OBJECTIVE:To evaluate the economic efficacy of 6 therapeutic schemes for hepatic lesions induced by chemotherapeutic drugs. METHODS: A total of 269 malignant tumor patients complicating hepatic lesion because of using of chemotherapeutic drugs were randomly divided into 6 groups (A, B, C, D, E and F) to be treated with Reduced Glutathione Sodium for Injection, Diammonium Glycyrrhizinate Injection, Compound Glycyrrhizin Injection, Polyene Phosphatidylcholine Injection, Compound Diisopropylamine Dichloroacetate Injection, Compound Ammonium Glycyrrhetate Injection, respectively. The curative effects were recorded and the cost-effectiveness analysis was conducted. RESULTS: In A, B, C, D, E and F groups, the effective rates were 91.67%, 75.00%, 86.05%, 84.78%, 87.50% and 85.42%, respectively, the costs were 798.28 yuan, 311.08 yuan, 859.88 yuan, 918.68 yuan, 1 092.28 yuan and 1 319.08 yuan, respectively, and the cost-effectiveness ratios were: 870.82, 414.77, 999.28, 1 083.60, 1 248.32 and 1 544.23, respectively. The incremental cost-effectiveness ratios for A, C, D, E, F groups as against group B were 2 922.62, 4 966.52, 6 212.68, 6 249.60 and 9 673.70, respectively. CONCLUSION: Group A was proved to be the safe, effective and economical therapeutic scheme for hepatic lesions induced by chemotherapeutic drugs.

Objective To analyze the clinical and pathological characteristics of thyroid nodules.Methods A retrospective analysis of the clinical data of 2843 Han patients with thyroid nodules from January 2009 to June 2011 in Henan province was performed.Results The most high-risk of thyroid nodule resided in the group aged 45-54.The main pathological manifestation was simple nodular goiter.The rate of preoperative misdiagnosis was 2.4％.22.1％ of the patients with thyroid nodules showed abnormal thyroid function,which was mainly as subclinical thyroid dysfunction.The positive rate of thyroid peroxidase antibody (TPOAb) in patients with thyroid nodule was 19.8％ while that of thyroid globulin antibody (TgAb) was 20.0％.Among all 2843 subjects,the prevalence of differentiated thyroid carcinoma (DTC) was 28.8％,and the incidence of DTC was accompanied by raised TSH levels.The prevalence of DTC exceeded 40％ in patients aged between 25 to 34 as well as more than 74 years old.The prevalence of DTC was up to 33.8％ in TgAb positive patients.There was no difference in TPOAb levels between DTC patients and non DTC patients (P =0.406),but the TgAb level in patients with DTC was significantly higher than that of non DTC patients (P =0.033).Conclusion Thyroid nodule patients aged 25-34 or older than 74 formed high-risk groups of DTC.The serum TSH level and TgAb level were positively correlated with the risk of DTC.

The quality of traditional Chinese medicine (TCM) is the concentrated reflection of its pharmaceutical value. We should pay attention to the quality of Chinese medicine because it is the core problem for the development of traditional Chinese medicine. Thequality of traditional Chinese medicine is the important connotation of Chinese medicine professional high-level personnel training. Thequality of Chinese medicine has become a priority of degree and diploma education in different levels of traditional Chinese medicine class specialized courses. The quality of Chinese medicine is an important content of traditional Chinese medicine curriculum system and includes the knowledge of Chinese traditional medicine quality factor, quality requirements, quality characteristics, quality management and quality evaluation, etc. This paper mainly discusses thequality of Chinese traditional medicine curriculum structure, textbook compilation and talent cultivation.

Objective To evaluate the efficacy of Coopdech bronchial blocker combined with a strengthened single-lumen tube for airway management in patients undergoing upper mediastinal tumor resection. Methods Twenty-two ASA Ⅱ or Ⅲ patients, aged 24-66 yr, weighing 48-78 kg, scheduled for elective resection of upper mediastinal tumor, were randomly divided into 2 groups (n=11 each):double-lumen tube group(groupⅠ) and Coopdech bronchial blocker combined with a strengthened single-lumen tube group(group Ⅱ).One-lung ventilation was achieved with a double-lumen tube in groupⅠ. The Coopdech bronchial blocker combined with a strengthened single-lumen tube was used for airway management and the Coopdech bronchial blocker was used for lung isolation when one-lung ventilation was required in group Ⅱ. The fiberoptic bronchoscope was used to assist endotracheal tube positioning in both groups. The intubation time, positioning time, the number of patients required for tube displacement, the number of fiberoptic bronchoscopy, increase in airway peak pressure, degree of lung collapse, postoperative sore throat and hoarseness, and the number of patients needing ventilator-assisted ventilation were recorded. Results The intubation time was significantly shorter, the number of patients required for tube displacement was significantly smaller,and the rate of increase in airway peak pressure and incidences ofpostoperative sore throat and hoarseness were significantly lower in group Ⅱ than in group Ⅰ (P＜0.05 or0.01). Conclusion The efficacy of the Coopdech bronchial blocker combined with a strengthened single-lumen tube for airway management is better in patients undergoing upper mediastinal tumor resection than the double-lumen tube.

Objective The CYP19 gene product enzyme aromatase mediates the conversion of the androgen testosterone to es -tradiol.The aim of this study is to investigate whether the CYP19A1 gene single nucleotide polymorphism (SNP) is associated with the susceptibility to polycystic ovary syndrome (PCOS) and serum hormone levels. Methods We conducted a case-controlled study, which included 373 PCOS patients and 313 healthy controls.We genotyped SNP rs2899470 in the subjects using the polymerase chain re-action-restriction fragment length polymorphism ( PCR-RFLP) method and analyzed the frequencies of genotypes and alleles as well as the association of different genotypes with age , menarchal age, body mass index (BMI), and serum levels of hormones. Results The gen-otypic distributions of rs2899470 GG, TG, and TT in the PCOS women were 44.5%, 49.6%, and 5.9%, respectively, significantly dif-ferent from 39.3%, 48.6%, and 12.1%in the healthy controls (P=0.013).The frequency of the G allele was 69.3%in the former, remarkably higher than 63.6%in the latter (P=0.025).The rs2899470 genotypic frequencies were associated with the serum E 2/T lev-els in the PCOS patients. Conclusion SNP rs2899470 in the CYP19A1 gene is associated with the susceptibility to PCOS , and so is the genotype of rs2899470 with serum E2/T levels, which may be attributed mainly to the reduced activity of aromatase .

Objective To investigate whether nimodipine could reduce complications after microvascular decompression in patients with hemifacial spasm. Methods 220 patients with hemifacial spasm , admitted into our hospital from May 2011 to Oct. 2013 , were all treated by microvascular decompression. They were divided randomly into two groups. Patients in the treatment group were treated with nimotop 50 mg/d after the operation for the first 3 days, then was orally taken 30 mg/d for a week. Patients in the control group were treated with the same after the operation without nimodipine. The postoperative complications including hearing deficit and peripheral facial paralysis were closely observed within three months after operation. Results The total effective rate was 100% in both groups. The incidence rate of peripheral facial paralysis and hearing deficit in treatment group was significant lower than that of the control group (P < 0.05). Conclusion Nimodipine has significant effect on reducing the incidence rate of peripheral facial paralysis and hearing deficit after microvascular decompression in patients with hemifacial spasm.

Objective To evaluate the prognosis value of the expression of galectin 3 in patients with acute ischemic stroke. Methods 165 Patients with acute ischemic stroke had been observated for 12 months and their occurrence of recurrent stroke e-vents were recorded.The concentration of galectin-3 was detected.Results 65 patients had recurrence stroke events with a rate of 39.39% within 12 months.It was also found that the serum concentration of galectin-3 in acute ischemic stroke recurrence patients were significantly higher than those of patients without recurrence,the difference was statistically significant(P <0.05).The rate of acute ischemic stroke recurrence in patients with high concentrations of galectin-3 was higher than that in patients with low concen-trations of galectin-3,the difference was statistically significant(P <0.05).Conclusion Galectin-3 is a good indicator to predict the prognosis of patients with acute ischemic stroke,and it could be used to evaluate the risk of recurrence in patients.

Objective To review the clinical features,etiology and differential diagnosis of hypopituitarism.Methods The clinical data of 260 patients with hypopituitarism admitted to our hospital during 2007 to 2011 were retrospectively analyzed.Results In 260 patients 96 were males and 164 were females,the average age of female patients was significantly higher than that of males[ (44 ± 16) vs.(32 ± 20) years; t =3.821,P =0.001 ].Patients under 20 years accounted for the highest proportion in male cases (38/96,39.6％) ; while patients aged 40 - 60 years were the highest proportion for female cases (86/164,52.4％).Pituitary tumor and postoperative damage was the most common cause for hypopituitarism accounting for 36.2％ (94/260),followed by Sheehan syndrome (86/260,33.1％).The most common manifestation of hypopituitarism was anemia (102 eases) ; 26 cases presented all pituitary function failure.The causes leading to hypopituitarism usually showed specific manifestations in imaging examinations.The overall misdiagnosis rate was 40.4％ (105/260)in this series,while that of etiological diagnosis was 25.4％ (66/260).Conclusions This study suggests that hypopituitarism caused by different causes can be diagnosed by disease history,clinical manifestations and pituitary imaging examination.

Objective To investigate the effect of lung protective ventilation regimen on regional cerebral oxygen saturation(rSO2)during one-lung ventilation(OLV)in elderly patients undergoing radical esophagus cancer resection.Methods Forty ASA Ⅰ-Ⅲ patients,aged 65-76 yr,weighing 45-75 kg,undergoing radical esophagus cancer reseclion,were randomly divided into 2 groups(n =20 each):conventional ventilation group(group CV)and prolective ventilation regimen group(group PV).Anesthesia was induced with midaaolam 0.05 mg/kg,sufentanil 0.4 μg/kg,rocuronium 1 mg/kg and propofol 1.5 mg/kg and maintained with 2％ sevoflurane and intermittenl iv boluses of rocuronium 0.5 mg/kg.Double lumen tube was inserted.Correct positioning was verified by fiberoptic broncboscopy.The patients were mechanically ventilated.In group CV,PEEP was set at 0,Vt was set at 10 ml/kg,and I:E was set at 1:2 during two-lung ventilation(TLV)and OLV.In group PV,PEEP was set at 5 cm H2O,Vt was set at 6 ml/kg,and I:E was set at 1:2 during TLV and OLV.PETCO2 was maintained at 35-40 mn Hg in both groups.Arterial blood samples were taken before induction of anesthesia,at 10 min of TLV and at 30 min of OLV for blood gas analysis.Qs/Qt was calculated and rSO2 was recorded at the same time.Low rSO2 (rSO2 score ＞ 3000％)was recorded during OLV.Results Compared with group CV,PaO2 and rSO2 were significantly increased,and Qs/Qt was significantly decreased at 30 min of OLV,and the incidence of low rSO2 was significanfly decreased in group PV(P ＜ 0.05).Conclusion Lung protective ventilation regimen can improve oxygenation,decrease intrapulmonary shunt,and reduce the occurrence of low rSO2 during OLV in elderly patients undergoing radical esophagus cancer resection.

Objective To compare the effects of different medications of fentanyl during anesthesia induction on fentanyl-induced cough.Methods Four hundred and twenty ASA Ⅰ or Ⅱ patients aged 18-60 yr undergoing selective operations under general anesthesia,were randomly divided into 4 groups ( n =105 each):group Ⅰ (control group) received successive intravenous injection of midazolam 0.05 mg/kg,fentanyl 2 μg/kg,propofol 2 mg/kg,and rocuronium 1 mg/kg,group Ⅱ (pre-injection group) received successive intravenous injection of midazolam0.05 mg/kg,fentanyl 0.5 μg/kg,propofol 2 mg/kg,rocuronium 1 mg/kg,and fentanyl 1.5 μg/kg,group Ⅲ (dilution group) received successive intravenous injection of midazolam 0.05 mg/kg,fentanyl 2 μg/kg (20 μg/ml),propofol 2 mg/kg,and rocuronium 1 mg/kg,and group Ⅳ (last injection group) received successive intravenous injection of midazolam 0.05 mg/kg,propofol 2 mg/kg,rocuronium 1 mg/kg,and fentanyl 2 μg/kg.Fentanyl concentration was 50 μg/ml in each group except group Ⅲ.Endotracheal intubation was performed 2 min after anesthesia induction.The incidence and severity of fentanyl-induced cough before intubation were recorded and the incidence of propofol-induced pain was recorded.Invasive arterial blood pressure (ABP) and heart rate (HR) were observed before induction (T1 ),immediately after induction (T2 ),at time of coughing (T3 ),and at time of endotracheal intubation (T4).Results ABP and HR had no significant differences at T1,T2,T3,and T4between the four groups (P ＞ 0.05).The incidence of propofol-induced pain had no significant differences between the four groups (P ＞ 0.05).The incidences of cough was 7.6％ in group Ⅱ,9.5％ in group Ⅲ,and 1.9％ in group Ⅳ,which were significantly lower than 35.2％ in group Ⅰ ( P ＜ 0.01).The incidence of cough in group Ⅳ was significantly lower than that in groups [ and Ⅲ (P ＜ 0.05).In the four groups,ABP and HR were significantly higher at T3 than that at T1 and T2 ( P ＜ 0.01 ).Conclusion Different medications of fentanyl including last injection,pre-injection,and dilution of fentanyl can significantly reduce the incidence of fentanyl-induced cough during anesthesia induction,and injection has the best effect.