OBJECTIVETo evaluate the diagnostic values of ultrasound (US) and (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET)/computerized tomography (CT) in diagnosing suspected thyroid carcinoma and lymph node metastasis.

METHODSThe clinical data of 28 patients who had undergone total or subtotal thyroidectomy with or without neck dissection from December 2011 to December 2012 in PUMC Hospital and had undergone US and FDG PET/CT before surgery were retrospectively analyzed. In each patient, US and FDG PET/CT images were retrospectively reviewed to determine the presence of carcinoma with or without loco-regional metastasis by level-by-level analysis. The potential correlation between imaging results and histopathology were analyzed.

RESULTSThere were 11 benign lesions,15 papillary carcinomas, one follicular carcinoma, and one medullary carcinoma. For thyroid carcinoma,the sensitivity and specificity were 88.2% and 63.6% for US and 76.5% and 54.5% for FDG PET/CT(P>0.05). For lymph node metastasis, the sensitivity was 68.0% for US and 60.0% for FDG PET/CT (P>0.05), and the specificity was 96.7% for US and FDG PET/CT.FDG PET/CT could provide more diagnostic information than US for patients with level 2 or 5 metastasis.

CONCLUSIONSCombination of US and FDG PET/CT is typically not needed for differentiating thyroid lesions.However, for patients with suspected lymph node metastasis of infrequently involved levels, the combination of US and FDG PET/CT may be a good choice.

Adolescent ; Adult ; Aged ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Positron-Emission Tomography ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Neoplasms ; diagnostic imaging ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

OBJECTIVETo establish a rapid specific method to identify the single-nucleotide polymorphisms (SNPs) of HBV polymerase gene region which are the methionine residue of the conserved YMDD motif.

METHODSTwo specific primers were designed to amplify interested gene region involved in SNPs which were also used as HBV DNA identification. Specific primers of SNaPshot were designed to detect 741A-G (YVDD), 743G-T (YIDD). The different fluorescent dye labeled ddNTP was used to further extend the strand of PCR product and was detected by ABI PRISM 310 Genetic Analyzer. Sera from 13 patients with chronic hepatitis B after lamivudine treatment were analyzed.

RESULTSAside from mutation of YMDD, there were mutations of 514C-A, 523C-A, 562T-A, 667C-A. The 13 samples were simultaneously tested with SNaPshot and DNA sequencing, the same results were obtained. The method of SNaPshot showed high specificity.

CONCLUSIONMutation of YMDD results in the changes of ATG codon, and there are new ATG codon in the upper strand of YMDD. SNaPshot technique is rapid, specific and accurate for the SNPs monitoring of HBV DNA mutation during lamivudine therapy. Two samples were determined by SnaPshot technique, identifying the co-existence of the mixed wild type and mutant type HBV infection.

Antiviral Agents ; therapeutic use ; Base Sequence ; DNA, Viral ; blood ; genetics ; Drug Resistance, Viral ; Gene Products, pol ; genetics ; Hepatitis B ; blood ; drug therapy ; virology ; Humans ; Lamivudine ; therapeutic use ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA

Objective To describe the prevalence of deliberate self-harm (DSH) and suicidal behaviors (SIB) as well as the relationship between them in a college student population.Methods A total of 4063 medical students were selected under the cluster sampling method in Anhui province.Data were analyzed by Pearson Chi-square and logistic regression.Results A total of 4063 ( 13.4％ )students reported that they had deliberately harmed themselves during the past 12 months.The acts of DSH with 1 and more than or equal to 2 times occurrence accounted for 3.7％ and 9.6％ among all the respondents.The act of DSH was significantly higher among boys than that among girls.Rates of suicide ideation,suicide plan,attempted suicide and SIB in the last year were 4.5％,1.4％,0.6％ and 4.9％,respectively.However no statistically significant difference was found in different sex.Students in the DSH group that with SIB were found to have lower positive coping levels (OR=0.5,95％CI:0.3-0.8),getting less support from fricnds (3-5 vs.less than or equal to 2:OR=0.6,95％CI:0.3-0.9;more than or equal to 6 vs.less than or equal to 2:OR=0A,95％CI:0.2-0.8),with higher negative coping levels (OR=2.1,95％CI:1.2-3.7),having more serious depressive symptoms (OR=2.9,95％ CI:1.6-5.2) and anxiety symptoms (OR=2.2,95％ CI:1.2-3.8),having more serious sleeping problems (OR=1.7,95％CI:1.1-2.8 ) and perceived fat (fat vs.moderate:OR=2.0,95％CI:1.1-3.6) than the DSH group without SIB.The rates of SIB in students with DSH behavior were significantly higher than those in students without those behaviors (OR=4.7,95％ CI:3.5-6.4).Psyehosocial variables could attenuate the relationship between the DSH status and suicidal events (OR=3.3,95％CI:2.4-4.5).The DSH frequency exhibited a curvilinear relationship to SIB (OR=3.1-10.0) and psychosocial variables also attenuated this relationship (OR=2.4-5.9).Conclusion It was well known that SIB was not a suicidal gesture but our findings suggested that the presence of DSH might trigger the suicidal attempts.

OBJECTIVETo compare efficacy and side effects of patient-controlled epidural analgesia (PCEA) with levobupivacaine, ropivacaine and racemic bupivacaine after cesarean section.

METHODSIn this prospective, randomized double-blind study, 90 ASA I-II full-term nulliparous women (aged 25-38 years with body weight of 59-87 kg) undergoing elective cesarean section under spinal-epidural anesthesia equally allocated into 3 groups. PCEA was administered with 0.125% levobupivacaine and 20 microg/ml morphine (group L, n=30), 0.125% ropivacaine and 20 microg/ml morphine (group R, n=30), and 0.125% bupivacaine and 20 microg/ml morphine (group B, n=30), respectively. The Visual Analog Scale (VAS) score, satisfaction rate, patients' overall impression of treatment, modified Bromage motor score, and incidence of side effects were recorded at regular intervals after operation.

RESULTSThe three groups were comparable with respect to the efficacy of analgesia, patients' overall impression of treatment, motor blockade and side effects. There was significant difference in patients' satisfaction rate between group R (70%) and the other two groups (93.3% in group L and 96.6% in group B, P<0.05).

CONCLUSIONPCEA with 0.125% levobupivacaine and morphine 20 microg/ml produces better analgesic effect with little side effects after cesarean section.

Adult ; Amides ; administration & dosage ; adverse effects ; Analgesia, Epidural ; Analgesia, Obstetrical ; Analgesia, Patient-Controlled ; Bupivacaine ; administration & dosage ; adverse effects ; analogs & derivatives ; Cesarean Section ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Humans ; Morphine ; administration & dosage ; Nausea ; chemically induced ; Pregnancy ; Prospective Studies ; Pruritus ; chemically induced ; Treatment Outcome ; Vomiting ; chemically induced

OBJECTIVETo study the incidence of injuries among residents living in the communities in Zhejiang.

METHODSA household questionnaire survey was conducted to 16 899 residents in four communities.

RESULTSThe incidence of injuries was 16.11% in total, higher in urban area than in rural area and higher in men than in women. The leading causes of injuries were falls (4.80%), knife-cutting or by sharp articles (3.86%), traffic accident (2.07%), collision (1.99%), scalds (1.13%) and animal bites (1.06%). Peak incidence of age group was different in different injuries, such as traffic accident was high in 45 - 60 age group and falls was high in 5 and 60 age group. Direct economic loss for each case with injury would cost 324.21 RMB yuan.

CONCLUSIONInjury was common and frequently occurred among residents at the community level which seriously on danger their health and families.

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Animals ; Bites and Stings ; epidemiology ; Burns ; epidemiology ; Child ; China ; epidemiology ; Community Health Services ; Dogs ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Wounds and Injuries ; epidemiology ; mortality

OBJECTIVETo investigate the effects of hydroquinone (HQ) on expression of topoisomerase IIα (TOPOIIα) in human bone marrow mononuclear cells, and to explore the role and possible regulatory mechanism of TOPOIIα involved in toxicity of HQ to hematopoietic cells.

METHODSAfter human bone marrow mononuclear cells were exposed to 50 µmol/L HQ (used the cells which were exposed to sterile distilled water as control); the activity of TOPOII was measured by TOPOII assay kit; the expression levels of TOPOIIα mRNA and protein were detected by RT-PCR technique and Western blotting method respectively; the chromatin immunoprecipitation (ChIP) assay was carried out to study the possible mechanism of TOPOIIα expression changes.

RESULTS(1) The activity of TOPOII was inhibited obviously; the protein and mRNA expression of TOPOIIα were 0.017 ± 0.029 and 0.610 ± 0.128, significantly lower than that in the control with the significant difference (P < 0.01) after treated with HQ for 10 h; (2) The decreased content of TOPOIIα was associated with descended level of histone H4 acetylation than in the control, from 1.198 ± 0.056 to 0.324 ± 0.229, with the significant difference (P < 0.01), without accompanied descended level of histone H3 acetylation, from 1.253 ± 0.045 to 1.177 ± 0.025 (P > 0.05); (3) TOPOIIα mRNA expression decreased gradually after HQ processing, and the chemical modification (histone H4 acetylation) of TOPOIIα promoter happened prior to the mRNA expression.

CONCLUSIONHQ could repress the expression of TOPOIIα in human bone marrow mononuclear cells; the change of histone chemical modification plays an important role in the benzene's hematopoietic toxicity.

Acetylation ; Adult ; Antigens, Neoplasm ; metabolism ; Bone Marrow Cells ; drug effects ; metabolism ; Cells, Cultured ; DNA Topoisomerases, Type II ; metabolism ; DNA-Binding Proteins ; metabolism ; Female ; Histones ; metabolism ; Humans ; Hydroquinones ; toxicity ; Male ; Young Adult

Objective To investigate the effect of seafood intake on the urinary iodine level in women for exploring an alternative to iodine supplementation.Methods Healthy pregnant women and non-pregnant women, aged 20～40 years,were selected during their health examination in local women'S health care in 2006.The types of seafood and its intake frequency were recorded from these women.and urine and kitchen salt samples were collected for iodine determination.Results A total of 198 women including 148 pregnant and 50 non-pregnant women were recmitod for this study;they had a median level of urine iodine of 87.51 mg/L.The median levels of urine iodine of83.49,91.52,166.45μg/L in three group women classified as hardly,seldom and often intake of see food showed significant difference(X2=6.202,P<0.05).Urine iodine level in non-pregnant women taking seafood (90.94μg/L)was higher than that in pregnant women(84.79μg/L),the difference being statistically significant (U=3318.00,P<0.05).The urine iodine in pregnant women with seldom intake of seafood(94.46 μg/L)was significantly higher than that in the hardly intake women(83.28 μg/L),the difference being statistically significant (U=1257.5,P<0.05).During late period of gestation,the urinary iodine in the women ofthree statUS of hardly. Seldom and often intake of seafood were 81.93,97.97 and 140.18 μg/L,respective,with significant differences among them.Conclusions A certain amount of seafood taken every week Can increase urine iodine levels,and a direct relationship Was observed.Therefore,we suggest that it is necessary to advocate taking seafood to pregnant women for prevention of cretinism,particularly in the air.as where iodized salt was difficult to implement.

Objective To evaluate the clinical effects and safety of heparin injection on hemiplegia following urokinase thrombolysis for acute ischcmic cerebral infarction. Methods Fifty-six patients with acute cerebral infarction matched the standards which could be treated with urokinase thrombolysis in our department from January 2004 to January 2008. Among the 56 patients, 36 cases with hemiplegia in 2 h after thrombolysis got their muscle force recover over Ⅲ scale. Then 36 cases were divided into the treated group and control group randomly; 18 cases in the treated group were treated by heparin sodium 1000 U/h intravenously for 5 d. They were monitored for their activated partial thromboplastin time (aPTT) and the injected heparin speed was regulated according to their aPTT to keep their aPTT between 1.5 to 2 times of the control value. The 18 cases in the control group were given oral aspirin 0.1 daily, 24 h after thrombolysis. The 2 groups were compared in the case numbers of hemiplegia reoccurrence and cerebral hemorrhage within 7 d and the National Institutes of Health Stroke Scale (NIHSS) scores. Results Though there were 5 cases with asymptomatic hemorrhagic conversion, there was no hemiplegia case again in the treated group. In the control group, 5 cases suffered from hemiplegia again and 2 cases asymptomatic hemorrhagic conversion. There were less cerebral infarction in the treated group than the control group after 14 d by brain CT. The neurological deficit improvement in the treated group was more efficient in the treated group than in the control group in 14 d. Conclusion The application of heparin for the prevention of hemiplegia in the patients with acute cerebral infarction with muscle recovery after urokinase thrombolysis is safe and effective and shows obvious clinical value when their aPTT is remained 1.5-2.0 times of the normal level.

OBJECTIVETo evaluate the usefulness of ultrasonography in distinguishing follicular carcinoma from adenoma.

METHODSThe ultrasound data of 37 patients with histopathologically confirmed follicular carcinomas who were treated in PUMC Hospital from January 2000 to November 2012 were retrospectively studied. In addition, 74 sex-and age-matched patients with histopathologically confirmed adenomas during the same period were enrolled as the control group. The pathologic results were regarded as the gold standard.

RESULTSIrregular shape (32.4% of follicular carcinoma vs 5.4% of adenoma), absence of thin halo (67.6% vs 36.5%), indistinct margin (21.6% vs 1.4%), hypoechoic appearance (64.9% vs 39.2%), punctuate calcification(40.5% vs 13.5%), absence of cystic change (78.4% vs 54.1%), and being complicated with other thyroid disease (56.8% vs 28.4%) were more frequently associated with follicular carcinoma than with benign adenoma (P<0.05). No significant difference in the echotexture and internal flow was observed between the two groups (P>0.05).

CONCLUSIONAlthough follicular carcinoma and adenoma share many sonographic features, irregular shape, absence of thin halo, indistinct margin, hypoechoic appearance, punctuate calcification, absence of cystic change, and being complicated with other thyroid disease favor a follicular carcinoma diagnosis.

Adenocarcinoma, Follicular ; diagnostic imaging ; Adenoma ; diagnostic imaging ; Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Gland ; diagnostic imaging ; Thyroid Neoplasms ; diagnostic imaging ; Ultrasonography ; Young Adult

OBJECTIVETo evaluate a facial rhytidectomy technique to reduce the complications of temporal alopecia and incisional scar hyperplasia.

METHODSThe 82 aged patients were divided into 2 groups in random way: group A in 46 with the use of the three-point relief-tension suspension technique and group B in 36 as control. In group A, the two point of every relief-tension suture was located respectively in the subcutis of the hairline and fascia under the incision. The parallel three sutures formed a mechanical plane to make the relief suture more strong and permanent. The temporal alopecia and incisional scar was observed with the follow-ups after the operation.

RESULTSWith the 82 cases of facial rhytidoplasty, the complications of the temporal alopecia and incisional scars in group A were much less than in group B.

CONCLUSIONSThis technique could decrease the complications such as temporal alopecia and incisional scars, and get a good and long term effect of temporal lifting simultaneously.

Adult ; Fasciotomy ; Female ; Humans ; Male ; Middle Aged ; Petrous Bone ; surgery ; Rhytidoplasty ; methods