Objective To summarize the experience of surgical treatment for thyroid nodules.Methods The clinical data of 352 patients with thyroid nodules who had received surgical treatment were collected and analyzed retrospectively.Results The post-operation pathological diagnosis showed these cases were composed of 182 thyroid adenomas,75 nodular goiters,38 adenomatous goiters,16 Hashimoto's diseases,40 papillary carcinomas and 1 follicular carcinoma.Surgical complications included 4 recurrent laryngeal nerve injuries,1 superior laryngeal nerve injury,1 chyle leak,2 neck hematomas,1 pneumoderma,2 wound infections,1 transient hypocalcemia and 1 death from tracheal collapse.9 cases of recurrence were observed.Conclusion Pre-operation evaluation of patients with thyroid nodules should be well performed in order to identify surgical indications.Appropriate surgical procedures and experienced surgical hands may help to reduce operation complications and recurrence rate.

Objective To assess the use of medical services by patients with chronic hepatitis B, cirrhosis resulting from hepatitis, or hepatic carcinoma and the composition of the expenses incurred. Methods A survey was made on the use of outpatient and inpatient services as well as the details of medical expenses incurred by 1 395 self-funded patients and patients enjoying social medical insurance in Shanghai. And an analysis was made on the composition of the expenses and direct medical expenses per annum. Results There was no significant difference between the self-funded group and the insurance group in the use of outpatient and inpatient services; in terms of medical expenses, those incurred by the insurance group were 30% to 50% higher than those incurred by the self-funded group; an analysis on the composition of outpatient expenses showed that drug expenses accounted for over 80% and examination and test expenses accounted for over 15%; an analysis on the composition of inpatient expenses showed that drug expenses incurred by the two groups both accounted for 45% to 60% of the total expenses and examination and test expenses accounted for 15% to 25%. Conclusion Social medical insurance reduces the economic burden of individual patients but significantly raises treatment expenses. The key to containing the rise of medical expenses lies in controlling the conversion of hepatitis B to cirrhosis and the irrational growth of inpatient drug expenses and examination and test expenses.

Adjuvant therapy of breast cancer in the child-bearing period tends to affect ovarian function of patients.Adjuvant chemotherapy has a great damage for ovarian function,and tamoxifen's extent of the damage is not yet clear,but gonadotropin-releasing hormone (GnRH) has a protective effect on ovarian function.In the adjuvant therapy,synthetic weigh the pros and cons,make the best individualized programs,is the future direction of the treatment of breast cancer.

Objective To investigate the expression of S-phase kinase associated protein 2 (Skp2) in rats with acute liver failure (ALF) and its significance. Methods There were 256 male SD rats used in this study, among which 240 were injected with D-galactosamine (D-GaIN) to set up ALF model. The rats were divided into 3 groups: ALF model group, free hepatocellular transplantation group, microencapsulated hepatocyte transplantation group, which were intraperitoneally injected with 2 mL of RPMI 1640 culture medium, free hepatocellular suspension and microencapsulated hepatocyte suspension, respectively. The other 6 rats were in control group and the rest 10 rats were used for hepatocyte isolation. Expressions of Skp2 protein in hepatocytes of rats at different time points were detected by immunohistochemical technique. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) were detected by automatic biochemistry analyzer. The survival rate in each group was observed. Comparisons among groups were done using one-factor analysis of variance. Results Levels of ALT, AST and TBil decreased more significantly by intraperitoneal transplantation of microencapsulated hepatocytes than those by intraperitoneal transplantation of free hepatocytes (P<0. 05). Skp2 labeling indices after 36 h of injection in ALF model group, free hepatocellular transplantation group and microencapsulated hepatocyte transolantation grouo were (28. 2±6.1) %, (41.4± 10. 5) % and (68. 0±10.8) %, respectively (F=29. 08 , P<0. 05). There were 4, 6 and 11 out of 15 rats survived in the 3 groups, respectively. Conclusion The dynamic observation of Skp2 expression could be used to judge the regeneration of hepatocytes.

Objective To investigate the clinical features of early postoperative inflammtory small bowel obstruction,and discuss its diagnosis,treatment and preventive measures.Methods The clinical data of 68 cases of early postoperative inflammatory small bowel obstruction were analyzed retrospectively.Results Within the 68 cases,65 cases were cured by non-operative treatment including gastrointestinal decompression,anti-inflammatory drugs,somatostatin,total parenteral nutrition(TPN) and traditional Chinese medicine.The mean time from the onset of symptoms to the recovery of bowel function was 14 days.Three cases were cured by transferring to operation.One case of them was transferred to operation for strangulated intestinal obstruction during the period of conservative treatment.One case underwent oper.ion because the patient didn t recover after 4 weeks expectant treatment.One case underwent operation for the impatience with the conservative treatment of both the doctors and the patient.Conclusion Non-operative therapy should be the first choice for the treatment of early postoperative inflammatory small bowel obstruction,and its therapeutical effect was well-accepted.

Objective To explore the clinical of value minimally invasive therapy for elderly gastric carcinoma patients with malignant obstructive jaundice after gastrectomy in improving the survival quality.Methods 12 gastric caecinoma patients with malignant obstructive jaundice after gastrectomy were treated by percutaneous transhepatic cholangial drainage(PTCD) plus biliary stenting.Results 12 patients were successfully accomplished the procedure of bile duct puncture and stenting.The life quality of 11 patients was promoted in varying degrees proved by reduced jaundice and normalization with transaminase level.One patient died of cardiac failure in a week.The one-year survival rate was 25 ％ (3/12),tow-year survival rate was 8.3 ％ (1 / 12).Complications occurred in 25 ％ of patients,including 1 case of hemobilia,and 2 cases of cholangitis.Conclusion The minimally invasive therapy of PTCD plus biliary stenting provided safe and effective bile drainage for elderly patients with malignant obstructive jaundice.

Objective To investigate the relationship of iPTH levels, calcium and phosphorus metabolism with cardiovascular event status in the chronic renal failure (CRF) patients. Methods This article retrospectivly studied the clinical and laboratory data of 87 CRF patients. 66 patients of A group didnt occur cardiovascular events,and 21 cases of B group occurred cardiovascular and cerebrovascular events. This article analyzed iPTH levels,serum calcium, phosphorus, calcium and phosphorus product and therelationship between cardiovascular and cerebrovascular events between the two groups. Results Decreased iPTH,increased serum C reactive protein and increased lipoprotein(a) had relationship with cardiovascular and cerebrovascular events in patients with chronic renal failure,but calcium,phosphorus,calcium and phosphorus product has nothing to do with the cardiovascular and cerebrovascular events. Cardiovascular and cerebrovascular events increased significantly in dialysis patients than in non - dialysis patients. Conclusiou Chronic renal failure patients on dialysis levels of serum iPTH, CRP level, LP(a) level and dialysis could lead to cardiovascular and cerebrovascular events.

AIM: To research the best processing method of Rhizoma Curcumae with water.METHODS: L 9(3 4) orthogonal table are decided with three effects: moistening time, steaming time, thickness of processed pieces. According to the amount of curcumin and volatile oil, orthogonal Design is applied to water processing Rhizoma Curcumae.RESULTS: The best processing method is: Rhizoma Curcumae is moistened for 20min, then cutting up to 3mm thick after steaming 30min.CONCLUSIONS:The steaming time has no obvious effect on the amount of curcumin in Rhizoma Curcumae, but if the amount of volatile oil is taken as marker. the steaming time has obvious effect.

Objective:To investigate the mechanism of the changes of the intestinal mucosal barrier in Severe acute pancreatitis.Methods:Twenty patients with Severe acute pancreatitis were admitted and 10 volunteers as the control group.The levels of serum tumor necrosis factor alpha(TNF_?)、nitric oxide(NO)、diamine oxidase(DAO) and the concentration of plasma endotoxin(ET) were measured.The ratio of lactulose to mannitol in urine was detected by HPLC with Pulsed Electrochemical Detection.Results:Compared with the control group,significantly increasing parameters could be seen in all the patients with Severe acute pancreatitis,including the ratio of lactulose to mannitol in urine (P

Urban and periurban agriculture (UPA) is the important part of modern agriculture. It can resolve the food supply to city residents, increase employments and improve the urban ecosystem. But without proper management and reasonable programming, UPA also can carry heavy burden to urban environment and impact people's health. This paper specifically analyzed the potential risks of urban agriculture and suggested preventive and control measures.