Severe tracheal stenosis can not only cause critical medical problems such as severe shortness of breath, hypoxia, and even orthopnea, but also impose overwhelming challenges on the physicians, particularly the anesthesiologist. Life-threatening airway obstruction can make the patient's gas exchange extremely difficult.Though several options could be offered regarding the treatment of tracheal stenosis, normally, tracheal resection and following reconstruction is the first choice for severe airway stenosis. Successful surgical intervention relies on the close communication and cooperation between surgeons and anesthesiologists. In these cases, airway management is the top issue for the anesthesiologist, and the level of difficulty varies with stenosis location, severity of stenosis, and surgical technique. Extracorporeal membrane oxygenation (ECMO), or cardiopulmonary bypass (CPB), is rarely utilized for the surgery, but for those impossible airways due to nearly complete tracheal obstruction, ECMO or CPB could be the final choice for anesthesiologists. Here we report a case of successful urgent airway management for tracheal resection and reconstruction assisted by temporary CPB.
Cardiopulmonary Bypass ; Emergencies ; Female ; Humans ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Trachea ; surgery

OBJECTIVETo explore the value of surgical treatment on spine metastatic tumor.

METHODS31 cases of spine metastatic tumor with severe pain or/and neurological deficit were selected and treated with various operative methods.

RESULTSExcept for 4 cases, all the patients survived from 3 months to 7 years (average 17.6 months). The patients had no complication during treatment. The symptoms and neurological functions recovered with various extent after operation.

CONCLUSIONSSurgical treatment should cautiously be adopted. When the spine metastatic tumor with severe pain and neurological deficit has no response to the conservative methods, the surgical treatment with decompression and internal fixation should be performed to improve the life quality for the patients.

Adult ; Aged ; Breast Neoplasms ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Quality of Life ; Spinal Neoplasms ; secondary ; surgery

OBJECTIVETo describe a new method of accessory nerve defect reconstruction with sternocleidomastoid muscle-great auricular flap.

METHODSThirty-four cases receiving traditional radical neck dissection were divided into two groups: single neck dissection group (n = 19) and accessory nerve reconstruction group (n = 15). Surgical procedure of the reconstruction was described in detail. Postoperative shoulder functions were compared between the two groups.

RESULTSAccessory nerve reconstruction group experienced much better shoulder function recovery than that in single neck dissection group.

CONCLUSIONSReconstruction of accessory nerve defects with sternocleidomastoid muscle-great auricular nerve flap is simple, effective and complication-free.

Accessory Nerve ; surgery ; Accessory Nerve Injuries ; Adult ; Aged ; Carcinoma, Squamous Cell ; secondary ; surgery ; Ear ; innervation ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; surgery ; Neck ; Neck Dissection ; methods ; Neck Muscles ; surgery ; Nerve Transfer ; methods ; Surgical Flaps ; Treatment Outcome

OBJECTIVETo explore arsenic-induced oxidative stress and the protective efficacy of α-lipoic acid and vitamin c.

METHODS50 male SD rats were randomly divided into 5 groups. Ten rats (the control group) were exposed to deionized water for 6 weeks, and the others were alone exposed to sodium arsenite (50 mg/L water) for 6 weeks, at the same time, three group rats were administered intragastrically (i.g.) with α-lipoic acid 10 mg×kg(-1)×d(-1) and vitamin C 25 mg×kg(-1)×d(-1) either alone or in combination. At the end of experiment, blood was drawn from abdominal aorta, and then the blood, brain and liver of rats were used for biochemical assays, including blood glutathione (GSH), δ-aminolevulinic acid dehydratase (δ-ALAD ), reactive oxygen species (ROS) and oxidized glutathione (GSSG) level. At the same time, the super oxide dismutase (SOD) activity, glutathione peroxidase (GSH-Px) activity, catalase (CAT) activity, ATPase activity of brain and liver were determined. The caspase activity of brain were also determined.

RESULTSThere were a significant increase in ROS level (P < 0.05), but a significant decrease in δ-ALAD activity (P < 0.01) in the chronic arsenic toxicity model group compared with the control group. These alterations were marginally restored by co-administration of vitamin C and α-lipoic acid individually, while significant recovery was observed in the animals supplemented with both the antioxidants together with arsenite in rat (P < 0.05). At the same time, there was a significant increase in the ROS and TBARS level of the brain and liver (P < 0.05), and caspase activity of the brain (P < 0.05), while there was a significant decrease in antioxidant enzymes and ATPase activity on arsenite exposure in rats (P < 0.05). These alterations were also marginally restored by co-administration of vitamin C and α-lipoic acid individually, while significant recovery was observed in the animals supplemented with both the antioxidants together with arsenite in rat (P < 0.05).

CONCLUSIONSArsenite-induced oxidative stress can be significantly protected by co-administration of α-lipoic acid and vitamin C individually, but the best effects could be observed with combined administration of two antioxidants during arsenite exposure in animals. The dietary intervention of or supplementation with natural dietary nutrients is possible to prevent the effects of arsenic in populations of risk.

Animals ; Arsenic Poisoning ; metabolism ; Ascorbic Acid ; pharmacology ; Male ; Oxidative Stress ; drug effects ; Rats ; Rats, Sprague-Dawley ; Thioctic Acid ; pharmacology

OBJECTIVESThe value of supraomohyoid neck dissection used in treating oral squamous cell carcinoma was discussed.

METHODSTwenty-seven cN0 patients with oral squamous cell carcinoma were entered into the study. Supraomohyoid neck dissection was performed to remove the lymphatic tissue of level I, II, and III. The operation duration and shoulder function were recorded.

RESULTSThe average operation duration was (1.6 +/- 0.2) h. Nineteen percent (5/27) of the cN0 neck were proved positive pathologically which included two cases in level I and four in level II (one case had both level I and II metastases). Shoulder function recovered in three months after operation. All patients were followed up from two years to four years and none of them had local or neck recurrence.

CONCLUSIONSSupraomohyoid neck dissection is a right choice for cN0 patients with oral squamous cell carcinoma with its advantages in both curing neck lymphatic metastases and preserving neck and shoulder contours and functions.

Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; surgery ; Neck Dissection ; methods ; Neoplasm Staging

Objective To investigate the discrepancy of aldosterone synthesis process and potential regulation abnormality between aldosterone-producing adenoma(APA) and normal adrenal(NA) with microarray. Methods cRNA probes labelled with biotin were prepared from mRNA of APAs(APA group,n=10) or NAs(control group,n=7).The probes were hybridized with oligonucleotide microarray of target gene expression profile.Expression levels were read from the fluorescent intensity scanned.The difference of gene expression profile was analyzed by computer software.Differentially expressed genes were verified by real-time RT-PCR. Results Compared with control group,97 genes were up-regulated and 168 genes were down-regulated in APA group.In the genes related to steroid hormone synthesis,only CYP11B2 was significantly up-regulated.In the physiologic regulators of aldosterone synthesis,CYB5A,CYP17A1,DUSP1 and HMGCR were down-regulated,while RENBP and NR1H2 were up-regulated.As a key enzyme in the biosynthesis of cortisol,the expression of CYP17A1 gene was inhibited. Conclusion Among the aldosterone synthesis related enzyme and corresponding regulatory genes in APA,CYP11B2 may be a key synthetase,and the suppressed physiologic regulators of aldosterone synthesis may indicate the existence of neoplastic modulation.

ObjectiveTo test the effect of human tremor detector in clinic based on the principle of photoelectrical transformation.MethodsFifty-five subjects including normal youth and elderly persons, patients with Parkinson's disease (PD), hyperthyroidism and cerebellor ataxia were tested with human tremor detector. The displacement, frequency spectrograph, velocity and acceleration of both hands in four kinds of postures and action were involved.ResultsThe physiological tremor and pathological tremor in different kinds of patients were significantly different (P<0.05). Especially in PD, both quantitive and qualitative data had a significant difference.ConclusionHuman tremor detector can provide the evidence for early diagnosis of PD.

OBJECTIVETo evaluate the effect of K2O addition on the crystallization property of dental glass-ceramics in the Li2O-SiO2-Al2O3-P2O5-ZnO system.

METHODSDifferent content of K2O was added into Li2O-SiO2-Al2O3-P2O5-ZnO glass system. The heat-treated system of the glass-ceramics was determined by differential thermal analyses (DTA), then the crystallization components and the microstmcture of the glass-ceramics with different content of K2O were investigated from X-ray diffraction (XRD) analyses and scanning electron microscopy (SEM).

RESULTSAddition of K2O helped to reduce the viscosity of the glass system and improved crystallization. More lithium disilicate crystals appeared after heated-treatment of the glass system which contained 5.3 wt% addition of K2O, and the homogeneously lath-shaped crystals were 4 gm in length.

CONCLUSIONCertain content of K2O can improve the crystallization property of dental glass-ceramics in the Li2O-SiO2-Al2O3-P2O5-ZnO system.

Ceramics ; Crystallization ; Dental Porcelain ; Glass ; Hot Temperature ; Microscopy, Electron, Scanning ; Silicon Dioxide ; X-Ray Diffraction

The aim of the study is to evaluate the effects of the single and mixed decoction of Thallus laminariae (kelp) and Glycyrrhiza glabra (licorice) on the metabolism and their difference. The mixed decoction of kelp and licorice and the single decoction were made and intragastrically administered to the SD rats. The effect on system metabolism, the toxicity of liver and kidney were assessed by GC-MS profiling of the endogenous molecules in serum, routine biochemical assays and histographic inspection of tissues from SD rats, separately. The mixed decoction of kelp and licorice induced more obvious pathological abnormalities in SD rats than a single decoction of kelp, while the extracts of licorice did not show any pathological change. Neither the mixed, nor the single decoction showed abnormal histopathology. After intragastric administration of extracts for 5 days, the mixed decoction induced a decrease of ALT (no significant change in the groups of single decoction) and an increase of BUN (so did the single decoction of kelp). Metabolomic profile of the molecules in serum revealed that the metabolic patterns were all obviously affected for the three groups, i.e., the mixed and single decoction of kelp and licorice. The rats given with the single decoction of kelp showed a similar pattern to that of the mixed decoction, indicating that the kelp primarily contributed the perturbation of metabolism for the mixed decoction. All three groups induced a decrease of branched chain amino acids, TCA cycle intermediates and glycolysis intermediates (e.g., pyruvic acid and lactic acid) and an increase of 3-hydroxybutyric acid. Kelp decoction showed stronger potential in reducing TCA cycle intermediates and glycolysis intermediates than the other two groups, while the levels of branched chain amino acids were the lowest after licorice extracts were given. These results suggested that the effect of the mixed decoction on metabolism was closely associated with both kelp and licorice. The continuous administration of single decoction of kelp and the mixed decoction of licorice and kelp resulted in pathological abnormalities in kidney of SD rats. The mixed decoction of kelp and licorice distinctly perturbed sera molecules and hence system metabolism, which showed associated with those of kelp and licorice. Although the metabolic effect was associated with both kelp and licorice, the results suggested kelp contributed to it primarily.
Animals ; Glycyrrhiza ; chemistry ; Kelp ; chemistry ; Kidney ; drug effects ; Liver ; drug effects ; Metabolomics ; Plant Preparations ; pharmacology ; Rats ; Rats, Sprague-Dawley

BACKGROUNDNevoid basal cell carcinoma syndrome (NBCCS) is a rare autosomal dominant disease characterized by a combination of development anomalies and a predisposition to tumour formation. Mutation of patched gene (PTCH), considered the molecular defect of NBCCS, in a Chinese NBCCS family was investigated in this study.

METHODSGenomic DNA was isolated from blood samples of all 12 members of this family. The mutated PTCH gene was screened by polymerase chain reaction amplification and direct sequencing.

RESULTSA new mutation of 3 bp (GAT deletion) was found in all seven affected members of this family. This mutation caused one aspartate deletion in the fourth transmembrane domain of the PTCH protein located within the sterol sensing domain (SSD). This deletion was not found in any unaffected members of this family nor in 200 control samples.

CONCLUSIONSOur findings suggest that one 3-bp deletion in PTCH gene was the cause of nevoid basal cell carcinoma in a Chinese family through affecting the conformation and function of PTCH protein.

Basal Cell Nevus Syndrome ; genetics ; Humans ; Mutation ; Patched Receptors ; Patched-1 Receptor ; Receptors, Cell Surface ; genetics