Résumé
Objective:To study the effect of totally endoscopic surgery and Miccoli surgery for papillary thyroid microcarcinoma. Methods Totally 64 patients with papillary thyroid microcarcinoma from April 2013 to April 2014 in our hospital were divided into the ob-servation group and the control group according to a random number table.And the intraoperative and postoperative situation of the two groups were compared.Results The number of lymph node dissection,postoperative hospital stay,hospital costs of the two groups had no sig-nificant difference (P >0.05).The blood loss,operative time,drainage time,amount of drainage,incision length,time of postoperative recov-ery of the observation group were significantly less than those of the control group with statistical significance (P <0.05).But the cosmetic score of observation group after operation was lower than that of the control group,and there was a significant difference (P <0.05).Postop-erative pain grade of the observation group was better than the control group with statistical significance (P <0.05).The complication rate of control group was significantly higher than the observation group (P <0.05).Conclusion Miccoli surgery for papillary thyroid microcarci-noma has more advantages compared with totally endoscopic surgery in terms of blood loss,operative time,drainage time,amount of drainage, incision length,time of postoperative recovery,and degree of pain.Moreover,it has a lower complication rate and high security,which should be the first choice in clinic surgery.
Résumé
BACKGROUND:As a kind of stressor, exercise-induced fatigue surely can lead to the material and functional changes of certain nerve nucleus within brain.It is still uncertain on what kind of nucleus closely relate to exer-cise-induced fatigue and what materials induce the functional or/and structural changes of tired central nerve.OBJECTIVE:To study the relationship between nitric oxide synthase (NOS) in ventromedial hypothalamic nucleus(VMH),dorsomedial hypothalamic nucleus(DMH) and exercise-induced fatigue.DESIGN:Randomized controlled study.MATERIALS:The experiment was completed in the Department of Human Anatomy of North University of China and Shanxi Medical University during October 2003 to January 2004.Twenty male Wister rats of clean class were selected.INTERVENTIONS:The rats were randomly divided into experimental group and control group with each of 10 rats.The rats in experimental group were made exercise-induced fatigue animal model by doing heavy load swimming until they were exhausted for 4 consecutive weeks. After the model was built,ABC immunohistochemical method was used to observe the expression of neuronal NOS (nNOS) in neurons of VMH ,and DMH and image analysis and statistic process were conducted.MAIN OUTCOME MEASURES:Number of nNOS positive cells in per unit visual field; Area and gray of positive substance.RESULTS:The number of nNOS positive cells in VMH of fatigue group was (25.25±7.35)/visual field which was much greater than that of control group (9.70±3.20)/visual field(P＜ 0.001).The area of nNOS positive substance was (3 867.75±1 940.41)μm2/visual field which was greater than that of control group(750.13±579.88)μm2/visual field(P ＜ 0.001). The number of nNOS positive cells in DMH of fatigue group was (30.25±7.87) /visual field which was much greater than that of control group (14.00±4.99) /visual field. And the area of nNOS positive substance was (4 512.06±1 243.93) μm2/visual field that was much greater than that of control group(782.46±711.46)μm2/visual field(P ＜ 0.001).CONCLUSION:The nNOS positive neurons in VMH and DMH neurons are closely related to the occurrence of central exercise-induced fatigue.Nitric oxide may play an important role in regulation of VMH and DMH to stress caused by fatigue.