Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Facial Paralysis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To evaluate the influencing factors for hypocalcemia after total thyroidectomy in thyroid carcinoma.Methods 650 patients with thyroid carcinoma undergoing total thyroidectomy from Jun.2009 to Dec.2011 were followed up and analyzed retrospectively.The relativity between persistent hypocalcemia and the following criteria were studied:age, sex, primary tumor stage, initial thyroid treatment, neck dissection cen-tral compartment dissection, inadvertent parathyroidectomy, and thyroid caspsular dissection.χ2test was used to analyze the statistical correlation between hypocalcemia after total thyroidectomy and the other clinical factors. Multiple logistic regression analysis was used to identify the multivariate correlation of clinical factors and hypocal-cemia after total thyroidectomy. Results Persistent hypocalcemia was found in 112 out of 650 patients (17.2%).Advanced stage(OR=2.121,95%CI 1.140-3.947,P=0.018),bilateral central compartment dis-section(OR=1.852,95% CI 1.199 -2.863,P =0.006),failure to use thyroid caspsular dissection(OR =2.307,95%CI 1.208-4.405,P=0.011)and IPE(OR=1.580,95%CI 1.029-2.427,P=0.037)were inde-pendent predictive factors for hypocalcemia after total thyroidectomy.Conclusions It has high incidence of persis-tent hypocalcemia in patients with andvanced-stage thyroid carcinoma after going total thyroidectomy.Thyroid caspsular dissection method, proper indications for bilateral central compartment dissection, and reducing IPE can help to reduce the incidence of persistent hypocalcemia and improve the life quality of patients after going thyroidectomy.

Objective To explore the gray matter loss of Alzheimer's disease (AD) patients by processing the magnetic resonance imaging (MRI) with computer. Method A voxel-based morphometry (VBM) method was applied in this study. Result Bilateral loss of gray matter in AD patients was found in the entorhinal/ hippocampal/parahippocampal cortex areas, amygdala, the head of the caudate nucleus, middle temporal gyrus, cingulate gyrus, inferior parietal lobule, insula and dorsolateral prefrontal cortex. Furthermore, area of right pulvinar, cortex of superior temporal gyrus and superior parietal lobule reduced significantly. On the other hand, somatosensory/motor cortex, cerebellum and occipital lobe were relatively intact. Conclusion VBM overcomes the shortcomings of region of interesting(ROI), such as time-consuming, dependence on observer, and poorly reproducible, and can analyze the gray matter loss objectively and automatically and have a good perspective for clinical applications.

Objective To observe the changes of VEGF and Ang-2 expression in streptozotocin(STZ)-induced diabetic rat retina after insulin therapy and explore possible roles of insulin in the development of diabetic retinopathy. Methods Diabetes was induced in 8-week-old male wistar rats by a single intraperitoneal injection of STZ. After three weeks,animals were randomly divided into four groups:(1)diabetic rats received intensive insulin therapy for 20 days;(2)diabetic rats received unregular insulin therapy,which caused the abrupt fluctuation of glycemic level;(3)diabetic control rats; and (4)normal control rats. After treatment,the animals were sacrificed with an overdose of anesthesia,and the eyes were enucleated and fixed in 4% paraformaldehyde immediately. Paraffin sections of retina were prepared.Expression of VEGF and Ang-2 was assessed by immunofluorescence stain and images analysis. Results Quantitative analysis showed VEGF and Ang-2 protein expression was increased by 2.38-fold and 2.41-fold in diabetic rats retinas as compared to non-diabetic rats retinas respectively (P0.05). Conclusion Intensive insulin therapy could decrease VEGF and Ang-2 expression in retina and has protective effect on diabetic retinopathy in STZ-diabetic rats.

Objective To explore the effect of Taijiquan on motor function and depression in patients with post-stroke depression. Meth-ods From January to October, 2015, 60 stroke patients with depression were randomly divided into control group (n=30) and Taijiquan group (n=30). Both groups accepted routine rehabilitation, while Taijiquan group accepted another training of six actions from simplified Taijiquan. They were assessed with Fugl-Meyer Assessment (FMA), Barthel Index (BI) and Hamilton Depression Rating Scale (HAMD) be-fore, and four and eight weeks after treatment. Results The scores of FMA and BI increased more in Taijiquan group than in the control group after treatment (t>2.351, P<0.05), while the score of HAMD decreased more (t>2.169, P<0.05). Conclusion Taijiquan can relieve the depression and improve the motor and activities of daily living in patients with post-stroke depression.

Objective:To count and analyze the residue of narcotics for injection after the use in operation rooms in order to find the possibility of risk avoiding and management standardization. Methods:A retrospective research method was adopted to count and analyze 10268 prescriptions including narcotics for injection in operation rooms from June to August in 2014. Results:Ketamine hydro-chloride injection had the largest residue and its remaining amount also occupied the largest proportion of medication. The second one was pethidine hydrochloride injection and the third one was remifentanil hydrochloride for injection. The highest ratio of remaining a-mount in each prescription was ketamine hydrochloride injection, and the second one was morphine hydrochloride injection and pethi-dine hydrochloride injection ranked the third. Conclusion:It is suggested to reduce the specification of medication with the highest ra-tio of remaining amount in each prescription such as ketamine hydrochloride injection, and improve the management efficiency for the use of narcotics in operation rooms.

Background and purpose:In recent years, energy-based instruments have been widely used in today’s open surgeries. Harmonic Focus? (HF) and Ligasure Small Jaw? (LSJ) are both custom-made for thyroid open surgery. This study aimed to explore the effcacy and safety of HF and LSJ in open thyroidectomy.Methods:The data from patients who undertook total thyroidectomy with central neck dissection by the same surgeon during last year in this hospital were reviewed. HF was used in 100 patients, and LSJ was used in 104 patients. The effectiveness was appraised by comparing operation time and postoperative volume of drainage on the ifrst postoperative day. The safety was appraised by comparing the incidence of postoperative complications.Results:The results of the effectiveness:the average duration of operation was (95.8±18.0) min for HF group, and (97.8±19.1) min for LSJ group, there was no statistical signiifcance (P=0.363). Postoperative volume of drainage on the ifrst postoperative day was (35.2±20.3) mL for HF group, and (36.3±23.8) mL for LSJ group, there was no statistical signiifcance (P=0.977). One patient (1.0%) had temporary vocal cord paralysis in HF and one had postoperative hematoma (1.0%) in LSJ group. Temporary hypo-parathyroidism was detected in 18 patients (18.0%) of HF group, and 16 patients (15.4%) of LSJ group. The decline of parathyroid hormone during the ifrst postoperative day was (12.3±12.8) pg/mL in HF group, and (13.9±13.4) pg/mL in LSJ group. The decline of serum calcium was (0.20±0.13) mg/dL in HF group, and (0.20±0.16) mg/dL in LSJ group. There were all no statistical signiifcances (P>0.05).Conclusion:Both HF and LSJ are safe and effective in open thy-roidectomy without similar operative complications.

Objective To investigate the optimal methods of detecting micrometastasis of sentinel lymph node(SLN) in papillary thyroid carcinoma(PTC).Methods Data of 51 consecutive PTC patients without clinical evidence of cervical lymph node metastasis were analyzed.They were conducted with SLN localization with blue dye,technetium-labeled sulfur colloid or the combination of them from Aug.2007 to Sep.2010.55 SLNs from 18 cases were selected.No metastasis was found to these 55 SLNs by routine pathological section.The 55 SLNs were serially sectioned at a 50 μm interval and stained by both HE and immunohistochemistry for detecting micrometastasis.Results SLN was successfully identified in all the 51 cases,with SLN identification rate of 100％.Among the 18 cases without metastasis to SLN by routine pathological section,5 cases were found micrometastasis by step sectioning plus immunohistochemically stains.The false negative rate was reduced from 15.4％ by routine pathological section to 2.6％ by step sectioning plus immunohistochemically stains.Conclusion Cytokeratin immunohistochemistry on series sections is a reliable method in detecting SLN micrometastasis in PTC.

Objective To investigate BAALC(brain and acute leukemia cytoplasmic)gene expression in patients with de novo acute myeloid leukemia(AML)and its clinical significance. Methods BAALC expression was determined by real-time quantitative polymerase chain reaction(RQ-PCR) in 63 de novo AML patients.The association between BAALC expression and therapeutic effect was analyzed.Results The correlation coefficiencies were over 0.99 for standard curves of RQ-PCR method. BAALC expression was detected in 49(78%)AML patients.The peripheral WBC counts,hemoglobin, platelet counts and the bone mahow blast cell percentage at onset in 31 AML patients with high BAALC expression were(26.3?18.1)?10~9/L,(78.3?21.8)g/L,(76.9?64.5)?10~9/L and(61.2?22.3)% and those of 32 AML patients with low BAALC expression were(30.2?21.7)?10~9/L,(81.6?30.9)g/L, (73.9?57.2)?10~9/L,(54.3?16.3)%,respectively.No statistic differences were found between these two groups.The AML patients with normal chromosome karyotypes are more likely to have a high BAALC expression(68%)compared with those with abnormal chromosome karyotypes(23%,?~2=12.093,P= 0.001).AML patients with normal cytogenetics and high BAALC expression shows significant lower CR rate (65%)compared with those with low BAALC expression(84%,?~2=6.573,P=0.013). Conclusion High BAALC expression may define an important risk factor in AML with normal cytogenetics and predicts an adverse prognosis.

Objective To investigate the left ventricular (LV) torsion parameters of type B WolffParkinson-White syndrome (B-WPW) and to explore alternation of the left ventricular motion pattern in patients with B-WPW.Methods Thirty-eight patients with B-WPW were studied.And 40 volunteers were selected as control.Two-dimensional speckle tracking imaging (2D-STI) was used to acquire left ventricular torsion parameters,including peak value and time to peak value of LV twist,LV apex rotation,and LV base rotation.Apical-basal rotation delay (RDA-B) was calculated.Biplane Simpson method was used to measure LV end-diastolic volume (LVEDV),end-systolic volume (LVESV) and ejection fraction (LVEF).All above parameters were measured in patients with B-WPW before (B-WPW-B group) and after (B-WPW-A group) radiofrequency catheter ablation and in control group.The QRS width of lead Ⅱ was recorded,and the relationships between all above parameters with the RDA-B or QRS width were analyzed.Results Compared with the contrd group,in patients with B-WPW,the peak value of LV apex rotation (RotA),LV base rotation (RotB) and LV twist (TwistLV) were lower(LV base was more obvious than LV apex)(P ＜0.05),the time to RotB (TTPB) was shorter (P =0.004),RDAB was longer(P =0.002),the left ventricular enlarged and the QRS prolonged (P =0.000).After radiofrequency catheter ablation,the left ventricular torsion parameters in patients with B-WPW recovered significantly(P ＜0.05),but still lower than those in the control group(P ＜0.05).Conclusions The left ventricular motion pattern of patients with B-WPW alters,including the changes of peak value and time to peak value in LV apex rotation,LV base rotation and LV twist,as well as LV myocardium dyssynchrony.The motion pattern of LV in patients with B-WPW is improved in acute stage after radiofrequency catheter ablation but not yet recover totally.