Congresses as Topic ; Humans ; Otorhinolaryngologic Surgical Procedures ; Voice ; Voice Disorders ; surgery

The epidemiology of inguinal hernia,the mesh's side effects on the spermatic cord,the spermatic cord blood vessels,the was deferens and the testicular in inguinal hernia hemiorrhaphy of tension-free were reviewed.The effects of the inguinal hernia herniorrhaphy and the mesh in clinical and animal experiments which affected on the male reproductive function such as the location.extent and pathological changeswere summarized,and the mechanism of the tension-free inguinal herniorrhaphy affecting the male reproducrive function were discussed.Improvingthe operation skills and the more appropriate choice of the mesh may protect the male reproductive function in tension-free inguinal hernia hemiorrhaphy.

Objective To explore the mRNA expressions of NLRP1 (NOD-like receptor 1 ) and NLRP3 inflammasomescomponents and related pro-inflammation cytokines in peripheral blood mononuclear cells (PBMCs).Methods A total of 21 septic patients,20 non-infectious SIRS patients and 20 health subjects were enrolled in this study.The mRNA expressions of inflammasomes components and related proinflammation cytokines were measured by using RT-PCR,and serum levels of IL-1β and IL-18 were measured using ELISA.One-way ANOVA was usedd to compare the data of all three groups,and SNK-q was employed to compare thedata among different groups.Spearman correlation analysis was used to analyze the correlation between these biomarkers and the severity of septic patients.Results ①The mRNA expression of NLRP1 in PBMCs of septic patients in early stage and non-infectious SIRS patients was down-regulated in comparison with healthy subjects (P ＜0.01 ).The expression of NLRP3 in septic patients was not differentfrom that in healthy subjects ( P ＞ 0.05 ),but NLRP3 mRNA expression in non-infectious SIRS patients was significantly higher than that in septic patients and in healthy subjects ( P ＜ 0.01 ).ASC ( apoptosis associated speck like protein containing a CARD) and caspase-1 mRNA expressions in septic patients and non-infectious SIRS patients were higher than those in healthy subjects ( P ＜ 0.01 ).There was no difference in level of IL-1β found among all groups.IL-18 mRNA expression in septic patients and non-infectious SIRS patients was higher than that in healthy subjects ( P ＜ 0.01 ),and that in non-infectious SIRS patients was highest.②)Serum protein level of IL-1β in septic patients was lower than that in healthy subjects (P ＜0.05 ),and serum level of IL-18 in septic patients was significantly higher than that in non-infectious SIRS patients and in healthy subjects ( P ＜ 0.01 ).③NLRP1 was negatively related to SOFA ( sepsis-related organ failure assessment) score (r =-0.44,P ＜ 0.05 ) and negatively related to APACHE Ⅱ score as well ( r =- 0.52,P ＜ 0.05 ).Conclusions NLRP1 mRNA expression was down regulated in patients with early sepsis and its expression was negatively correlated to the severity of septic patients,indicating the lower NLRP1 mRNA expression the severer illness.

Objective To investigate the clinical effect of arthroscopic debridement combined with patellofemoral peripheral denervated operation in treating patellofemoral arthritis.Methods One hundred cases of patellofemoral arthritis anterior knee pain in this hospital from January 2014 to September 2015 were selected and randomly divided into the observation group and control group,50 cases in each group.The control group was given the arthroscopic debridement treatment,while the observation group was given the arthroscopic debridement combined with patellofemoral peripheral denervated operation.The visual analogue scale (VAS) before and after treatment,and Lysholm and Kujala scores after treatment were compared between the two groups.Results There was no statistically significant difference in the VAS score before treatment between the two groups (P＞0.05).After treatment,the VAS score in the two groups were significantly decreased,moreover the VAS score in the observation group was lower than that of the control group (P＜0.05).After treatment,the Lysholm scores in the observation group and the control group were (80.93±4.21) points and (74.29±4.48) points,the knee Lysholm scores of claudication,joint noose,bearing weight,pain,instability,up and down stairs,jump,run,joint swollen and pain,squats were significantly better than those in the control group (P＜0.05);aftertreatment,the Kujala total score in the observation group and the control group were (76.48±6.54) points and (68.34-±-6.22) points respectively,the Kujala scores of claudication,walking distance,bearing weight,squat,up and down stairs,jumping,running,knee pain,long time kneebend,abnormal patellofemoral activity,anterior knee swelling,knee bending limitation,thigh muscle atrophy in the observation group were significantly better than those in the control group(P＜0.05).Conclusion Arthroscopic debridement combined with patellofemoral peripheral denervation surgery in the treatment of patellofemoral osteoarthritis can obviously relieve pain and improves the knee function and patellofemoral joint function.

ObjectiveTo observe the status of social supports of the patients with advanced cancer and probe the effective nursing measures to improve the social supports of the patients.Methods"Social support rating scale"of Xiao Shui-yuan was applied to investigate the social support state of a total of 58 advanced cancer patients and 63 patients with chronic diseases.ResultsThe total score of patients with advanced cancer was(32.86±6.86),of patients with chronic diseases was(41.83±7.88).Compared with chronic disease group,the patients with advanced cancer received less social supports(P<0.05).The marriage state and economic income were significant factors to influence social support.ConclusionsThe patients with advanced cancer received less social supports than patients with chronic disease.Nursing staff should evaluate the status of social supports correctly,provide health education on patients and members in the net of social supports,make use of relative resources,then improve the social support level of the patients.

Objective To analyze the effect of one-part form mini-implant in treatment of immediately and delayed repair of edentulous space. Methods Retrospectively analyzed 80 cases of edentulous space patients in our hospital from Jan. 2009 to Jan. 2011, and divided them into the immediately repair group ( observation group) and the delayed repair group ( control group) according to time of edentulous space repair. Patients of the two groups were given permanent PFM 3 months later, and regular clinical and X-ray examinations were made to evaluated clinical efficacy and complications of the two groups. Results The score of ISQ of the observation group was higher than that in the control group with significant difference (P <0. 05); and the postoperative complications of the observation group was significantly decreased compared to the control group with a significant difference (P <0. 05). Conclusion Mini-implant used in immediately repair in edentulous space can remove pain in a short time with less postoperative complications, it has more advantages than delayed repair of edentulous space.

Objective To explore the CD4 + CD25 + Foxp3 + regulatory T cell percentage and plasma levels of soluble CD25 molecules in peripheral blood of septic patients and their clinical value through prospective study. Method A total of 37 septic patients and 15 non-infectious SIRS patients, who conformed to the criteria of SIRS and sepsis which proposed by American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference ( ACCP/SCCM ) in 1997, were collected in ICU of Ruijin Hospital ( Shanghai Jiaotong University) from February 2009 to February 2010. Twenty-four health people were from Medical Center of Ruijin Hospital, who were excluded infection and (or) autoimmune diseases. There were 26 male and 11 female in sepsis group, average age ( 61.67 ± 11.87 ) years old; 8 male and 7 female in SIRS group, average age (67.06 ± 12.57)years old; 14 male and 10 female in health control, average age (56.54 ± 6.37 )years old. All selected patrents were excluded the autoimmune diseases and (or) patients within recent (30 days) had used or now used immunosuppressive agents. We therefore measured the Treg cell percentage in peripheral blood by Flow Cytometry and the plasma levels of IL-2sRa, IL-4, IFN-γ by ELISA. The data were analyzed by analysis of variance or nonparametric Kruskal-Wallis H test. Results ① The percentage of CD4 + CD25 + Foxp3 + regulatory T cells among septic patients, SIRS patients, and control group was: ( 66.82 ± 21.79 ) %, ( 51.79 ± 21.79 ) %, ( 56.45 ± 10. 68 ) %, respectively. septic patients showed the highest percentages of CD4 + CD25 + Foxp3 + regulatory T cell among CD4 + CD25 + T cells(P ＜ 0.05 ). ② The plasma levels of soluble CD25 in septic patients (425. 619 ± 270.12 ) were significantly higher than SIRS patients (381. 664 ± 189.83) and the control group ( 164. 1 32 ± 56.37 ) ( P ＜ 0.05 ). ③ The correlation analysis between the concentration of soluble CD25 molecules in plasma and the ratio of CD4 + CD25 + Foxp3 + regulatory T cells to CD4 + CD25 + T cells showed Spearman correlation coefficient =0.390, P = 0.003 ( P ＜ 0.05 ). Conclusion: the expression of natural regulatory T cells characteristically increased in septic patients. And the levels of soluble CD25 in peripheral blood were related to the percentages of natural regulatory T cells, which simplified the assessment of the immune status in Septic patients.

Objective To investigate the effect of argenin-glycin-aspartic acid (RGD) peptides on islet viability and function. Methods Rats were randomly divided into 2 groups: 1640 group and RGD group. Ficoll was used to purify islet in a discontinuous-density-gradient way. Islet concentration is 27% ,25% ,23% ,20.5% and 11% respectively. Acridine orange/ethidium bromide(AO/EB) fluorescent staining method was adopted to observe the effect of RGD peptides on islet viability. Radioimmunoassay was adopted to detect insulin level and measure insulin secretion index (SI). Caspase-9 cells and phospho-Akt 473-positive cells were determined by flow cytometry to investigate the influence of RGD peptides on caspase-9 activity and Akt. Results 600-700 IEQ islet was extracted from each rat by Ficoll purification through modified gradient centrifugation. AO/EB stain showed islet survival rate was more than 95% immediately after separation. Islets cultured in the medium of RPMI-1640 showed SI of 1.64 ±0.28 after 1 week, while islets cultured in the medium of RPMI-1640 containing RGD peptides showed SI of 2.28 ± 0.16 (P ＜ 0.05 ). Flow cytometry showed the level of activated caspase-9 was ( 22.66 ± 3.56 ) % if islet was cultured in RPMI-1640 alone for 1 week while the level was( 10.54 ± 1.96) % if islet was cultured in RPMI-1640 containing RGD peptides. There was statistical difference ( P ＜ 0. 05 ). The effect of RGD on Akt phosphorylation was also detected. Akt phosphorylation proportion was (31.47 ±4.08)% 1 week after cultured in RPMI-1640 while the value was(61. 054 ±6.03)% if cultured in RPMI-1640 containing RGD peptides. The difference had statistical significance (P ＜ 0. 05). Conclusion RGD peptides could inhibit apoptosis through the phosphorylation of Akt/PKB.

Objective To discuss the feasibility of laparoscopic closure of the internal ring and high ligation of the hernial sac in children with indirect inguinal hernia.Methods Laparoscopic closure of the internal ring and high ligation of the hernial sac was conducted in 21 children with indirect inguinal from January 2003 to December 2004 in this hospital.A 5-mm 30? laparoscope was introduced through the umbilicus.The internal ring and the posterior crus(PC) on the side of hernia were identified.A 3-mm dissection forceps was placed on the midline between the umbilicus and pubic symphysis.At the skin projection of the internal ring on the side of hernia,a round-tip needle with 3-0 Prolene suture grasped by a regular needle holder was passed directly into the abdominal cavity to suture the posterior crus and then penetrate out of the abdomen via the roof of the internal ring through the musculoaponeurotic arch of the transversus abdominis.Then the Prolene suture was cut off,and passed by using the Endoclose device into the extraperitoneal cavity at the skin projection of the internal ring.The dissection was continued from without outward around the sac to encircle the neck and an extracorporeal high circumferential ligation of the sac was finished.Results The operation was successfully completed in all the 21 cases.The operating time was 16~50 min(mean,32.9 min),the postoperative duration in hospital was 1~2 d,and the time to normal activity,1~4 d(mean,1.4 d),respectively.No postoperative bleeding,hematoma of scrotum,or incisional infection occurred.Follow-up checkups in the 21 cases for 1~24 months(mean,15 months) showed no recurrence.Conclusions Laparoscopic closure of the internal ring and high ligation of the hernial sac is a novel,feasible,reliable and effective herniorrhaphy for the treatment of pediatric indirect inguinal hernia.

Objective To explore the feasibility of la pa roscopic total extraperitoneal hernia repair without the use of the balloon diss ector. Methods Laparoscopic total extraperitoneal hernia repai r using no balloon dissector was completed in 10 cases of groin hernia from Nove mber 2003 to April 2004, including 7 cases of indirect inguinal hernia, 1 case o f occult indirect hernia combined with direct inguinal hernia, and 3 cases of di rect inguinal hernia (1 of which was recurrent hernia). Results All the 10 operations were successful. The mean operation time was 69.5 min, t he mean blood loss was 11 ml, the mean postoperative hospital stay was 2.1 days , and the mean duration to normal activities, 5.2 days.Complications included 1 case of disassociated inferior epigastric artery, 1 case of operation in wrong anatomic layer, and 1 case of laceration of the peritoneum, respectively. Follow -up observations for 1~6 months found no recurrence and neuropathic pain. Conclusions Laparoscopic total extraperitoneal hernia repair without the use of the balloon dissector is feasible, safe and effective.