lem and direct necessary intervention to improve the completion rate of whole small intestine examination.

Objective To investigate clinical features,diagnosis and surgery treatment of Hashimoto thyroiditis associated with thyroid carcinoma. Method Twenty-four cases of Hashimoto thyroiditis diagnosed by surgical pathology from January 2004 to December 2009 were associated with thyroid carcinoma. Results In the all 24 cases,22 cases (91.7% ,22/24) were associated with papillary thyroid carcinoma,including 12 cases (50.0% ,12/24) of micropapillary thyroid carcinoma,and 2 cases (8.3%, 2/24) were associated with medullay thyroid carcinoma. Thyroid colour ultrasound Doppler indicated that diffuse enlargement of thyroid with nodes occurred in 21 cases,account for 87.5%(21/24), single node occurred in 15 cases,account for 62.5%(15/24), 12 cases demonstrated thyroid nodes with calcification,account for 50.0%(12/24). Eight cases were examinated by fine-needle aspiration cytology biopsy(FNACB) before operation,examing results of 3 indicated thyroid carcinoma, account for 37.5%. Twenty cases were followed up 2 months to 6 years,no thyroid carcinoma recurred,4 cases missed. Conclusions Thyroid colour ultrasound Doppler examination plays an important role in diagnosis of Hashimoto thyroiditis associated with thyroid carcinoma before operation. It is necessary to investigate progressively the role of FNACB in diagnosis of Hashimoto thyroiditis associated with thyroid carcinoma before operation. Surgical exploration might become an important approach in diagnosis and treatment of Hashimoto thyroiditis associated with thyroid carcinoma.

Objective To construct the secretory expression vector of recombinant human C-reactive protein(rhCRP) for its se-cretory expression in Pichia pastoris ,rhCRP was expressed as a secretory protein and purified ,and the immunity reactivity of the purified protein was identified .Methods The DNA fragment of rhCRP which was designed and synthesized was cloned into pPICZαA vector .Recombinant plasmid pPICZαA/rhCRP was linearized by SacⅠand transformed into Pichia pastoris X-33 by elec-trotransformation .The rhCRP was secreted into the medium under the methanol induction .RhCRP was purified by Histamine affin-ity chromatography .The purified rhCRP was identified by SDS-PAGE and Western blotting ,and its immunity reactivity and stabili-ty was identified by indirect ELISA .Results The pPICZαA/rhCRP expression vector was successfully constructed .The rhCRP of 23 × 103 was inducted and successfully expressed as a secretory protein by the recombinant Pichia pastoris strains .The rhCRP was purified by one step up to 90 .42% purity ,and it was showed good immunity and stability by indirect ELISA .Conclusion The rh-CRP with higher purity and immunoreactivity was successfully obtained by using the Pichia pastoris expression system ,which pro-vided an important experimental basis for producing anti-human CRP antibodies and developing testing CRP reagent .

Objective To study face recognition rule of Chinese subjects during judging the differences of facial recognition of race,gender and their joint property.Methods Eye tracking technique and moving window experimental method were used.Results The present results showed that,in facial race recognition,gender recognition and joint property recognition,the key area of face recognition was eyebrow and eye.In face recognition process,the dominant area in face of information acquired was right facial area.The key brain area of facial cognition was right brain area.Conclusion The recognition performance of face racial recognition is the best than face gender recognition and joint property recognition.Asymmetrical perception effect in human face area is appeared in facial recognition.

Objective To investigate the associations between the polymorphisms in CD40‐1C/T polymorphism(rs1883832) and Graves′disease by Meta‐analysis .Methods We searched Pubmed ,CBM ,VIP ,CNKI ,Cochrane library and Wanfang ,covering and selecting literatures according to criterions .Statistical analysis was performed by using Revman5 .2 and Stata12 .0 .Results A total of 18 eligible literatures were included(5 198 cases and 4 417 controls) ,The pooling results suggested that significant differ‐ence in allele C/T frequency and genotype frequency were observed between patients with and control subjects (P<0 .05);the indi‐viduals of genotype CC and(or) CT have significantly increased Graves′disease risk(CC vs .TT :OR=1 .60 ,95% CI=1 .28-2 .00 , P<0 .01;CC vs .CT :OR=1 .25 ,95% CI=1 .14 -1 .37 ,P<0 .01 ;CC vs .CT+ TT :OR=1 .34 ,95% CI=1 .17 -1 .52 ,P<0 .01 ;CC+CT vs .TT :OR= 1 .36 ,95% CI= 1 .13 -1 .64 ,P< 0 .01) .From subgroup analysis ,we identified that the research subjects difference showed between thyroid anti‐body(Ab ± ) and thyroid anti‐body (Ab -) in control group ,which might be the cause of heterogeneity ,but the pooling results in sensitivity analysis were stable and no significant publication bias were found .No significant difference in allele and genotype frequency of CD40 SNP were observed between Graves′disease with ophthalmopathy group and Graves′disease without ophthalmopathy group ,Graves′disease with family history group and Graves′disease without family histo‐ry group(all P>0 .05) .Conclusion This Meta analysis indicated that the polymorphisms in the CD40 gene(rs1883832) was related with Graves′disease ,but had nothing to do with family history and Graves′disease with ophthalmopathy .

This study aimed at comparing the United States, Britain, Australia, the Netherlands and China’s national performance evaluation, and sum up the experience to provide a theoretical basis for the China’s development of hospital performance evaluation system. The study found that China needs to consider the patient's perspective, to establish a fixed third-party performance evaluation agencies, establish an effective incentive mechanism and feedback mechanism and combine a variety of assessment methods in the development of hospital performance evaluation index system.

Objective To analyse the clinical features of pelvic insufficiency fractures (PIF) in patients with cervical cancer after radiotherapy and explore the risk factors affecting its occurrence .Methods 55 cases of patients with cervical cancer that used radia-tion therapy as a single treatment were chosen in our hospital from February 2007 to May 2010 and the clinical features were ana-lysed;The fractures of spine ,sacrum ,sacroiliac joint ,ilium and pubis and femoral were observed and the density of fifth lumbar (L5 ) vertebrae ,left and right sacrum were detected via the CT or MRI (Hounsfield Unit)after 2-year follow-up ,the different factors on the incidence of PIF were explored .Results 12 cases (19 sites) of patients in 55 patients occured PIF after follow-up 2years ,the cumulative incidence was 21 .82% ;the distribution of PIF parts were followed :lumbar vertebrae had 5 cases ,sacral had 5 cases ,pu-bis had 4 cases ,sacroiliac joint had 2 cases ,iliac had 2 cases and femoral head had 1 case .The incidence rate of PIF that density of fifth lumbar vertebrae was ≤130 HU and >130 HU were 16 .36% and 5 .45% respectively ,the PIF′incidence rate that density of left side of sacrum was≤ -35 HU and > -35 HU were 18 .18% and 3 .64% respectively ,the incidence rate of PIF that density of right side of sacrum was ≤ -35 HU and > -35 HU were 20 .00% and 1 .82% respectively ,the density of the three parts all had statistical difference on the incidence of PIF (P<0 .05) .Univariate analysis showed that menopausal status and the average density of CT had statistical effects on PIF (P<0 .05);Multiple analysis showed that the average density of CT was the independent factors affecting PIF′incidence after radiotherapy .Conclusion The patients with cervical cancer may occur pelvic insufficiency fracture af-ter radiotherapy ,and its incidence is related to menopausal status and bone mineral density .

Objective To investigate the relationship between the plasma neutrophil gelatinase-associated lipocalin (NGAL)and endothelin-1 (ET-1) levels and cognitive dysfunction in chronic obstructive pulmonary disease (COPD) patients.Methods A case-control study was performed,consisting of 128 patients with COPD(68 patients without cognitive dysfunction and 60 patients with cognitive dysfunction) and 70 normal controls.All patients with COPD were diagnosed by pulmonary function tests and plasma levels of NGAL and ET-1 were determined by enzyme immunoassay.The cognitive function was evaluated by the MMSE and MoCA.Results ①Compared with normal control,the levels of plasma NGAL and ET-1 were increased(NGAL:(2.20±0.60) μg/L vs (1.69±0.73) μg/L,P＜0.05;ET-1:(26.19± 10.55)pg/ml vs (13.05±2.37) pg/ml,P＜0.05) in COPD patients without cognitive dysfunction and in COPD patients with cognitive dysfunction(NGAL:(3.80±2.75) μg/L vs (1.69±0.73) μg/L,P＜0.01;ET-1:(37.82±0.29) pg/ml vs (13.05±2.37) pg/ml,P＜0.01).Compared with the COPD patients without cognitive dysfunction,the levels of plasma NGAL and ET-1 were also increased in COPD patients with cognitive dysfunction (all P＜0.05).②The plasma NGAL levels were correlated negatively with MMSE scores(r=-0.524,P＜0.05),and negatively correlated with MoCA scores (r=-0.527,P＜0.05).The plasma ET-1 levels were negatively correlated with MMSE scores(r=-0.549,P＜0.05),and negatively correlated with MoCA scores(r=-0.558,P＜0.05).The levels of NGAL and ET-1 were positively correlated(r=0.564,P＜0.05).Conclusion NGAL and ET-1 may be involved in the pathophysiological process of cognitive dysfunction in patients with COPD,which provides a certain clinical value for the assessment of cognitive dysfunction in patients with COPD.

AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.

Humans ; Accidents, Traffic ; Colon, Sigmoid ; Forensic Medicine ; Autopsy ; Abdominal Injuries ; Thoracic Injuries ; Rupture