Objective To comprehend spatial characteristics of the cavity created by a working space market.Methods 40 patients were successively operated according to the surgJical mode of minimally invasive video-assisted thyroidectomy from Jan.2010 to Aug.2010.Instead of hand-retraction.a mechanical arm-working space marker type I(WSM-I(R)，MIEO Medinstr Co.Ltd，China)，was applied to establish a working space.After the pathway making，a cavity above the gland was created and adjusted properly by the space maker，and then，endoscopic view was built and manipulation in the cavity was progressed throughout the later process.Geometric measurement of the cavity were performed at abasic space positionjust after the initial cavitation，and parameters such as length，width and height of the cavity were measured with a specifically scale-marked puncture needle(MC1820，Bard4(R)Max·Cor(R)Instrument)through mini-holes lay in the lifting hook(φ4mm，middle point and distant point).Results13 cases received a lobectomy and isthmectomy.The other 27 cases received a partial thyroidectomy.Dimensional parameters were calculated as below.①The basic length of cavity button was(4.35±0.39)cm.The basic width of cavity button(distance at central point)was(4.66±0.53)cm.The basic central height of cavity was( 1.36±0.34)cm.The maximal central height archived by readjusting was(1.66±0.32)cm and a height increase of0.3 cm can be achieved(22.1％).②The basic peripheral height was(0.98±0.29)cm.The maximal peripheral height archived by readjusting directionally was(1.33±0.14)cm and a height increase of 0.35 cm can be achieved(35.7％).③Statistic analysis yielded a negative correlation between the cavity volume and the size of the nodule.Conclusions The working space created by WSM-I appears to be an laigh and irregular trapezoid stock with oblique roof formed by lifting hook.Although vertical height，especially the peripheral height，is a major restrictive dimension，the cavity can still be usable and enough for factual observation and manipulation，due tocompensating effectof endoscope，finite space requirement of harmonica anddirectional volume shiftingof WSM.

Hyperparathyroidism is an important complication of thyroid surgery.Identification is the premise of intraoperative pretection.At present,identification of the parathyroid gland relies on personal experience of surgeons.Amplifying display of endoscope or surgical magnifying glass,the use of dyeing agent such as methylene blue,nanocarbon,5-ALA or BB5-G1,the use of radionuclide imaging and contact endoscope,and biopsy like intraoperative frozen pathological examination and FNA are all important trials.This article is going to make a review of the methods.

objective To determine a proper fiducial photography distance setting for ideal amptitied endoscopic imaging of parathyroid gland by high definition endoscopy system.Methods 30 patients were operated with MIVAT mode (modified Miccoli's approach) for treatment of thyroid carcinoma from Apr.2013 to Mar.2014.High definition imaging was established by Image 1 Endoscopy System(Karl Storz Co.) to observe parathyroid gland and related fine anatomical structures during surgery.5 fiducial photography distances (1.0/1.5/2.0/2.5/3.0 cm) were separately tested during surgery.Maximally amplified parathyroid gland images of each setting were obtained by the approaching-amplifying photographic method,and then the size of the real parathyroid glands as well as their screen images were measured and recorded to calculate the magnification.A proper fiducial photography distance setting was determined postoperatively by comparison of the magnification times,as well as clarity,stability of the imaging and surgical maneuverability.Results ①90 parathyroid glands were successfully observed and measured.②At the longest fiducial photography distance (3.0 cm),the parathyroid gland could be stably magnified by 14.26±3.06(long trail)/12.62±2.88 (wide trail)times,but their contour and color not clear.③At the intermediate distance (2.5 cm),the parathyroid gland could be magnified by 16.74±3.15 (long trail)/14.81± 3.47(wide trail)times with the graphics stable,and the color and contour more clear,but the vascular pedicle and the tiny vessels under the capsule still blurred.④At the shortest distance (1.0 cm),the parathyroid gland could be magnified by 27.72±6.45 (long trail)/26.33±7.22(wide trail)times,not only the color and contour,but also the vascular pedicle and the tiny vessels under the capsule of the gland became further clearer,unfortunately the graphics was shimmy and unstable.Conclusions ①2.5 cm can be a proper fiducial photography distance for searching,identifying and preserving parathyroid gland in MIVAT,while 1.0 cm can be a special fiducial photography distance for further confirming parathyroid gland when necessary.② Current high definition endoscopy system can be applied to identify the parathyroid gland if fiducial photography distance was properly set and approachingamplifying photographic method was used.Along with the magnification of the imaging,the features of the parathyroid gland may become clearer,including its yellow-brown color and oval contour,as well as the detail structures such as the tiny vessels under the capsule and the vascular pedicle.

Objective To determine the best extraction process of ginkgo leaves with the total transfer rate of total flavonol glycosides and terpene lactones as the index.Methods The effects of ethanol concentration, solid-liquid ratio and extraction time on extraction process were investigated by orthogonal design method, and the contents of total flavonol glycosides and terpene lactones were detected by HPLC to calculate transfer rate.Results The optimum extraction conditions were as follows:85% ethanol refluxing and extracting for three times;the first time extracting with five-fold amount of solvent (V/W) for 3 hours;the last two times with three-fold solvent (V/W) for 2 hours.Conclusion This extraction process has the advantages of simplicity of operator, reason, energy conservation, high efficiency, and is suitable for industrial production.

Objective　To explore the role of acute infection of Chlamydia pneumoniae (Cpn) in respiratory diseases. Methods　Microimmunofluorescence test was used to detect IgG antibodies for Cpn in serum obtained from 93 inpatients and PCR was used to test Cpn in detection of Cpn DNA in throat specimens from 55 of the 99 patients. Results　Acute Cpn infection was diagnosed in 35.5% of the respiratory diseases. Antibodies for Cpn (titer of ≥512) were present in 47.6% of the pneumonia group, which may suggest that during 1998 to 1999, Cpn caused an epidemic in Beijing. They were also present in 50% of asthma group, 50.0% of pulmonary heart disease group and 26.3% of lung cancer group. Only five patients (9.1%) were positive by PCR. There exists discrepancy between serological and PCR results. Conclusion　Detection of IgG antibodies for Cpn conduces to diagnosis of acute Cpn infection and give advice for appropriate therapy.

Objective To prepare the phmaceutical reference materials of total lactones extract from ginkgo leaf for quantitative analysis.Methods A HPLC determination method was developed to investigate the uniformity and stability of the reference extract of ginkgo leaf total lactones using with bilobalide, ginkgolide A, ginkgolide B and ginkgolide C as the indexes.Three laboratories participated in the collaborative calibration test.Results The four components in reference extract had good uniformity and stability with RSD less than 2.0%;the marked values of the four components had been determined through statistical data analysis which provided by assigned traceability values.The values of bilobalide, ginkgolide A, ginkgolide B, and ginkgolide C were 39.54%, 29.03%, 15.96% and 11.69%, respectively.Conclusion The reference extract of ginkgo leaf total lactones can be prepared for quality control in future quantitative analysis.

Objective To assess the value of apparent diffusion coefficient (ADC)map with low b-value to monitor the ablated tissue after high-intensity focused ultrasonic (HIFU)treatment for uterine fibroids.Methods 25 patients with 34 uterine fibroids were treated with HIFU.All patients underwent the routine MRI scans (including pre-and post-contrast scanning)and monoexponential model DWI with b values of 150,600 and 1 000 s/mm2 before the surgery and within 24 hours after the surgery.The mean ADC values with different b-values of the ablated and non-ablated tissues between pre-and post-treatment were analyzed by one-way ANOVA test.The consistency of the ablation area between ADC maps with different b-values and contrast enhancement MRI were evaluated. Results With the b-value of 150 s/mm2 ,the mean ADC value of the ablated tissue was (1.48±0.27)×10-3 mm2/s,which was less significantly than that of pre-treatment (2.06±0.21)×10-3 mm2/s and non-ablated tissue (1.98±0.23)×10-3 mm2/s (P<0.05). However,there were no significant differences in ADC values with the b values of 600 s/mm2 and 1 000 s/mm2 among those areas (P>0.05).A fine consistency of the ADC map with the low b-value (150 s/mm2 )was found with non-perfusion volume on contrast-enhanced T1 WI,which was superior to that with high b-values (600 s/mm2 and 1 000 s/mm2 )(P<0.05).Conclusion ADC map with low b-value (150 s/mm2 )can be used to evaluate the blood-supply changes and ablated volume of uterine fibroids indirectly,which helps to assess the treatment effect of HIFU.

Objective: To explore the influence of school mental health education combined with family intervention on the mental and physical health of middle school students. Methods: A total of 280 students in six classes of the experimental middle school attached to Hebei Normal University were convenient selected as participants, and two classes in each grade were included in the experimental group and the control group. The experimental group received school mental health education and family intervention, while the control group only received school mental health education. The changes in GHQ, SCL-90 and common mental health problems were compared before and after intervention. Results: The total score of GHQ-12 was (5.06±1.33) in the experimental group after intervention and (15.62±3.84) before intervention. The total score of GHQ-12 in the experimental group after intervention was significantly lower than that before intervention, and significantly lower than that in the control group(t=13.65, 8.39, P<0.05). The scores for somatization, anxiety, depression, paranoia, interpersonal sensitivity, obsessive-compulsive symptoms, hostility, paranoia and psychosis in the experimental group were significantly lower than those in the control group(t=-13.21--6.71, P<0.05). After the intervention, the proportions of good interpersonal relationships, good parent-child relationships and after-school hobbies in the experimental group were 68.28%, 66.21% and 84.14%, respectively, which were significantly higher than those in the control group(35.56%, 40.74% and 51.85%, respectively), the proportions of people without intimate friends, early love and love after school were 9.66%, 9.66% and 4.14%, respectively, which were significantly lower than those in the control group(20.74%, 24.44%, 21.48%)(P<0.05). Conclusion School mental health education and family intervention can effectively improve the mental health of middle school students, improve their interpersonal relationships and promote their mental and physical health.

Objective To explore the changes and clinical significance of interleukin-1β (IL-1 β) and aquaporin 4 (AQP4) in children with hand-foot-mouth disease (HFMD) combined with encephalitis.Methods From January 2014 to June 2016,30 cases of HFMD patients without encephalitis in Wuxi Children's Hospital were selected as the general group,at an average age of (2.1 ± 1.1) years,including 13 male and 17 female.Thirty cases of HFMD combined with encephalitis were selected as the observation group,at an average age of (2.4 ± 1.2)years,including 12 male and 18 female.Twenty-six non-HFMD patients who underwent minor operations for inguinal hernia or hydrocele of testis were selected as the serum control group,including 25 male and 1 female.Twenty-six patients with non-infectious neurological disorders in the neurology department in the same period were selected as the cerebrospinal fluid control group,including 10 male and 16 female.The levels of AQP4 and IL-1β in children were detected by adopting enzyme-linked immuno sorbent assay(ELISA).Results The levels of IL-1β in cerebrospinal fluid in the acute phase and recovery phase of the observation group were (95.04 ± 20.06) ng/L and (77.63 ±14.51) ng/L respectively,while the levels of AQP4 in cerebrospinal fluid were (16.87 ± 10.02) ng/L and (9.13 ±6.64) ng/L respectively.The levels of IL-1β in serum in the acute phase of the observation group and the general group were (82.40 ± 18.56) ng/L and (50.20 ± 24.22) ng/L respectively.The levels of IL-1β,AQP4 in cerebrospinal fluid were significantly higher in the acute phase of the observation group compared with the controls,and the differences were statistically significant(all P ＜ 0.05).The levels of IL-1β and AQP4 in the recovery phase were lower than those in the acute stage,and the differences were statistically significant(all P ＜ 0.05).The levels of IL-1β in serum was significantly higher in the acute phase of the observation group compared with the general group,and the difference was statistically significant (P ＜ 0.05).The level of IL-1β in serum were significantly higher in the general group compared with the controls,and the difference was statistically significant (P ＜ 0.05).Conclusions AQP4 and IL-1β may participate in the pathological course of HFMD combined with encephalitis by promoting brain edema,which can be used as one of the laboratory indicators for early diagnosis of the severity of the disease.