Objective To introduce the clinical experience and investigate the significance and safety of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy.Methods A retrospective analysis was performed on 275 patients who underwent thyroidectomy among which 135 patients were treated by capsular dissection technique and harmonic scalpel (harmonic scalpel group),the other 140 patients were treated by electric knife and traditional ligation (traditional group).The thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications were compared between two groups.Results In harmonic scalpel group,the thyroidectomy operative time of total thyroidectomy and subtotal thyroidectomy was significantly shorter than that in traditional group [(50.0±6.9) min vs.(82.0± 14.4) min,(39.9±6.6) min vs.(73.1 ± 14.5) min](P＜0.01).The intraoperative bleeding volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(18.7 ± 10.9) ml vs.(41.9 ± 15.6) ml,(17.7 ± 9.3) ml vs.(42.2 ± 14.6) ml] (P ＜ 0.01).The postoperative drainage volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(40.7 ± 11.7) ml vs.(53.9 ± 17.5) ml,(42.7 ± 14.5) ml vs.(61.8 ±22.9) ml](P＜0.01).The rate of temporary hypoparathyroidism and temporary recurrent laryngeal nerve palsy had no significant difference between two groups (P ＞ 0.05).Conclusions Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy can significantly reduce thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications.Harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy should be widely used.

Objective To investigate the gene therapy of hypoparathyroidism (HPT) with hemopoietic stem cell s(HSCs) integrated with parathyroid hormone (PTH) gene.Methods Human PTH gene was amplified by polymerase chain reaction from pcDNA 3.1 -PTH templates and inserted into murine stem cell virus (MSCV) vectors. The plasmids recombinated with PTH gene were transfected into PA317 packaging cells and screened for positive clones with Geneticin. The condensed recombinant retroviruses were obtained and used to infect HSCs coming from umbilical cord blood. The infected HSCs were injected into the mice suffering from HPT. The change of symptoms and serum level of PTH and calcium in each group of mice was observed.Results Human PTH gene was proved to be inserted into MSCV vectors and the titres were up to 2?10 7 colony forming unit (CFU)/ml in condensed retroviral solution. The secretion of PTH reached 15 ng per 10 6 cells per 48 h. The wild type viruses were not detected by PCR amplification. The mice suffering from HPT recovered quickly and the serum level of calcium and PTH remained normal for about 3 months after the HSCs recombinated with PTH gene were injected into them. In the groups of mice subject to the injection of the recombinant retroviruses containing PTH gene, the serum level of PTH and Calcium was significantly increased in a short time, and then declined slowly. And the mice took on the manifestation of hypoparathyroidism again. The mice only subject to the implantation of HSCs were all dead within 20 days.Conclusion A long term therapeutic effect could be obtained by infusing the HSCs which were integrated with PTH gene into the mice suffered from hypoparathyroidism.

Although the type of XHD150B-IO 800mA X-ray machine possesses a damage protection electric circuit for the main thyristors, with the first switch of photographic hand valve pressed, abnormal instant exposure still appears when double (in different phase) or more than three main thyristors are broken through, short-circuited or mis-energized, and consequently the high voltage element or X-ray machine will break down. Therefore the original electric circuit must be improved. Material: A few of leads. Method: We exchange the conjunction sequence of three NO (normal open) contacting points of radiograph high voltage preparing work relay--MAG SW- R with three reverse parallel connection of main thyristors. Conclusion: The normal procedure of radiographic exposure won't be disturbed after the improvement. When whichever one or more than two main thyristors is broken through, short-circuited or mis-energized, the spoilage can be detected instantly and the protection circuit works correspondingly, which guarantees the safety of X-ray machine.

Objective To detective the carcinogenesis and operation principle of cyst canceration after internal drainage(ID) operation for congenital choledocal cyst (CCC).Methods The clinical data of 25 patients with cyst carcinoma after ID operation for CCC in the past 28 years were analysed retrospectively.Results The total canceration rate after internal drainage of CCC were 30.49%(25/82); after cystoduodenostomy was 35.29%(14/51),after cystojejunostomy was 22.58%(11/31), respectively. In the 25 cases, three of them were operated with Wipple operation , 4 with tumour resection plus biliary reconstrustion operation, 4 local resection with external drainage ,14 with external drainage only. Conclusions Internal drainage of CCC should be aborted becaus of the high canceration rate after the operation.

OBJECTIVETo study the effect of xenotransplantation with pig parathyroid cells, which was prepared using cell microencapsulation technique, on the treatment of hypoparathyroidism in rats without immunosuppressor.

METHODSParathyroid cells were isolated from 10 healthy newborn pigs and encapsulated in alginate-polylysine-alginate (APA) membranes. Thirty-two aparathyroid Wistar rats were randomly allocated to microcapsule, non-microcapsule, empty microcapsule, and control groups. Each rat was injected intraperitoneally with encapsulated porcine parathyroid cells, free porcine parathyroid cells, empty capsules or 0.9% NaCl, respectively. Total serum calcium and parathyroid hormone levels were monitored continuously for 40 weeks. And then, the transplant beds were retrieved and subjected to morphologic and electron microscopic examination.

RESULTSIn those animals xenotransplanted with microencapsulated porcine parathyroid cells, the calcium and PTH levels were consistently within the normal range during the 40 weeks. In contrast, no therapeutic effects were observed in rats in the non-microcapsule group. Furthermore, neither empty capsules nor 0.9% NaCl were shown to have any effect on the recipient's serum calcium or PTH levels. After 40 weeks, electron microscopic examination demonstrated that the parathyroid cells within the microcapsules had survived well in vivo.

CONCLUSIONSXenotransplantation of microencapsulated newborn pig parathyroid cells can successfully treat hypoparathyroidism in rats without using immunosuppressive drugs. The results of this study show the possible clinical use of microencapsulated porcine parathyroid cells.

Animals ; Animals, Newborn ; Calcium ; blood ; Capsules ; Hypothyroidism ; therapy ; Parathyroid Glands ; cytology ; transplantation ; Parathyroid Hormone ; blood ; Random Allocation ; Rats ; Rats, Wistar ; Swine ; Transplantation, Heterologous ; methods

OBJECTIVETo establish a clinical classification of pulmonary embolism (PE), and to evaluate the optional treatment strategies for different types of PE.

METHODSFrom December 1995 to July 2001, 45 patients with acute PE were hospitalized, of which 33 received intravenous thrombolytic therapy or interventional treatment.

RESULTSMisdiagnostic rate in the 45 patients with acute PE during first visit was 62.2% and mortality rate was 28.9%. Misdiagnostic rate in acute PE patients who had undergone surgery was 82% and mortality rate was 73%. The effective rate of thrombolytic therapy was 77.7%. Clinical symptoms rapidly disappeared in massive PE patients treated with interventional therapies.

CONCLUSIONSIntravenous thrombolytic therapy is one of the most effective methods for treating acute PE. Application of interventional therapy for severe acute PE is also promising.

Acute Disease ; Adolescent ; Adult ; Aged ; Anticoagulants ; therapeutic use ; Diagnostic Errors ; Humans ; Middle Aged ; Pulmonary Embolism ; diagnosis ; therapy ; Thrombolytic Therapy