Along with the improvement of the diagnosis techniques and the popularization of the health examination,the incidence of the thyroid nodule is growing rapidly.The management methods of the nodules depend on the correct diagnosis of the thyroid nodules,which could save the limited resources of the healthcare system.The diagnostic methods of the thyroid nodules developed in recent years are reviewed in this paper.

MicroRNAs (miRNAs) are small non-coding RNAs that contain 22 to 25 nucleotides and play important roles in post-transcriptional regulation of target genes. MiRNAs are involved in cell proliferation, differentiation, apoptosis, inflammation, and cancer development. Alveolar bone resorption is the main clinical manifestation of periodontitis. Osteoclasts are unique cells regulated by osteoblasts and inflammatory cytokines and are responsible for bone resorption in periodontitis. Recently, miRNAs have emerged as an important regulator of osteoclast differentiation and function. In this study, we review the recent research progress on the effects of miRNAs on osteoclast differentiation and function, particularly the mechanisms of miRNAs-mediated osteoclast formation and bone loss in periodontitis.
Bone Resorption ; Bone and Bones ; Cell Differentiation ; Cell Proliferation ; Humans ; MicroRNAs ; Osteoblasts ; Osteoclasts

Objective: To observe the haemodynamic changes within ovarian stromal blood flow in patients with polycystic ovary syndrome(PCOS). Methods: 41 patients with PCOS and 10 ovulatory women underwent transrectal ultrasound associated with Doppler flow measurement of the artery within ovarian stroma during the early follicular phase (days 2-5 of the menstrual cycle) or any day in patients with amenorrhea . Results:The peculiar vascular pattern wich one prominent blood vessel showed passing through the ovarian stroma from ovary gate. This sign was observed in all ovaries in patients with PCOS.There was no significiant difference in Vmax、PI、RI between left and right ovary.The Vmax,PI,RI of the right ovarian stromal artery were (18.99?3.12)cm/s, 0.74?0.12, 0.50?0.03 respectively. The indices of the left ovarian stromal artery were (18.76?3.23)cm/s, 0.75?0.11, 0.49?0.04 respectively. Conclusion: Vascularization of the ovarian stroma is prominent in patients with PCOS than in the control. The decreased vascular resistance to ovarian stromal perfusion in patients with PCOS may lead to perfusion increasment. TRS can be used as a non-invasive, convenient, and sensitive method for assessing the blood flow within the ovarian stroma.

Objective To investigate the related factors of clinical incidence and the ultrasound diagnostic value of endometrial polyps (EMP).Methods A total of 278 patients with clinical abnormal vaginal bleeding,menorrhagia,infertility,cervical polyps or physical examination showing EMP received vaginal ultrasound and hysteroscopy.The related clinical factors were recorded and single factors and multivariate unconditional Logistic regression analysis were carried.Results The univariate analysis showed that the number of pregnancy,menopause,placing intrauterine device,oral comtraceptives,history of hormone therapy,chronic endometritis,cervical polyp,merger endometriosis and obesity were the statistically significant factors of EMP incidence (P ＜ 0.05 or ＜ 0.01),which were used as dependent variables for multivariate Logistic regression analysis,indicating that menopause,chronic endometritis,history of hormone therapy and cervical polyp significantly affecting EMP incidence (P ＜ 0.05),with OR values of 4.068,4.122,3.770 and 3.983 respectively.Conclusion Menopause,chronic endometritis,history of hormone therapy,cervical polyps are the related risk factors of EMP.

Objective To investigate the clinical effects of subemergency treatment of femoral intertrochanteric fractures in elderly patients.Methods From June 2013 through February 2014,47 patients older than 65 years were treated for femoral intertrochanteric fracture at our department and completed full follow-ups.Of them,20 received subemergency operation.They were 9 men and 11 women,with an average age of 72.2 ± 4.8 years.By the Evans-Jensen classification,there were 2 cases of type Ⅰ,5 of type Ⅱ,5 of type Ⅲ,5 of type Ⅳ,and 3 of type Ⅴ.The time from injury to surgery ranged from 0.5 to 1.7 days (average,0.8 days).The other 27 patients underwent selective operation.They were 11 men and 16 women,with an average age of 74.9 ± 5.7 years.By the Evans-Jensen classification,there were 3 cases of type Ⅰ,6 of type Ⅱ,6 of type Ⅲ,7 of type Ⅳ,and 5 of type Ⅴ.The time from injury to surgery ranged from 2 to 5 days (average,3.4 days).We compared the 2 groups in terms of in-hospital complications,fracture healing time,length of hospital stay,and hip scores at the last follow-up.Results All the patients were followed up for 12 to 15 months (mean,13.4 months).The rate of in-hospital complications in the subemergency operation group (35.0％,7/20) was significantly lower than that in the selective operation group (51.9％,14/27),and the length of hospital stay in the former (12.1 ± 1.6 days) was significantly shorter than in the latter (16.1 ± 1.8 days) (P ＜ 0.05).There was no significant difference between the 2 groups in fracture healing time (13.1 ± 1.8 weeks versus 13.6 ± 1.2 weeks) (P ＞ 0.05).According to the hip scores at the last follow-up,the subemergency operation group had 16 excellent,2 good,one fair and one poor cases (with an excellent to good rate of 90.0％) while the selective operation group had 21 excellent,2 good,2 fair and 2 poor cases (with an excellent to good rate of 85.2％),showing no significant difference between groups (P ＞ 0.05).Conclusion Subemergency operation can reduce not only in-hospital complications but also length of hospital stay for old patients with femoral intertrochanteric fracture.

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Ⅰ-gel for airway management in the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy.Methods Sixty patients,aged 26-64 yr,weighing 54-90 kg,of ASA physical status Ⅰ-Ⅲ (Mallampati Ⅰ-Ⅲ),scheduled for elective laparoscopic surgery,were randomly divided into Ⅰ,Ⅱ and Ⅲ groups (n =20 each) using a random number table.In group Ⅰ,the nasogastric tube was inserted through the drain tube of LMA I-gel.In group Ⅱ,the nasogastric tube was inserted through the nostril before surgery.In group Ⅲ,the nasogastric tube was inserted through the nostril before surgery,and another nasogastric tube was inserted through the drain tube of LMA I-gel after induction of anesthesia.The hemodynamic parameters,SpO2,PET CO2 and peak airway pressure were monitored during surgery.The fiberoptic laryngoscopy scores were assessed and the development of nasogastric tube displacement was recorded after successful LMA placement.The LMA placement time,success rate of LMA placement at the first attempt,depth of placement,airway sealing pressure,and occurrence of air leakage of LMA and nasogastric tube drainage were recoded.The bloodstains and gastroesophageal reflux were observed after removal of LMA Ⅰ-gel.The pH values were tested at the tip of LMA and on the dorsal and ventral sides of the body of LMA by using pH test papers.The development of adverse reactions in the oropharynx was recorded within 24 h after surgery.Results The hemodynamics was stable and SpO2,peak airway pressure and PETCO2 were all within the normal range during surgery,and Ppeak was lower than airway sealing pressure in the three groups.There were no significant differences between the three groups in LMA placement time,success rate of LMA placement at the first attempt,depth of placement,airway sealing pressure,incidence of air leakage of LMA,fiberoptic laryngoscopy scores,time for removal of LMA I-gel,incidences of adverse reactions in the oropharynx,bloodstains within the body of LMA and gastroesophageal reflux,and pH values at the tip of LMA and on the dorsal and ventral sides of the body of LMA.There was no nasogastric tube displacement in Ⅱ and Ⅲ groups.There were 7 patients developing gastric juice outflow from drainage tube of the LMA I-gel and 2 patients developing gastric juice outflow from the nostril gastrictubes in group Ⅱ.Conclusion For the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy,insertion of LMA I-gel is easy,and I-gel LMA can assure good airway sealing and adequate ventilation.

Primary hyperparathyroidism (PHPT) in children is a rare condition,co-existing with vitamin D deficiency can lead to more diagnostic uncertainty.Here we report a case of a boy with PHPT complicated with vitamin D deficient rickets.The diagnosis and treatment of this patient was analyzed against literature review to summarize evidence-based clinical features of PHPT in children.We found that compared with adult PHPT,PHPT in children is associated with severer symptoms,higher serum calcium level,lower parathyroid hormone,preponderance of single adenoma in pathology,and higher cure rate of surgery.Co-existence of osteomalacia may induce reduction of the serum calcium level to the normal range,but cause more severe bone lesions.

Objectives To observe the clinical significance and application value of autologous blood transfusion in neurosurgery of primary hospital. Methods Four hundred and fourteen patients who underwent the neurosurgery operation and were subjected to intraoperative blood transfusion were selected, among whom 97 patients were subjected to autologous blood transfusion (observation group), and 317 patients were subjected to heterogenous blood transfusion (control group). The condition of intraoperative blood transfusion, changes of hemoglobin and hematocrit, blood transfusion related cost were compared between 2 groups. Results There were no statistical differences in operation time, infusion volume, rate of transfusion related complications and postoperation hemoglobin, hematocrit between observation group and control group (P>0.05). The patients in control group were infused with 189 000 ml, and the transfusion liquid volume proportion of total blood transfusion was 79.22%(189 000/238 580);13 patients in observation group were used the heterogenous blood transfusion with 5 400 ml, and the transfusion liquid volume proportion of total blood transfusion was 10.30%(5 400/52 430). Eighty-six patients (88.66%, 86/97) in observation group performed autologous blood collection and transfusion, the volume of autologous collection was 80 650 ml, and the volume of transfusion was 47 020 ml. Eleven patients in observation group did not perform autologous blood transfusion, among whom 6 patients was because of operational and mechanical reasons, and 5 patients performed collection but did not transfuse. The cost of heterogenous concentrated suspension red blood cell over 6 U was significantly higher than the cost of disposable material and injection of autologous blood:(2 287.06 ± 243.52) yuan vs. (1 595.08 ± 133.95) yuan, and there was statistical difference (P<0.05). The rate of heterogenous concentrated suspension red blood cell 6 U in control group was 14.83%(47/317), and the rate of over 6 U was 6.62%(21/317). Conclusions The autologous blood transfusion is safe and effective, and it is worth popularizing in neurosurgery of primary hospital. But in the process of its application, it is necessary to strengthen the user′s operating skills and ensure the quality of autologous blood transfusion.

Objective:To evaluate the effect of post-conditioning in brain injury induced by myocardial I/R on inflammatory factor and GFAP.Methods:Male Sprague-Dawley rats were randomly allocated into 3 groups (n=8):group Sham,group IR,group IPost.Myocardial IR was induced by occlusion of the anterior descending branch of the left coronary artery for 30 min.group IPost received 3 cycles of 10 s reperfusion followed by 10 s ischemia at the end of myocardial ischemia.The rats were sacrificed at 120 rain of reperfusion and the brains were removed for microscopic examination,inflammatory factors and GFAP.Results:Compared with group Sham,IL-6,IL-8 were significantly increased,IL-10 was down-regulated in group IR(P＜0.01).Post-conditioning can decrease IL-6,IL-8 and up-regulated IL-10(P＜0.01).When compared with group Sham,the expression of GFAP was higher in group IR(P＜0.05),however,the GFAP in group IPost is the most among these three groups(P＜0.01).Conclusion:Post-conditioning could protect brain by decreasing inflammatory factors,increasing GFAP,which both from brain injury induced by myocardial ischemia reperfusion.

Objectives:To study the ultrasonogram, diagnosis and significance of testicular microlithiasis (TM). Methods:The clinical data and ultrasonographic outcomes of 97 patients with the genital system diseases were retrospectively analyzed. Results:Five patients with TM were found, and the prevalence of TM is 5.2%. of 5 cases, 2 cases were associated with infertility, 1 cases with orchitis,1 case with seminoma, and 1 case with mature teratoma. Three cases with varicocele,2 cases with atrophic testis, 1 case with hydrocele and 1 case with spermatocele, were found out with the use of a high frequency transducer. The sonographic appearance of TM is multiple tiny(1-3 mm),no acoustic shadowing hyperechoic foci that are randomly scattered throughout the testicular parenchyma. Conclusions:Testicular microlithiasis has been associated with a variety of clinical entities, and it is an uncommon condition in which calcified concretions fill the lumen of seminiferous tubule, commonly diagnosed by high frequency (5～10 MHz ) testicular ultrasound. The accepted standard of TM is multiple small nonshadowing hyperechoic foci up to 3 mm in size, with five or more evident on a single sonogram.