Objective To investigate the effect of ANX A1 on the biological characteristics of papillary thyroid carcinom cells by interfering with the expression of Annexina A1 (ANX A1) in papillary thyroid carcinoma cells through small interfering RNAs (siRNA).Methods The designed highly efficient siRNA was used to conduct the specific interfence on ANXA1 expression in the papillary thyroid carcinoma TPC-1 cells.The effect of ANXA1 on TPC-1 apoptosis in PTC was observed by flow cytometry.Results The designed siRAN could efficiently inhibit the expression of ANXA1 mRNA in PTC,enhanced the cell apoptosis in TPC-1 cells in vitro.Conclusion siRNA can interfere with the expression of ANXA1 and promote the apoptosis of papillary thyroid carcinoma which suggesting that ANXA1 may be an important biological target for the treatment of papillary thyroid carcinoma.

Objective To explore the CT manifestations of pediatric mesenechymal hamartoma of liver (MHL).Methods Clinical data of 15 cases with MHL confirmed by surgery and pathology were retrospectively analyzed.All children were performed with CT scans including plain and enhanced scans,and the imaging features were analyzed.Results All the lesions were solitary,and 9 masses located at the right lobe of liver,4 located at the left lobe,the others located at both right and left lobe.The maximum diameter of lesions was from 5 cm to 30 cm,with an average of (11.52±6.84) cm.Ten cases were cystic and solid mixed,5 cases were solid.After contrast administration,the solid component and the septa of the masses showed enhancement while no enhancement was observed in the cystic component.Two cases had the spot-like calcification.Conclusion MHL has some special characteristics in the CT scan before surgery,which should be differentiated from other cystic and solid tumors of live.Some MHLs can be diagnosed when combined with the clinical information and CT images.

Objective To observe the changes of arm equilibrium pressure (Parm) in different occlusion time,the reference range of Parm in hemodynamic stable patients,and to explore the relationship between Parm and systemic hemodynamic parameters.Methods Mechanically ventilated postoperative abdominal surgery patients who admitted to ICU with stable hemodynamic status were enrolled.After hemodynamic data were recorded,arm stop-flow maneuvers were performed to measure Parm.At 10,20,30,40,50,60 seconds after occlusion,arterial pressure were measured twice within 5 minutes and recorded as the average value.Results Thirty patients were included.The Parm decreased gradually with the prolongation of the occlusion time.The value was not stable within 60 s,but the reducing extent was not obvious after 40s.The 95％ reference range of Parm 30 S was 23-44 mmHg(1 mmHg =0.133 kPa) and Parm 60 S was 19--35 mmHg.Parm at 30 s and 60 s were positively correlated with systolic arterial pressure,diastolic arterial pressure,mean arterial pressure,central venous pressure (all P ＜ 0.001),but not heart rate and pulse pressure.Linear regression analysis showed that Parm at 10 s,20 s,30 s only had linear correlation with diastolic arterial pressure (10 s,β =0.504,P =0.001;20 s,β =0.297,P =0.005;30 s,β =0.231,P =0.015),and Parm at 40 s,50 s,60 s were linear correlation with diastolic arterial pressure (40 s,β =0.220,P =0.004;50 s,β =0.210,P =0.004;60 s,β =0.213,P =0.004) and central venous pressure (40 s,β =0.516,P =0.018;50 s,β =0.513,P =0.01;60 s,β =0.472,P =0.023).Conclusion In mechanically ventilated postoperative abdominal surgery patients with stable hemodynamic status,Parm decreases when occlusion time is prolonged,which is not stable within 60 s occlusion.Arterial blood pressure and central venous pressure are positively correlated with Parm.

Objective To investigate the protective effects and molecular mechanism of peroxisome proliferate-activated receptor α(PPARα) activation on acute myocardial damage induced by isoproterenol (Iso) in rats. Methods Thirty male Wistar rats, weighting 160～180 g, were randomly divided into control group, Iso group, fenafibrate(FF) group(each n=10) according to physique quantity. Acute myocardial injury caused by Iso abdomen cavity injection induced ischemia was established and the protective effects of peroxisome proliferate-activated receptor α activation were accessed by the level of ereatine kinase(CK), lactic dehydrogenase(LDH) in serum as well as the activities of myoperoxidase(MPO) in myocardium, and the protein expressions of PPABα in myocardium by Western blot. Results The level of serum CK in control group, lso group and FF group, was (62.41±9.47),(101.71±11.05),(75.64±11.73)kU/L, respectively(F= 34.34, P<0.01). Whereas the level of serum CK in Iso group and FF group was higher than that in control group(P<0.01 or<0.05), the level of serum CK in FF group was lower than that in Iso group(P<0.01). The levels of LDH in these three groups were (5912.20±204.44), (6365.78±137.10), (6089.76±169.60) U/L, respectively(F= 17.54, P<0.01). Compared with the control group, the levels of LDH in Iso and Fir groups were significantly increased(P<0.01 or<0.05). But the level of LDH in FIr group was decreased compared with that in Iso group(P<0.01). The activities of myocardial MPO in these three groups were (1.95±0.10),(3.89±0.17),(2.49±0.19)U/g, espectively(F=391.68,P< 0.01). The activities of myocardial MPO in Iso and FF groups were higher than that in the control group (all P< 0.01), while the activities of myocardial MPO in FIr group were lower than that in lso group(P<0.01). The protein expressions of PPARα in myocardium of these three groups were 251.57±10.95,191.97±10.74,215.08±9.61, respectively(F=82.69, P<0.01). Conclusion PPARα activation by its actor FF can exert protective effects on the acute myocardial ischemia injury induced by lso in rats through inhibiting the release of inflammatory cell factors.

Objective To evaluate the clinical efficacy of infliximab (IFX) in Crohn′s disease (CD) and its effects on mucosal healing and promoting fistula closure.Methods Between September 2007 and February 2011,relevant clinical data of CD patients treated with IFX in the Department of Gastroenterology,Ruijin Hospital were collected and the efficacy and safety of IFX were retrospectively analyzed.After IFX therapy,the efficacy evaluation included laboratory index,clinical efficacy,efficacy of fistula closure and mucosal healing.The data were analyzed using t test and Wilcoxon signed-rank test.Results A total of 22 patients were enrolled in this study,11 males and 11 females; the mean age was 29.3 years.The dosage of IFX was 5 mg/kg to 10 mg/kg at week 0,2,6to induce remission,and every 8 weeks on maintenance therapy.Of 22 patients,16 patients were active CD.One case dropped out.At week 14,of the remaining 15 cases,11 cases achieved clinical remission,two cases achieved clinically effective and two cases were ineffective.Crohn′s disease activity index (CDAI) (112±80) and ESR [(13±11) mm/1 h] of week 14 decreased compared with that of week 0 [(186±88),(21± 15) mm/1 h,P=0.04 and 0.007].Two cases of 10 patients with fistula dropped out as a result of ineffective,while eight cases had a partial response and six patients sustained response during the maintenance therapy,but no fistula closed and completely disappear.Seven patients reviewed by endoscopy after five times IFX therapy (24 weeks),after therapy the simple endoscopic score for Crohn′ s disease (SES-CD) ( 3.21 ± 2.89 ) decreased compared with that before treatment (5.86±3.02) (Z＝-2.38,P＝0.018).Eleven times of adverse events were found in nine patients,infusion reaction and respiratory tract infection were more common and no severe adverse effect was observed.Conclusions IFX can rapidly improve clinical symptoms and with good safety.The effects in mucosal healing and fistula closure may occur at early medication.

OBJECTIVETo evaluate therapeutic effect of the needle-knife closed solution combined with minor adjusting of spine for treatment of neck-shoulder syndrome.

METHODSFrom April 2010 to August 2011,120 patients with neck-shoulder syndrome were treated with the needle-knife closed solution combined with minor adjusting of spine, and included 45 males and 75 females and aged from 40 to 68 years old. The disease course was from 3 days to 10 years. After the operation, all patients taken the medicine of activating blood circulation herbs. At the 3rd, 7th, 10th day after operation, spinal rotation massage was performed on these patients. After the healing of the needle points, traditional Chinese medicine herb fumigation was applied on the needle points, and the patients were directed to do the cervical spine exercise. Therapeutic effect of the patients was evaluated by the neck disability index (NDI).

RESULTSAll patients were followed up after 3 weeks' treatment. The pain of neck-shoulder was relieved, and the range of motion was improved,the NDI score lowered from 49.30 +/- 1.35 before treatment to 10.15 +/- 1.18 at 3 weeks after treatment (t = 2.116, P < 0.05).

CONCLUSIONThe needle-knife closed solution combined with minor adjusting of spine for the treatment of neck-shoulder syndrome can relieve the pain in the neck-shoulder and improved the motion of the neck. The key for the effect is accurate location before operation, sufficient adhesion solution during the operation and spinal minor adjusting after operation.

Adult ; Aged ; Female ; Humans ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Myofascial Pain Syndromes ; therapy ; Neck Pain ; therapy ; Shoulder Pain ; therapy

Objective:To evaluate therapeutic effect of the needle knife closed solution combined with minor adjusting of spine for treatment of neck shoulder syndrome. Methods:From April 2010 to August 2011,120 patients with neck shoulder syndrome were treated with the needle knife closed solution combined with minor adjusting of spine ,and included 45 males and 75 females and aged from 40 to 68 years old. The disease course was from 3 days to 10 years. After the operation ,all pa-tients taken the medicine of activating blood circulation herbs. At the 3rd,7th,10th day after operation,spinal rotation massage was performed on these patients. After the healing of the needle points ,traditional Chinese medicine herb fumigation was ap-plied on the needle points,and the patients were directed to do the cervical spine exercise. Therapeutic effect of the patients was evaluated by the neck disability index (NDI). Results:All patients were followed up after 3 weeks'treatment. The pain of neck shoulder was relieved,and the range of motion was improved,the NDI score lowered from 49.30±1.35 before treatment to 10.15±1.18 at 3 weeks after treatment (t=2.116,P<0.05). Conclusion:The needle knife closed solution combined with minor adjusting of spine for the treatment of neck shoulder syndrome can relieve the pain in the neck shoulder and improved the mo-tion of the neck. The key for the effect is accurate location before operation ,sufficient adhesion solution during the operation and spinal minor adjusting after operation.

Objective To investigate the effects of three laparoscopic bariatric operations on relieving type 2 diabetes in morbid obese patients. Methods From 2005 to 2009, 15 morbid obese patients with type 2 diabetes received bariatric operations in Shengjing Hospital including lapband operation (7 cases) , sleeve gastrectomy (7 cases) and gastric bypass(4 cases). All patients were followed up for more than 1 year. Results All patients recovered without major complications. Body weight decreased and BMI was respectively (27. 6 ± 2. 0) kg/m2, ( 26. 9 ± 1. 4) kg/m2 and (27. 5 ± 3. 0) kg/m21 year after operation. The excess BMI loss in three groups were (76. 4% ± 6. 8% ) , (83. 7% ± 4. 6% ), (85. 7% ±9. 5% ) 1 year after operation. On the other side, the fasting glucose levels and glycohemoglobin in gastric bypass group were much lower than that in other two groups. Conclusion All these operations were effective in controling the weights and fasting glucose levels, while the gastric bypass method is better than other two methods in weight and serum glucose control. Sleeve gastrectomy was better in weight and glucose control than lap band operation.

Objective To evaluate the outcome of super-selective embolization of renal artery for severe hemorrhage after percutaneous nephrolithotomy (PCNL) and its effect on renal function. Methods From May 2008 to Feb 2010,severe bleeding occurred in 7 patients after PCNL in our hospital.(5 males and 2 females,average age of 54.9 years ).All cases were treated with super-selective renal angiography and 6 cases underwent microcoil embolization. Results Renal angiography showed pseudoaneurysm in 5 cases,pseudoaneurysm with arteriovenous fistula in 1 case and no severe bleeding in 1 case.Successful coil embolization was confirmed in 6 cases by angiography,and bleeding stopped within 3 -7 days after embolization.Serum creatinine and blood urea nitrogen were 59 -98 μmol/L(mean,78.3 μmol/L) and 1.86 -6.92 mmol/L( mean,4.8 mmol/L) 2 weeks after embolization,respectively. Conclusions Super-selective embolization of renal artery for severe hemorrhage after percutaneous nephrolithotomy has the advantages of remarkable hemostatic effects and mild impaired renal function,which is of the first choice.

Objective To investigate clinical features of lower motor neuron lesion (LMNL) caused by the single level lower thoracic disc protrusion (LTDP),and to observe clinical outcomes of surgical treatment.Methods Between January 1997 and December 2009,17 patients with LMNL caused by single level LTDP underwent en bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation in our hospital.MRI and CT scans were taken to confirm lesion levels:T10-11 in 4 patients of whom 3 had patellar clonus and ankle clonus,T11-12 in 5 patients of whom 4 had ankle clonus,and T12L1 in 8 patients who only had positive Babinski sign.The neurologic status was assessed using the Japanese Orthopaedic Association (JOA) scoring system.The muscle strength of the tibialis anterior was assessed using the Manual Muscle Test (MMT).Sagittal Cobb angle and cross-sectional area of the dural sac at the level of maximal compression in MRI were also observed.Results All patients were followed up for 22 to 76 months (average,48.6 months).The mean JOA score increased from preoperative 5.88±1.11 to 9.53±0.94 at final follow-up (t=16.143,P＜0.05).The muscle strength of the tibialis anterior recovered to more than grade 4 in all patients.Postoperative Cobb angle was unchanged compared with that before operation.MRI indicated that the cross-sectional area of the dural sac at the level of maximum compression increased from preoperative 35.8±7.3 mm2 to postoperative 132.9±6.5 mm2 (t=70.78,P＜0.05).Conclusion LMNL can be caused by LTDP.The eu bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation can provide a satisfactory decompression effect and marked recovery of neurological function.