Objective To improve the ultrasonic differential diagnosis of thyroid lump through analyzing pathological and ultrasonic features of papillary thyroid carcinoma. Methods Records of 173 cases papillary thyroid carcinoma were analyzed retrospectively in terms of preoperative ultrasonic manifestation, lesion size, echo,boundary, calcification, blood supply, lymph node metastasis and accompanying diseases etc. Results The avthe 173 papillary thyroid carcinoma cases, the number of cancer nodule was 203. There was no statistical difference between papillary thyroid carcinoma lesion and papillary thyroid microcarcinoma lesion in terms of low echo and ill-defined borders (P ＞ 0. 05). The former is higher than the latter in blood flow speed, microcalcification rate, and preoperative ultrasonic diagnosis rate (P ＜0. 01, P ＜0. 05, P ＜0. 01 respectively). The mulifocality rate for the 173 cases with papillary thyroid carcinoma is 33.53% (58/173). There was no statistical difference between papillary thyroid carcinoma and papillary thyroid microcarcinoma in cancer lesion(P ＞0. 05), while the former has a higher rate of lymph node metastasis than the latter(P ＜0. 01). Preoperative diagnosis rate is higher in papillary thyroid microcarcinoma cases without other thyroid diseases than in cases with other thyroid diseases (P ＜ 0. 05). No statistical difference of preoperative diagnosis rate was seen between papillary thyroid carcinoma patients with other thyroid diseases and those without other thyroid diseases (P ＞ 0. 05). Conclusions The overall evaluation of thyroid nodule diameter, boundary, echo, small calcification, lymph node metastasis, blood supply, accompanying diseases and so on can improve diagnosis of primary papillary thyroid carcinoma.

Objective To investigate the relationship between the dynamic changes of platelet parameter and the severity of the neonatal hypoxia ischemic encephalopathy .Methods To search PubMed ,Ovid ,Springer Database ,Chinese Academic Journal ,VIP database and Wanfang database in the library literature and screen documents according to the inclusion criteria of diagnostic tests , then to extract the characteristic information .Using RevMan 5 .1 software to analyze the data ,and to carry out the Meta analysis se-lected the effects model according the results of tests for heterogeneity .Results According to the inclusion criteria ,it was won the 10 articles eventually .The Meta analysis results showed that the PLT in acute period of HIE patients was significantly 1 .65-2 .14 times the standard deviation lower than the control group .The MPV and PDW in acute period of HIE patients were significantly 1 .12-1 .61 and 1 .17-1 .99 times the standard deviation higher than the control group .The PLT in convalescent of HIE patients was 1 .85-2 .35 times the standard deviation higher than the acute period of HIE patients .The MPV and PDW in the convalescent of HIE patients were significantly 0 .68-1 .38 and 0 .81-1 .37 times the standard deviation lower than the acute period of HIE pa-tients .Obviously ,the PLT ,MPV and PDW in the convalescent of HIE patients were closed to the level of the control group .Conclu-sion Clinical observing HIE infant′s platelet parameter dynamically can be regarded as the index of HIE infant′s condition severity and monitoring condition change .

Objective To discuss the clinical symptoms of severe traumatic cerebral injury patients with paroxysmal sympathetic hyperactivity (PSH). These patients were given positive and effective prevention and treatment to reduce complications in order to improve prognosis. Methods Twenty patients with PSH were selected from October 2010 to October 2014 and were analyzed by gender, age, diagnosis, clinical symptoms, laboratory and equipment inspection to summary the treatment experiences of such patients. Results Of the 20 patients,14 were males and 6 were females,with age of 22-65 (35.4±9.5) years. Sixteen patients underwent unilateral or bilateral intracranial hematoma and decompressive craniectomy,and 4 patients were given conservative treatment. PSH occurred in these patients within 1 week after cerebral injury or surgery. However, the elderly might occur in the course of a few weeks or even months later. Each patient' s seizure frequency and duration had no significant regular pattern. The frequency varied from one time in several days to several times one day. Seizure duration was generally less than half an hour. All of the patients underwent CT and MRI examinations and showed different parts of the brain injury. But the damage of the brain stem, corpus callosum, basal ganglia and lateral ventricles beside sympathetic overactivity could lead to the occurrence of PSH. Most of the patients had a good effect after active drug treatment and symptomatic therapy. Conclusions PSH often occurs in severe traumatic cerebral injury patients. The doctor should pay attention to PSH. Early active and effective prevention and treatment can improve the prognosis of patients with PSH.

Secondary hyperparathyroidism is the most common complication of patients with chronic kidney disease.For patients poorly responding to medical treatment,parathyroidectomy would be the best choice.This article reviews the indications and modalities of surgical treatment for secondary hyperparathyroidism in patients with chronic kidney disease.

Objective To evaluate the diagnostic value of anti-nucleosome antibody for juvenile systemic lupus erythematosus (JSLE).Methods Fifty-four patients with JSLE,28 patients with non-JSLE and 26 healthy children were chosen in this study.antinuclear antibody(ANA),anti-nucleosome antibody (AnuA),anti-dsDNA antibody,anti-histone antibody (AHA) and anti-Sm antibody were detected by ELISA or western-blot method.The relevant clinical data were collected and analyzed.Results For diagnosis of JSLE,the sensitivity and specificity of AnuA was 77.78％ and 96.30％.The sensitivity of AnuA combined with ANA,anti-dsDNA and antiSm was higher than that of single detection.AnuA usually associated with fever,oral/nasal pharyngeal ulcer,lung damage,lymphocyte absolute value,urine protein and C3 level.Conclusion AnuA can be used as a serum marker for JSLE diagnosis.The detection of AnuA combined with anti-dsDNA and anti-Sm should be more helpful for diagnosis of JSLE.

Objective To quantitatively determine JAK2V617F mutation by fluorescence quantitative polymerase chain reaction (FQ-PCR)and to analyze its diagnostic value in chronic myeloproliferative disorders(CMPD).Methods FQ-PCR was adopted to detect the positive rate and the relative quantification of JAK2V617F gene mutation in the marrow samples of 68 patients with CMPD.Their diagnostic value in CMPD and their relation with the clinical data were analyzed.Results The marrow samples in 68 cases of CMPD were successfully amplified in wild-type and mutant JAK2V617F.The total positive rate of the JAK2V617F gene mutation was 66.2%(45/68).The positive rate was 75.0%(21/28)in the patients with polycythemia vera(PV),60.6%(20/33)in the patients with primary thrombocythemia(ET)and 57.1%(4/7)in patients with idiopathic myelofibrosis respectively.The posi-tive rate of JAK2V617F mutation in the PV patients was significantly higher than that in the patients with ET and IMF.The JAK2V617F relative quantification in the PV patients was positively correlated with the hemoglobin concentration and white blood cell(WBC)count,and which in the ET patients was positively correlated with the platelet count.Conclusion FQ-PCR can quickly and accurately detect JAK2V617F mutation and its mutation ratio,which provides an effective laboratory indicator for the clinical diagnosis of CMPD.Certain relation exists between the JAK2V617F relative quantification and the clinical hematological indexes of the patients.

Hyalinizing trabecular tumor (HTT) is a primary thyroid tumor discovered 20 years ago. This tumor is usually misdi-agnosed as papillary thyroid carcinoma because of their many similar nuclear features. Although controversy has focused on the malig-nant potential of HTT, results show that this tumor has a favorable clinical prognosis. Improving the preoperative diagnosis of HTT can reduce the scope of operation because misdiagnosis before or during surgery may lead to unnecessary total thyroidectomy. This study re-viewed the pathology, diagnosis, therapy, and prognosis of HTT.

Objective To investigate the characteristics of lymph nodes metastasis in papillary thyroid carcinoma (PTC) and to discuss surgical approach.Methods All patients underwent total thyroidectomy,central lymph nodes and lateral lymph nodes dissection in Department of Thyroid Surgery,the First Hospital of the Jilin University,from Dec.2011 to Dec.2012.Results With the increase of the number of positive central lymph nodes,lateral cervical lymph node metastasis rate increased as well and accompanied multi region metastasis trend.In 102 cases of lateral positive cervical lymph node patients,55 cases were in level Ⅱ,accounting for 53.92％,62 cases were in level Ⅲ,accounting for 60.78％,76 cases were in level Ⅳ,accounting for 74.51％,and 17 cases were in level V,accounting for 16.67％.In lateral lymph nodes metastasis,we found level Ⅳ was the most vulnerable area,followed by level Ⅲ,level Ⅱ and level Ⅴ.Conclusions Prophylactic central lymph node dissection should be performed in PTC patients.Patients with central lymph node metastasis especially with the number of positive lymph nodes ＞ 3 should be performed ipsilateral level Ⅱ-Ⅴ lymph node dissection.

Objective To investigate the clinical characteristics,diagnosis and treatment for Graves' disease associated with papillary thyroid microcarcinoma(PTMC) by retrospectively analyzing domestic and foreign literatures.Methods 32 patients of Graves' disease associated with PTMC treated at the Department of Thyroid Surgery,the First Bethune Hospital of Jilin University from Jun.2008 to Jun.2013 were collected.32 cases of PTMC with normal thyroid function were randomly selected by a random number table method from the same period as control.Results The experimental group had 32 patients aging from 24 to 71 years old,among whom 3 were males,and 29 were females with the male to female ratio was 1∶9.7.15 cases in the experimental group had positive central lymph node metastasis and the other 17 cases were negative,while in the control group 7 cases were positive and 25 cases were negative.The mean number of positive lymph nodes was 3 ± 2.88 in the experimental group and 1.71 ± 1.25 in the control group.The ratio of positive lymph node metastasis(the number of positive lymph nodes/the total number of lymph nodes,and the total number of central lymph nodes was ＞3)was (50.34 ±27.09) ％ in the experimental group and(33.5 ±30.79)％ in the control group.For the above 3 values of central lymph node metastasis,the experimental group were all higher than those of the control group (P =0.035,0.039,0.018 respectively).Conclusions Compared with patients of PTMC,patients of Graves' disease associated with PTMC are more likely to have central lymph node metastasis,more number of positive lymph node and higher metastasis ratio.In order to prevent the postoperative recurrence of Graves' disease and thyroid carcinoma local lymph node,total thyroidectomy plus central lymph node dissection should be the ideal operation method.