Objective To assess the therapeutic effect and opportune time of surgical treatment of hepaticolithiasis . Methods The clinical data of 92 patients with hepaticolithiasis who underwent surgical treatment were analyzed retrospectively. Results (1) The incidence of postoperative complications was 14.1% (13/92 cases), in choledochoscopy group it was 9.3%(4/43 cases) and in the non choledochoscopy group 18.4%(9/49 cases) ; in the emergency operation group it was 36%(9/25 cases) and in selective operation group 5.97%(4/67 cases) . (2) The incidence of residual stones was 22.9%(21/92 cases); in choledochoscopy group it was 13.9%(6/43 cases) and the non choledochoscopy group 30.6%(15/49 cases); in emergency surgery group it was 36%(9/25 cases) and in selective operation group 17.9%(12/67 cases).(3)One pationt died from ACST two days after operation . All of the patients were followed up for 4-10 years; there were 80 cases (86.9%) who had a good therapeutic outcome. Conclusions Logical surgical procedure associated with choledochoscopy and appropriate timing of surgical intervention can markedly improve the effect of surgical treatment of hepaticolithiasis and reduce the incidence of postoperative complications.

OBJECTIVE: To investigate the clinical feature, diagnose and therapeutic methods of paraglottic space primary paraganglioma. METHOD: One case of paraglottic space primary paraganglioma was reported and the relevant literatures were reviewed. RESULT: One case showed a hoarse voice, who was cured after the surgery of neck incision. NSE and CgA were positively expressed. CONCLUSION Paraganglioma of the paraglottic space is very rare. The diagnosis of paraglottic space primary paraganglioma bases on histopathology and immunohistochemistry. The immunohistochemistry and clinical character must be comprehensively analyzed to increase the diagnosis accuracy.
Female ; Glottis ; pathology ; Humans ; Middle Aged ; Paraganglioma ; pathology ; surgery

Aim To investigate the vasorelaxation effects of saponins from flower of Panax notoginsen on the isolated thoracica aorta ,and to explore its possible mechanism.Methods Total saponins were extracted and high phase liquid chromatography was utilized to describe saponins ingredients;SD rat thoracic aortas were isolated.In vitro vascular ring experiment was used to observe,basal state of saponins on vascular ring,and high concentrations of K+solution pre-con-traction and phenylephrine (PE ) pre-contraction caused by systolic and diastolic function of the re-sponse.And different inhibitors were combined to ex-amine the possible mechanism of notoginsenoside in vascular ring.Results Cumulative concentration of saponins had no significant effect on the basis of state vessels,but had significant effect on endothelium-in-tact aortic (MAX Relaxation 23.6%) rings pre-con-tracted by high concentrations of K+;endothelium and endothelial aortia had significant effect on PE pre-con-traction, and endothelium MAX relaxation was 55.5 1%.Calcium-free solution and saponin cultivated aortic rings significantly inhibited pre-contraction.Af-ter nitric oxide synthase inhibitor L-NAME and indom-ethacin incubating vascular ring ,it could significantly inhibited vasodilatory effect of saponin.Conclusion Saponins have concentration dependent diastolic func-tion on rat thoracic aorta,and its main ways cause vas-odilation.Endothelial dependent diastolic function is related to activation of nitric oxide synthase and cy-clooxygenase pathway.

Objective:To evaluate the optimized effect of infiltration between the popliteal artery and the capsule of the knee (IPACK)-adductor canal block (ACB) combined with general anesthesia when used for the total knee arthroplasty.Methods:Sixty patients of both sexes, aged 18-64 yr, with body mass index of 18-24 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective unilateral total knee arthroplasty, were divided into 2 groups ( n=30 each) using a random number table method: IPACK-ACB combined with general anesthesia group (group IA) and conventional anesthesia femoral nerve block-popliteal superior sciatic nerve block combined with general anesthesia group (group C). Before induction of general anaesthesia, 0.375% ropivacaine 15 ml was injected for IPACK and 0.375% ropivacaine 25 ml for ACB under the ultrasound guidance in group IA, femoral nerve block and popliteal superior sciatic nerve block was performed under the guidance of ultrasound combined with a nerve stimulator and 0.375% ropivacaine 20 ml was injected in group C. After confirming the efficacy of nerve block, total intravenous anesthesia was carried out to maintain bispectral index values at 40-60.Patient-controlled intravenous analgesia was performed with sufentanil after operation, and the visual analog scale score was maintained ≤ 3.The quadriceps muscle strength score was recorded when discharge from postanesthesia care unit and at 24, 48 and 72 h after surgery.The first postoperative off-bed time and development of foot drop in awake patients after surgery, requirement for rescue analgesia and adverse reactions were recorded.The postoperative length of hospital stay and score for patients′ satisfaction with postoperative recovery were also recorded. Results:Compared with group C, the postoperative quadriceps muscle strength scores and score for patients′ satisfaction with postoperative recovery were significantly increased, the incidence of postoperative foot drop was decreased, and the length of hospital stay and first postoperative off-bed time were shortened in group IA ( P<0.05). Conclusion:IPACK-ACB combined with general anesthesia may be an optimized strategy which is helpful for outcomes after total knee arthroplasty.

OBJECTIVE: To evaluate the clinical feature and therapy of rare aggressive fibromatosis in the head and neck. METHOD: Clinicopathologic data of 12 cases of aggressive fibromatosis in the head and neck were analysed. All cases underwent surgical excision, one case received radiotherapy in addition to surgery. RESULT: Six cases recurred after cutting off. One of them recurred twice no death was found following operation. CONCLUSION Aggressive fibromatosis in the head and neck is a rare benign, non-metastatic proliferation tumor of fibrous tissue with a capacity of infiltration to surrounding structures and a tendency of local recurrence after surgical resection. Complete surgical excision was considered to be the only effective method of cure. Chemotherapy and radiotherapy can be used in unsatisfactory surgical marginal recurrence.
Adult ; Female ; Fibromatosis, Aggressive ; diagnosis ; surgery ; Head and Neck Neoplasms ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Young Adult

Objective To investigate the cognition status and possible ways of patients′ privacy divulgence among medical staffs and patients, and to explore feasible strategies to protect the privacy. Methods A self-designed questionnaire about privacy cognition was used to investigate 92 patients and 59 medical staffs on one day in July 2014. Results The majority of patients had certain cognition of individual privacy;34. 8%, 30. 4% and 28. 3% of the patients thought the test outcomes, history of infection, illness conditions were private issues;63. 0%, 39. 1% and 31. 5% of the patients thought the perineum, pygal and chest were private parts. Medical staffs had significant higher privacy cognition compared with the patients ( P<0. 05);86. 4%, 86. 4% and 78. 0% of the staffs thought the emotional experiences, the history of infection, test outcomes were private issues;100. 0%, 89. 8% and 86. 4% of the staffs thought the perineum, pygal and chest were private parts. The private information of the patients would be divulged during the medical care such as:patient rounds and physical examinations, asking for the history of the illness, nursing, room layout, and talking between the medical staffs. Conclusions The medical staffs should enhance and motivate the concept of privacy among the patients in order to reduce the differences between these two groups and to improve the relationship between doctors and patients.

OBJECTIVE To analyze the situation of drug use in medical institutions of Guangdong area from 2017 to 2022， and to provide reference for the production， sale and procurement of drugs by government departments， medical insurance departments， pharmaceutical enterprises， drug sales enterprises and hospitals. METHODS Using the retrospective analysis method， based on original data from Guangdong hospital information network from 2017 to 2022， statistical analysis was conducted on the drug procurement amount of 118 medical institutions that had been online for the past 6 years， as well as the distribution of 14 major categories of drugs among all purchased drugs by online medical institutions， and sales amount of drug production enterprises. RESULTS The drug procurement amount of 118 medical institutions that had been online in Guangdong area from 2017 to 2022 showed a growth-negative growth-slow growth trend. Among the 14 major categories of drugs， the top 5 drugs in the list of consumption sum were anti-infective drugs， cardiovascular drugs， nervous system drugs， anti-tumor drugs， and digestive system drugs； among the top 200 drugs in terms of procurement amount， three major categories of drugs， namely the anti-infective drugs， anti-tumor drugs and cardiovascular system drugs， occupied the main position. The top 10 drugs in the list of procurement amounts were mainly anti-tumor drugs and cardiovascular system drugs； foreign manufacturers occupied the top 3 places in the list of sales amounts in medical institutions of Guangdong area. CONCLUSIONS In Guangdong area， the growth of drug procurement amount in medical institutions is gradually slowing down， the usage of anti-infective drugs is still abundant， the prevention and treatment of chronic diseases need great attention， and foreign pharmaceutical companies are in a leading position in the sales amount of medical institutions.

Influenza virus is one of the common pathogens causing acute respiratory infectious diseases, and is easy to cause acute respiratory distress syndrome (ARDS) after infecting human body, which is an important cause of death of influenza patients. Influenza-induced ARDS results from a combination of overwhelming inflammation and immune response, causing tissue damage and apoptosis. Furthermore, virus-mediated oxidative stress is another important mechanism. Viral infection can produce excessive reactive oxygen species, which damage the epithelial-endothelial barrier with pulmonary edema. In this content, numerous studies have highlighted the importance of antioxidants as a new therapy aimed at blocking both viral replication and virus-induced inflammation. Therefore, this paper summarizes the epidemiology and mechanisms of influenza-induced ARDS, the role of oxidative stress in the occurrence and development of influenza-related ARDS and the role of antioxidants in anti influenza virus infection, in order to provide reference for effective treatment of influenza patients, reducing mortality, developing new anti influenza drugs and preventing and controlling influenza epidemic.

Objective: To explore the efficacy of ossiculoplasty surgery under oto-endoscope in patients of conductive hearing loss with intact tympanic membrane. Methods: A retrospective study was conducted. The clinical data of 45 patients with conductive hearing loss who had undergone simple ossiculoplasty surgery between October 2015 and December 2017 from five hospitals in China (West China Hospital of Sichuan University, General Hospital of the People′s Liberation Army, Shanghai Ninth People′s Hospital, Shanghai JiaoTong University School of Medicine, Xijing Hospital, Fourth Military Medical University and Shenzhen Sixth People′s Hospital) were collected. There were 28 males and 17 females, with the age ranging from 12 to 69 years old. The tympanic membranes of those patients were intact before surgery. The lesion only occurred in the ossicular chain from CT and intraoperative exploration. The cases of otosclerosis, tympanosclerosis, cholesteatoma of middle ear, chronic suppurative otitis media, and tumor of middle ear were excluded. The postoperative complications, hearing improvements and operation time were observed. SPSS 23.0 software was used for statistic analysis. Results: There was neither sensorineural hearing loss nor facial paralysis after surgery in this group. Seven patients had transient mild tinnitus after surgery and gradually relieved during the follow-up period. Nine patients developed dysgeusia after surgery. Two patients developed dizziness after surgery, and the symptoms were mild and relieved during 1 week without special intervention. The air-bone gap (ABG) range of pre-operation was 22.5-45.7 dB, and the average ABG was (25.3±8.6) dB. The ABG range in the third month after surgery was 5.7-26.8 dB, and the average ABG was (9.3±8.6) dB. The mean value of ABG was significantly lower in the third month after surgery compared with that of pre-operation (t=2.31, P<0.05). The operation time of the surgeons in each research center was similar. The overall average of operation time was (43.56±18.25) min. There was no significant difference in the duration of operation between the centers (F=3.26, P>0.05). Conclusion The ossiculoplasty surgery under oto-endoscope has good efficacy.

Bivalves are species-rich mollusks with prominent protective roles in coastal ecosystems.Across these ancient lineages,colony-founding larvae anchor themselves either by byssus produc-tion or by cemented attachment.The latter mode of sessile life is strongly molded by left-right shell asymmetry during larval development of Ostreoida oysters such as Crassostrea hongkongensis.Here,we sequenced the genome of C.hongkongensis in high resolution and compared it to reference bivalve genomes to unveil genomic determinants driving cemented attachment and shell asymmetry.Importantly,loss of the homeobox gene Antennapedia(Antp)and broad expansion of lineage-specific extracellular gene families are implicated in a shift from byssal to cemented attachment in bivalves.Comparative transcriptomic analysis shows a conspicuous divergence between left-right asymmetrical C.hongkongensis and symmetrical Pinctada fucata in their expression profiles.Especially,a couple of orthologous transcription factor genes and lineage-specific shell-related gene families including that encoding tyrosinases are elevated,and may cooperatively govern asymmet-rical shell formation in Ostreoida oysters.