[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.

Objective To discuss the effect of operations for comminuted patella fractures with cable cerclage and revised tension band. Method Retrospective study of clinical effects of 120 patella fractures cases which used cable(cable group,55 cases) or NT-PC (NT-PC group,65 cases) to internal fix.Results At 10 to 38 ( 19.50 ± 1.15 ) months follow-up, all cured well in 12 weeks. Compared with the operative time, the amount of blood loss, length of hospitalization, time for cure, the incidence of complications,there were no significant differences between two groups (P ＞ 0.05 ). The B (o)stman score of cable group [(27.0 ±0.2) scores] was better than that of NT-PC group [(25.1 ±0.6) scores](P＜0.05). Conclusion Using cable cerclage and revised tension band to internal fix for comminuted patella fractures,the operations are facile and the results are satisfactory.

ObjectiveTo evaluate the clinical effect of sulfasalazine capsulae enterosolubilis with Yunnanbaiyao for ulcerative colitis. MethodsSixty patients with ulcerative colitis were randomly divided into two groups,thirty cases in treatment group and thirty cases in control group. Patients in treatment group received sulfasalazine capsulae enterosolubilis with Ytmnanbaiyao orally,patients in control group were given sulfasalazine capsulae enterosolubilis orally only. ResultsThe total effective rate of treatment group was 90. 0％ ,clinical recovery rate was 73.3％ ;The total effective rate of control group was 66.7％ ,clinical recovery rate was 43.3％ ,the differences was statistically significant(P ＜0.05). ConclusionThe clinical effect of sulfasalazine capsulae enterosolubilis with Yunnanbaiyao for ulcerative colitis was good,and should be used furthedy.

Objective To understand the changes of Th17 cells and related cytokines in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab and its significances.Methods Patients were assigned to 4 groups,there were 20 cases in the control group,31 cases in the initial treatment group,31 cases in CHOP group and 25 cases in RCHOP group.The percentage of Th17 cells in the peripheral blood of each group was tested by flow cytometry,the related cytokines IL-17,IL-21,IL-23,TGF-β in the peripheral blood were measured by enzyme-linked immunosorbent assay.Results The percentage of Th17 cells and the levels of IL-17,IL-21,IL-23 in the initial treatment group [(0.67±0.21) ％,(5.929±1.342) pg/ml,(130.632±17.945)pg/ml,(51.681±9.808) pg/ml] and the CHOP-CR group [(1.07±0.37) ％,(6.526±0.538) pg/ml,(132.119±7.700)pg/ml,(50.245±7.668) pg/ml] were both significantly lower than those in the control group[(2.53±0.63) ％,(8.435±2.031) pg/ml,(149.265±12.316) pg/ml,(55.303±7.778) pg/ml] (P ＜ 0.05).The level of TGF-β in the initial treatment group [(370.615±98.444) pg/ml] was significantly higher than that in the control group [(311.895±73.365) pg/ml] (P ＜ 0.05).The percentage of Th17 cells and the levels of IL-17,IL-21,IL-23 in the RCHOP-CR group [(2.38±0.59) ％,(7.724±0.780) pg/ml,(148.412±7.355) pg/ml,(55.668±7.532) pg/ml] were significantly higher than those in the initial treatment group [(0.67±0.21) ％,(5.929±1.342) pg/ml,(130.632±17.945) pg/ml,(51.681±9.808) pg/ml] and the CHOP-CR group [(1.07±0.37) ％,(6.526±0.538) pg/ml,(132.119±7.700) pg/ml,(50.245±7.668) pg/ml] (P ＜ 0.05).The level of TGF-β in the RCHOP-CR group[(283.904±59.223) pg/ml] was significantly lower than that in the CHOP-CR group [(341.481±95.597) pg/ml] (P ＜ 0.05).Conclusion Th17 cells might be negatively correlated with the DLBCL development,the reduced IL-23 and elevated TGF-β might suppress the differentiation of Th17 cells.Rituximab could elevate the percentage of Th17 cells in DLBCL patients,and it is related with the effect of chemotherapy.

Objective To investigate the relationship between single-nucleotide polymorphisms of IVS13-98G/T of human protection of telomeres 1 (hPOT1) genes and gastric cancer. Methods A total of 168 patients with gastric cancer (gastric cancer group) who had been admitted to Wuwei Cancer Hospital, Wuwei People's Hospital and Liangzhou District Hospital from December 2005 to July 2006 and 156 healthy people (control group) were genotyped by polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP) method, and the relationship between the distribution of genotypes and the risk faetors of gastric cancer was analyzed. The distribution of genotypes and allele frequency between the 2 groups were compared by chi-square test. Hardy-weinberg equilibrium test was adopted to determine whether the distribution of genotypes and allele frequency were representative. Relative risk and 95% confidence interval were calculated by non-conditional Logistic regression model. Results The frequencies of genotypes GG, GT and TT of hPOT1IVS13-98 G/T were 21.4%, 41.7% and 36.9% in gastric cancer group, and 24.4%, 51.9% and 23.7% in control group. The allele frequencies of G- and T-allele were 42.3%, 57.7% in gastric cancer group, and 49.7%, 50.3% in control group. There was no significant difference in allele frequencies of G- and T-allele between the 2 groups (X~2=3.58, P>0.05). Compared with genotype TT, the relative risks for GT and GG were 0.439 (95% CI: 0.251-0.767, P < 0.05) and 0.514 (95 % CI: 0.264-0.999, P=0.05). There was no influence of different genotypes of hPOT1IVS13-98 G/T, sex, smoking history, family history of cancer on gastric cancer. Conclusion Single-nucleotide polymorphisms of IVS13-98G/T of hPOT1 may be a protective factor of gastric cancer.

Objective To explore the impact of rituximab on Th17 cells and related cytokines in patients with diffuse large B-cell lymphoma (DLBCL) in vitro and its significance.Methods 20 cases of DLBCL untreated patients and 20 healthy subjects were enrolled in the name of DLBCL group and health control group, respectively.4 peripheral blood samples were collected from every case to separate peripheral blood mononuclear cells (PBMCs), which were assigned to 4 subgroups according to different culture conditions: blank subgroup(subgroup A), rituximab subgroup (subgroup B), rituximab and serum subgroup (subgroup C) and polarization subgroup (subgroup D) (added IL-6 and TGF-β).After cultured in vitro, the percentage of Th17 cells in each subgroup was tested by flow cytometry, and the cytokine IL-17 in the abovementioned culture fluid was measured by enzyme-linked immunosorbent assay (ELISA).Results In health control group, the percentage of Th17 cells and the level of IL-17 in subgroup D [(17.12 ± 4.90) ％ and (45.735±10.012) pg/ml] were significantly higher than those in subgroup A, B, C (P ＜ 0.05), and there was no difference in each other subgroup A, B, C (P ＞ 0.05).The percentage of Th17 cells and the level of IL-17 in the DLBCL subgroup A were significantly lower than those in health control subgroup A [(0.69±0.24) ％ and (6.012±1.312) pg/ml vs (2.43±0.61) ％ and (8.217±1.681) pg/ml (P ＜ 0.05)].In DLBCL group, after cultured with rituximab, the percentages of Th17 cells in subgroup B, C, D were (2.34±0.48) ％, (2.31±0.53) ％ and (16.92±4.81) ％, and the levels of IL-17 were (7.944±1.538) pg/ml, (7.957±1.533) pg/ml and (44.417±9.881) pg/ml, respectively, which were all significantly higher than those in subgroup A.Besides, the percentage of Th17 cells and the level of IL-17 in DLBCL subgroup D were significantly higher than those in subgroup B, C (P ＜ 0.05), while there was no difference between subgroup B and subgroup C.Conclusion Experiments in vitro confirmed that the percentage of Th17 cells in PBMCs of DLBCL patients was lower than that in healthy persons, and rituximab could elevate the percentage of Th17 cells in PBMCs of DLBCL patients.

Objective To investigate the clinical efficacy of combination treatment of Ambroxol,Ipratropium and Budesonide during perioperative period in elderly patients with cardiac adenocarcinoma and chronic obstructive pulmonary disease(COPD).Methods A total of 126 elderly patients aged over 65 years diagnosed as cardiac adenocarcinoma and COPD were selected,and no chemotherapy was given to them before operation.Patients were randomly divided into experimental group(n＝ 62)and control group(n＝ 64).Intravenous infusion of Ambroxol hydrochloride and atomizing inhalation of Ipratropium were given in both groups,and the experimental group received budesonide additionally.The pulmonary function,postoperative pulmonary atelectasis,pulmonary infection,antibiotics application and hospitalization after operation were compared between the two groups.Results The forced expiratory volume at the first second(FEV1),forced vital capacity(FVC)and FEV1/FVC were higher in experimental group than in control group [(1.79 ± 0.52)1 vs.(1.33 ± 0.38)L,(2.44 ±0.43)Lvs.(1.93 ± 0.36)L and(73.91 ± 8.17)％ vs.(62.87 ± 7.23)％,respectively,allP＜0.05].The postoperative pulmonary atelectasis and pulmonary infection were lower in experimental group than in control group(4.8％ vs.15.6％,6.5％ vs.18.8％,respectively,both P＜0.05).The time for antibiotics application after operation had no difference between the two groups[(4.81±1.20) days vs.(5.98 ± 1.17)days,P ＞ 0.05].There was a significant difference in postoperative hospitalization between the two groups [(8.37 ± 0.27) days vs.(11.80 ± 0.33) days,P ＜ 0.05].Conclusions The combination treatment of Ambroxol hydrochloride,Ipratropium and Budesonide during perioperative period achieves better therapeutic effects than does the combination treatment of ambroxol hydrochloride and ipratropium in elderly patients with cardiac adenocarcinoma and COPD.

Objective To compare the effect of octreotide combined with omeprazole and omeprazole alone in the treament of upper gastrointestinal bleeding.Methods Clinical data of 101 patients with gastrointesinal bleeding were retrospectively analyzed.According to the treatment,the patients were divided into the observation group(56 cases) and control group(45 cases).The patients in observation group were given octreotide and omeprazole,and patients in control group were given omeprazol alone.Then the results of the two groups were analyzed.Results The total effective rate of observation group was 91.07％,and was higher than that of the control group(73.33％) (x2 =5.61,P ＜0.05) ;The average hemostasis time of observation group was (15.9 ±3.9)h,and was shorter than that of the control group [(23.5 ± 4.7) h] (t =1.937,P ＜ 0.05) ; The hemoglobin level of the observation group was (116.7 ± 12.4) g/h after 72 hours treatment,and was higher than that of the control group [(91.5 ± 17.3) g/h] (t =2.013,P ＜ 0.05) ;The pH of observation group was higher than that of control group after 12h,24h,48h and 72h treatment(all P ＜ 0.05).Conclusion Octreotide combined with omeprazole is effective for upper gastrointesinal bleeding,and it can shorten the bleeding time and improve the cure rate.

Objective To discuss the curative effect of transplantation using donation after cardiac death (DCD) according with Chinese standard Ⅲ (C-Ⅲ).Methods The organs were obtained from 4 DCDs from 2011 to 2012,and the clinical data of DCD transplantation were retrospectively analyzed.Withdrawal of life support occurred in the operating room.Donor warm ischemia time was 7-15 min.Results The biopsy of liver was performed on the 3rd DCD.Eight cases were subjected to renal transplantations,and 3 to liver transplantations.One patient exhibited delayed graft function of the kidney from the 4th DCD.All patients made an uneventful recovery and were discharged from the hospital without rejection or surgical complication.They were followed up in outpatient department.Conclusion The use of DCD according with C-Ⅲ is an effective way to increase the number of organs available for transplantation,and can obtain satisfactory effects.

Objective To analyze the clinical effects of the diverse prevention strategies on donation after citizen's death (DCD) donor fungal infection.Methods A retrospective study was performed on the clinical data of the antifungal preventive scheme to 261 DCD donors from January 2015 to August 2015 (the first period) and September 2015 to December 2016 (the second period) in Tongji Hospital.During the first period,the donors were administrated by ICU doctors and the antifungal agents were not applied as routine.The processes of organ procurement and trim were in accordance with the past experience.During the second period,the donor maintenance was reinforced,including antifungal preventive scheme,aseptic manipulation of organ procurement and rinsing and immersing allografts with broad-spectrum antibiotics or diluting povidone-iodine solutions during organ trim.Microbial culture specimens were performed in 1 574 samples including blood samples,perfusion fluids and arterial tissues and the pathogen distribution at the different periods was identified.Result In the microbial culture specimens of 1 574 samples,907 strains of pathogens were detected,including 799 strains of bacteria and 108 strains of fungi.The positive rate of fungi was 12.0％ (108/907) of all pathogens,and 17.3％ (108/626) of fungal cultures specimens.The fungi positive rate in the second period (13.6％,59/433) was significantly lower than that in the first period (25.4％,49/193,P＜ 0.05).Conclusion It is essential to reduce the incidence of donor fungal infection by increasing the microbial cultures and antifungal preventive scheme.And it is necessary that the organ procurement organization team enhances the risk awareness of donor-derived fungal infection and improves the aseptic manipulation of organ procurement.Additionally,rinsing and immersing allografts with broad-spectrum antibiotics or diluting povidone-iodine solutions may be a better option for preventing the donor-derived fungal infection during the allograft trim.