ObjectiveTo discuss the correlation of BRAFV600E mutation with clinicopathologic characteristics or thyroglobulin (Tg) in papillary thyroid carcinoma (PTC) and its clinical significance. MethodsThe BRAFV600E mutations of 55 patients with PTC were detected by nested PCR. The relations between BRAFV600E mutation and the clinicopathologic characteristics were analyzed. Results①The BRAFV600E mutations happened in 29 patients with PTC, the mutation rate was 52.7% (29/55).②The BRAFV600E mutation rate was related with extracapsular spread, multiple lesions, regional lymph node metastasis or average Tg value > 1.0μg/L during 2 years after standardized treatment (P value was 0.01, 0.02, 0.02, 0.03, respectively), but which not related with the gender, age, tumor diameter, or TNM stage (P > 0.05). ConclusionThe BRAFV600E mutation in PTC might lead to increased tumor aggressiveness and it might be related with increased Tg value after standardized treatment.
An automatic control system was designed to suppress pathological tremor on wrist joint with two degrees of freedom (DoF) using functional electrical stimulation (FES). The tremor occurring in the wrist flexion-extension and adduction-abduction was expected to be suppressed. A musculoskeletal model of wrist joint was developed to serve as the control plant, which covered four main muscles (extensor carpi radialis longus, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris). A second-order mechanical impedance model was used to describe the wrist skeletal dynamics. The core work was to design the controller and a hybrid control strategy was proposed, which combined inverse model based on feed forward control and linear quadratic regulator (LQR) optimal control. Performance of the system was tested under different input conditions (step signal, sinusoidal signal, and real data of a patient). The results indicated that the proposed hybrid controller could attenuate over 94% of the tremor amplitude on multi-DoF wrist joint.
ObjectiveTo discuss the CT imaging differences between mass-forming intrahepatic cholangiocarcinoma (ICC) and poorly-differentiated hepatocellular carcinoma (HCC). MethodThe clinical and CT data of 28 patients with mass-forming ICC (mass-forming ICC group) and 27 patients with poorly-differentiated HCC (poorly-differentiated HCC group), who were confirmed by pathological diagnosis in the West China Hospital from February 2014 to August 2014, were collected and analyzed retrospectively. ResultsThe contour, margin, enhancement patterns in the arterial phase and portal vein phase of the tumor had significant differences between the mass-forming ICC group and poorlydifferentiated HCC group (P < 0.05), in other words, the lobulated shape (15/28, 53.6%), indistinct margin (17/28, 60.7%), peripheral enhancement in the arterial phase (21/28, 75.0%) and prolonged enhancement in the portal vein phase (14/28, 50.0%) were more often seen in the mass-forming ICC group, while the poorly-differentiated HCC group were mainly the round shape (17/27, 63.0%), partially well-defined margin (18/27, 66.7%), diffuse heterogeneous enhancement in arterial phase (20/27, 74.1%) and wash out in the portal vein phase (18/27, 66.7%). The presence of bile duct dilatation in the the mass-forming ICC group was significantly higher than that in the poorly-differentiated HCC group﹝57.1% (16/28) versus 14.8% (4/27), P=0.001﹞. The size and enhancement degree of lymph node in the mass-forming ICC group were significantly bigger or higher than those in the poorly-differentiated HCC group (average lymph node size: 1.7 cm versus 1.3 cm, P=0.009; average enhancement degree of lymph node: 62.6 HU versus 51.8 HU, P=0.031). ConclusionCT features, such as tumor contour, margin, enhancement characteristics, the presence of bile duct dilatation, and the size and enhancement degree of lymph node, might help for differentiating mass-forming ICC from poorly-differentiated HCC, so that more timely selection of appropriate treatment strategies would be made.
ObjectiveTo classify and analyze medical audit chargeback of a hospital and to propose management strategies. MethodsWe classified the project audit chargeback of a grade-three class-A comprehensive hospital in Chengdu from June to December 2013, and analyzed the underlying causes of the chargeback. ResultsThe total chargeback of the hospital from June to December 2013 was more than 30 000 items and the general amount involved was about 3 million yuan. The project number of recurring charges, excessive charges, unreasonable charges, anchored fees, inconsistent charges with doctors' advices, non-indications, disproportionate fees and charges over restriction accounts occupied respectively 42.99%, 39.71%, 9.15%, 5.73%, 0.35%, 0.17%, 1.44% and 0.46%; and the amount of money involved for those projects occupied respectively 8.84%, 52.55%, 14.44%, 10.70%, 2.54%, 1.15%, 8.91% and 0.88%. ConclusionThe reasons for project audit chargeback are complicated. By strengthening information technology, management of price and building negotiation mechanism with Medical Insurance and Pricing Management Institutes, we can reduce the amount of chargeback, protect the right of patients and enhance the efficient use of the health insurance fund, so that the hospital, medical insurance and patients can all get benefits.
ObjectiveTo identify the clinical significance of epileptic eye movement for localization of posterior epileptic seizures. MethodsThere were 12 posterior epileptic patients, who were undertaken the detailed presurgical evaluation and ictal SEEG recording, and the epileptogenic zone of whom was confirmed restricted within posterior cortex through the boarder of epileptic cortical resection and the result of epileptic surgery, included in the research. ResultsThe cluster analysis of posterior cortical area of interest showed that parieto-occipital sulcus (POS) with the adjacent cortical areas belonged to the Medial Group; intraparietal sulcus (IPS) with the adjacent areas belonged to the Intermediate Group; and the Lateral Group included anterior occipital sulcus (AOS) and posterior temporal cortex. Eyes forced stare had the significant correlation with IPS, POS and related cortical group. Contraversive eye deviation had no significant correlation with cortical eye field with the related cortical areas. ConclusionsForced eye stare was significant eye movement in posterior epilepsy, and had significant correlation with IPS and POS. Ipsiversive eye deviation and convergence binocular movement were rare semiology in posterior epilepsy, and AOS had significant correlation with the two type of epileptic eyes movement.
We present the binding ability of a new peptide (-CMPQVMPMC-) with dental enamel after being evaluated in the present study. Under a standard procedure, the recovery of M13 filamentous phage was greatly enhanced by displaying the peptide in phage coat protein pⅢ. Then the cyclic peptide was synthesized using a solid method. The effect of the cyclic peptide in vitro biomineralization was tested in a single-diffusion microtiter plate gel system. Absorbance at 405 nm of each sample was recorded for 24 h at every 6 h intervals. The relatively increased values of each sample were expressed as percentages relative to the blank group (100%). The cyclic peptide resulted in a concentration-dependent delayed nucleation. In addition, the overall values of peptide groups at the end of 24 h were lower than those in the control group but much higher than those in the BSA control group.
ObjectiveTo systematically review the correlation between acute gastrointestinal infection and IBS. MethodsLiterature search was performed in The Cochrane Library (Issue 8, 2013), PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data to collect the prospective cohort studies about association between acute gastrointestinal infection and IBS, from inception to August 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality using NOS, and then Meta analysis was conducted using RevMan 5.2 software. ResultsA total of 11 cohort studies involving 6 274 patients were included. According to the different follow-up times for subgroup analysis, the results of meta-analysis showed that, compared with the healthy volunteers who did not expose the acute gastrointestinal infection, the patients with acute gastroenteritis had a increase risk of irritable bowel syndrome within 3 months, 6 months, 12 months, and 2-3 years (3 months: RR=6.46, 95%CI 1.85 to 22.58, P=0.003; 6 months: RR=4.68, 95%CI 2.07 to 10.60, P=0.000 2; 12 months: RR=4.95, 95%CI 2.90 to 8.45, P < 0.000 01; 2-3 years: RR=3.11, 95%CI 2.72 to 3.56, P < 0.000 01). However, after the fifth year of acute gastroenteritis, there was no statistical significance in the risk of irritable bowel syndrome between the two groups (RR=1.69, 95%CI 0.68 to 4.24, P=0.26). ConclusionAcute gastrointestinal infection within 3 years after onset was associated with the risk of IBS. Sex, diarrhea duration, bloody purulent stools and abdominal cramps at acute stage are important risk factors of intriguing the occurrence of post-infectious IBS. The acute gastrointestinal infection and IBS are not associated in the fifth year; however, more high-quality trials are needed for further verifying the aforementioned conclusion.
Objective To explore the advantage of reconstruction belt for treating complicated acetabular fracture by combined anterior and posterior approaches through the comparison with reconstruction plate. Methods A retrospective analysis was made on the clinical data of 39 patients with acetabular fractures who met the selection criteria. After open reduction by combined anterior and posterior approaches was performed, fracture was fixed by reconstruction belt in 20 cases (trial group), and by reconstruction plate in 19 cases (control group). There was no significant difference in gender, age, cause of injury, time from injury to hospital, type of fracture, and preoperative visual analogue scale (VAS) score between 2 groups (P > 0.05). The number of plate shaping, plate shaping time, operation time, bleeding amount, perspective times, VAS score, modified Merled’Aubigne-Postel hip score, and related complications were recorded and compared. According to Matta standard, the fracture displacement was measured to evaluate the fracture reduction and fracture healing. Results The number of plate shaping, plate shaping time, operation time, bleeding amount, and perspective times in the trial group were significantly less than those in the control group (P < 0.05). The patients were followed up 12-29 months (mean, 21.1 months) in the trial group, and 12-27 months (mean, 20.5?months) in the control group. The VAS score was significantly lower at 7 days and 6 months after operation than at pre-operation, and at 6 months than at 7 days in 2 groups (P < 0.05), but difference was not significant between 2?groups (P > 0.05). At 6?months after operation, the Merled’Aubigne-Postel score of hip function in the trial group was 15.950±1.504, showing no significant difference when compared with the control group (15.895±1.629) (t= -0.110, P=0.913). The fracture displacement was (0.750±1.070) mm in the trial group and was (0.842±1.068) mm in the control group, showing no significant difference (t= -0.269, P=0.789). The X-ray films showed that all fractures healed in 2?groups. The healing time was (16.10±2.07) weeks in the trial group and was (15.84±2.14) weeks in the control group, showing no significant difference (t =0.382, P=0.075). Conclusion Reconstruction belt for complicated acetabular fracture by combined anterior and posterior approaches has similar effectiveness to reconstruction plate, but the number of plate shaping, plate shaping time, and perspective times are fewer.
ObjectiveTo evaluate the effectiveness of hemiarthroplasty combined with greater trochanter reattachment device for intertrochanteric fractures in elderly patients. MethodsA retrospective analysis was made on the clinical data of 34 patients (35 hips) with intertrochanteric fractures underwent hemiarthroplasty combined with greater trochanter reattachment device between February 2010 and April 2013.Of 34 patients,16 were males (16 hips) and 18 were females (19 hips),and the mean age was 85.6 years (range,77-95 years).All fractures were caused by falling.The left hip was involved in 20 cases,the right hip in 13 cases,and the bilateral hips in 1 case.There were 33 cases (34 hips) of fresh fracture,and 1 case (1 hip) of old fracture.Fractures were rated as type Ⅲ in 6 cases (6 hips),type IV in 11 cases (11 hips),and type V in 17 cases (18 hips) according to Evans-Jensen standard.All of the patients had different degree of osteoporosis and internal diseases. ResultsAll patients underwent surgery successfully.The operation time was 70-90 minutes (mean,76.6 minutes);the intraoperative blood loss was 260-400 mL (mean,301.5 mL);the postoperative drainage was 80-530 mL (mean,290.6 mL);and the hospitalization time was 10-12 days (mean,11.7 days).Postoperative infection of incision occurred in 1 case,which was cured after dressing;primary healing of incision was obtained in the other patients.No lower extremity deep vein thrombosis or other complications was observed.Twenty-six cases (27 hips) were followed up 12-48 months (mean,21.3 months).X-ray examination showed fracture healing,and the healing time was 2.5-3.5 months (mean,2.8 months).There was no dislocation,prosthesis loosening,dislocation,loosening of titanium cable,periprosthetic osteolysis,or other complications during the follow-up period.According to Harris hip score,the results were excellent in 8 hips,good in 15 hips,fair in 4 hips,and the excellent and good rate was 85.2% at 1 year after operation. ConclusionThe hemiarthroplasty combined with greater trochanter reattachment device is a feasible and effective method to treat intertrochanteric fractures in the elderly patients.It can allow early ambulation and improve quality of life,but it is necessary to strictly control the indications,and perioperative management should be paid attention.
Objective To determine the efficacy of D980-nm laser in dissolving fat and renewing skin, and to explore the clinical application of D980-nm laser in reconstruction of photodamaged skin. Methods Eighteen 12-14 month-old male Sprague-Dawley rats, weighing 400-450 g, were randomly divided into 3 groups (n=6). The rat skin at the left side was exposed to D980-nm laser irradiation at a density of 20 J/cm2, a power of 8 W, a pulse width of 20 ms, and a pulse frequency of 40 Hz for 1 time (group A), 2 times of 5-minute interval (group B), and 3 times of 5-minute interval (group C) as a treatment course, for 4 treatment courses with an interval of 1 week; the other side of the skin was not treated as the control groups (groups A1, B1, and C1, respectively). After 8 weeks, the skin was harvested for HE staining and immunohistochemical staining to observe the structure changes of skin, to measure the dermal thickness, to count the number of fibroblasts, and detect the expressions of transforming growth factor β1 (TGF-β1) and basic fibroblast growth factor (bFGF). Results Compared with groups A1, B1, and C1, the skin structure was significantly improved in groups A, B, and C. After D980-nm laser irradiation, the number of fat cells decreased; local angiogenesis was observed; the total number of fibroblasts and fibers increased; the collagen fiber had large diameter, and arranged closely and regularly; the dermal thickness and the number of the fibroblasts increased; and the expressions of TGF-β1 and bFGF were significantly enhanced, showing significant differences (P<0.05). With increased D980-nm laser irradiation times, the above indexes increased, showing significant differences between group C and groups A, B (P<0.05). Conclusion D980-nm laser treatment has lipolytic and tender effect on the skin, and the frequency of the treatment is an important factor in skin renewal.