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.

Objective To assess the value of the adjacent vessel sign (AVS)in differentiating malignant from benign lesions on breast MRI at 3.0 T.Methods Total 64 patients with 64 breast lesions including 35 malignant and 29 benign ones,underwent breast dynamic contrast enhanced MR scan.The 3D maximum intensity projection images were gotten and used to review the lesions.Sen-sitivity and specificity of the AVS were evaluated,and the reasons of the false positive and false negative lesions were also analyzed. Results The AVS differed significantly between benign and malignant lesions (P<0.001;positive-predictive-value:88.6%,sensi-tivity:88.6%,specificity:75.9%).Conclusion The adjacent vessel sign is significantly associated with malignancy.Thus,there is of great importance of this sign in differentiation of begnign and malignant lesions.

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.

0.05),but the benefit was significantly different (P

Objective To investigate the therapeutic effects of endovascular management for oculomotor nerve palsy caused by unruptured aneurysm of posterior communicating artery.Methods Endovascular treatment was carried out in 11 patients with oculomotor nerve palsy due to unruptured aneurysm of posterior communicating artery.The choice of the therapeutic opportune moment and the treatment way were retrospectively evaluated.The relationship between the therapeutic results and the treatment time and way was analyzed.Results Of the 11 patients,complete recovery of oculomotor nerve palsy was obtained in 10(90.91%) and partial recovery in one(9.09%).Conclusion Oculomotor nerve palsy cause by unruptured aneurysm of posterior communicating artery can be effectively treated by endovascular management,and the recovery of oculomotor nerve function depends on the time to take treatment and the degree of nerve palsy.

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.