[Objective] To discuss the operation mode of thyroid tiny papil ary caracinoma and offer foundation for clinical choice. [Method] Make analysis on the clinical data and fol ow-up results of 176 cases of the disease above. [Result] Al were made operation, and there ’re no death. Compare the resec-tion of deseased gland and isthmus with ful resection of the thyroid, the difference of hoarse sound and low-calcium occurrence rate had statistical mean-ing; on uni-lateral and double lateral central ALND, the hoarse sound and low-calcium occurrence rate had no marked statistical meaning. [Conclusion] The diseased gland and isthmus resection+double lateral ALND not only doesnt ’increase post-operation complications, but improves patients ’life quality, which is the main operation for thyroid tiny papil ary carcinoma.

Bombesin in central nervous system (CNS) is closely related to thermoregulation. Injection of bombesin into some parts of brain caused hypothermia significantly, especially in POAH, and this effect can be enhanced by the cold ambient temperature. The mechanism might be suppress heat production and disrupt the regulatory function of thermoregulatory centre. Morever, other neuropeptides, food deprivation and lesion of VMH (ventromedial hypothalamus) affected the action of bombesin.

Objective To observe and analyze the euthyrox intervention effect of early hypothyroidism after 131I therapy for hyperthyroidism. Methods 200 cases of patients with hyperthyroidism in our hospital from March 2014 to April 2016 were selected as the object of the experiment needs, all the patients were randomly divided into two groups, respectively into study group and control group, two groups there are 100 patients. All patients before admission were accepted 131I treatment, control group received routine treatment, the study group was treated with 131I in twentieth days after start of continuous use of euthyrox, 20 days of continuous use, the two groups of patients with thyroid ultrasound, thyroid gland imaging, thyroid function and perturbation the rate of iodine was detected and observed. And the two groups of patients in the clinical efficacy of different after treatment were compared. Results The patients in the study group and the control group in 3 months after treatment, 9 months and 12 months the incidence of hypothyroidism were compared, research The incidence rate of hypothyroidism group was significantly lower than the control group, the differences between the groups were statistically significant (P<0.05). Patients in the study group and the control group at the same time, the cure rate of hyperthyroidism compared to the study group was significantly higher than that of control group, with statistical significance (P<0.05). Conclusion In patients with early after 131I treatment for patients taking euthyrox can to some extent reduce the occurrence of hypothyroidism, but also can improve the cure rate of hyperthyroidism for the first time, a higher application value.

The differentiation of cells types and layers in the cerebellar cortex of 74 white micefrom the time of birth to the adult age were observed by the methods of Nissl, Golgi,Cajal and Golgi-Cox. The external granular layer of the folia of the cerebellar cortex attained the greatestthickness in the fourth on the fifth day; at the same time, mitosis was seen. There after,this layer became gradually thinner; from eighteenth to twentieth day after birth it even-tually disappeared. Some cells of the external granular layer differentiated into granular and stellatecells. The Purkinje cells after birth were in primitive form with perisomatic dendrites.From the eighth day on, perisomatic dendrites became atrophic and disappeared. In thethird week, the Purkinje cells reached the mature stage. The Purkinje cells after birth, besides the ones in their normal position, might befound in the submeningeal spaces, external granular layer, molecular layer, internal granu-lar layer and medulla of the cerebellum. A part of these displaced cells may be origi-nated from the external granular layer. With the disapperance of the external granular layer, the Purkinje cells becamecompletely matured. In accordance the animals in this period began to be able of in-dependent activities, such as running, jumping, etc.

The article reviewed the concept of normal binocular vision and general examination methods of binocular vision and its normal range.New investigation progresses about monocular and binocular depth perception in neuro-physiology and neuro-anatomy were introduced.The depth perception from monocular and binocular depth cues was integrated in parietal area of caudal intraparietal sulcus(CIP).Mono-eye also had depth perception.Strabismus and amblyopia could damage the binocular vision and binocular depth perception.Binocular vision damage and its treatment results with doffing suppression training,fusion training,and stereopsis training in strabismus and amblyopia patients were explained in detail in this article.

Objective: To investigate the familial clustering risk factors for hepatitis B in Shanghai area. Methods: A standard, two-page questionnaire was designed to investigate the risk factors for HBV infection in the family members of index cases. The risk factors were analyzed between families with HBV clustering and families without HBV clustering (controls). Results: A total of 870 family members from 298 families were investigated. Multivariable analysis showed that family members with liver cirrhosis (P = 0.004, OR = 2.548, 95% CI 1.352-4.800) and sharing of towels (P=0.016, OR=1.864, 95% CI 1.125-3.089) were the independent factors for familial clustering of hepatitis B. Conclusion: Family members with liver cirrhosis and sharing of towels are the major risk factors for intrafamilial transmission of HBV in Shanghai.

BACKGROUND: Autism is a kind of severe growth and development disorder that occurs in the infant period. It is basically characterized by social communication disorder, language development disorder, narrow area of interest, and stereotyped and repeated behavior to different extents, and is increasing in the worldwide. Education training is still taken as the major for the rehabilitation therapy of autism.OBJECTIVE: Case analysis is performed to provide elicitation for mainstreaming education training of children with autism and proper suggestions for education worker and children patients' parents.DESIGN: Case analysis.SETTING: Department of Rehabilitation, Nanjing Technical College of Special Education; Nanjing Shangxinhe Primary School.PARTICIPANTS: One male child patient, born in June 1998, was diagnosed as autism by Shenyang Children's Hospital. They met the diagnostic criteria of infantile autism of the 4th edition of diagnostic and statistical manual of mental disorders (1994, USA).METHODS: Comprehensive intervention was performed in the child with autism for 5 months. Education measures consist of: ① to well accept class learning. ② showing merits in class. ③ to well apply learning contents in life. ④ to establish friendship. ⑤ to establish good behaviors and eliminate abnormal behaviors. ⑥ to pay more attention in class.⑦ to train the perceptivity in class. ⑧ to choose proper examination methods. ⑨ to establish pleasant and confluent plate time. The procedures were as follows: we had one telephone interview to the teachers and parents of child patient every day, one face-to-face communication with the teachers, parents and classmates of child patient every week. Education strategy was regulated in time aiming to the concrete condition of child patient.Wechsler Intelligence scale was used to measure the intelligence quotient (IQ) at the beginning and end of the experiment. The changes in behavioral performance in class and playtime of patient were summed up.MAIN OUTCOME MEASURES: ① The measurement results of Wechsler IQ of patient at the end of the experiment. ② Changes in the behavioral performance of patient in class. ③ Changes in the behavioral performance of child patient in playtime.RESULTS: ① Measurement results of Wechsler IQ of patients at the end of the experiment were as follows: verbal IQ 80 points, performance IQ 110 points, full scale IQ 95 points. There was 30-point discrepancy between performance IQ and verbal IQ, and 9 points between the highest and lowest scores. The imbalance of intelligence development had turned better.② Changes in behavioral performance in class: The child patient was basically the same as other children. He could attend a class silently, followed the teacher to learn, did not disturb class, and show his brilliance with proper style. ③ Changes in the behaviors in playtime: made friends; was interested and participated in the games of the classmates, entered the classroom when he heard the ring without the help from the teacher.CONCLUSION: After 5-month rehabilitation training, the mainstreaming status of patient with autism is significantly improved as compared with before intervention. Application of various rehabilitation-training methods can improve the education effect of patient with autism.

Objective: To improve the low relief fund utilization rate, make the city minimal assurance relief patients enjoy double Medicaid assistance account and agricultural insurance or Medicare reimbursement policy. Methods: Based on the actual work, and actively explore, innovation, in the Oracle database platform, the transformation of His in outpatient service charge settlement system, establishing patient account data, through a patient's unique index related agricultural insurance or Medicare patient file information. Results:The outpatient service charge settlement system enabled for tailored low mental patients. Conclusion:the patients fully enjoy minimal assurance relief assistance account and agricultural insurance or Medicare reimbursement policy ofdouble Medicaid, andfirst diagnosis and treatment forbusiness conducted a preliminary exploration.

Objective To explore the correlative factors of hypotension among hemodialysis patients and to come up with nursing interventions.Methods The histories of 49 maintenance hemodialysis patients were retrospectively reviewed to find out the correlative factors of hypotension and summarize the nursing strategies.Results The major factors for hypotension included large volume of dehydration and fast speed of dehydration in 22 cases,malnutrition and hypoproteinemia in 8 cases,severe anemia in 6 cases,dysfunction of the autonomic nervous system in 5 cases,low concentration of sodium or high temperature of dialysate in 4 case and medication errors and eating too much before or during dialysis in 4 cases.Conclusion The nursing strategies including control of weight,correct assessment of dry weight,right performance of low temperature hemodialysis and sodiun profile hemodialysis as well as mental care to those with depression are critical for prevention of hypotension development in patients undergoing maintenance hemodialysis.

Objective To investigate the differences in the clinical application of the etiological subtypes of ischemic stroke according to the TOAST,ASCO and CISS criteria.Methods A total of 167 consecutive patients with fist-ever ischemic stroke were enrolled in the study.They were classified with the TOAST,ASCO and CISS criteria,respectively.The differences and consistency of subtype diagnosis of each etiology were compared.Results Compared with TOAST,ASCO grade 1 significantly increased the proportion of patients in a large atherosclerosis group (23.4％ vs.19.8％ ;x2 =4.167,P =0.031) and decreased that in a small vessel disease group (32.9％ vs.38.3％ ; x2 =4.923,P =0.022); similarly,CISS also significantly increased the proportion of patients in the large atherosclerosis group (37.1％ vs.19.8％ ;x2 =27.034,P ＜0.001)and decreased that in the small vessel disease group (19.2％ vs.38.3％;x2=25.289,P ＜ 0.001).However,ASCO grade 1 (34.1％ vs.28.1％;x2 =3.682,P=0.052) and CISS (32.9％ vs.28.1％;x2 =0.880,P =0.268) did not decrease the proportion of patients in a cryptogenic group.The consistency of the 3 typing methods was between moderate (other etiology group of TOAST/ASCO-1,κ =0.434) and excellent (cardioembolism group of TOAST/ASCO-1,κ =0.967).Conclusions Both ASCO-1 or CISS typing may not decrease the proportion of the patients with the subtype of cryptogenic stroke,but the consistency among all the subtypes was better.The design and characteristics of the diagnostic criteria in all subtypes with the 3 criteria should be considered in clinical practice.