Objective To explore the advantage of anterior cervical muscle group approach at sternal end transection in removal of bilateral huge thyroid neoplasm.Methods One hundred and seven patient underwent removal of bilateral huge thyroid neoplasm were selected.Fifty-two patients were given neck white line incision thyroid surgery (control group) and 55 patients were given anterior cervical muscle group approach at sternal end transection for thyroid surgery (observation group).The operative time,operation field exposure effect,amount of bleeding in operation,postoperative complications,and postoperative drainage volume were compared between two groups.Results The operative time [(88.53 ± 5.95) min],amount of bleeding [(18.58 ± 5.95) ml],and postoperative drainage volume [(47.58 ± 14.76) rnl] in observation group were less than those in control group [(113.98 ± 15.85) min,(39.27 ± 16.32) ml,(73.90 ± 14.40) ml] (P ＜ 0.05),the postoperative complication rate was lower than that in control group (P ＜ 0.05).Operation field exposure effect in observation group was better than that in control group (P ＜ 0.05).Conclusions Removal of bilateral huge thyroid neoplasm with the sternal end approach is feasible and simple.The operation field exposure is better than the neck white line incision,complications after operation is less.It is worthy of clinical application.

Objective To investigate the effect of isoflurane on lung ischemia reperfusion injury in rabbit in vivo Methods Thirty two healthy New Zealand white rabbits of either sex weighing 2 0 2 5kg were randomly divided into four groups of eight each:sham operation (group A): chest was opened and left main bronchus and pulmonary artery and vein were isolated but not clamped The lungs were ventilated for 120min; ischemia reperfusion (group B): left hilum was isolated and clamped for 60min, after declamping the lungs were ventilated for another 60min Isoflurane+ischemia reperfusion(group C): the lungs were first ventilated with 1MAC isoflurane for 15min then the left hilum was clamped for 60min, after declamping the lungs were ventilated with 1MAC isoflurane for another 60min Isoflurane(group D): left hilum isolated but not clamped The lungs were ventilated with 1MAC isoflurane for another 60min Animals were then killed by blood letting, left lung was excised for microscopic examination and measurement of wet/dry weight(W/D) ratio and MDA content Results The W/D ratio and MDA content of left lung were significantly higher in group B and group C than those in group A and group D, while W/D ratio and MAD content in group B were significantly higher than those in group C Microscopic examination showed that there were severe leukocyte infiltration and edema formation in alveolar spaces and alveolar structure was destroyed in group B and group C, but the changes were less severe in group C Conclusions Inhalation of 1MAC isoflurane before ischemia and during reperfusion protects the lungs against ischemia reperfusion injury in rabbit in vivo

Objective To investigate the effects of different doses of propofol on erythrocyte lipid peroxidation in patients undergoing open heart surgery Methods Twenty seven adult patients with rheumatic heart disease undergoing elective value replacement were divided randomly into three groups of nine patients each: control group (group C), low dose propofol group (group LP) and high dose propofol group (group HP) The patients were premedicated with intramuscular morphine 0 08mg/kg and scopolamine 0 06mg/kg Anesthesia was induced with propofol 2 0 mg?kg -1 (group LP and HP) or midazolam 0 2mg?kg -1 (group C), fentanyl 5 0 ?g?kg -1 and vecuronium 0 1mg?kg -1 After tracheal intubation the patients were mechanically ventilated Anesthesia was maintained with propofol 5mg?kg -1 ?h -1 (group LP) or 10mg?kg -1 ?h -1 (group HP) or Isoflurane inhalation (group C) in addition to fentanyl (total dose 40 60?g?kg -1 ) and vecuronium Blood samples were taken from internal jugular vein before operation (T 1), 60min after initiation of CPB(T 2), 15min (T 3) and 60min (T 4) after aorta declamping and 24h after termination of CPB (T 5) for determination of plasma and erythrocyte LPO (P LPO and E LPO) and erythrocyte SOD (E SOD) The shape of erythrocyte was also viewed under electron microscope Results The levels of P LPO and E LPO increased significantly after initiation of CPB and the level of E SOD was higher than baseline level at T 2, then decreased from T 3 to T 5 in the three groups (P

Objective To investigate the effects of chloroquine (CQ) on the acute lung injury (ALI) induced by total hepatic ischemia-reperfusion (I/R) .Methods Ninety SD rats of both sexes weighing 300-350g were randomly divided into 3 groups (n=30 each) : group A sham operation; group B total hepatic I/R and group C CQ + total hepatic I/R. The animals were anesthetized with 3% pentobarbital 45 mg?kg-1. Total hepatic I/R was produced by occlusion of hepatic hilum, supra-and infra-hepatic inferior vena cava for 20 min and the occlusion was then released for reperfusion. In group C CQ 10 mg?kg-1 in normal saline (NS) 1 ml?kg-1 was injected via right femoral vein 10 min before abdomen was opened. In group A and B NS 1 ml?kg-1 was given Ⅳ instead of CQ. The animals were killed at the end of 20 min ischemia (T0); 4 h of reperfusion (T1) and 48 h of reperfusion (T2) (n=10 at each time point). Blood samples were taken at T0 and T1 from portal vein of liver for determination of plasma D-lactate, endotoxin (ETX) and TNF-? concentrations. 48 h survival rate was recorded and the animals were then killed for microscopic examination of the lung.Results Portal vein plasma D-lactate, ETX and TNF-? concentrations at T0 and T1 in group B were significantly higher than those in group A. In group C pretreatment significantly attenuated the increases induced by hepatic I/R. The 48-hour survival rate was significantly higher in group C than in group B. The histologic damage was significantly lighter in group C than in group B. Conclusion CQ has protective effects on the lung against injury induced by total hepatic I/R.

Objective: To research the effect of Wenyang Huoxue Compound Preparation on platelet receptor and signal transduction in coronary heart disease rats with yang deficiency and blood stasis of heart.Methods: The coronary heart disease rat models were established by administering high fat diet,subcutaneous injection with pituitrin and being stimulated by cold methods.Then,to observe the effect of Wenyang Huoxue Compound Preparation on platelet receptor and signal transduction.Results: Compared with model group,the concentration of plasma von Willebrand factor(vWF),the content of thromboxane B2(TXB2),the platelet aggregation rate,the molecular number of GPⅡb/Ⅲa and the content of platelet?granularmembrane protein(GMP 140) in Wenyang Huoxue Compound Preparation group decreased apparently(P

The scale and questionnaires were used to analyze the constituent ratio of symptoms at different stages. The relationship between the main syndrome and pathogenesis of coronary heart disease at different stages was analyzed by statistical methods and the medical principles analysis Thus the successive order of main symptoms and the transforming relations were ascertained. So basic pathogenesis and evolution rule of symptoms that penetrated the whole process of the disease were expounded: the dificiency of syndrome and emotinal factors were the key to the whole process of onset of coronary heart disease.

Objective To observe the length of duration of free gas presence in abdomen after laparoscopic cholecystectomy (LC). Methods A Series of chest X-ray examinations following LC in 69 patients in this hospital from April 2002 to December 2002 were taken to review the condition of subphrenic free gas. Results Gas was detected on (1.8?1.1) days following LC and was completely absorbed within 6 days after LC. The logarithm of the length of duration of pneumoperitoneum had a parallel relationship with the subphrenic residual gas volume within 24 postoperative hours ( r =0.616, P =0.000), bore a negative relationship with the pneumoperitoneum time ( r =-0.228, P =0.014), and was not correlated with age, body weight, height, operation time and consumption of CO 2. Conclusions Clearing intraabdominal CO 2 gas away so far as possible can shorten the length of duration of gas presence in abdomen.

Objective To explore the relationship between the apoptosis of cerebellar granule cell and the changes of caspases-3 and Bcl-2 in rats with methylmercury intoxication.Methods We chronologically observed the pathological changes of cerebellum in rats given methylmercury[4 mg/(kg?d)] at day 11, 15, 18 and 19. The apoptosis of cerebellar granule cell was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL) method, and the relationship between the apoptosis and the expression of caspases-3 and Bcl-2 was evaluated.Results At day 18, some sparse TUNEL positive granular cells could be observed, mainly in deep lamina adjacent to the white matter. At day 19, the apoptotic cells markedly increased, while the number of granular cells decreased with a well preservation of Purkinje cells demonstrated by calvindine immunostaining. MRF-1 and glial fibrillary acidic protein(GFAP) dyeing demonstrated severe microglia reaction and astrocytosis. From day 11, caspasese-3 mRNA expression up-regulated, increased gradually and reached peak at day 18, then decreased markedly at day 19. In contrast, Bcl-2 mRNA expression down-regulated from day 11, and decreased obviously at day 19. Zic-1 as a marker of granule cell decreased gradually after methylmercury administration and indicated degeneration of granule cells.Conclusion Cerebellar granular cell degeneration induced by methylmercury is related to apoptosis mediated by caspases-3 and Bcl-2 down regulated.

A total of 12 imported falciparum malaria cases in Yangzhou City in recent years were investigated retrospectively and analysed stafisticaly.All the faleiparum malaria patients returned from malaria endemic area in Africa.No prevalence peak occurred and the symptoms in some patients were not typical.It is necessary to enhance health education for expoaed workers.

BACKGROUND: Ginsenoside Rb1 has been extensively used in the protection and treatment of heart, encephalon, lung, kidney and liver damage. However, its application in skin flap is rare.OBJECTIVE: To investigate the effects of intraperitoneal injection of ginsenoside Rb1 on the survival of the dorsal random-pattern skin flap with large length-to-width ratio in rats.METHODS: Healthy adult SD rats were randomly divided into experimental and control groups. A caudally based dorsal random pattern skin flap, 80 mmx20 mm (length: width = 4:1), was symmetrically made. Ginsenoside Rb1 (2 mg/kg) was intraperitoneally injected into the experimental group rats, and the same volume of normal saline was injected into the control group. Malonyl dialdehyde (MDA) and nitric oxide (NO) level of the flaps were tested 1 day after operation; the amount of viable tissues of the flaps were examined by planimetry 10 days after operation. Specimens from the proximal, middle and distal flaps were harvested for HE staining to examine the microstructure.RESULTS AND CONCLUSION: At the first day after operation, NO level was higher in the experimental group than the control group (P< 0.01), while MDA level was lower than the control group (P< 0.01). At the 10th day after operation, the survival rate of the flap was significantly greater in the experimental group than the control group (P < 0.001). Histological observation showed that compared with the control group, the edema and inflammatory cells infiltration were less, while the fiber hyperplasia and the microvascular growth were more obvious in the experimental group. Results show that intraperitoneal injection of ginsenoside Rb1 can enhance the blood supply of the flaps and improve the survival of the random-pattern skin flaps with large length-to-width ratio in rats. This may involve its effects of improving NO activity, decreasing lipid peroxidation, and promoting angiogenesis of skin flaps.