Objective To study the causes of misdiagnosis for differentiated thyroid carcinoma in teenager, the re-operative indication and style as well as the prevention of complication. Methods The clinical data of 36 cases of re-operative treatment for differentiated thyroid carcinoma in teenager from 1991 to 2002 were analyzed retrospectively.Results The incidence of residual cancer and cervical lymphnode metastasis in the patients was 38.9% and 30.5% respectively. The re-operative complications included 2 cases of hoarseness, and 3 cases of hand and foot spasm. Five-year and ten-year survival rates after reoperation were 90.4% and 88.9%, respectively. Conclusion Thyroid nodules in teenager should be guarded against malignancy. FNAB(Fine-Needle Aspiration Biopsy) is helpful for diagnosis before the operation, and pathological observation of frozen section during operation must be performed as routine examination. Choosing suitabel operative style could raise the operative excision rate and quality of life. The improved operation skill could reduce the operative complications.

Objective To explore a safe,high efficiency and rapid approach for the repair of huge sacral pressure sores. Methods From 1993 to 2001,17 cases of huge sacral pressure sore were repaired using the pedicled upper part gluteus maximum myocutaneous flap .Results The outcome of repair in stage Ⅰ was satisfactory in all the cases during the followed-up period for 1～9 years,the size of the flap ranged from 16cm?10cm to 10cm?8cm,No recurrence was occurred,The function of gluteus in donor areas was keeped maximally. Conclusions The method is a good treatment for huge sacral pressure sores. It possesses the advantages of easiness to perform,rich blood supply,no necessity of free skin graft in the donor areas,less complications,high success rate. The treatment can be completed in one stage.It is worthy of popularization.

Objective To systematically review the short-term and long-term efficacy of eversion carotid endarterectomy (eCEA) and patch carotid endarterectomy (pCEA) for the treatment of carotid artery stenosis.Methods The published literature on eCEA and pCEA control studies in medline,PubMed,Ovid,CNKI and CBM (1970.5-2016.10) databases were retrieved by computers.Two reviewers selected literature and extracted data independently according to the inclusion and exclusion criteria.Cochrane Collaboration Network Special Software Rev Man 5.2 was used to analyze the meta-analysis of short-term and long-term outcome measures.Results A total of 1 137 articles were retrieved.Ten studies were included and analyzed (3 of them were randomized controlled trial).A total of 3 213 patients were enrolled,including surgical intervention 3 299 case/time (1 512 in the eCEA group and 1 787 in the pCEA group).The results of meta-analysis showed that:(1) the mean operative time in the pCEA group was shorter 22±8 min than that in the pCEA group.The intraoperative utilization ratio of shunt tube,eCEA was significantly lower than pCEA,they were 12.6 %(53/421) and 50.2% (357/711) respectively (OR,0.11,95%CI 0.08-0.15,P<0.01).The postoperative incidence of stroke within 30 d (OR,0.42,95%CI 0.23-0.76,P=0.004) and the incidence of stroke after 30 d in eCEA were lower than those in pCEA (OR,0.26,95%CI 0.09-0.78,P=0.02).There was significant difference.(2) eCEA reduced the incidence of restenosis at day 30 after procedure (OR,0.57,95%CI 0.38-0.86,P=0.008).Conclusion Compared with pCEA,eCEA has the advantages of reducing the operation time and lowering the utilization rate of shunt tube.At the same time,eCEA can reduce the occurrence of stroke within 30 d and 30 d after procedure,and significantly reduce the incidence of restenosis.

Objective To study the technique and clinical effect of endoscopic surgery using high frequency electrotome with suction device for nasopharyngeal angiofibroma. Methods In this study, we retrospective analyzed the clinical data of 10 patients treated between January 2009 and December 2015. All these patients were treated by endoscopic surgery using high frequency electrotome with suction device. The average blood loss during surgery, tumor residual, recurrent tumor and duration of recovery were evaluated. Results The tumor was completely removed in all 10 patients. The average blood loss was 465 ml, there was no postoperative complication, all patients had no residual tumor, and there was no recurrent tumor over a follow-up of 6~18 months. Conclusion Though it was not preoperative transcatheter arterial embolization, the endoscopic surgery using high frequency electrotome with suction device can be used to treated nasopharyngeal angiofibroma which either limited to nasopharyngeal cavities and paranasal sinus with intraoperative blood pressure control.

Objective To evaluate the monitoring value of serum albumin and plasma von willebrand factor in patients with stroke.Methods Serum albumin and plasma von willebrand factor were measured from 145 patients with stroke(95 patients with nonpoor outcome and 50 patients with poor outcome) in two weeks and after six months from stroke onset to study the relationships with prognosis.Results Serum albumin level was significantly higher in patients with nonpoor outcome(mRS≤2) after six months stroke onset than those with poor outcome(mRS≥3) and was lower after six months stroke onset than in two weeks from stroke onset.On the other hand,plasma vWF level in patients with stroke was significantly higher than that in healthy controls and was higher in two weeks than after six months from stroke onset.Patients with poor outcome had higher plasma vWF level than patients with nonpoor outcome in two weeks and after six months from stroke onset,but had no significant difference.Conclusion The level of serum albumin and plasma von willebrand factor is related with nutritional status,active extent and prognosis in patients with stroke.

Non-motor symptoms are important components of the manifestations of Parkinson's disease, usually including neuropsychotic symptoms, sleep disorder, autonomic dysfunction, feels obstacle, and so on. This paper reviewed the manifestation, relevant factors,pathogenesis and treatment of non-motor symptoms of Parkinson's disease.

Objective To prepare the mouse anti recombinant human Galectin-7 antibody and the antibody was characterized in bladder cancer.Methods The gene coding for Galectin-7 was amplified by PCR from the cDNA of human foreskin cells and cloned into prokaryotic expression vector pET28a.Then the recombinant plasmid pET28a/Galectin-7 was transformed into E.coli BL21 (DE3)and expressed under IPTG induction.The recombinant Galectin-7 was purified through Ni2+-NT agarosegel column and the purified Galectin-7 used as imunogen to imunize the mouse.The titer and specificity of the anti-Galectin-7antibody from the mouse were analyzed by ELISA,Western blot and immunohistochemistry,respectively.Results The recombinant Galectin-7 was successfully expressed and purified,and the polyclonal ani-Galectin-7 antibody was suc-cessfully prepared.The titer of the antiserum was 1∶32 000 by ELISA.Western blot analysis showed this antiboday reacted specifically with Galectin-7.Immunohistochemistry analysis showed the antibody could recognize the native Galectin-7 in the human bladder cancer tissue.Conclusion The preparation recombinant Galectin-7 protein was as immunogen in rabbits.It was successful to produce high titer and high specificity of anti Galectin-7 polycolonal antibody.

ObjectiveTo investigate the safety and efficacy of carbon dioxide ( CO2 ) insufflation during ERCP.MethodsBetween January and August 2011,a total of 102 consecutive patients who underwent ERCP were randomized to accept CO2 insufflation ( n =52 ) of air insufflation ( n =50 ) during the procedure.ERCP was carried out with the same instrument by an expert endoscopist who was blinded to the insufflation gas used and the procedure was controlled at 30 minutes to 1 hour.The heart rate,oxygen saturation of the patient was continuously monitored during the procedure.Before the procedure and 1 hour after the end of operation,abdominal X-ray was taken to evaluate the width of intestine,and the degree of intestinal expansion was defined as normal,mild,moderate and severe according to the width increased.A questionnaire with 100 mm visual analogue scale (VAS) was used to quantify the abdominal pain and distention experienced at 1 hour,2 hours,and 6 hours after the procedure.The patients' vital signs,bowel dilatation,the average operating time,abdominal pain score and distention score on VAS,and complications in 2 groups were analyzed.ResultsThe baseline characteristics of 2 groups were comparable.ERCP was successfully performed in all the patients and no complication was observed.In CO2 group,the average operating time,mean heart rate and oxygen saturation were (45.2 ± 10.6) min,( 102.2 ± 10.3 ) bpm and ( 99.5 ± 0.5)％,which were (48.5 ± 11.2) min,( 100.3 ± 11.4) bpm and (98.9 ±0.6)％,respectively,in air group.There were no significant differences on these items between the 2 groups ( P ＞ 0.05 ).Moderate to severe intestinal expansion 1 hour after ERCP was found in 14 patients (26.9％ ) in CO2 group and in 28 patients (56.0％ ) in air group,and the latter was significantly higher than the former (x2 =11.61,P =0.009).Both of the mean abdominal pain and abdominal distention scores at 1 hour post-ERCP in CO2 group were lower than those in air group,but without significant difference (P ＞0.05).However,the mean abdominal pain scores at 2 hours and 6 hours post-ERCP in CO2 group were significantly lower than those of patients in air group (7.4 ±2.2 vs.18.7 ±4.6 at 2 hours post-ERCP,9.6 ±3.7 vs.20.1 ±4.5 at 6 hours post-ERCP,all P ＜ 0.05 ).Similarly,the mean abdominal distention scores at 2 hours and 6 hours post-ERCP in CO2 group were significant lower than those of patients in air group (7.6 ±3.6 vs.18.3 ±4.1 at 2 hours post-ERCP,8.9 ±3.7 vs.19.4 ±4.2 at 6 hours post-ERCP,all P ＜0.05).ConclusionThe use of CO2 insufflation instead of air during ERCP appears to be safe.Insufflation of CO2 during ERCP palliates the intestinal expansion,post-ERCP abdominal pain and distention comparison to insufflation of air.However,because of the single-center clinical observation with limited number of cases,the safety and efficacy of CO2insufflation during ERCP requires to be further evaluated.

A reporter system for φC31 integrase was developed in NIH3T3 cells. The reporter plasmid coding green fluorescent protein (GFP) coupled with red fluorescent protein (RFP) was eo-transfected with the plasmid coding φC31 integrase, to show the activity of integrase in the cells. Fluorescence activated cell sorter (FACS) was used to measure the proportion of the cells containing red and green fluorescence. The increment of green cells was positively related to the increase in the transfection with plasmid coding φC31 integrase. Approximately 90% of green cells were observed under a ratio of [plasmid-φC31-integrase]/[reporter plasmid] at 10 : 1. This suggests that the φC31 integrase reporter system provides a probe for the function of φC31 integrase in cells.

Objective To explore the feasibility of detecting of Y-STR of fetal DNA in m aternal plasm a using Ion Torrent PGMTM System . Methods A total of 16 fetal DNA sam ples from m aternal plasm as (8 cases from 38 w eeks gestational age and 8 ones from 12 w eeks) w ere prepared and a m ultiplex assay w ith 7 STR loci (DYS390,DYS391,DYS393,DYS438,DYS437,DYS456,DYS635) w as designed for m ul-tiplex-PC R am plification. U sing Ion Torrent PGMTM System , the results of Y-STR sequences and capillary electrophoresis w ere obtained and com pared. Results Y-STR specific alleles w ere detected in the m ater-nal plasm a of all the pregnant w om en having m ale babies of second and third trim ester, w hich w ere higher than that detected by capillary electrophoresis. C onsistent Y-STR genotypes w ere observed betw een fetal DNA from m aternal plasm a and genom ic DNA from the new born babies. Conclusion B ased on Ion Torrent PGMTM System , the prenatal Y-STR detection m ethod m ay provide a high-sensitive and high-throughput choice for prenatal STR detection in forensic testing.