Objective To explore the effect of trans-axillary single-port and bilateral breast of ipsilateral axillary approach in endoscopic thyroidectomy on area of skin flap ,complications and the corresponding impact damage .Methods A total of 72 patients who were underwent either BBIAA or TASPET in our hospital from February 2013 to April 2015,were divided into BBIAA group and TASPET group ,each group had 36 cases.The area of skin flap ,complications and the corresponding impact damage between two surgical methods were compared .Results The average separation of the flap area in TASPET group was significantly higher than that in BBIAA group (P<0.01).The VAS score of BBIAA group was (0.24 ±0.39) point,which was lower than (1.85 ±1.37)point of TASPET group,the difference was significant(P<0. 01 ) .The patients of BBIAA group had no complications ,while there were 10 patients suffered complications in TASPET group ,and the differ-ence of postoperative complications was significant (P<0.01).Conclusion Bilateral breast and ipsilateral axillary approach have the advan-tage of less operative time ,smaller separation of the flap area ,lower complication incidence and less damage on parathyroid gland and nerve , which had an ideal safety and cosmetic result .

Hypoxia-inducible factor-1α (HIF-1α)is a transcription factor that acts as a master regulator of gene expression induced by low oxygen conditions.HIF-1α is the most sensitive indicator of hypoxia and can be activated by systemic hypoxia,cerebral hemisphere ischemia and cerebral focal ischemia.HIF-1 expression can be induced by hypoxic-ischemic damage after cerebral infarction and exert its effects on hypoxia-inducible downstream genes,thus protecting hypoxic tissues and cells under hypoxic conditions via regulating the expression of its downstream target genes.This article reviews the expression of HIF-1α and its downstream target genes in acute cerebral ischemia,in order to provide a theoretical basis for gene therapy.

Objective To evaluate the efficacy of entecavir in lamivudine-refractory patients with chronic hepatitis B.Methods Literature from Medline,Embase and CBM between January 2001 to December 2008 were reviewed.Acccording to the including and excwding criteria,four randomized controlled trials (RCT) were enrolled.The results of the trials were reviewed and analysed in software Revman 4.2.Results Patients in the entecavir group enjoyed significantly higher negative conversion ratios of HBV-DNA and ALT,and positive seroconversion of HBeAg:RR were 13.90(95% CI 6.39～30.24,P＜0.00001),2.49(95% CI 1.40～4.45,P=0.002),and 3.53 (95% CI 2.85～4.38,P＜0.000 01) respectively.There was a trend for the improvement of negative conversion ratio of HBeAg (RR=2.27,95% CI 1.00～5.15,P=0.05),but the incidence of side-effects of the drugs has no difference (RR=1.05,95% CI 0.97～1.14,P=0.21).Conclusions Compared with lamivudine or placebo,entecavir can significantly decrease HBV-DNA,improve liver function and positive seroconversion ratio of HBeAg without raising the incidence of drug side-effects.

Objective: To study the diagnosis and treatment of primary hyperparathyroidism.Methods: The clinical data of 8 primary hyperparathyroidism patients(1992 2002) in our hospital were summarized and the references were reviewed.Results: It was found that primary hyperparathyroidism was liable to be misdiagnosed.Information on blood calcium,parathyroid hormone(PTH) and imaging may be helpful for diagnosis. Surgical resection(4 cases), anhydrous alcohol injection (2 cases), electron radiation (1 case) and internal medicine (1 case) were applied. Conclusion:Information on blood calcium,PTH and early imaging is helpful for diagnosis.Operation is the first choice of treatment, and for patients who can not tolerate surgery, anhydrous alcohol injection is an effective and safe treatment.

Abscess ; pathology ; Adenoma ; metabolism ; pathology ; Adenoma, Sweat Gland ; metabolism ; pathology ; Biomarkers ; metabolism ; Breast Diseases ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Female ; Fistula ; pathology ; Humans ; Keratin-7 ; metabolism ; Keratins ; metabolism ; Mucin-1 ; metabolism ; Nipples ; pathology ; Paget's Disease, Mammary ; metabolism ; pathology ; Receptor, ErbB-2 ; metabolism ; Sweat Gland Neoplasms ; metabolism ; pathology

Benzene ; adverse effects ; Hearing ; Humans ; Noise, Occupational ; adverse effects

Objective To compare the clinical efficacy of esomeprazole or omeprazole triple therapies on gastric ulcer patients complicated with type 2 diabetes mellitus.Methods Seventy-five patients with Hprelated gastric ulcer and type 2 diabetes mellitus were enrolled and were randomly divided into group A(n=39)and group B (n =36).Patients in group A were treated with esomeprazole,amoxicillin and clavulanate potassium dispersible tablets,Clindamycin.Patients in group B were treated with omeprasole,amoxicillin and clavulanate potassium dispersible tablets,Clindamycin.Patients in both groups were treated with hypoglycemic therapy.The efficacy and the Hp eradicate rate of the two groups were observed and compared.Results The cure effect in group A was 97.44％(38/39),much better than that of group B(80.56％(29/36);x2=5.598,P=0.025).The Hp eradicate rate in group A was 92.31％,also much better than that of group B(75.00％;x2 =4.172,P =0.041).Conclusion The clinical egicacy and the Hp eradicate rate of esomeprazole triple therapies on gastric ulcer patients complicated with type 2 diabetes mellitus is better than that of omeprazole triple therapies.Esomeprazole triple therapies and it is worthy of being clinically promoted.

Objective:To approach the effectiveness and safety of traditional Chinese medicine combined with risperidone in the treatment of schizophrenia,and to provide basis for their application in clinic. Methods:The Cochrane,Pubmed,EMBase,CNKI,Wanfang and VIP databases were used to retrieve the randomized controlled trials (RCTs ) and CCTs about traditional Chinese medicine combined with risperidone in the treatment of schizophrenia by computer;and manual retrieval was performed at the same time.The literatures met the standard were collected.The qualities of all the included studies were assessed by Cochrane Handbook and Meta-analysis was performed by use of the RevMan 5.2 software. Results:Fifteen trials and 1 314 patients were included in this review. The qualities of 11 studies were grade C.The Meta-analysis results showed that the clinical effective rate in traditional Chinese medicine combined with risperidone treatment group was higher than that in control group,the difference between two groups was statistically significant (OR= 2.11,95% CI: 1.59 - 2.81,P < 0.01 ).The incidence of adverse drug reactions (insomnia,extrapyramidal symptoms,akathisia)in traditional Chinese medicine combined with risperidone treatment group was lower than that in alone risperidone group, and there were significant differences between two groups (OR=0.25,95%CI:0.17-0.36,P <0.01).Conclusion:Traditional Chinese medicine combined with risperidone is superior to simple application of risperidone in the treatment of schizophrenia,and they can reduce the occurrence of adverse effects of medicine.

Objective To investigate the efficacy and safety of intraarterial or intravenous recombinant tissue plasminogen activator(rtPA) for patients with acute cerebral infarction.Methods 60 patients consistent with the inclusion criteria were divided into intra-arterial thrombolysis group, intravenous thrombolysis group and control group. rtPA of 10～20 mg was infused over the course of 30 minutes in intra-arterial thrombolysis group. rtPA was administered in a dose of 0.7～0.8 mg/kg(maximum dose 50 mg),with 100% as a constant infusion over a period of 90 minutes in intravenous thrombolysis group.24 hours late, both groups were followed by subcutaneous injection of low molecular weight heparin(0.4 ml,twice daily) for 7 days. The control group received only routine treatment. European Stroke Scale(ESS) and Barthel Index(BI) were used to evaluate the recovery of neurological functions.Results The efficacy in both thrombolysis groups was significantly higher than that in the control group(all P 0.05).But in intraarterial group, the stenosis of intracranial arteries or extracranial arteries could be found, and new thrombosis could be prevented by transluminal stent-assistant angioplasty. One case of intracerebral hemorrhage and one case of asymptomatic hemorrhage occurred in intraarterial thrombolysis group. One case of asymptomatic hemorrhage was found in intravenous thrombolysis group and control group respectively. No dead case was found in the three groups.Conclusion Thrombolytic therapy of intra-arterial and intravenous rtPA can be performed safely and efficaciously in patients with acute cerebral infarction within 6 hours from the onset.

The procedures for the calculation and measurement and calibration of output dose of the Siemens primus E accelerator with IAEA regulation are introduced to probe an accurate,rapid and effective method.The parameter value of measurement is determined according to IAEA regulations and absorbed dose calculation formal is briefed to the form that the reading of instrument multiplies exposure calibration coefficient Nx and Air temperature,pressure and humidity effects Ktp and cumulative correction factor Cf the precision of accelerator conform to the standard of QA&QC by the measurement and calibration of the Hospital Primus E accelerator in output dose.The methods of measurement and calibration can be used for the determination of output dose in precise radiotherapy of digital medical linear accelerator and clinical treatment.