This paper analyzes the disadvantages of traditional elevator used in tonsillectomy.Through clinical practice and on the basis of the structure of traditional elevator,a new elevator is designed which is similar to traditional one in appearance but different in its head,middle and end parts.With this elevator,the operative field is improved and thus operating period is decreased.

Objective: To quantitative analyze the expression of osteopontin(OPN) in oral squamous cell carcinoma(OSCC) tissues and its clinical significance.Methods: OPN expression was examined in 59 OSCC(with different clinical and pathological characteristics) and 12 normal oral mucosa(NOM) samples by using immunohistochemical method.The staining results were quantitatively studied by image analyzer.Results: OPN expression was much higher in OSCC sample than that in NOM sample(P

Three-dimensional conformal radiation therapy(3D-CRT) and intensity-modulated radiation therapy(IMRT) are becoming important parts for research of treatment in esophageal carcinoma patients.The advances of dosimetric study in 3D-CRT,IMRT of esophageal carcinoma and the evaluation indices are reviewed.

Objective To evaluate the diagnosis and treatment of children′s appendicitis.Methods Retrospective analysis of 2390 children patients with appendicitis undergoing appendectomy, and pathological classification was made.Results The simple type was in 237 cases (9.91%); purulent in 1798 (75.23%), among which 568 (31.59%) cases suffered perforation; Gangrenous in 212 (8.87%), with perforation in 159 (71.36%).During this period, there were 192 cases (7.4%) of appandiceal abscess.The perforation rate was 30.12%.That was 41.46% in children under 1-year of age, 44.96% in 1 to 4-year of age; 28.17% in 5 to 10 year of age; and 20.94% in over 10-year of age.Conclusion The incidence of postoperative pathology-proved simple type appendicitis is in inverse proportion to that of perforation.As a whole it reflects the strictness in which an individual case is indicated for a laparotomy.It is our believe that an incidence of 30% perforation is acceptable.

A clinically isolated syndrome(CIS) is a term that describes a first clinical episode in which a patient has symptoms and signs suggestive of an inflammatory demyelinating disorder of the central nervous system.And it often affects optic nerves,the brainstem,or the spinal cord,and 30％-70％ of the CIS patients may develop multiple sclerosis(MS).Disease-modifying treatments may delay the development from CIS to MS.Their use in CIS is limited because of uncertain long-term clinical prognosis,treatment benefits and adverse effects.This article reviews the advances of predictive markers of conversion to MS after a CIS,in order to provide the reference for clinical treatment.

Objective:To investigate the influence of Xuefu Zhuyu Decoction ( XZD) contained Drug-Serum on the expression of TLR4/NF-κB signals and LOX-1, TNF-α, ICAM-1, VCAM-1 in HUVECs, and to study its possible anti-atherosclerotic mechanism.Methods:HUVECs was cultured in vitro and divided equally into the normal group ,the model group,the ATV group and the XZD group in random.HUVECs were stimulated with LPS for 2 h,then treated separately with the drug-serum and atorvastatin for 24 h,finally measured the expression of TLR 4, MyD88, TRAF-6, NF-κB, LOX-1, TNF-α, ICAM-1 and VCAM-1 mRNA with real-time PCR,the expression of TLR4,NF-κB,LOX-1,TNF-α,ICAM-1 and VCAM-1 protein were analyzed by Western blot method .Results:Protein and mRNA expressions of TLR4,MyD88,TRAF-6,NF-κB,LOX-1,TNF-α,ICAM-1 and VCAM-1 increased significantly after LPS stimulation(vs normal control group,P<0.01),Xuefu Zhuyu Decoction decreased the high expression of TLR 4,MyD88,TRAF-6, NF-κB,LOX-1,TNF-α,ICAM-1 and VCAM-1(vs model group,P<0.05 ).Conclusion:Xuefu Zhuyu Decoction can block the high ex-pression of TLR4 and its downstream signal transduction pathway and the high expression of LOX -1, TNF-α, ICAM-1 and VCAM-1.Maybe it′s the mechanism of Xuefu Zhuyu Decoction exert the function of anti-artherosclerosis.

This experiment confirmed that the cause of rupture of the anastomosis in gastroenterostomy did not depend upon the layers of suture The rupture of anastomosis did not occur between the needle suture points if the submucosa was properly sutured, it may occur when the needle suture hole was gradually enlarged and connected each other So, it is reasonable that the distance of suture points should be kept about 0 5cm If the distance is too short or the suture layers are too many, it is not good for the healing of the anastomosis

ObjectiveTo investigate the clinical manifestation and pathological characteristics in the elderly ascending aortic dissection as well as the correlation between them.The cause of this disease and the pathologensis were also discussed. MethodsThe studies of the five elderly cases autopsy, clinical manifestations, pathological findings, histochemistry, and immunohistochemistry were done in the ascending aortic dissection tissues section. ResultsThe clinical manifestations of ascending aortic dissection in the elderly were complicated. The deteted results showed the retrograde degneration of smooth muscle cell in ascending aortic dissection wall and the reduction and fragmention of elastic fibers and fiberosis of collagen, and so on. ConclusionsAscending aortic dissection is a sort of blood vessel diseases seriously threatening the life of elder people. The diagnosis should be made by the combination of clinical manifestation with pathological findings in MRI and other examination methods.

BACKGROUND: Hematic protective has arisen widely attention in China and abroad due to the serious blood contamination and transfusion related diseases.OBJECTIVE: To observe hematic protective effect of hypertonic solution chloride hydroxyethy140 injection (HSH) on acute hypervolemic hemodilution (AHH) in maxilla Lefort Ⅰ osteotomy.METHODS: Totally 40 patients were randomly divided into the experimental and control groups, with 20 patients in each group. All patients were operated under tracheal intubation general anesthesia, in the experimental group, 4 Ml/kg HSH was infused with speed of 10 Ml/min, and the infusion was finished within 30 minutes. There was no treatment in the control group. Blood routine examination (including hematocrit, hemoglobin, blood platelets count) and routine coagulation test (including platelet, partial thromboplastin time, fibrinogen) was performed at the points of before AHH (T_0), at the end of AHH (T_1), 30 min after AHH (T_2),60 min after AHH (T_3), 3 hours after AHH (T_4), 1 day after operation (T_5), and 3 days after operation (T_6), respectively.Simultaneously, the capacities of blood transfusion, liquor transfusion, hemorrhage and urine during operation was recorded. RESULTS AND CONCLUSION: All the patients were included in the final analysis. Compared to the control group, the capacity of blood transfusion in the experimental group was smaller than that of the control group (P<0.05), with greater urine volume (P<0.05). However, the differences of liquor transfusion and hemorrhage had no significance (P>0.05). After controlled hypotension,the heart rates of patients at T_2 and T_3 were obvious increased than that of T_1 (P<0.05), the systolic pressure, diastolic pressure,and mean arterial pressure were significantly decreased (P<0.05). At T_1, T_2 and T_3 points, the heart rates of patients in the experimental group were greater than that of the control group (P<0.05). The systolic pressure, diastolic pressure, and mean arterial pressure had no dramatically differences between two groups (P>0.05). After AHH, the hematocrit and hemoglobin were obviously decreased in the experimental group at T_1, T_2, T_3 and T_4 points (P<0.05), with more blood platelets count and prolonged partial thromboplastin time (P<0.05). Compared to the control group, the Na~+, Cl~-was increased in the experimental group at T_1 and T_2 points (P<0.05), with greater hematocrit and hemoglobin at the T_5 and T_6 points (P<0.05). The results demonstrated that HSH can decrease or avoid transfusing blood in maxilla Lefort Ⅰ osteotomy.

Iatrogenic bile duct injury (IBDI) is a severe complication in general surgery, especially during laparos-eopic cholecystectomy. Many factors may cause IBDi, in which the conscientiousness, skill and experience of the surgeons play a more important role than the abnormal anatomy and patholo-gical changes of the patient. The Bismuth's classification, which originated from the era of open surgery, does not cover the whole spectrum of bile duct injuries. Strasberg's classification made a supplement by including other types of extrahepatie bile duct injuries. The variation of opportunities leads to different thera-peutic strategies. When the injuries are diagnosed intraopera-tively, a conversion to open surgery is the option of choice, and the prosthesis should be performed by a more experienced surgeon. If the bile duct injury is diagnosed in the early stage after operation, therapeutic principles are as follows: biliary peritonitis often required an emergency reoperation, while extra-peritoneal drainage is taken for patients with simple biliary leak. The most serious postoperative complication after IBDI is steno-sis, sometimes followed by fistula. Sufficient preoperative prepa-ration is essential, which includes controlling the biliary tract infection, improving the liver and renal function and nutritional state of the patient.