OBJECTIVE: To compare the advantages and disadvantages of real time recurrent laryngeal nerve (RLN) monitoring and conventional exposure during thyroid operation by Meta analysis. METHOD: The published articles of randomized controlled clinical trials were searched in data bases to compare the therapeutic outcomes of using real-time RLN monitoring and conventional exposure in thyroid surgery. The quality of the searched original studies was assessed and the outcomes which are in line with the requirements were analyzed. RESULT: Six articles met the inclusion criteria, which contained 12,646 RLN in total. There were 5,535 cases in the RLN monitoring group and 7,111 cases in the conventional exposure group. The results of Meta analysis showed that: the transient injury rate of the RLN in the monitoring group (OR=0.60, 95% CI=0.49-0.73, P<0.01) was lower than that in the conventional exposure group, but the permanent injury rate of the RLN in two groups had no statistical difference (OR=0.90, 95 % CI= 0.57-1.40, P>0.05). The RLN identification rate also had no statistical difference between the two groups (OR=9.79, 95% CI=0.17-548. 64, P>0.05). CONCLUSION The transient injury rate of the RLN is lower in the monitoring group than that in conventional exposure group, but the permanent injury rate and the RLN identification rate had no statistical difference between the two groups. The intraoperative nerve monitoring was useful in the prevention of the RLN injury in thyroid surgery.
Humans ; Monitoring, Intraoperative ; Parathyroid Glands ; Quality of Life ; Recurrent Laryngeal Nerve ; Recurrent Laryngeal Nerve Injuries ; prevention & control ; Thyroid Gland ; surgery ; Thyroidectomy ; adverse effects

In recent years, the importance of tyrosine phosphorylation in the nervous system of mammalian is gaining recognition. Tyros ine protein kinases exert important modulatory effect on the proliferation, diff erentiation, migration and metabolism-related singal transduction pathways in c ells. In this paper we reviewed the signal cascade process of three different ty rosine protein kinase families, including Trk, Src and Eph tyrosine protein kina se families. Furthermore, we discussed important role and possible mechanisms of these tyrosine protein kinases on the neuron synapse plasticity and learning an d memory process.

Objective To evaluate the clinical effect of itraconazole oral solutions on pulmonary candidiasis albicans in ICU patients.Methods A total of 71 patients with candida ablicans in their sputum clutures were randomized into two groups.The itraconazole group(n= 36)received itraconazole 200 mg,p.o.(including nasal feeding),q12h for 14 days.The fluconazole group(n=35)received fluconazole 400 mg for the first dose,then 200 mg,i.v.drip,qd for 14 days.Results There were 31 patients in the itraconazole group and 29 paitents in the fluconazole group who completed their treatment.In the itraconazole and fluconazole group,the clearance of candida ablicans was 64.52%(20/31)vs.65.55%(19/29),cleaning time(10.12?2.57)vs(8.87?1.95)days,effective rate 58.06%(18/31)vs 62.07%(18/29),recovery rate is 19.35%(6/31)vs 17.24%(5/29),occurrence of hepatic dysfunction is 25.81%(8/31)vs 24.14%(7/29),and withdrawal for inefficacy was 3.23%(1/31)vs 6.90%(2/29),respectively.These parameters did not have statistical significance.Conclusion Itraconazole oral solutions can be used effectively and safely in the treatment of pulmonary candidiasis albicans in ICU.Patients with renal dysfunction do not need to adjust the dosage.

OBJECTIVE: To observe the short and long-term efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in different age groups. METHOD: The clinical data of 113 adult patients with single PC-BPPV who underwent quick repositioning maneuver from July 2009 to February 2015 were retrospectively analyzed. The quick repositioning maneuver was to roll the patient from involved side to healthy side in the coronal plane for 180° as quickly as possible. The patients were divided into 3 groups according to different ages: young group (< 45 years), middle-age group (45 ≤ age < 60 years) and old group (≥ 60 years). The short and long term outcomes of the three groups were observed. RESULT: The left ear was involved in 58 cases (51.3%) and the right ear in 55 cases (48.7%). The short term improvement rates of the young, middle-age and the old groups were 92.5%, 93.6% and 92.3% respectively, and the long term improvement rate was 90.0%, 85.1% and 73.1% respectively. There was no significant difference among the three groups in short and long term outcomes (P > 0.05). The recurrence rate of the three groups was 5.0%, 6.4% and 15.4% respectively, also no significant difference (P > 0.05). CONCLUSION The quick repositioning maneuver along the coronal plane for PC-BPPV has a definite effect for every age groups. The method is simple, rapid and easy to master, and the patients are tolerated the maneuver well without evident side effect.
Adult ; Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Middle Aged ; Patient Positioning ; Retrospective Studies ; Semicircular Canals ; physiopathology

The oxidative stress, inflammatory cytokines and apoptosis have been strongly implicated in the pathogenesis of multiple diseases. Recently, more and more research findings have demonstrated that hydrogen-rich saline (HRS) has the anti-oxidant, anti-inflammatory and anti-apoptotic effects in vivo and in vitro, and can be used to treat multiple diseases, such as ischemia/reperfusion injury, stroke, neurodegeneration, sepsis, neuropathic pain and multiple organ dysfunction syn-drome diseases. This article reviews the possible mechanism of HRS for the treatment of diseases.

At present,the urinalysis has many puzzles and problems,this paper is proposed consensus of the key problems including standardization method in the urine formed elements examination,the urinalysis screening test,the results of reference intervals between the different examination methods,quantitative of the visible components,using centrifugal or non-centrifugal urine to do urine formed elements examination and the development direction of automatic urine sediment analyzer.These key problems are discussed and the consensus are put forward,in order to cause concern.( Chin J Lab Med,2012,35:790-791 )

Objective To study the effect of combining recombinet interferon α -2b gel and loop electrosurgical excision procedure (LEEP) to treat cervical intraepithehal neoplasia (CIN). Methods Prospective, randomly and control study was progressed in 80 patients with CIN Ⅱ-Ⅲ. Before carrying out LEEP, all women were performed high-risk HPV DNA detection by the method of HC2. Among them, forty women were. assigned to be the study group, in which the patients were added to use recombinet interferon α -2b gel for three courses of treatment before and after LEEP, the other forty women who carried out LEEP simply were assigned to be the control group. All patients were examined by hquid-based thinprep cytology test (TCT) and colposcopic site-specific biopsies to doubtful focus of infection in the 3rd, 6th, 9th and 12th month after treatment, and judged the effect by using HC2 in the 6th and 12th month after treatment. Results Eighty patients were not detected residue and recidivafion of CIN diagnosed by coiposcopic site-specific biopsies to doubtful focus of infection. In the study group, 3 women were abnormal detected by TCT, 37 women were negative detected by HC2, the negative rate was 92.5% when LEEP ended 6 months. The cure rate was 100.0% when LEEP ended 12 months. In the control group, 21 women were abnormal detected by TCT, 19 women were negative detected by HC2, the negative rate was 47.5% when LEEP ended 6 months, 8 women were negative detected by TCT, 25 women were negative detected by HC2, the cure rate was 62.5% when LEEP ended 12 months.In the 6th and 12th month after LEEP, the difference was distinguished in the cure rate between two groups. Conclusions There is double interrupted effects by combining recombinets interferon α -2b gel and LEEP to treat CIN. It can raise the one-time cure rate of the patients with CIN.

Aim Series of compounds,which were considered to be the antagonists of ET-1 receptor,were synthesized by Beijing Institute of Pharmacology and Toxicology.The biological activity of these compounds was screened and some active compounds were selected for further pharmacological characterization on pulmonary hypertension.Methods Radioligand binding assay was performed to study the binding affinity of compounds for ETA and ETB receptors.The biological activity of compounds was evaluated in isolated rat aortic ring and in systemic arterial pressure(SAP)of anesthetized rat experiments.In addition,hypotensive effect of compounds was investigated on monocrotaline induced pulmonary hypertension in rats.Results Compounds bind to ETA receptor had over 10 000 fold higher affinity than to ETB receptor.Contraction induced by ET-1 in isolated rat aortic ring was inhibited by compounds,and 1 ?mol?L-1 ETP-508 shifted the cumulative concentration-contraction response curve to ET-1 to right with no change in the maximal response.In vivo,the increase in SAP induced by ET-1 〔3.7 ?g?(0.5 ml)-1?kg-1〕 was inhibited by 2 mg?kg-1 compounds by intravenous infusion.Furthermore,BQ-485 and ETP-508 by intravenous infusion(0.4 mg?h-1)significantly inhibited 80 mg?kg-1(sc)monocrotaline induced pulmonary hypertension in rats.Conclusions These results indicate that ETP-508 and BQ-485 are highly selective ETA receptor antagonists and significantly inhibite monocrotaline induced pulmonary hypertension in rats.

Objective To investigate the effects of different depth of anesthesia on sublingual microcirculation. Meth?ods ASA gradeⅠ-Ⅱpatients (n=20) were scheduled for elective thyroid surgery and included in the prospective observa?tional study. Midazolam 0.05 mg·kg, sufentanil 0.3μg·kg-1 and rocuronium 0.6 mg·kg-1 were administrated intravenously to induce anesthesia which was then maintained by continuous intravenous infusion of propofol. Target medication concentra?tion increased 0.5 mg·L-1, regulated based on BIS. The patients underwent endotracheal intubation and mechanical ventila?tion. Sublingual microcirculations were evaluated by sidestream dark field (SDF) imaging at T1 (BIS baseline ), T2 (50 0.05). Conclusion When BIS value sit between 40 and 50, it can best inhibit stress response and attenuate the agitation of microcirculation.

Objective To investigate the role of Nrf2 on hydrogen treatment for intestinal injury caused by severe sepsis.Methods 152 male ICR mice were randomly divided into four groups:sham operation group,hydrogen control group,sepsis group,and hydrogen treatment group,each n=38.Sepsis model was reproduced by cecal ligation and puncture (CLP).The mice in sham operation group and hydrogen control group did not receive CLP,and the operative procedure was the same as follows.The mice in hydrogen control group and hydrogen treatment group received 1-hour inhalation of 2％ hydrogen 1 hour and 6 hours after sham operation or CLP.Twenty animals in each group were selected and observed for 7-day survival rate.Eighteen animals in each group were selected and sacrificed at 6,12 and 24 hours after CLP.The intestinal tissues were obtained to determine the expression of Nrf2 and high mobility group B1 (HMGB1) protein by Western Blot,and the expression of Nrf2 mRNA by reverse transcription-polymerase chain reaction (RT-PCR).The middle portion of jejunum was obtained to evaluate the degree of septic injury by light microscope after hematoxylin and eosin (HE) staining.Results There was no statistical signifieance in variables between sham operation group and hydrogen control group.Compared with sham operation group,the 7-day survival rate was significantly decreased in sepsis group (0 vs.100％,P＜0.05); compared with sepsis group,the 7-day survival rate was significantly increased in hydrogen treatment group (55％ vs.0,P＜0.05).Compared with sham operation group,the expression of Nrf2 protein (gray value) and Nrf2 mRNA were up-regulated in sepsis group at 6,12 and 24 hours after CLP (Nrf2 protein 6 hours:1.973 ± 0.350 vs.1.000 ± 0.000,t=4.411,P=0.002; 12 hours:2.367 ± 0.186 vs.1.000 ±0.000,t=10.210,P=0.000; 24 hours:2.517 ±0.280 vs.1.000 ±0.000,t=9.521,P=0.000; Nrf2 mRNA 6 hours:1.606 ± 0.271 vs.1.000 ± 0.000,t=3.631,P=0.002; 12 hours:1.692 ± 0.399 vs.1.000 ± 0.000,t=3.233,P=0.005; 24 hours:1.784 ± 0.341 vs.1.000 ± 0.000,t=3.894,P=0.001),and it was also the expression of HMGB1 (gray value) at 24 hours after CLP operation (1.507 ± 0.220 vs.1.000 ± 0.000,t=3.948,P=0.004).Compared with sepsis group,the expression of Nrf2 protein and Nrf2 mRNA in intestines were up-regulated at 6,12 and 24 hours after CLP in hydrogen treatment group (Nrf2 protein 6 hours:2.583 ± 0.395 vs.1.973 ± 0.350,t=2.765,P=0.024; 12 hours:2.725 ± 0.235 vs.2.367 ± 0.186,t=2.674,P=0.028; 24 hours:2.930 ± 0.212 vs.2.517 ± 0.280,t=2.595,P=0.032; Nrf2 mRNA 6 hours:2.008 ± 0.400 vs.1.606 ± 0.271,t=2.405,P=0.029; 12 hours:2.188 ± 0.475 vs.1.692 ±0.399,t=2.317,P=0.034; 24 hours:2.333 ±0.406 vs.1.784 ±0.341,t=2.728,P=0.015).Compared with sepsis group,the expression of HMGB1 was down-regulated significantly at 24 hours after CLP in hydrogen treatment group (1.147 ± 0.152 vs.1.507 ± 0.220,t=2.805,P=0.023).HE staining showed that there was significantly aggravated intestinal pathological injury in the mice of sepsis group; compared with sepsis group,the pathology was significantly less marked in hydrogen treatment group.Conclusion Through activation of Nrf2-antioxidant response element (ARE) pathway,hydrogen may increase the level of Nrf2,which is a kind of protective protein,in the intestine of mice,thus decreases the level of late pro-inflammatory factor,HMGB1,and it may protect the intestinal tissues in septic mice and increase the survival rate significantly.