Objective:To study the methods of protecting recurrent laryngeal nerve(RLN) in endoscopic thyroidectomy through the upper part of sternum.Methods:The clinilical data of 46 cases underwent endoscopic thyroidectomy through the upper part of sternum was analyzed.RLN was revealed when we performed nodulectomy or partial thyroidectomy.But during subtotal and near-total thyroidectomy the RLN was always revealed.Results:Forty-five of forty-six cases were compeleted successfully with endoscopic thyroidectomy.One case was converted to open thyroidectomy because of thyroid carcinoma.No intraoperative or postoperative hemorrhage,RLN injuried and deadlimb occurred.Conclusion:In order to reduce the injury of RLN,we should select the fitting cases strictly,master the opportunity and methods of revealed RLN.

Objective:To analyze effects of tectorigenin on improving cognitive deficits in rats with vascular dementia(VD)by regulating Toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor-κB(NF-κB)signaling pathway.Methods:A total of 72 rats were randomly divided into sham operation group,model group,low,medium and high doses[25,50,100 mg/(kg·d)]tectorigenin groups and positive control group[piracetam 324 mg/(kg·d)],with 12 rats in each group.Except for sham operation group,VD models were replicated in other groups.After successful modeling,different doses tectorigenin groups and positive control group were administered intragastrically with different doses of tectorigenin and piracetam,while other groups were administered intragastrically with same volume of normal saline for 28 d.Spatial learning and memory ability were detected by Morris water maze.Neurotransmitter levels in hippocampus interstitial fluid were detected by high performance liquid chromatography-electro-chemical.Brain-derived neurotrophic factor(BDNF)and tyrosine kinase receptor b(TrkB)expressions in hippocampus were detected by RT-qPCR and Western blot.TLR4/MyD88/NF-κB pathway-related proteins in hippocampus were detected by Western blot.Results:Compared with sham operation group,escape latency was longer,while stay time in target area and times of crossing platform were lower in model group(P<0.05).Compared with model group,escape latency was shorter,while stay time in target area and times of crossing platform were higher in medium and high doses tectorigenin groups(P<0.05).NE,DA,5-HT and 5-HIAA levels in model group were lower than those in sham operation group(P<0.05),which were higher in medium and high doses tectorigenin groups than model group(P<0.05).Compared with sham operation group,BDNF and TrkB mRNA and proteins levels were lower,while TLR4,MyD88 and p-NF-κB p65/NF-κB p65 proteins levels were higher in model group(P<0.05).Compared with model group,BDNF and TrkB mRNA and proteins levels were higher,while TLR4,MyD88 and p-NF-κB p65/NF-κB p65 proteins levels were lower in medium and high doses tectorigenin groups(P<0.05).Conclusion:Tectorigenin can improve cognitive deficits in VD rats,which may be related to regulating TLR4/MyD88/NF-κB signaling pathway.

With the development of social economy and the full opening of the three-child policy, more and more elderly people will become the main force in raising grandchildren in the future, and the mental health of the elderly in intergenerational raising has become the focus of the whole society. This article summarizes the causes of the intergenerational raising, the mental health status of the elderly in intergenerational raising, and reviews the influencing factors of the mental health of the elderly in intergenerational raising, in order to provide a reference for the construction of the social security system for the elderly and young people in China.

Objective:To explore the latent classes of recurrence risk perception in ischemic stroke patients and their relationship with health behaviors.Methods:Convenience sampling was used to select 312 patients with ischemic stroke from two ClassⅢ Grade A hospitals of Guangzhou from December 2022 to June 2023 as the research subject. Before discharge, the General Information Questionnaire, Recurrence Risk Perception Scale for Patients with Stroke, and Health Behavior Scale for Stroke Patients were used for investigation. One month later, the Health Behavior Scale for Stroke Patients was used for follow-up. Latent class analysis and multiple Logistic regression analysis were used to explore the latent classes of recurrence risk perception and their influencing factors, while multiple linear regression was used to analyze the relationship between latent classes of recurrence risk perception and health behavior at 1-month follow-up.Results:A total of 312 questionnaires were distributed, and 302 valid questionnaires were collected, with an effective response rate of 96.79%. One month later, 261 study subjects completed follow-up. The recurrence risk perception in ischemic stroke patients were divided into four classes of overall low perceived accuracy, light consequence-heavy disease-moderate perceived accuracy, heavy self-care-light diet-upper moderate perceived accuracy, and overall high perceived accuracy. Age, educational level, place of residence and monthly average income were influencing factors for different latent classes ( P<0.05). Compared with patients with overall low perceived accuracy, patients with heavy self-care-light diet-upper moderate perceived accuracy, as well as those with overall high perceived accuracy, showed better health behavior after discharge, with a statistically significant difference ( P<0.05) . Conclusions:Medical and nursing staff should provide targeted nursing interventions based on the common characteristics and individual differences of different classes of patients, helping patients correctly perceive the recurrence risk, improve health behavior, and prevent stroke recurrence.

Hyperkalemia is one of the common ion metabolism disorders in clinical practice. Hyperkalemia is defined as serum potassium higher than 5.0 mmol/L according to the guidelines at home and abroad. Acute severe hyperkalemia can cause serious consequences, such as flaccid paralysis, fatal arrhythmia, and even cardiac arrest. The use of renin-angiotensin- aldosterone system inhibitors, β-blockers and diuretics, low-sodium and high-potassium diets, and the presence of related comorbidities increase the occurrence of hyperkalemia. Hyperkalemia risk exist in all clinical departments, but there is a lack of a standardization in the management of multi- department cooperation in hospital. Therefore, a number of domestic nephrology and cardiology department experts have discussed a management model for multi-department cooperation in hyperkalemia, formulating the management standard on hospital evaluation, early warning, diagnosis and treatment, and process. This can promote each department to more effectively participate in nosocomial hyperkalemia diagnosis and treatment, as well as the long-term management of chronic hyperkalemia, improving the quality of hyperkalemia management in hospital.