122 cases of endoscopic thyroidectomies through modified chest and mammary areola approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the safety and feasibility of endoscopic thyroidectomies through modified chest and mammary areola approach.@*METHOD@#We retrospectively analyzed 122 cases of endoscopic thyroidectomies through a modified chest and mammary areola approach without extensive dissection of thoracic flap. The information about general status, surgical procedures and techniques, complications, etc. were summarized and discussed.@*RESULT@#One hundred and twenty-one cases were operated successfully while 1 case was converted to video-assisted thyroidectomy through infraclavicular approach. The maximum diameter of the mass was (2.05 ± 1.06) cm, mean operation time was (88.61 ± 27.87) min, the operative blood loss was (31.23 ± 16.14) ml, duration of postoperative drainage was (3.54 ± 0.88) d and overall drainage volume was (139.09 ± 95.93) ml. Parathyroid glands were detected in specimens of 9 cases while no case of permanent postoperative hypocalcaemia was displayed. 6 cases of hoarseness were developed. One case experienced conversion surgery, all the others obtained satisfactory cosmetic result. All cases were followed up for 0-24 months without relapse and metastasis of the disease.@*CONCLUSION@#Endoscopic thyroidectomy via a modified chest and breast areola approach can facilitated the procedure and avoid extensive dissection of thoracic flap, and proved to be safe and effective.

Comparison the application of 3D versus 2D laparoscopic thyroidectomy via modified chest and mammary areola approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the safety, effectiveness and feasibility of 3D laparoscopy in thyroidectomy via modified chest and mammary areola approach comparing with 2D.@*METHOD@#Twenty six cases received 3D laparoscopic thyroidectomy (3D group) and 34 cases experienced 2D (2D group). We compared the indexes about general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc between two groups.@*RESULT@#Eight cases of thyroid cancer were detected in 3D group and 3 cases in 2D group. While there was no statistical difference between two groups with respect to other observation indexes such as other general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc.@*CONCLUSION@#3D laparoscopic thyroidectomy via modified chest and mammary areola approach is a safe, effective and feasible procedure, and it may substitute the place of 2D in the future.

Medical Insurance Affecting on the Health of the Elderly in China：based on the exmination of limited information of the maximum likelihood method / 中国卫生经济

Objective: Based on overcoming the adverse effect of endogenous problem of causality; to study the effect of health insurance for the health of the elderly. Methods: To apply limited information maximum likelihood method and introduce instrumental variables for two-phase analysis. Results: The more to types of medical insurance participated, the easier the risk of chronic diseases could be reduced, but unfavorable to improve self-reported health. Conclusion: The government should develop social insurance under New Rural Cooperative Medical System, to improve the abilities of the elderly in participating in medical insurance.

Analyzing Two-Stage Models of Influencing Factors on the Elderly Health Status / 中国卫生经济

Objective: To check the influencing factors on elderly health status, especially the influences of financial support on elderly health. Methods: By controlling the endogenous, it empirically analyzed the relationship between financial support and the elderly health. Results: It is found that the overall health status self-evaluation of the elderly are well. Financial support, gender, registered permanent assistance, elderly economical condition ( wherher have savinh) and elderly Activity Center have insignificant effects on the elder health, especially financial support. Conclusion:To improve the national health level and relieve the pressure of the ageing population, the government can increase the income of middle-young people, increase pension and improve activity facilities.