Objective To investig the value of neck lymph dissection in re-operation for differentiated thyroid carcinoma (DTC) and direct the choice of re-operative pattern.Method Re-operation was performed in 122 cases with DTC,of which neck lymph dissection was performed in 88 cases and the clinical data were retrospectively analyzed.Of 88 cases,partial thyroidectomy was performed in 38 cases in the first operation,one lobe plus isthmus excision 16 cases,thyroiddectorny was perfomed in 2 cases,neck lymph nodes biopsy in 32 cases.Results 11 patients suffered from thyroid micro carcinoma.The metastasis rate of neck lymph node were 65.91% (58/88) and residual carcinoma rate was 31.59%(12/38). Conclusions Neck lymph dissection had definite curable effect on re-operation for DTC.Neck lymph dissection should be performed when tumor had involved capsule,enlarged lymph node was palpated in the neck and thyroid micro carcinoma was confirmed.Re-operation was necessary for recurrent thyroid carcinoma.Attention must be paid to the fullresection of recurrent lesions and preserving laryngeal nerve and parathyroid in re-operation.

Objective To investigate the safety and efficacy of sufentanil in pediatric surgery.Methods80 cases of pediatric surgery were prospectively selected pediatric methods in The Third People's Hospital of Xining from July 2013 to January 2015 as the research object, the patients were divided into two groups, control group and observation group, 40 cases in each group.The control group received remifentanil,observation group were given sufentanil, mean arterial pressure(MAP)and heart rate(HR)30min and 5min at each time point after extubation and 5min based value children after entering the operation room after induction were compared.The sedation scores of 5min, 15min and 30min after tracheal intubationwere recorded..ResultsThe pain scores in the observation grouppostoperative T4, T5, T6 each time were significantly higher than the control group (P<0.05);MAP and HRin the observation group at T0, T1, T2, T3 had no significant differencecompared with control group, MAP during T4 in the observation group was significantly higher than the control group (P<0.05);and HR in the observation group in the period of T4 was significantly lower than the control group (P<0.05).ConclusionThe application of sufentanil in pediatric surgery is effective and safe.

Objective To explore the effect of propofol and etomidate on anesthesia induction in pediatric surgery, and to provide evidence for the future use of anesthesia in pediatric surgery.Methods120 cases of pediatric surgery patients were prospectively selected pediatric in our hospital from May 2013 to January 2015 as the research object, randomly divided into 2 group respectively, control group and observation group, 60 cases in each group;the control group anesthesia was induced with etomidate, observation group anesthesia was induced with propofol, and the anesthetic effect were observed in the two groups, recovery and adverse reaction in the induction period of anesthesia.ResultsThe patients in the observation group anesthesia satisfaction scores were significantly higher than the control group (P<0.05) and the observation group;the recovery time and the time of leaving room were significantly shorter than the control group (P<0.05);in the observation group, respiratory depression, restlessness, throat and bronchial spasm, adverse reactions such as nausea and vomiting were significantly lower than the control group (P<0.05).ConclusionPropofol is more suitable for pediatric surgery than etomidate, and anesthesia effect is remarkable, fast recovery, worthy of clinical application and promotion.

0.05) and was significantly lower than that in groups of GNB and mycetes' (P

Objective To improve the freeze-dryer shelf temperature control effect.Methods The fuzzy-PID control algorithm that's adjusting the PID parameters in real-time in the control process,was adopted to control the shelf temperature,expecting to adapt the changing of process parameters of shelf.Results In the process of freeze-drying temperature control shelves,the shelf temperature static performance and dynamic performance were improved,and the effect of shelf temperature control was archived satisfyingly.Conclusion In the freeze-drying process,the process parameters of shelf are changed along with the drying time and the working environment.The conventional PID control is difficult to obtain satisfactory results.The fuzzy-PID controller,which can adjust PID parameters on real-time in the controlling process,be used in the shelf temperature control,and the result is satisfied.

Objective:To observe the effects of ultrasound-guided paravertebral nerve block combined with general anesthesia on intraoperative stress response, hemodynamics and postoperative pain of patients undergoing laparoscopic cholecystectomy.Methods:A total of 92 patients undergoing elective laparoscopic cholecystectomy in Wuhan Third Hospital between January 2017 and August 2019 wereselected. They were divided into the control group (63 cases) and the observation group (29 cases) by voluntary. The control group were given simple general intravenous anesthesia, and the observation group were given ultrasound-guided paravertebral nerve block combined with general intravenous anesthesia. Changes in hemodynamic parameters and concentrations of blood angiotensin-Ⅱ (AT-Ⅱ) and cortisol (Cor) in the two groups were observed. The cerebral state indexes (CSI) of both groups were recorded, and pain degree of patients was evaluated with the visual analogue scale (VAS).Results:The mean arterial pressure (MAP) and heart rate (HR) of the observation group were higher than those of the control group at 30 min after anesthesia, 30 min after operation, 3 hours after operation ( P<0.05), the stroke volume variation (SVV) was lower than that of the control group ( P<0.05); the AT-Ⅱ, Cor and CSI in the observation group were lower than those in the control group at each time point ( P<0.05); The dosage of narcotic drugs in the observation group was significantly lower than that in the control group ( P<0.05); The recovery time of spontaneous breathing, recovery time, extubation time and respiratory satisfaction time in the observation group were less than those in the control group ( P<0.05), and the VAS scores at 3 h, 6 h and 12 h after operation in the observation group were lower than those in the control group ( P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block combined with general anesthesia can effectively reduce the patient's stress response during laparoscopic cholecystectomy, with good analgesic effect, which is helpful to maintain the hemodynamic stability of patients.

Objective To investigate the role of micro-RNAs (miR-101 and miR-125a-5p) in autophagy of lipopolysaccharide (LPS) derived human THP-1 macrophages.Methods Human monocytic leukemia cell line THP-1 was cultured in vitro,and it was differentiated into macrophages after being induced with phorbol (50 μg/L) for 48 hours.THP-1 macrophages were stimulated with LPS in 0,250,500,1 000 μg/L respectively for 12 hours,miR-mimic was transfected into THP-1 macrophages as induced by Lipofectamine RNAiMAX,and the transfection efficiency of miRNA was determined with fluorescence microscopy.Enzyme linked immunosorbent assay (ELISA) was used to determine the levels of tumor necrosis factor-α (TNF-α) and monocyte chemotaxis protein-1 (MCP-1) in the supernatants of culture.Western Blot was used to detect the protein expressions of autophagy proteins ATG4D,Beclin1,and LC3 Ⅱ.The expression levels of miR-101 and miR-125a-5p were determined by quantitative reverse transcription-quantitative polymerase chain reaction (RT-qPCR).Results ① The releasing levels of TNF-α and MCP-1 induced by LPS with 250,500,1 000 μg/L were significantly increased as compared the cells without LPS stimulation [TNF-α (ng/L):1 336.1 ± 18.5,1 340.6±24.8,1 364.5± 14.9 vs.47.6±4.4;MCP-1 (ng/L):996.3 ±51.3,934.6±84.3,974.2±69.5 vs.21.3±6.5,all P ＜ 0.01],but no significant differences were found among the three LPS stimulation groups.The protein expressions of ATG4D,Beclin1 and LC3 1Ⅱ were up-regulated in the presence of different LPS concentrations (0,250,500,1 000 μg/L) for 12 hours in THP-1 macrophages (when compared with the cells without LPS stimulation,t value of ATG4D was 8.103,38.410,52.020,P value was 0.015,0.001,＜ 0.001;t value of Beclin1 was 3.026,5.328,3.482,P value was 0.047,0.034,0.037;t value of LC3 Ⅱ was 3.836,6.200,4.665,P value was 0.018,0.003,0.010),and the optimal concentration was 500 tg/L LPS.When THP-1 macrophages were stimulated with 500 μg/L LPS for 12 hours,the expression levels of miR-101 and miR-125a-5p were down-regulated significantly as compared with the cells without LPS stimulation [miR-101 (2-△ △Ct):0.68 ± 0.08 vs.1.95 ±0.26,t =8.047,P =0.001;miR-125a-5p (2-△ △Ct):0.23 ± 0.06 vs.1.69± 0.42,t =5.975,P =0.004].② The higher transfection efficiency was showed under fluorescence microscope.Westem Blot results showed the protein expressions of ATG4D,Beclin1 and LC3 Ⅱ were down-regulated as induced by an over-expression of miR-101 or miR-125a-5p in THP-1 macrophages,and more obviously down regulated by co-transfected with miR-101 and miR-125a-5p (compared with negative control group,t value was 14.550,5.855,14.180,P value was 0.005,0.014,＜ 0.001).Conclusion miR-101 and miR-125a-5p can inhibit the autophagy in LPS challenged THP-1 macrophages,and the potential mechanism might be related to target regulation of ATG4D.

Objective To study the effect of tanshinone ⅡA on the expression of P-selectin and ICAM-1 after cerebral ischemia reperfusion (I/R)injury in rats. Methods Rats were randomly divided into 4 groups: Sham operated group, I/R group, low dose Tan ⅡA treated group and high dose Tan ⅡA treated group. The focal middle cerebral artery occlusion (MCAO) model was made by suture-occluded method. Rats were pretreated with Tan ⅡA, ig for 3d,respectively before MCAO. After 90min MCAO following 24 hours of reperfusion, the expression of P-selectin and ICAM-1 was detected with using immunohistochemistry method. Result Compared with sham operated group, the expression of P-selectin and ICAM-1 increased after reperfusion for 24 hours in the ischemic territory(all P＜0.01).Compared with I/R group, the expression of P-selectin and ICAM-1 decreased in a dose dependent manner in low and high dose Tan ⅡA treated group(P＜0.01).Compared with that of I/R group, cerebral infarction volume was decreased in a dose dependent manner in low dose Tan ⅡA treated group and high dose Tan ⅡA treated group(all P＜0.01).The change of ischemic impairment in low or high dose Tan ⅡA treated group was less than that in IR group, and the change of ischemic impairment in high dose Tan ⅡA treated group was less than that in low dose Tan ⅡA treated group. Conclusion Tan ⅡA may reduce cerebral ischemia-reperfusion inflammation injure by decreasing the expression of p-selectin and ICAM-1.Tan ⅡA plays protective effect on cerebral ischemia injury, especially when high dose of Tan ⅡA(30mg/kg)was used.

OBJECTIVE:To investigate the preparation technic of pantoprazole sodium freeze-dried injection.METHO_ DS:The kinds of auxiliary were screened based on the color and luster,external appearance,pH value,clarity and the compatible stability of pantoprazole sodium lyphilization injection with other infusion solutions;the content and other associated material of freeze-dried injection were determined by HPLC method.RESULTS:With Mannitol being freeze-dried powder supporting agent and disodium edetate being metal ion chelation agent and pH value at9.5～11.5adjusted by NaOH,the calibration curves of the prepared freeze-dried injection was linear within12.0～60.0?g/ml in concentration(r=0.9998),the average recovery rate of which at100.26%,RSD=1.14%(n=9),the labeled amount at98.6%.CONCLUSION:The preparation technics is appropriate and the quality control method is simple and feasible.And the prepared freeze-dried injection is able to meet both the pharmaceutical and clinical requirements.

OBJECTIVE:To provide guidance for pharmacists to adopt a right method in participating in clinical drug treatment work.METHODS:In participating in clinical drug treatment work,pharmacists identified physicians’ drug treatment schemes by sticking to Guiding Principle of Clinical Use of Antibacterials and made remarks on the evaluation results.RES-ULTS & CONCLUSION:Through participating in clinical medical quality ward round,pharmacists can bring their professional advantages into full play,timely find out problems existed in the clinic drug treatment,guide clinical rational drug use,and play a key role in promoting drug treatment.