Objective To investigate whether routine exposure recurrent laryngeal nerves(RLN) during the procedure of thyreoidectomy would prevent permanent nerves injuries caused by thyroid surgery.Methods 1523 patients with thyroid disease underwent thyreoidectomy from January 1980 to December 2004.Routine exposure of RLN during the procedure of thyreoidectomy were in 274 cases(group 1) and not in 1249 cases(group 2),the incidence rates of temporary RLN injuries and permanent RLN injures were compared in these groups.Results 3 cases(3/274,1.1%) occurred permanent RLN injuries in group 1 and 47 cases(47/1249,3.8%) occurred RLN injuries in group 2.The incidence rate of permanent RLN injuries in group 1 was lower than that in group 2(P0.05) in these groups.Conclusion Exposure recurrent RLN during the procedure of thyreoidectomy can effectively prevent permanent nerves injuries caused by thyroid surgery.

50 years) with occipitocervical pain.

AIM: To investigate the effects of angiotensinⅡ receptor type Ⅰ antagonist irbesartan and angiotensin-converting enzyme inhibitor perindopril on the myocardial expression of connexin 43 (CX43), desmin and cardiac troponin T (cTnT) in the pressure overload-induced rat cardiac hypertrophy. METHODS: 40 male adult Sprague-Dawley rats were divided into 5 groups (8 animals for each): sham operation group and other four groups with ventricular hypertrophy caused by banding aortic artery. Drugs were given one week after operation as follows: sham operation group, normal saline (2 mL?kg~-1?d~-1 ig) was given; Operative groups: animals with ventricular hypertrophy were treated with normal saline 2 mL?kg~-1?d~-1 ig; Treatment groups: animals with ventricular hypertrophy were treated with perindopril 2 mg?kg~-1?d~-1 ig, irbesartan 20 mg?kg~-1?d~-1 ig or irbesartan 20 mg?kg~-1?d~-1 ig plus perindopril 2 mg?kg~-1?d~-1 ig, respectively. Left ventricular mass index (LVMI), transverse diameter of myocardial cell (TDM), and myocardial expression of CX43, desmin and cTnT by immunohistochemistry were performed at the end of 8 weeks of drug intervention. RESULTS: LVMI, TDM were remarkably decreased after drug intervention, compared to animals of operative group (P

Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty (TKA) of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group ( 112.67°) was higher than that of the control group ( 106.98° ), while the preoperative active range of the knee joint of the navigation group [(70.87 ± 10.87)°] was significantly lower than that of the control group [( 105.08 ± 30.67)°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.

Objective To improve the quality standard ofZushima Plaster.Methods TLC was used to do qualitative identification of daphnetin and 7-hydroxycoumarin inZushima Plaster. The contents of daphnetin and 7-hydroxycoumarin inZushima Plaster were determined by HPLC. The chromatographic column was Agilent Eclipse Plus C18 (4.6 mm×250 mm, 5μm), and the mobile phase consisted of acetonitrile-0.1% phosphoric asid (15∶85, V/V) at a flow rate of 1.0 mL/min. The column temperature was maintained at 30℃, and the detection wavelength was set at 327 nm. Results Characteristic spots of daphnetin and 7-hydroxycoumarin could be detected by TLC from the samples, and the spots were clear and specific without interference from negative samples. The calibration curve of daphnetin and 7-hydroxycoumarin were linear in the ranges of 0.180-1.800μg and 0.100-1.00μg (r=0.999 1,r=0.999 2), and the average recovery rates were 98.99% and 101.48%, RSDwere1.43% and 1.32%, respectively (n=9).Conclusion The established method appears easy to use, accurate and specific, and therefore can be used for the quality control ofZushima Plaster.

Objective To study the relationship between menstrual disorder and ovarian morphology of adolescent women in order to provide basis for diagnosis of adolescent polycystic ovary syndrome (PCOS).Methods We analyzed the clinical data of 212 patients with adolescent menstrual disorders 2 years after menstruation collected from the Department of Gynecology and Women's Health of First Affiliated Hospital of Xi'an Jiaotong University between September 2014 and September 2015.Results ① Oligomenorrhea was the most common in the 212 adolescent women (33.96 ％),followed by amenorrhea (16.51％).There was a significant difference in F-G score and acne score among patients with different types of menstrual disorder (F=1.39,1.77,all P＜0.05),the highest in those with oligomenorrhea.② The volume of the ovary,number of sinusoidal follicles,maximum area of the ovary in women with oligomenorrhea were significantly higher than those in non-oligomenorrhea women (t =2.89,5.76,6.23,all P＜ 0.05).③ Clinical manifestations differed significantly among normal ovarian group,MFO group and PCO group (x2=43.25,P＜0.05).Incidence rate of oligomenorrhea ranked the top in polycystic ovary group (49.30％),followed by multiple ovarian follicles group (42.59％),and there were significant differences in blood LH,T,and LH/FSH (F=3.45,2.43,2.76,all P＜0.05) was found in PCO group.There was significant difference in diagnosis of puberty PCOS (x2=26.58,P＜0.05).④ Among these 212 adolescent women,45 ones had puberty PCOS (21.23％).The ovary volume,number of sinus follicles,and the largest area in the obese patients were significantly higher than those in non-obese group (t =3.42,7.89,4.02,all P＜0.05);HOMA IR was also significantly higher than that in non-obese group (t =8.89,10.62,all P ＜ 0.05).Conclusion Oligomenorrhea is the most common menstrual disorder in adolescent women.Ovarian morphological abnormalities occur in most women with oligomenorrhea and obesity,who should be followed up regularly.

Objective To investigate the relationship between satisfaction of nursing service and nurses' personality and mental state.Methods 368 nurses ,288 patients and 234 dependents involved the investigation.Minnesota Multiphasic Personality Inventory(MMPI)was used to analyze nurses' personality.Symptom Checklist-90(SCL-90),Self-rating Depression Scale(SDS) and Self-rating Anxiety Scale(SAS)were used to analyze nurses' mental states.A self-made questionnaire on satisfaction was used to investigate the satisfaction degree of patients and dependents with nursing service.The data were analyzed by descriptive statistics and multiple regression analysis.Results The average score on satisfaction with the nurses' service was(8.29±0.98)and the average score on satisfaction with nurses' attitude was(8.19±1.21).The satisfaction with nurses' service was negatively correlated with the MMPI factors of manifest anxiety and dependency and positively with dominance of MMPI(both P<0.05).Satisfaction with nurses' attitude was negatively correlated with total score of SAS,dependency of MMPI,compulsion,anxiety,hostility and paranoid ideation of SCL-90(all P<0.05).Satisfaction with the service attitude was positively correlated with social responsibility of MMPI(P<0.05). Conclusion Satisfaction degree of patients and their dependents is related to nurses' personality and mental states.It's helpful to establish good relationship between nurses and patients and improve the clinical nursing service to perfect nurse's personality and relieve psychological stress on nurses.

Objective To observe the analgesic efficacy of epidural morphine for postpartum perineal pain in patients undergoing episiotomy.Methods After institutional reviewing board approval and patient consent,a total of 145 parturients requesting epidural labor analgesia and under-going episiotomy were randomized into three groups:M1,M2,and C,where in morphine 1 mg dis-solved in saline 10 ml,morphine 2 mg dissolved in saline 10 ml,or sole saline 10 ml was epidurally given immediately after umbilical cord clamp,respectively.Perineal pain at rest and movement within 24 hours after vaginal delivery were evaluated with present pain intensity (PPI).Further,the time in-terval between a moderate or severe PPI and epidural drug treatment were recorded.Besides,epidural morphine related side effects including nausea,vomiting,pruritus,and urinary retention were ob-served as well.Results The proportion of patients with moderate or severe pain at rest was signifi-cantly lower in group M2 (2.1%)compared to group M1 (15.7)and group C (19.1%)(P <0.05). Further,the time interval between a moderate or severe PPI and epidural drug treatment was signifi-cantly longer in group M2 (15.7±1.4 h)compared to group M1 (11.0±0.9 h)and group C (11.0 ±1.0 h)(P <0.05).No significant difference was found between groups M1 and group C with regard to morphine efficacy.However,the accumulated side effects including nausea,vomiting,pruritus, and urinary retention prominently increased in group M2 (102.1%)compared to group M1 (43.1%) and group C (12.8%)(P <0.05).Conclusion Although epidural morphine 2 mg may significantly decrease and postpone the occurrence of moderate or severe postpartum perineal pain,however,it de-serves consideration before clinical use owing to the increased side effects.

AIM: To investigate the correlation between renal transforming growth factor-?1 (TGF-?1) expression and cellular apoptosis, and effect of tea polyphenols (TP) on TGF-?1 expression and apoptosis. METHODS: Four group animals in a rat model of CsA-induced chronic nephrotoxicity were respectively treated by vehicle (olive oil, 0.1 mL?kg~(-1)?d~(-1), sc), TP (80 mg?kg~(-1)?d~(-1), ig), CsA (15 mg?kg~(-1)?d~(-1), sc) and TP (80 mg?kg~(-1)?d~(-1), ig) plus CsA (15 mg?kg~(-1)?d~(-1), sc). At the end of 28th day of treatment, renal creatinine clearance and tissue pathology were analyzed. The TGF-?1 expression was detected by immunohistochemistry and Western blotting. TUNEL assay, apoptosis-related enzymatic activity caspase-3 were also detected. RESULTS: Compared to CsA-treated rats, the animals treated with CsA plus TP showed a significant increase in the renal creatinine clearance (0.12?0.03 vs 0.22?0.02,P

ObjectiveTo evaluate the feasibility and value of mini-clinical evaluation exercise (Mini-CEX) in clinical neurology practice.MethodsNinety-four interns were randomly divided into observation group and control group,students in control group were teached and managed in accordance with existing management while those in observation group were evaluated by teachers after the 1 st,2nd and 3rd week.At the end of clinical practice,all the students( including students in control group and observation group)were cross assessed by teachers based on the methods mentioned above.Results The time to complete the assessment was about 25 - 40 min.The scores of nervous system examination at the end of the training were significant different between observation group and control group and the scores of diagnosis and treatment on the basis of examination were also significant different between observation group and control group ( P ＜ 0.05 ).ConclusionThe Mini-CEX assessment and feedback to promote teaching effect is feasible in the practice process of neurology,it can make up for the deficiency of current examination.