Objective To investigate the cosmetic results of endoscopic thyroidectomy via areola of breasts approach.Methods The incision was chosen to be along the areolar margin.One 12 mm incision was made at 3-clock position of the right areolar to introduce a 30? flexible laparoscope.Another 7 mm incision was made at 9-clock position of the right areolar for a grasping forceps.An additional 12 mm incision for the performance of ultrasonic scalpel was made at 11-clock position of the left areolar.Subcutaneous tissues were separated to create enough space for partial or subtotal thyroidectomy according to patient's conditions.Results The surgery was finished successfully in all 10 cases.The operation time ranged 110~230 min(mean,140 min).The estimated blood loss ranged 3~15 ml(mean,9 ml).There were no surgical complications after operation.Follow-up checkups for 3~5 months(mean,3.5 months) in 10 cases showed inconspicuous scars and no recurrence.Conclusions Endoscopic thyroidectomy via areola of breasts approach is a feasible and safe procedure with satisfactory cosmetic results.

BACKGROUND:The immunological rejection between host and graft is the leading cause of organ
transplantation failure. The traditional immunosuppressive agents have been unable to meet the needs of clinical treatment. Antibody-drug conjugate, as a type of new drugs, may be hope for the treatment of immune rejection. OBJECTIVE:To comprehensively analyze the composition of antibody-drug conjugates, mechanism of action, clinical research progress as wel as the development trend.
METHODS:A computer-based online retrieval was performed to search papers in CNKI and PubMed database using the key words of ADCs, immunosuppressive agents, immunotoxins, organ transplantation, graft rejection in Chinese and English. Recently published or published in the prestigious journals were selected in the same field. After excluding objective-independent papers and repeated studies, 42 papers were included for further analysis. RESULTS AND CONCLUSION:Antibody-drug conjugates, as highly effective and lowly toxic immunosuppressant, have achieved a breakthrough in treatment of targeting tumor, while the role of it in anti-immune rejection is stil at the exploratory stage. For islet transplantation, novel antibody-drug conjugates are required to block CD8+T effector by CD103/E-Cadherin pathway, and wil probably serve as a potential drug intervention for al ograft rejection.

The intermediate phenotype of vascular smooth muscle cell in adult is the dedifferentiation state returned from the high differentiation state , appeared on the damaged blood vessels. It is regulated by many factors. Its distribution, the characteristics of morphology and structure, the regulated transform factors and the molecular biological mechanism are introduced, and its functional significance and the role in vascular diseases are also discussed in this article.

Objective To investigate the expression and significance of signal pathway Wnt/β-catenin in prostate cancer stem cells.Methods Prostate cancer tissues,hyperplasia prostate tissues and normal prostate tissues were collected,then prostate cancer stem cells were selected from cell suspension in the culture system of serum-free medium by magnetic activated cell sorting system.Immunohistochemical SP test,RT-PCR and Western blot were applied to test the expression of Wnt and β-Catenin mRNA or protein in prostate cancer stem cells,hyperplasia prostate tissues and normal prostate tissues.Results The protein expression of Wnt and β-Catenin was higher in prostate cancer tissues compared with that in hyperplasia prostate tissues and normal prostate tissues;mRNA expression of Wnt and β-Catenin was higher in prostate cancer stem cells (4.57±0.83,3.93±0.78) than in hyperplasia prostate tissues (1.32±0.35,1.48±0.44) and normal prostate tissues (1.00±0.12,1.00±0.11),and the difference was statistically significant (F＝13.287,12.648,P＝0.000).Protein expression of Wnt and β-Catenin was higher in prostate cancer stem cells(0.87±0.10,1.12±0.23) than in hyperplasia prostate tissues(0.39±0.08,0.64±±0.11) and normal prostate tissues (0.33±0.09,0.45±0.10),and the difference was statistically significant (F＝16.625,14.417,P＝0.000).Conclusion Signal pathway Wnt/β-catenin is stimulated abnormally in prostate cancer stem cells,causing the occurrence of prostate cancer,providing a new research direction for treatment of prostate cancer.

OBJECTIVE:To establish the relationship of clinical pharmacist with hemodialysis patients through pharmaceutical care and select individualized therapeutic regime by pharmacists and physicians in order to reduce high blood pressure and improve quality of life in hemodialysis patients. METHODS:Hemodialysis patients with hypertension being in line with included cretria were collected and randomly divided into pharmaceutical care group(n=20) and non-pharmaceutical care group(n=21). RESULTS:After 3 months of treatment,in pharmaceutical care group SBP was decreased from 158 mmHg to 139 mmHg and DBP from 95 mmHg to 84 mmHg;in non-pharmaceutical care group SBP was decreased from 155 mmHg to 152 mmHg and DBP from 96 mmHg to 93 mmHg. There was significant difference between pharmaceutical care group and non- pharmaceutical care group (P

Adult ; Humans ; Male ; Neck Injuries

Objective To explore the distribution of serum Mg,A1,Ca,Fe,Zn and Cu ions in Tibetan population in drinking tea type fluorosis areas,and to provide a clue for pathogenesis of drinking tea type fluorosis.Methods Tibetans from six villages in Qinghai Province (Maqin County and Dari County),who were over 16 years old,born and grew up in those villages,were included.All of the participants were received epidemic questionnaire survey,tea water samples were collected and the fluoride concentration was tested based on the standard of Brick Tea Fluoride Content (GB 19965-2005).Meanwhile,the daily amount of brick tea consumption was surveyed to calculate the daily intake of tea fluoride.Blood samples were collected and the concentration of serum Mg,Al,Ca,Fe,Zn and Cu ions was tested by the method of inductively coupled plasma mass spectrometry (ICP-MS).All of the participants were diagnosed by X-ray,the parts we scheduled were forearm,shank and pelvic,then the skeletal fluorosis was diagnosed based on the Diagnostic Criteria for Endemic Fluorosis (WS/T 192-2008).Results A total of 170 people were surveyed,74 people were skeletal fluorosis,and 96 people were non-skeletal fluorosis.The median (quartiles) of daily intake of tea fluoride was 7.35 (3.00,12.30) mg.The concentration of serum Mg ion was 22.02 (17.30,23.67) mg/L,Al ion was 0.22 (0.14,0.38) mg/L,Ca ion was 100.03 (88.56,112.73) mg/L,Fe ion was 1.66 (1.26,2.36) mg/L,Zn ion was 0.80 (0.63,0.95) mg/L and Cu ion was 1.28 (0.99,1.48) mg/L.The concentration of serum Fe ion was higher in male [2.13 (1.37,3.09) mg/L] than that of female [1.56 (1.18,2.02) mg/L,Z =3.28,P ＜ 0.01].The concentration of serum Mg,Ca,Cu and Zn ions in ≥70 years old group was 15.09 (13.64,24.13),68.67 (58.67,97.24),0.97 (0.72,1.34),and 0.54 (0.48,0.74) mg/L,respectively,which was lower than those in ＜ 40 years old group [21.67 (20.08,22.76),98.71 (90.77,113.97),1.35 (1.21,1.71),and 0.78 (0.73,1.01) mg/L],the differences were statistically significant (Z =2.26,2.99,3.01,3.34,P ＜ 0.05).Fe ion in 40-49 years old group was 1.77 (1.45,3.02) mg/L,in 50-59 years old group was 1.92 (1.44,2.66) mg/L,both of them were higher than those of ＜ 40 years old group [1.34 (0.94,1.57) mg/L,Z =-3.25,-2.89,P ＜ 0.05].People whose daily intake of tea fluoride over 4 mg had a lower concentration of Ca ion [98.22 (75.48,111.22) mg/L] than people whose daily intake of tea fluoride ＜ 2 mg [110.24 (97.50,113.97) mg/L,Z =2.41,P ＜ 0.05].No significant difference was found between different degrees of skeletal fluorosis and non-skeletal fluorosis (P ＞ 0.05).Conclusions In the Tibetans who lived in the drinking tea type fluorosis areas,the concentration of serum Mg,A1,Ca,Fe,Zn and Cu ions is similar between skeletal fluorosis and non-skeletal fluorosis,which is also similar between higher daily intake of tea fluoride and lower daily intake of tea fluoride.However,it is different between older people and younger people.

OBJECTIVETo assess the clinical usefulness, accuracy, and safety of tele-manipulation for frameless stereotactic surgery using the CAS-R-5 robot system.

METHODSWe prospectively evaluated 32 patients underwent tele-manipulation of frameless stereotactic operations from Sep. 2005 to Sep. 2006. Tele-manipulations were performed via a digital data network by a neurosurgeon in Beijing while the patients were located in Yan'an. The distance is 1300 kilometers away. The accuracy of location and improvement of symptom were observed after operation. The period of follow-up was from 3 to 14 months (the average was 12 months).

RESULTSThe surgical operations in 32 cases were successful. Remote fiducial registration was performed with a mean accuracy of 1. 50 mm and the standard difference were 0.32 mm between the planned and actual target. There were no complications.

CONCLUSIONSDiagnosis and treatment for intracranial disease by tele-manipulation frameless stereotactic surgeries are reliable and safe.

Adolescent ; Adult ; Aged ; Brain ; pathology ; surgery ; Brain Diseases ; surgery ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Robotics ; methods ; Stereotaxic Techniques ; Surgery, Computer-Assisted ; Treatment Outcome

OBJECTIVETo retrospectively analysis the curative effect of wrist scaphoid bone fracture,and explore the causes and preventive methods of misdiagnosis.

METHODSFrom September 2007 to September 2010,16 patients with wrist scaphoid bone fractures were treated with plaster cast and cannulated screws fixation. There were 10 males and 6 females,ranging in age from 26 to 44 years with an average of 35 years. Among them, 12 cases manifested swelling pain of radial lateral wrist, tenderness at snuffbox area, wrist pain aggravated when stretching wrist joint, thumb or forefinger; 4 cases manifested no obviously symptoms and limited movement; 9 cases were early diagnosed; 5 cases were treated by plaster cast; 4 cases were treated with cannulated screws fixation; Among 7 cases with misdiagnosis, there were 4 cases without obvious symptoms and they were dealt with activating blood to dissipate swelling and pain process in preliminary stage. Four cases were treated with plaster cast and 3 cases with cannulated screws fixation.

RESULTSAll the patients were followed up from 3 months to 39 months (averaged 21 months). Among 16 patients, 9 cases were early diagnosis, 7 cases were misdiagnosis and the rate of misdiagnosis was 43.8%. Seven cases with screws fixation were no wound infection. There was 1 case with occurred chronic pain and declining wrist mobility in both plaster cast and screw group, and both of them were misdiagnosed. According to curative effect rating criteria,these 2 cases were classified into moderate, other 14 cases were excellent.

CONCLUSIONWrist scaphoid bone fracture are easy to misdiagnose, so early diagnosis and treatment is particularly important. The main causes of misdiagnosis are nonspecific symptoms at early stage, combination with other injuries, lack of knowledge and ignorance of the further examination. Therefore, detailed inquiries and particular examination, multi-dimensional radiography and CT scan or MRI scan are the main measures for prevention.

Adult ; Bone Screws ; Casts, Surgical ; Diagnostic Errors ; prevention & control ; Female ; Fractures, Bone ; diagnosis ; surgery ; Humans ; Male ; Retrospective Studies ; Scaphoid Bone ; injuries