Objective To evaluate the clinical significance of serum thyroglobulin autoantibody(TGAb) in thyroglobulin(TG)-negative and TGAb-positive patients with differentiated thyroid carcinoma(DTC)after thyroid ablation and ascertain the optimal operating point(OOP)of TGAb.Methods A total of 169 patients with histologically confirmed DTC and thyroid remnant ablation showed TG-negative and TGAb-positive results which were assessed by electrochemiluminescence immunoassay(ECLIA).The cases were divided into group A(59 cases)and group B(110 cases)with or without evidence of recurrence or metastasis,respectively.The receiver operating characteristic(ROC)curve and positive likelihood ratio of different threshold values were analysed according to their serum TGAb level.Results Serum TGAb level(1368?1343)IU/ml in group A was significantly higher than that(154?539)IU/ml in group B(P1000 IU/ml was 1.12 times that of 204 IU/ml≤TGAb≤1000 IU/ml,4.03 times that of 100 IU/ml≤TGAb

Objective The aim of this study was to evaluate the diagnostic value of thyroglobulin(Tg)mRNA in peripheral blood samples of patients with differentiated thyroid carcinoma(DTC)after remnant ablation.Methods Tg mRNA Was detected by reverse transcription-polymerase chain reaction(RT-PCR)in peripheral blood of 162 patients.SPSS 13.0 was used for date analysis.Results The Tg mRNA assay had higher sensitivity than the conventional serum Tg measurement[86.61%(97/112)vs 53.57%(60/112),X2=29.153,P＜0.001]which Was the"gold standard"for the identification of recurrence or metastases.In the anti-Tg antibodies(TgAb)positive DTC patients,the sensitivity of Tg mRNA was higher than that of serum Tg[86.54%(45/52)vs 0]in identifying recurrent or metastatic thyroid disease(X2=79.322,P＜0.001).There was a significantly positive correlation between Tg mRNA expression and the clinical stages(Kendall correlation coefficient=0.515,P＜0.001).There was no difference of Tg mRNA expression in peripheral blood among ages,sex,pathological types and location of metastases,respectively(Kendall correlation coefficient=0.020,0.069,0.050 and 0.028;all P＞0.05).Conclusions Circulating Tg mRNA is a more sensitive marker than serum Tg in identifying recurrent or metastatic DTC,particulady in patients during levo-thyroxine(l-T4)therapy and with TgAb-positive.The DTC patients who have positive expression of Tg mRNA indicates poor prognosis.

Objective To summarize the method of forearm skin flap with dorsal interosseous artery placed by turning the proximal end of the flap to the distal side of the wound to repair skin and soft tissue defect of palm and thumb of hand,and put forward the key points of operation.Methods From 2008 to 2013,the forearm skin flap with interosseous dorsal artery to repair skin and soft tissue defect of palm and the part between thumb and index finger in 20 cases.Dorsal interosseous artery in the forearm is passing through between superficial and deep layers of extensor muscles and sends out 5-13 cutaneous branches to dorsal antebrachium skin.The large skin flap has good blood supply with high survival rate.Results All flaps survived,and good results were achieved in all 20 cases.Conclusion The flap preserved two main arteries from upper limb with good blood supply,and the amount of blood supply of the flap depended on the size of flap,and the wound of donor site can be directly sutured up or covered with free skin graft,thus minimizing the alteration of appearance and function of donor area.

Objective:The objective of this study was to evaluate and compare the core attributes of the four general practice models in Guangzhou, Dongguan and Shenzhen, and to provide the suggestions for strengthening the general practice functions. Methods: We used the two stage sampling method in this study. Firstly, three CHCs in Guangzhou, two in Dongguan and two in Shenzhen, and the general medical outpatient department in the Shenzhen Hospital of the University of Hong Kong were selected. Secondly, we used the convenience sam-pling method to perform investigation. A PCAT-AE modified Chinese edition was adapted to measure the patients’ primary care experience. A total of 1 712 patients participated in the questionnaire survey, the number of which 1 645 copies were valid. Results: Generally, the general practice core attributes’ total scores from that hospital were higher than those from Guangzhou communities (55. 3 vs. 45. 9, P<0. 05), Dongguan commu-nities (55. 3 vs. 49. 2, P<0. 05) and the Shenzhen communities (55. 3vs. 51. 7, P<0. 05). Conclusion:The primary care implementation was different in accordance with the characteristics of regions, and the general practice core attributes had different characteristics in different models. It could constantly improve the primary care services to each model’s specific circumstances.

Objective:The general practice attributes constitute a basis for the high primary care performance. In this paper, the general practice attributes are measured, their influencing factors are analyzed, the causes of exist-ing problems are explored, and suggestions are straight forwarded to strengthen the general practice function. Meth-ods:In this study, a PCAT-AE modified Chinese edition was adopted. The research was conducted into 8 community health centers and the general outpatient clinic of the University of Hong Kong, Shenzhen Hospital. They were eligi-ble adult patients who could communicate properly and had visited the same general practitioners at least three times. One-to-one interviews were conducted and a total of 1 712 patients participated in the survey, a number of which 1 645 effective samples were considered for analysis. Results: The total general practice attributes score was 49. 0. The first-contact score of 69 . 8 , continuity score being 63 . 1 and the cultural competence score of 51 . 2 were relatively high. The scores for the access (40. 8) and community orientation (31. 0) were relatively low. The general practice attribute scores were influenced by the social demographic and health characteristics, and the health care service uti-lization. Also, the general practice core attributes were positively related to the patient satisfaction (OR>1). Con-clusion:Comparing to the numbers in the developed countries, the general practice attribute scores were still low in China. Therefore, to strengthen the general practice function, works could be done at the individual, organization and system levels.

Objective To understand current status and influencing factors of long-term care for elderly people who lived in rural areas of Beijing.Methods A total of 1022 elderly people (age＞60 years old) were enrolled in this cross-sectional study during December,2012 and January,2013.Demographic information,health status and needs of and intent to long-term care were learned through a questionaire survey.Chi-square test and muhiple non-conditional logistic regression analysis were used to identify the factors that were related to the respondents' selection.Results Nearly 6.6％ (61/1016) participants showed needs for long-term care.82.3％ (841/1013) respondents preferred household-based long-term care,while 7.53％ (77/1013) preferred community-based long-term care.In single factor analysis,education level,occupation,household income,living conditions,number of children living together,medical insurance,pension insurance,chronic diseases and self-report hearing ability,taste and touch were related with longterm care needs (x2values were 33.03,136.17,99.32,88.83,58.07,147.71,108.11,9.85,33.78,30.45 and 22.22,respectively; all P＜0.05).Multivariate analysis showed that occupation,income per capita,spouses living conditions,new corporative medical systems and self-report visual status were correlated with household-based long-term care (odds ratio (OR) were 2.48 (95％ confidence interval (CI) 1.21-5.10),0.82(0.71-0.95),1.64 (1.08-2.49),4.78 (2.93-7.82) and 0.72 (0.59-0.89),respectively).Conclusion Householdbased long-term care and health management system may be needed and chosen by the elderly living in rural areas of Beijing.

Objective To explore the characteristics of subjective quality of life and family environment in children with tic disorder (TD) combined with and without attention deficit hyperactivity disorder (ADHD). Methods The Inventory of Subjective Life Quality (ISLQ) for Child and Adolescent and Family Environment Scale-Chinese Version (FES-CV) were used to assess the subjective quality of life and family environment in 60 children with TD combined with ADHD (observation group) and 60 children with TD not combined with ADHD (control group). Results The scores in peer interaction, school life, self-cognition, depression experience, overall satisfaction of the observation group were lower than the control group (P<0.05) in ISLQ; the scores in intellectual-cultural orientation, cohesion and organization of the observation group were lower than the control group (P<0.05) in FES-CV. Conclusion Children with TD combined with ADHD had low subjective quality of life and poor family environment.

Objective To explore the characteristics of subjective quality of life and family environment in children with tic disorder (TD) combined with and without attention deficit hyperactivity disorder (ADHD). Methods The Inventory of Subjective Life Quality (ISLQ) for Child and Adolescent and Family Environment Scale-Chinese Version (FES-CV) were used to assess the subjective quality of life and family environment in 60 children with TD combined with ADHD (observation group) and 60 children with TD not combined with ADHD (control group). Results The scores in peer interaction, school life, self-cognition, depression experience, overall satisfaction of the observation group were lower than the control group (P<0.05) in ISLQ; the scores in intellectual-cultural orientation, cohesion and organization of the observation group were lower than the control group (P<0.05) in FES-CV. Conclusion Children with TD combined with ADHD had low subjective quality of life and poor family environment.

Five patients with mediastinal bronchogenic cyst (MBC) were treated with endoscopic submucosal tunnel dissection (ESTD) between January 2018 and October 2019 at the Department of Gastroenterology in Henan Provincial People′s Hospital. Lesions were located in the middle or lower esophageal level, with diameters≤3.5 cm. The tunnel establishment time was 13-18 min, and the tumor stripping time was 30-51 min. The number of titanium clips used for tunnel closure was 5-8. The tumors were completely resected. No major bleeding or hypoxemia occurred during the operation and no serious adverse reactions occurred after the operation. Postoperative pain scores were all ≤3. The hospital stay was 4-7 days. There was no tumor residue and recurrence during 4-23 months of follow-up.It is suggested that ESTD for MBC which derived from post mediastinum and located at the lower or middle level esophagus is safe and effective.

OBJECTIVE: To investigate the expression of monocyte chemotactic protein-1 (MCP-1) and its receptor CC chemokine receptor-2 (CCR-2) in coronary atherosclerosis plaques between sidden coronary death (SCD) and non-SCD. Methods The expression levels of MCP-1 and CCR-2 in SCD group, coronary atherosclerosis group (non-SCD), control group (normal coronary artery) were detected by immunohistochemistry. RESULTS: Positive rates of MCP-1 among the three groups were 78%, 47%, and 0%, respectively, with significant expressing differences between each two groups (P<0.05). Positive rates of CCR-2 among three groups were 72%, 47%, and 0%, respectively, with significant expressing differences between the SCD group and coronary atherosclerosis group as well as between the SCD group and control group (P<0.05), but with no significant expressing difference between coronary atherosclerosis group and control group (P>0.05). CONCLUSION Overexpression of MCP-1 and CCR-2 in coronary atherosclerotic plaques is closely correlated with SCD.
Chemokine CCL2/metabolism* ; Coronary Artery Disease/pathology* ; Death, Sudden, Cardiac/pathology* ; Humans ; Immunohistochemistry ; Receptors, CCR2/metabolism*