Objective To explore the measures to prevent recurrent laryngeal nerve (RLN)injury during thyroid surgery.Methods The clinical data of 223 patients undergone thyroid surgery were retrospectively analyzed.Among the 223 surgeries,69 sides were undergone regional protection act of RLN and 191 sides were performed RLN exposure.Results There were 2 cases of RLN injury from the regional protection operation of RLN,including 1 case of temporary nerve injury which could be resulted from surgery clamp and 1 case of permanent nerve injury which might be caused by mistaking ligation during surgery.There was only 1 case of temporary nerve injury in RLN exposure procedure which was probably caused by the postoperative nerve edema and was recovered 2 months after the operation.The total RLN injury rate was 1.35％.Conclusion For benign thyroid lesions and non-dorsal lesions or during partial excision of the gland,the regional protection of RLN is helpful to prevent RLN injury.In cases with dorsal lesions of thyroid or contralateral RLN injury,or during lobe subtotal resection,lobe resection and reoperation,exposing RLN to prevent injury is necessary.Taking different approaches based on the profiles of lesions and surgical procedures to prevent RLN injury can significantly reduce the risk of RLN injury.

Albendazole ; adverse effects ; Child, Preschool ; Drug Eruptions ; etiology ; Humans ; Tablets

Based on the full-length cDNA of BmalphaTX14 from Chinese scorpion Buthus martensii Karsch (BmK), gene of the mature peptide of BmalphaTX14 was cloned into the yeast expression vector pPIC9K. After transforming, screening and inducing, tricine-SDS-PAGE and Western blot proved that rBmalphaTX14 protein was expressed in the medium for up to 84 hours, getting nearly 120 mg/L. Recombinant BmalphaTX14 was purified rapidly and efficiently through Ni-NTA-agarose, polyethylene glycol precipitation and gel filtration chromatography. The purified rBmalphaTX14 proved to have the anti-insect activity by toxicity assay. Meanwhile, genomic gene of BmalphaTX14 was cloned and sequenced by PCR method, sequence analysis of this gene showed that BmalphaTX14 had an intron of 408 base pairs located at the signal peptide encoding region, which was similar with the characteristic of other alpha-type sodium ion-channel toxin. Considering both the genomic organization and the peptide function, BmaTX14 proved to be a membership belonging to alpha-type sodium ion-channel toxin.
Amino Acid Sequence ; Animals ; Base Sequence ; Cloning, Molecular ; Molecular Sequence Data ; Pichia ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; isolation & purification ; Scorpion Venoms ; biosynthesis ; genetics ; Scorpions ; genetics ; Sequence Analysis

OBJECTIVETo study the clinical value of muscle autograft denatured by microwave for repair of gap in removal of facial neuroma.

METHODSA case of patient with a larger facial nerve Schwann cell neuroma was reported. Based on the good results of our experimental research on rats recently, we completed the operation by transmastoid approach for removal of facial neuroma, and the gap of the nerve was repaired with muscle autograft denatured by microwave.

RESULTSThe patient was followed up for one year, and her facial function recovery on the affected side was satisfactory.

CONCLUSIONMuscle autograft denatured by microwave technique is convenient, highly efficient for repairing facial nerve gap after removal of facial neuroma.

Adult ; Facial Neoplasms ; complications ; surgery ; Facial Nerve ; physiology ; Facial Paralysis ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Microwaves ; Muscle, Skeletal ; transplantation ; Nerve Regeneration ; Neurilemmoma ; complications ; surgery ; Protein Denaturation ; Transplantation, Autologous

OBJECTIVETo analyze the situation of occupational health surveillance and the characteristics of occupational diseases in Guangzhou.

METHODSThe situation of occupational health surveillance and the morbidity of occupational diseases were studied retrospectively by use of the physical examination data collected from the labour hygienic reports of the city from 1993 to 2002. The data were divided into two groups: the first group from 1993 to 1997, and the second from 1998 to 2002.

RESULTSAnnual average of occupational health examination in the past 10 years was over 75%. The data in the second group (1998 - 2002) showed that the number of hearing loss observed subjects, noise surveilled personnels, dust and chemicals contraindicated personnels were significantly higher than those in the 1st group (P < 0.01). The morbidity of chronic occupational disease newly occurred was 91 cases in lst group, and 181 cases in 2nd group (P < 0.05), in which the incidence of chemical poisoning and noise induced hearing loss increased significantly but that of pneumoconiosis between two groups was not significantly different (P > 0.05). In the past 10 years, 581 cases of occupational diseases were diagnosed, of which, 309 cases (53.18%) were acute poisonings, while 272 cases (46.82%) were chronic occupational diseases. Pneumoconiosis, lead and benzene poisoning were common in chronic occupational diseases (16.70%, 16.87% respectively). With the passage of time, the incidence ages of pneumoconiosis, chemical poisoning and total occupational diseases tended towards younger. The difference was statistically significant (P < 0.01)

CONCLUSIONA normal system for occupational health surveillance has been developed in Guangzhou. Detectable rates in focused surveillance and contraindication have been obviously increasing. The incidence of occupational disease (mainly including acute occupational poisoning, pneumoconiosis, lead and benzene poisonings) is also going up. The incidence age of chronic occupational diseases tends to be younger accompanied with a shorter work history.

China ; epidemiology ; Humans ; Incidence ; Occupational Diseases ; epidemiology ; Occupational Health ; Retrospective Studies

OBJECTIVETo observe the regularity of change in high mobility group protein box 1 (HMGB1) content in serum and spleen of mice with multiple organ dysfunction syndrome (MODS), to analyze the correlation between HMGB1 content and major histocompatibility complex (MHC)-II---I-A(b) expression on monocytes in blood and spleen, and to explore the effect of HMGB1 on immune function of circulating monocytes and splenocytes.

METHODSOne hundred 8-week-old male 57BL/6 mice were randomly divided into normal group and experimental group subdivided into 8 subgroups: 3, 8, 12 hours, 1, 2, 3, 5-7 days and 10-12 days post zymosan injection (PZI). MODS model was replicated by injecting zymosan into the peritoneal cavity. At each time point, blood and spleen were collected to detect HMGB1 content and the rate of I-A(b) positive monocytes.

RESULTSIn normal and PZI 3-hour, 8-hour mice, serum HMGB1 was not detected, but it significantly increased at PZI 12 hours. In spleen of normal mice, there was low level of HMGB1 expression. In zymosan-treated mice, HMGB1 started to rise in spleen at PZI 3 hours. Subsequently, HMGB1 content in both serum and spleen significantly increased, and it reached the peak level in 1-2 days, decreased in 5 days, and then increased in 10-12 days. The number of I-A(b) positive monocytes in circulating blood and spleen decreased at 1-2 days (t equal to 9.589, 4.432, P <0.01) and 10-12 days following the challenge, forming a two trough like decrease, just corresponding with two-peak increase of HMGB1. However, at 3 hours after zymosan challenge, I-A(b) expression on circulating monocytes was downregulated (t =5.977, P less than 0.01), while that in spleen upregulated (t equal to 4.814, P less than 0.01).

CONCLUSIONIn mice with MODS, up-regulated HMGB1 expression can regulate I-A(b)expression on monocytes to depress their ability of presenting antigen, which results in immune disturbance contributing development of MODS.

Animals ; HMGB1 Protein ; analysis ; Histocompatibility Antigens Class II ; analysis ; Male ; Mice ; Mice, Inbred C57BL ; Monocytes ; immunology ; Multiple Organ Failure ; immunology ; Spleen ; immunology ; Zymosan ; pharmacology

BACKGROUNDSurgery is regarded as the most effective treatment to relieve pain and reduce complications in chronic pancreatitis (CP). Two major strategies exist: duodenum-preserving pancreatic head resection (DPPHR) and pancreatoduodenectomy (PD). Many studies suggest that DPPHR offers advantages during surgery and in the short-term; however, the long-term effects have not been thoroughly investigated. We analyzed the long-term outcomes of DPPHR and PD, over follow-up times of at least 1 year, to determine the optimal surgical treatment for CP.

METHODSWe systemically reviewed all CP surgical treatment reports, and only included randomized controlled trials (RCT) comparing DPPHR and PD, excluding unqualified studies using several pre-specified criteria. When multiple publications of a single trial were found, the most comprehensive current data were selected. Characteristics of the study populations and long-term postoperative outcome parameters were collected. The quality of the studies and data was analyzed using RevMan 4.2 software.

RESULTSFive trials were qualified for meta-analysis, with 261 participants in total (114 in the DPPHR group and 147 in the PD group). There were no significant differences in the age, gender, or indications for surgery of each group. At the mean of 5.7-year (1 - 14 years) follow-up examination, DPPHR and PD resulted in equally effective pain relief, exocrine and endocrine function, and similar mortality rates (P > 0.05); however, DPPHR patients had improved global quality of life and weight gain, and reduced diarrhea and fatigue (P < 0.05).

CONCLUSIONDPPHR and PD result in equal pain relief, mortality, and pancreatic function; however, DPPHR provides superior long-term outcomes.

Duodenum ; surgery ; Humans ; Pancreatectomy ; methods ; Pancreaticoduodenectomy ; methods ; Pancreatitis, Chronic ; psychology ; surgery ; Quality of Life ; Time Factors

Objective To investigate the application and advantages of alternative vascular hemihepatic occlusion in anatomic mesohepatectomy.MethodsThe clinical data of 57 patients with liver cancer who underwent operation in hepatobiliary surgery of Fuzhou general hospital from January 2014 to December 2017 were retrospectively analyzed.According to the surgery method, the patients were divided into observation group and control group, 34 cases in observation group were performed anatomic mesohepatectomy with alternative hemihepatic occlusion, 23 cases in control group were treated with non-anatomical liver lobectomy.The clinical effect of two groups were compared.Results The observation group was significantly better than the control group in terms of operation time, intraoperative blood loss, length of hospital stay, hospitalization costs, ALB at 1, 3, 5 days after surgery, ALT and AST at 1, 3, 5, 7 days after surgery, the differences were significant (P＜0.05).There was no perioperative deaths in the two groups.ConclusionApplied alternative hemihepatic vascular occlusion in anatomic mesohepatectomy can achieve good short-term curative effect and high safety.

BACKGROUNDPrecise evaluation of the live donor's liver is the most important factor for the donor's safety and the recipient's prognosis in living donor liver transplantation (LDLT). Our study assessed the clinical value of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for donor evaluation in LDLT.

METHODSComputer-assisted three-dimensional (3D) quantitative assessment was used to prospectively provide quantitative assessment of the graft volume for 123 consecutive donors of LDLT and its accuracy and efficiency were compared with that of the standard manual-traced method. A case of reduced monosegmental LDLT was also assessed and a surgical planning tool displayed the precise surgical plan to avoid large-for-size syndrome.

RESULTSThere was no statistically significant difference between the detected graft volumes with computer-assisted 3D quantitative assessment and manual-traced approaches ((856.76 ± 162.18) cm(3) vs. (870.64 ± 172.54) cm(3), P = 0.796). Estimated volumes by either method had good correlation with the actual graft weight (r-manual-traced method: 0.921, r-3D quantitative assessment method: 0.896, both P < 0.001). However, the computer-assisted 3D quantitative assessment approach was significantly more efficient taking half the time of the manual-traced method ((16.91 ± 1.375) minutes vs. (39.27 ± 2.102) minutes, P < 0.01) to estimate graft volume. We performed the reduced monosegmental LDLT, a pediatric case, with the surgical planning tool (188 g graft in the operation, which was estimated at 208 cm(3) pre-operation). The recipient recovered without large-for-size syndrome.

CONCLUSIONSComputer-assisted 3D quantitative assessment provided precise evaluation of the graft volume. It also assisted surgeons with a better understanding of the hepatic 3D anatomy and was useful for the individual surgical planning tool.

Computer Simulation ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; In Vitro Techniques ; Liver ; diagnostic imaging ; surgery ; Liver Transplantation ; Living Donors ; Organ Size ; Tomography, X-Ray Computed

OBJECTIVETo investigate the bacterial distribution and drug resistance in patients with surgical infections, and provide the basis for the standardization treatment of the surgical infection.

METHODSRetrospectively analyzed from January 2008 to December 2011 surgical infection in our samples bacteria identification and drug sensitivity test results.

RESULTSA total of 3829 nonduplicate isolates from 3257 samples, Gram-negative bacteria accounted for 62.4% (the main microbes were P.aeruginosa, K. pneumonia and E.coli etc) and Gram-positive bacteria accounted for 37.6% (the main microbes were Enterococcus, Staphylococcus and coagulase negative Staphylococcus). Incidence of Staphylococcus aureus and Enterococcus faecalis were on an obvious increase. For the performance of the high level of sensitive to Imipenem, Amikacin, Piperacillin and Tazobactam by E. coli and K. pneumonia. The Pseudomonas aeruginosa and Acinetobacter baumannii to cephalosporins, Carbapenems and Fluoroqinolones were higher resistant with Multidrug resistance. No vancomycin and teicoplanin resistant Enterococcus faecium were found. The prevalence of ESBL E.coli was 45.6%-61.5% and ESBL K.pneumoniae isolates were fluctuated. The methicillin-resistant S.aureus (MRSA) isolates were relatively high (21.1%-55.8%), and methicillin-resistant Staphylococcus epidermidis was higher than the other Gram-positive cocci. Vancomycin for Staphylococcus performance was highly sensitive.

CONCLUSIONSThe main composition of surgical clinical infection pathogens are Gram-negative bacillus, and the emergency of resistance of bacteria to antibacterial drugs is a common phenomenon. The resistant rate shows ascendant trend; Drug resistance is significantly higher in Pseudomonas aeruginosa and Acinetobacter baumannii. Antimicrobial resistance is a serious and challenging issue.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; Bacteria ; drug effects ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Retrospective Studies ; Surgical Wound Infection ; microbiology ; Young Adult