【Objective】 To investigate the tracer effect of carbon nanoparticle suspension in central neck lymph node dissection of differentiated thyroid cancer with other thyroid diseases. 【Methods】 A total of 500 patients with differentiated thyroid cancer hospitalized in Meizhou People's Hospital from July 2015 to July 2019 were retrospectively analyzed. Patients were divided into carbon nanoparticles group(group A, 314 cases) and non-carbon nanoparticles group(group B, 186 cases). Group A and B were further divided into 4 subgroups according to the classifications of no other disease (subgroup 0), with nodular goiter(subgroup 1), with Hashimoto's thyroiditis(subgroup 2) and large tumor(the diameter > 30 mm, subgroup 3), and the number of lymph nodes dissected in each group and the incidence of complications were analyzed. 【Results】 The number of lymph nodes harvested and metastasis rate in group A was higher than that in group B [6.0(3.0 ~ 9.0) vs. 3.0(1.0 ~ 5.3), P < 0.001; 24.4% vs. 20.7%, P = 0.041) ] . The number of lymph nodes harvested in group A0, A1 and A2 was higher than that in group B0 [8.0(6.0 ~ 11.0) vs. 3.0(2.0 ~ 6.0), P < 0.001) ] , B1 [4.0(3.0 ~ 6.8) vs. 3.0(0.0 ~ 5.0), P < 0.001) ] and B2 [8.0(5.0 ~ 12.0) vs. 4.0(0.0 ~ 6.5), P = 0.002] . The number of lymph nodes harvested in group A1 and A3 was significantly lower than that in group A0 [4.0(3.0 ~ 6.8) vs. 8.0(6.0 ~ 11.0), P < 0.001; 3.0(2.0 ~ 6.0) vs. 8.0(6.0 ~ 11.0), P < 0.001) ] . The incidence of hoarseness in group A1, A2 and A3 was comparable with that in group A0(P > 0.05), and the incidence of postoperative parathyroid dysfunction in group A2 and A3 was significantly higher than that in group A0(51.8% vs. 34.1%, P < 0.05; 54.2% vs. 34.1%, P < 0.05) . 【Conclusions】 The application of carbon nanoparticles in the operation of differentiated thyroid cancer increases the number of lymph nodes harvested, and the best effect is without complicated diseases. The tracking effect of carbon nanoparticles is affected by the combination of nodular goiter. When the maximum diameter of the tumor is greater than 30 mm, it has no obvious effect on the dissection of lymph nodes.

OBJECTIVETo compare clinical results of treatment of Pipkin type I and II femoral head fractures through modified Smith-Peterson(S-P) approach and modified Hardinge approach.

METHODSFrom July 2005 to July 2014, 42 patients with Pipkin type I and II femoral head fractures were treated with operation. A total of 23 patients in anterior group was treated with modified S-P approach including 17 males and 6 females with an average age of (29.3±9.4) years old, 5 cases of type I by excision of the fragement, 3 cases of type I and 15 cases of type II cases by fixation of the fragement. While a total of 19 patients in the lateral group was treated with modified Hardinge approach including 15 males and 4 females with an average age of (31.4±10.0) years old, 3 cases of type I by excision of the fragement, 4 cases of type I and 12 cases of type II by fixation of the fragement. Operative time, blood loss during operation and fracture healing time were observed and compared. The clinical and radiographic outcomes of the patients were measured using Thompson-Epstein scoring scale. The effect of hip reduction time of less than 6 h, 6 to12 h, and more than 12 h, the effect of surgery time within 24 h and more than 24 h after injury were compared.

RESULTSAll patients were followed up from 24 to 60 months with an average of(30.29±6.95) months. The operation time (61.96±12.22) min, blood loss (46.09±18.03) ml, and (74.74±10.06) min, blood loss (72.11±19.88) ml in lateral group in the anterior group were better than those of lateral group(<0.05). In anterior group, fracture healing time was(12.22±1.70) weeks, the results were excellent in 8 cases, good in 10 cases, fair in 4 cases and poor in 1 case, the excellent and good rate was 78.3%, the incidence of avascular necrosis of femoral head was 8.69%(2/23), and the incidence of heterotopic ossification was 13.04%(3/23). While in lateral group, the fracture healing time was(12.42±1.95) weeks, the results were excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 3 cases, the excellent and good rate was 68.4%, the incidence of avascular necrosis of femoral head was 10.53%(2/19), and the incidence of heterotopic ossification was 5.26%(1/19). There was no significant difference in fracture healing time, postoperative effect and postoperative complications between the anterior group and lateral group(<0.05). The effect of patients with reduction time of hip dislocation less than 12 h was significantly better than that of more than 12 h, there was no significant difference in the effect between reduction time within 6 h and 6 to 12 h. There was no significant difference in the outcome between surgical patients within 24 h and more than 24 h after injury.

CONCLUSIONSDislocated hip of Pipkin type I and II femoral head fractures should be closed reduction within 6 h. If conditions are limited, the reduction time can be accepted within 12 h. Both of modified S-P approach and modified Hardinge approach are effective in treating Pipkin type I and II femoral head fractures, and can obtain excellent outcomes. Moreover, modified S-P approach has advantage of less trauma, less blood loss, shorter operative time.

Objective Helicobacter pylori ( Hp ) infection is an important risk factor of the gastrointestinal disease, including chronic gastritis, peptic ulcer and gastric cancer. However, many recent experimental and clinical studies have shown that its addition to causing gastrointestinal diseases, but also associated with many diseases, and closely related with the occurrence of liver diseases. Summarized recent advances in the study of the relevant studies,including the relationship between hepatitis and cirrhosis,and the occurrence and development of liver cancer.

OBJECTIVE: To study the expression of BIRC6 in renal cancer tissues and investigate the effect of BIRC6 silencing on apoptosis and autophagy of 786-O cells. METHODS: Twenty surgical specimens of renal cancer tissues and adjacent renal tissues were collected from Meizhou People's Hospital between February, 2016 and December, 2018 for detection of BIRC6 protein expression using immunohistochemistry. Renal cancer 786-O cells were transfected with a control small interfering RNA (siRNA) or BIRC6 siRNA RESULTS: The expression of BIRC6 protein was significantly higher in renal cancer tissues than in the adjacent renal tissues. Western blotting showed that siRNA-mediated silencing of BIRC6 significantly lowered the expression of BIRC6 in 786-O cells. In the cells with BIRC6 silencing, treatment with 12.5, 25, 50, 100 and 200 μg/mL 5-FU resulted in significantly higher proliferation inhibition rates than in the cells transfected with the control siRNA ( CONCLUSIONS Interference of BIRC6 mediated by siRNA can inhibit autophagy and promote 5-FU-induced apoptosis to enhance the sensitivity of 786-O cells to 5-FU.
Apoptosis ; Autophagy ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Inhibitor of Apoptosis Proteins/genetics* ; Kidney Neoplasms/genetics* ; RNA, Small Interfering/genetics*

OBJECTIVETo investigate the relationship of upper cervical pedicle and vertebral artery (VA) location in order to improve the safety of transpedicular screw insertion.

METHODSThe vertebral arteries on 12 sides of 6 adult pate cadaverous specimens were dissected. The distance between VA and VA groove at the atlas needling point of transpedicle screw, and the distance between VA and the inner edge of axis cervical foramen, and the VA external diameter in axis cervical foramen were measured respectively.

RESULTSThe distance between VA and VA groove was (1.96 ± 0.72) mm on the left and (1.99 ± 0.61)mm on the right at the atlas needling point of transpedicle screw, the distance between VA and the inner edge of axis cervical foramen was (2.23 ± 0.43) mm on the left and (2.30 ± 0.39) mm on the right, the VA external diameter in axis cervical foramen was (3.03 ± 0.48) mm on the left and (2.98 ± 0.75) mm on the right.

CONCLUSIONIt is unlikely to injury VA when the transpedicle screws of upper cervical vertebrae were implanted correctly besides high straddled VA, and the individualization must be performed in the process.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Pedicle Screws ; Vertebral Artery ; anatomy & histology

【Objective】To analyze the risk factors of progression to end-stage renal disease（ESRD）in patients with diabetic kidney disease（DKD），and screen the high-risk population for early prevention.【Methods】The clinical data of 231 patients with diabetic nephropathy in our hospital were collected and followed up for 3 years. According to whether ESRD occurred，they were divided into non-progressing ESRD group（133 cases）and ESRD group（98 cases）. Classification tree model was used to analyze the risk factors related to ESRD，and the high-risk population was screened by node gain analysis.【Results】Four important explanatory variables were screened out by the classification tree model from the candi⁃ date variables related to early renal damage，including apolipoprotein B（ApoB），gender，diabetic retinopathy，systemic blood pressure（SBP）. ApoB level was an important factor for DKD progression. For DKD patients with the chronic kidney disease （CKD）3~4 stageswith ApoB> 1.14 mmol/L，theprobabilityofprogression toESRDfor 3 yearswas 75.0 %，and ifat the same time with diabetic retinopathy，the probability was 79.7 %.【Conclusion】The classification tree model can analyze the risk factors of progression to ESRD in DKD patients effectively，to identify the characteristics of high-risk populations.

Objective To observe the effects of dual-task motor training on motor and balance function for stroke patients. Methods From January, 2016 to June, 2017, 30 patients with stroke were assigned randomly into control group (n = 15) and treatment group (n = 15). Both groups accepted routine physical therapy, the control group accepted anti-gravity treadmill training, while the treatment group accepted dual-task training with anti-gravity treadmill, for four weeks. They were measured with balance training and evaluation system, and assessed with Fugl-Meyer Assessment-lower extremity (FMA-L), Berg Balance Scale (BBS) and modified Barthel Index (MBI), before and after treatment. Results The range of swaying on X axial (Rx) and Y axial (Ry), as well as rectangle area (RecArea) decreased after treatment in the treatment group (t > 4.719, P < 0.001), while RecArea decreased in the control group (t = 5.069, P < 0.001). Ry and RecArea were less in the treatment group than in the control group (t > 2.288, P < 0.05). The scores of FMA-L, BBS and MBI improved after treatment in both groups (t > 7.316, P < 0.001), and improved more in the treatment group than in the control group (t > 2.322, P < 0.05). Conclusion The dual-task training via anti-gravity treadmill may improve motor and balance function in stroke patients, and promote the activities of daily living.