ObjectiveTo study the therapeutic effect and feasibility of endoscopic thyroidectomy via breast areola approach. MethodEndoscopic thyroidectomy via breast areola approach was performed in 62 patients, including 16 cases of adenoma, 43 cases of nodular goiter, and 3 cases of thyroid carcinoma.ResultsEndoscopic thyroidectomy was succeeded in 62 patients, 2 cases of cutaneous emphysema, 1 case of light skin bum which diameter was 0.5 cm, 1 case of transient hoarse voice,and 1 case of puncture sinus tract bleeding. There was no converted to open surgery,no hypercapnia, no damage of recurrent laryngeal nerve or parathyriod glands. ConclusionEndoscopic thyroidectomy via breast areola approach is safe and effective,and has good cosmetic results.

Objective To study the clinical features of hand-foot-mouth disease(HFMD) in neonates.Method From April 2015 to May 2016,the clinical manifestations,laboratory examinations,treatments and prognosis of neonates with HFMD in our hospital were retrospectively analyzed.Result A total of 6 cases of neonatal HFMD were included,with 4 males and 2 females.The ages of 2 patients were ≤7 days and the other 4 patients 8 ～ 28 days.5 patients developed this disease during April to July,while the other one in January.2 cases had a definite contract history of HFMD.4 cases presented with fever and rashes in hand and foot,one case with fever,rash and oral ulcer,and one case with rash in hip and oral ulcer without fever.The nucleic acid test of enterovirus were positive in 4 cases.The symptoms of these neonatal HFMD were mild and recovered after symptom-relieving treatment.Conclusion HFMD in neonates with fever and/or rash should be considered during the HFMD epidemic period.

Objective To study the etiology,pathogenesis,diagnosis and treatment of non-traumatic splenic rupture.Method The clinical data of patients with atraumatic splenic rupture from our hospital were retrospectively analyzed,and the liferatures were reviewed.Results Most cases were male.The average age was high.The etiological factors were diverse,and the most common being blood diseases,virus infection,local inflammation and neoplasm.The pathogenesis is related to splenomegaly,increase in splenic fragility,altered haemostatic mechanisms,malposition of the spleen,and violent contraction of the diaphragm.It is more difficult to arrive at a diagnosis when compared with traumatic splenic rupture.Most patients required splenectomy,especially when the etiological factors were malignant blood diseases or splenic tumors.Some patients received non-operative treatment.The prognosis was related to the etiological factors and age.Conclusions The etiological factors of non-traumatic splenic rupture were diverse,and pathological splenic rupture was most common.A preoperative diagnosis was difficult,and splenectomy was the most common treatment.

Objective To discuss the protective effect of carbon nanoparticles lymphatic tracer on parathyroid glands in the operation of thyroid carcinoma. Methods Retrospectively analyzed the clinical data of 65 thyroid carcinoma patients from January 2014 to October 2014, and they were divided into 2 groups according to whether injected with carbon nanoparticles. The experimental group (30 cases) were injected with carbon nanoparticles in thyroidglands before major procedure, while the control group (35 cases) were not injected. In the experimental group, there were 22 cases accepted total thyroidectomy of the affected side gland + isthmus thyroidectomy + subtotal thyroidectomy of the offside gland, and 8 cases of total thyroidectomy. In the control group, there were 25 cases accepted total thyroidectomy of the affected side gland + isthmus thyroidectomy + subtotal thyroidectomy of the offside gland,and 10 cases of total thyroidectomy. And all the 65 cases ac-cepted centrallymph nodes dissection. Results After carbon nanoparticles injection, central lymph nodes became black while parathyroid glands did not become black. The experimental group showed (2. 6 ± 0. 8) parathyroids each patient, and no parathyroid was cut by mis-take;the control group showed (1. 9 ± 0. 7) parathyroids each patient, and 3 parathyroids were cut by mistake. and the difference between the two groups was statistical meaningful (P<0. 05). There was no permanent hypoparathyroidism in the two groups. There was 1 cases of temporary hypoparathyroidism occured in the experimental group, and 3 cases occured in the control group, and there was no statistical sig-nificance difference between the two groups. Conclusion Carbon nanoparticles is benefit to the identification of parathyroid in surgery, and it can reduce the incidence of inadvertent parathyroidectomy, but it cann’ t reduce the incidence of hypoparathyroidism after procedure.

Objective To compare the effect of ultrasound-guided Mammotome minimally invasive operation and traditional surgery in treating benign breast tumor.Methods Eighty patients with benign breast tumor admitted to People's Hospital of Beijing Daxing District from October 2015 to April 2016 were randomly divided into group A and group B.Patients in group A accepted ultrasound-guided Mammotome minimally invasive operation (n =40),while patients in Group B accepted traditional surgery (n =40).Operation time,incision length,blood loss,patient satisfaction,postoperative pain,and the occurrence rates of complications were compared between the two groups.Results All the tumors in two groups were removed.Patients in group A had shorter operation time (10.4 ± 1.0) min,less blood loss (4.1 ± 0.5) ml,smaller length of incision (0.34 ± 0.04) cm (P ＜ 0.05 or P ＜ 0.01);also had less occurrence of complication (P ＜ 0.05);and patients in group A had better patient's satisfaction (95％) (P ＜ 0.01).Conclusions Ultrasound-guided Mammotome minimally invasive operation is helpful to shorten operation time and incision length,and reduce blood loss,also improve satisfaction.It is valuable for application and popularization in primary hospital.

Objective To investigate the injury of the brain, lung and liver of the pups after maternal infection of human eytomegalovirus (HCMV) 3 days before pregnancy. Methods Thirty kunming mice aged 10-12 weeks were mated and divided into infection group and control group. The female mice in the infection group were given intraperitonealty 1×106 50% tissue culture infective dose of HCMV suspension 0. 5 ml 3 days before pregnancy, while those in the control group were given intraperitoncally supernatant of human fibroblasts. At 19 days of gestation, cesarean sections were performed. Pathology and HCMV DNA of the brain, lung and liver tissue of the fetus were tested through microscope and PCR. Kai-square test was used to compared the positive rates of HCMV DNA and viral isolation between these two groups. Results The positive rates of HCMV viral isolation and DNA in the fetal mice of infection group were as follow: brain (73.3% and 93.3%), liver (53.3% and 93.3%)and lung (60. 0% and 86.7%), while HCMV DNA and viral isolation was not detected in the control group (P<0.05). Under microscope, viromicrosome and tissue injury including necrosis, degeneration and bleeding were found in the tissues of brain, lung and liver in the infection group. Conclusions Maternal mice HCMV infection before pregnancy might vertically transmitted to the fetus and cause multi-organ injury.

ObjectiveTo analyze the clinical characteristics of inflammatory bowel disease (IBD) in neonates.MethodsFrom July 2010 to July 2015, seven neonates were diagnosed with IBD in Affiliated BaYi Children's Hospital, Clinical Medical College in Chinese People's Liberation Army General Hospital, Southern Medical University. The data regarding these neonatal cases were analyzed and compared with 45 children with IBD from literature. Thet-test andChi-square test were used for statistical analysis of the data.ResultsSix cases had ulcerative colitis, and one case had Crohn's disease, both occurred 2-20 days after birth, and were characterized by diarrhea, no increase in body weight, anemia and intermittent higher hypersensitive C-reactive protein. Compared with IBD in children, abdominal pain and abdominal mass were rarer, while anemia was more common in neonatal IBD. All fecal cultures and blood cultures in the seven cases of neonatal IBD were negative. Abdominal X-ray revealed intestinal wall thickening in four cases. Multiple ulcers were observed from the cecum to the rectum by colonoscopy. Chronic intestinal mucosal inflammation associated with acute inflammation were found on pathological examination. Six infants received treatment with 5-aminosalicylic acid (combined with glucocorticoid in four cases), and one received glucocorticoid treatment only. One infant was started on infliximab treatment from two years old. One of these seven cases died one month after discharge due to refusal to continue treatment, and the disease was controlled in the other six cases. After treatment, one infant was lost to follow-up six months after discharge, two were cured at six and 12 months old without further treatment, and three improved and continued treatment.ConclusionsIn neonates with diarrhea, anemia and no increase in body weight, especially when antibiotic treatment is ineffective, colonoscopy should be performed to facilitate early diagnosis of IBD. Standard treatments result in good outcomes.

OBJECTIVETo establish a UPLC-MS/MS analysical method for simultaneous determination of concentrations of isoorientin, scutellarin and cynaroside in rat plasma and to study their pharmacokinetic characteristics after intravenous injection of 3 doses of Fufang Hongcao in rats.

METHODAcidified plasma samples were precipitated for protein with methanol. Waters Acquity BEH C18 column was adopted for spectrum, with mobile phase as 0. 1% formic acid acetonitrile-0. 1% formic acid-water gradient elution. Detection was carried out by the multiple reaction monitoring (MRM) positive ion mode with ESI ionization source.

RESULTThree flavonoids show a good linear relationship, with the extraction recovery ranging between 78.56% and 101.91% and a high intra-and inter-day precisions and accuracy. The MRT of the three flavonoids were all lower than 22 min in rats.

CONCLUSIONThe above men tioned method is so specific, rapid, sensitive that it is suitable for pharmacokinetic studies of Fufang Hongcao injection in rats.

Animals ; Apigenin ; blood ; pharmacokinetics ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; pharmacokinetics ; Female ; Glucosides ; blood ; pharmacokinetics ; Glucuronates ; blood ; pharmacokinetics ; Luteolin ; blood ; pharmacokinetics ; Male ; Rats ; Tandem Mass Spectrometry ; methods ; Time Factors

A simple and selective ultra performance liquid chromatography-electrospray ionization tandem mass spectrometry (UPLC-ESI-MS/MS) assay was developed for the determination of the human plasma protein binding of four bioactive flavonoids (such as orientin and vitexin) in Polygonum orientale. Protein precipitation was used for sample preparation. Equilibrium dialysis technique was applied to determine the plasma protein binding under physiological conditions. The separation was achieved through a Waters C18 column with a mobile phase composed of 0.1%formic acid in acetonitrile and 0.1%aqueous formic acid using step gradient elution at a flow rate of 0.35 mL/min. A Waters ACQUITY?TQD system was operated under the multiple reaction monitoring (MRM) mode of positive electrospray ionization. All of the recovery, precision, accuracy and stability of the method met the requirements. Good correlations (r40.99) of the four compounds were found, which suggested that these compounds can be simultaneously determined with acceptable accuracy. Results showed that the plasma protein bindings of the four bioactive flavonoids were in the range of 74-89% over the six concentrations studied. The binding parameters containing protein binding affinity, protein binding dissociation constant, and protein binding site were studied. The maximum ability to bind with protein was also determined in the assay in order to understand the drug-protein binding of each compound better.

Objective To study the role of partial pressure of oxygen in the treatment of pulmonary hypertension induced by meconium aspiration syndrome. Methods Retrospective analysis was performed on 58 patients with meconium aspirate and pulmonary hypertension from January 1,2007 to December 31,2016, 28 patients in the death group,and 30 patients in the survival group. Blood gas analysis about two groups of children with mechanical ventilation were collected at four different time points:before mechanical ventilation ( 0 h) ,12 hours after mechanical ventilation,24 hours after mechanical ventilation and 72 hours after mechan-ical ventilation. The 80 mmHg(1 mmHg=0. 133 kPa) in blood gas analysis of the partial pressure of oxygen was used as the boundary point to study the effects about different blood oxygen partial pressures on the length of mechanical ventilation time in the survival group. Results Blood gas analysis showed that there were no significant differences in pH,partial pressure of oxygen,HCO3-,and lactic acid before mechanical ventilation in the two groups,but the pH values were significantly higher in the survival group after 12 h, 24 h,and 72 h of mechanical ventilation(t values:-2. 07,-3. 48,-7. 11;P <0. 05). Partial pressure of oxygen were higher in the surviving group at 12 h,24 h,and 72 h than those in the death group(t values-2. 87,-4. 88,-11. 29; P<0. 05). The HCO3-values of the survival group at 12 h,24 h and 72 h were higher than the death group, and the differences were statistically significant ( t values: -3. 90, -5. 60,-5. 76,P<0. 001). The lactic acid of survival group was significantly lower than the death group at 72 h after ventilation (t=5. 12,P<0. 001). Compared with the death group,partial pressure of carbon dioxide in 24 h,72 h decreased significantly in the surviving group(t values:5. 67,7. 60;P<0. 05). In the surviving group,the partial pressure of oxygen was maintained above 80 mmHg in 18 patients and the mechanical venti-lation time was (7. 17 ± 1. 95) d. The partial pressure of oxygen was below 80 mmHg in 12 patients of the surviving group and the mechanical ventilation time was (8. 67 ± 2. 50)d. The difference was statistically sig-nificant(t =12. 02,P <0. 001). Conclusion In the treatment of newborn with pulmonary hypertension caused by meconium aspiration,maintaining a higher pH value and a partial pressure of oxygen higher than 80 mmHg may be beneficial to the recovery of children with pulmonary hypertension.