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.

To characterize the ultra-fine particles of Atractylodes lancea (Thunb.) DC., Phellodendron chinense Schneid and the ERMIAO PILL*, a compounded preparation of the above two drugs, for the purpose to observe a deeper view on their physico-chemical properties. Methods　By comparing their particle size, porosity and specific surface area with light and scanning electron microscope. Results　The size of the ultra-fine particles were more uniform in size, 90% of which were under 20 μm, their specific area were increased by 60% ～ 190% and bulk density were around 0.42 g/cm3, and the great majority of the plant cells were broken as compared with the conventional coarse powder. Conclusion　Both A. lancea and P. chinense together with their combined preparation became smaller in particle size, more uniformly distributed with increased specific surface area and broken cell wall.

Objective To investigate the protection of superior parathyroid glands by improving dissection procedure of thyroid superior pole in total thyroidectomy surgery.Methods 136 consecutive cases undergoing two-step dissociating procedure of thyroid superior pole(the improved group) in total thyroidectomy plus central compartment dissections from Sep.2012 to Oct.2015 were retrospectively analyzed.Intraoperative observation of superior parathyroid and incidences of postoperative hypoparathyroidism were compared with conventional surgical methods (the conventional group) containing 113 cases from Jun.2009 to Sep.2012.All operations were performed by the same treatment group.Results Intraoperatively,249 (249/272,91.5％) superior parathyroid glands were identified in the improved group and 215 (215/226,95.1％) superior parathyroid glands were identified in the conventional group.The difference had no statistical significance (P＝0.114).Whereas,among identified superior parathyroid glands,242 (242/249,97.1％)of them were conserved in situ in the improved group and 198 (198/215,92.0％) were conserved in situ in the conventional group.The difference had no statistical significance (P＝0.013).Among superior parathyroid glands conserved in situ,225 (225/242,93.0％) had good blood supply in the improved group and 170(170/198,85.9％) in the conventional group.The difference had statistically significance (P＝0.001).28 (28/136,20.5％) patients displayed temporary hypoparathyroidism and 2 (2/136,1.5％) cases suffered permanent hypoparathyroidism in the improved group after surgery.Whereas,in the conventional method group,a higher incidence was observed in 37 (37/113,32.7％) cases of temporary hypoparathyroidism and 7 (7/113,6.2％) cases of permanent hypoparathyroidism respectively.The difference had statisticall significance (P＝0.003).Conclusions Two-step dissociating procedure technique offers protective effect on superior parathyroid glands function.It is worthy of popularization.

The questionnaire investigation showed that the clinicians in Sichuan Province have a rather good cognition of medical information with a strong desire for medical information.However, measures should be taken to alleviate the contradictions between their information need and access ability, and excellent medical information service should be provided for them at a low cost .

Objective To investigate the protective role of two-step decapping technique for superior parathyroid glands in total thyroidectomy surgery.Methods The clinical data of 136 consecutive cases underwenttwo-step decapping technique in total thyroidectomy plus central compartment dissection from April 2013 to January 2016 were retrospectively analyzed.And the incidences of postoperative hypocalcemia were was compared with conventional consecutive decapping surgical methods containing 113 cases from January 2010 to March 2013.All operations were performed by the same treatment group.Results In the two-step decapping group,28 cases(28/136,20.6％) displayed postoperative temporary hypoparathyroidism and a higher incidence were was observed in 37 cases (37/113,32.7％) in the conventional method group,the difference was statistically significant(x2 =4.737,P =0.03).Whereas,2 cases(2/136,1.5％) suffered permanent hypoparathyroidism in the two-step decapping group and 7 cases (7/113,6.2％) of permanent hypoparathyroidism in the conventional method group,the difference was statistically significant (x2 =3.954,P =0.047).Conclusion Two-step decapping technique can more effectively protect the parathyroid gland function.It is worthy of popularization.

Objective To evaluate result of invaginative esophagogastroanastomosis to prevent the leakage,anastomotic stenosis and reflux esophagitis in esophagectomy.Methods A method of invaginative esophagogastroanastomosis with esophageal mucus to gastric mucus and gastric seromuscular to esophagic nuscular were done in 148 cases cardiac cancer and 120 cases esophageal cancers.Gastro-esophagus full-thickness anastomosis were done in the control group including 112 cases cardiac cancer and 98 cases.Standardized rate and standard error toanalysis the date were adopted.Results It had significant difference between the two groups.Conclusion This anastomosis could avoid the esophagogastroanastomotic leakage,anastomotic stenosis and reflux esophagitis effectively.

Objective To determine the pattern and incidence of congenital coronary anomalies (CCA) in adults undergoing coronary angiography. Methods The diagnostic angiographic data collected from October 2000 to October 2006 were reviewed, from which congenital coronary anomalies were found, and their angiographic features were studied. Results Among 1520 adults undergone coronary angiography, anomalous coronary arteries were found in 58 cases (3.82%). Depending on the anatomic characteristics of anomalous coronary arteries, these 58 cases were classified as following. Anomalies of origin and distribution were found in 26 cases (1.71%), among them separated origin of left anterior descending and left circumflex from left coronary sinus were found in 14 cases, left main trunk and left circumflex arising from right coronary sinus in 1 case for each, single left coronary artery in 2 cases, right coronary arteries arising from ascending aorta in 4 cases, from left coronary sinus in 3 cases, and from posterior coronary sinus in 1 case, respectively. Anomalies of coronary termination were observed in 11 cases (0.72%), and all of them were coronary artery fistulas. Anomalies of intrinsic coronary arterial anatomy in 21 cases (1.38%), among them myocardial bridge in 18 cases, hypoplasia of left circumflex artery in 2 cases, and sinus node artery arising from left posterior ventricular branch in 1 case. No anomalous collateral vessels were found. Conclusion Coronary angiography is one of the important methods of detecting anomalous coronary arteries. Classification based on the anatomic characteristics can help clarify the pattern and incidence of congenital anomalies of coronary arteries in adalts.

Objective To choose the bestway of extracting procedure of Rhizoma corydalis. Methods The optimal extraction process is selected with the orthogonal design. The content of corydalis B and the yield of extracts were used to evaluate the factor levels. Results The ideal extraction process is:extracted with 75% alcohol for 2 times, first 6 times amount, soaked 0.5 h, refluxed 1.5 h, then 4 times amount, refluxed 1.5 h. Conclusions This extractive condition is the best way.

Object To characterize the ultra fine particles of Atractylodes lancea (Thunb ) DC., Phellodendron chinense Schneid and the ERMIAO PILL *, a compounded preparation of the above two drugs, for the purpose to observe a deeper view on their physico chemical properties Methods By comparing their particle size, porosity and specific surface area with light and scanning electron microscope Results The size of the ultra fine particles were more uniform in size, 90% of which were under 20 ?m, their specific area were increased by 60% ～ 190% and bulk density were around 0 42 g/cm 3, and the great majority of the plant cells were broken as compared with the conventional coarse powder Conclusion Both A. lancea and P chinense together with their combined preparation became smaller in particle size, more uniformly distributed with increased specific surface area and broken cell wall