OBJECTIVES: To investigate the therapeutic effect of Ziwuliuzhu acupuncture in a rat model of insomnia and its regulatory effect on the glutamic acid (Glu)/γ-aminobutyric acid (GABA)-glutamine (Gln) metabolic loop. METHODS: Forty male SD rats were randomly assigned to control group, model group, Najia group and Nazi group (n=10). In the latter 3 groups, rat models of insomnia were established by intraperitoneal injections of p-chlorophenylalanine and verified using a sodium pentobarbital-induced sleep test. After modeling, the rats in Najia and Nazi groups received acupuncture for 7 days at specifically chosen sets of acupoints based on the Ziwuliuzhu rationale in traditional Chinese medicine. Pathological changes in the hypothalamic tissue of the rats were examined with HE staining, and the levels of Glu and GABA in the hypothalamus were determined with high-performance liquid chromatography (HPLC)-mass spectrometry (MS)/MS. Immunohistochemistry was used to detect the expressions of GABAA receptors (GABAARs) in the hypothalamus, and the expression levels of glutamate decarboxylase (GAD65/67) and glutamine synthetase (GS) were determined with Western blotting. RESULTS: Compared with the model group, the rats in Najia and Nazi groups exhibited decreased Glu levels and GABAA receptor expression and increased GABA levels with a decreased Glu/GABA ratio in the hypothalamus. Ziwuliuzhu acupuncture significantly increased the protein expressions of GAD65 and GAD67 and lowered the expression of GS in the hypothalamus in the rat models of insomnia. CONCLUSIONS Ziwuliuzhu acupuncture produces sedative and hypnotic effects in rat models of insomnia possibly by regulating Glu and GABA-Gln metabolism to restore the excitatory/inhibitory balance between Glu and GABA.
Animals ; Rats, Sprague-Dawley ; Male ; Rats ; gamma-Aminobutyric Acid/metabolism* ; Sleep Initiation and Maintenance Disorders/therapy* ; Glutamine/metabolism* ; Glutamic Acid/metabolism* ; Acupuncture Therapy ; Hypothalamus/metabolism* ; Receptors, GABA-A/metabolism* ; Acupuncture Points

Objective:To study the clinicopathological features, diagnosis, treatment and prognosis of patients with solid pseudopapillary neoplasm of the pancreas (SPN).Methods:From Jan 2008 to Dec 2017, 112 pathology confirmed SPN patients who underwent surgical treatment at the Fourth Hospital of Hebei Medical University were followed up. The clinicopathological characteristics and diagnosis were analyzed.Results:Most SPN patients were young women, the ratio of male to female is 1∶7. SPN patients have no typical clinical symptoms. The preoperative diagnostic accuracy of SPN was 57.14% with imaging examination. Pathological diagnosis depends mainly on immunohistochemical staining. All patients underwent surgical resection. Follow-up ranged from 4 to 123 months. The mean follow-up time was 49 months. All patients were doing well and no recurrence or metastasis was found.Conclusions:SPN is a rare tumor with low malignant potential. Surgical resection is effective.

Objective:To explore the predictive value of various ultrasonic signs for papillary thyroid microcarcinoma (PTMC) .Methods:The ultrasonic data of of 603 micronodular goiter (MNG) in 396 cases and 640 PTMC in 539 cases, which were confirmed by pathology from Jan. 2013 to Dec. 2016, were retrospectively analyzed. According to the different inspection time, all nodules were divided into model group (2013-2014 years) and test group (2015-2016 years) . The tumor morphology, internal echo, microcalcification, and aspect ratio (A/T) were observed. Chi-square test and multivariate Logistic regression analysis were used to analyze the distribution differences of the four ultrasound features in PTMC and MNG, and their diagnostic value was evaluated.Results:There were statistical difference between model group and test group in ultrasonic signs including tumors shape, internal echo, microcalcification and aspect ratio according single factor analysis (chi square value was 283.540 and 298.119, 63.130 and 87.400, 26.342 and 50.152, 169.918 and 181.405; P<0.05) ;Multivariable Logistic regression analysis showed that irregular shape, hypoecho, A/T>1 and microcalcification were more common in PTMC ( P< 0.05) . OR values were 18.410 and 19.231, 2.560 and 6.380, 9.379 and 6.724, 3.102 and 8.830, and AUC prediction probability values were 0.916 and 0.911 respectively. Conclusions:Irregular shape, internal hypoechoic, microcalcification and A/T>1 are stable important ultrasonographic signs in predicting PTMC. Comprehensive analysis of various ultrasonic signs can improve the diagnostic efficiency.

To construct a eukaryotic expression plasmid containing the luciferase reporter gene (Fluc) to quickly detect apoptosis. Four amino acids, Asp-Glu-Val-Asp (DEVD), the recognize motif of Caspase-3, were introduced into the middle of the Fluc-C and N fragment. Meanwhile, four amino acids, Asp-Glu-Val-Gly (DEVG), were selected as a negative control. Subsequently, the recombinant gene was cloned into the N and C terminal end of the split intein, and named as pFluc-DEVD and pFluc-DEVG. Then the plasmids were transfected into cells and renilla luciferase was co-transfected in each sample as an internal control for transfection efficiency. Then the apoptosis level was detected by the double luciferase reporter gene and the Western blotting analysis. The results showed that when apoptosis occurred, the content of firefly luciferase expressed in the pFluc-DEVD plasmid transfected group was about 3 times higher than pFluc-DEVG plasmid transfected group. Furthermore, Western blotting detection indicated that the Fluc level was significantly increased in pFluc-DEVD transfected group when pre-treated by apoptosis stimulants. The activation degree of Caspase-3 was closely related to the expression of Fluc, and had a significant statistical difference. These results confirmed that firefly luciferase protein expressed by pFluc-DEVD plasmid can be cleaved by the intracellular Caspase-3 enzyme, and this plasmid can accurately reflect the cell apoptosis level, which provides a useful method for quantitative detection of apoptosis.
Apoptosis ; Genes, Reporter ; Luciferases, Firefly ; Transfection

Objective To investigate the diagnostic value of hyperenhancement sign on ultrasound,CT and their combination in diagnosis of thyroid benign and malignant nodules.Methods The contrast-enhanced ultrasound and enhanced CT datas of 172 thyroid nodules in 144 cases confirmed by operation and pathology were retrospectively analyzed,including 97 benign nodules and 75 malignant nodules.According to the degree of enhancement,these nodules were divided into iso-or low-enhancement and hyperenhancement.The distributions of ultrasound hyperenhancement,CT hyperenhancement and both of them in thyroid benign and malignant nodules,adenomatoid lesions and nodular goiters were analyzed,followed byx2 test for statistical analysis.Results In 172 thyroid nodules,the proportions of ultrasound hyperenhancement,CT hyperenhancement and both of them in thyroid benign and malignant nodules were 53.6％(52/97) and 20.0％(15/75)(x2＝20.090,P＜0.05),34.0％ (33/97) and 4.0％ (3/75) (x2＝23.033,P＜0.05),31.0％ (30/97) and 0％ (0/75) (x2＝28.096,P＜0.05),respectively.Their sensitivity and specificity of diagnosing benign nodules were 53.6％ (52/97) and 80.0％ (60/75),34.0％ (33/97) and 96％ (72/75),30.9％ (30/97) and 100％ (75/75),respectively.The proportions of ultrasound hyperenhancement,CT hyperenhancement and both of them in adenomatoid lesions and nodular goiters were 96.9％(31/32) and 32.3％(21/65)0x2＝35.946,P＜0.05),65.6％(21/32) and 18.5％(12/65)(x2＝21.250,P＜0.05),65.6％(21/32) and 13.8％ (9/65)(x2＝26.912,P＜0.05).Their sensitivity and specificity of diagnosing adenomatoid lesions were 96.9％(31/32) and 67.7％(44/65),65.6％(21/32) and 81.5％(53/65),65.6％(21/32) and 87.2％(56/65).Conclusions Ultrasound hyperenhancement,CT hyperenhancement for diagnosing thyroid benign nodules are of significant value.Especially for adenomatoid nodules,ultrasound hyperenhancement has a higher sensitivity,while CT hyperenhancement has a higher specificity.Their combination can further improve the diagnostic specificity,thus reducing the unnecessary surgical trauma.

OBJECTIVE The aim of the study was to evaluated the difference and consistency in tumor size measured by sonographic and pathological examination in papillary thyroid carcinoma(PTC).METHODS A total of 114 patients with PTC, including 122 malignant nodules, was collected from Hangzhou First People's Hospital between Jun 2012 and Jun 2014. The tumor sizes were measured by preoperative sonographic and postoperative pathologic evaluation. Pearson correlation analysis, paired t-test, and Bland-Altman plot were used to evaluate the correlation and consistency in tumor size measured by the two methods.RESULTS Pearson correlation analysis showed that the largest tumor size measured by sonography were positively correlated with pathologic size (r=0.957, P=0.000). Paired t-test showed that there were statistically difference between sonographic size and pathological size (8.24±5.06) mmvs (7.79±4.75) mm,P=0.001. The absolute difference value of the largest tumor size measured by the two methods was from zero to 6.5 mm, with the average of (1.03±1.14) mm. Bland-Altman analysis showed that the limits of agreement (LoA) of difference was from -2.41 mm to 3.33 mm, with the 95% confidence interval from -2.87 mm to 3.78 mm.Within the limit of the consistency, the maximum moduli was 2.9 mm.CONCLUSION There is a significant discrepancy between the preoperative sonographic and the pathologic size of the papillary thyroid carcinoma, which should be taken into account in clinical practice.

Objective To discuss the predictive value of multiple ultrasonic features combination in diagnosis of thyroid papillary carcinoma (PTC) more than 1.0 cm in diameter. Methods The ultrasonic features of 258 PTC nodules from 251 patients and 207 nodular goiter (NG) nodules from 190 patients in the First People′s Hospital of Hangzhou were retrospectively analyzed. All the nodules were confirmed by pathological examination after surgery. The ultrasonic features included the shape of nodules, internal echo,anteroposterior/transverse diameter ratio (A/T), and microcalcification. The χ2 test was used to analyze the differences of ultrasonic features between PTC and NG. Multi-variate analyses (Logistic regression) was used to analyze the predictive risk ultrasonic features of PTC. The sensitivity and specificity of ultrasonic features were analyzed based on the gold standard of pathological results. Results There were significantly differences between 258 PTC nodules and 207 NG nodules in irregular shape, hypoechogenicity,A/T > 1 and microcalcification (χ2 values were 121.511, 105.411, 41.483, 121.072, all P < 0.01). The results of Logistic regression showed that irregular shape, hypoechogenicity, A/T>1 and microcalcification were risk ultrasonic features of PTC. And their OR values were 5.013 (95%CI 2.919-8.610), 5.811 (95%CI 3.411-9.901), 15.399 (95%CI 7.576-31.301), 4.141 (95%CI 1.687-10.164) respectively. The sensitivity and specificity of single ultrasonic feature were 26.0%-79.5% and 71.5%-96.1%; the sensitivity and specificity of two ultrasonographic features combination were 11.2%-57.0% and 92.3%-99.0%; and the sensitivity and specificity of three or four ultrasonographic features combination were 8.1%-31.8% and 99.0%-99.5%.Conclusions Irregular shape, hypoechogenicity, A/T> 1 and microcalcification of thyroid neoplasm are important ultrasonic features of PTC. Although the sensitivity of single ultrasonic feature in diagnosing PTC is higher than that of multiple features combination, it has a lower specificity. Therefore, combination of multiple ultrasonographic features can improve the specificity in diagnosing PTC and reduce the misdiagnosis of PTC.

Objective To discuss the clinical efficacy of surgical treatment of pathologic vertebral surgery for thoracic and lumbar tuberculosis. Methods All of 322 cases of thoracic and lumbar spinal tuberculosis patients from December 2003 to June 2014 were retrospectively analyzed in our department. All patients were underwent debridement, fusion and nerve decompres?sion surgery. According to different fixed methods, patients were divided into pathologic vertebral surgery group (fixation complet?ed within lesions invaded motion unit) including 91 males and 100 females, with an average age of 41.53 years, and non?pathologic vertebral surgery group (long segments or short segment fixation) including 61 males and 70 females, with an average age of 42.72 years. We observed the tuberculosis cure rate, degrees of deformity, pain and neurological recovery, operative time, blood loss and complications by follow?up. Results The average follow?up time was 75.52 months in pathologic vertebral surgery group and 76.21 months in non?pathologic vertebral surgery group. The total number of pathologic vertebras in pathologic vertebral surgery group and non?pathologic vertebral surgery group were 277 and 218 respectively, and the average was 1.45 and 1.66. The total number of fixed segments was 277 in pathologic vertebral surgery group and 485 in non?pathologic vertebral surgery group, and the average fixed segments was 1.45 and 3.70. The cure rate was 85.86%in pathologic vertebral surgery group and 85.49%in non?pathologic vertebral surgery group at 6 months postoperatively, and 98.95%and 98.47%at the last follow?up time, with no signifi?cant difference between groups. Graft fusion rate was 89.00%in pathologic vertebral surgery group and 89.31%in non?pathologic vertebral surgery group 6 months postoperatively, 98.38%and 98.47%at the last follow?up time, without significant difference. In lumbar spine, the average correction of Cobb's angle was 12.4° in pathologic vertebral surgery group and 13.1° in non?pathologic vertebral surgery group, and the average angle loss was 1.3 and 1.4°, with no significant difference. In thoracolumbar, the average correction of Cobb’s angle was 10.9°in pathologic vertebral surgery group and 11.1°in non?pathologic vertebral surgery group, and the average angle loss was 1.7°and 1.5° respectively, without significant difference. However, in thoracic, the average correction of Cobb's angle was 10.2° in pathologic vertebral surgery group and 12.7° in non?pathologic vertebral surgery group, and the average angle loss was 3.6° and 2.5°respectively, with significant difference. The mean operation time was 210.45 min in pathologic verte?bral surgery group and 210.45 min in non?pathologic vertebral surgery group, with significant difference. The average blood loss was 726.12 ml in pathologic vertebral surgery group and 726.12 ml in non?pathologic vertebral surgery group, with significant dif?ference. The complication rate was 11.51%in pathologic vertebral surgery group and 11.45%in non?pathologic vertebral surgery group, with no significant difference. Conclusion Pathologic vertebral surgery surgery is a safe, effective and feasible method of operation for treatment of thoracic and lumbar tuberculosis, which can effectively preserve adjacent normal vertebral motion unit features. The thoracic surgery was less satisfactory than the lumbar and thoracolumbar surgery.