[Objective] To discuss the operation mode of thyroid tiny papil ary caracinoma and offer foundation for clinical choice. [Method] Make analysis on the clinical data and fol ow-up results of 176 cases of the disease above. [Result] Al were made operation, and there ’re no death. Compare the resec-tion of deseased gland and isthmus with ful resection of the thyroid, the difference of hoarse sound and low-calcium occurrence rate had statistical mean-ing; on uni-lateral and double lateral central ALND, the hoarse sound and low-calcium occurrence rate had no marked statistical meaning. [Conclusion] The diseased gland and isthmus resection+double lateral ALND not only doesnt ’increase post-operation complications, but improves patients ’life quality, which is the main operation for thyroid tiny papil ary carcinoma.

The article reviewed the concept of normal binocular vision and general examination methods of binocular vision and its normal range.New investigation progresses about monocular and binocular depth perception in neuro-physiology and neuro-anatomy were introduced.The depth perception from monocular and binocular depth cues was integrated in parietal area of caudal intraparietal sulcus(CIP).Mono-eye also had depth perception.Strabismus and amblyopia could damage the binocular vision and binocular depth perception.Binocular vision damage and its treatment results with doffing suppression training,fusion training,and stereopsis training in strabismus and amblyopia patients were explained in detail in this article.

The differentiation of cells types and layers in the cerebellar cortex of 74 white micefrom the time of birth to the adult age were observed by the methods of Nissl, Golgi,Cajal and Golgi-Cox. The external granular layer of the folia of the cerebellar cortex attained the greatestthickness in the fourth on the fifth day; at the same time, mitosis was seen. There after,this layer became gradually thinner; from eighteenth to twentieth day after birth it even-tually disappeared. Some cells of the external granular layer differentiated into granular and stellatecells. The Purkinje cells after birth were in primitive form with perisomatic dendrites.From the eighth day on, perisomatic dendrites became atrophic and disappeared. In thethird week, the Purkinje cells reached the mature stage. The Purkinje cells after birth, besides the ones in their normal position, might befound in the submeningeal spaces, external granular layer, molecular layer, internal granu-lar layer and medulla of the cerebellum. A part of these displaced cells may be origi-nated from the external granular layer. With the disapperance of the external granular layer, the Purkinje cells becamecompletely matured. In accordance the animals in this period began to be able of in-dependent activities, such as running, jumping, etc.

Bombesin in central nervous system (CNS) is closely related to thermoregulation. Injection of bombesin into some parts of brain caused hypothermia significantly, especially in POAH, and this effect can be enhanced by the cold ambient temperature. The mechanism might be suppress heat production and disrupt the regulatory function of thermoregulatory centre. Morever, other neuropeptides, food deprivation and lesion of VMH (ventromedial hypothalamus) affected the action of bombesin.

Objective To observe and analyze the euthyrox intervention effect of early hypothyroidism after 131I therapy for hyperthyroidism. Methods 200 cases of patients with hyperthyroidism in our hospital from March 2014 to April 2016 were selected as the object of the experiment needs, all the patients were randomly divided into two groups, respectively into study group and control group, two groups there are 100 patients. All patients before admission were accepted 131I treatment, control group received routine treatment, the study group was treated with 131I in twentieth days after start of continuous use of euthyrox, 20 days of continuous use, the two groups of patients with thyroid ultrasound, thyroid gland imaging, thyroid function and perturbation the rate of iodine was detected and observed. And the two groups of patients in the clinical efficacy of different after treatment were compared. Results The patients in the study group and the control group in 3 months after treatment, 9 months and 12 months the incidence of hypothyroidism were compared, research The incidence rate of hypothyroidism group was significantly lower than the control group, the differences between the groups were statistically significant (P<0.05). Patients in the study group and the control group at the same time, the cure rate of hyperthyroidism compared to the study group was significantly higher than that of control group, with statistical significance (P<0.05). Conclusion In patients with early after 131I treatment for patients taking euthyrox can to some extent reduce the occurrence of hypothyroidism, but also can improve the cure rate of hyperthyroidism for the first time, a higher application value.

Objective To investigate the effect of lead aVR on recent prognosis in patients with non -ST -elevation acutecoronary syndrome(NSTE -ACS).Methods 195 patients with NSTE -ACS were divided into ST segment elevation in lead aVR group(n =54 cases)and non -ST segment elevation in lead aVR group(n =141 ) according to ST segment elevation in lead on admission;clinical data,laboratory index and coronary artery lesion were recorded,and major adverse cardiac (MACE)in hospitalization time were also recorded.Results Compared with non -ST segment elevation in the lead aVR group,the heart rate of ST segment elevation in the lead aVR group was faster[(85.4 ±12.0)beats per minute vs.(79.3 ±13.2)beats per minute,t =2.959,P <0.05],systolic blood pressure and diastolic blood pressure were higher[(145.0 ±20.3)mmHg vs.(136.0 ±19.4)mmHg,t =2.874,P <0.05];NT -proBNP[(743.9 ±125.8)pg/mL vs.(416.4 ±95.3)pg/mL,t =19.625,P <0.05],cTnI[(3.4 ± 1.0)ng/mL vs.(1.2 ±0.4)ng/mL,t =21.994,P <0.05],CK -MB[(31.5 ±9.8)ng/mL vs.(19.8 ±6.5)ng/mL, t =9.682,P <0.05]were higher (P <0.05);LVEF were lower[(50.1 ±5.2)% vs.(53.8 ±5.7)%,t =4.153, P <0.05];the rate and amplitude of low ST segment in outside lead aVR also was higher[(9.5 ±3.8)mm vs. (7.4 ±2.8)mm,t =4.224,P <0.05];the rate of left main and three -vessel disease in ST segment elevation in lead aVR group were higher (P <0.05).Compared with non -MECE group,proportion of ST segment elevation in lead AVR on admission was higher (P <0.05).Logistic regression analysis showed that heart rate(OR =1.472),NT -proBNP(OR =1.732),cTnI(OR =1.893),left main coronary artery(OR =2.478)and three -vessel disease (OR =2.310)were risk for ST segment elevation in lead AVR(P <0.05).Logistic regression analysis also showed that ST segment elevation in lead AVR were risk for MACE(OR =1.474).Conclusion ST segment elevation in lead AVR has close relationship with large area of myocardial ischemia,and patients prognosis is poorer,which may be independ-ent risk factor for the recent outcomes of patients with NSTE -ACS.Early record of the change in the case of aVR lead ECG ST segment NSTE -ACS patients is of important value in evaluation of the condition and prognosis.

Objective: To investigate the effect of serum growth differentiation factor-15 (GDF-15) in patients with acute ischemic stroke (AIS). Methods: Our research included 2 groups: AIS group,n=120 patients and Control group,n=60 normal subjects from regular physical examination. The serum levels of GDF-15 were examined within 24 hours of AIS attack by ELISA in both groups, the relationship between GDF-15 and the neurologic impairment was assessed. According to modiifed ranking scale score after 3 months follow-up study, the AIS patients were further divided into 2 sub-groups: Disabled group, the patients with MRS ≥ 2, n=65 and Non-disabled group, the patients with MRS < 2,n=55. The GDF-15 levels were compared between 2 sub-groups. Results: GDF-15 level in AIS group was 1594.00 (1128.00-2411.00) ng/L which was signiifcantly higher than that in Control group 656.00 (507.00-764.00) ng/L,P<0.05. GDF-15 level was positively related to neurologic impairment in AIS patients (r=0.390, P<0.001). Modiifed ranking scale score indicated that after 3 months of follow-up study, GDF-15 level in Disabled group was 2411 (2188-2569) ng/L which was much higher than that in Non-disabled group 1128 (980-1597) ng/L, (Z=-5.684,P<0.001). Conclusion: The serum level of GDF-15 was higher in AIS patients than normal subjects, it was positively related to neurologic impairment, AIS patients with higher GDF-15 would have poor prognosis.

Objective To investigate the expression of proliferating cell nuclear antigen (Ki67) in hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) tissue and its correlation with clinicopathological parameters of HBV related HCC. Methods HBV-related HCC patients (n=134) were divided according to Ki67 index (the percentage of Ki67-posi?tive cells) into Ki67 index<10%group (negative group, n=30) and Ki67 index≥10%group(positive group, n=104). The cor?relation of Ki67 index with age, gender, glypican 3 (GPC3), histological grade, BCLC (Barcelona Clinic liver cancer) staging, portal involvement, AFP (AFP), liver function related child-pugh classification data were calculated in both groups. Ki 67 in?dex is set according to the interval score to assess the relationship between Ki67 score and BCLC classification. Results (1) SP staining showed, Ki67 present a trend of increase from normal liver tissue to well-differentiated to medium differentiat?ed tissue to poorly differentiated tissues intensity. (2) In positive group, Ki67 index was correlated with BCLC staging, portal metastasis, histological grade, GPC3 and AFP (P<0.05);By contrast, in negative group, Ki67 index was not correlated with any clinical parameter (P>0.05). (3) Ki67 score increases with the progress of BCLC classification. Conclusion In Ki67 positive group, Ki67 index combined with GPC3, histological grade, BCLC staging, portal involvement, AFP and liver func?tion child-pugh classification can assess the severity of the patients with HCC, which is expected to become an important in?dicator for the HBV-related HCC early diagnosis.

Malignant biliary obstruction is caused by biliary tract malignant tumors or by extrinsic compression from pancreatic cancer, liver cancer, etc. Clinically, the disease is characterized by jaundice, skin itching, hepatic failure, etc., and the patients endure a poor quality of life with a short survival time. The key point for the treatment of malignant biliary obstruction lies in dredging biliary drainage channel , timely reducing jaundice and protecting liver function. This paper reviews the relevant medical literature , that have been published both at home and abroad in recent years, concerning percutaneous transhepatic endobiliary radiofrequency ablation by using HabibTM EndoHPB catheter to treat malignant biliary obstruction in order to clarify the fact that percutaneous transhepatic endobiliary radiofrequency ablation is a safe and feasible treatment and this technique can effectively reduce the incidence of re-stenosis of implanted biliary metallic stent.

Objective To explore the main factors of hypokalemia in the patients with acute myocardial infarction after PCI.Method The clinical data of ninety-six patients with myocardial infarction after PCI were analyzed to look into the reasons for hypokalemia.Results Fifty-seven patients contracted hypokalemia,with a rate of 59.4%.The complication was cured by dietetic supplementation of potassium,oral supplementation of potassium,and potassium supplementation by atomization inhalation and intravenous infusion.The reasons for hypokelemia included inadequate input,over-ejectment,abnormal distribution of potassium and use of contrast agent.Conclusions Patients with myocardial infarction after PCI are more susceptible to hypokalemia.Therefore,it is a need to correct hypokelemia by means of potassium supplementation.