Objective:To evaluate the outcome of hypopharynx reconstruction using remaining larynx and pharynx in patients after hemipharyngectomy,partial laryngectomy and cervical esophagectomy.Methods:Twelve patients with advanced pyriform sinus cancer underwent hemipharyngectomy and partial laryngectomy.Two patients underwent cervical esophagectomy at the same time.All cases were reconstructed by the remaining larynx.Results:All cases were successful.Only one patient suffered from postoperative pharyngocutaneous fistulas,who had had perioperative radiotherapy.Patients could swallow ordinary foods and had no strictures after operation.Up to now,patients have been followed over 2 years,and two-year survival rate was 75%.One case has survived over 5 years. Conclusion:The hypopharynx reconstruction with remaining larynx and pharynx is simple and convenient.It is less invasive and has less complication.

Excimer laser was found in 1975, and has been used in corneal refractive surgery, which made a great progress and become rapidly developed. ArF laser of 193 nm has high accuracy because it can gasify corneal tissue molecule. Moreover, it does not produce heat effect on tissues surrounding irradiated sites, so not produce adverse effect on corneal structure. At present, excimer laser has been successfully used in corneal radial incision, excimer laser corneal refractive surgery, laser in situ keratomileusis, laser epithelial keratomileusis and laser subepithelial keratomileusis. With increasing understanding of excimer laser and accumulating clinical experience, novel, accurate and predictive excimer laser corneal refractive surgery will be developed.

Objective To understand the knowledge, attitude, practice (KAP) status and relative demand to combined oral contraceptives (COCs) in medical staffs of obstetric and gynecological department in Tianjin, providing reference basis for the effective intervention measures. Methods By using random, stratified and clustered sampling approach, we selected 382 medical staffs of obstetric and gynecological department in Tianjin. A self-administered Questionnaire on COCs KAP was employed to survey the general characteristics, awareness of COCs knowledge, attitudes to COCs, service capabilities of contraceptive counseling, prescribing behavior and request of continuing education. Results The respondents showed de?fects in COCs indications, non-contraceptive benefits, relationship with cancer and birth defects. The average knowledge score was higher in doctors than that of nurses. The higher the titles and qualifications, the higher the knowledge score. A to?tal of 90.11%of respondents believed that strengthening the contraceptive guidance can help to reduce pregnancy. Strength?ening the interpretation of misunderstanding (81.04%) and enhancing the treatment and follow-up of adverse reactions (62.09%) can help to reduce stop taking. Only 25.82%of respondents could provide detailed COCs relative consulting servic?es;42.96%of obstetricians and gynecologists refused prescribing COCs for women over the age of 40 for the purpose of con?traception. A total of 93.13%medical personnel showed demand on relative training. Conclusion It’s necessary to perform continuing education to medical staffs via different intervention, so as to improve their cognitive level to COCs, ameliorate COCs relative attitudes and behavior, and help them providing better service to women of childbearing age.

Objective To better understand the knowledge, attitudes, practice (KAP) and relative demand of precon?ception and prenatal care (PAPC) in medical staffs of obstetrics and gynecology department in Tianjin. Methods Using ran?dom, stratified and clustered sampling approach, we selected 382 obstetrics and gynecology personnels in Tianjin. A self-ad?ministered questionnaire on PAPC KAP was employed to survey their general characteristics, their awareness of PAPC knowledge, their attitudes to PAPC, their service capabilities of PAPC and their request of continuing education. Results The respondents were lacking of KAP in Calcium and Iron supplementation, alternative preconception examination and emerging prenatal examination but present good KAP in folic acid supplemen, necessary prenatal items and classic prenatal examination. Doctors′average knowledge score was higher than nurses′. The scores in primary health care institutions was significantly higher than that in tertiary and secondary medical institutions. Young and junior medical respondents showed higher awareness than older and senior ones. Most (91.21%) respondents believe that PAPC is necessary. But 86.54%of re?spondents are not confident enough to provide comprehensive PAPC services. There were 63.74%, 54.67%, 38.74% and 32.42%of the respondents who could provide special PAPC advisory of adverse pregnancy history, thyroid dysfunction, re?productive infections and diabetes respectively. The most urgent training contents include PAPC knowledge in presence of complications or risk factors, advances in prenatal diagnosis, nutrition during pregnancy and consulting skills. Conclusion It′s necessary to intervent obstetrics and gynecology personnels to improve their cognitive level to PAPC, as well as to amelio?rate relative attitudes and behavior so they can provide more scientific and comprehensive PAPC service.

Objective To investigate the correlation between serum interleukin-6 (IL-6) to albumin ratio (IAR) at admission and early outcome of patients with acute noncardioembolic ischemic stroke.Methods From January 2013 to May 2015,patients with acute noncardioembolic ischemic stroke admitted to the Department of Neurology,the First Affiliated Hospital of Xi'an Jiaotong University were enrolled retrospectively.Three months after onset,the clinical outcome were assessed by the modified Rankin scale (mRS),0-2 was good outcome,and ＞ 2 was poor outcome.The baseline clinical data,laboratory tests,and IAR in both groups were compared.Multivariate logistic regression analysis was used to determine the independent risk factors affecting early outcomes.Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of IAR for early outcome.Results A total of 236 patients were enrolled in the study,including good outcome in 143 (60.6％) and poor outcome in 93 (39.4％).Univariate analysis showed that age (62.99 ± 11.34 years vs.59.62 ± 11.83 years;t =-2.176,P=0.031),serum IL-6 (37.56 ± 3.82 ng/L vs.34.82 ± 3.13 ng/L;t =-6.016,P ＜ 0.001),IAR (1.02 ± 0.08 vs.0.93 ± 0.07;t =-9.474,P＜0.001),and the proportions of patients with severe stroke (6.5％ vs.0％;x2 =8.142,P =0.012) and combined CHD (30.1％ vs.18.2％;x2 =4.542,P =0.033) of the poor outcome group were significantly higher than those of the good outcome group.Multivariate logistic regression analysis showed that high IAR at admission was an independent risk factor for early poor outcome (odds ratio,5.192,95％ confidence interval 3.283-8.213;P ＜0.001).ROC curve analysis showed the optimal cut-off value of IAR predicting for early outcome was 1.00,and the area under the ROC curve was 0.807 (95％ confidence interval 0.748 to 0.860).The sensitivity was 62.4％,the specificity was 88.1％,the positive predictive value was 69.2％,the negative predictive value was 79.3％,and the accuracy was 75.4％.Conclusions High serum IAR at admission was an independent risk factor for early poor outcome in patients with acute noncardioembolic ischemic stroke.It had a certain predictive value for the outcomes.