Objective To discuss the value of ultrasonic examinion in laparoscope's thyroidectomy.Methods 41 cases who were performed in laparoscope's thyroidectomy were checked by color Doppler flow imaging and two dimensional sonography,the key of examination:(1)The length and depth of thyroid isthmitis.(2)Trachea curve degree and the depth in up-sternum.(3)The reference between thyroid,calvicle and sternum.(4)Thyroid tumefaction degree over sternomastoid.(5)Thyroid tumer's number,position and size.(6)Tumer's kind.(7)Bloodstream change.Results Only 1 case turned open.1 case recured in hyperthyroidism.Hoarseness occured in loose after operation and come-into being after 1 mouth.No trachea and parathyroid hurt appeared in any cases.The mean operation time was 125 minutes(range 86 to 193 minutes).The mean time stay in hospital was 9 days(range 6 to 15 days).Conclusion Ultrasonic examination before operation is very valuable.

Objective To observe the Cordyceps extract on experimental rats with diabetic kidney and to explore its mechanism of action.Methods The rat models of diabetic were established by intraperitoneal injecting streptozotocin.Kidney weight and the index of kidney were measured,and 1,4,7weeks blood sugar,serum creatinine,urine microalbumin and urea were dynamically observed for evaluating Cordyceps extract on experimental rats with diabetic kidney.Results The 1,4,and 7 weeks of kidney weight was (0.662± 0.062) g,(0.670±0.061) g,(0.657±0.063) g,renal index was (0.312±0.041) ％,(0.309±0.402) ％,(0.311 ±0.0317) ％,serum creatinine was (0.51±0.03)mg/d1,(0.57±0.03)mg/d1,(0.52±0.02)mg/d1,albumin was (1.77±0.17)mg/24 h,(1.52±0.19)mg/24 h,(1.56±0.11)mg/24 h.urea was (90.71 ±0.37)mmol/L,(91.57±0.48) mmol/L,(90.56±0.39)mmol/L in the normal control group respectively.While in the model group,the value of kidney weight was (0.879±0.037)g,(0.912±0.038)g,(0.871±0.393)g,renal index was (0.494±0.039)％,(0.487±0.038)％,(0.465±0.235)％,serum creatinine was (3.71 ±0.14) mg/d1,(3.51±0.12) mg/d1,(3.32±0.11)mg/d1,urinary albumin was (7.29±0.22)mg/24 h,(7.11±0.34)mg/24 h,(7.14±0.21)mg/24 h.urea was (109.59± 8.42),(92.52±2.41),(90.71 ±0.67) respectively.Compared with the normal control group these values were decreased significantly in the model group (P＜0.05).In the Cordyceps sinensis group kidney weight was (0.837±0.036)g,(0.747±0.029)g,(0.694±0.357)g,renal index was (0.412±0.024)％,(0.395±0.037)％,(0.361±0.027)％,serum creatinine was (1.44±0.11)mg/d1,(0.81± 0.04) mg/d1,(0.62±0.03) mg/d1,urinaryalbumin was (5.71±0.25)mg,(4.52±0.21)mg,(3.96±0.15)mg,urea was (109.59± 8.42) mmol/L,(92.52±2.41) mmol/L,(90.71 ± 0.67) mmol/L respectively.Compared with the model group these values were decreased significantly(P＜0.05) in the Cordyceps sinensis group.Conclusion Cordyceps sinensis extract has a protective effect on kidney of diabetic rats.

This paper reported 13 cases of delayed traumatic chest wall abscess from January 2012 to January 2015.All the patients were associated with type 2 diabetes.After local puncture for confirmative diagnosis, a chest wall abscess dissection was carried out as soon as possible.At each site of upper and lower pole, an indwelling drainage tube was placed for irrigation and negative pressure suction.Sensitive antibiotics were selected based on susceptibility test results.The drainage tubes were removed 7-14 days after surgery.There were 8 cases of primary healing of incision and 5 cases of secondary healing of incision.All the patients were cured.Follow-ups for 6-36 months (average, 17 months) showed no recurrence.

Objective To investigate the effects of hysteroscopic resection for mild-to-moderate uterine incision diverticulum after cesarean section.Methods From September 2010 to September 2014, hysteroscopic resection was performed under B-ultrasonography in 102 cases of mild-to-moderate uterine incision diverticulum after cesarean section.Results The operation was completed successfully in all the cases, without surgical complications.Outcome evaluation at 1 year after surgery showed cured in 89 cases (87.3%, complete disappearance of symptoms and recovery of normal menstruation), improved in 7 cases (6.9%, menstrual period shortened by 5-7 d, with or without lower abdominal dull pain and menstrual exacerbation), and ineffective in 6 cases (5.9%, no or slight symptom improvement).Conclusion Hysteroscopic resection is a safe, effective, and minimally invasive method for mild-to-moderate uterine incision diverticulum after cesarean section in patients demanding clinical symptom improvement without desire of fertility.

Objective To explore the clinical characteristics of patients with transjugular intrahepatic portosystemic shunt (TIPS) and literature review in patients with clinical features ,and provide clinical reference for carrying out the TIPS .Methods Totally 31 patients in our hospital from January 2009 to May 2014 who received TIPS treatment and strict follow‐up were retro‐spectively analyzed ,the preoperative basic situation ,laboratory index ,the incidence of postoperative bleeding again ,surgical compli‐cations ,the use of anticoagulant drugs and thrombosis ,dissolved ,etc .were statistical analyzed .Results In all patients with TIPS in the diagnosis of cirrhosis and portal hypertension ,hepatitis B ,hepatitis C cirrhosis and portal hypertension ,alcoholic liver cirrhosis and portal hypertension ,unknown cause of liver cirrhosis and portal hypertension ,Budd Chiari syndrome ,hepatitis B and hepatitis C cirrhosis and portal hypertension ,primary biliary cirrhosis and portal hypertension in proportion of 45 .16% ,16 .13% ,12 .90% , 12 .90% ,6 .45% ,3 .22% ,3 .22% respectively ;the incidence of postoperative bleeding again within six months was 9 .68% ;the Child‐Puhg score of preoperative and postoperative 1 week and 3 months ,6 months was (8 .35 ± 2 .52) ,(8 .32 ± 1 .76) ,(9 .29 ± 2 .55) ,(8 .10 ± 1 .85) respectively .Statistical results showed in postoperative 1 week and 3 months ,6 months ,there was no statisti‐cally significant difference compared with preoperative respectively (P>0 .05) ,postoperative 3 months liver function score of Child‐Puhg was higher than that of postoperative 1 week and 6 months (P<0 .05) operation;the rate of abdominal hemorrhage ,hepatic encephalopathy ,stent stenosis were 3 .22% ,22 .58% ,12 .90% ;the proportion of no postoperative taking anticoagulants ,taking as‐pirin ,clopidogrel ,and warfarin were 9 .68% ,38 .71% ,41 .94% ,9 .68% ,respectively ;the formation of portal vein thrombosis (inclu‐ding thrombosis increased) rate was 12 .90% ,thrombus dissolution rate was 100% .Conclusion In China ,liver cirrhosis and portal hypertension is the main source of TIPS and hepatitis B is a major cause of liver cirrhosis ;TIPS have no effect on liver function in Child‐Puhg score;hepatic encephalopathy ,stent restenosis is still the main postoperative complications of TIPS ;rules taking antico‐agulant drugs can dissolve thrombus of the portal vein and prevent thrombosis .

The most important harms of atrial fibrilation are stroke and the embolic events of the systemic circulation. The latest data have show n that the etiology of up to 1/3 of stroke patients w as atrial fibrilation. The stroke morbidity and mortality caused by atrial fibrilation are higher than other types of stroke. So the prevention of stroke is very important for patients with atrial fibrilation. The anticoagulant therapy is the core strategy for stroke prevention in patients with atrial fibrilation. This article reviews the advances in research on the safety and compliance of anticoagulation therapy in patients w ith atrial fibrilation.

OBJECTIVE:To investigate the effect of Xuebijing injection on coagulation function and prognosis in patients with sepsis. METHODS:50 patients with sepsis were randomly divided into control group and observation group according to the hospi-talization sequence,with 25 cases in each group. Control group received conventional treatment,and observation group was addi-tionally given Xuebijing injection(50 ml added into 5% Glucose solution or 0.9% Sodium chloride solution 250 ml intravenously, bid) on the basis of conventional treatment. Treatment course lasted for 7 d. The coagulation function,APACHE Ⅱscore after 7 days of treatment and 28 d mortality were compared between 2 groups. RESULTS:After 7 d treatment,the coagulation indexes were improved significantly in 2 groups compared with before treatment,and the APACHEⅡscores were decreased significantly in both groups;the observation group were significantly better than the control group,with statistical significance (P<0.05). After followed up for 28 d,the mortality rate of 2 groups were 16% and 28%,there was no statistical significance (P>0.05). CON-CLUSIONS:Xuebijing injection can inhibit blood clotting activation,correct the coagulation disorders,and improve the sepsis se-verity.

Comparison of assays of immunoreactive insulin (IRI) and specific insulin in evaluating islet β cell function and insulin sensitivity suggested that there were no significant differences in individuals with different glucose tolerance impairment by two assays. The evaluation of islet β cell function using IRI and insulin sensitivity is still valid in clinical practice.

Objective To discuss the preventive measures of anterior palatal fistula by modified the operation of cleft palate. Methods For 23 patients of complete cleft palate with alveolar ridge cleft, bilateral mucoperiosteum flap was moved forward as possible so as to close fistula front of hard palate, and incised junction of the hard and soft palate to prolong soft palate and the wound was repaired by buccal mucosal flap.The incidence of anterior palatal fistula and velopharyngeal closure after operation was observed. Results Twenty-three patients were rechecked 1 month after operation ,there was no anterior palatal fistula occurring,10 cases were examined by epipharyngoscope 1 year after operation,the velopharyngeal closure was 90%-100%. Six cases were followed up for 6 months,the velopharyngeal closure was 80%-85%. Conclusions For second-stage operation methods of anterior palatal fistula, there are too many discussions of selection criterias, advantages and disadvantages. If first-stage operation is taken measures to prevent anterior palatal fistula or decrease the diameter of fistula as possible. It reduces percentage of second-stage operation or decreases the difficulty. It should get more attention in the clinical works.