Objective To study the epidemiological and clinical features of primary hyperthyroidism complicated with thyroid cancer.Methods Clinical data of 30 cases of hyperthyroidism complicated with thyroid cancer(hyperparathyroidism group)were retrospectively analyzed.They were chosen from the 365 cases of primary hyperparathyroidism treated by operation from Jan.2002 to Jun.2011.At the same time,30 cases of thyroid cancer without hyperparathyroidism were randomly taken out as the control group.Results The incidence of thyroid cancer in primary hyperparathyroidism was 8.22％ (30/365).The median course,preoperative diagnostic rate of thyroid cancer,and lymph nodes metastasis rate for hyperparathyroidism group and control group was 875.00 vs 120.00 days(z =-2.501,P ＜0.05),40.0％ (12/30) vs 66.7％ (20/30) (x2 =4.286,P ＜0.05),and 20.0％ (6/30) vs 46.7％ (14/30) (x2 =4.800,P ＜ 0.05) respectively.All patients were followed up with the average of 4.5 years,ranging from 1 month to 9 yeas and a half.1 case(3.3％)in hyperparathyroidism group recurred hyperthyroidism 5 years after surgery.1 case(3.3％)recurred thyroid cancer 1 year after surgery and received operation again,and 1 case(3.3％)died half a year after operation from respiratory failure caused by lung metastasis of thyroid cancer in the control group.Conclusions Hyperthyroidism complicated with thyroid cancer has the characteristics of high incidence rate of thyroid cancer in the hyperthyroidism patients,long course,high preoperative misdiagnosis rate,low lymph node metastasis rate,favorable prognosis and so on.

Objective To assess whether it have difference between mannitol combined with glycerin fructose and only use mannitol for the treatment of cerebral hemorrhage ,which provides relevant evidence‐based basis for guiding clinical treatment of cerebral hemorrhage .Methods We used literature retrieval through to the China national knowledge internet (CNKI) ,China biolo‐gy medicine disc ,VIP Chinese periodical database ,Wanfang data knowledge service platform and manual retrieval ,and formulate the inclusion and exclusion to screening literature ;and using the Jadad quality evaluation method to evaluate literature which had been included ,heterogeneity inspection at the same time .If the effect of multiple resulted ,we used fixed effect model ;on the other hand , used a random effects model .Results Mannitol combined glycerol fructose significantly improved symptoms and nervous function in patients with cerebral hemorrhage ,and the difference was statistically significant (RR=1 .12 ,95% CI:1 .03 -1 .22 ,P<0 .01);mannitol combined glycerol fructose significantly decreasd impaired renal function and complications (RR=0 .34 ,95% CI:0 .25-0 . 47 ,P<0 .01);mannitol combined glycerol fructose significantly decreasd severe unbalance of electrolyte after taking the medicine (RR=0 .31 ,95% CI:0 .19-0 .49 ,P<0 .01) .Conclusion Compared to use mannitol only ,combination with mannitol and glycerin fructose could effectively improve the prognosis of patients with cerebral hemorrhage ,and reduce the side effects .

Aged ; Aortic Valve Insufficiency ; diagnostic imaging ; Echocardiography ; Humans ; Male

Objective: To develop a method for the quantitative determination of several salvianolic acids by HPLC and investigate the influence of danshensu and protocatechuic aldehyde on the degradation process of salvianolic acid B (SaB). Methods: HPLC method was applied to quantitative analysis on four components in the degradation sample of SaB. HPLC-MS method was applied to tentatively characterizing the structure of the degradation products. The effect of danshensu and protocatechuic aldehyde on the degradation of SaB were found out by the analysis of chromatogram and mass spectra of degradation samples. Results: Nine degradation products were found in the degradation samples of SaB, including danshensu, protocatechuic aldehyde, isomers of SaB, lithospermic acid, and its isomers. Protocatechuic aldehyde had stronger protective effect on SaB compared to danshensu at the same mass concentration. Additionally, the peak area of lithospermic acid isomers I and II increased when the initial concentration of protocatechuic aldehyde was increased. Conclusion The mild acidity of protocatechuic aldehyde might account for its stronger protective effect on SaB, and the connection between protocatechuic aldehyde and lithospermic acid isomers I and II might relate to the change of reaction balance.

Objective To provide the anatomical data for single-nostril transsphenoidal microsurgery for pituitary adenoma.Methods Microanatomic structures were observed and measured in 20 cadaveric a- dults heads.Results(1)The diaphragmal opering was 5 mm or greater broad in 90%.The mean thick- ness of the diaphragma sellae was (0.18?0.08)mm.(2) A sphenoid sinus with complete pneumatization was named as all-sellae type,its percentage in all specimens was 85%,85% sphenoid sinus had middle sep- tum of which only 18.8% located in the medial sagital section.(3)The meant thickness of the sellar floor was (0.81?0.34) mm,70% of which were not more than 1 mm.Of the sellar floors,that the shape was flatness reach 15%.(4) The relationship between ICA and sphenoid sinus had two aspects,one was to be mutually apart (55%),the other was to communicate (45%),which formers carinae on the lateral wall of the sphe- noid sinus,espeially in the superior surface of posterior part.The relationship between optic nerve and sphe- noid sinus,one was to be mutually apart (27.5%),the other was to communicate (72.5% ),which formers carinae on the lateral wall of the sphenoid sinus,especially in the superior surface of anterior part.(5) Three main types of the intercavernous sinus were the anterior intercavernous sinus,present in 80%,the inferior in- tercavenous sinus (25%),and the posterior intercavenous sinus (15%).Conclusion The knowledge of the anatomy of the sellar region and sphenoid sinus is helpful to safe operation in the single-nostril transsphe- noidal approach for pituitary,adenoma microsurgery.

OBJECTIVE:To observe the efficacy and safety of edaravone combined with nimodipine in the treatment of acute large area cerebral infarction. METHODS:78 patients with acute large area cerebral infarction were randomly divided into control group (38 cases) and observation group (40 cases). Control group received aspirin platelet aggregation,reduced intracranial pres-sure,maintained water and electrolyte balance,decreased cerebral edema,Xuesetong for injection,Ginkgobiloba injection,lipid and blood pressurelowering,maintained blood sugar and other conventional treatment;observation group additionally received 30 mg Edaravone injection,adding into 100 ml 0.9% Sodium chloride injection by intravenous infusion (drip completed within 30 min),twice a day+12 mg Nimodipine injection,adding into 500 ml 0.9% Sodium chloride injection by intravenous infusion,once a day,with drip rate of 0.5-1 mg/h,for continuous 10 d,then received 40 mg Nimodipine tablet,orally,3 times a day. The treat-ment course for both groups was 15 d. Clinical efficacy,blood oxygen saturation (SpO2),hemoglobin (Hb),total hemoglobin (HbT),reduced hemoglobin(MHb)before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the incidence of adverse reac-tions was significantly lower tahn control group,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in SpO2,Hb,HbT and MHb in 2 groups (P>0.05). After treatment,the SpO2,HbT and MHb were significantly higher than before,and observation group was higher than control group,the differences were statistically signifi-cant(P<0.05);Hb was significantly lower than before,the differences were statistically significant(P<0.05),but there was no significant difference between 2 groups (P>0.05). CONCLUSIONS:Based on the conventional treatment,edaravone combined with nimodipine shows significant efficacy in the treatment of acute large area cerebral infarction,it can effectively recovery neuro-logical function damage and protect the brain tissue,which can reduce the incidence of adverse.

The misuse of toxic drugsisseriousone of the threats of public health. In this study, toxic Hyoscyami Semen and its adulterants were identified by DNA barcoding. The genomic DNA was extracted from 61 samples including Hyoscyami Semen and its adulterants by reagent kit method. Their ITS2 sequences were amplified, and purified PCR products were sequenced. Sequence assembly and consensus sequence generation were performed using CodonCode Aligner v 4.25. The genetic distances, variable sites and the neighbor-joning (NJ) phylogenetic tree were computed by MEGA 6.0 in accordance with the Kimura 2-parameter(K2P) model. The results showed that the intra-specific genetic distances of Hyoscyamusniger were 0.005 which were smaller than inter -specific ones (0.360) of H. niger and their adulterants. The NJ tree showed that H. niger was clustered into one monophyletic branch, and clearly separated with other species. Therefore, ITS2 sequence was able to identify Hyoscyami Semen and its adulterants to ensure the safty of medicines.

Adult ; Antibodies, Monoclonal ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Follow-Up Studies ; Humans ; Leukocyte Common Antigens ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; Male ; Mucin-1 ; metabolism ; Prednisone ; therapeutic use ; Receptor Protein-Tyrosine Kinases ; metabolism ; Vincristine ; therapeutic use

Hepatic fibrosis models were induced by CCl4 in rats. To explore vascular endothelial growth factor (VEGF), transforming growth factor-beta1 (TGFβ1) mRNA expression and bcl-2, Bax protein expression levels of intervention and explore the mechanism of the Aralia chinesis anti-hepatic fibrosis. Sixty male Sprague-Dawlley (SD) rats were randomly divided into six groups: nomal group, model group, high-dose (10 mL x kg(-1)), medium-dose (7.5 mL x kg(-1)), low-dose (5.0 mL x kg(-1)) of A. chinesis treated group and colchicine treated group. The change of liver histopathology was observed by HE and Masson staining. The mRNA of VEGF, TGF-β1 were detected by RT-PCR. The protein of Bcl-2 and Bax were detected by Western blot. In the model group liver cell obvious degeneration, necrosis, a large number of collagen fibers of the cable hyperplasia, part visible pseudolobule formation. A. chinesis large, medium, low-dose group and colchicine group liver cell degeneration and necrosis reduced A. chinesis small, medium, and high-dose group was gradually reduced trend and A. chinesis large, middle dose group degree of reduction is particularly significant. Compared with model group, A. chinesis of large, medium and small dose group and colchicine group VEGF mRNA expression, A. chinesis of large, medium-dose group TGF-β1 mRNA expression reduce (P < 0.05); compared with colchicine group, A. chinesis of large, middle dose group of VEGF mRNA expression decreased (P < 0.05); A. chinesis of large, middle dose group of TGF-β1 mRNA expression decreased (P < 0.01), and compared with colchicine group, large dose group of of TGF-β1 mRNA expression decreased (P < 0.05). Compared with model group, A. chinesis of large, medium and small dose group and colchicine group Bcl-2 protein expression reduce (all is P < 0.05). But A. chinesis of large, medium and small dose group and colchicine group of Bax protein expression were increased (P < 0.05). A. chinesis regulation of VEGF, TGF-β1 may prevent the activation of hepatic stellate cells, liver tissue by up regulating the anti-apoptotic protein Bax and down pro-apoptotic protein Bcl-2 expression, thereby to improve the degree of liver fibrosis.
Animals ; Apoptosis ; drug effects ; Aralia ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; Hepatic Stellate Cells ; drug effects ; metabolism ; Humans ; Liver Cirrhosis ; drug therapy ; genetics ; metabolism ; Male ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; bcl-2-Associated X Protein ; genetics ; metabolism

Objective To investigate different anesthetic effects of remifentanil, sufentanil, and fentanyl in the pediatric tonsilloadenoiectomy. Methods Totally 210 cases of tonsilloadenoiectomy enrolled in our institution from March 2016 to February 2017 were selected as study objects. Children were divided randomly into three groups, with 70 cases in each group, including remifentanil group, sufentanil group, and fentanyl group. Child patients in the remifentanil group were induced by remifentanil with 1μg/kg, and were maintained with 0.1μg · kg-1 · min-1. Remifentanil was withdrawn 5 minutes before the end of operation. Child patients in the sufentanil group were induced by sufentanil with 0.2 μg/kg, and were maintained with 0.1 μg · kg-1 · h-1. Sufentanil was withdrawn 30 minutes before the end of operation. Child patients in the fentanyl group were induced by fentanyl with 2μg/kg, and were maintained with 1μg·kg-1·h-1. Fentanyl was withdrawn 30 minutes before the end of operation. During the anesthesia, the indexes of heart rate (HR), mean arterial pressure (MAP), and oxygen saturation were recorded in the three groups. The time of eyelash reflex disappearance, pain reflex disappearance, postoperation eye open, and extubation were also recorded. The incidences of perioperative adverse events were compared between the three groups. Results HR and MAP at time points of anesthesia induction, 5 minutes after anesthesia induction, and 10 minutes after anesthesia induction were higher in the remifentanil group than those in the other two groups (P<0.05). And the differences of the above indexes at all time points between sufentanil group and fentanyl group showed no statistical significance (P>0.05). The time of pain reflex disappearance, postoperation eye open, and extubation were higher in the fentanyl group than those in the other two groups (P<0.05). And the differences of the above indexes between sufentanil group and remifentanil group showed no statistical significance (P>0.05). Incidence rate of postoperative agitation was higher in the remifentanil group than that in the other two groups (P<0.01). And the difference of incidence rate of postoperative agitation between the sufentanil group and fentanyl group showed no statistical significance ( P>0.05). Conclusion The effect of sufentanil is better than remifentanil and fentanyl in the anesthesia of pediatric tonsilloadenoiectomy, with fast effect, fast analepsia, stable haemodynamics, and low incidence rate of postoperative agitation.