Adult ; Female ; Humans ; Middle Aged ; Thyroid Diseases ; microbiology ; Tuberculosis, Endocrine

Objective To study the clinical characteristics of thyroid carcinoma in young females,in order to improve the diagnosis and treatment of this disease.Methods The clinical data of 74 consecutive young female patients with thyroid carcinoma treated in our hospital in the recent ten years were analysed.In most of the cases,there was no firm texture or fixation of the thyroid nodules to surrounding structures on physical examination before operation.Ultrasonography was performed in all patients and multiple thyroid nodules were found in 61 cases(82.43%).Thyroid scintiscans were performed in 43 cases,and thyroid nodules were found in 41 cases.The cold,cool and warm nodules were found in 14,18 and 9 cases,respectively,by scintiscans.Fine needle aspiration biopsy(FNAB) was performed in 11 cases,and in 2 cases were negative,1 case showed abnormal cell,3 cases were suspicious of carcinoma,and 5 cases were confirmed papillary carcinoma.Results Papillary carcinoma was found in 70 cases,follicular carcinoma in 3 cases and medullary carcinoma in 1 case by histological examination,and benign disease was also accompanied in most cases.Lymph node metastases was found in 28 cases(37.84%),and the rate of metastases was significantly different than that of older female patients(16.46%) at the same time.There were 2 cases who died 3 years after operation because of metastases.Conclusions The lymph node metastases were prevalent in young female patients with thyroid carcinoma.The texture and mobility of the nodules cannot be used to differentiate benign from malignant nodules.We should carefully analyze every nodule found on ultrasonography.For the solid nodules with diameter larger than 1.0cm,we suggest operation;for the non-solid nodules with diameter larger than 2.0cm,we prefer scintiscans and FNAB for diagnosis.

Objective To analyze the changes of primary disease and demography of patients with end-stage renal disease (ESRD) who started dialysis between 2008 and 2013 in Zhejiang province, in order to provide statistical support for the improvement of dialysis quality.Methods The study retrospectively reviewed all the incident ESRD patients on dialysis registered in Zhejiang Dialysis Quality Control Center from 2008 to 2013.Their demographics and primary cause were investigated.Stratified analysis based on dialysis modality, duration and age were conducted.Results A total of 26 310 incident ESRD patients who started dialysis between 2008 and 2013 in Zhejiang were selected, among which 14 886 cases were male and 11 424 cases were female (male: female: 1.30: 1).The study gave priority to patients aged 45 and above (73.9％), with an average age of (55.7± 16.1) years.The top primary disease was chronic glomerulonephritis (51.3％), followed by diabetic nephropathy (17.3％) and hypertensive nephrosclerosis (6.4％).From 2008 to 2013, the incidence of dialysis was 46.3, 60.1, 71.2, 85.8, 104.1, and 119.9 per million population respectively.The average age of patients was increased year by year, from 52.4, 53.3, 54.8, 56.0, 56.9, to 57.6 years.The share of peritoneal dialysis, as well as the promotion of diabetic nephropathy in primary disease was on the rise.With the increase of age, the proportion of primary diseases such as diabetic nephropathy and hypertension nephrnsclerosis was increased.Conclusions In Zhejiang province, incident dialysis patients increase annually.More males than females are on dialysis.The average age and proportion of peritoneal dialysis are rising.The leading cause is chronic glomerulonephritis, but the incidence of diabetic nephropathy is on the increase, which requires attention.

Objective To investigate the expressions of intermedin /adrenomeduliin 2 (IMD/AM2) and its receptor calcitonin receptor-like receptor (CRLR) in the kidney of rats after renal ischemia reperfusion injury(IRI). Methods Male Wistar rats were divided randomly into two groups: sham group and operation group. Renal IRI model was induced by clamping both renal arteries. Blood and kidney were harversted at 0 h, 6 h, 12 h, 24 h, 48 h, 72 h after reperfusion, respectively. Renal histological changes were semi-quantitated. Expressions of IMD and CRLR in the kidney were detected by Western blot, and the content of IMD in serum was measured by radioimmunity at 12 h, 48 h, 72 h after repeffusion. Results Kidneys of renal IRI model rats displayed significant pathologic changes, and the changes were much severer at 48 h after reperfusion. The expressions of IMD and CRLR in kidney were significantly up-regnlated at 12 h, 48 h, 72 h after renal IRI (P<0.01). The level of IMD in serum increased at 12 h, 48 h, 72 h after renal IRI (P<0.05). Conclusion The expressions of IMD and its receptor are up-regulated in the kidney after renal IRI, which may participate in the pathophysiological changes induced by renal IRI.

Objective To construct eukaryotic expression vector encoding rat IMD gene and deliver it into rat renal tissue via ultrasound-mircobubbles. Methods IMD gene was inserted into pCDNA3.1 ( + )between Hind Ⅲ and EcoRI enzyme sites. The recombinant plasmid designated as IMD-pCDNA 3.1 wasconfirmed by restrictive enzyme digestion and sequencing. Eighteen male Wistar rats were randomized into 3groups, which were treated with no transfection, empty vector transfection and IMD transfection, respectively, in renal tissue via ultrasound-microbubbles. RT-PCR and Western blotting were applied to detect the expression level of IMD. Results Enzyme- digestion and sequencing data showed that IMD-pCDNA 3.1 was correctly constructed. The differences in ALT, AST, BUN and SCr were not significant; No obvious damage in the glomerular, tubular and interstitial was observed in all the treated groups;Compared with non-transfection group and empty vector-transfection group, IMD mRNA and protein expression in IMD transgenic renal tissue were significantly increased. Conclusion IMD-pCDNA 3.1 expression vector was successfully constructed and well expressed in rat kidney.

The two verities of Crgptococcus neoforinans were first observed as well growing with brown color changes on Guizotia abyssinica seed agar(GASA)and caffeic acid commeal agar(CACA.Then,C.neoformans var.neoformans was found in 18/26 pigeon droppings by both two media.C.neoformans var.gattii was not isolated by the two media in 76 Eucalyptus camaldulensis samples.However,an,overgrowth of filamentous fungus was more frequently seen on GASA.Our results suggest that CACA be capable of selevtively isolating C.neoformans with the advantages of less interference fron the overgrowth of filamentous fungi.

Objective To explore the accuracy of Vitek 2 compact advanced expert system (AES) in indicating and analyze the carbapenemases-resisting Enterobacteriaceae phenotypes,and further investigate the methods to make up the AES.Methods 28 Enterobacteriaceae strains with Imipenem-Nonsusceptible by Vitek 2 compact,but AES suggested all production of carbapenemases were isolated.And imipenem susceptibility was determined by the disk diffusion method.Modified Hodge test (MHT) and the metallo-β-1actamase was detected by the double disk synergy method.Resistance genes were detected by the PCR amplification.Results ESBLs gene was amplified from all 28 selected strains,16 of which was detected KPC gene,and no strain of metallo-β-1actamases-producing bacteria.With carbapenemase gene detection as the gold standard,the accuracy of AES was 57.1％.Disc diffusion method detection accuracy rate of imipenem was 100％,and for 100％ of MHT accuracy.PCR amplification,MHT and the disk diffusion displayed the same result in detecting carbapenemases,but different with AES (x2 =10.08,P＜0.05).Conclusion The indications of the presence of carbapenemases using AES was not completely correct with a certain false-positive,and it is necessary to take other methods,such as disk diffusion or MHT methods,and improve the reliability of medicine-sensitivity tests.

Objective To study the effect of Pinus yunnanensis on acute alcoholic liver injury in rats and explore its mechanism. Methods A model of acute alcoholic liver injury in mice was prepared by alcohol. The mice were randomly divided into normal control group, model group, positive control group, Pinus yunnanensis low-, medium-and high-dose groups. Mice in the medicine group were given the corresponding medicine by gavage once a day for 7 days. After the last three hours of intragastric administration, the liver and spleen index, ALT, AST and GSH in serum, SOD, MDA and NO in liver homogenates were measured. Histopathological changes of liver were observed by HE staining. Results Compared with model group, Pinecone of Pinus unnanensis high-, medium- and low-dose groups could significantly reduce the liver index in mice (P<0.01), and high dose groups could significantly reduce the number of spleen (P<0.01); The contents of AST in the medium- and high-dose groups significantly decreased (P<0.01) and the GSH activity significantly increased (P<0.05, P<0.01). There was no significant difference in serum ALT level, SOD activity, GSH activity and NO content in the liver tissues of Pinus yunnanensis groups (P>0.05). HE staining results showed that, the damage of liver tissue in mice of Pinus yunnanensis was significantly improved compared with the model group. Conclusion Pinus yunnanensis has protective effects on acute alcoholic liver injury in mice.

Objective To investigate the effect of intermedin (IMD) on renal ischemia/ reperfusion (I/R) injury after the up-regulation of IMD. Methods A total of 24 healthy Wistar male rats were randomly divided into four groups,sham-operated group,I/R group,IMD gene transfection +I/R group and empty plamid +I/R group.All the animals were killed at the end of 24 h of reperfusion.Histological changes and renal function were estimated.The expression and site of IMD were determined by Immunohistochemistry method,semi-quantitative RT-PCR and Western blotting.The protein expressions of endothelin 1 (ET-1),tumor necrosis factor αt (TNF-α) were detected by Western blotting. Results Compared with sham-operated group,tubulointerstitial pathological injury was significant aggravated in I/R group (7.6±2.3) and empty plamid +I/R group (7.0±1.8),and such injury was improved in IMD+I/R group (1.5±0.8) (P＜0.05).Compared with I/R group and empty plamid +I/R group,the renal dysfunction of IMD +I/R group was obviously lessened [BUN:(7.73±1.03) mmol/L vs (10.13±2.14) mmol/L,(9.77±1.92) mmol/L; Scr:(58.50±3.27) μmol/L vs (80.33±7.15) μmol/L, (75.67±7.58) μmol/L,all P＜0.05].IMD expression was weak in the plasma of tubulointerstitial cells in sham-operated group,and was up-regulated in I/R group. Compared with I/R group, immunohistochemical IMD expression increased obviously (262.03±67.89 vs 175.57±48.06,P＜0.01).The mRNA expression of IMD in IMD+I/R group was up-regulated significantly by 60.7％,66.1％ and the protein expression of IMD in IMD+I/R group increased significantly by 51.4％,55.9％ as compared to I/R and empty plasmid +I/R group.Meanwhile,the protein expressions of ET-1 and TNF-αt in IMD+I/R group were obviously lower compared with those in I/R group (ET-1:0.08±0.02 vs 0.17±0.02; TNF-α:0.21±0.04 vs 0.35± 0.02,all P＜0.05). Conclusion IMD gene transfected into kidneys of rats prior to I/R surgery can attenuate the over-expressions of both ET-1 and TNF-o in I/R injured rat kidneys as well as the damages to the structure and function of the kidneys.

Objective To explore the relationship between social participation and needs for rehabilitation of the disabled in Guangdong Province and to make a proposal for developing the rehabilitation strategies. Meth-ods The data of the Second National Sample Survey of Disabled Persons in Guangdong Province was used in this study. Ranked data analysis was made with the sub-items of the social participation assessment and the main needs of the disabled individuals. Results Significantly statistical differences were revealed with regard to the constitu-ent ratio of needs for rehabilitation services among people with different degrees of difficulties in social participation caused by hearing and visual impairments as well as physical and mental disabilities. No significant difference was found in terms of the constituent ratio of rehabilitation needs among those with difficulties in speech and those with psychiatric diseases. The major rehabilitation needs focused on medical service, assistive apparatus support and functional trainings. Conclusions The rehabilitation needs were different among different categories of disabled persons. Rehabilitation services should be provided accordingly.