[ABSTRACT]OBJECTIVETo explore the efficacy and safety of localization for parathyroid glands with intravenous low dosage of methylene blue in thyroidectomy. METHODSWe retrospectively reviewed the clinical data of 41 patients who suffered from thyroid papillary carcinoma between Aug, 2014 and Jan, 2015 (9 males and 32 females, with a median age of 46 years). Thirty eight patients underwent primary thyroidectomy and 3 patients underwent second operation. A variety of thyroidectomy was performed in all patients, and who also underwent intravenous (3-4) mg/kg methylene blue in operation. RESULTSEighty four parathyroid glands were stained. Among 39 patients who's parathyroid glands were stained, the mean dyeing time was (31.27±9.41) min. Dyeing rates and dyeing time were not significantly different between 3 mg/kg group and 4 mg/kg group (t=0.24 and 0.20, all P>0.05). None of patients had the hypoparathyroidism problem such as peri-oral numbness, tingling, muscle aches and spasms. According to postoperative monitoring of parathyroid hormone, all of patients had no permanent hypofunction of the parathyroid gland. Neurotoxic effects and other serious side effects were not observed in all patients. CONCLUSIONIntravenous low-dose methylene blue in thyroidectomy is a safe, easy, and effective technique that facilitates rapid identification of parathyroid gland.

Objective To study the effects of MMP-9 (Matrix Metalloproteinase-9, MMP-9) in the pathogenesis of abdominal aortic aneurysms (AAAs) by localizing the expression of MMP-9 in the aneurysmal tissues. Methods By means of immunohistochemistry, the frozen sections (5 μm) with aneurysmal tissues (n = 10) were incubated with MMP-9 antibody-added agents, then the sections were stained and observed under the microscope to localize the expression of MMP-9, which displayed a brown precipitate within the arterial walls. The normal arterial wall tissues(n= 10)and the diseased arterial wall tissues from the arterial occlusive diseases (AODs) (n= 15) were also immunized exactly the same way as control. Results A quantity of positive granules which appeared within the aortic media showed the strong expression of MMP-9 in the AAAs, with the positive rate reaching 95%(19/20), while no expression of MMP-9 was observed in the normal artery. However, the scattered distributed positive granules were scen within the arterial wall of some cases of the AODs, implying the weak positive expression of MMP-9 in this disease with the positive rate of 26.7%(4/15). There was a significant difference of the expression of MMP-9 within the arterial wall between the AAAs and AODs(P＜0. 01). Conclusion High expression of MMP-9 within the aortic media faciliatates the degradation of collagen and elastin fibres and subsequent dilation of the aortic artery , thus playing an important role in the pathogenesis of AAAs. To refrain MMP-9 from enhanced expressing within the aortic wall is of clinical significance in the prevention and treatment of AAAs.

Objective To discuss the diagnosis and management of tracheomalacia complicating large goiter. Methods Clinical data of 36 patients with large goiter complicated by tracheomalacia at Xijing Hospital between 1992 and 2004 were retrospectively reviewed. Preoperative Valsalva-Mueller test were performed in all patients before undergoing subtotal thyroidectomy with tracheal suspension, and two patients were treated by subtotal thyroidectomy with tracheal suspension and tracheostomy. Results Valsalva-Mueller test was positive in all patients. The compressed tracheal cartilage disappeared in 2 cases, became thin and soft in other 34 cases. Thirty-four patients who underwent subtotal thyroidectomy with tracheal suspension recovered and 2 patients were resued by tracheal suspension with tracheostomy. There was no mortality. Postoperative 34 cases were followed-up from 6 months to 13 years. Thirty-two cases had no postoperative respiratory obstruction, 2 patients died of unrelated diseases. Conclusions The diagnosis of tracheomalacia from large goiter is based on Valsalva-Mueller test and operative detection. Subtotal thyroidectomy with tracheal suspension is the treatment of choice for tracheomalacia complicating large goiter.

Objective To discuss the diagnosis, selection of type of operation, and prevention and treatment of perioperative complications of abdominal aortic aneurysm (AAA). Methods The clinical data of 96 (patients) who underwent open surgical treatment of AAA, at Xijing Hospital between January, 1990 and June, 2004 were retrospectively reviewed. Among those, 82 patients with infrarenal AAA underwent aneurysmectomy and graft repair. 12 cases were treated by aneurysmal wrapping with Dacron. In 2 patients with suprarenal false AAA, lateral aneurysmectomy and repair was performed. Results The distance between renal artery and the neck of the aneurysm was determined by arteriography, MRA or EBT. Ninty-three patients were cured, and three cases died, with an operative mortality of 3.1%(3/96). The operative mortality was 50.0%(2/4) in 4 cases who had urgent operation because of ruptured AAA, while the operative mortality rate of the cases undergoing elective surgical repair was 1.1%(1/92, P

BACKGROUND: Harmful stimuli induce increased production of calcitonin gene-related peptide(CGRP) in the spinal cord and dorsal root ganglion, causing also intense dilation of the microvessels. But it remains unknown whether vessel dilation and pain relief were accompanied by increased CGRP production when negative pressure is applied on the limbs for treatment of peripheral arterial occlusion diseases (PAOD).OBJECTIVE: To examine the changes of calcitonin gene-related peptide (GGRP) -immunoractive nerve fibers in the spinal cord and dorsal root ganglion in dogs with PAOD treated with negative pressure on the limbs.DESIGN: A randomized controlled retrospective study.SETTING: The department of general surgery of a military medical university.MATERIALS: This study was carried out at Xijing Hospital of the Fourth Military Medical University of Chinese PLA between January and August 2003. Seventeen adult male dogs weighing 12 - 18 kg, regardless of the gender, were selected.INTERVENTIONS: Seventeen dogs were randomly divided into three groups, namely the treatment group( n = 10), model group( n = 5), and the normal control group( n = 2). Posterior left leg ischemia was induced in dogs in the treatment and model groups, and those in the treatment group, but not the model group, were treated with negative limb pressure for 10 days 14days after model establishment. The spinal cord and dorsal ganglion at L1-5of these two groups were collected and stained immunohistochemically for observing the changes of GGRP-immunreactive nerve fibers. The dogs in the normal control group were also sampled in similar manner for immunohistochemical staining.MAIN OUTCOME MEASURES: Distribution of CGRP-immunoreactive nerve fibers in the spinal cord and dorsal ganglions of the three groups of dogs.RESULTS: In the dogs of the model group, GGRP-immunoreactive nerve fibers in the spinal cord and dorsal ganglions was significantly more numerous[ (75. 00 ±4. 30)%, (68.20 ± 2.60)% ] than those in the treatment and normal control groups[ (58. 20 ±5. 10)%, (52. 20 ±6.20)%; (37.00±4. 20)%, (34. 00 ± 1.40)%, P ＜ 0.01]. The positive nerve fibers were less strongly stained in the treatment group than those in the model group,but still stronger stained those in the normal control group, with significant difference between the three groups( P ＜ 0.01).CONCLUSION: Negative pressure on the limbs may attenuate the synthesis of CGRP-immunoreactive nerve fibers in the spinal cord and dorsal root ganglion and pain conduction following PAOD in dogs, so that harmful afferent stimuli are inhibited to relieve the pain in the limbs.

OBJECTIVETo clarity the original plants and the main application varieties of White Flos Gentianae.

METHODHerbal textual research, wild specimen collection, investigation and collection of the samples from Tibetan hospital, Tibetan pharmaceutical factory and medical material market were carried out simultaneously to identify the original plants of White Flos Gentianae.

RESULTThe results of varieties textual research and specimen identification showed that Gentiana szechenyii, G. purdomii and G. algida were in accord with the record of Tibetan herbal textual The three species above were the original plants of White Flos Gentianae. The identification of 20 batches samples showed that G. szechenyii was the main application variety. The other varieties were only used in Tibetan hospitals. All the samples above were flowering branches.

CONCLUSIONIt was necessary to strengthen the research on variety systematization of White Flos Gentianae make a further discussion on the taxonomy position of G. purdomii, G. algida and the white flos population. Its was also nessary to establish and improve the quality standard of different variety based on the principle of "one species, one name". The quality specification of White Flos Gentianae should be established and improved to standard clinical utilization and produce feeding. More study of resources investigation and cultivation of G. szechenyii should be carried on to meet the demand of produce and clinic.

China ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Flowers ; anatomy & histology ; chemistry ; growth & development ; Gentiana ; anatomy & histology ; chemistry ; classification ; growth & development ; History, Ancient ; Humans ; Medicine in Literature ; Medicine, Tibetan Traditional ; history ; Plants, Medicinal ; chemistry ; classification ; growth & development

Objective To study the impact of hypothyroidism on sperm motility in male rat.Methods According to body weight,20 male Wistar rats were randomly divided into control group and hypothyroidism group (1 ml/100 g/day,0.1％ propylthiouracil by intragastric administration for 60 days) 10 rats in eachgroup.Body weight of these rats was observed every 3 days.After the last intragastric administration,all rats were killed.The levels of thyroid hormones [total triiodothyronine (T3),total thyroxine (T4),and thyroid stimulating hormone (TSH)] were measured by radioimmunoassay.Sperm motility parameters[average path velocity(VAP),straight fine velocity (VSL),straightness (STR),amplitude of lateral head displacement (ALH),sperm density(p),curvilinear velocity (VCL),linearity(LIN),wobble (WOB),mean angular deviation (MAD) and beat cross frequency (BCF)] were measured by a WLJY-9000 color-detection system.Results Compared with the control groups[(298.20 ± 12.15) g,(344.00 ± 13.73)g],the weights of hypothyroidism group of the 30 days[(239.00 ± 15.02) g] and the 60 days [(232.67 ± 17.86)g] were significantly lower(t =7.704,11.380,all P ＜ 0.05).The levels of T3[(373.3 ± 101.3) ng/L] and T4 [(4.00 ± 0.89) × 103 ng/ml] of hypothyroidism group were significantly decreased compared with that of the control groups [(1000.0 ± 273.5)ng/L,(44.33 ± 7.84)× 103 ng/L,t =5.262,12.520,all P ＜ 0.05].Level of TSH[(5.77 ± 0.89) × 103 U/L] of hypothyroidism group was significantly increased compared with that of the control group[(1.87 ± 0.70) × 103 U/L,t =8.413,P ＜ 0.05].Values of VAP[(27.45 ± 1.59)μm/s],VSL [(21.08 ± 1.10)μm/s],STR[(70.53 ± 3.48)％] and ALH[(1.96 ± 0.26)μm] of hypothyroidism group were significantly increased compared with that of the control groups[(24.38 ± 2.59)μm/s,(17.99±2.06)μm/s,(65.93 ± 2.71)％,(1.53 ± 0.27)μm,t =2.687,2.404,2.420,3.175,all P ＜ 0.05].p[(5.07 ± 0.74)109/L] of hypothyroidism group was significantly decreased compared with that of the control group [(8.76 ± 1.01)109/L,t =6.463,P ＜ 0.05].VCL[(52.83 ± 5.56)μm/s],LIN[(38.58 ± 3.41)％],WOB[(52.64 ± 3.24)％],MAD [(64.21 ± 6.71) radian/s] and BCF [(8.93 ± 0.62) Hz] of hypothyroidism group were not significantly different compared with that of the control groups[(49.92 ± 6.43) μm/s,(36.52 ± 2.73)％,(52.49 ± 3.49)％,(62.77 ± 7.34)radia/s,(9.32 ± 0.61)Hz,t =0.805,1.089,0.037,0.341,1.033,all P ＞ 0.05].Conclusion Hypothyroidism can affect sperm activity in male rats,decrease sperm density and cause damage to the reproductive system.

Immunohistochemistry was used to detect the protein expression of Snail in 5 specimens jusxta-eancerous normal breast tissues, 35 specimens of cancerous tissues without metastasis and 20 specimens of breast carcinoma with lymphonode metastasis. Breast carcinoma cell line MDA-MB-231 was transfected with antisense Snail. Results showed that the expression of Snail protein was significantly higher in breast carcinomas than in their normal tissues. The mRNA and protein expressions of Snail in the breast carcinoma cells treated with antisense Snail was significantly decreased while the E-cadherin protein significantly increased (both P < 0.05). The number of invasive ceils treated with antisense Snail was (10.5±1.3)%, while in treated with EGFP was (68.2±2.1)% (P < 0.05). The abnormal expression of Snail contribute to the invasiveness of breast carcinoma. The antisense Snail could prevent the cells ability to invade in vitro, and the effect is related with the up-regulated E-cadherin protein.

Objective To evaluate the clinical effects of autogenous vein grafting for the treatment of atherosclerotic occlusion of the lower limbs. Methods Ninety cases of segemental atherosclerotic occlusion of the lower limbs underwent autogenous vein graft bridging procedures from Jan 2002 to Feb 2005 in our hospital. The immediate surgical results were compared with symptoms of pre-operation, and the long-term patency rate was evaluated. Results Total symptom relief was achieved in 87 cases, with the limbs pain disappearing, skin temperature going up, and the refractory ulcer tending to heal. There was a significant difference in ABI, perioperatively increasing from 0. 38?0. 11 to 0. 85?0. 18(P

ObjectiveTo diagnose and classify 249 patients with myelodysplastic syndrome (MDS) according to the WHO standards.MethodsAccording to the WHO standards,cell morphology,cytogenetics,immune phenotype and bone marrow pathologic biopsy in 249 cases of MDS were analyzed.ResultsGreat shape and oval cell of mature erythrocyte could be observed in all MDS patients peripheral blood. The incidence of immature erythrocyte,immature granulocyte,pelger-like abnormal nucleus and neutrophils cells without granular increased with subtypes progressing.These abnormal characteristics and proportion tended to more apparent with MDS subtypes progressing.With the dynamic follow-up,we found the rate of MDS transition to AL increased with subtypes progressing(P＜0.05 ).The immune phenotype analysis of 148 patients was undertook and found that the trend to express myeloid specific antigen (CD33) increased gradually with subtypes progressing The chromosome inspection in 138 patients was undertook and found that 53 patients (38.7 ％ with abnormal karyotype,mainly in 20q- and +8;16 cases with complex abnormal karyotype (28 ％), two patients in 5q-. 180 patients were underwent bone marrow biopsy at the same time and found that 19 patients with abnormal morphology;42 patients with bone marrow fibrosis.ConclusionsCombining with multiple index to detect the MDS contributes to the classification and diagnosis more accuratcly and long-term follow-up helps to judgment the prognosis.