Objective To compare the effect of high negative pressure drainage system and the traditional suction drainage system applied in thyroid surgery.Methods Eligible patients were selected randomly and divided into high negative pressure drainage group(30 cases) and traditional suction drainage group(30 cases).The draining rate within 24 hours after operation,delayed extubation rate,postoperative bleeding,rates of recurrent laryngeal nerve Injury,postoperative infection rate,degree of extubation pain and the incidence of severe pain of both groups were observed and difference of incidence of incision adhesions 1 month after operation were observed.Results The average drainage within 24 hours after operation in experimental group was (19.00 ± 6.79) ml,while (28.53 ± 14.74) ml in control group (P ＜ 0.05).Delayed extubation rate in experimental group was 3.33 ％,while 26.67％ in control group (x2 =4.71,P ＜ 0.05).Incidence of hematoma and bleeding after operation in experimental group was 0％,while 10％ in control group(x2 =1.40,P ＞ 0.05).No recurrent laryngeal nerve injury was found in either group,Incidence was 0％.The incidence of infection in experimental group was 0％,while 10％ in control group (x2 =1.40,P ＞0.05).The incidence of severe pain when extubation in experimental group was 0％,while 100％ in control group (x2 =60.00,P ＜ 0.05).Incidence of incision adhesions in experimental group was 0.33 ％,while 30％ in control group (x2 =6.14,P ＜ 0.05).Conclusion Draining rate,delayed extubation rate and incidence of incision adhesions could be reduced with high negative pressure drainage system applied in thyroid surgery,which is worthy of clinical.

Objective To evaluate the value of region Ⅵ lymph nodes in surgical treatment of cN0 papillary thyroid carcinoma(PTC). Methods 98 cases of PTC with cN0 which received functional lymph nodes dissection were collected. We analyzed the results of pathologic examination by region Ⅵ lymph nodes distinguished from lateral neck lymph nodes(Ⅱ～Ⅴ) retrospectively. Results In 98 cases, the rate of region Ⅵ lymph nodes metastasis was 20.4 %(20 cases); the rate of region Ⅱ～Ⅴ lymph nodes metastasis was 13 cases(13.3 %). In cases with region Ⅵ lymph nodes metastasis, the rate of Ⅱ～Ⅴ lymph nodes metastasis was 45.0 %(9/20). Meanwhile in cases without region Ⅵ lymph nodes metastasis, the rate of Ⅱ～Ⅴ lymph nodes metastasis was 5.1 % (4/78, P

Objective To verify the evaluation index system of clinical science and technology achievements, taking the evaluation of science and technology achievements in Guangdong province as a demonstration. Methods We specified the criteria for grading each index included in the evaluation index system that we proposed before. 5 experts in clinical medicine were invited to evaluate 20 achievements applying for the Award of Guangdong Science and Technology Achievements in 2010. The weighted sum of scores for each achievement was calculated and used for further analysis. The reliability and validation of the system were assessed. Results The Cronbach's ? coefficient of the index system was 0. 91, indicating good reliability. There were high correlation of each measure with the total score and their affiliated grade one index. The scores that the experts graded were correlated with the original results of evaluation (rs= 0. 71, P ＜0. 000 1), but there remained some inconsistence. Conclusion The demonstration based on investigation data indicates that the evaluation system is easy to handle and has satisfactory reliability and validation. It can be applied to the evaluation of science and technology achievements in clinical medicine.

Objective To set up a scientific, objective, reasonable, qualitative and quantitative,operational evaluation index system of clinical science and technology achievements, which provides the reference to evaluating clinieal science and technology achievements scientifieally. Methods The Delphi method was used to investigate 30 experts for weight of the index via questionnaire. Results The response rate was 100%. The Kendall's concordance coefficient was up to 0. 963. The final index system includes three first-class indicators, eight second-class indicators and 18 third-class indicators. The weight coefficeient of each class was identified. Conclusion The experts showed enthusiasm for this investigation. The agreement of respondents was high after two rounds of investigation. The index system can be used in comprehensive evaluation for science and technology achievements in clinical medicine. The index system takes a guiding effect for science and technology achievements to solve clinical services and problems.

Objective: To evaluate the analgesic effect of pregabalin combined with intrathecal sufentanil infusion for the treatment of breakthrough pain in patients with bone metastases. Methods: A total of 60 breakthrough pain patients with bone metastases were randomly divided to 3 groups: group A (pregabalin combined with intrathecal sufentanil infusion group,n=20), group B (placebo combined with intrathecal sufentanil infusion group,n=20) and group C (oral morphine sulfate controlled-release tablet group,n=20). The differences in visual analogue scale (VAS)between background pain and breakthrough pain, the seizure frequency of breakthrough pain, general satisfaction and side effects of the 3 groups were observed. Results: hTe seizure frequency and VAS of breakthrough pain in group A decreased signiifcantly after the treatment (P<0.05) and the general satisfaction was the best among the the 3 groups (P<0.05), with less nausea and vomiting, constipation, drowsiness and fewer other side effects. Conclusion: Pregabalin combined with intrathecal sufentanil infusion can effectively relieve breakthrough pain in patients with bone metastases.

Objective To assess the results of colonoscopy surveillance in 5 years after polypectomy of non-advanced colorectal adenoma and to identify its risk factors. Methods Patients undergoing colonosco-py and followed up with colonoscopy within 5 years between January 2003 and December 2013 were retro-spectively analyzed.No substance or only small quantity of clear water left in the intestinal tract and colono-scopes accessing ileocecus were regarded as complete examination. The initial colonoscopy was regarded as the baseline colonoscopy. Patients with non-advanced adenomas were assigned to the case group and those without were to the control group. Data of clinical characteristics and colorectal findings were estimated and risk factors were identified. Results A total of 828 patients were included,374 patients in the case group and 454 in the control group on baseline colonoscopy.The case group had a low incidence of advanced adeno-mas at a 1 to 5 years interval when compared with the control group,both with adequate baseline examination [1. 5%(5/ 326)VS 2. 2%(9/ 408),P = 0. 51]. The detection rates of advanced adenomas on follow-up colonoscopy at 1 to 3 years and 3 to 5 years in case group were 1. 7%(3/ 178)and 1. 4%(2/ 148),respec-tively(P>0. 05).Regression analysis showed age≥50 years old and being male were the independent risk factors for advanced adenomas recurrence within 5 years follow-up. No colon cancer was found in 828 patients during the follow-up. Conclusion Surveillance colonoscopy intervals within 5 years is of little benefit to pa-tients who had adequate polypectomy. Too early reexaminations due to concerns about advanced adenomas recurrence can be avoided.

Objective To investigate the relationship between the carotid intima-media thickness(IMT),the characterization of atherosclerotic plaque as well as the degree of carotid stenosis and ischemic stroke.Methods Tbe patients with first-ever acute ischemic stroke (ischemic stroke group)detected by color Doppler ultrasonogaphy and the outpatients and hospitalized patients without ischemic stroke in the same period(control groupl were collected retrospectively.The demogaphic data,vascular risk factors,and characterization of atherosclerotic plaque were compared between the two groups.Ischemic stroke group was divided into stroke subtype groups according to the TOAST classification.Their characteristics of carotid atherosclerosis were corapared.Restdt,A total of 200 patients with first-ever acute ischemic stroke and 200 patients without ischemic stroke were included in the study.The carotid IMT in the ischemic stroke group WaS sigaificantlv thicker than that in the control group(left side:1.04±0.22 mm vs.0.69±0.13 mm,t=7.34,P<0.01;right side:1.05 ±0.21 mm vs.0.71±0.16 mm,t=7.43,P<0.01).The proportions of the patients with moderate and severe stenosis were significantly higher(moderate stenosis:38% vs.14%,x1=7.64,P<0.01:SCVele stenosis:27% vs,6%,x2=7.93,P<0.01),and the proportion of patients with mild stenosis was no significant difference.The detection rate of carotid plaque in the ischemic stroke group was significantly higher than that in the control group(87.0% vs.31.5%,X2=7.01,P<0.01).The numbers of unstable plaque(tipid soft plaque,flat plaque,and mixed plaque)in the ischemic stroke group were 301(65.3%),and significantly mole than 65(31.7%)in the control group(x2=6.30,P<0.01).There was no significant difference in the distribution of carotid plaque between the two groups.The plaques were most common at the carotid artery bifurcation.Compared with those in other stroke subtypes.such as cardioembolism,small-vessel occlusion.stroke of other determined etiology,and stroke of undetermined etiology,the cm'otid IMT(left side:F=22.34,P<0.01;right side:F=21.41,P<0.01),and the proportion of Upid soft plaque(x2=7.93,P<0.01),carotid severe stenosis(x2=6.83,P<0.01),carotid occlusion(x2=14.00,P<0.01)in stroke patients with large-artery atherosclerosis were significantly incleased.Condusiom Carotid IMT,the numlbers of unstable Plaque as well as the degree of carotid stenosis were associated with the occurrence of isehemic stroke.

ObjectiveTo determine whether simvastatin alleviates lower urinary tract symptoms (LUTS) in patients with metabolic syndrome (MS) coexisting with benign prostate hyperplasia (BPH) and explore an optimized scheme of treatment. MethodsFrom February to June in 2011,30 male subjects with MS and LUTS caused by BPH in out-patients and in-patients from geriatric department were recruited.The patients were randomly assigned to receive orally simvastatin (40 mg) and tamsulosin (0.2 mg) quaque noete as combination treatment group or only tamsulosin (0.2 mg,quaque nocte) as single treatment group for 8 weeks.International prostate symptoms score (IPSS),quality of life (QOL),maximum flow rate (MFR) and prostate volume (PV),liver enzymes,creatinine and routine urine test were monitored to evaluate the effectiveness and safety before and after the treatment.Results In the two groups,the significant differences were found in the levels of IPSS,QOL and MFR,while there was no difference in PV between pre-treatment and post-treatment.The scores of IPSS after treatment were (6.4 ± 4.4) in combination treatment group and(4.2±3.3)in single treatment group (P＜0.05),and there were significant difference in scores of IPSS before and after the treatment between two groups (P＜0.05),suggesting better improvement in combination treatment group than in single treatment group.In two groups,there were no adverse events,and no changes were found in liver and kidney function,muscle enzymes and routine urine test.Conclusions Combined tamsulosin and simvastatin treatment may alleviate LUTS caused by BPH and are well tolerated with no adverse events.

Objective To investigate the awareness,willingness,motivation,and influencing factors of outpatients for participating drug clinical trials,and provide references for decision-making of drug clinical trials.Methods An amnonymous survey was conducted in the departments of internal medicine,surgery,gynecology,and obstetrics of a randomly selected tertiary referral center,and the results were statistically analyzed.Results A total of 1 067 available questionnaires were received.The total awareness rate of clinical trials was 31.02％,which was closely correlated with age and the degree of education.40.86％ of respondents were willing to participate in drug clinical trials.And 55.28％ of them chose yes because of the willingness to contribute to the development of medical science.People having cognition on clinical trials had more willingness to participate in drug(OR:1.361,95 ％ CI:1.042-1.777).59.14％ of the respondents refused to participate in drug clinical trials,68.62％ of whom refusing to participate mainly worried about the safety of drugs.57.37％ of the respondents comfirmed that they might change their idea if experts were involved.41.33％ were willing to accept training about clinical trials.Conclusion Investigators'overall cognition on clinical trials is closely correlated with the willingness to participate in drug clinical trials.There should propagandize drug clinical trials to make sure the improvement of drug clinical trial progress.

Objective To explore the therapeutic effect of Han-uvulopalatopharyngoplasty (H-UPPP) combined with coblation on treatment of type Ⅱ mild and moderate obstructive sleep apnea hypopnea syndrome (OSAHS).Methods According to the measuring parameters analyzed and clinical characteristics of velopharyngeal,68 patients were divided into 3 groups:group A (28 patients,treated by H-UPPP combined with coblation of tonsillectomy),group B (22 patients,treated by H-UPPP combined with drilling of tonsil) and group C (18 patients,treated by velopharyngeal multi-points drilling).After operation for 6 months,the pafor tients in 3 groups were detected by the polysomnography (PSG),Epworth sleepiness scale,and the parameters of velopharyngeal were compared.Results After operation for 6 months,the heal,excellence,efficiency and inefficiency patients in group A were 6,10,7,5 cases,in group B were 3,8,7,4 cases,in group C were 2,7,5,4 cases,there was no significant difference (P ＞0.05).After operation for 6 months,the apnea hyponea index (AHI) and the scores of ESS in group A,B,C were significantly lower than those before operation [(10.1 ± 2.3) times/h vs.(21.2 ± 2.5) times/h,(6.4 ± 1.0)scores vs.(16.2 ± 1.0) scores,(6.9 ± 1.3) times/h vs.(16.0 ± 1.4) times/h,(5.4 ± 1.3) scores vs.(14.5 ±1.5) scores,(7.7 ± 1.8) times/h vs.(16.0 ± 2.1) times/h,(4.1 ± 1.0) scores vs.(12.3 ± 1.9) scores],thelevel of LSaO2 was significantly higher (0.885 ±0.035 vs.0.737 ±0.030,0.871 ±0.046 vs.0.763 ±0.033,0.901 ±0.029 vs.0.820 ±0.034),there was significant difference (P ＜0.01),but there was no significant difference among 3 groups (P ＞ 0.05).After operation for 6 months,the pharyngomaxillary space,distance between uvula and posterior wall of pharynx,distance between anterior pillars in group A,B,C were significantly increased compared with those before operation [(24.6 ± 0.9) mm vs.(12.3 ± 1.2)mm,(11.6 ±1.2) mm vs.(5.4 ± 0.6) mm,(34.9 ± 1.2) mm vs.(28.3 ± 1.0) mm,(24.0 ± 0.8) mm vs.(14.3 ± 1.0) mm,(11.8 ± 0.8) mm vs.(6.3 ± 0.4) mm,(38.3 ± 0.8) mm vs.(31.9 ± 1.9) mm,(23.6 ± 1.4) mm vs.(19.9 ±1.1) mm,(7.3 ± 0.5) mm vs.(6.8 ± 0.6) mm,(38.5 ± 0.8) mm vs.(35.2 ± 1.0) mm],the length of soft palate was decreased [(31.9±0.9) mm vs.(38.3 ±0.9) mm,(25.6 ± 1.0) mm vs.(35.6 ± 1.2) mm,(29.9 ± 1.3) mm vs.(34.9 ±0.9) mtm],there was significant difference (P ＜0.01),but there was no significant difference among 3 groups (P ＞ 0.05).Conclusions H-UPPP combined with coblation on treatment of type Ⅱ mild and moderate OSAHS is effective and safe.According to the clinical characteristics of the patients to select suitable method is the key to get a satisfactory curative effect.