In the last decades, the incidence of thyroid cancer has continuously and rapidly increased, and the risk factors have become the focus of the whole society′s attention.The exposure of radiation in childhood and genetic predisposition are determinate risk factors for thyroid cancer.Goiter, benign nodules/adenomas and obesity are highly likely risk factors for thyroid cancer.Some menstrual and reproductive factors and dietetic factors are possible risk factors for thyroid cancer.

Objective To evaluate the efficacy of the operation in the treatment of postoperative re-hemorrhage after splenec-tomy with periesophagogastric devascularization for advanced schistosomiasis. Methods Forty-three re-hemorrhage patients,who received varicose ligation combined with pericardial devascularization through left thoracic cavity with esophageal incision from Oc-tober 2002 to October 2011,after splenectomy with periesophagogastric devascularization due to portal vein hypertension,were in-vestigated retrospectively and followed up for 1 to 9 years. Results Forty-three re-hemorrhage patients operated included 27 cas-es of selective operation and 16 cases of emergency operation. The mean follow-up time was 6.8 years. The hemostasis rate was 100%. 0ne died after the operation because of engaging in heavy labor,two had melena and were completely relived with the con-servative treatment,and all the rest had a good recovery. Conclusion The operation of varicose ligation combined with pericardi-al devascularization through left thoracic cavity with esophageal incision in the treatment of postoperative re-hemorrhage after sple-nectomy with periesophagogastric devascularization for advanced schistosomiasis has a satisfied efficacy.

Objective To explore clinical nursing pathway(CNP) teaching method for nursing practice students.Methods Nursing practice students ( n =120 ) were randomly divided into two groups:experimental group and control group.CNP teaching method was applied in experimental group while traditional teaching method was used in control group.The test results of theory,operational skill,comprehensive quality,patient's satisfaction degree and nursing mistake between the two groups were compared.Results The results of theory,operational skill,comprehensive quality,patient's satisfaction degree in experimental group were obviously better than those in control group(P ＜0.05),the result of nursing mistake in experimental group was greatly decreased compared with that in control group(P ＜ 0.05).Conclusion CNP teaching method is superior to traditional teaching method and it greatly improve the teaching quality.

A case of hereditary hemorrhagic telangiectasia was reported. Repeated hemorrhage in nasal and digestive system are main clinical manifestation. Capillary expanded on tongue and finger is the main physical sign. Main clinical manifestation and typical physical signs, combined with family history, can help to establish a diagnosis.
Humans ; Male ; Middle Aged ; Pedigree ; Telangiectasia, Hereditary Hemorrhagic ; genetics

Objective To compare the efficacy of laparoscopic appendectomy(LA) and open appendectomy(OA) for perforated appendicitis.Methods From January 2002 to December 2005,40 patients with perforated appendicitis were treated at Xuanwu Hospital,20 of them received LA,and the others underwent OA.The clinical data of the patients were retrospectively analyzed.Results The operative time in the LA group was significantly longer than that in the OA group [(75.8?11.6) min vs(54.8?9.5) min,t=6.264,P=0.000)].And the patients in the LA group returned to oral intake earlier than those in the OA group [(1.8?0.5) d vs(2.6?0.5) d,t=-5.060,P=0.000].Moreover,the periods of antibiotic use and hospital stay in the LA group were significantly shorter than those in the OA group [(3.8?0.7) d vs(6.3?1.2) d,t=-8.048,P=0.000;and(5.8?1.1) d vs(11.6?1.6) d,t=-13.359,P=0.000].Although 3 patients had incision infection in the OA group,while none of the LA group had such a complication,no significant difference was detected in the complication rate between the two groups(Fisher's exact test,P=0.115).Conclusions Laparoscopic appendectomy is superior to open surgery for perforated appendicitis because of its advantages of quick recovery,short hospitalization,less antibiotic use,and minimal invasion.LA is a safe,effective,and feasible procedure for perforated appendicitis.

Background and purpose:Icariin (ICA) is the important active flavonoids extracted from Berberidaceaeepimedium. It has been shown to be effective in suppressing cancers including lung cancer and gastric cancer. Thus, it is expected to be developed for cancer treatment. However, there were few studies on icariin as a promising anticancer drug for the treatment of thyroid cancer. The mechanisms underlying anticancer effects of ICA in thyroid cancer are rarely reported. This study was to explore the proliferation and apoptosis, intracellular ROS and antioxidant enzyme systems of the thyroid carcinoma cell line B-CPAP treated with different concentrations of ICA. It aimed to explore the mechanism underlying anticancer effects of ICA, and to determine whether it is concentration- or time-dependent manner.Methods:The proliferation of B-CPAP cell line treated with different concentrations of ICA was detected by cell counting kit-8 (CCK-8). The cell apoptosis and intracellular ROS were observed by flow cytometry. The expression of intracellular superoxide dismutase and intracellular malondialdehyde were measured by SOD detection kit and MDA assay kit, respectively. Bcl-2 and γ-HA2X were detected by Western blot.Results:ICA reduced B-CPAP cell activity, increased the rate of apoptosis in a dose- and time-dependent manner after 48 h (P<0.01). The ROS of ICA 50 mg/L and 200 mg/L groups were (2.12±0.14)-fold and (2.41±0.12)-fold of the control group, respectively. ICA promoted accumulation of malondialdehyde, and reduced antioxidant enzyme SOD activity. The SOD activity was decreased by (9.35±1.45)% (ICA 50 mg/L group) and (21.5±1.52)% (ICA 200 mg/L group) compared with the control group, respectively. The anti-apoptotic protein Bcl-2 in ICA 200 mg/L group was decreased by (13.64±1.71)%compared with the control group.Conclusion:Icariin inhibited activity of thyroid cancer B-CPAP cells in a dose- and time-dependent manner. It plays an important role in promoting intracellular ROS expression, inhibiting superoxide dismutase expression and decreasing Bcl-2, which leads to irreversible damage to the cell, thereby inducing apoptosis.

Objective To investigate the clinical efficacy ofβ-lactam combined with macrolides antibiotics in treatment of severe community-acquired pneumonia (CAP) in children. Methods Children with severe CAP on admission between 2012 February and 2012 April were divided into treatment group and control group. With the same symptom specific supportive treat-ment, the patients in the treatment group were treated with both cefmetazole and azithromycin, while the patients in the control group were treated with cefmetazole alone. The total effective rate, number of days of symptoms and signs disappeared and num-ber of days of hospitalization were observed. Results The total effective rate was 87.8%in the trearment group and 61.3%in the control group with significant difference (P<0.05). Compared with control group, the recovery time of temperature, time of pulmonary rale disappearing and cough retraction were reduced (P<0.05). As well as the number of days of hospitalization was decreased (P<0.05). Conclusions The treatment of severe CAP in children with combination of azithromycin and cefmetazole results in better curative effect. A combined medication ofβ-lactam and macrolides antibiotics may be rational and effective.

Objective To measure the mandibular thickness relative to the osteotomy line of mandibular angle plasty so that to provide the anatomical basis for operation.Methods 37 youth women patients mandible were scanned by spiral CT,then the three-dimensional reconstruction was done,the thickness of the mandible around osteotomy line were measured on the planes corresponding to the posterior margin of mandibukar ramus,the middle part of the mandibular ramus,the posterior line of the third molar,the line between the second and third molar,the line between the second and first molar and the line between the first molar and the second premolar.The data were analyzed by Spss 11.5.Results The thichest bone around the osteotomy line was under the second and third molar,then the bone thickness became thinner forward and backward.The thinnest bony was on the middle part of the mandibular ramus.Conclusion The result of this study is of significant for guiding operation and reducing the complications.

Objective: To compare the selective splenic artery embolization (SSAE) with non-operative therapy of traumatic splenic rupture (TSR). Methods: The clinical data of 23 patients with TSR receiving SSAE and 32 undergoing non-operative therapy between 1992 and 2006 in our hospital were retrospectively analyzed. Results: There was no blood transfusion in SSAE group, and one patient was received it in the non-operative therapy group. Two patients in SSAE group had complications with left pleural effusion, and one had left pulmonary infection. One patient with non-operative therapy complicated with spleen abscess (P=0.298). The ratio of successful management in SSAE and non-operative group were 100% (23/23) and 81.3% (26/32) respectively(P=0.035). All the patients in both groups were survival. The mean hospital days in non-operative group(11.9?4.6) were significantly longer than that in SSAE group(7.9?2.1, P=0.045). Conclusions: Splenic injuries with grade Ⅰor Ⅱ are suitable for preserving spleen management. SSAE may be more safe and effective than non-operative therapy.

The toxicity of HCN inhaled via the respiratory tract in dogs and the therapeutic effects of DMAP and AmNO2 for such form of HCN intoxication were studied. The LD50 of HCN when inhaled was 850.4?80.4?g/kg.When the dosage of 2?LD50 of HCN was given to the experimental animals, the signs of intoxication developed rapidly. Uneasiness, struggling, strident barking, and respiratory excitation were observed several seconds after the exposure. Subsequently there was spasm of the extensors and rigidity of the extremities. Finally general inhibition and paralysis ensued. Respiration and heart beat stopped 6 and 7 minutes after exposure. If DMAP (3.25 mg/kg intramuscularly) or AmNO2 (2 ampules through inhalation) was administered 15 seconds after exposure, the survival rate of the animals was 90% or 100% respectively.When the dosage of 4?LD50 of HCN was inhaled and the two drugs were administered 45 seconds after exposure, the survival rate of the animals treated with DMAP remained as high as 90% (9/10) .But the survival rate of those treated with two ampules of AmNO2 or even three ampules reduced to 20% or 40% respectively.The amount of HCN inhaled during respiratory intoxication, the problems of early diagnosis and the administration of DMAP at the site of accident were analyzed and discussed.