Objective To investigate the differentiated thyroid carcinoma diagnosis and treatment options. Methods From Feb. 2002 to Jan. 2008,78 patients received different surgical resection regarding the type of tumor size,number of tumor,ages and jugular lymphatic metastasis. Patients with unilateral differentiated thyroid carcinoma underwent the resection of ipsilateral isthmus of thyroid lobe or plus partial contralateral gland,and those with bilateral-lobe underwent total thyroidectomy or near-total thyroidectomy. High-risk patients (age >45 years,tumor size >4 cm,tumor size ≤4 cm,but surpass the envelop of thyroid) were performed by functional neck dissection or lymph node dissection of central region (Ⅵ area) besides postoperative endocrine therapy. Results Eleven cases underwent the resection of ipsilateral lobe with isthmus, 19 cases underwent surgical removal of ipsilateral lobe with isthmus plus partial contralateral gland,26 cases underwent near-total thyroidectomy and 22 total thyroidectomy. 25 cases underwent functional neck dissection, 23 cases underwent neck dissection of central region. There were 68 papillary thyroid carcinoma (87. 18%), 10 follicular thyroid carcinoma (12. 82%). There were 26 cases with lymphatic metastasis of Ⅵ area. Postoperative complications included 12 cases (15.38%) with deadlimb caused by hypocalcemia, 8 cases (10.26%) with transient recurrent nerve paralysis,2 cases (2.56%) with permanent injury of recurrent laryngeal nerves, 3 cases (3. 58%) with chylous fistula. Seventy-four(94. 87%) cases were followed up postoperatively for a period from 6 months to 6 years,which showed that no death occurred,but 6 relapsed with jugular lymphatic metastasis,after reoperation no distant metastasis occurred. Survival rate was 97. 30% (72/74). Conclusion Treatment of the differentiated thyroid carcinoma should be based on the size of tumor,number of tumor,age and jugular lymphatic metastasis. Lymph node dissection of central region was necessary for high-risk patients of differentiated thyroid carcinoma.

OBJECTIVE:To explore the role of clinical pharmacists in the treatment of pan-drug resistant Acinetobacter bau-mannii infection. METHODS:Clinical pharmacists participated in the treatment for a severe pneumonia case of pan-drug resistant A. baumannii infection. Clinical pharmacists supplied overall pharmaceutical care and suggestions with respects to initial medication scheme evaluation,pathogen judgment,therapy drug selection,ADR disposal,etc.,including anti-infective treatment of moxifloxa-cin 0.4 g,ivgtt,qd+meropenem 0.5 g,ivgtt,q8 h+linezolid 0.6 g,ivgtt,q12 h;anti-pan-drug resistant A. baumannii infection of cefoperazone sodium and sulbactam sodium 3.0 g,ivgtt,q8 h+tigecycline 50 mg,ivgtt,q12 h;liver protection of ademetionine 1, 4-Butanedisulfonate 1.0 g,ivgtt,qd+reduced glutathione 1.8 g,ivgtt,qd. RESULTS:After 25 d treatment,the patient hadn’t been fe-vered,and hemogram and hepatic function index decreased to normal value. CONCLUSIONS:Clinical pharmacist should be en-gage in anti-infective treatment and pharmaceutical care,and provide physicians reasonable medication suggestion so as to promote care rate in the clinic.

ObjectiveTo investigate the changes of non-linear dynamics characteristics of EEG during picture memory masks, and the application of non-linear dynamic analysis for memory research.MethodsEEGs of 30 healthy old volunteers were recorded under the states of opened eyes and picture memory. Correlation dimension (D2) was calculated for all subjects.ResultsD2 increased significantly during memory tasks compared with the rest state with eyes opened (P<0.05). In different memory tasks, the complexity of mental functions and the regions involved in the memory task were different.ConclusionNon-linear analysis is appropriate for the study of functional changes and working mechanism of brain during memory.

Based on the educational structure theory, the difference between mass education and elite education is probed at the macroscopic level to make it clear that the essence of Physician education and training program of excellence is elite education for occupational purposes; at the mi-croscopic level the orientation of English teaching for the class ofexcellent physicians is determined as English for occupational purposes. Moreover, the curriculum system of medical English is designed, and teaching materials associated with clinical medicine are selected, the language laboratory simulat-ing hospital scenes is constructed, and the transboundary team of teachers is built comprising university teachers and doctors in hospitals. At the level of individual, the competency model of English forexcellent physicianshas been developed, English competence requirements in medical industry being clearly established . In a word , the study of macrostructure points out the direction and target of English teaching for excellent physicians; the study of microstructure perfects the mode of English teaching forexcellent physicians;and the study of individual structure indicates the ultimate foothold of English education forexcellent physicians. Three aspects are integrated into an organic whole.

In accordance with students' learning needs and future professional development, individualized practices of formative assessment are analyzed in terms of diverse evaluators, accumula-tive learning contents, after-class tutoring, thus to maximize student's learning potentials, to be capa-bility-oriented, to make students highly qualified and competent for their future clinical position and academically developed. Additionally, the assessing competence of teachers is vital to the successful implementation of formative assessment. Importantly, each medical university can explore further into the practice of formative evaluation, based on the orientation of itself.

Objective To summarize and learn the biological properties and clinical features of interdigitating dendritic cell sarcomas (IDCS).Methods The first IDCS patient concurrent with acute myelomonocytic leukemia (AML-M4) described herein,to our knowledge,was studied and 62 IDCS cases reported previously in the literature were reviewed.Results The patient had a history of breast cancer as well as radiotherapy and chemotherapy of it,and the patient showed poor response to 4 cycles of sequential chemocherapy regimens.Based on the laboratory results,IDCS and AML-M4 in this patient were both of myelogenous origination.Furthermore,review of the 62 IDCS patients reported previously showed that as high as 17 ％ of the patients had malignant disease and received radiotherapy or chemotherapy before they got IDCS,and patients of this group had worse prognosis compared with counterpart.Conclusion IDCS has poor prognosis,and therapy-related type worse.Prophylactic measures and stringent screening of the second cancer in those who received chemoterapy or radiotherapy are appropriated and necessary.

To explore the antibacterial activity and mechanism of total alkaloids and berberine from Coptidis Rhizoma on Aeromonas hydrophila, and determine the effect of total alkaloids and berberine from Coptidis Rhizoma on minimum inhibitory concentrations, permeability and fluidity of cell membrane, conformation of membrane proteins and virulence factors of A. hydrophila. The results showed that both total alkaloids and berberine from Coptidis Rhizoma had antibacterial activities on A. hydrophila, with minimum inhibitory concentrations of 62.5 and 125 mg · L(-1), respectively. Total alkaloids and berberine from Coptidis Rhizoma could increase the fluidity of membrane, change the conformation of membrane porteins and increase the permeability of bacteria membrane by 24.52% and 19.66%, respectively. Besides, total alkaloids and berberine from Coptidis Rhizoma significantly decreased the hemolysis of exotoxin and the mRNA expressions of aerA and hlyA (P < 0.05, P < 0.01), the secretion of endotoxin and the mRNA expression of LpxC (P < 0.05, P < 0.01). The results suggested that the antibacterial activity of total alkaloids and berberine from Coptidis Rhizoma on A. hydrophila may be related to the bacteria membrane injury. They inhibited the bacterial growth by increasing membrane lipid fluidity and changing conformation of membrane proteins, and reduced the secretion of virulence factors of A. hydrophila to weaken the pathogenicity.
Aeromonas hydrophila ; drug effects ; genetics ; metabolism ; Alkaloids ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Bacterial Proteins ; genetics ; metabolism ; Bacterial Toxins ; biosynthesis ; Berberine ; pharmacology ; Cell Membrane ; drug effects ; genetics ; metabolism ; Coptis ; chemistry ; Drugs, Chinese Herbal ; pharmacology ; Membrane Fluidity ; drug effects ; Rhizome ; chemistry

OBJECTIVETo study the natural progress of different degree chronic periodontitis and its association with IL-1B-511 genetic polymorphisms. METHODS; 100 subjects with chronic periodontitis were selected and examined at baselined and in the 6 month and in 1 year on attatchment loss at 6 sites of each tooth. DNA samples were obtained with buccal swabbing technique and were further analyzed for IL-1B-511 genotype polymorphisms using PCR-RFLP-based method in all subjects.

RESULTSThe mean AL increases were 1.43 mm within 1 year. Among 100 subjects, 16 patients with moderate progression (0 mm < AL increase/a year < or = 1.0 mm), 84 patients with rapid progression of periodontal disease (AL increase/ a year > 1.0 mm). There was no significant difference for the distribution and frequency of IL-1B-511 genotype and alleles between the AL increase/ a year > 1.0 mm group and AL increase/a year < or = 1.0 mm group. The progression of periodontal disease (AL increase/a year > 1.0 mm group) was significantly higher in the non-severe chronic periodontitis group than in the severe group (P < 0.05). The percentage of molar was higher as far as the rapid-progress sites (AL increase > 2.0 mm both in the 6th and the 12th months examination) were concerned than that of premolar and anterior (P < 0.05). The number of progressed sites in the severe group was higher than the non-severe chronic periodontitis group (P < 0.05).

CONCLUSIONThe progress of chronic periodontits varies individually. No specific relationship was found between the progression of chronic periodontitis and IL-1 gene polymorphisms.

Adult ; Alleles ; Chronic Periodontitis ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Interleukin-1 ; Male ; Middle Aged ; Periodontitis ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

Objective To explore the methods and clinical value of transrectal ultrasound (TRUS) in detecting rectal gastrointestinal stromal tumor(GIST) with head scanning probe.Methods A total of 12 patients had the ultrasonic examination through the rectum with the head scanning probe.Preoperative ultrasonic findings were compared with the pathological results.Results Of the 12 patients,the patients were divided into three groups,including 3 cases with low-degree severity,6 cases with moderate-degree severity and 6 cases with high-degree severity.The lymph node metastasis was not found near intestines.Rectal GIST appeared as a hypoechoic mass with clear limit、regular form and expanded growth under TRUS.The CDFI showed abundant flow in the tumor and TRUS had an overall accuracy rate of 75.0%(9/12)in the diagnosis of rectal GIST.The accuracy of TRUS in the staging diagnosis of rectal GIST was 83.3%(10/12).Conclusion The TRUS with the head scanning probe is of great value for pre-operative diagnosis and staging of rectal GIST.Rectal water window and felicitous check-up technique can enhance the accuracy of TRUS.