Background:Gastroesophageal reflux disease(GERD)is a common disease,its incidence is related to geographic environment and race. Studies reported on epidemiology of GERD in minority groups are rare. Aims:To investigate the prevalence and related risk factors of GERD in She population in Ningde. Methods:Three natural villages of She population in Ningde were selected for undergoing the cluster random sampling method. GERD was diagnosed by gastroesophageal reflux disease questionnaire(GerdQ)with score ≥8,and questionnaire was used to detect the prevalence and risk factors of GERD. Results:A total of 936 residents completed the questionnaire,and 89 were diagnosed as GERD, the prevalence was 9. 50% . Univariate analysis showed that the risk of GERD was significantly increased in She population with body mass index(BMI)≥24 kg/ m2 ,intake of strong tea or oily diet(P all < 0. 01). Multivariate analysis showed that BMI ≥24 kg/ m2(OR = 3. 022,95% CI:1. 917-4. 765),intake of strong tea(OR = 2. 145,95% CI:1. 338-3. 438) and oily diet(OR = 2. 016,95% CI:1. 208-3. 318)were the risk factors of GERD. Conclusions:The prevalence of GERD is high in She population in Fujian Province,and the etiology may be related to overweight and diet habit.

Objective To study on the characterization of MICA/B genetic polymorphism in a northern Chinese Hunan Han population.Methods Ninty-five unrelated individuals were involved in this study and MICA/B genotypes were determined by two methods:PCR-sequence-specific primers (PCR-SSP) and PCR-sequence-based typing (PCR-SBT).Results In northern Hunan Han population,eleven MICA alleles were found,among which MICA * 010 (28.95％),MICA * 008 ∶ 01 (20.53％) and MICA * 002 ∶ 01 (15.79％) were the common alleles.Five MICA-STR(short tandem repeat) alleles were found,among which MICA * A5 (37.89％) and MICA * A5.1 (21.05％) predominated.In this population,ten MICB alleles were found.The common alleles were MICB * 005 ∶ 02/* 010 (58.42％),MICB * 002 ∶ 01 (10.00％),and MICB * 008 (7.89％).Two kinds of MICA-MICB haplotypes were MICA * 004-MICB * 004 ∶ 01 and MICA * 010-MICB * 005 ∶ 02/010 in significant linkage disequilibrium.This study also showed MICA/B gene with high polymorphism in different populations.Conclusion MICA/B alleles distribution in northern Hunan Han population with its unique characteristics.

OBJECTIVE: To explore the safety and feasibility of endoscopic thyroidectomies through modified chest and mammary areola approach. METHOD: We retrospectively analyzed 122 cases of endoscopic thyroidectomies through a modified chest and mammary areola approach without extensive dissection of thoracic flap. The information about general status, surgical procedures and techniques, complications, etc. were summarized and discussed. RESULT: One hundred and twenty-one cases were operated successfully while 1 case was converted to video-assisted thyroidectomy through infraclavicular approach. The maximum diameter of the mass was (2.05 ± 1.06) cm, mean operation time was (88.61 ± 27.87) min, the operative blood loss was (31.23 ± 16.14) ml, duration of postoperative drainage was (3.54 ± 0.88) d and overall drainage volume was (139.09 ± 95.93) ml. Parathyroid glands were detected in specimens of 9 cases while no case of permanent postoperative hypocalcaemia was displayed. 6 cases of hoarseness were developed. One case experienced conversion surgery, all the others obtained satisfactory cosmetic result. All cases were followed up for 0-24 months without relapse and metastasis of the disease. CONCLUSION Endoscopic thyroidectomy via a modified chest and breast areola approach can facilitated the procedure and avoid extensive dissection of thoracic flap, and proved to be safe and effective.
Blood Loss, Surgical ; Breast ; surgery ; Drainage ; Endoscopy ; Feasibility Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Surgical Flaps ; Thyroidectomy ; methods

AIM: To investigate the expression of microRNA-625-3p ( miR-625-3p) in colorectal carcinoma ( CRC) and its underlying mechanism .METHODS:Quantitative real-time PCR was employed to detect the levels of miR-625-3p expression in different CRC cell lines , CRC tissues and pair-matched adjacent normal tissues .The relationships be-tween the expression levels of miR-625-3p and the patients’clinicopathological parameters were estimated .The effects of miR-625-3p on the apoptosis and the cell mitotic cycle of CRC cells were analyzed with propidium iodide staining and flow cytometry.The effect of miR-625-3p on the apoptosis-related proteins was analyzed by Western blot .RESULTS: The ex-pression level of miR-625-3p in the CRC tissues was higher than that in the pair-matched adjacent normal tissues ( P <0.05).The expression of miR-625-3p in the CRC tumor tissues was significantly correlated with the tumor infiltrative depth , TNM stage and distant metastasis (P<0.05).The expression levels of miR-625-3p in CRC SW620 cells were higher than that in SW480 cells.The CRC cell mitotic cycle was significantly inhibited and cell apoptosis was significantly promoted when the expression of miR-625-3p was inhibited (P<0.05).The expression of Bax protein didn’t change and the expres-sion of Bcl-2 protein increased after miR-625-3p mimics were transfected into CRC SW620 cells(P<0.05).CONCLU-SION:miR-625-3p may be a promising approach for the treatment of CRC by promoting cell proliferation and inhibiting apoptosis .

OBJECTIVE: To explore the safety, effectiveness and feasibility of 3D laparoscopy in thyroidectomy via modified chest and mammary areola approach comparing with 2D. METHOD: Twenty six cases received 3D laparoscopic thyroidectomy (3D group) and 34 cases experienced 2D (2D group). We compared the indexes about general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc between two groups. RESULT: Eight cases of thyroid cancer were detected in 3D group and 3 cases in 2D group. While there was no statistical difference between two groups with respect to other observation indexes such as other general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc. CONCLUSION 3D laparoscopic thyroidectomy via modified chest and mammary areola approach is a safe, effective and feasible procedure, and it may substitute the place of 2D in the future.
Blood Loss, Surgical ; Breast ; surgery ; Drainage ; Humans ; Laparoscopy ; methods ; Postoperative Period ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods ; Treatment Outcome

Liver fibrosis is a common pathological process in the progression of various chronic liver diseases to liver cirrhosis and liver cancer, and liver biopsy with the highest accuracy in diagnosis cannot be used as a routine examination due to several drawbacks. This article introduces several serological and imaging methods used in clinical practice and analyzes their advantages/disadvantages and the current status of research. It is believed that thanks to the efforts of experts and scholars, noninvasive diagnostic methods have become more and more important and may replace liver biopsy and become an effective method for the diagnosis of liver fibrosis in the near future.

Objective To explore the clinicopathologic factors impacting recurrence and survival in rectal cancer patients after radical resection.Methods Clinicopathologic data of 1 166 patients with rectal cancer in Changhai Hospital,were recruited between 2005 and 2010.Kaplan-Meier analysis and the logrank test were used to evaluate the effects of the pathology on patients' survival.Cox regression model was used to assess independent factors associated with clinical prognosis.Results The 1,3,5-year overall survival rates were 94.3％,81.2％ and 76.5％,median survival time was 53 months.328 patients had recurrence and metastases,with a median recurrence time of 18 months.The independent prognostic factors for overall survival time were CEA,CA19-9,tumor distance to dentate line,surgical modality,radical operation,tumor invasion,tumor differentiation,lymph node metastasis and postoperative treatment.Surgical treatment,radical operation or not,tumor invasion and lymph node metastasis were statistically significant associated with tumor recurrence and metastases.Conclusions The important factors inffuencing the prognosis of rectal cancer patients were CEA,CA19-9,tumor distance to dentate line,surgical modality,radial operation,tumor in vasion,tumor differentiation,lymph node metastasis,and post operative treatment.

ObjectiveTo analyze the influencing factors for conversion of laparoscopic cholecystectomy to open surgery, and to provide a clinical reference for developing surgical procedures. MethodsA total of 278 patients receiving laparoscopic cholecystectomy in our hospital from January 2009 to December 2013 were analyzed. Among them, 31 patients were converted to open surgery during laparoscopic cholecystectomy, while the remaining 274 patients were not. The influencing factors for conversion to open surgery were investigated. The t test was applied in the comparison of continuous data, whereas the χ2 test was used for categorical data. The univariate logistic regression analysis was performed to investigate significant influencing factors, and the independent influencing factors were determined by multivariate logistic regression analysis. ResultsThe univariate analysis showed that sex (P=0.022), arteriosclerosis (P＜0.001), diabetes (P＜0.001), heart failure (P=0.002), previous upper abdominal surgery (P＜0.001), age (P＜0.001), body mass index (BMI) (P=0.003), gallbladder wall thickness (P＜0.001), the count of white blood cells (P＜0.001), and serum total bilirubin level (P=0.046) were significantly different between groups. The multivariate logistic regression analysis further showed that previous upper abdominal surgery (P＜0.001), sex (P=0.001), BMI (P=0.002), and the count of white blood cells (P=0.019) were independent influencing factors, among which previous upper abdominal surgery was the most significant one (OR=4.646， 95%CI: 2.012-10.729). ConclusionPrevious upper abdominal surgery, sex, BMI, and the count of white blood cells were independent influencing factors for conversion of laparoscopic cholecystectomy to open surgery. Careful evaluation of these factors before surgery would help to increase the operation efficacy, possessing an important clinical value.

Objective To investigate the expressions of platelet activation-dependent granule membrane protein and platelet-derived growth factor receptor-αB, and the ultra-microstructure changes of platelets in patients with acute ST-segment elevation myocardial infarction(STEMI). Method The expressions of platelet activationdependent granule of glycoprotein (CD62P)and platelet derived growth factor receptor αβ subtype (PDGFR-αβ)of platelets in peripheral blood in 36 patients with acute ST-segment elevation myocardial infarction(STEMI) hospitalized and another 34 healthy subjects over the same period (control group) were investigated by flow cytometry and data were analyzed. The changes of ultra microstructure and activity of blood platelets in those patients and control group were observed under the scanning electron microscope. Results The expressions of CD62P and PDGFR-αβin patients with STEMI group before treatment were (3.65 ± 1.87) % and (0.43 ± 0.39) %, respectively, and those after treatment were (0.96 ± 0.79) % and (0.28 ± 0. 24) %, respectively, whereas those in control group were (0.67 ± 0.35) % and (0.27 ± 0.22) %, respectively, which were much lower in control than those in patients with STEMI before treatment (P ＜ 0.01 or P ＜ 0.05) respectively. There were statistically significant differences in the expressions of CD62P and PDGFR-αβ in patients group between pre-treatment and posttreatment (P ＜0.01 or P ＜0.05), respectively. Obvious ultra-microstructure changes of platelet surface in patients with STEMI group were observed. Conclusions Due to platelet activation in AMI, the expressions of CD62P can be used as effective indicators for monitoring coronary heart disease, and the PDGFR-αβ can be used as a reference indicator. The platelet surface ultra-microstructure changes during platelet activation in patients with AMI can be found by scanning electron microscopy.

Objective To investigate the MRI manifestations of secondary toxoplasmosis encephalitis in HIV patients and summarize the characteristics of MRI changes.Methods MRI images of 3 5 HIV patients with secondary toxoplasmosis encephalitis were analyzed retrospectively.Results Of 35 patients,27 showed multiple lesions and 8 showed single lesion.Lesions mainly involved the brain gray matter j unction or basal ganglia.MRI showed lamellar,nodular or round lesions,which showed low signal on T1WI,and slightly higher and unevenly high signal on T2WI.Irregular liquid signal or nodular slightly lower signal was showed on T2WI in 14 cases,and short T1signal was showed in 15 cases.Circular lesions could be seen"cattle eye"in 18 cases.For 11 cases of enhanced scan of a single lesion,a ring enhancement was displayed,and coexistence of patchy,nodular and annular enhancement were showed in multiple lesions,in which parts of the multi-circular enhancemens were clustered.Conclusion MRI manifestations of HIV patients with secondary toxoplasmosis encephalitis show primarily multiple lesions on the gray matter j unction or basal ganglia.The lesions show high signal on T1WI and"cattle eye"on T2WI,and existence of flaky,nodular and ring enhanced lesion or clustered enhancement are showed on enhanced imaging,which is of a certain specificity.