Objective To study the effects and advantages of the treatment for simple bone cysts of the long bones in children with AO titanium elastic nail and autologous bone marrow injection. Methods Eighteen patients with a simple bone cyst at humerus or femur were managed with AO titanium elastic in-tramedullary nail combined with autologous bone marrow injection. There were eleven boys and seven girls in total, with the mean age of 8.1 years, ranged from 6 to 12 years. Twelve cysts was located in the proximal end of humerus, five in the proximal end of femur and one in the middle part of the shaft of femur. Twelve cysts were active and six inactive according to Neer standard. Radiographic evaluation was performed three, six, twelve and eighteen months after operation during the 11 to 23 months follow-up by taking anteroposteri-or and lateral X-ray pictures. Then we measured residual radiolucent areas on X-ray pictures and did statistic research with group comparison. Results Six cysts (33.3%) healed completely, and twelve (66.7%) healed with residual radiolucent areas which were visible on X-ray pictures 3 to 6 months after operation. Residual radiolucent areas on X-ray pictures gradually reduced during the different phases and it has statistical signif-icance by group comparison. There was no recurrence or major complication except for one patient with mild irritation of skin caused by the end of the nail up to now. Conclusion The treatment for simple bone cysts of the long bones in children combined with AO titanium elastic nail and autologous bone marrow injection not only has satisfactory healing rate but also can provide early stability to the long bones, and accelerate the healing of cysts which allows early mobilization and thus obviates the long-term need for a plaster cast and decreases the prevalence of the most common complication: a pathological fracture.

It was confirmed that acetylcholine signaling pathway and dopamine signaling pathway play critical roles in refractive development.Many evidences have supported that acetylcholine and its receptor antagonists were closely related to the formation of experimental myopia.Retinal dopamine signaling could exert a significant influence on refractive development,and its upregulation induced by light comprises an important component of the retinal clock network;meanwhile,the retinal dopamine signaling could also participate in the regulation of retinal circadian rhythms.The role of intrinsic retinal circadian rhythms in the developing process of myopia is gaining increasing attention.Moreover,it was also found that both acetylcholine and dopamine signaling pathways influence the development of myopia.Therefore,the present paper summarizes the two signaling pathways in the mechanisms of regulating myopia process,which provides an insight into the pathogenesis of myopia and clinical ideas for the effective prevention and treatment of myopia.

Objective To explore the effect of nutritional intervention on nutritional status,weight,physical strength and quality of life of patients with head and neck cancer treated by radiotherapy.Methods 77 patients with head and neck malignant tumors treated by radiotherapy were divided randomly into two groups,nutritional intervention group (NI) had 38 cases and control group (CG) had 39 cases.The status of nutrition,weight,physical strength and quality of life before radiotherapy,the end of radiotherapy and 3 months after radiotherapy in two groups were compared.Results The nutritional risks in two groups had no difference before radiotherapy.At the end of radiotherapy,the assessment score of the nutrition in NI was significantly lower than that in CG [(5.41±2.36) scores vs.(6.92±2.74) scores,t =4.935,P ＜ 0.05],and the average weight in NI was significantly higher than that in CG [(57.07±8.01) kg vs.(46.53±9.82) kg,t =2.670,P ＜ 0.05].At the end of radiotherapy and 3 months after radiotherapy,the physical strength in NI [(57.07± 8.01),(41.48±7.92) kg] were significantly higher than those in CG [(36.43±6.48),(37.94±8.03) kg] (t =2.670,P =0.021;t =2.361,P =0.037);the index of quality of life in NI [(51.37±6.56),(52.07±6.23) scores] were also significantly higher than those in CG [(46.93±6.98),(48.13±7.12) scores] (t =2.292,P =0.041;t =2.076,P =0.037).Conclusion Nutritional intervention can effectively maintain the nutritional status of head and neck cancer patients with radiotherapy,and improve continuously the physical strength and the quality of life.

Objective: To analyze the methods of Lishui Central Hospitals performance management, and evaluate the important role of performance management in the modern hospital management. Methods:Evaluate the hospital operation management data in recent 5 years, basing on the performance management measures of Lishui Central Hospital. Results: During 2007 to 2012, outpatients and emergency patients increased to 80.41%, discharges increased to 89.35%, operating table increased to 84.59%, total revenue increased to 121.61%, average length of stay decreased by 5.1 days, times cost of patients had been effectively controlled, and total assets increased by 149.21%. Conclusion: The reform of Central Hospital performance management has great significance in mobilizing the enthusiasm of workers and enhancing the level of hospital management, and will solve the difficulties of expensive medical treatment problems well.

Objective To study the clinical value of plasma BNP level in evaluation cardiac function of children with left-to-right shunt congenital heart disease.Methods 32 children with left-to-right shunt congenital heart disease were selected as the observation group.Then according to the heart load capacity,the observation group children were further divided into right ventricular group(14 cases) and left ventricular group(18 cases).20 cases of normal children were selected as the control group.Then plasma BNP level was determined by ELISA and the left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter(LVEDD),right ventricular end diastolic diameter(RVEDD),pulmonary blood flow/systemic blood flow ratio (Qp/Qs) and left heart Tei indices were determined by echocardiography.Results In the right ventricular group,the BNP level was (360.21 ± 56.78) ng/L,LVEDD was (35.71 ± 6.98) mm,RVEDD was (25.04 ± 5.52) mm,Qp/Qs was (1.74 ± 0.24) and left heart Tei index was (0.34 ±0.12).And in the left ventricular group,the BNP level was (384.57 ±55.18) ng/L,LVEDD was (45.27 ±7.26)mm,RVEDD was (12.34 ±2.18)mm,Qp/Qs was (1.78 ±0.19) and left heart Tei index was (0.36 ±0.11),which were significantly higher than those in the control group (F =307.00,18.92,84.24,91.47,3.44,all P ＜ 0.05).LVEF of the observation group had no obvious difference compared with the control group (F =1.51,P ＞0.05).The plasma BNP level of the right ventricular group was positively correlated with RVEDD,Qp/Qs and left heart Tei index (r =0.634,0.721,0.647,all P ＜ 0.05).The plasma BNP level of the left ventricular group was positively correlated with LVEDD,Qp/Qs and left heart Tei index(r =0.547,0.794,0.745,all P ＜ 0.05).There was no correlation between the plasma BNP level and LVEF of the observation group.Conclusion The plasma BNP level can help evaluation the early cardiac function of children with left-to-right shunt congenital heart disease,and combined with echocardiography can accurately reflect the early cardiac function of the left-to-right shunt congenital heart disease,which can provide basis for the clinical diagnosis and treatment.

This retrospective study was designed to analyze the early therapeutic outcome of radioiodine therapy in patients with Graves'disease. According to the follow up result after one year treatment, patients were divided into two groups on the basis of whether there was signs of hypothyroidism. 46 patients with hypothyroidism, 60 patients without hypothyroidism were selected randomly. The SAS software was used to assess the outcome of early hypothyroidism and the thyroid weight, the peak of 131 I uptake, absorption value by per gram of thyroid tissue, thyroglobulin autoantibody (TGA), and thyroid microsome autoantibody (TMA) levels. Rank sum test, t test and ? 2 test were used to compare the variable parameters between the two groups. Thyroid weight ( P =0 0106) and the peak of 131 I uptake ( t =2 1725, P =0 0321) between two groups had significant difference. The absorption value of the thyroid tissue ( P =0 4420), thyroid autoantibody (? 2 =1 156, P =0 282) had no significant difference between two groups. Patients with smaller gland weight and lower 131 I uptake had an inclination to have early hypothyroidism. Absorption value by per gram of thyroid, TGA and TMA levels had no influence on the outcome of 131 I treatment

Objective: To investigate the feasibility and advantages of supraclavicular approaching thyroidectomy for benign thyroid diseases. Methods: From February 2004 to December 2007, 64 cases of thyroidectomies were performed via the lateral cervical supraclavicular incision, and were selected as experimental group, of whom, there were 37 cases of thyroid adenomas and 27 cases of nodular thyroid goiters, respectively. At the same time period, 63 cases of consecutive thyroidectomies through the conventional anterior neck incision were selected as a control group, of whom, there were 39 cases of thyroid adenomas and 24 cases of nodular thyroid goiters, respectively. Results: All the operations in two groups were successfully accomplished. In the experimental group, there were 9 subtotal thyroidetomies, 40 subtotal lobectomies and 15 nodulectomies. While in the control group, there were 8 total thyroidetomies, 37 subtotal lobectomies and 18 nodulectomies. The statistical analysis between the two groups was carried out in terms of tumor size, operative time-consuming, blood loss, postoperative drain volume, time for return of motion and postoperative complications. There were no injuries of laryngeal recurrent nerve, superior laryngeal nerve and parathyroid glands. Two cases of postoperative complications in the experimental group and 3 in the control group were observed, respectively, the statistical differences were not significant between the two groups. Conclusion: The supraclavicular incision for thryoidectomy for benign thyroid diseases is a feasible and safe technique with a satisfactory cosmetic result. It is accessible to the treatment of bilateral thyroid diseases and can facilitate the detection of lymphatic metastases.

Objective To evaluate the development of early hypothyroidism of patients with hyperthyroidism after radioiodine131 therapy, its outcome and predisposing factors. Methods Sixty-one patients manifesting early hypothyroidism after treatment with 131 I were followed-up for over one year, and they were divided into two groups: temporary hypothroidism group (including those who had attained normal thyroid function and those with recurrent hyperthyroidism), and permanent hypothyroidism. The duration between treatment and appearance of hypothyroidism, gender, thyroglobulin antibody (TGA) and thyroid microsome auto-antibody (TMA) levels, thyroid weight, total dosage of 131 I, and peak of 131 I intake were compared between two groups. Results Over one half of the 61 patients manifested temporary hypothyroidism (3.3% with recurrent hyperthyroidism, 50.4% of them attained normal thyroid function). Based on the length of the interval between the beginning of the treatment and onset of hypothyroidism, they could be categorized into ≤3 month, 4～6 months became permanent hypothyroidic. The above indises determined during the treatment did not show relationship with the outcome. Conclusion It was therefore concluded that the time of appearance of hypothyroidism was the main factor which determined the outcome of 131 I therapy so far as hypothyroidism was concerned.

0.05).Conclusion Selective hepatic vascular occlusion is superior to complete hepatic vascular occlusion,and is worth being widely used.

Objective To investigate the clinical manifestation and diagnosis of Hashimoto thyroiditis (HT). Methods 45 HT patients diagnosed by fine needle aspiration cytology (FNAC) were enrolled in this study. Their medical history, clinical parameters, data of laboratory examination, colour doppler ultrasonic image and FNAC were analyzed. Results This disease was more common in women than in men, and most of cases occurred during 35～50 years old. Almost all cases had the symptoms of thyromegaly and laryngopharynx malaise. The patients had normal thyroid function, hypothyroidism or hyperthyroidism. The levels of both antithyroid globulin antibody and antithyroid microsome antibody increased in 39 cases. The ultrasonic imaging features of thyroid were such as following: diffusive nonhomogenous hypoecho pattern in 19 cases, numerous hypoecho micronodes in 15 cases, hyperecho micronodes in 3 cases, and hyperecho bandlike echo pattern with swelling of neck lymph nodes in 8 cases. Conclusion Diagnosis of HD should put emphasis on a complete medical history, physical examination and necessary laboratory tests. Antithyroid auto-antibody assay and thyroid ultrasonic examination were very important for diagnosis of HD, and FNAC may be indispensable in suspected cases.