Child ; Cough ; etiology ; therapy ; Female ; Humans ; Mental Disorders ; complications ; Psychotherapy

Objective To investigate the surgical techniques and clinical effects of anterior retropharyngeal approach in treatment of C2/3 fracture and dislocation.Methods Twelve patients with C2/3 fracture and dislocation treated via anterior retropharyngeal approach between November 2011 and April 2013 were included in the study.There were 7 males and 5 females aged from 19 to 65 years (mean,35 years).Primary pathologies included 7 patients with traumatic C3 fracture,2 with Hangman fracture and 3 with fracture and dislocation of the anteroinferior margin of C2 vertebrae.C2-C4 vertebrae were exposed using anterior retropharyngeal approach,followed by C2/3 discectomy or C3 corpectomy,decompression,interbody cage fusion or titanium mesh cage fusion,and anterior internal fixation.Results Exposure of lesion was sufficient for all patients and all operations were completed under direct vision,with mean operation time of 140 minutes and mean blood loss of 120 ml.One patient with reduced tone after operation gradually recovered in a week; one with dysphagia after operation recovered in 3 months; one with skin necrosis 7 days after operation was recovered by changing dressing; for the rest,there were no complications of incision hematoma,infection,or asphyxia.Ten patients were followed up for mean 15 months,which showed bony fusion in mean 6 months.At final follow-up,no implant loosening or displacement occurred.Conclusion Anterior retropharyngeal approach to C2/3 fracture and dislocation provides sufficient exposure of lesions,minor trauma,and less bleedings and complications,but as the local anatomy is complicated,there indeed exists a learning curve of the approach.

OBJECTIVE To understand the mechanisms,adverse effect and notices in use of quinalones.METHODS The adverse effect of quinalones used sinylely or in combination was collected and analyzed.RESULTS Serious central nerve system side-effects,phototoxicity,hepatotoxicity hemolytic anemia,uremia and so on could be found in few cases.Some quinolones could result in Q-T interval elongation inducing the severe ventricular dysrythmia.The serum glucose also could be affected when quinolones were used together with the medications for diabetes.CONCLUSIONS The key points for quinolones usage are rational use and paying attention to their safety.

Objective: To prepare the solid dispersion of Kyllinga brevifolia total flavonols (KBTF) for improving the dissolution rate of KBTF. Methods: The solid dispersion was prepared by the melted and dissolved method with the carriers of PVP K30, PEG 6000, PEG 4000, and Poloxamer 188 and the in vitro dissolution of KBTF solid dispersions was performed. The structure of the solid dispersion was characterized by SEM and IR. Results: The solid dispersion prepared with PVPK30 as carrier is better to improve the dissolution than those with other carriers, and drug-carrier (1:2) is the best. The results of SEM and IR showed that KBTF in solid dispersion took amorphous form. Conclusion: The solid dispersion technology can significantly increase the dissolution of KBTF in vitro.

Objective: To prepare Kyllinga brevifolia total flavonols (KBTF) solid dispersion controlled porosity osmotic pump tablets, and investigate the effects of core tablets and coating on its in vitro drug release behavior, so as to optimize the formulation. Methods: Using KBTF solid dispersion prepared by solvent method as drug core to increase the dissolution of KBTF in vitro, the optimal forrmulation of KBTF solid dispersion controlled porosity osmotic pump tablets was selected via the single factor investigation and orthogonal design. Results: The optimal formula was as follows: osmotic promoter was sodium chloride 100 mg, content of PEG 400 was 150%, content of DBP was 20%, and rate of weight growth of coating membrane was 2%. Conclusion: KBTF solid dispersion controlled porosity osmotic pump tablets with optimal forrmulation can stably release drugs in 12 h and the accumulative drug release rate was more than 90%, whilst its in vitro drug release behavior was up to the character of zero-order drug release.

AIM: To investigate the efficacy and safety of low dose mitomycin C (MMC) to prevent haze in trans photorefractive keratectomy (TransPRK) with moderate and high myopia, and to observe the changes of corneal density.METHODS: Sixty-one patients underwent TransPRK with moderate and high myopia.Eyes were divided into research group (0.1g/L MMC for 40s) and control group(0.2g/L MMC for 40s) randomly.There were 21 patients in research group and 40 patients in control group.Cornea epithelial healing time, pain score, visual acuity, manifest refraction, haze and cornea density were analyzed.RESULTS: The epithelial healing time (0.1g/L group: 3.86±1.11d, 0.2g/L group: 4.23±1.27d) and pain score (0.1g/L group: 2.01±0.58, 0.2g/L group: 1.79±0.7) were no significant difference between two groups(P=0.667, P=0.582).It was similar in spherical equivalent at 1mo and 3mo post-operation(0.1g/L group: 0.28±0.25, 0.05±0.23D;0.2g/L group:-0.13±0.17, 0.07±0.22D;P=0.178, P=0.490).The BCVA of control group decreased at 1mo and improved to the same level as pre-operation at 3mo(F=15.847, P<0.001);0.1g/L group showed the same trend, but the changes were no significant difference(F=3.038, P=0.093).There were also no significant difference in Haze between two groups post-operation(z=-0.709, P=0.479;z=-0.478, P=0.633).The change of cornea density was matched with the BCVA (0.1g/L group F=27.399, P=0.001;0.2g/L group F=8.313, P=0.001)and it was similar between two groups.CONCLUSION: The using of low dose MMC to prevent haze in TransPRK with moderate and high myopia is safe and effective.It is therapeutic equivalence to regular dose (0.2g/L).Besides the slit lamp, we can use the corneal density to measure the corneal transparency.

Objective: To study the prognostic significance of the subtype of SYT-SSX fusion gene, E-cadherin, β-Catenin and clinicopathologicel parameters for the metastasis of synovial sarcomas. Methods: A total of 98 synovial sar-coma patients with complete clinical and follow-up data were reviewed. RT-PCR was used to detect the subtype of SYT-SSX fusion geneo The expression of E-cadherin and β-catenin was detected by immunohistochemistry. Univariate and multivariate analyses were performed to analyze the influence of the above factors and clinicopathological parameters on the metastasis free survival to explore the factors affecting the metastasis of synovial sarcoma. Results: Of all the pa-tients, 69.4% (68/98) had metastasis during follow-up. The median metastasis free survival was 48 months. The metastasis free 1-, 2-, 3-, 4-, and 5-year survival rate after surgery was 97.5%, 75.5%, 63.5%, 54.0%, and 48.5%, respectively; 31.6% (31/98) patients were found with SYT-SSX1 and 68.4% (67/98) patients with SYI-SSX2. The positive rate of E-cadherin ex-pression was 38.8% (38/98), the positive rate of β-catenin expression was 39.8% (39198) on cellular membrane and 53.1% (52/98) in cellular nucleus/cytoplasm. Univariate analysis showed that age (P=0.003), mitotic figure (P=0.002), histological grade (P=0.001), the subtype fusion gene of SYT-SSX (P=0.014), E-cadherin expression (P=0.015) and β-catenin expres-sion on cellular membrane (P=0.020) were significantly correlated with metastasis free survival of synovial sarcoma pa-tients. Sex (P=0.190), tumor location (P=0.105), tumor size (P=0.180), histological type (P=0.354), necrosis (P=0.451), β-catenin expression in cell nucleus/cytoplasm (P=0.911), radiotherapy (P=0.193), and chemotherapy (P=0.249) had no sig-nificant correlation with metastasis free survival of synovial sarcoma patients. Multivariate analysis revealed that the sub-type of SYT-SSX1 fusion gene (RR=2.505, P=0.003), negative expression of E-cadherin (RR=3.282, P=0.000), patient age (RR=2.157, P=0.004), and grade Ⅲ (RR=1.784, P=0.030) were independent risk factors for metastasis of synovial sarco-ma. Conclusion: The subtype of SYT-SSX, expression of E-cadherin, histological grade and the age of patients are impor-tant factors for evaluating the metastasis and prognosis of synovial sarcoma.

Objective: To study the prognostic significance of cell proliferation and apoptosis, MVD and clinicopathologi-cal parameters for the recurrence of synovial sarcoma. Methods: We analyzed the clinical and follow-up data of 56 synovial sarcoma patients without metastasis. RT-PCR was used to detect the subtype of SYT-SSX fusion gene. The expression of Ki67 and MVD was detected by immunohistochemistry. Univariate analysis was employed to analyze the influence of the above factors and clinicopathological parameters on the recurrence free survival and to explore the influencing factors for the recurrence of synovial sarcoma. Results: Of all the patients, 73.2% (41/56) had recurrence during the follow-up. The median recurrence free survival was 19.5 months. The recurrence free 1-, 2-, 3-, 4-, and 5-year survival rates after surgery were 45.0%, 41.0%, 34.0%, 28.0%, and 28.0%, respectively. Ki-67 labeling index (LI) was 19.98%±11.64% and MVD was 51.83±21.92 per ×400. There was no significant difference in apoptotic index (AI) between the two groups (P=0.607). Χ~2 analysis showed that histological type (P=0.000) and MVD (P=0.045) were significantly correlated with the recurrence of sy-novial sarcoma. Univariate analysis showed that Ki67 LI (P=0.009), histological type (P=0.012) and radiotherapy (P= 0.014) were significantly correlated with the recurrence free survival of synovial sarcoma patients. Sex (P=0.015), tumor lo-cation (P=0.411), tumor size (P=0.801), necrosis (P=0.486), MVD (P=0.454), chemotherapy (P=0.272), and apoptotic grade (P=0.899) were not correlated with the recurrence free survival of synovial sarcoma patients. Multivariate analysis re-vealed that higher expression of Ki67 (RR=1.944, P=0.045), radiotherapy (RR=0.482, P=0.04), and histological type (RR= 0.207, P=0.031) were independent risk factors for the recurrence of synovial sarcoma. Conclusion: The expression of Ki67, radiotherapy and histological type are important factors for evaluating the recurrence and prognosis of synovial sarcoma.

Objective To study the experience of standardized management in operation room with Da Vinci S system. Methods From January 2007 to October 2010,we set up the standardized management rules for the staff and operation appliance. Results Through the rules being carried out, the satisfaction of the doctor was increased and the hospital infection was then controlled availability. Conclusions The standardized and integrated managements are important factors for the success of surgery.

Hamartoma ; Humans ; Splenic Diseases