Aged ; Chondrosarcoma ; Humans ; Laryngeal Neoplasms ; Male ; Middle Aged

BACKGROUND:Anterior cervical plate can maximize the intervertebral space height,expand intervertebral foramen,restore cervical physiological antecurvature,prevent instability due to implant micromovement,and increase graft fusion.However,the selection of entire autologous bone or Ti-mesh bone graft remains uncertain in application of anterior cervical plate.OBJECTIVE:To compare the complications of three different intervertebral fusion methods in anterior cervical decompression surgery.METHODS:A total of 92 cases of cervical spondylotic myelopathy were treated by anterior cervical decompression and three different intervertebral fusion methods.They were followed up for at least 3 months.Of them,6 underwent bone grafting alone,21 underwent autogenous bone graft with cervical plate-screw fixation,and 65 underwent pyramesh with anterior cervical plate-screw fixation.Complications were observed in all cases.RESULTS AND CONCLUSLON:A total of 2 of 6 autogenous bone grafting cases suffered from graft bone dislocation,1 suffered from pseudoarthrosis formation,and 1 suffered from donated ilium.Six of 21 autogenous bone graft with cervical plate-screw fixation suffered from loss of intervertebral height,and 3 suffered from pain of donated ilium.Eleven of 65 pyramesh with anterior cervical plate-screw fixation suffered from titanium mesh subsidence,1 case suffered from breakage of fixation screw.Simple autogenous bone grafting surgery was rarely used due to long duration of external fixation and too much complications.Autogenous bone grafting with anterior cervical plate-screw fixation surgery has shortage of grafted bone absorption and pain of donated ilium.Pyramesh with anterior cervical plate-screw fixation surgery overcomes the shortage of donated iliac pain,but remains the shortage of titanium mesh subsidence and lose of intervertebral height.

BACKGROUND:Degenerative lumbar scoliosis often appeared in the elderly, who may combine with other diseases, which can cause poor repair tolerance. Degenerative lumbar scoliosis commonly has a responsible vertebral body, so local decompression and selective fusion should be conducted. This can achieve nerve decompression, spinal stability, and is relatively minimaly invasive. OBJECTIVE:To explore the efficacy of selective interbody fusion, limited neural decompression combined with pedicle screw system fixation for degenerative lumbar scoliosis. METHODS:Clinical characteristics of 53 patients with degenerative lumbar scoliosis were retrospectively analyzed, and the indication and contraindication were investigated. Selective interbody fusion, and limited neural decompression combined with pedicle screw system fixation were performed in the patients. Treatment effect and complication were analyzed. During folow-up, Suk standard was utilized to judge bone graft fusion. Before treatment and during final folow-up, lower back pain score system recommended by the Japanese Orthopaedic Association was used for assessment, and the excelent and good rate of curative effects was calculated. Cobb’s angle on the sagittal and coronal positions was compared and analyzed before and after treatment. RESULTS AND CONCLUSION:The patients were folowed up for 12 to 36 months. According to low back pain score of Japanese Orthopaedic Association Scores, the excelent and good rate of curative effect was 89% during the last folow-up. According to Suk standard, the fusion rate of vertebra was 94%. The last X-ray films revealed that Cobb’s angle was averagely (4.3±2.3)° (0°-13.5°) on the coronal plane after treatment, and the correction rate of scoliosis was 56%. The Cobb’s angle was averagely (45.1±12.5)° (10.4°-65.3°) after treatment, and the correction rate of lordosis was 36%. Complications after repair consisted of cerebrospinal fluid leakage in two cases, nerve injury in two cases, instrumental failure in one case, and pulmonary infection in one case, and symptomatic deep venous thrombosis in three cases. These findings suggest that selective interbody fusion, and limited neural decompression combined with pedicle screw system fixation were effective and safe for degenerative lumbar scoliosis. The sequence of the lumbar vertebra on the coronal and the sagittal planes received reconstruction to different degrees, and could realize the stability of the lumbar vertebrae in the scoliosis.

OBJECTIVE: To study the effectiveness of repairing nearly circumferential defect with the submental flaps after resection of laryngeal function unpreserved hypopharyngeal cancer. METHOD: All the cases were treated with the submental flaps after resection of hypopharyngeal cancer with laryngeal function unpreserved. RESULT: All 13 flaps were alive. Hypopharyngeal fistula occurred in 2 cases. All patients had normal swallowing function. The patients were followed up 6-42 months. Of 13 cases,3 had recurrence at neck Lymph node, but no local hypopharyngeal recurrence was found. Seven cases were followed up more than 3 years, and only 3 of them survived. CONCLUSION Submental flap is an ideal tissue flap submental flap in repairing of approaching circumferential defects after hypopharyngeal cancer ablation with laryngeal function unpreserved for the repairment of after approaching circumferential defects after hypopharyngeal cancer ablation with laryngeal function unpreserved, For it is close to the defect region, safe, easy-to-obtain and easy-to-survive.
Fistula ; pathology ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Hypopharynx ; pathology ; surgery ; Larynx ; Lymphatic Metastasis ; Neck ; Neoplasm Recurrence, Local ; Reconstructive Surgical Procedures ; Surgical Flaps

OBJECTIVE: To investigate the prognosis-related influence factors of the residual symptoms after the canalith repositioning procedure (CRP) for the benign paroxysmal positional vertigo (BPPV) in the second affiliated hospital of dalian medical university. METHOD: Among patients who were diagnosed with BPPV and treated by CRP, the one that still show residual symptoms were enrolled in our study, then make a follow-up irregularly about the tendency of their residual symptoms' self-healing,and respectively record in their gender, age and chronic diseases and so on. Single-factor analysis and multi-factors analysis was utilized to investigate the residual symptoms' related influencing factors. RESULT: In this study, 149 cases of patients were in record, for the residual symptoms, 71 patients can go to self-healing, 78 patients can not; age is 23-88, 30 cases in the young group, 46 cases in the middle aged group, 47 cases in the young elderly group, 26 cases in the elderly group; patients suffering from high blood pressure are 76 cases, 76 cases had diabetes, 47 cases had hyperlipidemia, 110 cases had heart disease, 43 cases had ischemic encephalopathy. CONCLUSION The residual symptoms in the elderly females patients and patients suffering from the hypertension, diabetes, heart disease patients and ischemic encephalopathy are not easy to heal by itself, in which, the older and the fact suffering from the hypertension and diabetes are the risk factors influencing the prognosis of the residual symptoms.
Adult ; Aged ; Aged, 80 and over ; Benign Paroxysmal Positional Vertigo ; complications ; therapy ; Chronic Disease ; Diabetes Mellitus ; Female ; Heart Diseases ; complications ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Patient Positioning ; Prognosis ; Risk Factors ; Young Adult

Objective: To examine the correlation between atmospheric PM2.5 and emergency call for respiratory diseases. Methods: The daily emergency call for respiratory and cardio-cerebrovascular diseases was collected from Hangzhou Emergency Medical Center from 2018 to 2020, and meteorological and atmospheric pollutant data were collected from Hangzhou Municipal Center for Ecological and Environmental Monitoring during the same period, including daily mean air temperature, daily mean relative humidity, PM2.5, PM10 and SO2 levels. The correlation between atmospheric PM2.5 and emergency call for respiratory and cardio-cerebrovascular diseases was examined using a generalized additive model, and the risk of emergency call was predicted using excessive risk (ER) and its 95%CI. Results: The daily mean emergency call was 14 (interquartile range, 12) cases for respiratory diseases and 20 (interquartile range, 7) cases for cardio-cerebrovascular diseases in Hangzhou City from 2018 to 2020, and the daily mean PM2.5 mass concentration was 29.77 (interquartile range, 21.32) μg/m3. Cumulative exposure to PM2.5 for 5 or 6 d caused the largest effect on the emergency call for respiratory diseases, and an increase in PM2.5 by 10 μg/m3 led to a 1.93% (95%CI: 0.76%-3.11%) rise in the emergency call for respiratory diseases. Cumulative exposure to PM2.5 for 4 d caused the largest effect on the emergency call for cardio-cerebrovascular diseases, and an increase in PM2.5 by 10 μg/m3 led to a 1.88% (95%CI: 0.80%-2.97%) rise in the emergency call for cardio-cerebrovascular diseases. Cumulative exposure to PM2.5 for 7 d caused the largest effect on the emergency call for respiratory diseases among residents aged 60 years and older, and an increase in PM2.5 by 10 μg/m3 led to a 4.37% (95%CI: 2.70%-6.06%) rise in the emergency call for respiratory diseases. Cumulative exposure to PM2.5 for 4 d caused the largest effect on the emergency call for cardio-cerebrovascular diseases among residents aged 60 years and older, and an increase in PM2.5 by 10 μg/m3 led to a 2.44% (95%CI: 0.97%-3.52%) rise in the emergency call for cardio-cerebrovascular diseases. However, exposure to PM2.5 had no marked effects on emergency call for respiratory or cardio-cerebrovascular diseases among residents aged <60 years. Conclusions Elevated atmospheric PM2.5 mass concentration may lead to an increase in the daily emergency calls for respiratory and cardio-cerebrovascular diseases, notably among residents aged 60 years and older.

Objective To evaluate clinical use of tigecycline in hospital patients. Methods Basic diseases, pathologic examinations, concurrent medication, therapeutic efficacy and side effects of 40 patients in Lishui Central Hospital of Zhejiang Province from January 2012 to December 2014 were analyzed retrospectively. Results The effective rate of patients using tigecycline for anti-infection treatment in hospital was 42. 5%. The rates of rational use, basically rational use and irrational use were 17. 5%, 77. 5% and 5. 0%, respectively. Adverse drug reactions occurred in 6 cases of tigecycline use (15. 0%). Conclusion Clinical use of tigecycline in inpatients was basically reasonable in this hospital. The clinical curative effect of tigecycline was good in a variety of infections caused by sensitive bacteria. However, the incidence of adverse drug reactions was high. Attentions should be paid in clinical application.

AIM: To investigate the expression of FIZZ1/RELM? in lung tissue of chronic cigarette smoking rat,and to determine the relationship between airway inflammation and airway hyperresponsiveness.METHODS: Made rat model of chronic cigarette smoking was used.The expression of FIZZ1/RELM? in lung tissue was determined by immuno-histochemistry and in situ hybridization.RESULTS: In control rats,FIZZ1/RELM? protein and mRNA expressions were observed at low levels.In cigarette smoking rats,FIZZ1/RELM? expression increased in all the cells especially in bronchial smooth muscle cells,vascular wall cells and alveolar epithelial cells.CONCLUSION: FIZZ1/RELM? is a secreted peptide specifically expressed in lung.Cigarette smoking induces its upregulation,which possibly contributes to cigarette smoking-induced airway hyperresponsiveness.

Objective To investigate the effectiveness of three-drug (Relingqing, Prostant and Antibiotic) therapy to chronic prostatitis. Methods One hundred and twenty patients were randomly divided into 2 groups: three-drug treatment group (n=80) and antibiotic only group (n=40). After treated for 12 weeks, 120 cases of chronic prostatitis were evaluated with the pre- and post-massage test (PPMT) and chronic prostatitis symptom index (CPSI). Results In three-drug treatment group, 15 patients in 21 patients of type Ⅱ and 41 patients in 59 patients of type ⅢA were normal evaluated by PPMT. From the results of CPSI, the cure rate was 13.8% (11 cases), the symptoms of 48 patients (60.0%) were improved significantly whose CPSI decreased more than 15, and only 16 patients(20.0%)felt a little better whose CPSI decreased from 5 to 15, and the symptoms of 5 patients were not improved. There was statistical difference among three-drug treatment group and antibiotic only group. Conclusion The three-drug treatment is more effective in treating chronic prostatitis than the therapy of antibiotic only.

Objective To summarize the clinical experience of combined liver and kidney transplantation (CLKT). Methods CLKT was performed on 22 patients. The orthotopic liver transplantation (LT) was preceded with the classic fashion in 10 patients and piggyback fashion in 12 patients. The renal allograft was implanted to the iliac fossa routinely. After operation, the patients received an induction therapy with anti-CD25 monoclonal antibody or antithymocyte globulin ( ATG) and a maintenance therapy with tacrolimus (Tac), mycophenolate mofetil and prednisone. Results The CLKT was successfully performed on all 22 patients, and the graft function was restored well postoperation. During the perioperative period, an acute rejection episode of liver occurred in one patient and acute renal allograft rejection episode in 2 patients. The Tac toxicity occurred in one patient. The hemorrhage of digestive tract occurred in one recipient and the hemorrhage of peritoneal cavity in one patient. The pleural effusion occurred in 6 recipients. The pneumonia occurred in 2 cases and the peritoneal infection in one patient During a follow-up period of 6 months to 7 years 11 months, three patients died because of cytomegalovirus pneumonia in 2 patients and acute myocardial infarction in, one patient, The 1-, 3-, 5-year survival rate of recipients was 86,4 %, 81.3 %, 72.7 % respectively. Conclusion The CLKT is an effective method for treatment of patients with end-stage liver djsease and chronic renal failure.