Blepharoplasty ; Eyelids ; abnormalities ; injuries ; Humans ; Surgical Flaps

Background and purpose:Nowadays, about therapy of laryngeal carcinoma, people are paying more and more widely attention to ifnding out how to improve quality of patients’ life besides radical surgery. For glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, we performed modiifed frontolateral partial laryngectomy or modiifed cricohyoidoepiglottopexy, and contrastive analyzed the therapeutic efifcacy of the two ways. Methods:Sixty cases patients of glottic laryngeal carcinoma who treated in Hunan Provincial Tumor Hospital during 2005 to 2010, which invaded the anterior commissure or bilateral vocal cord, were randomly attributed to two groups as A and B;30 patients of group A were underwent modiifed frontolateral partial laryngectomy and repaired with bilateral sternohyoid muscle lfap, 30 patients of group B were treated by modiifed cricohyoidoepiglottopexy. Follow-up time of each patient was 5 years postoperation and clinical data were retrospectively analyzed. Results:The 5-year survival rate was 86.7%in group A as well as 83.3%in group B, and there was no statistical difference between two groups (P=0.718). Pronunciation function:22 cases in group A and 21 cases in group B whose pronunciation function can be competent in the noisy environment, and can pronounce“a”and“i”vowel;8 cases in group A and 9 cases in group B can pronounce only a“ha”,“hi”sound, that couldn’t communicate with others in a noisy environment. There was no statistical difference in pronunciation function between the two groups (P=0.774). Incidence of deglutition disorder 4 weeks postoperation:group A was 0 (0/30), group B was 16.7%(5/30), and the difference between the two groups was statistically signiifcant (P=0.026);average time of extubation postoperation:group A was (10±2.3) d, group B was (20±4.6)d, and the difference between the two groups was statistically signiifcant (P=0.0000);recurrence rate of dyspnea after extubation:group A was 16.7%(5/30), group B was 0 (0/30), and there was statistically signiifcant difference between the two groups (P=0.026). Conclusion: For the glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, there was no statistical difference in 5-years survival rate and function of pronunciation between modified frontolateral partial laryngenctomy and modified cricohyoidoepiglottopexy postoperation. The former had less postoperative deglution disorder, earlier extubation time, and to some extent, alleviated the suffering of the patients, but part of these patients needed secondary surgery due to dyspnea which resulted by radioactive tissue adhesion after extubation. The latter had more serious deglution disorder postoperation, longer recovery time, and relatively longer time to extubating, showed no again dyspnea after extubation, and had more extensive adaptation disease. In a word, each way of operation has its advantage respectively.

Objective To investigate the application of computer radiography system in combination with high kV radiography technique to diagnose cardiac disease.Methods 30 patients with cardiac disease were taken chest photographs,which chest photographs by CR system and high kV radiography technique were compared with these by common high kV radiography.Results The good rate of air tube occupied is 98% in therapy group,but the rate is only 70% in common group.The discrepant comparison is significant differences.Conclusion It is more significant that CR system in combination with high kV radiography technique than common photograph to diagnose cardiac disease.

Objective The controlled release BMP-2 and implantation into the acoustic bulla of the guineapig and the effects on the cochlea were observed.Methods The acellular cancellous bone was prepared,accompanied with BMP-2.The material accompanied with BMP-2 was implanted into one acoustic bulla of the animal,and the opposite side of the acoustic bulla was implanted with acellular cancellous bone without BMP-2.A total of 20 guinea-pigs were undergone this procedure.The ABR was tested on the animals before and after the operation immediately and 3 month after operation,respectively.3 month after operation,the animals were sacrificed.The osteogenesis induced by BMP-2,the acoustic bulla and the cochlea affected by BMP-2 were observed.The structures of hair cells were observed after being treated with silver nitrate.Results The animals recovered soon after surgery.The hearing thresholds of the animals reduced slightly after the operation,and recovered completely 3 month after.The bulla and the cochlea were normal in shape.The osteogenesis occurred in the pore of the acellular cancellous bone with BMP-2.No abnormal hyperplasia of bone in the hulla and the cochlea was found.The articulation between the stapes and oval window was not merged.The shape of the hair cells was normal and no obvious deletion of the hair cells was noted when compared with control group.Conclusion The controlled release BMP-2 could induce osteogenesis in the bulla of the animals.This material did not affect the shape of the bulla and the hearing thresholds.They did not induce any abnormal hyperplasia of bone in the bulla and might be used to reconstruct the affected ossicles.

OBJECTIVE To analyze the reasons of misdiagnosis and surgical complications of primary lymphoma of thyroid gland(PLT). METHODS The clinical data of 10 patients with PLT in our hospital from 1992 to 2006 were retrospectively analyzed. RESULTS All of 10 patients were misdiagnosed,the major surgical complication was hoarseness. CONCLUSION The misdiagnosis of PLT is often encountered. Mastering the clinical features,using fine-needle biopsy,rapid biopsy combining immunocytochemical method can diagnose the primary lymphoma of thyroid gland.

OBJECTIVE:To observe the preventive effect of Ca/Mg infusion combined with glutathione and carbamazepine on oxaliplatin-induced neurotoxicity.METHODS:65patients treated with oxaliplatin,5-fluorouracil and leucovorin for gas-trointestinal cancer were divided into treatment group undergoing treatment with Ca/Mg infusion combined with glutathione and carbamazepine,and control group without any preventive treatment.RESULTS:At the third cycle,7patients in the treat-ment group but17patients in the control group showed clinically evident neurotoxicity,which demonstrated the statistical difference between the two groups(P=0.036).After12cycles,neurotoxicity of grade2to3was observed in2patients in the treatment group but in9patients in the control group,which demonstrated the statistical difference between the two groups(P=0.022).CONCLUSION:Ca/Mg infusions combined with glutathione and carbamazepine can prevent oxaliplatin-induced neurotoxicity.

Objective To study the surgical treatment of major blood vessels invaded by tumors in order to raise the resection rate and postoperative survival rate. Methods Clinical data were analyzed on 26 patients undergoing (resection) of tumors along with reconstruction of major blood vessels from October 1998 to February 2004. Results Tweety-three cases were followed up for 2～65 months with median 42.8 months. Doppler ultrosonography and CTA examination were performed respectively during the follow-up process.In 5 patients with carcinoma of the head of pancreas who had inferior vein cava replaced and in 1 patient with cholangiocarcinoma who had portal vein replaced,3 were complicated with carcinoma embolism formation at 3,12 and 15 months respectively after surgery,(postoperative) graft patency was 50%;all of the 6 patients had recurrence of the tumor at 3,6,8,12,24 and 31 months respectively after surgery.Seven patients with tumor in pelvic cavity or in posterior space of peritoneum were followed up for about 2 years,1 of them had tumor recurrence ,but the graft kept patent,2 patients with sarcoma in the limbs were followed up for 1 year without tumor recurrence or vessel obstruction.Eleven patients with tumors in the neck were followed up for 3 months to 5 years without tumor recurrence or vessel obstruction. Conclusions (Combination) of resection of neoplasm and reconstruction of major blood vessels is safe,effective and practical method for patients with major wessels invaded by tumor.

Background and purpose:The pedicled pectoralis major myocutaneous lfap has been a common choice of tissue lfaps for head and neck reconstruction. Nowadays, with rapid advancement in microsurgery, free lfaps gradually replace the pedicled lfaps. However, not all patients are good candidates for reconstruction surgery using free tissue lfaps. Adjacent pedicled lfaps are safer and more reliable. This paper explores potential application of pedicled pectoralis major myocutaneous flap in reconstruction of complex surgical defects following resection of advanced head and neck malignancies through modification of their preparation and repair method.Methods:Flap design scheme and method of preparation were modiifed to improve the pectoralis major muscle lfap. Fifty-one patients with surgical defects from resection of head and neck malignancies received reconstruction surgery using modiifed pectoralis major muscle lfaps.Results:Modiifed pectoralis major muscle lfaps survived completely in 51 patients. The area of defect regained its shape and appearance after reconstruction surgery. The area of defect obtained excellent functional recovery. Postoperative functional injuries to the donor sites were minimized.Conclusion:Modiifcation in designing and preparing method of the pectoralis major muscle flap improved repair range and distance in reconstruction of complex surgical defect following resection of head and neck malignancies. It also reduced necrosis rate of skin lfaps. Postoperative donor and recipient sites regained their appearance and functions successfully. The pectoralis major muscle lfap is one of the important tissue lfaps used in reconstruction of surgical defect following resection of a head and neck malignancy.

Objective To explore the effect of chitosan on vascular smooth muscle cells inhibited proliferation from rabbit arteriovenous fistula and its mechanisms.Methods Established rabbit fistula model on carotid arteryinternal jugular vein.After 1 month cultured VSMCs with primary culture by tissue-pieces inoculation.Cultured VSMCs were divided into three groups:①normal control group.②FBS-treated group:cell were treated with 5％,10％,20％ for 48 h,respectively; established the model of rabbit VSMCs proliferation.③chitosan-treated group:VSMCs cultured with 20％ FBS were exposed to different doses of chitosan(10,100,500,1000,2000μg/ml) for 48 h.And VSMCs were treated for different time (0,12,24,48 h) with Chitosan 1000 μg/ml.Expression levels of PCNA and TLR4/ NF-κB were detected by Western blotting.RT-PCR were applied to measure the mRNA expression of PCNA and TLR4.The protein levels of TLR4 and NF-κB were detected by immunofluorescence.Results Compared with low concentration serum group,FBS-treated VSMCs exhibited a increase in mRNA and protein expression of PCNA and TLR4.FBS-induced protein expression of PCNA and TLR4/NF-κB were reduced by chitosan.Also mRNA expression of PCNA and TLR4 were reduced.They were dependent on concentration and time.In rabbit VSMCs TLR4 was mainly expressed in the cytoplasm and NF-κB expressed mainly in the nucleus.Compared with normal control group,TLR4 and NF-κB protein expression were significantly decreased by chitosan.Conclusion High concentration serum induced VSMCs proliferation.Chitosan can inhibit the proliferation of rabbit VSMCs.It is speculated that the mechanism may be related to the expression of TLR4 receptor activation,reducing expression of downstream factor MyD88 and NF-κB.It is suggest that chitosan can become potential new drugs of arteriovenous fistula prevention of intimal hyperplasia.

OBJECTIVE:To study the bioequiavailability of domestic roxithromycin tablets and imported ones.METH?ODS:20male healthy volunteers took single dose of150mg roxithromycin tablet orally in a random crossover design,blood concentrations were determined by LC-MS.RESULTS:The main pharmacokinetic parameters of domestic and imported tablets were determined respectively as follows,AUC 0～72 were(72.81?23.85)(mg?n)/L and(72.63?20.86)(mg?h)/L,AUC 0～∞ were(74.41?24.45)(mg?h)/L and(74.42?24.45)(mg?h)/L,C max were(6.46?1.51)mg/L and(6.58?1.55)mg/L,t max were(1.9?0.5)h and(1.8?0.5)h,t 1/2 were(13.56?1.35)h and(14.18?1.50)h,the relative bioavailability of the homemade tablet to imported one was(99.8?11.2)%.CONCLUSIONS:Domestic and imported roxithromycin are bioequivalent.