Objective To investigate the clinical significance of the expression of lymphocytes and cytokines in patients with laryngeal tuberculosis.Methods 96 cases of laryngeal tuberculosis were selected as the research objects.Of which 42 cases of infiltrating type,31 cases of ulcer type,mass type in 23 cases,the other 50 cases of healthy persons were selected as the healthy control group,all the research objects,extracting the morning fasting venous peripheral blood for detection of T lymphocyte subsets and cytokines were detected,and the results were compared.Results Invasive laryngeal tuberculosis CD3+ index (63.10 ± 5.33) ％ (t =1.922),CD4+ (40.32 ± 5.06) ％ (t =1.758),CD8+ (24.41 ± 4.59) ％ (t =1.710),compared with the control group,CD4+,CD3+ index significantly reduced,CD8+ index increased significantly,the differences had statistical significance (t =1.922,1.758,1.710,all P ＜ 0.05),and the ulcer type and mass type results compared with invasive had significant difference(all P ＜0.05).In the analysis of laryngeal tuberculosis pathological types,reduced the mass type CD3+,CD4+ T index and CD8+ index of lymphocyte increased obviously the most significant;all laryngeal tuberculosis in patients with IL-4,IL-10 and TNF-alpha significantly increased compared with the control group,while the IFN-gamma was significantly reduced,and the mass in the type of change was the most significant,the differences had statistical significance(all P ＜ 0.05).Conclusion The use of lymphocytes and cytokines detection can improve the laryngeal tuberculosis patients with the clinical diagnosis rate,with the detection results of different degree and different pathological types of laryngeal tuberculosis patients,can be used for preliminary assessment of laryngeal tuberculosis disease and pathological type,the choice of treatment modality for patients with guidance value,with in-depth clinical study and promotion application of value.

Objective:To evaluate efficacy of tympanic membrane PE tube placement combined with oral endoscopic adenoidectomy in treating otitis media with effusion(OME) in children. Methods:Selected 87 cases(102ears)patients of secretory otitis media as research subjects between January 2012 to August 2014, in department of Otolaryngology in Heilongjiang Province, randomly divided into observation group(45cases, 55ears) and control group(42cases, 47ears),observation group used tympanostomy tube siphon drainage method combined with adenoidectomy for treatment, control group alone tympanostomy tube siphon drainage therapy, postoperative complications recorded data of patients later from the hospital after six and twelve months. Results:Two groups of patients after six months treatment and after twelve months(x2=5.705, x2=7.460;P<0.05), the results were statistically significant(P<0.05);in the middle ear effusion time, recurrent ear number, the number of ear infections, the results were also statistically significant(t=7.662, x2=4.197, x2=4.752;P<0.05). Conclusion:Under the ear drum using endoscopic drainage siphon tube method combined with adenoidectomy can effectively reduce postoperative complications in patients with quick, injury, etc, with high short-term and long-term efficacy, worthy application.

Objective To investigate post-traumatic stress disorder (PTSD) and life quality (QOL) of children and adolescents with cancer,and analyze the correlation between PTSD and QOL and study whether PTSD would influence QOL.Methods We investigated PTSD by using the PTSD-SS,and investigated QOL by using the EORTC QLQ-C30 V3,and the data was performed by SPSS 17.0.Results The PTSD-SS total score and the scores of EORTC QLQ-C30 of function field and of whole life quality field were negatively correlated,and the PTSD-SS total score and the scores in symptom field and six single measurement of EORTC QLQ-C30 were positively correlated.Conclusions PTSD of children and adolescents with cancer was closely related with the poor functional status and the high level of symptoms problem.PTSD has affected QOL.The higher level the PTSD is,the lower level of QOL will be.

Objective To study clinical effect after laparoscopic abdominal preperitoneal inguinal hernia repair methodwithout stapler. Methods 80 cases of inguinal hernia(hospitalized from February 2015 to January 2017)were divided into two groups according to the random number table method ,with 40 patients in each group. Traditional laparoscopic peritoneal inguinal hernia repair method was applied in the control group. Free stapler group received free stapler laparoscopic preperitoneal inguinal hernia repair treatment method. Operation time , amount of bleeding during surgery , the average hospitalization time after operation , the total cost of hospitalization,postoperative pain score,postoperative recovery activities time,patients′satisfaction,operation effusion after operation occurred scrotal hematoma and other complications were comparedbetween the two groups of patients. Results In free stapler group,patients′ satisfaction rate was significantly higher than the control group (P < 0.05). Area of effusion,scrotal hematoma and other complications infree stapler group after surgery were significantly lower than the control group (P < 0.05). Total cost of hospitalization,postoperative pain score, postoperative recovery time activities in free stapler group were significantly better than those in the control group (P<0.05). Operation time,bleeding amount during the operation,average hospitalization time difference between the two groups were not statistically significant(P > 0.05). Conclusion Operation time and amount of bleeding were similar between traditional laparoscopic transabdominal preperitoneal inguinal hernia repair method and free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair.Clinical effect of free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair proves to be effective with less complications ,less pain, faster postoperative recovery, and can reduce the cost of treatment.Free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair has satisfactory cosmetic results and was well received by patients,worthy of promotion.

Objective:To evaluate the influence of depression and anxiety on sleep quality, and to provide a basis for preventing sleep disorders in community-dwelling older adults.Methods:Cluster sampling was used.A self-designed questionnaire, the Pittsburgh Sleep Quality Index(PSQI), the Patient Health Questionnaire-9(PHQ-9), and the Generalized Anxiety Disorder Questionnaire-7(GAD-7)were used for the survey.The sleep quality and the influence of depression and anxiety on sleep quality of 955 community-dwelling older adults aged 60 and above were investigated.Results:The detection rate of sleep disorders, depression and anxiety were 24.5%, 19.1% and 14.3%, respectively.There was a positive correlation between sleep quality scores(including the total score and the scores of each dimension)and the anxiety and depression scores( rs: 0.115-0.558, P<0.01 for all). After adjusting for possible confounding effects of gender, age, food intake or tea drinking before bed, Logistic regression analysis showed that the presence of depression( OR=3.555, 95% CI: 2.235-5.653, P<0.05)and anxiety( OR=1.812, 95% CI: 1.070-3.070, P<0.05)were significantly related to sleep disorders in the elderly.The multivariate adjusted population attributable risk of depression and anxiety for sleep disorders in the elderly was 32.56% and 16.09%, respectively.The presence of depression and anxiety were associated with 38.87% of the population attributable risk for sleep disorders. Conclusions:Depression and anxiety are important risk factors for sleep disorders in the elderly.Strengthening the identification and intervention of depression and anxiety is beneficial to improve the sleep quality of elderly living in the community.

Spinal vascular disease is rare in clinic, especially in cases of spinal cord embolism caused by abnormal embolism. It is rare in clinic and has not been reported in China. We report a case of pulmonary embolism complicated with abnormal spinal cord embolism due to lack of protein S activity and analyze its clinical data in order to improve clinical understanding of the disease.

Objective: To evaluate the outcomes of myelodysplastic syndromes (MDS) patients who received HLA-matched sibling donor allogeneic peripheral blood stem cell transplantation (MSD-PBSCT) . Methods: The clinical data of 138 MDS patients received MSD-PBSCT from Sep. 2005 to Dec. 2017 were retrospectively analyzed, and the overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (RR) , non-relapse mortality (NRM) rate and the related risk factors were explored. Results: ①After a median follow-up of 1 050 (range 4 to 4 988) days, the 3-year OS and DFS rates were (66.6±4.1) % and (63.3±4.1) %, respectively. The 3-year cumulative incidence of RR and NRM rates were (13.9±0.1) % and (22.2±0.1) %, respectively. ②Univariate analysis showed that patients with grade Ⅲ-Ⅳ acute graft-versus-host disease (aGVHD) or hematopoietic cell transplantation comorbidity index (HCT-CI) ≥2 points or patients in very high-risk group of the Revised International Prognostic Scoring System (IPSS-R) had significantly decreased OS[ (42.9±13.2) %vs (72.9±4.2) %, χ²=8.620, P=0.003; (53.3±7.6) %vs (72.6±4.7) %, χ²=6.681, P=0.010; (53.8±6.8) %vs (76.6±6.2) %vs (73.3±7.7) %, χ²=6.337, P=0.042]. For MDS patients with excess blasts-2 (MDS-EB2) and acute myeloid leukemia patients derived from MDS (MDS-AML) , pre-transplant chemotherapy or hypomethylating agents (HMA) therapy could not improve the OS rate[ (60.4±7.8) %vs (59.2±9.6) %, χ²=0.042, P=0.838]. ③Multivariate analysis indicated that the HCT-CI was an independent risk factor for OS and DFS (P=0.012, HR=2.108, 95%CI 1.174-3.785; P=0.008, HR=2.128, 95%CI 1.219-3.712) . Conclusions HCT-CI was better than the IPSS-R in predicting the outcomes after transplantation. The occurrence of grade Ⅲ-Ⅳ aGVHD is a poor prognostic factor for OS. For patients of MDS-EB2 and MDS-AML, immediate transplantation was recommended instead of receiving pre-transplant chemotherapy or HMA therapy.