OBJECTIVE: To investigate the efficacy of submucosal resection by CO2 laser in the treatment of recurrent laryngeal papilloma and the effect on prognosis. METHOD: A total of 11 patients diagnosed as recurrent laryngeal papilloma were included in this review. Papilloma was marked before operation and checked under fibro-laryngoscope. Papilloma was resected completely including the submucosal tissure with CO2 laser or microequipment. In widespread papilloma, false membrane in raw surface were cleared 7-10 days after operation. Surgical specimens (including membrane) were detected by routine pathology, HPV typing and immunohistochemical pathologic examination. The patients were checked once a month in the first 3 months after operation, and then once for every 3 months. Once the hoarseness and other symptoms aggravated or the disease was recurrent, the patients were treated immediately. RESULT: HPV viral DNA was found in 10/11 cases, with HPV11 (7/11 cases) and HPV6 (3/11 cases). Cases with regards to follow-up, from 6 months to 1 year, 3 cases were followed up 1 year after operation, without recurrence. Five patients including 2 children were followed up 6 to 12 months after operation, without recurrence. Two children underwent 2 or 3 operations, were followed-up more than 6 months withouting recurrence. CONCLUSION Papilloma submucosal resection could decrease postoperative recurrence and is worth to be further investigated.
Child ; DNA, Viral ; blood ; Human papillomavirus 11 ; isolation & purification ; Human papillomavirus 6 ; isolation & purification ; Humans ; Laryngeal Neoplasms ; diagnosis ; surgery ; Laryngoscopes ; Lasers, Gas ; Neoplasm Recurrence, Local ; Papilloma ; diagnosis ; surgery ; virology ; Papillomavirus Infections ; diagnosis ; surgery ; Postoperative Period ; Prognosis ; Respiratory Tract Infections ; diagnosis ; surgery

OBJECTIVE: To study the spontaneous rehabilitation and phonation quality of vocal cords after different types of CO2 laser microsurgery. METHOD: Surgical procedures based on Remacle system Type I, Type II, Type III, Type IV and Type V a respectively. Three hundred and fifteen cases with hoarseness based on strobe laryngoscopy results were prospectively assigned to different group according to vocal lesions apperence,vocal vibration and imaging of larynx CT/MRI. Each group holded 63 cases. The investigation included the vocal cords morphological features,the patients' subjective feelings and objective results of vocal cords. RESULT: There are no severe complications for all patients in perioperative period. Vocal scar found in Type I ,1 case; Type II, 9 cases ;Type III, 47 cases; Type IV, 61 cases and Type Va 63 cases respectively after surgery. The difference of Vocal scar formation after surgery between surgical procedures are statistical significance (χ2 = 222.24, P < 0.05). Hoarseness improved after the surgery in 59 cases of Type I , 51 cases of Type II, 43 cases of Type III, 21 cases of Type IV and 17 cases of Type Va. There are statistically significance (χ2 = 89.46, P < 0.05) between different surgical procedures. The parameters of strobe laryngoscope: there are statistical significance on jitter between procedures (F 44.51, P < 0.05), but without difference within Type I and Type II (P > 0.05). This happened in shimmer parameter and the maximum phonation time (MPT) as jitter. There are no statistical significance between Type IV and Type Va on MPT (P > 0.05). CONCLUSION Morphological and functional rehabilitation of vocal cord will be affected obviously when the body layer is injured. The depth and range of the CO2 laser microsurgery are the key factors affecting the vocal rehabilitation.
Cicatrix ; Hoarseness ; therapy ; Humans ; Laryngoscopes ; Laryngoscopy ; Laser Therapy ; Lasers, Gas ; Microsurgery ; Phonation ; Vocal Cords ; physiology ; surgery

Objective To evaluate the role of protein kinase Cα( PKCα)?nuclear factor E2?related factor 2 ( Nrf2)?heme oxygenase?1 ( HO?1) signaling pathway on endotoxic shock?induced acute lung injury ( ALI) in rabbits. Methods Thirty healthy male New Zealand white rabbits, aged 2 months, weighing 2?0-2?5 kg, were randomly divided into 3 groups ( n=10 each) using a random number table: normal control group ( group C);ALI group ( group ALI);PKCα inhibitor chelerythrine group ( group CHE) . In group CHE, chelerythrine 8 mg∕kg ( in 0?5 ml of DMSO) was injected intraperitoneally, and 30 min later, LPS 5 mg∕kg ( in 2 ml of normal saline) was injected via the auricular vein to induce ALI in ALI and CHE groups. The rabbits were then sacrificed at 6 h after injection of LPS or normal saline, and the lungs were removed for examination of the pathological changes which were scored and for determination of wet∕dry lung weight ratio ( W∕D ratio) , and the expression of Nrf2 and HO?1 protein and mRNA. Results Compared with group C, the pathological score and W∕D ratio were significantly increased, and the expression of Nrf2 and HO?1 protein and mRNA was up?regulated in ALI and CHE groups. The pathological score and W∕D ratio were significantly higher, and the expression of Nrf2 and HO?1 protein and mRNA was lower in group CHE than in group ALI. Conclusion The PKCα?Nrf2?HO?1 signaling pathway is one of the endogenous protective mechanisms underlying endotoxic shock?induced ALI in rabbits.

Objective To observe the effects of icarisid Ⅱ (ICS Ⅱ)on cognitive deficits and expression of synaptophysin(SYN)in chronic cerebral hypoperfusion(CCH)rat models.Methods 40 male SD rats were randomly divided into four groups:normal group,sham operation group,model group and ICSⅡgroup.The model was established by permanent bilateral common carotid artery occlusion(BCCAO).ICS Ⅱ group was administered ICS Ⅱ at a dose of 8mg·kg -1 ·d -1 by gavage on 1st day after modeling.Sham group and CCH group were injected double -distilled water.The escape latency(s)and spatial probe times were measured by water maze test.Then,the morphology change and expression of SYN in hippocampal were assayed by HE and immunohistochemistry analysis.Results At the 1st month and 2nd month,the escape latency in the model group[(40.02 ±4.95)s,(42.29 ±5.75)s]were significantly prolonged compared with the sham operation group[(26.43 ±2.68)s,(26.84 ±2.06)s](t =4.89,5.06,all P <0.05).And those in the ICS Ⅱ group[(30.58 ±3.03)s,(29.19 ±4.23)s]were significantly decreased compared with the model group(t =3.63,4.10,all P <0.05).The space probe times in the model group[(2.6 ±0.89)times, (2.40 ±1.14)times]were significantly reduced compared with the sham operation group[(6.00 ±2.16)times, (5.75 ±2.16)times](t =3.23,4.18,P <0.05).And those in the ICS Ⅱ group[(4.40 ±1.34)times,(5.00 ± 1.58)times]were significantly increased compared with the model group (t =2.49,2.98,all P <0.05).The average optical density of SYN in hippocampal in the model group[CA1:(0.121 ±0.009),(0.122 ±0.008);CA3:(0.172 ± 0.028),(0.173 ±0.021 )]were significantly reduced compared with the sham operation group[CA1:(0.131 ± 0.006),(0.136 ±0.007);CA3:(0.218 ±0.035),(0.204 ±0.018)](t =2.43,2.53,3.12,2.34,P <0.05). Those in the ICS Ⅱ group[CA1:(0.131 ±0.006),(0.132 ±0.006);(0.212 ±0.02),(0.208 ±0.022)]were significantly increased compared with model group(t =2.41,2.41,2.31,2.77,all P <0.05).However,there was no statistically significant difference of those index between the normal group and sham operation group(P >0.05 ). Conclusion ICS Ⅱ can improve the cognitive deficits in CCH rat models and this effect may be associated with increased expressions of SYN in hippocampal.

Ischemia reperfusion injury is an important factor which has been affected the recuperation of hepatic function after hepatectomy and liver transplantation,and is a complex course in pathophysiology with many factors.With the development of research on ischemia reperfusion injury,effective prevention measures of ischemia reperfusion injury also have made new progress.And this will greatly improve the prognosis of hepatic surgery.The mechanism and its prevention measure of hepatic ischemia reperfusion injury were reviewed in this paper.

Objective To explore the effects and mechanism in patients with ulcerative colitis (UC) treated by Yin Yang equilibrated preparation. Method 82 patients with UC as treatment group and 35 health parsons as control group underwent the testing. The serum and mucosal of all testing persons were taken pre and post treatment to detect CD+4 CD+25 regulatory T cells(Tregs) by flow cytometry at the end of one month,treating with SASP and Yin Yang equilibrated preparation. Result Compared with normal control group,the proportion of CD+4 CD+25 Tregs was markedly decreased in PB and mucesal of group A and B(P <0.01). But it was significanfly increased in therapeutic groups of SASP and Yin Yang equilibrated preparation, and their CD+4 CD+25 Tregs in PB and mucosal were much more than the control group at the end of one month after treating with SASP and Yin Yang equilibrated preparation(P <0.01 or P< 0.05). Conclusion CD+4 CD+25 Tregs with strong immune suppression play a central role in the initia-tion and development of UC,and the Yin Yang equilibrated preparation might exert its therapeutic effects on UC by the regulation of number and function of CD+4 CD+25 Tregs.

Objective To observe the effect of IcarisideⅡ (ICSⅡ) on spatial learning and memory impairments and axonal regeneration induced by chronic cerebral hypoperfusion (CCH) in rats.Methods 90 male SD rats were randomly divided into normal group,sham operation group,CCH group and ICS Ⅱ low,middle and high-dose treatment groups.The chronic cerebral hypoperfusion model was established by permanent bilateral common carotid artery occlusion.Then these rats in ICS Ⅱ low,middle and high-dose treatment groups were given ICS Ⅱ4,8 and 16 mg/(kg · d) by gavage on the 1st day after modeling.There were 5 rats in every group at each observing time(4,8 and 12 week).Morris water maze experiment was utilized to assess the escape latency and the target quadrant residence time while HE and immunohistochemistry analysis were applied to test the morphology change and expressions of GAP-43,MAP-2 and Nogo-A in hippocampal CA 1.Results Compared with those of sham operation groups at 4,8 and 12 week respectively,the escape latency in CCH group were significantly prolonged(40.02±4.95) s,(42.29±5.75) s,(53.68±6.14) s vs (26.43±2.68) s,(26.84±2.06) s,(31.53±4.12) s,P＜0.05;the target quadrant residence time were significantly reduced(28.53±2.40) s,(28.02±4.28) s,(22.60±4.03) s vs (33.34±2.89) s,(33.31 ±4.14) s,(31.63±2.20)s,P＜0.05);the expressions of GAP-43 and Nogo-A were increased with that of MAP-2 reduced(P＜0.05).Meanwhile,the neuropathological changes with more denatured neurons and less normal neurons were found in hippocampal CA1.However,compared with those of CCH group,the escape latency of ICS Ⅱ middle and high-dose groups (30.58±3.03) s,(29.19±4.23) s,(38.77±5.80) s;(28.90±2.98) s,(26.91 ±6.63) s,(36.51 ±3.98) s) were shortened (P＜0.05);the target quadrant residence time (32.54± 3.41) s,(32.69±3.47) s,(28.27±3.57) s;(32.69±3.54) s,(33.20±4.29) s,(28.07±4.04) s) were increased (P＜ 0.05);the expression of Nogo-A was decreased while those of GAP-43 and MAP-2 were conversely increased (P＜0.05).Moreover,few denatured neurons were observed in hippocampal CA1.But there were no differences for those indexs between CCH group and ICS Ⅱ low-dose treatment groups (P＞0.05).Compared with those in 8 week and 4 week,the escape latency and the target quadrant residence time were prolonged and reduced with the expression of Nogo-A increased in all groups except normal group and sham operation group(P＜0.05),the expressions of GAP-43 and MAP-2 were decreased in CCH group and ICS Ⅱ low-dose treatment group(P＜0.05),but there were no significant differences in ICS Ⅱ middle and high-dose treatment groups at 12 week(P＞0.05).However,there were no statistical significance of all indexes between 8 week and 4 week(P＞0.05).Conclusion ICS Ⅱ can improve the spatial learning and memory in chronic cerebral hypoperfusion rats,which may be achieved by neuroprotective effects and reducing the expression of Nogo-A consequently promotes the regeneration of axons.

Objective To evaluate the differences of toxicities,therapeutic efficacy and immune function between induction chemotherapy followed by sinusoidal chrono-modulated infusion and flat intermittent infusion of cisplatin (DDP)with intensity-modulated radiotherapy (IMRT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC).Methods Seventy patients with biopsydiagnosed stages Ⅲ and Ⅳ B NPC (according to the 2010 UICC staging system) were treated with two-cycle induction chemotherapy before chemoradiotherapy in Guizhou Cancer Hospital.The TPF chemotherapy regimen was administered as follows:The TXT and DDP with the dose of 75 mg/m2 was carried out by bolus infusing for the first day,the 5-FU with 750 mg · m-2 · d-1 was carried out by continuous intravenous pumping for the first day to fifth day(120 h).The induction chemotherapy was 21 days per cycle,for two cycles.After that all patients were randomly treated with 2-3 cycles of sinusoidal chronomodulated infusion or flat intermittent constant rate infusion of DDP with IMRT.Using a multi-channel programmed pump,the patients were given 12 h continuous infusions of DDP (100 mg/m2) for day one,repeated every 3 weeks for 2-3 cycles.DDP was administered from 10:00 am to 10:00 pm.Concurrent radiotherapy regimen was administered as follows:GTVnx 69.96-73.92 Gy/33 f,PTVnx 69.96 Gy/33 f,PTVnd 69.96 Gy/33 f,PTV1 60.06 Gy/33 f,PTV2 50.96 Gy/28 f.Results The main toxicities of chemoradiotherapy in the group of sinusoidal chrono-modulated infusion were bone marrow suppression:leukocytes,and then nausea,oral mucositis and hemoglobin.The main toxicities of chemoradiotherapy in the group of flat intermittent constant rate infusion were bone marrow suppression:hemoglobin,leukocytes,and then nausea,oral mucositis.No significant differences were observed for toxicities(P ＞ 0.05).After concurrent chemoradiotherapy,the complete response rate (CR),partial response rate (PR),stable disease rate(SD),progressive disease rate (PD) and overall response rate (ORR) were 11.4％,85.7％,2.9％,0 and 97.1％ in the group of sinusoidal chrono-modulated infusion.The CR,PR,SD,PD,ORR in the group of flat intermittent constant rate infusion were 22.9％,74.2％,2.9％,0,97.1％,respectively.However,there was no significant differences of effect in the two Arms (P ＞ 0.05).For sinusoidal ehrono-modulated infusion and flat intermittent infusion group,the 2-year overall survival(OS) were 82.9％ and 94.3％ respectively,the 2-year progression-free survival(PFS) were 77.1％,91.4％ respectively,and the 2-year distant metastasis free survival (DMFS) were 82.9％,91.4％ respectively.The value of CD3 + in the group of sinusoidal chrono-modulated infusion was higher than the group of flat intermittent constant rate infusion after therapy (Z =3.254,P ＜ 0.05).The value of CD4 +,CD8 +,CD16 + CD56 +,CD19 +,and CD4 +/CD8 + had no differences in two Arms (P ＞ 0.05).Conclusions No significance differences on the toxicities,therapeutic efficacy and survival were observed between the two groups,but immune function might be improved in the sinusoidal chrono-modulated infusion group.

Objective: To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi (HHRY) pills for endometriosis-associated dysmenorrhea. Methods: This study constitutes a multicenter, randomized, double-blind, placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period. A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio. The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale (VAS) scores and quality of life, whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain, duration of pain episodes (in days), frequency and quantity of the consumption of ibuprofen sustained-release capsules (or other non-steroidal anti-inflammatory drugs), and days off work/study for staff/student due to dysmenorrhea, ovarian cyst, and/or pelvic nodule size. The safety was monitored throughout the treatment period. All the analyses were based on the intention-to-treat principle. For continuous outcomes, simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups, with categorical data expressed as the number and percentage of occurrences. Differences were compared using the chi-square test or Fisher's exact test. The predefined analysis was adjusted for concomitant treatment, a variable considered to be associated with outcomes but unaffected by treatment allocation. Estimates of treatment effects were reported with 95% confidence intervals. Two-tailed P values ≤ .05 were considered statistically significant. Conclusion Positive results from this trial, upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.

Objective To investigate the effects of phonosurgery combined with botulinumtoxinof type A in-jection in adults with vocal nodules .Methods A total of 76 adults with diagnosis of vocal nodules were studied in this experiment .They were divided into two group according to the different treatments :the surgery group (n=40) ,and the group with the combined botulinum toxin of type A injection (n=36) .Preoperative and postoperative examinations consisted of electronic laryngoscope ,stroboscopic laryngoscope ,voice assessments of subjective and objective evaluations using GRBAS classification and voice disorder index (VHI) .The evaluation parameters were the longest phonation time (MPT) ,jitter and shimmer and dysphonia severity index (DSI) .The results from the two groups were compared .Results There were 5 cases cured ,28 cases improved and 7 cases of now effects in the surgery group .The effective rate was 82 .5％ .There were 30 cases cured and 6 cases improved in the combined in-jection group with the effective rate of 100％ .There were 22 cases with good glottis closure and 18 cases with incom-plete closure in the surgery group postoperatively ;in the combined injection group ,30 cases glottis closed well and 6 cases still closed incompletely .The differences of postoperative VHI ,MPT ,jitter ,shimmer and DSI in addition to G were significant different between the two groups .Conclusion Phonosurgery combined with botulinum toxin of type A injection is an effective way for the treatment of vocal fold nodules in adults .