Although pediatric thyroid nodules are rare,they have higher malignancy potential than those in adult.Prognosis is also different from adults;therefore,it is important to assess the diagnosis,differential diagnosis and treatment in children.The evaluation of thyroid nodules includes history collection,physical examination,laboratory test,ultrasound examination and fine needle aspiration biopsy (FNAB).Ultrasound and FNAB are of critical importance to assess the diagnosis.Ultrasound can not only accurately locate the lesion,but also provide the information including the size of the lesion,border,blood flow,and so forth.The cells of the lesion can be directly obtained by FNAB for analysis,which may further improve the accuracy of the diagnosis.The main concern in evaluation of thyroid nodules is the verification of whether a lesion is benign or malignant,as for benign nodules,only conservative treatment is needed,but for malignancies,more aggressive treatment is needed,such as lobectomy,total thyroidectomy,regional lymphadenectomy and so forth.Moreover,radioactive iodine therapy and complementary medicine should be recommended after thyroidectomy.

Objective To investigate the effect of stress induced by water restriction on the level of phosphorylated(ERK1/2) in rat brain. Methods Fifty-eight male Wistar rats were used and randomly divided into control group(C,n=4) and three experimental groups: TW(drinking at scheduled time),EB(empty bottle stimulus),WR(restricted water drinking),which were subdivided into three subgroups by time as 3d,7d, 14d(n=6 for each).In C group,water was freely accessed to the animal for one week.In the experimental groups the water supply was restricted following a week of accommodation and the other week for timed water supply training.In TW group,the water was supplied twice a day and 10 min for each in a fixed time. In EB and WR groups,the water was served only once a day for 10 min,and in the other scheduled time for water supply only an empty bottle without water was provided in the EB group and water was limited in the WR group.All the animals were deeply anesthetized 1h after the last stimulus and transcardially infused,then the brains were cut into free-floating sections and processed for immunohistochemical staining of pERKI/2 with ABC method.The expression of pERK1/2 positive staining was measured with image analysis system. Results The area of phosphorylated ERK1/2 was significantly increased in many brain structures,especially in paraventricular hypothalamic nucleus(PVN),supraoptic nucleus(SON),ventrolateral septum(LSV),medial amygdaloid nucleus(MeA),central amygdaloid nucleus(CEA) and nucleus of solitary tract(NTS) in TW,EB and WR group compared with C group.The expression of phosphorylated ERK1/2 in SON,LSV, MeA and CeA in EB and WR group were higher than that in TW group;pERK1/2 expression of LSV,MeA,CeA and NTS in EB group increased and went down more early and quickly than that in WR group.The response of phosphorylated ERK1/2 was dependent on both stimulus methods and time in all the nuclei mentioned above except PVN,in which only the stimulus time was related. Conclusion The level of pERK 1/2 was significantly altered in PVN,SON,LSV,MeA,CeA and NTS following stimulation of water restriction.The results indicate that the activated nuclei in the brain by physical and psychological stressors are different.

Objective To explore the relationship and clinical significance among glycosylated hemoglobin (HbA1c),fasting blood glucose (FPG),insulin (Ins),C peptide (CP)and urinary mirco-albumin (urine m-Alb)inpatients with type 2 diabetes melli-tus (T2DM).Methods A total of inpatients with type 2 diabetes were choose in this study and divided into mild diabetic group (HbA1c ≤ 9%)with 45 cases,severe diabetic group (HbA1c > 9%)with 44 cases.Twenty healthy persons were selected into control group.The levels of HbA1c,FPG,Ins,CP and m-Alb in urine of each group were detected and compared,the relationships of them were analyzed.Results There were significant differences on the levels of HbA1c,FPG,Ins,CP and m-Alb in urine of each group,and the former three indicators from low to high followed by the control group,the mild diabetic group,the severe diabetic group.There was no significant difference on the level of Ins between the control group and the severe diabetic group(P >0.05), but the level of Ins in the mild diabetic group was significant higher than that of the control group and the severe diabetes group (P <0.05).The CP level in the mild diabetic group was significant higher than that in the control group (P <0.05),and has a posi-tive correlation with the level HbA1c (r=0.427,P <0.05 ).The CP level in the severe diabetic group was significant lower than that in the control group,(P <0.05)and was negatively correlated with the level HbA1c (r=-0.415,P <0.05).Conclusion The joint detection of HbA1c,FPG,Ins,CP and urine m-Alb has positive significance to control type 2 diabetes,protect islet function and prevent diabetic nephropathy,CP is better than Ins on the assessment of the secretory function of islet,and CP might be in-volved in the occurrence and development of diabetic nephropathy.

Purpose:To study the therapeutic effect of rhG-CSF upon the severe hypogranulocytosis of children with acute leukemia after intensive chemotherapy. Methods:After intensive chemotherapy, the comparison between the group with rhG-CSF treatment ( n =136) and the control group ( n =65) was made on the ANC dropping time, the incidence rate and the degree of severity of the infection.Results:The period of ANC ≥0.5?109/L was shorter in the group with rhG-CSF treatment than that in the control group ( P

Objective To explore the clinical effects of low-frequency (50Hz) pulse electrotherapy (LFPE) in the treatment of prostatic pelvic floor muscular spasm syndrome (PPMS), and the influence of this procedure on the temperature of rabbit urethral mucosa. Methods (1) A series of 60 cases of PPMS had undergone LFPE; (2) Thirty-six rabbits were randomly divided into 6 groups: 3 experimental groups were treated for 15 min, 30min and 50 min, respectively, while the other 3 groups served as control groups. Results All cases had been followed for (1～16) months, with a mean of 6 months. Of the 60 cases, 12 were cured, 38 improved, and 10 failed,effective rate being 83.3%(50/60). In animal experiment, there were no significant differences between the experimental and control groups on temperatures of rabbit urethral local mucosa (t=1.3306, P=0.1049). Conclusions The study demonstrates that 50Hz pulse electrotherapy may be effectively applied to PPMS.

Objective To analyze the effect of total parenteral nutrition (TPN) and enteral nutrition (EN) in patients with acute pancreatitis. Methods Randomized controlled trials of TPN and EN in patients with acute pancreatitis were searched in Medline and China Biological Medicine Disk from Jan 1966 to June 2004. Eight studies were enrolled into the analysis. The detail about the trial design, characters of the subjects, results of the studies were reviewed by two independent authors and analysed by using Revman 4.2 software. Results Compared with TPN, EN was associated with a significantly lower incidence of secondary infections (RR 0.45, 95% CI 0.29-0.68, P=0.0002) and other complications(RR 0.67, 95% CI 0.47-0.96, P=0.03), fewer surgical interventions (RR 0.47, 95%CI 0.24-0.94, P=0.03) and shorter hospitalization. However, there was no significant difference in mortality (RR 0.61, 95%CI 0.32-1.18, P=0.14) between patients with TPN and EN. Conclusion EN could be the preferred nutrition feeding method in patients with acute pancreatitis.

Objective To investigate clinical efficacy of the Kirschner wire and nickel-titanium tension band fixation of patellar different types of patellar fracture.Methods 22 cases of patellar fractures were followed up,analyzed.Two methods of clinical treatment were compared.Results There was no significant difference between two methods of treatment.Transverse patella fractures with Kirschner wire tension band fixation was satisfied,but comminuted fracture of patella should adopt the nickel-titanium poly patella fixation.Conclusion Different types of patella fractures should be based on surgical indication to select different method of internal fixation.

Objective To explore the relationship between apolipoprotein E ( ApoE ) genotype and diabetic nephropathy (DN) in Chinese Han population of Guangdong province. Methods 63 cases of DN patients were selected as group A; 57 diabetes patients without complications as group B; 55 healthy persons as group C. ApoE genotype of all objects were measured. Results ApoE2 in the group A was the highest, while the differences in other groups were not obvious. Detection of ApoE3 and ApoE4 was not obvious in three groups. The Level of triglyceride (TG) was highest inε2 group, and the level of total cholesterol (TC) and low density lipoprotein LDL-C were highest in ε4 groups. Conclusions In Chinese Han population of Guangdong province , ApoE gene polymorphism and DN are closely interrelated , and the occurrence ofε2 is proportionate to DN.

The application of simulated therapy in surgical clinical teaching can stimulate the students' learning enthusiasm and improve their unified qualities in all-rounded way,improve the teacher's teaching level to acquire satisfactory results.

Metastatic tumors to the nasal cavity and paranasal sinuses are far less common than primary cancer in this location. The digestive system malignant tumor metastasis to the nose is rarer. The clinical presentation of metastases is similar to that of primary tumors and common symptoms include recurrent epistaxis, nasal obstruction and facial pain. Metastases to the nose and paranasal sinuses usually respond poorly to treatment and have a poor prognosis.
Carcinoma ; pathology ; Digestive System ; Humans ; Nasal Cavity ; pathology ; Nasal Obstruction ; Nose Neoplasms ; secondary ; Paranasal Sinus Neoplasms ; secondary ; Paranasal Sinuses ; pathology ; Stomach Neoplasms ; pathology