OBJECTIVE:To provide references for the improving of the quality control level for aseptic drug products.METHODS:The advantages of parametric release of aseptic drug products and its enforcement were elucidated by comparing it with the traditional quality control technique and referring to parametric release guideline of developed countries.RESULTS & CONCLUSIONS:Parametric release could provide high-level quality assurance for aseptic drug products.It is inevitable for parametric release to substitute the traditional quality control technique.

Objective To study and analyze the related factors of neonatal dopamine leakage in NICU and psychological intervention. Methods 100 cases of neonatal NICU patients who received intravenous infusion of dopamine in our hospital from February 2015 to October 2017 were selected and randomly divided into two groups,the control group and the experimental group,with 10 patients in each group.The patients in the control group were given routine nursing care,the patients in the experimental group were given comprehensive care and psychological intervention,and they paid attention to the psychological status of the patients,and carried out a comprehensive evaluation,and given positive care.The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding nursing mode,10 cases in the control group were transfused 100 times,and 30 cases of secondary leakage occurred,accounting for 30.0%.In the experimental group,10 cases were transfused 100 times,and 16 cases of secondary leakage occurred,accounting for 16.0%.The probability of dopamine leakage in the control group was significantly higher than that in the experimental group,with statistical difference.In the experimental group,9 parents were satisfied with the nursing work,and the satisfaction rate was 90.0%.In contrast,42 parents were satisfied with the nursing work,and the satisfaction rate was 80.0%. The satisfaction degree of nursing in the experimental group was significantly higher than that in the control group,and the difference was statistically significant.Conclusion The application of psychological intervention in neonatal NICU intravenous infusion of dopamine and comprehensive care,can reduce the occurrence probability of leakage of dopamine in a large extent,improve nursing satisfaction,to build a harmonious doctor-patient relationship is further applied in clinical significance.

Objective] The pathogenesis of HuangQin Tang is discussed little in six meridians syndrome differentiation, and which meridian syndrome does it belong to isn’t clear. So this article tries to discuss the belonging and pathogenesis of it. And the key point of using it in clinic will also be involved.[Method] Combining the observation of efficacy of XiaoChaiHu Tang and HuangQin Tang and the elaboration articles are related to that two prescriptions to analyze the difference of that two prescriptions in pathogenesis.[Result]It’s found that HuangQin Tang and XiaoChaiHu Tang all belong to ShaoYin in six meridian syndrome.But their pathogenesis is different. HuangQin Tang should be used in heat syndrome of ShaoYang disease which caused by heat pathogen of ShaoYang meridian and diarrhea will appear because belly is shocked. However, XiaoChaiHu Tang is used to drive cold pathogen of ShaoYang meridian. [Conclusion]Both of HuangQin Tang and XiaoChaiHu Tang belong to ShaoYang Meridian, but it’s known that HuangQin Tang is used less. And less discussion of HuangQin Tang should be blamed. The more we know on pathogenesis of HuangQin Tang, the better we use it.

Objective Hypothyroidism during pregnancy has been associated with impaired cognitive development and increased fetal mortality.In this retrospective study we attempt to identify the timing and adjustment of levothyroxine during pregnancy.Methods 20 women planning pregnancy after thyroidectomy because of thyroid cancer were observed before and throughout their pregnancies.Their thyroid function was measured before conception,and approximately every 4 weeks during pregnancy.The dose of levothyroxine was increased to maintain the thyrotropin concentration at preconception values throughout pregnancy.Results 21 pregnancies occurred in the 20 women and resulted in 20 full-term births.One woman had abortion.Their basal dose was all 100 μg.The dose increased by 12.5 μg a time to target the thyrotropin concentrations (0.1-0.25 mU/ml).The mean levothyroxine requirement increased 50 percent during the first half of pregnancy and plateaued by the 16th week.This increased dose was required until delivery.All the newborns and their mothers were healthy according to the follow-up.Conclusions We propose that women after thyroid cancer surgery should increase levothyroxine dose as soon as pregnancy is confirmed.Thereafter,serum thyrotropin level should be monitored and the levothyroxine dose adjusted accordingly.The adjustment dose is set at 12.5 μg and the maternal thyrotropin concentration is between 0.10 and 0.25 mU/ml,which guarantees healthy growth of fetus while suppresses thyroid tumor growth simultaneously.

Objective To understand the attitude and current situation of medical English stud y as well as its relevant factors among long schooling medical students so as to provide first hand information for constructing students-centered medical English teaching model. Methods A self-de-signed questionnaire including basic information of students, attitude and current situation of medical English students was given to 134 seven or eight year program clinical medical graduates from grade 2006 to grade 2008 in Tongji University. Questionnaires were collected timely and an-alyzed with SPSS 19.0 and results were described by percentage. Results Totally 132 copies of questionnaire were recovered with an recovering rate of 98.51%. 56.82%(75/132) students had interest in medical English study and 71.97%(95/132)students had a will to go abroad for learning exchange. Main pur-poses for students to learn medical English were ‘professional literature reading’(68.94%,91/132),‘SCI papers writing’(59.09%,78/132)and ‘international communication’(58.33%, 77/132). Main influencing factors of medical English study were ‘boring teaching methods ’ ( 45 . 45%, 60/132 ) ,‘difficult medical English’(41.67%,55/132) and ‘insufficient teaching time’(40.91%,54/132).Conclusions Medical students with long schooling have demand for medical English study;however, most of them have some difficulties in practical application. Measures should be taken from three as-pects including students, teachers and curriculum setting to improve students' medical English.

Objective To establish a way to measure the injury severity of articular surface due to posterior malleolus fracture and investigate its clinical significance based on three-dimensional reconstruction technique.Methods Between May 2009 and March 2014,138 cases of peri-ankle injury combined with posterior malleolus fracture were treated.Lateral radiographs were reviewed to measure the ratio of posterior fragment area to distal tibial plafond area using the common method.Three-dimensional CT images were examined to measure ratio of the area of injury using the three-dimensional measuring method.Statistical comparison was made using the t-test and intraclass correlation coefficient (ICC).Results Measurement failed on 33 lateral radiographs and 13 three-dimensional CT images.Six cases cannot be measured by both imaging technology,so results of 98 cases were compared.Ratio of posterior fragment area to tibial plafond area was (16.2 ± 7.2) ％ measured by radiographs and was (29.6 ±10.1) ％ by three-dimensional CT scans (P ＜ 0.05).Three-dimensional CT measurements showed higher intra and inter-observer agreement (ICC of 0.973 to 0.942) than that in radiographic measurements (ICC of 0.875 to 0.860).Conclusion Three-dimension CT assessment of the extent of injury to articular surface because of posterior malleolus fracture is reliable and reproducible,but radiographic assessment may underestimate the injury and influence the choice of surgical indications.

Objective To investigate the clinical characteristics and treatment of external auditory canal chol‐esteatoma (EACC) .Methods The clinical data of 38 cases(39 ears)with external auditory canal cholesteatoma from August 2006 to December 2014 were retrospectively analyzed .Results All the cases of EACC in this study had the external ear canal full of impacted squamous material or granulation tissue .The Holt and CT imaging examinations disclosed that 10 ears were phase I ,lesions were confined to the external auditory with no bone destruction .There were 23 ears were phase II ,the lesions were located in external auditory meatus with destruction of bone ,but with no involvement of the middle ear .There were 6 ears were phase III ,showing the lesions with disrupt external audi‐tory meatus and involvement of the middle ear ( mastoid and/or tympanic sinus) .Hearing impairment and aural fullness were the most common symptoms .The phase I cases were treated by removing cholesteatomas from the ex‐ternal auditory canal .Canaloplasty and/or tympanoplasty were performed in phase II cases .The phase III cases were successfully managed by modified radical mastoidectomy and/or tympanoplasty .There were 30 ears of tympan‐ic membrane were perfect and invaginate .There were 4 ears of ossicular chain were disrupted with one ear of facial nerve exposed .All surgeries were performed at once .No recurrence except in one patient was found during the fol‐low -up period .Conclusion The clinical stages can help identify the primary lesions and determine the choice of the best surgical approach .

Objective To investigate the effect of sustentaculum tali screw placement on outcomes following open reduction and internal fixation (ORIF) of intraarticular calcaneal fractures.Methods A retrospective analysis was made on 139 patients with intraarticular calcaneal fractures treated by ORIF from April 2008 to January 2012.According to Sanders classification,there were 9 patients with type Ⅱ fractures,87 with type Ⅲ fractures and 43 with type Ⅳ fractures.Fracture reduction followed by placement of calcaneal anatomic plate or anatomic locking plate was performed via calcaneal lateral L-shape incision.All the patients received X-rays and CT scans within postoperative 2 weeks.Placement of screws in sustentaculum tail was detected by CT volume rendering to visualize implants combined with multiplanar reconstruction imaging (MPR).Patients were divided into accurate fixation group (Group A,n =28),marginal fixation group (Group B,n =58),and non-fixation group (Group C,n =53) based on radiological results.Intra-and peri-operative parameters,time to partial weight-bearing,time to full weight-bearing,fracture healing time,and clinical outcome were compared among groups.Functional outcome was assessed using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale.Results Postoperative X-rays indicated accurate fixation of sustentaculum tail in 64 patients,marginal fixation in 22,and non-fixation in 53,but CT images manifested accurate fixation in 28 patients,marginal fixation in 58,and non-fixation in 53.Group A had operation duration of (93 ±11) min and intraoperative blood loss of (252 ± 27) ml,longer or higher than those in Group B [(85 ±8) min,(194±16) ml] and Group C [(57±6) min,(136 ±13) ml] (P＜O.05).There was no significant difference in mean hospital stay among the three groups (P ＞ 0.05).Ninety-two patients were followed-up for 12-38 months (mean 18.5 months) and 85 patients completed foot and ankle exercise as planned.Moreover,no significant differences were observed among groups concerning time to partial and full weight-bearing,fracture healing time and AOFAS score at the final follow-up (P ＞ 0.05).Conclusion Sustentaculum tali screw placement has no apparent effect on the short-term outcome of surgical treatment for calcaneal fractures.

OBJECTIVE: Discuss the clinical features of primary ectopic thyroid carcinoma. METHOD: The clinical data of three cases diagnosed of primary ectopic thyroid carcinoma in our department since 1990 were analyzed ret respectively and related literature was reviewed. RESULT: All three patients were young females that had cervical lumps before surgery. The pathology results confirmed the diagnosis of ectopic thyroid papillary carcinoma. All cases had followed up till now and no relapse signs occurred. CONCLUSION Ectopic thyroid tissue is resulting from developmental defects at early stages of thyroid gland embryogenesis. They can cancerization, the treatment of ectopic thyroid carcinoma is also controversial. Here,we report 3 cases of primary ectopic thyroid papillary carcinoma, all of which were removed by surgery, take thyroxin orally after surgery and have a great prognosis.
Adult ; Carcinoma ; diagnosis ; therapy ; Carcinoma, Papillary ; Female ; Humans ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnosis ; therapy

Objective:To investigate the recurrence of the neck and survival incidence of clinically possible pos-itive lateral cervical nodes in patients with well-differentiated papillary thyroid cancer and the essentiality of the performation of modified radical neck dissection. Method: Retrospective datum of 267 cases of papillary thyroid car-cinoma were collected and ananlyzed. They were divided into two groups with time; selective neck dissection with VI area was performed in 151 cases of group A and selective neck dissection was performed without VI area in 116 cased of group B. They were received the same treatment in the thyroid-total thyroidectomy on initial part and subtotal thyrodectomy on the other, and total thyroidectomy on both parts if both were invated. Incidence of posi-tive lateral cerivcal nodes of VI area in group A and the recurrence in the neck and survival incidence in groups B were analyzed. Result: Fiftynine patients in group A were treated with the modified radical neck dissection, and 22 patients of them were found metastasis in lateral cervical nodes with Ⅵ area. The other 92 patients were treated with neck dissection of Ⅱ,Ⅲ,Ⅳ,Ⅵ VI area, and 31 patients weren't metastasis, 33 patients were metastasis in both Ⅵ area and the others(35.8%), 17 patients were metastasis only in Ⅵ area(18.4%), 11 patients weren't metastasis only in Ⅵ area(11.9%). Thus, the incident of metastasis in Ⅵ area was 47.70% in group A(72/151). 47 patients in group B had metastasis in lateral cervical nodes though without performing VI area neck dissection (40.5%), and the survival rate of 5 years was 99.3%. The recurrence rate in the neck of group two was 6.0% (7/116). The metastasis rate of neck lymph node was higher in group A (54.9%) than group B(40.5%). Conclu-sion : Pretracheal and peripheral recurrent nerve lymph node are very susceptible to the metastasis of well-differenti-ated papillary thyroid cancer. The neck dissection of VI area could be performed as routine.