Objective To observe the effect of acupoint sticking plus cervical plexus block anesthesia on post-operative pain in patients undergone subtotal thyroidectomy.Method Sixty patients who were going to receive unilateral subtotal thyroidectomy were randomized into group A and group B, 30 cases in each group. Group A was intervened by acupoint sticking plus cervical plexus block anesthesia, while group B was by cervical plexus block anesthesia alone. The Visual Analogue Scale (VAS) scores under static and swallowing condition were recorded at 6 h, 12 h, 24 h, and 48 h after the operation. Tramadol hydrochloride tablets were given to help cease pain when static incision VAS>3, and the total dose and adverse reactions in 48 h after the operation were recorded.Result There were no significant differences in comparing the VAS scores at static and swallowing status between the two groups at 6 h, 12 h, 24 h, and 48 h after the operation (P>0.05). The total dose of Tramadol hydrochloride tablets used in 48 h after the operation was (110±55)mg in group A, versus (210±48)mg in group B, and the difference was statistically significant (P<0.05). There was a significant difference in comparing the occurrence rate of adverse events in 48 h after the operation between the two groups (P<0.05).Conclusion Acupoint sticking plus cervical plexus block anesthesia can effectively alleviate the pain after subtotal thyroidectomy, reduce the use of analgesics in 48 h after the operation, and lower the occurrence rate of post-operative adverse events.

Objective To explore the microsurgical technique in managing medial sphenoid ridge meningioma.Methods The clinical data of 23 cases of medial sphenoidal ridge meningioma were analyzed retrospectively.The main points of microsurgical treatment of medial sphenoid ridge meningioma were discussed.Results Of 23 cases of medial sphenoid ridge meningiomas,total removal was made in 15 cases,subtotal removal in 6 cases and partial removal in 2 cases.The microsurgical outcomes were satisfactory in all the patients and no patients died.Conclusion The microsurgery via the pterional approach to the medial sphenoid ridge meningiomas can greatly heighten total resection rate of the tumors.Total resection of the tumor depends on its position,character and degree of edema of surrounding tissues.Palliative operations combined with postoperative radiotherapy should be carried out for treating the tumors that can only be subtotally and partially removed.

Objective To develop a new method for the determination of inorganic sulfide in source water by ion chromatography combined with pulsed amperometric detector.Methods The source water samples were injected into ion chromatography system after being filtrated with 0.22 ?m nylon membrane.100 mmol/L of NaOH-250 mmol/L of the NaOAc-0.5% (V/V) ethylenediamine was used as the eluent,special polarizable anions separation column IonPac 3AS7 was selected and sulfide was separated from other anions by isocratic eluent following by three-waveform pulsed amperometric detection.Results The liner range of determination for sulfide was 5-1 000 ?g/L,the equation of linear regression was y=0.325 4x-1.305 3.The detection limit was 0.5 ?g/L,the recovery rates were in the range of 90.8%-96.7%,and the relative standard deviation was 1.32%.Conclusion The method is simple with good selectivity,high sensitivity and good reproducibility and is applicable to the determination of inorganic sulfide in source water.

Objective:To study effect of tripterygium glycosides(TG)on T-lymphocyte subsets in rats with idiopathic thrombocytopenic purpura(ITP),and further to discuss the possible mechanism of TG in treating ITP.Methods:ITP animal model was established by intraperitoneal injection of exogenous anti-platelet–serum(APS).Sixty model rats were randomly divided into five groups:normal group,saline group,the high and low dosage of TG groups,prednisone group.Every rat was giving liquid medicine by intragastric administration one time per day for ten days 36 hours after the first intraperitoneal injection of exogenous APS.The changes of peripheral hemogram,the amount of megakaryocyte of bone marrow and T-lymphocyte subsets were observed.Results:In high dosage of TG group,the number of platelet count increased obviously,the number of megakaryocyte in bone marrow,CD8+and CD4+decreased,and CD4+/CD8+increased.Conclusion:High dosage of TG had obviously therapeutic effect on IPT rat,such as increasing platelet count obviously,reducing number of megakaryocyte in bone marrow obviously and ameliorating T-lymphocyte subsets.The mechanism may be related to regulating the cell immune function.

Objective To observe the effect of Jiawei Siwu Decoction for idiopathic thrombocytopenic purpura (ITP) on the effi‐cacy and immune aspects of the model mice .Methods We used guinea pig anti mouse platelet serum immune IT P model ,then con‐duct the corresponding drug treatment .The mice were observed in peripheral blood ,bone marrow changes of nuclear cell count ,ser‐um IL‐6 content and changes in the spleen index .Results Compared with the model group of physiological saline of peripheral blood WBC ,prednisone group and Chinese medicine group PLT count ,bone marrow nucleated cell counts were significantly elevated (P<0 .01) ,the content of IL‐6 in serum were increased significantly (P<0 .01) ,no difference between the two treatment groups . Thymus and spleen index increased too (P<0 .05) .Conclusion Jiawei Siwu Decoction may be related to the regulation of cellular immunity ,increased serum IL‐6 content ,improve bone marrow hematopoietic microenvironment to achieve therapeutic effects in the ITP mice .

Objective To observe the effect of fenofibrate intervention on high-fructose-feeding-induced liver steatosis in rats and explore the possible mechanism. Methods Male Wistar rats were randomly divided into control group ,high fructose group and fenofibrate group[fenofibrate intervention started after 8 weeks of high fructose feeding ,30 mg/(kg · d)]. Rats were sacrificed after 12-week of high fructose feeding. Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),free triglyceride(TG)and liver TG content were determined;protein levels of fatty acid synthase(FAS),endoplasmic reticulum stress mark-er Bip and autophagy markers such as Atg7,Beclin1,LC3 and the related pathway mTOR in liver tissues were de-tected. Results Compared with those in control group and fenofibrate group,serum AST,serum total cholesterol, blood free TG and hepatic TG were significantly increased in high-fructose group(P < 0.01). The protein expres-sion of Fas,Bip and mTOR were significantly increased in high-fructose group compared with those in control group and fenofibrate group;the protein expression of Atg7,beclin1 and LC3 were significantly decreased in high-fructose group compared with those in control group and fenofibrate group. Conclusions Long-term high-fructose-feeding induces fatty liver and liver cell injury ,and may affect ERS and autophagy. High-fructose-feeding-in-duced fatty liver may be improved by fenofibrate and its underlying mechanism might be associated with Fas,ERS and autophagy in liver.

With the continuous improvement of treatment ability in intensive care unit (ICU), many critically ill and complex patients have survived due to the development of technology. However, most of them suffer from the psychological and physiological problems of post-intensive care syndrome (PICS). Therefore, the early identification and prevention of PICS is particularly critical. We should understand the pathophysiological mechanism of PICS, strictly implement ABCDEFG bundle management measures [including airway management (A), breath (B), reasonable analgesia and sedation treatment (C), prevention of delirium (D), early rehabilitation (E), family engagement (F), good communication (G)] during ICU hospitalization, and pay attention to reasonable nutritional support, optimizing blood glucose management, providing positive psychological intervention and support to patients through family members' encouragement and accompanying, ICU diary and other forms, following up the health status of patients transferred out/discharged from ICU, providing multi-disciplinary and professional continuing medical services, finding the entry point and timing of traditional Chinese medicine intervention, and giving full play to the advantages of integrated traditional Chinese and Western medicine treatment, which can improve the quality of life of patients. This article reviews the pathophysiological mechanism, risk factors, prevention and management measures, traditional Chinese medicine syndrome differentiation and treatment of PICS, in order to improve the early identification, diagnosis and treatment of critical patients with PICS, and improve the prognosis of patients.

Objective To observe the effect of fluoxetine on the depression neurologic impairment and activity of daily living after cerebral infarction.Methods 80 patients with acute cerebral infarction following depression were randomly divided into treatment group and control group, 40 cases in each group. Two groups were assessed with Modified Edinburgh-Scandinavia Stroke Scale(MESSS), Hamilton Depression Scale(HAMD) and Modified Barthel Index(MBI) before and after treatment.Results There were no significant difference between the two groups before treatment in HAMD, MESSS and MBI（P＞0.05）, while there were significantly different between the two groups in HAMD, MESSS and MBI 6 weeks after treatment（P＜0.01）. Conclusion Fluoxetine can alleviate depression of patients with acute cerebral infarction and improve the symptom of neurological function and the activity of daily living.

ObjectiveTo analyze the risk factors related to perforation of lateral wall by lower cervical pedicle screw instrumentation in the treatment of cervical spinal disorders. MethodsA retrospective review was made to analyze 214 cervical vertebral injury patients ( 1 024 pedicle screws were used) treated with pedicle screw instrumentation at C3-7 from July 2004 to July 2009. Lateral walls of 18 patients were perforated (a total of 28 pedicle screws). The surgeons assessed the position and the angle of the screw in the pedicle, and the relation and the distance between the screw and the pedicle walls by carefully probing intraoperative walls of cervical pedicles and studying postoperative thin-slice computed tomography (CT) scan of the fixed vertebral segments of the cervical spine. The data of patients with lateral wall perforation was recorded and analyzed statistically. ResultsPerforation of the lateral wall occurred in 18 patients (28 pedicle screws). Backward step by step Logistic regression analysis was used and two variables were selected in the end. ConclusionsRatio variance between inner and lateral wall is the risk factor of perforation in the lateral wall associated with lower cervical pedicle screw instrumentation, while the angle variance between implanted screws and CT measurements is the protection factor of perforation in the lateral wall.

ObjectiveTo explore the risk factors for upper gastrointestinal bleeding after craniocerebral trauma.MethodsTo retrospectively summarize the clinical features of 80 cases with craniocerebral truma and to analyze the risk factors for upper gastrointestinal bleeding.Results Upper gastrointestinal bleeding was present in 39 of the 80 cases(48.8％) .Twenty-one of the 39 cases with gastrointestinal bleeding died(53.8％)In the patients without gastrointestinal bleeding, 5 cases died (19.2％) .Among the factors affecting the gastrointestinal bleeding after craniocerebral trauma, Glasgow Coma Scale(GCS) score, septicemia, decerebration,hypotention, metabolic acidosis and hyperglucose were closely related risk factors(x2 = 13.96;x2 = 27.43;x2 =46.28 ;x2 = 27.33 ;x2 = 11.88 ;x2 =5.71 ,P ＜0.05 or P ＜0.01).ConclusionProphylaxis against related risk factors could reduce the incidence of gastrointestinal bleeding, improve the prognosis and decrease the mortality of craniocerebral trauma.