With the increasing number of complex and difficult thyroid cancer patients, the traditional medical model is difficult to solve the problem of diagnosis and treatment of patients optimally. In recent years, multidisciplinary team (MDT) model is applied clinically. For complex and difficult thyroid cancer diseases, the model can play a multidisciplinary advantage and provide more personalized and accurate diagnosis and treatment scheme for patients. The diagnosis and treatment of complex and difficult thyroid cancer involve thyroid surgery, otolaryngology, thoracic surgery, anesthesiology, endocrinology, nuclear medicine, radiotherapy, oncology, ultrasound, imaging, pathology and other disciplines. Based on the important role of MDT in diagnosis, treatment, nursing, postoperative management and clinical research of thyroid cancer, as well as the challenges and difficulties faced in implementation of MDT, the status and progress of multi-disciplinary comprehensive diagnosis and treatment of thyroid cancer will be systematically elaborated in the paper.

Objective:To investigate the prognostic factors and pathological characteristics of mixed subtype thyroid cancer (MSTC) .Methods:Data of 41 cases of MSTC, which were confirmed by postoperative pathology, among from 24, 912 cases of thyroid cancer admitted in Mar. 2005 to Aug. 2020 in the First Medical Center of Chinese People’s Liberation Army General Hospital, were retrospectively analyzed. 37 cases underwent surgical treatment, while 4 cases only underwent puncture to confirm the pathology due to physical conditions, and no surgical treatment was performed. The tumor size, number of lesions, capsule invasion, AJCC 8th TNM staging, surgical methods, radiotherapy and chemotherapy were collected. The MSTC patients in the group were followed up to obtain the postoperative situation. SPSS 25.0 and R studio statistical software was used for data processing, and Cox single factor and multivariate regression were used to analyze independent risk factors.Results:In the 41 cases, there were 9 cases of papillary carcinoma (PTC) mixed with follicular carcinoma (FTC) , and 8 cases of mixed medullary and follicular carcinoma (MMFTC) . There were 15 cases of poorly differentiated thyroid cancer (PDTC) , 4 cases of squamous cell carcinoma of thyroid (SCCT) , and 5 cases of undifferentiated thyroid carcinoma (ATC) . The median follow-up time was 18 months, and 11 patients died during the follow-up, with a mortality rate of 26.8%. Average onset age was (51.41+15.69) years. 4 cases had postoperative recurrence during the follow-up, including 2 cases of local recurrence, and 2 cases of distant metastasis. Single factor results showed that age, degree of tumor differentiation, surgical method, radiotherapy and chemotherapy were the risk factors affecting the prognosis of patients with MSTC ( P<0.05) . Multivariate analysis showed that age at diagnosis ( P=0.007) and surgical procedure ( P=0.017) were independent risk factors for prognosis in patients with MSTC. Conclusion:Middle-aged and elderly women are at high risk for MSTC, and the degree of tumor differentiation is proportional to survival. Due to the multi-type and pleomorphic pathological findings, a reasonable treatment plan has good effects on prognosis of MSTC.

Objective To investigate the expression of immunohistochemistry of gastrin(GAS),somatostatin(SS),proliferating cell nuclear antigen(PCNA) and Fas-ligand(Fas-L) in the sinus ventriculi of children with pediatric gastritis and to explore the significance of their expression in the pathogenesis of pediatric chronic gastritis.Methods Fifty cases of the sinus ventriculi mucosa samples were enrolled in 3 groups:chronic gastritis,helicobacter pylori(Hp) positive(group A,n=20);chronic gastritis,Hp negative(group B,n=19);control group,normal sinus ventriculi mucosa,Hp negative(group C,n=11).Immunohistochemistry En Vision were carried out including GAS,SS,PCNA and Fas-L.Results In the expression of GAS and SS,the values of group A and B were comparatively higher than those of group C,but there was no significant difference among them in statistics.In the expression of PCNA,the value of group A was comparatively higher and that of group B.The value difference between 2 groups was significant(P=0.019);in the expression of Fas-L,no significant difference was found among these 3 groups.Conclusions Expressions of GAS and SS both increase in children with chronic gastritis and maybe the increase of GAS and SS play a role in the pathogenesis of pediatric chronic gastritis;Hp infection promotes the multiplication of the sinus ventriculi membrana mucosa epithelium cell in pediatric chronic gastritis.

This research aimed at studying the effects of irrigation and rhizome length on the survival of ratio, yield and quality of Glycyrrhiza uralensis in wild tending condition. Employed the split-block design to carry out the field experiment, sampled with the quadrat method to measured the relative growth indexes and to estimate the yield, used the HPLC (high performance liquid chromatog- raphy ) method to measure the glycyrrhizin in the rhizome and adventitious root of the G. uralensis in this study. The quantity of the adventitious roots and the survival ratio were increased significantly as the length of the rhizome increased (P < 0.01), but the length of the rhizome had no remarkable effect on the content of glycyrrhizin. The average content of the glycyrrhizin in the adventitious root and rhizome could reach 3.03% and 2.12% after 3-year wild tending, respectively, and this results indicated that the quality of the glycyrrhiza using this method was much better than that from cultured glycyrrhiza with the reproducing method of seeding. so using the rhizome as reproductive material to produce the glycyrrhiza under the wild tending condition could get the high quality glycyrrhiza quick- ly and steadily, this phenomenon could be explained by the Hypothesis of synthetic inertia of the medicinal components from the wild material of G. uralensis. But the maximum yield with this method was just more than 945 kg x hm(-2) in this study. So the further work of how to increase the yield in the practical application with the method found in this study need to be done in the next research.
Agricultural Irrigation ; Culture Techniques ; methods ; Glycyrrhiza uralensis ; growth & development ; metabolism ; Glycyrrhizic Acid ; metabolism ; Rhizome ; growth & development ; Survival Analysis

OBJECTIVETo discuss the clinical effects of open reduction and internal fixation (ORIF) for treatment of patients with Lisfranc injury combined the second metatarsal base comminuted fracture.

METHODSFrom March 2007 to June 2012, 7 patients with Lisfranc injury combined the second metatarsal base comminuted fracture were treated including 5 males and 2 female aged from 22 to 51 years old (means 42 years), 4 of sprain and 3 of traffic injury. According Myerson classification, there was 1 case of type A, 3 of type B and 3 of type C. Kirschner wire was used to fix Lisfranc ligament placing from the medial cuneiform bone to the second metatarsal base during the operation. After the operation American Orthopaedic Foot and Ankle Society (AOFAS) criteria system were applied to evaluate the foot and ankle function. Preoperative and postoperative AP, lateral and oblique X-ray and CT scan were collected for radiographic evaluation.

RESULTSAll patients were followed up from 12 to 20 months (16.8 months in average). According to AOFAS criteria system, 3 cases were excellent result,3 good, 1 fair. All the wounds were primary healing without skin necrosis, infection, Kirschner loose,broken, or other complications.

CONCLUSIONKirschner wire had good clinical efficacy for fixing Lisfranc ligament injury with the second metatarsal base comminuted fracture, and could avoid arthrodesis.

Adult ; Bone Wires ; Female ; Humans ; Male ; Metatarsal Bones ; injuries ; surgery ; Middle Aged ; Tarsal Joints ; injuries ; surgery ; Wound Healing

OBJECTIVETo observe the effects of blood activating wind dissipating acupuncture (BAWDA) on blood pressure (BP) of prehypertension (PHT) patients.

METHODSTotally 60 PHT patients were assigned to the control group and the acupuncture group according to random digit table, 30 in each group. All patients were intervened by life style. BAWDA was additionally performed in patients in the acupuncture group for 6 weeks (30 times). The improvement of BP after intervened by acupuncture was observed. BP success rates and the proportion of PHT progressing to hypertension (HT) were also observed after 6-week intervention of acupuncture and at 1-year follow-up.

RESULTSSystolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased after 6-week intervention in the acupuncture. The BP control rate was 56.7% (17/30 cases) in the acupuncture group vs.10.0% (3/30 cases) in the control group with statistical difference (chi2 = 14.70, P < 0.01). At 1-year follow-up BP success rate was 36.7% (11/30 cases) in the acupuncture group, remarkably higher than that of the control group [13.3%, (4/30 cases)] (chi2 = 4.36, P < 0.05).

CONCLUSIONSBAWDA showed BP regulating roles in a gradually stable decreasing tendency. It also could elevate BP success rate of PHT, and reduce the risk of PHT progressing to HT.

Acupuncture ; methods ; Acupuncture Therapy ; methods ; Blood Pressure ; Humans ; Hypertension ; Prehypertension ; therapy ; Wind

Objective To investigate the optimal scanning parameters for diffusion tensor imaging of the cervical cord.Methods MRI and diffusion tensor imaging of the cervical cord was performed in 80 healthy adult volunteers.Different parameters including b values,the number of the diffusion sensitive gradient directions,the number of excitations,and slice thickness were applied and their effects on the quality of the images were compared.DTI was performed on the cervical spinal cord with different b-values (400,700,and 1000 s/mm~2)in group 1,with different numbers of diffusion gradient directions(6,13, and 25)in group 2,with different numbers of excitations(2,4,and 8)in group 3,and with different slice thicknesses(2,3,and 4 mm)in group 4.Two radiology experts gave a score to every image with double blind methods,then compared the image quality.Results In the comparison of the four different parameters,DTIs using a b value of 700 s/mm~2(2.25?0.58)showed better image quality than those with the b values of 400 s/mm~2(1.86?0.53)and 1000 s/mm~2(1.48?0.35)(P

Adult ; Aged ; Bone Transplantation ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Thoracic Vertebrae ; injuries ; surgery

Four-dimensional computer tomography (4D-CT) has a great value in lung cancer radiotherapy for its capability in providing lung information with respiratory motion. We employed a global graph cuts super-resolution (SR) reconstruction method to reconstruct high-resolution lung 4D-CT images. First, the high-resolution images reconstruction energy function was built based on a Maximum a posteriori Markov Random Field (MAP-MRF) formulation. The energy function was then transformed to a graph formulation, which was solved using graph cut algorithm. All the evaluation results showed that this approach outperformed the line interpolation and projection onto convex sets (POCS) approach with an improved structural clarity.

The safety of Chinese patent medicine has become a focus of social. It is necessary to carry out work on post-marketing clinical safety evaluation for Chinese patent medicine. However, there have no criterions to guide the related research, it is urgent to set up a model and method to guide the practice for related research. According to a series of clinical research, we put forward some views, which contained clear and definite the objective and content of clinical safety evaluation, the work flow should be determined, make a list of items for safety evaluation project, and put forward the three level classification of risk control. We set up a model of post-marketing clinical safety evaluation for Chinese patent medicine. Based this model, the list of items can be used for ranking medicine risks, and then take steps for different risks, aims to lower the app:ds:risksrisk level. At last, the medicine can be managed by five steps in sequence. The five steps are, collect risk signal, risk recognition, risk assessment, risk management, and aftereffect assessment. We hope to provide new ideas for the future research.
Clinical Trials as Topic ; Drug-Related Side Effects and Adverse Reactions ; epidemiology ; etiology ; Drugs, Chinese Herbal ; adverse effects ; chemistry ; economics ; therapeutic use ; Herbal Medicine ; economics ; legislation & jurisprudence ; Humans ; Patents as Topic ; Product Surveillance, Postmarketing ; Quality Control