A 41 years female patient was hospitalized with hoarseness for three months, without cough, expectoration and dyspnea. The symptom had no relief by application of antibiotics. Electronic laryngoscope showed that there were the grey neoplasms under subglottic anteriou commissure with broad base and slightly rough surface, and bilateral vocal cords were normal; throat CT showed subglottic irregular high density and calcification. The subglottal tumor resection was performed under the general anesthesia and laryngoscope CO2 laser assisted. In the operation, we found that the tumor was hard with surface of thin mucosa tissue, and there was white bone tissue under it. The removing tumor was about 0. 8 cm X 0. 6 cm X 0. 3 cm and was diagnosed as subglottic osteoma by pathologic examine. There was no recurrence in three months follow-up.
Adult ; Female ; Glottis ; pathology ; Hoarseness ; complications ; Humans ; Lasers, Gas ; Neoplasm Recurrence, Local ; Osteoma ; diagnosis

Objective To analyze the clinical efficacy of compound 18 norgestrel combined with estrogen in treatment of dysfunctional uterine bleeding. Methods 78 cases of patients with dysfunctional uterine bleeding in Beijing Ji Shui Tan Hospital and Dongguan city people's hospital of guangdong Province were divided into control group (n=39)and observation group (n=39)by using randomized single-blind allocation. The control group was only given estrogen,the observation group was used compound 18 norgestrel combined with estrogen. The clinical efficacy of the two groups was compared. Results 31 cases were cured and 7 cases were valid of the study group,the total effective rate was 97.4%,significantly higher than the control group's total efficiency of 71.8%,the difference was statistically significant (P<0.05). Each index of observation group and the control group were improved after treatment,the difference was statistically significant (P<0.05 );After treatment,the menstrual cycle in observation group was (29.7 ±7.1)d,the menstrual period was (5.6 ±0.5)d,hemoglobin content was (135.5 ±21.7)g/L,endometrial thickness was (0.63 ±0.15)mm, significant changes than the control group,the difference was statistically significant (P<0.05 ). Conclusion Compound 18 levonorgestrel combined with estrogen has a better effect in patients with dysfunctional uterine bleeding and it can significantly improve patients'hemoglobin,the menstrual cycle and the uterus film thickness and other indicators which is worth promoting in clinical.

Objective To achieve the software automatic updates and maintenance in the local area network which is developed based on the C/S structure. Methods Based on the existing software and hardware development platform,we use PowerBuilder to exploit and compile a program which can determine whether the software need to update automatically or not under the premise of unchanging the existing LAN software system. Results When the user terminal in the local area network runs this program,they can update it automatically whenever they need. Conclusion This method will greatly reduce the later maintenance software,upgrade works and also improve the work efficiency and accuracy.

Objective To investigate the extent and the relevant factors for local lymph node metastasis of gallbladder carcinoma. Methods Clinicopathologic features of 34 patients with gallbladder carcinoma who underwent radical resection were analyzed retrospectively. Results The overall lymph node metastasis rate was 68%(23/34), with 0(0/3) in T 1 stage, 43%(3/7) in T 2, 85%(11/13) in T 3, and 82%(9/11) in T 4. The metastasis rate was 29%(10/34) in gallbladder lymph nodes, 44%(15/34) in pericholedochal, 18%(6/34) in hepatic hilum, 24%(8/34) alongside proper hepatic artery, 21%(7/34) in periportal vein, 38%(13/34) in retropancreaticoduodenal, and 4/6 in paraaortic region. Conclusions Lymph node metastasis was determined by the depth of invasion of the primary tumor. The extent of surgical dissection was made according to the exploration and result of intraoperative biopsy.

Objective To evaluate the efficacy and safety of oral ibuprofen for closure of patent ductus arteriosus (PDA) in preterm infants.Methods The related literatures till December 31st,2011 in Cochrane Library,PubMed,EMBASE,Ovid,Springer,China Academic Journal Full-text Database,Wanfang Database,VIP Database and China Biological Medical Literature Database were searched.The inclusion criteria were:(1) the subject of the research was preterm infants with birth weight less than 2500 g and/or gestational age less than 37 weeks; (2) randomized or semirandomized controlled trial; (3) the intervention group received oral ibuprofen,while the control group received oral placebos / intravenous indomethacin or ibuprofen; (4) the main outcome was the failure rate of PDA closure; (5) hemodynamic changes with PDA were detected by ultrasonography.Meta-analysis was performed by Review Manager 4.22 software.Results Eleven randomized controlled trials were included,among which,three were high quality reports.Meta-analysis showed lower failure rate of PDA closure in subjects received oral ibuprofen than in those received placebos orally (RR =0.22,95 ％ CI:0.14-0.35),while the number of infants required operative closure of PDA decreased significantly (RR =0.16,95％ CI:0.03-0.86).Further analysis showed the effect of oral ibuprofen was similar to intravenous indomethacin (RR =0.93,95 ％ CI:0.57-1.53),but better than intravenous ibuprofen (RR=0.42,95％CI:0.26-0.67).However,oral ibuprofen did not reduced the ratio of patients required operation compared with intravenous indomethacin or ibuprofen (RR=0.58,95％CI:0.24-1.41).The incidence of gastrointestinal hemorrhage was higher in oral ibuprofen group than that in placebos(RR=1.99,95％CI:1.13-3.50).The serum level of creatine was lower in oral ibuprofen group than in intravenous indomethacin or ibuprofen group (weighted average=-19.10,95％ CI:-25.12-12.31).Compared with intravenous indomethcin group,less necrotizing enterocolitis cases were identified in oral ibuprofen group,but no statistical significance was found (RR=0.57,95％ CI:0.30-1.09).No long-term outcome was reported in any selected literature.Conclusions Oral ibuprofen for PDA closure in preterm infants appears to be as effective as intravenous or indomethacin,and more effective than intraveous ibuproten.Oral ibuproten represents better safety.

Objective:To determine the characteristics and differences in bleomycin-induced lung ifbrosis model by repeated low-dose intravenous injection and single dose intratracheal instillation of bleomycin.
Methods:Forty male ICR (Institute for Cancer Research) mice were randomly divided into a model group I, a model group II, and 2 control groups (10 mice in each group). In model group I, bleomycin was injected intravenously at 10 mg/(kg·d) for 14 consecutive days;and in model group II, bleomycin was instilled intratracheally at 5 mg/kg. The 2 control groups were given isotonic saline solution. At the 28th day, the mice were sacrificed and the bronchoalveolar lavage lfuid (BALF) was collected. The total cells and proteins in the BALF, pulmonary coeffcient, and hydroxyproline (HYP) content were determined. The pathological changes were observed by the eosin staining and Masson's trichrome staining.
Results:1) Both intravenous injection and intratracheal instillation of bleomycin resulted in severe and extensive inlfammation and ifbrosis in the lungs. The total cells and proteins in the BALF, HYP content, pulmonary coeffcient and the pathological score of pulmonary ifbrosis were all signiifcantly increased in the 2 model groups (P<0.01). 2) Fibrosis was mainly under the pleura or around the vessel in model group I, and it was located near the bronehia and bronchioles in model group II. 3) The death rate was higher in the model group II than that in the model group I. 4) Proteins in the BALF were significantly higher in model group II than that in model group I (P<0.05). There was no difference in the total cells in the BALF, the pulmonary coefficient, the HYP content, and the pathological score of pulmonary ifbrosis between the 2 groups (P>0.05).
Conclusion:The pulmonary fibrosis model can be successfully established by intravenous injection or intratracheal instillation of bleomycin, but the sites of pulmonary ifbrosis are different. The histological changes caused by the repeated low-dose intravenous injection of bleomycin is more similar to idiopathic pulmonary ifbrosis than that by the single dose intratracheal instillation.

Acute kidney injury (AKI), a common clinical dis-ease, is one complex pathophysiological process. In this review paper, the relationship and the molecular mechanisms of ische-mia-reperfusion, major surgery, rhabdomyolysis, pus sepsis and drug-induced renal toxicity associated with AKI were comprehen-sively reviewed. In addition, the prevention and treatment of AKI by Chinese medicine and the effective components were also reviewed. Therefore, our review aims to provide valuable infor-mation for treatment of AKI, and also for exploration of innova-tive new drugs.

Objective To explore the neuropsychological disorders and its mechanism of tuberothalamic artery infarction.Methods Clinical data of 9 patients with tuberothalamic artery infarction were analyzed retrospectively.Results Primary clinical manifestation of 9 patients were abulia,behavior disorders,thalamic aphasia,left spatial neglect,visual space function disorders,memory disorders.All of them,however,did not exist brain nerves lesion and disorders of motor and sense.Conclusion The clinical manifestation of tuberothalamic artery infarction patients are mainly neuropsychological disorders.

Objective Low-dose naloxone has been shown to reduce side-effects of morphine while morphine analgesia is not antagonized and may even be enhanced. The purpose of this study was to evaluate the effects of low-dose naloxone infusion (50 ng? kg-1? h-1 ) on morphine analgesia and plasma levels of opioid peptides in patients after abdominal hysterectomy.Methods Forty-two ASA Ⅰ- Ⅱ patients aged 36-50 yrs, weighing 55-67 kg undergoing abdominal hysterectomy under combined spinal-epidural anesthesia were enrolled in this study. Spinal puncture was performed at L2-3 interspace. The patients received intrathecal 0.75% ropivacaine 2.0-2.6 ml. 2% lidocaine was used for epidural injection. The block height was maintained at T8-6 . For postoperative analgesia the patients were randomized to receive either intravenous morphine infusion at 10 ?g?kg-1 ?h-1 (group M, n = 21) or IV morphine infusion (10 ?g?kg-1?h-1)+ naloxone infusion at 50 ng?kg-1?h-1 (group MN, n = 21). Pain was assessed using VAS (0-10) with 0 representing no pain and 10 representing the worst possible pain. Blood samples were taken from peripheral vein before anesthesia (T0), at the end of surgery (T1) and at 6, 24, 48 h (T2,3,4) after operation for determination of plasma levels of ?-endorphin (?-EP), dynorphin A1-13 (Dyn) and leu-enkepholin (L-EK) .Results The patients were comparable with respect to, age, weight, occupation and duration of operation between the two groups. Two patients (1 patient in each group) were excluded from the study because of their refusal to have repeated blood samples taken. The analgesia was significantly better in group MN than that in group M in terms of VAS scores. Plasma level of ?-EP was significantly lower at 6 h after operation (T2 ) but significantly higher at 24 h postop. (T3 ) in group MN compared with that in group M ( P

To investigate the role of Fas/FasL system in pathogenesis of hemodialysis(HD) and its correlation with clinical status, plasma levels of sFas/sFasL and the expression of Fas antigen on peripheral blood lymphocytes(PBL) membrane were assayed by ELISA and flow cytometry respectively. The CD3 + Fas + of PBL cells was singnificantly higher( P