Thyroid neoplasm is one of the most common endocrinal tumors. In general, thyroid cancer patients are usually presented with asymptomatic neck nodules. A differential diagnosis between malignant and benign thyroid neoplasm is very important for these patients. This review article primarily discusses biological markers used to aid the differential diagnosis of thyroid neoplasia, which may lead to a more rational approach to the treatment. It mainly describes the recent development of molecular biological markers VEGF-C, Cytokeratin-19, HBME-1, Pax8-PPAR and Galectin-3 for the differential diagnosis of thyroid neoplasms.

Background and purpose:Although cervical lymph node metastases is commonly found, papillary thyroid cancer(PTC) has a fairly good prognosis. The microarray or gene chip technique is an effective method to explore the biological behavior of cancers. This study aims to measure the differential expression of genes between papillary thyroid cancer with lymph node metastasis and normal thyroid tissue with the new technology. Methods:The total mRNA was extracted from the specimens of papillary thyroid cancer with lymph node metastasis and normal thyroid tissues. Both of samples were labeled with fluorescent Cy5 or Cy3, and then hybridized to the gene chip which it includes 14 112 human functional gene fragments. Differentially expressed genes were screened out by scanning and analyzing the fluorescent signals.Results:There are 1 212 differentially expressed gene fragments between the two groups that it account for 8.71% of the total sites. Among them, 22 sites showed remarkable difference with either upregulation or downregulation more than 8 times fold, 2 of 6 downregulation sites represent one same gene sequence: NM-001920, which is the mRNA of the protein decorin.Conclusions:Gene chip is an effective method to study the change of gene expression during the progression of a disease. As to PTC, it involves many genes. Decorin may be an important biomarker for the prediction of metastases to the cervical lymph nodes in PTC.

This paper discussed the background,new conceptual model,characteristics,methods and future development of International Classification of Impairments,Activities and Participation (ICIDH-2).The development of ICIDH-2(Chinese edition)also be analyzed.

Objective To explore the unmet needs and service of rehabilitation for Chinese people with disabilities. Methods The unmet needs and services of rehabilitation data from the Second National Sample Survey of Disability and 2006-2016 Statistical Bulletin on the De-velopment of People with disabilities in China issued by China Disabled Persons Federation had been analyzed. Results The unmet needs of rehabilitation for people with disabilities in China were mainly included health care and support, assistive devices, rehabilitation therapy and services, poverty alleviation, accessible facilities, accessible information, and other rehabilitation needs. The highest rate of unmet needs of rehabilitation was in the fields of health care (34.84%) and poverty alleviation (33.25%). There were significant differences in unmet needs of rehabilitation among people with different types of disabilities (χ2=40322.1, P<0.01). For all the types of disabilities, 41.46%had not re-ceived any service and support, 30.45%received health care and support, and 0.55%received accessible information. The main approaches recommended by professionals for people with disabilities were institutional rehabilitation, and community and family based services. The main services recommended by professionals to people with psychiatric (68.18%) or visual disabilities (60.28%) were health care, to people with hearing disability (51.67%) were assistive device, and to people with intellectual (57.36%) and speech disability (47.06%) were rehabil-itation therapy and training. There were significant differences both in rehabilitation approaches and contents among people with different types of disabilities preferred by professionals (χ2=12489.9,χ2=52528.93, P<0.01). Conclusion The unmet needs of rehabilitation for people with different types of disabilities were mainly included health care and assistance, assistive devices, rehabilitation training and services, and poverty alleviation. There were significant differences among people with different types of disabilities. For service delivery, the highest rate was in health care and assistance. The gap between the service and unmet needs of poverty alleviation for people with disabilities in China was the highest. There were significant differences in rehabilitation approaches and contents recommended by professionals among people with different types of disabilities. It was recommended to construct the national and local system of policy support system and rehabilita-tion service governance, to provide precision rehabilitation services based on the unmet needs of rehabilitation, to develop the comprehen-sive rehabilitation service delivery to achieve the goal of rehabilitation for all, and to conduct scientific research on rehabilitation by using International Classification of Functioning, Disability and Health to provide evidence and support for the development of rehabilitation.

Objective To investigate the technique of transarterial embolization of dural carotidcavernous fistulas(DCCFs)with low concentration(14%-25%)of n-butyl-cyanoacrylate(NBCA)and determine its value.Methods Eight patients with DCCFs were treated by transarterial embolization with low concentration of NBCA using a wedged microcatheter.Of the 8 patients,5 had unsuccessful transvenous embolization and 3 could not be treated with transvenous embolization.Results Transarterial embolization with low concentration of NBCA using a wedged microcatheter resulted in complete obliteration of the affected cavernous sinus and related shunts in 5 patients,no residual arteriovenous shunt was demonstrated on postembolization angiography.On clinical and angiographic follow-up 6-12 months later,complete resolution of clinical symptoms was observed in all 5 patients and there were no recurrent or residual DCCFs found.Partial obliteration of the involved cavernous sinus and the related shunt was achieved in the remaining 3 patients on immediate post-procedure angiography,but the volume of shunt diminished significantly.On clinical and angiographic follow-up 3 months later,in 2 patients,clinical symptoms were improved and the arteriovenous shunts were diminished;in the third patient,clinical symptom resolved and the shunt was obliterated.There were no major complications except for the transient worsening of ocular symptoms due to Ⅵ cranial nerve palsy in 1 patient.Conclusions Transarterial embolization of DCCFs with low concentration of NBCA using a wedged microcatheter was a safe and effective treatment method.It is an optimal alternative for the patients with DCCFs in which transvenous route was unsuccessful,or impossible.

Objective To study the correlation between the coagulation factor Ⅶ (F Ⅶ) and progressive hemorrhage after brain contusion in mice and provide the experimental evidence for the clinical application of recombinant human FⅦa.Methods Twelve male BALB/c mice were given liposomeencapsulated FⅦsiRNA via tail vein at doses of 1,3,5 and 10 mg/kg with 3 mice per dosage.The other 3 mice received equivalent volume of normal saline as controls.Two days after the injection,mice blood sampling was used to detect FⅦ mRNA expression in liver using real-time PCR,level of plasma FⅦ using ELISA method,and activity of plasma FⅦ using chromogenic substrate assay.The optimal dose at which F Ⅶ expression was inhibited was determined.Thirty BALB/c male mice were assigned to two groups (n =15 per group) according to the random number table:FⅦ-suppressing group,mice were injected with FⅦsiRNA at the optimal dose and control group,mice were injected with same volume of negative control vector.The model of brain contusion was established in both groups.Volume of hemorrhage following brain contusion was measured at 3,24 and 72 h postinjury,and hematoma volume at 24 and 48 h postinjury.Results Liposome-encapsulated siRNA delivery down-regulated FⅦ expression in the mouse liver.Level and activity of plasma FⅦ were also reduced significantly.The optimal siRNA dose was 3 mg/kg.At 3,24 and 72 h postinjury,relative volume of brain hemorrhage in FⅦ-suppressing group was 1.46 ± 0.10,1.82 ± 0.23 and 2.28 ± 0.15 respectively,significantly higher than that in control group (1.00 ± 0.25,1.20 ± 0.31 and 1.20 ± 0.22 respectively) (P ＜ 0.05).At 24 and 48 h postinju-ry,volume of hematoma in FⅦ-suppressing group was (6.7 ± 1.5)mm3 and (9.8 ± 1.0) mm3,significantly higher than that in control group [(5.2 ± 1.2) mm3 and (5.5 ± 1.5) mm3] (P ＜0.01).Conclusions Level of FⅦ in vivo relates closely to the progressive hemorrhage of brain contusion in mice.Administration of FⅦ is effective to reduce the incidence of progressive hemorrhage.

Background and purpose: The aim of this study was to determine the necessity of central compartment neck dissection in laryngeal cancer.Study Design: Retrospective study at a tertiary referral medical center. Methods:Patients with laryngeal squamous cell cancer who underwent neck dissection were evaluated, and a retrospective analysis of clinicopathologic factors and follow-up data were performed. Results: One hundred and eighteen patients from 1999 to 2009 were enrolled. There were 11.9% central compartment lymph node metastasis in all patients, including the 10 patients with central compartment lymph node metastasis in 34 patients underwent compartment neck dissection and 4 patients do not underwent compartment neck dissection but had central neck recurrence in the follow up time. Subglottic or pyriform extension were risk factors in central compartment lymph node metastasis and central neck recurrence (P=0.002). Central compartment lymph node metastasis had closed relationship with levelⅣmetastasis (P<0.001), extracapsular extension (P=0.001), vascular extension (P=0.015) and poor local control rates (P=0.035) respectively. Patients who were positive for lateral neck lymph node metastasis had poor disease-free survival rate (P=0.014) and poor local control rates (P=0.025), and supraglottic cancer had a trend to metastases to levelⅡ(P=0.044). Conclusion:Central compartment neck dissection might be considered a potential therapeutic approach for patients with laryngeal cancer.

如果我们的目标是对人类功能有一个综合的认识以及广泛的开发项目来完善个体和群体功能，我们需要开发适当的测量方法。2001年，第54届世界卫生大会批准的国际功能、残疾和健康分类（ICF），是第一个普遍共享的模式和功能、残疾和健康标志的分类，因此是开发测量工具和最终我们理解功能、残疾和健康的一个重要步骤。由于发展ICF在全世界达成广泛共识过程和提供关于ICF效度的越来越多的证据， ICF作为参考架构和分类已经被接纳和使用。然而，广泛的接纳和使用ICF作为参考架构和分类又依赖于与有关功能的分类和测量相关的理论与方法难题的解决。因此，本文首先描述了ICF类目怎样作为功能测量的基石，然后描述了基于ICF的实用工具和国际标准例如ICF核心分类（ICF Core Sets）的发展现状。最后，本文举例说明了怎样将大量的测量工具与ICF相匹配，反之亦然，有关将通过临床测验或以患者导向的测量工具获得的信息转换到ICF的方法学原则，以及基于ICF的临床和自我报告测量工具的开发。

This paper introduced the framework and approach, explained the new categories, and elaborated the implementation of International Classification of Functioning, Disability and Health (Children and Youth Version) (ICF-CY) in fields of rehabilitation for children with disabilities. The publishing and distribution of ICF-CY international Chinese version would be a big thing for the Chinese to implement ICF in related fields.