Objective To evaluate different laryngeal recurrent nerve dissections in thyroidectomy for benign and malignant thyroid diseases. Methods The chnical data of 572 patients undergoing thyroideetomy with at least one side nerve exposure were retrospectively analyzed.Results Among 572 cases,a total of 652 nerves were exposed,among those 451 were by lateral exposure,144 by inferior exposure,57 by superior exposure.Two non-recurrent laryngeal nerves were found in 572 cases.There were 6 cases referred to our department for postthyroidectomy hoarseness undergoing reexploration and it Was found that the laryngeal recurrent nerve were legated in 3 cases and severed in the other 3 cases.In this series,among those suffering from postoperative hoarseness at our own hospital,there were 3 cases in which the nerve was invaded by the tumor and it was unable to dissect the nerve intact from the tumor,while the other 4 were cases referred to our hospital for incomplete thyroidectomy and undergoing a difficult extensive second operation.Conclusions The use of lateral、inferior and superior exposure of laryngeal recurrent nerve dissection can ensure the safety and integrity of the nerve.

Objective To investigate the role of DRP1 and OPA1 in the process of apoptotic in hyperoxia induced lung injury of premature rats .Methods 48 premature Wistar rats were divided into control group in which rats were exposed tO 210 ml .L 1 oxy-en ,and hyperoxia group in which Rats were exposed to 950 mL .L 1 oxyen .The lung tissues of 2 groups were gained on the first day ,the second day and the seventh day with which that all mice were killed by cutting neck .Section of lungs were stained with hea-toxylin eosin to observe the pathological changes ,the protein expression in the lung cells which were linked with the change of plas-tosome ,then the premature rat lung tissue apoptosis in each group were evaluated .Results Compored with the contnx group ,the expression level of OPA1 in the hyperoxia group began to decrease on the first day and apparently decreased to the buttom line on the seventh day .On the other hand ,DRP1 in hyperoxia group began to increase on the first day ,while reached the summit on the seventh day .A few of TUNEL positive cells began to increase with time dependence .A lot of TUNEL positive cells could be found in hyperoxia group ,and the apoptotic index reached the peak on the 7 d .There is a significantly positive correlation between the cell apoptosis and the ratio change of DRP1 and OPA1 in high oxygen group(r=0 .725 ,P<0 .01) .Conclusion The classical pathologic characters of lung injury were found out in hyperoxia group ,and it changed obviously with time .

The expression of nm23-H1 and p53 genes were studied with ABC immunohistochemical method in 54 cases of gastric cancer and 57 cases of colorectal cancer. The result showed that the expression of nm23-H1 was 72.2% in gastric cancer and 64.9% in colorectal cancer, respectively. No significant difference was found between the expression of this gene and lymph node metastasis of the cancers. The mutant p53 protein expression was 53.7% and 52.6% in gastric and colorectal cancers, respectively. Although it was not correlated with lymph node metastasis, its expression was significantly higher in cancers with distant metastases, suggesting that the mutant p53 protein expression may be indicative of poor prognosis in gastrointestinal cancers.

Objective To evaluate radical resection for thyroid carcinoma in patients without lateral neck lymph node metastasis.Methods Clinical data of 132 thyroid carcinoma patients without lateral neck lymph node metastasis undergoing radical thyroidectomy were retrospectively analyzed.Results There were 35 male and 97 female patients.Age ranged from 18 to 62 years,median age was 34.2 years.All patients underwent ipsilateral lobectomy plus isthmectomy and Ⅵ level dissection.The rate of recurrent laryngeal nerve injury was 4.5% (6/132).Taking into account of tumor invaded nerve,the rate of dissection procedure caused injury was 1.6% (2/128).Conclusion Combination of ipsilateral lobectomy plus isthmectomy and Ⅵ level dissection constitutes radical thyroidectomy in papillocarcinoma of the thyroid gland without lateral neck lymph node metastasis,recurrent laryngeal nerve exposure is the key for this en bloc resection.

Objective To evaluate the salvage surgery for papillary thyroid cancer patients with residual neck metastatic lymph nodes after thyroidectomy.Methods Clinical data of 97 patients undergoing salvage neck dissection between September 2007 to June 2010 were analyzed retrospectively.Results Among 97 patients,residual metastatic lymph nodes were found in 80 patients in lateroposterial neck,overall residual rate was 82.47％.Residual rate was 85.71％ in 56 patients who underwent initial lateroposterial neck dissection in other hospitals:100％ in 8 patients who underwent berry-picking; 93.33％ in 30 patients who underwent partial dissection; 66.67％ in 18 patients who underwent whole neck dissection.Residual rate was 78.05％ in 41 patients who did not undergo initial lateroposterial neck dissection.The number of dissected lymph nodes was 15-45,with an average of 23 nodes removed and 8.21 metastatic lymph nodes per case.Residual metastatic lymph nodes were found in 67 patients in central neck,overall residual rate was 82.47％,residual rate was 53.85％ in 13 patients who underwent initial central neck dissection,and 71.42％ in 84 patients who did not undergo initial central neck dissection.Conclusions Correct imaging diagnosis decreases cervical residual metastatic lymph nodes in patients with papillary thyroid cancer.Successful salvage operation lies in choosing correct mode of neck dissection and carrying out sufficient dissection.

Objectives To reveal the epidemiological trends of leprosy and the achievements of leprosy control in Fujian Province. Methods In the light of methods of Basic Statistics in Handbook of Leprosy Control written by Ma Hai De, each statistic index was analyzed. Results① The incidence and detection rate decreased from 0.782/10 000 and 1.231/10 000 in the period of 1955～ 1959 to 0.036/10 000 in the period of 1990～ 1994 and to 0.033/10 000 in the period of 1995～ 1998 respectively;② prevalence dropped from the highest of 0.65‰ in 1959 to 0.007‰ in 1998;③ with the elapse of time, the average age at onset showed a shift to advance age group, and incidence of leprosy in children decreased dramatically;④ the ratio of MB to PB was higher in early period and in late period than that in middle period, and the male ratio of MB to PB was always higher than female ratio;⑤ the average disease duration reduced, and the disability rate of new cases decreased. Conclusion Through the comprehensive measures against leprosy, the endemic of this disease in Fujian Province has been evidently under control.

ObjectiveTo evaluate the feasibility of endoscopic thyroid adenoma excision. Methods Dogs were used to practice endoscopic thyroid surgery under anesthesia. On the basis of animal experiment, endoscopic technique was introduced into dissection of follicular nodule of the thyroid lobe. One male and 11 females, aging between 23～52, underwent endoscopic enucleation of thyroid tumors from March 2002 to October 2002. Results The procedure was successful in 11 cases with 1 case converted to open surgery. The average time of operation was 70*!min, and intraoperative blood loss was 5～20*!ml. The patients had minimal pain. The cosmetic result was excellent. The incisions were completely hidden even with open necked skirt. Conclusions The cosmetic result of endoscopic thyroidectomy is satisfactory.

Objective To evaluate the feasibility and effect of the treatment of hematopathy by laparoscopy plus small incision splenectomy. Methods Dissection and separation of the ligaments of the spleen with laparoscopy first. And then made a small abdominal incision to ligate and divid the pedicle of spleen to finish splenectomy. Sixteen cases of idiopathic thrombocytopenic purpura(ITP) and 4 cases of heriditary spherocytosis(HS), who were treated by medication but no effect or recurrence, were treated by this procedure. Results All the patients recovered smoothly without infection of the wound ,without fluid collection in the spleen fossa,and without great intraoperative blood loss.The operating time was 1.5～2.5h(average 2.2h), intraoperative blood loss was 30～85ml(average 65ml).Hospital stay was 4～7d( average 6d). No recurrence was found during the follow-up for 0.5 to 2.5 years in this series. Conclusions Laparoscopy plus small incision splenectomy in the treatment of some hematopathy has many advantages,such as less trauma, safety, effective and quick recovery.

HMGB-1, an ubiquitously expressed 25-KD nucleoprotein among mammals, belongs to the HMG family. Recent studies have identified that HMGB-1 is secreted by activated monocytes/macrophages via a non-classical ,vesicle-mediated secretory pathway. Extracellular HMGB-1 is an important proinflammatory cytokine. It participates in the pathogenesis of many diseases such as rheumatoid arthritis, sepsis , acute lung injury, and even leads animals death. Further studies of the mechanism and function of extracellular HMGB-1 may provide a novel strategy for the diagnosis and treatment of these diseases.

Objective To develop a portable and automatic quick screener for noise-induced hearing loss(NIHL),which is suitable for airman and ground crew.Methods Through using audio decoder chip VS1003 to achieve quick screener for noise-induced hearing loss and pre-exposing for special background noise.LPC2148 of ARM7-TDMI configuration was adopted as main controlling chip,and its software design was completed by multitask scheduler based on UCOS-Ⅱ,while the FAT system controlled the read-write to the files in SD card.The signal emergence,change in hearing class,frequency selection as well as records of subject reaction were automatically achieved.Results The system can produce stable signal of exact frequency according to GBZ49-2002 Diagnostic Criteria of Occupational Noise-induced Hearing Loss to output stability of the frequency and intensity of the audio signal,and the specific context of the noise pre-exposure function with screening of hearing impairment was achieved automatically.Conclusion Based on the great power of embedded system and VS1003,the portable and automatic quick screener for noise-induced hearing loss(NIHL) can be developed to carry out many functions,which has several features,such as simple structure,high integration,good stability and use of flexible etc.