In this article , the hot ethical concerns related to totally endoscopic thyroidectomy have been ana-lyzed and discussed .The author considers that this procedure is consisted with the patient′s no-harm and advanta-geous ethical principles , and the patient′s privacy is well protected .However , different procedures and operative risks should be well understood by the patients before the operation .Patient′s independence should be respected .

Objective: To explore the effects of HIF-1α (hypoxia-inducible factor-1α), β-catenin, IMP3 (insulin-like growth factor II mRNA-binding protein 3) and PCNA (proliferating cell nuclear antigen) on proliferation of gastric cancer SGC-7901 cells. Methods: The pcDNA™ 6.2-GW/EmGFP-miR- β-catenin plasmid was transfected into SGC-7901 cells to establish stably transfected cell line miR- β-catenin-7901. In this experiment, four groups were designed: control group (SGC-7901 cells were cultured under normoxic conditions), hypoxia group (SGC-7901 cells were cultured under hypoxic conditions), transfection group (miR-β-catenin-7901 cells were cultured under normoxic conditions), and combination of transfection and hypoxia group (miR-β-catenin-7901 cells were cultured under hypoxic conditions). The proliferation of SGC-7901 cells in four groups was detected by colony formation assay and cell doubling time assay. The expression levels of HIF-1α, β-catenin, IMP3 and PCNA proteins of SGC-7901 cells in four groups were detected by Western blotting. Results: As compared with the control group, the number of colonies was increased and the cell doubling time was shortened in hypoxia group (P < 0.05). As compared with the hypoxia group, the number of colonies was reduced and the cell doubling time was prolonged in the combination of transfection and hypoxia group (P < 0.05). The expression levels of HIF-1α, β-catenin, IMP3 and PCNA proteins in hypoxia group were higher than those in the control group (P < 0.05). The expression levels of HIF-1α, β-catenin, IMP3 and PCNA proteins in the transfection group were lower than those in the control group (P < 0.05). The expression levels of HIF-1α, β-catenin, IMP3 and PCNA proteins in the combination of transfection and hypoxia group were lower than those in the hypoxia group (P < 0.05). Conclusion: The proliferation of gastric cancer SGC-7901 cells may be related to the interaction of HIF-1α and β-catenin, which resulted in the increased expression levels of IMP3 and PCNA. Copyright © 2013 by TUMOR.

Objective To investigate the key points in the nursing work of esophageal waterperfused high-resolution manometry (WHRM).Methods Summarized the nursing experiences before,during and after WHRM of 153 patients.Results Only 5 cases could not finish the test due to failure of intubation.23 cases complained about nasopharyngeal discomfort but follow-up monitoring was unremarkable.Conclusion In order to ensure the completion of WHRM,nursing cooperation requires serious assessment and preparation before manometry,intimate observation of patients' condition during manometry,and keep the catheter disinfection after manometry.

Objective To evaluate the preliminary clinical outcome of the screw fixation of minimally displaced scaphoid fracture assisted by computerized imaging reconstruction and preoperative planning system.Methods From March 2013 to Feburary 2014,Five screws on five patients were treated.We calculated and designed the position of scaphoid screw guide wire and ensured the guide wire centrally placed in the scaphoid by using the computerized imaging reconstruction and preoperative planning system software.The appropriate length of the screw was measured too in the software.We also identified the entry and exit points of the guide wire on the custom orthoses splinting the wrist joint.Five patients with scaphoid fractures were treated with percutaneous screw fixation under the guidance of a C-arm fluoroscopy and a guide wire were inserted based on the entry and exit points calculated preoperatively.All of the scaphoid fracture was nondisplaced or less than 1 mm.The modified MAYO wrist scoring system was used to evaluate the pain,function and range of motion for the wrist joint during follow up.Results Total surgical time was 28.8 min (25-39 min)and Fluoroscopy time was 18.4 s (11-23 s).The fracture healing was observed at routine 8 weeks follow up.No complication such as infection or fixation failure was reported.Modified MAYO wrist score was 83.8 (81-88)at average followup at 15 months (6-12 months).Conclusion Computer assisted percutaneous screw fixation is an effective method for the treatment of nondisplaced scaphoid fractures.It leads to significantly reduced guidewire placement time and radiological exposure time while provides accurate placement of the screw.

Objective To evaluate the method and outcomes of radiocarpal joint reconstruction via nonvascularized and vascularized fibular bone graft after distal radius bone and joint defect.Methods Between November,1966 and March,2009,27 cases with distal radius bone and joint defect due to tumor en bolc excision (24 cases) or AO C3 type fractures (3 cases) were treated with nonvascularized or vascularized fibular bone graft.There were 9 males and 18 females.The mean age of these patients at the time of surgery was 27 years (rage from 16 to 67 years).There were 14 left sides and 12 right sides and 1 bilateral side.Nine cases with vascularized and 18 cases with nonvascularized fibular bone graft for radiocarpal joint reconstruction.The bone fixed with plate or/and k-wire.DASH scores,G/W wrist scores,PRWE scores were applied for writ function evaluation and the grasp power recovery rate and bone healing time was also compared during postoperative follow up.Results All 27 patients were followed with an average follow-up time being 9 years (range from 3.5 years to 44.0 years).The average length of fibular bone harvested was 10 cm for vascularized bone graft and 9 cm for nonvascularized.The all fibular bone was healed and the average healing time was 4.7 months (range from 3-8 months).No tumor recurrence or distance metastasis occurred during the follow-up.The average DASH scores was 7.97 (2.5-17.0),G/W scores of 24 patients ranged from 1 to 2,the wrist function result was excellent,account for 88.9％,and 3 cases from 3 to 7,function was good,account for 11.1％; the average grasp power recovery rat was 85.81％ (75％-104％); the average PRWE scores were 25.3(10.5-38.0).Comparison outcomes between the nonvascularized and vascularized fibular bone graft for radiocarpal wrist joint reconstruction,there was no significant statistics difference for bone healing time,DASH,G/W,PRWE scores and grasp power recovery rate (P ＞ 0.05).There were no other complications occurred except 3 patients had mild leg pain after long distance walking and 1 case fracture following patient's accident postoperative 11 years,and healed through conservative treatment.Conclusion The nonvascularized or vascularized fibular bone graft is an excellent choice and has less complication with maximal wrist function recovery for radiocarpal joint reconstruction following distal radius bone and joint defect due to all kinds of reasons,such as tumor en bloc excision,distal radius AOC3 type comminuted fracture.The vascularized fibular graft is recommended for larger than 12 cm bone graft.

Congenital Hyperinsulinism ; diagnosis ; Humans ; Infant, Newborn ; Male

Objective To clone and express surface antigen SAG4 gene of Toxoplasma gondii, and analyze its immunoreactivity. Methods Specific primers were designed based on the reported SAG4 gene of T. gondii RH strain (GenBank Accession No: AF340224.1). Using genomic DNA from T. gondii as templates, SAG4 gene was amplified by PCR. The PCR product was cloned into pMD19-T vector and identified by digestion with restriction enzyme and PCR. Then the target fragment was subcloned into pET28a(+) vector, transformed into E. coli BL21 and followed by expression of the protein induced by IPTG. The protein was identified by Western blotting. Results The target gene was amplified with the length of 537 bp. Sequence analysis showed that the predicted amino acid sequence was identical with that of SAG4 as a membrane protein in T. gondii. After induced by IPTG, the recombinant SAG4 protein existed in an inclusion body form. The recombinant SAG4 (Mr 18 740) was recognized by serum of infected mice. Conclusion SAG4 has been expressed and shows certain immuno-response activity.

Objective To study metabolism of polyunsantured fatty acid (PUFA) and to investigate the relationship between different PUFA compositions and △6 desaturase (D6D) activity in colorectal carcinoma (CRC).Methods Fresh frozen malignant CRC tissues were obtained from 61 patients and blood samples were detected in 38 patients.The PUFA composition in these samples was determined by gas-liquid chromatography on a capillary column.The fatty acid product-to-precursor ratios in blood and tissue as estimates of desaturase activity (D6D activity index),and its relationship with the ratios between different PUFA compositions were investigated.Results Metabolism of ω-6 PUFA dominated in PUFA metabolism path.The ratio of ω-6/ω-3 PUFA was 4.89 in blood samples and 10.15 in tissues.The ratio of LA/ALA was 101.92 in blood samples and 86.16 in tissues.The ratio of ω-6/ω-3 LC-PUFA was 2.86 in blood samples and 4.51 in tissues.The D6D activity index in ω-6 PUFA metabolic processes both in tissues (t =1 1.609,P =0.00) and blood samples (t =-9.151,P =0.00) were higher than that in ω-3 PUFA.Conclusion In colorectal carcinoma,the ω-6 PUFA metabolic not only plays an important role in the metabolism of PUFA,but also is more active than the ω-3 PUFA metabolic,and in some way links to the development of tumorigenesis in CRC.

AIM: To investigate the processing and HPLC fingerprint of Radix Scutellariae processed with wine,and to set up appropriate quanlity control standard. METHODS: chromatographic condition of HPLC-UV fingerprint consisted of Hypersil C_18 column(200 mm?5.0 mm,5 ?m),mixture of methanol,0.4% phosphoric acid and acetonitrile as a mobile phase in a gradient mode.Flow rate was 1.0 mL/min and detection wavelength was set at 277 nm. RESULTS: There were no evident differences among fingerprints of Radix Scutellariae that was normatively processed from the production areas. CONCLUSION: The process is feasible,and can be used to provide a basis for quanlity control of Radix Scutellariae.

Objective To evaluate and analyze the mental health of the seven year students in military medical universities. Methods SCL 90 was used to assess a total of 269 seven year students in military medical universities. The results were compared with the national norm, the five year students in military medical universities and the seven year students of local medical universities. Results Various mental health problems, including somatization, obsessive compulsion, depression, anxiety, hostility, paranoid ideation and psychotism, were found in 12 1% students. The mental health levels of these students were correlated with grades and sexes: mental health level of the lower grades was lower than that of the higher grades, and that of the female students was higher than that of the male students. Conclusion More mental stress responses are found in the seven year students in military medical universities.