Objective To summarize the experience of how to preserve parathyroid glands and their function in thyroidectomy. Methods Data of 872 patients with thyroid carcinoma who entered our hospital from May. 2006 to Oct. 2009 were retrospectively analyzed. Results Parathyroid damage rate was 2. 06% (18/872)and permanent hypoparathyroidism was 0. 23% (2/872). All occurred in total thyroidectomy. Conclusions Preserving blood supply for parathyroid and avoiding direct contusion or misresection are important for preventing hypoparathyroidism in thyroidectomy. Calcium supplementation should be given to patients with obviously low serum calcium level after surgery to prevent permanent hypoparathroidism.

Objective:To investigate the role of PUMA,a Bcl-2 family member,in oxaliplatin-induced apoptosis in colorectal cancer cells.Methods:In vitro,LoVo cells were treated with 1.2,2.4,4.8 ?mol/L oxaliplatin for 24 h and 4.8 ?mol/L oxaliplatin for 6,12,24 h,PUMA expression was assessed by Western blot analysis.The anti-sense PUMA plasmid was constructed by gene recombination.PUMA expression was suppressed by stable transfecting anti-sense PUMA plasmid into LoVo cells.The apoptosis was assessed by flow cytometry analysis(FCM) and proliferation rate was assessed by MTT assay.Results:Oxaliplatin induced PUMA expression in a time-and dose-dependent manner;stable cell lines expressing the anti-sense PUMA vector were established and named LoVo puma(-/-) cells;oxaliplatin-induced apoptosis was decreased by suppression of PUMA expression;the proliferation rate in LoVo puma(-/-) cells was higher than that in LoVo cells after oxaliplatin treated.Conclusion:Our data suggest that PUMA plays an important role in oxaliplatininduced apoptosis in LoVo cells and the sensitivity of LoVo cells to oxaliplatin was abrogated by suppression of PUMA expression.

Objective To analyze slowly the digestibility and postprandial glycemic response after consum of different cereal starch. Method Starch was quantified into different nutritional fractions using the in vitro Englyst test. Ten healthy subjects consumed 7 kinds of carbohydrate foods with 50 g normal maize starch, waxy maize starch, wheat starch, sticky rice starch, rice starch, potato starch or glucose. Blood samples from postprandial zero to 120 min after consumption of test materials were collected for measurement of glucose, glycemic index and extended glycemic index. Results Native cereal starch was ideal slowly digestible starch (SDS) and the proportion of SDS was about 50% based on Englyst test. The GI value of cereal starch was more than 90% and belonged to high glycemic index foods, but EGI was positive, regarding glucose powder as 100%. Conclusion Cereal starch with slow digestibility and similar glycemic response was a better carbohydrate material to provide a slow and prolonged release of blood glucose and maintenance of glucose homeostasis, which was potentially beneficial to health.

OBJECTIVETo explore the clinical efficacy of self-made Kirschner wire hook in the treatment of severely displaced proximal humerus fractures in children.

METHODSFrom January 2007 to February 2012,35 children with severely displaced proximal humerus fractures were treated with self-made Kirschner wire hook fixation,including 25 boys and 10 girls with an average age of 13.2 years old ranging from 5 to 17. The duration from injury to operation was 1 to 10 days with an average of 4.5 days. Preoperative diagnoses were confirmed by X-ray films as type III in 26 cases and type IV in 9 according to the Neer-Horwitz classification of the proximal humerus fractures. All fractures were close fracture without nerve or vascular injuries. Anatomical reduction was achieved by open reduction and the fractures were fixed by self-made Kirschner wire hook. Intra-operative and postoperative complications, postoperative radiographic examination, upper extremity length and range of shoulder motion were observed and recorded. Neer score system was used to evaluate shoulder function.

RESULTSAll patients were followed up from 6 to 18 months with an average of 12.1 months. The mean Neer score of the injured side was 94.2 +/- 4.8 (ranged, 84 to 99), 30 patients got an excellent result and 5 good according to the Neer scores. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. There were no complications related to the implant including loosening or breakage of the self-made Kirschner wire hook. The range of shoulder motion in the injuried side was similar to the normal side, except in abductor lift. All the patients could participate in normal physical activities.

CONCLUSIONThe method of open reduction and fixed with self-made Kirschner wire hook is a safe,effective,convenient treatment for severely displaced proximal humeral fractures in children.

Adolescent ; Bone Wires ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Range of Motion, Articular

Objective To investigate the anatomic feature and exposing methods of recurrent laryngeal nerve(RLN) in thyroid surgery. Methods The data of 327 cases of thyroid tumor were analyzed retrospectively. The anatomic feature, injury and prevention of RLN were discussed. Of all the cases, 293 RLNs (242 cases) were anatomically exposed. Results The temporary injury rates of RLN was 1.65% (4/242) in the exposed group and 8.23% (7/85) in the unexposed group with a persistent injury rate of 2.35%(2/85). The differences of temporary injury rates and persistent injury rates between the two groups were statistically significant (P<0.05). 67.23% (197/293) of the RLNs had two branches before entering larynx, 61.09%(179/293) of RLNs were posterior to the inferior thyroid artery and 31.39% (92/293) anterior to the inferior thyroid artery, 4.09% (12/293) passed through the bifurcation of inferior thyroid artery, and 4. 13% (10/293) were not related to the inferior thyroid artery. The incidence of non-recurrent laryngeal nerve (inferior laryngeal nerve) was 0.68% (2/293). Conclusions The anatomic relation of RLN is relatively complicated along its journey. The injury of RLN could be reduced with designed exposal during the thyroid surgery.

Objective To observe Meissner's corpuscles in prepuces of different shapes and ages. Methods The Meissner's corpuscles were detected with immunohistochemical stain in 204 prepuce sam- ples of different shapes and ages (3-59 years),and the density of Meissner's corpuscles in every sample was obtained as well.The difference of Meissner's corpuscle densities between phimosis and redundant pre- puce,and correlation between Meissner's corpuscle densities and ages were analyzed with Chi-square test and linear regression,respectively.Results The density of Meissner's corpuscles in redundant prepuce has begun to increase since infancy and reached the peak at the age about 15 years.No significant difference in densities of Meissner's corpuscles between phimosis and redundant prepuce was observed till the age of 20 years,and then there was a trend of disappearance of Meissner's corpuscles in redundant prepuce.A signifi- cantly negative correlation between the densities of Meissner's corpuscles and ages was revealed in redundant prepuce (r=-0.236,P=0.009),whereas an insignificantly positive correlation between the densities of Meissner's corpuscles and ages was shown in phimosis (r=0.193,P=0.084).Conclusions The den- sities of Meissner's corpuscles in redundant prepuce develop synchronically with genital differentiation and accord with the status of sexual function in adult males.The persistent high level of Meissner's corpuscles in adult phimosis might be a mechanism of physiological compensation.

Objective To evaluate the clinical value of 18floro-deoxyglucose positron emission tomography-CY(~(18)FDG PET-CT)in the diagnosis of lymph node metastasis from advanced esophageal carcinoma. Methods A prospective study is perfonued here to assess whether ~(18)FDG PET-CT can improve the diagnostic accuracy in lymph node metastasis for patients with advanced esophageal carcinoma.Thirty patients had undergone esophagectomy with extensive lymph node dissection.PET-CT findings were compared with that d CT with pathological finding as the final say.Results All patients were operated successfully without peri-operative complications.The pathological examination conformed metastasis in 22 patients and 49 out of 243 excised lymph nodes.In CT analysis,the sensitivity was 40.8%,specificity was 96.9%,with a diagnostic accuracy of 85.6%, The positive and negative predictive value was 76.9%,86.4% respectively;PET-CT resulted in a sensitivity of 93.9%,specificity of 91.2%,accuracy of 91.8%.The positive predictive value was 73.0% and negative predictive value was 98.3%,The difference of sensitivity(P＜0.001),accuracy(P＜0.05)and negative predictive value between the two radiological modalities was statistically significant(P＜0.001).Conclusions With a high sensitivity and accuracy in the diagnosis of lymph node metastasis,PET-CT appears necessary in preoperative examination for advanced esophageal carcinoma in the hope that surgical treatment be guided by the results of PET-CT,especially for the elder patients with poor pulmonary function or heart or brain complications. Moreover,it could be used as the basis of the conformal radiation therapy planning for inoperable patients.

Objective To investigate the feasibility and role of single-dose three-dimensional dynamic contrast-enhanced magnetic resonance angiography(SD 3D DCEMRA)in evaluating soft-tissue hemangioma of limbs.Methods The transit time(TT),signal intensity of peak enhancement(SPE)and duration of peak enhancement(DPE)of the femoral,popliteal and anterior tibial arteries at the level of the middle section were assessed in 30 healthy volunteers after intravenous bolus injection of single-dose contrast media at the rate of 3 ml/s.Forty-five patients with soft-tissue hemangioma and 9 patients with schwannoma of the extremities underwent both conventional MRI and SD 3D DCEMRA.The acquisition time of SD 3D DCEMRA ranged from 10 to 12 s,and early arterial,late arterial and venous phases of SD 3D DCEMRA images were acquired consecutively.The conventional MRI and SD 3D DCEMRA findings of the 45 patients with hemangioma were observed and compared with those of the 9 cases of sehwannoma.Results(1)The TT,SPE and DPE of the femoral,poplitcal and anterior tibial arteries were(15?5)s,(400?50),(11.9? 2.6)s;(19?7)s,(320?45),(16.8?3.6)s and(27?10)s,(270?39),(22.0?6.6)s respectively. The comparison of TT(F=6.91,P0.01).The tumoral feeding artery was visualized in all cases(100%).(3)Two cases of hemangioma missed on conventional MRI were correctly diagnosed on SD 3D DCEMRA owing to the visualization of both the tumoral mass and the feeding artery.(4)For schwannoma,neither the dynamic visualization of tumoral mass nor the feeding artery was demonstrated on SD 3D DCEMRA.Conclusion SD 3D DCEMRA is technically feasible to evaluate the limb soft-tissue hemangioma.Dynamic visualization of tumoral mass and demonstration of the tumoral feeding artery are the characteristic features of the tumor on SD 3D DCEMRA.

Objective To compare the differences of clinical characteristics between genotype B and C chronic hepatitis B(CHB)patients and to summarize clinical factors related to genotype C hepa- titis B virus(HBV)infection.Methods Seventy eight CHB patients who were diagnosed with genotype B or C infection by liver puncture biopsy and genotyping were enrolled.Their serum HBV DNA levels were detected.Severe hepatitis,liver cirrhosis,hepatocellular carcinoma and HBeAg positive rate were analyzed to determine the pathologic inflammation and fibrosis degree of liver tissue.Chi square test and Logistic multiple regression analysis were employed for the statistical analysis.Results The serum albumin and pre-protein were lower in genotype C CHB patients than that in genotype B.The alanine aminotrans- ferase,total bilirubin and prothrombin time were higher in genotype C CHB patients than that in genotype B.The rates of genotype C patients increased significantly with the grade of liver necroin- flammation progressing from GO to G4(1.8%,11.1%,20.4%,33.3%,33.3%) and the stage of liver fibrosis progressing from SO to S4(5.6%,5.6%,14.8%,33.3%,40.7%),but the rates of genotype B patients did not change significantly with the grade of liver necroinflammation(16.7%, 25.0%,25.0%,20.8%,12.5%)and stage of liver fibrosis progressing(16.7%,29.2%%,20.8%, 16.7%,16.7%).There was statistical significance in grades of liver necroinflammation(X~2= 11.49,P=0.022)and stages of liver fibrosis(X~2=13.56,P=0.006)between genotype B and gen- otype C patients.The rates of genotype C CHB patients were higher than,similar with and lower than the rates of genotype B patients of HBV DNA level above 1.0?10~6 copy/mL,between 5.0?10~2-1.0?10~6 copy/mL and under 5.0?10~2 copy/mL,respectively(51.8% vs 12.5%,35.2% vs 45.8% and 13.0% vs 41.7%).There was statistical significance of HBV loads between genotype B and genotype C patients(X~2=13.25,P=0.001).HBeAg positive rate in genotype C patients was significantly higher than that in genotype B patients(61.1% vs 25.0%,X~2=8.67,P=0.003).The rates of decompensated cirrhosis,compensated cirrhosis and no-cirrhosis in genotype C patients were higher than,similiar with and lower than the rates in genotype B patients,respectively(40.7% vs 4.2%,22.2% vs 20.8% and 37.0% vs 75.0%).There was statistical significance of the rate of cirrhosis between genotype B and genotype C patients (X~2=12.47,P=0.002).Conclusions The degree of liver necroinflammation and fibrosis,the HBeAg positive rate and the incidence of cirrhosis are all related with genotype C HBV infection.

Objective To investigate the effect of rehabilitation training on the sensory dysfunction after stroke.Methods Fifty three stroke patients with sensory dysfunction were randomly divided into 2 groups:a con- trol group and a treatment group.The control group composed of 25 patients was intervened with conventional treat- ment,while the treatment group composed of 28 patients with sensory training in addition to the conventional treat- ment.The effect of rehabilitation training of the two groups was evaluated by Fugl-Meyer Assessment (FMA) before and afer treatment.Results The FMA scores of patients of both groups increased significantly after 2 months of treatment (P