OBJECTIVE To discuss the clinical utility of the self-made curved laryngoscope.METHODS Clinical data of 198 patients with vocal cord polyps from September 2012 to October 2014 was analyzed retrospectively in which 99 cases were treated under the self-made curved larngoscopic surgeries (curved laryngoscope group) and 99 cases were treated by microlaryngoscopic surgeries (microlaryngoscope group).The duration of follow-up was 3 months in all patients.The clinical efficacy, times of inserting laryngoscope, glottic exposure and operation complications of two kinds of operations were observed and compared.RESULTS The total clinical efficacy in curved laryngoscope group showed no significant difference as compared with that in microlaryngoscope group. But for patients with difficult laryngeal exposure,the efficacy of curved laryngoscopic surgery was significantly better compared with that in the microlaryngoscopic surgery group. The results of times of inserting laryngoscope, glottic exposure and operation complications in the self-made curved larngoscope group were all better than those in microlaryngoscope group (P <0.05). CONCLUSION The operation under the self-made curved laryngoscope is a minimal invasive procedure to the laryngeal mucosa, with such more advantages like clear view of operation field and accurate management to the lesion tissue.Furthermore, the self-made curved laryngoscopic surgery is the first choice for the treatment of patients with difficult laryngeal exposure.

AIM: To investigate the key molecular mechanism of inflammatory response in alveolar epithelial cells induced by nontypeable haemophilus influenzae(NTHi).METHODS: A549 cells were co-cultured with NTHi(multiplicity of infection,MOI: 10) and harvested 15 min and 30 min after stimulation.The phosphorylation of p38 mitogen activated protein kinase(p38 MAPK) in A549 cells was detected by Western blotting.The intracellular expression of nuclear factor-?B(NF-?B) p65 was examined by flow cytometry 4 h after stimulation.A549 cells were preincubated with p38 inhibitor(SB203580) or NF-?B inhibitor(PDTC) for 1 h and then stimulated with NTHi for 24 h.The level of interleukin 8(IL-8) in the supernatants was determined by enzyme-linked immunosorbent assay(ELISA).RESULTS: The phosphorylation of p38 MAPK was rapidly induced by NTHi stimulation.The expression of NF-?B p65 in A549 cells after NTHi stimulation was significantly up-regulated compared with control group(P

OBJECTIVETo evaluate the colorectal cancer incidence among compliers and non-compliers in the population of colorectal cancer screening area, and to provide scientific basis for health economic evaluation of cancer screening.

METHODSBy screening different years build queue, to retrospectively compare the data of colorectal cancer screening from January 1, 2008 to December 31, 2013 and the data of cancer registration, and to analyze the colorectal cancer incidence rates among screening compliers and non-compliers, and to compare the average intervals between the end of screening and clinical cancer diagnosis using SPSS 19 statistical software. Mantel-Haenszel test was performed with a statistical significance level of α = 0.05.

RESULTSThe non-compliance rate was 38.24% among males and 28.49% among females (P < 0.001). The non-compliance rate was highest in the 40-44 and 70-74 years age groups and lowest in the 50-59 years age group. The compliers of the screening were followed up for 476,049 person-years, and there were 51 cases of colorectal cancer, with an incidence rate of 10.71/100,000. The non-compliers of the screening were followed up for 259 183 person-years, and there were 66 cases of colorectal cancer, with an incidence rate of 25.46/100,000, which was 1.38 times higher than that of the compliance group (χ2 = 21.699, P < 0.001). The incidence rate of colorectal cancer among subjects who were positive in initial screening but refused to receive an electronic colonoscopy was as high as 164.40/100,000, and the average delay time was 20.8 ± 16.8 months.

CONCLUSIONSThe colorectal cancer screening adherence among women is better than among men, and that of 50-54 years and 55-59 years age groups is better than in other age groups. The subsequent incidence rate of colorectal cancer in the non-compliance group is significantly higher than that of the compliance population.

Adult ; Age Factors ; Aged ; China ; epidemiology ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; epidemiology ; Early Detection of Cancer ; Female ; Humans ; Incidence ; Male ; Mass Screening ; statistics & numerical data ; Middle Aged ; Patient Compliance ; statistics & numerical data ; Retrospective Studies ; Sex Factors

Recent studies reported that thymoquinone (TQ), a component derived from the medicinal spice Nigella sativa (also called black cumin), exhibited inhibitory effects on cell proliferation of many cancer cell lines. This study was performed to investigate the anti-metastatic effect of thymoquinone on the pancreatic cancer in vitro and in vivo. The results showed that thymoquinone suppressed the migration and invasion of Panc-1 cells in a does-dependent manner. To investigate the possible mechanisms involved in these events, Western blotting analysis was performed, and found that thymoquinone significantly down-regulates NF-kappaB and MMP-9 in Panc-1 cells. In addition, metastatic model simulating human pancreatic cancer was established by orthotropic implantation of histologically intact pancreatic tumor tissue into the pancreatic wall of nude mice. And administration of thymoquinone significantly reduced tumor metastasis compared to untreated control. Furthermore, the expression of NF-kappaB and MMP-9 in tumor tissues was also suppressed after treatment with thymoquinone. Taken together, the results indicate that thymoquinone exerts anti-metastatic activity on pancreatic cancer both in vitro and in vivo, which may be related to down-regulation of NF-kappaB and its regulated molecules such as MMP-9 protein. Consequently, these results provide important insights into thymoquinone as an antimetastatic agent for the treatment of human pancreatic cancer.

Objective To evaluate the clinical effect of a novel computer-assisted navigation technique for intraoperative correction of femoral rotation deformity in diaphyseal fractures.Methods From November 2015 to November 2016,a navigation system (BrainLAB,Germany) was used in antegrade intramedullary nailing for 13 patients with femoral shaft fracture to intraoperatively restore the normal length and rotation of the fractured femur.They were 11 men and 2 women,with an average age of 38.2 years.The iujury affected the left side in 5 cases and the right side in 8.According to the Winquist Classification,there were 6 cases of type Ⅰ,3 ones of type Ⅱ,3 ones of type m,and one of type Ⅳ.This navigation system allowed the surgeons to detect and set the femoral anteversion (FAV) and length of the injured leg at the desired angle and length of the healthy contralateral femur,precisely matching the contralateral limb and restoring the normal length and rotation of the fractured femur.All the patients underwent postoperative CT scan of bilateral femora for measurement of the lengths and rotations which were conpared with the intraoperative values obtained with the navigation system.Results Additional operative time required for computerized navigation averaged 42.8 min (from 35 to 55 min).The mean length difference between the treated and untreated femora was 4.2 nnn (from 2 to 9 mm).The FAVs obtained from intraoperative navigation and postoperative CT scan were 34.0° ± 8.4° and 33.5° ± 8.3° in the healthy side and 31.2° ± 8.5° and 32.8° ± 9.0° in the injured side,showing no significant differences either between the 2 sides or between intraoperation and postoperation (P ＞ 0.05).The mean rotational difference between the 2 extremities were 4.8° ± 1.6° for the navigation and 3.8° ± 1.9° for the CT scan,showing an insignificant difference (P ＞ 0.05).All the incisions healed well with no intraoperative or postoperative complications.Conclusions This novel navigation technique may serve as a reliable tool to accurately correct the rotational malalignment of femoral shaft fractures intraoperatively,but care should be taken in every step of the navigation procedure to reduce complications.

Objective To investigate the effect of via-anal ileus tube used as a drainage in left-sided acute malignant colonic obstruction.Methods Forty-seven cases of left-sided acute malignant colonic obstruction were divided into control group (25 cases) and tube group (22 cases).The patients in control group received intraoperative colonic lavage for one-stage surgery.The patients in tube group received via-anal ileus tube for decompression before the surgery.Compared the difference of bowel movement recovery time,exhaust time,fasting time,postoperative hospitalization time,hospitalization costs and complication rate between two groups.Results The technically successful rate in tube group was 90.9％ (20/22),and one-stage surgery were performed.No anastomotic leakage or postoperative stenosis occunred after operation.There were 23 cases in control group who performed coloclysis in operation and one-stage surgery.The bowel movement recovery time,exhaust time,fasting time,postoperative hospitalization time and hospitalization costs in tube group were significantly lower than those in control group [(12.78 ± 2.07) h vs.(18.01 ±3.42) h,(78.76 ± 11.43) h vs.(96.38 ±13.09) h,(3.18 ±1.76) d vs.(5.51 ±2.95) d,(10.23 ± 2.33) d vs.(15.86 ± 6.74) d,(25 437.43 ± 2 343.67) Yuan vs.(31 051.32 ± 2 542.73) Yuan](P ＜ 0.01 or ＜ 0.05).After operation,there were 2 cases of stomas fistula and 2 cases of peritoneal cavity infection in control group,and none of them in tube group,the complication rate in control group was significantly higher than that in tube group [17.4％ (4/23) vs.0,P ＜ 0.05].Conclusions The via-anal ileus tube used as a drainage in left-sided acute malignant colonic obstruction is effective and safe,and can improve the rate of one-stage anastomoses,decrease the complication rate,promote the promote.It has important clinical value.

AIM:To investigate the effects of silymarin on lipopolysaccharide(LPS)-induced acute lung injury in rats and its possible molecular mechanisms.METHODS: Fifty-eight male SD rats,weighting 230-250 g,were divided into four groups randomly: normal control(n=12);acute lung injury group(n=15),receiving intravenous LPS(O55∶B5,5 mg/kg);silymarin alone group(50 mg/kg,n=15);intervention group(n=16,receiving silymarin 50 mg/kg and LPS 5 mg/kg).The specimens were collected 6 hours later.The following changes,including blood gas analysis,the lung wet/dry weight ratio,the pulmonary vascular permeability,histological manifestations,lung tissue myeloperoxidase activity,the levels of TNF-?,IL-1?,MCP-1 and SOD,GSH-Px as well as malonaldehyde and conjugated diene in plasma and lung tissue,were observed.RESULTS: Compared with control group,the lungs of the rats in LPS treatment group showed significant hyperemia and spotted hemorrhage.The inflammatory granulocyte infiltrating,diffused alveolar septum thickening and spotted hemorrhage were observed in pathological examinations.The lung wet/dry weight ratio and Evans blue content(per gram) increased significantly after LPS treatment.The myeloperoxidase activity in plasma and lung tissue,the levels of TNF-?,IL-1?,MCP-1 and SOD,GSH-Px as well as malonaldehyde and conjugated diene were increased significantly in LPS treatment group.However,in intervention groups,all the above-mentioned measurements were reversed significantly by silymarin treatment compared with LPS treatment group.CONCLUSION: Silymarin may decrease inflammatory reaction and oxidative stress,and further decrease lung damage induced by LPS in rats,all indicating protection of silymarin against acute lung injury.

Objective: To investigate the effects of grasp seed procyanidins(GSP,原青花素) on lipopolysaccharide(LPS)induced acute lung injury(ALI) in rats with renal function damage and the related possible molecular mechanisms.Methods: The homogenates of lung and kidney were prepared and venous blood were collected at 6 hours after injection of LPS and medicine.The changes of contents of creatinine(Cr),blood urea nitrogen(BUN),lactic acid(Lac) and nitric oxide(NO) in the blood were measured.The enzyme linked immunosorbent assay(ELISA) was used to measure the levels of tumor necrosis factor?(TNF-?),interleukin-1?(IL-1?),monocyte chemoattractant protein-1(MCP-1) and IL-6 in the serum,lung and renal cortex tissue homogenate in various groups.The histopathological changes of lung tissues were observed.The pulmonary vascular permeability and the lung wet/dry(W/D) weight ratio were determined;the malonaldehyde(MDA) content,Na+K+-ATPase,superoxide dismutase(SOD),myeloperoxidase(MPO) and glutathion peroxidase(GSH-Px) activities in lung and renal tissues were also determined.Changes of mitogen activated protein kinase(MAPKs) were detected by Western blotting,and the combination activity of nuclear factor-?B(NF-?B) to DNA was detected by electrophoretic mobility shift assay (EMSA) in lung tissues.Results: ①Compared with the normal rats in control group,the lungs of the rats in LPS treatment group and GSP group had significant hyperemia and spotted hemorrhage.The inflammatory granulocyte infiltration,diffuse alveolar septum thickening and spotted hemorrhage were observed in the pathological examinations,while in LPS plus GSP group the above mentioned pathological changes were milder.②Compared with control group,the lung W/D and pulmonary vascular permeability were much higher in the LPS treatment groups(P

Intrahepatic cholangiocarcinoma(ICC)is a primary liver cancer with its incidence only after hepatocellular carcinoma.Liver resection is currently the only established effective treatment for patients with ICC.However,the resectability of ICC is low and the long-term survival after surgery is far from satisfactory. With the advances in the understanding of the biological characteristics and prognostic characteristics of ICC, surgical strategy and techniques have improved in recent years, and the long-term survival has also been increased. The accurate clinical diagnosis of ICC, R0 resection, routine lymphadenectomy, effective adjuvant therapy after R0 resection, and multidisciplinary treatment including re-hepatectomy for recurrent ICC are important for achieving an optimal outcome.Down-staging management for patients with unresectable ICC may provide a chance of R0 resection in some patients. Further research on the biological heterogeneity of ICC,and the improvement of surgical treatment or the establishment of new treatment methods are the main research directions in the future.

Objective To evaluate the clinical effects of percutaneous micro-balloon compression (PBC) trigeminal ganglion for the treatment refractory trigeminal neuralgia. Methods Surgical results of 452 patients with trigeminal neuralgia treated by PBC from October 2009 to May 2013 were analyzed retrospectively. 125 cases aged over 80 years old and 70 cases′ pain belongs to the first branch neuralgia. Such procedures as Meckle′s cave cannulated with No.4 Forgarty catheter and the balloon inflated and compressed the gasserian ganglion monitored by X-ray were observed by PBC. Follow-up interview and curative effects were recorded. Results The average hospitalization was 6.1 days. Among them, 432(95.6%) cases had immediate relief from pain. The overall pain relief rate was 97.8% in our group without serious surgical complications. Postoperative complications include hemifacial numbness in 385 patients (85.2%), mild masseter muscle weakness in 248 patients (54.9%), diplopia in 2 patients. All symptoms relived or disappeared within 1 ~ 6 months. The average follow-up intervier period is 23.5 months. The recurrence rate is 10.2% (46 cases). Conclusion PBC is a safe and effective method with high pain relief rate in the treatment of refractory trigeminal neuralgia , especially for the treatment of the high risk patients , patients with recurrent symptoms or the patients suffered from the first branch neuralgia.