Objective To evaluate the feasibility and advantages of gasless endoscopic thyroidectomy via the infraclavicular approach.Methods A single 2-to 4-cm infraclavicular incision was made at the ipsilateral side under local anesthesia.The subplastysmal plane was dissected up to the anterior neck to build a gasless space by mechanical method.Afterwards,by using ultrasonic scalpel,thyroidectomy was performed.Results The procedure was completed in 34 cases with a mean operation time of(120?30) min and mean blood loss of(20?12) ml.After the surgery,3 patients developed subcutaneous fluid and 1 patient had incisional infection,all of the 4 patients were cured by conservative therapy.The 34 cases were followed up for 1 to 30 months with a mean of 18.5 months,during the period,none of them had recurrence.Conclusions Gasless endoscopic thyroidectomy via the infraclavicular approach is a simple and safe method with good cosmetic outcomes.

Aconitine ; poisoning ; Aconitum ; chemistry ; poisoning ; Cardiopulmonary Resuscitation ; Charcoal ; therapeutic use ; Female ; Hemoperfusion ; Humans ; Male ; Middle Aged ; Poisoning ; drug therapy

Objective:To improve the quality standard for Kangshiming mixtures. Methods:The identification of Angelicae Sinen-sis Radix, Astragali Radix and Phellodendri Chinensis Cortex was carried out by TLC. The contents of puerarin and paeoniflorin in the preparations were determined by HPLC. Results:The spots displayed in TLC were clear without interference from the negative control. The linear range for puerarin was 1. 64-49. 20μg·ml-1(r=0. 999 9) and 4. 22-63. 30μg·ml-1(r=0. 999 6) for paeoniflorin. The average recovery was 99. 63%(RSD=2. 14%,n=9) and 99. 05%(RSD=2. 70%,n=9) for puerarin and paeoniflorin, respectively. Conclusion:The method is accurate, reliable and specific, and can be used in the quality control of Kangshiming mixtures.

Objective To study the clinicopathological characteristics of hereditary nonpolyposis colorectal cancer (HNPCC) in Chinese population with different criteria and guidelines. Methods Twenty four families fulfilling Amsterdam Criteria (AC), 15 additional families fulfilling Japanese Criteria (JC) and the remaining 19 patients fitting Bethesda Guidelines (BG) were analyzed. Results In the 24 AC families there were 116 malignant tumor patients including 90 colorectal cancer (CRC) subjects and in the 15 JC families there were 54 malignant tumor patients including 33 CRC cases. The two groups displayed similar clinical features. Mean age of first CRC at diagnosis was 46.1 and 51.4 years old, respectively. The proximal colonic cancers accounted for 55.4% versus 44.8%. Synchronous and metachronous multiple CRCs occurred in 25.6% and 18.2% of patients respectively. Totally there were 55 extracolonic tumors in the two groups. Gastric and endometrial carcinomas were two most common extracolonic tumor types in our series. The tumors of the 34 probands showed more frequent exophytic growth pattern, higher occurance of poorly differentiated carcinoma, A / B Dukes stage and more Crohn's like lymphoid reaction ( P

Teaching competency is one of the basic skills for teachers to accomplish daily teaching routine.This article focused on issues like imbalanced development in teaching competency,young teachers' lack of solid basic teaching ability,teachers' weak research ability and their lack of research ability to support teaching process in local medical colleges.In theory it systematically explained the teachers' teaching competency structure.Through the implementation of three linkage training of university-faculty-teaching and research department,normalized and institutionalized training for teachers from teaching-hospital,cooperation between clinical and basic medicine teachers,teachers' basic teaching ability was improved.And by transforming teaching evaluation philosophy,setting teaching quality standards at different levels,strengthening teachers' teaching introspection,teachers' ability in teaching evaluation was increased.Besides,by delivering encouragement policy and project driven teachers were guided to upgrade research ability in order to reflect on teaching.

Objective To investigate the effects of Xuebijing injectio (Chinese herb preparation) on intestinal function and inflammatory responses in severe burn patients. Method Thirty-two patients with comparable severity in burn injury were randomly divided into Xuebijing injectio treatment group (n = 16) and control group (n = 16). Patients in both groups received routine burn therapy, while those in Xuebijing treatment group additionally received Xuebijing injectio 100mL in intravenous drip twice a day for 7 days. Before the treatment and on the 3rd and the 7th day after the treatment, blood concentrations of diamine oxidase (DAO), lipopolysaccharide (LPS) ,tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) were determined in both groups. Analysis was made by SPSS 12.0 software. Results The plasma levels of DAO, LPS, TNF-α and IL-6 were decreased in both groups after the treatment. However, the plasma levels of DAO, LPS, TNF-α and IL-6 in the Xuebijing treatment group were significantly lower than those in control group on the 3rd and 7th day after the treatment (P＜ 0.05).Conclusions Xuebijing injectio could protect intestinal function, decrease the plasma level of endotoxin and lessen zhe inflammatory responses in severe burn patients.

Objective To sum up experience with surgical excision of isolated local recurrence for renal cell carcinoma. Methods From March 2004 to November 2007, 7 patients (five cases un-derwent radical nephrectomy and two nephron-sparing surgery) with isolated local recurrence of renal cell carcinoma were treated at our department. All patients underwent extensive surgery for local re-currence. Results The mean patient age was 42 years (range 19 to 6). The mean time to local re-currence was 23.3 months (range 12 to 54). The Mean size of the recurrent tumor was 5.2 cm(range 2.5 to 10.5). Peritoneal exploration was performed in 7 patients and 5 had complete en bloc excision of the renal cell carcinoma mass. 2 patients gross disease was excised. The mean blood loss was 1050 (150-3000) ml. Surgical complications occurred in 2 patients, iliohypogastric nerve injure in one and ileus performation in another one. All patients recovered finally. Six patients were followed and one lost follow-up. Mean follow-up time was 13(8-27) months. One patient died of metastatic disease at 22 months after excision of the renal cell carcinoma mass. Conelusion En bloc excision of isolated locally recurrent renal cell carcinoma is possible, and complete surgical resection could lead to pro-longed disease-free survival.

This paper summarized nursing care in intra-hospital transfer of 13 critically ill patients with extracorporeal membrane oxygenation. The key points to guarantee safety of critically ill patients were establishing a well-trained professional team and developing standardized procedures,and applying checklist for ECMO Transfer. The key points in nursing were assessment and pretreatment,homogenized nursing during transfer and effective handover after transfer. As a result,six cases of avian influenza patients successfully completed CT ex-amination,five cases of lung re-transplant patients and two cases of lung transplant patients were successfully trans-ferred to the operating room.

Scr;and in this detection,Cys C had an obvious advantage to other items .Conclusions Cyc C is considered as one sensitive index of renal function impairment of infantile diarrhea sufferer;its sensitivity is advanced than Urea,Scr,and also is closely correlated with the state of diarrhea.

Objective To summarize the effect of laparoscopic repair of acute gastric perforation. Methods Patients with acute gastric perforation underwent laparoscopic repair and abdominal drainage under intravenous- inhalation general anesthesia after a histological biopsy. Results Forty-six patients with acute gastric perforation were successfully operated.Of which, 6 patients with pylonic perforation, 37 patients with perforation in the front wall of gastric antrum, 3 patients with perforation in stomach body. Thirty-three cases were received frozen section biopsy, only 1 case showed a cancer in the lesser curve of stomach body. There was no complications occurred and no operative mortality in this series. Of the 45 benign ulcers patients,31 patients were discharged 7 days after the operation, 14 patients were discharged 2 weeks after medication treatment.Three months after operation the symptoms of the 45 patients disappeared totally,they had normal diet,and got body weight 1-3kg. Pathological examination showed that no malignant cell was found in 45 benign ulcer patients. The cancer patient was discharged 9 days after operation and refusing to further treatment. Conclusions Laparoscopic repair is a safe mini-invasive method, and it isn′t breach the surgical principles,it allows the patients recover quickly and with less complications. The intraoperative biopsy can prevent misdiagnosis of cancer. It is an effective treatment for acute gastric perforation and worthy to be widely used.