Objective To analyze the changes in the composition of hospitalization of thyroid disease in Lianyungang City from 2002 to 2010,to learn the impact of iodine intake on thyroid disease in Lianyungang City after implementing universal salt iodization (USI),and to get epidemiologic evidence for prevention and control of iodine deficiency disorders scientifically.Methods Medical reports of the patients with thyroid disease were collected from hospitals at county level and above institutions in Lianyungang City from 2002 to 2010.Monitoring results of household iodized salt were also collected from five counties (districts) in Lianyungang City.The changes in the composition of hospitalization of thyroid disease were analyzed,and the relationship between thyroid disease and iodized salt was studied.Results ① A total of 3 559 patients with thyroid disease were enrolled in the study,the ratio between male and female was 1 ∶ 3.36.Mean age was (46.81 ± 14.94) years old and the peak age was from 40 to 60 years old.② Among the hospitalized patients with thyroid disease,the proportion of goiter patients,hyperthyroidism patients,thyroiditis patients,hypothyroidism and other thyroid disorders was 41.64％ (1 482/3 559),40.07％ (1 426/3 559),6.83％ (243/3 559),6.21％ (221/3 559) and 5.25％ (187/3 559),respectively.③In 2002-2010,the hospitalization rate of thyroid disease showed an upward trend (x2 =460.12,P＜ 0.01),and the hospitalization rates of hypothyroidism,goiter,hyperthyroidism,thyroiditis and other thyroid disorders were all increased year by year (x2 =50.54,281.91,85.15,19.51 and 65.01,all P ＜ 0.01).④From 2002 to 2006,among the patients with thyroid disease,the proportion of hyperthyroidism was the highest,and the range of values was from 42.03％ (124/295) to 53.02％ (114/215).Followed by goiter,and the range of values was from 34.55％ (142/411) to 39.25％ (73/186).From 2007 to 2010,the proportion of goiter became the highest,and the range of values was from 42.11％ (232/551) to 49.57％ (291/587).Followed by hyperthyroidism,and the range of values was from 33.05％ (194/587) to 40.47％ (223/551).⑤From 2002 to 2010,the coverage of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,all P ＜ 0.01).⑥There were positive correlations between the hospitalization rates of thyroid disease,hypothyroidism,goiter,other thyroid disorders and the coverage of iodized salt,and the consumption rate of qualified iodized salt (rs =0.83,0.93,0.82,0.87,0.83,0.93,0.74 and 0.91,all P ＜ 0.05).⑦There was a positive correlation between the hospitalization rate of hyperthyroidism and the consumption rate of qualified iodized salt (rs =0.72,P ＜ 0.05).Conclusions There are some changes in the composition of hospitalization of thyroid disease in Lianyungang city from 2002 to 2010.Iodine intake may affect the hospitalization rate of thyroid disease.

CMV related matrix protein pp65 antigenemia was screened in 100 Allo HSCT patients after transplantation. As control groups, samples from fourteen autologous HSCT patients, seventeen patients with various hematological malignant disorders, as well as twenty seven normal donors also were detected. CMV antigenemia was found in 91/100 Allo HSCT patients (91%) after transplantation. 56 % patients with antigenemia developed CMV disease. 54% patients developed acute GVHD. In 87 patients survived more than three months, 52 9% patients developed chronic GVHD. After follow up 18(4～36) months post transplantation, 21 patients died of CMV related diseases. Compared with autologous and non transplantation patients, CMV antigenemia and CMV diseases were particularly associated with Allo HSCT patients. It was obviously correlated with acute and chronic GVHD. CMV infection is a major factor affecting the clinical outcome of Allo HSCT patients.

Objective To research the anesthetic effect of ropivacaine compounding with dezocine on brachial plexus block.Methods From January 2011 to September 2013,180 cases upper extremity surgery patients were selected and divided into group A,group B and group C in Nanyang Central Hospital.Patients in group A received 25 mL 0.4%ropivacaine injection for brachial plexus block;based on group A,group B was injected 10 mg dezocine to assist anesthesia;group C received a mixture of 25 mL 0.4% ropivacaine and 10mg dezocine injection.The anesthetic effect and adverse reactions of the patients in three groups were recorded and compared. Results The onset of anesthesia of group C was(17.43 ±1.53)min,which was the shortest of three groups,but there were no significant differences.The duration of sensory blockade and duration of analgesia was(8.22 ±1.63)h and (11.33 ±1.90)h,which were all longer than group A and group B,and there was significant differences(P<0.05);the visual analogue scale(VAS) scores of group C at each time before surgery was the shortest,but there were no significant differences.The VAS scores of group C at 1 h,6 h,12 h and 24 h after surgery were all lower than group A and B,and there were no significant differences.Conclusion Ropivacaine compounding with dezocine on brachial plexus block can improve the effect of anesthesia,extend the duration of analgesia.

Objective To evaluate the clinical efficacy of China-made expanded polytetrafluoroethylene (ePTFE) in the treatment of facial defects and hollow deformities on the face. Methods Facial augmentation was performed in different sites as the forehead, temple, nose, chin, nosal base and maxilla, respectively, to correct the facial defects and hollow deformities, by using either China-made ePTFE (Experimental Group) or imported ePTFE (Control Group). Postoperative parameters between the two groups were compared. Results The Experimental Group included 16 patients (18 sites), in whom the postoperative follow-up was conducted for 6~9 months. In this group, a secondary infection (in the nose) occurred in 1 patient because the implant was placed too superficially and too close proximity to the incision, and the implant was removed out. Delayed healing of the incision (in the chin) with uncovered implant was found in 1 patient, who was cured by the change of dressing. In the rest of the patients, no obvious allergic, inflammatory or rejection reaction was seen and a good cosmetic result was achieved. The satisfactory rate of this group was 94.4%(17/18). The Control Group included 10 patients (20 sites). The implant was found bared and then removed in 1 patient (in the nose). The satisfactory rate of this group was 91.7%(11/12). There were no statistical differences between the two groups in the wound healing ( ? 2 =1 109, P =0 574), the adverse reaction ( P =1 000), and the clinical efficacy ( P =1 000). Conclusions China-made ePTFE gives histocompatibility as good as imported one. It is suitable for filling the soft tissue and can be used as a safe and economical alternative.

Objective To detect the expression of vascular endothelial growth factor(VEGF)-C and VEGF-D in normal gastric tissue and gastric carcinoma tissue,and further investigate the relationship between VEGF-C,VEGF-D and lymph vessel density (LVD),lymph node metastasis.Methods The expression of VEGF-C and VEGF-D in gastric carcinoma tissues were examined by using SP immunohistochemical method in 30 normal gastric tissue and 75 gastric carcinoma tissue respectively.The lymph vessel were marked by LYVE-1 and calculated LVD.Results The rate of positive expression of VEGF-C and VEGF-D in gastric carcinoma tissue was significantly higher than that in normal gastric tissue,there was significant difference [73.3 ％ (55/75) vs.33.3 ％ (10/30),66.7 ％ (50/75) vs.30.0 ％ (9/30),P ＜0.01].The level of LVD in gastric carcinoma tissue with lymph node metastasis (40 cases) was significantly higher than that in without lymph node metastasis (35 cases)[(8.85 ± 1.24)/HP vs.(4.75 ± 1.04)/HP](P =0.000).The level of LVD increased when the expression level of VEGF-C and VEGF-D gradually went up.Conclusions The level of LVD increases in gastric carcinoma tissue.VEGF-C and VEGF-D are two significant factors for LVD and lymph node metastasis.

Objective To explore the effect of transradial approach in percutaneous coronary intervention for elderly patient with coronary artery disease,and provide reference for clinic. Methods There were 198 patients older than 70 years with coronary artery disease in our hospital from March 2007 to March 2013,who were divided into the radial group(n=100) and the femoral group(n=98) according to differ-ent puncture pathways. The X-ray exposure time,operative time,amount of contrast medium,the success rate of puncture,achievement ratio of operation and venous complications were compared and analyzed. Results The X-ray exposure time,operative time,amount of contrast me-dium,the success rate of puncture,achievement ratio of operation of 2 groups has no significant differences(P>0. 05). The venous complica-tion of radial group was less than that of femoral group,the difference was statistical significance(P<0. 05). Conclusion The transradial approach in percutaneous coronary intervention for elderly patient with coronary artery disease was feasible and safe,with less complication.

Objective To explore the risk factors of hypotension of patient with acute myocardial infraction(AMI)after emergency per-cutaneous coronary intervention(PCI).Methods The data of 300 patients with AMI who received PCI in our hospital from January 2015 to August 2015 were collected.According to the symptom of hypotension,the patients were divided into hypotension group and normal group.The general information and relative clinical data were recorded and compared.The risk factors were analyzed by logistics regressive analysis. Results The incidence of previous angina of hypotension group was lower than that of normal group,the difference was significant(P <0.05), there was no difference in other general information between two groups(P >0.05).There was no difference in level of LDL-C between two groups(P >0.05).And the differences in peak value of CK-MB,inferior wall or right ventricular infarction were statistical significance (P <0.05).There was no significant difference in multi-vessel lesions(P >0.05),and the difference in others of coronary artery lesion be-tween two groups was statistical significance(P <0.05).Conclusion The peak value of CK-MB,inferior wall or right ventricular infarction and TIMI <2 after PCI can increase the possibility of hypotension after PCI,and angina pectoris before infarction can reduce the incidence of hypotension after PCI.

Objective We summarized the clinical experience of modified ileal ureter substitution for treating long segment ureteral defection.Methods We retrospectively analyze the clinical data of 2 patients with long segment ureteral defect who treated with Yang-Monti ileal ureter substitution between March 2015 and November 2015.One 75 years old male patient was diagnosed as upper ureteral malignance and solitary kidney.The length of defection from renal pelvis to bladder was 22 em.His serum creatinine was 100 μmol/L,blood urea nitrogen was 5.7 mmol/L,serum chloride was 98 mmol/L.Another one 41 years old female patient was diagnosed as middle and lower ureteral iatrogenic injury.The traumatic length was 15 cm.Her serum creatinine was 70 μmol/L,blood urea nitrogen was 5.1 mmol/L,serum chloride was 100 mmol/L.they were both treated by Yang-Monti ileal ureter substitution.The ileal intestinal segment was used for the ureteral replacement,which were more than 15 cm to the ilealcecum.The length of intestine was 10.0 cm and 7.5 cm,respectively.The ileal mesentery was preserved.After closing the mesangial hiatus,the ileal segment was pull into the retroperitoneal space and pulling out via descending colonic mesangial window.The ileal segment was divided into three parts,which was 2.5 to 3.0 cm in each part.Each part was opened via long axis and then rotated 90 degree.The 4-0 absorable suture was used to suture the edge of each intestinal part continuously.The sutured intestine was re-tubularized,using 4-0 absorable suture and the F16 catheter was used as the tube model.The length of reconstructed ureter was 22 cm and 18 cm,respectively.The neo-ureter was re-anastomosed with renal pelvis and bladder wall.Two F6 double J stents were placed in the neo-ureter.Results The operative time was 160 min and blood loss was 200 ml in the first case.In the second case,the operative time was 180 min and blood loss was 220 ml.No significant complications were noticed intra-operation and post-operation.Six months after operation,the male patient's serum creatinine was 112 pmol/L,blood urea nitrogen was 6.1 mmol/L,serum chloride was 106.0 mmol/L and electrolytes were normal.In another patient,serum creatinine was 79 μmol/L,blood urea nitrogen was 5.9 mmol/L and serum chloride was 103.0 mmol/L.The GFR was 24.9 ml/min and 22.1 m]/min 3 and 6 months after operation,respectively.Ureteral obstruction wasn't detected on IVU images 3 months after operation.Conclusions For patient with long ureteral defect,which cannot be replaced by other urinary tissue,YangMonti ileal ureter substitution is one of the optional modalities.As a new technique of ureteral substitution,Yang-Monti ileal ureter substitution is simple and fewer complications and can improve the quality of life in patient compared with traditional ureteral substitution.

Objective To explore the clinical curative effect of percutaneous coronary intervention ( PCI) for acute myocardial infarc-tion ( AMI) . Methods Retrospectively analyzed the clinical data of 138 patients with acute myocardial infarction who were admitted into our hospital from September 2012 to September 2014. The 138 patients were divided into the intravenous thrombolysis group (65 cases) and the PCI group (73 cases) according to the different way of treatment. And the basic clinical data, surgical outcomes, complications, and postop-erative follow-up results of the two groups were compared and analyzed. Results Reperfusion rate of related blood vessels,rate of TIMI flow reached grade 3, and score of left ventricular ejection fraction ( LVEF) in the PCI group were significantly higher than that of intravenous thrombolysis group, and the difference is statistically significant (P<0. 05). Degree of residual stenosis in the PCI group were significantly lower than that of intravenous thrombolysis group, and the difference is statistically significant (P<0. 05). Cacoethic ST-segment resolution and average hospital stay of the two groups had no significant difference (P>0. 05). Compared with the intravenous thrombolysis group, the curative effect of the PCI group was obviously better than the intravenous thrombolysis group with a statistically significant difference (P<0. 05). During the follow-up period, arrhythmia, angina, recurrence of myocardial infarction, and mortality within 6 months in the PCI group were all lower than in the intravenous thrombolysis group, and the difference is statistically significant (P<0. 05). Conclusion Per-cutaneous coronary interention for patients with acute myocardial infarction can effectively open the lesion vessels and relieve myocardial nec-rosis in patients, and it is of good curative effect.

Objective To explore the long-term efficacy of botulinum toxin type A injections on facial beauty and its long-term safety.Methods A total of 33 beauty-seekers with botulinum toxin type A treatment for more than five years were reviewed as observation group,using digital muscle palpation meter (Myoton PRO) for the determination of the orbicularis oculi muscle and masseter muscle tension (F),the muscle characteristic parameters,such as muscle hardness (S) using a homemade facial questionnaire test for satisfactory rate of beauty from both beauty-seekers and physicians.At sametime,33 normal adults that never accepted botulinum toxin injection with matched age and gender were collected as control group.The same-sex indicators were dtermined and compared with using statistic analysis t test.Results The pairwised parameters of the same sex and site were comparied between the two groups;average F and S values in the observation group were lower than those of the control group,but no statistically significant difference were observed between the two groups (P＞0.05);in the observation group,average appearance age was 7.3 years younger than the control group,and the facial shape improved significantly.Conclusions Long-term and repeated application of botulinum toxin A is able to remove crow's feet and decrease the masseter and so the injection is safe with high satisfaction to beauty-seekers.