1.Single stage and staged cochlear implant for chronic suppurative otitis media suffers.
Tao PAN ; Zijian WANG ; Jia KE ; Ke ZHANG ; Furong MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2013;27(22):1227-1231
OBJECTIVE:
To explore and summarize the operation method and operation stage for cochlear implant with chronic suppurative otitis media, to provide the clinical reference for cochlear implant with chronic suppurative otitis media.
METHOD:
The clinical data of 6 cases of cochlear implant with chronic suppurative otitis media from Jun 2006 to Mar 2009 in our hospital was analyzed retrospectively. The operation stage. surgical skill, possible risk and prognosis was analyzed and summarized.
RESULT:
3 of 6 cases received single stage subtotal petrosectomy and cochlear implant. 3 of 6 cases received subtotal petrosectomy, they received staged cochlear implant 1 to 6 months later. No complications occurred, all of the cochlear implanted had good open set speech perception.
CONCLUSION
Staged operation was the first choice for cochlear implant with chronic suppurative otitis media. Single stage operation took potential risks, it should be done cautiously. The key points for the operation was the clearance of the pathological tissue totally, this required good surgical skill and operation instrument.
Adolescent
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Aged
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Chronic Disease
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Cochlear Implantation
;
methods
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Female
;
Humans
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Male
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Middle Aged
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Otitis Media
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surgery
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Retrospective Studies
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Treatment Outcome
2.The relationship between coagulation-coagulation suppression system disorders and portal vein thrombosis in portal hypertensive patients
Qinghua ZHANG ; Ke LU ; Gang XU ; Guanyu YAO ; Wanneng PAN
Chinese Journal of General Surgery 2013;28(10):774-777
Objective To explore the correlation between coagulation and coagulation suppresion system disorders of portal vein thrombosis in patients of portal hypertension undergoing splenectomy.Methods Clinical data of 33 patients with postoperative portal vein thrombosis were enrolled.The clotting and coagulation inhibitor in portal vein blood and peripheral blood was detected and analyzed.Results The Hb,APTT,FIB,factor Ⅶ,protein C,AT-Ⅲ,CD62P of portal vein blood and peripheral blood before the surgery and on postoperative day 1,day 7,day 14 were no significant difference (P > 0.05).The WBC,PLT,PT,D-Dimer of in portal vein blood before surgery were (2.9 ± 1.4) × 109/L,(37.5 ± 20.7) × 109/L,(16.1 ± 2.9) seconds,(0.7 ± 0.3) μg/ml,which were significantly different from those on postop day 1 (13.7 ±4.4) × 109/L,(86.3 ±34.6) × 109/L,(6.9 ±5.7) seconds,(16.1 ±2.9) μg/ml; day 7 (10.7 ±4.3) × 109/L,(312.4 ±137.2) × 109/L,(14.4 ±2.9) seconds,(7.6 ±4.4) μg/ml and day 14 (7.7 ± 3.3) × 109/L,(486.3 ± 216.7) × 109/L,(14.4 ± 2.9) seconds,(5.5 ± 4.4) μg/ml (P < 0.05).WBC,PLT,PT,D-Dimer in preop peripheral blood were (2.4 ±0.8) × 109/L,(44.4 ± 25.8) × 109/L,(16.3 ± 3.0) seconds,(0.6 ± 0.4) μg/ml,which were significantly different from those on postop day 1 (13.7 ± 5.7) × 109/L,(75.1 ± 29.3) × 109/L,(13.7 ± 2.6) seconds,(6.8 ± 5.3) μg/ml; day 7 (10.6 ± 4.8) × 109/L,(337.9 ± 141.3) × 109/L,(14.0 ± 2.1) seconds,(7.6 ± 5.5) μg/ml and day 14 (7.8 ±3.9) × 109/L,(504.9 ±237.4) × 109/L,(14.0 ±2.1) seconds,(5.4 ±4.9) μg/ml postoperative (P < 0.05).Conclusions The cause of postsplenectomy portal vein thrombosis is multifactorial.The dysfunction of coagulation-coagulation suppression system was just one of the conditions conducive to portal vein thrombosis after splenectomy.
3.136 cases of the kidney injury were analyzed retrospectively
Ke PAN ; Zhizhong TANG ; Kaizhong ZHANG ; Aiming WU
Chinese Journal of Primary Medicine and Pharmacy 2005;0(02):-
Objective To improve the diagnosis and treatment of the kidney injury.Methods 136 cases of the kidney injury were analyzed retrospectively.Results 5 cases died,the other cases were cured.69 cases were followed up for 1~3 years,the cystic kidney function was all normal.Conclusion On time,accurate proceed assessment for the kidney injury,controlling strictly the digit advertises for the operation or not operation is a key to treating kidney injury.
4.The prevention and cure that bleeding after transurethral resection of prostate
Ke PAN ; Zhizhong TANG ; Kaizhong ZHANG ; Aiming WU
Chinese Journal of Primary Medicine and Pharmacy 2006;0(07):-
Objective To explore the prevention and cure methods of the urethra prostate electricity cutting(TURP) on the bleeding after the benign prostatic hyperplasia(BPH) treating.Methods 35 cases with BPH of the bleeding patients after TURP were statistically analyzed.Results 26 examples turned for the better after general treatment;6 examples turned for the better after resectoscope wash gore and gave or got an electric shock the hemostasis;3 examples changed to the surgical operation hemostasis cured.Conclusion Accurate disposal inside operation and process behind operation is a key to decrease bleeding after the TURP of the BPH.
5.Clinical analysis of tympanosclerosis: characteristics and treatment.
Shaoxing ZHANG ; Furong MA ; Tao PAN ; Jia KE ; Ke ZHANG ; Yu SONG ; Liwei JIANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(14):1238-1242
OBJECTIVE:
To explore the clinical characteristics, diagnosis and surgical management of tympanosclerosis.
METHOD:
The data of 73 patients who underwent surgery for tympanosclerosis were retrospectively analyzed with respects to the clinical characteristics, diagnosis and management.
RESULT:
Seventy-three patients with tympanosclerosis (involving 73 ears) , including 17 patients with sclerosis of tympanic membrane (type I), 23 patients with fixed Malleus-incus complex (type II), 8 (type III) with fixed stapes, and 25 (type IV) with extensive typannosclerosis. Sclerosis was seen most frequently in the malleus, incus and attic, followed by the tympanic membrane, incudomalleolar joint and other regions. Audiometry was performed for all the patients 1 weeks before and 1 year( the least) after operation, which were (51.70 ± 14.93)dB HL and (36.24 ± 11.58) dB HL respectively, with success rate 83% (61/73).
CONCLUSION
Most of the patients suffer from conductive hearing loss. Teatment of the sclerosis around stapes is a key point. Acording to the sites of lesion and hearing level, hearing structures should be reconstructed by the rules of tympanoplasty and stapes surgery.
Audiometry
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Ear, Middle
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pathology
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Hearing
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Hearing Loss, Conductive
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complications
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Humans
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Incus
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pathology
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Malleus
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pathology
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Myringosclerosis
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diagnosis
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surgery
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Retrospective Studies
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Stapes
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pathology
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Stapes Surgery
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Tympanic Membrane
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pathology
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Tympanoplasty
6.Prognostic value of inflammation-based scores and TNM stage for pancreatic cancer patients after radical resection
Zijian SU ; Qunxiong PAN ; Chongren WANG ; Jianhua ZHANG ; Shaoying KE ; Shengli ZHANG
Chinese Journal of Pancreatology 2016;16(5):298-304
Objective To compare the prognostic value of different inflammation-based prognostic scores and Tumor Node Metastasis ( TNM) stage for patients undergoing radical resection of pancreatic cancer with the routine TNM stage in clinical practice.Methods Clinical data of 185 patients with pancreatic cancer who underwent radical surgery were retrospectively analyzed.Based on the inflammation-based prognostic scores ( Glasgow prognostic score ( GPS ) , neutrophil lymphocyte ratio ( NLR ) , platelet lymphocyte ratio ( PLR) , prognostic nutritional index ( PNI ) and prognostic index ( PI ) ) before surgery, univariate and multivariate analyses were used for identifying influential factors on patients′survival.Homogeneity of different scoring systems was compared using likelihood ratio chi-quare test, and linear trend chi-square test, and receiver operating characteristic ( ROC) curve were performed to compare the differentiating ability and single trend of the selected scores with those of routine TNM stage.Results In univariate analysis, preoperative weight loss, serum C-reactive protein, serum albumin, CA19-9, radical surgery, NLR, PLR, GPS, PI, PNI and TNM stage were all significantly associated with patients′overall survival after surgery (P<0.001).In multivariate cox risk model analysis, TNM stage, radical surgery, GPS, NLR, PLR, PI and PNI were independent risk factors for patients′survival after surgery.ROC curve showed that GPS had higher AUC than other scoring systems, but TNM stage had the highest AUC.The homogeneity, differentiating ability and single trend of GPS were higher compared to other inflammation-based prognostic scores, but those of TNM stage were the highest.Conclusions The inflammation-based prognostic scores like GPS, NLR, PLR, PI and PNI were independent prognostic factors for pancreatic caner patients′survival after surgery, and the prognostic value of GPS was superior to that of NLR, PLR, PI and PNI.
7.Aapplied analysis of radiotherapy apparatus schedule optimization for tumor patients
Guishan FU ; Peng HUANG ; Pan MA ; Ke ZHANG ; Zhong ZHANG ; Jianrong DAI
Chinese Journal of Radiation Oncology 2015;24(2):176-179
Objective To design and develop a treatment unit selecting system in aim of enhancing work efficiency and safety,adjusting treatment unit workload,improving quality of medical care.Methods Various treatment techniques,immobilization devices and setup verification devices were modeled in software.Workload of treatment units were extract from the Record and Verify System.These two types of information were then combined with the unit's workload capability to calculate the optimal radiotherapy apparatus for tumor patient.Results The system had finished selecting radiotherapy apparatusv for more than 5 000 patients since its taking place of the old patient selecting methods.Maximum variation of daily treatment duration between treatment units had decreased from 4-5 hours (mean 4.22 hours) to 1-2 hours (mean 1.84 hours) since the system have been put into operation.Workload and device configuration of various units could be controlled by easily editing of the system configuration file.Conclusions The system developed not only accomplish patient selecting in an optimal and safe way,but also provide a way of easily control the treatment unit workload.
8.Therapeutic effect of compound danshen solution on hemorrhagic shock combined with coagulopathy in rats.
Jing-Ye PAN ; Yan-Jie ZHANG ; Ming-Shan WANG ; Ke-Ke JING
Journal of Experimental Hematology 2005;13(3):456-459
To investigate the effects of complex danshen solution and heparin on the changes of blood coagulation factors in rats with hemorrhagic shock, and to explore the therapy of coagulopathy by compound danshen solution, the rat model of hemorrhagic shock was set up, 40 SD rats were randomized into four groups: sham operation, shock, compound danshen solution and heparin groups, each group was composed of 10 SD rats. Plasma SFMC, TM, ATIII, D-D, t-PA, PAI levels and APTT were detected, incidences of bleeding complications between heparin and danshen group were compared. The results showed that plasma SFMC, D-D levels in shock group were higher but ATIII level in shock group was lower than that in sham operation group, compound danshen solution group and heparin group (P < 0.001), TM levels obviously increased in shock group and heparin group (P < 0.001). There was no significant difference between compound danshen solution and sham-operation groups. Plasma t-PA, D-D levels obviously increased after shock for 2 hours, PAI level reached the peak after shock for 4 hours, but t-PA decreased. After shock for 6 hours, plasma PAI descended, t-PA continually drop in, but PAI and D-D remained in higher levels. Plasma D-D level in heparin group was lower than that in shock group, t-PA level was higher than that in shock group, but there was no significant difference between in heparin and shock groups. Plasma t-PA, PAI and D-D levels in compound danshen solution group were lower than that in shock group. APTT of danshen group was lower than that of shock group and heparin group. Bleeding incidences was 30% in heparin group and 0% in danshen group, respectively. It is concluded that compound danshen solution may used to treat hypercoagulation and hyperfibrinolysis. In comparsion with heparin, danshen posses-ses advantages of safety with less bleeding complication and needs not tight monitor.
Animals
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Anticoagulants
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therapeutic use
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Blood Coagulation
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drug effects
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Blood Coagulation Factors
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metabolism
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Drugs, Chinese Herbal
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therapeutic use
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Female
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Fibrin Fibrinogen Degradation Products
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metabolism
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Heparin
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therapeutic use
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Male
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Partial Thromboplastin Time
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Phytotherapy
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Plasminogen Activator Inhibitor 1
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blood
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Random Allocation
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Rats
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Rats, Sprague-Dawley
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Salvia miltiorrhiza
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chemistry
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Shock, Hemorrhagic
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blood
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drug therapy
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Thromboplastin
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metabolism
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Tissue Plasminogen Activator
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blood
9.Immune responses specific for ESAT-6 expressed by recombinant Salmonella typhimurium
Hui ZHANG ; Liu LIU ; Shizhong GENG ; Maozhi HU ; Ke WEN ; Zhiming PAN ; Xinan JIAO
Chinese Journal of Microbiology and Immunology 2009;29(6):528-532
Objective To determine the immune responses induced by recombinant Salmonella ty-phimurium expressing the secreting antigen ESAT-6 of Mycobacterium tuberculosis. Methods ESAT-6 cod-ing gene was cloned and identified by PCR and sequencing. Prokaryotic expression plasmid pYA33-esat car-rying the ESAT-6 coding sequence was constructed firstly and electro-transformed into an attenuated strain X4550 of Salmonella typhimurium, the recombinant bacteria was named as X4550(33-esat). C57BL/6 mice were immunized intranasally (I. N) with 108 CFU recombinant bacteria at day 0 and 18. Cells from spleen, lung, mesenteric lymph node (MLN) and Peyer's patch (PP) were collected from mice after second immu-nization, and the specific IFN-γ-secreting cells and IL-4-secreting cells were detected by ELISPOT assay u-sing ESAT-6 peptide as stimulus. Furthermore, CTL effects were in vivo evaluated by CFSE assay. Results The results showed that cellular immune responses specific for ESAT-6 could be detected by ELISPOT assay. In lung and PP cells, immune responses against ESAT-6 were biased toward Th1 type, the frequency of IFN-γ-secreting cells was much higher than that of IL-4-secreting cells. In splenocytes and MLN cells, the anti-gen specific immune responses acted as Thl and Th2 balance, the frequency of IFN-γ-secreting cells was close to that of IL-4-secreting cells. CFSE assay indicated that recombinant bacteria could induce the high level of CTL effects specific for ESAT-6 peptide. Conclusion These results suggested that recombinant Sal-monella typhimurium X4550(33-esat) not only can induce cellular immune responses, but also can elicit specific CTL responses after I. N immunization. It also provided the useful information for the control of infec-tious disease of tuberculosis.
10.An experimental study of EUS-guided radiofrequency ablation of porcine pancreas in vitro
Peng PAN ; Dong WANG ; Zhaoshen LI ; Lei WANG ; Huagao ZHANG ; Ke QI ; Zhendong JIN
Chinese Journal of Pancreatology 2014;14(5):312-315
Objective To investigate the extent of radiofrequency ablation of pig pancreas in vitro with various power and duration,and to establish the regression equation of radiofrequency ablation of porcine pancreas in vitro.Methods Among the 4 settings of power (from 5 w ~ 20 w) and 11 settings of duration (from 40s ~ 240s),44 combinations were selected,and every combination was performed twice,then a randomization table including 88 combinations was established,and 88 ablation procedures on porcine pancreases in vitro were performed.The uhrasonography changes were observed,ablation widths (Y) were measured,and pathological examination was performed.In order to construct optimal model and to establish the regression equation of radiofrequency ablation,9 parameters (duration,power,duration × power,the square of duration,the square of power,the square root of duration,the square root of power,the natural logarithm of duration,the natural logarithm of power) derived from duration and power were analyzed via stepwise regression method.Results A rectangular echo enhanced region was observed along the working area of catheter when radiofrequency ablation started,and it gradually became wider during ablation.A hoar-like cylindrical ablation region that was clearly different from surrounding normal pancreatic tissue was formed.Carbonation of necrotic tissue could be observed after radiofrequency ablation under 15 w or 20 w.The optimal model showed a linear positive correlation between ablation width (Y) with the square of power and the natural logarithm of duration.The coefficient of determination of this model was 0.71.Both Fitting curve and Residual scatter diagram showed good fitting effect.Finally,a significant regression equation of radiofrequency ablation was established:Y (mm) =0.005 × E2 + 0.9374 × ln (t)-0.6943.Conclusions A significant regression equation of radiofrequency ablation is established,which provides experimental base for EUS-guided radiofrequency ablation of pancreatic tumors in clinical practice.