Objective To evaluate the relapse rate and the effect of 5-aminolevulinic acid photodynamic therapy(ALA-PDT) combined with fulguration in the treatment of perianal genital warts.Methods 67 patients with perianal genital warts were randomly divided into the three groups.22 cases in the fulguration and ALA-PDT treatment group performed the ALA-PDT treatment immediately after removal of dominant wart by fulguration,once a week,treatment for 3-4 times.22 cases in the ALA-PDT treatment group only underwent ALA-PDT treatment,once a week,treatment for one month.23 cases in the fulguration group were given the traditional fulguration methods one by one electrocautery fulguration gasification treatment for all skin lesions,a weekly batch treatment,treatment for a month.Follow-up six months after the last treatment to determine efficacy and recurrence rate.Results The cure rate of combined treatment group was 90.9％ (20/22),and recurrence rate was 9.1％ (2/22) ;cure rate of photodynamic group was 54.5％ (12/22),and its recurrence rate was 22.7％ (5/22) ; cure rate of fulguration group was 39.1％ (9/23),and the recurrence rate was 43.5％ (10/23).There were statistically significant differences in the cure rate and relapse rate between combination therapy group and electrocautery treatment group (P =0.000,P =0.017).Conclusion The fulguration combined with ALA-PDT in the treatment of perianal genital warts has high cure rate,low recurrence rate,and less side effects.

Objective To investigate the clinical efficacy of unilateral small incision Quadrant channel assisted MIS?TLIF unilateral pedicle screw fixation system in the treatment of degenerative lumbar disease. Methods From January 2011 to December 2013,a total of 56 cases with low back and leg pain were selected in the People′s Hospital of Dongguan,including 25 cases with lumbar disc herniation,18 cases with lumbar tube stenosis,10 cases with discogenic low back pain,2 cases of recurrence after posterior lumbar spine surgery,1 case of recurrence after transforaminal endoscopic surgery. Unilateral pedicle screw fixation was performed in the treatment of MIS?TLIF with expandable pipeline system. VAS and Oswestry dysfunction index scoring system( ODI) were used to evaluate of pain and functional recovery in patients with preoperative and postoperative pain and functional recovery,the Suk method was used to observe the bone graft fusion. Results There were 5 cases of non operative side waist back pain after operation,and the waist circumference and anti?inflammatory pain relief were improved after treatment. One case of postoperative subcutaneous fat liquefaction, was cured by dressing change. One patient with recurrence of MED intraoperatie cerebrospinal fluid leakage,was cured after treatment by the bed,dehydration and others. Other complications such as infection,screw loosening, nerve root injury and other complications had no found. After 1 month,the VAS score from preoperative ( 6. 82 ±0. 92) points fell to (1. 95±0. 55) points,ODI score from preoperative (35. 21±2. 73) points fell to (10. 05 ±1. 72) points, significantly improved compared with the preoperative, the differences were statistically significant( t=36. 775,65. 858,P<0. 05) ,based on the fusion of Suk judgment method,2 cases of patients with possible fusion,the rest were fusion. Conclusion Unilateral small incision under the quadrant assisted MIS?TILF unilateral pedicle nail stick system has obvious advantages in treatment of degenerative lumbar spine disease,as long as we choose to suitable cases and most patients can obtain satisfactory results.

BACKGROUND: The study of tissue-engineered cartilage with predetermined shaping and regeneration has provided novel ideas and techniques for repair of laryngeal cartilage erosion; however, due to the special natures of the morphology, location and function of laryngeal cartilage, tissue engineering research has not, to date, exhibited its ful advantages in the reconstruction of laryngeal cartilage. OBJECTIVE:To explore the feasibility of building tissue-engineered larynx-shaped cartilage using poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHH) as a scaffold filed and encapsulated with pedicled myofascial flaps. METHODS:Porous PHBHH was prepared and formed into a holow like larynx-shape, and the cel PHBHH composites were cultured for 1 weekin vitro prior to implantationin vivo. The cel-PHBHH composite was filed and encapsulated with myofascial flaps with the pedicle forin situ implantation in nine rabbits as experimental group. PHBHH scaffold with no chondrocytes was implanted alone in three rabbits as control group. Cartilage regeneration was assessed at 6, 12 and 18 weeks after surgery through morphological observation, histological and immunohistochemical detection. RESULTS AND CONCLUSION: In the experimental group, the shape and porosity (> 90%) of the material were ideal, the cels exhibited good adhesion with the material and the blood supply within the myofascial flap with pedicle was rich for effective filing and encapsulation of the cel PHBHH composite. Tissue-engineered laryngeal cartilage with the holow, semi-trumpet shape was idealy formed at 6 weeks after the surgery. Further maturation of the cartilage was observed at 12 and 18 weeks after the surgery. However, there was no cartilage tissue in the control group. This study shows that PHBHH is a suitable material for the formation of a holow, semi-trumpet shape with good celular compatibility. Myofascial flap filing and encapsulating can be used to build tissue-engineered laryngeal cartilage with a holow, semi-trumpet shape.

Objective To investigate the effects and advantages of laparoscopic hernioplasty for hernia.Methods From June 1995 to June 2005,222 patients with hernia were treated with laparoscopy.Transabdominal preperitoneal hernia repair(TAPP) were performed in 166 patients.Totally extraperitoneal hernia repair(TEP) were performed in 25 patients.Closure of the internal orifice of hernia was performed in 21 patients.Furthermore,incisional hernia in 2 patients, diaphragmatic hernia in 1 patient and mesenteric hernia in 1 patient were performed by laparoscopic hernioplasty and 6 patients with hernia of oesophagus finestra performed hernioplasty combined collapse gastric fundus with laparoscopy.In this series 45 patients associated with other abdominal disease were simultaneously treated with laparoscopy.Results All cases were operated successfully.The span of operation reduration was 42.5 min((10～180 min)).The average length of postoperative hospital stay were 4.6 days.There was one early failure owing to the use of too small a piece of mesh.Conclusion The results indicate that mesh repair of hernias is a satisfactory technique with a low recurrence rate and a low major complication rate.

BACKGROUND:A great development has been achieved in essential research on tissue engineered cartilage. However, its real application in otolaryngology has been rarely reported. It is faced with the topic to explore the simple and convenient method of repairing laryngeal cartilage by tissue engineering technique. OBJECTIVE:To compare the effect of porous spongy poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) seeded with chondrocytes or using senior tissue engineered cartilage in repairing al ogenic thyroid cartilage defects.METHODS:Chondrocytes at passage 3 were harvested from infant rabbits within 3 days. Porous spongy poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) seeded with chondrocytes composites were made by tissue engineering technique. The chondrocyte-poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) composites were co-cultured in vitro to form junior tissue engineered cartilage. And then respectively used for repairing the thyroid cartilage defects and directly transplanted with junior tissue engineered cartilage (experimental group A, n=5), or firstly the junior tissue engineered cartilage to be implanted subcutaneously for a period of time to further maturity for relative senior tissue engineered cartilage and secondly to be transplanted (experimental group B, n=5) into adult New Zealand white rabbits. Simple poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) sponge scaffold (control group A, n=4) and chondrocyte suspensions(control group B, n=4) were used as reparative materials in defect areas as control groups. Final y, the reparative effect was respectively studied grossly and histological y at 4 weeks (experimental group B) and 8 weeks (experimental group A, control group A and control group B) after transplantation. RESULTS AND CONCLUSION:The cartilage defects were wel repaired in the experimental groups. It was smooth between the reparative area and original cartilage without dents and defects. Both were similar grossly. But few chondrocytes at interfacial region between the reparative area and original cartilage and poor matrices were observed in the experimental group A. A Few chondrocytes and more matrices were observed in the experimental group B. Inflammatory cellinfiltration was not obvious in two experimental groups. Control groups showed soft tissue of dark-red color accompanied with local concave in gross specimens. Histological examination and special staining showed there were no cartilage-like structure and secretion of matrix components. The results showed that it is possible to repair thyroid cartilage defect using junior tissue engineered cartilage directly or junior tissue engineered cartilage after in vitro implantation in al ograft rabbits with immunity, and the immunoreaction is not obvious;in the same period, the repairing effect of mature tissue engineered cartilage is better than that of junior tissue engineered cartilage. However, application of junior tissue engineered cartilage directly can save time, costs, workload and operational link, and avoid the pain from secondary skin surgery, which is one of the more practical approaches.

Humans ; Bile Reflux/complications* ; Cross-Sectional Studies ; Risk Factors ; Gastric Mucosa

Objective To assess the efficacy and safety of ascending aorta banding technique combined with typeⅠhybrid aortic arch repair for the aortic arch diseases. Methods The clinical data of patients undergoing ascending aorta banding technique combined with type Ⅰ hybrid arch repair for aortic arch diseases from March 2019 to March 2022 in Beijing Anzhen Hospital were retrospectively analyzed. The technical success, perioperative complications and follow-up results were evaluated. Results A total of 44 patients were collected, including 35 males and 9 females, with a median age of 63.0 (57.5, 64.6) years. The average EuroSCORE Ⅱ score was 8.4%±0.7%. The technical success rate was 100.0%. All patients did not have retrograde type A aortic dissection and endoleaks. One patient died of multiple organ failure 5 days after operation, the in-hospital mortality rate was 2.3%, and the remaining 43 patients survived and were discharged from hospital. The median follow-up period was 14.5 (6-42) months with a follow-up rate of 100.0%. One patient with spinal cord injury died 2 years after hospital discharge. One patient underwent thoracic endovascular aortic repair at postoperative 3 months due to new entry tears near to the distal end of the stent. Conclusion Ascending aorta banding combined with typeⅠhybrid arch repair for the aortic arch diseases does not need cardio-pulmonary bypass. Ascending aorta banding technique strengthens the proximal anchoring area of the stent to avoid risks such as retrograde type A dissection, endoleak and migration. The operation owns small trauma, rapid recovery, low mortality and a low rate of reintervention, which may be considered as a safe and effective choice in the treatment of the elderly, high-risk patients with complex complications.