OBJECTIVE: The objective was to investigate the effectiveness of holmium-YAG laser-assisted septoplasty for septal deviations under local anesthesia. METHOD: All holmium-YAG laser-assisted septoplasty procedures performed at Beijing hospital (Beijing, China) between August 2009 and May 2012. These patients were operated upon in an outpatient surgical suite. RESULT: The success rate after surgery with regard to nasal obstruction (50 patients) is 92.0% (46 patients) of patients reporting remarkable improvement. Of the 32 patients with rhinologic headaches, A total of 28 subjects (87.5%) had their headache scores improved by 50% or more after surgery; nine (28.1%) were pain free at the last follow-up; four (12.5%) had a less than 25% reduction in their headache score. There were no patients with severe postoperative bleeding. There were no patients with septal perforation. CONCLUSION The holmium-YAG laser-assisted septoplasty is a useful approach to correct septal deviations. There is improved safety due to the enhanced viewing conditions and ample operating space during septal surgery, particularly in posterior septal spurs. The holmium-YAG laser-assisted septoplasty can limit the dissection to the area of deviation, thereby reducing postoperative swelling and the development of complications. It also has other advantages including lower medical costs, and faster return to full activity.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Nasal Septum ; surgery ; Treatment Outcome ; Young Adult

Objective To evaluate the accuracy of stroke volume variation (SVV) in monitoring blood volume during one-lung ventilation in patients undergoing thoracoscopy operation. Methods Twenty-two ASA Ⅰ or Ⅱ patients ( 12 male, 10 female) aged 18-60 yr undergoing thoracoscopy operation under general anesthesia were studied. Anesthesia was induced with midazolam, sufentanil, propofol and rocuronium and maintained with TCI of propofol and remifentanil and intermittent iv boluses of vecoronium. Robertshow double-lumen endobronchial tube was inserted. Correct position of the tube was verified by fiberoptic bronchoscopy. The patients were mechani40 mm Hg. Radial artery was cannulated and connected to FloTrac pressure transducer and Vigileo monitor. A loading dose of 6% HES 5 ml/kg was infused over 10 min. MAP, HR, CO and SVV were recorded before and at 3 min after loading dose. The change rate of SVV (SVV) and CI (△CI) were calculated. Increase in CI by 11% was considered effective volume expansion. The ROC curve for SVV in determining the volume expansion efficacy was plotted. The area under the curve for SVV and 95% confidence interval were calculated. Results (1) CO were significantly increased while SVV decreased after a loading dose of HES. (2) During two-lung ventilation 12 patients responded to the 6% HES loading dose.SVV correlated with△CI ( - 0.710, P ＜ 0.05). The volume expansion efficacy was determined by SVV 11.5 % (sensitivity = 82 %, specificity = 92 % ). The area under the curve for SVV and 95% confidance interval were 0.880 (0.580-0.987). (3) During one-lung ventilation 11 patients responded to the 6 % HES loading dose. SVV correlated with CI ( - 0.668 , P ＜ 0.05). The volume expansion efficacy was determined by SVV 9.5 % ( sensitivity = 77 %, specificity = 63 % ). The area under the curve for SVV and 95% confidance interval were 0.971 (0.917-1.024). Conclusion One-lung ventilation does not alter the ability of SVV in monitoring blood volume in patients undergoing thoracoscopy operation.

Objective To study the clinical characteristics of tracheotomy in patients with critical diseases and obesity aged 80 years and over. Methods A total of 120 patients with critical diseases and obesity undergoing tracheotomy from July 2006 to August 2011 were retrospectively reviewed,and divided into advanced age group(aged 80-99 years,n=60) and control group(aged 60-79 years,n=60).Surgery time,operation preparation,surgery skill and complication after surgery were compared between the two groups. Results A total of 60 patients undergoing tracheotomy were successfully performed by relative surgery skills according to characteristics of critical obesity in advanced age group.There was 1 case (1.7％) and 0 case with trachea cannula exodus,3 cases (5.0％) and 4 cases(6.7％) with cuff leak,4 cases (6.6％) and 3 cases(5.0％) with stoma bleeding,5 cases (8.3％) and 7 cases (11.4％) with subcutaneous emphysema in advanced age and control groups,respectively.Total complication rate was similar between the two groups of patients [13 cases (21.7％) vs.14 cases (23.3％),x2 =1.00,P＞0.05]. Conclusions Individualized procedure of tracheotomy may reduce complication of patients with critical diseases and obesity aged 80 years and over.

Objective To investigate the expression and purification I278T-mutant human cystathionineβsynthase(CBS) in E . coli .Methods Site-directed mutagenesis by overlap extension using the polymerase chain reaction (PCR) was employed to construct mutant plasmids pGEX4T-1-CBS(I278T) ,which was induced and expressed in a medium containing 3% ethanol ,purified by affinity chromatography to obtain mutated CBS (I278T) protein .The activity ,UV-visible absorption spectroscopy ,protein particle size and Zeta potential of the purified protein were measured .Results Plasmid pGEX4T-1-CBS(I278T) was successfully constructed .The yield ,the specific activity and activity recovery of purified mutant CBS (I278T ) protein were 2 .3 mg/L ,21 .4 U/mg and 22 .6% .S-adenosylmethionine(AdoMet) with final concentration of 1 mmol/L showed no activation toward mutant CBS (I278T) protein .Ac-cording to UV-visible absorption spectroscopy analysis ,purified mutant CBS(I278T) had characteristic absorption peaks at 429 nm and 550 nm for heme-binding proteins .Protein average particle size was 7 .5 -10 .1 nm ,mainly in the form of tetramers ,and Zeta potential was - 16 .3 mV .Conclusion The methods of expression ,purification and identification of I278T-mutant human cystathionineβsynthase in E .coli were successfully established .

Objective:To measure the voice samples of the normal aged in order to systemically study the fea-tures of the voice changes. Method :To collect and analyze 146 voice samples of the normal aged with sonogram.Result:The fundamental frequency of the voice of the aged decreases and rises in the male more than 80 yearsolder. The low frequency harmonics are regulation and the intensity is strong in the formant of the aged. Thedifference reduces in voice between male and female. The harmonics to noise ratio tends downwards and the am-plitude perturbation quotient tends upwards along with the growth of age in the aged male. The changes of the above-mentioned parameters are not significant in the aged female. Conclusion:The voice changes are normalphysiological ones in the normal aged. The changes of the parameters are used to evaluate normal aged voice andabnormal one. The changes show that the function in the aged phonation tends to decline to a certain extent andit must be protected and be trained.

AIM: To explore the change of delayed rectifier potassium channel (K_V) activity in alveolar macrophages (AM) in chronic obstructive pulmonary disease (COPD) rats. METHODS: COPD model was established by exposure of the animals to cigarette smoke. With whole-cell voltage- or current-clamp techniques, K_V activity, membrane capacitance and resting membrane potential (Em) in AM from COPD model and control rats were compared. RESULTS: (1) Significant increases in total mononuclear cells and AM in bronchoal aveolar lavage fluid (BALF) were found in COPD group compared with in control group. (2) The AM K_V current altitude in COPD group [(520.5?38.7)pA, (+50) mV, n=30] was significantly lower than that in control group [(713.6?44.4)pA, (+50) mV, n=30, P0.05), but had more positive Em (P

Objective To explore treatment of bile duct variation in Laparoscopic Cholecystectom.Methods The author retrospectively analyzed the clinical data of 7 cases with bile duct variation in 2 000 patients performing Laparoscopic Cholecystectomy.Among the 7 cases,2 cases had small hepatic duct openings in the gallbladder bed;2 cases had cystic duct openings in the right hepatic duct;2 cases had accessory right hepatic duct;and one case had rare variation whose right hepatic bile duct and the jejunum connect together.2 cases of the first variation had no bile leakage,adopting the suture method in LC.Among 2 cases of the second variation(all found in LC),one case had bile spillage in the junction of the cystic duct and the right hepatic duct,so the operator converses to laparotomy,cuts the gallbladder,sutures the break,and the patient had no bile leakage at last;The other one case was anatomized clearly under the cavity mirror.Among 2 cases of the third variation,one had no bile leakage,whose accessory hepatic duct was ligated in LC.The other one case had bile leakage after LC,so the operator converses to laparotomy,clips the accessory hepatic duct,and extract the drainage tube until there was no bile drainage.The last case was mistaken and cut it,the next day biliary peritonitis appeared,so the bile leakage was sewed up under the laparoscope.Results The seven cases were followed 1 ~3 years,they had no jaundice and their liver function was normal.Conclusion Careful-ly dissect Calot's triangle in LC,observe bile leakage after LC;improve the level of understanding and dealing bile duct variation in LC,don't cut the duct which is known to us.We should treat differently according to particular case.

Objective:To compare the effects between electroacupuncture (EA) at Chize (LU 5, the He-Sea point of the Lung Meridian) and Shangjuxu (ST 37, the lower He-Sea point of the large intestine) in rats with ulcerative colitis (UC) on the variations of mesenteric microcirculation and vasoactive intestinal peptide (VIP) in the colon, lung, and hypothalamus. The relative specificity of acupoints was also explored.
Methods: A total of 28 male Wistar rats were randomized into a normal group, a model group, a Chize (LU 5) group and a Shangjuxu (ST 37) group, 7 rats in each group. The UC model was established by enema with acetic acid. Since the third day after modeling, rats in the Chize (LU 5) group and Shangjuxu (ST 37) group respectively received EA at Chize (LU 5) and Shangjuxu (ST 37), 15 min each time for successive 7 d. The variations of mesenteric microvascular calibers and blood flow status were observed by a microcirculation microscopic tester; VIP in the colon, lung and hypothalamus was measured by radioimmunoassay.
Results:Compared with the normal group, the mesenteric microvascular calibers were significantly expanded in the model group (P<0.05); there was no significant difference between the model group and Chize (LU 5) group (P>0.05); compared with the model group and Chize (LU 5) group, the calibers were obviously shrunk in Shangjuxu (ST 37) group (P<0.05). The four groups showed no significant inter-group differences in comparing blood flow status (P>0.05). The colonic VIP levels in the model group and Chize (LU 5) group were significantly higher than that in the normal group (P<0.01,P<0.05); the VIP level in Shangjuxu (ST 37) group was markedly lower than that in the model group (P<0.01). There were no significant differences among the four groups in comparing VIP level in lung and hypothalamus (P>0.05).
Conclusion:The effects of Chize (LU 5) and Shangjuxu (ST 37) were different in treating UC. Shangjuxu (ST 37) showed a more significant efficacy in down-regulating VIP in the colon and regulating mesenteric microcirculation, while the effects of Chize (LU 5) were not obvious.

To evaluate the effect of components in Guanxin Ⅱ prescription on the pharmacokinetic profiles of paeoniflorin and ferulic acid. METHODS: Drug concentrations of rat plasmas after intravenous injection of paronia pall (PPE) or ferulic acid (FA) extract solution, as well as oral administration of PPE and FA solution, and different kinds of decoctions based on Guanxin Ⅱ prescription were determined by an HPLC system. NONMEM (nonlinear mixed-effect modeling) method was used to analyze the population pharmacokinetics of PF and FA. RESULTS: A two-compartment model with first order degradation in absorption phase, and an ordinary two-compartment model were adequately describe PF and FA pharmacokinetic profiles, respectively. The mean of PF population parameters, CL1, V1, CL2, V2, Ka0, and Ka1, were 0.509 L/h, 0.104 L, 0.113 L/h, 0.123 L, 0.135 /h, and 0.0135 /h, respectively, while the typical values of CL1, V1, CL2, V2, Ka1, and F in FA model were 0.295 L/h, 0.025 L, 0.0331 L/h, 0.0518 L, 0.110 /h, and 0.40, respectively. Inter-individual variabilities were estimated and dose formulation (DF) was identified as a significant covariate in the model. CONCLUSION: The results indicate that the pharmacokinetic behaviors of index components in Guanxin Ⅱ prescription can be influenced by different dose formulations administrated in rats.