Objective To study the significance of dissection and exposure of the recurrent laryngeal nerve(RLN) in thyroid surgery.Methods The clinical data of 1 082 patients who had undergone operations on thyroid were retrospectively reviewed.All cases were routinely operated with dissection and exposure of RLN.Results Six cases had injury of RLN(0.5%),3 cases showed parathyroid insufficiency(0.3%)and 2 cases had injury of the superior laryngeal nerve(0.2%) ofter operation.The incidence of operative complications in thyroid surgery was closely related with if exposure of the RLN.Conclusions Exposure of the recurrent laryngeal nerve is a key measure to decrease injury of parathyroids,superior laryngeal nerve and recurrent laryngeal nerve during thyroid surgery.

construction of a comprehensive,multifunctional and theory supported operation system is the organization basis on which occupation burnout can be scientifically and effectively interfered.Interference to occupation burnout is divided into nine subsystems by "participation" dimension which consists of organization,family and individual,and by "functional" matrix dimension which consists of the first grade prevention(development interfere),the second grade prevention(symptom interfere) and the third grade prevention(burnout interfere).Among these subsystems there exist factors of different target,content,mode and method etc.Their operation and interrelation form a complete working system via which an organization interferes occupation burnout.Promote the hospital management more scientificly and hominizaiton's in human resource.

Objective To evaluate the effect of twaist circumference(WC)on the blood pressure,lipid and glucose metabolism. Methods A baseline investigative data from community intervention target population for cardiovascular disease in Liuzhou was used. There were 7 660 residents (male was 3 894,female was 3 766),average aged 40.5?12.2 years. Their height,weight,WC,blood pressure,fasting plasma lipid and fasting plasma glucose(FPG) were detected. By WC length,they were divided as M

This paper introduces pediatrician training model in Britain, from medical students to consults, including its step-by-step training methods, multi angle multi-level evaluation methods, and em-phasis on the professionism and clinical competence. Through the comparison of the current pediatrician training model in China, this paper provides a reference for Chinese pediatrician training model in future.

[Objective] To explore whether necroptosis is involved in the mechanism of lung injury induced by intestinal ischemia-reperfusion.[Method] Thirty-two healthy male Sprague-Dawley rats were randomly assigned into 4 groups (n--8):sham operation group (sham group),isehemia/ reperfusion group (I/R group),necroptosis inhibitor necrostatin-1 group (Nec-1 group) and solvent dimethyl sulfoxide (DMSO) group (DMSO group).Model of intestinal I/R injury was produced by clamping the superior mesenteric artery for 1.5 h followed by 6 h reperfusion in rats.Necrostatin-1 1.0 mg/kg was administered 30 min before occlusion in Nec1 group,while the equal volume of DMSO was given instead in DMSO group.The rats were sacrificed at 6 h of reperfusion and the lung tissues were removed for measurement of wet-dry ratio and microscopic examination and scored.The expression of receptor-interacting protein 1 (RIP1) and receptor-interacting protein 3 (RIP3) in lung tissues was detected using Western-blot and immunohistochemistry.[Result] Compared with sham group,lung morphology score and wet/dry ratio in I/R,DMSO group raised (P ＜ 0.05).Lung morphology score and wet/dry ratio statistically declined in Nec-1 group compared with I/R and DMSO group (P ＜ 0.05),while there was no statistical difference of wet/dry ratio between sham group and Nec-1 group (P ＞ 0.05).As the result of westernblot and immunohistochemistry showed,the expression of RIP1 and RIP3 was up-regulated in I/R group and DMSO group (P ＜0.05),which was inhibited by Nec-1 in Nec-1 group (P ＜ 0.05).[Conclusion] Necroptosis is involved in the mechanism of lung injury induced by intestinal ischemia-reperfusion,and Nec-1,the special inhibitor of RIP1,can reduce the injury.

Objective To detect the strain features of regional wall abnormalities in patients with coronary artery disease during each diastolic period, and its possibility to evaluate regional left ventricular cardiocyte viability and diastolic function.Methods 54 patients with anterior myocardial infarction (MI group) and 78 normal subjects (NOR group) underwent Doppler tissue imaging, which were performed in 2-chamber-view by strain curves synchronously.Results In the NOR group, strain value of 66 cases (84.62%) showed an gradually increasing negative value from the apex to base to middle of left ventricle, while in the MI group, there were 9 cases (16.67%) with such a trend. IR phase: in the NOR group, 564 segments (90.38%) were upward wave bands, but in the MI group, there were 123 segments (28.47%) having such waves ( P<0.05). RF phase: in the NOR group, 576 segments (92.31%) were upward and steep wave bands, but in the MI group, the number of upward waves were obviously less (102 segments,23.61%) ( P<0.01). SF period: compared with the NOR group, which was horizontal, the MI group had upward wave bands ( P<0.05).Conclusion Regional myocardial ischemia and infarction can cause significant regional diastolic wall abnormalities of strain value in active diastolic phase. Regional diastolic wall motion abnormalities can be evaluated quantitatively and synchronously with high sensitivity by strain curve which has the potential value in cardiocyte viability and diastolic function.

Objective To investigate the effects of health-education on the behaviors of following doctor's instructions of the patients receiving anticoagulation after valve replacement. MethodsThirty patients who received anticoagulation after valve replacement took part in this study. Health-education for knowledge of anticoagulation after valve replacement was implemented among these patients, and questionnaires investigating compliance for medication were subjected to all cases after their discharge of ward. The awareness of knowledge of anticoagulation was compared between patients of pre- and post-health-education,and the compliance of medication after discharge was also analyzed. ResultsHealth education improves the patient's understanding and knowledge about anticoagulation and also improves their attention to the doctor's instructions. Conclusion Health-education can increase the awareness of the knowledge of anticoagulation and the compliance among patients.

Objective To measure the expression of peroxisome proliferator-activated receptor β/δ (PPARβ/δ) in epidermal keratinocytes from patients with psoriasis,and to investigate its regulatory factors.Methods Tissue specimens were obtained from both lesional and non-lesional skin of 20 patients with psoriasis as well as from normal skin of 15 human controls.An immunohistochemical method was used to examine the expression of PPARβ/δ in these tissue specimens.Epidermal keratinocytes were isolated from these tissue specimens and subjected to a primary culture.After several passages of subculture,non-lesional psoriatic keratinocytes were stimulated with different concentrations of GW501516 (an agonist of PPARβ/δ,0-100 ng/ml) and Ca2+ (0-3.0 mmol/L).Reverse transcription-PCR and Western blot were performed to measure the mRNA and protein expressions of PPARβ/δ in the primary keratinocytes and stimulated keratinocytes respectively.Results Immunohistochemistry showed that the expression intensity of PPARβ/δ was significantly higher in lesional psoriatic skin than in normal control skin (t =19.28,P ＜ 0.01) and non-lesional psoriatic skin (t =23.26,P ＜ 0.01).Increased mRNA and protein levels of PPARβ/δ were observed in lesional psoriatic keratinocytes as compared to normal control keratinocytes (both P ＜0.01) and non-lesional psoriatic keratinocytes (both P ＜ 0.01).Among these stimulated non-lesional psoriatic keratinocytes,those treated with GW501516 at 10 ng/ml and those with Ca2+ of 1.0 mmol/L showed the strongest expression of PPARβ/δ (both P ＜ 0.01).Conclusions The expression of PPARβ/δ,which is higher in lesional psoriatic skin,can be enhanced by GW501516 and Ca2+ in keratinocytes.

Objective To study effectiveness of System intervention to occupation burnout of medical staff.Methods Specimens were classified as interventional group and control group by 1:1 partnership rule.Systemic intervention,which came from organization,family and individual,was only applied to interventional group.The objective was to establish requirement and resource mechanism,continually increase response resource,and improve matching state of individual & job.It allowed full play to the first grade prevention(development intervention),the second grade prevention(symptom intervention)and the third grade prevention(burnout intervention).It determined effectiveness of intervention via indexes of occupation burnout,mental health and satisfaction within group or internal groups.Results Before systemic intervention,there was no significant difference between intervention group and control group(P＞0.05).After systemic intervention,the scores of burnout(emotion exhaustion(17.54±9.97)vs(14.30±11.87),P＜0.01;depersonalization(5.29±5.01)vs(4.63±5.65),P＜0.05;low personal accomplishment(6.47±4.89),(5.61±5.10),P＜0.01),check list-90(SCL-90),personal satisfaction in intervention group showed apparent difference compared with that in control group.But there was no significant difference in control group before and after intervention.Conclusion On the whole systemic intervention to health care staff obtains obvious achievement,effectively reduces emotional exhaustion,obsessive symptom and terror emotion,and enhances individual satisfaction.

Aim To determine whether pranlukast (ONO-1078), a cysteinyl leukotriene receptor antagonist, possesses therapeutic effect when administered after focal cerebral ischemia in mice. Methods Persistent focal cerebral ischemia was induced by middle cerebral artery occlusion. Pranlukast and edaravone, a positive control drug, were ip injected 1, 6 and 24 h after ischemia. The neurological deficits were evaluated by neurological scores and inclined plane test 24 and 48 h after the surgery. Forty-eight h later, the brain slices were prepared for measurements of infarct volume and the ratio of ischemic/non-ischemic hemispheres. Brain sections were cut and examined for neuron densities in different regions of the brain. The effects of pranlukast and edaravone were evaluated by the changes of these variables. Results Pranlukast (0.1 and 0.2 mg?kg -1) and edaravone (3 and 10 mg?kg -1) significantly reduced the neurological deficits, infarct volume (maximally 82.3%), ratio of ischemic/non-ischemic hemispheres, and attenuated the reduction of neuron densities in hippocampal CA1 region, cortex and striatum. Conclusion Pranlukast possesses therapeutic effect on ischemic insults when administered after ischemia as effective as edravone, indicating a therapeutic potential in the treatment of ischemic stroke.