Objective To investigate how to protect the parathyroid gland and complication prevention meas -ures better.Methods A total of 152 patients with thyroid surgery from January 2012 to January 2014 in our hospital were analyzed.Results 48 cases had symptoms of low PTH (31.56%), and 89 patients had the symptoms of low blood calcium(58.55%).There are 45 cases of asymptomatic hypocalcemia (29.61%).There was no permanent hypocalcemia.Conclusion In total excision of the thyroid gland , surgery doctors should carefully identify parathy -roid gland, enhance the technical levels of operation , protect the parathyroid gland artery and vein reflux , observe and deal with the complications in time , and do a good job in the prevention of complications .

Objective To investigate the effects of playful training on home environment and development in children with cerebral palsy. Methods89 children with cerebral palsy were divided into observation group (45 cases) and control group (44 cases). All children were treated with normal strengthen rehabilitation in hospital. The observation group received the training playfully. They were assessed with the Home Observation for Measurement of the Environment (HOME) and Bayley Scale of Infant Development (BSID) before and 6 months after treatment. ResultsAfter treatment, The HOME scores in observation group was significantly better than those before treatment and in control group （P<0.01）. The Psychomotor Dvelpment Index (PDI) of BISD was improved in both groups （P<0.01） with significant different between them（P<0.05）. The Mental Development Index (MDI) of BISD in observation group was significantly better than those before training and in control group （P<0.01）. ConclusionPlayful training can improve the development and home environment in children with cerebral palsy.

Objective To investigate the effect of apoptosis-related gene p53 on the apoptosis of retinal capillary cells in rats with spontaneously hypertensive (SHR) after ischemic reperfusion injury. Methods A total of 60 SHR rats were randomly divided into sham group (SHR-SH) and retinal ischemie reperfusion group (SHR-RIR), which were subdivided into 5 subgroups according to the time after RIR: 2, 6, 24, and 72 hours and 7 days, with 6 rats in each subgroup. Another 60 Wistar-Kyoto (WKY) rats were divided into the same groups as the SHR rats as the control. The RIR model was set up. The apoptosis of retinal capillary cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) methods and the expression of p53 was determined by streptavidin-perosidase (SP) immunohistochemistry. Results The apoptosis rate of retinal capillary cells in the 5 SHR-RIR groups was (8.64±0.56)%, (14.92±0.99)%, (24.72±2.98)%, (16.53±1.80)%, and (7.12±1.10)%,respectively. The expression of p53 in SHR-RIR groups increased at the 2nd hour after RIR, reached the peak at the 24th hour, kept the high level at the 72nd hour, and remained a little at the 7th day, which was significantly different from which in the SHR-SH groups (P<0. 01). The expression of p53 were higher in SHR-IR groups than that in the WKY-RIR groups (P<0. 01). Conclusions p53 may play a part in RIR injury by inducing or promoting apoptosis. The apoptosis of retinal capillary cells after RIR is more severe under the hypertension, and reaches the peak at the 24 hour after RIR.

Objective: To compare the efficacy between hypofractionated radiotherapy versus conventionally fractionated radiotherapy in post-mastectomy breast cancer by a meta-analysis. Methods: The controlled clinical trials of comparing hypofractionated radiotherapy versus conventionally fractionated radiotherapy in post-mastectomy breast cancer were searched from PubMed, EMbase, Cochrane Library, Wanfang database, VIP, CNKI, and CBM databases. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 software. The differences between two groups were estimated by calculating the odds ratio (OR) with 95% confidence interval (CI). Results: A total of 19 controlled clinical trials involving 2652 post-mastectomy breast cancer patients were selected in this meta-analysis according to the inclusion and exclusion criteria. The meta-analysis results demonstrated that no statistical significance was observed in the tumor-free survival (OR=1.10, 95%CI: 0.78-1.56, P=0.59), overall survival (OR=1.18, 95%CI: 0.92-1.53, P=0.19), locoregional recurrence (OR=1.01, 95%CI: 0.68-1.51, P=0.96), distant metastasis (OR=1.14, 95%CI: 0.82-1.59, P=0.43), skin toxicity (OR=1.01, 95%CI=0.80-2.16, P=0.96), cardiac toxicity (OR=1.17, 95%CI: 0.71-1.93, P=0.53) and pulmonary toxicity (OR=0.78, 95%CI: 0.44-1.37, P=0.38) between two groups. Conclusions Hypofractionated radiotherapy and conventionally fractionated radiotherapy post-mastectomy yield similar clinical efficacy, both of which are safe and efficacious radiotherapy patterns. However, the findings remain to be validated by large-scale randomized clinical trials with long-term follow-up of the advanced stage complications.

Objective: To compare the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy in patients with extrahepatic cholangiocarcinoma and gallbladder carcinoma by a meta-analysis. Methods: The controlled clinical trials of postoperative adjuvant radiotherapy versus non-radiotherapy of extrahepatic cholangiocarcinoma and gallbladder carcinoma were searched from PubMed, EMbase, Cochrane Library, Wanfang database, CNKI, Chongqing VIP and CBM databases. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 statistical software. The difference between two groups was estimated by calculating the odds ratio (OR) with 95% confidence interval (CI). Results: A total of 20 controlled clinical trials involving 1258 extrahepatic cholangiocarcinoma and gallbladder carcinoma patients were included in this meta-analysis. The meta-analysis demonstrated that the 5-year survival rate in the adjuvant radiotherapy group was significantly higher than that in the non-radiotherapy group (OR=1.67, 95%CI: 1.29-2.18, P=0.001). The 5-year survival rates in those with lymph node positive disease (OR=7.44, 95%CI: 1.24-44.72, P=0.03) and positive margins disease (OR=3.43, 95%CI: 1.56-7.75, P=0.002) were significantly enhanced by postoperative adjuvant radiotherapy. The local recurrence rate in the adjuvant radiotherapy group was significantly lower than that in the non-radiotherapy group (OR=0.56, 95%CI: 0.39-0.80, P=0.01), whereas the distant metastasis rate did not significantly differ between two groups (OR=1.22, 95%CI: 0.86-1.73, P=0.27). The incidence rates of acute toxicity and chronic toxicity of grade ≥3 caused by radiotherapy were 0-11.9% and 0-21.7%, respectively. Conclusion Compared with non-radiotherapy, postoperative adjuvant radiotherapy is a safer and more effective postoperative treatment for extrahepatic cholangiocarcinoma and gallbladder carcinoma.