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 investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules.Methods A total 456 patients (912 nodules) underwent microwave ablation in our department.Microwave ablation was carried out using microwave antenna under local anesthesia.Nodule volume,thyroid function and clinical symptoms were evaluated before treatment and at 1 ,3,6 and 12 months after the treatment to monitor changes in the volume,adverse effect and complications.Results 912 nodules were all studied with contrast-enhanced ultrasound immediately after the ablation,and all results showed “black hole”sign.The mean follow-up period after microwave ablation was (9±6)months (range,3-24 months).At 6-month follow-up,the mean volume reduction ratio of the solid nodules,mixed nodules and the cystic nodules was (61 ± 50 )%,(81 ± 33 )%,(89 ± 46 )%, respectively.The treatment was well tolerated and no major complications were observed except pain and transient voice changes (2.4%).Conclusions Microwave ablation is a safe and effective technique for the treatment of benign thyroid nodules.

Objective To evaluate the feasibility and efficacy of ultrasound-guided percutaneous microwave ablation combined with hormone suppression therapy for solitary papillary thyroid microcarcinoma.Methods A total of 25 patients with 25 nodules pathologically proven solitary papillary carcinoma 3.7 to 10.0 mm in diameter without clinically apparent lymph node,or distant metastasis were treated with microwave ablation equipement.Microwaves were emitted at 40 W for 200 -400 seconds and prolonged as necessary to attain confluent ablation zones.All patients were treated with both extended ablation therapy and levothyroxine that maintain TSH levels below 0.1 mU/L.Thyroid function test,nodule volume and clinical symptom were evaluated before ablation and during 1 ,3,6,9 and 12 months after treatment according to changes in tumor size,adverse reactions,complications and metastatic tumors.Three out of 25 patients received surgical treatment and the other 22 patients were followed up with routine ultrasound and contrast enhanced ultrasound.Results All 25 tumors were completely ablated by using mutiple plane fixed melting method and no serious or permanent complications occurred.No recurrence at the treatment site or distant metastase were detected,with a mean follow-up of 1 8 months.Histological examination showed no evidence of a tumor in the treated lesions in the 3 surgery patients.Conclusions Ultrasound-guided percutaneous microwave ablation appears to be a safe and effective technique for the therapy of solitary papillary thyroid microcarcinoma.

Objective Through comparing ultrasound-guided microwave ablation (MWA) with surgical resection for the treatment of nodular goiter to evaluate the effect of RFA on the thyroid function.Methods A total of 50 patients with nodular goiter,who were admitted to authors' hospital during the period from January 2010 to January 2013 to receive ultrasound-guided MWA,were selected and used as the study group;and other 96 patients with nodular goiter,who were encountered at authors' hospital during the same period to receive partial thyroidectomy,were collected and used as the control group.Of the 50 patients in the study group,RFA of unilateral lobe nodules was performed in 8 and RFA of bilateral lobe nodules in 42.Among the 96 patients in the control group,unilateral lobe nodules were seen in 52 and bilateral lobe nodules in 44.Postoperative complications were recorded,the serum FT3,FT4,TSH levels were determined at one week,as well as one,3,6 and 12 months after the treatment.The results were statistically analyzed.Results All patients were followed up for 12 months.In the study group,no complications occurred;one week after RFA the serum FT3 and FT4 levels increased while the serum TSH level decreased when compared with preoperative ones,and the differences were statistically significant (P＜0.05).In the control group,bleeding asphyxia occurred in one patient,hoarseness in 5 patients and hypocalcemia convulsion in 3 patients.One week after partial thyroidectomy,the serum FT3 and FT4 levels increased while the serum TSH level decreased when compared with preoperative data,and the differences were statistically significant (P＜0.05).One week after surgery thyroxine replacement therapy was routinely given to 44 patients who had received bilateral subtotal thyroidectomy.Three patients who had received unilateral subtotal thyroidectomy developed hypothyroidism at 3,6 and 8 months after the surgery respectively.In other 49 patients receiving unilateral subtotal thyroidectomy the serum FT3,FT4,TSH levels determined at one,3,6 and 12 months after surgery were significantly different from those in the patients of the study group (P＜0.05).Conclusion For the treatment of nodular goiter,ultrasound-guided MWA is quite safe.MWA has very slight effect on thyroid function and is definitely superior to subtotal thyroidectomy.Therefore,MWA is a minimally invasive technique which is worthy of clinical promotion.

Objective To investigate the effects of H_2O_2 on growth and proliferation in CNE-2Z cells.Methods To identify the effects of H_2O_2 on the growth and proliferation in CNE-2Z cells,Cell growth curves,MTT assay and plate colony formation rate were used;Meanwhile,Cell cycle distribution,proliferation index and apoptosis analysis were performed by flow cytometry(FCM) in human NPC cells CNE-2Z in vitro,before and after the action of H_2O_2;the protein expressions of Egr-1,p53,p16,Cyclin D1 were detected by Western-Blotting analysis.Results There were no EGR-1 and P16 proteins expressions in CNE-2Z cells by Western-Blotting analysis before the action of H2O2;the growth and proliferation of CNE-2Z cells were inhibited significantly by H_2O_2 compared with the control cells,and the apoptosis cells were increased.The increased expressions of EGR-1,P53,and Cyclin D1 protein were also shown in CNE-2Z cells by means of Western-Blotting analysis after the action of H_2O_2;but no P16 protein expression;The expression of EGR-1 protein was significant correlation with P53 protein expression,but no significant correlation with Cyclin D1 protein expression.Conclusion There was no EGR-1 protein expression in CNE-2Z cells,and EGR-1 protein can be induced expression rapidly and transiently by H_2O_2,which probably have an important!role in the growth inhibition and apoptosis.The promotor of Egr-1 gene also can be induced activation by radiation(ROS,reactive oxygen species),there is an important application in therapy of NPC and other tumors.

Objective To study the mid-and long-term outcomes and prognostic risk factors of mitral valve replacement (MVR) in children.Methods Retrospectively studied the cases(＜ 14 years) receiving MVR between July 2003 and March 2014 in our hospital,and recorded the gender,age,operation related data and the results of echocardiography,electrocardiogram and chest X-ray in the out-patient department.Results A total of 48 patients were followed up.Age was 8 months 15 days-13 years 9 months and 22 days,the average was (9.5 ± 3.9) years.24 cases were original operations,others were second operations.43 mechanical valves were used,as well as 5 tissue valves.The mortality was 8.3 ％ and the incidence of complications was 25.0％ during the hospitalization or within 30 days after the operations.Follow-up time was 4.7-150.7 months,the average was(62.0 ± 42.3) months.The long-term mortality was 9.1％,and the incidence of complications was 9.4％.Follow-up of left ventricular ejection fraction was 0.30-0.77,the average was 0.61 ±0.08.There was no redo-MVR or implantation of pace maker.The survival rates of 1 year,5 years and 10 years were (89.5 ± 4.5) ％、(83.0 ± 6.1) ％、(77.8 ±7.6)％,respectively.Children younger than 5 years was the risk factor for perioperative mortality or complications (OR =8.47,95％ CI:1.36-52.61).Children with perioperative complications was the risk factor for long-term mortality or complications(OR =9.97,95％ CI:1.39-71.76).Conclusion The results of children with MVR were satisfactory.To perform MVR in children older than 5 years if possible and to reduce the incidence of perioperative complications could improve the prognosis.

Objective: To investigate the relationship of clinicopathological characteristics with neoadjuvant chemotherapeutic efficacy and prognosis of inflammatory breast cancer (IBC) patients. Methods: Medical records of 81 patients who underwent neoadjuvant chemotherapy for IBC in Tianjin Medical University Cancer Institute and Hospital between January 2010 and December 2013, were retrospectively analyzed. Clinicopathological features, response to neoadjuvant chemotherapy, and prognostic factors were studied by univariate and multivariate analyses. Results: The 3-year overall survival rate (OS) and disease-free survival rate (DFS) of patients were 53.1％ and 37.0％, respectively. The pathologic complete response (pCR) rate of patients after accepting neoadjuvant chemotherapy was 13.6％ (11/81). Statistically significant association was observed between pCR and pathological types in IBC (P<0.05). However,pCR had no benefit in improving the clinical outcomes of IBC patients (P>0.05). Preoperative lymph node stage was an independent prognostic factor of overall survival (OS) and disease- free survival (DFS) in IBC patients (P<0.05). Neoadjuvant chemotherapy and lymph vessel tumor emboli were independent factors of DFS (all P<0.05). Conclusion: Clinicopathological characteristics of IBC patients affected chemosensitivity. We could predict the prognosis of these patients by preoperative lymph node stage and lymph vessel tumor emboli and select chemotherapy to achieve the best curative effect.

OBJECTIVE:To change the drug management mode in wards,promote drug use for patients timely and rationally. METHODS:Automated dispensing cabinet(ADC)was used to manage the drugs in some wards in our hospital,and introduce its use practice from aspects of drug management mode,pharmacists'management to ADC,related measures when using ADC manag-ing ward drugs,effect evaluation after using ADC(using species of base drugs,average time of dispensing temporary medical or-ders,drug returning times in 5 wards before and after using ADC as indexes),etc. RESULTS:Drug management method was es-tablished in ADC by screening drugs into the cabinet and developing process of taking drugs out. And pharmacists had achieved drug management in wards by establishing drug lists,conducting replenishment and inventory management,developing emergency plan,enhancing supervision and inspection,etc. Compared with before using ADC,average species of base drugs in the 5 wards increased from 65.8 to 157.2;average time of dispensing temporary medical orders dropped from 24.5 min to 5.8 min;and average drug returning times in 3 months decreased from about 200 times to about 20 times(P<0.05 or P<0.01). CONCLUSIONS:Us-ing ADC in wards for drug management has not only improved use convenience of drugs in wards,working efficiency of nurses as well as pharmaceutical care quality of pharmacists,but also has changed drug management mode and promoted rational drug use of patients.

Activation of the innate immune system requires recognition of pathogen-associated molecular patterns, such as NOD-like receptors. The NOD-like receptor protein 3 (NLRP3) inflammasome is involved in induction of the pro-inflammatory cytokine, IL-1beta, and subsequent inflammatory responses. NLRP3 inflammasome plays important roles in the inflammatory and innate immune responses associated with autoimmune/inflammatory syndrome. However, analysis of the tissue distribution and expression profiles in BALB/c mice is still incomplete. In this study, we investigated the tissue distribution and expression pattern of NLRP3 in BALB/c mice to further elucidate its function in innate immunity in this commonly used laboratory animal model. NLRP3 mRNA expression levels and tissue distribution of the protein were investigated by real-time quantitative PCR and immunohistochemical analyses, respectively. NLRP3 mRNA expression was higher in the kidney and inguinal lymph nodes than in other tissues. Cytoplasmic expression of NLRP3 was detected in the epithelial reticular cells of the spleen and thymus, lymphocytes in the inguinal lymph nodes, cardiac muscle cells, cerebral cortex neurons, alveolar macrophages, renal tubule cells and liver sinusoidal endothelial cells. The results of this study will assist investigators in interpreting site-specific functions and roles of NLRP3 in inflammatory responses.
Animals ; Carrier Proteins/*genetics/metabolism ; *Gene Expression Regulation ; *Immunity, Innate ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Organ Specificity ; RNA, Messenger/genetics/metabolism ; Real-Time Polymerase Chain Reaction ; Sequence Analysis, DNA

Objective To analyze the role of telehealth?based dialysis registration systems in real?time and dynamic reflection of renal anemia in hemodialysis (HD) patients, and discuss the prospect of its application in dialysis registration management. Methods The Red China project was to build up a dialysis registration system based on the WeChat mobile terminal platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, creatinine were recorded in this system. Hemoglobin (Hb) level was monthly recorded. The platform generated Hb statistics report for each HD center monthly, including the detection rate, target rate and the distribution level of Hb, and released it to physicians through the WeChat terminal of mobile phone. After that, physicians could change the treatment of anemia individually on basis of this report. Here the demographic and baseline laboratory parameters, the detection rate, target rate, the average level and the distribution of Hb from June 2015 to October 2017 after the project launched were analyzed. Results From June 2015 to October 2017, 8392 maintenance HD patients from 28 HD centers in Shanghai were enrolled, of whom 5059(60.3％) were male.The average rate age was (60.5 ± 13.7) years old. Baseline average Hb was (108.3±16.0) g/L. Baseline detection rate and target rate were 54.2％and 47.5％, respectively. After 28 months follow?up, the detection rate of Hb increased from 54.2％ to 73.6％ (P<0.001), the target rate of Hb increased from 47.5％ to 56.1％ (P<0.001), and the level of average Hb rose from (108.3±16.0) g/L to (110.7±16.0) g/L. The difference between average Hb in two consecutive months was less than 1.3 g/L. Conclusions The telehealth?based dialysis registration system can timely report the anemia situation of HD patients, which may improve the awareness rate of anemia, the degree of attention and the compliance of anemia monitoring, so as to improve the detection rate and target rate of Hb and reduce the fluctuation of Hb, which helps to maintain the HD patients to correct anemia in a timely, stable and long?term way. The telehealth?based dialysis registration system, as an improved mode of dialysis registration is a promising way for long?term management of renal anemia in dialysis patients.