OBJECTIVE To investigate the efficacy of coblation for early glottic cancer. METHODS Twenty-two patients with early glottic carcinoma (Tis-T2) without lymph node metastasis accepted resection of laryngeal cancer lesions using transoral endoscopic coblation,without pre-operative or post-operative radiotherapy and chemotherapy. All the patients were followed up for 30 to 70 months. RESULTS No severe complications such as dyspnea and bleeding occurred in these cases.Only mild postoperative pain happened to the patients.All patients could swallow and speak after operation. No recurrence occurred in 21 cases till now. One case, with poorly differentiated squarnous cell lesion in the anterior commissure invading subglottic area, recurred 4 months after operation. Salvage partial laryngectomy was performed and no recurrence was found after salvage operation. CONCLUSION The result suggests that transoral endoscopic coblation is a good method for early glottic cancer. It is worth popularizing.

Objective To e xplore the clinical value of adrenomedullin on children with acute heart failure treatment and progno-sis.Methods Selected 58 cases of AHF children,40 patients with pneumonia,40 cases of children with congenital heart disease and 50 healthy children as the object,radioimmunoassay was taken to detected plasma adrenomedullin and endothelin level,and analysed correlation between AMD,ET-1 and cardiac function.Results Pneumonia complicated with heart failure group,congenital heart disease complicated with heart failure group plasma AMD,ET-1 levels were significantly higher than those in the control group, congenital heart disease group and pneumonia group (P<0.05),congenital heart disease group and pneumonia group of plasma AMD,ET-1 levels were significantly higher than those in the control group (P<0.05).Heart failure stage plasma AMD,ET-1 lev-els were significantly higher than those of early stage and recovery period (P<0.05),heart failure early stage plasma AMD,ET-1 levels were significantly higher than those of early heart failure recovery period (P<0.05).There was a significantly negative cor-relation between with AMD,EF-1 levels and CI,LVEF in AHF children (r= -0.614,-0.793,-0.618,-0.547,P<0.05);AMD mutation rate was significantly higher than that of EF-1 (P<0.05).Conclusion Plasma levels of ADM are closely relate with heart function in AHF children,through the determination of plasma ADM level can assessment treatment and the prognosis of children with AHF,and worthy of clinical application.

Thulium fiber laser is a novel laser of good potential in lithotripsy, which gained the attention of urology society in recent years. This article aimed to discuss Thulium fiber laser referring to lithotripsy mechanism, ablation efficiency, laser safety, clinical application and so on. Thulium fiber laser shares a similarity of lithotripsy mechanism with Holmium laser, whereas Thulium fiber laser has a higher ablation rate, thinner fragments, and smaller retropulsion compared to Holmium laser. Thulium laser may bring revolution in the field of laser lithotripsy.

Objective To investigate the risk factors of color-ectal cancer and to provide scientific basis for prevention of colorectai canc-er. Methods A 1:1 matched case-control study was carried out in Dalian including 200 cases with colorectal cancer and 200 controls. We analyzedthe data with the univariate analysis and mutivariate conditional logistic re-gressiou,theu calculated the Odds Ratio and the 95% confidence. Results Conditional logistic regression showed that history of constipation, family history of other tumor,intake much bloat food ten yeats ago and easily an-gry were the risk factors of colorectal cancer, and intake much fresh vegeta-bles ten years ago was the protective factors of colorectal cancer. One way analysis showed that following factors were the risk factors of coloroctal cancer:there were pollution factor around home 10 years ago, belly CT test,sleep over twelve o'clock at night,family history of coloroctal cancer, history of pries, appendicitis and the operation history of appendicitis, intake much fry and bake food,seashell and animal liver before ten years ago,of-ten feel strew, don't like to communicate with others,pessimism,don't harmonization with colleague. And iutaking much chicken meat, bean prod-ucts,garlic ten years ago,doing exercise and the frequency of exercise,high income were the protective factors of colorectal cancer. Conclusion Coloroctal cancer was the result of many factors. But the incidence of that in Dalian city was related to history of constipation, family history of other tumor, easily angry, intake less fresh vegetables and intake much bloat food ten years ago.

Objective To analyze and summarize the characteristics of thyroid diseases on the MR diffusion-weighted imaging.Methods Forty-two patients with thyroid lesions,including 10 males and 32 females [age range 20-72 years,mean age (42 + 13) years] underwent MR DWI before surgery and biopsy.The diagnoses of thyroid lesions were confirmed by pathological results.ADC values of benign and malignant nodules,with different b values (b values was 300,500 and 800 s/mm2),were generated by using post-processing software Functool of GE company(USA).The independent-samples t test was used and ROC curve was made to evaluate the diagnostic efficiency of the ADC values by using statistical software SPSS 12.0.Results Histologically,there were 28 benign lesions and 14 malignant lesions.Benign lesions included 20 cases of thyroid adenoma,6 cases of nodular goiter and 2 cases of Hashimoto's thyroiditis respectively.Malignant lesions consisted of 11cases of thyroid papillary carcinoma,2 cases of follicular thyroid cancer,and 1case of dysplasia.mean ADC value of benign thyroid lesions was (2.39 ±0.38) ×10 -3 mm2/s and mean ADC value of malignant thyroid lesions was ( 1.60 ± 0.56) × 10 -3 mm2/s with b value of 300 s/mm2.The statistical difference was significant between them( t =5.35,P ＜ 0.05 ).The statistical difference of mean A DC values,between benign and malignant nodules with b value of 500 s/mm2 [ (1.85 +0.33 ) × 10 -3 mm2/s and ( 1.65 ± 0.42 ) × 10 -3 mm2/s ],was insignificant ( t =1.70,P ＞ 0.05 ).The statistical difference of mean ADC values,between benign and malignant nodules with b value of 800 s/mm2 [ ( 1.61± 0.30) × 10 -3mm2/s and( 1.44 +0.29) × 10 -3mm2/s],was insignificant (t =1.76,P ＞0.05 ).ROC curve indicated that the ADC value of 1.98 × 10-3 mm2/s or higher was the cut-off value for differentiating benign from malignant cold thyroid nodules,with a sensitivity of 85.7％,and a specificity of 78.6％.Conclusions The image quality is best with b value of 300 s/mm2.Mean ADC value of benign lesions was significantly higher than mean ADC value of malignant lesions with b value of 300 s/mm2.

Objective To investigate clinical efficacy and adverse reactions of Citric acid tandospirone in treating generalized anxiety neurosis.By doing this study,we provide clinical evidence for citric acid tandospirone in treating generalized anxiety neurosis.Methods 92 patients with generalized anxiety were randomly divided into the control group and observation group according to the random number table.There were 46 cases in each group.In the observation group,the patients were given acid citrate edge tandospirone.At the starting the patients were taken 15mg/d. After 3 days the dose increased to 35mg/d by 5mg.The average dose was (31 ±3.4)mg/d.In control group,accord-ing to different patients sleep condition,oxazepam tablets were taken.The daily dosage does not exceed 30mg/d.After two weeks,the dose was gradually reduced to the end.The clinical efficacy,HAMA score and adverse reactions in the two groups were compared.Results Compared to prior treatment,after 2 weeks and 4 weeks the HAMA score in the two groups were significantly different (P<0.05).Compared with the control group,the score in the two group had significantly different after two weeks treatment (t=2.16,P<0.05).The total effective in the observation group was 86.9 %.In the control group the total effective rate was 82.6%.There was no significant difference between the two groups (χ2 =0.33,P>0.05).The rate of adverse reaction in the observation group was 32.6%.The rate of adverse reaction in the control group was 63%.The rate of adverse reaction in the control group and observation group had sig-nificantly different (χ2 =8.58,P<0.05) .Conclusion Acid citrate edge tandospirone on the treatment of general-ized anxiety neurosis showed obviously effect and had fewer adverse reactions.The clinical program is worth of further study and clinical application.

[Objective] To explore the surgery protocol of the serious dislocation of acromio-clavieular joint,and compare the outcome of ORIF with AO/ASIF clavicle hook plate only to ORIF with eoraco-clavieular ligament reconstruction.[Method]Fity-two cases of the dislocation of acromio-clavicular joint were reviewed,Group A was ORIF only including 29 cases(male 20,female 9,mean age 45),according to the system of Rockwood,as TypeⅢ in 12 patients,TypeⅣ in 15 patients and TypeⅤ in 2 patients,the other 23 cases ORIF with eoraeo-clavieular l ligament reconstruction was Group B(male 15,female 8,mean age 50.6),according to the system of Rockwood,as TypeⅢ in 9 patients,TypeⅣ in 13 patients and TypeⅤ in 1 patients,AO/ASIF claviadar hook plates were used for all of the ORIF,and modified Weaver's method was used to reconstruct eoraco-clavieular ligament.Outcome was evaluated by Lazzcano scale after 8~12 months,and data was analyzed by SPSS 10.0.[Result]Good outcome was achieved in all of the patients,there was no significanty statistical difference between the two groups.[Conclusion]Clavicle hook plate is a kind of perfect internal fixation.Reconstruction of eoraco-clavleular ligament is not necessary if the AO/ASIF plate is used,unless serious avulsion of deltoid and trapezius muscle involved.

Objective The purpose was to explore the preventive measures of patellar baja following high tibial osteotomy for osteoarthritis, and the correlation between alteration in the inclination of the proximal tibial articular surface and patellar baja was evaluated as well. Methods In the group, there were 41 cases (48 knees), which included 30 males and 11 females, aging from 45 to 56 years with the mean age of 52 years. The size of resected bone of the arthritic knee needed to achieve a normal angle was calculated, and an additional 3 to 5 degrees of overcorrection was added to achieve approximately 10 degrees of genu valgum. The Insall-Salvati ratio, the inclination of the proximal tibial articular surface, the tibial tubercle height and the anatomic axis of the affected limbs were measured on the preoperative, postoperative as well as the final follow-up radiographs respectively. Chi-square test and linear regression analysis were used to assess the influence of loss of proximal tibial articular inclination on the patellar height. In the statistical analysis, loss more than 5 degrees of proximal tibial articular inclination and lowering more than 10% of the patella following tibial osteotomy were assumed of clinical significance. Results Compared with the preoperative results, the postoperative inclination of the proximal tibial articular surface was decreased by a mean of 6.14 degrees; the postoperative Insall-Salvati ratio was decreased by a mean of 10.6%; the postoperative height of the tibial tubercle was decreased by a mean of 3.13 mm. 64.6% (31/48 knees) endured loss more than 5 degrees of posterior tibial inclination after high tibial osteotomy, whereas 56.2% (28/48 knees) showed a relative lowering of patellar height more than 10%, as measured by the Insall-Salvati ratio. The loss of the normal posterior tibial inclination was found to have a statistically significant correlation with the subsequent loss of the patellar height. Conclusion The loss of inclination of the proximal tibial articular surface is found to have a correlation with the loss of the patellar height. Clinically, the result suggests that preserving the inclination of the proximal tibial articular surface at the time of high tibial osteotomy could minimize the risk of patellar lowering after the high tibial osteotomy.

Objective To assess the safety and effica cy of local lidocaine anesthesia for pain control during transrectal ultrasound-g uided 10-core biopsy of the prostate. Methods Transrect al ultrasound-guided prostate biopsy was performed for 150 consecutive men beca use of an abnormal digital rectal examination and(or) abnormal transrectal ult rasound scan and(or) elevated prostate specific antigen.100 paients were rando mly assigned to receive an injection of 2% lidocaine (group 1,50 cases)or norm al saline(group 2,50 cases)into the lateral and apical periprostatic region,3 ml in each point,the other 50 patients(group 3) served as controls.Immediate ly after biopsy the pain score was recorded independently by a nurse using 10-p oint visual analog scale(VAS). Results The pain score range was 0 to 7.5 in the group 1,0 to 9.1 in the group 2 and 0 to 7.4 in the co ntrol group,the mean pain scores being 2.0 in the group 1,4.0 in the group 2 a nd 3.7 in the control group.The diffrence between group 1 and group 2、3 was sig nificant( P

0.05). Measured by KT-1000 arthrometer, the posterior tibial translations in the group of the uni-bundle at 0? and 30? flexion were (5.9?0.4) mm and (6.2?0.5) mm; but the posterior tibial translations in the group of the double-bundle at 0? and 30? flexion were (3.5?0.3) mm and (4.0?0.4) mm. It was of statistical significance (P0.05). Conclusion The clinical results of double-bundle PCL reconstruction is superior to that of the uni-bundle. Arthroscopic double-bundle PCL reconstruction is able to restrict the posterior tibial translation and restore the stability of the knee joint within its full range of flexion.