At present,thyroid surgery is widely carried out during clinical practice.Because of preoperative or intraoperative misdiagnosis,nonstandard scope of operation,tumor recurrence and other factors,resulting in some cases needed to treat again.Due to the previous surgical scar adhesion and disordering of anatomical structure,the risk of injury of recurrent laryngeal nerve(RLN)increased manyfold.Intraoperative neuromointoring(IONM)is a technology for monitoring the functional integrity of the nervous system in state of dangerous by neural electrophysiological means.Better than the naked eye to identify and prompt the recurrent laryngeal nerve injury,to find the site of injury,IONM can significantly reduce the chance of transient RLN injury during thyroid reoperation as a sharp weapon to protect RLN.

Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerged human coro-navirus causing serious respiratory syndrome. The etiological and epidemiological characteristics of MERS along with the recent advances in MERS will be briefly described in this review.

Objective To research the optimal preparation technology of salinomycin micelle.Methods DSPE-PEG2000 was selected as the carrier.Salinomycin was selected as the model drug.The film dispersion method, the ethanol injection method and the dialysis method were used to prepare salinomycin micelles respectively.The comprehensive evaluation indexes included entrapment rate and drug-loading rate, release capacity and vitro cytotoxicity test in order to select the most suitable preparation technology of salinomycin micelle .Results The film dispersion method is the most suitable preparation technology of salinomycin micelle in the three methods.Its average grain diameter was (14 ±2.3) nm, entrapment rate was (82 ± 2.6)%, drug-loading rate was (6.3 ±2.1)%, IC50 to HepG2 tumor cells was 16.10 ±3.71.Conclusion The film dispersion method of salinomycin micelles has the advantages with the smallest size, the highest entrapment rate and the largest drug-loading rate, which has the function to kill tunmor cells and release slowly.

Intracranial aneurysm is a common disorder. With the ongoing improvement of medical imaging technique, the chance of finding an unruptured intracranial aneurysm in clinical practice has steadily increased. The rupture of aneurysms can result in subarachnoid hemorrhage and even in life-threatening conditions. Recent researches have indicated that the rupture risk of intracranial aneurysms bears a close relationship to the aneurysm's features, such as the size, site, shape, number, growth orientation, growth rate, etc. A further understanding of the features of unruptured intracranial aneurysm is very valuable for the effective prevention of its rupture.

BACKGROUND: Yishen jiangu granule is one of sheer traditional Chinese drugs, which has good effect of tonifying kidney, strengthening bone, reinforcing the spleen, nourishing qi and improving the body condition, mainly used to prevent the lassitude, rickets, osteomalacia and calcium-deficiency induced by kidney-deficiency.OBJECTIVE: To observe the preventive effect of yishen jiangu granule on the reproductive organs, physical strength as well as the ability of stress, and compare with the effect of longmu zhuanggu preparation which was characterized by invigorating spleen and replenishing qi, and tonifying kidney and replenishing essence.DESIGN: Completely randomized controlled design.SETTING: Institute of Traditional Chinese Medicine, Chengde Medical CollegeMATERIALS: A total of 180 Kunming mice, weighing 25-30 g, of half gender, of clean grade, were selected in this study. Longmu zhuanggu granule, which was composed of root of tangshen, tuckahoe, rhizome of lagehead atractylodes, huai yam, astragalus root, schisandra fruit, keel,oyster shell, tortoise plastron, dwarf lilyturf, Chinese date, licorice root,vitamin D, etc., was provided by Wuhan Jianmin Pharmaceutical Factory (batch number: 960618). Yishen jiangu granule, which was composed of 6 kinds of traditional Chinese medicine such as dark plum, Chinese wolfberry, oyster shell, etc., was manufactured by Institute of Traditional Chinese Medicine of Chengde Medical College (batch number: 950510).Hydrocortisone injection was produced by Bohai Pharmaceutical Factory of Tangshan city (batch number: 940303).METHODS: The experiment was completed in Institute of Traditional Chinese Medicine, Chengde Medical College from January to October 1997. ① A total of 180 mice were randomly divided into 6 groups with 30 in each group: normal group (5.0 mL/kg saline, muscle injection); model group (25 mg/kg hydrocortisone for the mice model with kidney-yang deficiency, muscle injection); longmu zhuanggu granule group (5.0 g/kg longmu zhuanggu granule, and 25 mg/kg hydrocortisone); three groups of yishen jiangu granule at different dosages (perfused respectively with yishenjiangu granule at the dosages of 1.25 g/kg, 2.5 g/kg and 5.0 g/kg;meanwhile, 25 mg/kg hydrocortisone, muscle injection). The mice were administered successively for 14 days. ② In 12 hours after giving the last medicine, each group was divided into 3 parts to go on with the following 3 sub-experiments: Firstly, the spermary and uterus of mice were taken out to determine their weight, then calculate the indexes (mass of uterus/body mass of mice); secondly, the mice were put into the water [water depth:30 cm, water temperature: (20±0.5) ℃], burden of tail of mice was weighed 10% of the body mass, then timed immediately, when the mice could not immerge from the water after their heads sank into the water for 10 seconds.It showed that they were exhausted (the time was regarded as the swimming time of mice); thirdly, 10 g sodalime was added into each bottle with wide neck whose volume was 150 mL, then one mouse was put into each of them,covered them and timed immediately. The breath of the mice was observed until they stopped breathing, then timing was over. This was the bearing time of mice on anoxia under normal pressure. ③ Difference of statistical significance between groups was determined by t-test.MAIN OUTCOME MEASURES: The mass indexes of reproductive organs, swimming time and the bearing time on anoxia under normal pressure of the mice in all groups.RESULTS: A total of 180 mice were all involved in result analysis. ① The mass indexes of spermary in mice in normal group, longmu zhuanggu granule group and yishen jiangu groups at high and middle dosages were significantly higher than those in model group (P ＜ 0.05-0.01); the mass indexes of uterus in mice in normal group, longmu zhuanggu granule group and yishenjiangu groups at high dosage were significantly higher than those in model group (P ＜ 0.01). ② The swimming time of the mice in model group was significantly shorter than that in the other 5 groups (P ＜ 0.01). ③The bearing time on anoxia under normal pressure of the mice in model group were significantly shorter than that in the other 5 groups (P ＜ 0.01).CONCLUSION: Yishen jiangu granule has the remarkable effect on kidney-tonifying. It can remarkably relieve the reproductive organ atrophy of the mice with kidney-yang deficiency, has remarkable effect on antifatigue, and also can increase the ability of stress.

BACKGROUND: The effect of cognitive therapy on psychological stress is not remarkable and optimal. Some psychocatharsis through physical activities cannot be accepted by many clients.OBJECTIVE: To explore an effective method to treat and relieve psychological stress.DESIGN: A controlled (the blank control and the self-control) observation study and single blind trial.SETTING: Department of Preventive Medicine, Medical College of Jinagsu University.PARTICIPANTS: Clients who suffered from emotional suppression or nervous stress would be tested with "psychological stress test". Forty clients, with scores over 5, were selected as the subjects. They were randomly divided into two groups matching of ages and scores: control group (n=20) and experimental group (n=20).METHODS: Clients in the control group were treated with common cognitive therapy by means of talking, and those in the experimental group accepted a sing a song loudly therapy. The song named as Qinghai-Tibet Plateau was selected for the treatment. The clients were requested to sing the song loudly in order to release their stress and vent their repression.The psychologist used the language introduction by background music to make a client under a special kind of psychological situation and emotional state when the music was played for one to two times. Then the psychologist would turn up gradually the volume of sound to the maximum when the music was played for the third time. The volume from the VCD would overwhelm that from the client's voice in order to cover up the singer's shyness. The client sung the song of Qinghai-Tibet Plateau loudly for four to five times. The therapeutic room was required to have a blanch curtain.The sound insulation also was required. The soundscape of the loudspeakers should be wide. The power magnifier should be strong. The loudspeaker should be high fidelity. The questionnaire of psychological stress test was adopted in both groups before and after therapy respectively. It had 30 items for the self-diagnosis of symptoms. The client was diagnosed as a low stress if his or her score reached 5, 11-20 as sever stress, and above 21 as adaptability disorder.MAIN OUTCOME MEASURES: Scores of stress level were observed before and after therapy in both groups.RESULTS: The scores in the control group before and after therapy were approximately the same (15.6±5.3 vs 14.7±4.8, t=1.739, P ＞ 0.05). The scores in the experimental group after therapy was significantly lower than those before therapy (11.6±5.8 vs 15.5±6.1, t=9.863, P ＜ 0.05). After therapy, the scores in the experimental group were significantly lower than those in the control group (11.6±5.8 vs 14.7±4.8, t=4.811, P ＜ 0.05).CONCLUSION: Sing a song loudly is an effective method that is easy to operate in treating psychological stress.

Objective:To meet the multitier needs of medical students′ health and health career development through the establishment of relevant mechanisms for medical charity and strengthening the social responsibility theme education among medical students. Methods:The present study was conducted in a stratified sample using the method of investigation mainly. The questionnaire was self -conducted; in the end 967 valid questionnaires were collected and combined with 48 relevant interviews. The data was analyzed using SPSS l6. 0. Results: The current positive trends of social responsibility among medical students are gratifying. The students had correct atti-tude to study but the initiative needed to be improved. The professional cognition was optimistic but the morality emphasis needed to be strengthened. The capacity cognitive was clearly but the awareness of accountability needs to be improved. The social consciousness was intense but responsibility needed to be strengthened. The life value was positive but the physical and mental health needed concerns. And it was needed to further strengthen social respon-sibility education. Conclusion: We should make full use of the excellent resources of the Affiliated Hospital of Medical College. With the medical charity starting point, the social responsibility should be strengthened through the Five in One promotion mechanism that including the culture education leading, clinical practice inspiring, social practice annealing, campus culture edifying, and powers of role model effecting.

Objective To observe the effect of acupuncture at lumbar Jiaji (EX-B 2) points plus botulinum toxin injection on the seated function of patients with spastic cerebral palsy.Method Sixty patients aged 1-4 years old with spastic cerebral palsy were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by acupuncture at lumbar Jiaji (EX-B 2) points plus botulinum toxin injection, while the control group was by conventional acupuncture plus botulinum toxin injection. After 3 treatment courses, the seated function zone (zone B) of Gross Motor Function Measure (GMFM) was used for evaluation, and the clinical efficacies were compared.Result Respectively after 1, 2, and 3 treatment courses, the total effective rates were 46.7%, 73.3% and 83.3% in the treatment group, versus 33.3%, 46.7% and 60.0%. There were significant differences in comparing the total effective rate between the two groups after 2 and 3 courses (P<0.05). After the first treatment course, the seated function score of GMFM was significantly changed in both groups (P<0.01). After the second course, the seated function score was significantly different from that after the first course in both groups (P<0.01). After the third course, the seated function score was significantly different from that after the second course in both groups (P<0.01). There was a significant between-group difference in comparing the changes of the seated function score during the second treatment course (P<0.01). There was a significant between-group difference in comparing the changes of the seated function score during the second treatment course (P<0.05). Conclusion Acupuncture at lumbar Jiaji (EX-B 2) points plus botulinum toxin injection can produce a more significant efficacy in improving the seated function of patients with spastic cerebral palsy.

ObjectiveTo explore the clinical efficacy of Ningmitai capsule for treatment of patients with diabetic urinary tract infection.Methods A total of 100 diabetes patients with urinary tract infection from Zunyi First People's Hospital in Guizhou Province and Longkou Family Planning Service Station in Shandong Province wereenrolled in the study and randomly divided into control and treatment groups after they were informed and gave consent. With basic therapy to lower blood glucose, 65 cases in the treatment group were treated with Ningmitai capsule(4 granules/time, every grain of 0.38 g), while another 35 cases of the control group were given Sanjin tablets (4 granules/time, every grain of 0.29 g), 3 times a dayfor 2 weeks in both groups. Before and after treatment, the clinical effect, blood routine, urine routine, blood glucose, negative conversion ratio of midstream urine bacteria culture and tradition Chinese medicine syndrome curative effect in both groups were observed.Results The total effective rate of treatment group was significantly higher than that of the control group〔88.52%(54/61) vs. 70.59%(24/34),P<0.01〕. Before treatment, the differences in red blood cell(RBC) and white blood cell(WBC) count in urine samples as well as RBC, WBC, hemoglobin(Hb) and glucose in blood samples had no statistical significance in the comparisons between the two groups(allP>0.05). Compared with those before treatment, after treatment, the urinary RBC and WBC were decreased in treatment group, while in control group WBC was decreased but RBC increased, and in the comparisons of above indexes between the two groups there were statistical significant differences〔RBC(cell/μL): 1.99±0.59 vs. 9.11±3.76, WBC(cell/μL): 23.09±6.18 vs. 63.72±25.76, bothP<0.05〕. The blood RBC was significantly lowered after treatment in control group(×109/L: 3.93±0.40 vs. 4.02±0.39,P<0.05). In both groups, after treatment, WBC, Hb and glucose in blood were reduced in comparisons to those before treatment, and no statistical significant differences were found(allP>0.05). Negative conversion ratio of midstream urine bacterial culture in treatment group was significantly higher than that in control group〔80%(4/5) vs. 0(0/2)〕. Syndromes of traditional Chinese medicine were ameliorated at different degrees after treatment in both groups. The effectiveness of treatment group on urinary urgency, yellowish turbid urine and swelling pain in lower abdomen were obviously more valid than that of control group〔urinary urgency: 90.0%(54/60) vs. 61.8%(21/34), yellowish turbid urine: 75.0%(39/52) vs. 47.6%(10/21), swelling pain in lower abdomen: 74.5%(35/47) vs. 70.6%(12/17),P<0.05 orP<0.01〕, but other symptoms were similar in the two groups(allP>0.05).ConclusionThe clinical efficacy of Ningmitai capsule is better than that of Sanjin tablet for treatment of patients with diabetic urinary tract infection, and no adverse reaction has been seen in clinical observation.

Objective To observe the therapeutic efficacy and postoperative complications of combined surgery and sequential surgery in treating proliferative diabetic retinopathy (PDR) and cataract.Methods The cilinical data of 59 patients (66 eyes) with PDR were retrospectively analyzed.The patients were divided into combined-surgery group and sequential-surgery group.Combined surgery was performed on patients with obvious lens opacity which was an obstacle to the ocular fundus surgery,while sequential surgery was performed on the patients with transparent lens or lens with light opacity on which ocular fundus surgery could be performed.Lens excision in cataractopoiesis could only be performed when the state of ocular fundus was stable and cataractopoiesis was the main cause of vision damage.A total of 28 patients (32 eyes) in combined-surgery group underwent vitrectomy combined with phacoemulsification and IOL implantation;31 patients (34 eyes) in sequential-surgery group underwent vitrectomy,lens excision and IOL implantation.Corrected visual acuity (BCVA) and complications were observed.The mean follow-up period was (25±8.5) months.The measurement data were analyzed with t test and enumeration data with 2 test.Results In combined-surgery group,visual acuity improvement was achieved in 27 eyes (84.4%),remained unchanged in 2 eyes (6.3%) and decreased in 3 eyes (9.4 %).In sequential-surgery group,visual acuity improved in 26 eyes (76.5%),remained unchanged in 2 eyes(5.8%)and decreased in 6 eyes (17.7%.).However,anterior chamber fibrin exudation occurred in 4 eyes in the combined-surgery group and no eyes in the sequential-surgery group;compared with each other,the difference is statistically significant (χ2=4.524,P=0.033).Conclusion Combined surgery and sequential surgery are all safe and effective on treating PDR and postoperative complications have no obvious correlation with the surgery procedure.