A male patient of 71 years old was admitted due to repeated hoarseness for two years which got worse accompanied with dyspnea so that to receive tracheotomy in another hospital more than one month ago. The two vocal cord biopsies carried out in the other hospital before showed vocal keratosis and squamous cell hyperplasia. Electronic laryngoscopy result showed normal epiglottis. a lot of saliva at hypopharynx, and rough arytenoid mucosa. The supraglottic area was remarkably swollen and the glottal area can not be observed clearly. The biopsy of throat was unable to conduct. Barium swallow examination revealed no obvious space-occupying lesion in piri form fossa or esophagus. Larynx CT scan showed a space-occupying lesion in the laryngeal cavity on the right side of the neck involving the thyroid cartilage. The patient was finally treated by total laryngectomy. cervical infected tissue resection. grafting transposition with pectoralis major flap and tracheostomy. The postoperative pathology showed laryngeal verrucous carcinoma.
Aged ; Carcinoma, Verrucous ; Humans ; Laryngeal Neoplasms ; Male

Objective To study the relationship between postoperative complications and preoperative conditions of pancreaticoduodenectomy.Methods The datas from 67 patients underwent pancreaticoduodenectomy involving age,level of albumin and total bilirubin, diabetes mellitus or other merging cruns and postoperative complications and fatality rate were retrospectively analyzed. Results Incidence rate of postoperative complications, was 29.8%; fatality rate was 4.5%. The main complications were pancreatic fistula, abdominal cavity infection, upper digestive tract bleeding, cardiac insufficiency, pneumonia, slash site dehiscence, guts fistula and so on. Conclusion Perioperative and management is important in preventing complications.

OBJECTIVE: To explore the value of computer-aided design/computeraided manufacturing (CAD/CAM) technology for individual reconstruction of the thyroid cartilage defects. METHOD: Select the 20 New Zealand white rabbits (male or female). Randomly divided into two groups. Group A in the pre-operative CT scan of the throat, three-dimensional reconstruction of the thyroid cartilage imaging, surgical removal of either side of the thyroid cartilage, defect implanted in the use of CAD/CAM technology and mirror technology to produce personalized restorative materials; Group B surgical resection either side of the thyroid cartilage, defect implanted production of non-personalized probably according to the experimental animals unilateral thyroid cartilage repair materials. After surgery by gross observation, electronic laryngoscopy observed experimental animals throat. RESULT: General check and electronic laryngoscopy show: the use of CAD/CAM technology to prepare the individual repair materials throat plays better supporting role than the non personalized materials. CONCLUSION CAD/CAM technology before surgery designed to provide a personalized solid model to improve the accuracy of the surgery, time saving surgery to reduce surgical complications.
Animals ; Computer-Aided Design ; Female ; Image Processing, Computer-Assisted ; Male ; Prostheses and Implants ; Rabbits ; Reconstructive Surgical Procedures ; Thyroid Cartilage ; surgery ; Tomography, X-Ray Computed

BACKGROUND:The auditory ossicle chain reconstruction is stil an important method to treat conductive deafness. Although a great variety of materials have been applied, the blood supply of otosteon after the implantation is ignored. Moreover, there is no real bone formed.
OBJECTIVE:To observe the angiogenesis of vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold which is implanted into the otocyst of guinea pig.
METHODS:Total y 60 guinea pigs were randomly divided into experimental group (vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold), col agen I control group (col agen I modifiedβ-tricalcium phosphate porous scaffold) and blank control group (β-tricalcium phosphate porous scaffold). The guinea pigs were executed under anesthesia at weeks 1, 2, 3, 4 respectively. The surface of scaffolds was observed by scanning electron microscopy. The angiogenesis of scaffolds were observed by hematoxylin-eosin staining and CD34 immunohistochemistry staining, and then the microvascular density was counted. The osteogenesis of the scaffolds was observed by toluidine blue staining.
RESULTS AND CONCLUSION:Endothelial cel proliferation and lumen formation could be observed after 1 week in the experimental group, and the angiogenesis reach the peak after 3 weeks with traffic branches formedbetween micropores. In the other two groups, the lumen formed at 2 weeks but no traffic branches were visible. The sprouting of new blood vessels in the pores were observed more in the experimental group than the other two groups (P<0.05). The adherence and proliferation of cel s could be examined in the surface and pores of the scaffold by scanning electron microscope. After 4 weeks, the osteogenesis could be observed by toluidine blue staining, especial y in the experimental group. These findings suggest that the vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold can realize an effective vascularization in the environment of guinea pigs’ middle ear. What’s more, the scaffold also can promote bone formation.

Objective To evaluate the influence of gestational diabetes mellitus (GDM) on maternal and perinatal outcomes in twin pregnancies. Methods We retrospectively analyzed the clinical features of both twin and singleton pregnancies, which delivered in Guangzhou Women and Children's Medical Center between January 1, 2012 and December 31, 2013. The twin pregnancies were divided into two groups:those with (GDM-T, n=51) and without GDM (non-GDM-T, n=130), which were matched by maternal age and delivery time (within one month) in a ratio of 1∶2 among singleton pregnancies with (GDM-S, n=102) and without GDM (non-GDM-S, n=102), respectively. The differences of adverse maternal and perinatal outcomes among these four groups were examined. The overall assessment of pregnancy outcomes was completed using Delphi method. Statistical analysis was performed with one-way analysis of variance, t test, Kruskal-Wallis test, rank test, Chi-square test or Fisher's exact test. Results (1) When compared to GDM-S and non-GDM-S group respectively, less women conceived with the help of assisted reproductive technology, higher proportion of women underwent and gestational age at delivery tend to be earlier in GDM-T and non-GDM-T group (all P<0.01). In oral glucose tolerance test,the fasting blood glucose level of GDM-T group was higher than the other three groups (F=21.716, P<0.01), the glucose levels at 1 and 2 h were higher than non-GDM-T and non-GDM-s respectively (both P<0.01), but no significant difference was found when compared with GDM-S group (P>0.01). Similarly, no significant difference was found in prenatal glycosylated hemoglobin value between GDM-T and GDM-S group (P>0.01). (2) There was no significant difference in the incidences of hypertensive disorders of pregnancy, anemia, premature rupture of membranes, oligohydramnios, placental abruption, postpartum hemorrhage, asphyxia neonatorum, small for gestational age, hypoglycemia of newborn, hyperbilirubinemia of newborn and perinatal death between GDM-T group and the other three groups(all P>0.01). Higher incidences of hypertensive disorders of pregnancy and postpartum hemorrhage were shown in the GDM-T group than in the GDM-S and non-GDM-S groups, respectively (both P<0.01). The incidences of preterm birth in GDM-T and non-GDM-T group were both higher than that in GDM-S and non-GDM-S, respectively [54.9%(66/102), 53.8%(140/260), 5.0%(10/102) and 3.0%(6/102), all P<0.01], while no significant difference was found between GDM-T and non-GDM-T group (P>0.01). (3) The overall assessment of pregnancy outcomes did not show any difference between GDM-T group and the other three groups (χ2=6.707, P>0.01). However, the score for fetal outcomes in the GDM-T group was higher than in the GDM-S and non-GDM-S group, but lower than in non-GDM-T group [M(Q)=1.0(2.3), 0.0(3.0), 0.0(0.0), 1.0(2.8) score, χ2=122.818, P<0.01]. Conclusions GDM does not increase the risk of adverse pregnant outcomes in twin pregnancies.

Objective To investigate the two kinds if thoracic cavity closed drainage contrast analysis and evaluate the pigtail catheter for treatment of spontaneous pneumothorax in adolescents.Methods This study included 53 adolescent patients with the first spontaneous pneumothorax in Huaihe Hospital of Henan University between January 2013 and December 2015.According to the different operation ways,they were divided into two groups:silicone tube and pigtail catheter group.The following post-operative data was evaluated:pain,subcutaneous emphysema,drainage time,hospital stay,new drain insertion,and wound healing at the site of insertion.Results There were 32 patients in the silicone tube group and 21 ones in the other group.The data revealed a significantly reduced the operation time and pain in the pigtail catheter group compared to the chest tube group(P ＜ 0.05).However,no statistical differences in success rate,postoperative hospital stay and complications incidence were found between the 2 groups.Conclusion Compared to common chest tube,the employment of pigtail catheter in the adolescent patients with pneumothorax significantly reduces the operation time and pain.Nevertheless,no statistically significant differences were discovered in success rate,postoperative hospital stay and the incidence of complications between the two corresponding groups.Thus pigtail catheter is competent in terms of closed thoracic drainage in adolescents who are the first diagnosed as spontaneous pneumothorax.

Esophageal cancer (EC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening and early detection are effective in reducing the incidence and mortality of EC. The development of the guideline for EC screening and early detection in line with epidemic characteristics of EC in China will greatly promote the homogeneity and standardization, and improve the effect of EC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of EC screening, China′s national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of EC screening and provide scientific evidence for the EC prevention and control in China.

Gastric cancer (GC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening, early detection and early treatment are effective in reducing the incidence and mortality of GC. The development of the guideline for GC screening, early detection and early treatment in line with epidemic characteristics of GC in China will greatly promote the homogeneity and standardization, and improve the effect of GC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of GC screening, China′s national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of GC screening and provide scientific evidence for the GC prevention and control in China.

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.