Papillary thyroid cancer (PTC) is the most common type in thyroid carcinomas.Recently,the prevalence and diagnostic rate of PTC has got significantly high with the general use of ultrasound.Nowadays,more and more studies have suggested that the coexistence of PTC and diabetes is common.They indicated that hyperglycemia would induce the deterioration of oxidative stress injury,chronic inflammation,insulin resistance,obesity,dyslipidemia,deficiency of vitamin D and dysimmunity.All of these may break the balance of oxidation and antioxidation and result in disordering signal pathway,accumulation of inflammatory cytokines,over activating of insulin and insulin-like growth factor-1,changing the metabolic pathways,which will promote the occurrence and progression of PTC.

X-box binding protein -1(XBP-1)is a newly found protein that plays significant roles in protein folding and endoplasmic reticulum construction .The expression of XBP-1 is widely displayed in various kinds of tumor and is shown to take part in tumorigenesis and tumor progression .This review briefly summarizes the biology of XBP-1 and focuses on recent findings concerning its role in immune evasion ,tumorigenesis ,devel-opment of cancer ,angiogenesis ,hypoxia ,invasion and metastasis .

Objective: To evaluate the depression and anxiety in patients with sleep apnea-hypopnea syndrome (SAHS). Methods: Fifty patients with SAHS were diagnosed with polysomnography (PSG) and 30 healthy controls underwent whole-night PSG monitory and evaluated by Zung Self-rating Depression Scale (SDS) and Zung Self-rating Anxiety Scale (SAS). Results: The total scores of SAS and SDS in SAHS group were significantly higher than those in control group ( P

Objective To compare the analgesia and side-effects of different concentrations of sufentanil combined with 0.125% ropivacaine for postoperative epidural analgesia after general thoracic surgery.Methods Thirty-six ASA Ⅰ-Ⅲ patients (25 males, 11 females) ages 21-64 yrs weighing 42-79 kg undergoing elective general thoracic surgery under general anesthesia were randomly assigned to receive patient-controlled epidural analgesia (PCEA) with 0.125% ropivacaine combined with sufentanil 0.4 (group A, n = 12) , 0.5 (group B, n = 12) or 0.6 ?g?ml-1 (group C, n = 12) . Epidural catheter was placed at T7,8 or T8,9 interspace. The PCEA pump was set up with back ground infusion of 2 ml?h-1 , a3ml bolus dose and a 30-min lock-out period. VAS scores was used to assess analgesia at rest and during movement. The total bolus doses, PCEA button pressing times (effective/actual), vital signs including MAP, HR, respiratory rate, SpO2 and side effects (nausea, vomiting, pruritus and dyspnea) were recorded. Results During the 48 hours after operation the VAS scores in group C were significantly lower than those in group A and B ( P

Objective To evaluate the clinical application of MRI guided percutaneous biopsy for the lesions of infratemporal space.Methods An open design 0.2T MRI set was used for MRI guided percutaneous biopsy in seven patients with the masses of infratemporal space. Results Of this series, the accuracy of needle puncture was 100% with diagrostic accuracy of 85.7% and no complications.Conclusions MRI guided percutaneous biopsy is helpful in the diagnosis for the lesions of infratemproal space.

Objective To evaluate nasal carriage and antimicrobial resistance of bacteria in health care workers (HCWs)in an intensive care unit (ICU),and provide basis for making prevention and control measures of health-care-associated infection(HAI).Methods From April 2014 to March 2015,nasal swabs from HCWs in ICU were collected,carriage and antimicrobial resistance of bacteria were detected.Results A total of 450 nasal swab speci-mens were taken,137 strains were isolated,isolation rate was 30.44%.There were no significant difference in na-sal carriage rates of bacteria in HCWs with different genders,ages,types of work,length of service,and education-al level (P >0.05);nasal carriage rates in HCWs at different seasons were significantly different (P <0.05 ).82 strains (59.85%)were gram-negative bacteria,the major were Klebsiella pneumoniae (21 .16%)and Enterobacter aerogenes (18.98%);55 strains (40.15% )were gram-positive bacteria,the major were Staphylococcus aureus (18.98%)and Staphylococcus epidermidis (15.33%).38 (27.74% )strains were multidrug-resistant strains. 7.69% (2/26)of Staphylococcus aureus were methicillin-resistant strains,3.45%(1/29)of Klebsiella pneumoniae and 3.85%(1/26)of Enterobacter aerogenes were imipenem-resistant strains.Conclusion Nasal carriage rate of bac-teria and detection rate of multidrug-resistant organisms in HCWs in ICU is high.

Objective To study the role of cutaneous nerve and protease activated receptor 2 (PAR2)in the development of pruritus in atopic dermatitis(AD).Methods Dermal sheets were prepared from chronically pruritic skin lesions of 7 patients with AD,as well as from the normal skin of 7 healthy human controls.Double labeled immunofluorescence was performed using mouse anti-protein gene product 9.5(PGP9.5)monoclonal antibody and rabbit anti-substance P(SP)polyclonal antibody to observe the morphological changes in cutaneous nerve fibers,and Image-Pro Plus 6 software was used to semiquantitively assess the length,diameter of nerve fibers,integral optimal density of PAR2 and SP in dermal sheets.Results Immunofluoresence double staining showed that PAR2 co-expressed with PGP9.5 or SP in cutaneous nerve fibers.Compared with the normal control skin,both the total length and average diameter of PGP 9.5-expressing nerve fibers were increased(11051.8±1900.9 μm vs 7264.0±2659.9 μm,4.23±0.15 μm vs 3.95±0.15 μm,both P＜0.01)in pruritic lesions,while only the average diameter of SP-expressing nerve fibers was up-regulated(3.99±0.20 μm vs 3.80±0.07 μm,P＜0.05),and the total length of them remained unchanged(4304.7±1455.0 μm vs 3380.0±1735.4 μm,P＞0.05).Also,increased integral optimal density was observed for SP and PAR in pruritic lesions in comparison with the normal control skin (27.71±16.52 vs 12.63±4.31.35.99±8.63 vs 22.69±9.56.both P＜0.05).Conclusion Our results indicate a hyper-plasia of cutaneous nerve fibers in chronic itchv skin lesions of AD and an increase in the expression of PAR2 and SP in the cutaneous nerve fibers,suggesting that the signal enhancement in PAR2 pathway may be related to the mechanism of pruritus in patients with AD.

Objective Clinical parenteral nutrition( PN) support still lacks in standards on some degree .This paper was to analyze the clinical application of PN support in our hospital in order to provide the basis for clinical rational drug use . Methods Random weighting method was applied to collect 5% hospitalized patients′information from each patient unit each month from April 2012 to March 2013 in Nanjing Gerneral Hospital of Nanjing Military Region .NRS-2002 nutrition risk screening was applied to eval-uate whether the patient needed PN support .Statistical analysis were carried out on patients supported with parenteral nutrition from department distribution, PN detailed components and distribution intervals of aII in one admixture non-protein calorie and nitrogen ra-tio. Results According to the survey, 393 patients had received PN support, including 217 cases′NRS score <3 and 176 cases′NRS score ≥3.General surgery department ranked the first in the cases of usingall in oneadmixture support.Among 133 cases receiving all in one admixture support, the course of 37 cases(27.82%) <7 d.The aII in one admixture non-protein calorie and ni-trogen ratio(100~150∶1) only took up 28.57%. Conclusion Although PN has got wide application in clinical departments, the rationality of prescription should be strengthened .Pharmacists should help doctors set up appropriate prescription from the aspect of pharmacy.

Objective To explore the effect of anti-TNF rcMAb in the treatment of patients with rheumatoid arthritis (RA) and its effect on peripheral blood Th1,Th17 and Treg cells.Methods Fifty rigorously screened RA patients were randomly divided to the therapy group (n=40) who received the combined treatment of anti-TNF rcMAb and MTX,and control group (n=10) who were given MTX along with placebo,both at week 0,2,6,and 14.The clinical data of the two groups were observed and accessed respectively at week 0 and 18.In addition,the percentage of Th1,Th17,Treg cells in the peripheral blood and the relative gene expressions of transcription factors T-bet,RORC,Foxp3 in these patients were also observed respectively before and after treatment.We used t inspection and x2 inspection as the statistical analysis methods in conducting this study.Results Comparing with the control group,more patients achieved ACR20,ACR50 and ACR70 response in the combined therapy group (Z=1.671,P=0.000 94).The percentage of peripheral blood Th1 cells decreased [week 0:(7.1±3.9)％; week 18:(4.2±2.8)％] and the percentage of Treg cells obviously increased [week 0:(1.5±0.8)％; week 18:(3.0±0.6)％,t=2.301,P=0.048] in the combined therapy recipients,while the percentage of Th1 cells fell [week 0:(9.1±3.1)％; week 18:(5.8±2.6)％] and that of Treg cells slightly increased [week 0:(1.2±0.6)％; week 18:(2.2±0.6)％] in the controls.The mRNA expressions of RORC and T-bet,the transcription factors of Th17 and Th1,were decreased respectively and that of Foxp3,the transcription factor of Treg,were elevated in both groups.Conclusion The combined therapy of anti-TNF rcMAb and MTX is very effective in RA patients.Good outcome is likely achieved by modifying the peripheral blood Th cell subsets in patients with RA.

OBJECTIVEDesign and make triple cannula dual-lumen vacuum extractor to improve effect of decompression in operation of intestinal obstruction.

METHODSTriple cannula dual-lumen vacuum extractor was applied in 32 patients who underwent operation of intestinal obstruction from 2012 to 2015 in our hospital. The effect of intestinal decompression and patient prognosis were observed.

RESULTS32 patients that used triple cannula dual-lumen vacuum extractor had good recovery except for one patient abdominal incision with fatty liquefaction. The other patients had one-stage healed without any complication such as intestinal fistula, abdominal infection etc.

CONCLUSIONApplication of triple cannula dual-lumen vacuum extractor in operation for intestinal decompression could avoid contamination of abdomen and injury of intestinal mucosa, which had satisfied effect of intestinal decompression and promoted the effect of operation for intestinal obstruction.