Objective:To evaluate the effects of endovascular embolization and microsurgical clipping on cognitive function in patients with intracranial aneurysm.Methods:A total of 80 patients with intracranial aneurysms,who were treated in Chongqing Hospital of Traditional Chinese Medicine from March 2014 to September 2015,were selected and randomly divided into control group(n=40) and experimental group (n=40).The control group was treated with microsurgical clipping,and the experimental group,with endovascular embolization.The postoperative cognitive function was assessed by the mini mental state examination scale (MMSE),and length of stay,in-hospital mortality rate,mortality rate in 1 year and the incidence of postoperative adverse reactions were compared between the two groups.Results:The total score (26.78± 0.85) of MMSE in the experimental group was higher than that (22.25± 0.63) of the control group (P＜0.05).The cognitive dysfunction rate (37.50％) of the experimental group was lower than that (55.00％) of the control group (P＜0.05).The length of stay [(6.7± 3.9) days] of the experimental group was lower than that [(9.6± 4.5) days] of the control group(P＜0.05).There were no significant differences in in-hospital mortality rate and mortality rate in 1 year,and the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Endovascular interventional therapy can improve the cognitive function of the patients with intracranial aneurysms and shorten the length of hospital stay.

Cerebral apoplexy is one of the main causes of death in the middle-aged and elderly population,which has higher mortality and disability rate.The incidence of the disease is increasing year by year and it is a serious threat to human life and health.Therefore,it is of great significance to find an effective target for the diagnosis and treatment of stroke.Thioredoxin (Trx) is the major thiol reducing agent in the cells,it is involved in many signal transduction pathways in the cells by regulating the redox state of the cell.It has disulphide reductase activity,which can reduce the oxidative stress injury in the rats after the stroke.Thioredoxin interacting protein (TXNIP) is an endogenous inhibitor of Trx,it can destroy the redox balance and promote the oxidative stress by binding/inhibiting the activity of Trx,while the inhibition or knockdown of TXNIP has obvious neuroprotective effects.Recent studies suggest that Trx/TXNIP may be involved in the pathophysiology of cerebral apoplexy by a variety of pathways.This article analyses the research status of Trx/TXNIP and studies the localization of Trx system in the central nervous system and the progress of Trx system in ischemic cerebral apoplexy.It reviews the mechanism of Trx/TXNIP in cerebral apoplexy and prospectes the signaling pathways involved in the pathophysiological process of Trx/TXNIP to provide new ideas for the treatment of cerebral apoplexy.

Objective Using the Chinese anthropomorphic chest phantom to measure the absorbed dose of various tissues and organs under different noise index, and to assess the radiation dose of MSCT chest scanning with the effective dose(ED). Methods The equivalence of the Chinese anthropomorphic chest phantom(CDP-1C) and the adult chest on CT sectional anatomy and X-ray attenuation was demonstrated. The absorbed doses of various tissues and organs under different noise index were measured by laying thermoluminescent dosimeters(TLD) inside the phantom, and the corresponding dose-length products(DLP) were recorded. Both of them were later converted into ED and comparison was conducted to analyze the dose levels of chest CT scanning with automatic tube current modulation (ATCM) under different noise index. Student t-test was applied using SPSS 12.0 statistical software. Results The Phantom was similar to the human body on CT sectional anatomy. The average CT value of phantom are -788.04 HU in lung,45.64 HU in heart,65.84 HU in liver,254.32 HU in spine and the deviations are 0.10%,3.04%, 4.49% and 4.36% respectively compared to humans. The difference of average CT value of liver was statistically significant(t=-8.705,P＜0.05),while the differences of average CT values of lung, heart and spine were not significant(t value were -0.752,-1.219,-1.138,respectively and P＞0.05).As the noise index increased from 8.5 to 22.5, the DLP decreased from 393.57 mGy·cm to 78.75 mGy·cm and the organs dose declined. For example, the average absorbed dose decreased from 22.38 mGy to 3.66 mGy in lung. Compared to ED calculating by absorbed dose, the ED calculating by DLP was lower. The ED values of the two methods were 6.69 mSv and 8.77 mSv when the noise index was set at 8.5. Conclusions Application of the Chinese anthropomorphic chest phantom to carry out CT dose assessment is more accurate. The noise index should be set more than 8.5 during the chest CT scanning based on ATCM technique.

OBJECTIVETo compare the clinical effects between hip anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery and posterior K-L approach combined with quadratus femoris bone flap transplantation for the treatment of femoral neck fracture of Garden III-IV in young and middle-aged patients.

METHODSFrom January 2004 to January 2011,46 patients with femoral neck fractures were treated by two kinds of operation. Among them, 20 cases were treated with anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery, included 12 males and 8 females with an average age of (32.1 ± 7.3) years old, involved 12 cases of Garden III and 8 cases of Garden IV. The other 26 cases were treated with posterior K-L approach combined with quadratus femoris bone flap transplantation, included 20 males and 6 females with an average age of (37.8 ± 6.9) years old, involved 16 cases of Garden III and 10 cases of Garden IV. The index of hospitalization (hospitalization time, total cost, operative time, intraoperative blood loss, postoperative complications), the quality index of operation (fracture reduction, position of internal fixation, fracture healing time, nonunion and femoral head necrosis) of two groups were observed and compared. Hip joint function were evaluated by Harris score.

RESULTSAll patients were followed up from 28 to 41 months with an average of 36 months. The intraoperative blood loss of group S-P (92.3 ± 10.4) ml was less than that of group K-L (132.4 ± 11.2) ml, there was significant difference between two groups (P < 0.05). The operation time of group S-P (81.4 ± 9.2) min was more than that of group K-L (67.1 ± 4.5) min, the difference was statistically significant (P < 0.05). One case in group S-P and 9 cases in group K-L appeared postoperative complications, there was significant difference between two groups (P < 0.05). The fracture healing time of S-P group (83.5 ± 7.3) d was shorter than that of group K-L (103.2 ± 12.6) d, there was significant difference between two groups (P < 0.05). At 30 months after operation, there were significant difference in Harris scoring between two groups (P < 0.05).

CONCLUSIONAnterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery for treatment of femoral neck fracture of Garden III-IV of young and middle-aged patients, it has characteristics in clear anatomic and easy to operate. As compared with K-L approach, S-P approach can better reserve residual blood supply of femoral neck. While combining with the iliac bone flap transplantation with deep circumflex iliac artery, it could better reconstruct the blood supply of femoral neck to promote fracture healing.

Adult ; Case-Control Studies ; Female ; Femoral Neck Fractures ; physiopathology ; surgery ; Fracture Healing ; Humans ; Iliac Artery ; Male ; Middle Aged ; Surgical Flaps ; transplantation

Objective To explore the expression of papillary thyroid carcinoma (PTC)-specific microRNAs in order to improve early diagnosis of PTC's and determine the invasiveness of PTC.Methods Thyroid samples from 51 cases were analyzed to investigate microRNA expression differences between benign and malignant thyroid nodules by using miRNA chip technique.The differences in the expression of microRNAs were validated by qRT-PCR,and their correlation with clinical and pathological features of PTC was analyzed.Results (1) qRT-PCR analysis showed that miR-30a-3p (U =60,P =0.003),miR-146b-5p(U =40,P =0.001) and miR-199b-5p (U =69,P =0.007) significantly different between benign and malignant tissues.(2) Expression of miR-199b-5p was significantly higher in PTC patients with margin invasion and of ipsilateral neck lymph node metastasis(P =0.010).Conclusions miR-199b-5p,miR-30a-3p and miR-146b-5p may be used to differentiate benign and malignant thyroid nodules; miR-199b-5p can help assess the invasiveness of PTC.

Central neck lymph node is the main site of metastasis of papillary thyroid cancer. However, the central area of dissection scope and integrity are still issues and controversies. The vast majority of papillary thyroid cancer in central lymph node dissection process, ignoring the lymph node posterior to fight recurrent laryngeal nerve (LN-prRLN), strictly speaking, does not do the central area of lymphatic adipose tissue intact, completely removed. This paper summarizes the recent literature on the LN-prRLN clinical dissection scope, the incidence of LN-prRLN transfer, LN-prRLN dissection impact on the incidence of complications, recurrence rate, mortality and survival rate were reviewed analysis, summarized the LN-prRLN dissection indications, clinical significance and importance.
Carcinoma ; surgery ; Carcinoma, Papillary ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Neck ; Neoplasm Recurrence, Local ; Recurrent Laryngeal Nerve ; surgery ; Survival Rate ; Thyroid Neoplasms ; surgery

Objective To investigate the expression of miR-199b-5p in papillary thyroid carcinoma ( PTC) and its relationship with clinical features .Methods Total RNA was extracted from 36 cases of PTC and the adjacent normal thyroid tissues by reverse transcription quantitative real-time polymerase chain reaction ( qRT-PCR)method to detect the expression of miR-199b-5p, and to analyze its relationship with clinical features such as the capsule invasion and lymph node metastasis .Results miR-199b-5p expression in PTC was related to lymph node status(χ2 =9.20, P=0.01), capsule invasion(U=36.00, P=0.047), but had no correlation with other clinical characteristics such as age , sex, tumor size, the number of tumor foci ( U =151.00, 87.00, 64.00, 87.00 respectively, P>0.05).ROC curve analysis showed that the specificity and sensitivity of miR-199b-5p in diagnosis of PTC were 82.1% and 72.7% respectively.Conclusion The abnormal expression of miR-199b-5p may be related to the occurrence , development and invasion of PTC .

[ABSTRACT]OBJECTIVETo study the expressions of 34βE12, Galectin-3 and HBME-1 in thyroid nodules, and to explore its diagnostic value for papillary thyroid carcinoma (PTC).METHODSEn VisionTM immunohistochemical technique was used to detect the expression of 34βE12, Galectin-3 and HBME-1 in 352 thyroid lesions. The correlation between the expressions of the 3 protein markers and clinicopathological characteristics was evaluated. The receiver operating characteristic area under the curve (ROC-AUC) and their index for diagnosis evaluation were also calculated.RESULTSThe positive rates of 34βE12, Galectin-3 and HBME-1 in 246 PTC lesions were significantly higher than those in benign nodules (P<0.001). There was no relationship between the expression of the 3 protein markers and clinicopathological characteristics (eg. gender, age, numbers of lesions, tumor size, capsular invasion, lymph node metastasis, TNM staging). The ROC-AUC of 34βE12, Galectin-3 and HBME-1 for diagnosis of PTC was 0.936, 0.915 and 0.898 respectively. The sensitivity of 34βE12, Galectin-3 and HBME-1 for diagnosis of PTC was 94.3%, 95.5% and 91.1% respectively, while the specificity was 81.1%, 71.7% and 83.0% respectively, and the diagnostic accuracy rate was 90.3%, 88.4% and 88.6% respectively.CONCLUSION The expressions of 34βE12, Galectin-3 and HBME-1 are statistically different between PTC and benign lesions, but no associations are found with clinicopathological characteristics, indicating the three protein markers have important diagnostic value for PTC.

OBJECTIVE The aim of the study was to evaluated the difference and consistency in tumor size measured by sonographic and pathological examination in papillary thyroid carcinoma(PTC).METHODS A total of 114 patients with PTC, including 122 malignant nodules, was collected from Hangzhou First People's Hospital between Jun 2012 and Jun 2014. The tumor sizes were measured by preoperative sonographic and postoperative pathologic evaluation. Pearson correlation analysis, paired t-test, and Bland-Altman plot were used to evaluate the correlation and consistency in tumor size measured by the two methods.RESULTS Pearson correlation analysis showed that the largest tumor size measured by sonography were positively correlated with pathologic size (r=0.957, P=0.000). Paired t-test showed that there were statistically difference between sonographic size and pathological size (8.24±5.06) mmvs (7.79±4.75) mm,P=0.001. The absolute difference value of the largest tumor size measured by the two methods was from zero to 6.5 mm, with the average of (1.03±1.14) mm. Bland-Altman analysis showed that the limits of agreement (LoA) of difference was from -2.41 mm to 3.33 mm, with the 95% confidence interval from -2.87 mm to 3.78 mm.Within the limit of the consistency, the maximum moduli was 2.9 mm.CONCLUSION There is a significant discrepancy between the preoperative sonographic and the pathologic size of the papillary thyroid carcinoma, which should be taken into account in clinical practice.

OBJECTIVE The objective of this study is to discuss when to dissect the lymph nodes behind the right recurrent laryngeal nerve (LN-prRLN) from the standpoint of the right cervical level Ⅵ-1 (superficial layer to the recurrent laryngeal nerve) lymph nodes in papillary thyroid carcinoma (PTC) patients.METHODS The clinical data of 306 bilateral or right PTC patients from the Hangzhou First People's Hospital who underwent dissection of level Ⅵ-1 lymph nodes and LN-prRLN between March 2014 and September 2015 were analyzed. We measured the number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci to predict the metastasis of LN-prRLN.RESULTS The number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci were risk factors of LN-prRLN metastasis(P<0.05). When the number of the level Ⅵ-1 metastatic lymph nodes was greater than 1.5, the AUC was 0.813 (the sensitivity was 78.43%, the specificity was 76.65%). The ROC showed that when the size of level Ⅵ-1 lymph nodes metastasis loci were more than 0.45 cm, the AUC was 0.726 (sensitivity was 90.20%, specificity was 48.90%).CONCLUSION In bilateral or right PTC patients with metastasis of level Ⅵ-1 lymph nodes, especially when the number of level Ⅵ-1 metastatic lymph nodes was greater than 2cm and the metastasis loci were more than 0.45 cm, we should dissect the LN-prRLN.