Objective To discuss pefioperative nursing observation in patients with hyperthy-roidism. Methods 35 patients with hyperthyroidism were given preoperative psychological guidance, pre-operative preparation, careful postoperative observation, prevention of complications,diet and rehabilitation di-rections. Results 35 patients were discharged smoothly 7 to 8 days postoperation. Conclusions Perfect preoperative preparation and close observation and care is the guarantee of successful operation for patients with hyperthyroidism.

Objective:To vealuate the effect of percutaneous transhepatic insertion of biliary setents(PTIBS) and arterial chemoenbolization for treatment of malignent biliary obstruction(MBO).Methods:Twelve patients with MBO were treated with PTIBS,following by arterial chemoenbolization in two weeks,one time each months.Results:Fourteen stents were placed in 12 cases.The total serum bilirubin level declined from 534?120 umol/L to 45?23 umol/L in 11 patients.The survival rate of 6 and 12 monthes were 83.3% and 50% respectively.Two cases were reobsturcted after 5 months of first stent implacemnt and were retreated by insertion of second stents.The total thirty-five times arterial chemoembolization was performed in 12 cases with remarkable effect.Conclusion:PTIBS combined arterial chemoembolization was an safe ;effective interventional treatment for MBO. [

Objective　To investigate the relationship between the pathological changes and the early anastomosis of the blood vessels in blast-wounded maxillofacial region. Methods　A total of 20 dogs were regionally exploded in the left maxillofacial region by KTY-04 electric detonator. Specimens of blood vessels were removed at different distance from the edge of the wounded area at both right after (group A) and 72 h (group B ) after wounded and observed. Free skin flaps with saphenous artery were transplanted to the wounded areas. One week, 2 weeks and 3 months after anastomosis, specimens were taken from the site of anastomosis and observed. Results　Falling off of most vascular endothelial cells and the disappearance of most internal elastic membrane of the artery were observed 3 cm from the wounded area in group A with 5 free flaps died. However in group B almost normal condition was seen at the same region. 12 from 15 flaps survived successfully. Conclusion　The blood vessels begin to proliferate and repair 3 d after blast wound and this may provide the pathological basis for the possible success in the transplantation of the free flaps with blood vessels.

Objective: To study the effect of different sorts of fertilizer on the content of tanshinone Ⅱ A, the effective element of cultivated Radix Salvia miltiorrhizae. Methods: Fertilize Radix Salvia miltiorrhizae with the several kinds of combination: the oddment cake(round flat cake made of residue of seed after extracting oil form it), pig manure, chicken manure, duck manure, human excrement, plant ashes, dregs of a decoction (residue of Traditional Chinese medicine material after being extracted), phosphoric fertilizer and compound fertilizer; and gather Radix Salvia miltiorrhizae one year later. Determine the content of Tanshinone Ⅱ A in cultivated Radix Salvia miltiorrhizae by HPLC. Results: The contents of Tanshinone Ⅱ A in Radix Salvia miltiorrhizae fertilized by different sorts of fertilizer are of significant difference. Conclusion: Plant ashes, oddment cake and compound fertilizer are good for growing of Radix Salvia miltiorrhizae and raises of the content of Tanshinone Ⅱ A.

Objective To assess the clinical significance of reverse trendelenburg position in preventing postoperative nausea and vomiting(PONV)in thyroid surgery.Methods 110 patients with papillary thyroid carcinoma(PTC) admitted from Feb.2013 to Mar.2014 were prospectively divided into experimental group and the control group according to whether reserve trendelenburg position was adopted.Univariate and multivariate method were used to analyze relations between PONV and surgical position,gender,age,body mass index,hypertension,surgical time,ASA classification,anesthesia,and motion sickness.Results Of the 110 cases of PTC,the incidence of PONV was 16.28％ (7/43) in the experimental group while it was 37.31％ (25/67) in the control group.The difference had statistical significance(P ＜ 0.05).Statistical analysis showed that PONV was related to patients'gender,surgical position,surgical time,and motion sickness,while only surgical position and motion sickness was the independent risk factors.Conclusion Reverse trendelenburg position surgery can help to prevent PONV and promote recovery.

Objective To assess clinical significance of the right side lymph node dissection behind recurrent laryngeal nerve (RLN) in papillary thyroid carcinoma (PTC).Methods Clinical data of 111 cases of PTC adimitted in our hospital (Department of Vascular and Thyroid Surgery,the Union Hospital of Fujian Medical University) from Feb.2013 to Mar.2014 were retrospectively analyzed.Central lymph node metastasis was analyzed.Univariate and multivariate analysis were made to analyze relations between the right side lymph node (Ⅵ b2) metastasis behind RLN and gender,age,tumor size,capsule infiltration and so on.Results Among 111 cases of PTC,71 had central lymph node metastasis (63.96％).Total metastasis number of the right side lymph node behind recurrent laryngeal nerve (Ⅵ b2) was 2.720±2.037,and the transfer rate was 27.03％ (30/111) (P＜0.05),all lower than those of Ⅵ bl.The one-way ANOVA results showed that metastasis of the right side lymph node behind RLN (Ⅵ b2) was related with age,lateral neck dissection,and Ⅵ b1 lymph node metastasis (P＜0.05) while Ⅵ bl lymph node metastasis was the only independent risk factor for metastasis of the right side lymph node behind RLN(Ⅵ b2) in PTC.Conclusion For patients with right PTC,the metastasis rate of Ⅵ b2 is high,thus dissection of this area is favorable and can accurately reflect lymph node metastasis and further to guide tumor staging and postoperative treatment.

Bletilla striata has been used as traditional Chinese medicine for several centuries. In recent years, the quality and quantity of wild B. striata plants have declined sharply due to habitat deterioration and human over-exploitation. Therefore, it is of great urgency to evaluate and protect B. striata wild plant resource. In this study, sequence-related amplified polymorphism (SRAP) markers were applied to assess the level and pattern of genetic diversity in twelve populations of B. striata. The results showed a high level of genetic diversity (PPB = 90.48%, H = 0.349 4, I = 0.509 6) and moderate genetic differentiation among populations (G(st) = 0.260 9). Based on the unweighted pair-group method with arithmetic average (UPGMA), twelve populations gathered in three clusters. The cluster 1 included four populations. There are Nanjing, Zhenjiang, Xuancheng and Hangzhou. The seven populations which come from Hubei Province, Hunan Province, Jiangxi Province and Guizhou Province belonged to the cluster 2. The cluster 3 only contained Wenshan population. Moreover, Mantel test revealed significant positive correlation between genetic distances and geographic distances (r = 0.632 9; P < 0.000 1). According to the results, we proposed a series of conservation consideration for B. striata.

ObjectiveTo evaluate the attentional ability following brain injury.Methods26 patients with brain injury including traumatic brain injury(TBI) and stroke, and 30 normal volunteers were randomly selected. Different attention tests(Continuous Performance Test, Stroop Color-Word Interference Test, Trail Making Test and Paced Auditory Serial Addition Task) were applied to assess the attentional ability of the patients and normal volunteesrs. Then the data were sorted out before statistical analysis was performed.ResultsThere was significant difference between the normal and brain injury groups in scores(P＜0.05). There was no significant difference between TBI and stroke in scores(P＞0.05).ConclusionThe multiple aspects of attention deficit existed in the patients with brain injury, including sustained attention, selective attention, divided attention and attentional switching. Clinical manifestations of attention deficit after traumatic brain injury and stroke is closely related with the injury site.

OBJECTIVETo study application of needlescopic assisted hemithyroidectomy and central neck dissection using bilateral breast approach.

METHODSTotally 145 cases of papillary thyroid cancer patients received endoscopic hemithyroidectomy in Fujian Medical University Union Hospital were randomized to needle assisted endoscopic group (NE group, n=81) and conventional endoscopic group (CE group, n=64). The average age of the patients was 35.9 years and 11 patients were male.All patients underwent hemithyroidectomy and central neck dissection through bilateral breast approach, the NE group additional used the MiniLap-assisted intraoperation.The operative time, postoperative complications and cosmetic results were analyzed by t-test and χ(2) test.

RESULTSThe operation time of thyroid gland in NE and CE Group was (42±7) min and (31±7) min(t=9.082, P=0.000), respectively. The operation time of central neck dissection was (33±6) min and (26±3) min (t=9.050, P=0.000), respectively.There were 4 cases occurs transient recurrent laryngeal nerve paralysis in CE group and no case occur in NE group(χ(2)=5.206, P=0.036). There was no significant different in other postoperative complications and cosmetic results.

CONCLUSIONSHemithyroidectomy and central neck dissection using bilateral breast approach and needlescopic assisted technique isa safe and reliable approach, with high cosmetic effect. Application needle assistive devices can shorten the operation time while no significant increase trauma in patients, it will makes endoscopic thyroid surgery easier to promote.

Adult ; Breast ; Carcinoma ; surgery ; Carcinoma, Papillary ; Endoscopy ; instrumentation ; Female ; Humans ; Male ; Neck Dissection ; Needles ; Operative Time ; Postoperative Complications ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods

Objective To analyze the factors affecting the prognosis of patients with pulmonary sarcomatoid carcinoma (PSC) and construct a nomogram prediction model for the prognosis of PSC patients. Methods Based on the SEER database, 1671 patients diagnosed as PSC from 1988 to 2015 were collected and divided into modeling group and validation group according to the ratio of 7:3. Univariate and multivariate Cox regression analysis were performed in the modeling group to explore independent risk factors affecting the prognosis and construct a nomogram survival prediction model. The consistency index and calibration curve were used for verification in the modeling group and the test module respectively. Results Age, gender, histological type, TNM stage, tumor diameter > 50mm, surgery, radiotherapy and chemotherapy were independent factors that affected the prognosis of PSC patients. The nomogram prediction model was constructed and verified based on independent factors. The C indexes of the modeling group and the test model were 0.790 (95%CI: 0.776-0.804) and 0.781 (95%CI: 0.759-0.803), respectively. The calibration curves of the modeling group and the test model indicated that the predicted survival rate was basically the same as the actual survival rate. Conclusion The nomogram prediction model constructed based on the results of multivariate analysis can predict the prognosis of PSC patients, and has high accuracy and consistency.