Objective To investigate the feasibility,safety and efficacy of endoscopic thyroid surgery and the traditional surgical method,in order to further promote the application of endoscopic technology in thyroid surgery.Methods 72 patients from July 2009 to July 2011 in Shaoxing City People's Hospital undergoing endoscopic surgical treatment and 36 cases treated by traditional thyroid surgery were collected,and the surgical data,recovery-conditions and patients' satisfaction were analyzed.Results Except the operation time,the observed indicators of the two laparoscopic groups were superior to those of the conventional thyroid group(P ＜ 0.05).The operation time,flap area,subcutaneous tunnel set-up time,postoperative 24 h visual analogy scale (VAS) score of the sternum group were superior to the areola path group (P ＜ 0.05).The difference of intraoperative blood loss,hospital stay,patient's satisfaction for the 2 groups had no statistical significance(P ＞0.05).Conclusions Laparoscopic surgery is superior to conventional thyroid surgery in treatment effects and patients' satisfaction.As for the surgical path,sternum path is slightly superior to the areola path.Surgeons should choose the best surgical approach and the path according to patients' specific conditions.

OBJECTIVE To analyze the incidence of pulmonary infection,the type of infection,the factors of bacterial colony change and so on among brain damage patients and to discuss the countermea sures.METHODS Totally 117 brain damage patients in ICU were investigated about hospital infection.RESULTS From them 31 cases were with pulmonary infection,the infection rate was 26.5%.From their sputa were isolated bacteriologically 112 strains of pathogens,the Gram-negative bacilli were dominant.The sensitive antibiotics were imipenem/cilastatin,cefoperazone/sulbactum and amikacin.The resistant to imipenem/cilastatin Gram-positive cocci were sensitive to vancomycin and sulfamethoxazole/trimethoprim.The fungal infection tended to grow,its resistance rate to fluconazole was increased upto 50.0%.CONCLUSIONS In the hospital infection multi-antibiotic resistance,and multiple infection are its characteristic,it should reasonably use the antibiotic,and establish the strict protection and isolation measures.

Objective To investigate the impact of accelerator′s multi-leaf collimator (MLC) on the radiotherapy dose with different gantry angles.Methods Measured with Mapcheck 2D diode array and 30 cm×30 cm×3 cm solid water, Pre-selecting the 30 appropriate single fields and 0°,45°,90°,270°,315° gantry angles of static and dynamic intensity modulated radiation therapy (IMRT), quantification analysis of the passing rate with MapCheck γ(3%/3 mm) and (5%/3 mm) analysis methods, and the same method to 30 examples static and dynamic IMRT plans.Results When the accelerator collimator angle is 0°,the 30 appropriate single fields′ passing rate of between 0°gantry angle and 45°,90°,270°,315°gantry angles of static and dynamic IMRT accordingly is 97.71% and 96.25%(t=1.70, P=0.389), 96.34% and 93.72%(t=2.95, P=0.002), 96.65% and 92.98%(t=2.87, P=0.005), 95.87% and 93.15%(t=2.71, P=0.006), 96.09% and 93.51%(t=2.89, P=0.004) with MapCheck γ(3%/3 mm) analysis methods, however, the passing rate also does not have the difference, respectively is 99.31%-99.73% and 98.89-99.68%(t=0.57-1.90, P=0.913-0.725) with MapCheck γ(5%/3 mm) analysis methods;the passing rate of 30 examples static and dynamic IMRT plans accordingly is 96.11%-96.76% and 94.88%-95.78%(t=1.02-1.61, P=0.317-0.235).Conclusions When the accelerator collimator angle is 0°, at different gantry angles, MLC leaves due to gravity, friction, inertia, etc caused by errors in place, the physical penumbra and leakage radiation will indeed affect the IMRT dose, however, the deviation of dose distribution is within acceptable 5%.

Objective To investigate the incidence of adverse pregnancy outcomes among women with syphilis in Zhejiang province during 2013-2014,and to explore the influence of anti?syphilis treatment on pregnancy outcomes. Methods A retrospective study was carried out according to the Information Management System for preventing mother?to?child transmission(PMTCT)of syphilis in Zhejiang province during 2013-2014. The incidence of adverse pregnancy outcomes was compared between women with syphilis and general women without syphilis, between treated and untreated women with syphilis, as well as between women with syphilis receiving and not receiving standard anti?syphilis treatment. The effects of anti?syphilis treatment and standard anti?syphilis treatment on pregnancy outcomes were analyzed. Results Data were collected from 3 985 women with syphilis and their children. Of these women, 12 had a stillbirth, and 3 973 a live birth. Totally, 3 210(80.55%)women received anti?syphilis treatment, 967(30.12%, 967/3 210) women received substandard treatment, and 775(19.45%)did not receive anti?syphilis treatment. Of the 3 985 fetuses or neonates born to women with syphilis, 45(1.13%)had abnormal clinical symptoms/signs. The incidence rates of low birth weight and early neonatal death were 7.00%(279/3 985) and 1.13%(45/3 985) respectively in fetuses or neonates born to women with syphilis, both significantly higher than those in fetuses or neonates born to general women without syphilis (3.18%[26 092/819494] and 0.13%[1 029/819 494], respectively, both P < 0.01). Among 775 untreated women with syphilis, the incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs were 15.61%(121/775), 10.84%(84/775), 2.45%(19/775), 3.48%(27/775)and 2.84%(22/775)respectively, all significantly higher than those in 3 210 women receiving anti?syphilis therapy (8.26%, 6.07%, 0.81%, 0.81% and 1.03%,respectively, all P < 0.01). Besides, the 967 women receiving substandard anti?syphilis treatment showed higher incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs than the 2 243 women receiving standard treatment (10.44%vs. 7.31%, 8.17%vs. 5.17%, 1.55%vs. 0.49%, 1.65%vs. 0.45%, 1.96%vs. 0.62%, respectively, all P<0.01). Conclusions The incidence of adverse pregnancy outcomes is high among women with syphilis in Zhejiang province during 2013-2014. Untreated and inadequately treated maternal syphilis is strongly associated with adverse pregnancy outcomes.

Objective To investigate the prevalence and risk factors of metabolic syndrome (MS) in residents in Pudong New District of Shanghai. MethodsA total of 5 584 residents aged 20-80 years were randomly selected from Pudong New District of Shanghai through multistage sampling and interviewed from April to July of 2008. Metabolic syndrome was defined according to three diagnostic criteria for MS, issued by the modified National Cholesterol Education Program Adult Treatment Panel Ⅲ criteria ( NCEP-ATP Ⅲ ), International Diabetes Federation (IDF), and Chinese Diabetes Society (CDS). ResultsThe crude prevalences of MS in the adult population in Pudong New District were 18.2％ and 13.1％ standardized ( male 19. 1％, female 17.4％, the age-standardized 15.6％ and 13.2％ ) with CDS criterion, 31.8％ and 24.4％ standardized ( male 28.4％ ,female 35.1％ ,the agestandardized 22. 7％ and 25.0％ ) with NCEP-ATP Ⅲ criterion, and 21.7％ and 17.0％ standardized ( male 15.9％ ,female 26.7％, the age-standardized 13.8％ and 19.2％ ) with IDF criterion. The age-specific prevalence of MS increased according to three diagnostic criteria, and the age-adjusted prevalence was higher in males than females in junior age groups and higher in females than males in senior ones. Significant differences were present among region, education, marriage status, smoking, work intensity, recreation, and physical activity according to some diagnostic criteria. ConclusionsSubstantial proportions of adults in Pudong New District of Shanghai suffer from metabolic syndrome, and there exists a tendency for young people involved. MS has become a noteworthy public health problem. It suggests that community-integrated control strategy of MS should be made a priority.

Objective To explore the expression of cyclooxygenase-2 (COX-2) in different epidermal tumors and its significance. Method The expression of COX-2 was detected by immunohistochemical staining of skin specimens from 10 cases of basal cell carcinoma (BCC), 8 squamous cell carcinoma (SCC), 8 Bowen′s disease (BD), 12 seborrheic keratosis (SK) and 10 normal volunteers. Results Compared with normal epidermal cells, COX-2 expression was significantly increased in BCC, SCC and BD cells. Especially, COX-2 expression in SCC was the most intensive. COX-2 expression in SK cells was similar to that of normal epidermal cells. Conclusion The up-regulation of COX-2 expression may play a potential role in the pathogenesis of epidermal tumors.

Objective To investigate the role of Fas antigen,Fas ligand(FasL)and soluble Fas(sFas)in the pathogenesis of vitiligo.Methods The expression of Fas and FasL on peripheral blood lym-phocyte(PBLC)was detected by flow cytometry.Serum sFas was quantitated using a dual antibody sandwich enzyme-linked immunosorbant assay(ELISA).Results The expression of Fas and FasL was significantly de-creased in patients with vitiligo vulgaris(43.45%and58.40%)than those in normal controls(58.30%and64.65%)(P

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in adult residents of Shanghai Pudong New Area. Methods A total of 5584 residents aged 20-80 years old were randomly selected from Shanghai Pudong New Area through multistage sampling and interview between April and July 2008. Fasting blood samples and morning urine samples were collected to detect Scr and urinary albumin and creatinine. Urine albumin to creatinine ratio (ACR) and glomerular filtration rate (GFR) was calculated to estimate the renal function. Logistic regression model was used to examine the associations of demographic and lifestyle factors with indicators of kidney damage. Results The age-standardized prevalence of albuminuria, reduced renal function and CKD was 9.9% (male 8.0%, female 12.4%), 1.1% (male 1.3%, female 0.9%) and 11.0%(male 8.8%, female 12.7%), respectively. The prevalence of CKD was higher in female and increased with age. No significant difference in the prevalence was observed between urban and rural areas. Elder, female, high blood pressure, high fasting glucose, dyslipidemia and obesity were associated with CKD independently. Conclusions The prevalence of CKD in Shanghai Pudong New Area is comparable to that previously reported in China or other developed countries, and even higher. CKD is going to be a public health problem and warrants the community-integrated control strategy to prevent the incidence of end-stage renal disease (ESRD) and related complications.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with neurofibromatosis type I (NF1). METHODS: Target capture high-throughput sequencing and Sanger sequencing were carried out to detect the pathological variant in a NF1 patient and his parents. RESULTS: The proband and his similarly affected father have both harbored a novel nonsense variant of c.2511G>A (p.trp837x) in the NF1 gene. The same variant was not found in his mother and 200 healthy controls. CONCLUSION The heterozygous nonsense variant of c.2511G>A (p.trp837x) of the NF1 gene probably underlay the pathogenesis of NF1 in this pedigree.
China ; Heterozygote ; Humans ; Mutation ; Neurofibromatosis 1/genetics* ; Pedigree

Objective:To observe the application effect of a self-designed assisted abdominal breathing rehabilitation device in elderly patients undergoing postoperative chemotherapy for lung cancer.Methods:Self-designed an assisted abdominal breathing rehabilitation device. Used the convenience sampling method, 116 elderly patients admitted to the First Affiliated Hospital of Anhui Medical University from April 2021 to April 2022 undergoing postoperative chemotherapy for lung cancer were selected as study subjects, and they were divided into control and observation groups by the random number table method, with 58 cases in each group. The control group received routine abdominal breathing training, and the observation group used auxiliary abdominal breathing rehabilitation device for abdominal breathing training, and compared the training compliance rate, lung function indexes and six minutes-walk test scores of the two groups before and after 2 weeks of training.Results:After 2 weeks of training, the training compliance rate of patients in the observation group was 100.00% (58/58), which was higher than 87.93% (51/58) in the control group, and the difference was statistically significant ( χ 2=7.45, P<0.05). After 2 weeks of training, FEV 1, FVC, FEV 1/FVC were (1.81 ± 0.29) L, (1.98 ± 0.32) L, (91.91 ± 5.98) % respectively in the observation group, and (1.49 ± 0.31) L, (1.73 ± 0.41) L, (87.11 ± 9.44) % respectively in the control group, there were statistically significant differences between the two groups ( t=-4.13, -2.60, -2.36, all P<0.05). After 2 weeks of training, the six minutes-walk test score was (0.86 ± 0.71) points in the observation group and (1.02 ± 0.74) points in the control group, and the difference was statistically significant ( t=2.05, P<0.05). Conclusions:An assisted abdominal breathing rehabilitation device helps to improve the training compliance rate, enhance lung function recovery and improve exercise endurance in elderly patients undergoing chemotherapy after lung cancer surgery.