Objective To discuss the feasibility and value of routine clinical preoperative examination predicting benign and malignant thyroid nodules. Methods The clinical data of 1630 patients undergoing thyroidectomy for nodular thyroid disease were analyzed retrospectively.The relationship between pathological diagnosis and physical examination,ultrasonographic parameters,the results of laboratory test and nuclear medicine test were examined to build a risk prediction model.The sensitivity,specificity and accuracy of the formula were tested. Results In 387 cystic nodules 0.78％ were malignant; In 1243 solid nodules 17.2％ were malignant.Among the 1243 cases,characters significantly related to malignancy were:age younger than 40 years,solitary lobe involvement,hypoechoic nodule,irregular margins,solid nodule,microcalcification,macrocalcification,max diameter ≤ 2 cm. The prediction formula was: malignancy indicator =0.80 × age + 0.59 × solitary lobe + 0.72 × hypoechoic + 0.82 × irregular margin + 1.32 × solid nodule + 1.90 × microcalcification + 0.70 × macrocalcification + 0.71 × max diameter.The threshold limit value was 2.8,and the sensitivity,specificity and accuracy of which were 74.4％,80.4％ and 75.2％,respectively. Conclusions Benign and malignant thyroid nodules could be differentiated roughly with the combination of patients' general information and the results of routine examination before operation.

Objective: To fix optimum extracting craft of polysaccharides in Siwu Decoction.(Radix Rehmanniae Preparata, Radix Angelicae Sinensis, Radix Paeoniae Alba, Rhizoma Chuanxiong). Methods: The orthogonal design was used and refluxing time (A). water totalling (B) and extraction time (C) were defined as factors of the design. Results: A factor and C factor had notable influence on the content of polysaccharides. Conclusion: Optimum extracting craft was defined as follows: A 2B 1C 2.

Objective To objectively evaluate the endpoint ot transcatheter arterial chemoembolization (TACE) using two dimensional color-coded digital subtraction angiography (2D-ccDSA).Methods Retrospective analysis of twenty-four patients diagnosed with hepatocellular carcinoma (HCC),treated by TACE and evaluated by post-processed 2D-ccDSA.All patients were examined by DSA before and after TACE procedure,all these DSA series were converted into color-code images,the time density curve (TDC) was derived from the 2D-ccDSA imaging.Time-to-peak (TTP) was measured for the ostia of the catheter,the origin of the tumor feeding artery (TFA) and the embolized site of the TFA; maximal TDC enhancement was measured for selected spots of the tumor parenchyma.The tumor blood supply time (TBST) for pre and post-TACE was calculated accordingly.Data were interpreted with paired t test using SPSS.Results The TTP of the ostia of the catheter and the origin of the tumor feeding artery (TFA) before TACE were (3.47 ± 0.96) and (4.09 ± 1.09) s,after the TACE were (3.49 ± 1.02) and (3.78 ± 1.05) s,respectively.There was no statistical difference between the pre-and post-procedural TTP of the two landmarks (t values were 0.10 and 1.15,P values were 0.92 and 0.26).TTP at the embolized site of the main TFA were [(4.62± 1.16) and (5.59± 1.57)s]for pre and post-TACE,the tumor blood supply time (TBST) was greatly delayed compared with that after the TACE procedure [(1.82± 1.10)s and (0.52±0.41)s].The mean maximal TDC enhancements of the tumor parenchyma areas were (3.03±0.88)units before TACE and (1.10±0.67)units after TACE.The differences were all statistically significant (t values were 3.32,6.04 and 8.93,respectively,P＜0.01) Conclusion It is feasible to use 2D-ccDSA to objectively assess the endpoint of TACE procedures.

ObjectiveTo evaluate the posterior paraspinal muscle approach in the treatment of thoracic and lumbar spine fractures and compare this method with the conventional approach.MethodsFrom October 2006 to October 2008,a total of 52 cases of non-neurological symptoms patients with thoracic and lumbar spine fractures were included in the study,including 37 males and 15 females with an average of 46.5 years(range,18-59 years).According to the Denis fracture classification,there were 17 compression fractures and 35 burst fractures with spinal space-occupying less than 1/3,including 1 case with T4 fracture,2 with T7 fracture,1 with T8 fracture,3 with T10 fracture,5 with Tn fracture,14 with T12 fracture,16 with L1fracture,9 with L2 fracture,and 1 with L3 fracture.The patients were divided into two groups,with 20 cases treated with the traditional approach and the other 32 cases with the posterior paraspinal muscle approach.All the patients were given pedicle screw fixation.ResultsNo significant differences were found in terms of gender,age,injured segment,operation time and follow-up period between the two groups.Compared to the traditional approach,the posterior paraspinal muscle approach was significantly advantageous in terms of time,the amount of bleeding,postoperative drainage,duration of recumbence,pain visual analogue score and Oswestry disability index after the surgery.All patients were followed up for average 21.5 months (range,12-36 months).Till the last follow-up,all patients with vertebral fractures were healed.No loosening or breaking of internal fixation was observed.ConclusionThe posterior paraspinal muscle approach for thoracic and lumbar spine fractures,retaining the posterior ligament complex,is an effective and minimally invasive treatment,with less trauma,less bleeding,the advantages of reliable clinical results.

AIM: To study the relation between prolon ge d survival of skin allograft by chuan-ke-zhi (CKZ, drug of Chinese herbal) and C D4+CD25+ regulatory T cells (CD4+CD25+ Tr) in mice. METHODS: Skin allograft and isograft model in mice were establi shed and CKZ was administered by intraperitoneal injection. To observe its influ ence on survival of the graft, three color fluorescent staining together with fl ow cytometry was used to analyze the change of CD4+CD25+ Tr. RESULTS: The survival of skin allograft in CKZ group was signifi cantly prolonged compared to control group, (19.5?2.3) days and (10.2?2.2) days, respectively, P0.05). CONCLUSION: CKZ has an effect of prolonging the survival of skin allograft. Enhancement of CD4+CD25+ Tr might be one of the mechanisms under lying its immunosuppressive effect.

ObjectiveTo observe the effect of the nine points for hemiplegia plus MOTOmed exercise training system on the lower-extremity function of the patients with post-stroke hemiplegia.MethodForty-five patients with post-stroke hemiplegia were randomized into 3 groups, 15 each.Group A was intervened by regular acupuncture treatment, group B was by the MOTOmed training system, and group C was by the nine points for hemiplegia during the exercise training by the MOTOmed system in addition to the regular acupuncture treatment. The National Institute of Health Stroke Scale (NIHSS) and Fugl-Meyer (FMA) scale were adopted for evaluation and comparison before intervention and after 4-week intervention.ResultBefore intervention, there were no significant differences in comparing the function of lower extremity among the three groups (P>0.05);after 4-week intervention, the observation indexes were improved in the three groups, and the improvement in group C was the most significant (P<0.05), and it was significantly different from that of group A and B at the corresponding time point (P<0.05). ConclusionThe nine points for hemiplegia plus MOTOmed exercise training can effectively improve the lower-extremity function in the patients with post-stroke hemiplegia.

Objective To evaluate the safety and efficacy of Zonisamide(ZNS) as adjunctive therapy in patients with refractory partial seizures receiving other antiepileptic drags (AEDs).Methods This was a randomized,double-blind,placebo-controlled study conducted at multi-centers.All 240 subjects were randomized to either the ZNS group or the placebo group in a 1:1 ratio.The double-blind treatment phase included a titration phase during which zonisamide dose inereased from 100 mg/day to 300 mg/day over 4 weeks and then a 12-week fixed-dose phase.The primary efficacy endpoint was,the median % reduction from baseline in all pattial seizure frequency(CPS+SPS+SGS)during the fixed-dose phase.The important secondaw endpoint wag the responder rate.Safety profiles and tolerance were also evaluated.Results The FAS analysis showed the median reduction from baseline in the ZNS group was greater than in the placebo group(48.4%vs 26.6%),the difference was significant for ZNS compared with placebo(F=4.904,P=0.028);The responder rates for all partial seizures(48.6%vs34.9%,X2=4.046,P=0.044)and for complex seizures(52.2% vs 33.3%,X2=5.607,P=0.018)were significantly higber in the ZNS group than in the placebo group in the FAS population.The overall adverse events(AEs)profile was comparable between the two groups.The most frequent AEs considered to be related to zonisamide by the investigator were headache,dizziness,somnolence,anorexia,nausea,etc.Conclusions ZNS is superior to placebo in reducing the frequency of partial seizures and well-tolerated.ZNS could be a choice of adjunctive therapy in patients with refractory partial seizures.

OBJECTIVE To observe the significance of(1,3)-?-D-glucan in different humor samples on the rat model of systemic trichosporosis.METHODS Established the animal model with systemic infection of trichosporosis,to collect the bronchoalveolar lavage fluid(BALF),plasma and urine samples for determining,and checked with G-test,nested PCR and fungus culture.RESULTS In the earlier infection(10d),the sensitivity of G-test in the samples of plasma,BALF and urine were 80.00%,86.67%,and 6.67%,respectively,and had significant difference with control group.In the 30 plasma samples,the average sensitivity of G-test and nested-PCR blood fungus culture was 76.76%,68.85%,and 3.33%,respectively.With the statistical analysis,the sensitivity of G-test had significant deviation than fungus culture(P

OBJECTIVE To identify if Trichosporon asahii exist cph1 gene homolog of Candida albicans,and analyze its nucleotide sequence.METHODS Nuclear DNA was extracted from the cells of T.asahii by using a simplified protocol,designed 29 pairs of primers according to the cph1 gene sequence of C.albicans and amplify by PCR.The PCR products were cloned and sequenced using the ABI377 nucleotide sequenator,and BLAST analysis.RESULTS An 827 bp gene was amplified successfully,which was homolog with the cph1 gene of C.albicans and their identity was 97.3%.CONCLUSIONS This trial determines the clone cph1 gene in T.asahii for the first time,which makes bases for the role of cph1 gene in the hypha formation.

Objective To compare the accuracy and clinical effect between X-ray stereotactic vacuum-assisted biopsy (SVAB) and metal wire guided lumpectony.Methods From January 2010 to June 2014,681 cases of breast micro-calcification biopsy were performed.Among them,78 cases were performed with SVAB and 603 eases were performed with the method of stereotaetic metal wire guided lumpectomy.All cases were non-palpable breast lesions (NPBLs) and breast imaging-reporting and data system (BI-RADS) assessment categories 4.The diagnostic accuracy and clinical effect were compared.Results The sensitivity of both methods was 100 ％ with no misdiagnosis.The underestimation rate of SVAB was 12.5 ％.Compared with the method of metal wire guided lumpectomy,SVAB had many advantages,such as easy to use,quickly performed,low rate of local deformation and lower rate of operative complications.77.5 ％ patients benefited from SVAB by avoiding open surgery of benign disease.Conclusions SVAB is an accurate,safe and convenient method of biopsy.It can be recommended as the preferred method of micro-calcification (BI-RADS 4).Additional operation should be performed on patients with the pathological diagnosis of middle and high grade of dysplasia and any kind of carcinoma.