Objective To investigate the feasibility of reconstruction of ureter with tubularized peritoneal free grafts for the treatment of avulsion of ureteral mucosa using animal models.Methods Twelve adult dogs were randomly divided into the reconstruction group(n=6) and the control group(n=6).Firstly,the model of avulsion of ureteral mucosa about 3-5 cm long was made.In reconstruction group,tubularized peritoneal free grafts and ureteral stents were placed in the injured ureters;and in control group,no operation was performed but to place the stents into the ureter.The curative effect was observed by IVU and histological examination 10 weeks after operation.Results In reconstruction group,IVU showed normal size and morphology of the kidneys.There was no hydronephrosis,and no obvious stricture of the part of ureter in which peritoneal free grafts were used as mucosa substitutes.In control group,IVU showed no image or only obscure enlarged outlines of the kidneys,and no image of the ureters.Atresia or severe stricture of the ureters was observed in all dogs in control group;while in reconstruction group,the peritoneal membrane was replaced by integrate transitional epithelium,and no obvious stricture was observed.Subepithelial abundant neovascularization was also seen.Conclusions For avulsion of ureteral mucosa exceeding 3 cm,placing stents only will lead to ureteral stricture or atresia,reconstruction using tubularized peritoneal free grafts as mucosa substitutes is an effective method.

Objective To investigate the clinical features and risk factors of adult nephrotic syndrome with pulmonary thromboembolism (PTE). Methods Sixty patients diagnosed with nephrotic syndrome and clinically suspected with PTE were enrolled in this retrospective study. Patients were divided into PTE group (n=32) and no-PTE group (n=28) according to the results of computed tomographic pulmonary angiography (CTPA). The single factor analysis and Logistic repres?sion analysis were used to analyse risk factors including age, gender, onset time, clinical symptoms, laboratory examination and pathological types. According to the independent risk factors, the receiver-operating characteristic curve (ROC curve) was used to determine PTE threshold value based on the evaluation index in nephrotic syndrome. Results Single factor analysis showed that there were significant differences in disease duration, hemoglobin, serum albumin, total cholesterol, low-density lipoprotein cholesterol, D-dimer and physical examination in P2 hyperthyroidism between two groups (P <0.05). Logistic regression analysis showed that D-dimer was independent risk factor of PTE. The analysis of ROC curve indi?cated that D-dimer optimal threshold was 1 015.50μg/L. Conclusion D-dimer is an independent risk factor of PTE in pa?tients with nephrotic syndrome. When D-dimer is greater than 1 015.50μg/L, should pay attention to the occurrence of PTE.

Objective In order to understand whether recombinant human growth hormone(r-hGH) can improve the idiopathic short stature(ISS) boys' final adult height(FAH).Methods We measured 16 cases diagnosed as ISS boys FAH, divided into 2 groups, of which 9 cases were not given r-hGH treatment, treatment group ,7 patients received r-hGH treatment, a dose of 0.1 ～ 0.13 U· kg-1·d-1, before going to sleep subcutaneous injection, duration of treatment was 6 ～ 20 months ( 11.9 ± 5.2 months).Results The treatment group compared with the average FAH FAH observation group had significantly improved the average(t =2.219,P<0.05).Conclusion r-hGH can improve the ISS boys FAH, but early treatment, the longer the course the more obvious effects.

ObjectiveTo investigate the neural mechanism of prospective memory(PM) using functional magnetic resonance imaging (fMRI).MethodsFifteen healthy volunteers were enrolled,and all subjects were scanned with fMRI while performing the event-based PM tasks (double-task paradigm,including the ongoing task and PM task).And the image data were preprocessed and analyzed by using SPM8 software.Results ( 1 ) Compared to the control task,bilateral rostral prefrontal cortex ( x,y,z =6/- 2,54/42,- 8/- 12,t =3.71 ),right somatosensory association area ( x,y,z =14,- 62,64,t =4.64 ),superior temporal gyrus ( x,y,z =42,- 46,16,t =3.95 ) and right paracentral lobule (x,y,z =10,-22,76,t =4.01 ) were activated significantly by the ongoing task (P ＜ 0.001 ).(2) Bilateral rostral prefrontal cortex ( x,y,z =- 2/6,42/54,- 12/- 12,t =3.28) and paracentral lobule (x,y,z =- 30/10,- 22/- 22,72/76,t =4.25 ),left postcentral gyrus ( x,y,z =- 38,- 46,64,t=3.13) and middle occipital gyrus ( x,y,z =- 30,- 70,0,t =3.97 ) were activated significantly by the PM task (P ＜ 0.001 ).ConclusionRostral prefrontal cortex (BA 10 area) is the major area of prospective memory,and medial BA10 area may be involved in the monitoring of external cues.The present study supports the gateway hypotheses of prospective memory.

BACKGROUND: Amnesic shellfish poisoning(ASP) is caused by consumption of seafood contaminated by marine neurotoxins, mainly domoic acid (DA).OBJECTIVE: To ensure the safety of shellfish consumption by determining DA in shellfish by means of liquid chromatography(LC) combined with quadrupole time-of-flight mass spectrometry(Q-TOF MS).DESIGN: A self-controlled prospective study SETTING: The experiment was carried out in the Center for Animal, Plant and Food Inspection and Quarantine, Shanghai Exit-Entry Inspection and Quarantine Bureau.MATERIALS: MUS-1B, a nominal sample of homogenized mussel tissue (containing 36 ± 1μg DA per gram, Batch No. MUS-1B 0159) and the standard DA solution (100 mg/L, Batch No. DACS-1C 352) were purchased from National Research Council of Canada (Halifax, Canada). Positive musscl samples were collected from the waters during the occurrence of red tide in China East Sea, and blank mussel samples were obtained from local seafood market. LC system (Waters 2695) combined with Q-TOF MS (Qultima, Micromass) and ultravilet (UV) detection (Waters 2487 ) was employed for analysis of ASP toxins.METHODS: The shellfish tissue samples were extracted with methanol-water (1: 1, V/V) and cleansed with a SAX solid-phase extraction cartridge. Separation was carried out on a Zorbax Eclipse XDB-18 column (250×2.1 mm, 3.5μm) with gradient elution of CAN-H20 containing 0.05% formic acid at a flow rate of 0.20 mL per minute. In a positive electrospray ionization DA was ionized effectively, and collision-induced dissociation(CID) produced predominant characteristic ions[M + H] +allowing sensitive TOF MS detection.MAIN OUTCOME MEASURES: ① Limit of quantification(LOQ); ②Accuracy and precision of LC/Q-TOF MS method.RESULTS: The average recoveries of DA spiked to tissue homogenates through the complete cleanse procedure ranged from 87.8% to 94.6%, and the relative standard deviations(RSD) ranged from 8.4% to 11.9%. TheLOQ in the shellfish tissue was 0.1 μg/g.CONCLUSION: LC/Q-TOF MS suits well the purpose of detecting and identifying ASP toxins in shellfish with high sensitivity and specificity, and may provide reference values for monitoring the safety of consumption of shellfish.

OBJECTIVE To evaluate the value of central compartment neck dissection for cN0 papillary thyroid carcinoma.METHODS The clinical data of 46 cases with cN0 papillary thyroid carcinoma in our hospital from Jan.1999 to June 2004 were retrospectively studied.The level Ⅵ lymph nodes were removed during the operation.RESULTS In 46 cN0 cases,there were 11 cases(23.9 %) pathologically proved lymph nodes metastasis after operation.Four patients developed neck recurrence and underwent neck dissection.CONCLUSION It is necessary to probe the level Ⅵ lymph nodes during the operation for cN0 papillary thyroid carcinoma patients.

Objective To investigate the relationship between thyroid and breast multiple primary carci-nomas.Methods A total of 24 cases of multiple primary tumors of thyroid and breast admitted from Jan .2011 to Jun.2013 in First Affiliated Hospital of Zhengzhou University were retrospectively analyzed .Results The 24 samples were confirmed as the tumor of thyroid and breast by ultrasonography .The patients underwent operation and adjuvant therapy after fine-needle aspiration biopsy , mammography and other relevant examinations .All the malignancies of thyroid and breast were confirmed by pathology .Among the 24 cases, 19 patients were invasive ductal carcinomas , 2 patients were diagnosed as intraductal carcinomas , 1 patient was confirmed as intraductal papillary carcinoma , 1 case was invasive lobular carcinoma with invasive ductal carcinoma , and 1 case was inva-sive ductal carcinoma with intraductal carcinoma .All the thyroid malignancies were papillary thyroid carcinomas . The results of immunohistochemistry indicated that , among the 24 patients of thyroid and breast multiple primary carcinomas , 11 cases were ER (+) in both thyroid cancers and breast cancers , moreover , 8 cases were ER (-) in both thyroid cancers and breast cancers .The difference between the expression of ER in the tumors of thyroid and breast had no statistical significance (P>0.05).Conclusions Ultrasonography is a simple and effective im-aging method that can discover the multiple primary tumors of thyroid and breast .For patients of thyroid cancer , breast cancer should be excluded routinely .The thyroid should also be examined simultaneously in breast cancer patients.Once the possibility of one gland tumor is discovered , we should pay more attention to the other gland . Particularly, the other gland should be examined carefully for patients with ER (+).

Objective To evaluate the efficacy and safety of tacrolimus 0.03％ ointment for the treatment of 2-year-old patients with moderate to severe AD.Methods An open-labeled,non-comparative,multi-center study was carried out,which included 59 2-year-old children with moderate to severe AD.All the patients were given topical tacrolimus 0.03％ ointment twice daily for 3 weeks.The evaluation of patients was scheduled at the baseline,1,2,and 3 weeks after the start of treatment.Clinical outcome parameters included the total response rate,eczema area and severity index score (EASI score),the percentage of body surface area (BSA％) affected,physician's global evaluation (PGE),children's dermatology life quality index (CDLQI),visual analog scale (VAS) pruritus score.Safety was assessed based on adverse events reported by patients or observed by the physicians.Results At the end of the treatment,the total response rate was 65.85％ with an EASI score of 4.18,and BSA％ of 16.41％.Of these patients,85.10％ achieved a satisfactory outcome,2.13％ achieved a complete cure,and all achieved an improvement,with no exacerbation observed.The 3-week treatment also resulted in a significant decrease in VAS pruritus score (from 6.80 to 3.21) and CDLQI (frown 7.06 to 2.91).Side effects mainly manifested as temporary burning sensation at the application site,and no severe adverse events associated with tacrolimus were observed.Conclusion Tacrolimus 0.03％ ointment seems safe and effective for the treatment of 2-year-old patients with moderate to severe AD.

Objective To evaluate the application of “expert-guided network tracking system” in training community general practitioner for hypertension management.Methods Total 855 general practitioners (GPs) from 20 community health service centers in Hangzhou,Jiaxing and Shaoxing of Zhejiang province were divided into two groups: 430 GPs from 10 community health centers received training for hypertension management using “ expert-guided networking tracking system” (intervention group) in December 2008 and 425 GPs from another 10 health centers received conventional training (control group).Questionnaire surveys about the knowledge and skill of hypertension management were conducted before and 3 y after training.Results The awareness rates of knowledge about hypertension prevention and control,non-drug therapy and drug therapy increased from 37.0％ (159/430),45.6％ (196/430),42.8％ (184/430) to 66.8％ (284/425),81.4％ (346/425),77.6％ (330/425),respectively and the accuracy of case analysis increased from 38.4％ (490/1290) to 73.3％ (946/1290) (P ＜0.01) after training in intervention group.Meanwhile the knowledge and case management abilities in control group were also improved after conventional training,but the degree was significantly lower than that in the intervention group.Conclusions “Expert-guided networking tracking system” can significantly improve the knowledge and skills for hypertension management in community general practitioners.

Objective To study the therapeutic effect of Fe3O4 nanometer magnetic fluid-induced hyperthermia on implanted liver cancer in nude mice under alternating magnetic field. Methods Nude mice model bearing implanted HepG2 was established. Mice were then randomly divided into 3 groups: the blank control group; the magnetic field group; nanometer magnetic fluid group. The magnetic field group were just put under the magnetic field; Nanometer magnetic fluid group received injection of PEG-PEI/Fe3O4 nanometer magnetic fluid under the alternating magnetic field. At the frequency of 40 kHz, and magnetic field of 5 kA/m, 15 minutes one day in the next 14 days. On the 7th day and the 15th day, the changes of tumor volume and weight were recorded, cell apoptosis were observed and recorded and pathological examination was done. Results On the 7th and the 15th day, in the nanometer magnetic fluid group, tumors' volume was smaller and the weight was lighter than other groups, and the tumor inhibitory rate of 54. 20% (t = 14. 506,P ＜0. 01 ) was significantly higher than the control group and the magnetic field group 22. 66% ( t = 7.497, P ＜ 0. 05 ). In the control group, tumor cells grew well, high density, the nucleus engrained, the shape irregular, the nuclear fission clear; compared with the control group, in the magnetic field group, tumor cells scatter thinly, intercellular substance increases, and necrosis area formed;in the nanometer magnetic fluid group, many of tumor cells died, their cell nucleus broke up and vanished,the blood vessel reduced obviously, and the tumor cell spread thinly. Conclusions Under the alternating magnetic field, PEG-PEI/Fe3O4 nanometer magnetic fluid inhibits liver cancer growth in nude mice model of HepG2.