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.

Objective To observe the effects of dendrobium nobile Lindl(DNL) on Nuclear factor(NF)-κB and interleukin(IL)-6 expression of renal tissue in diabetic rat model .Methods The diabetes mellitus rat model was induced by streptozotocin .All rats were divided into four groups at random :the normal control group(group N) ,diabetic control group(group diabetes mellitus) ,drug group one(group DNL1) ,drug group two(group DNL2) ,and administrated for 12 weeks .The levels of the fasting plasma glucose , urea nitrogen ,serum creatinine ,urine creatinine ,24 hours urinary protein were determined .NF-κB and IL-6 protein expression levels were measured by Western-Blot .IL-6 mRNA expression levels were measured by Real-time fluorescence quantitative PCR . Results Compared with group N ,the blood sugar ,urea nitrogen ,24 hours urinary protein of group diabetes mellitus were signifi-cantly higher(P<0 .01) ,creatinine clearance was significantly reduced (P<0 .01) ,the NF-κB、IL-6 protein expression levels and IL-6 mRNA level increased significantly (all P<0 .05) .Compared with group diabetes mellitus ,the blood sugar ,urea nitrogen ,24 hours urinary protein of group DNL1 and group DNL2 were significantly decreased(P<0 .05) ,creatinine clearance increased significantly (P<0 .05) ,the NF-κB、IL-6 protein expression levels and IL-6 mRNA level decreased significantly(all P<0 .05) .Conclusion The DNL could protect the kidney of diabetic rats ,reduce the levels of NF-κB 、IL-6 protein and IL-6 mRNA expression in renal tissue of diabetic rats .

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

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 establish the talent training mode for pharmaceutical specialty in retail pharmacies based on mod-ern apprenticeship,and improve the teaching quality of pharmacy major in vocational colleges. METHODS:According to the basic content of talent training program,the contents including the talent training goal orientation,the recruitment mode,the teaching plan formulation,the curriculum system development,the teaching arrangement,the length of schooling and the certificate acquisi-tion were studied to analyze the feasibility of carrying out the modern apprenticeship of pharmaceutical specialty in retail pharma-cies. RESULTS:Pharmaceutical talents should master the necessary medicine theory,knowledge of relevant laws,regulations and stores management;the trained people could be an enterprise recruitment of employees,enrolled high school students or the two-screening-students;the practical skills training should be highlighted,both sides of school and enterprise should work together to develop the teaching plan formulation;and the curriculum development committee was established to determine the level of knowledge and ability that the retail pharmacies must know and to give the formation of the course;double subject education,dou-ble tutor teaching,work and study alternation were used in the teaching implementation;and flexible educational system was de-signed. CONCLUSIONS:The establishment of talent training mode for pharmaceutical specialty in retail pharmacies based on mod-ern apprenticeship can improve the teaching quality of pharmacy major in vocational colleges. However,the establishment of course system should consider the sustainable development of students,and cautiously set targeted courses based on the characteris-tics of talents requirements in retail pharmacies.

Bronchopulmonary dysplasia( BPD) is a chronic lung disease that commonly occurs in pre-term. Since the 1980s,with the advances in perinatal care,survival rate of preterm has been raised,while BPD continues to be a significant cause of morbidity and mortality for premature infants. However,the treatment effect of BPD is unsatisfactory. It is urgent to search for innovative ways to reduce the respiratory injury that caused by BPD as well as to improve the quality of life. In recent years,mesenchymal stem cells′( MSC) research has pro-vided a new way for the treatment of BPD. This review primarily summarizes the current status of the MSC ther-apies and its possible mechanism on BPD.

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.