This paper reported a rare case of hypercalcemic crisis caused by a parathyroid adenoma with hemorrhage and cystic degeneration. Preoperative imaging examination of the patient was unable to determine the histological origin of the cervical cystic lesion. Despite aggressive medical treatment and hemodialysis, hypercalcemic crisis could not be relieved. Therefore, surgical exploration and excision of the cervical lesion were performed, and final diagnosis of parathyroid adenoma with hemorrhage and cystic degeneration was confirmed by pathology. Blood calcium level and renal function returned to normal after the surgery.

Objective:To explore the molecular mechanisms of a Chinese pedigree with hereditary factor Ⅺ (FⅪ) deficiency.Methods:All of the 15 exons, flanking sequences of the FⅪ gene and the corresponding mutation sites of family members were analyzed by the Sanger sequencing, followed by the extraction of the peripheral blood genomic DNA. And all the results were verified by the reverse sequencing. The conservation of the mutated sites was analyzed by the ClustalX-2.1-win. Three online bioinformatics software tools, including Mutation Taster, PolyPhen2 and the PROVEAN, were used to assess the possible impact of the mutations. Swiss-pdbviewer software was used to analyze the effects of mutant amino acids on protein structure.Results:Genetic analysis revealed that the proband had compound heterozygous mutations including a nonsense mutation of c. 1107C>A (Tyr369stop) in exon 10 and missense mutation of c. 1562A>G (Tyr521Cys) in exon 13. The same c. 1107C>A (Tyr369stop) was present in her father, the same c. 1562A>G (Tyr521Cys) was present in both her mother and daughter. Conservation analysis indicated that Tyr521 was a highly conserved site during evolution. The prediction of pathogenicity showed that both c. 1107C>A and c. 1562A>G were pathogenic mutations. Protein structure prediction showed that in the wild type FⅪ protein structure, Tyr521 formed a hydrogen bond with the Lys572 and Ile388, respectively. When Tyr521 was replaced by Cys521, the original benzene ring structure disappeared, and side chains of Lys572 added a hydrogen bond with the Cys521, which may chang protein catalytic domain structure. When Tyr369 was mutated to a stop codon, resulting in the truncated protein.Conclusion:The compound heterozygous mutations including the c. 1107C>A heterozygous missense variant in exon 10 and the c. 1562A>G heterozygous nonsense mutation in exon 13 may be responsible for the hereditary factor Ⅺ deficiency in this Chinese pedigree.

Objective To evaluate the change of clinicopathological features and prognosis of papillary thyroid cancer over a 15-year period.Methods The clinicopathological features and outcomes of papillary thyroid cancer patients were analyzed in three groups according to the time of diagnosis:group Ⅰ (1997-2001),group Ⅱ (2002-2006),and group Ⅲ (2007-2011).Results As time advanced,the average age of papillary thyroid cancer patients increased,tumor stage,like size,extrathyroid invasion and lymph node metastasis decreased dramatically (P ＜ 0.01).The percentage of multifocality and bilaterality increased.The long-term follow up data (median follow up time was 6.6 years),indicated that the 15-year over all survival was 97.8％ and the 15-year disease-free survival was 90.2％.Tumor ≥3 cm,bilaterality,extrathyroid invasion,lymph node metastasis and AJCC stage were correlated with tumor recurrence.By multivariate COX-regression analysis only lymph node metastasis and bilaterality were independent risk factors.Conclusion The clinicopathological features of papillary thyroid cancer changed over 15 years,with the percentage of early-staged patients increased.Lymph node metastasis and bilaterality are two risk factors for tumor recurrence.

Amniotic lfuid embolism refers to the accessible amniotic lfuid component of maternal circulation leading to a series of severe symptoms, such as pulmonary embolism, shock or even death. Up till now, AFE is a diagnosis of exclusion. The sensitivity and specificity of these methods were poor. With the increasing maternal mortality caused by AFE in forensic medicine, it is important to seeking for more precise diagnosis method. This review intends to provide methodological reference for forensic identification through the research progress of the diagnosis of AFE.

Objective To observe the changes of peripheral blood interleukin-2(IL-2) ,interleukin-4(IL-4) ,interleukin-10(IL-10) ,tumor necrosis factor-alpha(TNF-α) and interferon gamma (IFN-γ) in chronic hepatitis B(CHB) patients with positive e-anti-gen(HBeAg) treated by Bushenqingtou Decoction .Methods 60 cases of CHB with positive HBeAg were randomly divided into the treatment group and the control group ,30 cases in each group .The CHB treatment group received Bushenqingtou Decoction with the treatment course of 48 week ,while the CHB control group did not received the medication therapy .In the beginning and at 48 weeks of treatment ,the blood in the two CHB groups were collected for detecting HBV DNA ,IL-2 ,IL-4 ,IL-10 ,TNF-αand IFN-γ. Results Compared with before treatments ,the levels of IL-2 ,TNF-αand IFN-γafter treatments in the CHB treatment group were obviously increased ,while the levels of HBV DNA ,IL-4 and IL-10 were remarkably decreased (P<0 .01);however ,there were no statistical differences of the various indexes after the treatments in the CHB control group (P>0 .05) .Conclusion Bushenqingtou Decoction could inhibit the replication of HBV DNA in the CHB patients with positive HBeAg and improve the body immune func-tion .

The precise estimation of blood vessel centerline and width is a prerequisite condition for the quantitative and visualized diagnosis of blood vessel disease in fundus images. In this paper, a retinal blood vessel segmentation algorithm based on centerline extraction is proposed. According to the characteristics of the fundus image and retinal blood vessels, the image is convoluted with the masks of discrete Gaussian partial derivative kernels. The centerline is determined by differential geometric properties of the blood vessels and the width is also calculated. The precision of our method can reach sub-pixel level with a fast computation speed. The experiments on several kinds of fundus images showed that the method worked quickly and accurately.
Algorithms ; Fundus Oculi ; Humans ; Image Enhancement ; methods ; Retinal Vessels ; anatomy & histology

Objective To explore the surgical treatment of posttraumatic epilepsy in functional cerebral area Methods After preoperative evaluation,nineteen patients with intractable posttraumatic epilepsy of functional cerebral area underwent multiple subpial transaction under the electrocorticogram monitoring during the operation, combining with anterior corpus callosotomy, anterior temporal lobectomy and selective amygdalo-hippocampectomy. Results The follow-up results showed seizures of these patients improved considerably. According to Engel' s grading,among 19 cases,10 cases were grade Ⅰ ,7 cases were grade Ⅱ ,2 cases were grade Ⅲ ,and no cases were grade Ⅳ. Conclusions The satisfactory clinical outcome of the surgical treatment of intractable posttraumatic epilepsy in functional cerebral area could be obtained with the help of careful preoperative evaluation and multiple subpial transaction under the electrocorticogram monitoring.

Objective To investigate the clinicopathologic features and treatment of thyroid microcarcinoma (TMC). Methods From January 1997 to December 2006,311 patients who underwent surgery and defined as TMC(tumor size≤1 cm)were enrolled. Results TMC was identified incidentally by frozen pathologic examination on thyroidectomy specimens in tentative benign goiters in 181 patients; another 130 patients with clinically detectable primary tumors or suspected nodal metastases were grouped to as clinically overt TMC. The clinically overt TMC had a higher incidence of bilateral multifocal tumors (18.5%vs.9.4%,P=0.03),and cervical lymph node metastases(27.7%vs.10.5%,P=0.000)than that in clinically occult TMC group. Conclusion TMC may vary considerably in clinical and biologic behaviors between these two subtypes: clinically overt and occult. Lobectomy for single lesion, total or near total thyroidectomy for multifocal with central compartment nodal dissection should be performed, lateral nodal dissection was not carried out unless US or physical examination detected nodal metastases. Lobetomy, subtotal or more limited thyroidectomy for occult TMC, diagnosed incidentally following thyroid surgery for initially tentative benign thyroid disease, could all be treatment of choice depending on the preference of surgeons.

This paper introduced the fabrication process of the fused porcelain to molar crown with CAD/CAM technology. Firstly, preparation teeth data was retrieved by the 3D-optical measuring system. Then, we have reconstructed the inner surface designed the outer surface shape with the computer aided design software. Finally, the mini high-speed NC milling machine was used to produce the fused porcelain to CAD/CAM molar crown. The result has proved that the fabrication process is reliable and efficient. The dental restoration quality is steady and precise.
Computer-Aided Design ; Crowns ; Dental Porcelain ; Dental Prosthesis Design ; Humans ; Molar

This paper presents our work on the research process of virtual articulator simulation. Firstly, plaster models of upper jaw and low jaw are measured by 3D-optical measuring system and processed to get the available data. Secondly, complex physical modeling of the jaw motion is simplified and decomposed to a series of position transform, such as translation, rotation, etc.. Thirdly, opening/closing movement and laterotrusion is simulated by real-time updating display. Fourthly, the efficient collision detection algorithm is applied to dynamically compute occlusal contact regions and cutaway view. Finally, the current shortage of the virtual articulator simulation is discussed in detail and research prospect is forecasted.
Computer Simulation ; Dental Articulators ; Dental Occlusion ; Humans ; Imaging, Three-Dimensional ; Jaw ; physiology ; Models, Biological