Objective To observe effects of senior neurogenic hypertension treated with microvascular decompression(MVD) Methods All 692 cases of senior cranial nerve disease with MVD were retrospectively analyze, 236 cases of preoperative neurogenic hypertension(prosopalgia 179 cases,facial spasm 48 cases, glossopharyngeal neuralgia 9cases)were treated with MVD Results In 236 cases,145 Patients had cure results(61 4%),36cases obvious effectiveness(15 3%),18 cases effectiveness(9 7%),32 cases ineffectiveness (13 6%) Two hundred and eight cases have been flowed up for 74 months average,133 cases had cure prognosis,30 cases obvious effectiveness,18 cases effectiveness,27 cases ineffectiveness Conclusion It is pathogenesis of neurogenic hypertension that oppressing cranial nerve roots and bulb by abnormal vascular tab leads to long term aching stimulation and emotional stress MVD is an effective treatment of neurogenic hypertension

Primary liver cancer (PLC) includes hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (CC).In recent years, the incidence of PLC has increased significantly in the world.At present, the therapy for liver cancer tends to diversify, but surgical resection is still the first choice and the most effective treatment for HCC in general.As the biomedical, evidence-based medicine, and medical humanities are proposed, to achieve the best therapeutic effect and minimize the trauma has become the goal of modem surgery.Moreover, this could promote the transformation of surgical model from traditional experiential surgery to precision surgery.Besides, as the critical techniques of treating HCC in preoperative evaluation,operative procedures, perioperative management and the innovation of surgical instruments develop fast, precise liver resection has come into being.And now this concept is getting more and more attention from hepatobiliary surgeons.In this paper, the progress on the application of precise liver resection in the treatment of PLC is reviewed based on the preoperative evaluation and intraoperative procedures.

Objective To study the clinical value of peritoneal cavity non-drainage after the operation of acute perforating appendicitis.Methods 196 patients with perforating appendicitis were randomly divided into drainage group and non-drainage group.The incidence rates of wound infection and ankylenteron and hospital durations in the two groups were observed and compared with each other.Results The incidence rate of wound infection and ankylenteron were 19.0%,10.7% in the drainage group and 8.0%,4.5% in the non-drainage group respectively(P0.05).The mean postoperative hospital stay of the drainage group was(9.3?2.7)days,which was significantly longer that of the non-drainage group(5.1?1.9)days,P

Objective 　To investigate the factors associated with long-term efficacy of microvascular decompression for hemifacial spasm. Methods　253 cases of hemifacial spasm treated with microvascular decompression were followed 13 to 144 months (mean 73 months). Results　Hemifacial spasms were obliterated in 232 cases (91.7%) and were partially relieved in 10 cases (4%). However, hemifacial spasm recurred 11 cases (4.3%). We re-operated on those who had recurrent hemifacial spasm and found that the material used for previous decompression had moved. The movement of decompression material could be the cause of spasm recurrence. Conclusions　Upholding of depression material around the blood vessels against movement near the facial nerve plays an important role for improving the long-term efficacy of MVD for hemifacial spasm.

BRAFV600E mutation is the most common genetic alteration in the papillary thyroid carcinoma.It plays an important role in the tumorigenesis,invasiveness and metastasis of the papillary thyroid carcinoma.Testing of BRAFV600E mutation is of great value in diagnosis,which also can be used as a prognostic maker of papillary thyroid cancer.Inhibitors treatment targeted to BRAF kinase and its downstream effectors is a new area in the treatment of BRAFV600E mutated thyroid cancer.

TSH suppression therapy plays an important role in differentiated thyroid carcinoma. It can lower mortality and recurrence rate in high risk patients. Meanwhile, it also has potential side effects on cardiovascular and skeletal systems. Thus, TSH suppressive therapy should be individualized in regard to its possible benefit and potential adverse effects.

Objective To study the principle of chemokine stromal-dirived factors-1(SDF-1)in acute rejection,we test the expression of CXCR4 which is the receptor of SDF-1 in acute rejection following liver transplantation. Methods needle-biopsy specimens after liver transplantation were divided into four groups according to Banff schema.We analyzed the mRNA level of CXCR4 in each group by RT-PCR.Results In non-rejection group and control group,all samples expressed CXCR4 in small and medium dose.In rejection group,high level expression of CXCR4 related to high degree of acute rejection were found.Conclusion The CXCR4 plays an important role in acute allograft rejection of human liver after transplantation.To restrain the expression of CXCR4 may be au effective method of anti-acute rejection.

Objective To investigate the cause of reoperation for high differentiated thyroid carcinoma and the risk factors of neck lymph node metastasis in reoperation. Methods Retrospectively reviewed the clinical data of 54 high differentiated thyroid cancer patients from 1998 to 2005, who received reoperation and neck lymph node dissection simultaneously. Results The residual thyroid carcinoma rate and lymph node metastasis rate were higher in 39 patients who initially received partial thyroidectomy than in 15 who previousely underwent radical operation(P <0. 05). Age less than 45 years, lymphadenectasis before initial operation, tumor residued or relapsed, muhicentricity of primary cancer and blurred boundary between cortex and medulla of lymph node were the risk factors for ipsilateral lymph node metastasis(P <0. 05), while mul-ticentricity of primary cancer and contralateral thyroid cancer were the risk factors for contralateral lymph me-tastasis (P < 0. 05). Conclusions Individual standard radical operation and necessary lymph node dissection are important measures to prevent recurrence and reoperation. Completion thyroidectomy and modified or selec-tive neck dissection are recommended for reoperation patients with the risk factors of lymph node metastasis.

Postoperative hypothyroidism is the most common complication following thyroidectomy,and thyroxine replacement is needed to maintain thyroid function.Levothyroxine (L-T4) is the preferred drug for the treatment of hypothyroidism.L-T4 therapy can be initiated immediately after thyroid operation,and the dosages are influenced by target serum TSH and several other factors.Special consideration should be taken for such patients,including patients with poor compliance,during pregnancy,and elderly patients.Thyroid function should be measured every 4 to 6 weeks,optimal dosages are adjusted according to target serum TSH individually,avoiding under-treatment or over-treatment.T3 in divided doses or L-T4/T3 combination therapy can be served as alternative for those failed to L-T4 therapy alone.

Objective To study the effects of different type of parathyroid damage to the postoperative functional recovery of parathyroid,through establish an animal model by simulating total thyroidectomy and parathyroid damage during surgical operation.Methods Experimental rabbits for the study were randomly divided into A,B,C,D four groups (n =8),Group A (control group):simple exposure,exploration thyroid and parathyroid;group B (vascular injury group):total thyroidectomy and ligation bilateral parathyroid blood supply but keep the surrounding membrane;Group C (membrane damage group):total thyroidectomy and damage membrane but reservations blood supply.Group D (composite damage group):total thyroidectomy plus membrane and blood both damage;All animals were monitored of serum calcium and PTH,preoperative 1 days and postoperative 1 st day,3rd day,5th day,7t day;cut the parathyroid HE staining to observed survival of parathyroid tissue and pathology damage when 7th day after operation.Results (1) Animals in each group preoperative serum calcium and PTH were no significant difference (P ＞0.05);(2)Group A postoperative serum calcium decreased,but at 5th day returned to preoperative level (P ＞ 0.05);Group B and C postoperative 1st day,3rd day,5th day serum calcium decreased significantly(P ＜ 0.05)and to the lowest at 1 d and then gradually recovered,but group C faster recovered than group B (P ＜ 0.05);Group D postoperative 1 st day,3rd day serum calcium continued to decline significantly (P ＜ 0.05);(3) Group A postoperative serum PTH decreased,but at 7th days returned to preoperative level (P ＞ 0.05).Group B and C postoperative 1st day,3rd day,5th days serum PTH decreased significantly(P ＜0.05)and to the lowest at 1 d and then gradually recovered,but from postoperative 3rd day group C faster recovered than group B(P ＜ 0.05);Group D postoperative 1 st day,3rd day serum PTH continued to decline significantly (P ＜ O.05);(4) Pathology results:Group A parathyroid filled with chief cells and a small amount of vacuolar changes (5％ to 10％);Group B parathyroid hemorrhage,necrosis (40％ to 50％),part of the cell degeneration (30％ to 40％),center with fibrosis,seen granuloma and hyperplasia of parathyroid tissue in surrounding;Group C parathyroid bleeding (10％ to 20％),part of the cell degeneration (10％ to 20％);Group D parathyroid severe necrosis,almost no normal parathyroid tissue,significant fibrosis,less residual parathyroid tissue was scattered.Conclusions (l) The recover of Parathyroid function is influenced by the type of parathyroid in situ injury during thyroidectomy,composite damage of blood supply and membrane of parathyroid is the most serious,parathyroid ischemia necrosis,the function can not be restored,pure blood supply damaged,some can restore function,and the parathyroid gland with vascular pedicle can be recovered quickly.(2) Severe blood supply and membrane damaged,and even free parathyroid should be transplanted immediately during operation.