Objective To study the influence of hydroxyethylstarch 200/0.5 on hemodynamic and coagulation in hemodilution for paediatrics patients(AHH).Methods 64 paediatrics patients who would receive AHH were selected.All patients were randomly divided into HES group(received HES 200/0.5)and control group(received sodium lactate Ringer's),32 patients in each group.Hemodynamic efficacy and coagulation indexes were recorded before AHH(T0),30 min post-AHH(T1) and 60 min post-AHH(T2).Results There were no sinificant differences in MAP,HR,CVP,INR,APTT,CT and FIB compared with T0 or between groups.RBC,Hct and Hb were significantly lower compared with T0,but no significant differences were observed between groups.CI and PT were significantly higher compared with T0,but no significant differences were observed between groups.Conclusion There were no negative effects on hemodynamic efficacy and coagulation in paediatrics patients treating with HES 200/0.5.

Objective To explore the clinical effect of different operative methods in the treatment of papillary thyroid carcinoma.Methods Using random number method according to the proportion of 1∶1,95 patients with papillary thyroid carcinoma were divided into observation group(n=48) and control group(n=47).The control group was treated by ipsilateral lobectomy and isthmus resection and ipsilateral central lymph node dissection,the observation group was treated by total thyroidectomy plus ipsilateral central lymph node dissection.The tumor size,lymph node involvement,the score of KPS,the surgical complications and the rate of postoperative recurrence and metastasis of the two groups were compared.Results The tumor size,lymph node involvement and surgical complications in the observation group had no statistically significant differences compared with the control group(t=-1.367,P=0.175;t=-1.495,P=0.138;x2=1.642,P=0.232).After treatment,the effective rate of KPS score in the observation group was 81.25%,which was higher than 72.34% in the control group(Z=-3.639,P=0.000).The observation group had no recurrence,which was lower than 5 cases in the control group,the difference between the two groups was statistically significant(x2=5.390,P=0.006).The observation group found 1 case of metastatic patient,which was lower than 7 cases in the control group,the difference between the two groups was statistically significant(x2=5.053,P=0.031).Conclusion Total thyroidectomy plus ipsilateral central lymph node dissection in the treatment of papillary thyroid carcinoma has significant clinical curative effect.It can effectively reduce the risk of tumor recurrence and metastasis and improve the quality of life of patients.It is worthy of popularization and application.

Objective To explore the clinical effect of total thyroidectomy plus prophylactic central lymph node dissection in the treatment of multifocal papillary thyroid carcinoma.Methods Using EXCEL random number method according to the proportion of 1︰1,87 patients with multifocal papillary thyroid carcinoma were divided into treatment group(n=44) and control group(n=43).The control group was treated by ipsilateral lobectomy and isthmus resection and ipsilateral central lymph node dissection,the treatment group was treated by total thyroidectomy plus prophylactic central lymph node dissection.The tumor size,lymph node involvement,the score of SF-36,the complications and the rate of postoperative recurrence,metastasis and mortality of the two groups were compared.Results The tumor size,lymph node involvement and complications in the treatment group had no statistically significant differences compared with the control group(χ2=1.194,P=0.610;χ2=0.680,P=0.500,χ2=0.603,P=0.438).After treatment,the SF-36 scores of the two groups were significantly higher than before treatment(t=7.927,P=0.000;t=5.374,P=0.000).The SF-36 score of the treatment group was (76.47±13.72)points,which was significantly higher than (68.88±15.36)points of the control group(t=2.429,P=0.017).The patients were followed up for 6 months,there was no recurrence in the treatment group,while there were 5 cases in the control group,the difference was statistically significant(χ2=5.428,P=0.026).There was no metastasis in the treatment group,while there were 6 cases in the control group,the difference was statistically significant(χ2=6.594,P=0.012).Conclusion Total thyroidectomy plus prophylactic central lymph node dissection in the treatment of multifocal papillary thyroid carcinoma has significant clinical curative effect.It can effectively reduce the risk of tumor recurrence and metastasis and improve the quality of life of patients.It is worthy of popularization and application.

Objective To investigate the safety and effectiveness of laparoscopic surgery for early ovarian cancer. Methods Selected 90 early-stage ovarian cancer patients from January 2010 to December 2014 in Zhejiang Cancer Hospital as research subjects, and randomly divided into laparoscopic surgery group and laparotomy group. Then compared the age, BMI, ovarian cancer diameter, ovarian cancer staging, blood loss, operative time, surrounding or﹣gan damage, albumin difference before and after surgery, postoperative ventilation time, postoperative hospital stay, interval of postoperative to the first chemotherapy, postoperative fever cases, follow-up time, postoperative complica﹣tions, postoperative recurrence and postoperative death in two groups. Results Blood loss and operative time of la﹣paroscopic surgery group was less than that of laparotomy group (P< 0.05). Albumin difference before and after surgery of laparoscopic surgery group was less than that of laparotomy group (P< 0.05), postoperative ventilation time and interval of postoperative to the first chemotherapy of laparoscopic surgery group was less than that of la﹣parotomy group (P< 0.05), the incidence of postoperative fever and postoperative complications of laparoscopic surgery group was less than that of laparotomy group (P< 0.05), the recurrence rate and postoperative mortality rate of laparoscopic surgery group were slightly higher than that of laparotomy group, but the difference was not statisti﹣cally significant (PP> 0.05). Conclusion Laparoscopic surgery for early-stage ovarian cancer has a relatively good safety and efficacy. Laparoscopic surgery has advantages over open surgery in improving early ovarian cancer intra﹣operative situation and postoperative situation.

It is no doubt that obstetrics and gynecology contains profound philosophic thinking.To integrate the philosophical thinking of materialistic dialectics and dialectical unity in obstetrics and gynecology teaching is helpful to reveal the essence from obstetrics and gynecology phenomena.Application and cultivation of philosophical thinking may be useful to further explore students'comprehensive thinking potential and effectively improve the quality of obstetrics and gynecology teaching.

[Objective] Make textual research on the version origin of Yizong Baojing. [Method] Take the Lingyunlou carving copy of Yizong Baojing in Jiaqing Wuwu year(1798) of Qing Dynasty as the master copy, and lithographic copy of Shanghai Feiying Publishing House in the end of Qing Dynasty as the main checked copy, in the same time, take lithographic copies of Shanghai Wenruilou and Shanghai Jinzhang Publishing House in Minguo Times as reference copies, make careful investigation to many wondering points on version origin of the book, point out the problems and make serious comparison and analysis.[Result]Yizong Baojing was firstly carved in Jiaqing Wuwu year 3(1798) of Qing Dynasty, and published by Lingyunlou, thus came the Lingyunlou carving copy in Jiaqing Wuwu year(1798) of Qing Dynasty; to the end of Qing Dynasty, it was issued lithographical y by Shanghai Feiying Publishing House referring to the primary carving copy, then published by Shanghai Wenruilou, i.e. the lithographic copy of Shanghai Feiying Publishing House. This book is combined by many predecessors'medical books, very possibly from booksel ers or merchant of literature.[Conclusion]The study on the version origin of Yizong Baojing offers basic foundation for offspring's col ecting and studying the book, helpful to ancient TCM books protection and u-tilization, as wel as the development of TCM undertaking.

ObjectiveTo explore the curative effect about treatment acute coronry syndrome(ACS) by song ling xue mai kang drug used.Methods110 patients with ACS were randomly distributed into treatment group and control group,treatment group included 56 patients,control group included 54 patients,therapy of treatment group added song ling xue mai kang drug base on general treatmnet,but therapy of control group was only general treatment.It was time for four weeks.All patients were examinated blood lipid and C-reactive protein level(CRP) and liver kideny function end of four weeks,and follow-up cardiovascular ischemic event ( reangina attack,remyocardial infarction,heart failure,cardiol vascular death).Results C-reactive protein level of treatment group was less than its of control group,it was significant by statistics test( P ＜0.01 ).It was significant different about cardiovascular ischemic event between treatment group and control group( P ＜ 0.01 ).ConclusionIt was beneficial to patient of acute coronary syndrome about uesd song ling xue mai kang drug,it could reduce inflammatory reactive to happen in ACS,and reduce badness event of cradiolvascular.

Continuous blood purification is continuous, slow removal of water and solute molecules in the blood.So,it is a treatnent modality of organ supports.With the development of blood purification in children,application of continuous blood purification in children is beyond the field of renal replacement therapy.Treatment indications include systemic inflammatory response syndrome,sepsis,multiple organ dysfunction syndrome,acute respiratory distress syndrome,bums,etc.Continuous blood purification has become the most important treatment in pediatric intensive care unit.Because of the children's physiological features,blood purification equipment and the disease spectrum, continuous blood purification requires higher technology and presents more difficultits.

It is necessary for the improvement of the medical education and medical system to reform the model of clinical teaching.This article analyzes some problems of today's clinical teaching and clarifies specific demands and aims of teaching,learning and managing in the process of clinical teaching.In order to improve the quality of clinical teaching,the author puts forward some conceives about constructing the "three-in-one" system including teaching,learning and managing in clinical education.

Based on the characteristics of the onset age of acne,relationship of both inter-promotion and inter-restraint among the five elements between the liver and the lung,route of main and collateral channels,relationship among emotions,menstruation and acne,and clinical effects,etc.this article emphasized treating acne from the liver theory and discussed its theoritical and clinical evidence.According to this artical,the liver fire attacking the lung was the important pathogenesis of the occurrence of acne,Eliminating the liver fire was the important method of treating acne.