Objective To compare the differences of blood glucose detected by four methods with different instruments and specimen types at early stage in severely burned rats.Methods 24 Sprague-Dawley (SD) rats were randomly divided into two groups:control group 1 (Sham scald group,n=8) and scald injury group 1 (n=16).Blood samples of scald injury group 1 were collected at 12,and 24 hours after scald (n=8,each time).Another 20 SD rats were randomly divided into two groups:control group 2 (Sham scald group,n=10) and scald injury group 2 (n=10).Blood samples of scald injury group 2 were collected at 12 hours after scald.The rats in scald injury group 1 and 2 were placed into scalding water (95.0±0.5)℃ for 15 seconds to model third-degree burn with 30％ total burn surface area (TBSA).The rats in scald injury group 1 were given intraperitoneal injection with normal saline(40 ml/kg) immediately,while those in scald injury group 2 were given intraperitoneal injection with normal saline (40 ml/kg) 6 hours after scald.The rats in Sham scald group 1 and 2 were placed into warm water 37℃ for 15 seconds,and did not received injection.Portable glucometer/caudal artery (vein) blood,portable glucometer/abdominal aorta blood,spectrophotometer/femoral venous plasma,and spectrophotometer/abdominal aorta plasma were used to detect blood glucose.Results ①Compared with Sham scald group 1,the levels of blood glucose detected by portable glucometer/caudal artery (vein) blood and spectrophotometer/femoral venous plasma in scald injury group1 at 12,24 hours after scald were significantly increased(P＜0.05).Compared with Sham scald group 2,the levels of blood glucose detected by portable glucometer/abdominal aorta blood and spectrophotometer/abdominal aorta plasma in scald injury group 2 at 12 hours after scald were significantly increased(P＜0.05).②The comparison of portable glucometer/caudal artery (vein) blood and spectrophotometer/femoral venous plasma in Sham scald group 1,portable glucometer/abdominal aorta blood and spectrophotometer/abdominal aorta plasma in Sham scald group 2 had no statistical significance (P＞0.05).The levels of blood glucose detected by portable glucometer/caudal artery (vein) blood were significantly lower than those detected by spectrophotometer/femoral venous plasma (P＜0.05) in scald injury group 1.The comparison of blood glucose detected by portable glucometer/abdominal aorta blood and spectrophotometer/abdominal aorta plasma had no statistical significance in scald injury group 2 (P＞0.05).Conclusion Four kinds of methods used in this study shows that the levels of blood glucose were significantly increased at early stage in severely burned rats,and the portable glucometer/abdominal aorta blood is a relatively simple and fast method to detect blood glucose.

Objective To explore the diagnosis and management of functional pancreatic endocrine tumor.Methods Clinical data of 19 cases of functional pancreatic endocrine tumor were retrospectively analyzed.Results 15 cases of insulinoma,2 cases of gastrinoma and 2 cases of glucagonoma were qualitatively diagnosed.The positive rate of preoperative diagosis for type B ultrasonic inspection,CT,MRI,EUS,selective portovenous sampling and intraoperative type B ultrasonic inspection was 15.8％ (3/19),67.5％ (10/16),71.4％ (5/7),87.5％ (7/8),100％(2/2) and 85.7％(6/7) respectively.Of the total 19 cases,7 cases underwent open surgery,11 cases unde rwent laparoscopic surgery,and one case didn't undergo any surgery as liver metastasis had occurred when glucagonoma was diagnosed.The operation methods included tumor enucleation (n=13),distal pancreatic resection (n=3),distal pancreatic resection plus splenectomy (n=1),and pancreatic head resection with duodenum preserved (n=1).Conclusions The measurement of serum insulin,gastrin and glucagon is the main basis for qualitative diagonosis of pancreatic endocrine tumor.Two stage spinal CT thin scanning is the main method for tumor location.Intraoperative type B ultrasonic inspection is the supplement to preoperative location.Tumor enucleation is the main choice of treatment.

Objective To compare the survival conditions of patients with insulinoma after enucleation of insulinoma or partial resection of pancreas.Methods The clinical data of 99 patients with insulinoma,treated with surgery from May.2003 to Aug.2015 were retrospectively analyzed.Of the 99 patients,38 received enucleation of insulinoma alone and 61 received partial resection of pancreas.The overall data were analyzed by SPSS 21.0 software.Results Average survival of patients after enucleation of insulinoma (103.3 months) was longer than that of patients after partial resection of pancreas (77.5 months),and the difference had statistical significance (P=0.006).The difference of the incidence of most chronic or temporary complications had no statistical significance between the two groups (P＞0.05),except for new-onset diabetes (P=0.004).Conclusion Enucleation of insulinoma should be firstly recommended for patients with insulinoma in suitable size,which can provide patients with better survival condition.

Objective To investigate the early (within 72 hours) application and effect of endoscopic pancreatic and (or) biliary stents combined with Qingyi granules in treatment of acute biliary pancreatitis (ABP) patients.Methods A retrospective analysis was done to the 245 patients admitted for ABP from Jan.2012 to Jan.2016 in the First Hospital of Lanzhou University.133 patients (group A) were treated within 72 hours by endoscopic pancreatic and (or) biliary stents combined with Qingyi granules through feeding tube.112 patients (group B) were treated by endoscopic pancreatic and (or) biliary stents and feeding tube without Qingyi granules.Then the study was done to compare the difference of recover days of abdominal distension,abdominal pain,normalization time of amylase and WBC,length of stay,decrease level of PCT,and the incidence of ABP complications.Results Group A was superior to group B in terms of the recover days of abdominal distension (3.8±3.2)d vs (5.2± 2.4)d,abdominal pain (2.6±2.1)d vs (4.9±2.7)d,normalization time of amylase(2.8±1.6)d vs (4.4±3.7)d,WBC (2.6±1.3)d vs (4.1± 2.7)d,length of stay(9.4±2.1)d vs (12.6±3.3)d and postoperative PCT level(2.59±2.33)ng/ml vs (3.98±3.03)ng/ml,and the difference had statistical significance (P＜0.05),while there was no significant difference between the two groups in the incidence of ABP complications.Conclusions For ABP patients,early placement of endoscopic pancreatic and (or) biliary duct stents combined with Qingyi granules through feeding tube can remove the etiology,and block the disease from further progress.Early enteral nutrition can contribute to the recovery of intestinal mucosa and the maintenance of internal environment.Combined with Qingyi granules,it can relief the symptoms,decrease the laboratory index and shorten the hospitalization time.

Objective To study the function of early persistent vacuum suction drainage in patients with high risk of pancreatic fistula after pancreaticoduodenectomy (PD).Methods From Jul.2010 to Jun.2013,the clinical data of 286 patients undergoing PD were retrospectively evaluated.87 patients with high risk of pancreatic fistula were screened and then divided into early persistent vacuum suction drainage group (the observation group) and conventional drainage group (the control group) according to postoperative drainage manners.We statistically analyzed the two groups in terms of general information,blood loss,operative time,medical expenses,hospital stay,mortality and morbidity of complications such as pancreatic fistula.Results There were 40 patients screened into the observation group and 47 patients into the control group.No difference was found between the observation group and the control group in basic clinical data or surgical data.There was no statistical difference between the two groups in delayed gastric emptying,bile leakage,bleeding or the incidence of pancreatic fistula and intra-abdominal infection.The incidence of pancreatic fistula with grade B and C in the observation group was statistically lower than that of the control group(12.5％ vs 34.0％,P＜0.05).The incidence of intraabdominal infection in observation group was statistically lower than those in the control group (20.0％ vs 40.4％,P＜0.05).The incidence of total complications in observation group was statistically lower than that in the control group (60.0％ vs 83.0％,P＜0.05),but no difference was found between the observation group and control group in morality.Early persistent vacuum suction drainage could reduce hospital stay((21.93±7.14) days vs (28.70±12.45) days,P＜0.05) and clinical expense ((64.8±12.0) thousands vs (75.2± 14.6) thousands,P＜0.05) in patients with high risk of pancreatic fistula after PD.Conclusions Early persistent vacuum suction drainage can reduce the rate of grade B and C pancreatic fistula in patients with high risk of pancreatic fistula undergoing PD.The manner can also reduce the incidence of intra-abdominal infection,total complications and cost of hospital stay.This manner can accelerate postoperative recovery of patients undergoing PD and is worth of widely used.

Objective To analyze the anatomical relationship between Zuckerkandl's tubercle (ZT) and the recurrent laryngeal nerve(RLN),to reduce the incidence of RLN injury risk.Methods 280 patients undergoing total thyroidectomy from Jan.2008 to Jan.2013 were included in our study.A meticulous technipue of excapsular dissection was used to dissect thyroid.ZT's size,classification,and its relationship with RLN were studied and classified.Results A total of 280 thyroid gland lobes were dissected.ZT identified in the left was 94.1％(128/136),right 96.4％(160/166),and bilateral 72.8％(220/302).ZT grades were as the following:Grade 0,left 11.8％(16/136) and right 11.4％(19/166);Grade I,left 30.1％(41/136) and right 25.3％(42/166);Grade II,left 44.1％(60/136) and right 43.4％(72/166);Grade III,left 8.1％(11/136) and right 16.3％(27/166).There was no significant difference on ZT classification between the left side and right side.For ZT with grade I or above,112 cases were at the left side,among which type A was 90.2％(101/112),type B 0.9％(1/112),type C 7.1％(8/112),and type D 1.8％(2/112),and 141 cases were at the right side,among which type A was 92.9 ％ (131/141),type B 0.7％(1/141),type C 5.0％(7/141),and type D 1.4％(2/141).There was no significant difference between the left side and the right side in terms of type.Type A of ZT was the most common type.Conclusion As an important anatomic landmark,ZT is essential for locating and dissecting RLN during thyroid surgery,however,due to its complex anatomical relationship with adjacent organs and the variability of RLN and its branches here,from which to reveal RLN has the possibility of increasing the injury risk.

Objective To investigate the protection of superior parathyroid glands by improving dissection procedure of thyroid superior pole in total thyroidectomy surgery.Methods 136 consecutive cases undergoing two-step dissociating procedure of thyroid superior pole(the improved group) in total thyroidectomy plus central compartment dissections from Sep.2012 to Oct.2015 were retrospectively analyzed.Intraoperative observation of superior parathyroid and incidences of postoperative hypoparathyroidism were compared with conventional surgical methods (the conventional group) containing 113 cases from Jun.2009 to Sep.2012.All operations were performed by the same treatment group.Results Intraoperatively,249 (249/272,91.5％) superior parathyroid glands were identified in the improved group and 215 (215/226,95.1％) superior parathyroid glands were identified in the conventional group.The difference had no statistical significance (P＝0.114).Whereas,among identified superior parathyroid glands,242 (242/249,97.1％)of them were conserved in situ in the improved group and 198 (198/215,92.0％) were conserved in situ in the conventional group.The difference had no statistical significance (P＝0.013).Among superior parathyroid glands conserved in situ,225 (225/242,93.0％) had good blood supply in the improved group and 170(170/198,85.9％) in the conventional group.The difference had statistically significance (P＝0.001).28 (28/136,20.5％) patients displayed temporary hypoparathyroidism and 2 (2/136,1.5％) cases suffered permanent hypoparathyroidism in the improved group after surgery.Whereas,in the conventional method group,a higher incidence was observed in 37 (37/113,32.7％) cases of temporary hypoparathyroidism and 7 (7/113,6.2％) cases of permanent hypoparathyroidism respectively.The difference had statisticall significance (P＝0.003).Conclusions Two-step dissociating procedure technique offers protective effect on superior parathyroid glands function.It is worthy of popularization.

Objective To compare the clinical evaluation in diagnosis of thyroid nodules between fine needle aspiration(FNA) and core needle biopsy(CNB).Methods 82 cases with thyroid nodules undergoing FNA and 33 cases with thyroid nodules undergoing CNB were selected.Cytology,histopathology,and postoperative results were compared with postoperative pathology as the gold standard.Results The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate,false negative rate of FNA and CNB were 91.5％ vs 87.9％,93.2％ vs 87.5％,87.0％ vs 88.9％,94.8％ vs 95.5％,83.3％ vs 72.7％,13.0％ vs 11.1％,6.8％ vs 12.5％,respectively.There was no significant difference between FNA and CNB (P＞0.05).Conclusion Both of FNA and CNB examination show high accuracy,sensitivity and specificity in diagnosis of benign and malignant thyroid nodules,but FNA is more economical,safe,convenient and thus has more extensive clinical application.For lymphoma or borderline tumor,CNB examination combined with immunohistochemistry is of more advantages.

Breast cancer and thyroid diseases are common diseases in women.It is reported that breast cancer and thyroid diseases have some relevance.Breast cancer patients have relatively high incidence of thyroid dysfunction,thyroid node and thyroid cancer,which are easily misdiagnosed for lacking of obvious clinical manifestations and will affect the treatment and prognosis of breast cancer.In breast cancer patients,screening and diagnosis of thyroid function and disease through thyroid function detection and ultrasound examination should be strengthened.