Objective To compare and evaluate the oncological and functional outcomes between reserving thyroid partial laryngectomy and traditional partial laryngectomy for the treatment of stage T2-3glottic laryngeal carcinoma.Methods One hundred and twenty-eight patients treated from January 1999 to January 2009 were selected from all glottic laryngeal carcinoma patients with stage T2-3,who underwent surgery combined with radiation therapy.A retrospective review was randomized and matched by tumour subsite,TNM stage and age,which were confirmed by pathology and observation without thyroid perichondrium invaded or only local invasion of thyroid cartilage,there was no need to extensively resect laryngeal cartilages.Patients were divided into reserving thyroid partial laryngectomy group(study group) and traditional partial laryngectomy group (control group).Each group included 64 cases,which included T2N0 38 cases,T2N1 6 cases,T2N2 1 case,T3N0 17 cases,T3N1 2 cases.Local control rate,decannulation rate,the 3-year and 5-year accumulative survival rate were compared between two groups.Results The 3-year and 5-year accumulative survival rate were 89.8％ and 84.3％ in study group,91.5％ and 85.4％ in control group,there was no sognificant difference (x2 =1.687,P ＞ 0.05).The local control rate was 91.7 ％ (55/60) in study group and 93.2 ％(55/59) in control group,there was no significant difference (x2 =0.103,P ＞0.05).The decannulation rate was 98.3％ (59/60) in study group and 89.8％(53/59) in control group,there was significant difference (x2 =4.933,P ＜0.05).Conclusions Comparing with traditional partial laryngectomy,reserving thyroid partial laryngectomy is successful for treating properly selected stage T2-3 glottic laryngeal carcinoma.This operation has higher decannulation rate and lower complication,which is effective for reducing surgical invasion and facilitated the resumption of respiratory.

Objective To investigate the effect of electroacupuncture plus early rehabilitation training on the function recovery after surgery for cervical spinal cord injury. Methods Sixty patients with cervical spinal cord injury undergone anterior cervical decompression and internal fixation were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by electroacupuncture plus rehabilitation training, while the control group was by rehabilitation training alone. The Frankel’s grading (FG), Barthel Index (BI), and Functional Independence Measure (FIM) were adopted for evaluation before and after intervention. Results The FG was not significantly changed after intervention in both groups (P>0.05). After intervention, there was no significant difference in comparing FG between the two groups (P>0.05). The BI and FIM scores were significantly changed after intervention in both groups (P＜0.01). There were significant differences in comparing BI and FIM scores between the two groups (P＜0.05). Conclusion Electroacupuncture plus early rehabilitation training can promote the function recovery after surgery for cervical spinal cord injury, and improve the quality of life.

Objective:To investigate the eruption of cystic lesion associated impacted permanent teeth(CAIPT)of the jaws after fe-nestrating decompression in adolescents and to analyze the related factors that affect the eruption of CAIPT.Methods:32 cases of CAIPT were examined restrospectively by panoramic radiographs.The subjects were divided into erupted group(n =22),and nonerupt-ed group(n =10).Patient age,angulation of the CAIPT,the cusp depth,eruption space and the level of dental root formation meas-ured on intial panoramic radiograph,were subjected to statistical analysis.Results:The eruption of the impacted mandibular molar was significantly related to the cusp depth,level of dental root formation and the patient's age(P <0.05).The eruption of the impacted man-dibular premolar was significantly related to the cusp depth,level of dental root formation,the angulation of the tooth and the patient's age (P <0.05),but not to dental space for the eruption(P >0.05).Conclusion:The patient's age,angulation of impacted permanent teeth,cusp depth,eruption space,level of dental root formation should be considered in the management of CAIPT.

Objective To investigate the awareness rate of TCM knowledge, the application, and demand situation of Chinese appropriate techniques in health clinics in towns and townships of Hunan Province;To put forward the countermeasures of TCM continuing education. Methods 50%of the training doctors were adopted randomly from 4 training courses in health clinics in towns and townships in Hunan Province. The student number of each course was 49, 51, 53, 53, respectively. Self-designed questionaires were used to investigate 206 training doctors. Results 168 (81.55%) doctors’ degrees were technical secondary school degree and college degree;186 (90.29%) doctors’ professional titles were physician assistant and physician;The awareness rate of TCM knowledge was 63.83%;Different study backgrounds of doctors had different effects on the rate of TCM knowledge (χ2=42.42, P=0.01). The using rates of TCM appropriate techniques were all lower than 30%. 96.60%of doctors in health clinics in towns and townships hope to learn one or more TCM appropriate techniques to help diagnose and treat disease. Conclusion The degree, professional title, mastery of TCM knowledge, and TCM appropriate techniques were not optimistic. The doctors in health clinics in towns and townships showed strong desire for TCM appropriate techniques. The health department should combine the actual situation of doctors in health clinics in towns and townships and develop targeted TCM continuing education.

Objective To observe the effects of octreotide combined with enzyme supplementation in treatment of pain in chronic pancreatitis. Methods Fifty-six patients were divided into two groups. Thirty-six patients in the treatment group were treated with octreotide combined with enzyme supplementation,and twenty patients in the control group were treated with enzyme supplementation alone. The pain relief rate,analgesic requirement per day and average days in hospital were analyzed between the two groups. Results Compared with the control group,the treatment group presented better improvement of abdominal pain(P〈0. 05),less requirement of analgesics(P〈0. 05),and shorter duration in hospital(P〈0. 05). Conclusion Octreotide combined with enzyme supplementation is effective in alleviating pain and improving quality of life in patients with chronic pancreatitis.

Objective To compare the distribution patterns and analyze the antimicrobial resistance of pathogens of different clinical samples .Methods All pathogens were isolated from clinical specimens(blood ,urine and wound) ,the distribution of patho-gens and drug resistance were monitored continuously from October 2012 to October 2013 in Daling hospital .Results 279 strains weredetectedfrombloodculture.Thedistributionincidenceof Escherichiacoli,Klebsiellapneumoniae,coagulasenegativeStaphy-lococci(CNS) ,Staphylococcus aureus ,Enterococcus f aecalis were 28 .67% ,12 .19% ,13 .62% ,9 .68% and 8 .60% respectively .574 strains were detected from urine culture .The distribution incidence of Escherichia coli ,Candida ,Pseudomonas aeruginosa ,K leb-siella pneumoniae ,Enterococcus f aecalis were 38 .68% ,18 .64% ,7 .84% ,7 .49% and 3 .66% respectively .292 strains were detected from wound secretion .The distribution incidence of Staphylococcus aureus ,Escherichia coli ,CNS ,Pseudomonas aeruginosa ,En-terococcus f aecalis were 17 .12% ,14 .38% ,10 .27% ,7 .53% ,5 .48% respectively .Conclusion Clinical using of antimicrobial agents should monitor drug resistance and consider various factors .

Objective To assess the pulmonary function before liver transplantation in patients with end-stage liver disease. Methods One hundred and fifty-four patients with end-stage liver disease, who were waiting for liver transplantation in our hospital, were enrolled into the study. The pulmonary ventilation function,small airway function and diffusion capacity were measured and analyzed respectively. Results Among 154 subjects,140 (90. 9%, 140/154) patients had abnormal pulmonary function, shown as pulmonary diffusing capacity reduction;followed by restrictive ventilatory function reduction (42. 8% ,66/154) and small airway function reduction (37. 7%, 58/154 ), the least common manifestation was obstructive ventilatory function reduction (28.6 % ,44/154 ). Conclusion Abnormal pulmonary function in patients with end-stage liver disease is common, and the pulmonary function tests before liver transplantation has certain referential value for pulmonary function damage evaluation and postoperatively respiratory tract management.

Objective To investigate the best method of transfecting total RNA extracted from pancreatic cancer MiaPaCa-2 cells into dendrtic cells (DCs). Methods DCs were cultured from peripheral blood mononuclear cells induced by rhGM-CSF, rhIL-4 and TNF-α. Morphology of DCs was observed. Flow cytometry was used to detect the mature DCs specific surface markers:CD40, HLA-DR, CD83, CD86. Mixed lymphocyte (MLR) was used to determine the ability of DCs to stimulate allogeneic T cell proliferation.Liposomal transfection, electroporation method and passive transfection was used to transfect MiaPaCa-2 cell total RNA into DCs, Real time RT-PCR and MTT assay was used to determine the expression of MUC1 mRNA and the survival rate of the RNA transfected DCs. Results The cells acquired showed typical DCs morphology, the positive rate of CD40, HLA DR, CD83 and CD86 were 34.3% ,50.2% ,89.2% and 73.6%,and they showed a strong ability to stimulate allogeneic T cell proliferation. 48 h after transfection with MiaPaCa-2 cells total RNA by using electroporation, the MUC1 mRNA amount (45.39 ± 9.33) in DCs was higher than that of liposomes method (3 1. 68 ± 7.25) and passive transfection method (18.53 ± 3.26) . DCs survival rate was (80.36 ± 2.43)% by using electroporation, which was relatively lower than (91.48 ±5.42) % by using passive transfection method, but higher than (67.44 ± 2.51) % by using liposomes method,and it was stabilized around 80%. Conclusions Transfecting total RNA extracted from pancreatic cancer MiaPaCa-2 cells into DCs with electroporation is efficient and safe.

Objective To study the diagnosis and treatment of iatrogenic bile duct injury(IBDI).Methods The clinical data of 92 patients with IBDI who had been admitted to our hospital from January 1994 to December 2007 were retrospectively analyzed.Results The diagnosis of IBDI was based on the clinical findings,diagnostic abdominocentesis and imaging examination.Sixteen patients gave up treatment because of economic reasons,and 2 patients who were complicated with sepsis and multiple organ dysfunction syndrome died shortly after being transferred to our hospital.Forty-eight patients were treated by Roux-en-Y choledochojejunostomy,14 by endoscopic treatment.2 by bile duet repair+T tube drainage,3 by percutaneous catheter drainage,1 by choledochoduodenostomy,4 by percutaneous transhepatic cholangiodrainage,and 2 by ultrasound guided percutaneous puncture drainage.Sixty-two patients were followed up for 4 month to 10 years(mean,3.6 years),and satisfactory results were obtained.Conclusions Detection of IBDI during operation and prompt repair yield favorable outcome.Roux-en-Y choledochojejunostomy is the best choice for bile duct injury complicated with biliary stricture.Endoscopic and interventional treatments are important auxiliary measures in the treatment of bile duct injury.

Objective To investigate the efficacy of metholrexate combined with rmifepristone and laparoscopic surgery for treating ectopic pregnancy.Methods 85 patient with ectopic pregnancy were selected.41 cases treated with methotrexate and mifeprisione were considered as the control group,while 44 cases with laparoscopic surgery were considered as the observalion group on the voluntary basis.The clinical efficacy,serum β-HCG value and recovery time after 7d were compared between the two groups.Results After the treatment,the cure rate in the observation group was 100％ which was significantly higher than 90％ of the control group ( P ＜ 0.05 ),the serum β-HCG value of the observation group was lower and the restoration normal time was shorter than the control group ( P ＜0.05).Conclusions Laparoscopic surgery and conservative treatment of methotrexate combined with mifepristone are effective in the treatment of ectopic pregnancy.However,the clinical efficacy of the laparoscopic surgery is better and it has rapid recovery time,and it can completely cure the patients.