OBJECTIVE: To evaluate the clinical effect of acellular dermal matrix (ADM) on the repair of different tissue defects in pharyngeal and laryngeal cancer. METHOD: Twenty-three cases of pharyngeal and laryngeal cancer were analyzed retrospectively, including 16 patients with pharyngeal cancer, and 7 patients with laryngeal cancer. After surgery, the patients appeared two types of tissue defects respectively: hypopharynx tissue defect and neck skin tissue defect. These defects were repaired with ADM, and the clinical effects were observed. RESULT: Sixteen cases of hypopharynx tissue defect and 7 cases of neck skin tissue defect were repaired with ADM. One case in hypopharynx tissue defect group and 2 cases in neck skin tissue defect group undergone pharyngeal fistula postoperatively. CONCLUSION The repair of tissue defects in pharyngeal and laryngeal cancer with ADM had some advantages, such as good histocompatibility, low immune rejection, wide material sources and simple method. There were some differences in clinical effects between hypopharynx cavity defect and neck skin tissue defects, so the emphasis of the need to pay attention to is different in the clinical.
Acellular Dermis ; Dermatologic Surgical Procedures ; Humans ; Hypopharynx ; surgery ; Laryngeal Neoplasms ; surgery ; Mucous Membrane ; surgery ; Neck ; surgery ; Otorhinolaryngologic Surgical Procedures ; Retrospective Studies

Objective To analyze the pathogenesis, clinical features, treatment and prognosis of pulmonary hypertension (PHT) in systemic lupus erythematosus (SLE) patients. Methods Thirty-eight patients admitted during Jan 2001 to Aug 2008 were diagnosed as SLE associated with PHT and were analyzed retrospectively. Results All cases were female with the mean age of 35.7 yds. The mean period from PHT to the diagnosis of SLE was 2.3 years. Three cases were severe PHT with remarkable heart failure. Twenty-seven eases demonstrated Raynaund's phenomenon. Antinuclear antibody (ANA) was positive in all 38 cases and the titer was 1:320. Anti-DNA antibody, anti-Sin antibody, anti-U1RNP antibody and anti-SSA, anti-SSB were positive in 21 cases, 16 cases, 15 cases, 8 cases respectively. Antiphospholipid antibody and rheumatoid factor (RF) were elevated in 4 cases and 13 cases respectively. Seven cases were involved in lung fibrosis and pulmonary function test showed mild to moderate restrictive abnormality in these 7 cases. After treated with the combination of steroid and immunosuppressive agents, one case died on the 10th day and 2 cases died in 2 to 3 years after the diagnosis was established. The other 35 cases stayed stable. Conclusion PHT is one of the severe complications of SLE and often accompanied by poor outcome. Therefore early diagnosis and early combined therapy is very important.

OBJECTIVE: To establish a simple and rapid HPLC method for the determination of serum concentration of isofosfamide.METHODS: With cyclophosphamide as internal standard,the serum sample was extracted on C18 solid phase extraction column and determined on Zorbox-ODS C18 at room temperature.The mobile phase consisted of acetonitrile-water(25∶75) at a flow rate of 1 mL?min-1 and a detection wavelength of 200 nm.RESULTS: The linear range of ifosfamide was 2.5～200 ?g?mL-1(r=0.999 9),with the lowest detectable limit at 0.5 ?g?mL-1(S/N=3).Both the intraday and interday RSD were less than 5%.The extraction recoveries of ifosfamide at high,middle and low concentrations were ranged between 89.3% and 93.6% versus 77.6%～82.3% in chloroform-treated serum samples.CONCLUSION: The method which uses the C18 solid phase extraction column is of high recovery,and the sample treatment by which is simple,rapid,accurate,and pollution-free,and it is applicable for the monitoring of serum concentration and pharmacokinetic study of isofosfamide.

Objective To investigate the efficacy and safety of cervical dilatation balloon and Dinoprostone for promoting cervical ripening and induction of labor.Methods 80 maternal who were taken induction of labor were randomly divided into two groups,40 patients in each group,according to the order of admission,the study group and the control group used COOK balloon and Dinoprostone for promoting cervical ripening and induction of labor respec-tively,Bishop score before and after treatment,cervical ripening rate of maternal and neonatal outcomes were compared between the two groups of maternal.Results The study group′s Bishop score was (8.96 ±0.15)points,which was significantly higher than (6.02 ±0.34)points of the control group after treatment,the difference was statistically sig-nificant(t =3.75,P <0.05);The total effective rate of the study group for maternal cervical ripening and induction of labor was 97.5%,which was significantly higher than 67.5% of the control group,the difference was statistically sig-nificant(χ2 =5.31,P <0.05);The study group′s induction to the regularity of contractions time was (6.2 ±1.4)h, which was significantly lower than (11.5 ±2.1)h of the control group(t =13.28,P <0.05),and the study group′s vaginal delivery rate and cesarean section rate were 85.0% and 15.0% respectively,the difference was statistically significant,which compared with 62.5% and 37.5% of the control group (χ2 =3.88,6.49,all P <0.05);The two groups′maternal and neonatal outcomes showed no significant difference(t =0.17,0.43,0.31,0.82,all P >0.05).Conclusion The cervical dilatation balloon has a higher success rate for promoting cervical ripening and induction of labor which is safe and reliable that should be widely applied.

OBJECTIVE: To compare the clinical results between stapled and traditional suture closure total laryngectomy. METHOD: Fifty-three cases of laryngeal cancer with total laryngectomy were divided into 2 groups: 32 cases with traditional suture closure total laryngectomy (group A) and 21 cases with stapled total laryngectomy group (group B). Compare two groups in pharyngeal fistula, postoperative bleeding, dysphagia, and nasal regurgitation. RESULT: There was no difference of postoperative pharyngeal fistula between group A and B (P>0. 05). The incidence of dysphagia, nasal regurgitation, and postoperative bleeding in group B were 23. 8%, 14. 3% and 14. 3% respectively, which were obviously higher than that in group A (P<0. 05). CONCLUSION Stapled total laryngectomy has the advantages of reducing the operative time and simplifying the operation with some disadvantages such as higher standards of operation indications, higher incidence of dysphagia, higher nasal regurgitation, higher postoperative bleeding, and poor medical economic profit. Traditional suture closure total laryngectomy is recommended in clinical practice.
Deglutition Disorders ; Fistula ; pathology ; Humans ; Incidence ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Pharynx ; pathology ; Postoperative Complications ; Suture Techniques ; Sutures

OBJECTIVE: To observe the effect of tympanic injection of dexamethasone in the guinea pig endolymphatic hydrops and the change CFTR expression, to explore the effect of glucocorticoid treatment endolymphatic and its possible mechanism. METHOD: Thirty guinea pigs were divided into three groups: hormone group, water group, control group. The animals(hormone group, water group) in study were injected DDAVP 4 μg/kg in the first 7 d, and will increase to 6 μg/kg in the second 3 d. The control group was given normal saline, continuous 10 d. After twelfth days, the hormone group transtympanic injection of dexamethasone (5 mg/ml, 0.5 ml), and water group, control group transtympanic given normal saline (0.5 ml), continuous injection 5 d. Using immuno- histochemistry and Western blot to detect the cystic fibrosis transmembrane conductance regulator cochlear factor (CFTR) expression. RESULT: The water group ABR thresholds was significantly higher than that before the experiment (P < 0.01), and the water group was significantly higher than the rest of the groups (P < 0.01); Hormone group compared with the control group increased threshold value (P < 0.05). The control group had no endolym- phatic hydrops, the water group showed varying degrees of endolymphatic hydrops, cochlear duct and vestibular plus cochlear duct area ratio compared with the control group, hormone group was significantly higher (P < 0.01). hormone group area ratio was higher than the control group (P < 0.05). CFTR was primarily expressed in the stria vascularis, Corti's, spiral ligament, basilar membrane, cochlear ganglion,etc . The expression of CFTR in the water group was increased than that in the control group, and the hormone group (P < 0.01); the expression of hormone group increased compared with the control group (P < 0.05). CONCLUSION Tympanic injection of dexa- methasone can alleviate the desmopressin acetatein guinea pigs caused by membranous labyrinth, and the improve- ment of the hearing; Tympanic injection of dexamethasone can make the endolymphatic hydrops cochlea of guinea pigs decreased CFTR expression, indicating that the expression and possible mechanisms of CFTR intratympanic steroids reduce endolymphatic hydrops changes.
Animals ; Cochlea ; Cystic Fibrosis Transmembrane Conductance Regulator ; biosynthesis ; Dexamethasone ; pharmacology ; Ear, Inner ; Endolymphatic Hydrops ; drug therapy ; metabolism ; Glucocorticoids ; pharmacology ; Guinea Pigs ; Stria Vascularis

Abstract: Objective　To explore the efficacy and safety of photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) combined with antifungal drugs combined and comprehensive nursing intervention in the treatment of refractory kerion. Methods　From January 2019 to December 2022，6 cases of refractory kerion who were treated at the Fifth People's Hospital of Hainan Province with photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) combined with antifungal drugs. A solution with 20% concentration of ALA solution was uniformly dropped on the cotton sheet, shielded from light for 3 h, and irradiated with (633±10) nm LED red light for 20-30 min. The treatment was performed once a week, with one treatment course consisting of three sessions. Prior to treatment, debridement and fire needles pre-treatment were performed. Provide timely and targeted psychological care during treatment to alleviate psychological negative disorders and health education. Follow-up examinations were conducted 6 months after the treatment to evaluate clinical efficacy, safety and patient satisfaction. Results　Six children received standard ALA-PDT combined with antifungal drugs, supplemented by comprehensive nursing intervention. The cure rate of children reached 100%, and no disease relapse or atrophic scar was found. The satisfaction rate of patients and their families was 100%. Conclusions　PDT combined with antifungal drugs has obvious clinical efficacy in the treatment of kerion, especially when combined with comprehensive nursing intervention. This approach can help to relieve patients' anxiety, improve treatment outcomes, enhances patient compliance, and further improve patients' satisfaction.

Objective To explore the probable mechanism of tinnitus and the accompanied symptoms us-ing RS-FMRI. Methods We recruited 10 adults with chronic tinnitus and 10 health adults for fMRI in the resting state. Then we compared the differences of regional homogeneity(REHO)maps and functional connectivity to the whole-brain maps with the auditory cortex as a region of interest between the two groups. Results The REHO maps of tinnitus group showed significant differences in the automated anatomical labeling brain map including the middle frontal_gyrus (right),superior frontal_gyrus (left),entorhinal cortex_(right),middle occipital_gyrus (right),middle occipital gyrus(bilateral),lingual gyrus(left)and cuneate lobe(left). The functional connectivity maps of tinnitus group showed significant differences in lingal_gyrus(left)of AAL brain regions. The p threshold value was<0.001 in all results. Conclusion Tinnitus may cause abnormal neural activity in several non-auditory brain regions,which may be the neurophysiological mechanism of tinnitus accompanied symptoms.

BACKGROUND:The relationship between placing time after stem cel preparation and cel survival is the basis of safety and effectiveness for the clinical application. OBJECTIVE: To observe effects of different preservation solutions and different storage time on survival rate of umbilical cord-derived mesenchymal stem cels, and to provide important evidence for identifying effectiveness of stem cels. METHODS:Umbilical cord-derived mesenchymal stem cels were selected to prepare stem cel preparation, which was preserved in physiological saline, medium, medium+physiological saline, physiological saline containing epidermal growth factor, and medium containing low molecular heparin calcium suspension. Cold closet was selected for imitating celular transport conditions. Samples were obtained at 0, 6, 12, 18, 24, 30, 36, 42 and 48 hours. Total cel number and cel survival rate were detected. RESULTS AND CONCLUSION:The difference in cel number and survival rate was not great within 24 hours in each group. Twenty-four hours later, total cel number and survival rate were better in the medium and medium containing low molecular heparin calcium groups than in the physiological saline containing epidermal growth factor, physiological saline, and medium+physiological saline groups. These findings suggest that after stem cel preparation, the cel survival rate can reach more than 90% within 24 hours under refrigerated transport conditions. Nutritional ingredients and proper pH value of preservation solution can make the cel survival rate increased greatly.

Objective To assess the prognostic significance of pre-treatment hypercoagulable state in cervical cancer patients. Methods With retrospective analysis, pre-treatment coagulation indicators and platelets from 321 cervical cancer patients from stages I to IV were collected. The pre-treatment coagulation parameters were investigated along with tumor stage and survival data. Result Advanced tumor stage was associated with elevated fibrinogen (Fbg) and platelet (PLT) levels (P < 0.05). Patients with higher levels of Fgb, PTA and PLT suffered from higher risk of recurrence (P<0.05). Multivariate survival analyses showed that tumor stage, Fgb and PTA were independent prognostic factors for disease free survival. Conclusion Coagulation parameters can be served as useful tool for predicting recurrence of cervical cancer.