Objective To study the anatomy,exposure and operation method in prevention of recurrent laryngeal nerve injury in thyroid surgery.Methods The clinical data of 520 patients with thyroid disease in treatment of operation were retrospectively analyzed,and exposure of recurrent laryngeal nerve in 268 cases,non exposure of recurrent laryngeal nerve in 252 cases; resection of the majority of thyroid in 232 cases,resection of ipsilateral thyroid lobe+ isthmus+on the side of most resection operation in 220 cases; resection of ipsilateral thyroid thyroidectomy+contralateral subtotal+ipsilateral lymph node dissection operation in 68 cases.Results Exposure of recurrent laryngeal nerve in 268 cases.The recurrent laryngeal nerve in the external laryngeal branch was single 214 cases,accounted for 79.9％ (214/268); two 42 cases,accounted for 15.7％ (42/268),more than 12 cases,accounted for 4.5％ (12/268).The laryngeal recurrent nerve during thyroid artery through the rear 143 cases,accounted for 53.4％(143/268) ; during thyroid artery through the front 92 cases,accounted for 34.3％ (92/268); walk line between thyroid artery branches 33 cases,accounted for 12.3％(33/268).The thyroid permanent damage rate of exposure of recurrent laryngeal nerve surgery was 1.1％(3/268),lower than that in non exposure of recurrent laryngeal nerve surgery 6.0％ (15/252) (P ＜ 0.05).The thyroid permanent damage rate between resection of the majority of thyroid and resection of ipsilateral thyroid lobe + isthmus + on the side of most resection operation had no significant difference (P ＞0.05),compared with the former two,resection of ipsilateral thyroid thyroidectomy + contralateral subtotal + ipsilateral lymph node dissection operation increased significantly (P ＜0.05).Exposure of.recurrent laryrngeal nerve in benign 173 cases,6 cases of thyroid transient damage,permanent damage in 1 case; 95 cases of malignant thyroid,6 cases of thyroid transient damage,permanent damage in 2 cases,the thyroid permanent damage rate in both had no significant difference (P ＞ 0.05).Conclusion Exposure of recurrent laryngeal nerve operation can significandy reduce the incidence of recurrent laryngeal nerve injury,for the partial thyroidectomy,can chose non exposure of recurrent laryngeal nerve operation method.

Objective To investigate the correlation between vitamin E and community acquired pneumonia (CAP) .Methods A total of 128 cases of CAP(CAP group) and 135 people undergoing the healthy physical examination (excluding CAP ,control group) in our hospital from Jan .2016 to Dec .2016 were chosen .Each group was divided into the age subgroups of 0-17 years old ,18-40 years old and 41-65 years old .Vitamin E ,Chlamydia pneumoniae(CPn) and mycoplasma pneumoniae(MP) were detected in all the subjects .Then the obtained data were statistically analyzed .Results The average vitamin E was (15 .43 ± 4 .37)mg/L in the control group and (6 .37 ± 3 .24)mg/L in the CAP group ,the difference between the two group was statistically significant(P<0 .05) .In the control group ,there were 7 cases of MP positive and 6 cases of CPn positive .In the CAP group ,there were 32 cases of MP posi‐tive and 25 cases of CPn positive .The differences of MA and CPn positive between the two groups were statistically significant(P<0 .05) .The vitamin E levels in the 0 -17 years old ,18 -40 years old and 41 -65 years old subgroups of the control group were (14 .75 ± 4 .12) ,(16 .42 ± 4 .35) ,(16 .42 ± 4 .35)mg/L respectively ,while which in the various subgroups of the CAP group were (5 .43 ± 3 .18) ,(7 .74 ± 3 .65) ,(7 .74 ± 3 .65)mg/L respectively ,the difference in different age groups between the two groups was statistically significant(P<0 .05) .Conclusion Maintaining a high level of serum vitamin E level could effectively prevent CAP .

Objective To investigate the effect of neoadjuvant chemotherapy on gastric cancer based on FOLFOX7 or XELOX,so as to achieve evidence of clinical practice.Methods From January 2005 to June 2010,a retrospective analysis was performed for those patients with gastric cancer and underwent surgery.The patients were divided into neoadjuvant chemotherapy group and conventional chemotherapy group according to the chemotherapy method.The clinical efficacy,Ro resection rate and survival rate were evaluated in two groups.Results A total of 185 cases were included in neoadjuvant chemotherapy group (FOLFOX7 or XELOX,113 cases) and conventional chemotherapy group (72 cases).There was no significant difference in general status between two groups (P ＞ 0.05).Complete remission was in 48 cases,partial remission was in 51 cases,stable was in 14 cases,progression of disease was in 0 case in neoadjuvant chemotherapy group,and the effective rate was 87.6％ (99/113).Complete remission was in 30 cases,partial remission was in 25 cases,stable was in 15 cases,progression of disease was in 2 cases in conventional chemotherapy group,and the effective rate was 76.4％(55/72).There was significant difference in the effective rate between two groups (P＜ 0.05).The R0 resection rate in neoadjuvant chemotherapy group was higher than that in conventional chemotherapy group [60.2％ (68/113) vs.38.9％ (28/72)],and there was significant difference between two groups (P＜ 0.01).There was no significant difference in survival rate between two groups (P ＞ 0.05).Conclusion Neoadjuvant chemotherapy can reduce the tumor stage and improve the R0 resection rate,but has no obvious advantage in improving the survival rate during follow-up period.

Objective To investigate the up regulation of captopril on the platelet nitric oxide(NO) synthase and clinical application in patients with ischemic stroke.Methods The washed platelets in vitro of the patients with acute ischemic stroke and healthy controls were added with oxidized LDL(oxLDL) and captopril followed by measurement of platelet NO synthase activity.Plasma oxLDL,NO sythase,NO and platelet NO sythase,NO in 40 patients were measured before oral captopril and after oral captropril 1 month,3 months.Results (1)After the washed platelets in vitro were added with oxLDL,the platelet NO synthase activities of the patients and controls were all significantly decreased( P

Objective To compare the clinical effect of the peripheral balloon closure with surgical intervention for developed retroperitoneal hematoma(RPH) caused by femoral artery perforation .Methods A retrospecive analysis was performed on 2 492 consecutive patients underwent PCI from January 2005 to December 2013 in Guangdong people′s hospital .Twenty -four cases of developed RPH caused by femoral artery puncture operation for PCI were retrospectively analyzed ,13 cases of patients who took peripheral balloon closure were divided into balloon block group and the other 11 patients adopted surgery vascular repair process‐ing ,were enrolled in the surgical treatment group .Comparison was done among the hemostatic effect and the time ,and postoperative adverse events ,including lower limb blood supply obstacles for puncture side postoperative ,major adverse cardiovascular events (MACE) during hospitalization ,all‐cause mortality ;Multivariate logistic regression was used to assesse the RPH risk factors .Re‐sults The incidence of RPH caused by femoral artery perforation was about 0 .96% .During coronary intervention ,the following variables were found to be independent predictors of RPH caused by femoral artery perforation:female gender(OR=8 .94 ,95% CI:3 .75-21 .98 ,P< 0 .01) ,femoral artery ulcer(OR= 6 .43 ,P<0 .05) and multiple puncture (> 3 times) (OR= 7 .39 ,95% CI:2 .74-13 .76 ,P<0 .01) .Hemostatic success rates of the two groups were all 100% ;the average times of processing perforation were (76 .8 ± 34 .6) min and ((88 .5 ± 37 .3) min ,P<0 .05 ,the difference was statistically significant ;3 cases (23 .1% ) and 2 cases (18 .2% ) developed into postoperative severe anemia (Hgb<60 g/L) in each group ,P>0 .05;Each group had 1 case for in‐hospital MACE (7 .7% vs .9 .1 % ,P>0 .05);In the two groups ,there was no lower limb blood supply obstacles and death case .Conclusion For progress RPH caused by femoral artery perforation ,peripheral balloon closure can be a faster ,better sealing hemostatic ,and shorten the rescue time ,and the success rate is high ,and there is less postoperative adverse events .The safety and effectiveness be‐have good .

Objective To study the effect of type Ⅱ collagen (C Ⅱ) from Zaoeys dummies (Cantor)on the immune functions of rats with collagen-induced arthritis and to understand the mechanisms of RA treated with Zaoeys dhumnades (Cantor).Methods The rats with collagen-induced arthritis were randomly divided into three group:C Ⅱ from Zaocys dhumnades,bovine C Ⅱ and arthritis control group,a normal control group was set up,too.Every group had 7 rats.The C Ⅱ from Zaocys dhumnades and the bovine C Ⅱ group were fed with C Ⅱ from Zaocys dhumnades (15 mg/kg) and bovine C Ⅱ (15 mg/kg) per day respectivelyfor 15 days.The CD4/CD8 subset ratio,serum levels of anti-C Ⅱ antibody,TNF-a,IL-10,IL-1 and IL-4 in.rats were measured.Results In the arthritis group,CD4/CD8 subset ratio (P＜0.05) and serum levels of type Ⅱ collagen antibody (P＜0.01) and TNF-a (P＜0.01) were significant increased and IL-10 (P＜0.01) was significantly decreased.In the C Ⅱ from Zaocys dhumnades and bovine C Ⅱ group,CD4/CD8 subset ratio (P＜0.05) and the level of TNF-a (P＜0.01) were significantly decreased compared with the arthritis group,and had no difference compared with the normal group.The level of anti-C Ⅱ antibody was declined significantly compared with the arthritis group (P＜0.05) and had statistical difference with the normal group (P＜0.01).The level of IL-10 was significantly increased(P＜0.01),but lower than the normal group(P＜0.05).There was no statistical difference in the level of IL-1 and IL--4 in.all four groups.Conclusion C Ⅱ from Zaoeys dhum-nades (Cantor) is as effective as bovine C Ⅱ in modifying the immune functions of collagen-induced arth-ritis in rats.They can decrease the level of anti-C Ⅱ antibody,the level of TNF-a,CD4/CD8 subset ratio and increase the level of IL-10 in the peripheral blood of rats with collagen-induced arthritis.C Ⅱ from Zaocys dhumnades may be one of the important pharmacological active components that have the potential in treating rheumatoid arthritis.

OBJECTIVE To study effective and convenient method for paraffin oil sterilization.METHODS By using carrier qualitative germicidal test,to compare pressure steam sterilization,dry heat sterilization and cobalt-60(gamma)-ray radiation sterilization to test the sterilizing effect and operating procedure.RESULTS Pressure steam sterilization was unable to achieve 100% sterilizing effect,whether we extended the time or use the intermittent(sterilization).After dry heat or radiation sterilization processes,no microorganism was found.CONCLUSIONS Effect of sterilization with dry heat or radiation sterilization is trustable,but its packing,operation and equipment are requested strictly,and pressure steam sterilization may be not good for paraffin oil.

Purpose To detect the expression of Snai2 mRNA in gastric carcinoma and normal gastric mucosa and analyze its significance.Methods Total RNA was extracted with TRIzol from 30 cases of gastric carcinoma and mRNA was transcribed reversely into cDNA.The expression of Snai2 mRNA was examined by real-time PCR; then mRNA probes were prepared, the expression of Snai2 mRNA was detected by in situ hybridization on a tissue array,including normal gastric mucosa (20 cases) and gastric carcinoma (100 cases).Results Real-time PCR data showed they had different expression in different degrees of differentiation of the cancer: the poorer differentiation, the more expression (P<0.05). In situ hybridization results showed the positive rate in the carcinoma (54.2%) was higher than normal tissue (27.8%), with statistically significant difference (P<0.05).There were different positive rate in different degrees of differentiation: the poorer differentiation,the higher positive rate, but it had no statistical significance (P>0.05).Conclusions Snai2 could be a biomarker of malignant degree and disease progression,and used as a useful tool for evaluation of prognosis.

Objective To discuss the relationship between the substype of peripheral blood CD8 lymphocyte in patients with chronic hepatitis virus B and clinic condition and the replication of HBV. Methods CD45RO, CD45RA and CD28 of peripheral blood CD8 lymphocyte were detected by flow cytometry with multicolor fluorescence technology in 107 patients with chronic hepatitis virus B and 20 healthy volunteers. Results The total quantity of CD8 lymphocyte in patientswith chronic hepatitis virus B was not different from that in controls. The percent of CD3+ CD8+/CD45R0+ cells in patients with chronic active hepatitis was significantly higher than that of the control (15.7?3. 35)% vs( 8. 56?1. 12)% , P

Objective To evaluate the prevalence and impact of coronary artery disease (CAD) in aged patients with Stanford type B aortic dissection(AD).Methods From January 2008 to December 2011,CAG was routinely performed before aortography and thoracic aortic repair(TEVAR) to determine the prevalence of concomitant CAD in 200 consecutive Stanford type B AD patients who were older than 50 years.All patients received 1 year follow-up.Adverse events were compared between patients with and without concomitant CAD.Data analysis by SPSS 17.0 statistical software,using Student t test,Chi-square test and Fisher exact test.Results CAG showed 53 patients (26.5％) had CAD.Multivariate logistic regression analysis showed that male gender(OR =4.415,95％ CI:1.131-17.237,P =0.033) and age (OR =1.061,95％ CI:1.017-1.108,P =0.006) were independent predictors of Stanford type BAD coexisted with CAD.Age was also independent predictor of multi-vessel disease(MVD) and/or left main disease(LMD) (OR =1.096,95％ CI:1.009-1.191,P =0.023).At 30-day follow-up,there was no difference in the incidence of adverse events between patients with and without concomitant CAD.Patients with concomitant CAD showed higher incidence of myocardial infarction[3 (5.66％) vs.0(0),P =0.018] and stroke [4 (7.55 ％) vs.1 (0.68 ％),P =0.018].Conclusion The prevalence of CAD in aged patients with Stanford type BAD is relatively high.Concomitant CAD is associated with higher risk of cardio-cerebrovascular ischemic events while dose not increase the risk of adverse aorta related events.