OBJECTIVETo observe the effect of natural type ginsenoside Rg2 (Rg2) and its stereoisomers [20 (R)-Rg2 and 20 (S)-Rg2] at different concentrations on oxygen-glucose deprivation/ reperfusion (OGD/R) induced cortical neuronal injury model in vitro, and to explore the mechanism, and compare their differences of action.

METHODSCortical neurons after 7-day culture were randomly divided into 5 groups, i.e., the control group, the model group, the Rg2 group, 20 (R) -Rg2 group, and 20 (S) - Rg2 group. Cortical neurons in the Rg2 group, 20 (R)-Rg2 group, and 20(S)-Rg2 group were pretreated with 20, 40, and 80 μmol/L Rg2, 20 (R) -Rg2, and 20 (S) -Rg2 for 24 h to prepare OGD/R model. The cell survival rate, the activity of Caspase-3, the intracellular Ca2+ concentration, contents of superoxide dismutase (SOD) and malondialdehyde (MDA) were detected 24 h later.

RESULTSCompared with the control group, cell survival rates and activities of SOD obviously decreased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly increased with statistical difference (P < 0.05). Compared with the model group, cell survival rates and activities of SOD obviously increased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly decreased in 20 μmol/L Rg2 group, 40 μmol/L 20 (R) -Rg2 group, and 80 μmol/L 20 (S) -Rg2 group (P < 0.05). Compared with 20(S)-Rg2 group, cell survival rates increased and contents of MDA significantly decreased in 20, 40, and 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). The activity of Caspase-3 decreased and contents of SOD increased in 80 μmol/L 20 (R)-Rg2 group, and 40, 80 μmol/L Rg2 groups (P < 0.05). Ca2+ fluorescent optical gray value decreased in 40, 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). Compared with 20 (R)-Rg2 group, Ca2+ fluorescent optical gray value decreased in 80 μmol/L Rg2 group (P < 0.05); contents of SOD increased in 40 and 80 μmol/L Rg2 groups (P < 0.05); contents of MDA decreased in 20, 40, and 80 μmol/L Rg2 groups (P < 0.05).

CONCLUSIONSRg2 and its stereoisomers could improve cell vitality of cortical neurons against OGD/R induced injury. This might be related to improving anti-apoptotic capacities and antioxidant abilities, and reducing Ca2+ inflow. Besides, the neuroprotective effect of 20 (R) -Rg2 was better than that of 20 (S) -Rg2, but inferior to that of Rg2.

Antioxidants ; metabolism ; Apoptosis ; Calcium ; metabolism ; Caspase 3 ; metabolism ; Cell Survival ; Cells, Cultured ; Ginsenosides ; pharmacology ; Glucose ; Humans ; Malondialdehyde ; metabolism ; Neurons ; drug effects ; Neuroprotective Agents ; pharmacology ; Oxygen ; Random Allocation ; Reperfusion Injury ; Stereoisomerism ; Superoxide Dismutase ; metabolism

OBJECTIVETo study the relationship between BRAF mutation and clinicopathological features in papillary thyroid carcinoma (PTC).

METHODSFresh samples were examined for the presence of BRAF mutations in 43 patients with PTC and 20 patients with non-PTC thyroid disease and 40 normal thyroid tissues by polymerase chain reaction (PCR) and direct sequencing. The relationship between BRAF mutation and clinicopathological features was studied.

RESULTSBRAF mutation was detected in 39.5% (17/43) of PTC samples, in 0 of non-PTC thyroid disease samples and normal thyroid tissues. Significant association was seen between BRAF mutation and both extrathyroidal invasion and cervical lymph node metastasis (P<0.05, P<0.05). There was no significant relationship between BRAF mutation and gender, age at the time of diagnosis, tumor size and distant metastasis.

CONCLUSIONBRAF mutation is associated with extrathyroidal invasion and lymph node metastasis. It may increase the ability of invasion and metastasis of PTC and have influence on prognosis.

Adenocarcinoma, Papillary ; diagnosis ; genetics ; Adult ; Aged ; Carcinoma, Papillary ; diagnosis ; genetics ; DNA Mutational Analysis ; Female ; Humans ; Lymphatic Metastasis ; genetics ; Male ; Middle Aged ; Neoplasm Invasiveness ; diagnosis ; pathology ; Neoplasm Recurrence, Local ; diagnosis ; pathology ; Prognosis ; Proto-Oncogene Proteins B-raf ; genetics ; Thyroid Neoplasms ; diagnosis ; genetics ; Young Adult

BACKGROUNDThe feasibility and safety of endoscopic thyroidectomy were evaluated by an approach of systematic review of published studies in the past decade.

METHODSA database searching was performed on MEDLINE, Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials. Both comparative and non-comparative studies about endoscopic thyroidectomy were selected and analyzed. For the comparative studies, RevMan 4.2 was used for statistical analysis; and for the non-comparative studies, data analysis was performed by SPSS 13.0.

RESULTSSeven comparative studies involving 367 patients (video-assisted thyroidectomy (VAT), 174 patients; conventional thyroidectomy (CT), 193 patients) were included in VAT-CT group. Age, gender, operative types, and pathological diagnosis were similar. Compared with CT, the mean operative time for VAT was significantly longer (VAT, 80.0 minutes; CT, 61.9 minutes, P < 0.01), but the postoperative hospital stay was shorter (VAT, 1.7 days; CT, 2.5 days, P < 0.01). The complication rate for VAT was 6.9%, while that for CT was 9.3% (P = 0.35). Three studies analyzed the postoperative pain and cosmetic evaluation, and indicated that the VAT group was superior to the CT group, but there was no significant difference after a meta-analysis. Three comparative studies involving 273 patients (totally endoscopic thyroidectomy (TET), 145 patients; CT, 128 patients) were included in TET-CT group and the results generally resembled that of VAT-CT group. There were 18 and 14 non-comparative studies reporting the results of VAT and TET, respectively. The mean operative time for VAT was 76.8 minutes compared with 135.8 minutes for TET. The postoperative hospital stay was 1.8 and 3.8 days for VAT and TET respectively. The rates of conversion to open surgery for VAT and TET were similar (VAT, 2.8%; TET, 3.9%, P = 0.105). The complication rate for VAT was 8.6%, while that for TET was 3.5% (P < 0.01).

CONCLUSIONSThe feasibility and safety of endoscopic thyroidectomy were initially verified and accepted, and it should be considered as a valid option, offering some advantages to patients in terms of cosmetic results and postoperative distress.

Adult ; Endoscopy ; methods ; Humans ; Pain, Postoperative ; drug therapy ; Thyroidectomy ; adverse effects ; methods ; Video-Assisted Surgery

OBJECTIVETo study the predictors of level V metastasis in papillary thyroid carcinoma (PTC).

METHODSThe clinic data of 122 patients with PTC who underwent therapeutic lateral neck dissection between March 2004 and November 2010 was analyzed retrospectively. There were 31 male and 91 female patients. The median age at diagnosis was 38.5 years (ranging from 8 to 87 years). All the patients had undergone unilateral or bilateral lymph node dissection (II-VI or I-VI). Univariate analysis and multivariate analysis were performed using χ(2) test and binary Logistic regression test, respectively.

RESULTThe level V metastases was significantly associated with capsular invasion, extrathyroidal extension, preoperative distant metastasis, the size of primary, ipsilateral level IV lymph node metastasis and simultaneous metastases to ipsilateral level II, III and IV (χ(2) = 4.223 - 13.748, P < 0.05). Age, sex, tumor-multifocal, pTNM, central lymph node metastases ipsilateral level II lymph node metastases and ipsilateral level III lymph node metastases were not found to be associated with level V metastases (χ(2) = 0.882 - 3.167, P > 0.05). In multivariate analysis, extrathyroidal extension (OR = 8.32, 95%CI: 2.44 - 28.3, P = 0.001) and simultaneous metastases to ipsilateral level II, III and IV (OR = 7.81, 95%CI: 2.11 - 28.8, P = 0.002) were independent predictors of level V metastasis.

CONCLUSIONSExtrathyroidal extension, simultaneous metastases to ipsilateral level II, III and IV are risk factors for level V lymph nodes metastases in PTC. Dissection of level V lymph nodes should be considered for PTC patients with extrathyroidal extension and simultaneous metastases to ipsilateral level II, III and IV.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma ; pathology ; surgery ; Carcinoma, Papillary ; Child ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms ; pathology ; surgery ; Treatment Outcome ; Young Adult

Objective To explore the application of event-related potentials (ERP) by positive, negative, and neutral face expression images in the evaluation of mood disorders in brain traumatic patients.Methods ERP was tested by face expression images in 24 patients mainly with anxiety and depression symptoms (depression group) and 19 patients mainly with hostile and suspicion symptoms (hostile group), respectively.The findings were compared with those of the control group.Results There were no significant differences, between the depression group and the hostile group, on latencies and amplitudes of late positive potential (LPP) induced by the three types of face expression images, except the amplitude induced by negative face expression image.Compared with the control group, the latencies were extended and the amplitudes were lower in both depression and hostile groups.Within each group, the difference of latencies induced by the three images was not significant.The amplitudes induced by negative face expression image was higher than those induced by positive and neutral face expression images, with significant differences in the hostile group and the control group (P＜0.05) but not in the depression group.Conclusion Changes in latencies and amplitudes of LPP could be an objective indicator in the evaluation of mood disorders of brain traumatic patients.The LPP induced by negative face expression images could be more meaningful for patients mainly with anxiety and depression symptoms.

BACKGROUNDPreparing hyperthyroid patients for thyroid surgery with a combination of antithyroid drugs and thyroxine has long been controversial because this combination usually results in only partial inhibition of thyroid function. We therefore used large doses of antithyroid drugs to completely inhibit the synthesis of thyroxine and render the thyroid gland defunctionalized. We then administered physiologic doses of thyroxine to inhibit thyroid-stimulating hormone secretion. We have named this treatment "sequential thyroid defunctionalization followed by thyroxine supplementation."

METHODSFour hundred and seventy-one hyperthyroid patients seen at our hospital were divided into experimental and control groups. The control group was treated preoperatively with antithyroid drugs and iodine preparation. The experimental group was further divided into four subgroups and treated with "sequential thyroid defunctionalization followed by thyroxine supplementation". Each of the four subgroups received different doses of antithyroid drugs and thyroxine for differing time periods. Thyroid function was assessed at each stage of treatment, as were operative blood loss volumes and postoperative complications.

RESULTSCompared to the control group, the four experimental groups showed less thyroid congestion and surface varices at surgery. Patients in subgroup A also had thyroid glands that were almost histologically normal. The mean operative blood loss volume of the experimental group was less than that of the control group (326 +/- 163) ml in the control group; (196 +/- 57) ml in subgroup A; (230 +/- 71) ml in subgroup B; (240 +/- 80) ml in subgroup C; and (312 +/- 97) ml in subgroup D). The postoperative complication rate of the experimental group was 8.64% (21/243) whereas that of the control group was 17.54% (40/228).

CONCLUSIONSSequential thyroid defunctionalization followed by thyroxine supplementation is effective in reducing the bleeding volume and postoperative complication rate in selected hyperthyroid patients undergoing thyroidectomy.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Hyperthyroidism ; physiopathology ; surgery ; Male ; Middle Aged ; Thyroid Gland ; pathology ; physiopathology ; Thyroidectomy ; Thyroxine ; administration & dosage

OBJECTIVETo evaluate the efficacy and safety of Flos Abelmoschus manihot (Malvaceae) on type 2 diabetic nephropathy (DN).

METHODSThe Cochrane Library, PubMed/MEDLINE, Excerpta Medical Database, Chinese electronic literature databases, and the references of relevant articles were searched in March 2012 for randomized controlled trials (RCTs) that reported the effects of Flos A. manihot on type 2 DN patients with overt but subnephrotic-range proteinuria (500-3,500 mg/24 h). The quality of trials was evaluated using the Cochrane-recommended method. The results were summarized as risk ratios (RRs) for dichotomous outcomes or mean differences (MDs) for continuous outcomes.

RESULTSSeven trials (531 patients) were included. Flos A. manihot significantly decreased proteinuria [MD -317.32 mg/24 h, 95% confidence interval (CI) [-470.48, -164.17],P<0.01]. After excluding a trial that only included patients with well-preserved renal function, Flos A. manihot was associated with a significant decrease in serum creatinine (MD -11.99 μmol/L, 95% CI [-16.95, -7.04],P<0.01). Serious adverse events were not observed. The most common adverse event was mild to moderate gastrointestinal discomfort; however, patients receiving this herb did not have an increased risk for tolerated gastrointestinal discomfort (RR 1.48, 95% CI [0.39, 5.68],P=0.57).

CONCLUSIONSFlos A. manihot may be considered as an important adjunctive therapy with the first-line and indispensable therapeutic strategies for type 2 DN. High-quality RCTs are urgently needed to confirm the effect of Flos A. manihot on definite endpoints such as end-stage renal disease.

Abelmoschus ; chemistry ; Clinical Trials as Topic ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Diabetic Nephropathies ; complications ; drug therapy ; Flowers ; chemistry ; Humans ; Plant Extracts ; adverse effects ; therapeutic use ; Proteinuria ; complications ; Publication Bias ; Treatment Outcome

OBJECTIVETo study the related factors of central lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC),the indications and the extent of central neck dissection (CND).

METHODSA total of 153 cases treated between Jan. 2009 and Dec. 2010 was analysed retrospectively. Of the cases 28 males and 125 cases females, with a mean age of (44 ± 14) years. T1, T2, and T3 diseases accounted for 51, 10 and 81 cases, respectively; I, II, III and IV diseases for 88, 3, 26 and 36 cases, respectively. Multifocal tumors were found in 63 cases. The related clinicopathologic factors were analyzed, including sex, age, tumor size, extrathyroidal extension, and multifocal tumor.

RESULTSAll the cases had total/near total thyroidectomy and CND, of them 64 cases had unilateral neck dissection and 18 cases had bilateral neck dissection. CLN metastases existed in 68.6% (105/153) cases, 37.2% (57/153) for unilateral and 31.4% (48/153) for bilateral respectively. The rates of CLN metastasis were 86.6% (71/82) in cN1 cases and 47.9% (34/71) cN0 cases, respectively,and the rates of bilateral CLN metastases were 45.1% (37/82) in cN1 cases and 15.5% (11/71) in cN0 cases. Multivariate analysis showed that extrathyroidal extension (P = 0.002, OR = 3.502) was an independent risk factor for CLN metastasis and that lateral neck lymph node metastasis (P = 0.028, OR = 3.080), surrounding tissue invasion (P = 0.014, OR = 3.113), and maximum tumor diameter greater than 1 cm (P = 0.012, OR = 3.732) were independent risk factors for bilateral CLN metastases.

CONCLUSIONSIt is indicated that ipsilateral CND should be obligatory for PTC. Intraoperative frozen section examination should be routine. Bilateral CND should be conducted when ipsilateral CLN metastases accompanied by one of following issues such as more invasive tumor (surrounding tissue invasion, T3 or T4 disease), maximum tumor diameter greater than 1 cm, and lateral neck lymph node metastasis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma ; pathology ; Carcinoma, Papillary ; Child ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Retrospective Studies ; Thyroid Neoplasms ; pathology ; Young Adult

BACKGROUNDThe N400 component of event-related potentials (ERP) has recently drawn widespread attention at home and abroad. This study was to explore the relationship between N400 changes and risperidone treatment and rehabilitation infirst-episode schizophrenia (FES).

METHODSERP component N400 was recorded by Guangzhou Runjie WJ-1 ERP instruments, in 58 FES before and 6 months, 15 months after risperidone treatment, and in 62 normal controls. The patients' syndromes were assessed by Positive and Negative Syndrome Scale (PANSS). And the stimuli are Chinese sentences with matching (congruent) or mismatching (incongruent) ending words.

RESULTSN400 latencies were prolonged, and amplitudes were decreased in Cz, Pz, Fz, C3, C4, in FES compared with in NC, before treatment. The prolonged N400 latencies and decreased amplitudes were negatively correlated with the patients' positive scale and total scale of PANSS. There are significant differences of N400 amplitudes and latencies in 6 months and 15 months follow-up after treatment. Before treatment, 6 months and 15 months after treatment, N400 latencies are 446 ± 35 ms, 440 ± 37 ms, 414 ± 31 ms (F = 9.72, P < 0.01) in incongruent situation; N400 amplitudes are 5.2 ± 4.6 μV, 5.7 ± 4.8 μV, 7.3 ± 5.0 μV (F = 2.06, P > 0.05) in congruent situation, and 8.5 ± 5.9 μV, 10.1 ± 5.0 μV, 11.9 ± 7.0 μV (F = 3.697, P < 0.05) in incongruent situation.

CONCLUSIONSN400 could be used to predict the effects of treatment of schizophrenia to some degree. The linguistic and cognitive impairment in schizophrenia can be improved by antipsychotic drugs.

Adult ; Evoked Potentials ; Follow-Up Studies ; Humans ; Middle Aged ; Risperidone ; therapeutic use ; Schizophrenia ; drug therapy ; rehabilitation

OBJECTIVETo discuss the pattern of central lymph node metastasis of cN0 single thyroid papillary carcinoma and provide clinical evidence-supported proof for central lymph node dissection.

METHODSThe performed thyroidectomy and bilateral central lymph node dissection for 150 patients with cN0 single papillary thyroid carcinoma. The bilateral central lymph nodes were divided into 4 parts: the cornu inferius cartilaginis thyroideae region of ipsilateral central area, the lower part of ipsilateral central area, the cornu inferius cartilaginis thyroideae region of contralateral central area, the lower part of contralateral central area on the baseline of 1 cm below the cornu inferius cartilaginis thyroideae. We analyzed the differences and influencing factors of lymph node metastasis in these 4 parts.

RESULTSThe lymph node metastasis rate in lower part of ipsilateral central area was the highest (56.7%), followed by the lower part of contralateral central area (28.0%), the cornu inferius cartilaginis thyroideae region of ipsilateral central area (17.3%), and the cornu inferius cartilaginis thyroideae region of contralateral central area (0). In the logistic analysis of multiple factors, invaded thyroid capsule was an independent factor for lymph node metastasis in both the cornu inferius cartilaginis thyroideae region of ipsilateral central area (β = 0.1835, χ(2) = 0.3102, P < 0.05) and lower part of contralateral area (β = 0.3166, χ(2) = 1.4640, P < 0.05). The patients' age ≥ 45 years (β = 0.5737, χ(2) = 6.5923) and invaded thyroid capsule (β = 0.4258, χ(2) = 3.4735) were independent factors for lower part of ipsilateral central area (both P < 0.05).

CONCLUSIONThe cornu inferius cartilaginis thyroideae region of contralateral central area of cN0 single PTC patients could not be cleared routinely.

Adult ; Carcinoma ; surgery ; Carcinoma, Papillary ; surgery ; Female ; Humans ; Lymph Node Excision ; methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Thyroid Neoplasms ; surgery ; Thyroidectomy