Objective: To explore the clinical value of the treatment of bilateral vocal cord paralysis by tenoto-my and vocal process resection with CO_2 laser. Method: Eighteen cases of bilateral vocal cord paralysis after thy-roidectomy from March 2004 to June 2006 were retrospectively analyzed. Preoperative tracheotomy and CO_2 laser tenotomy and vocal process resection were performed. Result: All patients were able to breathe through the mouth and nose immediately after the operation. Fifteen patients were extubated within 8 weeks. Three patients were op-erated again after 4-6 weeks because of granulation hyperblastosis. All patients were followed up for 1. 6 years to 2. 3 years without breathing difficulties, aspiration and with satisfactory voice. Conclusion: The approach of CO_2 la-ser tenotomy and vocal process resection can effectively relieve breathing difficulty resulted from bilateral vocal cord paralysis, achieve satisfactory voice and avoid aspiration.

Objective To study the relationship between tyrosine phosphorylation(TP)and protein expression of insulin receptor substrate-1(IRS-1)and insulin resistance in patients with gestational diabetes mellitus(GDM).Methods IRS-1 expression and TP in skeleton muscle tissue were determined by Western blot and immunoprecipitation in women with GDM(GDM group,n=22),normal pregnant women(normal pregnancy group,n=22)and normal nonpregnant women(normal nonpregnant group,n=13).Fasting plasma glucose(FPG)and fasting insulin(FINS)were measured by oxidase assay and immunoradioassay. Results(1)The levels of FPG,FINS,and insulin resistance index were calculated according to homeostasis model assessment [ HOMA-IR;(5.6?0.8)mmol/L,(15.4?5.1)mU/L,and 1.2?0.5 ] in GDM group were significantly higher than those in normal pregnancy group [(4.4+0.5)mmol/L,(10.6 ?3.1)mU/L,and 0.8?0.3;P

In order to adapt to the rapid development of medical science and technology and in order to train a new generation of talented clinical students with comprehensive quality,this article further explores how to improve the teaching quality of obstetrics and gynecology through the use of a variety of teaching methods and improving the traditional teaching method.

CBS(Case Based Study)is a new teaching method,which is based on the case given.It requires students to answer questions according to the case. In the teaching,the students who are divided into groups,seek for resolvent by themselves. They should combine the information provided in the case,find the key answer and the relationship.The students gain the knowledge by reviewing and studying in the textbook,then analyse and solve questions with them. The application of CBS could make knowledge more relatively and systematic, moreover,it also make study more actively and initiatively.

Carcinoma, Medullary ; pathology ; Carcinoma, Renal Cell ; diagnosis ; metabolism ; pathology ; radiotherapy ; surgery ; Diagnosis, Differential ; Humans ; Keratins ; metabolism ; Kidney Neoplasms ; diagnosis ; metabolism ; pathology ; radiotherapy ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms, Squamous Cell ; pathology ; Nephrectomy ; Radiotherapy, Adjuvant

Antigens, CD20 ; metabolism ; Antigens, CD34 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; Male ; Melanoma ; metabolism ; pathology ; Middle Aged ; Prednisone ; therapeutic use ; Vascular Neoplasms ; drug therapy ; metabolism ; pathology ; Vincristine ; therapeutic use

Anion Exchange Protein 1, Erythrocyte ; metabolism ; Breast ; metabolism ; pathology ; surgery ; Cadherins ; metabolism ; Female ; Fibrocystic Breast Disease ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Humans ; Middle Aged ; S100 Proteins ; metabolism

Breast Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Leiomyosarcoma ; diagnosis ; pathology ; Middle Aged ; Skin Neoplasms ; pathology ; secondary

To investigate the relationships among plasma secreted frizzled-related protein ( sfrp) 5 level and body fat parameters, glucolipid metabolism, insulin resistance index, and inflammation. 89 subjects with normal glucose tolerance(NGT) and 87 patients with type 2 diabetes mellitus (T2DM) were enrolled and each group was divided into no-obese and obese subgroups. Obesity was defined as body mass index ( BMI)≥25 kg/m2 according to the World Health Organization -Western Pacific Region diagnostic criteria ( 2000 ) . Body fat parameters were measured and BMI, waist-hip ratio were evaluated, meanwhile, the levels of blood glucose-lipid parameters and fasting insulin were also determined. Insulin resistance index ( IR) was assessed by homeostasis model assessment ( HOMA) . The concentrations of plasma sfrp5 and interleukin 6 were detected by enzyme-linked immunosorbent assay. Plasma sfrp5 level in T2DM group was significantly lower than that in NGT group [(8. 35±3. 38 vs 11. 35±3. 69)ng/ml, P<0. 01]. The levels of plasma sfrp5 in subjects with obesity were also lower than those in subjects with no-obesity in both NGT and T2DM groups [(9. 46±2. 70 vs 13. 12±3. 62)ng/ml and(6. 70±2. 34 vs 10. 12±3. 45) ng/ml, both P<0. 01]. Plasma concentrations of sfrp5 in T2DM-obese group were significantly lower than that in NGT-obese group(P<0. 01). Correlation analysis showed that plasma sfrp5 levels were negatively correlated with waist-hip ratio, HbA1C, fasting insulin, triglycerides, waist circumference, fasting plasma glucose, interleukin 6, natural logarithm of HOMA-IR [ln(HOMA-IR)], and BMI(P<0. 01 or P<0. 05). Multiple linear regression showed that ln(HOMA-IR), BMI, triglycerides were independent related factors in influencing the levels of plasma sfrp5 (r2=0. 216, 0. 177, 0. 113, all P<0. 05). Plasma sfrp5 levels were decreased in obesity and T2DM subjects and were correlated with body fat disposition, glucose-lipid metabolism, insulin resistance and inflammation. Lack of sfrp5 may contribute to the pathophysiology of obesity and T2DM.

Objective To observe the effects of soybean,selenium and spirulina on hemoglobin(Hb)of rats intoxicated with fluorine and aluminiums.Methods According to body weight,84 SD rats were randomly divided into control group,high aluminum group,high fluorine group,high fluorine-aluminum group,high fluorine-aluminium intoxicated rats strengthened with soybean group,high fluorine-aluminium intoxicated rats strengthened with selenium group and high fluorine-aluminium intoxicated rats strengthened with spirulina group,12 in each group.Rats in the control group and the high aluminum group were fed with feed containing 5.2 mg/kg of fluorine and 6.8 mg/kg of aluminum.In other groups,fluorine wag 106 mg/Kg and aluminum 19.7 mg/kg.Fluorine and aluminum concentration in the drinking water of the control group and the high fluorine group were 0.69 mg/L and 0.20 mg/L,respectively.In other groups' drinking water,these values were 0.69 mg/L and 90.2 mg/L,respectively.Ninety days later,Hb concentration of the whole blood was tested.Results Hb concentration of the control group,the high aluminum group,the high fluorine group,and the high fluorine-aluminum group were (160.8±6.3),(142.2±15.9),(156.1±4.9)and(145.2±6.2)g/L,respectively.Fluorine had an effect on the concentration of Hb(F=29.56,P<0.05).The Hb concentration of the high fluorine-aluminum group,the strengthened with soybean group,the strengthened with selenium group and the strengthened with Spirulina group were(145.2±6.2),(150.7±17.7),(156.8±14.5),(154.5±17.8)g/L,respectively.Though the concentration of Hb had increased,there was no significant difference between the four groups(χ2=3.304,P>0.05).Conclusions High-dose fluorine could cause varied decrease in the concentration of Hb.However,aluminum has neitherantagonistic effect nor synergistic effect on the Hb of fluorotic Rat.Soybean,selenium and Spirulina show a trend to increase fluorotic rat's Hb,but they has no evident antagonistic effect.