Purpose:To study the significance of resecting the lymph nodes adjacent to the recurrent laryngeal nerve in the operation on cNo thyroid papillary carcinoma,and its value inselecting the fashion of operation .Methods:Reviewing the clinical-pathological material of 186 cases of cNo thyroid papillarycary cinoma,and analyzing the relationship between lymph nodes adjacent to the recurrent laryngeal nerve and lateral cervical nodes metastasis. Results:Of 186 cases of cNo thyroid papillary cacinoma,there were 42.5% (79/186) with metastatic lymph nodes adjacent to the recurrent laryngeal nerve,63.2% of which had lateral cervical nodes or distant metastasis,while only 8 cases had metastasis in the negative group. Conclusions:The thyroid papillary carcinoma with metastatic nodes adjacent to the recurrent laryngeal nerve means there is a higher chance of metastasis in regions of the neck. Resecting the lymph nodes adjacent to the recurrent laryngeal nerve and frozed pathological examination can be a basis to determine whether redical neck dissection should be performed.

Objective To explore the histological changes of the wrist interosseous ligaments after radiofrequency electrothermal shrinkage. Methods Six frozen fresh male adult cadaver wrist ligaments were exploited for the research. The ligaments of the right wrists were treated with radiofrequency electrothermal shrinkage with Arthrocare system, while the ligaments of the left wrists were kept as the normal control. The bone-ligament-hone samples of all the scapholunate (SL) and lunotriquetral (LT) ligaments were prepared, sectioned and then stained with the regular HE staining, toluidine blue staining, Sirius-red staining and immunohistochemistry staining of collagen Ⅲ. The image analysis software was used to compare the staining results. Results The histological structures of SL dorsal ligaments (SL-d) and LT volar ligaments (LT-v) were very similar, and the structures of SL volar ligaments (SL-v) and LT dorsal ligaments (LT-d) were also very similar. The membrane parts of both SL and LT ligaments showed the fibrous cartilage structure. The histological structures of SL-d and LT-v were much less destroyed by the radiofrequency than those of SL-v and LT-d. After radiofrequency electrothermal shrinkage, only the distribution areas of collagen Ⅰ and collagen Ⅲ were significantly changed in the membrane parts of SL and LT ligaments. Conclusion Radiofrequency electrothermal shrinkage treatment can cause minor structural damage to the collagen-dominant ligaments such as SL-d and LT-v, while it can lead to quite severe structural damage to the ligaments containing collagen and lots of loose connective tissue, such as SL-v and LT-d.

BACKGROUND: As a reliable marker of inflammation, intercellular adhesion molecule-1 (ICAM-1) plays an important role in atherogenesis. Recently, it is assumed in researches of recent years that chronic inflammation mediated by ICAM-1 is involved in hypertensive left ventricular hypertrophy probably, but there are still some objections reported. Tanshinone ⅡA is a kind of liposoluble extract from danshen(Radix Salviae Mitiorrhizae) . It is verified in animal experiment that it can inhibit hypertensive left ventricular hypertrophy.OBJECTIVE: To investigate the relationship between ICAM-1 and hypertensive left ventricular hypertrophy and the effect of tanshinone ⅡA on expression of ICAM-1.DESIGN:A randomized controlled observation was designed.SETTING: Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was performed in the Laboratory of Emergency Department of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from October 2002 to January 2004. Ten male WKY rats(10 WKY rats) of 12-week-old and 20 rats with spontaneous hypertension(20 SHR rats) were employed and divided into the control group(10 WKY rats), hypertension group(10 SHR rats) and tanshinone ⅡA group(10 SHR rats).injected from caudal vein for treatment and distilled water at the same dose was injected in the other two groups. Twelve weeks later, the rats were sacrificed and myocardium was collected for specimen preparation. Haematoxylin and eosin(HE) staining, VG staining, immunocytochemical staining and myocardial ED1 labeling were applied to determine myocardial macrophage infiltration degree. The reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay(ELISA) were used to determine the expressions of ICAM-1 mRNA and protein.MAIN OUTCOME MEASURES: Degree of macrophages infiltration and the expressions of ICAM-1 mRNA and protein in myocardium in each group.RESULTS: Twelve SHR and 10 WKY rats were employed in the experiment pared with the control group, ICAM-1 mRNA and protein expressions in hypertrophic myocardium were increased significantly in hypertension group (0.176±0.087,0.537±0.195;0.104±0.011,0.173±0.027, P ＜0.01or P ＜ 0.05) . Infiltration of macrophage was significant(0. 62 ±0.07,non Ⅱ A group, the expressions of ICAM-1 mRNA and protein were decreased significantly(0. 537 ±0. 195, 0.291 ±0. 106; 0. 173 ±0.027, 0. 125± 0. 014, P ＜ 0.01 or P ＜ 0. 05); the amount of macrophages infiltration was decreased(1.85 ±0. 23, 1.16 ±0. 17, P ＜ 0.05) and the degree of cardiomyocytic hypertrophy and interstitial fibrosis was remarkably relieved.CONCLUSION: Excessive expression of myocardial ICAM-1 and its mediated inflammatory cellular infiltration plays an important role in hypertensive left ventricular hypertrophy. The inhibition of tanshinone ⅡA on left ventricular hypertrophy may be contributed to decreased expression of ICAM-1 and alleviated inflammatory cellular infiltration in myocardium.

Objective To study the correlation between alanie aminotransferase(ALT) unqualified samples and hepatitis B sur‐face antigen(HBsAg) and hepatitis C virus antibody (anti‐HCV) detection and to investigate an effective measure for reducing the discard rate of donated blood .Methods 330 633 blood samples donated by volunteers in Shenzhen Municipal Blood Center from January 1 ,2009 to December 31 ,2013 were performed the ALT ,HBsAg and anti‐HCV detection .Then the correlation between the detection results of ALT and viral hepatitis .Results Among 33 0633 donated blood samples ,there were 932 cases (0 .282% ) of ALT positive and 2 965 cases (0 .897% ) of viral hepatitis positive ,the differences were statistically significant (P<0 .05) .915 cases were unqualified in ALT ,but negative in viral hepatitis ,which accounting for 98 .176% of all ALT unqualified samples ;the blood discard rate generated by ALT disqualification was 0 .277% (915/330633) .Conclusion Our study indicates that the statistical difference exists in the ALT unqualified rate and the viral hepatitis detection rate ,conducting the ALT detection has the lower coin‐cidence rate for expected viral hepatic ,many false positive lead to the discard of normal blood .Therefore ,whether to continue using the ALT detection as the auxillary detection indicator is still being negotiated .

To explore the clinical classification of hamate hook fracture and the treatment strategy for different type of fractures, 12 patients who suffered from hamate hook fractures were followed up retrospectively. According to the fracture sites and the prognosis, we classified the hamate hook fractures into 3 types. Type I referred to an avulsion fracture at the tip of hamate hook, type II was a fracture in the middle part of hamate hook, and type III represented a fracture at the base of hamate hook. By the classification, in our series, only 1 fell into type I, 7 type II, and 4 type III. The results were evaluated with respect to the functional recovery, recovery time and the association among the clinical classification, pre-operative complications and treatment results. The average follow-up time of this group was 8.4±3.9 months. Two cases were found to have fracture non-union and both of them were type II fractures. Six patients had complications before operation. Five cases were type II fractures and 1 case type III fracture. All the patients were satisfied with the results at the time of the last follow-up. Their pain scale and grip strength improved significantly after treatment. All the pre-operative complications were relieved. The recovery time of hamate hook excision was significantly shorter than that of the other two treatments. The incidences of both pre-operative complications and non-union in type II fractures were higher than those in type I and type III fractures. It was concluded that, generally, the treatment effects with hamate hook fracture are quite good. The complication incidence and prognosis of the fracture are closely related to the clinical classification. Early intervention is critical for type II fractures.

Objective To discuss the diagnosis and treatment of iatrogenic urethral injuries and preventive measures.Methods Various clinical parameters in 26 cases of iatrogenic urethral injury between January 2006 to January 2014 were analyzed retro-spectively.Results Twenty-five cases were confirmed in the operation,1 case of confirmed 2 days postoperatively.All patients were follow-up visit for 3-24 months normal renal function,only 1 case of urethral stricture.Conclusion Through effective prevention, early diagnosis and treatment,close follow-up visit can minimize the patient′s occurrence of iatrogenic urethral injury.

Objective: To investigate the trends in incidence of HIV/AIDS in China from 1990 to 2019 and to examine the effect of age, period and cohort on the incidence of HIV/AIDS, so as to provide insights into the improvements of the HIV/AIDS control measures. Methods: Data pertaining to incidence of HIV/AIDS in China from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 (GBD 2019) datasets, and the trends in incidence of HIV/AIDS in China from 1990 to 2019 was analyzed with annual percentage change (APC) and average annual percentage change (AAPC) using a jointpoint regression model. The effects of age, period and cohort on the incidence of HIV/AIDS in China were examined with an age-period-cohort model. Results: The age-standardized incidence of HIV/AIDS appeared an overall tendency towards a rise in China from 1990 (0.80/105) to 2019 (2.21/105) (AAPC=3.209%, P<0.05), and the incidence of HIV/AIDS showed a tendency towards a rise from 1990 to 1997 (AAPC=9.044%, P<0.05) and from 1997 to 2003 (AAPC=17.598%, P<0.05), a decline from 2006 to 2014 (AAPC=-8.412%, P<0.05) and remained relatively stable from 2003 to 2006 and from 2014 to 2019 (both P>0.05). The incidence of HIV/AIDS appeared a tendency towards a rise with age, and peaked among patients at ages of 25 to 29 years (4.93/105) and 75 to 79 years (7.38/105). The risk of HIV/AIDS appeared a tendency towards a rise followed by a decline with time, and a reduced risk of HIV/AIDS was found from 1990 to 1994 (RR=0.297), from 1995 to 1999 (RR=0.523), from 2005 to 2009 (RR=0.737), from 2010 to 2014 (RR=0.412) and from 2015 to 2019 (RR=0.351) in relative to the period from 2000 to 2004. The risk of HIV/AIDS appeared a tendency towards a rise with the cohort, and a higher risk of HIV/AIDS was found in the 1930-1934 cohort (RR=1.880) and 2000-2004 cohort (RR=2.978) in relative to the 1955-1959 cohort. Conclusions The incidence of HIV/AIDS appeared a tendency towards a rise followed by a decline in China from 1990 to 2019, and remained at a low level since 2014. The adolescents and elderly were high-risk groups of HIV/AIDS. A variety of health education interventions and intensified active HIV/AIDS screening are recommended.

Objective To evaluate the accuracy of contrast enhanced ultrasonography (CEUS) in determining the depth of myometrial invasion in endometrial carcinoma in stage Ⅰ.Methods Seventy-six patients previously diagnosed of endometrial carcinoma by curettage of uterine underwent transabdominal sonography (TAS) and CEUS to assess myometrial invasion,among which 48 patients proved to endometrial carcinoma in stage Ⅰ after total abdominal hysterectomy and bilateral salpingo-oophorectomy were studied.The findings of TAS and CEUS to determine endometrial carcinoma IA (no myometrial involvement or invasion of the inner half of the myometrium) and IB( invasion of the outer half of the myometrium) were compared with pathology after abdominal hysterectomy.Results Twenty one tumours (43.75%,21/48) were enhanced earlier than or simultaneously as myometrium and cervix,among which 12 cases were IA stages,while 9 cases were IB stages (P<0.05);and 27 tumors (56.25%,27/48)were enhanced late than myometrium and cervix.There was no statistical difference between TAS and CEUS in detecting endometrial carcinoma in IA and IB(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of TAS and CEUS in diagnosing endometrial carcinoma in IB were 61.25% vs 69.23%,77.14% vs 85.71%,50.00% vs 64.28%,72.92% vs 88.23%,72.92% vs 81.25% respectively.Conclusions CEUS is not superior to TAS in detecting deep invasion of endometrial carcinoma in stage Ⅰ.

Objective To quantitatively analysis the aortic valve leaf anatomical characteristics in aortic regurgitation(AR) patients by real-time three-dimensional transesophageal echocardiography (RT-3D-TEE),and screening the parameters which significantly affect AR to further reveal the mechanism of AR.Methods 32 patients with AR were enrolled as AR group and 20 cases of non-AR people were involved as control group.RT-3D-TEE was using to collect images in two groups and offline analysis was performed.4 sets of parameters of the aortic valves(left coronary valve,right coronary valve,and non-coronary valve):leaflet edge length(LL,RL,NL),leaflet height (LH,RH,N H),leaflet length/height ratio (LRa,RRa,NRa),leaflet tip plane distance(LTH,RTH,NTH) were acquired.Parameters of two groups were compared,and the parameters were incorporated into the logistic regression model,then the ROC curves were obtained.Results ①Compared with the control group,LL,RL,NL,RH,LRa,NRa,RRa in AR group increased (P ＜ 0.05),while the rest parameters had no statistical differences (P ＞0.05).②Multivariable logistic regression model gradually screening of the significant factors influencing the reflux,and as a result RL and RTH had significant influence on AR,P values were 0.001,0.011.③The ROC curve analysis showed that the area of RL or RTH curve were both greater than 0.5,which were 0.811 and 0.605 respectively.Conclusions The free edge length and free edge length/height ratio have changed unbalanced.Furthermore,right coronary valve parameters changed significantly,and this might be one of the possible mechanism of AR.

Objective To evaluate the efficacy of embryo thymus transplantation in the treatment of lupus-like BXSB mice,study the pathogenesis of SLE in BXSB mice and the therapeutic effect of embryo thymus transplantation.Methods The embryonic thymus of CB57L mice was transplanted to50day-old male BXSB mice.Levels of proteinuria,ANA,blood urea nitrogen(BUN),blood creatinine and the deposits of immunoglobulin(Ig)in the glomerulus were detected regularly for5months,and the number of mice died of SLE was observed.Results The levels of proteinuria,ANA,BUN,blood creatinine of the5,6,7month old mice in embryo thymus transplantation group were lower than that of5month old mice in control group.The efficacy of treatment in embryo thymus transplantation group were similar to that of dexamethasone treatment group,and the SLE-caused death was reduced in these two groups.However,the embryo thymus transplantation seemed not to reduce the deposits of lg in glomerulus significantly,the deposits of lg in the glomerulus were similar in all three groups.Conclusions Embryo thymus transplantation could improve renal functions and reduce the titer of ANA.Its efficacy is similar to that of dexamethasone.Embryo thymus transplantation has a short term therapeutic effect in the treatment of lupus-like BXSB mice.The deficiency of thymus in the BXSB mice may play an important role in the pathogenesis of lupus-like mice.Embryo thymus transplantation may be a valuable approach to treat SLE.