Objective To analyze the causes and possible mechanisms of vertigo for emergency,and to discuss the diagnosis and therapy methods.Furthermore, the possible effective preventions were suggested.Methods 86 elderly patients with vertigo for emergency were enrolled to analyze the causes through symptoms,signs and accessory examinations.Results The majority of the patients fell within the age range between 60～69 ,it occurred more frequently in female patients than in male.The main causes were cervical vertebra disease,hypertension atherosclerosis,acute cerebrovascular disease,hyperlipidemia,diabetes mellitus and autonomous nerve function disorder.Conclusion The mechanisms which induce vertigo in elderly patients are concerned with disturbance of vertebra-basal and blood supply system.It is not only resulted from single disease,but also from several factors.Moreover,it often co-exist with multi-diseases, which shows that symptomatic treatment is still the essential method for curing vertigo in elderly patients for emergency.

Objective To study the significance of dissection and exposure of the recurrent laryngeal nerve(RLN) in thyroid surgery.Methods The clinical data of 1 082 patients who had undergone operations on thyroid were retrospectively reviewed.All cases were routinely operated with dissection and exposure of RLN.Results Six cases had injury of RLN(0.5%),3 cases showed parathyroid insufficiency(0.3%)and 2 cases had injury of the superior laryngeal nerve(0.2%) ofter operation.The incidence of operative complications in thyroid surgery was closely related with if exposure of the RLN.Conclusions Exposure of the recurrent laryngeal nerve is a key measure to decrease injury of parathyroids,superior laryngeal nerve and recurrent laryngeal nerve during thyroid surgery.

Objective To investigate the effect of radiofrequency on sodium/iodide symporter expression in thyroid cancer cell. Methods 29 thyroid cancer patients with low or no expression of sodium/iodide symporter underwent radiofrequency ablation combining 131I radiotherapy. Whole-body nuclide imaging and serum Ig were examined before and after radiofrequency ablation. Results Whole-body nuclide imaging showed that there were 4 cases (4/29) positive before radiofrequency ablation, 19 cases (19/29) positive two weeks after radiofrequency ablation and 12 cases (12/29) positive four weeks after radiofrequency ablation. Four weeks after radiofrequency ablation, 4 cases showed an increased serum Ig level, 17 cases with a decreased serum Ig level and 17 cases without any change in serum Ig level. The total effective cases were 25 (25/29) and 15 cases (15/29) were completely cured. Conclusion Radiofrequency ablation induces thyroid cancer cells without sodium/iodide symporter expression to resume iodine intake and thus increased clinical effect of 131I on undifferentiated thyroid cancer.

Objective To evaluate the clinical value of lymph node micrometastases in central group(Ⅵ) lymph node in follicular carcinoma of thyroid.Methods Three hundred and twenty-six negative neck lymph nodes in 68 cases on routine pathological examination(pN0) were examined by keratin-19 monoclonal antibody and S-P immunohistochemistry to detect expression of keratin-19 to confirm lymph node micrometastasis in each neck lymph node,and compare the pathological type and follow-up data of all cases.ResultsThere were 46 neck lymph nodes showed positive lymph node micrometastasis among 326 negative neck lymph nodes that included 4 lymph nodes in group Ⅱ(4/42),5 lymph nodes in group Ⅲ(5/34),5 lymph nodes in group Ⅳ(5/49),1 lymph node in groupⅤ(1/17) and 31 lymph nodes in group Ⅵ(31/184).6 in 14 cases with positive lymph node micrometastases showed distant metastasis or local recurrence,but only 3 in 54 cases with negative lymph node that micrometastases distant metastasis or local recurrence(P

Objective This study aims to investigate the mutation spectrum and frequency of GJB2 , mtDNA12SrRNA,and SLC26A4 genes in Hui people,Tibetan,Tu nationality,and Mongolian patients with non-syndromic hearing loss in Qinghai province.Methods Peripheral blood samples were obtained from a total of 211 minority patients with nonsyndromic hearing loss in Qinghai province to extract genomic DNA.Three genes of GJB2,mitochondrialDNA12SrRNA,and SLC26A4 were screened for mutations in our study cohort using SNPscan technology.Results Among these 211 patients,5 Tu patients and 1 Mongolian patient were found to carry the ho-moplasmic mtDNAA1555G mutation.The GJB2 mutations detection rates were 11.38%,4.55%,5.88%,and 10%in Hui people,Tibetan,Tu nationality,and Mongolian patients,respectively.No statistically significant differences in the GJB2 mutations detection rates were found among all four ethnicities (P>0.05).c.235delC was the most prevalent mutation in both Tu patients and Mongolian patients.The allele frequency was 2.94% and 5%,respec-tively.While for Hui patients,c.299 300delAT was the most prevalent mutation with the allele frequency of 4.47%.The mutations detection rates of SLC26A4 were 6.5%,4.55%and 2.94%in Hui people,Tibetan,and Tu nationality patients,respectively.No statistically significant differences in the SLC26A4 mutations detection rates were found among all three ethnicities (P>0.05).c.235delC was the most prevalent mutation in Hui patients,the allele frequency was 2.44%.While for Tibetan patients,c.1226G>A was the most prevalent mutation with allele frequency of 2.27%.Conclusion A total of 10.9% of deaf patients have inherited hearing impairment caused by GJB2,SLC26A4,and mtDNAA1555G mutations.The mutation spectrum of GJB2 and SLC26A4 genes has the eth-nic specificity in nonsyndromic hearing loss patients of minority ethnicities in Qinghai province.

Objective:To investigate the content rationality of antimicrobial agent thimerosal in chloramphenicol eye drops. Meth-ods:Chloramphenicol eye drops with thimerosal at different concentrations were prepared, and the antimicrobial activity was studied. Results:When the test solution contained 0. 02 mg·ml-1 thimerosal, the antimicrobial activity could achieve the requirement in the pharmacopoeia. Conclusion:Thimerosal at different concentrations in the commercial chloramphenicol eye drops all can reach the anti-microbial effect. However, the thimerosal concentration in some eye drops is unreasonably high, which should be reduced.

Objective: To study whether domestic chloramphenicol eye drops with different ethylparabenin content meet the re-quirements in Chinese Pharmacopoeia. Methods:Antimicrobial effect test was used to examine the antimicrobial effect of the different eye drops. Results:The antimicrobial effect of the eye drops was in compliance with the requirements in the pharmacopoeia. Conclu-sion:The ethylparabenin concentration in the eye drops is higher than necessary. Boric acid and borax not only can adjust pH, but also show antimicrobial effect.

Objective To design an electrical system of extracorporeal shock wave lithotripter for children and adults uses.Methods The shock wave kernel parameters of child energy section of Dornier Delta Ⅱ lithotripter were tested such as peak sound pressure,pressure pulse width and pressure pulse rise time,and then energy calibration was executed for HK.ESWL008 child extracorporeal shock wave lithotripter to make the kernel parameters of the two lithotripters the same or similar to each other.An electrical system was designed with PLC system as the core control unit,involving in wave source 3D motion,large and small C-arms motion,water circulation system,B-type ultrasound positioning system,high-frequency X-ray imaging system,high-voltage condenser charging and discharging system,console and bedside-box-controlled display system as well as electromagnetic compatibility.Results Within A,B,C,1 and 2 energy sections for child lithotripsy the maximum and average differences between the kernel parameters of the two lithotripters were 7.1％ and 3.8％ respectively.There was no difference between the clinical experience by the two lithotripters,and HK.ESWL-008 child extracorporeal shock wave lithotripter passed EMC and safety detections by Guangdong Medical Devices Quality Surveillance and Test Institute of CFDA.Conclusion HK.ESWL-008 child extracorporeal shock wave lithotripter can be used for children lithotripsy clinically.

Objective To investigate the influence of chronic renal disease (CKD) on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and hospitalization.Methods Fifty patients clinically diagnosed as COPD complicating CKD in our hospital from January 2011 to June 2013 were selected as the observation group and 50 patients with CKD-free COPD were taken as a control group.The comparative analysis was performed by retrospecting the data of lung function,exercise tolerance and hospitalization situation in 1 year follow up.Results The mortality rate,total occurrence rate of AECOPD,occurrence rate of severe AECOPD,hospitalization rate,hospitalization time,self-rating test (CAT) score,mMRC dyspnea index,CRP and blood creatinine level in the observation group were higher than those in the control group,the difference was statistically significant (P<0.05);FEV1%pred,6MWD and creatinine clearance rate in the observation group were lower than those in the control group,the difference was statistically significant (P<0.05);FEV1/FVC had no statistical difference between the two groups (P>0.05).Conclusion The condition in COPD patients complicating CKD at 1 year after clinical diagnosis is significantly aggravated compared with COPD patients without complicating CKD,and the prognosis for patients complicated with CKD is poorer.

Objective To further control the indications and to improve the effect of intra-esophageal metallic stents.Methods 83 metallic stents were be planted into esophageal through endoscopy and under X-ray TV guiding using two kinds of stent meterials in 72 cases with benign or maligant stenosis(esophageal,cardiac orifice).Results The operation of planting stents was successful in all patients and the effect of treatment of esophageal stenosis with stents covered by dacron kint membrane was best.The clinical symptoms and food intaking ablities of all patients were improved.Conclusion Home-made nitinol stents can be plant in treatment of malighent esophageal stenosis.It should be first choice for the patients without indications of surgery or after operation.