OBJECTIVE: To study the efficacy of treatment with microsurgery in combination with local injection of type A botulinum toxin for vocal process granuloma. METHOD: 28 patients with vocal process granuloma received endotracheal intubation under general anesthesia. The lesion was removed with micro-scissor and CO2 laster under a self-retaining laryngoscope and microscope. The incision and mucous membrane surrounding the wound was closed with 8-0 absorbable suture. 4-point injection of botulinum toxin type A 8-15 u was then performed along the thyroarytenoid muscle and arytenoid muscle of the same side. Postoperative medication was administered based on disease causes. RESULT: All patients experienced vocal cord dyskinesia of the injected side 2-3 days after surgery. At 1 month after the surgery, wound healing was good in all the 28 patients, and the vocal cord movement was limited at the injected side. At 3 months, movement of the bilateral vocal cords was normal, and the vocal cord process mucosa was smooth. Patients were followed up for more than a year, and only one patient had recurrence in 2 months after surgery. The cure rate was 96. 4%. CONCLUSION Combination of laryngeal microsurgery and type A botulinum toxin local injection can shorten the treatment course of vocal process granuloma.
Anesthesia, General ; Botulinum Toxins ; administration & dosage ; Granuloma ; drug therapy ; surgery ; Humans ; Injections ; Intubation, Intratracheal ; Laryngeal Mucosa ; Laryngeal Muscles ; Laryngeal Neoplasms ; drug therapy ; surgery ; Laryngoscopes ; Larynx ; Microsurgery ; Postoperative Period ; Recurrence ; Vocal Cords ; Wound Healing

Objective To explore the effect and side effects of Group A Streptococcus Preparation(Sapylin)com-bined with mitomycin and lentinan combined with mitomycin in treating malignant pleural effusion through intrapleural catheter.Methods 70 malignant pleural effusion patients were selected in this study.All the patients were randomly divided into Sapylin group and lentinan group.One case with penicillin positive of the Sapylin group was adjusted to enter the lentinan group.After drainage of pleural effusion,the patients were divided into Sapylin group (34 patients) and lentinan group (36 patients).For the Sapylin group,Sapylin was prior injected and mitomycin was posterior injected.For the lentinan group,lentinan was prior injected and mitomycin was posterior injected.The side effects and clinical effect were observed and reported.Results The effective rate of Sapylin group was 85.3%,whereas 83.3%of lentinan group.There was no significant difference between the two groups(χ2 =0.051,P =0.822).Both groups had the following minor side effects:chest pain,fever,vomit and decreased white blood cells.No liver or renal injuries were reported.Conclusion The clinical outcomes of Sapylin combined with mitomycin and lentinan combined with mitomycin are both positive,in addition,the side effects are minor.

Acupuncture was frequently used for alternative treatments in Parkinson's disease because of its safety,but there was an argument whether acupuncture improves motor symptoms or not.Besides,few electrophysiological studies were designed for acupuncture combined with Parkinson's disease Using the technique of paired transcranial pulse magnetic stimulation,we measured the excitability of corticocortical inhibitory circuits to investigate effects of scalp acupuncture from 9 patients with Parkinson's disease.Although patients didn't take any short-term benefit in motor symptoms through the treatment of scalp acupuncture,there was no any adverse event,and some electrophysical effects developed in patients.The enhanced corticocortical inhibition on motor cortex possibly developed at longer interstimulus intervals,and there was a relatively increase in later part of motor-related cortical potentials on the central part and right-side near vertex around over sensory cortex,but was not significant in early potentials.So a further long-term study is essential to ascertain the physical mechanism and clinical effects in scalp acupuncture.

Objective To build a simulation model for outpatients queuing,using data from a general outpatient cardiovascular clinic of a general hospital in Shanghai and different rules in the process.The study employs time-interval controlled mode for appointment registration,for the purpose of analyzing characteristics of different queues.Methods Extraction of data of the clinic in a given month by means of HIS system to determine the parameters of the queuing models.Building the simulation model with Matlab to develop the plan of mixed queues and that of discrete queues,for analyzing the waiting time variations,with different number of doctors on duty and different number of appointments in one time interval.Resnlts In the Monday mornings for example,the mean waiting time of appointments or no-appointments are calculated by simulation with different queuing rules,different number of doctors on duty and different appointment quantities of one time interval.Conclusion The mean waiting times of appointments and no-appointments can be both sizably cut short by means of time-interval controlled appointment; different queuing plans are recommended for different departments; the simulation model should be further verified and optimized in practice.

Abstract BACKGROUND:Studies have found that Cu-Zn superoxide dismutase (SOD1) is associated with familial amyotrophic lateral sclerosis, opening up a new way of studying molecular genetics. So far more than 100 kinds of SOD1 gene mutations have been found. OBJECTIVE:To analyze the hot spot, research front and knowledge base of amyotrophic lateral sclerosis visualy. METHODS:Totaly 4 693 relevant articles published from 2005 to 2014 were retrieved from Web of Science in ISI with “Cu-Zn superoxide dismutase” or “SOD1” as search keywords. With the aid of CiteSpace III software, the visualization mapping of the network in co-cited articles and keywords was drawn to reveal knowledge base, hot spots and research front of SOD1. The parameters include the number of published papers and citations within 10 years, distribution of research countries and institutions, main source journals, research area of highly cited papers, keywords with high-frequency and emerging keywords with high-frequency in recent 5 years. RESULTS AND CONCLUSION:The number of published papers and citations in a year showed a trend of sustained growth. United State, China and Japan rank the top three in this area, in which Chinese Academy of Sciences has a great influence among the research institutions. The research fields of SOD1 focus on neurosciences and neurology, biochemistry and molecular biology and so on. The high impact factors of journals with a large number of articles reflect the importance and innovation of this research. Ten high-cited articles consist of the knowledge base on SOD1, directing to the finding of different sites of SOD1 mutation and the measurement of protein concentrations and activity of SOD. The hot spots of SOD1 mainly focus on oxidative stress, familial amyotrophic lateral sclerosis caused by SOD1 mutation and different types of transgenic animal models. The research fronts mainly focus on the finding of pathogenesis in amyotrophic lateral sclerosis, such as the aggregation of TDP-43, the interaction between astrocytes and motor neurons, optineurin and the inhibitor of nuclear factor-κB, hexanucleotide repeat expansion in C9ORF72 and autophagy.

Objective To investigate the incidence of thyroid space occupying lesion by ultrasound imaging in patients with breast cancer.Methods From 2009 to 2012,150 patients with breast cancer as experimental group and another 150 patients with breast benign diseases as control group underwent thyroid ultrasound examination.Ultrasound results of the two groups were analyzed to find the differences.Restult More obvious space occupying lesions were found in experimental group than those in control group (P＜0.05).Conclusion The incidence rate of thyroid space occupying lesion in the patients with breast cancer is higher than that in the patients with no breast cancer.

0.05).Conclusion The upper limit threshold of fasting U-Ca/Cr ratios in healthy premenopausal women is established,which can provide a reference for the bone metabolism of patients on the high-turnover status.

This study was aimed to investigate short-term modulation mechanism of scalp acupuncture according to the experimentation of cortical excitability and motor-related cortical potentials in ten normal volunteers.Through scalp needle stimulation in specific theoretical areas related to underlying cerebral surfaces,scalp acupuncture can be used as an effective therapy by changes in relative cerebral function,which is the basic principle.According to the available neurophysiological data in our study,the modulation of scalp acupuncture displayed in late part of motor-related cortical potential noticed mainly in the motor and sensory cortexes,contralateral to the needle stimulate site.Also,acupuncture can develop inhibition at longer interstimulus intervals,in paired pulse magnetic stimulation,from the somatosensory input of contralateral sensory cortex via scalp needle stimulation.In our study,it might be difficult to produce more acupuncture inhibition.The maintaining of scalp needles subcutaneously without other management after achieving needling sensations cannot achieve the requested strength of the acupuncture stimulation.

OBJECTIVE To evaluate the value of Epworth sleepiness scale(ESS) combined with home-based portable monitoring(PM) in the diagnosis of patients with obstructive sleep apnea syndrome(OSAS). METHODS Adult OSAS patients who visited Beijing Tongren Hospital and complained of snoring were included in this study. The overnight polysomnography(PSG) and the ESS were completed at the sleep center and the portable multi-channel monitoring was completed within one week. Subjects were divided into two groups according to their apnea hypopnea index(AHI) of PSG: simple snoring or mild OSAS group(AHI<15/h) and moderate-severe group(AHI≥15/h). The ESS score, respiratory disturbance index(RDI) of PM and other parameters were compared and the correlation of AHI with ESS scores, RDI were analyzed. The sensitivity and specificity of ESS score≥9 points, RDI≥15/h in the diagnosis of moderate-severe OSAS were calculated. RESULTS A total of 51 subjects were included in this study with 42 males(82.4％) and 9 females(17.6％). Mean age was(43.8±10.8) years, and the mean body mass index was(27.9±4.5)kg/m2; ESS scored 1-24 points and mean(8.6±5.0) points, 18 cases with ESS score ≥9 points; AHI ranged between 2.5 and 99.8/h with a mean of(37.4±29.8)/h. There were 19(37.3％) and 32(62.7％) patients in snoring-mild group and moderate-severe group, respectively. There was significant difference for ESS scores between the two groups(9.9±5.1 vs 6.6±4.2 points, P<0.05),RDI in moderate-severe OSAS group was significantly higher than that in snoring-mild group[(49.4±23.1)/h vs (6.8±4.5)/h, P<0.001)]. There was a positive correlation between the ESS score and PSG derived AHI(r =0.435, P =0.002); the PM derived RDI were significantly correlated with PSG derived AHI in snoring-mild group(r =0.706, P=0.001), moderate-severe group(r =0.873, P=0.000) and patients with ESS score ≥9 points(r =0.967, P=0.000). At a PSG threshold AHI=15/h, the sensitivity and specificity for ESS score ≥9 points were 45.2％ and 78.9％; the PM derived RDI≥15/h had a sensitivity and specificity of 84.4％ and 84.2％, respectively; the sensitivity and specificity for each individual screening tool along with the combination of ESS and PM were 100.0％ and 100.0％. CONCLUSION ESS combined with PM diagnostic method is a valuable measure for the diagnosis of moderate and severe OSAS patients.

Objective To investigate the effects of human amniotic membrane on the survival of the crossboundary perforator flap in rats through distal subcutaneous implantation.Methods From February,2016 to December,2016,38 SD rats weighing 270-300 g were randomly divided into experimental group and control group (n=19).A three-territory perforator flap (3 cm× 10 cm) with the iliac artery as the pedicel elevated on the right dorsum of the rats.Experiment group,a section of amnion was sutured to the distal subcutaneous of the flap and then the flap was sutured back to its donor site.Control group,after the flap elevated,directly sutured back to its donor site.The blood flow of the pedicel were detected by laser Doppler flowmetry at the day before surgery,1 day after surgery,3 and 7 days after surgery,with 3 rats in every group.When the rats were anesthetized,biopsies were taken from the choke area Ⅱ at the day before surgery,3 and 7 days after surgery,with 9 rats in every group.When the rats were anesthetized,HE was used to compare the diameter size of the artery and vein at the same site.At day 7,measure the survival area of the flap,and 3 of them observe the vessel of the flap by lead oxide-gelatine technique.Results The survival rate of the experimental group and the control group after 7 days were (89.09±4.23)％ and (74.56-±5.59)％ respectively,the experimental group was significantly higher than that of the control group (t=5.48,P=0.00).X-ray showed that 7 days after operation,the pedicel of iliac artery in the experimental group was bigger than that in the control group.The blood flow detection showed that the blood flow of the experimental group was higher than that of the control group (t=2.39,3.06;P=0.03,0.00,respectively) at day 1 and day 3 after surgery.Hematoxylin eosin staining showed that arteriovenous tube diameter at the Choke Ⅱ were gradually increased on the day3 and day7 after surgery in both group,but the experimental group diameter expanded multiple was higher than that of control group (t=3.52,3.50;P=0.02,0.02,respectively).Conclusion Human Amnion subcutaneous embedding may improve the blood flow of the vascular pedicle,expand the microvascular at Choke area Ⅱ,improve microcirculation,as a result to promote the survival of cross perforator flap,while the mechanism is needed to understanding.