OBJECTIVE: To investigate the feasibility and efficacy of CO2 laser assisted posterior cordotomy for patients with bilateral paralysis of the vocal cord. METHOD: Twenty-one patients with bilateral paralysis of the vocal cord underwent CO2 laser assisted posterior cordotomy in our hospital from Jul. 2009 to Jun. 2015. The causes of the bilateral paralysis of the vocal cord were thyroidectomy in 15 cases, cervical trauma in 2 cases, resection of pituitary tumor in 1 case, inflammation in 1 case and without cause in 2 cases. Ten patients underwent tracheotomy before the operation; 9 patients underwent tracheotomy after the operation; 2 cases without tracheotomy. RESULT: The tracheotomy tube was plugged next day after posterior cordotomy. Lots of patients were breathing well without any effort. A few patients were breathing hard, so the tracheotomy tube was plugged discontinuously. Seventeen patients were decannulated 1 year after operation. Two patients were failed to decannulated. The patients were followed up for 3 months 6 years after operation, and all of them were breathing well. CONCLUSION Our limited experience showed that CO2 laser assisted posterior cordotomyis an effective and reliable surgical procedure for patients with bilateral paralysis of the vocal cord.
Cordotomy ; methods ; Humans ; Inflammation ; complications ; Laser Therapy ; Lasers, Gas ; Neck Injuries ; complications ; Pituitary Neoplasms ; complications ; surgery ; Thyroidectomy ; adverse effects ; Tracheotomy ; Treatment Outcome ; Vocal Cord Paralysis ; surgery ; Vocal Cords ; physiopathology

Objective To study the pathogenesis, clinical symptoms, surgical treatment and preventive measures of esophagogastric-arterial fistula following resection for carcinoma of the esophagus and cardia. Methods The clinical data of 18 patients with esophagogastric-arterial fistula were retrospective analyzed. Results There were 14 patients of esophageal carcinoma and 4 patients of cardiac carcinoma.7 patients had supra-aortic esophagogastric anastomosis(2 near the apex of pleura) and 11 had anastomosis under the aortic arch. Fatal hemorrhage occurred postoperatively from 11 to 93 days. The interval between hemorrhage and death varied from being instant to 18 days.All patients died. Conclusion The surgical treatment provide an opportunity for those patients. Successful management is possible if early diagnosis is made and prompt surgical management is undertaken. Preventive measures of peptic ulcer and esophageal fistula can decrease occurrence of this complication.

Objective To construct the eukaryotic expression vector of pcDNA3.1-PEA-15 and express it in the human esophageal cancer (EC-109) cells,and to explore the effect of PEA-15 on EC-109 cells.Methods The PEA-15 gene was amplified from EC-109 by reverse transcriptase polymerase chain reaction (RT-PCR) and ligated to eukaryotic expression vector pcDNA3.1.After confirmation of recombinant plasmid was correctly by endonuc]eases digestion and DNA sequencing,the construct was transfected it into EC-109 through liposome inducing.The expression of PEA-15 in transfected EC-109 was detected by RT-PCR and Western blot.The cell growth inhibition ratio was evaluated by MTT assay.Results RT-PCR indicated that PEA-15 was highly expressed in EC-109 cells.The amplified fragment by RT-PCR was coincident with hypothesis enzyme digestion analysis and DNA sequencing confirmed that the pcDNA3.1-PEA-15 was constructed successfully.The expression of PEA-15 gene was increased obviously in the transfected EC-109 detected by RT-PCR and Western blot respectively (t =4.078,5.269,P ＜ 0.05).The cell growth inhibition ratio in the group which transfected pcDNA3.1-PEA-15 was significantly lower compared with the pcDNA3.1 transfect group after 72 hours (t =6.163,P ＜ 0.05).Conclusions The recombinant eukaryotic expression vector pcDNA3.1-PEA-15 is constructed successfully,and it can be expressed in EC-109.It also shows that PEA-15 has the function on cell growth which suggests that PEA-15 can inhibit the apoptosis of EC-109 cells and its expression involved in esophageal cancer development.

Objective To study the changes of apoptosis and cell cycle progression of Hela cells after the poly(ADP-ribose) polymerase(PARP) was inhibited by its inhibitor 3-aminobenzamid(3-AB) and the mechanisms of PARP interaction with Hela cells damaged by irradiation.Methods Hela cell line was used.Flow cytometry(FCM) was used to examine the PARP expression of control and 3-AB groups at 0,2,4,8,12 h after administration with 5 mmol?L-1 3-AB.The percentage of apoptotic cells and cell cycle progression of control,irradiation,3-AB plus irradiation groups were measured with FCM at 2,8,12,24 h after exposure to 2 Gy irradiation following administration with 5 mmol?L-1 3-AB.Results The percentage of Hela cells with positive expression of PARP protein decreased after administration with 3-AB and there was significant difference between 3-AB plus irradiation group and control group(P

Objective To establish a reconstructed human epidermis model in vitro, and to study the process of re-epithelialization. Methods A dermal substrate devoid of epidermis was prepared; a 2 mm skin biopsy explant was transplanted onto the dermal substrates. Visualization of epidermal cell migration was carried out by fluorescence imaging. The proliferation and differentiation of the new epithelial cells were observed using histopathological and immunohistochemical staining (Ki67). EGF was added to the culture medium of the experimental samples but not to that of the controls. Results After 3 days of culture, re-epithelialization was observed on the surface of the dermal substrate. A complete structure resembling regular epidermis was noted in 10 days. As compared to control samples, EGF-treated samples had larger area of re-epithelialization (t= 3.02, P

Objective To study the relationship between the changes of diffusion tensor imaging(DTI)and diffusion tensor tractography(DTT)of optic radiation and the defect of visual field.Methods DTI and DTT were performed in 37 patients with invasion of the optic radiation by intracranial lesions and in 20 normal control group at 3.0T MR scanner,the visual fields of all cases were examined.The relativity between FA values,ADC values and mean sensitivity(MS)values,mean defect(MD)values of visual field and the relativity between the morphological change of optic radiation and the defect of visual field were analysed.Results In comparison with control group,FA values decreased and ADC values increased in subject group,there were statistically significant differences(P＜0.001)between them.In disordered group,FA values were positive correlation with MS values(r=0.718)and negative correlation with MD values(r=-0.694);ADC values were negative correlation with MS values(r=-0.625)and positive correlation with MD values(r=0.538).DTT showed that the ventral tracts of optic radiation were damaged which oppeared as the defect of ditto quadrant of bilateral field vision in 9 cases,the dorsal tracts and the lateral tracts of optic radiation were damaged which appeared as the defect of inferior quadrant of bilateral field vision in 7 cases,the optic radiations were damaged extensively that caused symmetric or asymmetric congruous hemianopia of bilateral field vision in 21 cases.Conclusion DTI and DTT of optic radiation are intimately correlated with the examined results of visual field,it will be a objective index to extimate the function and the morphological changes of optic radiation.

BACKGROUND:Study confirmed that the de-epidermized dermis(DED)can be used as dermal substitute and may form epidermal structure after incubating keratinocytes.However,the cell biological activity,tissue structure characteristics and the basement membrane component analysis of dermal substitute have been reported less.OBJECTIVE:To investigate the cell activity and the tissue structure characteristics of DED.METHODS:Skin flap was treated with 56℃ phosphate buffered solution to remove the epidermis,and the dermal cell components were deleted by freezing and thawing with liquid nitrogen to obtain DED.The DED cell activity was detected with tissue culture method,hematoxylin nuclear staining was used to determine the DED cell nuclei,and vimentin immunohistochemistry was applied for fibroblast determinations.The basement membrane and its components were detected using Periodic Acid-Schiff staining and collagen type Ⅳ immunohistochemistry.Van Gieson stain,Weigart stain and those double staining were respectively used to determine DED collagen fibers and elastic fibers.The DED ultrastructure was observed under transmission and scanning electron microscope.RESULTS AND CONCLUSlON:Using tissue culture method,the cultured DED did not exhibit cell growth at 2 weeks.Hematoxylin-eosin staining showed no nuclear in DED,vimentin immunohistochemistry showed no vimentin expressed in DED.Van Gieson staining showed DED collagen fibers were stained as rose red,Weigert staining showed DED elastic fibers were stained as pu rplish black double staining further demonstrated uniform arrangement of collagen fibers and elastic fibers.DED surface and the remaining appendages were strongly positive for Periodic Acid-Schiff staining,and type Ⅳ collagen expression was significant.Transmission and scanning electron microscope results showed that,the DED elastic fibers and collagen overlap arranged with pore intervals,they intercrossed into a network.There is no living cell component in DED,dermal matrix surface and appending organ luminal wall still retain glycogen,type Ⅳ collagen and other basement membrane components,dermal matrix is rich in collagen and elastic fibers.it is a three-dimensional collagen matrix similar to in vivo dermis.

Objective To explore the clinical efficacy of indwelling suture in preventing re-adhesion of fallopian tube after fallopian tube recanalization(FTR). Methods Screen 93 patients with fallopian tube obstruction and FTR indications of prospective, the patients without other interference factors of infertility, they were randomized with random sampling into two groups (treatment group 50 and control group 43)and treated by FTR,then the treatment group with indwelling sutures in fallopian tube for 3 days, the control group were infused lipiodol into the tube and with a intrauterine cavity perfusion in 3 days. The two groups received followed up examination at 2,6 months after operation ( a treatment was repeated with the case of re-obstruction) . Follow-up for 12 months to appraise the pregnancy rate and the influence of pregnancy competence of tube with indwelling suture(6 months after operation, to collect and compare the pregnancy rate and ectopic pregnancy rate of patent tube in two groups). Results The tubal patency rate were 89.8%(53/59),89.5%(51/57)of treatment group at 2,6 months after operation and the control group were75.9%(44/58),75.0%(39/52), there was a significant difference between the two groups(2 m:χ2=4.027, P<0.05;6 m:χ2=3.958,P<0.05). One year after operation,the pregnancy rate of treatment group was 43.2%(16/37) , the control group was 20.6%(7/34) ,there was a significant difference(χ2=4.152,P<0.05). Six
months after operation, the pregnancy rate and ectopic pregnancy rate of patent tube in treatment group were 21.6%(11/51),2/11, the control group were15.4%(6/39),1/6, there was no significant difference between them(pregnancy rate:χ2=0.552,P>0.05). Conclusions The indwelling suture of fallopian tube can prevent re-adhesion better after FTR, then improve the long-term recanalization rate and the pregnancy rate. There is no change on the pregnancy competence of fallopian tube.

OBJECTIVE To study the clinical and pathological characteristics of antrochoanal polyps. METHODS From Oct. 1998 to Sept. 2004, 1023 cases(1895 sides)of chronic sinusitis and/or nasal polyps were treated with endoscopic sinus surgery. Forty-six patients were diagnosed with antrochoanal polyps; all had a unilateral lesion. The average age of these patients was 15a. The polyps from these patients were fixed in formalin and embedded in paraffin. The sections were cut,stained with HE and observed under light microscope. RESULTS All 46 patients were cured after following up for more than 1 year. The antrochoanal polyps were usually unilateral and appeared in younger patients. The main symptom was nasal obstruction. Macroscopically,they had a cystic intramaxillary portion and a solid intranasal portion. Microscopically,the polyps were covered by pseudostratified ciliated columnar epithelium. The inflammatory cell infiltration in submucous tissue was mainly that of neutrophil cells with few eosinophil cells. Edema and cyst were also found in the submucous tissue. CONCLUSION The pathological findings and clinical features of the antrochoanal polyps indicate that antrochoanal polyps has a different pathogenesis compared with the usual nasal polyps. It should be named antrochoanal cysts rather than antrochoanal polyps.

Objective To evaluate the safety of dynamic anterior plate fixation for cervical distractive flexion injuries and compare its rigidity between different types of plate design. Methods Twelve sets of cadaveric calf spine were used in this test. All the specimens were made into distractive flexion injury models (C4-C5) ac- cording to Allen's method. After discectomy and grafting, they were randomized into three groups in which Orion, Codman, and Window instrumentations were used respectively. The stiffness of each construct was tested in flexion, extension, lateral bending and axial torsion conditions sequentially. Results Compared with an intact cervical spine, the range of motion (ROM) of an injured cervical spine increased whatever plate was applied. Orion in- strumentation presented stiffness the closest to that of the normal control, except for less torsional stiffness. Codman instrumentation provided stiffness close to that for normal and Orion groups only in lateral bending. Window's was the weakest mad not enough in all kinds of movement. Conclusions Static anterior fixation is the first choice for cervical injuries. Dynamic plate fixation may sacrifice stiffness to some extent, especially when a shifting kind of design is to be chosen.