Objective To analyze the influence of total thyroidectomy (TT) on quality of life of patients with nodular goiter with iodine deficiency.Methods 70 patients who received TT in the hospital from June 2014 to July 2015 were randomly divided into two groups, 35 cases in each.Control group received subtotal thyroidectomy and observation group received total thyroidectomy.The situation of operation, thyroid function, therapeutic effects and quality of life in two groups were compared.Results Operation time and hospital stays of observation group were significantly longer than that of control group (P<0.05);There was no significant difference in intraoperative bleeding volume and curative effective rate between the two groups;Before surgery, there was no significant difference in thyroid function between the two groups;After surgery, thyroid function of both two groups decreased compared with pre-operation, but there was no significant difference;There was significant difference in VAS and health description system scores between the two groups.Conclusion TT in treatment of patients with nodular goiter with iodine deficiency has significant clinical efficacy with high cure rate and less complication, and it can improve quality of life of patients, which is beneficial to postoperative recovery and worthy of generalization in clinical application.

Objective To investigate the role of gastric acid in the esophageal adenocarcinogenesis induced by duodenal juice reflux in the rats. Methods Eight week old male Sprague Dawley rats, 125 in all, weighing approximately 200 g each, were used. Three types of surgical procedures were performed to produce gastroesophageal reflux (GER), duodenoesophageal reflux (DER) and duodenogastroesophageal reflux (DGER), and a group of sham operation (SO). The animals were fed with a standard diet. Esophageal mucosal pathological changes were examined 20 weeks after surgery. Results No pathological changes were found in the 15 SO rats animals. Significant esophagitis were observed in three reflux groups. In 35 DER and 32 DGER animals, the incidence of Barrett's esophagus (BE) was 91.4%, 84.4% respectively and the incidence of esophageal adenocarcinoma (EAC) was 25.7%, 53.1% respectively, significantly higher than those in the 24 GER animals ( P

AIM: To investigate the effect of single immunoglobin IL-1 receptor related protein (SIGIRR) on damage of alveolar epithelial cells in acute lung injury induced by lipopolysaccharide. METHODS: The acute alveolar epithelial cell injury model was constructed by stimulation of A549 cells with LPS. In order to over-express SIGIRR, the A549 cells were transferred with eukaryotic expression vector containing full length SIGIRR cDNA. The transcriptional activity of NF-κB was measured by dual-luciferase reporter assay system. The concentrations of IL-1β, TNF- α and IL-6 were detected by ELISA. The levels of these inflammatory factors between the transfected cells and untransfected cells were compared. RESULTS: The over-expression of SIGIRR inhibited the transcriptional activity of NF-κB. The increases in IL-1β, TNF-α and IL-6 concentrations in alveolar epithelial cells induced by LPS were observed. CONCLUSION: SIGIRR in alveolar epithelial cells inhibits TLR4 signals triggered by LPS and attenuates the inflammatory reactions in alveolar epithelial cells, which plays a protective role against the acute damage of the alveolar epithelial cells.

Objective To investigate the pathological manifestations of acute?stage radioactive myocardial damage and related mechanisms using an experimental animal model. Methods A total of 12 adult male Sprague?Dawley rats were randomly divided into control group and radiation group. In the radiation group, the model of radiation?induced myocardial damage was established by the irradiation of the anterior myocardial territory with 6?MV X?ray at a single dose of 20 Gy, and at 14 days after irradiation, HE staining was used to observe the morphological changes of cardiomyocytes and intercellular matrix, and Masson staining was used to observe the distribution of collagen fibers. The collagen volume fraction ( CVF) was used for semi?quantitative analysis. ELISA was used to measure the activity of total superoxide dismutase ( T?SOD) and the concentration of malondialdehyde ( MDA ) , and Western blot was used to measure the expression of the fibrosis marker protein collagen type I ( COL?1 ) and the endoplasmic reticulum stress?related proteins GRP78 and CHOP. The t?test, t ’?test, or nonparametric rank sum test was used for comparison between groups. Results At 14 days after local irradiation of the heart, the radiation group had disordered arrangement of cardiomyocytes, marked edema, rupture of some cardiomyocytes, mild karyopyknosis in cardiomyocytes, and infiltration of inflammatory cells in the myocardial interstitium, compared with the control group. Collagen fibers in the myocardial tissue were mainly distributed in the perivascular area and cardiomyocyte interstitium. The radiation group had a significantly higher CVF than the control group ( 11?35% vs. 5?23%, P=0?000 ) and a significant increase in the expression of COL?1 compared with the control group ( P=0?000) . The radiation group had significant increases in the activity of T?SOD and the concentration of MDA in the myocardial tissue compared with the control group ( T?SOD:156?61 U/mgprot vs. 137?06 U/mgprot, P= 0?042;MDA:2?36 nmol/mgprot vs. 1?31 U/mgprot, P=0?007) . Compared with the control group, the radiation group showed significant increases in the expression of endoplasmic reticulum stress?related proteins GRP 7 8 and CHOP ( P= 0?037 and 0?009 ) . Conclusions The pathological manifestations of acute?stage myocardial damage include degeneration of cardiomyocytes, inflammatory exudation in the interstitium, and deposition of collagen in the perivascular area and myocardial interstitium. Myocardial fibrosis can be observed in the acute stage of radiation?induced myocardial damage, and the mechanism may be related to oxidative stress and endoplasmic reticulum stress induced by radioactive rays.

Objective To evaluate the therapeutic effect of endoscopic cryotherapy for Barrett's esophagus (BE). Methods A total of 22 consecutive patients, who were diagnosed as BE from January 2008 to May 2009, underwent endoscopic cryotherapy by using pressurized gas of C02. The data including effective rate, therapy courses and procedure related complications were retrospectively analyzed.Results Except for 2 cases of withdrawal, the other 20 patients completed the treatment with a total therapy number of 42 times (mean 2. 1 times/patient) and were followed up for 6 months. Complete histologic reversal of BE mucus was achieved in all 20 patients after 1-3 times of cryotherapy, among whom complete endoscopic reversal was obtained in 9 and effective endoscopic reversal in 11. Histologic recurrence was observed in 3 cases during the follow-up, including 2 of occult intestinal metaplasia and 1 of mild intestinal metaplasia, which achieved a BE mucosal reversal rate of 85% (17/20). Procedure related complications included 1 case of esophageal ulcer and 3 cases of mild or severe esophagitis, which were all cured after acid suppression treatment. Conclusion Endoscopic cryotherapy in BE is effective and safe, with the advantages of easy manipulation, less complications and good compliances.

Objective To investigate the clinical effect of induction chemotherapy plus concurrent radiochemotherapy in the treatment of locally advanced non-small cell lung cancer (NSCLC) through a meta-analysis.Methods CBM, CNKI, Cochrane Library, PubMed, and EMbase were searched for the articles on comparison between induction chemotherapy plus concurrent radiochemotherapy and concurrent radiochemotherapy for patients with locally advanced NSCLC.According to the inclusion and exclusion criteria, the data on short-term outcome and survival were collected.A Meta-analysis was performed to evaluate the clinical effect of induction chemotherapy followed by concurrent radiochemotherapy.Results A total of 5 articles were included, which involved 845 patients.The results showed that the short-term outcome and the 2-and 3-year survival rates were similar between patients receiving induction chemotherapy plus concurrent radiochemotherapy and those receiving concurrent radiochemotherapy ( OR=0.875, 95% CI 0.507-1.510, P=0.631;HR=0.770, 95% CI 0.515-1.151, P=0.203;HR=0.809, 95% CI 0.559-1.172, P=0.262), but the patients receiving induction chemotherapy plus concurrent radiochemotherapy showed a significantly higher incidence rate of grade ≥ 3 leukopenia than those receiving concurrent radiochemotherapy alone ( OR=0.637, 95% CI 0.435-0.931, P=0.020).Conclusions Induction chemotherapy plus concurrent radiochemotherapy shows no significant advantages over concurrent radiochemotherapy alone in the short-term outcome and 2-and 3-year survival rates, but it significantly increases myelosuppression.Since there are few studies involving a limited number of cases included in this analysis, more multicenter randomized trials are needed to provide more detailed data and further clarify the clinical value of induction chemotherapy plus concurrent radiochemotherapy.

Objective To examine the effects of different pre-treatment nutritional status and inflammatory markers on acute adverse reactions in esophageal cancer patients during concurrent intensity-modulated radiation therapy (IMRT) and chemotherapy.Methods The acute adverse reactions of 338 eligible esophageal cancer patients who received concurrent IMRT and chemotherapy in our hospital from 2006 to 2014 were reviewed.The effects of different pre-treatment nutritional status, such as body mass index level (BMI), albumin level (ALB), total lymphocyte count (TLC), the presence or absence of anemia, and inflammatory indicators including neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR), on acute adverse reactions in the patients were examined.Data were analyzed using the chi-square test with continuity correction and logistic regression analysis.Results The incidence rate of malnutrition in the patients based on their nutritional status was 5.62%-54.14%.The incidence rate of grade≥2 acute radiation esophagitis (RE) was significantly higher in the low ALB group than in the normal ALB group (P=0.000).The incidence rate of adverse reactions in the hematologic system increased as TLC decreased (P=0.006), but the incidence rate of acute radiation pneumonitis (RP) was reduced as TLC decreased (P=0.001).In addition, the incidence rate of grade ≥2 acute RE was significantly higher in the anemia group than in the non-anemia group.Inflammatory marker analysis demonstrated that the incidence rate of acute RE was significantly higher in the high NLR group and high PLR group than in the low NLR group and low PLR group (P=0.000 and P=0.024, respectively).Logistic regression analysis of nutritional status and inflammatory markers showed that TLC was an independent risk factor for acute adverse reactions in the hematologic system (P=0.001), and ALB and PLR were independent risk factors for acute RE (P=0.017 and P=0.011,respectively).Conclusions Nutritional status and inflammatory markers are associated with concurrent chemoradiotherapy-induced acute adverse reactions in esophageal carcinoma patients, and hence may be valuable indicators of acute adverse reactions during treatment.In addition, nutritional treatment and support care should be actively provided to the patients to prevent the development of acute adverse reactions during treatment.

Objective:To study a classifier used to classify arrhythmia electrocardiogram (ECG) signals under the inter-patient paradigm to improve the accuracy of automatic classification and solve the limitations of manual diagnosis of arrhythmia.Methods:A SVM+XGBoost ensemble classifier with four modules including preprocessing, feature extraction, support vector machine (SVM) training and ensemble classification was constructed. ECG signal was preprocessed, and R-R interval, high-order statistics, local binary patterns and wavelet components were used as features to train independent SVM classifiers. Then, XGboost algorithm was used to integrate independent SVM classifiers and output arrhythmia classification results. The integrated classifiers were trained and tested on MIT-BIH database.Results:The overall classification accuracy of the ensemble classifier for arrhythmia was 0.867 and the average sensitivity was 0.782.Conclusions:The proposed ensemble classifier can realize automatic and accurate classification of arrhythmia ECG signals under the inter-patient paradigm, and can be used for clinical auxiliary diagnosis.

postoperative pathological examination results and radiotherapy toxicities. Results All the 45 patients completed preoperative concurrent chemoradiotherapy and surgery, with two cycles of chemotherapy in 39 patients and one cycle in 6 patients. The rates of R0resection and pathological complete response(pCR) were 95.6%(43/45)and 22.2%(10/45), respectively. There were 10(22.2%), 17(37.8%), 15 (33.3%),and 3(6.7%)patients with tumor regression grades 0,1,2,3,respectively. The rate of lymph node metastasis was 37.8%(17/45),and the lymph node ratio was 4.33%(46/1 062). The postoperative pathological examination showed that T and N downstaging after surgery was observed in 24 and 26 patients, respectively;the proportions of patients with T3-T4tumors and positive lymph nodes after surgery declined by 51.1%(P=0.000)and 42.2%(P=0.000), respectively. The overall incidence of radiation esophagitis/gastritis was 44.4%(20/45), and the incidence rates of grade 1, 2, and 3 radiation esophagitis/gastritis were 18%,22%,and 4%,respectively. The incidence of acute radiation pneumonitis was 6.7%(3/45), all in grades 1 and 2. There was one perioperative treatment-related death. Conclusions Two cycles of XELOX chemotherapy combined with concurrent 45 Gy radiotherapy before surgery in patients with locally advanced Siewert type Ⅱ and Ⅲ AEG can achieve a relatively high pCR rate,effectively reduce the lymph node metastasis rate, achieve downstaging, and increase R0resection rate. This regimen has many good advantages,including low incidence of acute toxicities,good tolerability,and acceptable rate of perioperative treatment-related deaths. The target volume delineation involving metastatic lymph nodes is feasible.

OBJECTIVETo evaluate the effects of polymorphisms in XRCC1 and APE1 genes on vinyl chloride (VC)-induced chromosomal damage in peripheral lymphocytes.

METHODSIn this study, 317 workers occupationally exposed to VC were recruited from a factory in Shandong Province, China. The micronucleus (MN) frequency in peripheral lymphocytes was used as an indicator of chromosomal damage. Polymerase chain reaction-restriction fragment length polymorphism and created restriction site combined with restriction fragment length polymorphism were used to determine the five single nucleotide polymorphisms in XRCC1 and APE1 genes in the base excision repair pathway. The association of chromosomal damage with these polymorphisms and the haplotype of XRCC1 was analyzed using Poisson regression and PHASE 2.0.2.

RESULTSIt was found that among the VC-exposed workers, individuals with XRCC1 polymorphisms (-77C/T, Arg194Trp, Arg280His, and Arg399Gln) had a significantly higher MN frequency than those with homozygous wild-type genotypes, with frequency ratios (FR) as follows, respectively: FR = 1.21, 95%CI: 1.05∼1.39 (P < 0.05); FR = 1.14, 95%CI: 1.00∼1.38 (P < 0.05); FR = 1.26, 95%CI: 1.11∼1.44 (P < 0.05); FR = 1.23, 95%CI: 1.08∼1.46 (P < 0.05). APE1 Asp148Glu was found of no significant relationship with MN frequency. Haplotype analysis of XRCC1 demonstrated that the MN frequencies in subjects with CTAA/CTAA and CCAA/CTAA were significantly higher than that in those with TCGG/TCGG (FR = 1.19, 95%CI: 1.02∼1.32, P < 0.05; FR = 1.41, 95%CI: 1.02∼1.87, P < 0.05). Furthermore, association was found between accumulated exposure to VC and XRCC1 polymorphisms (-77C/T, Arg194Trp, Arg280His, and Arg399Gln) after adjustment for age, sex, drinking, and smoking.

CONCLUSIONVC can induce chromosomal damage even when the exposure level is lower than the national occupational health standard of China (PC-TWA: 10 mg/m(3)); the polymorphisms in XRCC1 and APE1 are associated with chromosomal damage induced by VC.

Adult ; DNA-(Apurinic or Apyrimidinic Site) Lyase ; genetics ; DNA-Binding Proteins ; genetics ; Female ; Haplotypes ; Humans ; Male ; Micronuclei, Chromosome-Defective ; Middle Aged ; Occupational Exposure ; adverse effects ; Polymorphism, Restriction Fragment Length ; Vinyl Chloride ; poisoning ; X-ray Repair Cross Complementing Protein 1 ; Young Adult