Objective To investigate the clinical feature and treatment on rhypenous unilateral exophthalmoses and increase their correctness of diagnosis and treatment. Methods One hundred and thirty-seven rhypenous unilateral exophthalmoses patients' clinical data were analyzed. Results There were 39malignant tumors(28.5%)and 98 benign diseases(71.5%)in the 137 patients. All 137 cases underwent surgical operation. Eighty-three patients were treated through intranasal endoscopic surgery and 15 patients were treated through the outside of nose approach in 98 benign diseases. Ninty-two patients with exophthalmoses cured and 6 patients recovered incompletely after operation. After more than 1-year follow-up, no recurrence happened. The eyeballs of 32 cases were kept in 39 malignant tumors being used by operation combined with radiotherapy. Conclusions Rhypenous unilateral exophthalmoses has their clinical features. CT is an effective method for diagnosis of rhypenous unilateral exophthalmoses. Intranasal endoscopic surgery is the important method for benign rhypenous unilateral exophthalmoses.Patients with rhypenous unilateral exophthalmoses resulted from malignant tumors should be taken different measures according to different circumstances.

OBJECTIVE To study the clinical efficacy of voice training on voice recovery in patients with vocal cord polyps during perioperative period.METHODS A total of 72 patients with vocal cord polyp were chosen in this study and they were randomly divided into study group and control group. After operation, the control group received routine treatment, and the study group received voice training on the basis of routine treatment. The results of voice acoustic analysis in the two groups were compared at 8 weeks after operation.RESULTS After 8 weeks, the maximum phonation time(MPT), dysphonia severity index (DSI) and the highest frequency(F0-High) of the study group were significantly higher than that of control group (P<0.05). The fundamental frequency perturbation(Jitter) of the study group was markedly lower than that of the control group(P<0.05). There was no statistical difference in the fundamental frequency(F0), the lowest intensity(I-Low) and amplitude perturbation(Shimmer) between the two group (P>0.05).CONCLUSION Voice training in the early postoperative period of vocal cord polyps was helpful to the recovery of the voice.

Objective To investigate the practicability and safety of laparoscopic anatomical hepatectomy.Method 40 patients with space occupying lesions in the liver underwent laparoscopic anatomical hepatectomy between Jan.2008 and Mar.2012.The diagnoses were hepatocellular carcinoma (HCC) (n=13),recurrent HCC (n =1 ),cholangiocarcinoma ( n =1 ),metastatic cancer ( n=6),hepatolithiasis (n=10),hemangioma (n=7),FNH (n=1) and liver cell adenoma (n =1).Intraoperative ultrasound was routinely performed to locate lesions and intrahepatic structures.Selective hemihepatic vascular occlusion was applied during resection. High frequency cautery,CUSA and Ligasure were used to transect liver parenchyma. Hemolocks were applied when large blood vessels and bile ducts were encountered.Endo-GIA was used if necessary.The operations included right hemihepatectomy (n =3),left hemihepatectomy (n =10),resections of segment Ⅴ and Ⅵ (n=5),segment Ⅴ (n=3),segment Ⅵ (n =4),and segment Ⅳb (n =1).Result34 hepatectomics were performed laparoscopically.6 patients were converted to open surgery.There was no perioperative death. The operating time was 250.21±50.94 min,and intraoperative blood loss was 420.20± 120.10 ml.Bile leakage was diagnosed in 2 patients after operation.Conclusion With careful patient selection,and improvement in surgical technique and apparatus,laparoscopic anatomical hepatectomy has become safe and practicable.The operation has the advantages of minimal invasion and rapid recovery. It can be regarded as a standard procedure for selected benign and malignant lesions.

Objective To investigate the surgical procedure of restoring stenosed hilar bile duct by gallbladder lamella with cystic artery.Methods Based on extensive incising and hilar cholangioplasty,stenosed hilar bile duct was restored by gallbladder lamella with cystic artery.Results Among all the 12 pa tients,including 10 intrahepatic bile duct calculi patients,1 right hepatic duct injury and 1 left intrahepatic chaolangiocarcinoma,no cystic fistula,reflexed cholangitis and recurrent stone were noticed by post operative follow-up.Conclusion This procedure is a ideal method by remaining the normal function of Oddis sphincter while removing stenosis.

Objective: To overview the experience of postoperative nutritional management in live transplant patients. Methods: Postoperative nutritional therapy and nutritional status assessment in 18 liver transplantation (2 patients undergone retransplantation) were retrospectively analyzed. During the first 3 days after operation, patients were supported with total parenteral nutrition (TPN) and supplied with human albumin. On the 4th and 5th days after operation, patients were provided with parenteral nutrition (PN) and enteral nutrition (EN). And on days 6～10 after operation, patients were gradually transferred to total enteral nutrition and they restored the oral intake completely on days 12～18 after operation. Recombinant human growth hormone was postoperatively injected for 4～7 days. Results: Despite 3 cases who died from brain hemorrhage, respiratory failure and acute rejection respectively, other 13 cases recovered fluently. Conclusions: Appropriate postoperative nutritional therapy facilitated the recovery of liver transplant patient.

Objective To investigate the safety and long-term therapeutic results of anatomical hepatectomy for hepatocellular carcinoma (HCC).Methods 90 patients underwent anatomical hepatectomy from January,2003 to January,2010.The tumor size was ≤5 cm in 38 patients,and ＞5 cm in 52 patients.The tumor number was a single lesion in 58 patients,and multiple lesions in 32 patients.Cirrhosis was present in 46 patients (55.42％); cancer embolus was present in 34 patients (37.78％).There were 64 patients in Child-Pugh A and 26 patients in B.The operating time,blood loss and blood transfusion were recorded and analyzed.Complications and liver function were monitored after surgery.The Kaplan-Meier method was used to calculate the survival rates.Log-rank test was used to analyze factors associating with postoperative recurrence.Independent factors influencing tumor-free survival and overall survival were analyzed by Cox-model logistic regression.Result There was no perioperative death.The incidence of complications was 31.1％ (28/90).The recurrence rate was 51.1％ (46/90).The 1-,3-,5 year tumor-free survivals were 92.2％,67.3％ and 49.7％％00,respectively.Positive resection margin and satellite nodule were independent factors for recurrence (RR19.22,95 ％ confidence interval 5.85～63.17).The 1-,3-,5-year overall survivals were 94.4％,80.0％ and 60.0％,respectively.Positive resection margin and TNM were independent factors for overall survival (RR 2.013,95％ confidence interval 1.28～3.17).Conclusions Anatomical hepatectomy was a safe and efficacious procedure to treat HCC.Positive resection margin and TNM were independent factors associated with overall survival.Anatomical hepatectomy had the advantages in ensuring a lower rate of negative resection margin.

Objective To investigate the application value of continuous irrigation and vacuum suction by subcutaneous drainage tube for prevention of abdominal type Ⅳ incision infection.Methods A prospective,single-blind, randomized, controlled study was conducted based on the clinical data of 123 patients with abdominal type Ⅳ incision infection who were admitted to the First People's Hospital of Foshan between January 2008 and July 2014.Patients were divided into the experimental group and the control group based on the random number table and received open surgery.Patients in the experimental group were placed subcutaneous drainage tube with postoperative continuous irrigation and vacuum suction, while patients in the control group adopted the method of traditional abdominal closure without subcutaneous drainage tube.The levels of preoperative hemoglobin (Hb) and albumin (Alb), severity grading according to the American Society of Anesthetheologists (ASA), levels of Hb and Alb at postoperative day 1, 3, 7 were recorded and postoperative incision infection and bacteria culture were observed.Patients received bi-weekly regular return visit by outpatient evamination after discharged up to 3 months after suture removal.Measurement data with normal distribution were presented as x-± s and comparison between groups was analyzed by t test.Measurement data with skew distribution were presented as M (Qn) and comparison between groups were analyzed by rank sum test.Repeated measures data were analyzed by the repeated measures ANOVA.Count data were analyzed by the chi-square test.Results One hundred and twenty-three patients were screened for eligibility, and 65 were allocated into the experimental group and 58 into the control group.The levels of Hb and Alb at postoperative day 1, 3, 7 were (111 ± 15) g/L, (107 ± 18) g/L, (108 ± 13) g/L and 30 g/L (26 g/L,32 g/L), 31 g/L(28 g/L,33 g/L), 35 g/L(32 g/L,37 g/L) in the experimental group and (112 ± 13)g/L, (106 ±16)g/L, (106 ± 12)g/L and 30 g/L(25 g/L,32 g/L), 32 g/L(29 g/L,33 g/L), 37 g/L (32 g/L,38 g/L) in the control group, with no significant difference in the changing trends of the above indexes between the 2 groups (F =0.124, 0.007, P ＞ 0.05).There were 4 patients with incision infection in the experimental group and 12 patients in the control group, showing a significant difference (x2=2.723, P ＜ 0.05).The infections occurred at postoperative 4-6 days confined to subcutaneous tissues and unreached to muscular and below layers, and then were cured by incision open drainage without recurrence.Patients without incision infection were removed the stitches at postoperative 7-9 days.Incision bacteria cultures showed that Escherichia coli was detected in 8 cases (including 1 complicated with Enterococcus faecalis and 1 complicated with Klebsiella pneumonia and Pseudomonas aeruginosa), Pseudomonas aeruginosa in 1 case, Klebsiella pneumonia in 2 cases, Acinetobacter baumanii in 1 case, Enterobacter cloacae in 1 case and no bacteria in 3 cases.All the patients were followed up for 3 months after incision healing and survived well without recurrence and complications such as incision split and incision fistula.Conclusion Continuous irrigation and vacuum suction by subcutaneous drainage tube can be operated easily and effectively reduce the postoperative infection rate in abdominal type Ⅳ incision.

Objective To explore the influence of network intervention on lifestyle and behaviors habit of the middle -aged patients with hypertension.Methods All 300 middle -aged patients with hypertension were randomly assigned into the study group and the control group.Each group had 150 cases.All patients in the both two groups were given hypotensive drugs according to treatment specification of hypertension.The patients in the study group received a network intervention for 2 years,while the patients in the control group received an outpatient service follow-up.The difference of lifestyle and behaviors habit of the patients in the two groups were observed and compared. Results There were no significant differences with all items of the lifestyle and behaviors habit of the patients between the two groups before intervention(P >0.05 ).In the 12th end of month after intervention,there were no significant differences between the two groups with the items of smoking control,working and resting regularly,hobby and psychological balance(P >0.05),but other items in the study group were significantly better than those in the control group(Z =-3.062,-2.509,-2.239,-2.056,-2.126,-2.045,-2.023,all P <0.05).In the 24th end of month after intervention,all items in the study group were significantly better than those in the control group (Z =-4.078,-3.792,-2.080,-2.098,-1.985,-2.478,-2.173,-2.478,-3.290,-2.514,-2.730,all P <0.05 ).Conclusion The network intervention can significantly improve lifestyle and behaviors habit of the middle -aged patients with hypertension.Its effect is much better than that of outpatient service follow -up.

Objective To induce human mononuclear cell of cord blood into CD 3 activating killing (CD 3AK) cells with anti-CD 3 monoclonal antibody (CD 3McAb) and recombinant human interleukin-2 (rhIL-2), so that their proliferative activity, activity of killing action, phenotypes and level of secretory cytokines can be observed dynamically. Methods The increase of the number of cells was counted by Tapan-blue staining. The killing action can be measured by using methyl -thiazolyl-tetrazolium-array. The phenotypes of cells were analysed by using indirect immunofluorescence assay. The levels of IL-6, interferon-? (IFN-?) and tumor necrotic factor-? (TNF-?)in culture supernatants were analysed by using enzyme-linked irnmunosorbent assay(ELISA). Results The increase of the number of CD 3AK cells from cord blood was the highest amounting to 78.56 times in the second week. The killing action reached the peak on day 12, and all target cells (malignant cell lines) could be killed significantly. The heterogeneous phenotypes of CD 3AK cells showed that the number of cells with CD 3+, CD 8+, CD 25+, CD 38+, CD 16+ and CD 56+ increased significantly on day 7,14 compared with those of pre-culture (P

Objective To investigate the efficacy and safety of conversion therapy to mizoribine (MZR) for renal transplant patients who suffered MMF or Aza adverse reaction. Methods In 56 patients with adverse reactions at different time points after renal transplantation, there were 23 cases of pulmonary infection, 14 cases of bone marrow depression, 6 cases of hepatic functional lesion and 13 cases of diarrhea. The immunosuppressive protocols of these patients were changed to CNI + MZR + Pre when the adverse reaction occurred. During the follow-up period (11 to 53 months), the effect and adverse events of conversion treatment were observed. Results After conversion treatment, 1 of 23 patients with pulmonary infection was re-infected after 26 months and finally died of heart and lung function failure. In 14 patients with bone marrow depression, blood test returned to normal in 13cases. Six patients with hepatic functional lesion were administered hepatoprotection treatment and their liver function was restored without recurrence of impaired liver function. All 13 patients with diarrhea were relieved without recurrence. The serum creatinine was 123 ± 21.3 μmol/L and 119±18. 2 μmol/L before and after the conversion therapy respectively (P＞0. 05). During the follow-up period, all patients' graft function was good. The incidence of rejection was 1.7 % (1 case). Nine patients (16. 1 %) had a higher level of uric acid after conversion. One patient had finger and toe joint pain. The symptoms were relieved after symptomatic treatment. Conclusion There were high security and good effect of conversion therapy to MZR due to MMF or Aza adverse reaction. Besides, MZR conversion therapy for renal transplantation patients provided a new option for individual immunosuppression.