We describe a case of bilateral thyroid carcinoma in a 48-year-old woman. She was admitted to our hospital as a case of cervical nodular goiter. Multifocality of the thyroid nodules were evaluated by preoperative ultrasonography. The patient received bilateral thyroid lobe total resection and bilateral IV lymph node dissection. Medullary thyroid cancer was confirmed by intraoperative frozen pathology in the right lobe of thyroid gland and papillary thyroid microcarcinoma in the left lobe of thyroid gland. No tumor recurrence and metastasis were found after 3-months follow-up.
Female ; Humans ; Middle Aged ; Thyroid Neoplasms ; diagnosis ; pathology ; surgery

Objective To investigate the effect of El A gene on the radiosensitivity of human laryngeal carcinoma cells and its correlated mechanisms. Methods The Ad-E1A and Ad-β-gal were amplifieated in Hek293 cells, extracted by freezing (-80℃) and thawing(37℃) repeatedly (3 times) , purificated by the method of density gradient of CsC1 and titrated by plaque assay method. Then they were transfected into human laryngeal carcinoma cells (Hep-2) and authenticated by RT-PCR. The radiosensitivity of Hep-2 cells transfeeted with or without El A were studied by cell surviral curve. Finally we investigated the correlated mechanisms including cell apoptosis studied by flow cytometry and VEGF content studied by RT-PCR. Resuits The radiosensitivity of Hep-2 cells transfected with El A was intensified, Do and Dq were lowered and α was increased. Flow cytometry showed that the apoptosis rate of cells with E1A or with El A and radiotherapy was increased. The VEGF content of the cells transfeeted with E1 A or treated by radiotherapy was decreased, which reached the lowest level when the cells were treated with the both mathods. Conclusions E1 A gene can intensify the radiosensitivity and contribute to the apoptosis of human laryngeal carcinoma cells. El A gene and radiotherapy can markedly decrease the VEGF content.

ObjectiveTo investigate personal reflections of head nurses on 360-degree performance assessment system. Method Twenty-three head nurses being involved in 360-degree performance assessment received semi-structured interviews and the data were analyzed with content analysis.ResultThe head nurses were positive about the assessment system,believing that the assessment system was helpful for detecting the weak links of daily work and thinking that the assessment indexes varied in weights with different clinical disciplines.ConclusionsThe 360-degree performance assessment was beneficial for ability promotion of head nurses and continuous improvement of nursing quality.Hospital administrators should continuously improve and promote 360-degree performance assessment system.

Objective To investigate the clinical and pathological features of microscopic thymoma(MT).Methods The histopathological features of 12 cases of MT were observed by histopathologic and immunohistochemical methods.The pathological morphology,diagnosis,and differential diagnosis were discussed combined with literature.Results 6 cases of MT were accompanied by myasthenia gravis(MG) symptoms.Focal hyperplastic thymic epithelial islands were accompanied by large tracts of mature adipose tissue in 12 cases of MTs,and immunohistochemistry showed CK positive.Cyst formation was found in 5 cases,lymphoid hyperplasia in 7 cases,and vascular proliferation in 5 cases.Conclusions MG may be the clinical manifestation of MT.MT can occur in thymic cortex,medulla and cortex and medulla junction.Since the tumor is small and the lesions are multiple,it can not be found by X-ray or CT examination.Diagnosis depends on histopathological examination.Correct understanding of the clinical and pathological features of MT has guiding significance on the treatment and prognosis judgment of MT.Thymic resection was recommended for MG patients either with or without thymoma.

Objective To investigate and eompare the diagnostic values of linear reference region model (LRRM) and Extended Tofts model in quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis of benign and malignant breast lesions under different temporal resolutions.Methods Eight five suspicious breast cancer women underwent bilateral DCE-MRI exam, 37 patients were benigns and 48 patients were malignants.Among those, 31 patients(15 malignant, 16 benign) were scanned with 18 s per phase, and 54 patients(33 malignant, 21 benign) were scanned with 7 s per phase, and they were assigned into breast cancer group, benign lesion group and healthy gland group proven by surgery or biopsies.For the same model, Ktrans values of the three groups under different time resolution were first analyzed using Kruskal-Wallis H rank sum test.Receiver operator curve (ROC) was used to analyse the diagnostic efficiency of K values.Results Under high and low temporal resolutions, K values of the healthy group were (0.048 ±0.022) and (0.090±0.040)/min for extended Tofts model,(0.301 ±0.197) and (0.287±0.225)/min for LRRM model respectively.K values of the benign group were (0.289±0.163) and (0.211 ± 0.080)/min for extended Tofts,(0.624 ± 0.358) and (0.593 ± 0.165)/min for LRRM respectively.K values of the malignant group were (0.959±0.451) and (0.524±0.285)/min for extended Tofts,(1.576±0.935) and (0.956±0.180)/min for LRRM respectively.There were significant differences among the three different groups(P＜0.05).Area under the ROC to differentiate benign and malignant breast lesions for Extended Tofts in high temporal, LRRM in high temporal, Tofts in low temporal and LRRM in low temporal were 0.941, 0.876, 0.850 and 0.933, with Ktrans cutoff values of 0.304, 0.917, 0.252 and 0.789/min,and sensitivity of 93.9％, 80.0％,80.0％, 80.0％;specificity of 85.7％, 90.5％, 81.2％, 87.5％ respectively.Conclusion Under low temporal resolutions, Ktrans of LRRM model had better sensitivities and specificities in differentiation of benign and malignant breast lesions than Extended Tofts model, which was the opposite in high temporal resolutions.

Objective To investigate the value of quantitative dynamic contrast-enhanced MRI (DCE-MRI)in diagnosis of breast adenosis.Methods 54 patients with breast glandular lesions diagnosed as 4th or 5th grade in BI-RADS and proved by pathology un-derwent routine 3.0T quantitative DCE-MRI.Quantitative parameters including volume transfer constant (Ktrans ),plasma volume fraction (Vp )were measured.According to the pathological findings and MRI morphological characteristics,the lesions were divided into breast cancer group,adenosis group and control group.The contralateral healthy side of the adenosis group was regarded as control group.The quantitative parameters of the three groups were statistically analyzed.Results Pharmacokinetic parameters of Ktrans and Vp were (0.289±0.1 63)min-1 and 0.042 8±0.045 respectively in adenosis group (n=21),(0.959±0.45 1)min-1 and 0.057±0.079 in breast cancer group (n=33),and (0.048±0.022)min-1 and 0.01 6 ±0.01 9 in control group (n=21).Ktrans and Vp between adenosis and control group had statistical significance(Z =-5.733,-2.844,all P <0.05),Ktrans between breast cancer group and adenosis group had statistical difference (Z =-5.421,P =0.000 ).Vp between breast cancer and adenosis group had no statistical difference (Z=-0.009,P =0.993).Area under curve (AUC)of the receiver operator curve (ROC)to differentiate benign and malignant lesions of Ktrans were 0.941.When the cutoff were 0.304 min-1 ,the sensitivities and specificities were 93.9%,85.7%. Conclusion Quantitative DCE-MRI shows good diagnostic value in differentiation of breast glandular lesions and cancer.

Proton pump inhibitors are H+ /K+-ATPase inhibitors, which can efficiently inhibit gastric acid secretion for a long time. As the latest inhibitory gastric acid drugs, proton pump inhibitors are the best choices for acid-related diseases such as gastroe-sophageal reflux disease, peptic ulcer and gastrointestinal lesions caused by nonsteroidal anti-inflammatory drugs. Proton pump inhibi-tors have significant inhibition to basal gastric acid, night gastric acid and gastric acid secretion caused by gastrin and food stimulation. This article reviewed the pharmacokinetic characteristics of five proton pump inhibitors in domestic market.

ObjectiveTo evaluate the clinical value of infrahyoid myocutaneous flap in the reconstruction of mouth floor tissue defects. MethodsInfrahyoid myocutaneous flap was made including stenohyoid,thyrohyoid,omohyoid and the affiliated skin based on the axis of superior thyroid artery,vein and ansa cervicalis. The clinical data of 11 patients with reconstruction of mouth floor tissue defects using infrahyoid myocutaneous flap (maximum area was 8 cm × 3 cm) from Match 1993 to June 2009 were retrospectively reviewed.ResultsSeven infrahyoid myocutaneous flaps which reserved platysma branch of superior thyroid artery were all alive, while 2 patients presented epidermal necrosis of 4 un-protected patients. The follow-up period was range from 24 months to 195 months, one patient received salvage surgery for local regional lymphatic recurrence in level Ⅰ,which survived without diseases until now.The rest cases had turned out a success.No dysphagia,dysphonia,and tongue extension difficulty was reported in any patient.ConclusionInfrahyoid myocutaneous flap is one of the valuable donor sites for the reconstruction of mouth floor tissue defects after radical oncologic operations,especially for those with early stage carcinoma of the mouth floor.

Adult ; Aged ; Ankle ; blood supply ; Arteries ; Diabetic Foot ; diagnosis ; physiopathology ; Elbow ; blood supply ; Female ; Foot ; blood supply ; Humans ; Laser-Doppler Flowmetry ; Male ; Middle Aged

Objective To investigate the effects of a proliferation-inducing ligand(APRIL)gene silencing by small interfering RNA(siRNA)on cell cycle and proliferation of colon carcinoma SW480 cells.Methods The siRNA plasmid vector targeting APRIL gene,named as siRNA-APRIL,was transfected into SW480 cells,transfected with scrambled vector as a nontargeting control and nontransfected group as another control.APRIL mRNA and protein expression were examined by real-time PCR and Western blot,respectively.Cell proliferation activity was analyzed by cell counting kit-8(CK-8),cell cycle was detected by flow cytometry,and p21 together with p27,two important regulatory genes in cell cycle,were measured by RTPCR.Results Compared with nontargeting control and nontransfected control,APRIL expression was inhibited significantly at both mRNA and protein level by siRNA-APRIL being transfected in SW480 cells(P ＜0.05).Cell proliferation ability was drastically repressed after siRNA-APRIL being transfected at 48 h,72 h and 96 h(P ＜ 0.05).After transfected 48 h,the percent of Go/G1 phase cell was significantly increased,S and G2/M phase cell were significantly decreased,the number of cell in apoptosis was increased and the expression of p21 and p27 mRNA were up-regulated(P ＜ 0.05).There was no significant difference when compared the two control groups each other(P ＞ 0.05).Conclusion siRNA-APRIL can effectively knockdown the expression of APRIL gene in SW480 cells,moreover,it can inhibit the cell proliferation and induce G0/G1 phase cell cycle arrest,which occurrence may involve in upregulation the mRNA expression of p21 and p27.