Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

Objective： This prospective randomized clinical trial was conducted to evaluate the necessity of drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. Methods： A total of 116 patients who underwent total thyroidectomy or lobectomy for benign thyroidal disorders were randomly allocated to be drained or not. Operative and postoperative outcomes including operating time, postoperative pain assessed by visual analogue scale （VAS）, total amount of intramuscular analgesic administration, hospital stay, complications, necessity for re-operation and satisfaction of patients were all assessed. Results： The mean operating time was similar between two groups （the drained and non-drained groups）. The mean VAS score was found to be significantly low in the non-drained group patients in postoperative day （POD） 0 and POD 1. The mean amount of intramuscular analgesic requirement was significantly less in the non-drained group. One case of hematoma, two cases ofseroma and three cases of transient hypoparathyroidism occurred in the non-drained group, whereas one case of hematoma, two cases of seroma, two cases of wound infections and two cases of transient hypoparathyroidism occurred in the drained group. No patient needed re-operation for any complication. The mean hospital stay was significantly shorter and the satisfaction of patients was superior in the non-drained group. Conclusion： These findings suggest that postoperative complications cannot be prevented by using drains after total thyroidectomy or lobectomy for benign thyroid disorders. Furthermore, the use of drains may increase postoperative pain and the analgesic requirement, and prolong the hospital stay. In the light of these findings, the routine use of drains might not be necessary after thyroid surgery for benign disorders.     

Clinical and genetic analysis of two Chinese families with benign familial neonatal convulsions

Benign familial neonatal convulsions (BFNC) is a rare autosomal dominant inherited epilepsy syndrome. Two voltage-gated potassium channel genes, KCNQ2 and KCNQ3, have been identified as the genes responsible for BFNC. Here we report two Chinese families with clinical histories of typical BFNC. Using six microsatellite markers, two located at KCNQ2 locus and four at KCNQ3 locus, linkage analysis was performed in the two families, which excluded the linkage of BFNC to KCNQ3, but could not exclude the linkage to KCNQ2. Direct DNA sequencing of the KCNQ2 gene in the two families was performed, and two formerly unknown polymorphisms were identified, but no KCNQ2 mutation was found in the two families. Our study suggests the genetic heterogeneity in Chinese families with BFNC and proves the existence of a new gene locus for BFNC.     

Case Report： Adrenal myelolipoma within myxoid cortical adenoma associated with Conn＇s syndrome

The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare, for both tumors present usually as separate entities. There are only 16 such cases reported worldwide. To the best of our knowledge, the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported. A 32-year-old Chinese woman with 4-year history of hypertension was presented in our study. Computed tomography （CT） of the abdomen showed a large heterogeneously-enhancing mass （4.5 cm in diameter） in the left suprarenal region. Clinical history and laboratory results suggest a metabolic disorder as Conn＇s syndrome. The patient underwent a left adrenalectomy, and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma. The patient was postoperatively well and discharged uneventfully. In the present case report, we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn＇s syndrome, and the methods of the diagnosis and differential diagnosis.     

Preparation of Latex Film with Macropores and Their Applications in Pigment Dyeing

Aiming at improving the permeability of the pigment dyed fabrics,two kinds of hydrophilic polymers(polyvinyl pyrrolidone(PVP),and polyethylene glycol(PEG)were fed into the styrene-butyl acrylate(St-BuA)copolymer latex binder respectively to prepare films with macropores.The effects of the post-added polymers on the latex film formation process and film structures were studied and the performance of the dyed fabrics was evaluated.It was found that the drying process could still be divided into three stages even after the addition of PVP and PEG.And the water evaporation rate during the first and last stage remained the same as usual.However,after the addition of PVP,the onset of the second stage was delayed to high volume fraction,and PVP formed into spherical dispersion phase with 300 nm in diameter.It provided a great deal of interface between the latex polymer and the PVP phase,which led to an increase in the water evaporation rate during the second stage.A different case was found after the feeding of PEG.Firstly,the first stage ended at low volume fraction and a decreased evaporation rate was observed in the second stage.Secondly,the PEG dispersion appeared as finger-like structure in the transmission electron microscopy(TEM)images with 9μm in length.After rinsing,pores were found only in the films formerly containing PVP or PEG,and the shapes and the sizes were closely correlated with the initial morphologies of the PVP or PEG domains.However,the shade of color,the abrasion fastness,and the permeability of the dyed fabric were independent of the type of the post-added hydrophilic polymer.     

Reusing Test Cases Based on the Function Point

Reusing test cases from existing test case library is quite common in the software testing field. Testing practice tells us that there is a strong relationship between the granularity of a function unit under testing and that of the test case. A function unit with small granularity usually results in the test cases with the same small granularity. Therefore a test case defined as the function point,i. e.,the smallest size function unit,was provided for the first time.Though test cases with smaller granularity usually have better reusability,the cost of accurately reusing and integrating such test cases is also higher. In order to balance the test case reusability and the cost of test case reuse,a novel test case reuse model based on the function point was proposed in this paper. In this model,a reusable test case for specification-based testing was defined and some reuse strategies and three formal reuse methods were given. Finally,the complete automatic software process was realized by a reusing generation tool. The new method has improved reuse accuracy,while greatly enhances the software productivity.     

The Influence of Nitrate Salts and Complex Metal Ion to Regio-Selective Synthesis of 2-Nitro-5,10,15,20-Tetra-(4-Methoxyphenyl)Porphyrinato Metal

A series of 2-nitro-5,10,15,20-tetra(4-methoxyphenyl) porphyrinato metals were regioselectively synthesized with nitrate salts as nitrating reagent in acetic acid/acetic anhydride for preparation of 2-substituted porphyrin. The influence of nitrate salts and complex metal ion to the reaction were investigated. The extent of 2-nitration increased with the electronegativity of the central metal. When Cu(NO3)2·3H2O was used as nitrating reagent, almost quantitative yields of 2　nitro porphyrin were obtained in the case of Cu(Ⅱ) or Ni(Ⅱ) chelates, while Zn(Ⅱ) or Mn(Ⅲ) chelates gave 50% and 30% yields respectively. If Zn(NO3)2·10H2O was used as nitrating agent, no product was found for Cu(Ⅱ) or Ni(Ⅱ) chelates, 12% was found for Zn(Ⅱ) chelates. The other metal ion and nitrate salts were also found in quite different influence.     

Leaching of a copper flotation concentrate with ammonium persulfate in an autoclave system

The leaching behavior of a copper flotation concentrate was investigated using ammonium persulfate (APS) in an autoclave system. The decomposition products of APS, active oxygen, and acidic medium were used to extract metals from the concentrate. Leaching experiments were performed to compare the availability of APS as an oxidizing agent for leaching of the concentrate under atmospheric conditions and in an autoclave system. Leaching temperature and APS concentration were found to be important parameters in both leaching systems. Atmospheric leaching studies showed that the metal extractions increased with the increase in APS concentration and temperature (up to 333 K). A similar tendency was determined in the autoclave studies up to 423 K. It was also determined that the metal extractions decreased at temperatures above 423 K due to the passivation of the particle surface by molten elemental sulfur. The results showed that higher copper extractions could be achieved using an autoclave system.     

Reovirus, isolated from SARS patients

Beijing has been severely affected by SARS, and SARS-associated coronavirus has been confirmed as its cause. However, clinical and experimental evidence implicates the possibility of co-infection. In this report, reovirus was isolated from throat swabs of SARS patients, including the first case in Beijing and her mother. Identification with the electron microscopy revealed the characteristic features of reovirus. 24 of 38 samples from other SARS cases were found to have serologic responses to the reovirus. Primers designed for reovirus have amplified several fragments of DNA, one of which was sequenced (S2 gene fragment), which indicates it as a unique reovirus (orthoreovirus). Preliminary animal experiment showed that inoculation of the reovirus in mice caused death with atypical pneumonia. Nevertheless, the association of reovirus with SARS outbreak requires to be further investigated.     

Evaluation and modification of inclusion characteristics in HK40 heatresistant cast steel

Specifications of inclusions such as the type, morphology, number, composition, size, and place of inclusions in HK40 heat-resistant casting steel were studied by optical microscopy and scanning electron microscopy equipped with an energy-dispersive spectroscopy system. The effects of calcium silicide (CaSi) addition on these characteristics were evaluated at two pouring temperatures of 1420℃ and 1470℃. It was found that most of the appeared inclusions were in the type of chromium oxide. CaSi addition had a significant effect on the morphological modification, size and distribution of inclusions as well as changing the composition to oxide-sulfide compounds.     

Comparison of SETAM with security use case and security misuse case: A software security testing study

A software security testing behavior model,SETAM,was proposed in our previous work as the integrated model for describing software security testing requirements behavior,which is not only compatible with security functions and latent typical misuse behaviors,but also with the interaction of them.In this paper,we analyze the differences between SETAM with security use case and security misuse case in different types of security test requirements.To illustrate the effectiveness of SETAM,we compare them in a practical case study by the number of test cases and the number of faults detected by them.The results show that SETAM could decrease about 34.87% use cases on average,and the number of faults detected by SETAM increased by 71.67% in average,which means that our model can detect more faults with fewer test cases for software security testing.     

人工股骨头置换治疗57例高龄股骨粗隆间粉碎性骨折

目的:探讨人工股骨头置换治疗高龄股骨粗隆间粉碎性骨折的适应证及相关临床问题。方法:收集57例高龄股骨粗隆间粉碎性骨折病例资料进行回顾性分析。所有患者均在麻醉下采用骨水泥型人工股骨头置换治疗。结果:本组2例术中灌注骨水泥时出现毒性反应,经抢救后恢复正常;术后15例有不同程度的肺部感染,并有1例出现呼吸衰竭;1例出现心功能衰竭转内科治疗;3例出现深静脉血栓形成;9例有老年反应性精神障碍。以上并发症经治疗后治愈或缓解出院。术后下床时间5~14 d,平均8 d;住院时间14~35 d,平均19 d。3例失随访,1例在随访中死亡,53例完成随访。随访时间6个月~3年,平均随访时间1年5个月。49例恢复接近伤前状况,4例恢复后明显差于伤前状况。随访期内未发现感染、假体脱位及松动病例。结论:人工股骨头置换治疗高龄股骨粗隆间粉碎性骨折具有手术简单,术后能保持肢体长度,病人卧床时间短,并发症少,功能恢复快等优点,是治疗高龄股骨粗隆间骨折较理想方法,但高龄患者要重视原发病的治疗和并发症的处理。     

外伤性肝破裂并发腹腔室膈综合征的诊断和处理

目的 :总结外伤性肝破裂并发腹腔室隔综合征 (ACS)的诊断和处理经验。方法 :回顾性分析 2例外伤性肝破裂 ,失血性休克并发 ACS病例 ,皆以其临床特征得出诊断。一旦确定 ACS诊断 ,立即开腹减压。用 3L 无菌静脉营养用透明塑料袋 ,剪开两边成三角帽状覆盖于膨出肠曲 ,并缝于切口皮缘 ,暂时性“关腹”。结果 :采用剑突至耻骨联合大切口开腹减压 ,结果满意。 1例术后 ACS缓解 ,但因呕吐窒息死亡 ,1例治愈出院。结论 :诊断 ACS的关键是认识 ACS的临床特征 ,ACS一旦确诊应及时开腹减压 ,唯有作正中大切口开腹才能充分减压 ,用 3L无菌塑料袋暂时性“关腹”是理想的选择     

急性颅内血肿并静脉窦损伤15例报告

目的探讨急性颅内血肿并静脉窦损伤诊断、治疗、手术方法。方法急性颅内血肿清除时修补静脉窦损伤,术中行明胶海棉压迫,硬脑膜悬吊8例,上矢状窦前1/3损伤断裂结扎1例,间断缝合、骨膜、硬脑膜翻转修补缝合5例,术中修补硬脑膜6例。结果本组治愈11例,上肢感觉障碍2例,死亡2例,1例死亡于手术中。结论对于静脉窦损伤患者尽量做到早诊断、早治疗,抢救患者的生命,提高治愈率。     

静脉动脉化手术治疗下肢动脉闭塞症100例临床分析

应用分期或一期静脉动脉化手术治疗下肢动脉闭塞症．远端无理想流出道100例／108条肢体．随访1～10年，大部分病人疗效良好．认为术前的动脉造影能显示病变部位与程度，为选择术式提供了依据．一期术式与分期术式相比，有见效快，不需二期手术的优点．并对术式选择与手术并发症进行了探讨．     

36例低位及超低位直肠癌TME保肛手术治疗分析

目的:探讨低位及超低位直肠癌TME保肛手术的手术可行性及优点.方法:回顾分析我院自2003年3月-2006年6月的36例低位及超低位直肠癌TME的保肛手术治疗情况.结果:无手术死亡,无吻合口漏;有1例发生局部肿瘤复发,占2.7%.19例(52.7%)出现直肠前切除综合征.结论:TME保肛术可以有效降低复发率并保留了肛门功能,应成为低位直肠癌治疗的首选术式.     

PCR检测白血病患者外周血中EB病毒的DNA

目的：了解白血病患者ＥＢ病毒感染情况。方法：收集２１例急性淋巴细胞白血病、１例慢性淋巴细胞白血病、１５例急性粒细胞白血病、８例慢性粒细胞白血病患者及３２例正常对照组的外周血,分离单个核细胞,提取ＤＮＡ,应用ＰＣＲ方法检测ＥＢ病毒ＤＮＡ。结果：在１例初诊慢性粒细胞白血病病人样本中发现ＥＢ病毒阳性,余均为阴性。结论：白血病患者存在ＥＢ病毒感染情况,但并不普遍。     

顺行性下肢静脉造影临床分析

目的：分析下肢顺行静脉造影结果和临床诊治下肢静脉疾病的应用价值．方法：收集内蒙古民族大学附属医院2003～2005年间60例共65条下肢静脉造影资料进行分析．结果：经造影X线表现正常10条占（15．4％），深静脉瓣膜功能不全26条（40％），单纯浅静脉瓣功能不全4条（6．2％），深静脉血栓形成25条（38.5％）．结论：顺行静脉造影简便安全，创伤少，效果好，能为临床提供准确的诊治信息，可作为诊治下肢静脉疾病的首选方法．     

18例隆突性皮肤纤维肉瘤临床病理分析

目的：观察18例隆突性皮肤纤维肉瘤的临床及病理组织学特点,探讨诊断及鉴别诊断.方法：对18例隆突性皮肤纤维肉瘤进行回顾性分析.结果：复查18例隆突性皮肤纤维肉瘤的常规石蜡切片,并对部分病例进行重复切片,18例中有10例术后复发,其中4例2次复发,1例4次复发,无1例转移.组织学特点为梭形瘤细胞围绕小血管排列呈车辐状结构,且遍布整个瘤体;瘤细胞成分单一,核轻度异型,核分裂像少见;瘤细胞常向皮下脂肪呈树枝状浸润性生长.结论：隆突性皮肤纤维肉瘤发生于真皮,病程长,常反复复发,罕见转移.临床上第一次手术尽可能做局部广泛切除,可降低复发率.     

体外循环下儿童室间隔缺损修补术19例

目的回顾总结体外循环下儿童室间隔缺损修补术的治疗体会。方法对19例室间隔缺损的儿童施行体外循环下室间隔缺损修补术,对其中3例合并卵圆孔未闭予以同期修补。结果1例出现残余漏,无临床症状,1例术后出现急性右心衰竭,2例出现肺部感染,均经相应处理控制了病情,随访1-8个月,全组病人恢复良好。结论体外循环下室间隔缺损修补术是治疗儿童室间隔缺损最有效的治疗方法之一。