Objective To explore the efficacy of tigecycline combined with cefoperazone/sulbactam in the treatment of infections due to multiple drug resistant strains and pandrug-resistant acinetobacter baumannii, so as to guide the reasonable clinical medication.Methods A total of 16 cases of ventilator associated pneumonia caused by multiple drug resistant strains and pandrug-resistant acinetobacter baumannii treated in the First Hospital of Shijiazhuang from November 2012 to November 2014 were retrospectively analyzed, and the severity of the infection, clinical efficacy and mortality were observed.Results The multiple drug resistant strains and pandrugresistant acinetobacter baumannii were frequently detected in the 16 patients.Fifteen cases had been used other antibiotics before tigecycline, such as imipenem, cefoperazone/Shubatan, minocycline etc.The severity of underlying disease was assessed with the acute physiology and chronic health score(APACHE Ⅱ sore) within 24 h of admission, on the first day of tigecycline (TGC) therapy and after 7 days of TGC therapy.It showed that the average APACHE Ⅱ score were (25±6.0), (24.2±6.4) and (17.8±6.6) within 24 hours of admission(P＜0.01), on the first day of TGC therapy and after 7 days of TGC therapy.Thirty days after application of the TGC, the bacterial eradication rate was 56.25％ (9/16).The effective rate was 87.5％ (14/16).The failure rate was 12.5％ (2/16).Conclusion The effect of the tigecycline combined with cefoperazone/sulbactam on the clearance of the multiple drug resistant strains and pandrug-resistant acinetobacter baumanniiis is satisfied.

Objective: To investigate effects of Erbie Decoction on the hepatocyte apoptosis-related factors Fas/Fas-L in rat with liver fi brosis,and to explore its anti-fi brosis mechanism. Methods: To Induce immune Liver fibrosis of rat model were established by intraperitoneal injection of pig serum. 48 rats were randomly divided into normal group, model group, pretreatment groups(high, middle and low dose groups of Erbie Decoction, and Fufang Biejia Ruangan Pills group. One week after the feeding adaptation, in addition to the normal group, other groups were given intraperitoneal injection of pig serum, each rat with 0.5ml, twice a week. At the same time, pretreatment groups were given intragastric administration daily. After 9 weeks, the expression of TGF-?1 and Fas/Fas-L were detected with immunohistochemistry assay. Results: Compared with normal group, in model group, TGF-?1 and Fas/Fas-L increased obviously(P

Objective To explore the clinic value of the vocal acoustics on voice evaluation in larynx leukoplakia pa?tients. Methods Dr. Speech software was used to perform voice acoustic analysis and deduce EGG parameters in 48 sub?jects with larynx leukoplakia and 50 normal subjects. Voice acoustic analysis parameters (Jitter, Shimmer, NNE, HNR, SNR, MPT), EGG parameters ( EGG-Jitter、EGG-Shimmer、EGG-NNE、EGG-HNR、EGG-SNR, CQP,CIP) and EGG wave?form were compared between two groups. Results For voice acoustic analysis, Jitter, Shimmer, NNE in larynx leukoplakia group were higher than those in normal group while HNR, SNR in larynx leukoplakia group were lower than those of normal group. What’s more,MPT in larynx leukoplakia group was obviously shorter than that in normal group with, statistically sig?nificant difference (P<0.05). For EGG analysis, EGG-Jitter, EGG-Shimmer, EGG-NNE were higher in larynx leukoplakia group than those in normal group with significant difference (P<0.05). EGG-HNR and EGG-SNR in larynx leukoplakia group were lower than those in normal group. Furthermore, CQP and CIP in larynx leukoplakia group were higher than those normal group with statistically significant difference (P<0.05). Most patients’(72.9%) EGG waveform showed gradually ac?celerate phase velocity and fast close phase, which represent a spike-like shape. Conclusion Voice acoustic analysis com?bined with EGG provide objective indicators to assess degree of hoarseness, and to provide sonic evidences for prevention, recurrence, assessment and pronunciation correction of the larynx leukoplakia.

OBJECTIVE To investigate the effect of obstructive sleep apnea hypopnea syndrome(OSAHS) on the quality of voice. METHODS Electroglottography (EGG) method was used for detecting the vocal cords vibration, waveforms of electroglottography and voice parameters such as Jitter, Shimmer, normalized noise energy (NNE), contact quotient(CQ), contact index (CI), contact quotient perturbation(CQP), contact index perturbation(CIP), and the in 82 OSAHS patients and 53 healthy subjects. The voice parameters were analyzed with Dr.Speech software, RESULTS While in normal pronunciation, the Jitter, Shimmer, NNE, CQP and CIP were (1.037±1.493)%, (5.627±1.872)%, (-16.109±1.719)dB, (2.638±0.633)% and (166.789±30.492)% in 22 mild OSAHS patients, (1.578±0.362)%, (8.478±1.635)%, (-11.517±1.614)dB, (6.043±0.936)% and (255.210±91.224)% in 24 moderate OSAHS patients, and (2.138±1.384)%, (14.888±4.089)%, (-7.677±2.151)dB, (11.749±7.164)% and (431.233±259.266)%in 36 severe OSAHS patients respectively. They were all higher than those in 53 normal subjects as (0.517±0.303)%, (3.299±2.196)%, (-21.933±5.477)dB, (1.322±0.942)% and (58.834±131.849)%. The regularity of vocal fold vibration in all patients with OSAHS was seriously out of whack. EGG waveform was irregular. CONCLUSION The OSAHS patients have structural changes in their upper airway, it will cause non-physiological breathing and lead dry of the vocal cord mucosa and weak elasticity. Their EGG parameters will get higher and vibration will be irregular seriously. We should pay attention to the voice qualities of the OSAHS patients and let them receive treatment as early as possible.

Objective To investigate the voicing acoustic characteristics of sulcus vocalis patients with mini-mum glottal area(MGA) .Methods 60 normal subjects (30 male ,30 female) ,and 62 subjects with sulcus vocalis (33 male and 29 female)were recruited .They all had stroboscopic laryngoscopy ,and had MGA measured when say-ing /i:/using software supporting KIPS .The acoustic parameters consisted of vocal cord fundamental frequency (F0) ,jitter and shimmer ,normalized noise energy ( NNE) ,harmony to noise ratio (HNR) and signal noise ratio (SNR) ,maximum phonation time(MPT) and respectively make correlation analysis with voice MGA .Results The voicing MGA of male patients with sulcus vocalis was 434 .74 ± 112 .83 ,larger than the males with normal vocalis 298 .25 ± 93 .63 .This was statistically significant (P<0 .05) .The voicing MGA of females with sulcus vocalis was (484 .75 ± 143 .91) ,significantly larger than those of females with normal vocalis (293 .43 ± 93 .73) and the differ-ence was statistically significant (P<0 .05) .The voicing MGA on both males and females with sulcus vocalis was noticeably relation to the F0 (r=0 .972 ,P<0 .05) and (r=0 .928 ,P<0 .05) ,Jitter (r=0 .978 ,P<0 .05) and (r=0 .910 ,P<0 .910) and Shimmer (r=0 .973 ,P<0 .05) and (r=0 .921 ,P<0 .05) ,normalized noise energy(r=0 .883 ,P<0 .05) and (r=0 .960 ,P<0 .05) ;and negative relation to the signal noise ratio (r= -0 .947 ,P<0 .05) and (r = -0 .957 ,P<0 .05) ,signal noise ratio (r= -0 .959 ,P<0 .05) and (r= -0 .944 ,P<0 .05) ,max-imum phonation time (r= -0 .891 ,P<0 .05) and (r= -0 .936 ,P<0 .05) .Conclusion Patients with pathological sulcus vocalis have glottal areas larger than normal .Acoustic analysis of the voices of the sulcus vocalis can be used as an objective laboratory examination .

OBJECTIVETo explore the advancement of the endoscopic video system in parapharyngeal space tumor resection.

METHODSThirty cases parapharyngeal space tumor patients underwent endoscopy-assisted tumors resection in otorhinolaryngology-head and neck surgery of Tianjin First Central Hospital. The passway included trans-oral cavity in 6 cases, 21 cases with trans-neck side and trans-neck-parotid gland in 3 cases.

RESULTSTumors of all cases were completely resected, without residual tumor. It was included 23 cases of benign tumors (14 cases of parotid pleomorphic adenoma, 8 cases of neurilemmoma, lymph node tuberculosis in 1 case), malignant tumor in 7 cases (2 cases of metastatic carcinoma, 2 cases of malignant mixed tumor, 1 case of malignant neurilemmoma, 2 cases of adenoid cystic carcinoma). Tongue deflection was recorded in 2 cases. There were neither wound infection or bleeding. All the cases were followed up after operation without recurrence. Seven cases of malignant tumor patients were all alive with follow-up 1 year in 1 case, 3 years in 4 cases, 2 cases for five years.

CONCLUSIONSEndoscopy-assisted tumors resection can deal with visual lesion corner and allow previous part no visibility surgery into all operation under direct vision. It contributed to improve the quality of operation, reduce the surgery complication. It was worth to be wide spreaded in clinic.

Adenoma, Pleomorphic ; Adult ; Aged ; Carcinoma, Adenoid Cystic ; Endoscopy ; Female ; Head ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Neck ; Neoplasm Recurrence, Local ; Neoplasm, Residual ; Neurilemmoma ; Parotid Gland ; Parotid Neoplasms ; Pharynx ; surgery ; Salivary Gland Neoplasms