Objective To conduct a meta-analysis to explore the merits and disadvantage of total endoscopic thyroidectomy and conventional open thyriodectomy.Methods A database searching was performed on the Chinese BioMedical Literature on disc(CBM),China National Knowledge Infrastructure(CNKI),wanfang database,VIP database and PubMed database.Prospective randomized controlled studies about total endoscopic thyroidectomy and conventional open thyroidectomy were selected and analyzed.RevMan 5.2 was used for statistical analysis.Results Eleven studies matched the selection criteria,which involved 1082 patients,among whom 505 patients underwent total endoscopic thyrodiectomy (endoscopy group) and 577 patients underwent conventional open thyroidectomy (open group).Outcomes of total endoscopy group and open group in satisfaction,operation time,drainage fluid,complications and post-operative hospital stay etc were compared.Meta analysis showed endoscopy group were supeior to open group in terms of intraoperative blood loss (WMD＝-17.86,95％ CI:[-26.18,-9.54]),postoperative hospital stay (WMD＝-0.95,95％ CI:[-1.40,-0.50])and patients' satisfaction (WMD＝4.03,95％ CI:[1.20,13.58])while the operation time was longer in endoscopy group than in open group (WMD＝12.61,95％ CI:[2.85,22.38]).There was no statistical significance on postoperative drainage(WMD＝ -0.70,95％ CI:[-32.79,31.39]) or complications (RR＝0.84,95％ CI:[0.54,1.29])for the two groups.Conclusions Total endoscopic thyriodectomy has advantages in terms of satisfaction,post-operative hospital stay,and intraopetative blood loss while it takes more operation time.There is no difference among drainage fluid or complication.

As a new therapy in past twenty years,biological agents have been approved for the treatment of inflammatory bowel disease (IBD). However,biological agents currently used for IBD treatment require intravenous or subcutaneous injections,and some require infusion under close observation. Therefore,it is of positive clinical significance to find a safe and effective oral biological agent. This article reviewed recent advances in study on novel oral biological agents in the treatment of IBD.

Objective To investigate the correlation between deep vein thrombosis(DVT) and clinical laboratory tests in the regulation of hemostasis. Methods Endothelin-1 (ET-1), thrombomodulin (TM), P-selectin, prothrombin fragment _ 1+2 (F_ 1+2 ), thrombin-antithrombin complex (TAT), thrombus precursor protein (TpP) and D-Dimer (D-D) were measured in DVT patients (n=72) and normal individuals (n=20) with ELISA method. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were evaluated for each of the items, and the area of the underlying receiver operating characteristic curve (AUC ROC ) was used to appraise diagnostic efficiency. Results Except ET-1, there were significant differences between the DVT group and normal control group in the other items. The AUC ROC of P-selectin, F_ 1+2 , TpP and D-D was bigger than that of ET-1, TM and TAT (P0.05). The TpP had the highest sensitivity, NPV and accuracy, and the D-D had the highest specificity and PPV. Conclusion The increase of D-D and TpP could reflect the occurrence of continuous coagulation and fibrolysis respectively. Thus the combination of measuring TpP and D-D could provide better laboratory evidence for the diagnosis of patients with DVT.

Air Pollution, Indoor ; analysis ; Anesthetics ; analysis ; Environmental Monitoring ; methods ; Isoflurane ; analysis ; Methyl Ethers ; analysis ; Operating Rooms

BACKGROUND: Previous studies have demonstrated that the well combination of decellularized matrix and appropriate seeded cells could construct a tissue-engineered kidney.OBJECTIVE: To review advances in kidney tissue engineering and decellularized matrix.METHODS: The first author retrieved CNKI, Wanfang and PubMed databases for articles addressing kidney tissue engineering published from January 1996 to April 2016. The key words were decellularized matrix,extracellular matrix,tissue engineering, kidney, seeded cells in English and Chinese,respectively.RESULTS AND CONCLUSION: The decellularized matrix loses its immunogenicity due to the removal of cellular components, while it retains the important bioactive components of the extracellular matrix and the ultrastructure of the tissues and organs, making it more and more important in kidney tissue engineering. The decellularized matrix especially exerts an important role in the tissue-engineered construction of the entire kidney as driven by recently emerging all-organ acellular cell technology. Remarkable advances in kidney tissue engineering and decellularized matrix have been made in recent years, and realized the construction of a certain functional tissue-engineered kidney. However, there are still many challenges on the way to construct a completely functional tissue-engineered kidney.BACKGROUND: Previous studies have demonstrated that the well combination of decellularized matrix and appropriate seeded cells could construct a tissue-engineered kidney.OBJECTIVE: To review advances in kidney tissue engineering and decellularized matrix.METHODS: The first author retrieved CNKI, Wanfang and PubMed databases for articles addressing kidney tissue engineering published from January 1996 to April 2016. The key words were decellularized matrix,extracellular matrix,tissue engineering, kidney, seeded cells in English and Chinese,respectively.RESULTS AND CONCLUSION: The decellularized matrix loses its immunogenicity due to the removal of cellular components, while it retains the important bioactive components of the extracellular matrix and the ultrastructure of the tissues and organs, making it more and more important in kidney tissue engineering. The decellularized matrix especially exerts an important role in the tissue-engineered construction of the entire kidney as driven by recently emerging all-organ acellular cell technology. Remarkable advances in kidney tissue engineering and decellularized matrix have been made in recent years, and realized the construction of a certain functional tissue-engineered kidney. However, there are still many challenges on the way to construct a completely functional tissue-engineered kidney.

Focal intrahepatic strictures (FIHS) refers to local strictures or stenosis of the intrahepatic bile duct induced by various factors. FIHS is easily leading to misdiagnosis and miss diagnosis. At present, most of the techniques or examinations for making position as well as qualitative diagnosis of FIHS have poor sensitivity. Paying more attention to the medical history and combined applications of various inspection methods might help to improve the diagnostic level of FIHS. In terms of treatment, we suggested for patients with suspected malignant strictures or those who were failure of medical treatment, dilation, drainage and pathological diagnosis of FIHS could be conducted by endoscopy before determining the indications and procedures of surgery based on a new anatomy classification system of FIHS.

Objective To evaluate the curative effect and safety of emergency therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and treatment strategy of mobidity and combined diseases for patients aged over 90.Methods The clinical and follow-up data of 116 cases treated by ERCP from January 2002 to December 2006 were analyzed retrospectively.Results The success rate was 97.41% for biliary drainage.The occurrence rate of mobidity was 21.24%(24/113),of which 6 cases of acute pancreatitis (25.00%),2 cases of upper gastrointestinal bleeding (8.33%),12 cases of electrolyte disorders (50.00%),acid-base balance disorders in 4 cases (16.67%).Except the higher incidence of hypokalemia disorders of emergency group than out-patient group (P=0.003),the rest of the mobidity rates were similar in the two groups.The mortality rate and deterioration rate of combined disease between the two groups were also similar.Conclusion Simplify operations,rapid drainage,positive preoperative preparation can effectively reduce the incidence of mobidity and avoid the aggravation of combined diseases.Emergency ERCP for treatment of patients aged over 90 is safe and effective.

OBJECTIVE To understand the current situation of infection management in outpatient stomatology department of our city,and to further strengthen the hospital infection standardization management. METHODS The hospital infection management was investigated in outpatient stomatology department of 18 medical institutions. RESULTS The qualified rate of the city level hospital infection management was 75-100%,and that of the county area level was 40-80%.The disinfection and isolation were not standardized,the standardized prevention consciousness among medical staff was weak,and the hand cleaning and disinfection was insufficient. CONCLUSIONS The stomatology department has a hidden danger to emergence of hospital infection,its infection management should be further strengthened.

OBJECTIVETo evaluate the efficacy and safety of testosterone undecanoate (TU) in the treatment of late-onset hypogonadism (LOH) by meta-analysis.

METHODSWe searched Pubmed (until April 1, 2014), Embase (until March 28, 2014), Cochrane Library (until April 17, 2014), CBM (from January 1, 2001 to February 2, 2014), CNKI (from January 1, 2001 to February 2, 2014), Wanfang Database (from January 1, 2000 to February 2, 2014), and VIP Database (from January 1, 2000 to Febru ary 2, 2014) for randomized controlled trials of TU for the treatment of LOH. We evaluated the quality of the identified literature and performed meta-analysis on the included studies using the Rveman5. 2 software.

RESULTSTotally, 14 studies were included after screening, which involved 1 686 cases. Compared with the placebo and blank control groups, TU treatment significantly increased the levels of serum total testosterone (SMD = 6.22, 95% CI 3.99 to 8.45, P < 0.05) and serum free testosterone (SMD = 4.35, 95% CI 1.86 to 6. 85, P < 0.05) but decreased the contents of luteinizing hormone (WMD = -2.23, 95% CI -4.03 to -0.42, P < 0.05), sex hormone binding globulin (WMD = 2.00, 95% CI 1.38 to 2.63, P < 0.05). TU also remarkably reduced the scores of Partial Androgen Deficiency of the Aging Males (WMD = -9.49, 95% CI -12.96 to -6.03, P < 0.05) and Aging Males Symptoms rating scale (WMD = -2.76, 95% CI -4.85 to -0.66, P <0.05) but increased the hemoglobin level (SMD = 2.35, 95% CI 0.29 to 4.41, P < 0.05) and packed-cell volume (SMD = 4.35, 95% CI 1.36 to 7.33, P < 0.05). However, no significant changes were shown in aspertate aminotransferase, alanine transaminase, prostate-specific antigen, or prostate volume after TU treatment (P > 0.05).

CONCLUSIONTU could significantly increase the serum testosterone level and improve the clinical symptoms of LOH patients without inducing serious adverse reactions. However, due to the limited number and relatively low quality of the included studies, the above conclusion could be cautiously applied to clinical practice.

Androgens ; therapeutic use ; Hemoglobin A ; metabolism ; Humans ; Hypogonadism ; blood ; drug therapy ; Luteinizing Hormone ; blood ; Male ; Prostate-Specific Antigen ; Randomized Controlled Trials as Topic ; Sex Hormone-Binding Globulin ; metabolism ; Testosterone ; adverse effects ; analogs & derivatives ; blood ; pharmacology

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors