Objective To explore central lymph node metastasis (CLNM) of cN0 papillary thyroid carcinoma(PTC).Methods We evaluate the clinical data of 245 patients with cN0 unilateral TPC undergoing total thyroidectomy and bilateral central lymph node dissection.Results Central lymph node metastasis of cN0 TPC was 36.8％ (91/245),significantly related to gender(x2 =5.626,P =0.018),age (x2 =6.255,P =0.012),tumor size (x2 =20.063,P ＜ 0.001) and capsule invasion (x2 =15.024,P ＜ 0.001).The central lymph node metastasis was 51.7％ (60/116) in 116 patients with tumor size ＞ 1 cm,and the contralateral CLNM was 22.4％ (26/116) which was related to capsule invasion (x2 =9.737,P =0.002) and delphian LNM(x2 =10.982,P =0.001) There were 6 cases (2.4％) suffering from temporary unilateral recurrent laryngeal nerve injury.96 cases (39.2％) suffered from temporary hypoparathyroidism and 3 cases (1.2％) from permanent hypoparathyroidism.The median follow-up time was 40 months.6 cases were found regional lymph node recurrence on the ipsilateral side.Tumor size ＞ 1 cm was significantly related with recurrence (P =0.008),as CLNM with higher recurrence rate (P =0.001).Conclusions CLNM is common in cN0 PTC patients,and central lymph node metastases increase the risk of recurrence.Prophylactic bilateral central lymph node dissection is suggested for tumor size ＞ 1 cm cases.

Objective To study the clinical significance of recognizing Zuckerkandl tubercle (ZT) during thyroid surgery. Methods One hundred and sixty-one patients (218 sides) having underwent thyroid lobectomy or thyroidectomy were retrospectively analyzed. The presence of ZT, the position and size of ZT, and the relationship between ZT and recurrent laryngeal nerve (RLN), superior parathyroid (SP) were observed. Results In 218 sides, 179 sides (82.1%) found ZT, with right side in 93 cases and left side in 86 cases. The main relationship between ZT and RLN was A type, accounting for 90.5%(162/179). There were no statistical differences in ZT grade and the relationship type between ZT and RLN between left side and right side (P>0.05). There was negative correlation in ZT grade and the relationship type between ZT and RLN (r=-0.269, P<0.01). In right side, 92.3%(72/78) of SP located on the top of ZT at 10-11 o′clock position;in left side, 94.6%(70/74) of SP located on the top of ZT at 1-2 o′clock position. Conclusions ZT is an important anatomical mark in the thyroid surgery, which helps to identify and protect the RLN and SP, so as to reduce surgical complications.

5 ml groups were 95.5% and 81.1% respectively. This difference was statistically significant (P5 ml groups were 4.5 % and 32.1%, respectively (P50 Gy was increased statistically, but the occurrence of complications was also increased. Conclusions Stereotactic radiosurgery improves the outcome of the elderly patients with brain metastases. Radiation dosage and tumor volume are significantly related with the therapeutic efficacy and the occurrence of complications.

Animals ; Humans ; Lymph Nodes ; pathology ; Lymphangiogenesis ; physiology ; Lymphatic Metastasis ; Lymphatic Vessels ; metabolism ; pathology ; Neoplasms ; metabolism ; pathology ; Vascular Endothelial Growth Factor C ; metabolism ; physiology ; Vascular Endothelial Growth Factor D ; metabolism ; physiology

Objective: To explore the mechanism of An-pressing manipulation in improving post-stroke muscle spasticity, by observing the changes of γ-aminobutyric acid (GABA) and glycine (Gly) in plasma and gray matter of L1-L3 spinal cord anterior horn in post-stroke rats with muscle spasticity after An-pressing manipulation intervention. Methods: Ten of 80 adult male Sprague-Dawley (SD) rats were randomly selected as the blank group, and the remaining 70 were used for modeling. The middle cerebral artery occlusion (MCAO) rat model was established by insertion suture occlusion method in the left external carotid artery. Thirty rats with a Longa neurological score of 2-3 points and a modified Ashworth spasticity scale score of 1-, 1+, or 2 were included in the experiment. Using the random number table method, the 30 successfully modeled rats were randomly divided into a model group, an An-pressing tendon group and an An-pressing muscle belly group. Two days after modeling, rats in the An-pressing tendon group and An-pressing muscle belly group received An-pressing manipulation on the tendon and belly of quadriceps femoris muscle respectively, with the pressure of (350±50) g and the frequency of 5 s/time, 15 min per session, once a day for 5 continuous days. After the 5th treatment, the tension of the rat quadriceps femoris muscle was evaluated using the modified Ashworth spasticity scale. The Gly levels in rat plasma and L1-L3 segments of spinal cord were determined by enzyme-linked immunosorbent assay (ELISA). The GABA levels in rat plasma and L1-L3 segments of spinal cord were measured by high performance liquid chromatography (HPLC). Results: The decrease in rat muscle tension scored by the modified Ashworth spasticity scale in the An-pressing tendon group was more significant than that in the An-pressing muscle belly group (P<0.01); the increases in Gly and GABA levels in the rat plasma and L1-L3 segments of spinal cord were more significant in the An-pressing tendon group than those in the An-pressing muscle belly group (all P<0.01). Conclusion: Based on the theory of 'anti-stretch reflex' of tendon organs, the use of An-pressing manipulation to induce the 'anti-stretch reflex' by stimulating the tendon organs can improve the muscle spasticity of rats, which is better than An-pressing the muscle belly. Increased levels of Gly and GABA in rat plasma and L1-L3 segments of spinalcord may be one mechanism of An-pressing manipulation to improve muscle spasticity by stimulating tendon organs.

Objective To explore a more reasonable and effective therapeutic regimen and evaluate prognostic factors in hepatoblastoma patients after combined therapy.Methods Sixteen patients diagnosed on hepatoblastoma between Jan.2000 and Nov.2007 were reviewed and followed-up.Resection with chemotherapy was taken among 16 cases.Chemotherapy included pre-operation and post-operation.Five cases were cured by transcatheter arterial chemombolization(TACE).Six cases were cured by single chemotherapy(both TACE and single chemotherapy were taken in 2 cases).Five cases weren't cured by pre-operation chemotherapy.Nine cases were subjected to curative resection,3 cases to alleviative resection,2 cases with single chemotherapy,1 case with single TACE,and 1 case refused operation and left hospital.Their mean survival duration was 13.5 months(3-98 months).SPSS 13.0 software was used to analyze the data.Results The total survival rate of cases as stage Ⅳ as lower than cases as stage Ⅰ,Ⅱand Ⅲ.Both alpha-fetoprotein(AFP)100 000 ?g/L cases had worse survival rate.The prognosis of mixed type was better than fetal type,embryonal type and anaplasia type.The survival rate of cases with standard chemotherapy was higher than cases with unstandard chemotherapy.And the surgical resection cases had better survival chance than non-surgical resection cases.The survival rate of surgical residual cases was worse than non-surgical residual cases.Conclusions Chemotherapy can improve the total survival rate and long-term survival rate of hepatoblastoma patients.TACE is a safe and effective choice for hepatoblastoma patients.We need to be alert and make the diagnosis as early as possibe,and treat it early and properly.

Background Various studies have suggested that inflammatory factors such as leucocytes and macrophages are involved in the occurrence and development of diabetic retinopathy (DR),and many cytokines promote the occurrence of DR.However,the relationship of aqueous and serum monocyte chemotactic protein-1 (MCP-1) and macrophage migration inhibitory factor (MIF) change with DR is unclear.Objective This study was to investigate the effects of MCP-1 and MIF in aqueous and serum during DR development.Methods Eighty patients with type 2 diabetes were enrolled from Beijing Shijitan Hospital.These patients received phacoemulsification or phacoemulsification and vitrectomy from September,2010 to June,2011.Twenty-six cataract patients in the same stage (without diabetes) who underwent phacoemulsification surgery served as controls.According to the clinical stage of the DR,the diabetic patients were classified as the non-DR group (NDR) (20 eyes),non-proliferative DR group (NPDR) (38 eyes) and proliferative DR group (PDR) (22 eyes).Aqueous humour and periphery blood samples were collected during the operation to detect MCP-1 and MIF using enzyme-linked immnunosorbent assay (ELISA).Written informed consent was obtained from each subject before any relevant medical examination.Results The average aqueous MCP-1 levels were(1660.78±562.98),(1463.26± 623.41),(686.76±186.16) and(494.35±148.59) ng/L in the PDR group,NPDR group,NDR group and control group,respectively,showing a significant difference among the 4 groups (F=37.968,P=0.000).No significant differences were found in the aqueous MCP-1 levels between the control group and NDR group (P=0.169),or between the NPDR group and PDR group (P=0.117).However,the aqueous MCP-1 levels were significantly elevated in the PDR group,NPDR group and NDR group compared with the control group (P=0.000).The average aqueous MIF levels were (6.85±1.99),(3.56±0.90),(1.10±0.48) and (0.86 ± 0.46) μg/L,respectively,with significant differences among them (F =144.502,P =0.000).Multiple comparisons between groups were found to be significantly different (P =0.000) according to the LSD-t test,except between the control group and NDR group (P =0.475).A significant positive correlation was seen between the aqueous MCP-1 level and MCP-1 level in all study participants (r =0.564,P =0.000).However,serum levels of MCP-1 and MIF were not statistically significantly different among the 4 groups (F =2.158,P＞0.05;F =0.813,P＞0.05).Conclusions The increase of the aqueous MIF and MCP-1 levels is associated with the progression of diabetic retinopathy.The results suggest that MIF and MCP-1 promote the occurrence of DR.

Background Light stimulation at different wavelength influences the development of eyes.It has been showed that blue light can inhibit the growth of eyeball.To study whether blue light exposure can delay the extension of myopia is an interested research project.Objective This study was to investigate the effect of blue light with short wavelength on ocular growth in form deprived myopia (FDM) in guinea pigs and provide a new option for the prevention and treatment of myopia.Methods Thirty-six 2-week-old guinea pigs were reared in the environment of white light.The right eyes of the animals were occluded to establish the FDM models.The models were randomized into the deocclusion + blue light exposure group,simple deocclusion group and continuous occlusion group according to the random number table.The right eyes of the models were deoccluded for 1 hour per day to give the blue light (430 nm) irradiation in the deocclusion + blue light exposure group,and the right eyes were deoccluded for 1 hour per day only in the simple deocclusion group.In the continuous occlusion group,the right eyes of the models were occluded until the end of this experiment.Anterior chamber depth (ACD),lens thickness (LT) and vitreous cavity depth (VCD) were measured by A-type sonography.The binocular diopter of the guinea pigs was detected using retinoscopy in the mydriatic condition.In the fourth week after experiment,the retinal sections were prepared for the regular histopathological examination,and the scleral tissues next to 1 mm from optical nerve were exacted to obtain the dry weight of scleral tissues.Results In the right eyes of the animals,no significant differences were found in the diopter,ACD,LT and VCD before experiment among the 3 groups (all at P＞0.05).At the end of experiment,the refraction of right eye in the deocclusion + blue light exposure group,simple deocclusion group and continuous occlusion group was (+1.11±0.17)D,(+0.90±0.15)D and (-2.73±0.19)D respectively,with a significant difference among them (F=1 445.470,P=0.000).The VCD in the three groups was (3.70±0.09) mm,(3.78±0.11) mm and (3.91 ± 0.08) mm,respectively,showing a significant difference (F =13.243,P＜0.01).In addition,the dry weight of sclera tissues was (0.61 ±0.09)mg in the deocclusion + blue light exposure group,(0.54± 0.08)mg in the simple deocclusion group and (0.43 ± 0.07)mg in the continuous occlusion group,with a significant difference among the 3 groups (F=10.458,P＜0.01).However,there were no significant differences in the ACD and LT among the 3 groups (F=0.203,0.084,both at P＞0.05).Moreover,in the left eyes,no significant differences were found in the diopter,ACD,LT and VCD before experiment among the 3 groups (all at P＞0.05);while at the end of the experiment,the diopter of the continuous occlusion group was significantly lower than that of the deocclusion + blue light exposure group and simple deocclusion group (all at P＜0.05).No significant differences were seen in the ACD,LT,VCD and dry weight of sclera among the 3 groups (all at P＞0.05).Retinal structure was normal in the left eyes of various groups.However,the retinas were thinner in the right eyes of the deocclusion + blue light exposure group with clear layers; while atrophy of the outer segment of photoreceptor and disorder of cell arrangement were seen in the right eyes of the continuous occlusion group.Conclusions During sensitive period of visual development,blue light stimulation can arrest the extension of posterior sclera and elongation of vitreous cavity,which restrains development of myopia.This blue light at the wavelength of 430 nm is safe to retina.

Objective To evaluate the effect of tripterine on hydrochloric acid-induced acute lung injury(ALI)in mice.Methods Eighteen pathogen-free healthy adult male ICR mice,aged 7-9 weeks,weighing 25-30 g,were divided into 3 groups(n=6 each)using a random number table:control group(group C),hydrochloric acid-induced ALI group(group ALI)and tripterine group(group T).ALI was induced by a single intratracheal instillation of hydrochloric acid 2 ml/kg(pH 1.5)via a 24-gauge angiocatheter inserted into the trachea in pentobarbital sodium-anesthetized mice.Tripterine 3 mg/kg was injected intraperitoneally once a day for 3 consecutive days,and then the model was established in group T.The mice were sacrificed at 6 h after instillation,and lung specimens were obtained for microscopic examination and for determination of the levels of tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),macrophage migration inhibitory factor(MIF)and myeloperoxidase(MPO)in lung tissues.Results Compared with group C,the levels of TNF-α,IL-6,MIF and MPO were significantly increased at 6 h after instillation in ALI and T groups(P<0.01).Compared with group ALI,the levels of TNF-α,IL-6,MIF and MPO were significantly decreased at 6 h after instillation in group T(P<0.01).The pathological changes of lung tissues were significantly attenuated in group T compared with group ALI.Conclusion Tripterine can attenuate hydrochloric acid-induced ALI in mice.

Through our pre-investigation and literature analysis, it was found that rhubarb could be categorized into two types, chrysophanol-type and rhein-type, based on the proportion of the two constituents in the total content of anthraquinones after acid hydrolysis. In this paper, the antimicrobial activities of chrysophanol-type and rhein-type rhubarbs against Staphylococcus aureus were compared with microcalorimetric analysis, in order to illustrate the bioactive differentiability between the two chemotypes. For the aim to display the distinction of chrysophanol and rhein percentage in total anthraquinones, the sampling volume was regulated to make the total anthraquinones equivalent, thus, the antimicrobial difference was only attributed to the difference of chemotypes. The results indicated that the antimicrobial difference between the two chemotypes was confirmable labeled at the biothermokinetic parameters of S. aureus growth affected by the rhubarb samples. The growth rate constant (k1) of the first exponential phase for the growth of S. aureus affected by the rhein-type rhubarb was significantly lower than that of chrysophanol-type (P<0.01), which suggested stronger antimicrobial activity of rhein-type rhubarb than that of chrysophanol-type. However, the antimicrobial activities of rhein-type rhubarbs were not positively correlated to the contents of rhein. It suggested that the antimicrobial activity of rhubarb might be related to some unknown components which were of same accumulating pattern of rhein. The findings in present study provided some experimental evidence on categorizing rhubarb into two chemotypes through the difference of antimicrobial activity on S. aureus by microcalorimetric analysis and, further, offered references to revision of the commercial specification of rhubarb from chemical view.