Adenolymphoma ; metabolism ; pathology ; surgery ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; Humans ; Keratins ; metabolism ; Ki-67 Antigen ; metabolism ; Male ; Metaplasia ; pathology ; Middle Aged ; Parotid Neoplasms ; metabolism ; pathology ; surgery

BACKGROUND: The clinical application of one-level osteotomy and multilevel osteotomy has been well documented, but currently few studies were reported to compare their biomechanical characteristics.OBJECTIVE: To investigate the biomechanical characteristics of one-level osteotomy with Dick screw fixation and multilevel osteotomy with Luque instrumentation in the treatment of kyphosis.DESIGN: Randomized comparative experiment.SETTING: Laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University.MATERIALS: Fresh specimens of thoracic and lumbar spinal segments obtained from 12 3 or 4-year-old calves.METHODS: The experiment was conducted in the laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University between September 2002 and September 2003. Fresh spinal segments T8-L5 from 12 calves were randomized into an intact group, Dick screw group with one-level osteotomy with Dick screw fixation and Luque group with multilevel osteotomy with Luque instrumentation, with 4 spesimens in each group. Lateral bending test of the specimens was performed to examine the physiological overload using an Instron 5 500 universal material testing machine at the constant speed of 10 mm/minute until fracture or dislocation was induced. Changes in the loading were recorded and the induced injuries observed to obtain the load-displacement curve of the injury test.MAIN OUTCOME MEASURES: The load-displacement curve of the destructive right bending test in each group.RESULTS:All the data of 12 canines were involved in the result analysis.The spinal segments of the intact group yielded to the force of 3 600 N with a flat and smooth load-displacement curve, and those of Dick screw group yielded to a load of 2 800 N with also a relatively flat curve, while in Luque group, the segments did not yield until a load of 7 160 N, followed by drastic decrease of the resistance to less than 4 000 N, generating a flat and smooth curve afterwards.CONCLUSION: Luque instrumentation is a little more preferable than Dick screw in terms of the maximum resistance, but this difference does not justify the clinical decision of their superiority. Both techniques benefit postoperative recovery of spinal function with strong stability.

Objective To summarize the methods of diagnosis and results of surgical treatment of pancreatic insulinoma. Methods The clinical data of 137 patients with insulinoma treated in our hospital during the past twenty-six years were reviewed retrospectively.Results There were 77 males and 60 females. All of them were characterized by the Whipple′s triad. The sensitivity of ultrasonography, CT and MRI for localization was 35.1%, 67.9% and 58.1% respectively. One hundred and tweenty-six patients underwent operation. Of them, 102 cases had tumor enucleation, 4 cases had pancreaticoduodenectomy, 16 cases had distal panreatectomy, and the other 4 cases had only laparotomy. Of the 122 patients, who underwent resection, the tumor was benign in 118(96.7%) and malignant in 4(3.3%). The diameter of the tumor was less than 2cm in 86.9% of cases. In 98.4% of cases the tumors were single and in 1.6% of cases were multiple. 13.1% of the tumors located in the head, 46.7% in the body, and 40.2% in the tail.Conclusions Whipple′s triad and the measurement of fasting glucose, IRI, IGR, C-peptide, and proinsulin levels contribute to the diagnosis of insulinoma. However, the preoperative tumor localization is still difficult. Tumor enucleation is the technique of choice when feasible. Patients in whom tumor localization is unsuccessful at operation should be carefully evaluated to be certain of the diagnosis, and in general should not undergo blind resection.

OBJECTIVE To investigate bacterial contamination of throat spray in different patient groups before and after using it and explore the satisfactory disinfection methods for decreasing the rate of hospital acquired infection.METHODS The methods were used in accordance with Disinfection Technology Criteria.We compared the germicidal effect of five kinds of methods.RESULTS Bacterial contamination was very serious after using throat spray,many bacteria,even pathogens,as well as the normal flora from the region of nasopharynx had been found there.Bacterial contamination was more serious in ENT department patient than in endoscopy patient after using throat sprays.Burning,alcohol,iodophor and disinfectants containing iodine with alcohol were better than oxidized potential water method on disinfection effect.CONCLUSIONS Much attention should be paid to the contamination of throat spray,selecting the most effective disinfection methods,hospital infections caused by invasive manipulation could be prevented when correct methods are adopted.

ObjectiveTo diagnose and classify 249 patients with myelodysplastic syndrome (MDS) according to the WHO standards.MethodsAccording to the WHO standards,cell morphology,cytogenetics,immune phenotype and bone marrow pathologic biopsy in 249 cases of MDS were analyzed.ResultsGreat shape and oval cell of mature erythrocyte could be observed in all MDS patients peripheral blood. The incidence of immature erythrocyte,immature granulocyte,pelger-like abnormal nucleus and neutrophils cells without granular increased with subtypes progressing.These abnormal characteristics and proportion tended to more apparent with MDS subtypes progressing.With the dynamic follow-up,we found the rate of MDS transition to AL increased with subtypes progressing(P＜0.05 ).The immune phenotype analysis of 148 patients was undertook and found that the trend to express myeloid specific antigen (CD33) increased gradually with subtypes progressing The chromosome inspection in 138 patients was undertook and found that 53 patients (38.7 ％ with abnormal karyotype,mainly in 20q- and +8;16 cases with complex abnormal karyotype (28 ％), two patients in 5q-. 180 patients were underwent bone marrow biopsy at the same time and found that 19 patients with abnormal morphology;42 patients with bone marrow fibrosis.ConclusionsCombining with multiple index to detect the MDS contributes to the classification and diagnosis more accuratcly and long-term follow-up helps to judgment the prognosis.

Objective To explore the effect of anterior decompression plus posterior intradural release in treatment of old thoracolumbar fractures with paraparesis. Methods A total of 22 patients with old thoracolumbar fractures with paraparesis were admitted to our hospital since January 2004 to Jan-uary 2008. Before admission, all patients were treated with decompression and internal fixation with pos-terior pedicle system, with bony compression to the spinal cord found through CT scanning and intact spi-nal cord found by MRI but without obvious neurofunction recovery. Of all, 20 patients were kept with the original posterior fixation except for two patients that were fixed with Z-plate after removal of posterior hardware. Autologous bone grafts from iliac were utilized in all patients. Intradural release was done 3-6 months after anterior decompression. Results Of all, 19 patients were followed up for 17-49 months (average 28 months). Twenty patients obtained varied recovery of neurofunction after anterior decompres-sion, with ASIA motor scores increasing from average 59.4 points before decompression to 71.3 after de-compression. The followed-up patients won further recovery after secondary posterior intradural release, with ASIA motor scores further increasing to average 80.6 points. Conclusion For patients with old thoracolumbar fractures combined with paraparesis, the release of intradural sear and fibrocompression is also important besides anterior decompression.

Objective To study the relationship between the expression of cytochrome c ( Cyt c) and programmed cell death 4 (PDCD4) in pancreatic cancer, and investigate the pathway of PDCD4 inducing the apoptosis of pancreatic cancer cells. Methods Pancreatic cancer specimens from 69 patients who received pancreatic resection from 1990 to 2002 in First Affiliated Hospital of China Medical University were collected. The expression of Cyt c in the 69 paraffin specimens of pancreatic cancer was detected by immunohistochemistry, and the expression of Cyt c in 8 samples of cold-preserved fresh pancreatic cancer and normal pancreatic tissues were detected by Western blot. The expression of PDCD4 and Cyt c in pancreatic cancer was analyzed by paired t test and chi-square test. Results Compared with normal pancreatic tissues, the expression of Cyt c in pancreatic cancer was significantly decreased. The positive expression rate of Cyt c in 69 samples of pancreatic cancer was 41% (28/69). The expression of Cyt c was positive in most patients with positive expression of PDCD4, and the expression of PDCD4 was negative in most patients with negative expression of Cyt c. The expression of PDCD4 and Cyt c was closely correlated with each other (χ2= 10.52, P < 0.05). Conclusions There is a close relationship between the expression of PDCD4 and Cyt c in pancreatic cancer. PDCD4 may induce the apoptosis of pancreatic cancer cells through mitochondrial pathway.

Objective To observe the variations in intraocular pressure(IOP)in vocal cord polyp resections supported by pedestal Iaryngoscope with Tono-Pen tonometer.Methods The IOP of patients (grade Ⅰ-Ⅱby ASA)who underwent vocal cord polyp resections supported by pedestal laryngoscope were detected by Tono-Pen tonometer 5 minutes later on supine position before the operation(T1),5 minutes later on cervical hyperextension position before the operation(T2),5 minutes later on cervical hyperextension position after the operation(T3),5 minutes lateron supine position after the operation(T4),20 minutes later on supine position after the operation(T5)after general anesthesia respectively.At each point the changes of mean arterial pressure(MAP),heart mte(HR),end-tidal carbon dioxide partial pressure(PETCO2),and airway pressure(PAW)were observed as well.Results There were no differences in MAP,HR,RETCO2,PAW at each point statistically.The IOP increased significantly at T2,T3,T4 compared with IOP at T1[(19.0±1.8),(25.7±1.9),(17.8±1.9)mm Hg(1 mm Hg=0.133 kPa)vs(11.9±1.7)mm Hg](P＜0.05).The differences between IOP at T2 and T3 were manifest(P＜0.05).So it Was the situation when the IOP at T3 and T4,T4 and T5 were compared(P＜0.05).The IOP at T5 was(12.1±1.5)mm Hg,there was no difference compared with T1.Conclusion The IOP increases gradually from the point when the patient put on cervical hyperextension position before the operation after general anesthesia and achieves the summit when the patient put on cervical hyperextension position after the operation,finally,decreases back to the preoperative level when the patient put on supine position after the operation.

Aim To study and compare the pharmaco-kinetic parameters of roxithromycin under normoxic and hypoxic rats. Methods A highly effective and rapid ultra-performance liquid chromatography with tandem mass spectrometry ( UPLC-MS/MS) method with posi-tive electrospray ionization source was successfully de-veloped and validated for quantification of roxithromy-cin in rat plasma. Sprague-Dawley rats were randomly divided into the hypoxia and normoxic groups. Each rat obtained a single dose of roxithromycin with 10 mg · kg-1 via intragastric administration. The pharmacoki-netic parameter comparison between normoxic and hy-poxic groups was calculated by SPSS software using in-dependent sample t test method. Results The main pharmacokinetic parameters of roxithromycin between the normoxic and hypoxic rats were:the AUC(0-t) 7 576 and 3 761 μg·h·L-1 , MRT(0-t) 5. 6 and 7. 7 h, T1/2 3. 4 h and 3. 9 h, CL 1. 5 and 3. 0 L · h-1 · kg-2 , tmax3. 1 and 3. 4 h, Cmax 1 116 and 372 μg·L-1 , re-spectively. The levels of Cmax and AUC of roxithromy-cin in hypoxic rats were statistically lower than those in normoxic rats. Conclusion The exposure level of rox-ithromycin in hypoxic rats markedly decreased. Our re-sults may provide an important experimental basis to adjust the dosage for roxithromycin in hypoxic clinical practice.

OBJECTIVETo investigate the clinical effects and operative options for the treatment of Forestier disease.

METHODSFrom June 2005 to May 2012, 8 patients with progressive dysphagia due to Forestier disease were treated through anterior approach, their clinical data were retrospective analyzed. There were 6 males and 2 females, aged from 65 to 83 years old with an average of 73 years. Among the patients, osteophytes removal was performed in 3 cases, osteophytes removal with discectomy and fusion was performed in 2 cases, osteophytes removal with corpectomy and fusion was performed in 3 cases. According to Bazaz dysphagia score to assess the improvement of the patients' symptoms before and after operation.

RESULTSAll patients were followed up from 12 to 40 months with the mean of 18.5 months. Seven cases were asymptomatic and 1 case had mild symptom in the last follow-up. Radiographs showed the space enlargement between vertebral body and trachea.

CONCLUSIONIt is effective to treat patients with progressive dysphagia due to Forestier disease through surgical method. And the operative options depend on the stability of cervical spine and the neurological symptoms of the patients.