Objective To assess the effect of arterial embolization in treating hyperthroidism by colour ultrasonography.Methods Forty two cases of hyperthyroidism were treated with thyroid arteries embolization. A few days before and 1, 3, 6 months after embolization, the echograms of thyroids were observed including the volumes of thyroids and the internal diameters of thyroid arteries were measured with colour ultrasonography respectively. The Vs, Vd, Vm, PI, RI were measured with the Doppler and the quantities of blood flow were calculated. The relationships of changes for all these parameters and T 3, T 4 and TSH were analysed. Results Before artery embolization all thyroids were enlarged with diffusely homogenous or heterogenous low echos and nodules in some patients accompanied by widenings of the thyroid arteries and their branches full of blood supply. The volume of thyroids decreased after artery embolization. 1 3 months later the echo of thyroids enhanced and got coarse with decrease of the thyroid vasculature and narrowing of vessel calibers except a few star or spot like blood streams were sometimes seen within the thyroids and no blood flow signals found in some cases. 3 6 months after embolization, the echo of thyroids decreased gradually or unevenly distribnted. All the parameters of blood flow before and after the treatment showed statistically significant differences( P

Objective: To compare the clinical outcome between ministernotomy and standard median sternotomy in aortic root replacement. Methods: A total of 60 patients underwent aortic root replacement (ARR) between July 1999 and October 2001 in Fu Wai Hospital. 15 patients who underwent ARR by ministernotomy were defined as the MINI group. The comparable group was 45 patients who underwent ARR by standard median sternotomy (STD group). Results: There was no post-operative death in each group. Early postoperative complications occurred in 3 (20.0%) of the MINI group and in 5 (11.1%) of the STD group (P= 0.661). In the MINI group, both the mean opera ting time and the cardiopulmonary bypass time were significantly longer than that in STD group (P=0.027, P=0.015). There was no significantly difference in ao rtic cross-clamping time between two groups. In the MINI group, the mean intubation time, postoperative blood transfusion amount, the mediastinal drainage and duration of hospital stay were less than that of the STD group. But, they all showed no statistical significant differences. Conclusion: Both approaches for patients undergoing AAR resulted in acceptable morbidity. AAR by ministernotomy provides a potential benefit of less trauma and reduction of blood transfusion.

Objective To explore the influence of different lengths and contents of glass-fiber post on the fracture resistance of teeth, and to investigate the optimal length and content of glass-fiber post used for restorative treatment. Meth-ods Forty-two intact single canal mandibular premolars were collected from orthodontic patients and were divided into three experimental groups (A, B and C). All the teeth were endodontically treated after cut off the crowns from the 2 mm above cemento-enamel junction. The post lengths were10 mm in A group, 8 mm in B group, and 6 mm in C group.There were two subgroups for each experimental group (A1, A2, B1, B2, C1, C2 ), 7 teeth for each subgroup.The 42%glass fiber post was used in A1, B1 and C1 groups. The 75%glass fiber post was used in A2, B2 and C2 groups. All of groups were restored with resin cores and metal crowns. The fracture resistance was measured with universal testing machine and recorded the root frac-ture pressure data and the mode of all the teeth. Results The fracture resistance was significantly higher in group A than that of group B and group C (P<0.05), and the fracture resistance was significantly higher in group B than that of group C (P<0.05). The fracture resistance was significantly higher for 75%glass fiber post than that of 42%glass fiber post (P<0.05). Conclusion Within a certain range, the longer the length of glass fiber post, the greater the tooth fracture resistance. The fracture resistance of fiber content is better for 75%glass fiber post than that of 42%glass fiber post.

Objective To investigate the change of serum CA724, CA242 and AFP levels before and after transcatheter artery chemoembolization (TACE) treatment of primary hepatic carcinoma(PHC)patients as well as its clinic significance. Methods Patients of PHC (n=45) and healthy adults (n=40) were enrolled. Serum samples were collected from each healthy people and PHC patients 2 days before TACE,l week and 1 month after TACE. Electrochemiluminescence Immunoassay (ECLI) was used to determine serum CA724, CA242 and AFP levels, and correlations among three indexes as well as their relationships with clinical data were also analysed., Change of serum CA724 and CA242 levels before and after TACE were compared in AFP<400μg/L group and AFP≥400μg/L group. Results Serum levels of CA724, CA242 and AFP in PHC group were significantly higher than that in healthy control groups before TACE therapy(P<0.05). Positive rates of serum CA724 and AFP were higher in PHC group(P<0.01)than that in healthy control group. AFP decreased significantly at both 1 week and 1 month upon TACE treatment compared with that at before teratment(P<0.01). CA724 was significantly lower at one month after treatment than that at before treatment(P<0.05). But there was no significant difference in CA242 before and after treatment(P>0.05). CA724 and AFP expressions are associated with tumor size(P<0.05). After one month of therapy, serum CA724 level was obviously decreased in both AFP<400μg/L and AFP≥400μg/L groups. Before and after TACE therapy, there was a positive correlation between the expression of AFP and CA724(r=0.754,P<0.05). Conclusion Serum CA724 can be used as one of the tumor markers to assist the evaluation of curative effect of TACE on PHC.

Objective To investigate the value of 18F-FDG PET/CT for differentiating multiple myeloma from bone metastases with undetermined origin.Methods A retrospective study was performed on patients with multiple bone destructions and without extraosseous primary malignant tumor in 18F-FDG PET/CT imaging.A total of 26 patients (12 males,average age 55.4 years) with multiple myeloma and 20 patients (9 males,average age 50.2 years) with multiple bone metastases confirmed by biopsy or histopathology from January 2011 to December 2013 were included into this study.The characteristics of 18F-FDG PET/CT and urine Bence-Jones protein were used to establish the diagnostic criteria.Myeloma was diagnosed if two or more of the following conditions could be satisfied:more than 10 bone lesions,osteolytic or mixed bone destruction,SUVmax＜4.0,and positive urine Bence-Jones protein.Two-sample t test and x2 test were used.Results The average number of bone lesions in multiple myeloma patients was 15.8,which was more than that (7.8) in patients with bone metastases.About 71.8％ (296/412) of bone lesions in multiple myeloma and 28.8％ (45/156) of bone metastases were osteolytic.The percentage of osteolytic lesions was significantly higher in multiple myeloma (x2=87.2,P＜0.05).The SUVmax of bone lesions of multiple myeloma and bone metastases were 3.81 ±2.17 and 5.82± 3.44 (t =8.29,P＜0.05) respectively.According to the diagnostic criteria,the sensitivity,specificity and accuracy of 18F-FDG PET/CT for the differentiation of myeloma from bone metastases were 88.5％ (23/26),85.0％ (17/20) and 87.0％ (40/46).Its diagnostic efficiency was higher than urine Bence-Jones protein (sensitivity:65.4％ (17/26);x2=3.90) and original 18 F-FDG PET/CT evaluation (specificity:10/18,accuracy:64.1％ (25/39);x2 =3.99,6.12) respectively (all P＜0.05).Conclusion Combining the evaluation of structural properties and metabolism on 18F-FDG PET/CT with urine Bence-Jones protein level may provide additional value for the differentiation of multiple myeloma from bone metastases with undetermined origin.

Objective To evaluate the effect of remifentanil on mean arterial pressure (MAP), heart rate (HR) and QTc interval during tracheal intubation of general anesthesia patients. Methods Seventy-five ASA Ⅰ -Ⅱ grade patients were selected and allocated to receive either saline (group C), remifentanil 0.50 μg/kg (group R1) or remifentanil 0.75 μg/kg(group R2) by random digits table with 25 cases in each, they were administrated as a bolus intravenous, followed by a continuous infusion at 0.10 μg/ (kg·min), 1 min before laryngoscopy. All patients received fentanyl 3 μg/kg,propofol 1.0 - 1.5 mg/kg and vecuronium 0.1 mg/kg. The ECG.MAP and HR were recorded prior to induction of anesthesia (T0), 2 min following the start of drug intravenous of fentanyl and propofol with vecuronium (T1), 1 min following remifentanil or saline (T2), before laryngoscopy(T3), 30 s (T4), 2 min (T5) and 4 min (T6) after intubation. Results The QTc interval was significantly prolonged immediately following intubation in group C and group R1, but it remained stable in group R2, compared with the QTc interval just before laryngoscopy. In group R2, QTc interval was significantly shorter at T4-T6 compared to group C(P＜ 0.05 or ＜ 0.01). QTc interval significantly increased from baseline at T4 in group R1 and T4-T6 in group C (P＜ 0.05 or ＜ 0.01). The number of patients with QTc interval ＞ 440 ms were significantly greater immediately following tracheal intubation in group C than that in group R2 [44% (11/25) vs. 12% (3/25)] (P ＜ 0.05). Conclusions QTc interval increases following tracheal intubation during induction of anesthesia using fentanyl and propofol. Intravenous of remifentanil attenuates the QTc interval prolongation associated with tracheal intubation. In addition, remifentanil decreases the hemodynamic responses to tracheal intubation.

Objective To evaluate the effectiveness of epidural saline washout on regression of sensory and motor block after epidural anesthesia in elderly patients.Methods A total of 70 males with ASA Ⅰ or Ⅱ who were subjected lumbar epidural anesthesia with 10 ml of 1.73% bicarbonate-lidocaine and fentanyl 50 μg (1 ml).At the end of transurethral surgery,the washout group (35 cases) received an epidural bolus of 20 ml saline while the control group(35 cases) did not,extracted the epidural catheter after 10 minutes.Results Mean times of 3-dermatomal sensory regression for pinpric, 1-grade of motor block, and the rate of 1 h motor block were significantly shorter in the washout group than those in the control group [(24.6 ± 15.9) min vs(32.8 ± 16.7) min, (32.7 ± 13.4) min vs(47.9 ± 22.6) min,5 cases (14.3%) vs 14 cases (40.0%)](P < 0.05 or < 0.01 ).There was no difference in pain-killer utilization, postoperative pain scores no more than 3 scores and side effects between the two groups (P > 0.05).Conclusion It suggests that epidural washout facihtates regression of both sensory and motor block following epidural anesthesia without reducing the postoperative analgesic benefit.

Objective To study the relationship among depression associated type 2 deabetes mellitus (T2DM) and personality and quality of life.Methods A total of 246 cases of hospitalized T2DM patients were investigated by schedule tables:self-rating depression scale (SDS),Eysenck personality questionaire (EPQ) and adjusted diabetes-specific quality of life scale (A-DQOL).According to the results of SDS,patients were divided into depression group (171 cases) and non-depression group (75 cases).Correlation analysis and regression analysis were carried out for the collected data.Results There were differences in satisfaction,influence,anxiety Ⅰ,anxiety Ⅱ,neuroticism and extraversion between the two groups(P ＜ 0.05 or P ＜ 0.01).Depression extents was related to the quality of life,neuroticism,extraversion and course(r =-0.243-0.392,P ＜ 0.05 or P ＜ 0.01).Anxiety Ⅱ,satisfaction and course enter the regression equation of depression (β =-0.205-0.322,P ＜ 0.05 or P ＜ 0.01).Conclsion Anxiety Ⅱ,satisfaction and course are key factors inducing depression in T2DM.Neuroticism and extroversion may be the predisposing personality characteristics in T2DM patients with depression.In clinical work,it is helpful for treatment by changing personality and mood of patients.

Objective To explore the clinical characteristics of localized peritoneal mesothelioma by the retrospective analysis of the clinical data and its relationship with asbestos exposure.Methods A total of 22 cases with localized peritoneal mesothelioma confirmed by pathological test and they were selected as our subjects in the Central Hospital of Cangzhou from Jan.2007 to Dec.2012.The information of all cases was collected.The incidence,asbestos exposure history,clinical manifestations,imaging studies,pathological type,immunohistochemistry and tumor markers of peritoneal mesotheliom patients were recorded or measured.Results Of 22 cases,female accounted for 68.18％.The periods from onset symptoms to treatment time was from 2 days to 1 year with an average of 83 days.Clinical symptoms were verified including localized abdominal pain (11 cases,50.00％),abdominal mass (8 cases,36.36％),abdominal distension (6 cases,27.27％),ascites (10 cases,45.45％).Patient was with increased platelet and carcinoma antigen 125.Abdominal computerized tomography showed that local mass was seen and 12 cases were with asbestos spot.Ultrasound-guided peritoneal biopsy was confirmed as the main diagnostic method followed by Laparotomy.Epithelial type was the main pathological type (19 cases,86.36％),following the fleshy tumor type and mixed type.Eighteen cases had asbestos exposure history.Conclusion Localized peritoneal mesothelioma is a rare disease.However,the incidence is high in the current region due to asbestos exposure.Abdominal pain and local mass are the main clinical symptoms,and the main pathology is epithelial typeas well as surgery is the main therapy.

Objective To summarize the methods and results of surgical treatment of coarctation of the aorta associated with aortic dissection.Methods Analyzed the clinical data of 10 patients with aortic coarctation associated type B aortic dissection who underwent one-stage surgical repair between 2011 and 2013 in Anzhen Hospital.There were 7 males and 3 females with the age ranged from 23 to 56 years,average at 41.2 years.All patients were diagnosed by UCG and CTA.There are three key points to determine the operation method,diameter of the aortic arch and descending aorta,and the extent of dissection.Descending thoracic aortic replacement with short stented elephant trunk was performed in 3 patients,thoracic and abdominal aortic replacement in 1 patient,ascending-abdominal aorta bypass with arch or descending aortic ligature in 3 patients.Results One hospital death occurred(10％).There was no severe surgical complication.No death or reoperation occurred during follow up period.Conclusion Aortic coarctation associated type B aortic dissection is a rare and complex disease.Surgical treatment is an effective and safe method for the disease.