FAH mRNA relative to a healthy control was 0.44 for the patient, 0.77 for his mother and 1.07 for his father. Moreover, both PIRA-PCR and cDNA sequencing showed significant reduction of the FAH mRNA with R237X nonsense mutation. The missense mutation of L375P was not reported previously and prediction software showed that this mutation decreased the stability of protein structure and affected protein function.

CONCLUSIONSThis is the first case of HT1 analyzed by molecular genetics in China. The R237X mutation in FAH down- regulates the FAH gene expression, and the L375P mutation perhaps interrupts the secondary structure of FAH protein.

Child, Preschool ; China ; Humans ; Hydrolases ; genetics ; Male ; Molecular Sequence Data ; Mutation ; Mutation, Missense ; genetics ; Nonsense Mediated mRNA Decay ; genetics ; Real-Time Polymerase Chain Reaction ; Tyrosinemias ; genetics

OBJECTIVETo observe the therapeutic effect and safety of perineal, crissal and progenital pruritus treated with acupuncture according to differentiation.

METHODSSelf-control method was applied in these 32 cases. Changqiang (GV 1), Huiyin (CV 1), Qugu (CV 2), Sanyinjiao (SP 6) and Ashi points etc. were punctured as main points, and adjunct points were added according to differentiation: Taichong (LR 3) and Ququan (LR 8) etc. were added for wind and heat excess of liver meridian, Xuehai (SP 10) and Quchi (LI 11) etc. were added for blood deficiency and wind dryness. Itchiness, skin lesions sign scores and therapeutic effects were observed before and after treatment.

RESULTSThe total scores of itchiness before and after treatment were 6.06 +/- 1.46 and 2.19 +/- 1.71 respectively, and the total scores of skin lesions sign were 4.38 +/- 2.21 and 1.50 +/- 1.44, indicating that the scores and the total scores of itchiness and skin lesions sign reduced obviously after treatment (P < 0.05, P < 0.01); the cured and markedly effective rate was 73.4% (11/15) for wind and heat excess of liver meridian, and 70.6% (12/17) for blood deficiency and wind dryness, presenting similar therapeutic effect (P > 0.05). Hematoma or ecchymosis appeared in 2 cases, and disappeared spontaneously after 2-3 days, without obvious adverse reaction.

CONCLUSIONSimple perineal, crissal and progenital pruritus treated with acupuncture according to differentiation is effective, safe and applicable.

Acupuncture Therapy ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Pruritus Ani ; therapy ; Pruritus Vulvae ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo study the prevalence and clinical characteristics of the A to G mutation at nucleotide 3243 of the mitochondrial tRNA(Leu(UUR)) gene in familial diabetes in Shanghai, Jiangsu and Zhejiang Province of China.

METHODSThe mt3243 A to G mutation in 770 randomly selected, unrelated probands of diabetic pedigrees were screened by PCR-RFLP technique and PCR-direct sequencing. Genetic and clinical analyses were further performed in the probands and their family members.

RESULTSThirteen diabetic patients (13/770, 1.69%) with mt3243 A to G mutation were detected. Eleven diabetic patients and 8 normal glucose tolerance (NGT) first-degree relatives of these 13 probands were also found bearing the mutation. Seventeen patients were associated with sensory hearing loss. In the 24 patients harboring the mutation, the majority had lower body mass index (BMI), 18 showed typical maternal inheritance, 15 had sensory hearing loss, 13 had insulin resistance and 14 required insulin therapy due to secondary failure to oral hypoglycemic agents.

CONCLUSIONThe mutation of mt3243 A to G in the mitochondrial tRNA(Leu(UUR)) gene is an important cause of diabetes in Shanghai, Jiangsu and Zhejiang Province of China. Mitochondrial gene mutation diabetes (MDM) is clinically characterized by early onset, emaciation, maternal inheritance, sensorineural hearing loss, and lower islet beta cell function, and some have insulin resistance.

Asian Continental Ancestry Group ; genetics ; China ; epidemiology ; DNA, Mitochondrial ; genetics ; Deafness ; genetics ; Diabetes Mellitus ; genetics ; Genetic Testing ; Hearing Loss, Sensorineural ; genetics ; Humans ; Insulin Resistance ; genetics ; Molecular Sequence Data ; Mutation ; Prevalence ; RNA, Transfer, Amino Acyl ; genetics

Objective To evaluate the effects of unsupported arm exercise in patients with chronic obstructive pulmonary disease.Methods Databases such as Cochrane Library,PubMed,EMbase,CNKI and WanFang were searched to recruit eligible randomized controlled trials.The effects of unsupported arm exercise was determined by meta-analysis with RevMan 5.3 after data extraction and quality appraisal.Results Totally 11 RCTs were finally recruited.The results of meta-analysis supported the effectiveness of unsupported arm exercise on improving dyspnea in patients with chronic obstructive pulmonary disease[WMD=-0.76,95％CI(-l.33,-0.20),P=0.008],as well as the effectiveness on enhancing upper arm activity [WMD=25.75,95％CI (10.45,41.05),P=0.0010] and exercise tolerance [WMD=33.98,95％CI (10.20,57.76),P=-0.005].While it failed to support the effectiveness on improving lung function and quality of life(P＞0.05).Conclusion Unsupported arm exercise is effective to improve dyspnea,enhance upper arm activity and exercise tolerance,and is worth introducing in rehabilitation exercise in patients with chronic obstructive pulmonary disease.However,the effects on lung function,quality of life are still inconclusive.Strict designed,multi-centered RCTs with large sample size are needed in the future to gain reliable effectiveness of unsupported arm exercise.