Objective To observe the effects of recombinant human thyroid stimulating hormone(rhTSH)mediated 131I therapy for differentiated thyroid carcinoma(DTC).Methods 96 patients of DTC from January 2011 to May 2013 in the Central Hospital of Nanyang which randomly divided into study group and control group,48 cases in each group.Two groups of patients underwent total thyroidectomy or subtotal operation.The study group received rhTSH mediated 131 I radioiodine therapy,the control group received the therapy of thyroid hormone withdrawal mediated 131 I radioiodine therapy. Results The levels of the serum thyroid stimulating hormone(TSH)and thyroid immune globulin(Tg)of the control group were significantly difference that compared before treatment with radioiodine therapy to clear thyroid(P<0.05).The levels of the serum free thyroxine T3(FT3),free thyroxine T4(FT4)were significantly lower than that before stoping thyroid hormone(P<0.05).The levels of the serum TSH and Tg of the study group were significantly higher after injected rhTSH than before(P<0.05);but the levels of the serum FT3,FT4 were no significant difference.The levels of the serum TSH 、FT3、FT4、Tg of the study group were significantly higher than that of control group after treated (P<0.05 ).The effectively rate of control group with radioiodine therapy was 66.7%from 131 I whole body imaging showed after 3~6 months,while study group was 70.8%,two groups of radioiodine therapy effective rate were significant difference(P<0.05 ).The security of study group was higher than that of control group(P<0.05 ). Conclusion The application of rhTSH can similar effectively improve the level of serum TSH in patients as method of stoping with thyroid hormone,but the adverse reactions in patients are fewer and the treatment time is shorter.

Objective Portal hypertension and ischemia/reperfusion (I/R) have been implicated in small-for-size liver graft dysfunction. Matrix metalloproteinases-2 (MMP-2) and MMP-9 are critically involved in hepatic I/R injury. The goal of this study was to investigate the role of MMP-2 and MMP-9 in acute small-for-size graft injury. Methods 108 rats were divided into three groups:100 % (full-size), 50 % (half-size) and 25 % (quarter-size) liver transplantation groups. Blood and liver samples were collected to assess liver function, hepatic malondialdehyde (MDA) content, tissue myeloperoxidase (MPO) activity and histological changes. ELISA, real-time PCR, gelatin zymography, and immunohistochemistry were used to determine the expression pattern of MMP-2 and MMP-9 in liver grafts. Results The expression levels of MMP-9 were significantly higher in quarter-size and half-size grafts than those in full-size liver grafts 6, 12, and 24 h after reperfusioa And theelevated levels of MMP-9 were related to graft size inversely. However, MMP-2 was expressed and remained in all groups invariably. MMP-9 overexpression was accompanied by extensive liver I/R injury, as evidenced by significant increases in hepatic microscopic damage scores, MDA content,MPO activity and liver function levels. Furthermore, MMP-9 was found mainly to locate around periportal area. The presence of the active form of MMP-9 was significantly higher in small-for-size grafts, which was correlated with sinusoidal dilatation, congestion and hemorrhage. Conclusion These results support critical function of MMP-9 in acute small-for-size liver graft injury. Moreover,portal hypertension may be a crucial trigger for expression and activation of MMP-9.

Objective To investigate the recovery of affected side kidney function after upper urinary tract obstruction was relieved Methods 78 patients who had been diagnosed with upper urinary tract obstruction were enrolled from January to December of 2015 in our hospital.All patients received the surgery to relieve the obstruction.GFR of the affected side kidney was done after one months of the surgery.The average age was(51.3 ± 12.8)years old.The reason of obstruction was upper urinary tract calculi (72 cases) and upper urinary tract stenosis (6 cases) respectively.All the patients received CT and ECT before and after operation.All the patients was divided into 3 groups by the decreased degree of affected side kidney function,including moderately decreased group [15 rnl/min ≤ GFR ＜ 30 ml/min,n =43,mean value =(23.1 ±5.0) mL/min],severely decreased group [7.5 rnL/min≤ GFR ＜ 15 ml/min,n =23,mean value =(11.2 ± 2.3) ml/min],and extreme severely decreased group [GFR ＜ 7.5 ml/min,n =12,mean value =(4.3 ± 2.9)ml/min].Linear correlation analysis was used to analysis the relationship analysis between the GFR value (pre-operation,post-operation) and the renal cortical thickness.The follow up time of extreme severely decreased group extended to 8-12 months.Results The GFR of moderate decreased group recovered to(30.6 ± 8.5) ml/min,regained averagely (7.56 ± 7.62) ml/min;the severely decreased group recovered to (13.1 ± 4.5) ml/min,regain (1.94 ± 3.38) ml/min.Extreme severely decreased group recovered to (11.1 ± 3.4) ml/min,regained averagely (6.75 ± 4.76) rnl/min,the GFR mean value after operation 8-12 months recovered to (12.7 ± 3.6) ml/min.All groups got significant recovery of kidney function of the affected side.The correlation coefficient between GFR value and the renal cortical thickness was 0.59 (before the surgery) and 0.70 (after the surgery) respectively (P ＜ 0.05).Conclusions Most of affected side kidneys got different degree of recovery.Obstruction influenced the accuracy of ECT at the time of evaluating the actual renal function before operation.The kidneys which had been supposed should be resected in presurgical evaluation could recover to the level of kidney reserve after the surgery.

Objective:To investigate the effect of exposure to histological chorioamnionitis(HCA) on premature infants with respiratory distress syndrome(RDS)complicated with bronchopulmonary dysplasia(BPD).Methods:The clinical data of premature infants with gestational age<32 weeks and survival>14 days who were born in the department of obstetrics and admitted into NICU at Qingdao Women and Children′s Hospital from January 2018 to December 2020 were collected.According to placental pathology, they were divided into positive HCA + positive RDS group(observation group)and negative HCA + positive RDS group(control group). T-test, rank sum test and χ2 test were used to analyze the occurrence and clinical characteristics of BPD between the two groups.For premature infants with positive HCA who were diagnosed as BPD, Spearman rank correlation was used to analyze the correlation between HCA stage and BPD severity. Results:There were a total of 162 premature infants with RDS.The average gestational age at birth was 29.29(28.29, 30.43) weeks, and the average birth weight was 1.32(1.13, 1.55)kg; the incidence of BPD was 69.8%(113/162), and the mortality rate of BPD was 2.7%(3/113). There were 114 cases in the observation group and 48 cases in the control group.The incidence of BPD in the observation group was 76.3%(87/114), which was higher than that in the control group(54.2%, 26/48), and the difference was statistically significant( P<0.05). Further study of 87 premature infants with positive HCA who were diagnosed as BPD showed that, the correlation between the stage of HCA and the severity of BPD had not been confirmed( rs=0.062, P=0.571). Serum C-reactive protein before the mother used antibiotics and procalcitonin on the first day after birth in the observation group were higher than those in the control group, and the differences were statistically significant( P<0.05). Among 113 premature infants with RDS who were diagnosed as BPD, the time of antibiotic use, length of stay in intensive care unit and hospitalization cost in positive HCA group were higher than those in negative HCA group, and the differences were statistically significant( P<0.05). Conclusion:HCA exposure will increase the risk of BPD in premature infants with RDS.In addition, HCA also increases the intake period of antibiotics, length of stay and cost of intensive care unit in premature infants with BPD.

Objective To investigate the effect of interferon-γ(IFN-γ) on the expression of indoleamine 2,3-dioxygenase(IDO),and tryptophanyl-tRNA-synthetase (TTS) in thyrocytes; and to study the relevant immunopathological significance in Graves' disease.Methods The expressions of IDO and TTS genes in IFN-γ stimulated Nthy-ori3-1 cell line and human thyrocytes,as well as in human thyroid tissues were determined by realtime quantitative PCR.Results IDO and TTS genes were expressed slightly in both Nthy-ori3-1 cell line and human thyrocytes,and were significantly up-regulated after IFN-γ stimulation(P＜0.01).Compared to healthy controls,TTS mRNA level was higher in thyroid tissues of patients with Graves' disease (P =0.018 2),while IDO mRNA level showed no difference,but was notably correlated with IFN-γ mRNA level (R2 =0.716,P =0.002).Conclusion In the early stage of Graves' disease,thyrocytes may decompose local tryptophan by enhancing the expression of IDO and TTS under IFN-γstimulation,thus inhibit auto-reactive function of lymphocytes and balance excessive autoimmune reaction.

Objective To compare the clinical effects of proximal femoral nail antirotation (PFNA) and proximal femoral nail antirotation-Ⅱ (PFNA-Ⅱ) in the internal fixation of femoral intertrochanteric fracture.Methods A retrospective study was conducted of the 54 patients with femoral intertrochanteric fracture who had been treated at our department from May 2009 through July 2014.During May 2009 and November 2011,27 of them were treated with PFNA;during December 2011 and July 2014,the other 27 of them were treated with PFNA-Ⅱ.The 2 groups were compared in terms of operation time,intraoperative blood loss volume,hidden blood loss volume,intraoperative and postoperative complications,fracture healing time and Harris hip score at the last follow-up.Results In the PFNA group,27 patients were followed up for an average time of 22.6 ± 4.8 months.In the PFNA-Ⅱ group,27 patients were followed up for an average time of 19.5 ± 4.6 months.The PFNA group had significantly more intraoperative blood loss volume (130.1 ± 74.3 mL),and significantly higher rates of intraoperative lateral wall fracture of the proximal femur (18.5％,5/27),postoperative lateral thigh soft tissue irritation (22.2％,6/27) and postoperative thigh pain (22.2％,6/27) than the PFNA-Ⅱ group [46.3 ± 23.1 mL,0,3.7％ (1/27),3.7％ (1/27),respectively] (P ＜ 0.05).There were no significant differences between the 2 groups in operation time,hidden blood loss,postoperative complications of internal diseases,fracture healing time,or Harris hip score of last follow-up (P ＞ 0.05).Conclusion Compared with PFNA,PFNA-Ⅱ may lead to a smaller volume of intraoperative blood loss and a lower incidence of complications related to internal fixation.

Objective To investigate the changes of circulating miRNAs expression profiles in different subtypes of ischemic stroke according to the Trial of Org 10 172 in Acute Stroke Treatment.Methods We selected 16 patients diagnosed as acute ischemic stroke at first time in the Department of Neurology,the Affiliated Hospital of Medical College Qingdao University from November to December in 2012.They were divided into large artery atherosclerosis (LAA) stroke group (n =8) and small artery occlusive (SAO) stroke group (n =8).At the same time,8 healthy checkup subjects were selected as control.High-throughput sequencing was used to detect the expression profiles of miRNAs in the plasma,and the high-throughput sequencing results were validated by quantitative real-time polymerase chain reaction.We performed the miRNAs variance analysis and associated bioinformatics analysis.Results Thirty hundred and sixty-nine miRNAs were detected in LAA group,SAO group and the control group.We found remarkable differences (fold change ＞2,P ＜0.01) in the expression of 12 miRNAs,including let-7a-5p,miR-744-5p,etc.,between any two groups of the three groups.Thirty-four miRNAs,containing miR-126-5p,miR-23a-3p,miR-143-3p,etc.,had a lower expression (fold change ＞2,P ＜0.01)in LAA group than that in the control group.In comparison with the control group,miR-1304-3p and miR-451a were significantly down-regulated (fold change ＞ 2,P ＜ O.01),while 27 miRNAs were significantly up-regulated (fold change ＞2,P ＜0.01) in SAO group.The expression levels of miR-146b-5p,miR-23a-3p and miR-451 a were validated in accordance with the results of real-time PCR.Target gene prediction and functional analysis revealed that target genes regulated by differential expression of miRNAs were mainly associated with cell proliferation,adhesion,metabolism and other biological functions.Conclusion miRNAs are differently expressed in the plasma of LAA group,SAO group and healthy control group,which suggest that miRNAs might play different roles in the pathogenesis of LAA stroke and SAO stroke by regulating downstream target genes.

Objective To investigate the difference of expression profiling of plasma miRNAs (microRNA) between the patients with small artery occlusive stroke (SAO) and the healthy subjects.Methods Eight patients with SAO classified by TOAST were selected and 8 healthy subjects were used as a control group.High-throughput sequencing technology was used to detect the expression profiling of plasma miRNAs.The differentially expressed miRNAs were screened.Real-time fluorescent quantitative polymerase chain reaction was used to validate the results,and the target gene prediction and bioinformatics analysis were performed.Results The miRNA difference analysis showed that the expression profilings of miRNA-127,miRNA-99b-5p,miRNA-320,and other 19 miRNAs in the SAO group were significantly upregulated compared with those in the control group (all P＜0.01),while miRNA-451a and other 5 miRNAs in the SAO group were significantly downregulated compared with those in the control group (all P ＜0.01).The validated results of miRNA-127,miRNA-99b-5p,miRNA-320,and miRNA-451a with real-time fluorescent quantitative polymerase chain reaction were consistent with those of the high-throughput sequencing.Bioinformatics analysis showed that the miRNA-regulated target genes expressed differentially were mainly correlated with cell proliferation,adhesion,phylogenetic development,macromolecule metabolism,and other biological functions.Conclusions There are significant differences in the expression profiling of plasma miRNAs between the patients with SAO and the healthy subjects,suggesting that miRNAs may play a regulatory role via target genes in pathogenesis of SAO.

Objective To evaluate the diagnostic accuracy of CMS50F for screening in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Sixty-four volunteers with suspected OSAHS underwent simultaneous noc?turnal polysomnography (PSG), micromovement sensitive mattress sleep monitoring system(MSMSMS)and CMS50F. The ap?nea-hypopnea index (AHI) detected by PSG and MSMSMS was used as the diagnostic standard for OSAHS. The reliability of CMS50F for monitoring sleep was assessed. Results There was no statistic difference in CMS50F-ODI3 and PSG-AHI be?tween normal, mild and moderate OSAHS groups(P>0.05). The CMS50F-ODI3 was smaller than the PSG-AHI in severe OSAHS patients(P < 0.05). There was a positive correlation between CMS50F-ODI3 and PSG-AHI(r=0.855, P < 0.05). PSG-AHI≥5 events per hour was used as the threshold value to diagnose OSAHS, the sensitivity and specificity of CMS50F were 94.5%and 88.9%. There were no significant differences in CMS50F-ODI3 and MSMSMS-AHI between normal, mild and moderate OSAHS patients(P>0.05). The value of CMS50F-ODI3 was smaller than MSMSMS-AHI in severe OSAHS patients (P < 0.05). There was also a significant correlation between CMS50F- ODI3 and MSMSMS-AHI (r=0.867,P <0.05). MSMSMS-AHI≥5 events per hour was used as the threshold value to diagnose OSAHS, the sensitivity and specificity of CMS50F were 94.5%and 88.9%. Conclusion CMS50F can be used as a portable and reliable device for screening of pa?tients suspected OSAHS.

Objective To summarise and analyze the clinical effecacy of endovascular treatment(internal holmium laser incision,bal-loon dilation,ureter dilator,rigid ureter dilation)for ureteral stricture.Methods The clinical data of 628 patients from January 2010 to Jan-uary 2015 in our hospital were analyzed.The relevant operation indicators,postoperative complications and recovery condition were recorded and analyzed.Results The operation time was 5.5 to 29 minutes,with average time of 16.5 minutes,no ureteral avulsion,ureteral fragmen-tation and massive haemorrhage happened.All patients were followed up for 6 to 36 months,591 cases(94.1%)were cured,29 cases (4.6%)of postoperative stricture recurrence received endovascular treatment again,8 patients(1.3%)conversion to open ureterolithotomy. Conclusion Endovascular treatment of ureteral stricture is diversified within holmium laser incision,it has the advantages of shorter opera-tion time,fewer complications,less trauma,repeatability and so on,which is an effective and safe treatment method.