Objective To evaluate the clinical application of autologous fat and acellular dermal matrix (ADM ) in vocal fold medialization .Methods A total of 16 New Zealand white rabbits of both sexes were divided into two study groups (8 rabbits in each group) ,after unilateral recurrent laryngeal nerve section ,autologous fat or ADM were injected into paralyzed vocal folds .Laryngoscopic exams were performed 2 ,4 ,8 ,and 12 weeks after implanta‐tion ;then larynx specimens were sampled and serially sectioned in axial plane from the false vocal fold to the sub ‐glottis .After section was stained with HE ,histologic behavior of the graft were evaluated by optical microscope , volume of remaining material were calculated by autoCAD software .Results The remaining volume of autologous fat and ADM reduced gradually ,there were no statistically significant differences between the 2 groups .In 2 weeks , fat cells survival was mass distribution ,as its necrosis and absorption ,intraimplant resulted in a plurality of cavitati‐on ,encapsulated by fibrous connective ,mixed with a little survival fat cells .In 12 weeks ,obvious capsule formation surrounded lipoma composed of fiber connective tissue .In the ADM group ,2 weeks after injection ,intra - implant fibroblast activity and neovascularization was noted ,later fibroblast infiltration increased gradually .In 12 weeks ,the implantation maintaun the basic outline and have compact organizational structure ,but not forming obvious bounda‐ries with the surrounding tissue .Conclusion Comparing degree of absorption ,there were no statistically significant differences between autologous fat and ADM in the study ,but histological outcome of ADM is closer to the original organization .In future ,ADM optimization or combination with other materials ,will have a larger development and clinical application value .

"Same treatment to different diseases" is the key theoretic basis for clinical research of combination of TCM and WM.The article explores its application in developing new Chinese drugs,exemplified with "Huaxia Small Onion Preparation" made by Pro.Zhang Jiemei.

Objective: To research the effect of Xinkai Kujiang method on gastric myoelectrical activity and autonomic nerve function in functional dyspepsia(functional Thirty,FD) rat,and to reveal the overall regulatory mechanism of Xinkai Kujiang method and help for the clinical trials and treatment.Methods: FD rats being the experiment subject,we observed the effects of Xinkai Kujiang method on FD rat gastrointestinal movement,including the following index,the main frequency,power,even the percentage of slow wave duality.Meanwhile we observed the effect of Xinkai Kujiang method on FD rat heart ratevariability(HRV),evaluated the effect on autonomic nerve function,and revealed FD rats overall adjustment mechanism.Results: Before treatment,the result of model group,weikangning group and the normal control group was significantly different(P0.05),but that of weikangning and the model group had significant differences(P0.05),weikangning group change trend was significantly different(P

Background and purpose:Nowadays, about therapy of laryngeal carcinoma, people are paying more and more widely attention to ifnding out how to improve quality of patients’ life besides radical surgery. For glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, we performed modiifed frontolateral partial laryngectomy or modiifed cricohyoidoepiglottopexy, and contrastive analyzed the therapeutic efifcacy of the two ways. Methods:Sixty cases patients of glottic laryngeal carcinoma who treated in Hunan Provincial Tumor Hospital during 2005 to 2010, which invaded the anterior commissure or bilateral vocal cord, were randomly attributed to two groups as A and B;30 patients of group A were underwent modiifed frontolateral partial laryngectomy and repaired with bilateral sternohyoid muscle lfap, 30 patients of group B were treated by modiifed cricohyoidoepiglottopexy. Follow-up time of each patient was 5 years postoperation and clinical data were retrospectively analyzed. Results:The 5-year survival rate was 86.7%in group A as well as 83.3%in group B, and there was no statistical difference between two groups (P=0.718). Pronunciation function:22 cases in group A and 21 cases in group B whose pronunciation function can be competent in the noisy environment, and can pronounce“a”and“i”vowel;8 cases in group A and 9 cases in group B can pronounce only a“ha”,“hi”sound, that couldn’t communicate with others in a noisy environment. There was no statistical difference in pronunciation function between the two groups (P=0.774). Incidence of deglutition disorder 4 weeks postoperation:group A was 0 (0/30), group B was 16.7%(5/30), and the difference between the two groups was statistically signiifcant (P=0.026);average time of extubation postoperation:group A was (10±2.3) d, group B was (20±4.6)d, and the difference between the two groups was statistically signiifcant (P=0.0000);recurrence rate of dyspnea after extubation:group A was 16.7%(5/30), group B was 0 (0/30), and there was statistically signiifcant difference between the two groups (P=0.026). Conclusion: For the glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, there was no statistical difference in 5-years survival rate and function of pronunciation between modified frontolateral partial laryngenctomy and modified cricohyoidoepiglottopexy postoperation. The former had less postoperative deglution disorder, earlier extubation time, and to some extent, alleviated the suffering of the patients, but part of these patients needed secondary surgery due to dyspnea which resulted by radioactive tissue adhesion after extubation. The latter had more serious deglution disorder postoperation, longer recovery time, and relatively longer time to extubating, showed no again dyspnea after extubation, and had more extensive adaptation disease. In a word, each way of operation has its advantage respectively.

Background and purpose:The pedicled pectoralis major myocutaneous lfap has been a common choice of tissue lfaps for head and neck reconstruction. Nowadays, with rapid advancement in microsurgery, free lfaps gradually replace the pedicled lfaps. However, not all patients are good candidates for reconstruction surgery using free tissue lfaps. Adjacent pedicled lfaps are safer and more reliable. This paper explores potential application of pedicled pectoralis major myocutaneous flap in reconstruction of complex surgical defects following resection of advanced head and neck malignancies through modification of their preparation and repair method.Methods:Flap design scheme and method of preparation were modiifed to improve the pectoralis major muscle lfap. Fifty-one patients with surgical defects from resection of head and neck malignancies received reconstruction surgery using modiifed pectoralis major muscle lfaps.Results:Modiifed pectoralis major muscle lfaps survived completely in 51 patients. The area of defect regained its shape and appearance after reconstruction surgery. The area of defect obtained excellent functional recovery. Postoperative functional injuries to the donor sites were minimized.Conclusion:Modiifcation in designing and preparing method of the pectoralis major muscle flap improved repair range and distance in reconstruction of complex surgical defect following resection of head and neck malignancies. It also reduced necrosis rate of skin lfaps. Postoperative donor and recipient sites regained their appearance and functions successfully. The pectoralis major muscle lfap is one of the important tissue lfaps used in reconstruction of surgical defect following resection of a head and neck malignancy.

Objective To study the effect and mechanism of Xinkai Kujiang method(TCM treatment with the pungent and bitter herbs to regulate the gastrofunctions)on the functional dyspepsia(FD)rats.Methods Twenty-four rats were randomized into control group,model group,and Weikangning(herbal medicine for dyspepsia)group,with 8 in each.After a 7-day adaptive feed,the FD models were made with the clipping tail stimulation.Seven days after modeling,the Weikangning group was given Weikangning Capsule 0.625g/kg by gavage,twice a day,and the other two groups were given normal saline in the same dosage.The medication was appliey in succession for 12 days,and on the thirteenth day,the serum and gastric tissues were collected for detecting the lab indications:plasma motilin(MTL),plasma nitric oxide(NO),gastric tissue MTL,nitric oxide synthase(NOS),and the expression of Cajal interstitial cells(ICC)and gastrointesinal smooth muscle cells(SMC).Results Compared with the control group,the level of plasma MTL in the model group was significantly decreased,the level of NO significantly increased,and the expression of MTL,ICC and SMC positive neurons in the stomach myenteric nerve plexus was significantly weakened,but the expression of NOS positive neurons was significantly strengthened(P

Objective: To investigate the effects of extract of Bulbus Allii Caespitosi on cardiocyte viability of swines with myocardial reperfusion injury by analyzing the 18F-fluorodeoxyglucose ((18)F-FDG) position emission tomography (PET) imaging. Methods: Twenty-four swines were randomly divided into sham-operated group, untreated group, trimethazine group and extract of Bulbus Allii Caespitosi group. Myocardial reperfusion injury was induced by plugging the anterior descending coronary artery of swine with sacculus. Bulbus Allii Caespitosi or trimetazidine was given twice daily for 28 days. Then myocardial perfusion was detected with (18)F-FDG PET/CT and the radioactivity distribution was evaluated. Results: Compared with the untreated group, Bulbus Allii Caespitosi and trimetazidine could improve the activity of myocardial cells after myocardial infarction (P<0.01), and there were no significant differences between Bulbus Allii Caespitosi and trimetazidine (P>0.05). Conclusion: Bulbus Allii Caespitosi can improve myocardial metabolism after ischemia and reperfusion in swines.

Objective: To explore the status quo and countermeasures of the scientific research ability of professional surgical postgraduates under the standardized training mode of residents. Methods: Fifty-five students in Beijing Friendship Hospital, Capital Medical University during September 2015 to December 2017 were enrolled in the present study. Questionnaire was used to collection the data in order to evaluate the current research abilities and provide feedbacks for the adoption of improvement measures of research skill. The results of the survey were entered into the computer using EpiData 3.0 software, and descriptive analysis of the data were performed using Excel 2010 and SPSS 20.0 to calculate the percentage of each indicator. Results: The results showed that 38(69.1%) graduate students were able to assist the instructor in basic research work, and 17(30.9%) graduate students showed low enthusiasm for independent design and writing of the paper. In addition, 23(41.8%) graduate students hoped to improve their research capabilities and added more training courses. 10(18.2%) students hoped to strengthen the training of the clinical subject tutors, and thought that the communication and contact with the tutor was not enough. Conclusions The professional postgraduates overvalue clinical practice and undervalued scientific research. This article introduces ways of strengthening the cultivation of scientific research awareness, optimizing curriculum system, playing the core role of mentors, establishing incentive system and scientific research platform to enhance scientific research capacity.

OBJECTIVE: To summarize the experience of improving survival rate of microsurgical free flap transfers for head and neck reconstruction. METHOD: One hundred and seventy-nine consecutive microsurgical free flap transfers performed in patients with head and neck region defects after surgical procedure due to carcinoma were reviewed. The microsurgical free flap survival rate and postoperative complication were evaluated. RESULT: The overall success rate of flap was 98.9%. The overall complication rate was 7.8%. The flap crisis rate was postoperative flap crisis incidence rate was 4.4%. The success rate of immediate surgical exploration within 6 hours successfully rescued the flap in were 6 six cases, and the other else two cases cut died flap and repaired the region defect in the head and neck with pectoralis major myocutaneous flap. CONCLUSION Key factors in improving the succeess rate are to guarantee vascular anastomosis patency, to achieve a good haemostasis, and to promptly closely observe discover blood vessel flap crisis after operation in the first 6 hours and immediate surgical exploration.
Anastomosis, Surgical ; Carcinoma ; surgery ; Female ; Free Tissue Flaps ; transplantation ; Head and Neck Neoplasms ; surgery ; Humans ; Image Processing, Computer-Assisted ; Male ; Postoperative Complications ; Survival Rate ; Thigh

OBJECTIVE: To review the clinical manifestations and management of nasal sinus mucoceles invaded the skull base and orbit. METHOD: Medical records for 30 patients of paranasal sinus mucoceles invaded the skull base and orbit were reviewed retrospectively. CT and MRI were important tools for diagnosing nasal sinus mucocele. The patients received endoscopic surgery to remove mucocele, some of them were operated auxiliary incision. Steroid therapies were given after the operations and routine examination with endoscopy were carried out during follow-up. RESULT: All cases were successfully performed surgery without complications after the surgeries, or the majority of symptoms. However, vision recovery was observed only in some patients. Recovery of vision depended on the timing of surgery and severity of initial visual loss. Delay treatment can seriously compromise the recovery of vision impairment. Moreover, the patients without light perception before surgery had poor visual recovery even when optic nerve decompressions were performed. CONCLUSION Endoscopic surgery has effect on nasal sinus mucocele with visual loss. Because visual recovery depends on prompt diagnosis and surgical intervention,a good understanding of the disease and prompt imaging studies are important.
Adult ; Aged ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucocele ; pathology ; surgery ; Orbit ; pathology ; surgery ; Paranasal Sinus Diseases ; pathology ; surgery ; Retrospective Studies ; Skull Base ; pathology ; surgery ; Young Adult