Setting Li Dai Zhong Yao Pao Zhi Zi Liao Ji Yao as clue, this article searched each edition of China Pharmacopoeia, National Processing Standard of Traditional Chinese Medicine issued in 1988, and relevant materials of local processing standards and modern processing study, and concluded and combed the contents about Asari Radix et Rhizoma processing in ancient and modern literature. There are records about Asari Radix et Rhizoma processing methods in history, including net processing, cutting processing, heating processing and processing excipient. However, Asari Radix et Rhizoma processing methods in modern time are relatively simple. In addition to the version of the Processing Standard of Traditional Chinese Medicines in Shanghai issued in 2008, containing the honey Asari Radix et Rhizoma, other editions of China Pharmacopoeia and processing standards only recorded net processing and cutting processing. Recent research showed that processing methods of modern stir frying processing, alkali processing, wine processing, low temperature ultrafine comminution processing and so on, can effectively reduce the toxicity of Asari Radix et Rhizoma and enhance the safety of clinical application. This article summarized the history and research progress of Asari Radix et Rhizoma processing, and provided a reference for the study on modern processing.

Objective To investigate the clinical significance of the three iodide transporters in thyroid diseases. Methods Literatures about the Na+/I-symporter (NIS), pendrin and human apical iodide transporter (hAIT) in recent years were reviewed and their expressions in different thyroid diseases were also analyzed. Results NIS proteins express at the basolateral membrane of thyrocytes in normal thyroid tissue, while pendrin and hAIT proteins are limited to the apical membrane of thyrocytes lining in the follicular lumen. In the tissues of thyroid carcinomas, it was found that the NIS proteins expressed in the cytoplasm and their expressions decreased; The mutation of NIS gene may be one of the main causes of congenital hypothyroidism. The expression of prendrin protein may be related to the function of follicles: its expression level increased significantly both in Graves diseases and toxic adenomas, but significantly decreased in differentiated thyroid carcinoma. However, the correlation between the decrease and the degrees of differentiation of carcinoma cell line are still disputable. The expression of hAIT protein does not significantly altered in hyperfunctioning tissues. It only slightly decreased occasionally in hypofunctioning adenomas, but it decreased significantly in thyroid carcinomas. Conclusion The abnormal expressions of the three iodide transporters may be related closely with the type of thyroid diseases. However, their pathogenic mechanisms and the causes of their abnormal expression are still unknown, which need to be studied further.

Objective To compare the disadvantages and advantages of open thyroid surgery when using the harmonic scalpel (HS) vs conventional hemostasis (CH). MethodsOne hundred and fifty-one patients and 70 patients underwent thyroid surgery with HS or CH respectively. The tumor diameter, incisional length, the total operative time, thyroidectomy time, intraoperative bleeding volume, postoperative drainage volume and surgical complications were compared. The incisional length and the surgical complications in and after learning curve with harmonic scalpel were compared. ResultsThere was no significant difference between the HS and CH group at baseline. Incisional length, total operative time, thyroidectomy time, intraoperative bleeding volume and postoperative drainage volume in HS group were significantly lower than those of CH group (P0.05); the incisional length after learning curve was shorter than that in learning curve in HS group (P

Objective To assess the value and usage of real-time monitoring of the recurrent laryngeal nerve (RLN) during thyroid reoperation by RLN monitor. Methods One hundred and one patients were under general anesthesia and thyroidectomy. NIM-Response electromyographic (EMG) monitor system was used for assistant of dissection,exposure and protection of the RLN during the surgical procedures. Results There were 192 RLN were exposed during the surgeries in all 101 patients. The unilateral RLN injured in 10 patients was not specially explored the same side nerve. Among them 190 nerves were confirmed intact,the rest 2 nerves were resected because of tumor involving. Conclusion s NIM-Response electromyographic monitor system is sensitive and accurate for preserving the integrity of RLN during the thyroid reoperations. It is valuable for protecting RLN against iatrogenic injury. This system deserves general utilization for thyroid surgery,especially reoperation.

Objective To investigate effectiveness of treatment of Upper urinary tract calculus by MPCNL application.Methods From May 2000 to May 2007,causing artificial kidney hydronephrosis for the affected kidney,established renal percutaneous channels(F16～18),which established the single channels of 202 cases,dual-channel of 14 cases,by Ureteroscopic Lithotripsy and holmium laser lithotripsy.Results 183 cases of 216 patients were One-time stone;33 cases were second stone.The average clearance rate is 90.32%,the average operation time is 79min,average valume of about bleeding is 80ml,the average hospitalization days are 8 days,kidney ostomy average stay 7.5 days.Of the operation,9 cases of obviously bleeding(4%)before and after operation,1 case uncontrollable bleeding after interventional treatment failure with Nephrectomy,others to stop beeding by symptomatic treatment,2 cases find urinary extravasation postoperative and cured by adjusting location of renal ostomy.Conclusion Minimally invasive percutaneous nephrolithotomy for the treatment of Upper urinary tract calculus is safe and effective for patients with less trauma,quicker recovery and high learance rate,the efficacy is satifactory.

Parafossarulus striatulus, Pseudorasbora parva and brood ducks are involved in the lifecycle of Metorchis orientalis. Natural nidi of M.orientalis are confirmed in Huaihe River Basin.

Objective To investigate the effect of sevoflurane on blood pressure in patients with different ages and the optimal concen-tration of sevoflurane. Methods 60 patients underwent selective LC operation with conventional induction and sevoflurane maintenance were divided into three groups:the youth group (34 patients), the middle age group (20 patients) and the older age group (6 patients). The SBP, DBP, MAP, CETsev, number of patients, age of patients before induction and 10 min(T1), 20 min(T2), 30 min (T3), 60 min (T4) after induction were recorded. Results Fluctuate of blood pressure were in the normal range after anesthesia maintenance, and MAP were fluctuated within the range of ± 20% before induction. The age under different CETsev were of no significant difference in each time point (P>0. 05). The age composition ratio in different CETsev were of no significant difference in each time point (P>0. 05). As the time of anesthesia extended, the number of patients under 0% ~1%CETsev decreased from 35 to 11; the number of patients under 1% ~2%CETsev increased from 10 to 20;and the number of patients under 2% ~3%CETsev maintened in 14 approximately. Conclusion The effect of sevoflurane on blood pressure of different ages is approximate. 2% ~3% CETsev is the most optimal concentration during the main-tenance of anesthesia.

Objective To investigate the classification of cerebral arteriovenous malformation (AVM) associated with hemodynamics correlative aneurysms and its efficiency treated by endovascular treatment.Methods The clinical data of 17 patients of AVM associated with hemodynamics correlative aneurysms undergoing endovascular treatment were analyzed retrospectively.Results Eleven cases of aneurysms with great divergence between the aneurysm and arteriovenous malformation were embolized,6 cases of aneurysms without a great divergence between the aneurysm and arteriovenous malformation,1 case of aneurysm was treated with stent,other 5 cases of aneurysms were not treated.Eleven cases of arteriovenous malformations were embolized completely,4 cases were embolized 71％-90％ and 2 cases were embolized 50％-70％.Six cases with residual were given radiotherapy.Follow-up 3 months to 3 years,there were no cases of cerebral hemorrhage or death.Unhandled 5 cases of aneurysm and 1 case of stent implantation with the follow-up by using digital subtraction angiography,laneurysm with a stent was closed.Three aneurysms were disappeared and 2 aneurysms were reduced significantly among the 5 cases of aneurysms without treatment.One case of aneurysm occlusion in patients with stent implantation.Conclusions Classification based on a great divergence artery or not between the aneurysm and arteriovenous malformation is more instructive for clinical treatmen of cerebral arteriovenous malformation associated with hemodynamics correlative aneurysm.If it has not a great divergence artery between aneurysm and arteriovenous malformation,arteriovenous malformation after a thorough treatment,aneurysms need not be treated.The endovascular treatment for cerebral arteriovenous malformation associated with hemodynamics correlative aneurysms has a good efficiency and can be treated as a priority.

To explore the clinical manifestations, diagnosis and treatment of pulmonary thromboembolism associated with protein C (PC)/protein S (PS) deifciency. Two male patients 29 and 26 years old diagnosed with PC deifciency and/or PS deifciency were retrospectively analyzed and related literatures were reviewed. The most common symptoms were pain in the lower limbs with chest pain or decreased vision. Color dopper lfow imaging (CDFI) showed lower deep venous phlebothrombosis. Multislice CT angiography (CTA) revealed pulmonary embolism. The level of serum homocysteine (HCY) increased and the level of plasma PC/PS content decreased to PC 57.4%, and PS 28.9%in patient 1, while PS 33.4%in patient 2. Poor routine anticoagulant response was observed. After the diagnosis of PC/PS deficiency, vitiamin B6 and B12 anticoagulant therapy was added, and the symptoms in the patients improved significantly. Congenital thrombophilia should be taken into consideration for young patients with lower deep venous thrombosis and pulmonary embolism which occur recurrently without obvious predisposing causes before 40. Plasma PC/PS concentrations or activity help a lot in the diagnosis and treatment.

Objective To study the clinical value of Na+/I-symporter(NIS)expression on thyroid carcinoma diagnosis and 131I therapeutic effects prediction.Methods Thirty-one cases of thyroid carcinomas enrolled in this hospital from 1998 to 2006 were included.Using immunohistochemical method,NIS expression location,positive cell staining and expression intensity were observed,which was calculated by immunohistochemical scores(IHS)and NIS expression level was compared between primary and metastatic carcinoma.Results NIS was over-expressed on the basolateral membrane in positive control——Grave disease tissue,and showed no staining in negative control.NIS was expressed in cytoplasm in all 31 primary carcinomas,and IHS was over or equaled to 4 in 80.65% of them.Except for 2 no staining,NIS was expressed in cytoplasm in the rest 28 metastatic carcinomas.NIS expression was related to the pathological type of thyroid carcinoma,the strongest in PTC,then FTC,and the weakest in fvPTC.NIS expression in metastatic carcinoma was related to that in primary carcinoma.Conclusion NIS is over-expressed in cytoplasm in most thyroid carcinoma,and the iodide uptaking defect is mainly due to its wrong location.It has great potential to be applied in clinic by that it can help with the differential diagnosis of benign and malignant thyroid diseases,especially between FTA and FTC,and that it can help predict the therapeutic effects of 131I therapy following thyroid operation.