Effects of different viscoelastic agents on corneal endothelium of patients after phacoemulsification and foldable IOL implantation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the effects of dual viscoelastic agents DisCoVisc and sodium hyaluronate on corneal endothelium of patients after phacoemulsification and foldable intraocular lens(IOL)implantation.METHODS: A total of 247 patients(285 eyes)with cataract treated in Jingmen Aier Eye Hospital between June 2017 and December 2019 were selected, and they were divided into DisCoVisc group(123 cases, 141 eyes)and sodium hyaluronate group(124 cases, 144 eyes)by random number table method. Both groups were treated with phacoemulsification and foldable IOL implantation. DisCoVisc and 1.7% sodium hyaluronate were used as viscoelastic agents in DisCoVisc group and sodium hyaluronate group, respectively. The two groups were compared in terms of intraoperative ultrasound time(UST), cumulative dissipated energy(CDE), time for aspiration of viscoelastic agents after IOL implantation, corneal edema at 1d, 1wk, 1 and 3mo after operation, corneal endothelial cell density(ECD)and ECD loss rates before operation and at 3mo after operation, coefficient variation of corneal endothelial cell size(CV), percentage of corneal hexagonal endothelial cells(6A), intraocular pressure, the proportions of patients with uncorrected visual acuity ≥0.5 and central corneal thickness(CCT)values before and after operation at 1d, 1wk and 1mo.RESULTS:There was no statistically significant difference between the two groups in UST, CDE, aspiration time of viscoelastic agents(P >0.05)or corneal edema both rate on day 1 after operation(P>0.05). Corneal edema disappeared at 1 wk after operation. The ECD loss rate in DisCoVisc group was significantly lower than that in sodium hyaluronate group at 3mo after operation(P<0.05). Intraocular pressure, the proportion of patients with uncorrected visual acuity ≥0.5 and CCT values showed no statistically significant differences between the two groups before and after operation at 1d, 1wk and 1mo(P >0.05).CONCLUSION: DisCoVisc, as the viscoelastic agent in phacoemulsification and foldable IOL implantation for patients with Emery-Little grade Ⅱ-Ⅲ lens nucleus hardness, can better protect the patients' corneal endothelium.

L-arginine promotes the survival of extended dorsal perforator skin flap through activating L-arginine-nitric oxide pathway / 中国组织工程研究

BACKGROUND: Studies have shown that nitric oxide(NO) can effectively improve blood supply and promote flap survival, but the specific mechanism is still unclear. OBJECTIVE: To explore the effects of L-arginine(L-Arg) on the survival of extended dorsal perforator skin flap in rats by activating L-Arg-NO pathway. METHODS: Animal models of extended dorsal perforator skin flap were successfully established in 81 male Sprague Dawley rats, which were then divided into a L-Arg group, a blank group and a L-NAME group. L-Arg(400 mg/kg per day) and nitro-amino-methyl-L-arginine(L-NAME; 40 mg/kg per day) were injected intraperitoneally in the L-Arg group and L-NAME group immediately and 1-7 days after operation, respectively, while the same volume of isotonic sodium chloride solution was injected intraperitoneally in the blank group at the same time points. Flap survival rate was measured. Angiography was performed to observe appearance and distribution of blood vessels at 7 days after operation. NO concentration of choke II zone was detected immediately, 1, 3, 5, and 7 days after operation. Tissue samples were harvested from the choke II zone for detecting density and caliber of new blood vessels using hematoxylin-eosin staining and the expression of vascular endothelial growth factor and matrix metalloproteinase was detected by western blot, respectively. The study protocol was approved by the Animal Ethics Committee of the 94 th Hospital of the PLA Joint Logistics Support Force(approval No. 2015 KYLL046). RESULTS AND CONCLUSION: The highest survival rate of flap appeared in the L-Arg group, (89.47±3.17)%, which was significantly higher than that in the other groups(F=49.908, P < 0.001). At 7 days after operation, the vascular structure in the choke II zone of the L-Arg group was relatively complete with clear trajectory. The vessels that had expanded to achieve true anastomosis extended along the longitudinal axis of the flap to the end of the flap. In the blank group and L-NAME group, the vascular structure and vascular trajectory in the choke II zone were disordered. Moreover, the vascular structure at the end of flap in L-NAME group disappeared. NO concentration in L-Arg group was increased after surgery, peaked at 3 days after operation, and then decreased gradually. Microvessel density and caliber in the L-Arg group were significantly higher than those in the other groups at 7 days after operation(P < 0.001). Western blot showed that the expression of vascular endothelial growth factor and matrix metalloproteinase-2 were significantly higher in the L-Arg group than the other groups at 3 after operation(P < 0.05), while at 7 days after operation, the expression of vascular endothelial growth factor in the L-Arg group was significantly higher than that in the other groups(P < 0.05), but the expression of matrix metalloproteinase-2 showed no significant difference among the three groups. To conclude, NO could promote microvascular growth and dilatation in the choke II zone of extended dorsal three-vascular perforator flaps in rats; L-Arg could increase the NO concentration in tissue by activating the L-Arg-NO pathway, which is beneficial to the survival of skin flap.

Changes of IL-21 and Its Mediated JAK/STAT Signaling Pathway in Patients with Immune Thrombocytopenia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the correlation between JAK/STAT signaling pathways and pathogenesis of immune thrombocytopenia(ITP).</p><p><b>METHODS</b>Twenty-six newly-diagnosed ITP patients was included in this study. They all meet the clinical and hematological criteria for the diagnosis of ITP, and patients with coronary heart disease, severe refractory hypertension, diabetes or with severe liver or kidney function incompetence were ruled out. 24 healthy control without autoimmune diseases, viral infectious diseases and with normal liver and kidney functions were also included. The expressions of Jak3, p-Jak3 mRNA, Stat3, and p-Stat3 were tested and the changes in levels of IL-21 mRNA, IL-21 cell secretion after DEX intervention and AG490 blockade were measured.</p><p><b>RESULTS</b>Compared with the healthy control, patients with ITP had significantly high expressions of Jak3, p-Jak3 mRNA, Stat3 and p-Stat3 protein, which significantly reduced after AG490 blocking (P<0.01). The expression of IL-21 mRNA and the secretion of IL-21 obviously decreased after DEX intervention, but increased after AG490 blocking(P<0.01).</p><p><b>CONCLUSION</b>The pathogenesis of ITP associates with the activation of JAK/STAT signaling pathways, and IL-21-mediated JAK/STAT signaling pathways play regulatory role in ITP.</p>

Choke vessel growth in perforator flaps and the conception of angiosome / 中国组织工程研究

BACKGROUND: Perforator flaps are used to repair skin and soft tissue defects. As a bridge between adjacent perforator vessels, choke vessels play an important role in the survival of extended perforator flap. OBJECTIVE: To review the research status and progress of the growth of choke vessels in perforator flaps. METHODS: A computer-based search of PubMed, CNKI and SinoMed databases was performed for the relevant literature concerning the research status and progress of the growth of choke vessels in perforator flaps published from 1984 to 2017. The keywords were "perforator flap, perforator vessels, choke vessels, choke zone" in English and Chinese, respectively.RESULTS AND CONCLUSION: Totally 51 articles were included for summary. Perforator flaps are extensively used to repair skin and soft tissue defects caused by various factors. Adjacent perforter vessels are connected by choke vessels, and the extended perforter flap survival is closely related to the dilatation and growth of choke vessels. Similarity may exist between the growth of choke vessel and angiogenesis. Hypoxia and ischemic preconditioning and inflammatory environment may promote the growth of choke vessels.

Particle-associated periprosthetic osteolysis after hip arthroplasty: the underlying biological mechanisms / 中国组织工程研究

BACKGROUND: Loosening of the sterile prosthesis in joint replacement is a simple radiological phenomenon, but a complex immune process. The abrasive particles produced by the implant usually lead to osteolysis, which is known as particle-associated periprosthetic osteolysis. OBJECTIVE: To summarize the characteristics of particle-associated periprosthetic osteolysis in order to provide reference for early identification and treatment, thereby improving the patients' prognosis. METHODS: The first author retrieved PubMed database for the articles addressing particle-associated periprosthetic osteolysis using the English keywords of "wear particles, particle-associated periprosthetic osteolysis".RESULTS AND CONCLUSION: (1) Osteolysis can induce bone resorption, but the relevant clinical, animal and in vitro studies have shown that particle-associated periprosthetic osteolysis involves various biological reactions, not only osteoclasts, and the bioactivity highly depends on the property and quantity. (2) Although total hip arthroplasty has achieved rapid progression, particle-associated periprosthetic osteolysis and aseptic loosening are still the main factors for the life of prosthesis. (3) Biomarkers can be used as simple and objective diagnostic and prognostic criteria for osteolysis after total hip arthroplasty. (4) Further research is needed to identify new biomarkers in periprosthetic osteolysis to develop new treatments to reverse or inhibit the particle-associated biological response.

Role of SUMO-specific proteases in tumor biological behavior / 上海交通大学学报（医学版）

SUMOylation is a dynamically reversible process that needs to be modified by a specific ligase, while its inverse reaction deSUMOylation is catalyzed by a group of SUMO-specific proteases (SENPs). SUMO-modified target protein molecules are closely related to development and disease, especially tumor, metabolism, inflammation and immunity. SENPs play an important role in SUMO protein maturation and deSUMOylation. This review discussed the functions of SENPs in the development and progression of tumors and related mechanisms.

Influence of EDC ethanol solution on dentin shear bond strength with a self-etch adhesive system / 北京大学学报(医学版)

Objective:To evaluate the bonding ability of one representative self-etch adhesive system by applying the micro-shear bond strength test method with different concentrations of carbodiimide [1-ethyl3-(3-dimethylaminopropyl) carbodiimide,EDC] ethanol solution pretreatment.Methods:Extracted sound human third molars were collected from patients ranging 18 to 40 years.In the study,80 molars were first sectioned to prepare a flat middle coronal dentin surface and then were randomly divided into 5 groups (n =16) according to without/with different surface treatments [blank control;80％ (volume fraction) ethanol control;EDC ethanol solution of three concentrations (0.01 mol/L,0.3 mol/L and 0.5 mol/L)].Each specimen underwent a micro-shear bond strength test and failure mode observation.The data collected were subjected to statistical analysis using one-way ANOVA and post hoc Tukey's test to analyze the difference of the micro-shear bond strength,and chi-square test/Fisher's exact test for the failure mode frequency of the micro-shear bond strength test specimens at a significance level of P =0.05.Results:The micro-shear bond strength of the three concentration EDC treatments were (35.29 ± 8.97) MPa (0.01 mol/L EDC treatment group),(40.24 ±9.68) MPa (0.3 mol/L EDC treatment group),(37.38 ±9.66) MPa (0.5 mol/L EDC treatment group) separately;and that of the 80％ ethanol group was (37.49 ± 7.76) MPa.All micro-shear bond strength value of the above four groups was statistically higher than that of the blank control group [(33.81 ± 7.98) MPa].The immediate microshear bond strength and failure mode was of no statistically significant difference among all the groups.It was noticed that the immediate micro-shear bond strength of 0.3 mol/L was higher than that of all the other groups,especially higher than that of the 80％ ethanol pretreatment group despite that there was no significant difference among all the groups.And the test of failure mode indicated that the cohesive failure was more common,while the frequency of adhesive failure was rare in each experimental group.Conclusion:EDC pretreatment had no adverse effect on the immediate micro-shear bond strengths of Clearfil SE Bond.Meanwhile,EDC treatment did not cause more adhesive failure in immediate micro-shear test,which had further denoted what was said above.However,it needs more research to illustrate the antienzymatic role of EDC in dentin bonding.

Value of Acoustic Radiation Force Impulse Imaging in the Diagnosis of Early Non-alcoholic Steatohepatitis / 中国医学科学院学报

Objective To evaluate the value of acoustic radiation force impulse(ARFI)imaging in the diagnosis of early non-alcoholic steatohepatitis(NASH).Methods Totally 32 SD rats were randomly divided into high-fat diet group(n=24)and normal-diet group(n=8)by using the random number table. At the end of the 4,8,12,and 16week,six rats from the high-diet group and two rats from the normal-diet group were selected blindly for weighting,blood biochemical test,conventional ultrasound,and ARFI imaing. HE staining was used for pathological observation. Results None of the 32 rats developed liver fibrosis. Based on the pathological results,these rats were divided into M1 [mild-to-moderate simple fatty liver(SS)],M2(severe SS),M3(severe SS with early NASH),and C groups(normal control). Early NASH was seen only in the severe hepatic steatosis groups,and its distribution had a significant difference(P=0.006). The diagnostic accuracy of conventional ultrasound based on histological results was 34.4%(11/32). The ARFI value of M3 group was significantly lower than that of M2 group [(1.16±0.04)m/s vs.(1.22±0.05)m/s;t=2.301,P=0.04),and the low-density lipoprotein of M3 group was significantly higher than M2 group [(1.53±0.07)mmol/L vs.(1.21±0.22)mmol/L;t=3.075,P=0.01),while other clinical indicators had no statistical difference between these two groups. Conclusions The development of early NASH is associated with the severity of hepatic steatosis. ARFI value can provide important information to identify early NASH in patients with severe hepatic steatosis.

Role of Thyroid Ultrasound in the Diagnosis of Thyroid Nodules with Atypia of Undetermined Significance / 中国医学科学院学报

Objective To evaluate the role of ultrasound for thyroid nodules with atypia of undetermined significance(AUS).Methods From January 2014 to December 2015,83 thyroid nodules with AUS diagnosed by ultrasound-guided fine-needle aspiration biopsy were collected from 1984 subjects. On the basis of ultrasonic features,each thyroid nodule was prospectively classified into one of three categories: low suspicion for malignancy,intermediate suspicion for malignancy,and high suspicion for malignancy. Results Among 83 lesions,19 lesions(22.9%) were confirmed malignant,8 lesions (9.6%)were benign,56 lesions (67.5%)had no abnormal changes during clinical follow-up. The nodules were solitary in 36 cases (43.4%)and multiple in 47 cases(56.6%).The maximum diameter was (1.2±0.7)cm. Based on the ultrasonic feature of 19 malignant cases,16 cases (84.2%) were classified as high suspicion for malignancy,2 cases(10.5%) as intermediate suspicion for malignancy,and 1 case(5.3%) for low suspicion for malignancy. Univariate and multivariate analyses revealed that the degree of malignancy of thyroid nodules was significantly associated with ultrasound image classification[OR=9.23(2.96-28.79),P=0.00],but not with age,gender,nodule number,and nodule size (all P>0.05).Conclusion Ultrasound diagnosis by using the present thyroid ultrasound classification system can be helpful for distinguishing malignant and benign AUS thyroid nodules.

Value of Quantitative Three-dimensional Doppler Ultrasound in the Differentiation of Benign and Malignant Thyroid Nodules / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the role of quantitative three-dimensional (3D) power Doppler ultrasound in differentiating malignant and benign thyroid nodule.</p><p><b>METHODS</b>A total of 92 lesions in 86 patients were preoperatively examined using 3D power Doppler ultrasound. The Virtual Organ Computer-aided Analysis(VOCAL)-imaging program was used to analyze the stored volume ultrasound. The differences in the mean gray value (MG), vascularization index (VI), flow index(FI), and vascularization flow index (VFI) were compared between benign and malignant lesions.</p><p><b>RESULTS</b>The MG of the malignant thyroid nodules was significantly lower than that of the benign ones (28.27±7.21 vs. 32.89±8.73,P=0.007). The benign nodules had significantly higher VI,FI,and VFI than the malignant nodules [VI:(40.43±26.55)% vs. (26.87±23.06)%,P=0.011;FI:41.03±7.19 vs. 37.51±7.17,P=0.022;VFI:18.23±14.60 vs. 11.47±12.47, P=0.009]. Also,76.5% (39/51) of the malignant nodules and 92.7% (38/41) of the benign nodules had higher VIs in the shell of the lesion than that of the whole lesion,and 80.4%(41/51) of the malignant nodules and 95.1% (39/41) of the benign nodules had higher FIs in the shell of the lesion than that of the whole lesion.</p><p><b>CONCLUSIONS</b>Quantitative 3D power Doppler ultrasound provides a useful tool in distinguishing benign and malignant thyroid nodules. The malignant thyroid nodules have lower echoes than the benign nodules, wherese the benign nodules have larger blood flow than the malignant nodules.</p>

Bioequivalence of highly variable drug clopidogrel bisulfate and food effects on its pharmacokinetics / 中国药学杂志

OBJECTIVE: To investigate the bioequivalence of clopidogrel bisulfate under fasting and fed conditions and the effect of food on the pharmacokinetics of clopidogrel in chinese volunteers.

Ultrasonographic features of thyroid nodules accompanied by Hashimoto thyroiditis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To compare the ultrasound imaging characteristics of benign and malignant thyroid nodules on the background of Hashimoto's thyroiditis (HT).</p><p><b>METHODS</b>Totally 120 consecutive patients with pathologically confirmed benign (n=60) or malignant (n=60) thyroid nodules in Peking Union Medical College Hospital since January 2013 were retrospectively analyzed, and their preoperative ultrasound images were reviewed.</p><p><b>RESULTS</b>Sixty cases (100%) of the malignant nodules were papillary thyroid cancers. In the benign group, 33 cases (55.0%) had nodular changes of HT, 26 (43.3%) had nodular goiter, and one (16.7%) had adenoma. Compared with the benign ones,the malignant nodules were more likely to be solid (91.7% vs. 68.3%, P=0.001), hypoechoic (96.7% vs. 48.3%, P=0.000), ill defined (95.0% vs. 41.7%, P=0.000), irregular (96.7% vs. 43.4%, P=0.000), and more easily to have such characteristics as micro-calcification (71.7% vs. 30.0%, P=0.000), absence of regular halo (96.7% vs. 65.0%, P=0.000), taller-than-wide sign (46.7% vs. 13.3%, P=0.000), and locally increased or irregular blood flow (61.7% vs. 26.7%, P=0.000).</p><p><b>CONCLUSIONS</b>Ultrasound has an ideal overall sensitivity in differentiating nodules on the background of HT. Solid structure, hypo-echogenicity, ill-defined margin, irregular shape, and absence of regular halo are good screening ultrasound markers. Except for the A/T≥1, the other variables have less satisfactory diagnostic specificity.</p>

Pharmacokinetics of deflazacort tablets in healthy Chinese volunteers / 药学学报

Deflazacort (DFZ, a prodrug) is well absorbed and rapidly metabolized into the active metabolite 21-hydroxydeflazacort (21-OH DFZ) after oral administration. The aim of this study is to evaluate the pharmacokinetic properties of 21-OH DFZ in healthy Chinese volunteers after a single and multiple oral administration of DFZ tablets under fed condition. Twelve volunteers (six males and six females) were administered a single dose of 6 mg or 12 mg or 24 mg of DFZ in three different periods separately, according to the 3 x 3 Latin square design. Between each administration period there was a washout period of one week. The multiple-dose study of 12 mg dose DFZ per day for 7 consecutive days was started after a 1 w washout period when the single-dose study completed. The pharmacokinetic parameters of 21-OH DFZ after the single oral administration of 6 mg, 12 mg and 24 mg DFZ tablets were as follows: (37.7 +/- 11.6), (61.5 +/- 17.7) and (123 +/- 23) ng x mL(-1) for C(max); (1.90 +/- 0.32), (1.96 +/- 0.27) and (2.13 +/- 0.34) h for t1/2; (96.6 +/- 25.9), (190 +/- 44) and (422 +/- 107) ng x h x mL(-1) for AUC(0-14 h), respectively. After the multiple dose administration, the mean plasma concentration at steady-state C(av) was (7.00 +/- 1.66) ng x mL(-1) and the degree of plasma concentration fluctuation DF was 7.7 +/- 1.2. The results showed that the pharmacokinetic characteristics of 21-OH DFZ in healthy Chinese volunteers were linear over the dose range of 6 to 24 mg. No significant gender differences were found in the pharmacokinetics of 21-OH DFZ in healthy Chinese volunteers. After the multiple dose administration of 12 mg DFZ for 7 d, no accumulation of 21-OH DFZ in healthy Chinese volunteers was observed.

Ultrasonographic and general pathologic features assessment of small intestinal lymphoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the ultrasonographic and morphologic features of intestinal lymphoma.</p><p><b>METHODS</b>The ultrasonographic and morphologic features of 19 patients with intestinal lymphoma were retrospectively analyzed. RESULTS All the patients were confirmed as non-Hodgkin's lymphoma by endoscopy or pathology. Of these 19 cases,the involved locations included ileum(n=14),duodenum(n=3),and ileocecum(n=2). The main sonographic types included mass type(n=12),bowel wall thickening type(n=1),and nonspecific signs(n=6). The mass type was characterized by solid and cystic-solid hypoechoic(including marked hypoechoic)foci,with well-defined margin,and rich blood signals were visible in large masses. The bowel wall thickening type was characterized by the thicking of bowel walls,showing hypoechoic(including marked hypoechoic),along with posterior acoustic enhancement. The nonspecific signs included e.g. dilatation of intestine and mesenteric lymph node enlargement. Morphologically,the tumor was featured by intestinal mass in intestinal mucosa or the circumferential thickening of intestinal wall.</p><p><b>CONCLUSION</b>Small intestinal lymphoma has typical ultrasonographic features,and ultrasonography can provide useful information in the diagnosis of small intestinal lymphoma.</p>

An individualized approach combining local flaps with radiotherapy for the treatment of auricle keloid / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate an individualized approach to the treatment of auricle keloid to maintain the normal appearance of external ear and meanwhile reduce the recurrence.</p><p><b>METHODS</b>Different local flaps were performed according to the location of the keloid in our approach. The auricle was divided into different anatomical regions and all the patients received local postoperative radiotherapy.</p><p><b>RESULTS</b>Of 68 patients with auricle keloid received the individualized approach, 3 cases suffered delayed healing due to partial flap necrosis. The remaining patients were followed up for 8-21 months(mean:11.5 months) . Recurrence occurred in one patient(1.47%) .</p><p><b>CONCLUSION</b>The individualized approach combining local flaps with radiotherapy in treating auricle keloid can effectively maintain the normal ear appearance with low recurrence rate.</p>

Diagnosis of thyroid nodules with ultrasound-guided fine needle aspiration: comparison of solid lesion and complex lesion / 中华超声影像学杂志

Objective To compare the efficacy of ultrasound-guided fine-needle aspiration(US-FNA)biopsy in diagnosing solid and complex thyroid nodules with different size. Methods One hundred and seventy-five thyroid FNA biopsies were prospectively performed on 168 patients ranging from 4 to 75 years of age. Sixty-three nodules were surgically excised and the others were clinically followed-up. The cytology diagnoses were categorized into four groups: benign, malignant, suspicious and unsatisfactory. Results There was no significant complication in the all 115 solid and 60 complex thyroid lesions and there were 36and 3 malignant nodules respectively in solid and complex thyroid nodules. The nondiagnostic rates of solid and complex nodules were 7％ and 8％. The accuracy of US-FNA in diagnosing complex thyroid nodules was comparatively equal to that of in solid thyroid nodules. In solid thyroid nodules, the sensitivity and accuracy in ≤1 cm group were similar to that of in ＞1 cm group. Conclusions US-FNA was an accurate and reliable method to diagnose thyroid solid and complex lesions.

Ultrasound-guided fine needle aspiration in the diagnosis of thyroid nodule / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of ultrasound-guided fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodules.</p><p><b>METHODS</b>US-FNA was performed for 175 thyroid nodes in 168 patients aged 4 to 75 years in Peking Union Medical College Hospital from November 2004 to December 2008. The diagnostic data obtained from US-FNA were compared with those confirmed by surgical pathology and clinical follow-up. The US-FNA results were classified as benign, malignant, suspicious, or unsatisfactory.</p><p><b>RESULTS</b>Among these 175 thyroid nodules, surgical pathology and clinical follow-up confirmed that there were 39 malignant nodules and 136 benign nodules, while US-FNA showed that 124 aspirates (70.9%) were benign, 24 (13.7%) were malignant, 14 (8.0%) were suspicious, and 13 (7.4%) were unsatisfactory for interpretation. For US-FNA, the sensitivity was 81.1%, specificity was 93.6%, accuracy was 90.7%positive predictive value was 78.9%and negative predictive value was 94.4%. Post-puncture bleeding was observed in 3 nodules (1.7%).</p><p><b>CONCLUSION</b>US-FNA is accurate and reliable in diagnosing thyroid nodules.</p>

Ultrasonographic features of medullary thyroid carcinoma and their diagnostic values / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Medullary thyroid carcinoma (MTC) is a rare malignant tumour and usually difficult to diagnose with ultrasound. The aim of the study is to summarize the sonographic features of MTC and evaluate their diagnostic values.</p><p><b>METHODS</b>We analyzed the sonographic features of 35 MTCs and 50 benign nodules with respect to nodular size, echogenecity, internal content, shape, height/width, border, peripheral halo, calcifications and colour flow pattern. The ratio of long to short axis, echogenecity, internal content and calcifications were also assessed in cervical lymph nodes. The differences in sonographic features between MTCs and benign nodules were analyzed with Chi square test. The diagnostic efficiency of each sonographic feature was determined.</p><p><b>RESULTS</b>The main sonographic features of MTC were hypoechogenicity (including marked hypoechogenicity) (n = 34, 97%), internal solid content (n = 29, 83%), taller than wide (n = 34, 97%), well defined border (n = 24, 69%), microcalcifications or macrocalcifications (n = 23, 66%). The echogenicity, internal content, shape, peripheral halo and calcifications were significantly different between these two groups, while the tall/wide, border, and perinodular and intranodular vascularisation were not significantly different. Among all the individual sonographic features, irregular shape had the highest diagnostic efficiency with a sensitivity of 51% and specificity of 92%. The combination of marked hypoechogenicity, microcalcifications, and irregular shape yielded a sensitivity of 77% and specificity of 86%.</p><p><b>CONCLUSIONS</b>The typical sonographic features of MTC are hypoechogenicity, predominantly solid, irregularly shaped with intranodular micro- or macro-calcifications. The combination of multiple sonographic features is helpful, but not definitive, for the diagnosis of MTC.</p>

The relationship between CD4(-) CD8(-) T cells in the peripheral blood of patients with pancreatic carcinoma and IL-4, IFN-gamma levels / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between CD4- CD8- T cells ratio and IL-4, IFN-gamma levels in the peripheral blood of patients with pancreatic carcinoma.</p><p><b>METHODS</b>Flow cytometer was used to analyze the CD4- CD8- T cells ratio in the peripheral blood of patients with pancreatic carcinoma and the IL-4, IFN-gamma levels were detected by ELISA.</p><p><b>RESULTS</b>The ratio of CD4- CD8- T cell in CD3+ T cell from 25 pancreatic carcinoma patients was (4.2 +/- 1.7)%, the ratio of CD4- CD8- T cell in CD3+ T cell from 45 healthy person was (6.3 +/- 2.6)%, there was significant deviation between the two groups (P < 0.01). The IL-4 level of 25 pancreatic carcinoma patients was (86.3 +/- 23.3) fg/L, the IL-4 level of 45 healthy person was (56.2 +/- 9.2) fg/L,there was significant deviation between the two groups (P < 0.01). The IFN-gamma level of 25 pancreatic carcinoma patients was (16.4 +/- 4.8) fg/L before operation, the IFN-gamma level of 45 healthy person was (27.4 +/- 3.8) fg/L, there was significant deviation between the two groups (P < 0.01). The ratio of CD4- CD8- T cell in pancreatic carcinoma patient after operation was higher than before operation. It could be found negative correlation between CD4- CD8- T cells ratio and IL-4 level in pancreatic carcinoma patient,it could also be found positive correlation between CD4- CD8- T cells ratio and IFN-gamma level in pancreatic carcinoma patient. In pancreatic carcinoma patient, the CD4- CD8- T cells ratio and IL-4 level was significant associated with clinical stage (P < 0.05), but no relationship with histological differentiation (P > 0.05), it could be found no relationship between IFN-gamma level and clinical stage, histological differentiation (P > 0.05).</p><p><b>CONCLUSION</b>The CD4- CD8- T cells ratio in the peripheral blood of patients is decreased,it may be participate in the carcinogenesis and development of pancreatic carcinoma by influence the IFN-gamma levels.</p>

The clinical significance of heparanase expression in human pancreatic carcinoma tissue / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between heparanase 1 (Hpa1) expression and the development of human pancreatic cancer.</p><p><b>METHODS</b>Real-time PCR and Western blot methods were used the expression of Hpa1 in 37 cases of pancreatic cancer were analyzed quantitatively. The relationship between the expression of Hpa1 and the clinicopathological features of pancreatic cancer was analyzed.</p><p><b>RESULTS</b>The expression of Hpa1 mRNA in pancreatic cancer was 23.53 +/- 4.13, in pancreatic tissues was 4.08 +/- 2.14 and in pancreatic cancer adjacent tissue was 16.93 +/- 3.06 by real-time PCR detected (P < 0.01). The expression of Hpa1 protein in normal tissue was 0.36 +/- 0.14, in pancreatic cancer adjacent tissue was 1.21 +/- 0.37 and in pancreatic cancer tissue was 1.76 +/- 0.28 by Western blot detected (P < 0.05). The expression of Hpa1 mRNA and Hpa1 protein in pancreatic cancer tissue were both higher than pancreatic cancer adjacent tissue and normal tissue. The expression of Hpa1 was significant associated with TNM grade and Invasion to nerves or vascellum lymph node metastasis separately (P < 0.05). But no relationship between histological differentiation and the tumor size (P > 0.05).</p><p><b>CONCLUSIONS</b>The Hpa1 overexpressed in pancreatic cancer tissues and its abnormal expression may be involved in the oncogenesis and development of pancreatic cancer.</p>