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 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 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 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.

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 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 investigate the practicability and safety of laparoscopic anatomical hepatectomy.Method 40 patients with space occupying lesions in the liver underwent laparoscopic anatomical hepatectomy between Jan.2008 and Mar.2012.The diagnoses were hepatocellular carcinoma (HCC) (n=13),recurrent HCC (n =1 ),cholangiocarcinoma ( n =1 ),metastatic cancer ( n=6),hepatolithiasis (n=10),hemangioma (n=7),FNH (n=1) and liver cell adenoma (n =1).Intraoperative ultrasound was routinely performed to locate lesions and intrahepatic structures.Selective hemihepatic vascular occlusion was applied during resection. High frequency cautery,CUSA and Ligasure were used to transect liver parenchyma. Hemolocks were applied when large blood vessels and bile ducts were encountered.Endo-GIA was used if necessary.The operations included right hemihepatectomy (n =3),left hemihepatectomy (n =10),resections of segment Ⅴ and Ⅵ (n=5),segment Ⅴ (n=3),segment Ⅵ (n =4),and segment Ⅳb (n =1).Result34 hepatectomics were performed laparoscopically.6 patients were converted to open surgery.There was no perioperative death. The operating time was 250.21±50.94 min,and intraoperative blood loss was 420.20± 120.10 ml.Bile leakage was diagnosed in 2 patients after operation.Conclusion With careful patient selection,and improvement in surgical technique and apparatus,laparoscopic anatomical hepatectomy has become safe and practicable.The operation has the advantages of minimal invasion and rapid recovery. It can be regarded as a standard procedure for selected benign and malignant lesions.

Objective To evaluate the efficacy of self-disigned long-thick silicone prothesis in the treatment of severe microgenia.Methods A long-thick silicone prothesis was designed according to the measurement results gained by a coordinate caliper.The designed long-thick silicone prothesis was sterilized by uperization.The procedure commenced under local anesthesia for all patients.The prothesis was placed through an intraoral incision.The digital photographs were taken at the pretreatment visits and 3 months and 12 months after treatment follow-up to observe the change of the chin projection.Results 20 cases of severe microgenia were treated with this technique.All wounds healed primarily.There was no infection,extrusion and rejective reaction.The profiles of chins were improved obviously and reached aesthetic standard.Only one implant required adjustment 3 months after first operation because of displacement.After 12 months follow-up the reshaping contour of the chins were satisfied.Locations of silicone prothesis were stable.No differences of the chin projection were observed.All patients were satisfied with their cosmetic results.Conclusions Implanting long-thick silicone prothesis to correct severe microgenia is safe,effective,simply,cheap and less invasive.

Objective To investigate the safety and long-term therapeutic results of anatomical hepatectomy for hepatocellular carcinoma (HCC).Methods 90 patients underwent anatomical hepatectomy from January,2003 to January,2010.The tumor size was ≤5 cm in 38 patients,and ＞5 cm in 52 patients.The tumor number was a single lesion in 58 patients,and multiple lesions in 32 patients.Cirrhosis was present in 46 patients (55.42％); cancer embolus was present in 34 patients (37.78％).There were 64 patients in Child-Pugh A and 26 patients in B.The operating time,blood loss and blood transfusion were recorded and analyzed.Complications and liver function were monitored after surgery.The Kaplan-Meier method was used to calculate the survival rates.Log-rank test was used to analyze factors associating with postoperative recurrence.Independent factors influencing tumor-free survival and overall survival were analyzed by Cox-model logistic regression.Result There was no perioperative death.The incidence of complications was 31.1％ (28/90).The recurrence rate was 51.1％ (46/90).The 1-,3-,5 year tumor-free survivals were 92.2％,67.3％ and 49.7％％00,respectively.Positive resection margin and satellite nodule were independent factors for recurrence (RR19.22,95 ％ confidence interval 5.85～63.17).The 1-,3-,5-year overall survivals were 94.4％,80.0％ and 60.0％,respectively.Positive resection margin and TNM were independent factors for overall survival (RR 2.013,95％ confidence interval 1.28～3.17).Conclusions Anatomical hepatectomy was a safe and efficacious procedure to treat HCC.Positive resection margin and TNM were independent factors associated with overall survival.Anatomical hepatectomy had the advantages in ensuring a lower rate of negative resection margin.