Objective To explore the feasibility of individualized preoperative preparation for thyroid nodular disease concomitant with hyperthyroxinemia. Methods According to different clinical manifestations,traditional preoperative medical preparation, impulse preoperative medical preparation and propranolol preoperative medical preparation were respectively made on 43 cases of thyroid nodular disease concomitant with hyperthyroxinemia and without eye proptosis. Preoperative medical preparation wasn't performed on 12 eases of hyperthyroxinemia without apparent hypermetabolism and basal metabolic rate less than 20%. Hospitalization time and incidence of intraoperative and postoperative complication were observed and recorded. Results Intraoperative and postoperative thyroid crisis or serious complications didn't occur in all 43 cases of thyroid nodular disease concomitant with hyperthyroxinemia and without eye proptosis. Hospitalization time differs for patients with different preoperative preparation. Conclusion It was feasible to make individualized preoperative preparation for thyroid nodular disease concomitant with hyperthyroxinemia.

Objective To investigate the clinical significance of retaining axillary sheath in axillary lymph node dissection of breast cancer surgery. Methods Four hundred and two patients received modified radical mastectomy from January 2004 to January 2008 and followed up for 12 months were retrospectively analyzed. They were divided into two groups (group A and B) according to whether retaining axillary sheath in operation. Compared the morbidities of axillary effusion and edema of upper limbs between two groups. Results The morbidity of axillary effusion after operation in group A (5.3%, 13/243 ) was lower than that in group B (10.7%,17/159)(P＜0.05). Based on the data followed up for 1,6, 12 months after operation, the morbidity of edema of upper limbs in group A were also lower than those in group B (P ＜0.01). Conclusion Retaining axillary sheath when there is no evidence of lymph node metastasis in axillary sheath, will prominently lower the morbidities of axillary effusion and edema of upper limbs,improve the life quality of patients.

Objective To investigate the diagnosis、 treatment and prognosis of hashimoto's disease(HD) complicated with thyroid multiple nodules.Methods Clinical data of 129 cases of HD complicated with thyroid multiple nodules under want surgery in three years were analyzed retrospectively and followed up.Results All patients were received different scope of thyroidectomy according to the situation of thyroid nodules.The histologic examination after operation indicated there are 36 cases(27.9%) complicated with nodular goiter;23 cases(17.8%) complicated with thyroid cancer;3 cases(2.3%) complicated with thyroid adenomas;1 cases(0.78%) complicated with toxic goiter.Conclusion HD complicated with thyroid multiple nodules patients had difficulty in preoperative diagnosis of nodular nature and should be operate.

BACKGROUND: Tendon injury is a common injury in the department of hand surgery. The postoperative recovery of hand function is always affected by tendon adhesion after tendon repair. To prevent tendon adhesion, especially the adhesion after flexor tendon repair is always the key in the rehabilitation of hand surgery.OBJECTIVE: To investigate the impact of decimeter wave therapy on tendon adhesion and healing after flexor tendon repair.DESIGN: Randomized controlled study based on experimental animal SETTING: Provincial Institute of Orthopaedics.MATERIALS: The study was conducted in Hebei Provincial Institute of Orthopaedics from January 2001 to June 2003. Totally 28 Leghorn chickens were randomly divided into decimeter wave therapy group and operation control group.METHODS: The flexor digitorum profundus tendons of Leghorn chickens were transected and repaired. Decimeter wave therapy was applied to the toes on chickens of decimeter wave therapy group. Animals were executed at week 3 or 6 after operation for macroscopical observation and histological observation under optical and electron microscopes, and biomechanical analysis.MAIN OUTCOME MEASURES: Principle index: results of macroscopical observation and the observatory results under optical and electron microscope, and the results of biomechanics. Secondary index: results of the classification of tendon adhesion and healing.RESULTS: It could be seen under macroscopical and histological observation that the adhesion significantly reduced in decimeter wave therapy group. The protein synthesis of fibroblast was significantly more than that of the control group under electron microscope. As indicated by biomechanical analysis, the tendon gliding distance[ (5.37 ± 1.06) mm at week 3, (6.76 ± 1.52) mm at week 6]and the rehabilitative compliance( 1. 04 ± 0.65 at week 3)of decimeter wave therapy group were bigger than those of the control group respectively [ (4.43 ±1.03) mm, (5.33±1.27)mmand0.63±0.31](P ＜0.05), and the anti-tension strength of decimeter wave in therapy group (N, 26. 93 ± 4. 80,47. 12 ± 7.76) was significantly bigger than that of the control group respectively(21.29 ±4. 88 and 38.96 ±7.52) (P ＜0. 01).CONCLUSION: Decimeter wave therapy can effectively promote tendon healing and reduce tendon adhesions and provide prerequisites for early rehabilitative training after flexor tendon repair. Hence, it is an ideal assistance in the prevention of tendon adhesion.

Objective To explore the isolation, culture of nestin positive cells of the pancreas in newborn rats. Methods The whole pancreas of neonatal rats were digested with collagenase, followed by incubation under pH 7. 6 serum RPMI 1640 for 24 - 36 h and then under pH 7. 4 serum free RPMI 1640 (bFGF.EGF 20 ng/ml.1% N2) for 18-24 d. The expression of insulin.glucagon and nestin were detected by immunofluorescence technique. Nestin.CK19 were detected by RT-PCR. Resides Cells attached to the surface of plates after 24 h incubation under pH 7. 6 condition, and islet-like masses were obtained after 18 -24 d incubation. A monolayer of cells grew out after 24 h of passage of islet-like masses. Nestin positive cells was detected after 24 - 36 h incubation, with no expression of insulin and glucagon. Positive cells of insulin and glucagon were detected in islet-like masses after 24 h passage. Nestin positive cells were detected by RT-PCR in islet-like masses after 24 h passage, but no CK19. Conclusion Insulin and glucagon were expressed in islet-like masses after passage. Nestin positive cells in the pancreas of neonatal rats possessed character of islet stem cells.

Objective To explore the method of isolation, identification and in vitro differentiation of islet stem cells in neonatal rat. Methods The whole pancreata of neonatal rats were digested with collagenase, then,under the (condition) of pH 7.4～7.6,the digested tissue fragments were cultured with serum and serum-free RPMI 1640 (( bFGF), EGF, N2).The whole formation process of new islet cell-like cell masses was examined.The insulin (release) test was used to detect islet function. The expression of nestin was tested by immunocytochemistry. Results The nestin positive cells can be found within 36 h of culture of the digested pancreatic fragments.After addition of bFGF,ECF,N2,nestin positive cells proliferated fast and formed new islets-like cell masses after 18～24 d, and (insulin)ssion could be confirmed. Conclusions The nestin positive cells of pancreatic cells possess the character of islet stem cells, and can form islet like cell masses through culture in vitro.

Portal hypertension (PH) is a common clinical syndrome, and the main risk factor for death is esophageal variceal bleeding. Therefore, the early and accurate diagnosis of PH can reduce the incidence rate of serious complications and mortality rate. Hepatic venous pressure gradient, as a main method for the diagnosis of PH, has certain limitations in clinical application, and thus it is necessary to explore new noninvasive diagnostic techniques. Up to now, ultrasound elastography has become one of the important methods for the noninvasive assessment of PH. This article elaborates on its current application and prospects in the assessment of PH.

Objective:To explore the risk factors of sarcopenia in liver cirrhosis and construct a diagnosis model for sarcopenia in cirrhosis.Methods:73 patients with liver cirrhosis hospitalized in Department of Gastroenterology of Shanxi Provincial People's Hospital between June 2021 and June 2022 were included. Common measurements in liver cirrhosis and abdominal CT scans of all patients were collected. The cross-sectional area of skeletal muscle at L3 level was calculated by sliceomatic and the skeletal muscle index (SMI) was subsequently obtained by height standardization. The patients were divided into sarcopenia group and non-sarcopenia group using Asian cut-off per European Working Group on Sarcopenia in Older People-2nd meeting (EWGSOP2) criteria. Risk factors related to sarcopenia in cirrhosis were analyzed and a subsequent diagnosis model was established.Results:among the cirrhotic patients included in the study, the prevalence of sarcopenia was 65.75% (48/73), 47.73% (21/44) in males and 93.10% (27/29) in females, respectively. There were significant differences in age, sex, BMI, liver function grade per Child Pugh classification, etiology, ferritin level, prothrombin time and hemoglobin level between sarcopenia and non-sarcopenia groups (P < 0.05). Age, liver function, sex and ferritin level were closely related to the occurrence of sarcopenia in cirrhosis. A diagnostic model was developed based on these 4 indexes and the area under curve reached up to 95.7%.Conclusion:≥ 60 years old, female, Child-Pugh C grade and ferritin < 29.60 μg/L are independent risk factors for sarcopenia in cirrhosis and the model with these indexes shows good diagnostic value for sarcopenia in cirrhosis.