Objective To discuss the appropriate excision area of the thyroid microcacinoma. Methods 46 patients with thyroid microcarcinoma confirmed by pathology result were analyzed, in which 28 patients under-went thyroid lobectomy of lesion side and subtotal lobectomy of the other;8 patients were treated with subtotal lo-bectomy of both side;3 patients were treated with lobectomy of one side and partial resection of the other, while the rest 7 patients underwent the surgery of lesion side lobectomy and neck dissection plus subtotal lobectomy of the other side. Results No complicaitons were observed. All patients were follow-uped for 1 ～ 5 years. 2 patients were disgnosed as recurrance 3 years and 4 years after the operation respectively. The rest survived without recur-rance. Conclusions The appropriate surgery approach for thyroid microcacinoma might be lesion side lobectomy and subtotal lobectomy of the other side.

OBJECTIVE: To supply reference for the implementation and popularization of clinical pharmacist system as well as the establishment of the quality standards and assessment system for the pharmaceutical care in China.METHODS: By literature reviewing method,the pertinent literature about quality standards and assessment system of pharmaceutical care at home and abroad since 1990s were retrieved systematically,sorted and analyzed.RESULTS & CONCLUSIONS: The quality assessment of the pharmaceutical care can help enhance the level of pharmaceutical care,demonstrate the value of clinical pharmaceutical care,and facilitate the establishment and evolvement of the clinical pharmacist system.When drawing useful experiences from such countries like American and Britain,China should attach great importance to the cooperation between schools of higher learning and practitioners and the application of scientific methods and taking into consideration of the practical situation of the hospitals in carrying out clinical quality assessment for pharmaceutical care.

Objective To investigate the pathogenic constitution of thyroid nodular diasease and it' s di-agnosis and treatment.Methods A retrospective analysis was performed on data of 576 patients accepted hospi-tal therapy with thyroid nodular diasease from January 2004 to June 2008.Results Definite diagnosis of all easeswere made by surgery biopsy or fine needle aspiration-cytology.529 eases were benign lesions, another 47 eases were malignant lesions.Condusions Ultra-sound , FNAC and frozen sections have important value in differenti-al diagnosis for the thyroid nodules, nodular goiter is most common, and which have a close relationship with thy-roid carcinoma.Regular surgical resection would reduce the recurrence of thyroid nodular diasease and avoid missed diagnosis for thyroid carcinoma.

The establishment of quality evaluation of traditional Chinese medicine system that not only accords with Chinese medicine function characteristics but also is recognized as international medical circles, is an arduous task in urgent need of solving the current modernization of traditional Chinese medicine in the process of internationalization. It is difficult to evaluate atraditional Chinese medicine by detection of single active components in traditional Chinesemedicinewiththe western medicine quality controlmethod due to the overall effects of traditional Chinese drugs, the components of the overall diversity, targets, and the complexity of the interaction between components of unpredictable make the Long-term since, domestic and foreign scholars continue to explore and put forward a series of quality evaluation of traditional Chinese medicine to promote the development of traditional Chinese medicine. This article summarized the related academic ideas and developments to, providea new thought and perspective for the quality control of traditional Chinese medicine.
Drug Evaluation ; methods ; standards ; Drugs, Chinese Herbal ; chemistry ; Humans ; Medicine, Chinese Traditional ; standards ; Quality Control

Objective To investigate the prognostic outcome of open reduction and internal fixation(ORIF)with radial head resection in treatment of comminuted radial head fractures so as to discuss the corresponding operation options.Methods A series of 23 patients with Mason type Ⅲ or Ⅳ radial head fractures were enrolled in the study including 11 males and 12 females.Eight patients(three with Mason type Ⅲ and five with Mason type Ⅳ)underwent radial head resection and 15(seven with Mason type Ⅲ and eight with Mason type Ⅳ)received open reduction and internal fixation including nail and plate fixation in eight and screw and K-wire fixation in seven.The outcomes were assessed in regard of range of motion,radiographic findings,visual analogous scale(VAS)of pain,patient satisfaction degree,disabilities of the arm,shoulder and hand score system(DASH)and the Broberg & Morrey elbow performance score system.Results The follow-up period ranged from 12 to 65 months(mean 35 months),which showed fracture healing in all patients,with no traumatic arthritis happened.The mean range of flexion and extension arc at the elbow of ORIF group and resection group was 132°and 79.4°(P＜0.01)and the patient satisfaction was 9.1 and 8.0(P ＜0.05)respectively.According to the Broberg & Money elbow performance score system,the score was average 93.9 in the ORIF group,with excellent result in nine patients,good in five and fair in one,while the score was average 80.6 in the resection group,with excellent result in two patients,good in two and fair in four.There was statistical difference between two groups(P ＜0.01).The DASH score of the ORIF and resection group was 2.9 and 18.1 respectively(P＜0.05).Conclusions ORIF has better elbow motion,elbow function,daily living and satisfactory outcomes than radial head resection and is recommended for treatment of Mason type Ⅲ or Ⅳ radial head fractures for repair of the radial head as far as possible.

Objective To analyse the mutation of K17 gene in a pedigree with steatocystoma multi-plex. Methods Blood samples were obtained from 3 affected and 3 normal individuals in a family with steatocystoma multiplex, as well as from 50 unrelated healthy individuals. Mutation scanning was carried out by PCR and direct sequencing. Results A heterozygous nucleotide transition (C→T) at position 428 in exon 1 of KI7 gene, which leads to the substitution of CGC (arginine) by TGC (histidine) at codon 94, was detected in the affected individuals, but not in normal family members or the 50 unrelated individuals. Conclusion A missense mutation (428C→T) in KI7 gene has been detected in affected individuals of this family, which seems to be a molecular basis of pathogenesis of steatocystoma multiplex.

Objective To study the function of the toll-like receptor-4 (TLR-4) signaling pathway in the synthesis and secretion of pulmonary artery smooth muscle cells of rats with COPD. Methods The primary pulmonary artery smooth muscle cells (PASMCs) of rats with COPD were digested, separated and purified. Then they were randomly divided into control group, LPS group, TLR4 inhibitor group (TAK242) and LPS + TLR4 inhibitor group. RT-PCR, Western blot were used to detect the expression level of TLR-4 and NF-κB among groups. The levels of IFN-γ and PDGF-AB in supernatant with PASMCs in each group were detected by ELISA. Results LPS increased the expression of TLR-4、 NF-κB and the levels of IFN-γ and PDGF-AB. The expression of TLR4, NF-κB and the levels of IFN-γ and PDGF-AB were significantly reduced after inhibiting the expression of TLR4(P < 0.05). Conclusion TLR-4 signaling pathway involved in the inflammatory response and pulmonary vascular remodeling which increased the synthesis and secretion of IFN-γ and PDGF-AB in PASMCs. It provides a theoretical approach for the early intervention of clinical with COPD.

OBJECTIVE: To provide references for the evolvement of the administration of drug labels and package inserts in China. METHODS: By content analysis in non-contact research, 23 law documents relevant to American drug labels and package inserts were collected from FDA website, of which, 7 were acts, 1 federal regulation and 15 guiding principles RESULTS: The drug labels and package inserts of the prescription drugs and the over-the-counter drugs in US were administrated in classification with an emphasis on the contents and formats. CONCLUSIONS: A set of comprehensive lawful system for drug labels and package inserts has been established in American, from which China should draw experience to ensure the comprehensiveness, objectiveness and accuracy of drug information and guarantee safety and efficacy of drugs.

Objective To observe and contrast the effects of dexmedetomidine and ketamine on the restlessness and analgesia during recovery period of anesthesia after tonsillectomy in children. Methods Sixty ASA Ⅰ-Ⅱ child patients underwent tonsillectomy and adenoidectomy were randomly divided into three groups, group P (appropriate amount of placebo was given in the operation), group D (dexmedetomidine) and group K (ketamine). Data of mean arterial pressure and heart rate of three groups were documented before anesthesia (T0), during extubation (T1), 5 min (T2), 10 min (T3), 15 min (T4) and 30 min (T5) after extubation were recorded. The analepsia time, adverse reactions, restlessness score and pain score were collected in three groups of patients. Results Compared with group P, values of mean arterial pressure and heart rate were more stable at T1, T2 and T3 in groups D and K (P<0.05). The restlessness score, incidence of restlessness and adverse reactions were lower in groups D and K than those in group P (P<0.05), and which were lower in group D than those of group K (P<0.05). Conclusion Both dexmedetomidine and ketamine can play an analgesic role in recovery period of anesthesia and reduce restlessness, adverse reactions and pain score in child patients. Moreover, dexmedetomidine is more effective on inhibiting restlessness and adverse reactions.

Background Studies show that retinal neurodegeneration may precede retinal microvascular changes in diabetes mellitus.The apoptosis of retinal ganglion cells (RGCs) is an early finding in retinal neurodegeneration.Toll-like receptor 4 (TLR4) is proved to be up-regulated in diabetic rats retina.However,the impact of TLR4 on RGCs damage in retinal neurodegeneration is poorly understood.Objective The aim of this study was to investigate the expressing change of TLR4 induced by high glucose in RGCs in order to offer a basis for the prevention diabetic retinal neurodegeneration and the study on targeting drugs.Methods RGCs were isolated and purified from the retinas of SPF SD rats aged postnatal 1-3 days by using papain digestion method and then were identified by immunofluorescence technology to detect the expression of Brn3a,a specific marker of RGCs.The cells were divided into normal control group and 10,20,30 mmol/L glucose groups.The expressions of TLR4 mRNA and protein in the ceils were detected by real-time fluorescence quantitative PCR and Western blot analysis in 24 and 48 hours after addtion of glucose.All procedures performed in studies were in accordance with the Association for National Institutes of Health (NIH) Statement for the Care and Use of Laboratory Animals recommendations.The protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University.Every effort was made to minimize animal discomfort and stress.Results The normal cells grew well with the shape of near roundness after inoculaton.The cells were gradually enlarged and clustered with obvious axons and dendrites 24 hours after purifying.Brn3a showed the positive expression in cultured cells.At 24 hours and 48 hours after glucose culture,the cell structures were gradually invisible in most cells.The expressions of TLR4 mRNA in the cells were 0.945 ±0.237,1.180±0.193 and 0.827±0.213 at 24 hours and 1.509±0.422,2.433±0.617 and 1.435±0.410 at 48 hours after culture in the 10,20 and 30 mmol/L glucose groups,respectively,which were significantly higher than 0.600±0.099 and 0.724±0.302 in the normal control group (all at P＜0.01).The expressions of TLR4 protein in the cells were 0.442±0.147,0.626±0.128 and 0.330±0.153 at 24 hours and 0.464±0.121,0.930±0.441 and 0.394±0.158 at 48 hours after culture in the 10,20 and 30 mmol/L glucose groups,respectively,which were significantly higher than 0.090±0.050 and 0.094±0.070 in the normal control group (all at P＜0.01).Conclusions A large number of RGCs die in a high-glucose environment in vitro,meanwhile,the expression of TLR4 up-regulates in the cells,indicating that TLR4 maybe participate in the damage of RGCs induced by high glucose.