Objective To study the value of endoscopic management of thyroid disease through periareola approach. Methods From Nov. 2008 to Feb. 2010, 20 cases were treated by endoscopic throidectomy using bilateral areola three-hole method. The chest skin and platysma were separated and CO2 (6 - 8mmHg pressure)was inflowed to establish the operative space. Thyroid tissues were cut and separated by harmonic scaple. Recurrent laryngeal nerve, superior laryngeal nerve and parathyroid gland were preserved. Results Operations were successfully completed using endoscope, among which there were 1 case of thyroid cyst resection, 5 cases of thyroid adenoma resection, 8 cases of thyroid unilateral partial resection, 3 cases of thyroid bilateral partial resection and 3 cases of thyroid sub-total resection. The average operation time was (100. 0 ± 30. 5) min. Blood loss was (70. 0 ± 15. 0) ml. 1 case of neck skin burns and 3 cases of subcutaneous hydrops appeared. No convertion occured. Conclusion Endoscopic thyroidectomy through periareolar approach is a safe minimal invasive surgical procedure with excellent cosmetic results.

Objective The current study was to investigate the clinical and pathological features of macroscopic hematuria associated acute kideny injury (MH-AKI) in patients with IgA nephropathy (IgAN) and its associated prognostic factors.Methods We performed an analysis on the clinical and pathological features of biopsy-proven IgAN patients diagnosed during 2004 to August of 2007,who had experienced MH associated AKI.The patients enrolled in the study were followed up.The renal lesions were evaluated with Katafuchi pathological scores of IgAN.Results 5 patients with IgAN had experienced at least one episode of MH-AKI,accounting for 1.3% of IgAN diagnosed during the same period and 13.5% of IgAN patients with macroscopic hematuria.High proportion of tubules filled with red blood cell casts and tubular injury were demonstrated in all biopsy specimens.Renal function of 3 patients completely recovered within 14 days.One patient (patient 4) got quick recovery in the first month of the disease but completely recovered 418 days later.The other patients only had an incomplete recovery during the 20-month follow-up.The incompletely recovered one had relatively an older age,longer persistence of MH,more sclerotic glomeruli and a more severe tubule-interstitial damage.Conclusion AKI is commonly seen during episodes of MH in patients with IgAN.Not all patients with MH-AKI showed a complete recovery.Age,duration of MH,proportion of glomerular sclerosis and the severity of tubular necrosis might be the risk factors of an incomplete recovery of renal function.

Epilepsy is a common nervous system seizure disease in children,20%-30% of them is intractable epilepsy.The pathogenesis of intractable epilepsy in children is not yet identify.Some research think that this may be associated with resistance of a variety of diffe-rent mechanisms of antiepileptic drug and abnormalities of multidrug resistance gene expression.The most investigation of multidrug transpor-ter is P-glycoprotein,multidrug resistance-associated protein.They are present in cell membrane and belong to adenosine triphosphate-dependent membrane transport protein.Studies have showed that over-expression of multidrug transporter in temporal lobe brain tissue of patients with refractory epilepsy and animal model of chronic epilepsy reduce the concentration of therapeutic drug in cells.They result in resis-tance by releasing the energy and transferring large amounts of anti-epileptic drugs to exterior of brain capillary endothelial cells in way of active transport.The relationship between multidrug transporter′s structure,distribution,functions and drug-resistant epilepsy are reviewed.

Adult ; Aged ; Female ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Postoperative Hemorrhage ; etiology ; Tracheotomy ; adverse effects ; Young Adult

Thanks to the three decades of reform and opening up,hospitals in China have made tremendous achievements in their development,yet facing new ehallenges as well.to address these challenges,there is an urgent need for these hospitals to further their reform under the guideline of the scientific concept of development.This will help them strengthen their hospital culture,quality control,technology,human resources development,and their leadership,in order to achieve a better and faster growth,better serving the role to build a harmonious socialist society.

Biomarkers ; blood ; Biopsy, Needle ; utilization ; Hepatitis C ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; pathology

OBJECTIVETo observe differences of immediate effect of twirling reinforcing-reducing manipulation at head acupoints on muscle force in patients with acute ischemic stroke.

METHODSA total of 126 patients who met the inclusive criteria were randomly divided into a twirling reinforcing group, a mild reinforcing-reducing group and a twirling reducing group, 42 cases in each one. The lines between Baihui (GV 20) and bilateral Taiyang (EX-HN 5) were selected and treated with successive insertion of three needles. The twirling reinforcing method was used in the twirling reinforcing group, and mild reinforcing-reducing method was used in the mild reinforcing- reducing group, and twirling reducing method was used in the twirling reducing group. Each needle was manipulated for 1 min, which was repeated once every 10 min. The needles were retained for 30 min. Muscle force was evaluated immediately after treatment.

RESULTS(1) Muscle force of upper limb: after acupuncture, the muscle force of proximal and remote ends were all improved significantly in three groups (all P < 0.05), which was more obvious in proximal end (all P < 0.05). The improvement of the muscle force of proximal end in the twirling reinforcing group was superior to those in the mild reinforcing-reducing group and twirling reducing group (both P < 0.05); the differences of the muscle force of remote end were not significant among three groups (all P > 0.05). (2) Muscle force of lower limb: after acupuncture, the muscle force of proximal and remote ends was all improved significantly in the three groups (all P < 0.05). The improvement of the muscle force of proximal end was superior to that of remote end in the twirling reinforcing group and mild reinforcing-reducing group (both P < 0.05).

CONCLUSIONThe twirling reinforcing manipulation at head acupoints is superior to mild reinforcing-reducing and twirling reducing manipulation for muscle force in patients with acute ischemic stroke, which is more significant in proximal end of limbs.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Ischemia ; therapy ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Stroke ; physiopathology ; therapy ; Treatment Outcome ; Upper Extremity ; physiopathology

Adult ; Femur Head Necrosis ; chemically induced ; drug therapy ; Glucocorticoids ; therapeutic use ; Humans ; Male ; Paraquat ; poisoning

Female ; Fibrosarcoma ; diagnosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis

Objective To establish a UV spectrophotometry method and an HPLC method respectively for the determination of the total content of coumarin and contents of four main constituents of coumarin in Fraxini Cortex extract.Methods UV spectrophotometry was used for the determination of the content of total coumarin in Fraxini Cortex extract. The reference substance was Aesculin, and the maximum ultraviolet absorption wavelength was 334 nm. The HPLC method was used to determine the contents of Aesculin, Fraxin, Aesculetin and Fraxetin in Fraxini Cortex extract, using gradient elution with acetonitrile-phosphate solution (0.01%) as mobile phase on Agilent ZORBAX SB-C18 chromatographic column (4.6 mm × 250 mm, 5μm) at room temperature.Results For the UV method, the linear range of the mass concentration of Aesculin was 5.76-23.04μg/mL (r=0.999 9), and the average recovery was 100.6% (RSD=1.8%). For the HPLC method, the linear ranges of the mass of Aesculin, Fraxin, Aesculetin and Fraxetin were 0.055 0-3.850 0μg (r=0.9997), 0.053 9-3.773 0μg (r=0.999 8), 0.060 0-0.660 0μg (r=0.999 9), and 0.056 2-0.618 2μg (r=0.999 9), respectively, and the average recoveries were 96.97% (RSD=1.26%), 100.80% (RSD=2.22%), 99.04% (RSD=2.47%), and 98.77% (RSD=1.94%), respectively.Conclusion Both of the two methods are simple, accurate and reliable, and can be used for the quality control of total coumarin and the main constituents of coumarin in Fraxini Cortex extract.