Objective To determine the predictive factors for lateral lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC). Methods From January 2002 to December 2009,77 patients with PTMC were treated by modified radical neck dissection. We analyzed the association between lateral LNM and clinical factors, US features, hematological parameters and pathologic features of PTMC. Results The rate of lateral LNM was 39% in 77 PTMCs (30/77). We found a statistically significant association between lateral LNM and age, pathologic features ( extrathyroid invasion and central LNM), higher platelet counts and US features of PTMC (upper pole location,contacting area of the tumor with the capsule of throid gland > 25% of the perimeter of the tumor) in univariate analysis (statistic values were 2.425,6. 392,12. 584,2. 143,8.755 and 6.89,respectively,Ps< 0.05). Age,pathologic features (central LNM) and US features of PTMC (upper pole location) were found to be independent predictive factors for lateral LNM in multivariate analysis ( OR and 95%C/ was 0.942(0.889 -0.998) ,4. 396( 1. 241 - 15. 573) and 4.436( 1. 194 - 16. 482) ,P was 0. 042, 0.022 and 0.026,respectively). Conclusion In patients with PTMC,independent factors in predicting lateral LNM were age, US features of PTMC ( upper pole location) and pathologic features (central LNM ). These patients should receive relatively aggressive initial treatments and vigilant follow-up.

Objective To investigate the trend of cardiac reserve function during the normal labor.Methods Sixty-three cases were chosen randomly from hospitalized maternal women in the First Affiliated Hospital of Chongqing Medical University from 2010 June to December ( six months).The digital technique of heart sound signal processing was used to analysize cardiac reserve function parameters including the heart rate ( HR),the ratio of the amplitude of the first heart sound to the second heart sound and the ratio of diastolic to systolic duration (D/S) of pregnant women.Results ( 1 ) Comparisons of cardiac reserve function between uterine contractions and relaxations during labor:①Latent phase of labor ( cervix dilation ＜ 3 cm ):HR was ( 87.3 ± 14.0 ) beats/min in uterine contractions and ( 82.8 ± 12.5 )beats/min in uterine relaxations,the ratio of D/S was 1.14 ±0.27 in uterine contractions and 1.21 ±0.22 in uterine relaxations,the comparisons of the above two were statistically significant,P ＜0.05 ; But the ratio of S1/S2 was 2.19 ±0.82 in uterine contractions and 2.28 ±0.81 in ueterine relaxations,the comparison was not statistically significant,P ＞ 0.05.② During early active stage of labor ( cervix dilation 3-6 cm):HR was (89.3 ± 15.4) beats/min in uterine contractions and (83.1 ± 13.5) beats/min in uterine relaxations,the ratio of D/S was 1.09 ± 0.30 in uterine contractions and 1.20 ± 0.27 in uterine relaxations,the comparisons of the above two were statistically significant,( P ＜0.05 ) ;But the ratio of S1/S2 was 2.42 ± 1.08 in uterine contractions and 2.29 ±0.83 in ueterine relaxations,the comparison was not statistically significant ( P ＞0.05 ); ③During late active stage of labor (cervix dilation 6-10 cm),HR was (95.4 ± 18.7 ) beats/min in uterine contractions and (86.2 ± 15.6) beats/min in uterine relaxations,the ratio of D/S was 1.01 ±0.25 in uterine contractions and 1.18 ± 0.25 in uterine relaxations,the comparisons of the above two were statistically significant,( P ＜ 0.05 ) ; But the ratio of S1/S2 was 2.61 ± 1.26 in uterine contractions and 2.67 ± 1.19 in ueterine relaxations,the comparison was not statistically significant ( P ＞ 0.05 ).④ The second stage of labor (cervical dilation ≥ 10 cm ):HR was (109.4 ± 19.7 ) beats/min in uterine contractions and (93.5 ± 16.7 ) beats/min in uterine relaxations,the ratio of D/S was 0.89 ± 0.23 in uterine contractions and 1.14 ±0.26 in uterine relaxations,the ratio of S1/S2 was 3.66 ± 1.37 in uterine contractions and (2.81 ± 1.07 ) in uterine relaxations,the comparisons of all were statistically significant (P＜0.05).(2)Comparison of cardiac reserve function in uterine relaxations of each stage of labor:①Maternal heart rate gradually increased from latent stage of labor to the second stage of labor,and decreased postpartum,the comparison was statistically significant ( P ＜ 0.05 ) ;② The ratio of S1/S2 of maternal gradually increased from latent stage of labor to the second stage of labor,and decreased postpartum,the comparison was statistically significant( P ＜0.05 ) ;③ The ratio of D/S gradually decreased from latency to the second stage of labor,and increased postpartum,the comparison was statistically significant( P ＜0.05 ).(3) Comparison of cardiac reserve function in uterine contractions of each stage of labor:① Maternal heart rate gradually decreased from latent stage of labor to the second stage of labor,the comparison was statistically significant( P ＜ 0.05 ) ;② The ratio of S1/S2 of maternal gradually increased from latent stage of labor to the second stage of labor,the comparison was statistically significant( P ＜ 0.05 ) ; ③ The ratio of D/S gradually decreased from latency to the second stage of labor,the comparison was statistically significant (P ＜0.05).Conclusions The maternal cardiac reserve function decreased in uterine contractions than relaxation during labor; With the progress of labor,the maternal cardiac reserve function declined,especially in the second stage of labor,and recovered in postpartum stage.

Objective To establish the solid phase extraction (SPE) with GC/MS technology for fish poi-soning cases to determine five pesticides in fishpond. Methods By three solid phase extraction column including Oasis HLB cartridge, Bond Elut C18 and SampliQ C18, the recovery rate was compared to ex-tract and purify five pesticides in fishpond. The effects of different kinds and dosages of eluents on ex-tract rate were also reviewed. Results Using Bond Elut C18 as solid phase extraction column and 3 mL benzene as eluent, the linear range of mass concentration of five pesticides in fishpond was 1-50 μg/mL, and the correlation coefficient was 0.996 2-0.999 6. The limit of detection was 3.4-26 μg/L and the re-covery was 61.49%-102.48%. The relative standard deviations was less than or equal to 3.01%. Conclu-sion With high sensitivity, good accuracy and precision, SPE -GC/MS has simple and quick operation and less solvent. It can be applied to determination of five pesticides in fishpond.

BACKGROUND: To summarize the progress of tissue engineering in repairing spinal cord injury in recent years.DATA SOURCES: A computer-based online search of PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) and CNKI database (www.cnki.net/index.htm) was performed for articles published between September 1999 and September 2009 with the key words of "spinal cord injury, tissue engineering" in English and Chinese, respectively. Articles published recently or in authoritative journals in the same field were selected.DATA SELECTION: Inclusion criteria: clinical or experimental study about tissue engineering in repairing spinal cord injury.Repetitive studies were excluded. A total of 29 articles were included.MAIN OUTCOME MEASURES: Seed cell selection of tissue engineering; requirements of scaffold materials of tissue-engineered spinal cord, neurotrophic factor for regeneration, special internal environment construction for regeneration.RESULTS: Seed cells of tissue-engineered spinal cord include Schwann cells, olfactory ensheathing cells, embryonic stem cells, neural stem cells and bone marrow stromal stem cells. Scaffold materials involve synthetic or modified natural materials, such as polyglycolic acid, polylactic acid, and lactic acid/glycolic acid copolymer, which benefit cell attachment and nutrition factor aggregation following surface modification. Antibodies that promote or inhibit nerve growth factor in combination with polyoxyl are coupled to function as tissue-engineered scaffold, which may be approaches to repair spinal cord injury by tissue engineering in combination with stem cell transplantation and electric field/magnetic field stimulation.CONCLUSION: The optimal elements for tissue engineering are the key role in repairing spinal cord injury by tissue engineering.

Objective To investigate the effect of dexamethasone on expressions of angiopoietin-1,2 (Ang-1,2) in rats with acute lung injury induced by phosgene.Methods A total of 36 SD rats were randomly (random number) divided into 3 groups:normal control group that consisted of the rats with air exposure,phosgene group that consisted of the rats with exposure to 8.33 mg/L phosgene (purity 100％,of the same volume as the inhaled air in the normal control group) for 5 minutes and dexamethasone group that consisted of the rats with caudal vein injection of 2.5 mg/kg dexamethasone an hour before exposure to the same dose of phosgene.Wet and dry ratio of the lung (W/D) was calculated,and leukocyte count and total protein content of bronchoalveolar lavage fluid (BALF) were recorded 2 hours later.The concentrations of Ang-1,2 in the serum and BALF were measured by enzyme-linked immunosorbent assay (ELISA).Reverse transcription-polymerase chain reaction (RT-PCR) was used to determine the mRNA levels of Ang-1,2 and Tie-2 in the lung tissue.The protein expression of Ang-1,2 and Tie-2 in the lung tissue were quantified by Western blot.Results Compared with phosgene group,the lung W/D,protein content of BALF and WBC count in dexamethasone group were significantly decreased (P ＜ 0.01).Compared with normal control group,Ang-1 and Tie-2 expressions in phosgene group were significantly decreased (P ＜ 0.01).Compared with phosgene group,the serum,BALF and lung tissue of Ang-1 and Tie-2 expressions in dexamethasone group was significantly increased (P ＜0.01).Compared with normal control group,the serum,BALF and lung tissue of Ang-2 expressions in phosgene group were significantly increased (P ＜ 0.01).Compared with phosgene group,the serum,BALF and lung tissue of Ang-2 expressions in dexamethasone group were significantly decreased (P ＜ 0.05,P ＜ 0.01).Conclusion Dexamethasone has a beneficial effect on acute lung injury induced by phosgene in rats by inhibition of Ang-2 and increase in Ang-1 and Tie-2 expressions.

This study was aimed to optimize the extraction process conditions of lycopene in tomato. Ketchup was used as raw material. Method verification, single factor experiment and orthogonal method were used in the study on extraction process of lycopene. The results showed that the best optimization process conditions of lycopene extraction with ethyl acetate: extraction temperature at 50℃, extraction time for 40 min, ethyl acetate concentration of 80%, solid-to-liquid ratio of 1?2 (g·mL-1). Under these conditions, the extraction rate of lycopene reached 15.564 mg·100g-1. It was concluded that the extraction process of lycopene can provide experimental basis for further development and utilization of lycopene.

Objective To investigate the difference of curative effects between the complete video assisted thoracic surgery (C-VATS)and traditional open surgery in the treatment of elderly patients with lung cancer,and to clarify the specially curative effect of C-VATS.Methods 80 patients with lung cancer without diabetes mellitus,chronic brouchitis and heart diseases aged over 65 years were enrolled in the study.They were divided into C-VATS group and open surgery for lobectomy (OPEN)group (n=40)according their wishes.The operation time,number of lymph nodes removed,amount of intraoperative blood loss,postoperative thoracic drainage,chest tube duration, postoperative hospitalized time, postoperative pain degree, incidence of postoperative complications, preoperative and postoperative sedentary heart rate (HR)of the patients in two groups were compared.Results The operation time in C-VATS group(193.12 min±59.06 min)was longer than that in OPEN group(167.17 min±54.01 min) (P<0.05),and the number of lymph nodes removed in C-VATS group(14.6±7.5)had no significant difference compared with OPEN group(15.2 ± 4.5)(P>0.05).The postoperative pain degree in C-VATS group(2.54 ± 0.12)was lower than that in OPEN group(4.61 ± 0.10)(P<0.05);the postoperative chest rube duration in C-VAS group(6.14 d ± 3.32 d)was short than that in OPEN group (11.67 d ± 4.13 d);the postperative hospitalized time in C-AVA group(8.52 d±3.25 d)was shorter than that in OPEN group (14.76 d±6.11 d)(P<0.05).There were no significant differences of intraoperative blood loss(231.28 mL±203.15 mL vs 213.33 mL± 187.18 mL),postoperative thoracic draginage(1 597.83 mL± 1 049.29 mL vs 1 690.68 mL± 1 043.37 mL), incidence of postoperative complications between C-VATS group and OPEN group(P>0.05).The postoperative sedentary HR in C-VATS group and OPEN group were significantly higher than preoperative;the postoperative sedentary HR recovered to the preoperative level 3 d after operation in C-VATS group and it recovered to the preoperative level 7 d after operation in OPEN group. Conclusion Compared with traditional open thoracic surgery, C-VATS owns the characteristics such as less trauma, less pain, less hospital stay and better postoperative recovery in the aged patients with lung cancer.

Hypoxia/ischemia is a common clinical pathophysiological process and cause of death,and it is a common problem in extreme conditions such as high altitude,astronautics and diving.Hamartin is a kind of effective endogenous neuroprotectant and could increase cell tolerance to acute hypoxia or ischemia, thus,is of significance to research.The role of hamartin in hypoxia/ischemia has been a research focus of many scientists.Elucidating the related protective effect and its DNA methylation on hypoxia/ischemia can not only reduce injury,but also lay a basic for further studying the role of hamartin and its DNA methylation in other pathophysiological processes and provide theoretical guidance for the following clinical study.In this paper,we review the structure,mechanism and role of hamartin and the effect of its DNA methylation on hypoxia/ischemia.

Background Studies showed that macophenolic acid (MPA)down-regulates and inhibits the expression and secretion of tissue growth factor and inflammatory factor,and further impacts the proliferation and inflammation process.Pterygium is an inflammatory and proliferative lesion.Whether MPA has an inhibitory effect on pterygium is unclear.Objective This study was to investigate the antifibrotic effects of macophenolic acid on pterygium fibroblasts(PFBs) in vitro and discuss its mechanism.Methods Pterygium tissue was obtained from pterygium patient during the surgery.PFBs were cultured using explants and identified with vimentin immunohistochemisty.0,0.125,0.250,0.500,1.000 μmol/L MPA were added into the culture medium,respectively,and the cells were cultured in the medium without MPA as the control group.MTT colorimetry was used to find the optimization effective concentration of MPA and evaluate their inhibitory effect on PFBs,and BrdU fluorescence staining was used to assess the growth statue of PFBs.Expressions of nuclear factor-κB(NF-κB),p65 and inhibitor of NF-κB-α(IκB-α) in the cells were detected by Western blot.Results The cells was spindle in shape 3 days after cultured and showed the vortex and radial arrangement with the positive response to vimentin.With the increase of MPA,the proliferative value of PFBs (A560)showed gradually decline,with a significant difference among the five groups (F =42.874,P＜0.01).In addition,the proliferative value of PFBs (A560) significantly lowed as the prolong of MPA active time(F=26.038,P＜0.01).BrdU fluorescence staining showed a significant decrease of DNA synthesis of PFBs with the elevation of MPA dose among the five groups(F=175.279,P＜0.05),and the A560of PFBs DNA synthesis in different concentrations of MPA groups was lower than that of the control group (all at P＜0.05).No apoptotic and necrotic cell was found after MPA action by DAPI staining.The expression level of p65 in the PFBs was 0.886±0.072 and 1.542±0.124 in the MPA group and the control group,indicating a declined value in the MPA group(P＜0.05).However,the expression value of IκB-α in the cytoplasm PFBs was significantly higher in the MPA group compared with the control group(2.141 ±0.305 vs.1.559±0.267) (P＜0.05).Conclusions MPA has an inhibitory effect on the growth of PFBs,which probably is related to the arresting of NF-κB pathway.

This paper analyzed and discussed on the importance of doctor-patient communica-tion skills and the differences between foreign countries and China. Meanwhile, it pointed out the drawbacks of doctor-patient communication skills training for medical students in China and proposed some countermeasures including finding out influence factors, searching for reference books, provid-ing guide for doctor-patient communication theory and skills, formulating teaching pattern, building evaluation mechanism, and establishing a communication platform of doctor-patient communication skills for medical students.