Objective To explore the feasibility of minimally invasive video-assisted thyroidectomy (M IVAT). Methods Clinical data of 8 consecutive patients with ben ign thyroid nodules treated by MIVAT in this hospital from September 2002 to Sep tember 2004 were retrospectively reviewed. Results All the pro cedures were successfully completed. The operative time was 90~150 min (mean, 12 0 min), and the hemorrhage volume, 10~30 ml (mean, 20 ml). No complications happ ened and no conversions to open surgery were needed. All the patients were compl etely recovered and discharged from hospital 3~4 days after the surgery. Follow- up checkups for 6~12 months (mean, 9 months) in the 8 patients found normally he aled wounds and no paraesthesia. Conclusions MIVAT is safe and effective, with excellent cosmetic outcomes.

Adolescent ; Child ; Child, Preschool ; Chronic Disease ; Cough ; etiology ; Female ; Humans ; Male ; Rhinitis ; complications ; diagnosis ; drug therapy ; Sinusitis ; complications ; diagnosis ; drug therapy

BACKGROUND: Fixation of bone fracture is one of the fundamental methods for bone fracture healing. The technique of AO has a lot of defects, such as negative effect induced by "stress dodging". Recently, the technique of CO is praised highly by national and international scholars. OBJECTIVE: To observe the influence of external fixation of small splint on healing of long bone fracture of rabbit, and compare to the internal fixation of steel plate.DESIGN: Randomized and controlled animal trial. SETTING: Research Institute of Orthopedics, Hubei College of Traditional Chinese Medicine.MATERIALS: The experiment was performed at the Laboratory of Orthopedics, Hubei College of Traditional Chinese Medicine from April 2006 to April 2007. Thirty rabbits were randomly divided into small splint fixation group and steel plate fixation group with 15 rabbits in each group. Small splint was self-made of fir-barks with good elasticity, and composed of exterior, interior, front and back splints. The upper part of the splint was wide and the lower part was narrow. We sting an eyelet in the small splint that is used in front and behind part. A hole was drilled in the front and back splints close to the tubercle of tibia. Steel plate was provided by Jiangsu Golden Deer Group (Type HA2.0). METHODS: The standard models of transverse fracture of 3 mm in the meta-infer 1/3 of left tibia were established. In small splint fixation group (SSF group), the fracture was fixed by plaster stone, and 5 days later, replaced by external fixation of small splint. The steel fixation group (SF group) was fixed by steel plate with 4 holes. Animals were executed 14, 24, and 34 days after surgery, respectively. The growth condition of bony callus in fracture sites was observed, and the histomorphology of bony callus and bone cell production during fracture healing was observed. MAIN OUTCOME MEASURES: Macroscopic observation of rabbit tibial bony callus, and histomorphology of bony callus and bone cell formation. RESULTS: In SSF group, the bony callus formed early, and there were plentiful and active osteoblast. Thirty-four days after surgery, bony union was observed in fracture sites. In SF group, there was little fibrous bony callus in the fracture ends 14 days after surgery, accompanied by granulation tissue. Twenty-four days after surgery, sparing cartilage synostosis was observed. On day 34 days, bony callus span the fracture ends, but fracture ends did not connect completely yet. Compared with the SF group, the quantity of bony callus and the speed of fracture healing were superior in SSF group. CONCLUSION: The external fixation of small splint can promote osteoblastic differentiation and proliferation, absorption of hematoma, calcification of the bony callus, and the growth and rebuilding of bone trabecula.

Objective To study the expression and transcription of PKC? in renal tissue of streptozotocin-induced diabetic rats. Methods Hyperglycemia was induced with streptozotocin(55 mg/kg) in Sprague-Dawley rats. After 5 weeks, the expression of PKC? protein and mRNA was measured by immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. Results In diabetic animals, the expression of PKC? was greatly enhanced especially in the proximal tubules and the glomeruler mesangial areas with upregulating of the membrane-associated PKC?. RT-PCR analysis showed that mRNA level of PKC? increased by 1.67 folds in diabetic rats as compared with the normal ones. Conclusion The expression of PKC? protein and mRNA is upregulated in early diabetic nephropathy, which suggests an interaction between PKC? and the pathogenesis of diabetic nephropathy.

Objective To investigate the role of mitochondrial KATP channel in the mechanism of the protective effect of ischemic preconditioning (IP) against ischemia-reperfusion (I/R) injury.Methods Forty-eight Wistar rats of both sexs weighing 250-350 g were used in this study. Forty rats were randomly divided into 5 groups ( n = 8 each): group A I/R; group B IP+ I/R; group C diazoxide (DZ mito-KATP channel activator) + I/R; group D 5-HD (mito-KATP channel blocker) + IP + I/R and group E 5-HD + DZ + I/R. Another 8 animals were used for electron microscopic examination of normal mitochondria as control. The animals were anesthetized with intraperitoneal pentobarbital 30 mg?kg-1. The hearts were immediately excised and passively perfused in a Langendorff apparatus with K-H solution at 5.8 kPa perfusion pressure and 36.5-37.5℃ via aortic cannulation. A fluid-filled latex balloon was via left atrium in left ventricle for the measurement of left ventricular function. I/R was induced after 30 min stabilization by clamping aortic cannula for 40 min followed by 30 min reperfusion. In group B and D the isolated hearts underwent 2 episodes of 5 min ischemia followed by 5 min reperfusion before I/R. In group C and E DZ 50 ?mol?L-1 was infused for 10 min and in group D and E 5-HD 100 ?mol?L-1 was infused for 10 min before I/R. HR, LVSP, LVEDP and coronary flow (CF) were measured at the end of stabilization (T0 , baseline), immediately before I/R (T1 ) and at 10, 20 and 30 min of reperfusion (T2.3.4.), and left ventricular developed pressure (LVDP= LVSP- LVEDP) was calculated. Myocardial tissue was obtained at the end of 30 min reperfusion for electron microscopic examination of mitochondria. Mitochondrial ultrastructure was assessed by Flameng scoring system (0 = normal, 4 = severely damaged) .Results Ischemic and DZ preconditioning significantly increased LVDP and decreased LVEDP and Flameng score. 5-HD pretreatment partly antagonized the protective effect of IP and completely antagonized that of DZ against I/R injury. Conclusion Ischemic preconditioning protects the heart against I/R injury mainly by activating mitochondrial KATP channel.

ObjectiveTo investigate the clinical efficacy of the fixation of elderly fracture of proximal humerus with locking compression plate(LCP) by mini-incision approach from lateral shoulder.Methods31 elderly patients suffered from elderly fracture of proximal humerus were treated with locking compression plate(LCP) by mini-incision approach from lateral shoulder, male 13 cases, female 18 cases; aged from 56 to 72, average 62-8 years old; fractures according to Neer classification: type Ⅱ(8 cases), type Ⅲ (19 cases), type Ⅳ (4 cases). Cause of injuries: traffic accident (9 cases), falling (20 cases), other injuries(2 cases).ResultsThe patients were followed up 6 to 36 months, an average of about 24 months. Fracture healing time was 2-2 ～ 6-4 months, on average 3-7 months; No wound infection occurred. Post-operative functional score (Neer score) revealed: excellent(18 cases), good (11 cases), fair (2 cases), the ratio of excellent(18 cases), good (11 cases) was 93-5%. ConclusionFixation of elderly fracture of proximal humerus with locking compression plate(LCP) by minimally invasive approach from lateral shoulder is a safe, reliable and minimally invasive procedure with good reduction and stable fixation. Early post-operative functional exercise may be permitted for preventing shoulder joint adhesion.

Objectives To investigate the effect and mechanism of terbutaline sulfate on pulmonary fluid transport in pre-mature rats. Methods Pregnant rats were randomly divided into 5 groups (control group, premature group, low-dose terbutaline group, high-dose terbutaline group and dexamethasone group). Drugs were administered by gavage after rats were fertilized for 16 days and continued for 3 days. Premature rats were taken out from the 19 days pregnant rats, and mature rats were delivered on the due day. Lungs were collected, and the ratio of pulmonary wet weight to dry weight (W/D), Na+, K+-ATP ase activity and concentration of cyclic adenosine monophosphate (cAMP) were measured in lungs. Results The W/D rate, Na+,K+-ATPase acti-vity and cAMP concentration in lungs had significant difference among different groups (P<0.01). The W/D rate was highest in premature group and lowest in the control group. It was lower in the high-dose terbutaline group than in the low-dose terbutaline group and the dexamethasone group (P<0.05). The Na+,K+-ATPase activity was lowest in premature group and highest in high-dose terbutaline group. It was higher in dexamethasone group, low-dose terbutaline group, and high-dose terbutaline group than in premature group, and it was higher in high-dsoe terbutaline group than in low-dose terbutaline group and dexamethasone group (P<0.05). The cAMP levle was lowest in premature group and highest in high-dose terbutaline group. It was higher in dexamethasone group, low-dose terbutaline group, high-dose terbutaline group than in premature group, and it was higher in high-dose terbutaline group than in low-dose terbutaline group and dexamethasone group (P<0.05). Conclusions Terbutaline sulfate facilitates lung fluid transport in premature rats, leading to reduce the W/D rate in terbutaline-treated group. We speculate that this effect is related to the increased cAMP level and Na+, K+-ATPase activity in lung tissue.

Objective To explore the competency of community health administrators in a survey of such administrators at large in Shanghai. Methods McClelland's Competency Dictionary was used to set two benchmark positions, while the behavioral event interviewing and questionnaires were made to survey 19 community health service centers in Shanghai. Results The competency model benchmarking on the head of a medical branch consists of 6 character clusters, 11 characteristic items, 27 evaluation dimensions and 27 typical behavior descriptions. The model benchmarking on the community team leader consists of 5 character clusters, 8 characteristic items, 21 evaluation dimensions and 21 typical behavior descriptions. Conclusion Findings of the survey provide objective criteria for competence appraisal of community health administrators, and serve as reference for formulating their development plans as well.

Objective To discuss the effective measures for skin allergy caused by hyaline mem-brane after deep venous catheterization. Methods Patients (102 eases) were divided into the control group(50 cases) and the test group(52 cases).3M hyaline membrane was patched on the skin directly to fix the catheter after successful puncture in the control group.While in the test group 3M hyaline membrane was patched on the skin after 3M painless protective membrane was sprayed on the skin. Results The incidence of skin allergy in the test group was lower than that of the control group. Conclusions Spray of 3M painless protective membrane before usage of hyaline membrane to fix the catheter could prevent the incidence of skin allergy after deep venous catheterization.

Objective To investigate the expression and translocation of protein kinase C (PKC) ?Ⅱ isoform in renal tissue of diabetic rats and the effects of blocking renin-angiotensin system (RAS) on them. Methods Diabetic rats induced with streptozotocin were randomized to 4 groups. (1) Diabetic control without treatment. (2) Treatment with irbesartan (40 mg?kg -1 ?d -1 ). (3)Treatment with fosinopril (40 mg?kg -1 ?d -1 ) and (4) Treatment with a combination of irbesartan and fosinopril (20 mg?kg -1 ?d -1 each). Six normoglycemic rats served as normal control. After 4 weeks, blood glucose and insulin were measured and expression and translocation of PKC?Ⅱ in renal cortex and medulla were assessed by immunohistochemistry and Western blot. Results The expressions of total and membrane fraction in renal cortex of diabetic control rats weredecreasedto66.0%and50.0% of the values of normal control rats respectively (both P