Objective To investigate the effects of compound danshen dripping pill (CDDP) on carotid intima￣media thickness (CIMT) and cardiac function in patients newly diagnosed as hypothyroidism. Methods The total of 40 subclinical hypothyroidism patients and 40 hypothyroidism cases was enrolled.The clinical hypothyroidism patients were treated with L￣T4 as the conventional treatment, and comprehensive CDDP plus levothyroxine (L￣T4 ) as treated groups (CDDP group) for 6 months. The therapeutic effect was evaluated by combining with data of thyroid function, blood lipid profile and ultrasound.The 40 healthy subjects were chosen as normal control group. Results Compared with normal control group, the levels of TC and LDL￣C were higher (P<0.05) in subclinical hypothyroidism group, which were more obvious in the clinical hypothyroidism group (P<0.01), CIMT increased markedly (P<0.05), the left ventricular systolic functions (ejection fraction) and diastolic functions (mitral flow velocity E and A wave ratio) were markedly decreased (P<0.05) in the clinical hypothyroidism group.Upon treatment, the blood￣lipids were improved (P<0.05), CIMT were reduced (P<0.05), the left ventricular functions were restored to near normal with the attainment of euthyroidism in both groups of clinical hypothyroidism;the reduction of CIMT and the improvement of the left ventricular functions were faster in CDDP group than that in the conventional treatment group (P<0.05). Conclusion Disturbance of blood lipid in hypothyroidism patients, CIMT growth and impaired left ventricular function objectively indicate the existence of cardiac and cerebral vascular risk, while CDDP helps improving lipid metabolism, reversing CIMT and cardiac function, reducing cardiovascular risk, blocking or delaying cardiovascular event chains.

Objective To explore the correlation among serum immunoglobulin G4 (IgG4),transforming growth factor-β1 (TGF-β1),connective tissue growth factor (CTGF) and Hashimoto thyroiditis (HT) thyroid fibrosis.Methods Case-control study.A total of 159 patients with HT visiting the Wuhan Union Hospital were collected from May 2013 to March 2015.All patients were divided into IgG4 HT group (IgG4≥1.35 g/L,n =39) and non-IgG4 HT group (IgG4 ＜ 1.35 g/L,n =120).The serum IgG4,TGF-β1 and CTGF were determined by enzyme-linked immunosorbent assays.The levels of serum thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured by electrochemiluminescence immunoassay.Meanwhile,ultrasound of the thyroid gland was performed.Statistical analysis was performed by use of SPSS 17.0 software.The Mann-Whitney U test was used to compare two independent samples of non-normal distribution data,Fisher's exact test was employed to analyze thyroid imaging differences,correlation test was performed to examine various correlations,multivariate Logistic regression analysis was used to evaluate thyroid fibrosis risk factors.Results Compared with that of non-IgG4 HT group,IgG4 HT group:TPOAb [(455.2 ± 169.7) vs.(186.5 ± 102.3),U =27.0,P=0.003],TgAb [(984.6±452.7) vs.(289.3 ±245.1),U=30.5,P=0.017],TGF-β1 [(1.45±0.97) vs.(0.30±0.22),U=119.0,P=0.035] andCTGF [(88.65±14.39) vs.(62.21± 8.76),U =69.0,P =0.039] were significantly higher,thyroid ultrasound showed obvious fibrosis (35/4 vs.32/88,x2 =48.03,P =0.000);significant positive linear correlation between IgG4 and TPOAb (r =0.719,P =0.000),CTGF and TGF-β1 (r =0.500,P ＜ 0.01) respectively.Logistic regression analysis indicated that all the serum IgG4,TPOAb,TGF-β1 and CTGF were independent risk factors of thyroid fibrosis [IgG4,odds ratio (OR) =1.968,P =0.014,95％ confidence interval (CI) =1.287-2.041;TPOAb,OR =2.537,P =0.012,CI =1.322-2.869;TGF-β1,OR =1.549,P =0.023,CI =1.105-1.498;CTGF,OR =1.185,P =0.046,CI =1.204-1.625].Conclusion The highlevel of circulating antibodies,IgG4,TGF-β1 and CTGF were significantly associated with thyroid fibrosis,and were independent risk factors of HT fibrosis.

Objective:To explore the serum IgG4 level in patients with IgG4-related Hashimoto thyroiditis(IgG4 HT),and its clinical implications.Methods:The serum IgG4 was determined in 129 patients with HT using enzyme-linked immunosorbent assays and classified into two subgroups based on IgG4 level:IgG4 HT group(IgG4≥135 mg/dl)and non-IgG4 HT group(IgG4<135 mg/dl).And the levels of serum thyroid hormone and thyroid peroxidase antibodies(TPOAb)and thyroglobulin antibodies(TgAb)were measured by electro-chemiluminescence immunoassay.Ultrasonic imaging of the thyroid gland were detected.Results:The TPOAb levels correlated significantly with both serum IgG4 levels(r=0.437 1,P=0.012 7)and IgG4/IgG ratios(r=0.396 2,P=0.023 5)in the patients with HT.Compared with that of non-IgG4 HT group(n=97),IgG4 HT group(n=32):①The mean age was lower(P=0.029 3);②Higher levels of serum TPOAb(P=0.002 1)and TgAb(P=0.012 8);③Ultrasound imaging:the more obvious thyroid nodule(P=0.022 6);④Logistic regression analysis showed that serum IgG4 and TPOAb were the risk factor for thyroid nodules(OR=1.672,P=0.021;2.549,P=0.014 ).Conclusion: IgG4 HT patients existed corresponding clinical characteristics.For the HT-patients with elevated serum IgG4,thyroid function and morphology should were more closely monitored.

We report the results of nephrectomy under laparoscopy for 3 patients. Three patients were subjected to laparoscopy for the treatment of hydronephrosis of no function under general aneshesia. Succesiful operation was performed in the 3 patients without complication, the average operation time being 240 minutes, and hospitelization duration averaging 4.5 days.

AIM: To investigate the alteration and its significance of T help 17 cells(Th17) in patients with chronic lymphocytic thyroiditis(CLT). METHODS: Patients were divided into 3 groups: CLT patients with euthyroidism (n = 15), CLT patients with hypothyroidism (n = 30) and healthy control group(n = 20). The ratio of Th17 lymphocytes subpopulations in the preipheral blood were evaluated by technique of flow cytometry. Production of thyroid autoantibody (TPO-Ab, TG-Ab) were measured by electro-chemiluminescence immunoassay (ECLIA). RESULTS: Compared with the healthy control group, in CLT group: The frequencies of Th17 in peripheral blood were found to be significantly higher in patients with CLT than healthy control group (P < 0.01); Production of TPO-Ab and TG-Ab markedly increased in CLT patients than healthy control group (P < 0.01). There was significant correlation between the positive expression of thyroid autoantibody and the changes of Th17 subpopulations (r=0.50, r=0.43 respectively; P < 0.01). CONCLUSION: The frequencies of Th17 cell increased in patients with CLT which may suggest a potential role for Th17 in the progression and happen of CLT.

Adult ; Bone Neoplasms ; pathology ; surgery ; Femur ; pathology ; surgery ; Humans ; Male ; Osteochondroma ; pathology ; surgery ; Young Adult

Objective To investigate the expression and significance of Insulin like growth factor-ⅡmRNA binding protein3 (IMP3) in gastrointestinal stromal tumors (GIST). Methods One hundred and fifteen cases of GIST were subjected to immunohistochemical staining for IMP3 (SP method) and ki67 (iVisionTM method ). The relationship between IMP3 expression with clinicopathologic parameters and Ki67 proliferation indexes were analyzed. In situ hybridization detection of IMP3 mRNA was performed in 20 cases of GIST positive. Results The expression rate of IMP3 was 56.2%(65/115) in GIST positive. A significant correlation can be found between IMP3 expression and tumor of infiltration , coagulative necrosis , metastasis , nuclear atypia , diameter , mitotic count , risk grade of NIH (P < 0.05), while there was no significant correlation between IMP3 and gender, age, primary location, categories of cell type (P>0.05). There was positive correlation of IMP3 expression and Ki67 labeling indexes by Spearman analysis. Positive expression with IMP3 can be observed in 3 cases of recurrence.It may play important role in invasive and development and may be an important factor of prognosis in GIST.

Objective:To consolidate ten years of clinical experience on the application of breast fiberoptic ductoscopy (FDS) in breast intra-ductal lesion. Methods:The clinical data of 1 368 cases of patients with nipple discharge were retrospectively collected and analyzed. Results:Significant differences were observed in the FDS diagnoses of patients with nipple discharge. The rates of tumor de-tection by FDS diagnosis were significantly higher when bloody and serous nipple discharge was used rather than milky and watery nip-ple discharge. For non-tumor nipple discharge, local drug perfusion via FDS was an effective treatment. A total of 303 patients had tu-mor resection or segmentectomy under localization via FDS, and 44 had segmentectomy after breast duct infusion of methylene blue. The diagnostic rate of localization via FDS (97.0%) was higher than that of breast duct infusion of methylene blue (86.4%). Conclu-sion:FDS is an accurate method for diagnosing patients with nipple discharge. In addition, it is also a good local drug perfusion method for patients with breast inflammatory nipple discharge ductoscopy. For patients with tumorous nipple discharge, localization via FDS can help improve the detection of the lesions, which can be removed by surgery.

Objective To study the early diagnostic value of olfactory function measurement to Alzheimer disease (AD). Method Detected the thresholds of detectability, identification threshold with pictu.re-based odor identification test in 21 AD patients (AD group) and 21 healthy elderly people (control group), and evaluated the relationship with mini-mental state examination (MMSE). Results AD group was impaired on threshglds of detectability [(1.81±0.75) scores], identification threshold [(2.48±0.68) scores]compared with control group [(1.24±0.89) scores and (2.00±0.71) scores, P< 0.05]. The thres holds of detectability and identification threshold were related to MMSE in AD group (r =-0.50,-0.54, P< 0.01). Conclusion The early diagnostic value of olfactory function measurement to AD is very great.

Objective To reveal the changes of catecholamine and lactate levels in myocardial interstitial fluid during cardiopulmonary resuscitation in order to prove the protective effects of sildenafil pretreatment on post-resuscitation myocardial function in swine model of ventricular fibrillation (VF).Methods Twenty-four swine were randomly (random number) divided into three groups:saline group,sildenafil group and shame operation group.Sildenafil in dose of 0.5 mg/kg dissolved in 40 mL of saline was given to swine once intraperitoneally 40 min prior to VF in sildenafil group.The equivalent volume of saline (0.9％ NaC1) alone was administered instead in saline groups.There was no treatment in shame operation group.After ventricular fibrillation untreated for 8 min,open-chest cardiopulmonary resuscitation was initiated.The hemodynamic variables were recorded at baseline,4 min,1 h and 6 h after restoration of spontaneous circulation (ROSC).The interstitial fluid from the left ventricle wall was collected by using the microdialysis tubes at given intervals,in which the levels of dopamine,norepinephrine,epinephrine,and lactate were measured.The samples for pathological examination were taken at 24 hours after ROSC.Results The levels of catecholamine and lactate in the sildenafil group were lower than those in saline group at all different intervals (P ＜ 0.05 or P ＜ 0.01).The cumulative defibrillation energy was lower in the sildenafil group than that in the saline group (P ＜ 0.05).The hemodynamic changes and myocardial histological damage in sildenafil group were milder than those in saline group (P ＜ 0.05).The pathologic changes of myocardium and mitochondria in saline group were more severe than those in sildenafil group.Conclusions Sildenafil pretreatment prior to VF can effectively reduce endogenous catecholamine secretion and lactate levels in myocardial tissue,protecting the myocardium and improving post-resuscitation myocardial function.