The application of transesophageal echocardiography (TEE) in perioperative monitoring was introduced,and its involvement in non-cardiac surgery was described.The advantages and disadvantages of TEE were analyzed when applied to cardiac and non-cardiac operations for congenital heart disease,coronary disease,vascular heart disease,aorta disease and etc.The abuse of vasoactive drug or fluid is avoided due to subjective evaluation on cardiac function and volume load.TEE facilitates the anesthetist in diagnosis and evaluation of the patient with heart diseases,and the surgeon in immediate assessment of the operation,which can be used for real-time monitoring of cardiac function and hemodynamics.

Objective To investigate the clinical effect ofFuzheng-Shugan decoction on the treatment of patients with the treatment nodule.Methods A total of 80 patients with thyroid nodule from Jan.2014 to Dec.2015, divided into two groups. The efficacy, thyroid stimulating hormone, high risk factors, the maximum diameter and volume of thyroid nodules were observed.Results The effective rate of observation group was significantly higher than of the control group (90.00%vs.27.50%,χ2=32.237,P=0.000). The shortness of breath (1.62 ± 0.86vs. 4.35 ± 1.13,t=12.159), foreign body sensation (2.53 ± 0.62vs. 4.23 ± 0.56,t=12.289), irritability (1.56 ± 0.53vs. 3.52 ± 1.25,t=9.130), sweating (1.85 ± 0.62vs.4.23 ± 0.56,t=18.017), tongue (1.58 ± 0.93vs. 3.71 ± 1.25,t=8.646) and neck pain (0.82 ± 0.35vs. 3.92 ± 0.65,t=26.558) in the obversation group were significantly lower than those in the control group (P<0.05). The thyroid stimulating hormone levels in the observation group (1.05 ± 0.21 mIU/Lvs. 2.16 ± 0.71 mIU/L,t=9.482), were significantly lower (P<0.05). The maximum diameter (8.52 ± 4.72 mmvs. 12.27 ± 5.69 mm,t=3.208) nodule volume (0.26 ± 0.71 cm3vs. 0.96 ± 1.02 cm3,t=3.562) and high risk factors (2.73 ± 1.45vs. 4.05 ± 1.36,t=4.199) in the observation group were significantly lower than those in the control group (P<0.05).Conclusion TheFuzheng-Shugan decoction can improve TCM syndrome, reduce the risk factors, and effectively reduce the nodule maximum diameter and volume.

Objective To investigate how to protect the parathyroid gland and complication prevention meas -ures better.Methods A total of 152 patients with thyroid surgery from January 2012 to January 2014 in our hospital were analyzed.Results 48 cases had symptoms of low PTH (31.56%), and 89 patients had the symptoms of low blood calcium(58.55%).There are 45 cases of asymptomatic hypocalcemia (29.61%).There was no permanent hypocalcemia.Conclusion In total excision of the thyroid gland , surgery doctors should carefully identify parathy -roid gland, enhance the technical levels of operation , protect the parathyroid gland artery and vein reflux , observe and deal with the complications in time , and do a good job in the prevention of complications .

Objective To investigate the clinical effects of the automatic ligation of hemorrhoids bleeding hemorrhoids treatment.Methods A retrospective analysis of patients with bleeding hemorrhoids Center in January 2012 -February 2014, 117 patients were randomly divided into control group 57 cases, the study group 60 cases, including patients in the control group with traditional ligation surgery .Study group patients will be automatically liga -tion of hemorrhoids treatment , compared to the results of the two groups of treatment .Results The control group were 59.6% efficiency, and the study group of patients were 95.0% efficiency, which was higher than the efficiency of the study group of patients with a significant difference statistically significant (p <0.05).Conclusion Automati-cally ligation of hemorrhoids treatment of hemorrhoids can be applied to obtain the desired clinical effect , which is a effective and safe treatment for species , and worthy of further application in clinic .

Pulmonary asthenia is one of the chronic consumptive lung diseases because of the weakness of pulmonary lobe. It would be the outcome of many chronic lung diseases with poor prognosis. In recent years, preventing and treating pulmonary asthenia by traditional Chinese medicine (TCM) has been one of the research focuses and some fruits have been received. This paper summarized pulmonary asthenia from the aspects of etiology and pathogenesis, syndrome differentiation, TCM treatment so as to provide theoretical basis and proofs for treatment of pulmonary asthenia by TCM.

Objective To investigate the changes of dendritic cell subsets and CD 80,CD86 expression in peripher-al blood in patients with immune thrombocytopenia (ITP), and to evaluate the changes of serum interleukin -2(IL-2), serum interleukin-4(IL-4), serum interleukin-10(IL-10) and interferon-γ(IFN-γ) before and after dexam-ethasone treatment, overall, further analyzing the relationship between them and dexamethasone .Methods Collec-ting blood samples of 60 ITP patients and 10 normal controls with heparin anticoagulation , and distribution of den-dritic cell subsets of ITP and normal controls was detected by flow cytometry , and the changes of serum IL-2, IL-4, IL-10 and IFN-γwere detected by enzyme linked immunosorbent assay (ELISA).Results The percentage of DC2 was increased in ITP patients compared with the control group (P <0.05) and there was no statistically significont difference after dexamethasone treatment ; the expressions of CD80 on DC1 and DC2 were increased compared with the control group(P <0.05), as well as the expression of CD86 on DC2 and the percentage of them decreased after treatment.The serum IL-2, IFN-γlevels before the dexamethasone treatment were higher than the normal control group(P <0.05),then decreased after treatment.However, the serum IL-4, IL-10 levels were lower than the nor-mal control group before the treatment (P <0.05), increased after treatment.Conclusion The disorder of the number and function of DCs and the changes of the serum IL -2, IL-4, IL-10 and IFN-γlevels may play important roles in the pathogenesis of ITP.Moreover, there is a probable key relationship between them and the effects of dexamethasone treatment.

OBJECTIVE:To prepare Shangyangyu gel and establish a standard for its quality.METHODS:Shangyangyu gel was prepared using carbamer 940 as matrix.Its content was identified by spectrophotography,with the wavelength set at 516nm,and its other compositions were determined by TLC.RESULTS:The concentration of L-shikonin had good linear correlation with absorbance in the range of 8.048～ 40.24? g? mL-1(r=0.999 8).The average recovery rate was 99.45%(RSD=1.13%).CONCLUSION:This method for preparation of Shangyangyu gel was simple in technique and the standard can be used for the quality control.

Objective To study the epidemic and distribution characters and its relevant risk factors of children injury in Fuzhou city.Methods Using stratified cluster sampling with probability of selection proportional to size in three random selected stages,8 800 families from 44 communities of 22 towns over 11 counties of the whole Fuzhou city were investigated.There were 30 214 family members were surveyed with questionnaire,including 8 405 children aged between 0 to 17 years old.Result The results showed the general rate of non-fatal injury was 6.38% for children between 0～17 yrs,and it was the highest(7.90%)in children of 5～9 yrs;the rate was higher in the male than in the female,and the rate of the urban districts was higher than that of the rural areas.The first three types of children injury were caused by animal biting,falling and traffic accident.Among the children of 1～17 yrs,there were 6 children died in fetal injury,of 5 cases(83.3%)were drown.Conclusions Injury has become one of the important social and health problems to children growth.Therefore,to protect children health and safety,the intervention measures against children injury should be carried out as soon as possible.

Tumors of the sacrum are rare.The valve of adjuvant is uncertain,and en bloc tumor resection remains the primary mode of treatment.But en bloc tumor resectiong often leads to unstability of the pelvic ring.Therefore,the most factor providing the successful outcome in the management of sacral tumor is how to establish stability in the lumbo-sacrai junction.The various spinopelvic reconstruction techniques are reported in the literature.This includes various methods triangular frame reconstruction,or lilac rod or iliac screw fixation,modified galveston,custom-made prosthesis and so on.The authors review the modes of reconstruction after sacral tumor resection and discuss the outcomes.

Objective To study the mechanism of Chinese Medicine in treating adenomyosis.Methods Thirty-seven patients in the Chinese Medicine treated group(17 cases of adenomyosis) and the control group(20 cases of adenomyosis,non-drug treated) underwent hysterectomy.Endometrium was looked as eutopic endometrium and adenomyosis as ectopic endometrium.Expression of MMP-9 and TIMP-1 in eutopic and ectopic endometrium were measured by immunohistochemical techniques.Meanwhile the levels of CA125 in serum were measured.Results The ectopic endometrium of the Chinese Medicine treated group expressed lower level of MMP-9,higher level of TIMP-1 and lower ratio of MMP-9/TIMP-1 than the ectopic endometrium of the control group(P