Objective To study the diagnosis and treatment of occult thyroid cancer with metastasis. Methods The clinical data of 18 cases of occult thyroid cancer with metastasis were analyzed retrospectively . Results All cases underwent operations. No death occurred during the operation and hospitalization .Postoperative metastasis occurred in 5 cases(27.8%). There was significant difference between the patients with metastasis and the other 100 patients without metastasis(P

Objective To study the etiology, diagnosis and treatment of acute occlusion of abdominal aorta(AOAA). Methods Clinical data of 35 patients with AOAA admitted to our hospital from January 1980 to August 2001 were analyzed retrospectively. Results There were 17 patients with acute aortic embolism(AAE) and 18 patients with acute aortic thrombosis(AAT) . All cases had total occlusion of abdominal aorta,and bilateral iliac arteries were involved. All the 35 cases underwent operations, including bilateral transfemoral thromboembolectomy by Fogarty balloon catheter in 18 cases, thromboembolectomy via laparotomy aortotomy in 11 cases, aortobiiliac reconstruction in 2 cases, aortobifemoral bypass in 2 ( 1 had profundaplasty) and axillobifemoral bypass in other 2 cases. Operative mortality was 25.7%(9/35). After the operations, artery embolism recurred in 3 cases; 3 patients required amputation; renal failure occurred in 3 cases and paraplegia in 4; ischemic colitis occurred in 5, impaired sexuality in 1 and incomplete intestinal obstruction in 1. Conclusions AOAA is an urgent disease with high mortality. Fast preoperative diagnosis and prompt operation are the keys to salvage the patient. Color Doppler is the first choice of diagnosis. Fogarty balloon catheter thromboembolectomy and vascular reconstruction are effective treatments for this disease.

OBJECTIVE:To observe the amount of thoracic cavity drainage24h after using highdose reptilase during in?tracardiac surgery.METHODS:32patients undergoing operation were randomly divided into group R(reptilase group,n=17)and group C(control group,n=15).In group R,reptilase2KU was injected before opening the thoracic cavity,reptilase1KU was added to prefilling fluid of extracorporeal circulation machine and reptilase2KU was intravenoulsy dripped after stopping machine until the end of operation.RESULTS:Compared with group C,the amount of thoracic cavity drainage reduced by35%(P

Objective To study the management and curative effect of the thyroid cancer suspected clinically but with inconclusive frozen-section intraoperatively. Methods The clinical data of 29 consecutive cases of thyroid cancer suspected clinically but with inconclusive frozen-section intraoperatively admitted to our hospital during Jan 1980 to Dec 1999 were analyzed retrospectively. Results Among these 31 suspected patients 29 were negative on frozen-section but confirmed thyroid cancer on postoperative paraffin-section. 20 underwent total involved lobe thyroidectomy in one-stage and other 11 as a second stage. No case recurred or metastased in the follow-up. Complication incidence was significantly different between one-stage and two-stage procedure (P

Objective To study the diagnostic value of air plethysmography (APG) in deep venous valvular incompetence of lower limbs and the relationship between deep venous reflux and calf muscular pump function. Methods Sixty-five varicose cases (89 limbs) were detected by APG in alterations of venous filling index (VFI), ejection fraction(EF), residual volume fraction(RVF) and outflow fraction(OF). Of 89 limbs, 18 limbs were in GradeⅠ of deep venous reflux, 24 in Grade Ⅱ, 18 in Grade Ⅲ and 12 in Grade Ⅳ. Integrated vectors analysis (Hotelling T 2test) was done with these index. Venography was performed in all patients. Results There were statistical differences in VFI between each two Grades of deep venous reflux except for between Grade Ⅰ and Ⅱ. There were also statistical differences in EF,RVF and OF between Grade Ⅳ and the other Grades. Hotelling T 2test showed significant testing efficiency of APG. ConclusionsDeep venous valvular insufficiency of lower limbs can be assessed by APG. VFI is a reliable quantitative index for evaluating the degree of deep venous reflux. There may be an exponent relation between deep venous reflux and calf muscular pump function.

Objective To screen a new schistosome vaccine candidate. \ Methods\ Schistosoma japonicum adult cDNA library was screened using sera from immune rabbits vaccinated with irradiated cercariae and monoclonal antibodies against membrane antigen of S.japonicum schistosomula. Three different fragments of S.japonicum cDNA genes were cloned into pGEM-T vector. The sequences of the inserts were determined using an automatic DNA sequencer and were analysed using Blast program. One of the unknown genes (B8) was selected and its ORF sequence (291 bp) was subcloned into eukaryotic expression vector. The recombinant plasmids were identified by restrictive enzymes and PCR amplification. The positive recombinant plasmids (pBK/SjB8) were transformed into host bacteria XL1-blue, and were then induced by IPTG for expression. SDS-PAGE and Western blotting analysis of total cellular protein from the bacteria were performed to detect the gene products. Results The results demonstrated that ORF of SjB8 gene was subcloned into the plasmid pBK-CMV and could express as fusion protein in XL1-blue. The results of SDS-PAGE and Western-blot also showed that the molecular weight of the fusion protein with 3 kDa ?-galactosidase was approximately 13\^6 kDa and the actual molecular weights of the SjB8 was 10\^6 kDa. The expressed fusion product of pBK/Sj-B8 could be recognized by immune serum and McAb. Conclusion A new gene of S.japonicum vaccine candidate (SjB8) was cloned into eukaryotic expression vector pBK-CMV and could express 10\^6 kDa schistosome protein. The results provide foundation for further study of the protein for its posibility as candidate vaccine.

ObjectiveTo analyze the effect of external valvuloplasty of the superficial femoral vein for primary deep venous valvular incompetence in the lower limbs (PDVI). Methods Consecutive seventy four cases(96 limbs) of PDVI were enrolled for prospective study, and color Doppler velocity profile technology and APG were performed preoperatively, the first month, the third month and the first year postoperatively. Results Postoperative venous reflux volume, VFI and score of venous dysfunction significantly decreased ( P

Associating liver partition and portal vein ligation for two-staged hepatectomy(ALPPS) is a novel approach for hepatectomy.The case we reported was a 68 years old male patient diagnosed with hilar cholangiocellular carcinoma and obstructive jaundice.ALPPS surgery was operated.Since the patient's left lateral lobe volume was less than 40％ of the whole liver volume (merely 33.91％),the ligation of the right portal vein,plus in situ split of the junction zone between left medial and left lateral liver lobe and the dissection of portal lymph nodes as the first stage operation was conducted.Abdominal CT on the 8th day after the operation reported an increase on the volume of left lateral lobe by 32％ to 41.5％ of the whole liver volume.On the 12th day after the first stage operation,an extended right trilobate hepatectomy combined with left hepatic duct intra-jejunum drainage was performed as the second operation.The patient completely recovered and was discharged three weeks after the second stage operation.

Objective To investigate the morphological and immunophenotypic characteristics of phyllodes tumors (PT) and explore their significance in differential diagnosis and evaluation of prognosis.Methods 48 specimens with PT were observed under light microscope with HE and immunohistochemical staining (EnVision method).The antibodies including CD34,CD10,CD117,p53,and Ki-67 were used.10 cases of fibroadenoma were compared and the clinical data and follow-up results were analyzed retrospectively.Results All of 48 cases with PT presented as well-circumscribed masses with typically leaflike structures composed of double-layered epithelial component arranged in clefts and overgrowing hypercellular mesenchymal component.31 benign,12 borderline,and 5 malignant PT were diagnosed based on stromal overgrowth,cellular pleomorphism,mitosis,margins,and others.Focal necrosis was detected in 3 malignant cases and liposarcoma component existed in 1 case.Immunohistochemical staining showed that the positive rates of CD34 were 93.5 ％,58.3 ％,0 in benign,bordline,and malignant PT respectively,there were significant differences between each groups (P ＜ 0.05).The expression of CD10 were 25.8 ％,83.3 ％,80.0 ％,its expression in benign group was significantly different compared with bordline and malignant PT (P ＜ 0.05).p53 was expressed in three groups with no significant difference (P ＞ 0.05).CD117 and Ki-67 had high expression comparatively in malignant PT.All cases were treated surgically with a local recurrence rate of 22.9 ％.Conclusions Reasonable surgery pattern based on accurate histopathological diagnosis is crucial to reduce the local recurrence rate of PT.Immunohistochemistry examination in PT is helpful to the differential diagnosis and evaluation of prognosis.

Objective To establish the quality standard of Qubizhitong gelata.Methods An HPLC method was used for the determination of paeonol with UV absorbance detection.The separation was performed using a Welchrom C18 with a mobile phase consisting of methanol-water (V∶V =45∶55).The UV detector operated at 274 nm.A TLC method was used for distinguishing Radix et Rhizoma Cynanchi Paniculati,Borneolum syntheticum and Curcumae Longae Rhizoma.Results and Conclusion The negative comparison displayed no disturbance.Linearity was within the range of 10 -320 μg/ml (r =0.9998).The average recovery was 97.42% and RSD was 1.01% (n =6).This method is suitable for quality control of Qubizhitong gelata.