Objective To investigate the risk factors related with the recurrence of multifocal papillary thyroid microcarcinoma(PTMC).Methods The data of 126 patients undergoing surgery from Jan.2001 to Jun.2011 proved to be multifocal PTMC by pathology were rctrospcctively analyzed.Logistic multifactor regression analysis was used to analyze the clinicopathological factors that may influence the recurrence of PTMC.Results The median age of the 126 patients was 46 years(ranging from 15 to 78 years old).The recurrence rate was 14.3％ (18/126) and the overall survival rate was 98.4％ with the medium follow-up of 75 months (ranging from 24 to 150 months).Multivariate analysis showed that extra-thyoidal extension,neck lymph node metastasis and non-total(or near total)thyroidectomy were the independent risk factors for the recurrence of multifocal PTMC (P =0.008,0.027,0.022 respectively).Conclusions Extension beyond the thyroid and metastatic neck lymph node predict a high risk of recurrence.Total or near total thyroidectomy can reduce the risk of recurrence.

OBJECTIVE:To compare the efficacy and safety of alfacalcidol and strontium ranelate in the treatment of senile menopausal osteoporosis. METHODS:158 elderly menopausal patients with osteoporosis were randomly divided into control group (79 cases)and observation group(79 cases). All patients were orally given 1 Calcium carbonate D3 tablet,once a day. Based on it, control group was given 2 Alfacalcidol soft capsules,once a day. Observation group was additionally given 1 bag of Strontium ranelate dry suspension,orally before bedtime,once a day. The treatment course for both groups was 12 months. L2-4 and BMD of femoral neck,osteocalcin,TPINP and VAS and ADR before and after 6 and 12 months in 2 groups were observed. RESULTS:Before treatment,there were significant differences in the BMD of L2-4 and femoral neck,osteocalcin,TPINP and VAS scores be-tween 2 groups(P>0.05). BMD of L2-4 and femoral neck in control group after 12 months and in observation group after 6 and 12 months were significantly higher than before,and it gradually increased be time in observation,observation group was higher than control group;TPINP and VAS scores in control group after 12 months and in observation group after 6 and 12 months were significantly lower than before,and it gradually decreased be time,observation group was lower than control group,the differenc-es were statistically significant(P<0.05);osteocalcin levels in 2 groups were significantly higher than before,and it gradually in-creased be time,the difference was statistically significant (P<0.05),but there was no significant difference between 2 groups (P>0.05). There were no ADR during treatment. CONCLUSIONS:Based on the conventional treatment,the efficacy of alfacal-cidol and strontium ranelate is superior to alfacalcidol alone in the treatment of senile menopausal osteoporosis,with similar safety.

Objective To describe the epidemiological characteristics of suicide death and self?harm/suicide in China from 2006 to 2016. Methods Data in this study are from the datasets of National Death Cause Surveillance from 2006 to 2016 and the National Injury Surveillance Dataset 2016. The age?standardized death rate based on the population census in 2000 was used to describe the trend of suicide over years. This study also described the epidemiological characteristics of suicide death and the demographic characteristics, suicide methods and severity of patients who sought medical help after committing suicide or self?inflicted injury in 2016. Results Age?standardized suicide mortality had been declining from 9.23/100 000 in 2006 to 5.33/100 000 in 2016 by 42.25%. Suicide mortality increased with age. In 2016, the suicide mortality in China was 7.05/100 000, and among people over 85 years old was 49.49/100 000. In 2016, the dominant two suicide methods were poisoning (39.12%) and sharp injury (25.62%). The first leading method of suicide in rural population, urban population and young people aged 10?to 17?year?old was poisoning (65.13%), sharp injury (29.90%) and fall (25.47%), respectively. As age increased, the severity of suicide/self?inflicted injury increased. The proportions of serious cases among young people aged 10?to 17?year?old and older people aged 60 years old and above who sought medical help after committing suicide or self?inflicted injury were 4.88% and 26.86%, respectively. Conclusion China's suicide mortality has been declining and special attention should be given to the suicide of old people.

Objective To describe the epidemiological characteristics of suicide death and self?harm/suicide in China from 2006 to 2016. Methods Data in this study are from the datasets of National Death Cause Surveillance from 2006 to 2016 and the National Injury Surveillance Dataset 2016. The age?standardized death rate based on the population census in 2000 was used to describe the trend of suicide over years. This study also described the epidemiological characteristics of suicide death and the demographic characteristics, suicide methods and severity of patients who sought medical help after committing suicide or self?inflicted injury in 2016. Results Age?standardized suicide mortality had been declining from 9.23/100 000 in 2006 to 5.33/100 000 in 2016 by 42.25%. Suicide mortality increased with age. In 2016, the suicide mortality in China was 7.05/100 000, and among people over 85 years old was 49.49/100 000. In 2016, the dominant two suicide methods were poisoning (39.12%) and sharp injury (25.62%). The first leading method of suicide in rural population, urban population and young people aged 10?to 17?year?old was poisoning (65.13%), sharp injury (29.90%) and fall (25.47%), respectively. As age increased, the severity of suicide/self?inflicted injury increased. The proportions of serious cases among young people aged 10?to 17?year?old and older people aged 60 years old and above who sought medical help after committing suicide or self?inflicted injury were 4.88% and 26.86%, respectively. Conclusion China's suicide mortality has been declining and special attention should be given to the suicide of old people.

OBJECTIVE: To explore the effect of traditional Chinese herbal medicine (TCM) for nourishing liver and kidney, clearing meridians and removing toxic substances, on the neurobehavioral manifestations and the activity of the dopamine D2 receptor in rat with levodopa-induced dyskinesias (LID). METHODS: The rat model of Parkinson's disease (PD) was established by injecting 6-hydroxydopamine (6-OHDA) into right substantia nigra of brain, then, the model of LID in rat was produced by injecting levodopa (LD) and benserazide for 4 weeks. The rats were divided into normal control group, 4-week LD treated group, 4-week LD plus TCM treated group, 8-week LD treated group, and 8-week LD plus TCM treated group, and the effect of the TCM on neurobehavioral manifestations was observed. The radioligand binding assay (RLBA) and Scatchard drawing were used to measure the maximal binding capacity of receptor (Bmax) and equilibrium dissociation constant (KD) of the dopamine D2 receptor in corpora striatum. RESULTS: Compared with the 4-week LD treated group and 8-week LD treated group, TCM could decrease abnormal involuntary movement scores of the rats with LID; the RLBA revealed that the dopamine D2 receptor Bmax significantly increased (P<0.05, P<0.01) and the KD significantly decreased (P<0.05). CONCLUSION: TCM can improve the activity of the dopamine D2 receptor and relieve the symptoms of LID.

Objective To document the MRI features of renal angiomyolipoma (RAML) containing minimal fat and to explore whether the MR features vary depending on the tumor size. Methods The MR findings of 15 cases of pathologically-proved RAML containing minimal fat were reviewed retrospectively from January 2008 to March 2010. All patients underwent MR in a 1.5 T or 3.0 T scanners. The MR features of the lesions were analyzed, with emphasis on the signal intensity and homogeneity on T2WI, in regards to pseudocapsule, lipid component, hemorrhage, cystic degeneration or necrosis, blood vessels, interface with renal parenchyma and enhancement pattern. All lesions were categorized into 2 groups; those with diameter ＞4 cm and those with diameter ≤4 cm. The difference of imaging characteristics between these two groups was analyzed using Fisher exact test. Results All 15 lesions demonstrated hypointensity on T2WI compared to the renal parenchyma. Homogeneous signal intensity on T2WI was seen in 6 lesions (6/15); peritumoral pseudocapsule in 3 lesions (3/15); cystic degeneration or necrosis, hemorrhage in 5 lesions (5/15); flow void of blood vessels in 2 lesions (2/15); lipid component in 4 lesions (4/15); angular interface with renal parenchyma in 10 lesions (10/15); homogeneous enhancement in 8 lesions (8/15). Fifteen lesions were divided into two groups; 9 categorized into group 1 (the maximum diameter ≤ 4 cm) and 6 into group 2 ( the maximum diameter ＞ 4 cm). Cystic degeneration or necrosis was seen in 0 of 9 in group one and 5 of 6 in group two respectively, hemorrhage(0 of 9 and 5 of 6 respectively) and pseudocapsule(0 of 9 and 3 of 6 respectively. The difference between these findings in the two groups demonstrated statistical significance (P ＜ 0. 05). Conclusion The MR features of RAML containing miminal fat were hypointensity on T2 WI,angular interface with renal parenchyma and homogeneous contrast enhancement, however, these findings can vary depending on the tumor size.

As a common disease in clinical, the treatment of lumbar disc herniation (LDH) focused on local intervertebral disc, such as surgery and other interventional therapy treatment, but postoperative complications and recurrence rate has been a difficult problem in the field of profession. With the development of spine biomechanics and anatomy, researches on lumbar herniation also increased. Researchers discovered that the incidence and prognosis of LDH were inseparable with local muscle and soft tissue. As the deep paraspinal muscles, multifidus muscle plays an important role to make lumbar stability. Its abnormal function could reduce the stable of lumbar spine, and the chronic lumbar disease could also lead to multifidus muscle atrophy.
Animals ; Humans ; Intervertebral Disc Displacement ; physiopathology ; surgery ; Lumbosacral Region ; physiopathology ; surgery ; Paraspinal Muscles ; physiopathology

Objective To establish the method of testing immunoglobulin G (IgG) with Fc sialylation, and to investigate the clinical significance of IgG with Fc sialylation in systemic lupus erythematosus (SLE), especially in those with neuropsychiatric manifestations (NPSLE). Methods Seventy-five SLE including thirty patients with neuropsychiatric manifestations (NPSLE) and forty-five non-NPSLE patients, 30 rheuma-toid arthritis (RA) patients, 32 juvenile idiopathic arthritis (JIA) patients and 41 healthy controls were recruited in this study. Standard method of testing lgG with Fc sialylation was established by a lectin based sandwiched enzyme linked immunosorbent assay (ELISA). The levels of IgG with Fc sailylation were assayed, and its clinical significance was evaluated. Results There were no difference in the levels of serum IgG with Fc sailylation in RA group (0.82±1.81) mg/ml, JIA group (0.69±1.30) mg/ml, healthy control group (0.64± 1.09) mg/ml, and the levels of IgG with Fc sailylation in SLE group (0.12±0.17) mg/ml (P<0.01), especially in NPSLE group [(0.03±0.03) mg/ml, P<0.01] was significantly lower than that of control groups. The perc-entage of IgG with Fc sialylation in control group (4.64±5.90)% were significantly higher than that in non-NPSLE (1.88±2.16)% (P<0.01) and in NPSLE (0.29±0.47)% (P<0.01). The percentage of IgG with Fc sial-ylation was negatively associated with SLEDAI score (r=-0.43, P<0.01). Conclusion Significantly low level of serum IgG with Fc sialylation was associated with disease activity in SLE patients, especially in NPSLE patients, lgG with Fc sialylation may be a new target for therapeutic strategy.

Objective To establish a swine model of 10 min prolonged cardiac arrest (CA) induced by electrically triggered ventricular fibrillation,and then evaluate the quality of the model and the value in the establishment of post-cardiac arrest syndrome.Methods Fourteen domestic healthy swine weighing 38 ±3 kg were selected for study.Ventricular fibrillation was induced for 10 min,and then cardiopulmonary resuscitation (CPR) was initiated and continued for 5 min.The resuscitated animals were observed for 72 h after resuscitation.The resuscitation outcomes and survival rate were recorded.The functions of heart,lung and brain,and systemic inflammatory response and tissue perfusion were regularly evaluated for 72 h post-resuscitation.Results Eleven of the fourteen swine obtained restoration of spontaneous circulation (ROSC),and the rate of successful resuscitation and 72 h survival were both 78.6％.Significantly worse post-resuscitation myocardial function was found in all animals compared to the value prior to CA and the myocardial function was evaluated by decreased stroke volume and global ejection fraction,and increased levels of serum cardiac troponin-Ⅰ and n-terminal pro brain natriuretic peptide.Postresuscitation extra-vascular lung water index and pulmonary vascular permeability index were significantly increased accompanied with significantly decreased oxygenation index compared with the values before CA,indicating the occurrence of acute lung injury.In addition,post-resuscitation systemic inflammatory response and tissue low perfusion evidenced by significantly higher levels of serum tumor necrosis factor-α and interleukin-6 and arterial blood lactate were observed.Consequently,severe neurological deficit with significantly higher levels of serum neuron-specific enolase and S-100B was observed following 72 h postresuscitation.Conclusions This swine model of prolonged cardiac arrest induced by electrically triggered ventricular fibrillation was a well established model with high success rate of resuscitation,significant vital organ injury and relatively long duration of survival;it is an excellent model for the study of post-cardiac arrest syndrome.

Aim To investigate the role of calcitonin gene related peptide(CGRP),ATP sensitive potassium channel(KATP)and spinal nerve in the protective effect of intrathecal morphine preconditioning against myocardial postischemia injury in rats.Methods Rats were established intrathecal catheter placement and myocardial ischemia reperfusion models were randomly assigned to 10 groups:control group(CON);intravenous dimethylsulfoxide group(DMSO);intravenous CGRP8-37 group(CGRP8-37,a selective CGRP receptor antagonist,3 nmol?kg~-1);intravenous glibenclamide group(GLI,a non-selective KATP channel inhibitor,0.3 mg?kg~-1);intrathecal 10 ?l of 1% lidocaine group(LID);intrathecal 3?1 ?g?kg~-1 morphine preconditioning group(MPC);intravenous 3 nmol?kg~-1 CGRP8-37+MPC group(CGRP8-37+MPC);intravenous 0.3 mg?kg~-1 GLI+MPC group(GLI+MPC);intravenous 0.3 mg?kg~-1 GLI+LID group(GLI+LID).Indicators to be observed were MAP,HR and RPP(MAP?HR),the volume of area at risk(AAR)and infarct size(IS),and the area of myocardial infarction,which was demonstrated by IS/AAR.Results Compared to CON group,the volume of IS and IS/AAR was reduced in MPC,LID,LID+MPC and GLI+LID group(P