40 cases of parotidectomy were reviewed.Anterograde approach(group A)and retrograde approach(group B)for facial nerve dissection were used in 1 7 and 23 cases respectively.1 patients in group A and 8 in group B presented symptoms of temporary facial nerve paralysis(P <0.05).The anterograde method is safer and quicker.

Objective To investigate the ultrasonographic manifestations of traumatic neuroma after neck dissection in papillary thyroid carcinoma (PTC).Methods A retrospective analysis was performed in 21 patients with 26 lesions who underwent neck dissection.The ultrasonographic characteristics were reviewed,including numbers,location,size,shape,margin,echogenicity,with or without direct continuity to the nerve fiber,the presence of internal hyperechogenicity and blood supply.Results Among the 26 lesions of 21 patients,25 lesions were in the lateral cervical area while the other one was in the central cervical area.The mean shortest diameter of the lesions was (3.5±1.0)mm and that of longest diameter was (9.1±2.9)mm.Totally 13 lesions were oval in shape and the other 13 were round.The clear margin was found in 13 lesions and fuzzy margin was observed in another 13 lesions.All the lesions were heterogeneously hypoechoic.The presence of internal hyperechoic areas were found in 16 lesions.The direct continuity with the nerve fiber was found in 20 lesions,while the other 6 lesions were not continued to the nerve directly.Color Doppler flow imaging showed that 20 of the 26 lesions existed a little blood flow signal and the other 6 lesions showed no flow signal.During the ultrasound-guided fine-needle aspiration biopsy (US-FNAB),21 patients complained about the intolerable serious pain and the pain relieved when the needle removed.Conclusion Traumatic neuromas are hypoecho lesions located in the operation area after neck dissection in PTC with distinctive ultrasonographic features,especially the direct continuity with the nerve fiber,as well as the clinical histories and sharp pain during US-FNAB,which can help to diagnose.

T polymorphism of TGF-?1 gene related with the degree of L_(4?5) and L_5S_1 disc degeneration.

Objective To explore the optimal power of experimental pancreatic endoscopic ultrasonography (EUS)-guided radiofrequency ablation (RFA) therapy.Methods Six healthy live minipigs were randomly divided into two groups according to random number table,which received RFA under EUS or in laparotomy.Each pig in each group was randomly allocated to received RFA at different power (5 W,10 W,15 W).The impedance was monitored and the time for each therapy was recorded.The width diameter of coagulation necrosis from RFA was measured by EUS and gross pathology.Results RFA was completed in all pigs smoothly with stable life signs and without complications.Gross and micro pathologic observation confirmed formation of coagulation necrosis lesions.The width diameter of lesions from EUS-RFA was similar to that from surgery RFA,both having a maximum value at 10 W power (11 nun VS 10 mm).Conclusion The optimal power of experimental pancreatic EUS-RFA in pig is 10W,which should be further explored for the clinical purpose.

There is a new research model named 'registry study/patient registry' in Western medicine, which could be referred to by Chinese medicine researchers, such as active safety surveillance. This article will introduce registry study from different aspects as the developing history, features, and application in order to inform Chinese medicine researchers of future studies.
Marketing ; Medicine, Chinese Traditional ; adverse effects ; economics ; Phytotherapy ; adverse effects ; economics ; Registries ; Safety Management ; methods

97 cases of jaw bone fractures were treated with rigid internal fixation.16 cases had malocclusion postoperation.The etiology was analyzed and the prevention methods were proposed.Intermaxillary elastic traction or fixation and craniomaxillofacial fixation or craniomentum elastic traction were performed to treat the malocclusion.By this way,14 cases were cured.1 case was operated again to resume the normal occlusion,1 case received occlusal adjustment.Incomplete reduction,incorrect operative performance,deficiency of postoperative intermaxillary fixation and incorrect intermaxillary fixation were the main causes to malocclusion.So anatomic in time reduction,correct operative performance,intermaxillary fixation,application of craniomaxillofacial fixation or craniomentum elastic traction instead of intermaxillary fixation for some special cases are effective methods to correct postoperative malocclusion.

Objective To explore the efficacy of craniotomy and aneurysm clipping in elderly patients with ruptured intracranial aneurysms.Methods Totally 75 elderly patients with ruptured intracranial aneurysms in our hospital who underwent craniotomy and intracranial aneurysm clipping:approaching into head by wing point based on CT image,selecting the appropriate position and angle for clipping the aneurysm.Surgical efficacy and postoperative complications were observed.Prognosis was assessed by Glasgow Outcome Scale (GOS).Results 77 aneurysms presented in 75 patients and 76 aneurysms were clipped.The main postoperative complications were intracranial hematoma (5 cases),pulmonary infection (4 cases),electrolyte imbalance (10 cases),intracranial infection (2 cases),arrhythmia (3 cases),gastrointestinal bleeding (5 cases),cerebral infarction (3 cases).GOS assessment demonstrated that prognosis in 48 cases was good (64.0％),16 cases was moderate disability (21.3％),6 cases was severe disability (8.0％),2 cases was vegetative survival (2.7％),3cases was in death (4.0％).The cure rate was 64.0％ and the overall good-prognosis rate was 85.3％.Conclusions Craniotomy and aneurysm clipping has a better surgical efficacy and a high cure rate in elderly patients with ruptured intracranial aneurysm.

Objective To summarize the characteristics of nosocomial infections in the patients treated in intensive care unit (ICU).Methods The incidence of nosocomial infections was monitored in ICU from March 2012 to August 2012.The incidence rate of infection was adjusted with Average Severity of Illness Score (ASIS)score and analyzed in relation to three invasive pro-cedures.Pathogen distribution of nosocomial infections in ICU was also analyzed.Results Nosocomial infection was identified in 357 of the 3 700 ICU patients (9.65%).The overall daily infection rate was 30.34‰,specifically,49.10‰ for ventilator asso-ciated pneumonia (VAP),13.86‰ for catheter-related bloodstream infections (CRBSI),and 1.09‰ for catheter-associated urinary tract infections (CAUTI).Of the 688 bacterial isolates,gram negative bacteria accounted for 82.70%.The top three bacterial species were Acinetobacter baumanii ,Pseudomonas aeruginosa ,and Klebsiella pneumoniae .Conclusions ICU is the focus for surveillance of nosocomial infections.Objective investigation is critical for nosocomial infection surveillance.

ObjectiveThe purpose of the study was to summarize the characteristics of cellular and humoral immunity in children with Kawasaki's disease (KD),and to explore the role of cellular and humoral immunity in the pathogenesis of KD.MethodsOne hundred and ninety-six subjects with KD were diagnosed and observed.The serum IgG,IgM,IgA and C3,C4 levels were detected by velocity scatter turbidimetry.The levels of T lymphocyte subsets,natural killer cells (NK cells),and B cells were analyzed by flow cytometry.Chi-square test,independent t-test and Spearman analysis were adopted to analyze data.ResultsOne hundred and seventy-two cases were diagnosed as typical KD,24 cases were incomplete KD,17 cases were refractory KD,179 cases responded to IVIG therapy,and 34 cases were CAL.The occurrence of coronary artery lesion (CAL) in the refractory KD group was 52.9％,which was evidently higher than those patients responding to IVIG therapy(14.0％,P＜0.05).In the group of KD,the level of CD19 absolute value(1165±556)/μl was higher than that in the control group(P＜0.05),the ratio of CD4/CD8 (2.19±0.77) was higher than that in the control group (P＜0.05),the levels of serum IgM ( 1.41 ±0.45) g/L,IgA (0.81 ±0.35) g/L,C3 ( 1.31 ±0.26) g/L were higher than those in the control group (P＜0.05),the levels of CD8 (671±308)/μl,NK (337±233)/μl absolute value were lower than those in thc control group (P＜0.05).In refractory KD subgroup,the levels of CD19 absolute value,serum IgM,C3 and the ratio of CD4/CD8 were higher than those in the subgroup responding to IVIG therapy(P＜0.05),while the levels of CD8,NK absolute value were lower than those in the latter(P＜0.05).In the CAL subgroup,the levels of CD19 absolute value,serum IgM,IgA and the ratio of CD4/CD8 were higher than those in the non-CAL subgroup (P＜0.05),while the levels of CD8,NK absolute value were lower than those in the latter(P＜0.05).The differences of all data between typical KD subgroup and incomplete KD subgroup were insignificant (P＞0.05).The severity grade of CAL was positively correlated with the ratio of CD4/CD8(P＜0.05).ConclusionThere are cellular immunity and humoral immunity disturbances in the acute stage of KD,while cellular immunity disturbances are more striking.Cellular immunity and humoral immunity are all involved in the pathogenesis of KD.The immunity dysfunction is more significant in refractory KD and CAL.The occurrence rate of CAL is high in refractory KD.The ratio of CD4/CD8 is relevant to the severity of vascular injury.

Adult ; Aged ; Arsenic Poisoning ; drug therapy ; etiology ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Male ; Middle Aged