Thymic carcinoid is an uncommon component of Multiple Endocrine Neoplasia Type 1 (MEN1).The low penetrance and the high mortality made TH-NET one of the most fatal tumor components of MEN1.Here we are discussing the pathology and pathogenesis, as well as epidemiology, screening strategy, diagnosis, therapies, and analysis of prognostic factors of thymic carcinoid associated to MEN1.

Objective To explore the accuracy and practicability of the three-dimensional ultrasound in real-time intellectual positioning navigation.Methods The phantom was applied in the real-time intellectual positioning guided biopsy of three dimensional ultrasound,free-hand ultrasound-guided biopsy and bracket-guided biopsy with different depths(5 cm,10 cm) and different sizes of the targets (6 mm and 15 mm).The time spent,the length of the sample and the success rate of biopsy were compared among three groups,and statistical analysis was done.Results ①The different sizes of targets with different depths were shown in three kinds of biopsy that the real-time intellectual positioning guided biopsy of three-dimensional ultrasound spent more time than bracket-guided biopsy,less than free hand ultrasound-guided biopsy.The difference was significant (P ＜0.05).The aquired red-dyed sample was longer in the real-time intellectual positioning guided biopsy of three-dimensional ultrasound compared to free-hand ultrasound-guide biopsy and bracket-guided biopsy,the difference was significant (P ＜0.001).②For real-time IP-guided biopsy of three-dimensional ultrasound with same depth,larger size of targets(15 mm) spent less time than smaller saize of targets (6 mm),the difference was significant (P ＜ 0.05).However,compared to smaller saize of targets(6 mm),success rate of biopsy in larger size of targets(15 mm) had no significant difference (P =0.238 at depth of 5 cm,P =0.479 at depth of 10 cm).③For real-time intellectual positioning guided biopsy of three-dimensional ultrasound with same size,time spent was less in the targets at the depth of 5 cm than in the targets at the depth of 10 cm,the difference was significant (P＜0.05).The aquired red-dyed sample was longer in the targets at the depth of 5 cm than in the targets at the depth of 10 cm,and success rate of biopsy in the targets at the depth of 5 cm was higher too (P ＜0.05).Conclusions The real-time intellectual positioning guided biopsy of three dimensional ultrasound spend less time with high accuracy and success rate of biopsy,especially for smaller and deeper targets,can be clinically applied with accuracy and practicability.

Objective To investigate the relationship between vascular endothelial function and insulin resistance(IR) and the incidence of metabolic syndrome(MS).Methods A seven-year follow-up study was conducted in 583 simple obese subjects who were chosen in 2000.Body fat,blood pressure,lipid profile,plasma glucose,insulin resistance index(HOMA-IR) and endothelium- dependent dilatation(EDD) were measured before and after the follow-up.Results A total of 177 new cases with MS were found during this seven years,which was 33.78% of all subjects who were followed up in 2007.Cumulative incidence of MS among seven-year was 38.14% in the impaired EDD group and 48.11% in the impaired EDD with IR group,both rates were higher than that of the IR group(25.00%)(P

Calcium oxalate crystal is a common cell ergastic substance in plant tissues. Although the mechanism of its synthesis and degradation is not yet clear, it shows a good application prospect in the aspects of calculosis treatment, food safety, plant disease control, pipeline engineering, and saline-alkali utilization. In this review, we discussed the mechanism of synthesis and degradation of calcium oxalate crystals and their physiological functions, and showed the practical application of related research results in urinary stone disease and other fields.

Medullary thyroid cancer (MTC) is characterized hy the secretion of calcitonin that is derived from parafollicular cells.20％-25％ of MTC are hereditary.Compared with other types of thyroid cancer,MTC is prone to recurrence,metastasis,and younger onset age.RET gene germline mutation accounts for the hereditary MTC,and somatic mutation is responsible for part of sporadic cases.A good correlation between phenotype and genotype is reported.We present in this article a case of medullary thyroid cancer patient with genetic diagnosis and treatment as well as postoperative follow-up together with RET gene screening results in her family members in order to call attention to the diagnosis and treatment of MTC.

[Summary] Graves'ophthalmopathy ( GO) is the most common extrathyroidal manifestation of Graves disease ( GD) . It is an organ-specific autoimmune disorder. The estimated incidence of GO in the general population is 16 women and 3 men per 100,000 population every year. Approximately 3%-5% of patients with GO are exposed to the potential of losing their sight and requiring optimized medical intervention. For the clinicians it is helpful to assess the degree of activity and severity of GO;both are important in deciding whether a patient requires intervention and which type of intervention is indicated. These interventions include management of hyperthyroidism, measures to relieve local symptoms, immunosuppressive therapies for active moderate and severe GO, and finally rehabilitative surgery for inactive patients.

ObjectiveTo retrospectively analyse the data of patients with suspected primary aldosteronism (PA) during the last five years.The receiver operating characteristic (ROC) curve was used to evaluate the value of aldosterone to renin ratio (ARR) in screening primary aldosteronism.MethodsThe clinical data of ARR in supine and upright positions were collected in 590 patients with suspected during January 2006 to August 2010.There were 357 patients diagnosed as primary aldosteronism and 233 patients as essential hypertension among these patients.100 patients with suspected primary aldosteronism took the upright and random ARR during September 2010 to April 2011 ; Among these patients,29 patients were diagnosed as primary aldosteronism and 71 as cases of essential hypertension.ROC curve was made to retrospectively define the method and the cut-off value of the supine,upright or random ARR.ResultsThe area under the curve(AUC) of the supine ARR in the 590 patients who took the supine and upright ARR during January 2006 to August 2010 was 0.838 (0.805-0.867 ) and the AUC of the upright ARR was 0.873 (0.843-0.899 ).There was significant difference between these two AUC readings (P＜0.01 ).The AUC in the upright ARR of the 100 patients who took the upright and random ARR during Septeuder 2010 to April 2011 was 0.962 (0.928 -0.995 ) and the AUC of the random ARR was 0.944 (0.893-0.994 ).There was no significant difference between these two AUC readings (P＞0.05).The upright ARR cutoff value with 400 ( pg · ml-1 )/( ng· ml-1 · h 1 ) yielded a sensitivity of 91.9％ and a specificity of 64.2％ to diagnosis of PA.ConclusionUpright ARR value was more suitable in the screening test than supine ARR value.Random ARR showed similar effect as the upright ARR.In our research,under strict control of the drug,position and detection time,ARR value with 400 ( pg · ml-1 )/( ng· ml-1 · h-1 ) can be the cutoff point in screening the suspcctcd PA patients.

Objective To develop a convenient method efficiently expands the frequency of specific CTLS.Methods We used different concentrations of CMV-speeific epitope peptides pp65 to stimulate PBMCs for expansion of CMV-specific CTLs.CMV-specifie CTLs were doubly labeled by tetramers-PE and CD_8-FITC for FACS analysis.Results The method expands CMV-speeific CTLs efficiently.CMV-specific CTLs were expanded from 1% to 20% of PBMCs quickly(namely 40% of CD_8~+ T cells).The method provided a large number of cells with tetramer staining of CD_8~+ T cells for FACS analysis from a single blood sampling.Conclusions Peptides stimulation methods are convenient,easy to operate and expanded CMV- specific CTLs efficiently.The increased frequencies of CMV-specific CTLs allowed the data of different individuals to be easily compared and sequentially evaluated.The methods lay the base for adoptive immunotherapy to prevent CMV disease.

Objective To study the expression and function relations of the p63 in ovarian serous carcinoma,and compare them with normal ovary tissue.Methods RT-PCR,in situ hybridization and im- munohistochemistry were used to detect the expression of the p63 in ovarian serous carcinoma,ovarian bor- derline serous tumors,ovarian benign serous tumors and normal ovary tissues.Results All samples ex- pressed p63 mRNA through RT-PCR and immunohistochemistry,while the levels of expression in ovarian tu- mors was higher than that of normal ovary.p63 in human borderline and malignant ovarian tumors was higher than that in human benign ovarian tumors with significant difference,which suggested p63 may play great roles in the origin and progression of ovarian tumors.The result of in situ hybridization showed that positive expression rate of p63 mRNA in ovarian cancer (92.1%) was significantly higher than that in normal ovary(0) or LWP ovarian cancer(50.0%).Conclusion Expression of p63 plays an important role in the development of varian carcinoma,and along with the difference of histological stage and clinico-pathological stage,the ex- pression of p63 gene and protein level were different.

OBJECTIVETo study clinical effects of short-segment fixation and injured vertebra bone grafting through injured pedicle for the treatment of thoracolumbar burst fractures under MAST Quadrant retractor via a paraspinal muscle approach.

METHODSThe data of 42 patients with thoracolumbar burst fractures treated from June 2009 to September 2012 were reviewed. There were 19 males and 23 females, with an average age of (55.2±11.9) years old. The mean injury time was (5.8±4.3) days. Fracture segments included T10 in 3 cases, T11 in 6 cases, T12 in 13 cases, L1 in 9 cases, L2 in 7 cases, and L3 in 4 cases. According to Denis classification, 9 patients were type A, 21 patients were type B, 5 patiens were type C, 5 patients were type D, and 2 patients were type E. All the patients were treated with short-segment pedicle screw-rod system fixation under MAST Quadrant via the paraspinal muscle approach. The operative time, blood loss, complications and the height of vertebra, kyphosis Cobb angle, VAS scores, JOA scores were measured before and after treatment.

RESULTSAfter treatment, the vertebral height and kyphosis Cobb angle were restored. Compared with preoperative results, postoperative vertebral height and kyphosis Cobb angle, VAS scores and JOA scores were all improved. But there was no statistically significance in vertebral height, kyphosis Cobb angle between postoperative at 1 week and 1 year.

CONCLUSIONInternal fixation combined with injured vertebra bone grafting through the injured pedicle for the treatment of thoracolumbar burst fractures via the paraspinal intermuscular approach under MAST Quadrant is a safe, minimally invasive, effective and satisfactory method.

Adult ; Aged ; Aged, 80 and over ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery