Objective:To discuss the appropriate thyroid operation for the treatment of bilateral multinodular goiter.Methods: 328 bilateral multinodular goiter patients undergoing surgery in the department of general surgery of Capital Medical University Beijing Tongren Hospital from June 2012 to June 2016. were retrospectively analyzed. Of these patients, 85 underwent hemithyroidectomy combined with contralateral nodule resection or subtotal resection and 243 underwent bilateral subtotal thyroidectomy. The rate of postoperative complications and recurrence between hemithyroidectomy combined with contralateral nodule resection or subtotal resection and bilateral subtotal thyroidectomy were compared.Results: The follow-up time was 1 month to 48 months after operations. In hemithyroidectomy combined with contralateral nodule resection or subtotal resection group 1 patient developed recurrent laryngeal nerve palsy, 2 patients had transient hypoparathyroidism and 1 patient had hematoma in the operative cavity. In bilateral subtotal thyroidectomy group, 2 patients developed recurrent laryngeal nerve palsy and 2 patients had subcutaneous hematoma. The rate of recurrent disease was 2.35%(2 patients) in hemithyroidectomy combined with contralateral nodule resection or subtotal resection group and 7%(17 patients) in bilateral subtotal thyroidectomy group. There was no patient in both groups needed reoperation.Conclusions:Hemithyroidectomy combined with contralateral nodule resection or subtotal resection had similar complication rate compared with bilateral subtotal thyroidectomy, but it had a significantly lower risk of recurrence than bilateral subtotal thyroidectomy, Furthermore, the rest one lobe could be resected for many times which would not cause severe complications. Hemithyroidectomy combined with contralateral nodule resection or subtotal resection is worthed to be recommended.

Objective To observe the effect of exercise on the expression of TNF-α in the adipose tissue of insulin resistant rats fed a high fat diet. Methods Thirty healthy male rats were randomly divided into a high fat di- et group and a normal chow group. Eighteen weeks later, the high fat group was randomly divided into a resting group fed with the high fat diet only, and an exercise group fed the high fat diet, but receiving swimming training for 6 weeks. Changes in their metabolism of glucose and lipids were observed, and the insulin sensitivity index was calcu-lated. Meanwhile, the level of TNF-α mRNA in their adipose tissue was detected with a real-time fluorescence quan-titative polymerase chain reaction (PCR), and protein in the adipose tissue was measured using Western blotting. Results After 18 weeks of high fat diet feeding, the insulin sensitivity index of the high fat diet group decreased sig-nificantly as compared to the normal chow group, suggesting that insulin resistance had been acquired in the high fat diet group. 24 weeks later, the insulin sensitivity index of the resting group had decreased further, again significantly when compared to the normal chow group. Compared to the resting group, the insulin sensitivity index of exercise group was significantly higher, and the expression of TNF-α mRNA and protein in their adipose tissue was significant- ly increased. Conclusion Insulin resistance can be induced by high fat diet feeding. Exercise can improve insulin resistance by increasing the expression of TNF-α in adipose tissue.

Child ; Erythropoietin ; adverse effects ; Humans ; Male ; Recombinant Proteins ; Red-Cell Aplasia, Pure ; chemically induced

Choroidal metastasis is one of the most common malignant tumors inside the eyes. It causes pain, hypopsia and some other related symptoms. It reduces the quality of the patients' life. It's significant for the patients to be detected and treated early, therefore they will have better vision and longer life. The treatments of choroidal metastasis are developing quickly. Both the vitreous cavity injection of targeted drug and gene therapy are hot topics of research. This paper summarizes the etiology, development, diagnosis and treatment of choroidal metastasis nowadays.

S100A4, a member of S100 superfamily of Ca~(2+)-binding proteins, is a polypeptide containing 101 amino acids. S100A4, which is overexpressed in most tumor cells, plays pivotal roles in growth, invasion and migration of tumor by regulating cell cycle progression, differentiation, apoptosis, invasion and metastasis of cells. This article reviews S100A4′s structure, function and potential application as the new target in the therapy of tumors.

A simple and rapid expression and purification method of recombinant firefly luciferase was developed for bacteria detection. A modified luciferase gene from North American firefly Photinus pyralis was cloned into pET28a expression vector and the recombinant protein was produced in Escherichia coli BL21. The recombinant luciferase, equipped with a polyhistidine affinity tag, was purified by immobilized metal ion affinity chromatography (IMAC). The approach generated an abundant expression and an efficient purification of a recombinant luciferase with final yield 1.995mg/L of cell culture. Experiments on the recombinant luciferase also showed that the relative light units (RUL) of the enzyme were 5.8×108, and the specific activity was 2.9×1010 RLU/mg. By applying adenosine triphosphate (ATP) bioluminescence to detection of the coin bacteria using the recombinant protein, the ATP content of bacteria was 9.48×10-16mol/mL, and was identical to the bacteria counts (4500CFU/mL) in order of magnitude. Taken together, our results provided a simple and efficacious method of the preparation of recombinant luciferase, which could be applied in the determination of bacteria via ATP bioluminescence.

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.

Objective To search a new,simple,minimally invasive,safety and effective method to treat the cervical disc herniation.Methods 210 patients with cervical disc herniation received percutaneous nucleoplasty were evaluated.Results They were followed prospectively from two weeks to two months,fifty-nine patients improved significantly,the general clinical effective rate was 96.2%.No complication occurred.Conclusion The percutaneous nucleoplasty is an effective,rapid suited to outpatient,minimally invasive and safe procedure for cervical disc heriation.

This article explored professor Wang Qingqi's clinical experiences in treating gastroesophageal reflux disease(GERD) with traditional Chinese medicine(TCM).According to clinical observation,the key pathogenesis of GERD is abnormal rising and falling of vital energy,presenting in the five aspects of incoordination between the gallbladder and stomach,incoordination between the liver and stomach,stagnation of liver-qi with deficiency of the spleen,weakness of the spleen and stomach and qi-stagnancy and blood stasis.It will get a good curative effect when adopting the TCM methods of acrid-release and bitter-downbearing therapy,worm-like paired Chinese material medica and the opposite complementary relationship therapy.

0.05).Conclusions Neither the new nor old SIRS diagnostic criteria had a high conforning rate with neonatal critical illnesses;There was no significant difference between them in each clinical item.It shows that the new SIRS diagnostic criteria is not superior to the old one,therefore we should improve the neonatal SIRS diagnostic criteria in the future.