Objective To explore the clinical significance of preoperative ultrasound-assisted drawings in location of thyroid micronodule resection .Methods A total of 88 patients ( 137 nodules ) who underwent thyroid micro-nodule resection were enrolled in the prospective randomized controlled study .All patients were randomly divided into two groups:46 patients (68 micronodules) in experimental group and 42 patients (69 micronodules) in control group.Inclusion criteria:the maximum diameter of nodule≤1.0 cm. Preoperative thyroid ultrasound was conducted .Patients in experimental group also underwent ultrasound-assisted location of thyroid micronodule .Results The diagnostic accuracy rate of US was 81.82%(69/88) in all patients .With the help of ultrasound-assisted location , all nodules in experimental group were found quickly and accurately.The resection rate of experimental group was 100%(46/46).Whereas 4 nodules (in 4 patients ) were missed in control group with a resection rate of 90.5% (38/42).The postoperative US examinations after 3 months showed that all nodules were completely removed in experimental group while 4 nodules retained in control group .Conclusions Preoperative ultrasound-assisted drawings in location of thyroid micronodule plays an important role in thyroid nodule resection .It is great value of clinical application .

This study was aimed to evaluate effects of different production techniques of Shuxue Tongmai (SXTM) capsules for blood coagulation function and thrombosis formation among mice. The observation was made on the clot-ting time, bleeding time and instauration rate of collagen-adrenaline model of mice. The results showed that com-pared with SXTM II and Ⅲ production technique, the SXTM I production technique of the same dosage group can prolong the clotting time of mice significantly (P < 0.05), and increase the instauration rate of collagen-adrenaline model of mice significantly (P< 0.05). There was no significant difference on the bleeding time of mice between the SXTM I production technique of same dosage group and the saline group. It was concluded that the SXTM had an-ticoagulative and antithrombotic effects. And the SXTM I production technique receives better effects.

OBJECTIVETo investigate the genetic association between schizophrenia and polymorphism of D-amino acid-oxidase (DAAO) gene.

METHODSA total of 112 parent/offspring trios in which the proband met the Amerecan Classification and Diagnostic Criteria for Mental Disorders (Fourth Revised Edition) were included in this study. Correlation analysis between schizophrenia and DAAO gene polymorphism and haplotype relative risk analysis were conducetd by using PCR and SNP typing in all the nuclear families.

RESULTSThe rs3918347 allele was correlated to schizophrenia (P = 0.014). Allele A was a protective factor (Z = -2.37) and allele G the hazard factor (Z = 2.37). The frequency of rs3918347 allele A was 0.41 and that of the allele G was 0.59. The rs3741775, rs3825251 and rs4964770 alleles were not associated with schizophrenia. Three haplotypes of C/G in the rs3825251-rs3918347, G/T in the rs3918347-rs4964770, C/G/T in the rs3825251-rs3918347-rs4964770 were associated with schizophrenia (P = 0.021, 0.036, and 0.028, with genotype frequencies of 0.33, 0.28, and 0.15, respectively).

CONCLUSIONThe nucleotide polymorphism of DAAO gene is associated with schizophrenia in Chinese population.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Carrier Proteins ; genetics ; Female ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Schizophrenia ; genetics ; Young Adult

OBJECTIVETo evaluate the application value of preoperative ultrasound-guided drawing for locating thyroid micronodule in surgery.

METHODSA total of 88 patients (with 137 thyroid micronodules) who underwent thyroid surgery was included in the prospective study. Preoperative thyroid ultrasound was conducted in all patients. Select criteria: the maximum diameter of nodule ≤ 1 cm. All patients were randomly divided into two groups: 46 patients (68 micronoduls) in experimental group with ultrasound-guided drawing location of thyroid micronodule and 42 patients (69 micronoduls) in control group without ultrasound-guided drawing location of thyroid micronodule.

RESULTSAll thyroid micronodules of experimental group were found quickly and accurately in surgery, and 4 micronodules in 4 patients of control group were not found in surgery. US examinations 3 months after surgery showed that all micronodules in experimental group were completely removed and 4 micronodules in control group retained.

CONCLUSIONUltrasound-guided drawing is a useful technique for locating and searching accurately thyroid micronodule in surgery.

Humans ; Parathyroid Glands ; Prospective Studies ; Thyroid Nodule ; diagnostic imaging ; Ultrasonography

BACKGROUNDMutations in the fibrillin-1 gene have been identified in patients with Marfan syndrome (MFS). This study aimed to identify the molecular defects in the fibrillin-1 gene in a Chinese family with Marfan syndrome, accompanied by aortic aneurysms/dissection.

METHODSTwo patients and one non-carrier in the family underwent complete physical, ophthalmic, and cardiovascular examinations. Genomic DNA was extracted from leukocytes of venous blood of these individuals in the family as well as 50 healthy normal controls. Polymerase chain reaction amplification and direct sequencing of all 65 coding exons of fibrillin-1 gene were analyzed.

RESULTSWe found a novel mutation (c.8547T > G, p.Tyr2849X) in exon 65 of fibrillin-1 gene in a Chinese proband with Marfan syndrome, accompanied by aortic aneurysms/dissection. Sudden death at a young age of affected members was seen due to aortic aneurysms/dissection. By evaluating genotype-phenotype correlations of patients with mutations in the 3' end of fibrillin-1 gene (exons 64 and 65), we also found that the presence of nonsense mutations occurring in exons 64 and 65 appeared to be an indicator of early-onset aortic risk and sudden death.

CONCLUSIONSThese results expand the mutation spectrum of fibrillin-1 gene and help in the study of the molecular pathogenesis of Marfan syndrome, indicating that mutations occurring in the 3' end of fibrillin-1 gene may play an independent functional role in the pathogenesis of Marfan syndrome.

Adult ; Female ; Fibrillin-1 ; Fibrillins ; Genotype ; Humans ; Male ; Marfan Syndrome ; etiology ; genetics ; Microfilament Proteins ; genetics ; Middle Aged ; Mutation ; Phenotype

OBJECTIVETo identify the disease-causing gene mutations and to reveal the relationship between the genotype and the phenotype in Chinese patients with hypertrophic cardiomyopathy (HCM).

METHODSOne hundred unrelated patients with HCM and 120 controls were enrolled in this study. The full encoding exons and flanking sequences of the cardiac myosin binding protein C gene (MYBPC3) were amplified with PCR and the products were sequenced.

RESULTSA novel missense mutation c.706T > C was identified in exon 6 of MYBPC3 gene in three HCM patients, which resulted a Serine (S) to Glycine (G) exchange at amino acid residue 236 (S236G). The clinical phenotypes of the three patients were different (2 obstructive HCM, 1 non-obstructive HCM). The 120 controls were normal in the genetic test.

CONCLUSIONSThe novel S236G mutation in MYBPC3 gene was a hot-spot mutation in Chinese patients with HCM.

Adult ; Asian Continental Ancestry Group ; genetics ; Cardiomyopathy, Hypertrophic ; genetics ; Carrier Proteins ; genetics ; Case-Control Studies ; DNA ; Female ; Genome, Human ; Humans ; Male ; Middle Aged ; Mutation ; Phenotype ; Young Adult

OBJECTIVETo evaluate the efficacy and safty of the humanized anti-epidermal factor receptor monoclonal antibody h-R3 in combination with radiotherapy for locoregionally advanced nasopharyngeal carcinoma.

METHODSTotally, 137 patients from 7 medical center around China were randomly divided into combined therapy group or control group. There was no difference in Karnofsky performance score between two groups. All patients in both groups received radical conventionally fractionated radiotherapy to the total dose of D(T) 70-76 Gy. For the combined therapy group, h-R3 was added at a dose of 100 mg i.v. weekly for 8 weeks started at the beginning of radiotherapy.

RESULTSOf the 137 eligilbe patients, 70 were in the combined therapy group treated by h-R3 plus radiotherapy and 67 in the control group by radiotherapy alone. The intent-to-treat (ITT) population consisted of 130 patients, while the per-protocol (PP) population was composed of 126 patients. The efficacy was assessed respectively at three point of time: the end of treatment, the 5th- and 17th-week after treatment. The complete response (CR) of the combined therapy group was significantly higher than that of the control group in both ITT and PP (ITT: 65.63%, 87.50%, 90.63% versus 27.27%, 42.42%, 51.52%; PP: 67.21%, 90.16%, 93.44% versus 27.69%, 43.08%, 52.31%; P < 0.05, respectively). The most common h-R3-related adverse reactions were fever (4.3%), hypotension (2.9%), nausea (1.4%), dizziness (2.9%) and rash (1.4%), which could be reversible if treated properly. Radiotherapy combined with 100 mg h-R3 i. v. weekly was tolerable and did not aggravate the side effects of radiation. The quality of life in the combined therapy group was comparable to that in the control group.

CONCLUSIONThis phase 1 multicenter clinical trial shows that h-R3 in combination with radiotherapy is effective and well-tolerated for the treatment of locoregionally advanced nasopharyngeal carcinoma.

Adult ; Aged ; Antibodies, Monoclonal ; adverse effects ; therapeutic use ; Carcinoma, Squamous Cell ; pathology ; therapy ; Combined Modality Therapy ; Female ; Fever ; etiology ; Humans ; Hypotension ; etiology ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; therapy ; Neoplasm Staging ; Quality of Life ; Radiotherapy ; adverse effects ; methods ; Receptor, Epidermal Growth Factor ; immunology ; Remission Induction

Objective To design a multi-function first-aid module integrating instruments with the box to solve the existing problems in integration, operation, deployment, withdrawal, environmental adaptability and etc, so as to realize integrated storage, transport and operation of the instruments. Methods The module had its structure, modes of deployment and withdrawal, instruments buffering and vibration isolation, ergonomics and etc designed with the technologies of integrating box and instruments, integration, buffering and vibration isolation, centralized oxygen and power supply as well as the methods of system modeling,structure simulation and CAD.Results The first-aid module was gifted with the functions of respiratory and circulatory rehabilitation,vital signs monitoring,emergency treatment of complex and multi injuries, which could be used as a 2 000 mm×800 mm×600 mm emergency treatment platform when deployed. There were 4 angles for adjusting the backboard to form anti-shock positions for the severe casualties.The module had the time for deployment and withdrawal not more than 5 min,and was easy to deploy,withdraw,transport and store.Conclusion The module behaves well in structure,function,layout,operation and military service when used for the treatment of the severe casualties in the tent-form field medical system,which contributes to enhancing the casualty treatment efficiency and prognosis.[Chinese Medi-cal Equipment Journal,2018,39(5):12-16]

OBJECTIVETo evaluate the long-term effect of sodium glycididazole (CMNa) as a hypoxic radiosensitizer on the radiotherapy for nasopharyngeal carcinoma.

METHODSBetween May 1999 and May 2002, 211 patients with pathologically confirmed nasopharyngeal carcinoma were randomized into group-A treated by radiotherapy plus CMNa or group-B by radiotherapy alone. The staging was determined according to 92' Fuzhou staging systerm. The type, procession and dosage of radiotherapy were identical in both groups. The early adverse effect grade was assessed based on the CTC2.0 criteria and the late adverse effects were evaluated according to the RTOG/EORTC criteria. The median follow-up time was 52 months. All the data was analyzed by the SPSS 13.0 software. Characteristics and adverse events of these patients were compared between the two groups using t-test and the Wilcoxin rank sum test. Time-to-event curves were estimated using the Kaplan-Meier method. The prognostic parameters were analyzed using univariate analysis and the Cox multivariate regression analysis.

RESULTSThe clinical data of the two groups were comparable. The 3-year survival was 88.4% in group-A, while 75.2% in group-B, with a statistically significant difference between two groups (P = 0.010). Univariate analysis showed that the 3-year survival was statistically correlated with N-staging ((N0-1, 86.9%, N2-3 73.8%, P < 0.001), T-staging (T1-2 85.6%, T3-4 79.3%, P = 0.014), TNM staging (P = 0.039), and whether using CMNa or not during rediotherapy (Group-A 88.4%, Group-B 75.2%, P = 0.010). The 5-year recurrence-free survival, 5-year metastasis-free survival and 5-year overall survival were 75.8%, 74.9% and 77.7% in Group-A, while 63.0%, 63.0% and 62.4% in Group-B with a statistically significant difference between two groups (0.013, 0.022 and 0.010, respectively). If stratified in the subgroups, the overall survival of stage III - IV patients was statistically different between group A and B (P = 0.009), however, not of stage I - II patients (P = 0.502). Cox multivariate regression analysis showed that the independent prognostic parameters for survival were N-stage (RR = 3.288) , T-stage (RR = 2.147) and use of CMNa during rediotherapy (RR = 0.407). However, there was no statistically significant difference between two groups in acute or late adverse effects on nervous system or heart, which suggested that use of CMNa during radiotherapy would not aggravate the toxicity caused by radiotherapy.

CONCLUSIONSodium glycididazole is well tolerable effective as a hypoxic radiosensitizer, which can improve the efficacy of radiotherapy and the long-term result of nasopharyngeal carcinom a patients, especially for the stage III - IV patients.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Metronidazole ; adverse effects ; analogs & derivatives ; therapeutic use ; Middle Aged ; Multivariate Analysis ; Nasopharyngeal Neoplasms ; pathology ; radiotherapy ; Neoplasm Staging ; statistics & numerical data ; Prognosis ; Proportional Hazards Models ; Radiation-Sensitizing Agents ; adverse effects ; therapeutic use ; Time Factors ; Treatment Outcome ; Vomiting ; chemically induced

Objective To study the clinical experience on pancreaticoduodenectomy (PD) in thepast three years from a single operation group at the Cancer Institute and Hospital of Tianjin Medical Universiy.Methods The clinical data of 118 patients who underwent PD from January 2015 to December 2017 were collected and analyzed retrospectively.Results Of the 118 patients who underwent PDs,102 underwent open pancreaticoduodenectomy (OPD) (86.4％),and 16 laparoscopic pancreaticoduodenectomy (LPD) (13.6％).There were 54.2％ males with a age of (56.0±12.0) years (39.83％ over 60 years).Malignancy was confirmed by pathology in 73.7％ (87/118 patients).The operative time was (324.0±95.6) minutes.Intraoperative blood loss was (192.8±97.5) ml and R0 resection was achieved in all patients.The postoperative complication rate was 46.6％ (55/118).The median postoperative hospital stay was (19.9±9.5) days.There was no perioperative mortality.The operation time of LPD was significantly longer than OPD,but there was no significant difference in intraoperative bleeding,lymph node clearance,postoperative complication rate and postoperative hospital stay (P＞0.05).Conclusions PD is safe and feasible.The postoperative complication rate was relatively high but all patients were discharged from hospital after appropriate treatment.Compared with OPD,LPD is a better alternative for patients.