Objective To summarize the experience in diagnosis and treatment for chronic lymphocytic thyroiditis or complicated with other thyroid diseases. Methods Seventy-seven patients were diagnosed as chronic lymphocytic thyroiditis or complicated with other thyroid diseases by operation and histological examination at this department from November 2002 to March 2005. All their clinical records including general information, the results of careful physical examination, thyroid correlated hormone tests, color Doppler, fine needle aspiration cytological examination and some intraoperative examinations have been retrospectively analyzed in this report. Results There were 53 cases of simple chronic lymphocytic thyroiditis, 10 cases complicated by papillary carcinoma, 1 case complicated by follicular carcinoma, 2 cases complicated by non-Hodgkin’s lymphoma, 6 cases complicated by nodular goiter, 4 cases complicated by follicular adenoma, and 1 complicated by parathyroid adenoma. Almost all the operations were successfull and the symptoms of the diseases were alleviated. Seventy-two patients had been followed up ranging from two months to two years differently and none of them relapsed. Sixty-three of these patients have received thyrine inhibition and vicariousness treatment, 2 patients who complicated by non-Hodgkin’s lymphoma had been hospitalized and 7 patients complicated by carcinoma were treated with iodine-131. Conclusion The clinical manifestations of chronic lymphocytic thyroiditis are complex, and it often complicated with other thyroid disease, which make it difficult to diagnose the diseases before operation. However, some ancillary methods such as careful physical examination, thyroid correlated hormone tests, !color Doppler and fine needle aspiration cytological examination may improve the accuracy of preoperative diagnosis. Intraoperative thyroid lamellar section and frozen histological examination are also very important for intraoperative diagnosis and operative modality selection.

Objective To study the inhibiting effect of genistein and cisplatin on tumor recurrence and metastasis after hepatectomy in mice. Methods A posthepatectomy high-metastatic-and-recurrent athymic mouse model simulating human HCC was established.Genistein,cisplatin,and combination genistein and cisplafin respectively were given intraperitoneally.Mice were sacrificed after 4 weeks,the volume and pulmonary metastasis of the recurrent tumor was observed.Caculate q value using Jin Zhengjun formula was used to evaluate the synergistic effect of combination genistein and cisplatin.Immunohistochemistry and real time fluorescent quantitation PCR were used to detect the expression of MMP2 and MMP-2 mRNA in liver recurrent tumor. Results Compared with single drug group,mice in genistein combined with cisplatin group had smaller liver recurrent focus volume,less pulmonary metastasis.Genistein and cisplatin displayed additional inhibiting effect on tumor recurrence and metastasis after hepatectomy in vivo,and displayed synergistic inhibiting effect on pulmonary metastasis.The MMP-2 expression of the recurrent tumor in single cisplatin group increased compared with control group(t=26.17、P＜0.05),while in single genistein group and genistein and cisplatin combined group it decreased(t=5.58,13.90,P＜0.05).The expression of MMP-2 mRNA in genistein group was 90%the level of the control group,in cisplatin group it was 2.06 times that of the control group,in combination genistein and cisplatin group it was 44%the level of the control group. Conclusions In vivo,genistein reinforces the effect of cisplatin in inhibiting tumor recurrence and metastasis after hepatectomy,possibly by a mechanism in which genistein inhibits the up-regulation of MMP-2 induced by cisplatin.

Abstract BACKGROUND: Sodium hyaluronate is an effective treatment for osteoarthritis, but the underlying mechanism remains unclear. There is evidence that abnormal expressions of matrix metaloproteinase (MMP)-1, -3 and -9 and tissue inhibitor of metaloproteinase (TIMP)-1 and -2 show great effects on osteoarthritis. OBJECTIVE: To assess the influence of intra-articular injection of sodium hyaluronate on expressions of MMPs-1, 3, 9 and tissue inhibitor of TIMPs-1, 2 in the rabbit cartilage after osteoarthritis. METHODS: Twenty-four mature New Zealand white rabbits were divided into normal control, model, and sodium hyaluronate groups. The model and sodium hyaluronate groups underwent unilateral anterior cruciate ligament transection, and rabbits in the sodium hyaluronate group received 0.3 mL of 1% sodium hyaluronate via intra-articular injection at 4 weeks after modeling, once a week for 5 weeks. At 11 weeks folowing surgery, the rabbits were kiled and the cartilage was harvested to extract total RNA. mRNA expressions of MMPs-1, 3, 9 and TIMPs-1, 2 in the cartilage were analyzed using real-time PCR for each group. RESULTS AND CONCLUSION:Compared with the model group, the range and extent of cartilage damage was reduced in the sodium hyaluronate group (P < 0.01), and Mankin scores were noticeably decreased (P < 0.05). In the cartilage, mRNA expressions of MMPs-1, 3, 9 were enhanced and mRNA expressions of TIMPs-1, 2 were down-regulated in the model group. However, the mRNA expression levels of MMPs-1, 3, 9 and TIMPs-1, 2 in the articular cartilage were not obviously changed in the sodium hyaluronate group. These results suggest that MMPs-1, 3, 9 and TIMPs-1, 2 are involved in the progression of osteoarthritis and the therapeutic mechanism of sodium hyaluronate is not realized through the down-regulation of their expressions during development of osteoarthritis. Sodium hyaluronate for treatment of osteoarthritis is a complex process and the underlying mechanisms require further investigation.

Objective To investigate the efficacy of pancreaticoduodenectomy by using the da Vinci robotic system.Methods The clinical data of 10 patients who received pancreaticoduodenectomy (PD) by the da Vinci robotic surgical system at the Ruijin Hospital from March 2010 to March 2011 were retrospectively analyzed.The perioperative condition of the patients,incidence of complications and postoperative survival were observed.Results Operations were successfully performed on all the patients,and there was no conversion to open surgery.Nine patients received pancreaticojejunostomy,and 1 received pancreaticogastrostomy.The mean operation time,operative blood loss and postoperative duration of hospital stay were 449.5 minutes (range,405-510 minutes),614 ml (range,340-1100 ml) and 22.7 days (range,14-39 days),respectively.One patient developed pancreatic obstruction which was alleviated by operation.Two patients developed pancreatic fistula and were cured by conservative treatment.One patient developed anastomotic bleeding and was cured by conservative treatment.The results of pathological examination confirmed that 3 patients were diagnosed as with pancreatic ductal adenocarcinoma,2 with duodenal papillary adenocarcinoma,1 with ampullary adenocarcinoma,2 with serous cystadenocarcinoma,1 with carcinoid tumor and 1 with pancreatic duct stone and inflammatory mass.All patients were followed up for 6-12 months.The prognosis of the 9 patients was good,except for 1 patient who had tumor recurrence at the sixth month after operation.No mortality was observed.Conclusion PD performed with the da Vinci robotic surgical system is safe,and its efficacy is comparable to that of open surgery.

BACKGROUND:More and more evidence suggests that macrophages and inflammation reactions are involved in the formation and development of nephrolithiasis. Previous studies have found that calculi crystals can stimulate macrophages to release high mobility group protein B1.
OBJECTIVE:To investigate the synergistic effect of high mobility group protein B1 in calcium phosphate induced release of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 from human macrophages.
METHODS:(1) The induced U937 cells were respectively stimulated with RPMI (blank), 100 mg/L calcium phosphate, 100μg/L high mobility group protein B1 and 100 mg/L calcium phosphate+100μg/L high mobility group protein B1 for 1, 2 and 4 hours to col ect cellsupernatant. (2) The induced U937 cells were respectively stimulated with 100 mg/L calcium phosphate, 100 mg/L calcium phosphate+10μg/L high mobility group protein B1, 100 mg/L calcium phosphate+50μg/L high mobility group protein B1, 100 mg/L calcium phosphate+100μg/L high mobility group protein B1 for 4 hours to col ect cellsupernatant. Levels of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 were determined by ELISA.
RESULTS AND CONCLUSION:The levels of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 in the cellculture supernatant of 100 mg/L calcium phosphate group and 100μg/L high mobility group protein B1 group were both higher than those in the blank group in a time-dependent manner (P<0.05). The levels of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 in the cellculture supernatant of different concentrations of high mobility group protein B1 groups were al higher than those in the 100 mg/L calcium phosphate group in a concentration-dependent manner (P<0.05). The results suggest that both calcium phosphate and high mobility group protein B1 can induce the release of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 from human macrophages and the high mobility group protein B1 has the synergistic effect with calcium phosphate to induce interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 from human macrophages.

Objective To investigate and assess the clinical effect of treatment of children′s fractures at distal radial or radial-ulna through incision and Kirschner wire′s interior fixation without coursing epiphysis.Methods The treatment of children′s fractures at distal radial or radial-ulna in our hospital between 1996 and 2005 were reviewed,91 cases via Kirsehner-wire′s internal fixation were dealt.According to the way of placing Kirschner wire,the patients were divided into 2 groups.Group A of 53 cases eschewing epiphysis and passed bone-cortex.Group B of 38 cases got intramedullary fixation and passed epiphysis for 38 cases.After 6-100 months′ follow-up investigation,the 2 groups were comporred by analyzing statistics and the number of cases which involved repeatedly setting of Kirschner wire during operation,anatomical restoration,replacement,Kirschner-wire moving,infection,wrist′s dysfunction and bridge between the epiphysis.Results The fractures in both groups were recovering well.Besides,both were at the low rate of repeated replacement,Kirschner wire moving and infection.However,there were significant differences on repeated setting of Kirschner wire during operation,wrist′s dysfunction and bridge between the epiphysis,of which group B were higher than those in group A.Conclusions While the children′s fractures at distal radial or radial-ulna will be reduced by incision and fixing with Kirschner wire,the way of eschewing epiphyses and passing bone-cortex is better because it accords with anatomic character of children.It can not only fix reliably and bring satisfying clinical treatment effect,but also cause little complication.Thus,it is superior to the way of intramedullary fixation and passed epihysis.

Objective The aim of this study was to investigate the mechanism underlying pruritus by comparing the epidermal growth factor receptor inhibitor(EGFRI)-erlotinib mouse model with the substance P(SP)-induced pruritus mouse model. Methods Two randomized groups of mice were treated with erlotinib or SP to induce pruritus. Behavioral and skin manifestations were observed. Pathological images and neurokinin 1 receptor(NK-1R)expression of the skin were determined. Concentration of interleukin(IL)-31, IL-33, histamine, leukotriene B4, and SP was analyzed by enzyme-linked immunosorbent assay. Nitric oxide was analyzed by colorimetry. Results Transient pruritus induced by erlotinib appeared 2 to 5 days after treatment. In contrast, continuous pruritus was observed during the first hour, but was then gradually relieved. These two shared similar scratching behavior. Concentration of neurotransmitters showed similar trends in changes among the erlotinib group and SP group. Immunohistochemical expression was also consistent between the erlotinib group and SP group. Conclusions Erlotinib-associated pruritus is related to release of signaling factors through the SP/NK-1R signaling pathway.

Not Abstract.

AIMTo establish chromatographic fingerprint of Carthamus tinctorius L. by RP-HPLC in order to control the quality of Carthamus tinctorius L.

METHODSThe gradient elution mode was applied in chromatographic separation, and data were analysed by "Computer Aided Similarity Evaluation" software to compare the quality of Carthamus tinctorius L. samples from different habitats.

RESULTSSamples from different habitats were of high similarity, though a few samples showed evident difference in fingerprint graphics.

CONCLUSIONThe RP-HPLC fingerprint method is repeatable, feasible in analysis of Carthamus tinctorius L. and can be used in quality assessment of Carthamus tinctorius L. Chemical components in Carthamus tinctorius L. samples from various habitats are similar, and their ratios between each other are stable.

Carthamus tinctorius ; chemistry ; Chalcone ; analogs & derivatives ; chemistry ; isolation & purification ; China ; Chromatography, High Pressure Liquid ; methods ; Ecosystem ; Flowers ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Quinones ; chemistry ; isolation & purification

Objective To investigate the clinical effect of urethral plate combined with unilateral crescent flap in the treatment of hypospadias in children.Methods The clinical data of 14 cases of hypospadias treated from March 2017 to March 2018 were retrospectively analyzed,with average age of (3.3 ± 2.1) years.The external urethral orifice was located in the middle and distal part of the ventral side of the penis,with mild and moderate bends of the penis.The prepuce was piling up on the penile dorsal side,the ventral skin was deficient,and there was no concomitant disease such as penis scrotum transposition or cryptorchidism.All children were primarily treated with urethroplasty with urethral plate and one crescent flap.One side of the free urethral plate had a crescent superficial fascia,which was used as the new urethral material together with the urethral plate.By design,the urethra sutured deviating from the midline.The external urethral orifice was formed by trimming the anterior opening of urethra in the form of shallow "V" shape,and the new urethra was covered with the dorsal fleshy vascular pedicle.The pterygoid flap of the penis was sutured to form the penile head,and the foreskin was cut to cover the body of the penis.The specimens were taken for HE staining.Results The operation was successfully completed in 14 children.The length of the penis was measured before it is stretched out.The penile length was(3.5 ±0.5)cm,the penile diameter was(1.2 ±0.3) cm at the coronal sulcus,and the diameter of the tortoise head was (1.5 ± 0.3) cm at the pterygoid.The width of urethral plate was (0.6 ± 0.1) cm.Remeasurement was performed after complete correction of penile bending deformity.The length of the penis was (3.5 ± 0.5) cm,and the urethral defect was (1.7 ± 0.7)cm.According to Barcat method,there were 2 cases of coronal sulcus type,7 cases of anterior penile type and 5 cases of middle penile type.The results of HE staining showed that the number of blood vessels in the dorsal prepuce and fascia was (8.5 ± 2.1),dorsal foreskin plate was (5.1 ± 1.6),ventral prepuce internal plates was (7.6 ± 1.8),and ventral outer prepuce plates was (4.8 ±1.6).The number of superficial fascia vessels and deep fascia vessels were (10.3 ± 1.4) and (4.2 ± 1.7).The analysis of variance showed that there was significant difference in the mean number among groups(P =0.036),which was compared with each other by SNK-q test.The number of fasciae in dorsal prepuce was the most abundant,there was significant difference between dorsal and outer prepuce(P =0.033),and there was also significant difference with ventral prepuce(P =0.047).But there was no significant difference between the two groups(P =0.326).There was no significant difference in the number of blood vessels between the dorsal and ventral prepuce (P =0.682).The number of superficial fascia vessels near the skin was significantly more than that of deep fascia(P =0.037).On the transverse plane,there are more branches of the superficial fascia to the urethral plate at the junction of the ventral external plate and the urethral plate.All 14 cases were followed up for 3 to 9 months with an average of(5.4 ± 2.1) months.The penis was straight and satisfactory,urethral orifice was not cracked,urination was laborious and not forked,and there was no fistula.One patient with middle penile type developed postoperative infection and was controlled after antiinfective treatment.One patient with anterior penile type had slight urination after operation,but had no difficulty in urination.F6 metal urethral dilator was used to dilate for 2 months,and the urination was normal.Conclusion Urethral plate combined with crescent flap urethroplasty for hypospadias has a satisfactory appearance and fewer complications.It provides an optional operative method for the children who need no transection of urethra plate to straighten the penis,especially for the poor development of the penis and the insufficiency of the new urethral materials.The superficial fascia tissue on both sides of the urethral plate is an ideal material for the new urethra because of its abundant blood supply adjacent to the urethral plate and direct vascular connection.