OBJECTIVE: To explore the changes of parathyroid hormone (PTH) and serum calcium alter total thyroidectomy and summarize the methods to prevent and treat the hypoparathyroidism and hypocalcernia. METHOD: Seventy-three patients with total thyroidectomy in our hospital were divided into three groups according to the scope of the operation. The serum concentrations of PTH and calcium were measured and compared before surgery and after surgery 1 h, 1 d, 3 d and 5 d. RESULT: In three groups, the serum concentrations of PTH and calcium were significantly decreased (P<0. 05) after surgery and low serum PTH and hypocalcemia occured. The severity of low serum PTH and hypocalcemia was as follows: total thyroidectomy with bilateral compartment lymph node dissection (CLND)>total thyroidectomy with unilateral CLND>total thyroidectomy. The differences were statistically significant. The levels of PTH after surgery 1 hour and 1 day were effective to predict hypocalcemia. CONCLUSION Total thyroidectomy can affect the parathyroid function. The greater the scope of surgery, the higher the possibility of postoperative hypoparathyroidism. The reasonable operative procedures and more protection of parathyroid during operation can reduce the incidence of hypoparathyroidism. The level of postoperative PTH can be used as a predictive index of hypocalcemia.
Calcium ; blood ; Humans ; Hypocalcemia ; blood ; Hypoparathyroidism ; blood ; surgery ; Incidence ; Lymph Node Excision ; Parathyroid Glands ; physiology ; Parathyroid Hormone ; blood ; Postoperative Period ; Thyroidectomy

39 cases underwent total thyroidectomy in our department since January 2009 to December 2012 were retrospectively analyzed. There were 9 males and 30 females who were in their age ranged from 19 years old to 68 years old with a middle age of 46 years old. There were 34 cases of papillary adenocarcinoma, 3 follicular adeno-carcinoma, 1 anaplastic carcinoma and 1 squamous cell carcinoma. Among the 37 cases who were initial surgical management patients, there were 11 T1,14 T2,6 T3,6 T4;and there were 19 N0,12 N1a,6 N1b,1 M1. There was no permanent hypocalcaemia. Temporary hypocalcaemia occurred in 11 cases, 2 cases had recurrent laryngeal nerve injury, 1 case with lung infection.

Objective To determine the genetic subtypes and susceptible population of Cryptoccocus neoformans in China. Methods We analyzed 129 strains of Cryptococcus neoformans isolated during the period from 1980 through 2006 in 18 Prov-inces and municipalities of central and eastern China using epidemiological method,PCR fingerprint,and multilocus sequence typing (MLST).Results About 71.5% (91/129)of the clinical strains were isolated from the patients without any recognizable immunodeficiency.Only 8.5% (11/129)of the strains were from AIDS patients.The remaining 20.9% (27/129)were from patients with underlying diseases other than HIV infection.Furthermore,PCR fingerprinting and MLST showed that serotype A strains exhibited a unique VNⅠsubtype,which was distinguishable from the reference VNⅠmolecular types.For convenience we named this unique genotype as VNⅠc.Conclusions People without any recognizable immunodeficiency are the main susceptible population of the 129 clinical strains of Cryptococcus neoformans ,which contrasts with the reports from other countries.The different genetic subtypes of Cryptococcus neoformans between China and other countries may contribute to such a difference.

Objective To explore the validity and security of Simulect (basiliximab) induction immunosuppressive therapy in terms of prevention of acute allograft rejection in sensitive recipients.Methods Thirty-six adult recipients of cadaveric kidney transplant with panal reactive antibody 30 %～ 50 % were assigned randomly in a 1∶1 ratio to receive either two doses Simulect or matching placebo. Both patient groups also received baseline triple immunosuppression with the cyclosporine microemulsion, MMF and steroids. A total 40 mg Simulect was given in two doses of 20 mg eachon day 0 about 2 h before transplantation and the day 4 after transplantation respectively.Results No hyperacute rejection and delayed graft function occurred in the two groups. No apparent adverse and toxic events were recorded in the Simulect group. The incidence of acute rejection 3 months after transplantation was 11.1 % in Simulect group compared with 50 % in the placebo group ( 77.8 % reduction, P

0.05).The graft function of high dose group returned to normal within 3 to 7 days after operation.Delayed recovery of graft function occurred in 2 cases of routine dose group;in 1 case it returned to normal on the 21st day after operation, in the other the serum creatinine level fell down to 300 ?mol/L on the 45th day.There was no severe adverse event such as fever,chill,headache,heart-throb,dyspnea during ATG intravenous perfusion.And no serious infection occurred in the 2 groups during the first 3 months postoperatively.Hepatic function damage occurred in 1 case of high dose group.Follow-up ranged from 4 to 14 months.All recipients of high dose group survived with good graft function;5 of them could do housework. Only one graft lost its function in routine dose group. Conclusions On the basis of optimal selection of the donor and recipient,preoperative single-bolus high-dose ATG is effective and safe for the sensitive recipients as immune induction therapy, which may become one of the new induction treatments before transplantation.

Objective To evaluate the difference of efficacy between continuous subcutaneous insulin infusion(CSII)and continuous intravenous insulin infusion(CVII)with human insulin in patients with diabetic ketoaciduria or ketoacidosis(DKA). Methods 120 patients with DKA were randomized into two groups,one was CSII group by a portable insulin pump(60 cases),the other was CVII group(60 cases).Results Both of CSII and CVII were effective in controlling blood glucose levels.CSII therapy provided better glycemic control(P

Objective To investigate the safety and efficacy of the conservative laparoscopic operation in treatment of tubal pregnancy by drug water pressure embryo separation. Method 58 cases with tubal pregnancy without rup-ture, the first focus on internal injection of MTX dilution 5 ml to 3 ml, and then to the near corner of the uterus in-jection of 3 ml MTX dilution, and then the line to retain the fallopian tube laparoscopic embryo removal. Results After 2 weeks, the blood β-HCG was monitored, and the average follow-up was 18 months. There was no persistent ectopic pregnancy, the fallopian tube was unobstructed, 22 cases were married of 16 cases (72.73 %) in the in-trauterine pregnancy. Conclusion Separation of ectopic pregnancy and proximal tubal MTX injection method laparo-scopic conservative surgery in the treatment of fallopian tube pregnancy by methotrexate (MTX) dilution water pres-sure, curative effect is exact, retained the fallopian tube of the normal anatomy and physiological function treatment of tubal pregnancy is safe and effective method.

Objective To explore the teaching effect of acute poisoning course among students majoring in rescue medicine. Methods From March to June 2013, 30 students majoring in rescue medicine were randomly divided into two groups for the clinical practice. Case-based learning was used in experimental group and cases was tracked from one department to another in chronological order or in reverse order to explore the cause of poisoning and the development of disease and to ob-tain the complete medical records of patients. Traditional rotating internship was used in control group. Poisoning cases in the department were taken as the starting point and end point and the medical records of patients were obtained. The clinical teaching effect was compared between the two groups through questionnaire survey and final examination. The data were calculated by SAS 9.2 software, mean comparison between the two groups was conducted by t test and enumeration data were analyzed by chi-square test. P<0.05 stands for statistically significant difference. Results The number of cases in the experimental group was more than that in the control group during the same internship period ((15±3) vs. (9±5),P<0.01). Skill score of experimental group was significantly higher than that of the control group((79.1±6.9) vs. (66.2±6.7), P<0.01). Theory examination results between two groups had no obvious difference((88.4±5.7) vs. (87.8±6.3),P>0.05),however, theory examination results were increased significantly in this year compared with those of previous year((88.1±6.0) vs. (79.3±12.8), P<0.01). Questionnaire survey demonstrated that teachers and students' satisfaction were 95.3%(143/150) and 93.3%(140/150) respectively regarding the ten advantages of the track-ing type internship. Conclusions Tracking type internship with poisoning case-based learning is a good combination of lecture-based learning and problem-based learning. It is helpful to cultivate and exercise students' ability to apply the knowledge.

Objective To investigate the influence of outward development training on psychological tenacity and subjective well‐being among college students with civil aviation specialty ,in order to provide the theoretically supported coping model and in‐tervention mechanism for improving the mental health level of college students .Methods Totally 139 college students of aviation safety technological management specialty were selected as testees ,including 72 individuals in the experiment group and 67 individu‐als in the control group .The experiment group adopted the outward development training for conducting intervention ,while the con‐trol group conducted the arrangement at the corresponding time period according to the college management .Both two groups were measured by using the Psychological Resilience Scale for Adolescents and the Happiness Index Scale before and after the outward development training intervention .Then the scores in the two groups were compared between before and after intervention . Results The factor scores ,total score of the Psychological Resilience Scale and the total happiness index before intervention had no statistical difference between the two groups (P>0 .05) .The 3‐factor scores of interpersonal assistance ,active cognition and emo‐tional control ,and total happiness index after the outward development training intervention were risen ,showing statistical differ‐ence compared with before intervention (P<0 .05);whereas the 2‐factor scores of target concentration and family support and the total scores of Psychological Resilience Scale had no statistical difference between before and after intervention (P>0 .05) .The fac‐tor scores ,total score of the Psychological Resilience Scale and the total happiness index at corresponding time in the control group had no statistical difference between before and after intervention (P>0 .05) .The 3‐factor scores of interpersonal assistance ,active cognition and emotional control ,and the total happiness index after intervention had statistical differences between the two groups (P<0 .05);but the 2‐factor scores of target concentration and family support and the total score of the Psychological Resilience Scale had no statistical difference between the two groups (P> 0 .05) .Conclusion Conducting the outward development training could effectively promote the shaping and fostering of psychological resilience and subjective well ‐being among college students of civil aviation specialty .

An overall improvement of teaching quality is the core task of the reform and the development of higher education. Based on the analysis of the main factors of affecting the teaching quality in universities and combined with the implementation of “views on improving the overall qual-ity of higher education”by the Education Ministry, countermeasures for improving the teaching quality of undergraduates have been proposed such as increasing higher education funds investment to im-prove the condition of running a school, paying attention to the construction of teaching management staff to improve the level of teaching management, establishing Teacher Development Research Center to consolidate the fundamental position of undergraduate teaching , utilizing the high-quality social resources to implement the collaborative education innovation, and improving the personnel training system to strengthen the teaching quality standard .