OBJECTIVE: To discuss the role of the central lymph node dissection in the treatment of papillary thyroid carcinoma. METHOD: Collect 136 patients who underwent thyroidectomy with papillary thyroid carcinoma in our hospital in 2011-2012,all are conducted with lymph node dissection in the central area as well as resection of primary lesion. Functionl lateral neck lymph node dissection were used for patients with clinical lateral neck lymph node metastasis. RESULT: In 136 patients, 56. 6%(77/136) of the central lymph node metastasis were detected. Positive rate was 47. 5% in 101 cN0 patients and 82. 9% in 35 cN1 patients. CONCLUSION In the case of not increasing risk of surgery, resection of thyroid cancer primary lesion the central lymph node at the same time is a surgical procedure to be recommended.
Carcinoma ; pathology ; surgery ; Carcinoma, Papillary ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Neck ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy

The sensor of naringin(NG), a non-electroactive substance, was prepared based on the molecular imprinting technique.Using cyclic voltammetry technique (scan rate is 100 mV/s), the naringin imprinting sensitive film, poly-o-aminophenol was coated on the surface of a graphite electrode in the presence of naringin which was considered as the template, and characterized by SEM and X-ray reflective spectrophotometry (XRR).Using K_3Fe(CN)_6 as an electroactive marker, the electrochemical properties of the NG sensor were investigated by CV, electrochemical impedance spectroscopy (EIS), differential pulse voltammmetric and chronoamperometric.The results showed that the imprinted electrode was significantly different from the non imprinted electrode in morphologies and electrochemical properties, and a linear relationship between the peak current and the naringin concentration was found in the range of 6.0 × 10 ~(-5)-1.4 × 10 ~(-4) mol/L with a detec tion limit of 1.6 × 10 ~(-5) mol/L.Moreover, the imprinted electrode exhibited a good selectivity and rapid response to the naringin template molecules, as well as an excellent reproducibility(RSD = 1.8 %, n=5).

ObjectiveTo explore the role of activation and expression of absent in melanoma 2 (AIM2) in pathogenesis of hepatitis B virus (HBV) associated glomerulonephritis (HBV-GN).MethodsFifty-four patients with HBV-GN were recruited into the investigational group,and 25 patients with chronic glomerulonephritis (CGN) and 6 patients with chronic hepatitis B (CHB) were included as negative control group and positive control group,respectively.Immunohistochemistry was used to detect AIM2,Caspase-1 and interleukin (IL)-1β expressions in both kidney tissues from the investigational group and negative control group and liver tissues from positive control group.The differences between groups were compared by chi-square test,and the correlation analysis was conducted by Spearman correlation test.ResultsThe positive expression rates of AIM2 in 54 patients of HBV-GN group and 25 of CGN group were 81.4 ％ and 4.0％,respectively (x2 =38.746,P＜ 0.01).AIM2 was found to be expressed in all 6 CHB patients.In HBV-GN group,the expression of AIM2 was positively correlated with Caspase-1 (rs =0.444,P＜0.01),and the expression of IL-1β was also positively correlated with Caspase-1 (rs =0.515,P＜0.01 ).In HBV-GN group,the expression of AIM2 in patients with HBV DNA≥1 ×105 copy/mL was significantly higher than that in those with HBV DNA＜1 × 105 copy/mL (x2 =6.097,P＜0.05).ConclusionThe activation of AIM2 may play a role in the pathogenesis of HBV-GN through Caspase-1 activation and inflammatory factor IL-1β release.

Objective To evaluate the clinical outcomes of a hovel porous β-tricalcium phosphate (β-TCP)and control allograft for the repair of lacunar bone defects caused by solitary bone cyst curettage.Methods From January 2003 to December 2008,the patients with solitary bone cyst were randomized into an experimental(55 cases)and a control(40 cases)group.The control group received particulate allograft bone as the graft material,and the experimental group received β-TCP.At 1 week,1,2,3,6,12,24,48months after surgery,a new radiographic scoring system was employed to calculate the biodegradation of bone graft and evaluate the influence of multiple factors.Histologic characteristic of the degradation process of β-TCP were also evaluated.Results All the cases were followed up for average 28.4 months.Radiographic semi-quantitative analysis revealed that the biodegradation effieiencies were not significantly difierent between β-TCP and allografts(P=0.424).Degradation percentage of the implanted β-TCP or allograft was higher in younger patients than those in the older ones.Degradation of β-TCP was significantly higher than that of allografts over 3 years after surgery(P=0.04).In the experimental group,β-TCP degradation was greater in the loose packing treatment than that in the dense packing treatment (P=0.03).Histological observation demonstrated that the process of new bone formation accompanied the degradation of β-TCP.Conclusion The interporous β-TCP could be an advantageous alternative to allografts for repair bone defects caused by bone cyst.The clinical application of β-TCP is safe and reliable,which shows better biodegradation and osteogenesis than allografts in long-term follow-up.

Objective To explore the application of ultrasound- guide modified Seldinger technique for upper arm PICC insertion in infant patients. Methods Use the ultrasound-guide modified Seldinger technique to inserted PICC for 27 infant patients. Results All 27 cases were inserted successfully, success rate of the one puncture reached 92.6%. Conclusions By adequate preparation for infants, effective immobilization and good cooperation of operators, and combined with techniques which prevent PICC misplacement, overcome the shortcoming of bad vessel and non-compliance of infant patients, develop the advantage of ultrasound, could improve the rate of successful catheterization of upper arm PICC insertion in infant patients, and protect the vessels.

Objective To analyze the image and histological results of the combined use of allograft/extracorporeally frozen tumor-bearing bone and vascularized fibular flap for the reconstruction of bony defects following tumor resection,guiding clinical practice.Methods From March 2007 to June 2013,we enrolled 63 patients who had combinative biological reconstruction after bone tumor resection (11 in humerus,22 in femur,21 in tibia,4 in calcaneus).There were 36 male and 27 female in this series.The average age at time of operation was 20 years,ranging from 9 to 48 years.The follow-up ranged from 16 to 102 months with average of 48 months.We investigated the X-ray and CT images for all patients and histological findings of two patients.Patients were assessed functionally with the Musculoskeletal Tumor Society 93 score.Results Three patients with local soft tissue recurrence and one patient with infection underwent amputation.The survival of construct was 93.6％.Bone union achieved in all cases with the average MSTS score of 92.8％.Bone union ranged from 11 to 28 months in allograft group and 9 to 14 months in devitalized tumor bearing bone group.Significant difference of bone union time was found between two groups (Z=-3.638,P=0.000).Viability of the fibular grafts was verified in 58 of 63 patients (92％).Three types of images were observed in complex.Osteopenia and spongy change in fibula were found in 51 patients (81％) with stable fixation of the complex.Five complexes with failed blood supply of fibula and stable fixation revealed no density change of fibula,small amount of callous formation and relative delayed union.In seven complexes (11％) with unstable complex due to patients' incompliance,fibula reacted with dense hypertrophy and microfracture.Fusion of grafts with amount of callus was obviously observed.Union at allograft-host bone junctions occurred by residual host bone-derived external callus and fibular-derived internal callus that bridged the junction and filled the gap between abutting cortices.Callus from fibular graft was mature than that from periosteum of residual host bone.Internal repair was observed at the internal surface of the allografts.Fibula showed significant spongy changes.Conclusion Recycled tumor-bearing bone in combined with fibular flap is a reliable reconstruction as an alternative to traditional Capanna technique.The survival of the fibula is a cornerstone in success of complex reconstruction.Sponginess of fibula and internal repair of allograft compromise the intensity of complex,necessitating the strong instrumentation during reconstruction.

Objctive To search for the therapeutic method of children's nephrotic syndrome.Methods Sixty-six cases oe children's nephrotic syndrome were randomly divided into 2 groups,impulsion group (34 cases) and control group (32 cases). Dexamethasone (1．5~3 )/mg (kg?d) added into (100~150)ml 10%GS solution, intravenous drip in impulsion group, one time a day, totat 3 days, the fourth day stoped. The fifth day started again and used one time evcry two days, total 6 times. Prednisone(1．5~3)mg/(kg?d) were taken next day and total 4 weeks, then grandually decreased the dose. Only prodnisone was used in control group, the method and dose were the same as impulsion group.Results Complete remission. partial remission inefficacy ere 23, 7 and 4 cases respectiye1y in impulsion group and 22, 5 and 5 cases respectively in control group, the effective rates of the 2 group are 88．23%and 84．38% (P＞0．05). The times of state of illness stabilization are respectively 11．3?7．2 and 10．48?6．34 months in the 2 groups. The side effect of impulsion group is bigger than that of control group.Conclusion Children's primary nephrotic syndrome should be treated for 8 weeks by routine hormone induction therapy, if no remission, impulsion therapy could be used.

Objective: To study the quality and transdermal properties of matrine microemulsion-based hydrogel (MBH) to provide basis for the development of the preparation.Methods: The stability of MBH was observed at 4 ℃ for 3 months and the changes of particle appearance, viscosity, pH and matrine content were observed.The transdermal permeation of MBH was investigated by a dual chamber permeation and diffusion device with excised mouse skin as the barrier.Taking rabbits as the experimental subjects, the irritation of MBH to the normal skin and damaged skin was investigated.Results: The appearance, viscosity, pH and matrine content of MBH at 4 ℃ in 3 months did not change significantly.In vitro transdermal test showed that MBH had a good penetration rate on mouse skin, and no skin irritation occurred after single or multiple administrations.Conclusion: MBH has good stability and high rate of transdermal penetration without skin irritation, which is a promising drug delivery system of matrine with good application prospects.

Objective To investigate the clinical characteristics and treatment of acute postrenal acute renal dysfunction associated with ceftriaxone.Methods Twenty-five cases of the ceftriaxione-associated acute postrenal renal insufficiency were reviewed.There were 16 males and 9 females,mean age 28years.The serum contents of BUN and Cr were ( 18.6 ± 7.0) mmol/L and (635.5 ± 248.7 ) μmol/L,respectively.All patients were divided into two groups depending on the therapy:11 patients accepted the drug therapy (alkalinization of the urine,antispasmodic,etc) and 14 patients accepted the intraureteral cannula.The clinical characteristics and the treatment effect were compared between the 2 groups.Results The patients of the intraureteral cannula group ( 1.4 ± O.7 d) went to hospital earlier than the drug therapy group (3.0 ± 1.4 d) ( P =0.045 ) after the symptom of oliguria or anuria appeared.There were no significant differences in serum creatinine,urea nitrogen,and the age between the 2 groups ( P ＞ 0.05 ).All the patients were cured after treatment.There were no significant differences in recovery time (2.9 ± 1.1 d and 3.2 ± 1.2 d,P =0.963) and hospitalization time (7.0 ±2.3 d and 5.9 +3.9 d,P =0.568) between the 2 groups.Conclusions The acute renal failure associated with ceftriaxone should have high attention.The prompt medical attention,including the intraureteral eannula and the drug therapy,can both achieve the satisfying curative effect.

Objective To evaluate the efficacy of naloxone used in the postoperation of cerebral tumor.Methods Eighty patients were randomly assigned to receive (treated group:40 patients) or not re- ceive (control group:40 patients) naloxone.Both the two groups accepted the conventional therapy.Re- sults After operation,the content of?-EP,ET decreased continuously but the one of the treated groups was more obviously than that of the control groups (P