Objective To compare the disadvantages and advantages of open thyroid surgery when using the harmonic scalpel (HS) vs conventional hemostasis (CH). MethodsOne hundred and fifty-one patients and 70 patients underwent thyroid surgery with HS or CH respectively. The tumor diameter, incisional length, the total operative time, thyroidectomy time, intraoperative bleeding volume, postoperative drainage volume and surgical complications were compared. The incisional length and the surgical complications in and after learning curve with harmonic scalpel were compared. ResultsThere was no significant difference between the HS and CH group at baseline. Incisional length, total operative time, thyroidectomy time, intraoperative bleeding volume and postoperative drainage volume in HS group were significantly lower than those of CH group (P0.05); the incisional length after learning curve was shorter than that in learning curve in HS group (P

Objective To assess the value and usage of real-time monitoring of the recurrent laryngeal nerve (RLN) during thyroid reoperation by RLN monitor. Methods One hundred and one patients were under general anesthesia and thyroidectomy. NIM-Response electromyographic (EMG) monitor system was used for assistant of dissection,exposure and protection of the RLN during the surgical procedures. Results There were 192 RLN were exposed during the surgeries in all 101 patients. The unilateral RLN injured in 10 patients was not specially explored the same side nerve. Among them 190 nerves were confirmed intact,the rest 2 nerves were resected because of tumor involving. Conclusion s NIM-Response electromyographic monitor system is sensitive and accurate for preserving the integrity of RLN during the thyroid reoperations. It is valuable for protecting RLN against iatrogenic injury. This system deserves general utilization for thyroid surgery,especially reoperation.

Background and purpose:The prognosis of ovarian cancer is poor and the diagnosis is relatively late. It is needed to search for early diagnosis and treatment for ovarian cancer. This study investigated the expression of serum miRNAs in patients with malignancy or benign ovarian tumor preoperativey and analyzed its correlation with clinicopathological progress and prognostic features of epithelial ovarian cancer.Methods:Forty-eight miRNAs which have been reported to be related to ovarian cancer were ordered. The differential expression of 48 miRNAs in the serum of patients with malignant or benign epithelial ovarian tumors was detected by TaqMan low density array. The differentially expressed miRNAs were further confirmed by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR). The relationship between the expression level of selected miRNA and clinical clinicopathological factors, progress and prognosis were analyzed.Results:TaqMan low density array and further RTFQ-PCR showed that only miR-125b was sig-nificantly increased in 135 ovarian cancer patients as compared with 38 individuals with benign tumor. The expression of miR-125b was higher in early stage patients than that in advanced stage patients (P=0.039). The patients without residual tumor expressed more miR-125b than patients with residual tumor (P=0.013). The high level of miR-125b was signifi-cantly correlated with longer progress free survival (PFS) (P=0.003), but not correlated with overall survival (OS) (P=0.069). Conclusion:MiR-125b may play an important role in the pathogenesis of epithelial ovarian cancer and prognosis. It may be a potential gene to predict the recurrence of epithelial ovarian cancer, but the change of gene expression at different stages and its underlying mechanism need further research.

Adult ; Aged ; Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; Carcinoma, Squamous Cell ; therapy ; Chemoradiotherapy ; Diarrhea ; chemically induced ; Dose-Response Relationship, Drug ; Female ; Humans ; Leukopenia ; chemically induced ; Middle Aged ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; therapeutic use ; Radiotherapy, Conformal ; Thrombocytopenia ; chemically induced ; Uterine Cervical Neoplasms ; therapy ; Vomiting ; chemically induced

Objective To explore the extent of axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes.Methods In this series,95 patients underwent complete axillary lymph node dissection (CALND) following positive sentinel lymph nodes identified and 97 patients underwent partial axillary lymph node dissection (PALND) at the absence of positive sentinel lymph nodes.The influence of different extent of axillary lymph node dissection was evaluated.Results The positive rate of level(Ⅰ + Ⅱ) non-sentinel lymph nodes (NSLN) and level Ⅲ lymph nodes was 68.4％ and 29.5％,respectively,in CALND group.In PALND situation,57.9％ CALND cases would have changed pathologic stage from pN1 to pN2 or pN3.But with level Ⅲ lymph node dissection followed PALND,only 2.1％ cases had changed pathologic stage from pN2 to pN3.Multivariate logistic regression showed that the number of positive SLNs (OR =2.157) and positive rate of SLNs (OR =10.374) were risk factors for having positive level Ⅲ lymph nodes.CALND needed longer operation time and larger postoperative drainage volume.Conclusions In cases of breast cancer with ≥ 3 positive sentinel lymph nodes,complete axillary lymph node dissection should be considered.

Objective To investigate the value of differential diagnosis of the configuration of QRS complex in lead aVR in patients with inferior wall myocardial infarction. Methods The configuration of QRS in 52 patients with pathological Q-wave both in lead Ⅲ and aVF were analyzed and the result of selective coronary arteriography was compared. Results 13 patients with the configuration of QRS in lead aVR appeared rS ( s), while 10 patients appeared QS(qs) and 29 Q(q)r,correlated with 12,4 and 0 patients with coronary arteriography showed stenosis or occlusion lesion in fight coronary artery or left circumflex artery (χ2 = 35.56, P = 0.000). Conclusions The con-figuration of QRS in lead aVR is helpful to differential diagnosis of the patients with pathological Q-wave both in lead Ⅲ and aVF. Patients with the configuration of QRS in lead aVR appear rS(s) could be diagnosed as old myocardial infarction,but excluded from old myocardial infarction while appearing Q(q)r.

Objective To explore the origin of the regenerating axons which grow into peroneal nerve after"?" fashion double end to side neurorrhaphy to tibial nerve Methods The right peroneal nerve of Wistar rat was cut about 5mm long segment off, the proximal and distal stumps of it were end to side coapted to the windows, opened by removing the epineual sheath on the tibial nerve trunk with 7～10mm distance At 18 months after the operation, the action potential(AP) between distal segment of peroneal nerve and proximal peroneal/or tibital/or sciatic nerve was tested Aftr that, the distal segment of peroneal nerve was removed and embed by resin, and semithin section and superthin section were observed by light or electronic microscope Results The morphological study clearly revealed that there were correspondent regenerating axons in the distal peroneal nerve segment, meanwhile the AP through the distal peroneal and proximal tibial/or peroneal nerve was measured clearly Conclusion "?" double end to side suturing to tibial nerve fashion neurorrhaphy can cause nerve regeneration from proximal tibial and or proximal peroneal to distal peroneal nerve

Objective To study the clinical value of Na+/I-symporter(NIS)expression on thyroid carcinoma diagnosis and 131I therapeutic effects prediction.Methods Thirty-one cases of thyroid carcinomas enrolled in this hospital from 1998 to 2006 were included.Using immunohistochemical method,NIS expression location,positive cell staining and expression intensity were observed,which was calculated by immunohistochemical scores(IHS)and NIS expression level was compared between primary and metastatic carcinoma.Results NIS was over-expressed on the basolateral membrane in positive control——Grave disease tissue,and showed no staining in negative control.NIS was expressed in cytoplasm in all 31 primary carcinomas,and IHS was over or equaled to 4 in 80.65% of them.Except for 2 no staining,NIS was expressed in cytoplasm in the rest 28 metastatic carcinomas.NIS expression was related to the pathological type of thyroid carcinoma,the strongest in PTC,then FTC,and the weakest in fvPTC.NIS expression in metastatic carcinoma was related to that in primary carcinoma.Conclusion NIS is over-expressed in cytoplasm in most thyroid carcinoma,and the iodide uptaking defect is mainly due to its wrong location.It has great potential to be applied in clinic by that it can help with the differential diagnosis of benign and malignant thyroid diseases,especially between FTA and FTC,and that it can help predict the therapeutic effects of 131I therapy following thyroid operation.

OBJECTIVE To investigate the role of TLR4 signaling pathway in secretory otitis media of rats.METHODS Rats SOM models were made by infusing FS and LPS to the middle otocysts. The rats were killed separately at the 3rd, 5th, 7th, 9th,11th and13th day(5 rats each time). And then the expressions of TLR4, iNOS, IL-8mRNA of middle ear mucosae were detected. NF-?B was also detected through the method of immunohistochemistry. RESULTS The expressions of TLR4mRNA, iNOS and IL-8mRNA in middle ear mucosae of SOM group were significantly higher than that of control group. Immunohistochemistry method showed that the activation of NF-?B in middle ear mucosae was obviously increased in SOM. CONCLUSION The expression of TLR4 was obviously increased in SOM and it activates the NF-?B, promotes the expression of downstream IL-8. That maybe the mechanism which cause SOM.

Objective:To explore the relations of adolescents'behavioral problems to genetic and environmental factors.Methods:66 twin pairs aged 12 to 18 years in Chongqing were included in the study.The Youth Self-Report (YSR) was used to evaluate behavioral problems.The blood sample was collected to identify zygosity of twins.Genetic effects were evaluated by comparing the phenotypic correlationamong monozygotic twins(rMZ) and the phenotypic correlation among dizygotic twins(rDZ).Structural equation modeling (SEM) was performed to evaluate the relations of adolescents behavioral problems to the additive genetic factors (A),shared environment factors (C) and individual specific environmental factors (E).Results:MZ correlations of Social problems and Delinquency were less than DZ correlations(rMZ ＜ rDZ).It prompted that data was not suitable for genetic analysis.MZ correlations(rMZ) of any others (including social withdrawal,somatic complaints,anxiety/depression,thinking problem,attention problems,self-destructive/identity problem)were less than 2DZ correlations (2rDZ).It prompted to fit the ACE model.The optimal model was AE model.Among the contribution of the additive genetic factors (A) and individual specific environmental factors (E)to the total variance,the genetic factors ranged from 0.52 to 0.57 and individual specific environmental factors ranged from 0.43 to 0.48 in anxiety/depression and self-destructive/identity problem.For social withdrawal,somatic complaints,thinking problem and attention problems,the genetic factors ranged from 0.17 to 0.45and individual specific environmental factors ranged from 0.55 to 0.83.Conclusion:There is no obvious relationship between genetic effects and adolescent social problems or delinquency.Other behaviors problems (social withdrawal,somatic complaints,anxiety/depression,thinking problem,attention problem,self-destructive/identity problem)are correlated with additive genetic factors and individual specific environmental factors.Additive genetic factors have high-correlation with anxiety/depression and self-destructive/identity problem,and individual specific environmental factors have high-correlation with other factors.