OBJECTIVE The short-term efficacy of endoscopic adenoid hypothermic plasma ablation and its effect on Eustachian tube function. METHODS 75 patients with obstructive sleep apnea hypopnea syndrome who were treated in our hospital from March 2013 to March 2015 were divided into two groups according to the different operative methods: nasal power cutting group(30 cases) and low temperature plasma ablation group(45 cases), comparison of the two groups of patients with surgery time, intraoperative blood loss and follow-up after 6 months of clinical efficacy and Eustachian tube function. RESULTS The time of resection, operation time and intraoperative blood loss were significantly better in the low-temperature plasma ablation group than that in the rhinectomy group, the difference was statistically significant(P<0.05); The incidence of complications in the low-temperature plasma ablation group was significantly higher than that in the rhinectomy group, and the difference was significant(P<0.05); there was no significant difference between the two groups in the total effective rate and the postoperative disease-specific quality of life questionnaire(OSA-18) and there was no significant difference in the quality of life between the two groups(P>0.05). CONCLUSION The clinical efficacy of low-temperature plasma ablation is close to nasal dynamic cutting, but low-temperature plasma ablation surgery in the amount of bleeding was significantly less than the nasal excision. This surgical approach is minimally invasive and safe, but its postoperative secondary infection and secondary bleeding is high, so this need for further study.

Objective To study the cause of misdiagnosis of pancreatic carcinoma(PC) in order to obtain the final diagnosis as early as possible,and increase the rates of early diagnosis and resection of PC.Mothods We petrospectively reviewed 102 cases of PC from 1991 to 1997,and analyzed the diagnostic accuracy of prehospitalized and admitted for PC.Results The average time from initial symptoms and jaundices to admision was 197 days and 60 days,respectively.The misdiagnostic rates of the first consult and multicosult or hospitalized in other hospitals were 100% and 85%,respectively.The most frequently misdiagnostic disease was peptic ulcer(25 cases),the rest were cholelithiasis(14 cases),hepatitis(11 cases),biliary tract ascarides(5 cases).Osteophyte proliferation(3 cases),colilis(3 cases) and others(3 cases).8 cases underwent surgery in other hospitals while 7 cases of them misdiagnosis in operation.The diagnostic rates of B-U and CT after admison were 85% and 95%,respectively.According to operative findings,60% cases had wide-ranging celiac metastasis in which 40% had hepatic metastasis simultaneously,alse 75% had local invasion and lymphatic metastasis.Only 10% and 2% patients underwent radical resection and palliative surgery respectively, while 10% patients had conservative treatment.Conclusion We demonstrated that there are high misdiagnositic rate,low radical rate and delaying final diagnosis for PC.It is urgent to increase its initial diagnostic rate and apply for CT in early stage would be the best device.

Objective Probe into different method safe and effective fixation method,clinical result and cliniical to indications of different treatments in intertrochanter fracture of femur in the old elderly.Methods Adopting the femur near end dissecting type to lock the stencil plate fixation 14 of 58 cases of old intertrochanter fracture of femur separately.the hip screw of motive force(DHS) fixation was used in 24,femur near end stencil plate fixation in 20,and the blood loss,operation time,ossicle split off situation and fracture heal time were compared among the three groups.Sanders grade results and complications were followed up.Results Postoperative follow up Was done in all patients,from 8 months to 3 years,averaged 1.5 years.three groups of skill type fine rate of the three groups being 92.9%,92%,90%respectively.Conclusions Different methods showed good clinical results in treating the old intertrochanter fracture of femur,each having its indications.Operation should be done should follow based on fracture type,age,physique factors and patient's osteoporosis intensity,choosing the best healing solution by characteristics of intermal flxation while each combining.The hook board(ALHP)is suitable for old patients with serious osteoporosis,DHS for Evans Ⅰ,Ⅱ types and some Evans Ⅲ type,and femur near end dissecting type stencil plate for Ⅳ and Ⅴ types fractures.

Objective To investigate prevention and treatment of parastomal hernia. Methods Clinical data of parastomal hernia of 44 cases were analyzed respectively with special respect to clinical features and repair methods. Result Simple sutures were used in 23 cases, mesh repair in 16 cases, stoma relocation plus mesh repair in 5 cases. Postoperative recovery was satisfactory in 39 cases. Incisional infection occurred in 5 cases, and hernia recurrence developed in 3 cases (6.8%) during a follow-up of 6 to 108 months (average 49 months) in 41 patients. Conclusion The causes of parastomal hernia are miscellaneous especially incisional infection; Perioperative malnutrition must be corrected companying diseases properly controlled, and operative technique improved to prevent the incidence of parastomal hernia; Surgery is the only cure for parastomal hernia. Mesh repair and/or stoma relocation is sometimes necessary.

Objective To analyze the efficacy and prognosis of different antiviral agents on compensated hepatitis B cirrhosis.Methods Eight hundred and sixty-five cases of Hepatitis B patients with compensated cirrhosis were randomly divided into five groups:A group(n =143,subcutaneous injection interferon 3 million U every other day for 48 weeks),B group(n =171,orally treatment with lamivudine 100 mg/d for 48weeks),C group(n =137,orally treatment with adefovir 10 mg/d for 48 weeks),D group(n =83,oral treatment with entecavir O.5 mg/d,for 48 weeks) and E group(n =331,treated with general hepatoprotective drugs).Clinical symptoms and signs,changes in liver function were observed and prothrombin time activity degrees (PTA),quantitative HBV-DNA,HBeAg seroconversion and HBeAg/HBeAb conversion situation were detected.Results There were significant differences on HBeAg seroconversion between A group and other four groups after treated for48 weeks(31.5％ vs 13.5％,22.6％,18.1％,5.7％,x2 =58.56,P ＜0.01) and at the end of follow up (33.1％ vs 14.2％,23.3 ％,23.6％,6.4％,x2 =52.87,P ＜ 0.01).Patients' condition in A,B,C,D groups progressed slowly,and their incidence rates of decompensate cirrhosis were significantly lower than that in group E(x2 =122.41,P ＜ 0.01).The incidence rate of liver cancer in group A was significantly lower than that in B,C,D,E groups (x2 =19.61,P ＜ 0.01).Conclusion Antiviral therapy of interferon and nucleoside drugs can slow the progression of compensated Hepatitis B cirrhosis and reduce the incidence rates of decompensate cirrhosis.And interferon can significantly reduce the incidence rate of liver cancer.

Objective To investigate the expressions of IL-8,MCP-1 and MIP-1? and their biological significance in pancreatic carcinoma and chronic pancreatitis, and investigate the relationships of their expressions in pancreatic cancer tissues.Methods Immunohistochemical method of avidin-biotin complex was used to examine surgically removed specimens from 51 cases of pancreatic carcinoma and 10 cases of chronic pancreatitis. Results The positive rates of expression and the scorings of IL-8,MCP-1,MIP-1? were significantly higher in pancreatic carcinoma than that in chronic pancreatitis(P

Multicolor imaging (MCI) based on confocal scanning laser ophthalmoscopy can gather more diagnostic information than traditional fundus photographs through utilizing three wavelengths of laser to scan posterior retina, which gain different layer reflected signal since the depth of penetration into retina is different for each wavelength. Currently, it provides important information and reference value for diagnose of different layer diseases on retina or choroid combining MCI with OCT, FAF, FFA and so on. However, there are still misunderstandings in the diagnosis of retinal diseases with MCI. Careful observation of retinal details in MCI, CFP and other imaging methods is more conducive to the correct diagnosis of fundus ophthalmopathy.

Objective:To investigate association between genetic polymorphism in the grainyhead-like 2 gene (GRHL2)and noise-induced hearing loss (NIHL)in the Chinese population.Methods:A matched case-control association study was employed,In which,3 790 workers exposed to continuous and steady-state occupational noise in a steel factory participated.The questionnaires were adopted to col-lect individual features and audiometry tests performed.In the sstudy,286 subjects were diagnosed as ca-ses,Which were each designated on the basis of the matched criterion,and 286 paired samples were se-lected finally.Noise intensity was measured according to the standards given in ‘Measurement of Noise in the Workplace’(Occupational Health Standard of the People’s Republic of China,GBZ /T1 89.8 -2007).Cumulative noise exposure (CNE)was calculated,according to monitoring data on A-weighed sound pressure level and employment time.Genomic DNA was obtained from peripheral blood samples using 2 mL DNA extraction Kit following the manufacturer’s protocol.Five single nucleotide polymor-phisms (SNPs)of GRHL2 were genotyped by multiplex SNP genotyping kit.The continuous variables and categorical variables were analyzed by t-test and chi-square test respectively.Multivariate Logistic re-gression was used to test the association between genetic frequency and disease status,with adjustments for the possible confounding variables.The haplotypes were established and their frequencies in the two groups were assessed by haploview and phase softwares.Results:All the five SNPs (rs373571 3, rs3824090,rs373571 4,rs373571 5 and rs61 1 41 9)were in Hardy-Weinberg equilibrium (HWE)(P >0.05).The subjects carrying rs373571 5 GG genotype had a higher NIHL risk than those carrying the GA genotype under the co-dominant model (OR =0.644,95% CI:0.442 -0.939,P =0.022)after ad-justment for height,blood pressure,drinking status and smoking status.After being stratified by CNE,in the CNE ≥ 98 dB (A)group,rs373571 5 polymorphism was associated with the NIHL under the co-dominant model (OR =0.509,95% CI:0.281 -0.923,P =0.026)after adjustment for height,blood pressure,drinking status and smoking status as well.However,no statistical significant difference was found in variant genotypes of the other SNPs between the case and control subjects.Four-locus (rs373571 3,rs3824090,rs373571 4 and rs373571 5)haplotypes were constructed,and no risk or protec-tive haplotypes was identified.Conclusion:It is suggested that GRHL2 polymorphisms may be associated with development of NIHL.

Objective To compare the simple cases of hand-foot-mouth disease(HFMD) with HFMD patients complicated with encephalitis and HFMD cases complicated with pulmonary edema (PE). To explore predictor factors of disease progression and unfavorable prognosis. Methods Forty-one EV71-infected children admitted to the Fuyang First People's Hospital in Anhui Province from March to May in 2008 were investigated in the research, who were classified as encephalitis-complicated cases ( encephalitis group, n = 15 ), PE-complicated cases ( PE group, n = 15 ) and simple cases (simple group, n= 11 ). Their clinical manifestation, laboratory findings, and immunophenotypes of peripheral blood lymphocyte were analyzed to find predictors associated with disease progression and unfavorable outcomes. Results The mortality rate in PE group was 66.7%, which was significantly higher than that in encephalitis group. Ninty-three point three percent cases in PE group and encephalitis group were younger than 3 years old, with statistic difference compared to simple group. Patients in PE group had higher total blood white cell (WBC) counts and higher absolute neutrophil counts and tended to have higher breathing rate, heart i'ate and glucose level than encephalitis group. The percentages of T cells and natural killer (NK) cells were significantly lower among patients complicated with encephalitis than simple HFMD patients.Conclusions PE is one predictor for poor prognosis. Factors correlated with unfavorable outcome include high WBC, high absolute neutrophil counts; elevated breathing rate, heart rate and glucose level. The immunophenotypes of peripheral blood lymphocytes can also predict the disease progression.

Objective:To evaluate the nutritional status of elderly inpatients with heart failure, and to analyze risk factors for malnutrition.Methods:A total of 221 patients with heart failure in our hospital from January 2018 to March 2019 were enrolled in the study.The demographic characteristics and medical record data were collected.All patients received Nutritional Risk Screening 2002(NRS-2002)and a questionnaire survey relating to heart failure.We investigated the effects of risk factors on the detection rate of malnutrition by using Mann-Whitney U test or Chi-square test, and the independent risk factors for malnutrition were analyzed by multivariate Logistic regression analysis.Results:The detection rate of nutritional risk was 45.2% in 221 patients.The detection rate of nutritional risk increased along with lower degree of education and worse cardiac function( P<0.05). The detection rate of nutritional risk was higher in patients with peripheral vascular disease and osteoporosis than in patients without them( P<0.05), and in patients with the increased numbers of complication and drugs( P<0.05). Patients with nutritional risk had a higher degree of frailty and a worse quality of activities of daily living( P<0.05). Multivariate Logistic regression analysis indicated that great age, ejection fraction, B-type natriuretic peptide(BNP), NYHA classification, numbers of drugs and diseases, frailty, low quality of life were independent risk factors for nutritional risk, and Digoxin was the independent protective factor for nutritional risk( P<0.05). Conclusions:The great age, severity of heart failure, numbers of drugs and diseases, frailty, low quality of daily life may be the independent risk factors for nutritional risk in elderly patients with heart failure, and oral Digoxin may be the independent protective factor for nutritional risk.