According to operative modalities,128 patients with unilateral benign thyroid disease were divided into hemithyroidectomy group (n =68) and subtotal thyroidectomy group (n =60).The operative duration of hemithyroidectomy group was (63 ± 14) min,intraoperative blood loss (54 ± 15) ml,postoperative drainage volume (64 ± 10) ml and hospitalization stay (5.9 ±0.8) days.The hospital charge of (8 335 ± 278) yuan was less than that of subtotal thyroidectomy group (P ＜ 0.05).The incidence rate of postoperative hoarseness,water bucking,low calcium and hypothyroidism had no significant inter-group difference (P ＞ 0.05).But the postoperative recurrence rate of hemithyroidectomy was significantly lower than that of subtotal thyroidectomy group (P ＜ 0.05).Treating patients of unilateral benign thyroid disease with hemithyroidectomy yield excellent efficacies.It is worthy of wider clinical application.

Objective To compare adductor canal block(ACB)with topical anesthesia for postoperative analgesia in the patients undergoing arthroscopic knee surgery.Methods Sixty patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status ⅠorⅡ,scheduled for elective arthroscopic meniscectomy,were divided into 2 groups (n=30 each) using a random number table:ACB group and topical anesthesia group(TA group).In group ACB,0.2% ropivacaine 20 ml was injected into the adductor canal under the guidance of ultrasound at 30 min before operation to perform ACB.In group TA,0.25% ropivacaine 20 ml was injected into the articular cavity at 5 min before the end of operation.The development of effective analgesia (VAS scores ≤4)and weakened quadriceps femoris muscle strength(muscle strength 0-2 grade,post-operative muscle strength was assessed by using manual muscle testing),related complications(local anesthetic intoxication,bleeding at the puncture site and hematoma) and occurrence of postoperative nausea,vomiting and delayed emergence were recorded.Results Compared with group TA,the rate of effective analgesia within 12 h after surgery was significantly increased (P<0.01),and no significant change was found in the incidence of weakened quadriceps femoris muscle strength,nausea and vomiting in group ACB(P>0.05).Local anesthetic intoxication,bleeding at the puncture site,hematoma or delayed emergence was not observed in the two groups.Conclusion ACB produces better efficacy for postoperative analgesia than topical anesthesia in the patients undergoing arthroscopic knee surgery.

Leukemia inhibitory factor (LIF) plays important roles in varieties of biological processes. This factor is highly conserved in mammalian animals and only one heterozygous LIF mutation was reported to cause the infertility of women. A LIF mutation was generated and the evidences were provided that the mutation of mature LIF at the 29th amino acid totally abolished its functions, including stimulation of STAT activation assayed by Luciferase reporter gene expression and EMSA experiments. In addition, the mutated LIF failed to inhibit the proliferation of M1 cells. The data indicated that the mutation of LIF did not have a dominant negative effect but lost the biological functions, suggesting that the 29th amino acid is critical for maintaining the activities of LIF.

Objective:To investigate the clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease of different sizes.Methods:From June 2008 to June 2011, 132 patients with single benign thyroid lesion in the Second People′s Hospital of Changshu were selected as observation group.According to the size of the lump, 132 patients with single benign thyroid disease were divided into two groups: ≤2cm group(64 patients) and >2cm group(68 patients). In addition, 62 patients with single benign thyroid lesion underwent subtotal thyroidectomy at the same time were randomly selected as control group.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost and postoperative complications (hoarseness, water bucking, low calcium, hypothyroidism, tumor recurrence) of the two groups were recorded and compared with the control group.Results:The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost of ≤2cm group were less or shorter than those of the control group[(3.6±0.4)cm vs.(4.5±0.6)cm, (40.1±9.6)min vs.(76.2±15.3)min, (52.2±17.8)mL vs.(82.1±16.8)mL, (49.8±15.7)mL vs.(78.1±12.4)mL, (4.9±0.9)d vs.(6.1±1.2)d, (7125.2±219.4)CNY vs.(8321.2±308.1)CNY, t=9.935, 15.917, 9.690, 11.205, 6.363, 25.161, all P<0.05]. The incidence of postoperative hoarseness in ≤2cm group was lower than that in the control group[0.0%(0/132) vs.6.5%(4/62), χ 2=4.4244, P<0.05]. The incidence of postoperative hypothyroidism in ≤2cm group was lower than that in the control group[0.0%(0/132) vs.8.1%(5/62), χ 2=5.374, P<0.05]. The incidences of postoperative water bucking, low calcium and tumor recurrence of ≤2cm group had no statistically significant differences compared with those of the control group (χ 2=2.097, 1.040, 0.968, all P>0.05). The operating time, hospital cost of >2cm group were less than those of the control group[(49.6±12.7)min vs.(76.2±15.3)min, (7 641.6±382.4)CNY vs.(8 321.2±308.1)CNY, t=10.820, 11.090, all P<0.05). The incision size, intraoperative blood loss, postoperative drainage volume, hospital day of ≤2cm group had no statistically significant differences compared with those of the control group( t=1.740, 1.709, 1.850, 1.487, all P>0.05). The incidences of postoperative hoarseness, water bucking, low calcium and hypothyroidism of ≤2cm group had no statistically significant differences compared with those of the control group (χ 2=2.175, 0.443, 1.105, 1.670, all P>0.05). The patients were followed-up for 7-10 years, the postoperative recurrence rate in >2cm group was higher than that in the control group[10.3%(7/68) vs.1.6%(1/62), χ 2=4.232, P<0.05]. Conclusion:Compared with conventional subtotal thyroidectomy, extended lumpectomy in the treatment of patients with small single benign thyroid disease(≤2cm) has good effect.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost, postoperative hoarseness and postoperative hypothyroidism are less than subtotal thyroidectomy.And it don't increase tumor recurrence rate of ipsilateral thyroid gland.So it is worthy of clinical application.But it is not suitable for larger single benign thyroid disease (>2cm) because of higher recurrence rate.

Objective: To investigate the anesthetic effect of the iliac fascia gap block in patients with senile femoral intertrochanteric fractures and its effect on stress indicators. Methods: A total of 100 elderly patients with intertrochanteric fractures were selected and randomly divided into control group(n=50) and observation group(n=50) by digital table.The control group was treated with general anesthesia.The observation group was anesthetized with iliac fascia gap block on the basis of the control group.The levels of norepinephrine(NE), epinephrine(E) and cortisol(Cor) were measured by double antibody radioimmunoassay.The effects of anesthesia and stress indicators of the patients were compared. Results: The dosages of propofol and remifentanil in the observation group were (721.21±21.24)mg and (421.25±8.94)μg, respectively, which were less than those in the control group [(946.46±24.35)mg and (545.42±9.13)μg, t=18.832, 19.231, P<0.05]. The time of extubation, the recovery time of anesthesia and agitation score in the observation group were (12.31±0.94)min, (16.43±1.21)min and (1.64±0.39)points, which were significantly lower than those in the control group[(18.43±1.21)min, (24.34±1.43)min, (2.54±0.64)points, t=21.124, 18.432, 19.831, all P<0.05]. Before anesthesia, there were no statistically significant differences in stress indicators and VAS score between the two groups (all P>0.05). The NE, E, Cor levels at 24h after operation had no statistically significant differences between the two groups (all P>0.05). The postoperative 24h VAS scores in the two groups were lower than those after extubation and before anesthesia(t=14.395, 13.882, 19.662, 12.501, all P<0.05). After anesthesia, the levels of NE, E Cor and VAS score in the observation group were (0.61±0.08)μg/L, (0.07±0.02)μg/L, (112.5±20.51)μg/L and (5.64±0.46)points, respectively, which were significantly lower than those in the control group [(0.84±0.12)μg/L, (0.98±0.06)μg/L, (178.42±29.49)μg/L, (6.75±0.49)points, t=10.773, 12.507, 11.295, 15.774, all P<0.05]. The incidence rate of adverse reaction of the observation group was 8.00%, which was lower than 6.00% of the control group, but the difference was not statistically significant(P>0.05). Conclusion The use of iliac fascia gap blockage in elderly patients with intertrochanteric fractures is effective and can reduce the dose of anesthetic drugs, reduce perioperative stress response, and does not increase the incidence of adverse reactions, it is worthy of application.

Objective:To compare the efficacy of superior trunk block (STB) versus interscalene brachial plexus block (ISB) in the patients undergoing arthroscopic shoulder surgery with general anesthesia.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-70 yr, undergoing elective arthroscopic shoulder surgery, were divided into 2 groups ( n=30 each) using a random number table method: ISB plus general anesthesia group (group IG) and STB plus general anesthesia group (group SG). In group IG and group SG, 0.375% ropiacaine 15 ml was injected around C 5-C 6 nerve roots and superior trunk, respectively.SpO 2, diaphragmatic excursion, diaphragmatic paralysis, dyspnea and Horner syndrome were recorded at 30 min after injection.General anesthesia with tracheal intubation was then performed in all the patients, and remifentanil or phenylephrine was used to maintain hemodynamics stable.The use of remifentanil was recorded at the end of operation, the visual analogue scale score was performed after patients regained consciousness, and the duration of sensory and motor blockade was recorded at 24 h after operation. Results:Compared with group IG, the decrease in the amplitude of SpO 2 was significantly decreased, and diaphragmatic excursion was increased, the incidence and degree of diaphragmatic paralysis were decreased, duration of sensory blockade was prolonged, the incidence of Horner syndrome and dyspnea was decreased ( P<0.05), and no significant change was found in the requirement for remifentanil, postoperative visual analogue scale score, and duration of motor blockade in group SG ( P>0.05). Conclusion:STB not only provides better perioperative analgesia, but also reduces the incidence of diaphragmatic paralysis when compared with ISB in the patients undergoing arthroscopic shoulder surgery with general anesthesia.