Objective: To evaluate the diagnostic efficacies of BRAF^V600E testing and Bethesda system for reporting thyroid cytopathology (BSRTC) in thyroid nodules with thyroid imaging reporting and data system (TIRADS) category 4 and 5. Methods: A total of 187 thyroid nodules in 187 patients underwent the examinations of ultrasound-guided fine needle aspiration cytology (FNAC) and BRAF^V600E mutation were analyzed retrospectively. Receive operating characteristic (ROC) curve was used to investigate the diagnostic values of both methods and the clinical application of BRAF^V600E combined with BSRTC was evaluated. SPSS17.0 software was used to analyze the data. Results: Among 187 thyroid nodules, 123 were malignant nodules confirmed with histopathological examination and 64 benign nodules determined by FNAC, histopathological examination, or long-term follow-up. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BRAF^V600E test were better than those of BSRTC [69.1%, 98.4%, 98.8%, 62.4%(χ²=77.3, P=0.000) vs 62.6%, 93.8%, 95.1%, 56.6%(χ²=54.4, P=0.000)]. While the sensitivity, specificity, PPV and NPV of the combined test of BRAF^V600E and BSRTC for diagnosis of malignant thyroid nodules were 87.8%, 92.2%, 95.6%, 79.7%(χ²=112.6, P=0.000), respectively. The area under the ROC curve for the combined test was higher than that for each of tests (0.900 vs 0.858 or 0.838). Conclusions The combined test of BRAF^V600E mutation and BSRTC has a higher diagnostic efficacy for malignant thyroid nodules compared with BRAF^V600E mutation or BSRTC alone.

Permeability is a key factor in the bioavailability of oral drugs. Therefore, in the early stage of drug discovery, accurate and efficient evaluation of drug permeability is essential. The parallel artificial membrane permeability assay (PAMPA) with Caco-2 cells model was used by the industry as early evaluation methods. At present, the Ussing chamber rat model is also widely used. This review summarizes the human data for the in vivo single-pass perfusion technique (Loc-I-Gut) – the gold standard, and then focuses on the basic principles, experimental operation, and efficiency of the three in vitro methods, with correlation to the effective permeability coefficient (P_eff) and fractional absorbed (Fa) in man. We provide recommendations for the use of proper permeability methods at different stages in drug discovery and development.

OBJECTIVETo observe degenerative intervertebral disc and to examine innervation of degenerative discs in the rabbit anular-injury model.

METHODSTwo different magnitudes of anular injury at 5 mm depth were performed by 11 blade or 16 gauge needle at the L3-L4 or L5-L6 discs in New Zealand white rabbits (n=48, 2.5-3.0 kg). Disc degeneration was evaluated by radiographic, MRI and histological examination at different time points after surgery. To identify nerve ingrowth into disc, two general markers PGP 9.5 and GAP 43, for nerve fibers were examined by immunohistochemistry.

RESULTSignificant decreases in disc height and signal intensity in magnetic resonance imaging were observed in 11 blade group and 16 G puncture group (P<0.01). 16 G puncture group induced slower and more progressive disc degeneration companed with the stab group and control group. At the 12-week time point, nucleus pulposus tissues were extruded and scar tissues formed outside the disc. In stab discs, nerve ingrowth was scattered on the surface of injury site and in the deeper part of the scar tissues, more than 1 mm from the surface. However, in punctured discs, PGP 9.5 and GAP 43-immunoreative fibers were only observed in the outmost part of the scar tissues and superficial area. More nerve fibers were observed in stab group.

CONCLUSIONInnervation may act as a source of discogenic pain which is associated with intervertebral disc degeneration caused by disc anular injury.

Animals ; GAP-43 Protein ; metabolism ; Intervertebral Disc ; injuries ; innervation ; pathology ; Intervertebral Disc Degeneration ; diagnosis ; diagnostic imaging ; etiology ; Low Back Pain ; etiology ; Lumbar Vertebrae ; Male ; Nerve Fibers ; pathology ; Rabbits ; Radiography ; Random Allocation ; Ubiquitin Thiolesterase ; metabolism

BACKGROUNDLaparoscopic cholecystectomy (LC) has been a standard operation and replaced the open cholecystectomy (OC) rapidly because the technique resulted in less pain, smaller incision, and faster recovery. This study was to evaluate the value of blunt dissection in preventing bile duct injury (BDI) in laparoscopic cholecystectomy (LC).

METHODSFrom 2003 to 2015, LC was performed on 21,497 patients, 7470 males and 14,027 females, age 50.3 years (14-84 years). The Calot's triangle was bluntly dissected and each duct in Calot's triangle was identified before transecting the cystic duct.

RESULTSTwo hundred and thirty-nine patients (1.1%) were converted to open procedures. The postoperative hospital stay was 2.1 (0-158) days, and cases (46%) had hospitalization days of 1 day or less, and 92.8% had hospitalization days of 3 days or less; BDI was occurred in 20 cases (0.09%) including 6 cases of common BDI, 2 cases of common hepatic duct injury, 1 case of right hepatic duct injury, 1 case of accessory right hepatic duct, 1 case of aberrant BDI 1 case of biliary stricture, 1 case of biliary duct perforation, 3 cases of hemobilia, and 4 cases of bile leakage.

CONCLUSIONExposing Calot's triangle by blunt dissection in laparoscopic cholecystectomy could prevent intraoperative BDI.

Adolescent ; Adult ; Aged ; Bile Duct Diseases ; prevention & control ; Cholecystectomy, Laparoscopic ; methods ; Common Bile Duct ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective To evaluate the clinical application and significance of lengthen-stem bipolar-femur prosthetic replacement for the treatment of old-age patients with intertrochanteric fracture osteoporosis.Methods 28 cases of patients aging from 75 to 99 years old of intertrochanteric fracture osteoporosis treated with lengthen- stem cemented bipolar prosthesis were studicd from March 2000 to December 2006.After taking the blank margin, the bones of different sizes were replaced and the steel wire was fixed.After determining the depth of the front an- gle,the artificial bone was placed.Results After 28 examples attaining the following-up examination for 7 months to 3 years,with an average of 1.5 years,its function according to Harris standard was evaluated 3 months after the operation,8 examples were excellent,13 examples good,5 examples pass,2 examples inferior.The excellent or good rate reached 75% ,with no abnormal cases,no joint dislocation during the followed-up period.1 example had the phantom phenomenon 1 year after the operation.2 examples among the inferior had got more serious internal medicine disease which affected the restoring function.1 example died of the internal medicine disease 1 year after the operation.Conclusion By using the lengthen-stem bipolar-femur prosthetic replacement for the treatment of old patients with inrertrochanteric fracture osteoporosis,the patients will restore quickly after the operation and can carry a heavy load at an early time.The illness complication and the mortality rate will be redaced.But its related disease must be strictly dealt with and the surgery operating skill must be grasped.

The objective of this study was to evaluate the efficacy and toxicity of the fludarabine combination with high-dose cytarabine (Ara C), idarubicin and granulocyte colony-stimulating factor (G-CSF) (IDA-FLAG regimen) in treatment of refractory/relapsed acute leukemia (AL) patients. 4 patients were male aged from 32 to 44 years, consisted of 3 cases of acute myeloid leukaemia (AML) and 1 cases of acute lymphocytic leukaemia (ALL). All the patients were treated with idarubicin (10 - 12 mg/m(2)/d, days 1 to 3), fludarabine (50 mg/d, days 1 to 5), cytarabine (2 g/m(2)/d, days 1 to 5) and granulocyte colony-stimulating factor (G-CSF, 300 microg/d, days 0 to 5). The results showed that after one course of induction therapy, 4 patients all achieved complete remission (CR), in which 2 patients were in continuous CR after a follow-up of 3 and 4 months; 1 patient relapsed after 10 months and another one patient died of thrombotic thrombocytopenic purpura at 4 months after allogeneic peripheral blood stem cell transplantation. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicity and the early death were not observed in these patients. In conclusion, the IDA-FLAG regimen is effective in treatment of patients with refractory and relapsed AL, the adverse effects from this regimen were well tolerated by patients, which gains time for further treatment.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cytarabine ; therapeutic use ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Idarubicin ; therapeutic use ; Leukemia ; drug therapy ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Vidarabine ; analogs & derivatives ; therapeutic use

OBJECTIVETo search for chemical constituents with structural diversity from Laurencia tristicha to supply for biological assay.

METHODCompounds were isolated by means of column chromatography over normal phase silica gel and Sephadex LH-20, recrystallization and HPLC. Structures were identified by spectroscopic methods including 1D NMR, IR and MS. Cytotoxicities of the purified compounds were evaluated by MTT method.

RESULTSeven compounds were isolated from L. tristicha. Their structures were elucidated as cholesterol (1), cholesta- 5-en-3beta, 7alpha-diol (2), beta-stigmasterol (3), phytol (4), zeaxanthin (5), 4 -hydroxybenzaldehyde (6), indolyl-3-carbaldehyde (7). In the cytotoxic assay compound 2 was active against human cancer cell lines HCT-8, Bel-7402, BGc-823, A549 and HELA with IC50 values of 1.90, 2.02, 1.99, 6.52 and 1.20 microg x mL(-1), respectively. Compound 4 showed cytotoxicity against HCT-8 and HELA with IC50 value of 3.51 and 2.04 microg x mL(-1), and other compounds were inactive ( IC50 > 10 microg x mL(-1)).

CONCLUSIONCompounds 1-7 were isolated from L. tristicha for the first time. In additon, compounds 2 and 4 were cytotoxic against several human cancer cell lines.

Antineoplastic Agents ; chemistry ; isolation & purification ; pharmacology ; Cell Line, Tumor ; drug effects ; Cholestenes ; chemistry ; isolation & purification ; pharmacology ; Cholesterol ; chemistry ; isolation & purification ; pharmacology ; Humans ; Inhibitory Concentration 50 ; Laurencia ; chemistry ; Phytol ; chemistry ; isolation & purification ; pharmacology

OBJECTIVETo investigate the perioperative management of severe obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSFifty-three patients with severe OSAHS received uvulopalatopharyngoplasty with uvula preservation and radiofrequency tongue base reduction. All the patients were treated with automated continuous positive airway pressure (CPAP) for 3-7 days before operation and automated antibiotic therapy administered in the oropharynx, with 24 h ECG monitoring postoperatively. Polysomnography were carried out before and 6 months after surgery.

RESULTSThe preoperative apnea hypopnea index (AHI) and lowest SaO(2) (LSaO(2)) were 58.4-/+5.1/h and 0.650-/+0.059, respectively, which were 15.5-/+3.2/h and 0.864-/+0.064 at 6 months after surgery, respectively, showing significant changes after surgery (P<0.01). Dyspnea occurred in 2 cases after operation, intraoperative bleeding in 1 case, primary bleeding in 2 cases and hypertension crisis in 1 case.

CONCLUSIONSevere OSAHS patients are subject to great surgical risk. Application of auto-CPAP before operation can significantly improve the patients' tolerance of surgery and anesthesia, and reduce the surgical risks and preoperative complications.

Adult ; Continuous Positive Airway Pressure ; methods ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Palate ; surgery ; Perioperative Care ; methods ; Pharynx ; surgery ; Polysomnography ; Reconstructive Surgical Procedures ; methods ; Sleep Apnea, Obstructive ; physiopathology ; surgery ; Treatment Outcome ; Uvula ; surgery

Objective To study the effect of borneol on myelin of the central and peripheral nervous systems. Methods The rats were divided randomly into low-dose borneol treatment group (10 mL/kg,n=18) and high-dose borneol treatment group (13 mL/kg, n=18). Controls (n=18) were chosen and treated with 10 mL/kg paroline. Rats were sacrificed 24, 48 and 72 h after the treatment, and the blood, brain and sciatic nerves of these rats were prepared, respectively; the level of serum myelin basic protein (MBP) was detected and the morphological structure of myelin was observed with transmission electron microscope. Results The content of serum MBP in the 2 treatment groups was advanced markedly as compared with that in the control group 24, 48 and 72 h after the treatment (P<0.05);however, no significant difference was noted between the 2 treatment groups (P>0.05). The content of serum MBP was the highest 24 h after the treatment, gradually decreased following the prolongation of time; significant difference was noted between each 2 time points (P<0.05). Transmission electron microscope indicated abnormality in myelin of the central nerves at all time points, showing inordinate shape, rupture between layers and tangle among fibers; the abnormality was the most obvious 24 h after the treatment, gradually abatement following the prolongation of time; decreased myelin in the sciatic nerves was showed only at 24 h after the treatment, while normal at other time points. Conclusion A certain degree of abnormality of myelin of the central and peripheral nervous systems in rats can be caused by borneol.

OBJECTIVETo evaluate the changes in the expressions of endothelial nitric oxide synthase (eNOS) and plasminogen activator inhibitor-1 (PAI-1) and the alterations of nitric oxide (NO) concentration in atrial endocardium in atrial fibrillation (AF) in order to investigate the mechanisms that contribute to thrombosis.

METHODSIn canine AF was produced with rapid atrial pacing at 400 bpm for 6 weeks, whereas the controls had no atrial pacing. NO production was measured by NO-specific microelectrode. The expression of endocardial eNOS and PAI-1 protein were determined by Western blot analysis and immunohistochemical Staining. Plasma levels of PAI-1 were analysed by Enzyme-linked immunoadsorbent assay.

RESULTSLeft atrial NO concentration was decreased in AF than that in controls [(23.4 +/- 5.8)nmol/L vs (63.8 +/- 16.1)nmol/L, P < 0.01]. Endocardial eNOS expression was also significantly decreased (855 +/- 217 vs 2320 +/- 694, P < 0.05), whereas the expression of the PAI-1 was increased (3164 +/- 827 vs 1371 +/- 352, P < 0.01). Neither NO concentration, nor PAI-1, eNOS expression were altered in the right atria at the same time. A significant increase for plasma levels of PAI-1 was also detected in AF group. No correlation was found between eNOS and PAI-1 protein expression (r = 0.217, P > 0.05).

CONCLUSIONIn the canine model AF was associated with a marked decrease in endocardial NOS expression and NO concentration and with an increase in PAI-1 expression in the left atrium, which may contribute to the thrombosis in AF.

Animals ; Atrial Fibrillation ; complications ; metabolism ; pathology ; Disease Models, Animal ; Dogs ; Female ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Plasminogen Activator Inhibitor 1 ; metabolism ; Thrombosis ; etiology ; metabolism ; pathology