Objective To analyze the relationship between T lymphocyte subsets,neutrophil to lymphocyte ratio(NLR) and lung cancer pathological classification,clinical stage of non-small cell lung cancer.Methods The proportion of T lymphocyte subsets in 60 patients with lung cancer were detected by flow cytometry,the NLR were measured by blood sampling.Results The proportion of CD4+T lymphocytes,the proportion of CD8+T lymphocytes,CD4+/CD8+ and NLR in patients with lung adenocarcinoma,lung squamous cell carcinoma,small cell lung cancer patients were not statistically significant.The proportion of CD4+T lymphocytes and CD4+/CD8+ in patients with advanced non-small cell lung cancer(stage Ⅲ~Ⅳ) were lower(P<0.05) than in the early group(stage Ⅰ~Ⅱ).The proportion of CD8+T lymphocytes and NLR in patients with advanced non-small cell lung cancer(stage Ⅲ~Ⅳ) were higher(P<0.05) than that of early stage group(stage Ⅰ~Ⅱ).Conclusion The T lymphocyte subsets and NLR in the peripheral blood of non-small cell lung cancer patients have a certain correlation with the clinical stage of non-small cell lung cancer,which can be used as a reference index for clinical staging.

Objective To evaluate operative methods and the clinical effect for comminuted calcaneal fractures.Methods 21 cases(24 feet)of comminuted calcaneal fractures were treated by one stage bone grafting plus open reduction and internal fixation with plastic calcaneus titanium plate.The fractures were classified according to the Sanders system into Sanders Ⅱ,Ⅲ and Ⅳ subgroups.Results All cases were followed up for 9～20 months(14months in average).All cases recovered with good healing of fracture.According to Maryland score,the results were excellent in 14 feet,good in 7 feet,fair in 2 feet,and poor in 1 foot.The excellent and good rate was 87.5％.Conclusions By using the method of internal fixation with plastic calcaneus titanium plate,fracture site can be well exposed,which is helpful to recover calcaneus to its normal length,width,height,Gissane angle and Bohler angle.A reliable internal fixation is helpful for early stage functional excise after surgery,which can maximize the recovery of the ankle function.

Objective To explore the clinical application and safety of treatment of percutaneous radioactive 125I seed implantation treatment in lung metastases under CT guidance.Methods Twenty-seven lung metastatic malignancy cases (67 nodules) were studied.Eighteen cases (46 nodules) were hepatic cancer,4 cases (9 nodules) were prostate cancer,and 5 cases (12 nodules) were breast carcinoma.Diameters of lung nodules ranged from 0.5 cm to 4.0 cm with an average diameter of 2.1 cm.125I seeds were embedded under CT guidance,using 2 to 33 particles/nodule with an activity of 18.5 to 29.6 MBq/grain for each particle.Tumor matched peripheral dose was 90-120 Gy.Postoperative validation and quality evaluation followed.Results Four months later,24 nodules showed CR,30 showed PR,5 showed NC and 8 showed PD.The total effective rate was 80.6％ (54/67).In the course of treatment,11 patients had pneumothorax,3 had heavy lung compression and 4 had hemoptysis.All conditions were improved by pleural puncture or under close follow-up observation.Conclusion 125I seed implantation is an effective and safe technique in treatment of metastatic lung tumors under CT guidance.

Objective Ti study the applicatiin if the clinical nursing pathway in patients with sleep apnea hypipnea syndrime (OSAHS).Methods The patients were divided inti 2 griups.The cintril griup was applied riutine nursing interventiins after surgery while the ibser-vatiinal griup was cinducted by clinical nursing pathway.Results The average hispitalizatiin time and medical cists were much liwer in ibservatiinal griup while awareness if diseases if pa-tients and degree if satisfactiin were higher in the ibservatiinal griup.The difference was statisti-cally significant(P <0.01).Conclusion The standardized management based in clinical nursing pathway can imprive the quality if nursing and primite mental rehabilitatiin if patients with 0SAHS.

Objective To explore investigate the feasibility of transoral removal of macrosis benign neoplasms in parapharyngeal space.Methods Sixteen patients with well-defined macrosis benign parapharyngeal space tumors treated by surgery from January 2005 to December 2012 were enrolled in this study.All patients were assessed by CT scan,MRI and CT angiography before surgery.Surgery for the tumors with complete peplos,locating at medial side of carotid and accessible from the oropharynx was completed with the assistance of endoscope,bipolar electrocoagulation or radiofrequency ablation system.Results All neoplasms were removed by transoral approach.Tracheotomy was performed in 4 cases.All patients were treated successfully with good postoperative recovery and no significant complications.Postoperative pathological examination showed there were 9 cases of pleomorphic adenoma,5 cases of neurilemmoma and 2 cases of neurofibroma.By the follows-up of 1-8 years (median 31 months),among 16 cases only one case of neurofibroma recurred.Conclusion The transoral removal of macrosis benign neoplasms in parapharyngeal space is safe,manimally invasive and feasible in selected cases,with a high local control rate and a low surgical complication rate.

Objective To study the use of the quality control circle(QCC)for patients suf-fering from sleep apnea hypopnea syndrome(OSAHS).Methods The control group was given rou-tine nursing interventions after surgery.The observation group was carried by QCC method.Re-sults The days of staying in hospital,medical costs,and complications in the observation group were lower in the control group,health knowledge score,degree of satisfaction and curative effect were all higher than that in the control group P <0.01).Conclusion The standardized man-agement based on QCC can improve the quality of nursing and promote mental rehabilitation of pa-tients with 0SAHS.

Objective Ti study the applicatiin if the clinical nursing pathway in patients with sleep apnea hypipnea syndrime (OSAHS).Methods The patients were divided inti 2 griups.The cintril griup was applied riutine nursing interventiins after surgery while the ibser-vatiinal griup was cinducted by clinical nursing pathway.Results The average hispitalizatiin time and medical cists were much liwer in ibservatiinal griup while awareness if diseases if pa-tients and degree if satisfactiin were higher in the ibservatiinal griup.The difference was statisti-cally significant(P <0.01).Conclusion The standardized management based in clinical nursing pathway can imprive the quality if nursing and primite mental rehabilitatiin if patients with 0SAHS.

Objective To study the use of the quality control circle(QCC)for patients suf-fering from sleep apnea hypopnea syndrome(OSAHS).Methods The control group was given rou-tine nursing interventions after surgery.The observation group was carried by QCC method.Re-sults The days of staying in hospital,medical costs,and complications in the observation group were lower in the control group,health knowledge score,degree of satisfaction and curative effect were all higher than that in the control group P <0.01).Conclusion The standardized man-agement based on QCC can improve the quality of nursing and promote mental rehabilitation of pa-tients with 0SAHS.

Reports a case admitted in the Ward I of Department of Surgery of Zhengzhou Renji Hospital in June 2017. A young child who suffered destructive injury of left forearm, wrist and palm with severed 3rd-5th fingers. Tendon and neurovascular repairs of forearm, wrist and palm were performed with pedicled abdomina flap and the 3rd-5th fingers ectopic replantation in Phase I surgery. In the Phase II surgery, the abdomina flap division was carried out. The replantation of severed fingers after ectopic replantation and the reconstruction of foot defect with free anterolateral thigh flap(ALTF) were carried out in Phase III surgery. In Phase IV surgery, fingers functional reconstruction and foot flap thinning were performed. Four years after surgery, the thumb oppositions to middle, ring and little fingers could be completed, with slightly limitations. The appearance and texture of transferred foot flap were good, and the child could walk and run almost normally.

OBJECTIVE To explore the changes of brain white matter of the patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)with magnetic resonance diffusional kurtosis imaing(DKI).METHODS There were 38 patients with OSAHS examined by polysomnogram(PSG)from November 2017 to June 2021,and 32 non-OSAHS controls matched in gender and age who were included in this study.All the subjects were scanned by DKI.The different encephalic regions through comparing kurtosis fractional anisotropy(KFA)values of all encephalic regions between the two groups were found,and the relationship between the KFA values of the different encephalic regions in OSAHS patients and the apnea-hypopnea index(AHI),lowest saturation oxygen(LSaO2)and the percent of the total record time spent below 90%oxygen saturation(TS90%)in PSG were analyzed.RESULTS The KFA values of white matter fiber tracts in corpus callosum,bilateral corona radiata,cingulate gyrus,right superior cerebellar peduncle and inferior cerebellar peduncle of OSAHS group were obviously lower than control group(P<0.05).After controlling for age and body mass index(BMI),the partial correlation between AHI and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus in OSAHS group were also negative(r=-0.344,-0.380,-0.406,-0.53,P<0.05).The partial correlation between LSaO2 and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus,right superior cerebellar peduncle in OSAHS group were also positive(r=0.366,0.406,0.446,0.404,0.342,P<0.05).The partial correlation between TS90%and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus,right superior cerebellar peduncle and inferior cerebellar peduncle in OSAHS group were also negative(r=-0.414,-0.352,-0.355,-0.336,-0.456,-0.360,P<0.05).CONCLUSION Recurrent apnea and hypoxemia at night of OSAHS patients can cause damage to white matter fibers in parts of encephalic regions.