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 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 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 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 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 investigate the method of quality control on the whole process in sterilization supply department. METHODS According to issued by Ministry of Health all kinds of criteria and inspections,the whole process in sterilization supply department was analyzed,and then the quality was controlled. RESULTS The whole process of sterilization was standardized,systematized and programmed. CONCLUSIONS The quality control on the whole process is an effective measure to ensure the rate of supply eligibility and support.

Facing the background of "team spirit"in constructing harmonious society and the development of relief medicine,the article analyzed the current situation of "team spirit education"and the dilemma of relief medical teaching,and put forward the suggestion of developing "team spirit education"in relief medical teaching.