Objective:To investigate the clinical effect of surgical procedures on patients with chronic sinusi-tis. Method: 104 patients with chronic sinusitis were treated by endoscopic and Caldwell-Luc's approaches. Thelesions were cleared away completely. Result:The clinical cure rate was 96.1％ after 6～12 months (average 9months ) follow up. Conclusion:It suggests that patients with severe maxillary sinus diseases might be cured byendoscopic and Caldwell-Luc's procedure.

Objective To understand the status of disinfection in hospitals in Zibo. Methods Sanitary investigation on the disinfection quality of indoor air ,hands of doctors and nurses,surface of objects,the sanitary quality of disinfection reagents in use and the intensities of ultraviolet ray emitted from ultraviolet lamps was carried out in 34 general hospitals with bed capacity of more than 100 and special hospitals in Zibo. Results The total qualified rates of above indexes were 86.77% for municipal hospitals ,78.77% for district (county)hospitals,61.63% for factory and mine-hospitals respectively,and between them revealed significant differences (?2=59.95,P

Objective To study the roles of apoptosis and expression of the related genes in minor labial salivary gland of patients with primary Sjogren′s syndrome (pSS). Methods Biopsies of minor submucosal labial salivary gland (SG) were obtained from 30 patients with pSS and 10 control individuals. The in situ end labeling and immunohistochemical staining were used to detect the apoptotic cells and the expression of Fas, FasL and Bcl-2. Results The percentage of apoptotic acinar and ductal epithelial cells (AEC and DEC) in labial salivary glands of patients with pSS was significantly higher than that of control respectively, but the percentage of apoptotic infiltrating mononuclear cells (IMC) showed no significant difference compared with that of control, pSS AEC and DEC showed increased expression of Fas/FasL and decreased expression of Bcl-2, whereas pSS IMC showed increased expression of Fas, Fas/FasL and Bcl-2. There was significant positive correlation between the percentage of apoptotic cells and the cells expressing Fas and FasL in pSS AEC DEC and IMC, respectively, and there was significant negative correlation between the percentage of the apoptotic cells and that of cells expressing Bcl-2 in pSS DEC and IMC, but there wasn′t correlation between the percentage of the apoptotic cells and that of cells expressing Bcl-2 in pSS AEC. Conclusions The apoptotic cells increased in the epithelial cells and decreased in IMC of the labial salivary glands may be one of the mechanisms leading to the glandular destruction found in pSS. In pSS labial salivary glands, the expression of Fas and FasL may promote apoptosis, while the expression of Bcl-2 may inhibit apoptosis. The increased expression of Bcl-2 in pSS IMC indicates that IMC may be able to escape apoptosis, resulting in inflammatory cell foci.

Objective To discuss how to reduce the incidence of postoperative infection and am-putation of patients after earthquake.Methods The wound infection and corresponding therapeutic outcome were analyzed in 592 patients in front line hospitals and station hospitals.Results The inci-dence of infection was 30. 7% in patients treated in front hospital within 8 hours post-trauma but 79. 9% after 8 hours post-trauma. There included 1 patient(0. 2%) with amputation due to clostridial myonecro-sis and 5(1. 2%)with amputation due to serious infection. Incidelice of postoperative wound infection was 7. 1% after selective operation for close injury. The incidence of infection in patients in station hospi-tals was 50. 8%, with no amputation, because they received debridement and antibiotics in site or front line hospitals. No postoperative infection was found in patients with close injury treated with selective op-eration in station hospitals. The major bacteria of wound infection in either front line hospitals or station hospitals were enterococcus faecalis and Eschrichia Coli. Incidence of combined infection was higher than that of single infection. And Gram-Negative bacillus infection exceeded Gram-Positive bacillus infection. The major wound infection obrained effective control through treatment with sensitive antibiotics.Con-clusions After earthqiale, the incidence of infection in patients with open injury is high, with high am-putation rate due to serious infection. Therefore, we propose performing as soon as possible debridement and external fixation with antibiotic treatment but reducing internal fixation. The postoperative infection late of patients with close injury in front line hospitals is much higher than that in station hospitals;their-fore, patients with stable vital signs should be transported to station hospitals as early as possible in order to reduce incidenee of infection.

Objective To describe a new technique with mini-open reconstruction of lateral ligaments of ankle with partial tendon of its peroneus brevis and evaluate its effect in treatment of chronic lateral ankle instability. Methods A total of 11 cases of chronic lateral ankle instability;at mean age of 27.6 years(16-42 years),were treated with mini-open reconstruction of the lateral ligaments of the ankle with partial tendon of its peroneus brevis.The mean delay between the initial episode of ankle sprain and the surgery was 10.3 months(4-32 months).Postoperatively,all cases were examined with MRI,stress X-rays and comparative stability of bilateral ankle inspection at clinical follow-up.The function of the ankle were evaluated bv American Orthopaedic Foot & Ankle Society (AOFAS)score and ankle-hind foot scale. Results The average duration of follow-up was 17.5 months(12-37 months).The mean AOFAS ankle-hindfoot score was 88.3 points(72-96 points)at the time of the latest follow-up,including excellent result in 6 cases(55%),good in 4(36%)and fair in 1(9%).MRI results showed that the ruptured lateral collateral ligaments of the ankle were repaired and remodeled very well in all patients.There was no recurrence of the ankle instability or other complications. Conclusion Mini-open reconstruction of the lateral ligaments of ankle with partial tendon of its peroneus brevis is safe and effective for treatment of chronic lateral ankle instability.

Objective To investigate the inflammation levels of 2-diabetes patients before and after 3 months of improving glycemic control.Methods A longitudinal study was performed in a subgroup of 48 subjects with T2D and poor glycemic control.Forty-four healthy individuals were taken as control group.The serum concentration of C-reactionprotein (CRP),interleukin-6 (IL-6),interleukin-6 (IL-8),transforming growth factor-β1 (TGF-β1) and transforming growth factor-β1 (MCP1) in all participants were measured simultaneously by multiplexed Luminex assay.Results The serum levels of CRP,MCP-1 of 2-diabetes patients were 3.96 (3.45,5.58) mg/L and (195.0± 129.8) ng/L,significant higher than those in control group (2.25 (1.24,3.22) mg/L,(148.5±85.7) ng/L),and the differences were significant(t=-2.580,P=0.010;t=-2.118,P =0.047).No significant difference was found in the serum levels of IL-6,IL-8,TGF-β lbetween the two groups (P＞0.05).TGF-β1 level in patients with good glycemic control decreased to 26.85 (23.17-31.12) ng/l,significant lower than that before glycemic control (43.5(26.5-62.25) g/L;Z=-2.191,P=0.028),and there were no significant differences among the other 4 kinds of inflammatory factors before and after blood glucose control(CRP:Z =-0.937P =0.372;IL-6:Z =-0.875,P =0.396;IL-8:Z =-1.215,P =0.286;MCP-1:t =-1.846,P=0.065).Conclusion Low grade systemic inflammation status in T2D patients.Improvement of glycemic control reduces TGF-β1 levels and plays a key role in delaying the development of diabetic nephropathy.

Objective To introduce a new modified Bristow operation with mini-open incision and evaluate jts clinical outcomes in treatment of recurrent anteroinferior shoulder dislocation. Methods A total of 11 patients with recurrent anteroinferior shoulder dislocation were treated with modified Bristow op-eration with mini-open incision.The anterior skin incision with 3-5 mm was made to explore the coracoid process with"moving window"technique.Then.the coracoid process and its short head of biceps were os-teotornjed.transferred and fixed on the anteroinferior potion of scapular neck through the rotator cuff inter-space.All patients were followed up for an average period of 15.8 months(6-48 months)by using modified Rowe score. Results The average operation time was 45 minutes(40-65 minutes).The modified Rowe 8core ranged from 80 to 95 points.excellent in all patients, with SUCCESS rate of 100% and without any re-currence or complication. Conclusions Compared with traditional operation.the modified Bristow oper-ation has smaller incision,less trauma.shorter operation duration and better clinical results.

Objective To evaluate the clinical results of proximal humeral internal locking sys-tem(PHILOS)self-locking plates in treatment of proximal humeral fractures. Methods There were 35 patients including 19 males and 16 females(at mean age of 53.5 years,ranging from 29 to 92 years)with proximal humeral fractures treated with PHILOS plate.According to the Neer's classification sys-tem,there were two-part fractures in 19 patients,three-part fractures in 15 and four-part fractures in 1.Surgery was performed with PHILOS serf-locking plate via dehopectoral approach.All patients were fol-lowed up for mean 18.9 months(6-46 months)and evaluated by using Constant score and X-rays. Re-suits X-rays proved that all fractures got good reduction and complete healing during 8-12 weeks.The latest Constant scores was mean 89.5 points(82-94 points).There were no complications including plate loosing.humenral head necrosis or gleno-humeral ioint osteoarthritis. Conclusion PHILOS plate is a good choice for treatment of proximal humeral fractures because of its advantages including easy operation,stable fixation,good clinical results and few complications.

Objective To discuss the application value and improvement of principle of multi-echelon medical care in emergent rescue of the injured in Chinese Wenchuau earthquake. Methods The author analyzed and evaluated the medical rescue that was done at disaster site, in the front line hospital and higher level hospitals during earthquake. Results A total of 4 689 patients were treated at disaster site, including 413 patients with severe injury, of whom 3 died. Different kinds of operations including debridement were performed at disaster site, with infection incidence of open wound was nearly 80%. In the front hne hospital, 1 400 patients were treated, with 200 operations done. Of all, 110 patients with severe trauma were treated emergenfly, with an amputation rate of 3.0% and postoperative infection incidence of 66.8%. In the station hospitals, 125 patients received definite surgeries, with 1-5 surgeries per injury site. There was no postoperative cross infection, amputation or death. Conclusions The multi-echelon medical care is the basic mode for medical rescue of large number of patients in natural disaster rescue. First aid at disaster site should be performed as early as possible. Transportation is crucial for successful rescue and an improved patient grading system can help increase the efficiency of rescue. The front line hospitals should mainly provide life support, debridement and fixation of simple fracture, while the specific treatment and definite surgery should be carried out in the station hospitals.

Objective:To investigate the optic nerve subarachnoid space area (ONSSA) in patients with normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG) and its correlation with related factors.Methods:Fifty-three patients with NTG (Group A) and 46 patients with POAG (Group B) were selected from January 2016 to May 2019 in Gaozhou Traditional Chinese Medicine Hospital of Guangdong Province. None of them received any treatment. Another 40 patients with health examination (Group C) were selected. Body mass index, blood pressure, 24-hour intraocular pressure, visual field damage, visual axis length and central corneal thickness were measured in each group. Two-dimensional ultrasound was performed to analyze the difference of ONSSA in the retrobulbar 3 to 7 mm range in each group, and the correlation between ONSSA and clinical related factors was analyzed.Results:The ONSSA in group A was significantly smaller than that in group B and group C: (5.07 ± 0.83) mm 2 vs. (6.19 ± 0.90) and (6.57 ± 1.43) mm 2, the differences were statistically significant ( t = 5.219 and 6.107, P < 0.05). ONSSA in group A was positively correlated with the mean intraocular pressure and maximum intraocular pressure of 24 hours ( r = 0.658 and 0.479, P < 0.05), while ONSSA in group B and C was not correlated with the mean intraocular pressure and maximum intraocular pressure of 24 hours ( P > 0.05). ONSSA was not correlated with age, body mass index, mean arterial pressure, central corneal thickness, visual field damage and visual axis length ( P > 0.05). Conclusions:ONSSA of NTG patients is lower than that of POAG patients and healthy people, and the ONSSA of NTG patients is correlated with the mean intraocular pressure and maximum intraocular of 24 hours.