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Objective@#To evaluate the predictive accuracy of fine needle aspiration (FNA) and BRAF V600E mutation in distinguishing papillary thyroid carcinoma and other thyroid nodules.@*Methods@#This retrospective cohort study included 93 patients with papillary thyroid carcinoma who treated at Department of Thyroid Surgery, the Second Affiliated Hospital of Zhejiang University, College of Medicine from September 2016 to May 2018. There were 21 males and 72 females with age of (43.2±11.3) years (range: 19 to 67 years). All the patients got the examinations of FNA and BRAF V600E mutation by Amplification Refractory Mutation System, and subsequently underwent thyroid surgeries. The results of cytopathology, frozen section and pathology were collected and analyzed. The predictive accuracy of FNA cytology and BRAF V600E mutation was calculated.@*Results@#In the 93 collected cases, 91 were diagnosed as papillary thyroid carcinoma postoperation, and the accurate predictive rate was 97.8%. Subgroup analysis was performed according to Bethesda System, the predictive rates were: unsatisfactory (Ⅰ) 6/6, benign (Ⅱ) 0/0, atypia of undetermined significance or follicular lesion of undetermined significance (Ⅲ) 16/17, follicular neoplasm or suspicious for follicular neoplasm (Ⅳ) 97.2% (35/36), suspicious for malignancy (Ⅴ) 100% (28/28), and malignant (Ⅵ) 6/6, respectively.@*Conclusion@#Thyroid nodules with BRAF V600E mutation can be strongly speculated as papillary thyroid carcinoma.
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Objective To explore the technique and significance of intraoperative neuromonitoring (IONM) for scarless in the neck endoscopic thyroidectomy (SET) via breast approach.Methods From Apr.2015 to Oct.2015,101 consecutive patients undergoing SET with IONM were included.During the operation,patients received radical resection of the thyroid cancer by Wang's seven-step method.The lymph nodes in the central area were dissected and Wang's multi-functional separation forceps were implemented for recurrent laryngeal nerve (RLN) positioning,monitoring and protection.Also,time required for RLN positioning and exposure,postoperative transient and permanent RLN damage incidence were calculated to assess the feasibility of IONM under SET.Results Among 101 patients,130 RLNs in total were exposed.The average time required for RLN positioning under IONM was (3.26 ± 1.08)min,with round-nerve management time of (13.95 ± 4.58)min.Nerve signal change happened in 16.9％(22/130) patients.Positive predictive value was 13.6％ and negative predictive value was 100％.The overall accuracy rate was 85.4％.Conclusion IONM during SET is feasible,and can be helpful for the localization and functional protection of RLN and was useful to predict vocal cord paralysis.
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Objective@#To summarize the preliminary experience with transoral endoscopic thyroidectomy via vestibular approach (TOETVA).@*Methods@#A total of 150 consecutive patients with thyroid disease underwent TOETVA from November 2014 to February 2017 at Department of Thyroid Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine. The patients were comprised of 138 females and 12 males. The mean age of the patients was (31.7±7.6) years (ranging from 15 to 51 years). There were 108 patients of differential thyroid carcinoma (T1 or T2 ≤3 cm, cN0 or cN1a, M0) and 42 patients of benign thyroid disease (solid nodule ≤6 cm). The criteria analyzed were clinicopathologic characteristics, types of operation, operation time, complications and results of follow-up.@*Results@#Two cases were converted into open surgery due to an incredible unexpected tumor size and tracheal invasion, respectively. One hundred and three patients with papillary carcinoma underwent transoral central neck dissection (CND), with the mean operation time of (146±34) minutes for hemithyroidectomy with CND, and (187±36) minutes for total or near total thyroidectomy with CND. The mean number of lymph node yields was 8.2±4.7, and the lymph node metastasis rate was 41.7% (43/103). Regarding postoperative complications, transient hoarseness occurred in 3 patients, and permanent recurrent laryngeal nerve occurred in 2 patients. One patient had local infection or transient mental nerve palsy. Transient hypocalcemia occurred in 31.8% of 22 patients who underwent total, near-total, or subtotalthyroidectomy, and no permanent hypocalcemia was registered. Mean hospital stay after operation was (3.5±0.6) days (ranging from 2 to 5 days). Mean follow-up period was (11.5±7.8) months (ranging from 1 to 28 months), no recurrence or metastasis occurred.@*Conclusions@#TOETVA is feasible and safe for strictly selective patients. It brings perfect cosmetic effect. Long-term follow-up and further study is needed to assess its curative effect.
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Objective To inspect the applicability of fast reading training on college students with hearing impairment and variability with cognitive flexibility. Methods Sixty-two hearing impaired students were divided into intervention group (n=30) and control group (n=32). The intervention group received fast reading training eight times, and the control group accepted conventional reading practice. They were subgrouped into high level and low level of cognitive flexibility according to their achievements of Cognitive Flexibility Scale for Col-lege Students. They were asked to read four essays before and after intervention, respectively. Results For the reading speed and valid read-ing speed, the effects of intervention were significant (F>66.62, P80.35, P9.68, P<0.01). For the comprehension, the effect of the time of training was significant (F=4.96, P=0.003), but it was not for the intervention (F=1.269, P=0.265) and cognitive flexibility (F=1.475, P=0.230). Conclusion Fast reading training may improve the read-ing speed of college students with hearing impairment, and may be more effective for those with high level of cognitive flexibility.
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Objective To discuss the morphological changes of neurons infected with street strain of rabies virus (RV),and to explore the mechanism of the neuronal dysfunction caused by RV.Methods Invivo,the C57/BL mice were randomly divided into experimental group(n=10)and control group(n=10).The mice in experimental group were inoculated intracranially at 30 μL RV suspension (10TCID50 ), and the mice in control group were inoculated with identical volume of cell maintenance medium.Anti-RV antibody was used to detect the RV antigen distribution in brain tissue of the mice.Invitro,the primary hippocampal neurons were cultured for 1 week and the cells were infected by RV.The proliferation of RV was detected by immunofluorescence method after infection for 72,96,and 120 h.Results The RV antigen was found in neurons and neuronal dendrites of hippocampus CA1 4 d after infection;however, the RV antigen was detected only in neuronal dendrites of hippocampus CA1 7 d after infection.The number of infected neurons was the most 120 h after infection,and the number of infected dendrites was decreased.Conclusion RV can infect and injure the neuronal dendrites of hippocampus CA1 region and lead to neuronal dysfunction of the mice.
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OBJECTIVE: To study the role of nuclear factor-kappa B (NF-kappaB) and cycloxygenase-2 (COX-2) in the onset of phlegm obstruction due to lung-deficiency in rats and the therapeutic mechanism of Huatan Recipe. METHODS: Twenty-four SD rats were randomly divided into normal group, model group and treatment group, with 8 rats in each group. The rats in the model group and treatment group were exposed to sulfur dioxide and cold wind to establish the rat model of phlegm obstruction due to lung-deficiency, and the rats in the treatment group were also treated with Huatan Recipe, a compound traditional Chinese medicine. The expression of NF-kappaB in the bronchial epithelial cells of the rats was tested with the method of immunohistochemistry, and the COX-2 mRNA in the lung tissues of the rats was measured by using reverse transcription-polymerase chain reaction. RESULTS: The expressions of NF-kappaB and COX-2 mRNA in rats of the model group were higher than those of the normal group (P<0.01), and the expressions of NF-kappaB and COX-2 mRNA in rats of the treatment group were obviously lower than those of the model group (P<0.01). CONCLUSION: The NF-kappaB and COX-2 play an important role in the onset of phlegm obstruction in rats. Huatan Recipe may prevent the development of phlegm obstruction by down-regulating the expressions of NF-kappaB and COX-2 mRNA.
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@#ObjectiveTo evaluate the value of Token Test in testing Chinese aphasia and study the mechanism of bilateral hemispheric asymmetry.Methods33 patients with left hemispheric cerebral vascular diseases and 30 patients with right hemispheric cerebral vascular diseases were studied by Token Test and Aphasia Battery of Chinese(ABC). ResultsThe statistical analysis shows that the score of Token Test was significantly correlated with all tests of ABC in both left and right hemispheric damages groups(P<0.01), and that the score of Token Test was significantly negative correlated with infarction areas in left hemispheric damages groups (P<0.01),but incorrelated with infarction areas in right hemispheric damages groups(P>0.05). There is a significant correlation between the score of Token Test and the severity of the aphasia(P<0.01). Conclusions Token Test was closely related with ABC. It can be effective to detect some higher neuropsychological function disorder.
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Objective:Study on characteristics of two synthesizd peptides based on CSFV E2 protein. Methods:B cell epitopes of CSFV E2 antigen were predicted using accessibility and flexibility schemes, associated with antigenicity , secondary structure and multiple sites prediction. Two antigen peptides (Pep1 and Pep2) have been designed and synthesized and their reactivety were detected with 8 McAbs and antiserum against mE2 protein, then the peptides were conjugated with BSA and immunized rabbits respectively. Results:Both Pep1 and Pep2 could react with antiserum and McAb A11, Pep2 could interact with McAbD5 and McAbD8. Only Pep1 BSA conjugate can stimulate high level and specific antibodies.Conclusion: The peptide1 has good antigenicity.