Objective To investigate the risk for recurrent thyroid carcinoma.Methods Clinical data of 56 cases of recurrent thyroid carcinoma were retrospectively analyzed and summarized possible causes of relapse.Results Student's test revealed that age,initial operative approach,pathological types,postoperative medication and radionuclide therapy were associated with recurrence (P ＜ 0.05),but gender was not associated with recurrence (P =0.240),and resection of single gland was associated with recurrence (P =0.006),but resection of both gland was not so (P =0.153).Multivariate analysis indicated that initial operative approach was the dependent factors for recurrence(P ＜ 0.05).Conclusion Some patients that prone to recurrence should be strengthened regular follow-up.Standard treatment should be used for The recurrences diagnosed.

Journal Club education method is widely used in resident training in foreign countries.Its function in neurosurgery clinical training is gradually focused on.This method will promote the mastery of new concept,new method and new technique by the residents,help them to form good reading habit and improve their ability to solve actual clinical problems.The application of Journal Club education method in neurosurgery clinical training in our country may have positive influence on the standardized training of clinicians and the spreading of evidenced-based medicine.

Objective:To establish a method for the determination of related substances in enoxacin gluconate injection by HPLC with gradient elution. Methods:HPLC was performed on a DiamonsilTM C18 column (250 mm × 4. 6 mm, 5 μm), the mobile phase A was 0. 025 mol·L-1 phosphonic acid solution (adjusting pH to 3. 0 with triethylamine)-methanol- acetonitrile (80∶10∶10) and the phase B was 0. 025 mol·L-1 phosphonic acid solution (adjusting pH to 3. 0 with triethylamine)-methanol-acetonitrile (350∶325∶325) with gradient elution at a flow rate of 1. 1 ml·min-1 , the detection wavelength was 269 nm and 284 nm, the injection volume was 20μl, and the column temperature was 40℃. Results:Under the HPLC conditions, the samples had good stability and separation. The calibration curve was linear within the concentration range of 19. 80 ng·ml-1-19. 80 μg·ml-1(r=0. 999 9) for 5-hydroxymethylfur-fural with the detection limit of 0. 18ng, and the average recovery was 99. 68% with RSD of 0. 12% (n=9). Conclusion:The method is accurate, sensitive, specific and reproducible, and can be used in the determination of related substances in enoxacin gluconate in-jection.

Objective To investigate epidemiological characteristics in hospitalized adolescents and children who suffered from traffic injuries,such as source and location of an accident,the victim's gender arid age,and the site of injury.Methods The chosen subjects were 163 hospitalized children aged 1 to 18 years old,who were admitted to general hospitals in Shanghai in the years of 2004 to 2005 as a result of traffic injuries.Descriptive statistics and analysis were used to interpret the data.Results Children of immigrant workers and suburban residents were the main victims ;the main cause of injury was the collision between the motor vehicle and the pedestrian;this type of traffic injury was the most prevalent among children between 5 to 9 years old;and the locations of the injury was most commonly found in the head,the face, and the extremities.Conclusions From this statistical evidence,it could be concluded that it would be worthwhile for the government to pay more attention to children of immigrants and suburban residents to effectively educate them about traffic safety and knowledge,tt is also advisable to improve the safety protection and post - traffic injury care of children passengers.

Objective To investigate and analysis the prevalence rate of hospital infection and community infection,and to reduce the incidence of hospital infection.Methods First we investigated hospitalized patients in September 9,2013 by two ways which in-clude bedside investigation and reviewing the medical records;and then described the prevalence case of infection and the usage of antimicrobial agent by descriptive approach.Results Seven hundred and seventy patients were investigated with the rate of 100.00%;18 patients were hospital infection cases,the infection rate was 2.34%;most of the hospital infection cases was occur in lower respiratory tract;228 patients were community infection cases.The infection rate was 29.61%;the primary affected areas of community infection were respiratory and gastrointestinal tract;the structure of hospital infection pathogens were almost the same with the community infection,most of them were G- bacteria;186 patients were used antimicrobial agent in that day,the usage rate was 24.16%.Conclusion Promoting the managements of high risk departments and susceptible affected areas,making relevant rules of operation are the focus of our works in the future.

OBJECTIVE:To investigate influential factors of standardization of clinical research on therapeutic efficacy of Yao-tongning capsules,and to provide direction for reasonable and standard development of clinical research. METHODS:Retrieved from CJFD,VIP and Wanfang database,RCTs about Yaotongning capsules in the treatment of related disease were collected. After data extraction and quality evaluation,Meta-analysis was conducted by using Rev Man 5.3 statistical software. The effects of the di-alectical situation,treatment course and route of administration on the evaluation of therapeutic efficacy of Yaotongning capsules were compared;based on this,the concepts of index evidence-based value which reflected clinical standardization were put for-ward,and its effects on Yaotongning capsules were investigated. RESULTS:A total of 71 RCTs were included,involving 11009 patients. Results of Meta-analysis showed therapeutic efficacy of Yaotongning capsules was better than that of other drugs in dialecti-cal case(P=0.02),while therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs in non-dialectical case(P<0.01);therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs when treatment course was shorter than 30 days(P<0.05),while treatment course was longer than 30 days,there was no difference in therapeutic efficacy between Yaotongn-ing capsules and other drugs(P=0.99). When did not take medicine according to the instruction,therapeutic efficacy of Yaotongn-ing capsule was inferior to that of other drugs(P<0.05);when taking medicine according to the instruction,there was no differ-ence in therapeutic efficacy between Yaotongning capsules and other drugs(P=0.94). When evidence-based value was ≥5,thera-peutic efficacy of Yaotongning capsules was better than that of other drugs(P=0.03);when evidence-based value was equal to 4, there was no difference in therapeutic efficacy between Yaotongning capsules and other drugs(P=0.56);when evidence-based val-ue was ≤3,therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs(P<0.05),with statistical significance. CONCLUSIONS:It is an important guarantee of playing therapeutic efficacy of Yaotongning capsules to regularly use drugs strictly according to the principle of dialectical treatment,and take drugs according to treatment course and instructions. Clinical trials should be standardized strictly in accordance with the instructions,so as to provide objective and fair clinical findings.

Objective To discuss the reasons of death in the in-patients with percutaneous coronary intervention(PCI).Methods Retrospective analysis was done in 33 cases who died in or after the procedures among 3 252 in-patients with PCI.Results 4 patients died in procedures and the others died after procedures.The major reasons of death in order were:cardiogenic shock,ventricular fibrillation,acute left heart failure,multiple organ failure,heart rupture and acute renal failure.The in-hospital mortality rate was 1.01%.Conclusion The major reasons of death of patients with PCI are cardiogenic shock,ventricular fibrillation and acute left heart failure.Taking some measures will reduce the in-hospital mortality rate.

Objective To observe the injury of myocardium and to investigate the role of oxidative stress after limbs ischemia reperfusion in rats. Methods 20 male healthy Wistar rats were randomly divided into 2 groups: control group(C) and ischemia-reperfusion group (IR). The biochemical methods were used to measure the contents of malondialdehyde (MDA), myeloperoxidase (MPO), ATP, lactic acid (LD) and ATPase of myocardium. The levels of creatine kinase (CK) and creatine kinase MB isoenzyme (CK-MB) in plasma were also observed. The morphologic changes of myocardium were observed with microscope. Results It was found that after rats’ limbs suffering from ischemia-reperfusion, the level of ATP decreased, the activities of three kinds of ATPase (Na~+-K~+-ATPase, Ca~ 2+ ATPase and Mg~ 2+ ATPase) decreased in different degree (P

Objective To observe the effect and complications of Hoffmann Ⅱ metal external fixator in the treatment of open fractures of tibia and fibula. Methods 40 patients with open fractures of fibula received fracture reduction and fixation with HoffmannⅡmetal exter-nal fixing frame by C arm X-ray machine,who were followed up for 12 months,and the efficacy and the incidence rate were observed. Results Among the 40 cases,27 cases (67. 5%) were recovered,11 cases(27. 5%) were delayed healing,2 cases(5%) did not heal. 11 cases (27. 5%) with the pin loosening,8 cases (20%) with pin tract infection,7 cases (17. 5%) with the pin tract aseptic,1 cases (2. 5%) with infection of bone,1 cases (2. 5%) with knee flexion and extension slight abnormality. Conclusion Hoffmann Ⅱ metal external fixator in the treatment of open fractures of tibia and fibula has certain advantages,and the curative effect is exact,but there are still complications,we should pay attention to prevention to avoid adverse consequences.

Objective To investigate the efficacy and safety of oxcarbazepine (OXC) suspension for treating the 2 to 4 years old patients newly diagnosed as partial epilepsy.Methods A total of 62 patients between 2 to 4 years old diagnosed as partial epilepsy,selected from the outpatients of the pediatric neurology in the hospital from October 2009 to March 2011,were randomly divided into the experimental group of 32 patients and the control group of 30 patients.Experimental group:OXC suspension,the initial dose was 8-10 mg· kg-1 d-1,orally taking 2 times every day,increasing the dose by 10 mg · kg-1 d 1 once every 7 days to the complete control of the seizure,the target dose was 20-40 mg· kg-1 · d-1 Control group:oral administration of carbamazepine (CBZ) group,the initial dose was 5 mg· kg 1 · d-1,increasing the dose once every 5-7 days up to 10-15 mg · kg-1 · d-1,if necessary,the dose could be 20 mg · kg 1 d-1 to maintain.The observation period was 26 weeks.Results The rate of valid cases in OXC group after 13 weeks and 26 weeks were both 78.1％ (25/32),and the rate of non-attack cases were 53.l％ (17/32) and 50.0％ (16/32),respectively; the rate of valid cases in CBZ group after 13 weeks and 26 weeks were 76.7％ (23/30) and 70.0％ (21/30),respectively,and the rate of non-attack cases were 50.0％ (15/30) and 40.0％ (12/30) (x2 =0.022,0.004 ; P =0.883,0.947 respectively.).In the 26th week,the quit rate of OXC group was 6.2％,while the quit rate of CBZ group was 13.4％.The rates of adverse reactions of OXC and CBZ were 15.6％ and 26.7％,respectively,with no significant difference.Conclusion OXC suspension monotherapy for 2 to 4 years old patients with partial epilepsy was significant effective,and no significant difference when compared with carbamazepine group.The rate of the adverse reactions in the OXC group was relatively fewer,and the extent was slight.