In order to explore the relationship between xenograft rejection and cytokines, the proliferative responses and cytokine contents from human lymphocyte were detected in porcinehuman mixed lymphocyte culture (MLC) and compared with human allo-MLC. The results showed that the proliferative responses in the former was equal to or stronger than that in the latter, and the kinetics of IL-2 and IFN-Y in both supernatants were similar but the peak of IL-4 from the former was higher than that from the latter (P<0.05). This suggests that cytokines are likely to play roles in porcine-human MLC.

OBJECTIVE: This paper highlights the therapeutic effect of tragus cartilage and temporalis fascia graft on repairing bone and skin defect in external auditory canal. METHOD: Forty-one surgical patients were recuited, including 39 cases of external auditory canal cholesteatoma and 2 cases of osteoma. External auditory canal bone wall and skin defect and mastoid air cells exposure were found during operation. We followed up these cases periodically (in 3 weeks, 3 months, 6 months and 1 year later respectively) after repairing the patients' external auditory canal bone wall and skin with tragus cartilage and temporalis fascia graft. RESULT: Twenty-nine cases healed perfectly while other 12 cases grew small granulation in 3 weeks. After shaving granulations and tamping Tela Iodoformum, wounds healed in the following week. The epithelization of the external auditory canal in our patients was complete after 3 months and no stenosis were found. Natural morphology of external auditory canal was maintained without mastoid air cells exposure after 6 months to 1 year of time. CONCLUSION It is not only convenient to acquire the tragus cartilage and temporalis fascia, but also easy to repair the defect of external auditory canal bone wall and skin. It can reconstruct the wall of external auditory canal, obliterate mastoid cells and perfectly maintain the normal form of external auditory canal via the cartilage.
Adolescent ; Adult ; Cartilage ; surgery ; Child ; Ear Auricle ; surgery ; Ear Canal ; surgery ; Fasciotomy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVE: Dissecting adult cadaver's tragal cartilage and researching its clinical application in ear surgery. METHOD: Dissect the bilateral tragal cartilage of 22 adult cadavers immersed in formalin (both of male and female are 11). Measure and compute the average value of the length, width, thickness and area. Summarize autologous tragal cartilage's clinical application in ear surgery. RESULT: The statistic values of male tragal cartilage were: length (22.55 ± 0.89) mm, width (19.00 ± 1.09) mm, thickness (1.04 ± 0.09) mm, and area (315.70 ± 32.57) mm2. The statistic values of female respectively were (19.36 ± 0.86) mm, (15.73 ± 0.69) mm, (0.93 ± 0.06) mm, and (229.64 ± 13.97) mm2. Tragal cartilages were utilized in 419 middle ear surgeries in my department, including tympanoplasty(type I 189 cases, type II and III 116 cases), atticotomy (65 cases), and the repair of the lateral skull base (3 cases). The postoperative effect was satisfactory. CONCLUSION Tragal cartilage is in the operation region, which is convenient to be harvested and shaped. Hence, the donor can satisfy the requirement of general ear surgery and it is suitable for widely application in ear surgery.
Adult ; Cadaver ; Cartilage ; anatomy & histology ; Ear Auricle ; anatomy & histology ; Female ; Humans ; Male ; Otologic Surgical Procedures ; Tympanoplasty

OBJECTIVE: To investigate the reconstruction method of lateral attic wall with tragal cartilage and temporalis fascia graft. And analyze the postoperative result of its clinical application. METHOD: From Jan 2005 to Jul 2014, 45 patients whose middle ear disease were limited to attic received this surgery in our department. Among 31 cases of cholesteatoma otitis media and 14 cases of external auditory canal cholesteatoma were included. In order to expose the attic fully, we operated epitympanotomy through retroauricular incision and then removed the scutum and lateral attic bone wall. After eliminating the lesions, we reconstructed the lateral attic bone wall with tragal cartilage, covered the cartilage with temporalis fascia and then repaired the tympanic membrane and external ear canal skin. After surgery, all patients were followed up at 10 days, 1 month, 2 months, 6 months and 1 year. RESULT: Two months after surgery, 45 patients' achieved one-stage wound healing. Six months later, all of the patients' operation area had epithelized completely. After 1 year, 37 patients had recovered the normal shapes and stable audition; 7 cases patients have different level tympanic membrane retraction; 1 patient suffered from tympanic membrane retraction and recurrent cholesteatoma. CONCLUSION With regard to the lesion limited to the attic, we can remove it by operating epitympanotomy through retroauricular incision, and then reconstruct the lateral attic wall with tragal cartilage and temporalis fascia. By the support of the cartilage, we can keep the epitympanic aeration, reduce the retraction of pars flaccida membrana tympani, and maintain the fundamental shape of lateral attic wall.
Cartilage ; transplantation ; Cholesteatoma ; surgery ; Ear Auricle ; Ear Canal ; Ear Diseases ; surgery ; Ear, Middle ; pathology ; Fascia ; transplantation ; Humans ; Mastoid ; Otitis Media ; surgery ; Tympanic Membrane ; surgery ; Tympanic Membrane Perforation ; surgery

Objective To study the design and application of customized navigation module manufactured by digital modeling and 3D-printing technology in the minimal-invasive-puncture surgery for cerebral hemorrhage. Methods Eight patients with cerebral hemorrhage, admitted to our hospital from October 2015 to December 2015 and aged from 33-80 years old (with an average age of 55.7), including 6 male and 2 female, were chosen as study objects. The 3-dimensional image was obtained by three dimensional reconstruction technique. A perfectly personal navigation module included puncturing-guidance-channel was designed and printed by 3D-printing technology. The printing module was tested in surgery. The module was tightly attached to the puncturing area, and the puncturing was performed following the guide system during the surgery. Post-operation cerebral CT scan was performed to evaluate the surgery effect. Results All the 8 patients successfully received surgery. Post-operation cerebral CT scan showed satisfied results which were classified based on accuracy: 6 enjoyed highly accurate results, one qualified result and one acceptable result. The actual puncture direction was the same with that in the pre-operation mimic process. No puncture failure, blood vessel or nervous injury symptoms were found. Conclusion Pre-operation personal 3D printing navigation is an accurate, safe and effective novel method to treat cerebral hematoma.

Objective To compare the clinical efficacies of endoscopy-assisted microvascular decompression and microscopic microvascular decompression.Methods PubMed,Cochrane Library,Embase,VIP,CNKI and Wanfang database were retrieved.The randomized controlled trials comparing trigeminal neuralgia and hemifacial spasm treated with endoscopy-assisted microvascular decompression and microscopic microvascular decompression were chosen.The retrieval time was from the establishment of the database to April 1st,2017.After the detected literatures being screened,extracted and evaluated,a Meta-analysis was performed using RevMan 5.3 software.Results Finally,a total of 10 trials with 1010 patients were enrolled.The results of Meta-analysis showed:(1) in the aspect of effectiveness,patients from the neuroendoscope group had significantly better prognosis (RR=1.110,95％CI:1.060-1.160,P=0.000) and statistically lower relapse rate (RR=0.100,95％CI:0.020-0.530,P=0.007) as compared with the microsurgery group;(2) in the aspect of safety,patients from the neuroendoscope group had fewer postoperative complications (RR=0.650,95％CI:0.530-0.800,P=0.000) and lower postoperative paralysis incidence rate (RR=0.580,95％CI:0.360-0.930,P=0.020) as compared with the microscope group.There were no significant differences in the operation time,incidence of cerebrospinal fluid leakage,hearing loss or intracranial infections between the 2 groups (P＞0.05).Conclusion As compared with those in patients accepted microscopic microvascular decompression,the prognosis of patients accepted endoscopy-assisted microvascular decompression is better,the relapse rate is lower,and safety is higher.

OBJECTIVE: To observe the short-term efficacy of autogenous bone pate and Palva graft for obliterating huge remnant mastoid cavity in canal wall down approach. METHOD: Retrospective analysis clinical data of twenty-one cholesteatomatous cases operated by one surgeon from 2004 to 2007. In twelve cases, simultaneous III type tympanoplasty (Sheehy, P. O. P) was performed. Other 9 cases had undergone mastoidectomy elsewhere before the admission. Six of them were still draining with huge remnant mastoid cavity, and the rest three patients had relapsed cholesteatomas with intermittent draining and huge mastoid cavity. Normal saline solution perfusion was used to measure the volume of remnant mastoid cavity. The criterion of huge remnant mastoid cavity is more than 8 ml. RESULT: Of twelve primary cases with III type tympanoplasty, 11 patients maintained a small, dry, and healthy mastoid cavity after twenty-seven days. The average increase of hearing level of them was 17.5dB, and the air-bone gap is less than 20 dB. Of one patient, bone pate was infected and was discharged. A dry mastoid cavity was achieved until fifty-five days after surgery. The patient is keeping a big air-bone gap caused by displacement of ossicle chain prosthesis. Just eighteen days later, other nine cases of revision mastoidectomy achieved a small, dry, and healthy mastoid cavity, with lightly improved hearing level. CONCLUSION Obliteration of a canal wall down huge mastoid cavity by Palva graft with autologous bone pate is a reliable and effective technique that results in a small, dry, low-maintenance mastoid cavity. The short-term efficacy of simultaneous III tympanoplasty is satisfactory if patient selection is suitable.
Adolescent ; Adult ; Cholesteatoma ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Retrospective Studies ; Surgical Flaps ; Transplantation, Autologous ; Treatment Outcome ; Tympanoplasty ; methods ; Young Adult

Objective To discuss the surgical strategy and clinical effects of robotic assisted laparoscopic antegrade inguinal lymphadenectomy for penile cancer.Methods We retrospectively analyzed the clinical data and surgical strategy on the 7 cases,who undergoing robotic assisted laparoscopic antegrade inguinal lymphadenectomy,from August of 2016 to August of 2017.The mean age of 7 patients was (49.7 ± 7.5) years old,ranged from 40 to 62 years old,the mean BMI was (27.97 ± 3.86) kg/m2,ranged from 21.76 to 33.21 kg/m2 . There were 4 cases of T1,2 cases of T2,1 case of T3,1 case of N1,3 cases of N2,3 cases of N3 according to TNM stages.Preoperative preparation was as follows,preoperative cardiopulmonary assessment,inguinal and pelvic CT or MRI,ultrasound of lower extremity venous,bowel preparation.The patients were placed in a supine position,with an indwelling catheter,with the head positioned lower than the hip at an angle of about 15 degrees,legs were spread apart around 45 degrees,and both knees were slightly bent and externally rotated.The da Vinci robotic patient cart was pushed forward between legs of the patient.A blunt separation was carried out between Scarpa's fascia and the surface of the aponeurosis of the obliquus externus abdominis prior,then subcutaneous space was established by a self-made balloon dilatation.Results 7 cases were completed successfully without robot reposition without any conversion.Operative time of each side ranged from 50 to 90 min (70.0 ± 12.5)min.The blood loss of each side was less than 10 ml.In the 7 cases,the number of nodes removed from left inguinal region ranged from 7 to 18 (14.0 ±3.3).The number of nodes removed from right ranged from 5 to 21 (11.0 ± 3.3).Pelvic lymphadenectomy was completed in the meantime by original trocar site on 4 cases.Till now,no perioperative complications,such as flap necrosis,delayed healing of incision,cellulitis,occurred in inguinal region,except lymphorrhagia in 3 cases.During a follow-up within 3-14 months,there was no recurrence or metastasis in 6 cases except one died from tumor progression with systemic metastasis.Conclusions Antegrade inguinal lymphadenectomy for penile cancer by using Da Vinci robotic surgical system is safe and effective.This technique also appears to diminish the wound related complications associate with the standard open approach.Compared with the similar surgery,we conducted bilateral inguinal lymphadenectomy without patient cart reposition,which simplify the procedure and reduce the using of trocar.According to individual clinical conditions,pelvic lymphadenectomy also can be completed in the meantime by original trocar.

Objective To identify meaningful objective examination methods by analyzing the results of vari-ous objective examinations of children with recurrent vertigo(RVC).Methods Fifty children with RVC(29 in ver-tigo attacking group,21 in vertigo non-attacking group)and 20 children without RVC were selected.All partici-pants underwent a series of relevant objective examinations,the results of each examination were statistically ana-lyzed and the characteristic differences of each examination between the RVC group and the control group were ob-tained.Results ① The abnormal rate of sleep SpO2,high stimulation rate ABR and AHI in the RVC group were significantly higher than those in the control group(P＜0.05).② The abnormal rate of sleep SpO2 and high stimu-lation rate ABR in the vertigo attacking group were higher than those in the vertigo non-attacking group.There was a statistical difference between the two groups(P＜0.05).③ Pure tone audiometry(or conditioned play audiome-try),acoustic immittance,cranial MRI,positional test and vHIT were normal in both RVC group and normal con-trol group.Conclusion Continuous sleep SpO2 and high stimulation rate ABR are correlated with RVC,especially RVC during vertigo attacking.AHI is correlated with RVC,but not with the onset of vertigo.Clinically,continu-ous sleep SpO2 monitoring,PSG and high stimulation rate ABR can be used as auxiliary examinations for the diagno-sis of RVC.

Objective:To understand the characteristics and explore the influencing factors of HBsAg positivity in methadone maintenance treatment (MMT) clinic patients.Methods:A face to face interview and medical record review were conducted in 1 040 patients at three MMT clinics in Guangxi from September to November in 2014. The questionnaire information included general demographic characteristics, drug use history, MMT status, sexual behaviors, and health status, etc. Blood samples were collected from the patients at the same time for the detections of the level of HBsAg, anti-HBs and anti-HCV. By using χ2 test, unconditional logistic regression model and Bayesian network model the influencing factors for HBsAg positivity in MMT clinic patients and the complex network relationship among these factors were explored. Results:A total of 1 031 MMT clinic patients were surveyed, the HBsAg positive rate was 11.35 % (117/1 031). The anti-HCV positive rate was 71.77 % (740/1 031), among the anti-HCV positive patients, the HBsAg positive rate was 10.27 % (76/740). After adjusting for the confounding factors, anti-HBs positive persons might not be HBsAg positive ( OR=0.05, 95 %CI: 0.03-0.09), and anti-HCV positive persons might not be HBsAg positive too ( OR=0.30, 95 %CI: 0.17-0.52) compared with anti-HBs negative and anti-HCV negative persons, respectively. The persons with family history of hepatitis B virus infection were more likely to be HBsAg positive compared those with no such family history ( OR=5.30, 95 %CI: 2.68-10.52). Bayesian network model analysis results showed that family history of hepatitis B virus infection and anti-HBs were directly related with HBsAg positivity. Anti-HCV, intravenous drug use in the past three months and other drug using during treatment were indirectly related with HBsAg positivity. Conclusions:Anti-HBs, family history of hepatitis B virus infection, anti-HCV, intravenous drug use in past three months and other drug use during treatment were related with the HBsAg positivity in MMT clinic patients. So, it is necessary to enhance health education, improve health awareness and decrease high risk behaviors to reduce the rate of HBV infection.