Objective To investigate the diagnosis、 treatment and prognosis of hashimoto's disease(HD) complicated with thyroid multiple nodules.Methods Clinical data of 129 cases of HD complicated with thyroid multiple nodules under want surgery in three years were analyzed retrospectively and followed up.Results All patients were received different scope of thyroidectomy according to the situation of thyroid nodules.The histologic examination after operation indicated there are 36 cases(27.9%) complicated with nodular goiter;23 cases(17.8%) complicated with thyroid cancer;3 cases(2.3%) complicated with thyroid adenomas;1 cases(0.78%) complicated with toxic goiter.Conclusion HD complicated with thyroid multiple nodules patients had difficulty in preoperative diagnosis of nodular nature and should be operate.

Objective To investigate the expression of p53 up-regulated modulator of apoptosis (PUMA) and p53 protein and relationship with clinicopatbological parameters in human gastric cancers. Methods Primary gastric carcinoma and adjacent normal mucosa were obtained from 84 consecutively enrolled patients undergoing gastric cancer resection at Peking University People's Hospital during the period from April 2001 to May 2003. Immunohistochemistry staining was used to measure the expression of PUMA and p53 proteins both in normal and malignant tissues. Results PUMA expression is significantly weaker in primary gastric carcinoma compared to adjacent normal mucosa (P <0. 01 ). Weak PUMA expression in gastric cancer correlates with depth of tumor invasion ( P < 0. 01 ), advanced pTNM stage ( P < 0. 05 ) and poor overall survival of patients ( P < 0. 05 ). p53 protein expression in gastric carcinoma is significantly higher than adjacent normal mucosa ( P < 0. 01 ). There was a significant negative correlation between the expression of PUMA protein and p53 protein in gastric carcinoma (P < 0. 05 ). Conclusion PUMA expression in gastric carcinoma is significantly lower compared to adjacent normal mucosa. Weak PUMA expression in gastric cancer correlates with depth of tumor invasion, later pTNM stage and poor overall patient survival.

Team-oriented scientific project competition-based ideas and measures in teaching of Medical Information Analysis course were studied by introducing non-medical cases into discussion and analysis , simulating brain storm conference , and supplementing team competition .

OBJECTIVETo analyze the causes of delayed union or nonunion of the ulna after intramedullary nailing in pediatric forearm fractures.

METHODSFrom February 2005 to February 2010,5 patients with forearm fractures who were treated with titanium elastic nailing (TEN) were identified to fulfill the criteria of having developed a delayed union or nonunion of the ulna. The causes of delayed union or nonunion were investigated according to mechanism of injury, fracture location, treatments methods and postoperative management. All patients were male and the age was 3 to 14 years old with an average of 9.4 years. All fractures were located on the mid-third part of forearm. Two cases had a re-fracture. Among them, 3 cases caused by high-energy injury and 2 cases by falling down. Open reduction were performed in 4 cases while the other one was treated with closed reduction. Four patients were immobilized in an above-elbow cast, postoperatively.

RESULTSAll patients were followed up from 7 to 19 months with an average of 11.4 months. There were 4 delayed union and 1 nonunion. Three patients healed after the removal of the nail and avoidance of weight-bearing. Two patients healed by replacing another fixation. No patients had soft-tissue irritation or nail-entry-site infections.. The clinical effect was evaluated according to Daruwalla and Price scores with 3 excellent and 2 good of the results.

CONCLUSIONSUsing titanium elastic nailing for the treatment of pediatric both-bone forearm fractures is a good method. However,strict indication selection should be followed to avoid delayed union or nonunion.

Adolescent ; Child ; Child, Preschool ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Retrospective Studies ; Ulna Fractures ; physiopathology ; surgery

Objective To study early treatment strategy for brain hernia combined with hemorrhagic shock and the effect on prognosis of patients with severe head injury.Methods 252 cases of patients with severe head inju-ry and brain hernia combined with hemorrhagic shock in the mergency intensive care unit were divided into the obser-vation group and control group according to the stochastic indicator method,each group in 126 cases.The two group were treated with early treatment strategy and traditional treatment mode,respectively.The advantages and effect of two modes were analyzed.Results The majority of patients had united injury,such as soft tissue injuries,pelvis and spine fractures.There were 136 cases of patients with mild brain hernia and the rate of patients with hemorrhagic shock was 62.30%(157/252).The mortality was 34.13% in the observation group and 48.41% in the control group.There was significant difference(χ2 =5.306,P=0.021).The ratio of patinents with mild disability was 56.35%(71/126) in the observation group and the control group was 35.71%(45/126).The severe disability,vegetative state and death was 43.65%(55/126) in the observation group after the follow-up of 6 months.It was significantly lower than that of the control group(χ2 =5.306,P=0.001).Conclusion The early strategy treatment has a positive effect on reducing the mortality of brain hernia combined with hemorrhagic shock of patients with severe head injury the GOS for the prognosis disability increases significantly.

Objective To study the NR5A1 gene mutation in patients with idiopathic hypogonadotropic hypogonadism(IHH), and to find the new mutation point.Methods Sixty-one IHH patients and 100 normal control subjects were collected and genomic DNA was extracted from blood samples.These patients were with normal karyotype and no abnormality was discovered in magnetic resonance imaging (MRI) scan of the pituitary.Other endocrine diseases were also excluded.The 2-7 exons and splice-sites of NR5A1 gene were amplified with polymerase chain reaction.DNA of the coding sequence and splice-sites of NR5A 1 were sequenced by double deoxidizing terminal end sequencing method in 61 IHH and 100 normal control subjects.The results of sequencing were compared with their corresponding sequence data.61 IHH kindreds were investigated and the clinical data of these patients were collected.Finally, the phenotype and genotype positive cases were analyzed.Results Six patients carried NR5A1 gene mutational sites in 61 cases of IHH.Analysis of sequencing results from 100 age and ethnicity matched control subjects did not show any of these novel changes.Conclusions One mutation in NR5A1 gene may affect protein structure and function, which should be considered in male IHH patients with normal karyotype and without insufficiency of adrenal function.

Objective To classify the accessory fissures and assess the frequency of accessory fissures of the lung by 64-slice spiral CT (MSCT). Methods Of 2664 patients, 847 patients were included in this study excluding the patients with pulmonary parenchymal distortion, pleural disease or lobectomy. Allvolume raw data with a slice thickness of 0.6 mm were reformatted in sagittal and coronal orientations with 3 mm thickness and the accessory fissures were assessed. Results A total of 177 accessory fissures in 144 patients (17.0%) were detected. Most of the accessory fissures were incomplete except 10 fissures on the right lung (8.2%) and 2 fissures on the left lung (3.6%) were complete. The most common fissurewas the superior accessory fissure on the right low lobe (n = 112,13.2%) ,followed by the left minor fissure (n= 51,6.0%), the right inferior accessory fissure( n = 6,0. 7% ), the left superior accessory fissure ( n =4, 0.5%), the azygos fissure (n = 3,0.4%) and the accessory fissure on the right upper and middle lobe(n = 1,0.1%). Conclusion 64-slice CT is an efficient method to observe and classify the accessory fissures of the lung with MPR technique and can provide reliable and useful imaging information for the clinician.

BACKGROUND: Immunoloregulation of mesenchymal stem cells (MSCs) is commonly approved. Previous studies have confirmed the ability of Flk-1~+ bone marrow MSCs (BMSCs) to inhibit T/B lymphocyte proliferation in vitro. OBJECTIVE: To investigate the therapeutic effect of Flk-1~+ BMSCs in collagen-induced arthritis mice.METHODS: A total of 18 healthy male DBA-1(H-2K~q) mice aged 10 weeks were randomly divided into 3 groups. All the mice were injected at the base of the tail with bovine type II collagen (CII), and received a booster injection of CII on day 21 to establish the CIA mice model. DBA-1(H-2K~q)mouse Flk-1~+ BMSCs were isolated in vitro by the density gradient centrifugation and adherence screening. Following initial immunity, mice in the cell transplantation group were infused with Flk-1~+ BMSCs (1-2)×106 cells/mouse via the caudal vein. Mice in the cell transplantation group were injected with the same volume of Flk-1~+ BMSCs during booster. Mice in the model control group were injected with an equal volume of saline 0 or 21 days following initial immunity. Following initial immunity and booster immunization, claw pad thickening and clinical score were observed, changes of joint pathology and dynamic changes in serum factor mass concentration were determined in mice. RESULTS AND CONCLUSION: Compared with the model control group, no significant difference in claw pad thickening and mean clinical score was detected in the cell transplantation group following initial immunity (P > 0.05), with the presence of obvious damage to synovial membrane and inflammatory cell infiltration. Mass concentration of each serum cell factor was similar. The claw pad was significantly thickened (P < 0.01), mean clinical score reached 3.35 points, with severe damage to synovial membrane, proliferation of blood capillary in the cell transplantation group following booster immunization. Interleukin-6 levels were greatly increased at day 28 following initial immunity (P < 0.1), but decreased at day 35 following initial immunity (P < 0.1). Results indicated that in the collagen-induced arthritis mouse models, Flk-1~+ BMSC transplantation did not obtain prospective therapeutic efficacy, but aggravation of arthritis was observed in the cell transplantation group following booster immunization. Upregulation of interleukin-6 concentration could aggravate the behavior symptom of rheumatoid arthritis mice.

AIM To study the chemical constituents from Nepeta angustifolia C.Y.Wu.METHODS The ethyl acetate fraction of N.angustifolia 70％ ethanol extract was isolated and purified by silica,Sephadex LH-20,ODS and semi-preparative HPLC column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and identified as oleanolic acid (1),betulinic acid (2),ursolic acid (3),3-sitosterol (4),angelicin (5),bakuchiol (6),blumenol C glucoside (7),psoralen (8),methyl rosmarinate (9),hesperidin (10).CONCLUSION Compounds 5-8are isolated from genus Nepeta for the first time,compounds 1,4-10 are first isolated from this plant.

In order to understand the electricity frequency specialties of blood, we have developed a wide frequency electricity characteristic testing system and used it to test the amplitude frequency property and phase frequency property of the blood in different states and constituents at 1 Hz to 20 MHz. Further analysis on the results of tests helped us know some important properties of blood at even more microcosmic levels from a new angle. Meanwhile, some problems and considerations on the improvement of the electricity model of biotic tissue and blood were pointed out. (1) From 1 Hz to 5 KHz, the impedance of blood descended 99%. (2) Simple equivalent circuit of resistance and capacitance must be used in series equivalent but not in usual parallel connection equivalent. (3) Experiment indicated, equivalent circuits of blood need more analysis, because simple equivalent circuit of resistance and capacitance is liable to gross error. (4) When the three element model is used for measuring the resistance of inside liquid, capacitance of cell membrane and the resistance of outside liquid of blood, the three testing frequencies must be very similar.
Blood ; Blood Physiological Phenomena ; Electric Impedance ; Electrophysiology ; Humans ; Models, Biological