Objective To investigate the characteristics of lymph nodes metastasis in papillary thyroid carcinoma (PTC) and to discuss surgical approach.Methods All patients underwent total thyroidectomy,central lymph nodes and lateral lymph nodes dissection in Department of Thyroid Surgery,the First Hospital of the Jilin University,from Dec.2011 to Dec.2012.Results With the increase of the number of positive central lymph nodes,lateral cervical lymph node metastasis rate increased as well and accompanied multi region metastasis trend.In 102 cases of lateral positive cervical lymph node patients,55 cases were in level Ⅱ,accounting for 53.92％,62 cases were in level Ⅲ,accounting for 60.78％,76 cases were in level Ⅳ,accounting for 74.51％,and 17 cases were in level V,accounting for 16.67％.In lateral lymph nodes metastasis,we found level Ⅳ was the most vulnerable area,followed by level Ⅲ,level Ⅱ and level Ⅴ.Conclusions Prophylactic central lymph node dissection should be performed in PTC patients.Patients with central lymph node metastasis especially with the number of positive lymph nodes ＞ 3 should be performed ipsilateral level Ⅱ-Ⅴ lymph node dissection.

Objective To explore the effect of intraoperative parathyroid hormone (IOPTH) examination on parathyroidectomy for primary hyperparathyroidism.Methods The clinical data of 41 PHPT patients who received IOPTH monitoring (IOPTH group) from Jan.2009 to Dec.2014 were retrospectively analyzed.The clinical manifestation,examination and changes of parathyroid hormone and calcium before and after operation were collected.Results There were 12 males and 29 females.36 cases had parathyroid adenoma,and 5 cases were parathyroid carcinoma.23 cases were positive in 24 cases of 99Icm-MIBI parathyroid adenoma radionuclide examination,and 2 cases were positive in 3 cases of parathyroid carcinoma radionuclide 99Tcm-MIBI inspection (P＝ 0.213).10 mins after tumor resection,PTH in all cases decreased by 50％ or more than that before tumor resection except for one case of parathyroid carcinoma.23 cases appeared hypocalcemia in 36 cases of parathyroid adenoma after surgery and 2 cases appeared hypocalcemia in 5 cases of parathyroid cancer patients (P＝0.361).No postoperative hoarseness,cough,bleeding occoured.Patients were followed up from 6 to 72 months.Hypocalcemia symptoms recovered 2 weeks to 3 months after surgery.No permanent hypoparathyroidism occured.One case of parathyroid carcinoma died of hypercalcemia 5 months after surgery.The remaining 40 cases survived without recurrence or death.Conclusions Intraoperative PTH monitoring can help doctors analyze whether all the hyperthyroidism glands have been removed,which can help to avoid miss diagnosis of multiple gland disease and unnecessary bilateral neck exploration.This method is highly accurate so it is recommended for routine use in PHPT surgery.

Objective To explore the role and value of neuroendoscopy-assisted microscope technique in the operation of sellar region tumor. Methods Sixty-three cases of saddle area treated by neuroendoscopy-assisted microscopy during 2015—2017 of neurosurgery in Weifang people' s hospital (neuroendoscopy-assisted microscope technique group) were collected and analyzed. Seven-six patients with sellar area treated by simple microscopic resection from 2013 to 2015(simple microscope group) were retrospectively analyzed. Tumor resection rate, postoperative complication rate and postoperative recurrence rate, the effect of operation was compared and evaluated. Results In the neuroendoscopy-assisted microscope technique group and simple microscope group, the total resection rate of tumor was 95.24％(60/63) and 80.26％(61/76), the incidence of vasospasm was 3.17％(2/63) and 13.16％(10/76), and the incidence of nerve injury was 0(0/63) and 6.58％(5/76). There were significant differences (P<0.05). The postoperative infection, cerebrospinal fluid leakage and postoperative recurrence rate between two groups had no significant differences (P>0.05). Conclusions Endoscopic microscopically assisted resection of sellar area can not only increase the total resection rate of tumor, but also reduce the incidence of complications.

OBJECTIVETo study the antioxidant constituents from the root of Rubus crataegifolius.

METHODThe constituents isolation and purification from the root of R. crataegifolius was carried by reported column chromatography including silica gel, toyopearl, and their structures were elucidated on the basis of spectral compounds. DPPH method was used to evaluate the free radical scavenging activity of the isolated compounds.

RESULTNine compounds were isolated from the root of R. crataegifolius, and their structures were identified as follow: euscaphic acid (1), kaempferol-3-O-beta-D-galactopyranoside (2), tormentic acid (3), 2alpha, 19alpha, 24-trihydroxyurs-12-ene-3-oxo-28-acid (4) , 2alpha-hydroxy-oleanolic acid (5), ursolic acid (6), daucosterol (7), beta-sitosterol (8) and polydatin (9). By experiment of antioxidant activity, the result showed compounds 2 and 9 revealed DPPH free radical scavenging rates were 95.60% and 75.23% at the concentration of 50 mg x L(-1).

CONCLUSIONCompounds 1-8 were isolated from this plant for the first time, and compounds 2 and 9 showed the significant antioxidant activity.

Antioxidants ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Rosaceae ; chemistry

OBJECTIVETo systematically assess the clinical efficacy of high-frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) for treating pediatric acute respiratory distress syndrome (ARDS).

METHODSData from randomized controlled trials comparing HFOV and CMV in the treatment of pediatric ARDS published before July 2016 were collected from the Cochrane Library, PubMed, Medline, CNKI, and Wanfang Data. Literature screening, data extraction, and quality assessment were performed by two independent reviewers according to the inclusion and exclusion criteria. The selected studies were then subjected to a Meta analysis using the RevMan 5.3 software.

RESULTSA total of 6 studies involving 246 patients were included. The results of the Meta analysis showed that there were no significant differences between the HFOV and CMV groups in the in-hospital or 30-day mortality rate, incidence of barotrauma, mean ventilation time, and oxygenation index (P>0.05). However, compared with CMV, HFOV increased the PaO/FiOratio by 17%, 24%, and 31% at 24, 48, and 72 hours after treatment respectively, and improved oxygenation in patients.

CONCLUSIONSAlthough the mortality rate is not reduced by HFOV in children with ARDS, this treatment can result in significant improvement in oxygenation compared with CMV. Further large-sample, multicenter, randomized clinical trials will be required to draw a definitive conclusion.

High-Frequency Ventilation ; Humans ; Oxygen ; blood ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; mortality ; therapy

The changes of microRNA expression in rat hippocampus after traumatic brain injury (TBI) were explored. Adult SD rats received a single controlled cortical impact injury, and the ipsilateral hippocampus was harvested for the subsequent microarray assay at three time points after TBI: 1st day, 3rd day and 5th day, respectively. We characterized the microRNA expression profile in rat hippocampus using the microRNA microarray analysis, and further verified microarray results of miR-142-3p and miR-221 using quantitative real-time PCR. Totally 205 microRNAs were identified and up-/down-regulated more than 1.5 times. There were significant changes in 17 microRNAs at all three time points post-TBI. The quantitative real-time PCR results of miR-142-3p and miR-221 indicated good consistency with the results of the microarray method. MicroRNAs altered at different time points post-TBI. MiR-142-3p and miR-221 may be used as potentially biological markers for TBI assessment in forensic practice.

Aim To explore the correlation of serum angiopoietin-1(Ang-1)and human cartilage glycoprotein-39(YKL-40)levels with coagulation function and inflammatory response in patients with Kawasaki's disease(KD)compli-cated with coronary artery lesion(CAL).Methods From January 2018 to December 2022,90 children with KD were selected as the study subjects,and 90 healthy children who were examined in this hospital during the same period were selected as the control group.According to whether CAL was combined,they were divided into non-CAL group(69 cases)and CAL group(21 cases),the levels of serum Ang-1,YKL-40,coagulation function,and inflammatory factors were compared between the two groups.Pearson analysis was used to investigate the relationship between serum Ang-1,YKL-40 levels and coagulation function,inflammatory reaction indicators in children with KD combined with CAL.Multi-variate Logistic regression analysis was used to identify the factors affecting CAL in children with KD.Results There were significant differences in serum Ang-1 and YKL-40 levels among the control group,the non-CAL group and the CAL group(all P＜0.05).With the increase of the severity of the disease,the serum Ang-1 level in the control group,the non-CAL group and the CAL group decreased gradually,and the YKL-40 level increased gradually(all P＜0.05).Serum Ang-1 was negatively correlated with fibrinogen(FIB),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),in-terleukin-6(IL-6)and white blood cell count(WBC)(all P＜0.05),YKL-40 was positively correlated with FIB,CRP,TNF-α,IL-6 and WBC(all P＜0.05).Multivariate Logistic regression analysis showed that YKL-40 was a risk factor for CAL in children with KD,and Ang-1 was a protective factor(P＜0.05).Conclusion The level of serum Ang-1 de-creased and the level of YKL-40 increased in children with KD complicated with CAL,which was correlated with coagula-tion function and inflammatory response.

Objective To explore the incidence and related predictive factors for acute symptomatic esophagitis in patients with locally advanced non?small cell lung cancer ( NSCLC ) treated with intensity?modulated radiation therapy ( IMRT) . Methods Data were collected retrospectively from 256 patients with inoperable or unresectable stage Ⅲ NSCLC treated in our hospital between January 2007 and December 2011. The radiotherapy target volume included primary lung cancer and lymphatic drainage area involved,with a median dose of 60 Gy in 30 fractions (50-70 Gy).Of all the patients,109 patients (42.6%) received concurrent chemotherapy. Grade ≥2 acute esophagitis ( AE ) ( symptomatic esophagitis ) which occurred during radiotherapy and within 3 months after completion of radiotherapy served as the outcome event. National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0( NCI?CTCAE3.0) was used to evaluate the grade of AE. The logistic regression model was used to analyze the predictive factors. Results A total of 174 patients ( 68%) had treatment?related grade ≥2 AE;154 patients ( 60. 2%) had grade 2 AE and 20 patients (7.8%) had grade 3 AE.The median dose when grade≥2 AE occurred was 30 Gy (11?68 Gy).For grade≥2 AE,multivariate analysis showed that esophageal V5?V60,mean dose,and age were independent predictive factors (P=0.021,0,0.010).For grade ≥3 AE,multivariate analysis showed that esophageal V50?V60 ,concurrent chemotherapy,and body mass index ( BMI) were independent predictive factors ( P= 0.010,0.003,0.019 ) . Old age and higher BMI were the protective factors for grade≥2 and ≥3 AE, respectively. Conclusions For patients with locally advanced NSCLC treated with IMRT, esophageal V50—V60 and concurrent chemotherapy are predictive factors for grade ≥3 AE,and esophageal V50 has a high predictive value for both grade ≥2 and ≥3 AE.

The occurrence and development of tumors are closely related to the body's immune function.It has been confirmed that immunotherapy plays a role in the treatment of various cancers.Some traditional Chinese medicines can control the growth and metastasis of tumors by enhancing anti-tumor immunity.Even in the immunosuppressive tumor microenvironment,traditional Chinese medicine can exert anti-tumor effects by upregulating immune responses.Further research on the regulation of the immune mechanisms by traditional Chinese medicine will provide new insights into how traditional Chinese medicine controls tumor growth and metastasis and help improve its effectiveness in the clinical treatment of various cancers.This article aims to provide a theoretical reference for the role of immunoregulation in tumors,summarize its mechanisms in tumors,and traditional Chinese medicine intervention research in tumors for the prevention and treatment of tumors with traditional Chinese medicine.