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.

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.

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.

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 review our clinical experience with primary surgical repair of tetralogy of Fallot in neonates and premature infants and to discuss the timing of repair and major factors in treating this patients perioperatively.Methods From January 2012 to September 2015,a series of 19 consecutive neonates and premature infants(M/F =12/7) with tetralogy of Fallot were admitted in our center to receive surgical treatment,with a mean age of(17.3 ± 5.5) days(12-28 days) and a mean body weight of(2.9 ±0.7) kg(2.1-4.3 kg).All the 19 cases were symptomatic with cyanosis,saturation on room air 0.79 ± 0.12 (0.48-0.92),and shortness of breath.Before operation,2 cases were receiving an infusion of prostaglandin E1,5 were mechanically ventilated.7 were more than moderate anemia with hemoglobin of 55-87 g/L.All the patients received echocardiography,ECG and chest X-ray.The McGoon ratio and Nakata index were 1.09 ± 0.30 (0.8 to 1.6) and (135.5 ± 54.2) mm2/m2 (63-212 mm2/m2) respectively.18 cases received one-stage surgical repair and 1 premature infant under two-stage operation with the VSD closure after right ventricular outflow tract(RVOT) transannular patch augmentation.All the VSDs in the 18 cases were closed with continuous suture and RVOT were enlarged with autologous pericardium patch transannularly or not.Balanced and modified ultrafiltration were applied in all the patients.Patients were strictly followed up with a standard protocol focusing on right ventricular function and arrythmia.Several characteristics(e.g.time of operating,mechanical ventilation and ICU stay,complications,hospital stay time,cost of hospitalization) were compared between this group of patients and other TOF patients during the same period in our center.Results All the one-stage operations were successful.There was no mortality and major complication.Mean CPB and aortic clamping time were(111.5 ± 31.6)min (76-153min) and (73.3 ± 11.6) min (64-89 min) respectively.10 VSDs were closed with transventricular approach,6 witht transatrial appraoch and 2 with transatrial-ventricular approach.12 cases (66.7 ％) had a transannular RVOT patch,4 (22.2 ％) with single RVOT patch and 2 (11.1％) with transannular RVOT and left pulmonary artery patch.Atrial communication were left open in 15 cases (83.3 ％).The time of mechincal ventilation and ICU stay were (123.7 ± 59.5) h (39-239 h) and (10.1 ± 3.2) days (5-19 days) respectively.All the patients were followed up for (31.8 ± 15.7) months (9-57 months).There was no mortality and major complication.ECG showed that there was no severe arrythmia except for 3 complete right branh bundle block.The latest echocardiography results showed that right heart function was normal in all the cases and RVOT grandients was less than 30mmHg except one with 35 mmHg.There were 2 cases with residual shunt less than 2 mm and 8 cases with pulmonary valvular regurgitation less than moderate degree.Compared with other TOF cases during the same period,there was no difference according to the data mentioned above except with more time of mechnical ventilation and ICU stay and more cost of hospitalization.Conclusion Primary repair of TOF can be performed safely in symptomatic neonates and premature infants,regardless of age and body weight,with favorable early and mid-term results.Excellent teamwork and accurate prenatal and postnatal diagnosis were the two major factors in yeilding good results in these patients.

Objective To investigate the clinical effects of endoscopic sphincterotomy (EST) or endoscopic retro-grade cholangiopancreatography (ERCP) and laparoscopic common bile duct exploration (LCBDE) combined with la-paroscopic treatment of gallbladder and common bile duct stones. Methods 80 patients suffered cholecystolithiasis with choledocholithiasis were selected from June 2013 to June 2015. According to surgical method, patients were di-vided into EST + LC group (38 cases) and LCBDE + LC + ERCP group (42 cases). Clinical data, treatment effects, postoperative complications rate related indicators of liver function were compared between the two groups. Results The maximum diameter of stones, diameter of common bile duct and the number of stones in LCBDE + LC + ERCP group were significantly longer and larger than EST + LC group, the differences were statistically significant ( <0.05). Compared with EST + LC group, single success rate of ERCP + LC + LCBDE group was higher, operative time was shorter, but its operation cost was higher, the differences were statistically significant ( < 0.05). The suc-cess rate, rate of conversion to laparotomy and hospital stay between the two groups showed no significant difference ( > 0.05). Postoperative complication rate of ERCP + LC + LCBDE was 21.42 %(9/42), and postoperative compli-cation rate of EST+ LC was 26.32 % (9/42), the difference between the two groups were not clear ( > 0.05). The serum direct bilirubin, alanine aminotransferase and aspartate aminotransferase in the two groups were increased slightly after one day of operation, and those indexes returned to normal levels after three days of operation. Conclusion The operation methods of LCBDE+LC+ERCP and EST+ LC are both effective treatment for compli-cated choledocholithiasis. The success rate of LCBDE+LC+ERCP is higher, the operative time is shorter, which is good for larger stones.

Objective　To clone the partial positive regulatory fragment of Na+/H+ exchanger-1 (NHE-1) gene from human lung cancer cells. Methods　After BamHⅠ and EcoRⅠ cut sites were added to the 5' ends of the upstream and downstream primers respectively, the partial positive regulatory sequence of NHE-1 gene was cloned with the length of 170 bp from genomic DNA of lung cancer cell line A549 cells with PCR method. The cloned fragment was ligated to plasmid pUC18. Finally, the constructed recombinant was identified with enzyme cut, PCR and DNA sequencing. Results　The cloned fragment was about 170 bp in size and successfully ligated to pUC18 with identifiation of double enzyme cut and PCR. DNA sequencing approved that the fragment cloned was objective one with 168 bp in length. Compared with the reported sequence, two t were lost. Conclusion　The positive regulatory fragment of NHE-1 gene from human lung cancer cells was successfully cloned.

Objective To evaluate the therapeutic efficacy of gamma knife in treatment of primary trigeminal neuralgia Methods Retrospectively analysis of 120 cases with primary trigeminal neuralgia treated by gamma knife in our department From Jan. 2003 to Mar. 2008 were performed. All cases were treated with the 4 mm collimator and targeted at the proximal nerve at the root entry zone located by MRI. The target dose varied from 80 -90 Gy. Results After a follow-up of 20. 0 ±4. 5 months, complete relief of pain occurred in 69 patients (57. 5%), 50% -90% relief in 34 (28. 3%), relief less than 50% in 12(10.0%) but no relief in 5(4.2 %).The efficient rate was 95. 8% . The common complications include numbness, absence of corneal reflex. 83 patients (69. 2%) experienced temporal facial numbness and 14 patients (11. 7%) reported continuous numbness after treatment of the gamma knife. Conclusions Gamma knife radiosurgery is a minimally invasive technique for the treatment of primary trigeminal neuralgia with few complications.