Objective To analyze clinical features of papillary thyroid microcarcinoma(PTMC) and to evaluate the diagnosis and treatment for PTMC.Methods The clinical data of 447 cases of PTMC receiving surgical treatment and confirmed by pathology were reviewed.Color Doppler ultrasonography was used to identify thyroid nodules and cervical lymph nodes,and frozen section was used to confirm the pathological diagnosis during operation.104 cases received unilateral lobectomy,22 cases received unilateral lobectomy plus isthmectomy,321 cases received total thyroidectomy,257 cases underwent central neck dissection,and 54 cases underwent lateral neck dissection(level Ⅵ included).All cases took levothyroxine to maintain low TSH level after operation,and were followed up through telephone or in out-patient clinic.Results Central compartment node metastasis was found in 144 patients,and lateral neck metastasis was found in 41 cN1 cases.The age,extra-capsular invasion and multifocal carcinoma were independent risk factors of PTMC.The number of positive nodes in level Ⅵ was positively correlated with the risk of lateral node metastasis.395 cases were followed-up successfully for 20 to 42 months,with the media follow-up of 32 months.During the follow-up,recurrence or metastasis was found in 15 cases,and no death happened.Conclusions PTMC has no specific symptoms,and was difficult to be diagnosed before operation.Physical examination and color Doppler ultrasonography should be used as routine examination.Thyroid lobectomy and total thyroidectomy plus central node dissection should be major surgical treatment for PTMC patients.Lateral neck dissection should be considered in all cN1 patients.

Objective To investigate the effects of homemade tirofiban on activated-platelet and prethrombotic state in rabbit model of iliac artery injury by balloon angioplasty.Methods Forty New Zealand white rabbits,lavaged with aspirin(12 mg/kg)and clopidogrel(16mg/kg)8～12hs before the experiment,followed by abrosia,were divided into 3 groups.The iliac artery injury models were set up successfully only in 30 out of the forty rabbits.Rabbits in the pre-treatment group(n=11)received homemade tirofiban right after being lavaged and the drug was given to the treatment group(n=13)later after the iliac artery was injured by PTCA balloon.Placebo was given to the control(n=6)after the injury.Blood samples were drawn before and after the procedure for platelet aggregation,sP-selectin and 6-Keto-PGF1? analysis.Changes in iliac systolic blood pressure(SBP)and diastolic blood pressure(DBP)were monitored throughout the operation.Iliac arteriography and pathological study were carried out in some animals for analysis of the composition of thrombus.Results(1)The sP-selectin levels were different between the pre-treatment group and the treatment group(58.1?26.2 ?g/L vs 24.8?14.3 ?g/L pre-operation;53.2?40.2 ?g/L vs 53.5?27.7 ?g/L post-operation,respectively,P

Observing the clinical curative effect of orthopedics lotion to treat traumatic ankle arthritis, the outpatient department of orthopedics in Guang'anmen Hospital collected 60 cases who were diagnosed as traumatic ankle arthritis. The cases who already met the inclusion criteria, were randomly divided into the treatment group (30 cases) and control group (30 cases). Thirty patients in treatment group were received fumigation treatment with orthopedics lotion; 30 patients in control group were treated by intra-articular injection of sodium hyaluronate. After 5 weeks treatment, the effects on the both groups would be observed and analysed. Baird-Jackson scoring system was used to assess the overall curative effect. Visual analogue scales (VAS) was used to assess analgesic effect. BJ scores of pre-treatment and post-treatment in both the treatment group and the control group were compared, P <0O. 01, significantly different; and the BJ scores after treatment of two groups were compared by paired t-test, the t value is 1. 76, there was no significant difference between two groups. Both of the treatments were effective, but there was no significant difference in overall curative effect between the two kinds of treatment. The VAS scores after treatment of two groups were compared by paired t-test, the t value was 2. 282, and there was a significant difference between two groups (P <0. 05). The analgesic effect shown in treatment group was better than the control group. The results suggest that: orthopedics lotion is a effective way to treat traumatic ankle arthritis, and it has significant effect on analgesic.
Adult ; Ankle Injuries ; complications ; Arthritis ; complications ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Orthopedics ; methods ; Treatment Outcome

目的观察羟基磷灰石义眼胎植入术临床效果。方法 40只眼于眼球摘除同时植入羟基磷灰石义眼胎。义眼胎用自体巩膜包裹,植入眼眶深部,眼外肌固定于巩膜上,分层缝合眼球筋膜和球结膜。结果随访1～5年,3 6眼术后半年以上行羟基磷灰石义眼胎钻孔栓钉植入术,成功安置活动义眼。1只眼义眼胎暴露行再次手术修补,1眼术后2个月发生绿脓杆菌感染,经治疗痊愈。结论羟基磷灰石义眼胎具有良好的组织相容性,是理想的眶内植入物材料。

Child ; Humans ; Nephrology ; Pediatrics

OBJECTIVETo compare the effect on surgical indicators and functional outcome between preoperative skeletal traction and skin traction for adult femoral fracture and guide the choice of preoperative traction method of adult femoral fractures.

METHODSFrom February 2008 to September 2012, 68 patients aged greater than 18-year-old with femoral fractures were treated and randomly divided into two groups according hospitalization order,the odd with skeletal traction of tibial tubercle (group A) and the even with skin traction (group B). In group A, there were 25 males and 9 females with an average age of (36.3±9.9) years old,including 11 cases with transverse fracture, 15 cases with oblique fracture, 8 cases with spiral fracture. In group B, there 26 males and 8 females with an average age of (37.1±11.0) years old,including 10 cases with transverse fracture, 13 cases with oblique fracture,11 cases with spiral fracture. The operative time,blood loss,the number and amount of blood transfusion ,fracture healing time, hemoglobin, pain scores and functional scores between two groups were analyzed and compared. Results:All patients were followed up, the follow-up time was (33.5±6.5) months in group A, (31.3±7.5) months in groupB. In group A,the operation time was (108.8±14.2) min and the intraoperative blood loss was (383.1±117.1) ml and the postoperative blood transfusion was 14 cases and the blood transfusion was (350.0±122.5) ml and the average bone healing time was(15.0±3.3) weeks. In group B, the operation time was (111.6±12.7) min and the intraoperative blood loss was (392.0± 116.7) ml and the blood transfusion was 11 cases and the blood transfusion was(327.3±129.1) ml and the average healing time was (15.5±3.4) weeks. These obseration indicators had no significant difference between two groups. There was no significant difference between two groups in terms of Hemoglobin, the pain scores before and after traction, the femoral fractures efficacy score,knee function score and knee range.

CONCLUSIONPreoperative skeletal traction does not reduce surgery time, blood loss and pain and so on. The bone healing time and limb functional outcomes were also not significantly improved.

Adult ; Blood Loss, Surgical ; Bone and Bones ; surgery ; Dermatologic Surgical Procedures ; Female ; Femoral Fractures ; physiopathology ; surgery ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Male ; Middle Aged ; Preoperative Period ; Traction ; Young Adult

Objective To explore efficacy and mechanism of recombinant human granulocyte-colony stimulating factor(rhG-CSF)in treatment of different leukopenia.Methods A total of 50 patients were divided into 4 groups:aplastic anemia(AA)group(n=10),myelodysplastic syndromes(MDS)group(n=10),drug-induced leukopenia group(n=20)(subdivided into hyperplasia group and hypoplasia group by the degree of cellularity)and iron deficiency anemia group(control group,n=10).The concentrations of G-CSF of peripheral blood were measured by ELISA method.The ratio of CD34+ cells and G-CSFR expression in blood marrow mononuclear cells(BMMNC)were measured by flow cytometry.Granulocyte colony-forming units(CFU-G)of MNC were cultured.Clinical efficacy of rhG-CSF to all patients were determined.Results The concentrations of G-CSF were higher in AA and drug-induced leukopenia groups than those of MDS and control groups(P0.05).Expressions of G-CSFR were lower in hypoplasia group than those in hyperplasia and control groups(P0.05).The ratio of CD34+ cells was lower in AA group than that of other groups(P0.05).Concentrations of CFU-G were lower in AA and MDS groups than those in drug-induced leukopenia and control groups(P0.05).The efficacy of rhG-CSF was superior in drug-induced leukopenia group than in MDS group,and superior in MDS group than in AA group(P

Adolescent ; Adult ; Female ; Herbicides ; poisoning ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; Rural Population ; Young Adult

Objective: To evaluate the effect and safety of low-dose naloxone combined with sufentanil and ropivacaine for postoperative patient-controlled epidural analgesia (PCEA) in elderly patients undergoing total hip replacement. Methods: A total of 60 elderly patients (ASA I-II) undergoing total hip replacement were randomly assigned to two equal groups: Group C was given 0.5 μg/ml sufentanil in 0.15% ropivacaine; Group N was given the same solution with 0.09 μg/(kg·ml) naloxone. The 2 groups were followed up in a double-blinded manner: the visual analogue scale (VAS) for pain score was recorded at 2, 6, 12, and 24 h to evaluate the analgesia effect. Meanwhile, the incidences of postoperative nausea and vomiting (PONV), pruritus, sedation, respiratory depression, and hypotension were also recorded. Results: The VAS pain score in Group N was significantly lower than that in Group C at 6, 12 and 24 h (P<0.01). The incidence of PONV in Group N was significantly lower than that in Group C (P<0.05); the incidences of other opioid-induced side-effects were not significantly different between the 2 groups. During the course of analgesia, the vital signs of 2 groups were stable; no patients had respiratory depression or hypotension. Conclusion: Low-dose epidural naloxone can enhance the analgesic effect of sufentanil. With timely postoperative monitoring, low-dose naloxone combined with sufentanil and ropivacaine is safe and effective for postoperative patient-controtled epidural analgesia in elderly patients undergoing total hip replacement.

In 4 602 subjects for routine check-up,blood uric acid,total cholesterol,triglyceride,high density lipoprotein-cholesterol,and low density lipoprotein-cholesterol were determined.Results showed that the overall prevalence of hyperuricemia in Nanning,Guangxi was 19.8％ (28.8％ in male,9.4％ in female).Blood uric acid and lipids in hyperuricemia group were higher than those in normal uric acid group(all P＜0.01).Serum uric acid had a positive correlation with total cholesterol,triglyceride,low density lipoprotein-cholesterol,but it was negatively correlated with serum high density lipoprotein-cholesterol.The prevalence of hypercholesterolemia was 30.8％,and that of hypertriglyceridemia was 22.2％.Logistic multi-factor regression analysis showed that men,high total cholesterol,triglyceride,and low density lipoprotein-cholesterol could be independent risk factors for hyperuricemia,and that high density lipoprotein-cholesterol was a protective factor.The prevalence of hyperuricemia in population of Nanning,Guangxi during health examination is high.Hyperuricemia is closely associated with dyslipidemia.Timely intervention of hyperuricemia can reduce the related diseases effectively.