Objective To examine the clinical effect and learning curve of endoscopic thyroidectomy via chest-areolar approach in the treatment of benign thyroid nodules. Methods From January 2012 to May 2016,49 patients underwent endoscopic thyroidectomies via chest-areolar approach in Xuanwu Hospital ,Capital medical university. The clinical characteristics ,prognosis and operation time were retrospectively analyzed. The patients were divided into 9 groups according to the surgical sequence ,and the learning curves were analyzed by using moving average method. Results 49 endoscopic thyroidectomies via chest-areolar approach were performed successfully. The average size of the nodules was(2.80 ± 0.62)cm. 10 patients underwent bilateral thyroidectomy and 39 underwent unilateral thyroidectomy. The average operation time was(157.49 ± 21.23)min. 2 cases received re-operation due to postoperative pathology of malignancy. There were no postoperative recurrent laryngeal nerve injuries. 11 patients suffered from asymptomatic hypocalcemia with parathyroid hormone in the normal range. All of the patients were satisfied with the cosmetic results. The learning curves indicated that 35 endoscopic thyroidectomies were needed to be performed in the early study stage. Conclusions For surgeons with experience of conventional thyroidectomies,endoscopic thyroidectomy via chest-areolar approach is feasible and safe for selected patients. There is a significant learning curve in the application of endoscopic thyroidectomy. In the early study stage of endo-scopic thyroidectomy,35 cases are basically required for beginning surgeons to practice the surgical operation.

Objective To understand the current circumstance of the surgical resident training bases in Beijing Methods The reassessment data of the 11 surgical resident training bases in Beijing were collected and analyzed. Results 73%(8/11)surgical resident training bases have passed the assessment; and 27%(3/11)have not completely reached the requirements The most prominent problems found in the reassessment were that the numbers of clinic and emergency patients in some departments;the qualification and teaching level of the instructors;the administration in the training process;the test after finishing the rotation and the training results, Conclusion Surical resident training bases criterion,instructor for resident training and administration in the training process are the most important factors which influence the surgical resident training results

As the basis of the health management of the elderly, weight management should receive attention from medical practitioners.However, there is an ongoing debate on the ideal range of body mass index for elderly in China.This article aimed to find the suitable body mass index for Chinese old people by reviewing the literature regarding the body mass and obesity of the elderly.Lots of evidence show that overweight and mild obesity appear to be the optimal weight status for the elderly.

Objective To evaluate the role of multidetector CT(MDCT) and high magnetic field MRI in diagnosis of small cystic-solid renal mass. Methods Fifty-two cases with small renal cystic-solid mass(≤3 cm) were consecutively collected,including small cystic-solid renal cell carcinoma(n=25),carcinoid(n=1),complex cysts(n=16),small angiomyolipoma(n=7) and benign cystic nephroma(n=3).All were examined by both 1.5T MRI and multidetector CT at intervals between 3 days and 2 months. Results All cases were proved by pathology.Multi-planar reconstruction techniques were useful for MDCT in differentiating small cystic-solid renal mass,with the sensitivity of 98.1%,which was as high as MRI.However,the accuracy for MDCT was 71.2%,significantly lower than that of MRI(90.4%)(P=0.001).MRI helped to identify the components and structure of renal masses,and behaved better in the detection of pseudo-capsule of renal cell carcinoma(57.7%).Conclusion High magnetic field MRI may play an important role in the diagnosis of small renal cystic-solid masses,and it may be feasible as a noninvasive examination when CT can not make the ultimate determination.

Adult ; Bone Nails ; adverse effects ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

CBS(Case Based Study)is a new teaching method,which is based on the case given.It requires students to answer questions according to the case. In the teaching,the students who are divided into groups,seek for resolvent by themselves. They should combine the information provided in the case,find the key answer and the relationship.The students gain the knowledge by reviewing and studying in the textbook,then analyse and solve questions with them. The application of CBS could make knowledge more relatively and systematic, moreover,it also make study more actively and initiatively.

Objective To explore the change of serum zinc level of children with rotavirus(RV) enteritis and efficacy of zinc supplementation on children with rotaviral enteritis.Methods One thousand one hundred and eighty-three healthy children were enrolled in this study,who were divided into different groups,and the zinc levels of children in every different age group were detected.These levels were used as normal levels of children in Dongguan district.One hundred and forty-three diarrhea patients in this 2 years were enrolled.Confirmed dia-gnosis was depended on the RV test in patients′ stool.The children with diarrhea were randomly divided into zinc treatment group (n=72) and conventional therapy group (n=71).The serum zinc levels in RV enteritis was analyzed.The patients in conventional therapy group were received diarrhea conventional therapy inchuded smectite and fluid infusion and so on;in addition to diarrhea conventional therapy,zinc gluconate 20 mg/d (10 mg/d below 6 months of age) for successive 14 days were given the patientsin zinc treatment group.The different efficacy of the 2 groups and the changes of serum zinc in treatment group were analyzed.Results Compared with normal children,the ones suffering from RV enteritis had lower serum zinc level(P0.05).Conclusions The ones suffering from RV enteritis have lower serum zinc level.In addition to diarrhea conventional therapy,giving zinc treatment has better effect on enhancing curative effect of RV enteritis.On the other hand,the suggestion of zinc supplement made by WHO is also suitable for Chinese children.

Blepharospasm is a focal dystonia of the orbicularis oculi muscles, producing excessive eye closure. The etiology and pathogenesis is still unclear now. lt is usually appearing in adult period and predominant in females. The symptoms are typically triggered by stress, fatigue, intense light or individual factors. At advanced stages patients develop functional blindness. At present the main treatments include: botulinum toxin ( BTX ) , surgical procedures, systemic and ocular drugs and traditional Chinese medicine treatment. BTX administration has been an effective treatment. Surgical procedures have good effect but should be limited to the rare patients that do not respond to botulinum toxin treatment. A great variety of drugs have poor results. Chinese medicine has a certain therapeutic effect. Transcranial magnetic stimulation can improve symptoms. The epidemiology, anatomy, physiology, clinical manifestations, differential diagnosis, pathogenesis and treatment system were reviewed in this paper.

Objective To explore the sero-prevalence and risk factors for herpes simplex virus 2 (HSV-2) infection and unprotected sexual behavior in an ethnically diverse population of HIVinfected subjects in a county of Yunnan province. Methods HIV-infected individuals attending for routine follow-up by local Center for Disease Control and Prevention (CDC) were recruited to participate in the study under 'informed consent'. A face-to-face questionnaire interview was administered to each participant. Blood was drawn for HSV-2 testing by HerpeSelect HSV-2 ELISA (Focus Diagnostics) and CD4+ T counting. Results A total of 300 HIV-infected individuals participated in the study. The mean age of the subjects was 37.6 years with 76.7% as males. Ethnically, Han, Dai and Jingpo accounted for 44.3%, 37.3% and 16.0% of the sample, respectively. Half of the subjects reported HIV acquisition through injection drug use. The sero-prevalence of HSV-2 was 35.0%. Results from multiple logistic regression analysis indicated that individuals who acquired HIV through heterosexual contact were more likely to be HSV-2 positive than those who acquired HIV through injection drug use (OR=4.244,95%CI: 1.924-9.364),whereas Dai (OR=0.300,95% CI: 0.152-0.593) and Jingpo (OR=0.376, 95% CI: 0.167-0.850) were less likely to be HSV-2 positive than the Hans. Among 105 people who were co-infected with HIV/HSV-2, 60 had sexual intercourses in the past 3 months and 41.7% of them reported no or inconsistent use of condoms. Most unprotected sexual contacts occurred within married couples. Conclusion HSV-2 infection was highly prevalent among HIV-infected individuals in this county, and a significant proportion of HIV/HSV-2 co-infected subjects engaged in unprotected sex. HSV-2 testing, behavioral and biomedical interventions among HIV-infected individuals and their sexual partners should be involved in the local HIV prevention and control programs.

OBJECTIVE:To provide references for clinicians in the choice of antihypertensive drugs.METHODS:The antihypertensive efficacy 6 classes(or 15 kinds) of antihypertensive drugs in a monotherapy in the treatment of 370 patients with essential hypertension(EH) were compared.RESULTS:The blood pressure was effectively lowered by all of the antihypertensive drugs except doxazosin,and doxazosin and torasemide showed inferior efficacy in the reduction of diastolic blood pressure(DBP).CONCLUSION:Calcium antagonists with prolonged action,angiotensin converting enzyme inhibitor(ACEI),angiotens-in receptor antagonist,and the monotherapy of Terazosin or Indapamide can all effectively bring down the blood pressure.It is suggested that low-dose doxazosin and torasemide should not be used alone in treating essential hypertension.