Objective To investigate the clinical effect of the ultrasonic scalpel and electric knife in open thyroid surgery.Methods The clinical data of 182 patients underwent thyroid surgery were retrospectively analyzed.100 cases in the observation group were used the ultrasonic scalpel surgery and 82 patients in the control group were given electric knife surgery.The average surgical incision length,mean operative time,mean blood loss and postoperative complications were compared between the two groups.Results The average incision length of the observation group was (36.7 ± 6.1)mm,average time of thyroidectomy was (25.3 ± 5.1)min and blood loss was (14.2 ± 5.1)ml,which were significantly lower than those of the control group (P ＜ 0.05).The incidence rate of adverse reaction between the two groups had no significant difference(P ＞ 0.05).Conclusion Compared with electric knife,the use of ultrasonic scalpel in thyroid surgery can significantly reduce blood loss,shorten the operation time,the prognosis and clinical efficacy is good,it is worth to be further promoted in clinical.

Objective To assess the violence risk levels of the community patients with severe mental illness and Analyze the associated factors.Methods A working group composed of psychiatrists,community police,FIMITIC staff,community physicians,neighborhood or village committee members was established.501 community patients with severe mental illness were evaluated with Violence Risk Assessment Scale by working group.While the data of the general demograpbic,medical history and violence history was investigated.Logistic regression analysis was used to explore the factors associated with violence.Results In 501 patients,risk levels of grade 0:124cases (24.8％),grade 1:165 cases (32.9％),grade 2:118 cases (23.5％),grade 3:59 cases (11.8％),grade 4:28 cases (5.6％) and grade 5:7 cases (1.4％).Logistic regression analysis showed four significant risk factors,which were schizophrenia (OR 4.139),no taking medicine (OR 6.883),unstable condition (OR 234.534) the number of previous violence(OR 3.457) (P ＜ 0.05).Logistic regression equation:Logit (severe violence) =-8.511 + 1.420 (schizophrenia) + 1.929 (no taking medicine) + 5.458 (unstable condition) +1.241 (the number of previous violence).Conclusion The results of violence risk assessment and risk factors have directive significance for management of community patients with severe mental illness.

Melatonin has a significant inhibitory effect on various cancers,especially on breast cancer.In estrogen receptor (ER)-positive human breast cancer,anti-cancer effects ofmelatonin on breast cancer cells and transplanted tumors mainly achieve by suppressing ER mRNA expression and ER transcriptional activity via the MT1 receptor.In addition,melatonin regulates the transactivation of other members of the nuclear receptor super-family,estrogen metabolizing enzymes,and the expression of related genes.Furthermore,melatonin also suppresses tumor aerobic metabolism,critical cell-signaling pathways relevant to cell proliferation,survival,metastasis,and drug resistance.Melatonin demonstrates both cytostatic and cytotoxic activity in breast cancer cells that appears to be cell-type specific.Studies on animal and human models indicate that disruption of the circadian nocturnal melatonin signal promotes the growth,metabolism,and signaling of human breast cancer,resulting in invalid hormone therapy and chemotherapeutic resistance in breast tumors.

Objective To dynamically observe the expressions of Toll like-receptor 2 (TLR-2),TLR-4 and inflammatory cytokine IL-1 beta and TNF alpha,and analyze the correlation between TLR-2,TLR-4 and inflammatory response on rat cornea alkali burn.Methods Forty SPF healthy SD rats were excluded the anterior segment disease,the right eye was set as burn experiment and the left eye as normal control,Ⅲ level corneal alkali burn model was established with concentration of 1 mol · L-1 NaOH(At the establishment and after the establishment of the model,the inconsistent degree of corneal bums,the corneal perforation and hyphema in rats,etc.,were removed,and finally randomly selected 32 eligible rats),then were randomly grouped into 3 days,7 days,14 days and 21 days group,8 eyes in each group.The rats were observed and photographed anterior segment of each group,evaluated the corneal inflammation index,then removed the eyeball of the rats in the corresponding time points.The eyeballs were made into pathological tissue section and stained with HE method.The number of inflammatory cells in the cornea was calculated,and the expression of TLR-2,TLR-4,IL-1 beta and TNF alpha was detected in the rat cornea with method of Western blot protein detection at the same time.The differences of each group were analyzed,and the correlation was assessed between TLRs and inflammatory factor.Results There were the expressions of TLR-2,TLR-4,IL-1 beta and TNF alpha in the normal rat cornea,and its expressions were gradually increased after alkali burn,reached the peak at the 7 days,then decreased gradually,the difference of each group (the 3 day,the 7 day,the 14 day,the 21 day) was statistically significant (all P ＜ 0.05).The expressions of TLR-2 and IL-1 beta (r =0.986,P ＜ 0.05),TNF alpha (r =0.986,P ＜ 0.05) were positive correlated.The expressions of TLR-4 and IL-1 beta(r =0.975,P ＜ 0.05),TNF alpha (r =0.990,P ＜0.05) were positive correlated.Conclusion TLRs participates and may start immune inflammatory response after corneal alkali burn,mediates the production of inflammatory cytokine.

In this paper the basic feature of the participating teaching approach is elaborated,and the problems needing to be paid attention to in the process of its application and fulfillment are also discussed.

Objective Our aim is to compare the safety and benefits of laparoscopic versus open incision hernia repair.Methods Forty-seven patients in our hospital were analyzed with prospective randomized double-blind study following either laparoscopic or open hernia repair.And others prospective randomized studies(PRS)were analyzed.Results Overall complication rate was similar in both groups(8.5% versus 9.2% in the laparoscopic and open groups respectively),but some early complications in the laparoscopic group maybe require a reoperation.Operating time was similar in the laparoscopic group.There was shorter length of stay and higher expense in the laparoscopic group and there was significant difference in the pain scores and medications,resumption of diet,or activity scores.At 2 weeks,there was no difference in the activity or pain scores,but physical function and physical health scores on the short-form 36(SF36)quality of life assessment forms were little in the laparoscopic group.Regardless of the technique(P=0.158).The result of PRS meta-analyses is that operating time was simila in the laparoscopic group.There was longer length of stay in the Laparoscopic group.And the rate of wound infection is significantly higher in the open groups.Conclusion Unlike other minimally invasive procedures,Laparoscopic hernia repair did not offer an advantage over open hernia repair in all studied parameters except pain,activities and quality of life scores at 2 weeks.It also took similar to perform.The choice of the procedure should be based on surgeon or patient preference.

The interaction between immune response and metabolic regulation can be viewed as a central homeostatic mechanism,dysfunction of which will lead to many diseases.This nonlinear interaction,which has the characteristic of super-complexity,can’t be controlled unless it is studied as a holism and the change of condition is researched.To study this homeostasis,bottom-up method used in system biology is limited.Ying-wei theory of TCM uses another method to describe di erent states of metabolic and immune systems e ectively.The unique approaches and rich experiences applied in TCM are of great value.

Objective:To compare the social adaptability of Chinese and Japanese children Method:306 preschool children in Xi'an and 215 Japanese children were sampled The research instrument was the Infant-Junior Middle School Social Adaptive Capacity Scale Result:In the six fields of social adaptability, Chinese children had lower scores than Japanese children, except for that of sports Conclusion:Chinese preschool children have lower social adaptive capacity, which may be due to the overprotective attitude of Chinese parents or grandparents

Objective To analyze and classify the characteristic of plain X-ray, CT scan, MRI and pathologic findings in ossification of the ligamentum flavum of the thoracic spine. Providing the clinic criterion to verify the extent and progression of ossification of ligaments based on medical imaging findings. Methods Twenty-four patients with thoracic myelopathy due to ossification of the ligamentum flavum underwent surgical decompression posteriorly. There were 18 males and 6 females with age ranging from 42-76 years (mean, 57.9 years). The morphology of ossification on the CT scan was divided into isotype and non-isotype. The signal intensity of ossification was compared with that of spinal cord on T2 stage in MRI, whose results were divided into four types, such as no signal, low signal, iso signal and high signal. There were two types of ossification in pathologic findings, the mature and immature ossification. 73 segments of ossified ligaments removed from surgery were evaluated and classified individually on the base of their X-ray, CT scan, MRI and pathologic findings. 27 segments of ossified ligaments were examined immunohistochemically by use of TGF-?1 antibody. The relationship between classification of X-ray, CT scan, MRI and pathology of the ossified ligaments were compared on the basis of individual segment, to determine whether there was correlation between these findings. Results The relationship between the pathologic findings of the 73 ossified fragments and the manifestation for the CT classification and MRI signal showed: 18 isotype ossification on CT scan turn out to be mature; and among the 55 non-isotype ossification, 51 were immature and 4 were mature. 22 no signal ossifications on MRI were confirmed as mature type; all the 50 low signal ossifications were immature type; and 1 iso signal ossification was immature type. 100% were matched between MRI and pathological findings, 94.5% matched between CT and pathological findings. Conclusion The extent and progression of ossification of ligaments may be verified and predicted clinically on the base of CT scan and MRI findings, which provide the clinic criterion to guide the extent and timing of decompression.

Objective To investigate the diagnostic value of MR cholangiopancreatography(MRCP) and volume imaging body exam(VIBE) in the obstructive jaundice.Methods 119 patients with obstructive jaundice underwent MRI examination of upper abdomen using the special sequences of MRCP and VIBE.The qualitative diagnosis of obstructive jaundice was evaluated with MRCP and VIBE in comparison with that of percutaneous transhepatic cholangiography(PTC),endoscopic retrograde cholangiopancreatography(ERCP) and operation.Results The corresponding diagnostic rate was 94.1% for obstructive jaundice with MRCP and VIBE,of that the corresponding rate in calculus obstruction,malignant obstruction,and the benign obstruction except calculus obstruction was 100%,94.3% and 83.9% respectively.There was significant difference between malignant obstruction and benign obstructive(P