OBJECTIVE: Through the application of eustachian tuboplasty assisted with hypothermy plasma ablation, we evaluate its efficacy in the threatment of adult refractory otitis media with effusion. METHOD: We retrospectively reviewed the charts of 48 cases (61 ears) suffering from adult refractory otitis media with effusion from January 2012 to December 2013. According to the admission date, the patients were divided into the control group (17 cases, 22 ears) and the treatment group (31 cases, 39 ears). In the control group, the patients were treated with drugs and physical therapy. In the treatment group, the hypothermy plasma ablation technology was used to ablates the hypertrophic tissues around the eustachian orifice besides the pharmaedogical interventions. The recurrence rate of the two groups were analyzed and compared in 1 year after treatment. Pure tone audiometry and acoustic immittance measurement were taken for the two groups in differernt periods (one week prior to operation, one months, three months, six months and one year after operation respectively) to evaluate their hearing change and the recurrence rate (within six months after treatment and one year respectively) objectively. RESULT: In the control group, 2 cases (2 ears) were lost to follow-up, and the recurrence rate was 65% (13/20) in 1 year. In the treatment group, four case were lost to follow-up,and the recurrence rate was 14.3% (5/35) in 1 year. The difference was statistically significant (P<0. 01). There were similar hearing improvement in the two groups after treatment in 1 month, but the hearing improvement in the treatment group increased with time. There were no complications occuring during the operation and post-operation. Within a month after operation, the majority of ears(28/35) obtained significant hearing improvement with the decreasing air-bone-gap comparision with the pre-operation (P < 0.01), and the preoperative tympanogram of 16 ears with type B or C turned to type A (P < 0.01). There were no both statistical significance in the variation of air-bone-gap and tympanogram of comparison with results between three months and six months, six months and one year postoperatively (P > 0.05). CONCLUSION This study confirmed the efficacy of eustachian tuboplasty assisted with hypothermy plasma ablation in the threatment of adult refractory otitis media with effusion caused by eustachian tube opening disorder was significant. It can reduce the recurrence rate significantly in one year and allow sustained hearing improvement within three months postoperatively.
Acoustic Impedance Tests ; Adult ; Audiometry, Pure-Tone ; Cryosurgery ; Eustachian Tube ; surgery ; Humans ; Lost to Follow-Up ; Otitis Media with Effusion ; drug therapy ; surgery ; Plasma Gases ; Postoperative Period ; Recurrence ; Retrospective Studies ; Tympanoplasty

Objective To investigate the effect of rapid repeated cold air inhalation stimulation on cold-sensitive chan-nel transient receptor potential ankyrin 1(TRPA1) associated inflammatory cytokines in living lungs .Methods A total of 20 male Wistar rats were randomly and evenly divided into 4 groups:cold air inhalation group , warm air inhalation group , TRPA1 channel agonist inhalation group and normal group , respectively . Tracheal intubation was carried out after anesthesia in rats of cold air inhalation group , and the tubes were linked to the air temperature controlled device with the temperature controlled at ( 2 ±1 )℃.The rats of warm air inhalation group were treated in the same way as cold air inhalation group except for the temperature at (36 ±1)℃.The rats of both groups were treated for 3 times, 1 hour each time.There were 12 hour intervals between treatments .The rats of TRPA1 channel agonist inhalation group were treated with atomizing inhalation of 60 mmol/L acrolein at room temperature (24 ±2)℃for 3 times, 1 hour each time.There were 12 hour intervals between two treatments .The rats were sacrificed after the last treatment .The tracheas and left lung tissues of all rats were taken and total RNA was extracted .The mRNA expressions of TRPA1, interleukin 1 beta ( IL-1β), interleukin 5(IL-5),and neutrophil chemoattractant chemokine (CXCL-1/KC)in the rat lungs were detected by real-time quantitative PCR .Results TRPA1 was expressed in rat lung tissues .In the short term cold air inhalation group , the expressions of IL-1β,IL-5 and CXCL-1/KC mRNA in the rat lungs were higher than those of the warm air inhalation or the normal groups .Similar results were also found in the specific TRPA 1 channel positive agonist ( acrolein ) inhalation group . Conclusion In living animals, the TRPA1 channels of the lungs can be activated by short-term cold air(<17℃),which results in the increasing expression of some inflammatory cytokines in lungs .

Objective To investigate the effects of insulin-like growth factor-1（IGF-1）on the cell proliferation of human non-small-cell lung cancer（NSCLC） and the possible molecular mechanism.Methods MTT assay was used to examine the effects of IGF-1 （0.1,1,10,100 ng/mL）on the cell proliferation of NSCLC cell lines（A549,LK2,H460）,Flow cytometry（FCM）and Western blot to ana-lyze the cell cycles and the protein expression of S-Phase Kinase-Associated Proteins 2（Skp2）and CDC20 homolog 1（CDH1）,respectively.Results The cell proliferation of NSCLC cell lines（A549,LK2,H460）could be promoted by the IGF-1 at different concentrations and the proliferation rate peaked when the cells were treated with 1 ng/mL IGF-1.Compared with control,the percentage of the S-phase cell population was significantly increased after the treatment of IGF-I（P 〈 0.01）and the protein expression of SKP2 also increased obviously（P 〈0.05）.However,there was no change in the CDH1 protein expression（P 〉 0.05）.Conclusion IGF-1 may accelerate the cell-cycle pro-gression of NSCLC cells by negatively modulating p27 protein via the up-regulation of SKP2 protein expression.

OBJECTIVE To assess the skills and key points with frontal ostium in Draf IIa endoscopic frontal sinus surgery.METHODS We retrospectively reviewed 607 cases of patients who underwent endoscopic sinus surgery between September, 2004 and December, 2007, 84 cases(147 sides)of patients who underwent Draf IIa endoscopic frontal sinus surgery.The period of follow-up were 7 to 40 months.RESULTS All of 84 cases(147 sides) of patients, frontal ostium drainage was restored in 58 cases(102 sides, 69%), improved in 16 cases(28 sides, 19 percent), invalid in 10 cases(17 sides, 12%).CONCLUSION Endoscopic sinus surgery is an effective way for the treatment of chronic frontal sinusitis.Draf IIa endoscopic frontal sinus surgery is an easy and useful technique to restore the drainage of frontal ostium.

OBJECTIVE: To observe the CT imaging features of anatomic structure related to endoscopic axilla approach for surgery of the frontal recess and frontal sinus. METHOD: Thirty patients without a history of frontal sinus disease were undergone 16 line high speed spiral computed tomography. The computed tomographic images were analyzed to measure the related structures. RESULT: The vertical distance from the front attachment point of the middle turbinate to the skull base was 13.88 +/- 2.59 mm. The horizontal distance from the top point of the axilla of the middle turbinate to the anterior wall of the frontal sinus outflow tract was 5.77 +/- 12.32 mm, to the anterior wall of the nasal cavity was 13.67 +/- 12.54 mm, to the lamina papyracea or lacrimal sac was 5.89 +/- 1.69 mm. CONCLUSION Sixteen line high speed spiral computed tomography is helpful to endoscopic axilla approach for surgery of the frontal recess and frontal sinus.
Adult ; Aged ; Aged, 80 and over ; Endoscopy ; methods ; Female ; Frontal Sinus ; diagnostic imaging ; surgery ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, Spiral Computed ; Turbinates ; diagnostic imaging ; surgery ; Young Adult

Objective Using Sevoflurane in general anesthesia in cesarean operation , to evaluate change of stress response by monitoring maternal plasma concentrations of HSP70 and the expression of HSP70 in the placenta tissue and provide an ideal and basis of safty and effectiveness in obstetric general anesthesia. Methods Sixty caesarean operation puerperas undergoing general anesthesia in women and children′s hospital of Guangdong province were selected and randomly divided into the sevoflurane group (S group) and the propofol group (P group) through random number table, each group had 30 cases. We tested materal blood concentration and expression of HSP70 in placenta tissue. Results HSP70 concentration (when) in the P group was significantly higher than that before surgery (P < 0.05); Comparing with the group S at the same time point, the difference was statistically significant (P < 0.05); In expression of HSP70 in placental tissue, P group was obviously higher than the S group (P < 0.05), Conclusion Sevoflurane used in general anesthesia for cesarean operation is safe and effective , which can reduce the concentration of HSP70 in maternal blood and expression of HSP70 in placental tissue.

Objective To prepare the long-circulating liposomes of paraoxonase(PON).Methods The long-circulating liposomes of paraoxonase were prepared by film dispersion method.The encapsulation efficiency was determined by gel column.The effects of the factors on the encapsulation efficiency,such as the weight ratio of paraoxonase to phospholipid,cholesterol(Choi) to phospholipid,PEG-cholesterol (PEG-Chol) and the iron strength of water phase,were investigated respectively.Then the formulation was optimized by orthogonal design.Results The encapsulation efficiency of the paraoxonase liposomes was 87.66±3.46%,and the average diameter of the liposomes was about 126 nm.There was no significant change on encapsulation efficiency on 15 d at 4 ℃,and the activity of paraoxonase was maintained basically stable.Conclusion The preparation of PEG-modified paraoxonase liposomes was easy and practicable,and the property investigation in vitro showed that the paraoxonase liposomes were stable.

Objective To investigate the effect of hyperacute intensive antihypertensive treatment on the prognosis of intracerebral hemorrhage in basal ganglia region. Methods From January 2013 to December 2015,100 patients with intracerebral hematoma in basal ganglia region (onset ≤3 h)at the Neurological Intensive Care Unit,the First Affiliated Hospital of Dalian Medical University were enrolled prospectively. They all randomly received the intensive antihypertensive or standard antihypertensive treatment voluntarily. They were divided into either an intensive antihypertensive group or a standard antihypertensive group according to the random number table (n = 50 in each group). Within 1 h after beginning to treatment,the target systolic blood pressure was controlled in 130 -140 mmHg in the intensive antihypertensive group,the target systolic blood pressure was controlled in 160 -180 mmHg in the standard antihypertensive group,and the target systolic blood pressure was maintained respectively in the following 7 d. Head CT was performed gain at 24 h after treatment. The intracranial hematoma expansion was evaluated. The National Institutes of Health Stroke Scale (NIHSS)and the modified Rankin scale (mRS)were used to
evaluate their prognoses. The differences of the cumulative mortality in both groups were compared at the same time. Results The incidences of hematoma expansion of the intensive antihypertensive group and the standard antihypertensive group were 12. 0% (6/ 50)and 30. 0% (15/ 50)respectively. There was significant difference between the 2 groups (χ2 = 4. 882,P = 0. 027). There were no significant differences in NIHSS scores within or between both groups at each time points (all P > 0. 05). They were followed up for 90 d,no adverse events occurred in both groups. The favorable prognosis rates of the neurological function were 36. 0% (18 / 50)and 18. 0% (9 / 50)respectively in the intensive antihypertensive group and the standard antihypertensive group. There was significant difference between the 2 groups (χ2 = 0. 411,P =0. 043). Kaplan-Meier curves showed that the cumulative mortality at 24 h,within 7 d and 90 d in the intensive antihypertensive group and the standard antihypertensive group were 4. 0% (2 / 50),6. 0%(3 / 50),and 10. 0% (5 / 50),respectively,those of the standard antihypertensive group were 10. 0%(5 / 50),24. 0%(12 / 50),and 30. 0%(15 / 50),respectively. The results of Log-rank test found that there was significant difference in cumulative mortality between the 2 groups (χ2 =6.280,P =0.012). Conclusions The intensive antihypertensive treatment in the hyperacute cerebral hemorrhage is safe and feasible in basal ganglia region. It contributes to improve prognosis of neurological function,and reduce the incidence of hematoma expansion and the 90 d cumulative mortality.

Objective To review our experiences in portaazygous disconnection for the treatment of portal hypertension and to analyze the causes of postoperative complications. Methods We reviewed the results of 236 patients with portal hypertension who were treated with disconnection from April 1994 to July 2002. Results Postoperative complications occurred in 65 of all the patients(the incidence rate was 27.5%). Twenty-four patients experienced postoperative infection(10.2%),12 patients suffered from intraabdominal massive bleeding(5.1%),12 from massive ascites (5.1%),8 patients suffered from recurrent upper gastrointestinal bleeding (3.4%),7 patients experienced acute thrombosis of portal venous system(3.0%). Two patients suffered from multiple organ dysfunction syndrome (1.0%). The operative mortality was 3.4%(8/236). The main causes of death included intraabdominal massive bleeding and severe infection with MODS. Conclusions The occurrence of postoperative complications was related with the selection of patients,thorough portaazygous disconnection and perioperative management.

For recently 30 years,with the progress of science,the development of intracavitary technology has been constantly improved and expanded.Reascularization technology makes the cure of vaso-occlusive disease a great leap.Because of its small trauma,repeatable,high security,near future curative effect,interventional therapy is distinctly superior to the traditional treatment such.Peripheral vascular lumen treatments including the balloon dilatation,stent-assisted angioplasty,catheter guided thrombolysis,and percutaneous mechanical thrombectomy,etc.Although angioplasty has become the best choice but the preferred treatment has limitations,such as for long and severe calcification of arteries occlusion surgery is difficult,immediate and long-term patency rate is low,the postoperative complications is frequent;Used for plaque ulcer and potentially thromboembolic disease,body highly risks of distal embolization;Inherent retraction force for postoperative lumen,intimal inflammation restenosis,stent thrombosis cause problems frequently.However,the percutaneous mechanical thrombectomy system is aimed at solving the clinical problems with good combination of engineering and technology research.The purpose of this paper is to expound the existing mechanical embolus removal system:SilverHawk/TurbjHawk aod Straub Rotarex thrombus,that is to elaborate its development status and clinical analysis.