Value of modified TI-RADS in the diagnosis of medullary thyroid carcinoma / 中华肿瘤杂志

Objective@#To investigate the value of modified thyroid imaging reporting and data system (TI-RADS) in the sonographic diagnosis of medullary thyroid carcinoma (MTC), and to evaluate the sonographic differences among MTC, papillary thyroid carcinoma (PTC) and benign nodules in order to improve the ultrasound diagnostic accuracy of MTC.@*Methods@#646 cases of thyroid lesions confirmed by pathology in our hospital were divided into the MTC group (64 cases), PTC group (414 cases) and benign group (168 cases). The ultrasonographic characteristics of these groups were retrospectively analyzed. All of the 646 cases were classified by modified TI-RADS grading criteria. The diagnostic accuracy of MTC and ultrasonic manifestations of MTC, PTC and benign nodular were assessed.@*Results@#The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of modified TI-RADS for MTC were 87.5%, 89.9%, 72.6%, 88.8%, and 67.2%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of modified TI-RADS for PTC were 96.1%, 59.5%, 85.4%, 86.2% and 85.6%. The intraclass correlation coefficient (ICC) of three different physicians for thyroid nodules was 0.983 by the modified TI-RADS. MTC were mostly located in middle and upper parts of the thyroid (85.9%, 55/64), hypoechoic or extremely hypoechoic (89.1%, 57/64), with relatively smooth margin (35.9%, 23/64), aspect ratio<1 (53.1%, 34/64), abundant blood flow (31.2%, 20/64), and high lymph node metastasis rate (51.6%, 33/64). These differences were statistically significant when compared to PTC (P<0.05).@*Conclusions@#Repeatability of modified TI-RADS for MTC was high, and is slightly lower than that for PTC. MTC had specific features: mostly located in middle and upper parts of the thyroid, hypoechoic or extremely hypoechoic, relatively smooth margin, aspect ratio<1, abundant blood flow and high lymph node metastasis rate.

Practice of contestants selection and training methods under the new rules of National Oral Medical Skills Competition / 中华医学教育探索杂志

Participating in the National Oral Medical Skills Competition can push forward the teaching reform and curriculum construction,and promote the standardized development of teaching.According to the changes of competition level,rules and content of the National Oral Medical Skills Competition,the selection and training methods have been reformed.By designing the training programs,quantifying the scoring standards,strengthening the oral physician guidance and strengthening the psychological counseling and other trainings,satisfactory results have been achieved.

Application of one-part form mini-implant in immediately and delayed repair of edentulous space / 局解手术学杂志

Objective To analyze the effect of one-part form mini-implant in treatment of immediately and delayed repair of edentulous space. Methods Retrospectively analyzed 80 cases of edentulous space patients in our hospital from Jan. 2009 to Jan. 2011, and divided them into the immediately repair group ( observation group) and the delayed repair group ( control group) according to time of edentulous space repair. Patients of the two groups were given permanent PFM 3 months later, and regular clinical and X-ray examinations were made to evaluated clinical efficacy and complications of the two groups. Results The score of ISQ of the observation group was higher than that in the control group with significant difference (P <0. 05); and the postoperative complications of the observation group was significantly decreased compared to the control group with a significant difference (P <0. 05). Conclusion Mini-implant used in immediately repair in edentulous space can remove pain in a short time with less postoperative complications, it has more advantages than delayed repair of edentulous space.

Clinical research of percutaneous vertebroplasty or percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures induced by glucocorticosteroid / 北京大学学报(医学版)

Objective:To investigate the clinical characteristics of vertebral compression fracture ( VCF) in glucocorticosteroid-induced osteoporosis ( GIOP) and risk of vertebral refracture after percuta-neous vertebroplasty ( PVP) or percutaneous kyphoplasty ( PKP) .Methods:In the study, 570 cases who received PVP or PKP as treatments of VCF from January 2010 to December 2013 were retrospective re-viewed, of which 42 were GIOP and 21 were followed up as GIOP group, and the other 528 were primary osteoporosis and 391 were followed up, of which 84 were selected as Control group based on age and gen-der.The fracture location, ratio of single segment fracture and multiple segments fracture in the two groups were compared.In the final follow up, the reoperation rates for vertebral refractures by the Kap-lan-Meier method in the two groups were compared.Results:The follow up periods were (24.0 ±13.1) months in GIOP group and (25.8 ±14.4) months in control group(P>0.05).In GIOP group, there were 11 cases with one-segment fracture, 2 with two-segments fracture, 3 with three-segments fracture, 2 with four-segments fracture, 2 with five-segments fracture and 1 with eight-segments fracture.In Control group, there were 67 cases with one-segment fracture, 12 with two-segments fracture, 3 with three-seg-ment fracture, and 2 with four-segments fracture.The ratio of single segment fracture in GIOP group was significantly lower than that in Control group(52.4% vs.79.8%,P=0.01).There were 50 fracture segments in GIOP group and 109 fracture segments in Control group.The ratios of fracture segments loca-ted in thoracic segments(T1-T10), thoracolumbar segments(T11-L1)and lumbar segments(L2-L5) were 18%, 46%and 36% in GIOP group and 11.9%, 58.7% and 29.4% in Control group ( P >0.05).The refracture rate in GIOP group was higher than that in control group (23.8%vs.6.0%).The survival rate was lower in GIOP group than that in control group ( Pthoracic segments>lumbar segments).The risk of multiple segments VCF was higher in GIOP than in primary osteoporosis. The risk of vertebral refractures after PVP or PKP was higher in GIOP than in primary osteoporosis.

Electrophysiologic study of f-wave amplitude in chronic atrial fibrillation associated with rheumatic heart disease / 第二军医大学学报

To investigate the electrophysiologic characteristics of f-wave amplitude and to evaluate its role in development and persistence of chronic atrial fibrillation (AF) associated with rheumatic heart disease (RHD). Methods: Epicardial mapping was performed in 44 patients with chronic AF of RHD who underwent heart valve surgery. Ten patients with supraventricular tachycardia served as the control group. Results:The f-wave amplitude of left atrium (LA) and middle and low LA posterior regions were significantly lower than those of the control group. The f-wave amplitudes of the upper, middle and low sections in LA posterior region were significantly lower than those in right atrium (RA) (P<0.05). The f-wave amplitudes were compared before and after electrocardioversion in 14 patients with chronic AF. The mean atrial electrogram amplitude during sinus rhythm was significantly higher than that during AF (P<0.01).The f-wave amplitude in left appendage was higher than that in LA posterior region (the upper,middle and the lower part),P<0.05.The f-wave amplitude in the upper section of LA was significantly higher than that in the middle section. The f-wave amplitude in AF group was not correlated to the diameter or volume of both atria. Conclusion: There are amplitudes differences between the upper, middle and lower LA,suggesting that the middle and lower sections of LA posterior wall may be the region producing anisotropy and reentrant circle.

Observation of cardiac function in rats with myocardial infarct after autologous smooth muscle cell transplantation / 中国组织工程研究

BACKGROUND: Cell transplantation is a new technique to treat myocardial ischemic diseases in recent years. There are not many reports regarding smooth muscle cell(SMC) transplantation at moment.OBJECTIVE: To investigate the impact of autologous SMC transplantation on the survival and the restoration of cardiac function after myocardial infarct.DESIGN: An observatory comparative study based on experimental animals.SETTING: Institute of cardiothoracic surgery in a military medical university of Chinese PLA.MATERIALS: The study was conducted in the Institute of Cardiothoracic Surgery of the Second Military Medical University of Chinese PLA from January 2003 to June 2003. Totally 24 male adult SD rats in cleanness grade with a body mass of(300 ± 20) g were randomly divided into two groups,i. e. ,transplant group and control group with 12 rats each. All rats were fed in clean environment.METHODS: Autologous SMC was separated and extracted from the ductus deferens of SD rats by enzymic digestion for culture and amplification in vitro. BrdU-labeled autologous SMC was directly injected into the scarring tissues of cardiac infarct area induced by the ligation of anterior descending branch of left coronary artery 2 weeks ago in rats of transplant group. DMEM culture medium of same volume was injected into the rats of control group. Cardiac function was evaluated by ultrasound examination before and 4 weeks after transplantation. The survival of the transplanted SMC and its effect of vasoformation in myocardial scarring tissues were detected by immunohistochemical staining.soformation in myocardial scarring area after autologous SMC transplantation;after transplantation.RESULTS: Transplanted autologous SMC survived and formed muscle-like tissues in myocardial infarct area. Compared with control group, left ventricnlar end diastolic volume(LVEDV) of transplant group was significantly reduced( P < 0.01), left ventricular ejection fraction(LVEF) was significantly elevated( P < 0.01 ), and the vasoformation in myocardial scarring tissue was significant( P < 0.01 ).CONCLUSION: Autologous SMC transplantation can prevent ventricle enlargement after myocardial infarct, promote vasoformation in infarct area, and ameliorate cardiac function.

The effect on cardiac function of autologous smooth muscle cells transplant into ischemic myocardium of rat and observation of its long-lerm survival / 中华老年医学杂志

Objective The long-term effects of cell transplant on cardiac function are unknown. Therefore, we tested the survival and functional impact of rat autologous smooth muscle cells up to 12 weeks after transplant into infracted hearts. Methods Autologous smooth muscle cells were acquired from the ductus deferens of adult Sprague-Dawley rats(weight,300g), and cultured for 4 weeks before transplant. 4 weeks after left coronary artery ligation, the cultured cells(4?10 6 , n=10), marked with 5-bromo-2'-deoxyuridine(BrdU), or culture medium alone(n=10) were injected directly into infarcts of the heart. Cardiac function was assessed by echocardiography before and 12 weeks after transplantation. BrdU in the cells and smooth muscle cells were identified by immunohistochemical staining technique using monoclonal antibodies against BrdU and ?-smooth muscle actin. Results Grafted autologous smooth muscle cells were presented in infarcts and formed musclelike tissue. They thickened the wall of the left ventricle〔(2.36?0.31) vs (1.03?0.11)mm,P

Efficient generation of human angiopoietin-1 recombinant adenovirus by COS/TPC homologous recombination / 中国病理生理杂志

AIM: To generate the angiopoietin-1 recombinant adenovirus for the further studies about adenoviral mediated angiopoietin-1 gene transfer in ischemic myocardium and its effect on the development of neoangiogenesis.METHODS: Angiopoietin-1-PAxCAwt cosmid DNA and adenoviral DNA-TPC were cotransfected to 293 cells by the use of calcium phosphate precipitation method. All recombinant adenoviruses were propagated and titrated in 293 cells, purified by cesium chloride density purification, dialyzed, and stored at-70 ℃. RESULTS: The result shows that the direction of the insert in the cosmid is correct and the replication-deficient angiopoietin-1 recombinant adenovirus was generated efficiently by COS/TPC homologous recombination, with the titers of 5.6?10 11 pfu/L. The viral stocks were demonstrated to be free of replication-competent wild type adenoviruses. The virus stocks in high titer were harvested in our experiment. CONCLUSION: The COS/TPC is an efficient method to prepare recombinant adenovirus and the angiopoietin-1 recombinant adenovirus could be further used in gene therapy.

Effects of transplanting autologous smooth muscle cells on cardiac function after cardiac infarction / 第二军医大学学报

Objective:To investigate the effects of transplanting autologous smooth muscle cells on cardiac function after cardiac infarction. Methods:Autologous smooth muscle cells were isolated from the ductus deferens of SD rats, and cultured for 4 weeks before transplantation. Two weeks after the left coronary artery ligation, the cultured cells(4?10 6), labeled with 5 bromo 2' deoxyuridine(BrdU), were transplanted into the scar tissue in the left ventricular free wall by direct injection(transplant group, n =12). Control group were treated with culture medium alone(control group, n =12). Heart function was assessed by echocardiography 2 weeks after the left coronary artery ligation and 4 weeks after cell transplantation. Then the hearts were immunohistochemically processed using monoclonal antibodies against ? smooth muscle actin and BrdU for the identification of transplanted smooth muscle cells. Vascular endothelial cells were stained for factor Ⅷ using monoclonal antibodies. The blood vessels were counted on the tissue sections under light microscope. Results:The injected autologous smooth muscle cells survived in the infarcted scar tissue and formed muscle like tissue at the site of transplantation 4 weeks later. Left ventricular end diastonic volume(LVEDV) decreased [(0.78?0.16) vs (0.92?0.15) ml, P

An assessment of hydrodynamics of the C-L pugestrut valve prosthesis in vitro / 第二军医大学学报

Objective: To assess the hydrodynamic performance of C L pugestrut valve prosthesis in vitro . Methods: The leakage, steady flow and pulsatile flow of the valve prosthesis was tested in vitro with the C L standard valve and Medtronic Hall valve prosthesis as control. Results: The rate of leakage of the C L pugestrut valve was (298?66) ml/min, accorded with the demand of clinical use. The steady flow pressure drop across the C L pugestrut valve was significantly lower than the C L standard valve( P

Change of plasma cyclic nucleotide in patients of rheumatic heart disease with pulmonary hypertension / 第二军医大学学报

Objective:To study the change of plasma cyclic nucleotide in patients of rheumatic heart disease with pulmonary hypertension and to evaluate the relationship between plasma cyclic nucleotides and hemodynamics. Methods:Plasma cGMP and cAMP were examined by radioimmunoassay, hemodynamic data were obtained with Swan Ganz catheter and the HP compact configurable monitors. Results:Plasma cyclic nucleotide increased in patients of rheumatic heart disease with pulmonary hypertension and had an obvious correlation with the level of PAPM, PVR, PAWP and CI. Conclusion:Increased cAMP and cGMP is one of the pathophysiological characters of pulmonary hypertension, cAMP and cGMP, as the second messenger, may play an important regulating role in the development of pulmonary hypertension.

Clinical significance of liver pathological changes in patients with rheumatic heart valve disease / 第二军医大学学报

Objective: To study the clinical significance of liver pathological changes in patients with rheumatic heart valve disease (rheumatic heart disease, RHD). Methods: Forty one patients with RHD and tricuspid valve incompetence in 30 patients underwent heart valve replacement. Light microscopy and H 800 transmission electron microscopy were used to observe liver tissue harvested by biopsy performed before institution of cardiopulmonary bypass. Results: Typical pathological changes of liver as the following: (1) Changes of liver intercellular substance including sinusoid widening, blood stasis, liver fibroplasia. (2)Hepatocyte changes: hepatocyte swollen, mitochondria swollen, crest disappearence, hepatocyte degeneration and necrosis. There was correlation between liver pathological changes and magnitude of tricuspid valve regurgitation. Conclusion: To improve liver pathological changes, it is important to operate on patients with rheumatic heart diseases and tricuspid valve incompetence as early as possible and to eliminate tricuspid valve regurgitation.

Change of sodium-hydrogen exchanger m RNA expression in lung of patients with pulmonary hypertension and its clinical significance / 第二军医大学学报

Objective:To examine the sodium-hydrogen exchanger(NHE-1) m RNA expression in lung of patients with congenital heart disease,and to explain the cause of pulmonary vascular remodeling.Methods:Twenty-two patients with congenital heart disease were divided into 2 groups:non-pulmonary-hypertension group(s PAP

Effects of controlled reperfusion of warm blood cardioplegia on reducing myocardial ischemia/reperfusion injury in cat heart / 第二军医大学学报

To test the hypothesis that the controlled reperfusion of warm blood cardioplegiacontaining mannitol would result in more effectively improved recovery of myocardial function by prevent-ing or reducing a potentially harmful component of reperfusion. Methods: Thirty-two cats were divided in-to four groups. Group Ⅰwas not subjected to ischemia or reperfusion injury. Group Ⅱ was subjected to60 min hypothermic ischemia. Group Ⅲwas subjected to 60 min hypothermic ischemia and 60 min reperfu-sion. Group Ⅳ was controlled reperfusion with warm blood cardioplegia containing mannitol. Results:Myocardial functlon was significantly depressed after 60 min reperfusion- Increased myocardial water con-tent and low ATP c0ntent were observed also. Controlled reperfusion with warm bl0od cardioplegia con-taining mannitol was helpful to improve the recovery of myocardial function and ATP content, and to re-duce the myocardial water content. Conclusion: These results indicate that controlled reperfusion after is-chemia provides benefit in avoiding myocardium from reperfusion injury.

Alterations of Myocardial Mitochondrial Function Subjected to Ischemia/Reperfusion Injury in Cats / 第二军医大学学报

The effect of myocardium subjected to 60 min ischemia and 60 min reperfusion on the level of lipid peroxides (LPO) and function of myocardial mitochondria and activity of superoxide dismutase (SOD) was studied in cat cardiopulmonary bypass. Myocardial mitochondrial function was slightly depressed after 60 min ischemia but significantly depressed after 60 min reperfusion. Increased lipid peroxides content and decreased SOD activity were observed at 60 min ischemia. After reperfusion, the SOD activity continued decreasing, but LPO elevated apparently. These results support a hypothesis that the free radicals may contribute to the myocardial mitochondrial reperfusion injury.

Protective Effect of Controlled Reperfusion with Warm Blood Cardioplegic Containing Mannitol on Mitochondrial Function after Myocardial Ischemia / 第二军医大学学报

This study tested the hypothesis that controlled reperfusion with warm blood cardioplegia containing mannitol would result in more effectively improved recovery of myocardial mitochondrial function by preventing or reducing a potentially harmful component of reperfusion. Myocardial mitochondrial function was significantly depressed after 60 min reperfusion, but slightly depressed in the controlled reperfusion group. Significantly increased MDA content and decreased SOD activity were observed after 60 min reperfusion. Hearts in the controlled reperfusion group had low MDA content and might protect the activity of SOD. The- results indicate that controlled reperfusion after ischemia provides benefit in avoiding myocardial mitochondrial reperfusion injury.