The recent development and wide application of ultrasonography and ultrasonography-guided fine needle aspiration biopsy have greatly facilitated the detection of papillary thyroid microcarcinoma (PTMC).Currently, the occurrence, development and pathological features of PTMC are not clearly understood.Therefore, no consensus on the diagnosis and treatment has been reached.Patients with PTMC are suggested to be closely observed and periodically examined with ultrasonography in some countries such as Japan, and these patients are to be operated when the tumor enlarged or new lymphatic metastasis are found.Operation is the first choice in the European and American countries, and the long-term survival rates of these patients are nearly 100％.For the PTMC patients with the risk factors such as thyroid capsule invasion, lymphatic metastasis,multi-focal lesion, higher degree of malignancy, thyroid stimulating hormone suppression therapy was given after operation, which may reduce the local recurrence rate.In China, we should hold well thelimitation and choose the best way for different patients according to the personalized principle in clinical practice.

Objective Through the correlation study of fibroblast growth factor 23 (FGF-23) and chronic heart failure to investigate the pathogenesis of chronic heart failure and provide a new method for chronic heart failure diagnosis.Methods One hundred and twenty-eight chronic heart failure patients (chronic heart failure group) were involved in this study.According to the level of left ventricular ejection fraction (LVEF),they were divided into LVEF slightly lowing group (LVEF 40％-50％,50 patients),LVEF moderately lowing group (LVEF 30％-39％,35 patients),LVEF severely lowing group (LVEF ＜30％,43 patients).Fifty healthy people was as control group.The level of FGF-23,parathyroid hormone (PTH),creatinine (Cr),urea nitrogen (BUN),blood calcium,blood phosphorus,N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The patients in two groups were performed color Doppler ultrasonography.Results The level of FGF-23,blood phosphorus,PTH,left ventricular mass index (LVMI),NT-proBNP in chronic heart failure group were significantly higher than those in control group [68.44(55.85-94.73) ng/L,34.18(30.57-38.87) ng/L,(1.13 ± 0.13) mmol/L vs.(1.02± 0.12) mmol/L,(15.51 ± 3.99) ng/L vs.(9.97 ± 0.89) ng/L,(112.27 ± 52.02) g/m2 vs.(71.37 ± 12.95) g/m2,(6 265.3 ± 15 991.6) ng/L vs.(76.12 ± 51.80) ng/L](P ＜ 0.01).The level of blood calcium,glomerular filtration rate (GFR) in chronic heart failure group were significantly lower than those in control group [(2.28 ±0.16) mmol/L vs.(2.48 ±0.13) mmol/L,(78.28 ± 14.20) ml/ (min ·1.73 m2) vs.(85.03 ± 14.44)ml/ (min·1.73 m2)] (P ＜ 0.01).Spearman correlation analysis showed that FGF-23 had positive correlation with age (r =0.256,P ＜0.01),blood phosphorus (r =0.326,P ＜0.01),PTH (r =0.584,P ＜0.01),NT-proBNP (r =0.799,P ＜ 0.01),LVMI (r =0.540,P ＜ 0.01),and had negative correlation with blood calcium (r =-0.308,P ＜ 0.01),GFR(r =-0.527,P ＜ 0.01).The level of FGF-23 was increased when LVEF reduced.Conclusions It has significant correlation between the level of FGF-23 and the degree of chronic heart failure.It suggests that the level of FGF-23 can evaluate the myocardial systolic function and ventricular remodeling.

[ ABSTRACT] AIM:To investigate the role of protease activated receptor-2 ( PAR-2 ) in the process of tryptase mediated IEC-6 cell injury.METHODS:The rat intestinal epithelial cell line IEC-6 was treated with tryptase at different concentrations (1 μg/L, 10 μg/L, 100μg/L and 1 000μg/L) in the presence or absence of PAR-2 antagonist FSLLRY-NH2 for 12 h respectively.The cell survival rate was detected by MTT assay.The protein levels of PAR-2 and cleaved-caspase 3 were determined by Western blotting.The LDH activity was also measured.RESULTS:Compared with control group, the cell survival rates were significantly decreased in 100 μg/L and 1 000 μg/L tryptase treated groups, the LDH activities were significantly increased in 10 μg/L to 1 000 μg/L tryptase treated groups, and the protein levels of PAR-2 and cleaved caspase 3 were significantly increased in 100μg/L and 1 000μg/L tryptase treated groups (P<0.05).Com-pared with 1 000 μg/L tryptase treated group, the LDH activity and cleaved caspase 3 protein level were dramatically de-creased while the survival rate was significantly increased in the presence of PAR-2 antagonist FSLLRY-NH2 (P<0.05). CONCLUSION:Tryptase induces IEC-6 cell injury in a dose-dependent manner by activating PAR-2.

Objective To analyze clinicopathologic features and treatment strategy of postsurgical incidental papillary thyroid microcarcinoma(PTMC).Methods A total of 305 patients undergoing surgery for thyroid diseases from Apr.2012 to Mar.2013 were retrospectively analyzed.Results Among the 305 patients,19 patients(18 females and 1 male)showed PTMC incidentally after surgery.The mean age was (43.2 ± 12.8)years (ranging from 23 to 67 years old).All patients underwent subtotal thyroidectomy,including 17 endoscopic surgery and 2 open surgery.All frozen sections were benign during operation while pathologic results were PTMC after surgery.The average size of tumors was(2.2 ± 1.5) mm which all was unicentric with no lymph node enlargement intraoperatively.Immunohistochemistry showed that the positive rate of cytokeratin 19,galectin-3,mesothelial cell,and CD56 was 87.5％,43.8％,81.3％ and 18.8％,respectively.There were 4 cases of B-raf V600E mutation found in 6 patients.All patients discharged 1 to 3 days after surgical treatment with no complication and received levothyroxine therapy with a suppressive dose of thyrotropin(TSH).131I therapy was not given.Conclusions PTMC is found more common in female and younger age under 45 years.Tumor is usually unicentric and less than 5 mm.Lymph node metastasis is rare.Immunohistochemistry and B-raf V600E mutant test can help the diagnosis.Initial endoscopic subtotal thyroidectomy is effective.There is no need of further surgery and 131I therapy.

Objective To investigate the infection situation of L-form bacteria in urinary calculi from the patients with urolithia-sis in a hospital to provide a scientific basis for postoperative anti-infection and prevention of urinary stone recurrence.Methods The calculi samples in 265 cases of urinary calculi from October to December 2015 were collected and performed the culture of com-mon bacteria and L-form bacteria respectively.Culture of common bacteria and bacterial L-forms.Results Among 265 cases of uri-nary calculi ,8 cases(3% ,8/265) were L-form Bacterial combined with common bacterial infection ,only 7 cases(2.6% ,7/265) were L-form bacterial infection ,80 cases (30.0% ,80/265) were common bacterial infection.15 strains of L-form bacteria were detected and 96 strains of common bacteria were detected.The drug resistance of L-form bacteria was significantly increased compared with common bacteria.Conclusion The positive rate of L-form bacteria culture of urinary calculi is lower than other domestic reports. Adding hypertonic medium for conducting L-form bacterial isolation and culture in the patients with urinary tract infection can re-duce the false negative.

Objectives To evaluate the effect of probiotics enteral nutrition therapy on the inflammatory reaction and immune function in acute necrotizing pancreatits(ANP)in rats.Methods 100 SD rats were divided randomly into control group(C group,n=20),ANP gruop,enteral nutrition group (EN group,n=20),probiotics group(P group,n=20)and enteral nutrition plus probiotics group(PEN group,n=20),ANP were induced by retrograde injection of 5% sodium tautocholate(1.5ml/kg)into the biliary and pancreatic duct.The nasojejunal tube was placed via gastric route.The rats were sacrificed at 12h,24h,48h and 72h after ANP modeling.Serum MIF and amylase levels,as well as CD_3~+,CD_4~+,CD_8~+were measured and MIF was determined by immunohistochemistry and the histopathological changes in pancreatic tissue were observed.Results Serum MIF and amvlase levels were all increase when compared with that in C group.72h after ANP modeling,srum MIF leves in EN,P,PEN groups were(117.59±1.86)μg/L,(108.39±1.99) μg/L and (95.33±1.96) μg/L,respectivdy;serum amylase levels were (2799±161)U/L,(2482±140)U/L and (2146±572 )U/L,respectively;the values in P and PEN groups were significantly lower than that of EN group(P＜0.05),the values in PEN groups were significantly lower than that of P group (P＜0.05 ).After ANP induction,CD_4~+/CD_8~+ values in EN,P and PEN groups were 0.93±0.12,1.31±0.13,1.51±0.10,respectively;the values in P and PEN groups were significantly higher than that of EN group(P＜0.05 ),the values in PEN groups were significantly higher than that of P group (P＜0.05 ).MIF positive rates in C,ANP,EN,P and PEN group were 45%,96%,95%,65% and 60% ,respectively;the values in P and PEN groups were significantly lower than those of ANP and EN group (P＜0.05 ).At 72 h,the damage of pancreatic tissue was more severe in EN and P groups than that in PEN group.Conclusions Probioties enteral nutrition could effectively regulate inflammation mediator and cytokines in rats with ANP,and enhance immune function.

BACKGROUND:Xenogeneic ligament is readily available, which has ligament scaffold structure and is conducive to tissue ingrowth and creeping substitution. After processing, the xenogeneic ligament, with the presence of good growth scaffold function, can be completely eliminated antigenicity that can cause immune rejection. OBJECTIVE:To study the feasibility of biological xenogeneic ligament graft instead of alogeneic ligament graft for reconstruction of goat anterior cruciate ligament. METHODS: Twenty-four healthy adult goats were randomly divided into A, B, C groups, and then, the left knee joints of goats were removed to establish animal models of anterior cruciate ligament injury in the three groups. After the establishment of the tibia and femoral bone tunnel, groups A, B, C were respectively transplanted with biological xenogeneic ligament graft combined with bone marrow mesenchymal stem cels, biological xenogeneic ligament graft alone, and alogenic ligament. RESULTS AND CONCLUSION: After implantation, no rejection but good biocompatibility was found in the group A, in which, the transplanted ligament as a functional scaffold for anterior cruciate ligament reconstruction, and new tissues in-grew and replaced the scaffold under intraarticular environment to form the new ligament with good bone tendon healing. However, there were no differences in histology, immune response, biomechanical findings between groups A and C. Additionaly, in the group A, the host tissues were found to grow into the scaffold and establish a micro-circulation. These findings indicate that xenogeneic ligament combined with bone marrow mesenchymal stem cels can accelerate the establishment of micro-circulation and promote the growth of ligaments, especialy improve the ligament revascularization significantly, but has no influence on the biological characteristics of the ligament.

Objective To explore the microsurgery methods in patients with early intracranial aneurysm rupture. Methods Sixty-seven patients with early intracranial aneurysm rupture received the emergency microsurgery after releasing cerebrospinal fluid from improved Paine point via pterion craniotomy. Thirty-nine patients received surgery within 1 d after intracranial aneurysm rupture, and the other 28 patients were within 1-3 d. Results The therapeutic effect was evaluated by Glasgow outcome score (GOS) at discharge. Among the 45 patients with Hunt-Hess Ⅰ-Ⅲ grade, cure was in 41 cases, improved in 4 cases. Among the 22 patients with Hunt-HessⅣ-Ⅴgrade, cure was in 6 cases, improved in 6 cases, moderate disability in 4 cases, severe disability in 1 case, and death was in 5 cases. Conclusions The microsurgery of clipping aneurysm directly via pterion approach is still by far the most reliable treatment. And releasing cerebrospinal fluid from improved Paine points can effectively reduce the acute brain swelling of early operation, which will make it an effective adjuvant therapy to emergency microsurgery of clipping aneurysm.

Objective To conduct the comparative comprehensive evaluation on the actual healthy effects and safety of two kinds of healthy foods capsule A and B made of Chinese medicinal herbs on sale through the low-nutritional sub-health mice model com-bined with the benefit-damage index-general score(BDI-GS) approach ,and to perform the discussion on the relevant problems a-round healthy foods .Methods The experimental healthy ICR male mice during growth period were fed with maize low-nutritional feed and the mixed feed with 3 doses of 0 .25% ,0 .5% ,0 .75% healthy foods for 12 d and the mice body masses were recorded .Af-ter dissection ,9 items of the organ index and their BDI ,GS and serum biochemical indicators were performed the statistics .Results In the capsule A ,the medium and high dose groups manifested certain health-promoting effect ,while the slight negative effect exis-ted in the low dose group ,which was expressed in the GS values ;but in the capsule B ,3 doses all caused the damage to main internal organs in different degrees ,which was expressed in BDI<1 .0 and GS<9 .0 .Conclusion At present ,despite of possessing similar ingredients ,Chinese medicinal healthy foods in market are of greater differences in intrinsic qualities ,and even partial products have some adverse effect ,the healthy functions and safety are not enough to be fully ensured .Through the systematic evaluation of the BDI-GS system ,the criteria of marketing threshold for healthy foods will be increased so as to enhance their effects and safety level .

Objective To investigate the pathogenesis in patients with uterine leiomyoma complicated by amyloidosis. Methods A total of 36 uterine leiomyoma patients were recruited in this study, and divided into two group by Congo red staining:amyloidosis group (n=6) and non-amyloidosis group (n=30). (1) Amyloidosis deposition was observed in amyloidosis group. (2) HE staining was used to compare changes of inflammatory cells in two groups. (3)PAS staining was used to observe polysaccharide difference in two groups. (4)Values of serum hemoglobin (HGB), white blood cell count (WBC), lymphocyte absolute value (LYM), neutrophil absolute value (NEU), total protein (TP), albumin (Alb) and prealbumin (PA) were com?pared between two groups. Results (1)Leiomyoma entity cells were negatively Congo red stained, while 5 out of 6 pseudo-capsule fiber deposition and 2 out of 6 blood vessel were positively Congo red stained. (2)Infiltrations of inflammatory cells were observed in two groups. (3) The PAS positive staining was found in amyloidosis deposition and non-amyloidosis deposi?tion groups. (4)There were no significant differences in HGB, WBC, NEU, LYM, TP, Alb and PA levels between two groups (P>0.05). Conclusion Metabolism changes resulted from cell function alterations in local micro-environment by uterine leiomyoma may be related to the formation of the amyloidosis.