Objective To discuss the value of ultrasonic examinion in laparoscope's thyroidectomy.Methods 41 cases who were performed in laparoscope's thyroidectomy were checked by color Doppler flow imaging and two dimensional sonography,the key of examination:(1)The length and depth of thyroid isthmitis.(2)Trachea curve degree and the depth in up-sternum.(3)The reference between thyroid,calvicle and sternum.(4)Thyroid tumefaction degree over sternomastoid.(5)Thyroid tumer's number,position and size.(6)Tumer's kind.(7)Bloodstream change.Results Only 1 case turned open.1 case recured in hyperthyroidism.Hoarseness occured in loose after operation and come-into being after 1 mouth.No trachea and parathyroid hurt appeared in any cases.The mean operation time was 125 minutes(range 86 to 193 minutes).The mean time stay in hospital was 9 days(range 6 to 15 days).Conclusion Ultrasonic examination before operation is very valuable.

HepG2 cells were pre-incubated with insulin (Ins 0,1,0. 1,0.01 μol/L) and dexamethasone ( Dex 0,3,0. 3,0.03 μol/L) alone or together for 24 h to induce insulin resistance (IR) in vitro, the resistant level was estimated by glucose consumption, the optimal model of insulin resitance was chosen, and at the same time its lasting time of resistance was determined. In order to investigate the effects and mechanisms of mifepristone on in sulin-resistant HepG2 cells induced by insulin and dexamethasone, mifepristone and pioglitazone were adminis tered 24 h after the optimal model of insulin-resistant HepG2 cells was established. The glucose consumption, in tracellular concentrations of glucose, glycogen, ATP, and free fatty acid (FFA) in each group were detected. The expression of InsR-mRNA and GR-mRNA was detected by semi-quantitative reverse transcription and polymerase chain reaction (SqRT-PCR). Results revealed that pretreatment with insulin (0. 1 μmol/L) and dexamethasone (0.3 (μol/L) for 24 h caused optimal insulin resistance of HepG2 cells which lasted for 36 h. Compared with control group, the glucose consumption, intracellular glucose, glycogen, ATP contents and the level of InsR-mRNA in model cells decreased while FFAs concentrations and GR-mRNA increased. However, the tendency of insulin resistant HepG2 cells was obviously attenuated by pioglitazone at the concentration of 0. 2 mmol/L and mifepris tone at 200μmol/L and 20 μol/L while mifepristone at 2 μol/L had no effect on insulin-resistant cells. The findings indicated that mifepristone at 200 μol/L and 20 μol/L improved the insulin resistance via modulating intracellular glucolipid metabolism and the expression of InsR-mRNA and GR-mRNA.

Objective To investigate the clinical application of pulse indicator continuous cardiac output (PICCO) target oriented role monitoring technique on hemodynamics in patients with intractable heart failure.Methods Eighteen patients with intractable heart failure were selected as control group and received regular treatment including internal medicine under monitoring by central venous pressure.Another 18 patients with refractory heart failure were selected as PICCO group and given the internal medicine under PICCO monitoring.Intrathoracic blood volume index(ITBVI),global end diastolic volume index(GEDVI),extravascular lung water index (EVLWI),cardiac index (CFI),N-terminal B type natriuretic peptide precursor(NT-proBNP) and left ventricular ejection fraction(LVEF) were recorded.The data including mortality rate,ventilation time,intensive care time,APACHE Ⅱ score and the re-hospitalization rate were also record at 28th day.Results Compared with before treatment,ITBVI,GEDVI,EVLWI in PICCO group were (1 282.6 ± 196.4) ml/m2,(1 026.8 ±92.1) ml/m2,(12.9 ± 5.5) ml/kg respectively,significant different from that before treatment ((907.4±78.3) ml/m2,t =8.75,P =0.001; (715.2 ±61.8) ml/m2,t =6.48,P =0.003; (6.5 ± 1.2)ml/kg),t =2.94,P =0.033) and they are all back to normal level.The indices of CFI,NT-proBNP,LVEF in PICCO group were improved than before treatment (CFI:(3.1 ±0.5) L/min vs.(4.8 ± 1.3) L/min,t =2.56,P=0.042) ;NT-proBNP:(6 438.3 ±249.5) ng/L vs.(1 371.6 ±87.5) ng/L,t =5.12,P =0.019) ;LVEF:(26.9±3.1)％ vs.(54.3 ±2.5)％,t =2.62,P =0.040)).Mortality at 28th D in PICCO group was 16.7％,lower than that of control group (33.3％,x2 =4.99,P =0.026).The indices of assisted ventilation time,intensive care time,APACHE score of lⅡ and the rehospitalization ratein PICCO group were better than that of the control group ((8.5 ±2.3) dvs.(3.2±0.8) d,t=24.31,P＜0.05;(14.9±2.3) dvs.(8.3 ±2.0)d,t=12.26,P=0.002;(23.4±1.3) vs.(14.7±1.6),t=9.52,P=0.011;38.9％ vs.11.1％; t=5.79,P =0.020).Conclusion PICCO provides effective guidance for intractable heart failure patients hemodynamic monitoring of goal orientation.

Objective Through the two D-dimer content detection of the fracture patients and healthy con-trols,and analyze the difference between them ,to explore the correlation between fractures were detected two D-dimer and the importance and the patient′s condition.Methods 306 of fracture patients were collected for determination of D-dimer content were detected at the same time ,100 healthy people as control two D-dimer content;analysis of the correlation between the fracture in 306 cases patients with D-dimer content .Results The plasma D-dimer level of pa-tients with two fracture(10.7 ±2.6)mg/L,which was significantly higher than that of healthy subjects (0.3 ±0.1) mg/L(t=11.07,P<0.01);The fracture number,fracture patients plasma D-dimer detection results content is high-er,the more serious condition .Conclusion The plasma D-dimer level was significantly higher in patients with two fractures,coagulation Stata ,fibrinolytic enhancement ,easily lead to venous thrombosis and disseminated intravascular coagulation in patients with more complications such as fracture;fracture,the higher the content of plasma D-dimer, patients with more serious ,there is correlation .

Objective:To discuss the mechanism of Baoganning anti-liver fibrosis.Methods:liver fibrosis rat models were established by complex factors.Automatic biochemical analyzer was used to detect TC、TG and RIA isotope analysis was used to detect serum leptin.To observe the influence of Baoganning on TC、TG and leptin level of liver fibrosis model rats. Results:Compared with the normal group,levels of serum TC,TG decreased apparently in model and every drug groups(P0.05).Conclusion:Baoganning can effectively prevent and treat liver fibrosis in rats,which may be closely related to the improvement of liver function,adjustment of lipid and reduction of serum leptin.

Objective To explore the anti-hepatic-fibrosis mechanism of Baogan Ning(BN).Methods Fifty Wistar rats were randomized into 5 groups: normal group,model group,high-and low-dosage BN groups(35.4 and 17.7 g/kg respectively),and colchicine group(0.11mg/kg).Rat models of hepatic fibrosis were induced by multiplex factors.Hepatic protein was extracted,and the expression of hepatic leptic receptors of OB-Rb,JAK2 and STAT3 was detected with Western Blot method.Results The protein expression was not obvious in the normal group,and the color of protein band in the medication groups was light but dark in the model group.Compared with the normal group,the expression of OB-Rb,JAK2 and STAT3 increased in the model group.However,the expression of OB-Rb,JAK2 and STAT3 decreased in the medication groups as compared with the model group.And the expression of OB-Rb,JAK2 and STAT3 decreased in the BN groups as compared with the colchicines group.Conclusion The anti-hepatic-fibrosis mechanism of Baogan Ning is probably related with the inhibition of OB-Rb expression,thus inhibit the JAK2/STAT3 message pathway.

ObjectiveTo investigate the inhibitory effect of dacarbazine and an oncolytic adenovirus carrying interleukin-24 (IL-24) on transplanted melanoma in nude mice.MethodsNude mice were inoculated with human A375 melanoma cells to establish a model of malignant melanoma.Then,the mice were divided into 4 groups to be treated with an oncolytic adenovirus carrying interleukin-24 (ZD55-IL-24),dacarbazine,the combination of ZD55-IL-24 and dacarbazine,and phosphate buffer(PBS),respectively,for 3 days.Seven days after the end of the treatment,some mice were sacrificed followed by the determination of IL-24 and E1A protein levels in tumor tissue by Western blot.The tumor volume was measured on a daily basis for 30 days.ResultsIL-24 and E1A were highly expressed in melanoma cell-bearing nude mice treated with ZD55-IL-24 and dacarbazine.At 30 days after the inoculation,the average volume of transplanted melanoma was (2346.5 ± 576.0) mm3 in the combination group,significantly different from that in the ZD55-IL-24 group((4141.6 ± 1348.2) mm3,P ＜ 0.05),dacarbazine group((5230.1 ± 922.8) mm3,P ＜ 0.05),and the control group ((7135.1 ± 1002.3) mm3,P ＜ 0.05).ConclusionThe ZD55-IL-24 in combination with dacarbazine exhibits a remarkably inhibitory effect on the proliferation of melanoma transplanted into nude mice.

ObjectiveTo study the risk factors and pathogenic characteristics of ventilator associated pneumonia(YAP). MethodsRisk factors of VAP,pathogens and drug resistance in 118 patients in ICU were analyzed retrospectively. ResultsThe incidence of VAP was 44.9％, and age, the mechanical ventilation time, state of consciousness,tracheotomy,the antibiotic combination are risk factors of incidence of VAP. 53cases of VAP(68.2％ )were infected by Gram negative bacilli,25.9％ were by Gram positive cocci,and 5.9％ were by fungi. Drug resistance was observed obviously. ConclusionThe occurrence of VAP was related with multiple factors. The gram negative bacteria are the major pathogens of VAP, and the rate of drug resistance was high. The occurrence of VAP could severely affect patients' prognosis.

Objective　To study the expression of p73 in human non-small cell lung cancer (NSCLC) and the relationship between p73 expression and clinico-pathological parameters. Methods　Expression of p7 3 gene was detected by RT-PCR in 32 human NSCLC tissues, tissues adjacent to ca ncer and non-cancer lung tissues. Results　p73 gene expression up-regulated substantially and detected in 87.5%(28/32) of human NSCLC tissues while expressed at low level in tissues adjacent to cancer and non-cancer lung tissues. Conclusion　Marked up-regulation of p73 gene expres sion is found in human NSCLC.

Objective To explore the causes,clinical manifestations,diagnosis and treatment method of femoral artery pseudoaneurysms (IFPSA) after ultrasound-guided percutaneous coronary intervention.Methods Ultrasound-guided repair by compression was applied to all cases,of which the failed cases were treated with ultrasound-guided thrombin injection.Results IFPSA was confirmed by ultrasound imaging in 39 cases,18 of which were cured by compression repair,with the average compression duration of (36.78 ± 1.71 )min.Another 21 cases were cured by the thrombin injection,after compression repair failed,with average time for thrombosis (0.33 ± 0.06 )min.All the patients were re-evaluated by ultrasound 24 h after treatment,confirming the successful closure of the pseudoaneurysms.No recurrence of pseudoaneurysm was observed during a half-year post-operative follow-up.Conclusion Ultrasound-guided compression repair and ultrasound-guided thrombin injection into the cavity are safe and effective treatments for femoral arterial pseudoaneurysms after coronary intervention.