ObjectiveTo study the diagnosis of thyroid cancer concurrent with multiple thyroid nodules.Methods The clinical data of 23 patients of multiple thyroid nodules with thyroid cancer undergoing exploration from May 1988 to December 2000 were analyzed retrospectively.ResultsThe diagnosis of concurrent carcinoma was made preoperatively in 6 cases. 13 out of the 23 patients underwent second operation for the postoperative pathology being malignant. Thyroid cancer was identified concurrent with benign nodules in 20 cases. Conclusion Thyroid cancer when found on the background of multiple thyroid nodules is often coexistant with benign thyroid disease, hence the diagnosis is difficult to make clinically. Second operation is sometimes inevitable when the pathology identified a cancer in preoperatively diagnosed benign nodules.

Objective To analyze the effect of perioperative blood transfusion in orthopedic surgery.Methods A total of 201 patients who underwent an orthopedic surgery in our hospital in October 2015 to September 2016 were reviewed.Hemoglobin concentrations,hematocrit,postoperative hospital stay,infection and other related data were analyzed.Results 90 patients were transfused with blood and in 111 patients were not during orthopedic surgery (massive blood transfusion group including 17 cases;non massive blood transfusion group including 94 cases).Hemoglobin concentrations of transfusion group (103.09±16.37)g/L was lower than the non transfusion group (115.79± 13.68)g/L before liying hospital,postoperative hospitalization time of transfusion group (12.012±8.36) was longer than that of non transfusion group (16.14 ± 10.47)days.Postoperative infection rate in non transfusion group was 1.11％,and in transfusion group was 15.32％,in massive transfusion group is 52.94％.Conclusion Perioperative blood transfusion is not conducive to the recovery of hemoglobin level patients in orthopedic surgery,prolong hospital stay and increase the rate of infection after surgery.Perioperative blood transfusion makes it difficult to support the outcome of the disease

0.05)compared to bare metal stents.Conclusion Age is an important clinical factor influencing mortality rate after PCI in patients with coronary artery disease,and the use of drug-eluting stents should be the preferred for the improvement of long-term outcomes in the elderly.

Objective To investigate the prevalence of H.Pylori infection and antibiotic resistance in patients with peptic ulcer.Methods A retrospective analysis of 429 endoscopy and H.Pylori culture results in the First People's Hospital of Hangzhou from 2012 to 2013 was conducted.The rate of H.Pylori infection in patients with peptic ulcer, and the resistance rates of H.Pylori to metronidazole, levofloxacin, clarithromycin,amoxicillin, gentamicin, furazolidone were analysed.Results The positive rate of H.Pylori in people with peptic ulcer was 53.1％ (228/429).The resistance rates to metronidazole, levofloxacin, clarithromycin,amoxicillin, gentamicin and furazolidone were 94.7％ (216/228), 18.9％ (43/228), 18.9％ (43/228), 0, 0 and 0.Double antibacterial resistant rates of metronidazole and clarithromycin, metronidazole and levofloxacin were 18.0％ (41/228) and 17.1％ (39/228).Triple antibacterial resistant percentage of levofloxacin + metronidazole + clarithromycin was 8.3％ (19/228).The resistance rate of clarithromycin in 43 patients who were also resistant to levofloxacin was 46.5％ (20/43), while the resistance rate of clarithromycin in 185 patients who were also sensitive to levofloxacin was 12.4％ (23/185)with significant difference(x2 =26.480,P =0.000).A positive association between the resistance to levofloxacin and to clarithromycin was found.Conclusion The H.Pylori infection is closely related to the occurrence of peptic ulcer.Without the basis of culture results in patients with H.Pylori positive, amoxicillin, gentamicin and furazolidone could be the first choices in clinical,because of their low resistance rates.Clarithromycin can be used as an alternative.

Objective To establish a HPLC method for determination of Peoniflorin in Zhongzi Sanda Pill.Method Kromasil-C18 column(5 ?m,4.6 mm?250 mm) was used.Mobile phase was methanol-water(30:70).The detective wavelength was at 230 nm.The flow rate was 1.0 mL/min.Results There was a good linear relationship between the injection amount 0.11～2.14 ?g and a good peak form for Peoniflorin in Zhongzi Sanda Pill.The average recovery rate was 98.2%(RSD=1.72%,n =6).Conclusion This method is convenient,effective and accurate for the quality control of Peoniflorin in Zhongzi Sanda Pill.

Thebasic ideas for developingChinese herbal specimens databaseand its specific processes were described, the problems in its development were pointed out with measures put forward for their solution.

Objective To evaluate the diagnostic value of DCE-MRI and breast MR reporting and data system(BI-RADS-MR)in differentiation of breast lesions. Methods Seventy-five patients with 75 pathological-confirmed breast lesions underwent DCE-MRI before treatment and DCE-MRI quantitative analysis. Two senior doc-tors assessed the imaging features blindly by BI-RADS-MR. The pathology results were set as a gold standard. The receiver operating characteristic curve(ROC)interpretation of two physician′s curve analysis was used to evaluate the sensitivity,specificity of BI-RADS classification. Results According to the BI-RADS MR score,38 breast cancer patients were rated as 1 case in grade Ⅰ,0 case in grade Ⅱ,4 cases in gradeⅢ,13 cases in gradeⅣ,20 cases in grade V;37 breast benign tumors were rated as 17 cases in grade Ⅰ,5 cases in grade Ⅱ,12 cases in gradeⅢ,3 cases in gradeⅣandⅤ0 cases. The statistical difference of Tpeak,S max,K1 between benign and malig-nant breast tumors were significant(P<0.05). On ROC,the area under the curve was 0.940,95%confidence in-terval was from 0.887 to 0.994. The sensitivity of BI-RADS in the diagnosis of breast cancer was 94.59%and speci-ficity was 92.11%. Conclusion DCE-MRI combined with BI-RADS-MR classification in diagnosis of benign and malignant breast tumors has an important value and can improve diagnosis and differential diagnosis level.

Objective To investigate the association of the gene polymorphism of plasminogen activator inhibitor 1 (PAI 1) with the cerebral infarction and recurrent cerebral infarction (RCI). Methods The plasma PAI 1 activity, by means of chromgenic substrate assay, and the sequence polymorphisms of 4G/5G in promotor region and (CA)n dinucleotide repeats in the 4th intron of PAI 1 gene, by amplified fragment length polymorphism assay, were measured in 50 patients with first ever cerebral infarction (FCI), 45 patients with RCI and 60 healthy controls.Results The plasma PAI 1 activities in both FCI patients (1.13?1 1 AU/ml) and RCI (1.13?0.150 AU/ml) were remarkably higher than that in the controls (0.7?0.25 AU/ml) (both P

0.05).The plasma levels of tPS and fPS in patients with GG genotype [(13.67?1.4 9) and 6.07?0.61)?g/ml] were lower than those in patients with AA and AG genotypes [(15.73?1.24),(6.72?0.55)and(15.15?1.48),(6.63?0.66)?g/ml](all P

BACKGROUND:Many previous experiments have confirmed that transforming growth factor?1(TGF-?1) plasmids can inhibit or decrease the injection in nerve transplantation,but there has rare report about their effects on vein transplantation.OBJECTIVE:To investigate the action pathway of immune tolerance of allogenic femoral vein transplantation in rats induced by local injection of TGF-?1.DESIGN,TIME AND SETTING:A randomized block animal observational experiment was performed at Animal Experimental Center of Harbin Medical University from March 2007 to April 2008.MATERIALS:A total of 18 Wistar rats were selected to assign as donors.A total of 48 Sprague Dawley rats were selected to assign as recipients and randomly divided into four groups with 12 rats in each group:autograft,allograft,immunosuppressant,and TGF-?1 groups.METHODS:The rats in the immunosuppressant group were administated(i.p.) cyclosporin A(10 mg/kg) one time per day from three days before transplantation till they were sacrificed.Each rat in the TGF-?1 group was injected 40 ?g TGF-?1 plasmids into two ends of femoral vein.Vein transplantation was performed in the autograft and allograft groups.MAIN OUTCOME MEASURES:Imaging,histology and immunological assays of these groups were conducted at two weeks after transplantation.RESULTS:In the autograft group,the endothelial cells of vein were flat,and nuclear membrane thickened.In the allograft group,the exfoliated endothelial cells and fragments,as well as subendothelium were observed.In the immunosuppressant group,the nuclear membrane of endothelial cells thickened,and rough endoplasmic reticulum expanded widely.In the TGF-?1 group,the expand of rough endoplasmic reticulum and mitochondrial vacuolation were observed.Tight junction could be seen between adjacent cells.Histologic and immunologic parameters in the TGF-?1 group were better than those in the immunosuppressant and allograft groups.The absorbance value of lymphocyte culture in the autograft,allograft,immunosuppressant,and TGF-?1 groups were 1.07?0.14,4.15?0.67,1.77?0.23 and 1.38?0.23,respectively.The absorbance value of lymphocyte culture in the TGF-?1 group was significantly lower than that in the immunosuppressant and allograft groups(P