Objective To study the effects of compound factors of simulated weightlessness and noise in spaceship on auditory function ,and the expression of apoptotic marker Caspase -3 in inner ear in guinea pigs ,and study the influence of compound factor above on its hearing loss and apoptosis of inner ear .Methods Thirty -six guinea pigs were randomly divided into four groups ,6 in control group ,10 in simulated weightlessness with noise group (Group A) ,treatment estrogen group (Group B) and prevention estrogen (Group C) ,respectively .All the experiment groups were suspended posterior limb ,with the exposure of the simulated noise circumstance in space-ship .Estrogen prevention group received intramuscular injection of estradiol benzoate for 3 days before the experiment ,while estrogen treatment group was treated in the same way for 8 days from the beginning of experiment to 3 days after the experiment .Bilateral auditory brainstem response thresholds (ABR) were tested in pre- exposure ,post-exposure and 3 -day recovery respectively .Cochleae were obtoined for immunohistochemistry staining to observe the expression of the apoptotic marker Caspase -3 in inner ear .Results At the time point of post -exposure ,ABR threshold in Group B was lower than those in Group A by 14 .5 dB and Group C by 9 dB .For the ABR change of pre ,and post-exposure ,Group B was lower 12 .75 dB than those of in Group A and 7 .75 dB than in Group C .For the ABR change between pre ,and post-recovery ,ABR threshold of Group C was higher than those of in Group A by 14 .5 dB and in Group B by 7 dB .These differences were significant (P<0 .05) .The expression of Caspase-3 was positive in the hair cell ,spiral ganglion cells and stria vascularis of three groups in both post exposure and 3-day recovery .The expression of Caspase-3 in hair cell and stria vascularis was strongly positive in spiral ganglion cells in Group C in post -exposure ,while it was slightly positive in Group B .After 3 -day recovery ,Group A turned to negative ,while Group B and Group C were still in positive expression with an increase of that in post -ex-posure .Conclusion Estrogen treatment could effectively reduce the hearing loss and the apoptosis of inner ear in-duced by the compound factor of weightlessness and noise .Preventive use of estrogen could not produce an instant protection on the hearing loss induced by exposure ,and the apoptosis was enhanced .However ,it speeded up the procedure of recovery and reduced the apoptosis of inner ear .

Objective To evaluate the clinical efficacy of Compound Sophorae Flavescentis Radix (Kushen) Injection combined with gamma knife for treatment of locally advanced pancreatic carcinoma. Methods Totally 65 patients of locally advanced pancreatic cancer were randomly divided into two groups:32 cases of simple gamma knife group (group A), 33 cases of Compound Kushen Injection combined with gamma knife treatment (group B). Patients received enhancement computed tomography scanning and CA199 review at 1, 3, 6, 9, 12 months after treatment, and once every six months, a total of 36 months of follow-up. Short-term and long-term efficacy was observed after treatment, and survival curve analysis was carried out. Results Clinical benefit response was 53.13% in group A and 84.85% in group B (P=0.006);median survival time of two groups was 11.00 months in group A and 23.00 months in group B;the average survival time in group A was 16.37 months, and 22.28 months in group B (P=0.017). In the two groups, treatment of the 65 patients was completed smoothly as planned, and no one had serious complications, such as pancreatic leakage, skin burns, viscera perforation and radioactive enteritis. Conclusion Compound Kushen Injection combined with gamma knife can treat locally advanced pancreatic carcinoma safely and efficiently, which can improve patients’ life quality, especially in cancer pain control.

OBJECTIVE To study the results of the reoperation for thyroid cancer. METHODS The clinical data of 288 cases who underwent reoperation for thyroid cancer were analyzed retrospectively. There were 69 male and 219 female. There were 249 cases (86.5 %) with papillary adenocarcinoma, 27 cases(9.4 %) with follicle adenocarcinoma, 6 cases (2 %) with medullar cancer, and 6 cases (2 %) with anaplastic cancer pathologically. The types of operation were lobectomy and near total lobectomy. The unilateral or bilateral neck dissections were performed in selected cases. RESULTS Pathological examination reveal that there were 63 cases of cancer residual in the ipsilateral side and 33 cases of the opposite side. The cervical node metastasis were present in 164 cases of patients at the same side. CONCLUSION The ipsilateral side lobaectomy and/or contralateral side near total lobectomy should be employed for the thyroid cancer patients. The neck dissection should be performed in most of the patients.

OBJECTIVE: To Study the clinical features of congenital microtia and atresia . To evaluate the methods and results of the same microtia surgery, ear canal and middle ear reconstruction. METHOD: Statistically analysis of the data of the hospitalization microtia 62 ears of 58 cases of patient in our department from January 2005 to October 2010 waw conducted. These patients with congenital ear malformations are associated with aural atresia, ossicular chain abnormalities, severe conduction Deafness. All patients received preoperative temporal bone CT examination and reconstruction, hearing examination. Operation was given in two phases, first operation aim to form a line of ear, ear canal reconstruction, ear reconstruction, the second one aim to line of ear skin graft, cranial angle of the ear reconstruction. The preoperative and postoperative data were retrospectively analyzed. RESULT: The auricle plus external auditory canal, middle ear reconstruction came out with a good shape of the ear and the ear canal in close proximity to the normal population. Most patients' hearing were improved after surgery. CONCLUSION Surgeries of patients with congenital ear malformations and aural atresia should be carefully designed according to the three-dimensional reconstruction of multislice spiral CT reconstruction, which can provide information about surgery approach and middle ear abnormality. The whole ear shape and hearing ear after reconstruction are improved after the surgery.
Adolescent ; Angioplasty ; Congenital Microtia ; surgery ; Ear ; Ear Auricle ; abnormalities ; surgery ; Ear Canal ; abnormalities ; surgery ; Ear, External ; abnormalities ; surgery ; Hearing ; Hearing Loss ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Skin Transplantation ; Tomography, X-Ray Computed

Objective:To investigate the efficacy and safety of dual wavelength pulsed dye laser combined with 30% supramolecular salicylic acid in the treatment of moderate and severe facial acne.Methods:Sixty patients with moderate and severe acne that visited the Dermatology Department of the First Affiliated Hospital of Chongqing Medical University from May 2020 to January 2021, were selected and randomly divided into observation group and control group, with 30 patients in each group. The observation group was given dual-wavelength pulsed dye laser combined with 30% supramolecular salicylic acid. 30% supramolecular salicylic acid was used once every two weeks, for a total of six times. Dual-wavelength pulsed dye laser was given once a month, for a total of three times. The control group was only given dual-wavelength pulsed dye laser, once a month, a total of three times.Results:Twenty-two cases (73.33%) in the observation group were effective, while 14 cases (46.67%) in the control group were effective. The efficacy of the observation group was better than that of the control group, and the difference was statistically significant (χ 2=4.44, P<0.05). There were no obvious adverse reactions in both groups. Conclusions:Dual-wavelength pulsed dye laser combined with 30% supramolecular salicylic acid is effective and safe in the treatment of moderate and severe facial acne, which is worth popularizing.

Objective? To study the clinical observation and nursing strategies for myelosuppression caused by induction chemotherapy for stage Ⅲ and stage Ⅳ laryngeal and hypopharyngeal cancers. Methods? The clinical data of 8 patients admitted during March 2015 to June 2017 who developed myelosuppression after induction chemotherapy using taxol + cisplatin + fluorouracil (TPF) were retrospectively analyzed for nursing strategies. Key nursing strategies included in the analysis were basic care, psychological care, condition observation and monitoring, medication care, infection prevention, infection management, prevention and treatment of anemia and bleeding, diet care and activity care. Results? After induction chemotherapy, 8 out of 15 (53.33%) stage Ⅲ and stage Ⅳ laryngeal and hypopharyngeal cancer patients developed myelosuppression, among which 3 patients showedⅢ-Ⅳ degree myelosuppression. Granulocyte colony stimulating factor (CSF) was administered by intramuscular injection to manage reduced granulocyte level in 2 cases. The granulocyte level in both patients went back to normal after 3-5 days. Platelet and recombinant human thrombopoietin were administered by intravenous injection to manage reduced platelet in 1 case. The platelet level of the patient started to increase after 3 days. All patients successfully recovered from myelosuppression before being discharged. Conclusions? For stageⅢ and stageⅣ laryngeal and hypopharyngeal cancer patients who developed myelosuppression after chemotherapy, enhanced basic care, psychological care and close observation of condition developments are essential to the patients' smooth recovery from myelosuppression.

Objective:To explore the effects of enhanced recovery after surgery (ERAS) in perioperative nursing among pharyngolaryngeal neoplasm patients undergoing transoral robotic surgery with Da Vinci surgical system.Methods:From June 2016 to December 2018, this study selected 44 pharyngolaryngeal neoplasm patients undergoing transoral robotic and minimally invasive surgery with Da Vinci surgical system in Otolaryngology Head and Neck Surgery of Beijing Anzhen Hospital affiliated to Capital Medical University as subjects by convenience sampling. All of patients were divided into experimental group and control group with the method of random table, 22 cases in each group. Control group carried out routine nursing, while experimental group implemented ERAS nursing. This study compared the indexes of postoperative recovery and the score of Visual Analogue Scale (VAS) of patients between two groups.Results:In experimental group, the time of getting out of bed, removing drainage tube, taking food, indwelling nasogastric tube and hospital stay after surgery was shorter than those in control group with statistical differences ( P<0.05) . The score of VAS of control group one day after surgery was higher than that in experimental group with a statistical difference ( P<0.05) . Conclusions:ERAS for pharyngolaryngeal neoplasm patients undergoing transoral robotic surgery with Da Vinci surgical system can promote their postoperative rehabilitation.

OBJECTIVE To investigate the monitoring of tacrolimus blood concentration in patients with nephrotic syndrome （NS），and to establish a prediction model for tacrolimus blood concentration. METHODS Data from 509 concentration monitoring sessions of 166 NS patients using tacrolimus were collected from January 1， 2020 to August 31， 2023 in Zhongshan Hospital Affiliated to Xiamen University. The relationship of efficacy and adverse drug reaction（ADR） with blood concentration was analyzed. A multilayer perceptron （MLP） prediction model was established by using the blood concentration monitoring data of 302 times from 109 NS patients with genetic information， and then verified. RESULTS In terms of efficacy， the median blood concentration of tacrolimus in the non-remission group was 2.20 ng/mL， which was significantly lower than that in the partial remission group （4.00 ng/mL， P＜0.001） and the complete remission group （3.60 ng/mL， P＝0.002）. In terms of ADR， the median blood concentration of tacrolimus in the ADR group was 5.01 ng/mL， which was significantly higher than that in the non-ADR group （3.37 ng/mL） （P＝0.001）. According to the subgroup analysis of the receiver operating characteristic curve， when the blood concentration of tacrolimus was ≥6.65 ng/mL， patients were more likely to develop elevated blood creatinine [area under the curve （AUC） was 0.764， P＜0.001）； when the blood concentration of tacrolimus was ≥6.55 ng/mL， patients were more likely to develop blood glucose （AUC＝0.615， P＝ 0.005）. The established MLP prediction model has a loss function of 0.9， with an average absolute error of 0.279 5 ng/mL between the predicted and measured values. The determination coefficient of the validation scatter plot was 0.984， indicating an excellent predictive performance of the model. CONCLUSION Tacrolimus blood concentration has an impact on both efficacy and ADR in NS patients. The use of the MLP model for predicting blood concentration exhibits high accuracy with minimal error between predicted and measured values. The model can be used as an important tool in clinical individualized medication regimens.