Objective To discuss the pathological morphological features of the macrofollicular variant of papillary thyroid carcinoma ( MFPTC ) .Methods Clinical data of 2 cases of MFPTC were reviewed .The his-topathological and immunohistochemical features were analyzed .Relevant literatures were reviewed .Results The histological characters of MFPTC mainly included its multiple macrofolliculus , plenty of colloid and atypical nuclear morphology.Immunohistochemistry stain showed cytokeratin-19, Galectin-3 and HBME-1 expressed simultaneously. Conclusions MFPTC is a thyroid papillary carcinoma with unique histological characters .It should be differen-tially diagnosed from some benign lesions such as nodular goiter and follicular adenoma .Immunohistochemical stain of cytokeratin-19, Galection-3 and HBME-1 may be very helpful in the diagnosis and differential diagnosis .

Objective To summarize the related factors and nursing countermeasures of complications after the laparoscopy-assisted surgery for congenital hypertrophic pyloric stenosis.Methods Clinical data about the occurrence of complications and nursing points were retrospectively analyzed in 106 cases of neonates and infants.Results Surgical complications occurred in 16 cases,including mucosal perforation in 2 cases,abdominal cavity hemorrhage in 1 case,puncture hole infection in 1 case,repeated postoperative vomiting caused by incomplete pyloric separation in 1 case,postoperative hypercapnia in 2 cases,subcutaneous emphysema in 1 case,8 cases of postoperative hypothermia.No operative deaths.No poking holes hernia and abdominal organ injury.By careful observation and nursing,all cases got rid of postoperative complucations.Within postoperative 3～7 days,they were recovered and discharged,no nursing complications occurred.Conclusions Early discovery of complications and timely nursing intervention are important guarantee for patients to pass through laparoscopic surgery smoothly and obtain swift recovery.

OBJECTIVE:To investigate the effects of Shenfu injection on hemodynamecs in patients after the success of cardiopulmonary resuscitation(CPR),and explore the protective effects of which on myocardial injury. METHODS: A total of 178 patients with return of spontaneous circulation in central intensive care unit were randomly assigned to receive 50 mL Shenfu injection iv gtt(group SF) or Mg-contained polarized solution(control group). Hemodynamic indexes were monitored,and serum myocardium enzymes(CK) and cardiac troponin I(CTn I) were determined simultaneously before and after treatment. RESULTS: Patients in both group presented with low blood pressure BP,low cardiac output and myocardial injury after CPR. In the treatment group compared with control group,the hemodynamic indexes were markedly improved,the cardiac pumping function,cardiac output,cardiac index,stroke volume and mean arterial pressure were all significantly increased,while serum CK,CK-MB,LDH,AST and CTn I levels were all decreased obviously after treatment.CONCLUSION: Shenfu injection can markedly improve hemodynamic indexes,enhance the myocardial contractile force,effectively decrease serum myocardium enzymes and repair the damage of myocardial cells caused by the myocardial ischemia and anoxemia after cardiac arrest in patients with return of spontaneous circulation after cardiac arrest.

Objective To investigate risk factors for feeding intolerance of preterm infants under the reactive scope model guidance, and provided empirical evidence for effective prevention and treatment of feeding intolerance in preterm infants. Methods Checked the cases of 242 preterm infants been treated in the neonatal department from August 2014 to January 2015 according to the order of admission. Through literature reviewing and expert consultation, the clinical observation table was designed based on the reactive scope model, and risk factors for feeding intolerance of preterm infants were investigated by single factor analysis and logistic regression analysis from the feeding intolerance (FI) group and non-FI group. Results The incidence of feeding intolerance in preterm infants was 33.8%(70/207), feeding intolerance in preterm infants often occurred during the period of being fed within 72 hours, and the clinical manifestations were gastric retention, abdominal distension and emesis. Single factor analysis showed that gestational age, birth weight, fetal distress, aminophylline application, intrauterine infection, breast milk feeding and twice stool interval were the related factors to the feeding intolerance. Logistic regression analysis showed that gestational age and birth weight were the protective factors of FI. Fetal distress, aminophylline application, twice stool interval >3 d were the risk factors of FI. Conclusions Gestational age and birth weight were the protective factors of FI. Fetal distress, aminophylline application, twice stool interval>3 d were the risk factors of FI.

Objective To compare the emergence characteristics between propofol total intrave-nous anesthesia (TIVA)and sevoflurane induction and maintenance anesthesia (VIMA)under the guidance of Narcotrend,and to see if the recovery of consciousness after different anesthesia regimen will be of identical Narcotrend index (NTI).Methods Sixty ASA Ⅰ or Ⅱ patients undergoing elective transsphenoid pituitary tumor resection were randomized to receive deep anaesthesia (D)or light anaesthsia (L)with propofol (P)/remifentail (group PD and group PL)or sevoflurane (S)/remifentanil (group SD and group SL).During surgery,anesthesia was maintained at a depth of NTI at 46-37 or 56-47 for deep or light anesthesia respectively.After surgery,group comparisons of the NTI at extubation,recovery time,and the time interval between NTI 80 and extubation (Tdelay )were performed by analysis of variance.Results The NTI at consciousness was significantly lower in group PD (84.2±2.7)and PL(84.9±2.5)compared with group SD (88.6 ±3.4)and group SL (89.9 ± 3.3)(P < 0.05 ).The Tdelay was significantly longer in group SD (9.4 ± 4.6 )min compared with group SL (4.7±2.4)min (P <0.05),but there was no difference between group PD and group PL. Compared with other groups,the recovery time was longer in group SD (P <0.05).Conclusion The results indicate that the NTI values at recovery of consciousness are not identical between patients re-ceived proposfol or sevoflurane anesthesia.

Objective To compare the effect of underwater treadmill training (UWTT), body weight support treadmill training (BWSTT) and conventional gait training (CGT) for walking ability and balance function in hemiplegic patients after stroke. Methods 43 patients were divided into CGT group (n=14), BWSTT group (n=13) and UWTT group (n=16). Based on conventional gait training, the UWTT group and BWSTT group respectively accepted UWTT and BWSTT for 4 weeks. They were assessed with Functional Ambulation Category (FAC), maximum walking speed (MWS), 6 Minute Walk Test (6MWT), and dynamic balance function and static balance function with Active Balancer before and after training. Results All the patients improved in all items after training (P<0.05), while the UWTT group improved more in the 6MWT and balance function items than the BWSTT group (P<0.05). Conclusion UWTT is more effective for hemiplegic patients after stroke in walking ability and balance function than BWSTT.

Objective To investigate the clinical features and treatment of a group of patients of mitochondrial encepha-lomyopathy with actic acidosis and stroke (MELAS) with onset of status epileptics. Methods Clinical features, EEGs, image ifndings, and therapeutic data of 4 cases with onset of status epileptics patients ifnally diagnosed as MELAS were retrospectively reviewed. Results Four Patients were onset with status epileptics. The levels of serum lactic acid, ammonia, myocardial enzymes were increased, and the serum sodium level was reduced, and accompanied with metabolic acidosis. EEG found corresponding paroxysmal and interictal activities. Brain images showed basal ganglia calciifcation, brain atrophy, and acute cortex edema. Genetic detection found mtDNA3243 mutation. Conclusions The status epilepticus was commonly present in MELAS. The treatment of epileptic attack in this disease was dififcult, which needs early diagnosis. Appropriate anti-leptic drugs and relevant treatment to symptoms are important to alleviate cerebral injury.

Objective To evaluate the efficacy of combination therapy of cholinergic receptor blocker Tolterodine and Alpha-adrenergic receptor blocker Tamsulosin sustained-release capsules on benign prostatic hyperplasia(BPH)with overactive bladder(OAB) in elderly men.Methods A total of 97 male BPH patients aged 80 years and over(80～98 years old,mean 87.7 years old)were enrolled in this study,who met the diagnosis and treatment guidelines of OAB formulated by Chinese Urological Association and were admitted to our hospital from Jan.2015 to July.2015.Patients were randomly divided into Tamsulosin group(n＝ 51,treated with Tamsulosin) and combination group(n＝ 46,treated with Tamsulosin and Tolterodine).Results In Tamsulosin group after treatment,the international prostate symptom score(IPSS) was reduced from (18.3 ± 2.7) to (13.3 ± 3.1) (t ＝ 14.94,P ＜ 0.05),OAB symptom score(OABSS) from (9.3 ± 2.7) to (6.8 ± 1.9) (t ＝ 3.92,P ＜ 0.05),and post void residual volume(PVRV)from(36.5±32.3)ml to(16.2±12.1)ml(t＝14.98,P＜0.01).And the daily frequency of urgency,urgency incontinence and nocturia were improved in Tamsulosin group after treatment.IPSS,OABSS and PVRV were improved more significantly in combination group after treatment than in Tamsulosin group,and the daily frequency of urgency,urgency incontinence and nocturia were reduced more significantly in combination group than in tamsulosin group(t＝-5.23,-3.98,9.01,11.5,14.8,P＜0.01).While there was no significant difference in prostate volume (PV)and PVRV between the two groups after 8 weeks of treatment(t＝ 1.22,-0.94,P＞0.05).The total incidences of adverse events (mainly mouth dryness)had no significant differences between the Tamsulosingroup and the combination group(8.7％ vs.5.9％,x2 ＝99.47,P＞0.05).No acute urinary retention was found in the two groups.Conclusions The combination therapy of Tamsulosin and Tolterodine has better efficacy and safety than single Tamsulosin application in the treatment of BPH with OAB in elderly men.

Objective The purpose of the study was to develop an instrument to measure nursing professional values held by Chinese nurses.Methods 381 nurses were enrolled for the survey on their professional values by the draft of nursing professional values assessment tool(NPVAT).With the item analysis,such as dispersion degree,correlation efficient,discriminability,alpha coefficients index and exploratory factor analysis,the items were selected.Results As a result of the item analysis,the final version of NPVAT was composed of 20 items selected from a total of 32 items.Exploratory factor analysis resulted in a four-factor solution explaining 51.99％ of the common variance.Conculsions The NPVAT developed in this research can be used for measuring the nursing professional values among nurses.