Objective To investigate the risk factors and prevention of recurrent laryngeal nerve injury during thyroid operation.Methods The clinical data of 2180 patients with thyroid operation were retrospectively analyzed.The potential relationship of the incidence rate of recurrent laryngeal nerve injury were evaluated,such as age,gender,nature of lesions,thyroid pathology,anesthesiology,operation times,whether or not to reveal recurrent laryngeal nerve.Results The overall incidence rate of recurrent laryngeal nerve injury postoperatively was 2.7％ (59/2180).The incidence rate of recurrent laryngeal nerve injury in patients with thyroid malignant neoplasms,repeated surgery and without reveal recurrent laryngeal nerve were 6.7％ (33/492),5.6％ (15/267),4.4％ (39/891),significantly higher than those in the patients with thyroid benign neoplasms,first time operation and with reveal recurrent laryngeal nerve [1.5％ (26/1688),2.3％ (44/1913),1.6％ (20/1289)] (P ＜ 0.01).In the patients with thyroid dorsal lesion,the incidence rate of recurrent laryngeal nerve injury in the patients without reveal recurrent laryngeal nerve was significantly higher than that in the patients with reveal recurrent laryngeal nerve[13.7％(29/212) vs.2.9％(12/417),P＜0.01].Conclusion Thyroid malignant neoplasms,repeated surgery and without reveal recurrent laryngeal nerve can increase the risk of recurrent laryngeal nerve injury,routine reveal recurrent laryngeal nerve in the patients with thyroid dorsal lesion can decrease the incidence rate of recurrent laryngeal nerve injury.

Dan Dan (bile heat syndrome) is common in clinical disease of digestive system. It relates to the gallbladder and stomach. It is different from biliary diseases, and general stomach disease as well. This article introduced the application ofHuanglian WendanDecoction on bile heat syndrome treatment, worthy of clinical reference.

Patient one was a 19-year-old woman of periodic fever with urticaria during the first week of life.And there were typicalfacies,oligoarthritis and central nervous system involvement.She also exhibited a persistent elevation of acute phase reactants.The diagnosis of chronic infantile neurological cutaneous and articular syndrome was made.Short-term dosing of tumor necrosis factor-α receptor antagonist was administrated and was substituted by glucocorticoid and methotrexate.Another two males had an earlyonset of increased acute phase reactants during inflammation attacks.One of them had recurrent fever with urticaria-like rash,arthralgia and headache.Muckle-Wells syndrome was diagnosed on basis of NLRP3 gene mutation (c.92A ＞ T).And another had recurrent urticaria-like rash with conjunctivitis,oligoarthritis,hepatosplenomegaly and increased serum IgD.The clinical diagnosis was mevalonate-kinase deficiency.Autoinflammatory diseases should be suspected by physicians and diagnosed with a combination of phenotype and genotype.Biological agents,especially interleukin-1 antagonist,have broad prospects in the therapy of autoinflammatory diseases.

Objective:To screen the best decocting technology by multi-index comprehensive score combined with response sur-face. Methods:The content of paeoniflroin and the ratio of dry extraction were used as the indicators, and response surface Central Composite with two factors and five levels was used in the experimental design. The effects of the ratio of solvent to solid, decocting du-ration and decocting times on the preparation process of tonic semifluid extract of ten ingredients were studied. Results:Design Expert 8. 0. 6b software was used for the data analysis. A quadratic mathematical model between the factors and the comprehensive score of paeoniflroin content and the ratio of dry extraction was established. Combined with the actual production, the best decocting conditions were as following:the ratio of solvent to solid was 10. 6 ml·g-1 , the decocting duration was 96 min, and decocted 3 times. Conclu-sion:The optimal decocting technology is scientific, reasonable and stable.

Objective To study the effect of multi drug combination therapy of children allergic purpura.Methods 80 cases of children with Henoch Schonlein purpura in our hospital from May 2014 to May 2016 were selected,these children were randomly divided into methylprednisolone,cimetidine and loratadine treatment group(treatment group)and methylprednisolone treatment group(control group),40 cases in each groups,the clinical curative effects,rash regression time,joint pain relief time,abdominal pain relief time,hematochezia disappeared time,urine recovery time,hospitalization time,incidences of adverse reaction and recurrences of the two groups were statistically analyzed.Results The total treatment efficiency of the treatment group was 95％(38/40),which was significantly higher than the control group 70％(28/40),the difference was statistically significant(P<0.05),the rash regression,joint pain relief time,abdominal pain relief time,hospitalization time of the treatment group were significantly shorter than the control group(P<0.05),but the differences the stool disappear time,urine recovery time,incidences of adverse reactions,recurrence rate between the two groups were not significant.Conclusion The effect of multi drug combination therapy of children with allergic purpura is better than single drug alone,can shorten the time of disappearance of symptoms of patients,reduce hospital stay.

ObjectiveTo summarize the experiences for nursing esophageal cancer patients undergoing chest laparoscopic intrathoracic esophagus anastomosis.Method The clinical data of 67 esophageal cancer patients before and after chest laparoscopic intrathoracic esophagus anastomosis were retrospectively reviewed for summarizing nursing experience.Result All 67 patients were discharged successfully,including 2 contracting anastomotic leak symptoms but cured by conservative therapy,4 contracting lung infections but cured after antimicrobial therapy,and another 2 contracting acute renal failure and cured by way conservative therapy as well.Conclusion Comprehensive preoperative preparation,accurate surgical operation and effective pre- and post-operative nursing measures can accelerate the healing,improve the cure rate and reduce the occurrence of complications.

Wingless type protein (Wnt protein) is a group of protein which plays an important role in the process of animal growth and hemopoiesis,the signaling pathway they conducted was called Wnt signaling pathway,and its abnormal activation can lead to many tumors,include lung caner.As a tumor suppressor gene,WIF-1 can restrain the activation of Wnt signaling pathway,which can avoid lung cancer.WIF-l's methylation can downregulate the expression of WIF-1,which can activate Wnt signaling pathway and cause lung cancer.So the detection of WIF-1's methylation may contribute to clinical diagnose of lung cancer,and therapy of WIF-1 's methylation may be one of the treatment metheds of lung cancer.

Objective To study children′s social adaptive capability and their relative factors.Methods Five hundred and twenty-seven children in 4 different kindergartens were surveyed by using the social adaptive capability-measuring list from infant to junior school student which revised by ZUO Qi-hua and questionnaire of family situation which compiled by TAO Gong-min and Zhu Xiao-qin.Results Twenty-five point three percent of the surveyed children′s social adaptive capabilities were higher than normal level.Sixty-eight point nine percent of them were at normal level.Four point seven percent of them were at edge level.The rest were at a slightly lower level.The influencing factors included the educational level of parents,the educational manner of the parents and their marriage relationship.Conclusions It is necessary to do some investigation to find problem eariler on children′s social adaptive capability.Suitable educational methods and good family environment are important to improve children′s social adaptive capability.

Objective To study the level of serum high-sensitive C-reactive protein and HbA1c in diabetes patients with blood stasis syndrome,and to investigate the relationship among them.Methods 58 cases of diabetes patients with blood stasis syndrome and 65 cases without blood stasis syndrome were observed.The level of FPG,hsCRP,HbA1c,24 h UAER,TC,TG,HDL-C and LDL-C were estimated.Results The level of FPG,LDL-C,TG,HbA1c,hsCRP of diabetes with blood stasis syndrome were higher than the control group(P 0.05).In patients with blood stasis syndrome,the hsCRP was positively correlated to HbA1c,24 h UAER,BMI,LDL-C,TC,TG,but the multifactor regression analysis indicated that hsCRP was only correlated to the HbA1c independently.Conclusions The long-term hyperglycemia and inflammatory may be one of the reasons for the formation of blood stasis syndrome of diabetes patients,hsCRP and HbA1c may be new evidences for diagnosis of diabetes patients with blood stasis syndrome.

Objective To investigate the feasibility of laparoscopic repair for ingunal hernia after peritoneal dialysis. Methods Laparoscopic repair of inguinal hernia was conducted in 26 patients with chronic renal insufficiency who had received peritoneal dialysis for a long time. For indirect inguinal hernia, a piece of mesh was placed in the abdominal cavity and the internal ring was sutured and ligated under laparoscope. For direct inguinal hernia, the hernia sac was high suspended and then the mesh onlay was placed under laparoscope. Results The laparoscopy was successfully performed in all the 26 patients, without conversions to open surgery. No postoperative hematoma of scrotum or refractory neuralgia was observed. Follow-up examinations for 6~12 months (mean, 9 months) showed no recurrence. Conclusions Laparoscopic herniorrhaphy for inguinal hernia after peritoneal dialysis is feasible, effective, and safe.