Objective To summarize the therapeutic experience on malignancy patients complicated with hyperthyroidism.Methods Clinical date of 10 cases of surgical malignancy complicated with hyperthyroidism admitted from May 2004 to May 2010 in Tianjin Medical University General Hospital were analyzed retrospectively.Results Four cases were treated by subtotal thyroidectomy before radical operation for cancer.Radical operation for cancer was performed on 6 patients after clinical symptoms of hyperthyroidism were controlled by perioperative antithyroid agents.Postoperatively 3 patients complicated with clinical manifestations similar to thyroid crisis.There was no postoperative mortality.Chemotherapy was given to 10 patients,and 1 patient was discontinued for chemotherapy caused leucopenia.Conclusions Hyperthyroidism should be controlled by surgery or antithyroid agents before patients of malignant diseases could proceed with radical surgery.Proper preoperative medication and effective postoperative management can reduce operation risk and help the patients get through the perioperative period safely.

Objective To study the antitumor activity of betaine and its effect on the glycometabolism of S_(180) bearing mice. Methods On the basis of S_(180) bearing mice, taking tumor inhibition rate, the activity of LDH and ALD in serum as indexes which were determined by test kits. Results The different dosages for tumor inhibition rate of betaine are 39.8%, 25.7%, and 17.7%, respectively, betaine of high dosage can remarkably decrease the activity of LDH, and ALD (P

OBJECTIVE:To extract and separate the water-soluble chemical constitutions from Radix Isatidis.METH ODS:The Radix Isatidis water extract underwent adsorption by D 101 macroporous resin,the portion eluted by ethanol of different concentrations was isolated and purified on silica gel column repeatedly,the physicochemical constants and the spectra data of the compound obtained were determined and its chemical constitutions were identified.RESULTS:3compounds temporarily separated from Radix Isatidis water extract,were identified as:syringin(Ⅰ),indole—3—acetonitrile—6—O—?—D—glucopyranoside(Ⅱ)and(+)—isolariciresinol(Ⅲ),respectively.CONCLUSION:For the first time,compound(Ⅰ)and compound(Ⅱ)were isolated from Radix Isatidis.

OBJECTIVE:To isolate the chemical constituents from Radix isatidis.METHODS:The 95% ethanol extract of Radix Isatidis underwent adsorption by silica gel,and the portion eluted by different solvents was isolated and purified on silica gel column repeatedly.The physico-chemical constants and spectral data of the obtained compounds were determined and their chemical structure was identified.RESULTS:6 compounds were separated from chloroform and n-Butanol parts of Radix Isatidis and identified as:cholesterol(Ⅰ),indigotin(Ⅱ),indirubin(Ⅲ),p-Hydroxybenzaldehyde(Ⅳ),salicylic acid(Ⅴ),lariciresinol-4,4'-2-O-?-D-glucopyranoside(Ⅵ),respectively.CONCLUSION:For the first time,compound(Ⅰ)and compound(Ⅳ)were isolated from Radix Isatidis,this finding serves as reference.

Objective To evaluate the effectiveness and safety of autologous granular fat graft applied for penile lengthening and augmentation.Methods After all the superficial ligment and 1/3-2/ 3 part of the deep suspensory-ligament had been cut off for penile lengthening,local pedicaled fasciaadipose flap was designed to fill the depression,the pre-centrifuged autologous granular fat was injected into the space beneath Buck's fascia for penile augmentation.Normal length,pulling penis length,diameter,circumference and complications were evaluated.Results 34 cases were performed and followed up for 3-18 months,both ideal length and diameter increase of penis were achieved.The differences of nomal length,pulling-length,the diameter and circumference were (2.8±0.1) cm,(2.1±0.2) cm,(0.9 ± 0.1) cm,(2.8 ± 0.1) cm,respectively.The common complications included poor wound healing in 4 cases,preputial edema and subcutaneous scleroma in 8 cases for 3 months.Conclusions Autologous granular fat graft for penile augmentation during the lengthening surgery is a reliable and effective method and easy procedure.Detail processing can decrease the complications.

Objective To evaluate the efficacy and safety of sirolimus and tacrolimus after renal transplantation.Method PubMed,Web of knowledge,Medline and the Cochrane controlled trials register,Chinese Biomedicaldatabase,and Vip database were searched with the terms and Boolean operators as (kidney transplantation OR renal transplantation) AND (sirolimus OR rapamycin OR rapamune) AND (tacrolimus OR FK506 OR prograf).Results retrieved were updated on November,2015.Data were extracted for patient and graft mortality,acute rejection (AR),wound complications,infection,GFR,withdrawl.Professional meta analysis software RevMan 5.3 was employed.Result Altogether,1810 patients from 10 randomized controlled trials (RCTs) were included.Patients in the sirolimus group showed a decreased rate of graft mortality and infection (RR =0.63,95％ CI,0.45-0.89,P=0.009;RR=4.42,95％ CI,1.73-11.31,P=0.002).Patients in the sirolimus group showed an increased rate of AR,wound complications,GFR,withdrawl (SMD=-0.52,95％ CI,-0.73-0.31,P＜0.000 01;RR=0.54,95％ CI,0.40-0.73,P＜0.000 1;RR=0.17,95％ CI,0.11-0.25,P＜0.000 01;RR =0.44,95％ CI,0.37-0.51,P＜0.000 01).The patient mortality was insignificantly different between two groups.Conclusion This meta-analysis concluded that sirolimus showed advantage over tacrolimus about safety when used early after renal transplantation.The options of immunosuppressive regimens after kidney transplantation should be based on the specific condition.To obtain more reliable and accurate clinical data,the RCTs with more rational design,higher methodological quality,larger sample size,including domestic patients,longer follow-up are still needed.

Objective To investigate the inhibitory effect on rat MHC Ⅱ transactivator (C Ⅱ TA) and MHC Ⅱ gene expression by plasmid vector-based RNAi technology. Methods According to C Ⅱ TA ge-netic information, three short hairpin RNA (shRNA) sequences were designed and the corresponding plas- mid vectors were constructed. Rat dendritic cell (DC) was transfected in vitro and rat spleen was transfected in vivo. Real time RT-PCR and flow cytometry were used to detect the expression of C Ⅱ TA and MHC Ⅱ in DC and spleen after transfection. Results C Ⅱ TA-shRNA plasmids were successfully constructed. Com-pared with control groups, the mRNA transcription levels of C Ⅱ TA and MHC Ⅱ and the expression level of MHC H were significantly inhibited in all three pC Ⅱ TA-shRNA experimental groups ( P < 0.01 ). There was positive correlation between the expression of C Ⅱ TA and MHC Ⅱ. Among the three shRNA groups, the first one showed the strongest inhibitory effect. Conclusion The expression of rat C Ⅱ TA and MHC Ⅱ can be obviously inhibited by plasmid vector of shRNA targeting C Ⅱ TA gene, which can be used for further investi-gation of gene therapy.

Objective To investigate the feasibility of inhibiting Galα (1,3)-Gal expression in mouse vascular endothelial cells by lentivirus-mediated RNAi.Methods The shRNA specified to α1,3-GT mRNA was designed and synthesized in vitro and cloned into the lentivirus vector.EOMA cells were infected by recombinant lentivirus.Real-time RT-PCR was used to detect mRNA transcriptional levels of αl,3-GT as well as immunofluorescence and flow cytometry were applied to detect Galα(1,3)-Gal antigen level after gene transfection.Co-culture of infected EOMA and serum of human was done and the survival rate was measured by MTT.Results The αl,3-GT shRNA sequences were cloned into the recombinant lentivirus vector correctly and the lentivirus was produced successfully.The transfection efficiency to EOMA was 75 %.Real-time PCR revealed that the mRNA transcription of α1,3-GT was obviously inhibited by α1,3-GT shRNA recombinant lentivirus with the rate of 88 % (P＜0.05),while there were no obvious differences among control group,no shRNA lentivirus group and negative-shRNA lentivirus group (P＞ 0.05).Immunofluorescence and flow cytometry demonstrated the same results that Galα(1,3)-Gal antigen expression in EOMA transfected by α1,3-GT shRNA lentivirus was less than that of control group,no shRNA lentivirus group and negative-shRNA lentivirus group (P＜0.05),but there were no obvious differences among the later three groups (P＞0.05).After co-culture with serum of human,MTT showed the survival rate of EOMA infected by α1,3-GT shRNA lentivirus was obviously increased (P＜ 0.05).Conclusion Recombinant α2,3-GT shRNA 1entivirus is constructed successfully,which can inhibit the expression of α1,3-GT and Galα1,3-Gal in EOMA by RNAi and control hyperacute rejection in vitro.

Objective To determine the baseline echocardiographic characteristics and the time course and degree of recovery of left ventricular (LV) systolic dysfunction in patients with tachycardia-induced cardiomyopathy ( TCM ) . Methods Seven hundred and fifteen patients received radiofrequency cather ablation ( RFCA ) for tachycardiarrhymias from July 2010 to July 2013 were screened in this study. Only 33 patients with reduced left ventricular ejection fraction (LVEF) (LVEF<50% and improved≥15%) were diagnosed with tachycardia-induced cardiomyopathy and were included in the study. Patients with early improvement (over 25%increase in LVEF at 1-week follow-up compared to the baseline ) were enrolled in the improved group , and the rest patients were enrolled in the improved group. All Patients received transthoracic echocardiography for LV size and function detection at 1 week and at 3,6,12 months follow-up. Results The average baseline of the LV end-diastolic diameter, and the LVEF were (55 ± 10.7)mm and (38 ± 4.6)%, repectively. Early improvement ( over 25%increase in LVEF at 1-week follow-up compared to the baseline ) in the improved group was observed in 16 patients. Patients with early improvement had higher LVEF at 12-month follow-up compared to the patients without early improvement [(69.2± 4.2)% vs (58.1 ± 6.9)%, P < 0.001]. Conclusions RFCA is proved to be a relatively safe and effecient treatment method. Atrial fibrillation related to TCM , rhythm control is superior to the rate control. The early improvement in LVEF may potentially predict the complete reversibility of LV systolic dysfunction.

Objective To evaluate the optimum ratio of medicine dosage for dexmedetomidine mixed with sufentanil used for patient?controlled intravenous analgesia ( PCIA) after Nuss procedure in pedi?atric patients with pectus excavatum. Methods Sixty pediatric patients diagnosed with pectus excavatum, aged 5-12 yr, weighing 18-50 kg, of ASA physical statusⅠorⅡ, scheduled for elective Nuss procedure under general anesthesia, were randomly divided into 3 equal groups using a random number table:different ratios of medicine dosage while dexmedetomidine was added to sufentanil groups ( SD1-3 groups) . Postopera?tive analgesia was as follows: group SD1 received sufentanil 1 μg∕kg + dexmedetomidine 2 μg∕kg; group SD2 received sufentanil 1 μg∕kg + dexmedetomidine 3 μg∕kg; group SD3 received sufentanil 1 μg∕kg +dexmedetomidine 4 μg∕kg. A mixture of tropisetron 0?1 mg∕kg and dexamethasone 0?1 mg∕kg ( in 100 ml of normal saline) was added in each group. The PCA pump was programmed to deliver 0?5 ml with a lockout interval of 15 min and background infusion at 2 ml∕h. The PCA pump was connected immediately after the end of operation, and sufentanil with a dosage of 0?1μg∕kg was used as a rescue analgesic within 48 h post?operatively. The VAS score was maintained below 4. The requirement for rescue analgesics was recorded. The Ramsay sedation scores was recorded at 4, 8, 12, 24 and 48 h postoperatively, and the occurrence of adverse reactions such as nausea and vomiting, bradycardia, over?sedation, respiratory depression, agitation and shivering was recorded within 48 h after surgery. Results No pediatric patients developed nausea and vomiting, respiratory depression, bradycardia, over?sedation, and shivering. No pediatric patients required rescue analgesics in SD2 and SD3 groups. Compared with group SD1 , the requirement for rescue analgesics and incidence of agitation were significantly decreased, and Ramsay sedation scores were increased at 4 and 8 h after operation in SD2 and SD3 groups. Ramsay sedation scores were significantly higher at 4 h after oper?ation in SD3 group than in SD2 group. Conclusion Dexmedetomidine 3 μg∕kg mixed with sufentanil 1μg∕kg is the optimum ratio of medicine dosage when used for PCIA after Nuss procedure in pediatric patients with pectus excavatum.