Objective To establish a experimental autoimmune thyroiditis(EAT) rat model and to observe pathological change levels of CD4 + T lymphocyte infiltration in thyroid tissues under different iodine nutrient conditions.Methods One hundred and thirty-five four weeks old female Lewis rats(body weight about 80 g) were divided into control(NC),model(TG),high iodine-Ⅰ (HⅠ),high iodine and model-Ⅰ (HⅠ + TG),high iodine-Ⅱ (H Ⅱ),high iodine and model-Ⅱ (H Ⅱ + TG) groups according to body weight by random number table.There were 20 rats in NC,HⅠ and H Ⅱ groups,and 25 rats in TG,H Ⅰ + TG and H Ⅱ + TG groups.The rats of HⅠ and HⅠ + TG groups drank deionized water containing iodine 25.7 mg/L; rats of HⅡl and H Ⅱ + TG groups drank deionized water containing iodine 423.3 mg/L; rats of NC and TG groups drank distilled water.Rats of TG,HⅠ + TG and H Ⅱ + TG groups were immunized with 0.1 ml thyroglobulin(Tg,8.0 g/L) in incomplete Freunds adjuvant (IFA),once two weeks for three times.Urine samples were collected after immunization for 8 weeks; after immunization for 15 weeks,rats were killed,blood samples and thyroid tissues were taken.Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry; pathological changes in thyroid tissue were observed by Hematoxylin-Eosin (HE) method ; immunohistochemical method was used to identify the infiltration of inflammatory cells in thyroid tissue.Results The difference of rat thyroid relative quality between groups was statistically significant (F =44.428,P ＜ 0.05).Compared with NC group (0.085 25 mg/g),thyroid relative qualities were increased in experimental groups (TG,HⅠ,HⅠ + TG,H Ⅱ,H Ⅱ + TG groups:0.095 22,0.092 85,0.097 48,0.096 55,0.095 33 mg/g,all P ＜ 0.05).The difference of urinary iodine between groups was statistically significant(x2 =106.4,P＜ 0.05).Compared with NC group(456.45 μg/L),urinary iodine levels in TG,HⅠ,HⅠ +TG,HⅡ,HⅡ + TG groups(800.08,18 633.20,13 869.00,87 889.97,61 661.51 μg/L) were increased(all P ＜ 0.05).The pathological changes of rats in each group were increased with increasing of iodine intake.Rats in NC group had normal thyroid structure; in TG,HⅠ groups,a small amount of lyrnphocytes were found between thyroid follicular; the lymphocytes infiltrated into the follicular in HⅠ + TG group; rats in H Ⅱ,H Ⅱ + TG groups had follicular fusion,and diffused inflammatory cell infiltration.There was a tendency of increased CD4+ T lymphocyte infiltration in rat thyroid with increasing of iodine intake.There was no CD4+ T lymphocyte positive staining in NC group; TG group had a small amount of positive cells; HⅠ group had scattered yellowish-brown positive cells.HⅠ + TG group had a focal lymphocyte infiltration; HⅡ group had follicular expansion obviously; follicular structure damage in HⅡ + TG group was serious,and showed a diffused yellow dye.Conclusion Excessive iodine intake and Tg immunization can induce and aggravate the incidence of autoimmune thyroiditis in rats,and pathological change situation has exacerbated with increasing of iodine intake; excessive iodine intake may also lead to an increased tendency of CD4+ T lymphocytes infiltration in thyroid tissue of EAT rat.

Objective To assess the clinical value of three-dimensional ultrasonography (3DUS) in normal vascular structures and vascular diseases. Methods Thirty-nine 3DUS images were reconstructed,including 17 normal vascular structures and 22 vascular diseases. 3DUS reconstruction was introduced by the maximum intensity projection (MIP) method. A series of 3DUS image was performed using GE Logiq 500 and Logiq 700. Results In all cases, 3DUS images were constructed within 10-30 seconds after free hand scanning. Internal, external and common carotid arteries were also showed in the same rotating 3DUS display simultaneously. The continuity of the transplanted hepatic portal vein were demonstrated clearly in rotating mode 3DUS display and consistent with angiography or computer tomography findings. In cases of various vascular diseases, the degree and location of stenosis or aneurysm of the vessels could be stereoscopically visualized, easy to understand especially for a surgeon who evaluates a preoperative state. Conclusions The 3DUS can display normal or abnormal vascular anatomy clearly. 3DUS image could supply more information than original two-dimensional image, and is useful in the diagnosis of various vascular diseases.

OBJECTIVE:To compare the quality of fungus and bacteria counting culture medium of drug microbial limit test among different manufacturers.METHODS:Culture medium for 7 kinds of nutrient agars and 5 kinds of sodium rose red bengal agars for sale or self-made were enrolled in study.The content of water and nitrogen,pH value were determined.The number of microcolonies which were recovered from 5 kinds of representative bacterial strains was calculated,and the size and number of microcolonies were compared.RESULTS:Physicochemical index of culture medium,the size and number of microcolonies were different among different manufacturers.CONCLUSION:The quality of culture medium is different among different manufacturers,which is associated with physicochemical index.

Two hunderd and seventy patients with thoracic lesions (including 10 patients with chest wall lesions, 36 with pleural lesions, 130 with intrapulmonary lesions, 81 with mediastinal lesions and 13 cases with partial or complete opacity of hemithorax) were evaluated by ultrasonography during a period of 58 months from January 1987 to October 1991. The value and limitation of ultrasonography in the diagnosis of thoracic lesions were discussed on the basis of comparison with radiographic diagnosis. In 125 of 270 patients percutaneous needle biopsies guided by ultrasonography were performed with an accuracy rate of 97.5%. Slight amount of pneumothorax occured in only two cases (1.60%) after the biopsy.

Objective To study significance of anicteric biliary tract dilatation in early diagnosis and treatment of patients with periampullary carcinoma.Method Review the resection rate and survival rate of 16 periampullary carcinoma patients with anicteric biliary tract obstruction found out by B-ultrasound,CT or PTC during 13 years(1986-1999).Result The operative resection rate was 87.50%(14/16) ,5-year survival rate was 43.75%(7/16),3-year survival rate was 62.50%(10/16).Conclusions Biliary tract dilatation existed before icterus occurred,while syndromes such as upset of upper abdomen,reclusion, epigastralgia distention and anorexia, may occur 1-3 months ahead of icterus occurred in patients with periampullary carcinoma. If the patient has syndromes mentioned above, more than 40 years of age and biliary tract dilatation found by B-ultrasound, CT,PTC or ERCP, periampullary carcinoma should be considered. The patients should be checked by operation,so as to raise the operative resection rate and survival rate.

ObjectiveTo summarize the experience of right mini-thoracotomy in the treatment of congenital cardiac defects.MethodsA total o f 1258 patients with congenital cardiac defects received right thoracotomy approach correction u nder cardiopulmonary bypass between October 1994 and March 2003. The cardiac def ects included 293 cases of atrial septal defect, 604 cases of ventricular septal defect, 98 cases of atrial septal defects associated with ventricular septal de fects, 177 cases of Fallot's Tetralogy, 29 cases of partial endocardial cushion defects, and 57 cases of other defects. Complicating anomalies were as follows: patent ductus arteriosus, left superior vena cava, mitral insufficiency, anomalo us pulmonary venous connection, right ventricular outflow tract obstruction, etc .ResultsAmong the 9 fatal cases (0.7%) in the study, 5 succu mbed to low card iac output, 2 to severe pulmonary infection, 1 to perfusive lung injury, and 1 t o pulmonary hypertension crisis. Postoperative complications occurred in 36 case s (2 9%). The cardiopulmonary bypass time was (60 3?32 1) min (range, 15 min ～359 min), the aortic crossclamping time was (37 7?24 6) min (range, 3 min～ 205 min ), the duration of postoperative mechanical ventilation was (19 7?34 4) hours ( range, 1 5 hours～401 hours), and the postoperative hospital stay was (8 0?12 1) days (range, 5 days～300 days).ConclusionsRight mini-thorac otomy is minimall y invasive, without impairing the integrity of the bony thorax. It gives excelle nt cosmetic results and prevents patients from postoperative pigeon chest.

Objective By comparing the detection rates of subclinical thyroid diseases in women(pregnant,lactating and child-bearing age)between iodine deficient regions (supplied iodized salt)and water-borne iodine excess regions (consumed non-iodized salt),and to find the different prevalence of subclinical thyroid disease between two regions under their different iodine source and iodine levels, and to provide reference for screening susceptible population with iodine-related thyroid diseases.Methods The iodine deficiency but salt iodine surpplying regions were selected from six provinces in our country,the local people who were pregnant women,lactating women and 18 to 45 years old women of child-bearing age,a total of 991 cases were investigated.The iodine nutrition levels of the pregnant women were grouped by <150,150-249,and ≥500μg·L-1;the iodine nutrition levels of the lactating women were grouped by <100 and ≥100μg·L-1 .The high water-iodine regions in Shanxi Province were selected,and according to the water-iodine levels 50-99,100-149,149-299,and more than 300μg·L-1 four regions were selected;20 cases of three kinds of people mentioned above were selected in each region,a total of 241 cases.The blood and urine samples were collected, and the serological thyroid function indexes were detected by chemiluminescence immunoassay method or radioimmunity method, and the urine-iodine was detected with cerium catalytic spectrophotometric method. Results In iodine deficient regions and water-borne iodine excess regions, the concurrence rates of subclinical hypothyroidism(hypothyroidism for short)and thyroid antibody positive of women were 2.32% and 4.98%,respectively;accounting to about 1/3 to 1/2 of those subclinical hypothyroidism population.The prevalence rates of subclinical thyroid diseases in the women population between the two regions were 27.55% and 34.85%,respectively;nearly accounting for 1/3 of the women population.The subclinical hypothyroidism detection rates of the three populations in high water iodine regions were significantly higher than those in iodine deficient regions(P<0.05).The lactating women’s detection rates of thyroid antibody positive and subclinical hypothyroidism with antibody positive in high water iodine regions were significantly higher than those in iodine deficient regions(P<0.05).With different iodine sources,when took appropriate iodine,there was no statistical difference of the detection rates of subclinical thyroid diseases among three kinds of women(P>0.05). With the increase of iodine exposure levels,the prevalence of women who suffered from subclinical hypothyroidism and thyroid antibody positive was increased,the coincidence rate was also increased.The detection rates of low T4 concentration and total subclinical thyroid disease of pregnant women in iodine nutrition<100μg·L-1 group were significantly higher than those in iodine nutrition 250-499μg·L-1 group (P<0.05).The detection rates of low T4 concentration and total subclinical thyroid disease of lactating women in iodine nutrition <100μg· L-1 group were significantly higher than those in iodine nutrition >100μg·L-1 group (P<0.05).Conclusion When the iodine intake is appropriate, iodine intakes from salt or from water have no effect on subclinical thyroid diseases. When the iodine intake increases,the prevalence of subclinical thyroid diseases will increase too.

Objectives To analyze and compare four correction methods for measuring thyroid volume,and to find out the best one for thyroid volume correction of children aged 8-10.Methods In 2012 and 2013,the project was carried out in iodine deficient rural areas (water iodine below 10 μg/L) of Jilin and Gansu Provinces,10 villages in each province were chosen as survey sites,and 40 children of 8 to 10 years old were chosen from each village,half boys and half girls.Utrasonography was adopted to determine the thyroid volume,and height and weight were measured.The thyroid volume was corrected by Body Mass Indicator(BMI),weight and height,body surface,and height,separately.Body Mass Indicator corrected Volume (BMIV),Weight and Height corrected Volume Indicator(WHVI),Body Surface Area corrected Volume(BSAV) and Height corrected Volume Indicator(HVI) were calculated and compared with their original thyroid volumes to find out the best one.Results Datas of 450 and 408 children were collected from Jilin and Gansu Provinces,separately.According to their original thyroid volumes,goiter rates of Jilin and Gansu were 10.4％ (47/450) and 0.5％ (2/408),respectively.All these four methods could decrease the difference between provinces and sexes.Among the four methods,WHIV and BSAV were abnormal for correction of different ages,heights and weights.HVI had the most normalized distribution and stronger correlation with the original thyroid volumes than others(r =0.961).The HVI corrected results had similar distribution with the original thyroid volume but the data were different.After being adjusted by 1.7 × HVI,the results were close to the original thyroid volumes.Goiters in Jilin and Gansu Provinces,were 9.1％(41/450) and 0.5％(2/408),respectively,after correction.Conclusion The 1.7 × HVI is the most suitable method for correcting the thyroid volume of children aged 8-10.

Objectives To study the changes of thyroid function under different urinary iodine levels and pregnant trimesters,and to investigate the urinary iodine standard of pregnant women,taken thyroid function as a golden standard.Methods Early,mid and late trimester pregnant women in the iodine deficient rural areas of Gansu and Jilin Provinces were selected,at least 70 cases were included for each trimester in each province.Pregnant women included were physically healthy;cases should be excluded if their immediate relatives had a thyroid disease history.Urinary iodine,free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),and edible salt iodine from pregnant women's home were tested.The urinary iodine was measured with the method for determination of iodine in urine by As3+-Ce4+ catalytic spectrophotometry (WS/T 107-2006).Thyroid function was tested by chemiluminescence method,salt iodine was determined by direct titration method (GB/T 13025.7-1999).Results Totally 439 pregnant women were investigated in the two provinces.Median of urine iodine was 178.6 μg/L;for the 215 women in Gansu,the value was 156.4 μg/L;for the 224 women in Jilin,the value was 206.4 μg/L.Along with the increase of urinary iodine,the FT3 of Gansu decreased from 5.77 pmol/L to 5.34 pmol/L,TSH increased from the lowest 2.63 mU/L to 3.75 mU/L;the FT3 of Jilin increased from 4.41 pmol/L to 4.45 pmol/L,TSH increased from the lowest 0.92 mU/L to 1.50 mU/L.Five indicators of thyroid function of more than 97％ pregnant women were in normal range and FT3 was the most stable in the three trimesters.FT3 of the three triimesters in Gansu was 6.27,5.76,5.28 pmol/L,respectively,and that in Jilin was 4.50,4.42,4.32 pmol/L,respectively.The 5％ and 95％ quantile were 55.24,581.27 μg/L of urinary iodine,of pregnant women with normal thyroid function.Conclusions Under different urinary iodine levels,pregnant women's thyroid function is relatively stable.TSH has showed an increasing trend with increasing iodine level.Along with the progress of pregnancy,the urinary iodine is different among the three pregnancy periods,but the thyroid function is stable.The pregnant women with normal thyroid function have a urinary iodine level between 50-600 μg/L.

Objective To review the surgical results of 28 cases of endecardial cushion defect combined with double-ori-rice mitral valve. Methods Of 860 consecutive patients with endocardial cushion defect, double-orifice mitral valve was iden-tiffed in 28 patients (3.26% ) form October 1996 to November 2007. Intracardiac deformities were corrected simultaneously during the operation. Preoperative mitral valve function, surgical procedures and incidence of pestoperative mitral valve dys-function were reviewed and compared between patients with total endecardial cushion defect ( group Ⅰ, n = 11 ) and partial en-docardial cushion defect ( group Ⅱ, n = 17). Results There were 4 operative deaths in group Ⅰ caused by severe pulmonary inflammation in 3 cases and low cardiac output in 1 case. Two cases were identified as severe mitral valve dysfunction or steao-sis in reoperaticu or autopsy. There was no later death. Mitral valve function is not eatisfactory in group Ⅱ as compared with group Ⅰ in 3 to 89 months of follow-up( averaging 33 months). Conclusion Double-orifice mitral valve is a high risk factor for operative death in total endocardial cushion defect and the longer term results of partial endocardial cushion defect combined with double-orifice mitral valve is not satisfactory.