Objective To observe the changes of T lymphocyte subsets and natural killer (NK) cells in patients with late stage non-small cell lung cancer (NSCLC) before and after treatment with PD-1 inhibitor and its clinical effect.Methods Totally 23 patients with NSCLC in Guangzhou Modern Hospital from January 2015 to January 2016 were collected.All patients were given 6 cycles of PD-1 inhibitor treatment after chemotherapy or targeted drug treatment failure.Peripheral venous blood was collected before and after treatment to detect the percentage of CD3 +,CD4 +,CD8 + and NK cells in peripheral blood lymphocytes.The curative effects were evaluated by chest CT after treatment of 2,4,6 cycles.Results Compared with before treatment,the proportions of CD3+ (69.56％ ±7.81％ vs.63.91％ ±6.43％,t =2.679,P =0.005),CD4+ (39.01％ ±4.98％ vs.36.09％ ±4.77％,t =2.031,P =0.024) and CD4+/CD8+ (1.82 ±0.48 vs.1.49 ± 0.32,t =2.743,P =0.004) were increased after treatment,with significant differences.While compared with before treatment,the proportions of CD8 + (24.08％ ± 5.13％ vs.26.04％ ± 6.44％,t =1.142,P =0.130) and NK cells (22.68 ％ ± 9.56％ vs.21.45 ％ ± 10.01％,t =0.426,P =0.337) had little changes,with no significant differences.There were 3 patients with complete remission,10 patients with partial remission,8 patients with stable disease and 2 patients with progressive disease when completing 6 cycles of PD-1 inhibitor treatment.Ten patients showed untoward effects such as mild sleepiness,thirst,tussis,pruritus and rash,and they were well tolerable.Conclusion PD-1 inhibitor can improve the patient's cellular immune function,and can achieve a more satisfactory short-term efficacy and acceptable adverse reactions,which maybe bring new hopes for patients with NSCLC.

OBJECTIVE:To establish a method for simultaneous determination of the contents of three components in synthesis and actual satongfeng injection.METHODS:A flexible tolerance simplex method was used for multi-wavelength spectrophotometry with interval of 1nm in 258～290nm wavelenth,33 wavelenths were selected.RESULTS:The linear range and average recoveries rate of sodium salicylate,phenazone and caffeine were 0～42,0～12,0～6?g?mL-1 and(99.93?0.22)%,(99.85?0.24)% and(100.19?0.40)% respectively.All were agreed with those by standard method.CONCLUSIONS:This method is easy in operation,fast and reproducible,applicable to automatic analysis,and therefore can be used for the quality control of the preparation.

OBJECTIVE To study the anatomical dimension of the path to the petrous apex via the infralabyrinthine approach. METHODS Thirty dry temporal bones were dissected along the internal carotid canal. The distances from the vertical portion of the facial nerve to the genu of the internal carotid canal,the vertical portion of the facial nerve to the petrous apex,the genu of the internal carotid canal to the posterior surface of the petrous bone were measured. Ten heads of adult cadaver were dissected to gain access to the petrous apex via the infralabyrinthine approach. The horizontal and vertical dimensions of the approach window created were measured. RESULTS The vertical portion of the facial nerve to the lap of the internal carotid canal was (13.26?1.66)mm,portion of the facial nerve to the petrous apex was (34.48?1.07)mm,the lap of the internal carotid canal to the posterior surface of the petrous bone was (9.68?1.53)mm. The mean dimensions of the window in dissected bones were(5.76?3.38)mm vertically and (6.42?2.65)mm horizontally. Thirteen sides had been doing well with the infralabyrinthine approach. CONCLUSION The possibility of those anatomical variations should be considered when the infralabyrinthine approach is being planned to manage the petrous apex lesion. The infralabyrinthine approach is useful to the patients with good hearing.

To investigate the role of fibrinolysis in adhesion formation in the middle ear,40 patients(45 ears) with otitis media with exudation (OME) were randomly divided into 3 groups:Dexamethasone(G1),Batroxobin1BU/ml(G2),and Batroxobin 2BU/ml(G3).The results were assessed by tympanotomy and irigation to compare the efficacy of treatment of batroxobin and dexamethasone.31 patients (33 ears) were analyzed for statistical significance.The efficacy of the treatment was evaluated by qualitative analysis of symptom and the Hearing Threshold of Air conduction of pure tone audiometry (AHT) at frequencies 0 25～2kHz,and by quantitative analysis of AHT.Cure rates of G1,G2,G3 were 41 7%(5/12),54 5%(6/11),70%(7/10) respectively;G3 was higher than G1 and G2( P 0 05). After treatment AHT of G3 was lower than G2 and G1( P

0 05). However, difference was found between ears of AOM and normal ones ( P

Objective To study the surgical approach of the jugular foramen and the clinical anatomy of the transmastoid endoscoPy-assisted jugular foramen surgery.Method The transmastoid endoscopy-assisted jugular foramen surgery was simulated in 15 adult cadaveric specimens(3O side). The main anatomic mark in the surgical approach was studied,and the distance between the important stmcture to the glomus jugular has been measured. Results The distance between the glomus jugular and the Vertlcal segmental of the facial nerve,the anterior wall of the glomus jugular to the facial nerve,the glomus jugular to the posterior semicircular canal and tympanic cavity were(3.58±1.32)mm,(5.07±2.93)mm,(4.68±3.47)mm and(0.14±4.32)mm.In 30 cases,the top of the glomus jugular inferior the tympanic cavty in 5cases, 7 cases behind the facial nerve and the tympanic, 16 cases the facial Berve is m the middle of the glomus iugular. 2 cases is near the inferior wall of internal auditory meatus.the cranial nerve and blood vessel in the jugular foramen is clearly to be show. Conclusion It is a samPle and little damaged way to use the transmastoid endoscopy-assisted jugular foramen surgery and it is hopeful to Protect function of the facial Berve,acoustic nerve and the post-cranial nerve.

Objective To evaluate the prognosis of recurrent laryngeal cancer after surgieat treatment, the study was designed to investigate the relationship of VEGF and Cath-D expression in patients with recurrent laryngeal carcinoma. Methods Five hundred and seventy-four cases of laryngeal carcinoma treated in our department from 1958 to 1999 were retrospectively reviewed. All patients were observed for 3 years postoperatively. The whole set of tissue microarrays prepared with tumor tissue from 574 patients, including recurrent tumor tissue from 56 patients, and also 39 normal laryngeal tissue from normal subjects. The tissue chips were analyzed by the SABC immunohistochemical method. Results VEGF and Cath-D were expressed in most of the laryngeal carcinoma and normal laryngeal tissue, but the positive ratio of them was different. There was higher expression of VEGF and Cath-D in recurrent laryngeal carcinoma compared with that in laryngeal carcinoma without recurrence and normal laryngeal tissue (P

Objective To evaluate the prognosis of laryngeal cancer in terms of postoperative recurrence,the study was designed to investigate the relationship of E-cadherin,CD44,and Tenascin expression in patients with recurrent laryngeal carcinoma. Methods 574 cases of laryngeal carcinoma treated in our department from 1958 to 1999 were retrospectively reviewed. All patients were observed for 3 years postoperatively. The whole set of tissue microarray contained tumor tissue from all these patients,including recurrent tumor tissue from 56 patients,39 normal laryngeal tissue from normal larynx. The tissue chips were analyzed by the SABC immunohistochemical method. Results E-cadherin,CD44,and Tenascin were expressed in most of the laryngeal carcinoma and normal laryngeal tissue,but the positive ratio was different. There was lower expression of E-cadherin in recurrent laryngeal carcinoma compared to that in laryngeal carcinoma without recurrence,and the difference was statistically significant ( P

Objective To explore the best way for reconstruction of local defect after subtotal or extended resection of the temporal bone. Method The reconstruction of 33 patients who had undergone subtotal or extended resection of temporal bone between July 1993 to June 2003 in our hospital were retrospectively analysed. Results Thirty-three patients, aged 14-69 years old (average 45.0) were enrolled. Among them, 26 were suffering from malignancy (12 with recurrences, undergoing several operations). Subtotal resection of temporal bone was performed in 22 cases and extended resection in 11. Total survival rate of reconstructive tissues was 81.8%(27/33), in which pectoralis major island musculocutaneous flap accounted for 77.8%(7/9), temporalis musculocutaneous flap survived 100% (9/9), pedicled temporalis musculocutaneous flap associated with other local musculocutaneous flap survived 100%(4/4), 60.0% (3/5) of upper sternocleidomastoid musculocutaneous flap survived, and 66.7% (4/6) of fat transplantation survived. Nature and extent of the diseases, preoperative radiotherapy, relapse and postoperative leakage of cerebrospinal fluid were important influential factors for postoperative healing. Conclusions Reconstructive measures depended on the nature and extent of diseases, necessary size of tissue, local circulation, and influential factors of healing. The optimum way for the repair of a small defect after resection of non-malignant tumor was fat transplantation with dermis, and pedicled temporalis musculocutaneous flap for malignant tumors. Pectoralis major island musculocutaneous flap was employed in large defect and that with lack of blood supply. Skin grafting met several failures in these patients. Theoretically, free scapular skin flap is the optimum way for defects after subtotal or extended resection of temporal bone.

Objective To investigate the common complications related to glomus jugulare tumors surgery,their influencing factors,and to search for the effective treatments of these complications.Methods A retrospective study was undertaken on the complications observed in 47 patients with glomus jugulare tumors who underwent 51 times of operation via trans external auditory canal approach,the retroauricular approach,and modified infratemporal fossa approach type A.All cases were followed up over 1 month after surgery.Results Of 51 cases,the most frequent complication was total conductive hearing loss which occurred in 21 cases(41.2%),facial paralysis was found in 15 cases(29.4%) and lower cranial nerve palsy was found in 14 cases(27.5%) after one month.Other complications were cerebrospinal fluid(CSF) leak,hearing disability and vertigo,each in 3 cases(5.9%);cerebral infarction,partial auricle necrosis and parotid gland fistula,each occurred in one case(2.0%).Pre-operative selective embolization of feeding vessels can reduce intraoperative blood loss significantly in most cases.Effective hemostasis and hypotensive anesthesia during operation were the important ways to prevent complications and hematoma within operating field.CSF leak in this series was an uncommon complication.Two cases with CSF leak from the wound had been successfully controlled with conservative treatment.One case with CSF leak required surgical management.None of these patients developed meningitis.Conclusions There is a low level of serious post-operative complications in operation on glomus jugulare tumor.Factors found to be relevant to post-operative complications are tumor type and tumor size.The key factors to avoid the complications include surgical experience,surgical skill and preoperative evaluation of patients′ imaging information.