[ABSTRACT]OBJECTIVETo study the clinical effect of CO2 laser in the treatment of hypertrophic ventricular dysphonia.METHODSFrom December 2011 to December 2013, 40 patients with hypertrophic ventricular dysphonia were treated in our department. Conservative treatment had no valid for all of them. All the patients were examined with strobolaryngoscope and voice analysis (including fundamental frequency, jitter, shimmer and harmonic to noise). After general anesthesia, the hypertrophic ventricular cords were excised with CO2 laser under suspension laryngoscope.RESULTS The Hoarseness were better in all the patients after operation. The ventricular cord and mucosal waves of the vocal cord were normal. The jitter and shimmer were lower than that before operation, but the fundamental frequency and harmonic to noise were higher than that before operation. There were no complications. CONCLUSIONThe treatment of hypertrophic ventricular dysphonia with CO2 laser under suspension laryngoscope is safe, reliable and practical.

Diagnostic methods play important role in theoretical system of Inner Canon of Huangdi.There are 74 articles about diagnostic methods,which contains near 50 kinds of TCM diagnostic methods referred to pulse diagnosis,colour inspection and so on.This paper analyze the connotation and extension of the term "diagnostic method",establish a theoretical framework of dynamic whole concept,bi-directional discrimination,characteristics of triple pathogens and four kinds of methods.The diagnostic model of"shape-spirit-transporting qi"and the modern language"nature-biology-psychology-society" four-dimensional diagnostic method are constructed.

Objective To investigate the evaluation of different levels of QRS-T angle in patients with acute myocardial infarction (AMI).Methods A total of 186 AMI patients from January 2010 to May 2016 in our hospital as the research object.The review method was used to analyze the clinical and followup data of the patients.The left ventricular ejection fraction (LVEF),plane QRS-T angle,white blood cell (WBC) and isoenzyme count and creatine (CK-MB) were evaluated and compared.Results (1) The age of the patients with heart failure was larger than that in the patients with normal heart function,and the proportion of myocardial infarction and hypertension and diabetes distributionthe in two groups had statistically significant difference (P ＜ 0.05);(2) The WBC and CK-MB levels of patients with normal cardiac function were lower than those in patients with heart failure.The planar QRS-T angle ＜ 50 degrees,between 90 degrees and 100 degrees and more than 100 degrees were statistically significant between normal heart function patients and failure heart function patients (P ＜ 0.05),and with the decrease of LVEF the levels of QRS-T angle increased;(3) The sensitivity and specificity of 90 degrees ≤ QRS-T angle ＜ 100 degrees and QRS-T angle greater than 100 degrees were 96.32％ and 95.98％,95.02％ and 94.68％,and those were different with the sensitivity and specificity of WBC,CK-MB and other QRS-T angle(P ＜ 0.05).Conclusions Different planar QRS-T angle on the evaluation of cardiac function insufficiency has certain clinical value,but when the 90°≤ QRS-T angle ＜ 100° and QRS-T angle ≥ 100° have better sensitivity and specificity with no difference between two QRS-T angles.The QRS-T angle≥ 90° can be used as one of the indicators for the evaluation of cardiac function insuffieiency.

Enzyme-linked immunosorbent assay ( ELISA) was applied to detect the antibody against CoxA16 and EV71 among 0~14 age groups. In 1 000 cases of children, the total positive rate of anti-EV71 IgM was 19. 9%, the total positive rate of anti-EV71 IgG was 47. 7%, the total positive rate of anti-CoxA16 IgM was 22. 8%, the to-tal positive rate of anti-CoxA16 IgG was 51. 3%. There was a negative correlation between positivity for EV71 IgM and positivity for CoxA16 IgM(χ2 =2. 794,P>0. 05). There was also a negative correlation between positivity for EV71 IgG and positivity for CoxA16 IgG(χ2 =2. 793,P>0. 05). The positive rate of IgG antibody against CoxA16 and EV71 was higher in neonatal group in which anti-EV71 IgG was 41 . 5% and anti-CoxA16 IgG was 49 . 5%. The lowest positive rate of IgG antibody against CoxA16 and EV71 was in infant group in which anti-EV71 IgG was 38. 0% and anti-CoxA16 IgG was 43. 5%. Except for neonatal group,the positive rate of IgG antibody against Cox-A16 and EV71 increased gradually with the age growth, there were statistical differences among the age groups (χ2=27. 04 and 19. 98,P<0. 01). With the age growth,the positive rate of IgM antibody against EV71 and CoxA16 increased,there were statistical differences among the age groups(χ2 =41. 12 and 37. 13,P<0. 01). There were not statistical differences between gender groups (χ2 =0. 51,1. 77,0. 36 and 2. 12,P>0. 05).

Humans ; Occupational Exposure ; Paraquat ; poisoning

Objective To explore a new therapeutic method to intractable rejection after liver transplantation.Methods Low dose prograft and rapamycin were given to 2 patients with intractable acute rejection and 2 patients with intractable chronic rejection confirmed by biopsy after liver transplantation, which had no response to normal treatment. The blood concentration of prograft was controlled in 3～5 ?g/L and rapamycin in 6～12 ?g/L. Rapamycin was withdrawn and prograft was increased to normal dose while the rejections were rectified.Results Four allograft rejections were all reversed in the end with this method. In the course of this therapy, one of the 4 patients had CMV pneumonia and cured with antiviral therapy. One had diabetes and another's diabetes got more critical. The blood glucose recovered to the primary level after the withdrawal of rapamycin.Conclusion The intractable acute and chronic rejection which has no response to normal treatment can be reversed by combined use of low dose prograft and rapamycin.

Objective To discuss the long-term effect of orthotopic liver transplantation to patients with hepatic myelopathy. Methods The clinical data of 2 patients with hepatic myelopathy undergoing liver transplantation were analyzed retrospectively. The condition of recovery of muscle strength of the patient's double lower limbs was carefully observed both pre-and post operatively. Results The patient's clinical symptoms were well improved and liver function recovered to normal. Hepatic myelopathy was controlled. The follow-up duration of 2 cases was 18 and 43 months respectively. The muscle strength of lower limbs was recovered from 1 degree to 3 and 4 degree respectively. Conclusion Liver transplantation can effectively control the development of hepatic myelopathy and it is obviously useful for recovery of double lower limbs.

Objective To explore the clinical and pathological characteristics and surgical treatment of primary retroperitoneal neurogenic tumor(PRNT). Methods 93 cases of PRNT were confirmed by operation and pathology from 1990 to 2003, and their clinical data were analyzed retrospectively. Results Primary neurogenic tumor accounted for 93 of 452 patients with primary retroperitoneal tumor in the same period. They included 24 cases of neurilemoma(25.8%), 19 cases of malignant neurilemoma(20.4%), 14 cases of chemodectoma(15.1%), 16 cases of neurofibroma(17.2%), and 20 cases of other rare tumors (21.5%) . The diagnostic rate of CT and MRI was 65.6% and 73.9%, respectively. In all but two patients the tumors were resectable. The resectability rate was 97.9%(91/93). The 3-year and 5-year survival rate in patients with benign and malignant tumors were 95.9%,80.1% and 42.4%,10.5%, respectively. There were 8 cases(13.1%) and 14 cases(43.8%) with recurrence after operation in benign and malignant tumors respectively. Conclusions CT and MRI are helpful in diagnosis. Surgical resection is the first choice of treatment. Prognosis in benign tumor is good, but postoperative recurrence of malignant tumor is frequent.

Objective To investigate the effect of transcutaneous electrical nerve stimulation (TENS) on baseline eyes-closed brain activation and on pain-related EEG activity when TENS is applied contralatarally to the hand of pain. Method 128-channel electroencephalography (EEG) was recorded in four conditions including baseline,heat pain test,TENS stimulation and contralateral TENS modulation in 15 right-handed healthy young males. The Short Form McGill Pain Questionnaire was employed to assess pain sensation. Fast Fourier Transformation analysis (FFT) was performed to calculate absolute EEG power spectra based on 7 bands spectrum. Results ① The fronto-central beta-1 activity was significantly enhanced by TENS compared to eyes-closed [eyes-closed:(290±201)μV2,TENS:(385±224)μV2,t=3.323,P<0.01].②TENS markedly relived pain sensation assessed by SF-MPQ and significantly increased the posterior-anterior alpha-1 power [pain:(332±221)μV2,TENS modulation:(378±243)μV2,t=3.683,P<0.01] and fronto-central and posterior beta-1 activities [pain:(348±213)μV2,TENS modulation:(397±240)μV2,t=2.362,P<0.05]. Conclusion TENS,used as a peripheral nerve stimulation,mainly activates sensorimotor cortex.The increased Alpha-1 activity implies that TENS is likely able to relieve pain affective.