OBJECTIVE To study the clinical application and its advantage of cervical tongue-shaped flap in tracheal stoma after total laryngectomy.METHODS A tongue-shaped flap was retained underneath the U-shape incision in front of the neck.When tracheal stoma was made,the tongue-shaped flap was sutured with the mucous membrane of tracheal posterior wall.A little bit tissue of tracheal anterior wall in the broken end could be cut off and sutured with the skin under the tracheal stoma.RESULTS The diameter of the tracheal stoma was or not less than 3.0 cm?2.5 cm after operation.All the cases were followed up for 1 to 4.5 years after surgery.The tracheal stoma of all the cases grown downwards to 2.0～1.8 cm after a half to one year and then maintained invariably.The tongue-shaped flap and the skin around the tracheal stoma maintained smooth.It was not necessary for the patients to wear the trachea cannulas.CONCLUSION This method has lots of advantages such as less pain,lower medical cost and the increased recovery rate.

[Objective] To investigate the effect of one-stage bilateral hip replacement in the treatment of late stage of hip joint ankylosis.[Methods]Ninteen patients(38 hips)with hip ankylosis were taken as research samples.Patients underwent biologically total hip replacement with posterolateral incision and acetabular plastic repair after second osteotomy.The ankle between acetabulum and femoral body was modulated according to the pre-operative deformation.A larger artificial prosthesis was installed.Early functional exercises were taken after operation.[Results]All cases were given a mean follow-up of 5.5 years(1~8 yrs).Dislocation was found in 2 cases and recovered after manual reduction.Slight fissure fractures were found in 2 hips and no special management was given.Slight heterotopic ossification was found in 6 hips,with grade Ⅰ in 3 hips,grade Ⅱ in 3 hips according to Brooker Classification.No obvious functional influence was found.The flexion-extension range increased from 0? pre-operation to average 81?(65?~115?)and the mean moving range reached 160?(110?~230?).[Conclusion]Bilateral hip replacement is a good method to reconstruct the hip function,promote the living standard.Artificial joint damage in the traditional two stage operations was avoided.It also has advantages of less medical expenses for patients and less pain after surgery.Functional exercises could be started earlier.It is a satisfactory method for the treatment of hip joint ankylosis.

OBJECTIVE: To study the effect of melittin on apoptsis and necrosis of osteosarcoma cell line U2 OS in vitro. METHODS: Osteosarcoma cell line U2 OS was treated with melittin. The growth and proliferation was observed by MTT assay and cell counting, and the necrosis was estimated by Trypan blue staining. The cell apoptsis, Fas and Apo2. 7 expression were detected by cytometer. RESULTS: The data showed that melittin could inhibit the proliferation of U2 OS dose-dependently at 16 and 64 mg/L. Cell apoptsis was detected by cytometer, when the cells were treated by 16 mg/L and 32 mg/L of melittin respectively, and the percentages of Fas and Apo2. 7 positive cells were increased. CONCLUSION: Melittin inhibits the proliferation of osterosarcoma cell line through up-regulating Fas expression and inducing apoptsis.

ObjectiveTo investigate the efficacy and safety of aripiprazole in treating schizophrenia with clozaping as control.Methods70 cases with schizophrenia were randomly divided into the experimental and control group with 35 cases in each group.The effectiveness and safety were evaluated with positive and negative syndrome scale and treatment emergent symptoms scale before and at the ends of week 1,2,4,6,and 8 after starting treatment respectively.ResultsThere was no significant difference in effectiveness between two groups.However,the score reduce rates about cognitive factors and negative symptoms of the aripiprazole group was better than that of the clozaping group(P<0.05).The main side effects in aripiprazole group were mild headache,anxiety,insomnia and etc.ConclusionAripiprazole is an effective and safe neuroleptic,specifically in improving cognitive function and negative symptoms.

Using geometry principle of the spiral CT localization , functional relation was deduced between the bed coordinates and the diagram layers coordinates, i.e.when gantry angle is zero degree, the function relation type is Twm= S190/Cos? + M; Otherwise, it is Twm= S190/Cos? +M. Combined with the actual operation of CT localization, the formula of the CT localization is:Twm=S190/Cos?+M. Finally, the physical meaning and the simplified condition of the formula were discussed.

Objective To investigate the clinical application of remifentanil in awake state for removal of tumors in functional brain area. Methods Twenty-four patients with tumors in functional brain area were divided into two groups by random digits table with 12 cases each:control group and remifentanil group. Infiltration anesthesia was used in all patients with 0.2% ropivacaine. Remifentanil was injected intravenously with micropump in 0.05-0.10 μg/ (kg·min) in remifentanil group and 0.9% sodium chloride was instead of remifentanil in control group. Patients remained awake during surgery in both groups. The hemodynamic changes and complications during operation were monitored. The satisfaction for surgical procedure was evaluated. Results The patients in two groups could be completed in awake state with surgery;mean artery pressure, heart rate in remifentanil group during opening or closing skull or intracranial period were significantly higher than those in control group(P< 0.05). There were no conspicuous complication in two groups such as respiratory depression, nausea, vomitting and dysphoria. The satisfaction score in remifentanil group[(3.3 ?0.6) scores] was higher than that in control group[(2.4 ?0.5) scores],there was significant difference between two groups (P<0.05). Conclusion Awake brain tumor surgery could be completed in rational use of remifentanil on the base of good local anesthesia, and hemodynamics are stable and the patients are well tolerated.

Objective To study the protective effects of propofol pretreatment on ischemia-reperfusion injury in rabbit heart. Methods Forty New Zealand white rabbits (40 male, weighting 2. 5 ± 0. 36kg) were randomly assigned to 4 groups, including sham operation group, ischemia reperfusion (IR)group, IR + ischemia preconditioning (IP) group and IR + Propofol preconditioning (PP) group (n =10 each). The myocardial ischemia-reperfusion model of rabbits was established by coronary artery ligation.The levels of high energy phosphates (ATP, ADP and AMP) in myocardial tissue were measured by HPLC.The activities of serum lactate dehydrogenase (LDH), serum creatine kinase-MB (CK-MB) superoxide dismutase (SOD) and malondiadehyd (MDA) in myocardial tissue were assayed. Results The content of ATP, ADP, AMP, and the activity of SOD in PP group and IP group were higher than that of IR group, and the content of LDH, MDA and CK-MB in injured myocardial tissue in PP group and IP group were obviously lower than that of IR group (P ＜0. 05, P ＜0. 01). No difference was found in PP group and IP group(P＞0. 05). Conclusion Propofol preconditioning as well as ischemia preconditioning protected the myocardial tissues from the ischemia-reperfusion injury by improving the myocardial energy metabolism, the debasement of the oxyradical level and the antagonism the reaction of lipid peroxides.

Objective To evaluate osteogenetic effectiveness of hyaluronic acid (HA) mixed with adenovirus mediated human bone morphogenetic protein-2 gene(Adv-hBMP-2) transfected bone marrow derived mesenchymal stem cells(BMSCs) of rabbits in the repair of radial shaft defects of rabbits. Methods The BMSCs were collected from bone marrow of rabbits, cultured and transfected by Adv-hBMP-2 in vitro. The radial shaft defects (1.5 cm) models of 20 rabbits (40 sides) were created and then respectively injected the cells and/or materials according to the following four groups (n=10): Ⅰ, Adv-hBMP-2 transfected BMSCs+HA; Ⅱ, Adv-hBMP-2 transfected BMSCs; Ⅲ, HA; Ⅳ, control. Results The bone defects of 6 out of 8 sides in the group Ⅰ were repaired completely and partial bone marrow cavities were revasculized. Only 3 sides were repaired completely in the group Ⅱ and no side was repaired completely in the groups Ⅲ and control. There were statistic significance between each groups in X-ray scores. In the groups ofⅠand Ⅱ, much woven callus formed in the sites of the bone defects in the 4-8th week after injection. Partial bone marrow cavities were revasculized in the 12th week after injection; while in the groups of HA and control, the sites of bone defects were mainly full of fibrous tissue and no healing happened. Both ends of the bone defects were hardened. There was significant difference statistically in the new trabecular bone area in the groups ofⅠand Ⅱ. The maximum vertical loading and elastic modulus were significant differenct in the group ⅠandⅡ. The ratios of average maximum vertical loading/normal value of radial shaft in the groups ofⅠandⅡwere 75.86% and 45.45%, respectively. Conclusion The tissue-engineered bone made by HA mixed with Adv-hBMP-2 transfected BMSCs can repair the bone defects in the radial shaft of rabbits. HA is a safe, effective carrier for tissue engineering.

Objective To explore the correlation between the polymorphism of TRIB3 gene rs2295490 and coronary heart disease (CHD) with dyslipidemia.Methods In the case control study,we enrolled 220 CHD patients as observation group (60.15 years mean age,150 males and 70 females) and 151 age and gender matched healthy individuals as control group (59.22 years mean age,102 males and 49 fe males).Genotypes of TRIB3 gene rs2295490 polymorphisms in the two groups were detected by PCR and sequence-based testing.At the same time,blood glucose (GLU),total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) were measured.The correlations between the polymorphism of TRIB3 gene rs2295490 and CHD,biochemical indicators of two groups were analyzed,respectively.The comparison of genotype and allele frequency between two groups used x2 test,while the comparison of biochemical indexes between two groups used t test.Results In the control group,genotypic frequencies of AA,AG and GG of TRIB3 gene rs2295490 were 57％,35％ and 8％,and the frequencies of A and G alleles were 75％ and 25％,respectively.In the CHD group,genotypic frequencies of AA,AG and GG of TRIB3 gene rs2295490 were 50％,41％ and 9％,and the frequencies of A and G alleles were 71％ and 39％,respectively.There was no significant difference of genotype and allele frequencies of polymorphism of TRIB3 gene rs2295490 between CHD and healthy controls(x2 =1.74,P =0.42;x2 =1.26,P =0.243).In the CHD group,the HDL-C levels of the AA genotype were higher than those of AG + GG genotype (t =-9.78,P =0.00);The TG,LDL-C levels of the AA genotype were lower than those of AG + GG genotype (t =2.59,P =0.01;t =6.15,P =0.00).All the differences were statistically significant.Conclusions TRIB3 gene rs2295490 polymorphism has no correlation with CHD,but the G allele may be correlated with dyslipidemia in CHD patients.

Objective To investigate the serum levels of liver function-related proteins (cholinesterase,ChE;album,Alb,prealbumin, PA;transferrin,TRF;ferritin,FRT;C-reactive protein,CRP;and ceruloplasmin,CER)and assess their clinical diagnostic significance for chronic hepatitis B virus (HBV)carriers.Methods The study selected 86 HBV carriers who were diagnosed in the Affiliated Yong-Chuan Hospital of Chongqing Medical University from January 2012 to July 2014 (the observation group).Additionally,102 healthy individ-uals who underwent physical examination in the hospital were selected (the control group).Biochemical indices including serum ChE,Alb, PA,FRT,TRF,CRP,and CER levels were measured in both groups.Liver biopsy was performed in part of the observation group.Group comparison of continuous data was performed using the independent-samples t test.Results Serum CER levels in the observation and con-trol groups were (0.20 ±0.04)g/L vs (0.29 ±0.06)g/L,showing a statistically significant difference (t=2.03,P=0.03).No signifi-cant differences occurred in the rest of biochemical indices between groups (P>0.05 for all).Serum CER levels were significantly de-creased in patients with higher severity of liver inflammation and fibrosis [(0.23 ±0.01)g/L vs (0.18 ±0.02)g/L,t=-2.6,P=0.01;(0.22 ±0.02)g/L vs (0.17 ±0.04)g/L,t=-3.2,P=0.004].Conclusion The change in serum CER level can reflect the severity of liver inflammation and fibrosis in the early stage.Thus,serum CER level may become an important index for early diagnosis and treatment of HBV carriers.