The article is intended to introduce the readers to the concept and background of Web accessibility in the United States. I will first discuss different definitions of Web accessibility. The beneficiaries of accessible Web or the sufferers from inaccessible Web will be discussed based on the type of disability. The importance of Web accessibility will be introduced from the perspectives of ethical, demographic, legal, and financial importance. Web accessibility related standards and legislations will be discussed in great detail. Previous research on evaluating Web accessibility will be presented. Lastly, a system for automated Web accessibility transformation will be introduced as an alternative approach for enhancing Web accessibility.

Thyroid carcinoma is the most common endocrine maligancy, and the worldwide incidence has been rising in recent years. Differentiated thyroid carcinoma is the most common thyroid malignancy, which include thyroid papillary carcinoma and follicular thyroid carcinoma, accounting for about 90 percent of thyroid carcinoma incidence. Currently, surgical treatment, iodine radiotherapy and TSH suppressive therapy are the commonly accepted effective treatments for differentiated thyroid carcinoma, and most patients can be cured. But there are still some patients not sensitive to the general treatments, who have lost the treatment of opportunity. Molecular targeted therapy is an agonistic or suppressive treatment for molecular biology targets of malignant tumor, and currently is a frontier research in the field of malignancy treatment. By retrieving and analyzing the related literature of molecular targeted therapy of thyroid carcinoma through PUBMED in the past 5 years, the article introduced the current status of molecular targeted therapy of thyroid carcinoma.
Adenocarcinoma, Follicular ; drug therapy ; Carcinoma ; drug therapy ; Carcinoma, Papillary ; Humans ; Molecular Targeted Therapy ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; drug therapy

Objective To evaluate the efficacy of percutaneous pneumatic nephrolithotripsy combined with ultrasonic lithotripsy for the treatment of renal calculi. Methods From January 2005 to December 2006, 132 cases of renal calculi were treated by percutaneous pneumatic nephrolithotripsy and ultrasonic lithotripsy. Percutaneous nephrolithotripsy was performed under the guidance of B-ultrasonography, and then the calculi were removed by pneumatic nephrolithotripsy combined with ultrasonic lithotripsy.Results Single-tract procedure was performed on 122 cases, while two-tract in the other 10. One-stage lithotripsy was performed on 127 cases, and two-stage operation was carried out in 5. The operation time ranged from 30 to 150 minutes with a mean of (60?12) minutes. The stone clearance rate was 90.2% (119/132) one week after the operation. Five patients had 200-to 500-ml hemorrhage 1 to 4 days after the operation, and were cured by blood transfusion and anti-infection treatments. No serious complications were found in the other patients. The nephrostomy tube was withdrawn 4 to 7 days (mean 6 days) after the operation. The hospital stay was 6 to 22 days with a mean of 15 days. Among the patients, 98 were followed up for 3 to 20 months (mean 13 months). No hemorrhage, infection, or recurrence of renal calculi was found during this period. Conclusion Percutaneous pneumatic nephrolithotripsy combined with ultrasonic lithotripsy is safe, effective, with mild surgical trauma and a few complications for patients with renal calculi.

Objective To investigate the effect of Bcl-2 gene knockdown on apotosis , proliferation and drug sensitivity of gastric carcinoma HGC-27 cells. Methods The HGC-27 cells were divided into five groups:the untreated control group , the control siRNA group , the specific siRNA targeting Bcl-2 gene group , 5-FU treated group and the combination group (Bcl-2 siRNA and 5-FU treatment). Then flow cytometry and MTT assays were performed to detect the apoptosis and proliferation of HGC-27 cells. The cysteine protease activityand Cytochrome C release level were tested by ELISA method. Results Bcl-2 knockdown enhanced apoptosis and inhibited proliferation of HGC-27 cells. Comparedwith the 5-FU-treated group , the cell apoptosis level, activities of Caspase-3 and Caspase-9, plasma Cytochrome C were significantly increased in the combination group(P <0.01). Conclusion Bcl-2 gene knockdown induced apoptosis, inhibited cell proliferation and enhanced the drug sensitivity of 5-FU in gastric cancer cells , which might be considered as a potential therapeutic strategy forgastric carcinoma.

Objective To evaluate the application of percutaneous suture-mediated closure device (Perclose ProGlide) in patients undergoing percutaneous endovascular aortic procedures.Method From Apr 2011 to Jun 2012,23 patients underwent percutaneous endovascular aortic procedures.The stent delivery system used included one 24Fr,twelve 22Fr,two 20Fr,one 18Fr,two 16Fr,four 14Fr,one 10Fr and four 6Fr.The success rate,complications and the technical feasibility was analyzed.Result The success rate was 93.3％ (28/30),in which two patients were converted to open surgery because of severe stenosis and bleeding of femoral artery.There was no hemorrhage,hematoma,false aneurysm,thrombosis,and serious artery stenosis during the follow-up period ( 8 ± 4 months).Conclusions Percutaneous suture techniques is safe and effective in patients undergoing percutaneous endovascular aortic procedures.Percutaneous suture techniques can be safely used to the branch of aortic arch.

Objective To analyse the recurrence rate of patients with Budd-Chiari syndrome (BCS) after radical correction.Method We retrospectively analyzed the clinical characters and follow-up of patients who underwent radical correction and suffered recurrence.Patency rate of inferior vena cava (IVC) and hepatic veins (HVs) were examined.We present the causes of recurrence and clarify risk factors for recurrence by survival analysis.Result Among the 102 patients undergoing radical correction,34 patients suffered from postoperative recurrence,including 32 cases of IVC lesions,21 cases of HVs lesions (19 patients suffered concurrently from IVC and HVs lesions).One patient received reoperation,16 patients received balloon angioplasty of IVC or HVs,3 patients received stent implantation,and 14 patients received conservative treatment.Conclusions The recurrence rate is high after radical correction for BCS.Once the abnormal syndrome recurs,the patients can be managed by radical correction,balloon or stent angioplasty.The main causes of recurrence are thrombosis of IVC,compression of caudate lobe,scar contracture,and the risk factors for recurrence are concurrent hypercoagulation status,too short period of postoperative anticoagulation (less than 6 months).

International medical community has seen the prevail of outpatient teaching for medical students in recent years. A student-centered and faculty-run teaching clinic was set up based on current outpatient resources in 2008 by Division of General Internal Medicine (DGIM) in Peking Union Medical College Hospital (PUMCH). We concluded that teaching clinic was an effective teaching mode for medical students to improve clinical skills, diagnostic proficiency and health-care professionalism in internal medicine.

Objective To summarize and analyze clinical characteristics of glycogen storage disease (GSD)typeⅠcomplicated with hepatocellular carcinoma to improve clinical recognition to it.Methods First case of GSD type Ia complicated with hepatocellular carcinoma(HCC)in China was reported and another 14 cases with detailed clinical data reported in literatures were reviewed in this paper.Results The case was man at age of 19 with chief complaint of hepatic mass founded casually.For all the 15 cases(other 14 from literature reports),mean age at diagnosis of HCC was 32.3 years and average time interval from diagnosis of GSD to diagnosis of HCC Was 23.1 years,as compared to 23.3 years and 14.6 years,respectively in three cases with both hepatitis B virus(HBV)and hepatitis C virus(HCV)seropositive.Serum level of alpha fetoprotein(AFP)was elevated in six patients.Tumor could be located at all lobes of the liver and mainly in the right lobe(eight of 15 cases),with varied size and solitary or multiple tumor.Conclusions Symptoms in GSD typeⅠcomplicated with HCC Was latent at onset.and AFP measurement was questionable in its diagnosis.It is important that physicians should keep more alert to risk of HCC in patients with GSD for its early diagnosis.

BACKGROUND: As magnetic resonance (MR) contrast, a large number of clinical and experimental researches have been done on superparamagnetic iron oxide (SPIO), while the report on the labeled cell passaged cells is rare.OBJECTIVE: MR imaging was performed to the labeled bone mesenchymal stem cells (BMSCs) and its passaged cells in vitro, in order to establish the base of monitoring magnetic labeled BMSCs with magnetic resonance imaging (MRI) in vivo.DESIGN, TIME AND SETTING: The cytological in vitro experiment was performed at the Imaging Research Institute and Institute of Rheumatology and Immunology of North Sichuan Medical College Hospital from June 2006 to January 2007. MATERIALS: Two clean female albino rats (Animal Center, North Sichuan Medical College), SPIO (Schering AG,Germany) were used in this study.METHODES: Bilateral femur and tibia bone marrow was extracted from rats. BMSCs were harvested and purified using the adherent method, and then labeled with 600 μL ferric oxide-polylysine compound (42 mg/L iron concentration) in vitro. MAIN OUTCOME MEASURES: Cell maker-positive rate and the MR signal intensity were respectively measured to the labeled cells and its passaged cells under the inverted microscope and magnetic resonance imaging. RESULTS: Following Prussian blue staining, labeling rate of SPIO labeled cells at the first passage was 100%. With increased passage, the labeling rate was reduced from the first to fifth passages. Compared with non-labeled PBS control, there was no significant difference in signal intensity in the first and second passages cells, but the signal intensity percentage was gradually decreased with signal intensity of increased cell passage from the third passage. Cell labeling rate was negatively correlated with T2~*WI signal intensity (r=-0.986 6, P <0.005). CONCLUSION: The iron particles in the magnetic labeled cells can be passaged to the offspring cells, and can be monitored in a certain period of time with MRI in vitro. These results firstly introduced that SPIO-labeled cell iron particles can decrease with cell passage.

Objective:To study the clinical application and postoperative complication of double stapling technique (DST) in anus-preserving operation of low and middle rectal cancer. Method:From April 2002 to April 2006, clinical data of 75 cases with low and middle rectal cancer were analyzed retrospectively. Of those 32 cases used DST underwent sphincter-reserving operation(SPO),regard as study group;and 43 cases used SST received SPO, as control group. Clinical pathologic parameters、 postoperative complication and tumor recurrence were compared between the two groups. Results:Operation of all the 75 patients was successful without operative mortality. In DST group patients, defecation function was different from SST group after postoperative 3 and 6 months (P