Objective To investigate the causes and treatment of recurrent laryngeal nerve (RLN) injury during the operation of thyroidectomy. MethodsClinical data of 48 patients that RLN were injured during thyroidectomy in and out of our hospital from Jun. 2003 to Mar. 2007 were reviewed. ResultsNo patient died while operation and staying in hospital. There were 47 cases of unilateral RLN injury, 1 case of bilateral RLN injury; 21 cases (43.7%) were injured because of suture or scar adhesion, 13 cases (27.1%) were partly broken with formed scar, 14 cases (29.2%) were completely cut off; The locations of RLN injuries were closely adjacent to the crossing of the inferior thyroid artery and RLN in 13 cases (27.1%) and 35 cases (72.9%) were within 2 cm below the point of RLN entering into throat. The injured RLN were repaired surgically in 43 cases, among which 39 cases’ phonation and vocal cord movement were restored completely or had their vocal cord movement recovered partly; There were only 4 cases that the phonation and vocal cord movement were not recovered. Another 5 cases that did not take any repair did not recovered naturally. ConclusionThe location of most RLN injuries caused by mechanical injury during thyroid surgery is closely adjacent to the entrance of RLN into throat. Early nerve exploratory operation should be performed once the RLN is injured, and the method of repair should be decided according to concrete conditions of injury.

Objective To study portal vein hemodynamics changes after autoiogous bone marrow stem cell transplantation in patients with liver cirrhosis. Methods The hemodynamic parameters, including portal vein diameter, average portal blood flow velocity and spleen size, were determined by Colour Doppler Ultrasonography in 50 patients after autologous bone marrow stem cell transplantation and all cases were followed for up to 6 months. Results (1) After autologous marrow stem cell transplantation, the portal vein diameter reduced significantly at different timepoints compared to before the treatment ([1.41 ± 0. 15] cm, [1. 38 ± 0. 11]cm,[1.36±0. 17] cm vs. [1. 53 ±0. 18] cm,t = 1. 987,1.994,1. 976, Ps < 0.05), but we found no significant difference in the comparisons among different timepoints (F = 2. 35 ,P >0.05). (2) After autologous marrow stem cell transplantation, the average portal blood flow velocity increased significantly at different timepoints compared to before the treatment ([15. 7 ± 3. 6] cm/s, [16. 1 ± 2.4] cm/s, [15. 9 ± 3.0] cm/s vs.[11.4 ± 3. 3] cm/s ,t = 2. 345, 2.460,2. 381, Ps < 0. 01) , but we found no significant differences in the comparisons among different timepoints (F = 2. 14, P > 0.05) . (3) After autologous marrow stem cell transplantation,the spleen size reduced significantly at different timepoints compared to before the treatment ([4.8±0.3]cm,[4.7±0.6]cm,[4.8±0.5]cm vs. [5. 2 ±0. 7]cm,t =2. 289,2. 390,2.425,Ps <0.01), but we found no significant differences in the comparisons among different timepoints (F = 2. 26, P > 0.05) .Conclusion The autologous bone marrow stem cell transplantation can effectively improve the portal vein blood flow,reduce the spleen size,alleviate portal hypertension in patients with liver cirrhosis.

Objective To analyze the MRI features of intracranial ectopic germinomas compared with pathologic findings.Methods MRI manifestations of intracranial ectopic germinomas in 24 cases verified by operation and pathology were retrospectively analyzed.Results Tumors were located at suprasellar region in 5 cases,basal nucleus region in 6 cases,round lateral ventriculus in 2 cases,pellucid septum and lateral ventriculus in 1 case,3 cases suprasellar and pineal region in 3 cases,basal nucleus and pineal region in 3 cases,pineal region and round lateral ventriculus in 2 cases,lateral ventriculus,and third ventricles as well as pineal region in 2 cases.Lesions were showed marked enhancement in 22 cases and 10 cases had cystic degeneration on MRI.Pathologically,18 of 24 cases were seen clear border,cystic degeneration 11 cases,hemorrhage 2 cases and calcification 2 cases.Conclusion Intracranial ectopic germinomas are common in male children and are of MR characteristics,its MRI findings are correlated with pathology.

By using the whole-cell clamp-patch technique, the effects of dexamethasone on calcium channel current (Ica) and nicotine receptor channel current (I_(NIC)) were examined. The acute action of glucocorticoid on adrenal medullary chromaffin cell (AMCC) of rats was a significant inhibition of I_(NIC), while no apparent effect was observed on Ica induced by electricity. The results suggest that the acute action of glucocorticoid on catecholamine release in rat AMCC may be directly related to nicotine receptor.

[Objective]To explore the surgical feasibility and clinical outcome of pedicle screw instrument for treatment of irreducible atlantoaxial dislocation and to choose an effective method of internal fixation.[Method]From June 2003 to February 2009,14 pationts with atlas dislocation followed by upper cervical cord compression were treated surgically with oral anterior soft tissue release combined with posterior reduction and pedicle screw instrument.Preoperative CT,MRI and radiographs as well as intraoperative screw placement and bone graft were administered in all pationts.Only cervical collars were used as external support for 3 months in occipitocervical fusion.[Result]All screws were successfully placed in atlas and axis.Forteen patients were followed up for an average of 18 months.Bone fusion was achieved in all cases with no complications of nerve,internal fixation failure and redislocation.Neurological recovery was significantly improved in 12 cases and took a turn for better in 2 cases.[Conclusion]Pedicle screw instrument in atlas and axis has the advantages of direct screw placement,short-segment fusion,intraoperative reduction and high fusion rate.It is a better alternative for atlantoaxial dislocation.

AIM: To study the effects of calcium channel blockers (CCB) on nicotinic acetylcholine receptor current (I_(NIC)) in rat adrenal medullar chromaffin cells (RAMCs). METHODS: By using the whole-cell clamp-patch technique, we have investigated the effects of nifedipine(NIF)、?-conotoxin GVIA and ?-agatoxin IVA on I_(NIC) induced by nicotine(NIC) before and after RAMCs perfusion. RESULTS: After perfusing RAMCs for 5 min, different kinds of calcium channel blockers at different concentration showed significant inhibitory effects on I_(NIC) induced by 50 ?mol/L NIC. The peak inhibition rates of 10 ?mol/L NIF、400 nmol/L ?-conotoxin GVIA and 100 nmol/L ?-agatoxin IVA were (61.7?5.1)%,(29.3?7.4)% and (17.6?7.5)%, respectively. CONCLUSION: The acute effects of different kinds of CCBs on RAMC were that they obviously inhibited I_(NIC) induced by NIC. These results suggest that CCBs may inhibit catecholamine secretion by directly blocking nicotinic acetylcholine receptor channel. [

Objective To study the choice of initial operative approach for thyroid nodule and the necessity of reoperation after local excision of differentiated thyroid cancer.Methods Clinical data of 138 patients with differentiated thyroid cancer after local tumor excision had reoperation at our hospital during a period of four year were retrospectively reviewed.All the reoperations were bilateral thyroidectomy and cervical lymph node excision.Results There were 76.8% patients with residual cancer in thyroid and cervical lymph node.There were 23 patients(16.7%) with recurrent laryngeal nerve injury that included 22 cases with unilateral and 1 case with bilateral injury after the initial operation,and 19 of the 23 patients with recurrent laryngeal nerve injury recovered after nerve repair.After thyroid reoperation,3 cases(2.2%) had recurrent laryngeal nerve injury,2 cases(1.4%) had partial parathyroid gland injury,2 cases(1.4%) had superior laryngeal nerve injury,but there were no cases of esophageal injury or postoperative bleeding.Conclusions The incidence of residual cancer is high after local excision for differentiated thyroid cancer,therefore,reoperation with bilateral thyroidectomy and cervical lymph node excision is necessary.

ObjectiveTo evaluate the reliability and validity of Chinese version of the Manager's Activities Scale (MAS). MethodsMAS was administered to 350 nurses and evaluated for the reliability and validity using SPSS17.0 and AMOS 17.0. ResultsThe Cronbach's α of MAS was 0.92 and the testretest reliability was 0.902 and the content validity was 0.96.The correlations between each item and total scale were ranged from 0.720 to 0.823.One factor was extracted by exploratory factor analysis and could explain 56.98％ of the total variance.The confirmatory factor analysis revealed a good fit of the model to the data based on various fit indices (x2/df ratio =1.301,GFI=0.963,AGFI＝0.927,NFI=0.966,IFI＝0.992,TLI=0.987,CFI=0.992,RMSEA=0.039). ConclusionsChinese version of MAS is reliable and valid,and can be used in the research of Chinese nursing leadership.

[Objective]To construct the new training mode of professional master degree of Chinese material medica. [Method]Based on idea of work and practice in Guangzhou University of Traditional Chinese Medicine, we put forward the training mode of professional master degree of Chinese material medica. [Result]In the course of training of three years, insistency should be persisted in object, claim, check and management. To choose a graduate teacher respectively in the col ege and the enterprise, they have their own emphasis on training. Look upon the continuous training, elaborately select the practical case, and first study in col ege, and then practice in enterprise. [Conclusion]The training mode is putting forwardIt is the same and consistent in three years, the system is of double teachers, al are for use, and production is continuously bound up with learning”,worth other TCM col eges learning.

Objective] To analyze the application of the idea of Stomach Qi of Treatise on Cold-Induced Disease in the differentiation of disease and pulse. [Method] To choose and analyze the articles, line by line, related to stomach Qi, including trying to treat, diet, stool and pulse, and to conclude the application of stomach Qi thought in disease diagnosis, cure and predicting the condition of disease.[Result] Treatise on Cold-Induced Disease advocating trying drug and food, if there was fever after drug and food, it meant stomach Qi was impaired, and it was hard to cure the diseases. On the contrary, there was stomach Qi, it was easy to cure the diseases. By using Xiao Chengqi Tang to try, if there was flatus to turn, it meant that stomach Qi was strong, and Catharis could be used. On the contrary, catharis could not be used. Being able to eat meaned that there was sthenic fever in middle energizer,or stomach Qi was recovering, or middle energizer was very deficient. Being not able to eat meaned the different condition of stomach Qi, according to the accompaning symptoms. Though observing the amount, shapes, colours,smel and frequency of feces, the conditions of heat and cold, deficiency and excess of a disease could be concluded. If syndrome and pulse were consistent, it meant that Stomach Qi stil existed, and a serious il ness could be cured. conversely stomach Qi was extremely deficient, and it was hard to cure a mild il ness. Floating FuYang pulse and too creek pulse being smal er than ChongYang pulse al meaned stomach Qi existing.[Result] Treatise on Cold-Induced Disease often judged the ups and downs of stomach Qi according to the differentiation of disease and pulse ,to predict the condition of disease.