Objective To evaluate the diagnosis and differential diagnosis methods for chronic lymphocytic thyroiditis(CLT).Methods One hundred and eight patients with CLT were treated in our department during recent 20 years,the clinical data were analyzed retrospectively.The diagnostic methods included thyroid function measurement,anti-thyroid antibody measurement,image detection,fine needle aspiration,diagnostic drug therapy and biopsy exam during operation.The preoperative examinations and diagnoses of 94 patients,who had received operation,were compared with postoperative pathological results.Results Forteen of the 108 cases did not receive any operation,of whom,9 had a definite diagnosis of CLT by fine needle biopsy under color ultrasound and 5 by drug(prednisone) diagnostic treatment.Before operation,57 patients were diagnosed as nodular goiter,16 as thyroid cancer and 13 as nodular goiter associated with hyperthyroidism.Only 8 patents were diagnosed as CLT with nodular goiter.Postoperative pathological reports were simple CLT in 59 cases(62.7%),CLT with nodular goiter in 19(20.2%),CLT with hyperthyriodism in 10(10.6%)and CLT with thyroid cancer in 6(6.3%).The preoperative misdiagnosis rate reached 91.5%(86cases).Conclusions It is easy for CLT to be misdiagnosed because of the complex clinical manifestations.Careful analysis of examination results,especially thyroid function measurement,anti-thyroid antibody measurement and image detection is significant for confirming the diagnosis.The fine needle biopsy and diagnostic drug treatment are better methods for CLT diagnosis.Unwarranted operation should be avoided in patients with CLT.

Histone deacetylase7 (HDAC7) belongs to Ⅱ a histone deacetylases.HDAC7 can alter chromosome structure and regulate gene transcription,and plays an important role in tumorigenesis and tumor angiogenesis.Increasing evidences show that HDAC7 can maintain the vascular integrity and continuity,and regulate the expression of angiogenic genes.HDAC7 also can regulate the migration and proliferation of vascular endothelial cells,and regulate angiogenic effect mediated by VEGF and other proangiogenenic factors contributing to tumor angiogenesis.Therefore,studies of the mechanisms in which HDAC7 contributes to tumor angiogenesis and the development of HDAC7 inhibitors could provide a new direction to tumor diagnosis and therapy.

The experience in the management of 108 cases of deeply situated meningiomas is presented. Complete removal of the tumor has been possible in 83 cases (76.9%), partial resection in 22 cases (20.3%). The surgical results were excellent in 72.2% and fair in 16.7%. Early diagnosis and an attempt to remove completely of such tumors should always be considered as the treatment of choice. In order to reach this goal, we propose:(a)wide exposure, induced hypotension, hypothermia, interruption of the blood supply at the base of the tumor, and careful hemos-tasis are essential; (b) in addition, microsurgical dissection to avoid injury of the neighbouring important structures as well as vital areas of the brain are mandatory. The removal of an unusual giant mening-ioma arising in the medial aspect of the sphenoid ridge illustrated these points well. The tumor was13?10?8cm in size and 864g in weight. The patient recovered uneventfully and his general condition has remained good for years. Recent CT scan showed no recurrence.

Objective To evaluate the effect of various rewarming regimes on rectal temperature and hemodynamic parameters of dogs after open abdominal injury and seawater immersion. Method 30 healthy dogs were subjected to open abdominal injury and 2-hour seawater immersion. Then dogs were divided into three groups: group A (n=10) received no special warming treatment, in group B(n=10) electric blanket was used to warm up to 42℃, in group C (n=10) animals were warmed by 1/3 saline solution in 42℃ for 20 minutes and continuous perfusion of the abdominal cavity with 1/2 saline solution for 2 hours. The changes in body temperature, heart rate, MAP, CVP and CO were observed before and after rescue. Results The results of group A were not satisfactory. The rectal temperature, MAP, HR and CO were not recovered to normal after 6 hours of treatment. and the rectal temperature was 34.8℃ after 6 hours. The rectal temperature rose to 36.9℃ after being rewarmed with an electric blanket in group B. The result was better than that of group A. But there was tachycardia. The effects of rewarming from hypothermia in group C was satisfied. All hemodynamic parameters and rectal temperature recovered after 4 hours treatment. Conclusion Cold seawater immersion after open abdominal injury would result to hypothermia, and intra-corporeal rewarming should be the optional treatment.

Objective To evaluate the effect of seawater immersion on hemodynamics and pathological changes in dogs with perforating injury of the intestine. Methods Thirty healthy adult dogs were subjected to perforating injury of the intestine. Ten injured dogs were immersed in artificial seawater after the injury. An equal number of injured dogs were immersed in normal saline solution. Control group dogs (n=10) were not subjected to salt water immersion. Hemodynamical and pathological changes were observed at different time intervals after injury. Results Obvious hemodynamic disorder and serious pathological changes were found after seawater immersion. Normal saline solution group and control group dogs did not show obvious disorders in hemodynamics and pathology. Conclusion Seawater immersion is one of the main factors leading to the disturbance in hemodynamic and pathological changes after perforating injury of the intestine.

Objective To investigate the impact of rivaroxaban and low molecular weight heparin on hidden blood loss after unilateral first half artificial hip replacement surgery.Methods According to the digital table,a total of 80 cases because of femoral neck fractures in elderly patients with unilateral arthroplasty artificial hip and a half after surgery were randomly divided into the rivaroxaban group and low molecular weight heparin (LMWH) group,40 cases in each group.In both groups,respectively,after 12 h begin daily oral rivaroxaban 10 mg and subcutaneous low molecular weight heparin 5 000 u,compared the two groups around the actual amount of perioperative blood loss,blood loss was dominant,recessive blood loss and hidden blood loss accounts,the actual percentage of total blood loss,and recorded 35d bleeding events.Results The total amount of blood loss,dominant blood loss,hidden blood loss and the hidden blood loss accounted for the actual percentage of the total amount of blood loss of the rivaroxaban group were (671.00 ± 55.61) mL,(313.88 ± 14.53) mL,(350.00 ± 29.41) mL,(52.00 ± 5.22) ％,respectively,which of the the LMWH group were (662.00 ± 30.19) mL,(288.87 ± 15.33) mL,(372.00 ± 35.10) mL,(56.00 ± 6.71) ％,there were no significant differences between the two groups (t =0.93,0.93,0.83,1.03,all P ＞ 0.05).Conclusion For patients first underwent unilateral hip replacement surgery artificial half,perioperative using rivaroxaban or LMWH has no significantly differences in hidden risk of bleeding and bleeding event rate.

ObjectiveTo investigate the hemodynamic changes after multiple firearm injuries in a swine model. Methods Twelve pigs were divided into 2 groups randomly, with control group ( n =6) subjected to catheterization only. Multiple trauma group ( n =6) was subjected to tangential fracture of parietal bone and comminuted fractures of bilateral femora (ISS≥16) using 5 8 mm bullets. The hemodynamic changes, including MAP, PAP, PAWP, CO, SVRI and portal vein blood flow, were observed at different time intervals up to 72 h after trauma or catheterization. At the same time, gastric pHi was measured as well. Results Compared with control group pigs in multiple trauma group suffered a hyperdynamic circulation developed at 48～72 hours. The cardiac output rose and vascular resistance declined obviously. The pulmonary artery pressure and pulmonary capillary wedge pressure elevated significantly. Mean artery pressure, portal vein blood flow and gastric pHi declined significantly. Conclusion Without severe blood loss and hemorrhagic shock, the decrease of portal vein blood flow and viscera underperfusion still took place after multiple firearm injuries.

Objective To evaluate the changes in water, electrolyte and acid-base balance after seawater immersion in cases of open abdominal trauma associated with intestinal rupture, and to obtain a theoretical basis for the early treatment of open abdominal injury with intestinal rupture in naval combat. Methods A canine model of open abdominal trauma with intestinal rupture was established in 26 healthy adult dogs, and they were divided randomly into three groups. All animals were subjected to abdominal wall incision and intestinal rupture. Seawater immersion group(n=10) was immersed into artificial seawater after trauma; normal saline solution group(n=6) was immersed into normal saline solution after trauma; control group (n=10) had no immersion. The 3 groups were observed for changes in water, electrolyte and acid-base balance, and the results were analysed and compared. Results Signficant disturbance of water, electrolyte and acid-base imbalance were observed in the seawater immersion groups, but no significant changes of these parameters were seen in the control group and normal saline group. Conclusion Seawater immersion is the main factor leading to the disturbance of body metabolism after open abdominal trauma with intestinal rupture.

Objective To observe the effect of supernatant liquid from brain tissue on the differentiation of adipose-derived stem cells (ADSCs) into neural cells in normal brain tissues, the homogenate of infarcted cerebral hemisphere and the opposite side in the rats. Methods The ADSCs were obtained from rat retroperitoneal adipose tissue. The normal brain tissues, the homogenate of the infarcted cerebral hemisphere and thc opposite side got from middle cerebral artery occlusion in rats were used to induce ADSCs. Immunocytochemistry or immunofluorescence were used to identify the cell types at the 3rd day. Positive expression rate was counted by fluorescence microscope. Results (1)The neuron-specific enolase (NSE) positive cells, microtubule-associated protein 2 (MAP-2) positive cells and glial fibrillary acidic protein (GFAP) positive cells were much more in the homogenate of the infracted cerebral hemisphere than in others (P＜0.05). (2)The NSE positive cells, MAP-2 positive cells and GFAP positive cells were much more in the homogenate of the normal brain tissues and the opposite side than normal level ( P ＜ 0. 05 ) . Conclusions The homogenate of the infracted cerebral hemisphere and the opposite side can induce adipose-derived stem cells into neural-like cells and express neural cells markers in rats.

Objective:To establish the method for the determination of emodin and danshensu Pinggan oral liquid. Methods:The contents were determined by HPLC. The chromatographic conditions for emodin were as follows: an Agilent Eclipse XDB-C18 column (150 mm × 4. 6 mm, 5μm) was used and the mobile phase was methanol-water (80 ∶20). The detection wavelength was 287 nm and the flow rate was 1. 0 ml·min-1 . The column temperature was 25℃ and the injection volume was 20 μl. The chromatographic condi-tions for Danshensu were as follows:an Agilent Eclipse SB-C18 column (150 mm × 4. 6 mm, 5 μm) was used and the mobile phase was methanol-1% acetic acid solution (2 ∶98). The detection wavelength was 280 nm and the flow was 1. 0 ml·min-1. The column temperature was 30℃ and the injection volume was 20 μl. Results:Emodin had a good linear relationship within the range of 26. 75-428. 00 μg·ml-1(r=0. 999 9). The average recovery was 102. 7% and RSD was 0. 76% (n=6). Sodium Danshensu had a good linear relationship within the range of 10.17-162.77 μg·ml-1(r =0.999 9). The average recovery was 100.5% and RSD was 1. 47% (n=6). Conclusion:The method is simple, accurate and reproducible, which can be used for the quality control of the prep-aration.