Objective To evaluate the effect of percutaneous device closure guided by transesophageal echo-cardiography (TEE)on atrial septal defect(ASD)via right internal jugular vein(RIJV)in children.Methods A total of 8 cases with secundum ASD were recruited as candidates to receive percutaneous device closure via RIJV between July 22 and November 5,201 5 in Heart Center,Dalian Children′s Hospital.In this group,5 boys and 3 girls who were 5 months to 1 0 years old were included.The youngest patient was a 30 weeks premature infant of 5 months old,with 3 -month correction gestational age.All patients were clearly diagnosed as ASD by transthoracic echocardiography(TTE) before operation.Five patients had single central type ASD which were 5 -8 mm in diameter,and 3 patients had multi-ple(1 biforate and 2 cribriform)ASD which were 1 0 -1 2 mm in shunt range.New type Fustar curve adjustable sheath was delivered after RIJV accessed.By passing through the ASD by adjusting the depth and bending of the tips of sheath,then the device was delivered and released to close the ASD.The procedures were always guided and monitored by TEE.After the devices were released,the position of device,residual shunt,and the effect of valves were assessed by TEE or TTE.Results All patients were tested with TEE and TTE after procedure,devices were stable and well shaped,and the defects were closured well without any residual shunt.All the patients were followed up more than 6 months.No hydropericardium,thrombogenesis,tachyarrhythmia,complete atrioventricular block or other complications were found.Conclusions To close ASD with new type curve adjustable sheaths via RIJV may have wide indications, short operation path,well curative effect,minimal invasion and fast recovery in pediatrics,especially fit for the small age children with a big ASD who are difficult to treat via femoral vein.

The characteristics and rules of acupoint selection of acupuncture for trigeminal neuralgia were analyzed. By searching CNKI, VIP, WF, literature regarding acupuncture for trigeminal neuralgia from 1980 to 2013 was collected to establish an acupuncture prescription database. The data mining technology was applied to analyze the characteristics and rules of the acupoint selection. As a result, a total of 180 papers were included, involving 148 acupoints. It was found that the acupoints that had high frequency of selection included Hegu (LI 4), Xiaguan (ST 7), Fengchi (GB 20) and trigger points. The acupoints selected were distributed in 14 meridians, in which yangming meridian of hand-foot had a frequency of 41. 58%. The special acupoints including crossing points, yuan-primary points and five-shu points were widely used, accounting for 65. 9%. As for the branch of trigeminal nerve, the top-3 selected acupoints were Yangbai (GB 14), Yuyao (EX-HN 4), Cuanzhu (BL 2) in the first branch, Sibai (ST 2), Quanlian (SI 18), Yingxiang (LI 20) in the second branch, Jiache (ST 6), Xiaguan (ST 7), Dicang (ST 4) in the third branch. In conclusion, it is believed that the clinical treatment of trigeminal neural gia focuses on local acupoints in combination with nerve distribution-based acupoints and distal acupoints, also the special acupoints are emphasized.
Acupuncture Points ; Acupuncture Therapy ; Data Mining ; Humans ; Medicine in Literature ; Meridians ; Trigeminal Neuralgia ; therapy

This paper analyzed the problems in eight-year program medical education including vertical curriculum design,traditional teaching model and written test-based evaluation system based on the theory of translational medicine and evidence-based medicine.With the social progress,these old systems are not helpful to produce innovative thinking,mobilize students'subjective initiative and cultivate self learning capacity.Finally,this paper proposed measures for curriculum reform from the aspects of curriculum design,teaching mode transformation and evaluation optimization aiming at reaching the educational goal of eight-year program.

OBJECTIVE:To prepare captopril hydrophilic gel sustained-release tablet and study the influencing factors on its release METHODS:With HPMC as the matrix,the tablets were prepared by direct compression method and influencing factors on release were studied RESULTS & CONCLUSION:The in vitro release of prepared tablets conformed to Higuchi equation The HPMC matrix tablet could release in a sustained way when the proportion of HPMC was at least 15% in weight and the best proportion was 60%;The dissolution of Methocel K was slower than 60RT or 75RT;Taking lactose as the filler was better than starch or CaSO4;When the proportion of lactose increased,the dissolution sharply decreased;The tablet dissolved more rapidly with paddle method than with rotating basket methos,compression force and pH of dissolution medium affected the release very little

Background and purpose: Neck lymph node metastasis, most of which presents in central neck compartment, is common in patients with papillary thyroid carcinoma (PTC). The objective of this study was to investigate the relationship between the number of dissected central neck lymph nodes and clinical outcome after radioactive iodine (RAI) ablation in pN1a PTC with no more than 5 lymph nodes involvement. Methods: A total of 167 PTC patients who had 1-5 proven metastatic lymph nodes according to postoperative pathological diagnosis were retrospectively analyzed, all of whom underwent total or near total thyroidectomy and central lymph node dissection. After a median follow-up period of 26 months, the clinical outcome of each patient was evaluated as excellent response (ER), indeterminate response (IDR), bio-chemical incomplete response (BIR), or structural incomplete response (SIR) according to the new American Thyroid As-sociation guidelines. The accumulative ER rate (ERn) was calculated in patients with different numbers of dissected lymph nodes (ERn was defined as the proportion of patients who achieved ER with the dissected lymph node number of ≤n). The relationship between the number of dissected central neck lymph nodes and ERn were investigated. Results: As the increase in the number of dissected central neck lymph nodes,there was also an overall increase in ERn, especially when n rose from 1 to 10. The values of ER1, ER5, ER10 and ER30 were 25.0%, 66.7%, 74.7% and 79.1%, respectively. Besides, the proportion of patients who achieved ER was higher in those with 10 or more dissected lymph nodes than in those with less than 10 (85.7% vs 73.3%, P=0.05). In the multivariate logistic regression analysis, both the dissected central lymph node number of ≥10 (OR=2.720, 95%CI: 1.052-7.033, P=0.039) and the level of preablation stimulated thyroglobulin (OR=0.955, 95%CI: 0.926-0.984, P=0.003) were shown to contribute independently to ER. Conclusion: As the increas-ing number of dissected central neck lymph nodes, the percentage of pN1a PTC patients that achieved ER after RAI ablation generally rises. In pN1a PTC patients with no more than 5 lymph nodes involvement, a central compartment dissection with 10 or more lymph nodes might help them achieve ER after RAI ablation.

Objective To explore role of functional neck dissection for lower collar-shaped incision at hair margin behind ear in the treatment of differentiated thyroid cancer. Methods The clinical data of 11 patients with thyroid papillary carcinoma who underwent func-tional neck dissection for lower collar-shaped incision at hair margin behind ear were retrospectively analyzed. Results The incisions of all patients were unseen in daily life and patients were satisfied with the postoperative appearances. No case of shoulder syndrome,postoperative local recurrence and distant metastasis was observed. Conclusion Functional neck dissection for lower collar-shaped incision at hair margin behind ear is effective in the treatment of differentiated thyroid cancer. Meanwhile it can obviously improve patients’ postoperative appearance and life quality,therefore it is worth clinical application.

OBJECTIVE:To optimize the extraction technology of total flavonoids for Bone healing formulation in order to use it for preparation research. METHODS:With the content of total flavonoids as the index,L9(34)orthogonal test was employed to investigate the effects of volume fraction of the solvent ethanol,the amount of solvent,extraction times and extraction time on the extraction of total flavonoids for Bone healing formulation to determine the optimal levels of the factors,and verification tests were conducted. RESULTS:The optimal extraction technology of total flavonoids was 1 h reflux extraction for 3 times,with 70% etha-nol 10 times as much as the amount of medicinal materials. Verification tests showed the average content of total flavonoids was 62.03 mg/ml(RSD=0.84%,n=3),that is to say,6.20 g total flavonoids might be extracted from 100 g medicinal materials for the formulation. CONCLUSIONS:The optimal technology is stable and feasible and can be used for the extraction of total flavo-noids for Bone healing formulation and provide a experimental basis for the preparation of Bone healing liniment.

OBJECTIVE:To investigate transdermal behavior in vitro of total flavonoids and its monomer components in Guyu liniment. METHODS:Vertical Franz diffusion cell was adopted to perform a test on excised mouse skin as transdermal barrier. UV spectrophotometry was used to determine the content of total flavonoids,and HPLC to determine the content of monomer flavo-noid hydroxysafflor yellow A(HSYA)to observe transdermal absorption in vitro within 12 hours. RESULTS:The accumulative per-meation quantity Q of the total flavonoids and HSYA in Guyu liniment increased with time(t),demonstrating a significant correla-tion with t1/2,and transdermal absorption was in conformity with Higuchi equation (r=0.995 6,0.999 5);permeate flux of total flavonoids and HSYA were 126.24,47.516μg/(cm2·h). CONCLUSIONS:The transdermal behavior of total flavonoids in Guyu lin-iment is similar to that of HSYA. Both belong to matrix diffusion-type transdermal drug delivery system,with the characteristic of long-term sustained release.

Objective To investigate the relationship between the initial change of Tg and clinical outcome in DTC patients with pulmonary metastases after 131I treatment.Methods A total of 47 DTC patients (13 males,34 females;average age (41.6±16.3) years) with pulmonary metastases from January 2008 to June 2014 were retrospectively analyzed.Patients were divided into 3 groups according to the variation of Tg: G1 with a declined (more than 50％) Tg;G2 with a declined (less than 50％) Tg or an increased (less than 10％) Tg;G3 with an increased (more than 10％) Tg.The median follow-up time was 1 501 d.Clinical outcomes were divided into remission,stable disease and progressive disease according to the serum test and imaging results.Data analysis was performed by χ2 test and Fisher exact test.Results The percentage of G1,G2,G3 patients was 44.7％(21/47),40.4％(19/47),and 14.9％(7/47) respectively.Results of follow-up showed 19.0％(4/21) patients achieved remission and 81.0％(17/21) with stable disease in G1.There were 2/19 with remission,12/19 with stable disease and 5/19 with progression disease in G2.All patients (7/7) had progressive disease in G3.The clinical outcome was related to the variation of Tg after 131I treatment (Fisher exact test,P<0.01).Conclusions Initial Tg after 131I treatment could be a predictor to the outcome of patients.The increased Tg level indicates a high possibility of 131I refractory disease.

Background and purpose:This study aimed to investigate the relationship between lymph node metastatic rate (LR) and response to radioiodine therapy in patients with papillary thyroid carcinoma (PTC).Methods:A total number of 143 PTC patients after radioiodine therapy were included and classified into 4 groups [Ⅰ(0%-10%),Ⅱ(>10%-25%),Ⅲ(>25%-50%),Ⅳ(>50%)] according to the lymph node metastatic rate, and the responses to initial radioiodine therapy after a median follow-up period of 20.7 months were evaluated. They were classiifed into 4 groups [excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR), and struc-tural incomplete response (SIR)] according to the guideline proposed by 2015 American Thyroid Association. One-Way analysis of variance,χ2 test and Kruskal-Wallis test were used to evaluate the differences in basic clinicopathological features and clinical responses among the 4 groups. The ROC curve was analyzed to evaluate the clinical value of lymph node metastatic rate for predicting ER and optimal cut-off point.Results:There were no signiifcant differences in gender and T-stage among 4 groups (P>0.05). However,Ⅰ group was signiifcantly older than the other 3 groups (P=0.001). With the increase of lymph node metastatic rate, the number of ER cases decreased, while cases of BIR and SIR generally increased. Compared with the other 3 groups, less cases of ER (27.8%), while more BIR (27.8%) or SIR (11.1%) were observed in groupⅣ (H=18.816,P=0.000). Cut-off value of lymph node involved rate was 52.27%, with a better speciifcity of predicting ER. Area under the ROC curve was 0.668.Conclusion:The higher lymph node metastatic rate in patients with PTC, the worse clinical outcome it could be. A cut-off value of lymph node metastatic rate 52.27% is a speciifc independent predictor for the clinical outcome in PTC patients treated with radioiodine therapy.