Objective To explore the measures to prevent recurrent laryngeal nerve (RLN)injury during thyroid surgery.Methods The clinical data of 223 patients undergone thyroid surgery were retrospectively analyzed.Among the 223 surgeries,69 sides were undergone regional protection act of RLN and 191 sides were performed RLN exposure.Results There were 2 cases of RLN injury from the regional protection operation of RLN,including 1 case of temporary nerve injury which could be resulted from surgery clamp and 1 case of permanent nerve injury which might be caused by mistaking ligation during surgery.There was only 1 case of temporary nerve injury in RLN exposure procedure which was probably caused by the postoperative nerve edema and was recovered 2 months after the operation.The total RLN injury rate was 1.35％.Conclusion For benign thyroid lesions and non-dorsal lesions or during partial excision of the gland,the regional protection of RLN is helpful to prevent RLN injury.In cases with dorsal lesions of thyroid or contralateral RLN injury,or during lobe subtotal resection,lobe resection and reoperation,exposing RLN to prevent injury is necessary.Taking different approaches based on the profiles of lesions and surgical procedures to prevent RLN injury can significantly reduce the risk of RLN injury.

Objective To identify the anatomical basis for aging orbit-malar fold forming orbitmalar groove and its underlying mechanism.Methods Thirteen cadavers (26 hemifaces) were dissected in this study (9 male and 4 female heads).All specimens were fixed in 10％ formalin,with age ranges from 22 to 78 years.The lateral orbital region was dissected in layers by mieroinsrument using 10 X loupe magnification,especially at the palpebral and the lateral orbital part,and then the anatomy layer was described; the lateral orbital thickening (LOT) was performed carefully to evaluate whether there were multiple anatomical contributions to anatomy.Anatomic observations were systematically recorded,sketched,and photographically documented.Results The lateral orbital layers included skin,subcutaneous adipose tissue,orbicularis oculi muscle,middle temporal fascia,and periosteum.The lateral orbital thickening was a triangular condensation of fascia,which extended over the lateral orbital rim onto the adjacent medial tem~ral fascia,the lateral orbital thickening was measured (9.28 ±0.45) mm in transverse width from Vertex triangle to lateral canchal,the inner part of the LOT sanwiched between orbibularis and obital septum,which consisted of upper lid and lower lid part,the lower lid part presented transverse V shape,the top part of the transverse V was adhesive to fascial tissue over tarsal plate.The distance to lateral canthus angular was 21.69-37.21 mm,and the under part was adhesive to low orbital rim the low arm distance to lateral canthus angular was (13.55 ±0.52) mm.Vertex of.V to lateral canthus angular vertical distance was (11.35±0.27) mm.Conclusions The reason why aging orbit-malar fold forms orbital-malar groove is the atrophy of the subcutaneous adipose tissue and the middle temporal fascia fat.

Objective To investigate the forming mechanism of smile anatomically,and to analyze the changes of aging characteristics of mid-lower face.Methods Ten (with 20 sides) adult fresh cadaveric heads were fixed by formalin,and then nasolabial fold morphology was observed under 10X operating magnifying glass,and compared with alteration of the middle and lower face aging features under the state of smiling and static according to observation from 50 doctors' and out-patients' photos.Results The nasolabial fold was the boundary between fatty and fat-free zone in the middle face,the lateral side of which was malar fat pad.The nasolabial fold was the linear area,which was formed by the insertions of seven mimetic muscles on the skin.When smiling,the nasolabial fold and cheek groove,got deep and extended,cheek stripe became obvious.While smiling,malar fat pad shifted up,and tear trough became deformity..64％ disappeared and 36％ getting shallow and appearance improved; orbit-malar fold showed 100％ horizontal part disappeared,74 ％ vertical part became shallow and improved,and 26％ stayed stable; mid-cheek fold showed 78％ dissovled,22％ getting shallow and improved; Labiomandibular fold showed 100％ Ⅲ degree disappeared,100％ Ⅱ degree dissovled,74％ Ⅰ degree disappeared,and 26％ getting shallow and ameliorated; submaxilla line showed 18％ getting smooth and 82％ remained.Conclusions Smiling is produced by movement of mimetric muscles,and its orgin is from nasolabial fold.A smile could make malar fat pad upwards to mask some aging characteristics of middle and lower face,which is helpful to form a younger face.

Objective To investigate the clinical efficacy of plum blossom acupuncture plus focused ultrasound therapy for neurodermatitis. Method Sixty neurodermatitis patients were randomized to a treatment group (30 cases) and a control group (30 cases). The treatment group received plum blossom acupuncture plus focused ultrasound therapy and the control group, conventional treatment with halometasone cream. The clinical therapeutic effects were evaluated. Result The total skin lesion score had no statistically significant post-treatment difference between the two groups of patients (P>0.05) and had a statistically significant pre-/post-treatment difference within the groups (P<0.01). The total efficacy rate was 96.7% in the treatment group and 86.7% in the control group. At three and six months after treatment the recurrence rate was lower in the treatment group than in the control group and the difference was statistically significant (P<0.05, P<0.01). Conclusion Plum blossom acupuncture plus ultrasound has a marked therapeutic effect on neurodermatitis. It is a simple and ideal therapeutic method.

A new eremophilane derivative, (3aR,4R,5S,7S,7aS)-2-acetyl-7,7a-dihydroxy-3a,4-dimethyl-3a,4,5,6,7,7a-hexahydro-3H-inden-5-yl acetate (1) and three known compounds, 10beta-hydroxy-eremophil-7 (11)-en-12,8alpha-olide(2), beta-sitosterol (3) and beta-daucosterol(4) have been isolated from Ligularia intermedia. The compounds were isolated by column chromatography on silica gel and Sephadex LH-20,and identified on the basis of spectral analyses (MS, 1H-NMR, 13C-NMR).
Asteraceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Naphthalenes ; chemistry ; isolation & purification ; Sesquiterpenes

The paper is aimed to search more natural plant antioxidants and further research and develop new medicinal plant resources in Guizhou. The Guizhou special miao medicine "bod zangd dak" was extracted with 60% ethanol. The antioxidant activity of the different polarity components separated from the extract was tested by DPPH method with ascorbic acid as positive control. The results showed that the IC50 of the different polarity components was as following: ascorbic acid (0.033 4 g x L(-1)) < ethyl acetate components (0.052 3 g x L(-1)) < total tannins components (0.054 9 g x L(-1)) < 60% ethanol extraction components (0.076 7 g x L(-1)) < butanol extraction components (0.110 g x L(-1)) < water-soluble polysaccharides components (0.168 g x L(-1)) < water extraction components (0.174 g x L(-1)) < water components after extraction (0.226 g x L(-1)) < total polysaccharides components (0.645 g x L(-1)). It is concluded that the different polarity components have different free radical scavenging activity and that provides a scientific basis for further search of the active ingredients and the activive mechanism.
Antioxidants ; chemistry ; isolation & purification ; Biphenyl Compounds ; chemistry ; China ; ethnology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Free Radicals ; chemistry ; Medicine, Chinese Traditional ; Picrates ; chemistry ; Plant Roots ; chemistry ; Plant Stems ; chemistry ; Smilax ; chemistry

This paper takes the records of “the fire therapy” in “Shanghan Zabing Lun” for example,starting from the characteristics of natural fire,to explore how the traditional Chinese medical (TCM) physicians recognize the process of metaphorical cognition from “natural fire” to the “fire therapy”,the understanding of the mechanism of fire therapy in traditional Chinese medicine comes from the ancient knowledge and experience of the natural fire.The mapping from source domain “natural fire” to the target domain “the fire therapy”,makes ancient TCM experts realize fire could be used to drive out evil spirits and cure of disease.The mechanism of smoking,ironing,warm acupuncture,fire needle,moxibustion and other five kinds of fire therapies originate from the characteristics of fire,such as warming,rising,transforming and destroying.

Objective To observe the clinical effect of treating Alzheimer's disease (AD) using transcranial magnetic stimulation.Methods One hundred and ninety-six patients with Alzheimer's disease were randomly divided into an observation group and a control group,each of 98.The observation group was given transcranial magnetic stimulation of the left and right dorsolateral frontal lobes of the brain and simultaneously given "8-shaped" coil stimulation.The stimulation intensity was 80％ of the motor threshold with a sequence of 2 s of stimulation at 5 Hz and 30 s rest for 30 min in each session.There were two sessions a day for 28 days.The control group was treated with identical pseudo-stimulation.Moreover,both groups were treated with intravenous injections of 20 ml of Ginkgo biloba extract dissolved in 250 ml of sodium chloride,or in the control group a glucose injection,one daily for two weeks.Before and after the treatment,the cognition,behavior and neuropsychological symptoms of both groups were evaluated using the mini mental state examination scale (MMSE),the AD rating scale (ADAS-cog),the activity of daily living (ADL) scale,a neuropsychiatric questionnaire (NPI) and an AD behavioral pathology rating scale (BEHAVE-AD) to compare the clinical effects.Results There were no significant differences in the groups' average scores on any of the evaluations before the treatment.After the treatment,the average MMSE and ADAS-cog scores in both groups had improved significantly,but with significantly greater improvement in the observation group.After the treatment,the average ADL,NPI and BEHAVE-AD scores of the observation group and the average ADL score of the control group were significantly lower than before the treatment.No significant differences were observed in the average NPI and BEHAVE-AD scores of the control group.After the intervention,the average ADL,NPI and BEHAVE-AD scores in the observation group were significantly lower than those of the control group.The total effectiveness rate of the observation group (90.8％) was significantly higher than that of the control group (62.2％).Conclusion Transcranial magnetic stimulation can significantly improve the cognitive,behavioral and neuropsychological status of patients with Alzheimer's disease.

Objective To study the dynamic air quality of clean ICU so as to provide evidence for hospital infection management in clean ICU.Methods Flat natural sedimentation method,six percussive determination of planktonic bacteria and dust particle counting method were used to get samples at three different time periods,different regions for four consecutive days in 100 000 air clean ICU.Results The counts of 0.5μm,5 μm dust particles at different time ( morning,afternoon,evening) were significantly different( F =78.85,89.94 ;P ＜ 0.01 ) and the monitor results of different regions( single rooms,double rooms,hall) were significantly different( F =20.21,16.17; P ＜ 0.01 ).The number of planktonic bacteria at different time (morning,afternoon,evening) were significant different(F =14.21,P ＜0.01 ),while there was no difference in different regions ( single rooms,double rooms,hall) ( F =0.98,P ＞ 0.05 ).There was significant difference of depositing bacterial counts at different time and regions( F =5.68,17.05,P ＜ 0.01 ) and there was a positively correlation between planktonic bacterial counts and depositing bacterial counts ( r =0.612,P ＜ 0.05 ).Each level of bacterial average counts of six percussive samplers measured was significantly different (F =8.35,P ＜ 0.01 ),with fifth grade most and fourth grade following.Conclusions Air quality of ICU is not good especially when making ward round; Less than 5 μm particles dominant; the counts of planktonic bacteria and depositing bacteria is increasing when dust particles counts increase,and the air quality of single rooms and double rooms is better than that of the hall.

Objective To investigate the effect of employers' respirator and hat wearing method on class 100 000 clean ICU air quality,in order to provide basis for hospital infection management in ICU.Methods For the control group,the first day (d1) and third day (d3),every employer was demanded to wear a respirator and a hat before entering the ICU.For the observation group,the second day (d2) and forth day (d4),employers were demanded not to wear any respirator or hat.During all four days,they must wear respirator and hat before any nursing operation.Air quality was sampled by class 100 000 clean air using flat panel natural settlement method,dust planktonic bacteria method and particle counting method.The amount of dust,plankton bacterium and descending bacteria were monitored for 4 days and compared between two groups.Results The difference of 0.5 μm dust particles in ICU between the control group and the observation group were statistically significant ( F =40.95,P ＜ 0.05 ).As to 5.0 μm dust particles,there was no significant difference between two groups (F =2.86,P ＞ 0.05 ).0.5 μm dust particles in ICU was lower at d1 and d3,and the difference was statistically significant ( F =40.95,P ＜ 0.05).The number of 0.5 μm dust particles had significant difference between different periods of a day:the morning time segmcnt＞ evening ＞ afternoon ( F =80.72,P ＜0.05 ).The number of 0.5 μm dust particles in the observation group was higher than that in the control group,and the difference was statistically significant ( F =68.84,P ＜ 0.05 ).The number of 5.0 μm dust particles had significant difference between different time periods of a day:the morning time segment ＞afternoon ＞ evening ( F =98.17,P ＜ 0.01 ).The number of dust particles at hall was larger than that at single and double rooms (P ＜0.01 ),but the number had no difference between single room and double room.More subsidence bacteria and floatingbacteria was detected during dl and d3 in the control group,and the difference was statistically significant ( P ＜ 0.01 ).Besides,the difference of the number of subsidence bacteria and floating bacteria in ICU between different time periods was also statistically significant ( P ＜ 0.05 ).Conclusions The number of 0.5 μm dust particles in ICU is smaller when workers wear hats and respirators,while the number of 5.0 μm dust particles remains the same.Under the other conditions remain unchanged,the mainly cause of number increase of dusts,planktonic bacteria and sedimentation bacteria in the morning rounds is the increasing number of working staff.ICU staff has no apparent effect on dynamic class 100 000 clean ICU air quality whether they wear respirators or hats.This kind of behavior is not the key management elements in clean ICU environment.