AIM: To evaluate the significance of cytokeratin19 (CK19) expression in diagnosing micrometastases in lymph nodes in patients with laryngeal carcinoma. METHODS: Forty cases of laryngeal carcinoma together with 163 lymph nodes were studied by the staining with hematoxylin and eosin(HE)and immunostaining with antibody against cytokeratin 19 (CK19) on histological sections of the primary tumor and regional lymph nodes. RESULTS: In all cases, CK19 was positively expressed in the primary tumor. Among 163 lymph nodes, metastases were confirmed by HE in 23 lymph nodes, and in 42 lymph nodes staining with immunohistochemistry, micrometastases were found in 19 lymph nodes. Micrometastases in the lymphonodes were significantly related to the T staging. CONCLUSION: Immunohistochemical staining is a valuable method for the detection of node micrometastases in patients with laryngeal carcinoma.

Based on the survey of the learning preference of Kunming Medical College students,we analyze relationship between students’learning style and personalities.In order to match different learning style,teachers must find some strategies in their English teaching.

According to an activity that create a model public health department , to strengthen internal man-agement, standardize the word flow, strive to achieve public interest, longterm, specification system and science of the public heath work , and strengthen the sense of mission and responsibility which general hospital of heath technical personnel should have .

Objective To investigate the possible mechanism and re-ablation of recurrent atrial arrhythmias after atrial fibrillation(AF) ablation by utilizing the Carto system and double LASSO technique.Methods A total of 77 AF patients were enrolled and among them,56 with paroxysmal AF and 21 with persistent AF.Eight-F Swartz long sheaths were positioned in the left atrium by transseptal technique.One to two LASSO catheters were placed in the ipsilateral pulmonary veins(PV).The anatomy of the left atrium and PV was established using the Carto system.PV selective venography was carried out to identify the PV ostium.Continuous circular lesions(CCL) were made at the left atrium at 0.5 to 1.0 cm outside the PV ostium.Irrigated radiofrequecy energy was delivered in all the patients.The end point of the CCL was defined as absence of all PV spikes documented with LASSO catheters within the ipsilateral PVs.Results A repeat ablation was performed in 14 patients who experienced highly symptomatic atrial tachyarrhythmia.During the repeat procedures,conduction gaps in the previous CCL were found in 13 out of the 14 patients,and a typical atrial flutter was found in the other patient which was eliminated by ablation of the tricuspid isthmus.During the second procedure,pulmonary vein tachycardia was demonstrated in 7 patients.The pulmonary vein tachycardia activated the LA via the conduction gaps.All conduction gaps were successfully ablated by irrigated RF applications.After the second procedure,12 out of the 14 patients were free of AF during 3 to 30 months of follow-up.Conclusion Continuous circular lesions(CCL) in the left atrium utilizing the Carto system and double LASSO technique had a high success.In patients with recurrent atrial tachyarrhythmia after CCLs,recovered PV conduction is a main cause for the recurrence.

It is proposed that following peripheral nerve injury abnormal sprouting of Aβ fiber primary afferent neurons in the spinal cord contributes to the allodynia that often occurs with such injury. The present investigation is to determine whether this sprouting is reversal after compression of peripheral nerve was relieved. In a rat model of neuropathic pain made by rat sciatic nerve compression,chorela toxin B subunit conjugated horseradish peroxidase (CB-HRP) was used to trace the termination of Afiber primary afferents and sections were reacted for using tetramethylbenzidine (TMB) as the chromagen. We demonstrated that the compression to the sciatic nerve also results in hyperalgesia and novel transganglionic CB-HRP staining in laminae Ⅱ, and this sprouting can not be reversed by decompression. This structural reorganization in central nervous system and its irreversible character may contribute to the development and maintenance of neuropathic pain.

Objective To discuss the application of scenario simulation technique in emergency rescue training of hospital grave pubic health events.Methods Based on the simulate function in the scenario simulation technique,we designed the emergency drill script of hospital grave pubic health events,set the simulate scene,communication system and indicators measuring emergency rescue,drilled and trained the hospital rescue crews,compared with the rescue crews trained in routine method.40 nurses were selected before or after the application of scenario simulation technique separately.Results The qualified rate of indicators such as communication and medical rescue system that were trained by scenario simulation method was higher than the rescue crews trained in routine method.Conclusions Scenario simulation technique would improve the training effect of emergency rescue in hospital grave pubic health events.

Objective To observe the effects of parathyroidectomy(PTX) on bone metabolism and bone mineral density(BMD) in maintenance hemodialysis patients with secondary hyperparathyroidism (SHPT).Methods A total of 26 dialysis patients with SHPT were treated with PTX.Serum calcium,phosphorus,alkaline phosphatase(ALP) levels were determined by standard methods.The levels of serum intact parathyroid (iPTH),osteocalcin (OC),procollagen type Ⅰ aminoterminal propeptide (PINP),β-crosslaps (β-CTX) were measured by chemiluminescence.BMD was measured by dual energy X ray absorptiometry.iPTH,OC,PINP,β-CTX,serum calcium,phosphorus,ALP were measured before parathyroidectomy and 1,3,6,12,18,24 months after operation.Lumbar spine (LS) and femoral neck (FN) BMD were measured before and 24 months after PTX.Results Compared with that before operation,serum OC[(104.49±25.42) μg/L vs (695.46±355.62) μg/L,P ＜ 0.01] and PINP levels [(248.36 ± 159.38) μg/L vs (809.28 ± 283.50) μg/L,P＜ 0.01] progressively decreased 3 months after PTX,and serum β-CTX levels [(1.60±0.64) μg/L vs (3.37±1.34) μg/L,P ＜ 0.01] decreased 1 month after PTX.Compared with that before operation,BMD levels increased 24months after PTX in LS[(0.88±0.23) g/cm2 vs (0.78±0.23) g/cm2,P ＜ 0.01] andFN[(0.96±0.19) g/cm2 vs (0.84±0.24) g/cm2,P ＜ 0.01],and Z-scores were also increased in both LS[(-1.24±0.55) vs (-1.66± 0.24),P ＜ 0.01] and FN[(-1.51 ±0.72) vs (-1.93 ± 0.40),P ＜ 0.01].Correlation analysis showed that baseline iPTH was positively correlated with ⊿Z-score in FN (r=0.584,P=0.002) and LS (r=0.400,P=0.043),and so did the OC with ⊿Z-score in FN (r=0.651,P ＜ 0.001) and LS (r=0.509,P=0.008).Conclusion The levels of OC,PINP and β-CTX are reduced and BMD is improved in hemodialysis patients with SHPT after PTX.

Objective To discuss the recent clinical efficacy of percataneous pedicle screw internal fixation for thoracolumbar fractures without neurological deficit in the new field comprehensive operation rescue shelter at the war or disaster treatment place.Methods Retrospectively analyzed the clinical data of 29 patients with thoracolumbar fractures who were rescued by our hospital.Those patients included 18 males and 11 females,with the average age of (31.54±2.86) years old.All these patients underwent percutaneous pedicle screw internal fixation in the new field comprehensive operation rescue shelter.Clinical and surgical evaluation including surgery time,blood loses,exercise time after operation and complications.Functional outcomes of pre-operation and post-operation were evaluated by visual analog scale (VAS) and Oswestry disability index (ODI).Cobb's angle and fracture vertebral body front height were compared before and after operation as well.Results All these patients were all successfully completed operation in the field comprehensive operation rescue shelter,and the general post-operation condition was well.The operation time was (86.55±16.15)min,the blood loss was (42.35±6.55)mL,the exercise time after operation was (1.20±0.61) days.There was no complications after operation, and pain of thoracolumbar after operation was obviously alleviated.There was statistical differences in terms of Cobb's angle,fracture vertebral body front height,VAS score and ODI score between pre-operation and post-operation (P<0.05).Conclusion The percataneous pedicle screw internal fixation in the new field comprehensive operation rescue shelter is a quite effective method for thoracolumbar fractures without neurological deficit, and this method is worthy of promoting at the scene when war or disaster urgency treatment.

Objective To study the change of postprandial triglyceride (TG) concentrations after a high-fat meal in patients with coronary heart diseases (CHD), patients with essential hypertension (EHP) and healthy controls, and to explore the optimal time point to measure postprandial TG metabolism. Methods Fifty-four CHD patients, thirty-six EHP patients and twenty-five healthy controls were recruited. The concentrations of serum TG in fasting state and at 2, 4, 5, 7 h after a single high-fat meal (800 kcal, including 50 g fat) were measured. Results The postprandial serum TG concentrations increased significantly at 2, 4, 5 h point in all subjects (all P

Objective To discuss the short-term effect of Sextant system fixation for thoracolumbar fractures without neurological deficit in the field comprehensive operation rescue shelter.Methods There were 32 patients with thoracolumbar fractures without neurological deficit which rescued by our hospital.Those patients included 18 males and 14 females, with average age of (25.54±2.86) years old.All patients were undergoing internal fixation with Sextant system in the field comprehensive operation rescue shelter.Clinical and surgical evaluation including surgery time,intraoperative blood loss,postoperative ambulation time and wound healing time were observed.Functional outcomes of pre-operation and postoperation 3-days were evaluated by visual analog scale(VAS) and Oswestry disability index(ODI).Cobb angle and front height of fracture vertebral body were compared between pre-operation and postoperation 3-days.Results The operation time was (96.55±14.15)minutes, intraoperative blood loss was (45.25±3.55)mL, postoperative ambulation time was (1.20±0.61)days.There were statistical differences in terms of Cobb angle,front height of fracture vertebral body,VAS and ODI between pre-operation and postoperation 3 days.Conclusion The Sextant system fixation in the field comprehensive operation rescue shelter is a timely,safe and effective method for thoracolumbar fractures without neurological deficit,which is deserved to utilize at the scene when war or disaster urgency treatment.