Eosine Yellowish-(YS) ; Frozen Sections ; Hematoxylin ; Humans ; Staining and Labeling

Objective To Explore the significance of successful exposing and recognizing Zuckerkandl's tuhercle(ZT)during thyroidectomy.Methods Three hundred and seventy patients(501 sides) underwent lobectomy or total thyroidectomy from January 2009 to June 2011 were included in this study.The ZT was assessed in terms of its presence or absence,size and anatomical association with the recurrent laryngeal nerve(RLN)and superior parathyroid(SP).Results ZTs were found in 412 of 501 sides ( 82.2％ ),among which 368(89.3％ ) ZTs were located in the middle third of the lateral lobe of the thyroid gland.ZTs passed over the RLN in 379 of 412 sides(92.0％ ).When the ZTs were located in the middle or lower third of the lateral lobe of the thyroid gland,the SPs were all located in the cranial portion of ZT.The SP was adhered to the ZT in 80.1％ of the cases.RLN damage rate was 0.40％,and no SP damage occurred.Conclusion Exposing and recognizing Zuckerkandl's tubercle during thyroidectomy is of important clinical significance,which helps to identify and protect RLN and SP,so as to reduce surgical complications.

Objective To study the influence of various doses and injection rates of contrast agent on CT perfusion in rabbits' liver with a deconvolution mathematical model. Methods Eight rabbits were enrolled in the experiment. Randomized block design was adopted. The treatment factor (contrast medium injection rate) was classified into 0.5, 1.0, 1.5 ml/s, while the subjects were divided into 3 blocks with contrast medium injection dose of 0.5, 1.0 and 1.5 ml/kg. The data obtained at CT perfusion imaging were then transferred to the workstation. Absolute values of 7 perfusion parameters (hepatic arterior fraction, blood flow, blood volume, permeability surface, mean transmit time, hepatic artery perfusion and portal vein perfusion) were measured with perfusion software (Perfusion 3). Results The dose of contrast medium had significant effect on peak enhancement of the aorta, the portal vein and liver tissue (P<0.05), whereas the injection rates had significant influence on the arrival time to peak enhancement of the aorta and the portal vein. However, the dose of contrast medium and injection rates had no significant effect on perfusion parameters (P>0.05). Conclusion CT perfusion imaging with a deconvolution mathematical model can quantify the hemodynamic functional status in liver with stable results. This technique does not need strict confinement to dose and injection rate of contrast medium, and has great potential value to be put into clinical use.

BACKGROUND:Medical devices from animals are commonly used in clinical application. Despite their efficiency is widely accepted, their safety, especialy immunity has been concerned. OBJECTIVE:To investigate immunity risk control to medical devices from animals for safety consideration. METHODS:Using “α-Gal antigen, immunity, xenotransplantation” in Chinese and English as the key words, the first author conducted a computer search of Science direct database (www.sciencedirect.com), Wiley-Blackewel database (http://onlinelibrary.wiley.com) and Wanfang database (www.wanfang.com.cn) through screening the titles and abstracts. RESULTS AND CONCLUSION:Increasing evidence shows that, Gal α1-3Gal antigen (α-Gal antigen) is recognized as the major antigen and abundantly expressed on glycoconjugates of non-primate mammals and New World monkeys. In contrast, the α-gal epitope is not expressed on glycoconjugates of humans and Old World monkeys. Instead, they produce a very large amount of natural anti-α-Gal antibody that specificaly binds the α-gal epitope. The binding of human natural anti-α-Gal to α-gal epitopes expressed on non-primate mammal animals was expected to be unique immunological barrier in xenotransplantation. Therefore, it is important to choose raw materials, reduce or eliminate the α-Ggal epitope, establish highα-Ggal epitope detection methods with high sensitivity and good repeatability for achieving a greater safety and efficiency of medical devices from animals.

Aneuploidy ; Biomarkers, Tumor ; metabolism ; DNA, Neoplasm ; genetics ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Nucleolus Organizer Region ; metabolism ; Proliferating Cell Nuclear Antigen ; metabolism ; S Phase

Objective: To observe the clinical effect of traditional Chinese medicine enema combined with rhubarb acupoint in the treatment of severe acute pancreatitis(SAP) complicated with paralytic ileus. Methods: A total of 60 SAP patients complicated with paralytic ileus treated in the First People's Hospital of Huzhou from June 2015 to June 2017 were selected and randomly divided into two groups by random lottery method, with 30 cases in each group.The two groups were treated with routine anti-infection and rehydration.The control group was treated with traditional Chinese medicine enema combined with placebo, and the observation group was treated with traditional Chinese medicine enema combined with rhubarb on Shenque acupoint, and the two groups were treated for 7d.The recovery time of blood amylase, bowel sounds recovery time, first self defecation time, local complications and mortality were observed in the two groups. Results: The recovery time of blood amylase, the recovery time of intestinal sound and the time of the first defecation were (8.87±2.30)d, (2.88±1.09)d and (3.51±1.32)d, respectively, which were significantly shorter than those of the control group [(10.29±2.01)d, (3.67±1.30)d and (4.57±1.41)d], the differences were statistically significant(t=-3.601, -3.607, -4.251, all P<0.001). The incidence rate of local complications in the observation group was 6.7%(2/30), which was significantly lower than 36.7%(11/30) in the control group(χ²=16.875, P<0.001), and there was no statistically significant difference in the mortality rate between the two groups(χ²=3.333, P=0.068). Conclusion The application of Chinese medicine enema combined with the acupoint of rhubarb in the treatment of SAP patients complicated with paralytic ileus can effectively promote the recovery of intestinal peristalsis, shorten the duration of paralytic intestinal obstruction, reduce the complications and improve the clinical effect.

Objective: To explore the effect and safety of fractional 1565 nm laser on white striae gravidarum (SG) in abdomen and observe the influencing factors of treatment effect. Methods: Thirty-six patients, aged 24-39 years old, were randomly divided into two groups(group A, n=16, group B, n=20): patients in group A underwent two passes of laser treatment: striae were locally scanned at moderate level energy(35 mJ/μb) with high density(300 dot/cm²), and high level energy (45 mJ/μb)with low density(150 dot/cm²)was adopted for the whole area.Group B received one pass of treatment at moderate energy with high density 35 mJ/μb, 300 dot/cm²). All patients received three laser treatments at a 6 weeks interval. Improvement of SG appearance was assessed by blinded reviewers, 3 months after the last treatment, using a percentage category scale. Meanwhile, patients satisfaction was evaluated. The impact of skin aging on laser treatment was evaluated. Patient satisfaction scores and side effects were evaluated. Results: All patients completed the overall trial. The average improvement of scores was 1.69±0.95, which contributed to a fairly good response rate of 88.89%. The patients satisfactory and very satisfactory rate was 58.3%(21/36). There was no significant difference in improvement score between group A(1.88±0.89) and group B(1.55±1.00) (P< 0.01). The operation duration of group B was shorter than group A, (29.6±4.9)min vs.(53.7±5.5)min, P<0.05. There was a moderate negative correlation between aging and laser treatment effect (r=-0.553). The abnormal color of skin(erythema and post-inflammatory hyperpigmentation) in group A lasted longer than group B, (9.17±4.03)d vs. (6.73±2.29)d, P<0.05.The pain score during treatment was tolerable, with the score of 2.61±0.76. Conclusions The treatment with fractional 1565 nm laser can improve the appearance of SG. It is more timesaving when the entire implicated area treated by one pass at moderate level energy with high density. Skin aging will discount the effect.

Objective:To introduce the clinical experience and treatment effect of congenital radial longitudinal deficiency in children with one-stage bilobed flap combined with centralization by circular external fixation.Methods:Analysis and statistics from 14 children with radial longitudinal deficiency were summarized in our hospital from January 2006 to December 2018, 8 males and 6 females; aged 3 to 17 years, average 9.7 years. 3 patients on the left side, 10 patients on the right side, 1 case bilateral.1 case was type Ⅱ, 7 cases were type Ⅲ, 6 cases were type Ⅳ.2 cases were with scoliosis. The radial angulation of 30°- 90°(average 67.3°) before operation. In the first phase, bilobed flaps were used to completely release soft tissue and restore dynamic balance. After the centralization, it was fixed with a circular external fixation. Three cases underwent ulnar osteotomy and forearm extension at the same time. Follow-up indicators: Observe the flap survival in the short term, and follow up on the radial deviation of the wrist and the degree of wrist mobility for a long time.Results:In one patient, the distal part of the dorsal wrist flap was necrotic, the necrotic part was removed and directly sutured 12 days later, and the rest all survived. During a follow-up period of 2 to 8 years (average 3.6 years), the average radial angulation was 9.3° (2°to 17°), the average flexion of the wrist was 46.7°(25°to 70°), and the average extension was 14.7° (5°to 20°). One case which forearm extension had a fractured nonunion and bone graft with internal fixation was performed in 9th after surgery, and ulna healed in 3 months after bone grafting. The forearm radial deflection was significantly improved in all patients, and functional recovery was satisfactory.Conclusions:Treatment of radial longitudinal deficiency in children in one-stage bilobed flap combined with centralization by circular external fixation is an effective clinical treatment method. It can reduce the number of operations, obtain satisfactory appearance and receive good functional recovery.

Objective:To introduce the clinical experience and treatment effect of congenital radial longitudinal deficiency in children with one-stage bilobed flap combined with centralization by circular external fixation.Methods:Analysis and statistics from 14 children with radial longitudinal deficiency were summarized in our hospital from January 2006 to December 2018, 8 males and 6 females; aged 3 to 17 years, average 9.7 years. 3 patients on the left side, 10 patients on the right side, 1 case bilateral.1 case was type Ⅱ, 7 cases were type Ⅲ, 6 cases were type Ⅳ.2 cases were with scoliosis. The radial angulation of 30°- 90°(average 67.3°) before operation. In the first phase, bilobed flaps were used to completely release soft tissue and restore dynamic balance. After the centralization, it was fixed with a circular external fixation. Three cases underwent ulnar osteotomy and forearm extension at the same time. Follow-up indicators: Observe the flap survival in the short term, and follow up on the radial deviation of the wrist and the degree of wrist mobility for a long time.Results:In one patient, the distal part of the dorsal wrist flap was necrotic, the necrotic part was removed and directly sutured 12 days later, and the rest all survived. During a follow-up period of 2 to 8 years (average 3.6 years), the average radial angulation was 9.3° (2°to 17°), the average flexion of the wrist was 46.7°(25°to 70°), and the average extension was 14.7° (5°to 20°). One case which forearm extension had a fractured nonunion and bone graft with internal fixation was performed in 9th after surgery, and ulna healed in 3 months after bone grafting. The forearm radial deflection was significantly improved in all patients, and functional recovery was satisfactory.Conclusions:Treatment of radial longitudinal deficiency in children in one-stage bilobed flap combined with centralization by circular external fixation is an effective clinical treatment method. It can reduce the number of operations, obtain satisfactory appearance and receive good functional recovery.