OBJECTIVE To summarize the use of intraoperative neuromonitoring system for monitoring and protection of recurrent laryngeal nerve during thyroid surgery. METHODS There were 21 cases in this study, included 5 cases with thyroid cancer, 9 cases with thyroid benign tumor and 7cases with hyperthyroidism. Intraoperative neuromonitoring system includes the host monitor, stimulus detection pin of recurrent laryngeal nerve, special EMG endotracheal intubation tube which contacts vocal cord, grounding conductive circuit electrode, and anti-jamming probe. Operation method: a "three-step method" was adopted. First we revealed the cervical vagus nerve trunk and tested our instruments, and then dissected and protected the recurrent laryngeal nerve, followed by removal of thyroid tissue. RESULTS In all 21 patients, operative side recurrent laryngeal nerve were exposed from lower thyroid blood vessels to the larynx. All patients were phonated as well as before operation, and without drinking cough. CONCLUSION The intraoperative neuromonitoring system can avoid damage of the recurrent laryngeal nerves when we exposed the recurrent laryngeal nerve before resection of the thyroid tissue and tumor.

The histopathological changs of the dog eyes caused by acute and subacute toxic effectsof hematoporphyrin monoether--PsD-044 were observed in this research. The results showed thatPsD-044 could lead to keratoscleritis and scleral perivasculitis. Phototoxic cyclitis and inflammatory edema of the retina were more serious in deferred killed animals, suggesting that it is necessary to avoid exposure to light after the administration of PsD-044.

Objective To observe the clinical efficacy of electroacupuncture plus nasal irrigation in treating upper airway cough syndrome (UACS).Method A total of 114 UACS patients were randomized into 3 groups, 38 cases in each group. Group A was treated with acupuncture plus electrical stimulation with sparse-dense wave, group B was intervened by nasal irrigation with Shuang Huang Lian, and group C was treated with the two methods together. The clinical efficacies of the three groups were compared.Result The total effective rates were respectively 84.2%, 73.7% and 94.7% in group A, group B and group C. The total effective rate of group C was significantly different from that of group A and group B (P<0.05).Conclusion Electroacupuncture plus nasal irrigation can produce a more significant therapeutic efficacy compared to electroacupuncture or nasal irrigation alone.

ObjectiveCluster analysis method was applied to analyze the data of brick-tea-born fluorosis,to clarify the provincial and municipal classification hierarchy in nation-wide epidemic areas and to guide the prophylaxis and treatment of the disease.MethodsPrevalence survey database of the 2007 national brick-tea-born fluorosis was analyzed.Detection rate of second degree and above clinical skeletal fluorosis as clustered index,clustering analysis of all survey data was carried out,clustering figure was drawn,and analysis of variance and multiple comparison was done.ResultsThe provincial level of the nation-wide epidemic areas of the brick-teaborn fluorosis could be classified into three categories:the first category including Tibet and Sichuan province,the second category including Qinghai province,and the third including Inner Mongolia,Gansu,Xinjiang and Ningxia provinces; The city-level they were also could be classified into three categories:the first category including Aba,Shigatse region and Lhasa,the second including Wulanchabu,Hulun Buir,Baotou,Qinghai state,Guoluo state,Haixi state,Xining city,Haidong state,Ganzi state,Longnan city,Jiuquan city,Urumqi city and the state of Bortala,and the other cities were the third category cities.The differences of clinical skeletal fluorosis detection rate between the first,second,and third provincial and municipal categories(35.18％,16.21％,5.22％,41.16％,19.64％,4.19％) were statistically significant (all P ＜ 0.05).ConclusionsBrick-tea-born fluorosis can be classified by using cluster analysis at the provincial and municipal levels.Cluster analysis results can provide a scientific basis for effective implementation of the prophylaxis and treatment of brick-tea-born fluorosis.

The specification of decoction pieces and quality uniformity are the important factors to influence the efficacy of clinical medicine. Considering the deficiency of diversity, poor quality uniformity and confusion of decoction pieces specifications, we first propose a new idea of precision decoction pieces (PDP) based on clinical demands and fresh-processed technology. In order to explain the idea, a study case of aconite SUP is provided, including the optimized specification design, processing technology, extraction effects, quality uniformity, and toxic and efficacy variation and so on. The results showed that preparing 5 mm PDP by fresh-cutting is rather simple and practicable, with high efficiency and large yield; then, this technology could significantly decrease the ingredients loss and increase the efficacy components; moreover, it was helpful for achieving the quality uniformity and best extraction effects. This work revealed the quality superiority of PDP, and provided a good strategy and example for the standard of decoction pieces specification and modernization of processing technology.
Aconitum ; chemistry ; Chemistry, Pharmaceutical ; methods ; Chromatography, High Pressure Liquid ; Particle Size ; Plant Extracts ; chemistry ; pharmacology ; Quality Control

OBJECTIVE:To establish the quality standard of Chushi pill. METHODS:Microscopic identification and TLC were adopted for the qualitative identification of Cortex moutan,C. dictamni,Angelica sinensis,Rubia cordifolia and Gardeniae fructus in Chushi pill;HPLC was performed to determine the contents of paeonol and baicalin. It was performed on column of Kro-masil 100-5 C18 with mobile phase of methanol-water-phosphoric acid(47∶53∶0.2,V/V/V)at the flow rate of 1.0 ml/min,the detec-tion wavelength was 280 nm,the temperature was 25 ℃ and the volume was 10 μl. RESULTS:The microscopic identification showed microscopic characteristics of C. moutan and C. dictamni,and characteristics of A. sinensis,R. cordifolia and G. fructus were identified by TLC;the linear range of paeonol was 0.106 24-2.124 8 μg(r=0.999 9)and baicalin was 0.059 04-1.180 8 μg (r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 2.06%;average recoveries were respective-ly 101.56%(RSD=1.68%,n=9)and 100.16%(RSD=1.13%,n=9). CONCLUSIONS:The method is simple,accurate and re-producible,and can be used for the quantity control of Chushi pill.

OBJECTIVETo investigate therapeutic effects of vacuum sealing drainage (VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.

METHODSFrom October 2007 to February 2011, 397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years (ranging age from 20 to 73 years). According to AO classification, 74 feet were type I, 211 feet were type II, 108 feet were type III and 19 feet were type IV. The mean time from injury to operation was 5.6 h ( 2 to 12 h). The mean treatment time of was 10 months (4 to 19 months).

RESULTSOne hundred and forty-one patients were primarily healed, 97 patients were sutured at stage II. Split-thick skin grafting was performed at stage II was performed in 103 patients; free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure; Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months (averaged 10 months). The wounds healed well.

CONCLUSIONVSD for soft tissue defects caused by ankle injury is a simple and effective method, but can not replace debridement and transfer flap.

Adult ; Aged ; Ankle Fractures ; Debridement ; Drainage ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Skin Transplantation ; Treatment Outcome ; Vacuum ; Young Adult

This study was aimed to find the fragmentation pathways of Schisandrin B using the Discovery Studio by electrospray ionization mass spectrometry (ESI-MSn). The first and multi-stage mass spectrum diagrams were obtained. The results showed that mass spectrometry fragments of Schisandrin B was analyzed under the positive mode, the cracking rings are mainly occurred, and free radicals such as H2O, -CH3 and -OCH3 were lost. It was concluded that this study enriched the mass spectral decomposition, and provided basis for the study on chemical constituents of lignan compounds.

Objective to investigate the feasibility and outcomes of different surgical treatments for adrenal metastasis after previous radical ne-phrectomy for patients with renal cell carcinoma. Methods A total of 18 adrenal solitary metastasis of renal cell carcinoma were identified from da-tabase of two institutions between 2003 and 2013. Clinical and pathologic data were collected and analyzed. Results Of 9 patients who had ipsilater-al metastasis of the renal tumor,the estimated blood loss were obviously fewer in the transperitoneal LA group. Of 9 cases who had contralateral me-tastasis of the renal tumor,the fasting time[(1.4±0.8)h vs(4.0±1.4)h,P = 0.036]and length of hospital stay[(4.5±1.2)d vs(7.0±4.5)d,P =0.041]were obviously fewer in the retroperitoneal LA group. the averages of the fasting time and length of hospital stay in the retroperitoneal LA group were obviously smaller than in the transperitoneal LA group. Conclusion LA for treatment of renal cell carcinoma metastasis is technically feasible in selected patients. transperitoneal and retroperitoneal LA can be respectively recommended as an appropriate approach for isolated adrenal metastases of ipsilateral and contralateral renal cell carcinoma after nephrectomy.

Aim To investigate the effect of Ajuga decumbens(HBG), Poria cocos(FL) and their combination on the metastasis of invasive breast cancer cells and the related mechanisms.Methods We conducted several assays including cell adhesion assay, scratch assay and transwell invasion assay.Western blot analysis was employed to detect the expression of associated proteins of EMT and MAPK signaling pathway.Results FL,HBG and their combination could significantly inhibit the adhesion, migration and invasion of MDA-MB-231 and SK-BR-3 cells.HBG and FL had markedly synergistic effect, and the best compatibility ratio was 10 ∶1.HBG, FL and their combination could reverse EMT of breast cancer cells, which increased the levels of epithelial biomarkers, such as β-catenin, E-cadherin and ZO-1, and reduced the levels of mesenchymal biomarkers, such as vimentin.Moreover, treatment of the cells with HBG, FL and their combination resulted in marked inhibition of phosphorylation of ERK1/2, JNK and p38.Conclusions The combination of HBG and FL have the ability to inhibit breast cancer cell invasion by targeting the expression of MAPK pathway as well as suppressing the epithelial-to-mesenchymal transition.