Objective To retrospectively evaluate the necessity to dissect the recurrent laryngeal nerve in operation of thyroid gland.Methods From Jan 2004 to Jan 2009,there were 512 patients in our hospital who underwent operation of thyroid gland,and they were divided into two groups aecording to whether or not the recurrent laryngeal nerve was dissected during the operation.The rate of injury of recurrent laryngeal nerve between the two groups was compared.Results Among the 189 cases in dissection of recurrent laryngeal nerve group,3 cases(1.59%) had hoarseness after operation,and in the 323 cases without dissection of the recurrent laryngeal nerve group,5 cases(1.55%) had hoarseness after operation,but the difference was not significant(1.59% vs.1.55%).However,in the high risk cases between the two groups,the difference was significant(1.02% vs.3.95%).Conclusions Whether oe not to dissect the recurrent laryngeal nerve should be decided by the specific circumstances.For most benign lesions,one should,if possible,not expose the recurrent laryngeal nerve;but for large thyroid neoplasms,second or multiple operations and thyroid cancer,exposure of recurrent laryngeal nerve is necessary.

Objective To observe the solo-allied expression of Survivin, Smad4/dpc4 and APC gene, and study the relationship between the three genes and biological behavior of colorectal cancer. Methods The expressions of Survivin, Smad4/dpc4 and APC gene were detected by SP immunohistochem-istry among the cases from 40 eu-intestine ,80 large intestinal adenoma and 80 CRC. Results The positive rate of survivin protein in the eu-intestine, the large intestinal adenoma and CRC was 0,35.0% ,75.0% , respectively. The positive rate of Smad4/dpc4 protein was 100% , 95. 0% , 78. 8% , and the positive rate of APC protein was 100% ,80.0% ,45.0% , respectively. In the eu-intestine, APC + Smad4/dpc4 Z- expressed in 40 cases, with the incidence of 100%. In the large intestinal adenoma, APC + Smad4 expressed in 38 patients, with the incidence of 47. 5% , and the three genes expressed in 29 patients with the incidence of 23. 8%. In the CRC, two genes expressed in 57 patients, with the incidence of 71. 3% , and three genes expressed in 28 patients, with the incidence of 35.0%. Conclusion The detection of survivin was a new indicator in early diagnosis of CRC. It was significant in the diagnosis of CRC that energetic search for the positive rate level realm of survivin. The catastrophe or absence of Smad4/dpc4 gene not only induced the genesis of CRC but also encouraged its growth. Smad4/dpc4 was ant- carcinomatous gene intimately correlated to the CRC. Detection of APC gene had very important significance, it could be helpful to conduct the research of tumorous aetiology, nosogenesis and early diagnosis. The allied detection of Survivin, Smad4/dpc4, APC gene played a very important role in early diagnosing and healing the CRC.

Objective To summarize the experience of the ventriculoperitoneal shunt (VPS) in communicating hydrocephalus and its complications. Methods The clinical features, operative techniques and outcome of 100 patients with hydrocephalus were analysed retrospectively. Results Ninety-five (95%) cases had a good result. Postoperative complications were found in 6(6%) cases including shunt apparatus blockage (4 cases) and shunt infection (2 cases). All the cases improved after taking the corresponding measures. Conclusion VPS is the most common shunt style for communicating hydrocephalus. The shunt apparatus blockage and infection are common postoperative complications. Intraoperative aseptic technique, the minimally invasive procedure, and the optimal placement of shunt tube may play an important role in improving the outcome of cerebrospinal fluid shunting surgery for communicating hydrocephalus.

Objective To study the distribution of Nogo-A in the retina and the changes after the optic nerve(ON) injury in hamsters. Methods In this experiment,ON was crushed at 2?mm behind of the eyeball.After 3?d,5?d and 7?d post-axotomy,the Nogo antiserum immunoreactive staining on section of the retina was performed. Results Nogo was expressed at every layer of the retina with the strongest expression on 3?d post-axotomy.The numbers of Nogo-A positive RGCs decrease as the survived time increased.Conclusion Nogo-A in the retina is not unique secretion from the neuroglia.The change in the distribution and level of expressed of Nogo-A in the retina is correlated with time advancement after injured of ON.

Extramural vascular invasion of rectal cancer is an important factor affecting the prognosis of patients with rectal cancer. Accurate diagnosis of extramural vascular invasion before surgery can guide the formulation of treatment plans, thereby improving prognosis and long-term survival of patients. Magnectic resonance imaging examination and computed tomography examination are the main examination methods for preoperative evaluation of rectal cancer. The authors review the role of imaging examinations in the evaluation of extramural vascular invasion of rectal cancer.

Objective To investigate the effects of tetramethylpyrazine(TMP)on acute kidney injury(AKI)induced by cisplatin(Cis)and its related mechanisms.Methods Sixty SPF male C57BL/6J mice were randomly divided into control group(Ctl),TMP group,Cis-induced AKI model group(Cis group)and TMP treated AKI model group(Cis+TMP group).The contents of BUN and Scr were detected,and the apoptosis of renal tissue was detected by TUNEL staining.The structural changes of mitochondria in renal cortex of each group were observed by transmission electron microscope,and the expression of ROS in renal tissue was detected by DHE staining.The expression of PGC-1α and the phosphorylation of Drp1(p-Drp1Ser637/Drp1)in renal tissue were detected by Western blotting assay.Proximal renal tubule epithelial cell line HK-2 was cultured in vitro and divided into Ctl group,TMP group,Cis group and Cis+TMP group.Proliferation activity of cells in each group was detected by CCK-8 assay,apoptosis was detected by Annexin V-FITC/PI method,ROS expression and mitochondrial membrane potential were detected by DCFH-DA fluorescence probe and JC-1 staining.The expression of PGC-1α and p-Drp1Ser637/Drp1 were detected by Western blotting assay.Results Compared with Ctl group,the contents of BUN and Scr in Cis group and Cis+TMP group were significantly increased(P<0.05),cell apoptosis of renal tubular and the damage of renal cortical mitochondrial structure were significantly increased(P<0.05).However,the expression of PGC-1α protein and p-Drp1Ser637/Drp1 ratio in renal tissue were significantly decreased(P<0.05),and no significant changes were observed in TMP group(P>0.05).Compared with Cis group,the change trend of above detection indexes in Cis+TMP group was significantly decreased(P<0.05).Compared with HK-2 cells in Ctl group,the proliferation activity,mitochondrial membrane potential,PGC-1α protein expression and p-Drp1Ser637/Drp1 ratio of Cis group and Cis+TMP group were significantly decreased(P<0.05),while the apoptosis ratio of Cis and Cis+ TMP group was significantly decreased(P<0.05).The ROS expression and Drp1 protein expression in mitochondria were significantly increased(P<0.05),but no significant changes were observed in TMP group(P>0.05).Compared with Cis group,the change trend of above detection indexes in Cis+TMP group was significantly decreased(P<0.05).Conclusions TMP can ameliorate CIS-induced apoptosis and mitochondrial damage in renal tubular epithelial cells in vitro and in vivo,which may be related to PGC-1α pathway.

Objective:To investigate the association between pulse pressure(PP) and new-onset diabetes in overweight and obese people.Methods:A prospective cohort study was conducted in overweight or obese participants selected from Kailuan Study who underwent 2006-2007 annual checkup and met the inclusion and exclusion criteria. PP was calculated by blood pressure and participants were divided into 4 groups according to PP quartile. The cumulative incidence of new-onset diabetes of different PP groups was calculated by Kaplan- Meier method and compare by Log- Rank test. The multivariate Cox proportional hazards model was used to analyze the association between different PP groups and new-onset diabetes. Results:During an average follow-up of 8.45 years, 8 922 diabetes was identified. The cumulative incidence rate of the Q1, Q2, Q3, and Q4 groups were 22.12%, 24.48%, 27.97%, and 33.44% respectively, which were statistically different( χ2=368.16, P<0.01). Cox proportional hazards regression analysis showed that after adjusting for multiple confounding factors, compared with Q1 group, the hazard ratio for diabetes in Q2, Q3, and Q4 groups were 1.07(1.00-1.14), 1.13(1.05-1.21), and 1.17(1.09-1.27) respectively. And the HR of diabetes event in pulse pressure(per 1 SD increase) was 1.04(1.02-1.07). Similar results were found in participants who were over-weight, obese, with normal blood pressure or hypertensive without drugs use. Conclusion:PP is positively correlated with the new-onset diabetes. High PP is one of the risk factors for developing diabetes in overweight and obese people.

Objective:To explore the effects of integrated traditional Chinese and western medicine nursing based on emotional nursing on infertile patients with obese polycystic ovary syndrome (ob-PCOS) .Methods:Totally 80 infertile patients with ob-PCOS admitted at the Department of Reproductive Medicine of Affiliated Hospital of Jining Medical University were selected by convenient sampling and divided into a control group and an intervention group according to the random number table, with 40 patients in each group. Patients in the control group received routine nursing, while patients in the intervention group underwent integrated traditional Chinese and western medicine nursing based on emotional nursing. Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to compare the negative emotion between the two groups, and the Generic Quality of Life Inventory-74 (GQOL-74) was utilized to compare the body weight, waist-to-hip ratio, and body fat percentage of the two groups of patients.Results:After the intervention, the SAS and SDS scores of the two groups were lower than those before the intervention ( P<0.05) , and the intervention group was lower than the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of GQOL-74 in the two groups were higher than those before the intervention ( P<0.05) , and the scores in the intervention group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The body weight, waist-to-hip ratio, and body fat percentage of the intervention group were lower than those before the intervention ( P<0.05) , and were lower than those of the control group, with statistically significant difference ( P<0.05) . Conclusions:The integrated traditional Chinese and western medicine nursing based on emotional nursing can amiloride the negative emotion of infertile patients with ob-PCOS and improve their body weight, waist-to-hip ratio, body fat percentage, and quality of life.

Objective:To explore long-term outcome and risk factors of recurrence in stage Ⅲ gastric cancer patients who underwent radical gastrectomy and adjuvant chemotherapy.Methods:The clinical and pathological data of patients with stage Ⅲ (AJCC V8) gastric adenocarcinoma were analyzed retrospectively. All patients received radical gastrectomy and adjuvant chemotherapy consisting of oxaliplatin, fluoropyrimidines with or without docetaxel in our center during 2006 and 2011.Results:A total of 324 patients were enrolled into the study. With a median follow-up time of 108 months, 175 (54%) patients developed tumor recurrence. One hundred and eighty-three (56.5%) patients died, including 169 (52.2%) dying of gastric cancer recurrence. The median disease-free survival (DFS) was 35 months, and the median overall survival (OS) was 64 months. The 5-year OS rates were 58.2%, 51.5% and 25.6% in patients with stage ⅢA, ⅢB and ⅢC diseases, respectively ( P<0.01). Multivariate analysis revealed that T4b cancers ( P=0.02), higher lymph meta node ratio (LNR) ( P<0.01) and perineural invasion ( P=0.01) were independent negative prognostic factors, while more than 12 weeks of adjuvant chemotherapy may improve survival. Higher LNR was correlated with locoregional ( P<0.01), distant lymph node metastases ( P<0.01), and peritoneal metastases ( P=0.038). Perineural invasion ( P=0.047) was prone to peritoneal metastases. More than 12 weeks of adjuvant chemotherapy could reduce the risk of haematogenous metastases ( P=0.023). Conclusions:Outcomes were significantly different in subgroups of patients with stage Ⅲ gastric cancers after radical gastrectomy. Higher LNR and perineural invasion could predict poor prognosis and different recurrence patterns.