Objective To evaluate the effectiveness of mouth gag which can inserted into lavage tube during gastric lavage. Methods The Sixty- six cases of acute poisoning patients with gastric lavage according to random number table method were randomly divided into two groups, 33 cases in each group. Observation group used the inserted mouth gag, and the control group used the metal ones. Results The observation group were lower than the control group at the time required to insert the lavage tube [(2.23±0.19)s to (3.26±0.30)s] and the incidence of complication rate [18.2%(6/33) to 45.5%(15/33)], the oral cavity bleeding [6.0%(2/33) to 30.3%(10/33)], lavage tube displacement [0(0/33)to 24.2%(8/33)], lavage tube twisting[0(0/33) to 24.2%(8/33)], the difference was statistically significant (P<0.01), while higher in the rate of successful intubation[100.0%(33/33)] to [54.5%(18/33)], the difference was statistically significant, χ2=19.4,P<0.01. Conclusions The application of the mouth gag which can insert into gastric lavage improved the successful intubation rate, saved the rescue time, reduced the complication and improved the nursing quality.

Objective To analyze the expression of TBX1 gene in kidney tissues in patients with clear cell renal cell carcinoma(ccRCC)and in?vestigate its molecular genetics mechanism during the tumor development. Methods Real?time quantitative polymerase chain reaction(qRT?PCR)was used to detect the expression of TBX1 mRNA in 12 cases of clear cell renal cell carcinoma tissues and the corresponding normal kidney tissues adjacent to carcinoma .The protein expression of TBX1 was assayed by Western blot in both groups. Results Both TBX1 mRNA level and the protein level were significantly up?regulated in ccRCC tissues compare to those in normal kidney tissues adjacent to carcinoma(all P<0.05). Conclusion Over?expression of TBX1 gene might be a potentially pathogenic mechanism of ccRCC.

Objective To investigate the indication of approach,type of fixation and the clinical outcome of minimally invasive internal fixation for treatment of pelvic anterior ring injury.Methods From January 2012 to August 2016,data of 32 patients with 44 pelvic anterior ring injuries who had been treated with minimally invasive internal fixation were retrospectively analyzed.There were 22 males and 10 females with an average age of 38.2 years old (range,20-65 years).14 patients were injured by traffic accident,12 patients by falling and 6 patients by crush injury.There were 4 cases of pubic symphysis diastasis,27 fractures of anterior ring which included 12 billatral fractures and 1 combined vertical displacement of pubic symphysis associated with pubic fracture.According to AO classification,there were 3 cases in A2.3,3 cases in B1.2,4 cases in B2.2,4 cases in B2.3,2cases in C1.1,1 case in C1.2,5 cases in C1.3,4 cases in C2,6 cases in C3.There were 25 patients associated with other injuries,including brain injury in 2,thoracic injury in 17,abdominal injury in 8,urogenital system injury in 5,lumbosacral nerve plexus injury in 4 and the extremity or lumbar fracture in 19.The average period from injury to operation was 9.2 d (range,5-32 d).4 patients who had the pubic symphysis diastasis,3 had pelvic anterior ring fracture medial obturator foramen and 1 combined vertical displacement of pubic symphysis associated with pubic fracture were reduced by modified Pfannenstiel incision and fixed with cannulated screws,while 36 patients with fractures of lateral obturator foramen were reduced by modified Pfannenstiel incision associated with small ilial crest incision and fixed with locking reconstruction plates,and 25 patients received the fixation of pelvic posterior ring injury simultaneously.Results The average time of operation was 44.5 min (range,30-65 min),and the average amount of blood loss intraoperative was 56.2 ml (range,20-150 ml).All patients were followed up successfully,with an average time of 28.2 months (range,16-42 months).All the fractures were healed with an average time of 4.5 months (range,3-9 months).According to Matta standard of reduction assessment,30 fractures' reduction were excellent,12 were good and 2 were fair,which the rate of satisfaction was 95.5％ (42/44).Neither reduction loss or fixation failure nor infection occurred,and the occurrence rate of complication was 9.1％ (4/44),including one patient with fatal liquefaction and was cured 3 weeks after wound dressing,one patient with lateral femoral cutaneous nerve injury who was cured within 3 months by oral drug and 2 patients who complained discomfort of inguinal area because of the fixation prominence and were lessened by physical therapy.Conclusion Minimally invasive internal fixation can be recommended for treatment of pelvic anterior ring injury because of the advantages of less damage,safer manipulation,less complications and good prognosis.

Objective:To evaluate the clinical efficacy of 1 064 nm/755 nm dual wavelength laser on hair removal.Methods:A total of 60 patients aged 18-52 (30±7) years in our hospital from January 2017 to December 2017 were collected. 1 064 nm and 755 nm laser hair removal was performed at the same symmetrical areas or two different areas in the same patient. We performed 6 sessions of laser treatment at 6-week intervals and the effect was evaluated 6 weeks after the last session.Results:The hair removal efficacy was 96.7% (58 cases) at 1 064 nm, 96.7% (58 cases) at 755 nm laser treatment. There was no significant difference in the effective rate between two wavelengths laser hair removal methods ( P>0.05). The incidence of pigmentation was 1.7% (1 case) at 1 064 nm laser and was 3.3% (2 cases) at 755 nm laser without significant difference ( P>0.05). No hypopigmentation, blister or scar appeared in all patients. The total satisfactory rate was 95.0% (57 cases) at 1 064 nm, 98.3% (59 cases) at 755 nm laser treatment, respectively. Conclusions:1 064 nm/755 nm dual wavelength laser has definite therapeutic effect and safety on hair removal.

Objective:To measure the anatomical parameters of three-dimensional available space of S 1 and S 2 vestibules on Chinese adults by imaging methods, and discuss their clinical values. Methods:Data of 200 cases of pelvic CT with complete posterior ring were collected from January 2015 to January 2021, included 110 males and 90 females. The ages ranged from 21 to 63 years (average, 40.72±10.70 years). Then the parameters of both the left vestibule and the right vestibule of S 1 and S 2 such as vestibular width, vestibular height and vestibular area were measured by the three-dimensional CT reconstructions. Statistical analyses were performed among the groups which were classified according to the gender, side of vestibule to compare the difference of vestibular morphological characteristics among different groups. Results:The average vestibular area of S 1 was 425.71± 45.07 mm 2 (range, 296.3-604.4 mm 2), which was 449.80±28.62 mm 2 (range, 338.3-604.4 mm 2) in males and 388.25±34.01 mm 2 (range, 296.3-498.4 mm 2) in females. The average vestibular width was 28.52±4.34 mm (range, 17.1-36.3 mm), 31.77±2.33 mm (range, 22.46-36.30 mm) in males and 24.55±2.55 mm (range, 17.1-26.1 mm) in females. The mean vestibular height was 21.05±2.29 mm (range, 17.5-32.0 mm), with 21.34±2.37 mm (range, 18.5-32.0 mm) of men and 20.69±1.60 mm (range, 17.5-25.6 mm) of women. The mean S 2 vestibular area was 230.19±35.57 mm 2 (range, 142.5-297.3 mm 2), which was 258.91±28.04 mm 2 (range, 218.3-297.3 mm 2) in males and 205.61±24.12 mm 2 (range, 142.5-258.6 mm 2) in females. The average vestibular width was 15.94±1.72 mm (range, 12.4-20.3 mm), 16.51±1.59 mm (range, 14.4-20.3 mm) in male and 15.25±1.63 mm (range, 12.4-18.1 mm) in female. The mean vestibular height was 14.30±1.20 mm (range, 12.9-17.8 mm), 15.49±1.46 mm (range, 13.6-17.8 mm) in males and 13.73±0.93 mm (range, 12.9-16.1 mm) in females. There were significant differences in vestibular width, height and area between S 1 and S 2 (vestibular width t=3.934, P< 0.001; vestibular height t=3.692, P< 0.001; vestibular area t=4.816, P< 0.001). There were significant differences in S 1 vestibular width, S 1 vestibular height, S 1 and S 2 vestibular area between male groups and female groups (S 1 vestibular width: t=2.969, P=0.003; S 1 vestibular height: t=0.316, P=0.049; S 1 vestibular area: t=1.975, P=0.049; S 2 vestibular area: t=2.023, P=0.044). While there was no significant difference in S 2 vestibular width and height between the two gender groups. There were significant differences in S 1 and S 2 vestibular width, height and area between male and female groups ( P < 0.001). There were no significant difference in parameters between the left and right values of the same vestibular site. Conclusion:The parameters of S 1 sacral vestibule are larger than that of S 2. It implies that S 1 was more feasible to insert iliosacral screws than S 2; lesser diameter iliosacral screws should be selected to insert into S 2. The female S 1 vestibule is smaller than the male, so the iliosacral screws placement has more stringent requirements on the selection of the insertion point and the direction of the screw. And the surgeon can utilize the intact contralateral sacral vestibule as the damaged side to proceed the iliosacral screw inserted simulation.

AIM:To establish and characterize the patient-derived esophageal squamous-cell carcinoma xeno-graft (PDECX) in mice.METHODS:The samples of human esophageal cancer were grafted into severe combined immu-nodeficient ( SCID) mice.The xenografts were transferred to SCID mice when the first passage of xenografts grew up .The growth of tumors in the first, second and third passages was observed .HE staining was performed.The expression of CK5/6, p63 and p40 in the patient samples , and the first and third passages of the xenografts were detected by immunohisto-chemical analysis.The expression of mTOR, p-mTOR, p70S6K, p-p70S6K, Akt1, p-Akt (Ser473), Erk1/2 and p-Erk1/2 were determined by Western blot .RESULTS:The PDECX was successfully established .The positive expression of CK5/6, p63 and p40 in the xenografts was consistent with that in the patients ’ samples.The levels of phosphorylated and total proteins of proliferation-related signaling pathways were different in the xenografts from different patients .CONCLU-SION:The PDECX model adequately reflects the tumal heterogeneity that is observed in the patients .

Objective:To compare the clinical outcomes between minimal-invasive triangular fixation with orthopedic robot and traditional open fixation method for unilateral unstable sacral fracture patients.Methods:Data of 24 consecutive patients with unilateral unstable sacral fracture who were treated from August 2014 to February 2018 were retrospectively analyzed. All patients were associated with anterior ring injuries of pelvis and received magnetic resonance of nerve (MRN) preoperatively to exclude the compression of sacral nerve by bone. All patients received surgical treatment of sacral fractures with triangular fixation and the fixation of pelvic anterior ring injuries simultaneously and two groups were divided according to the different surgical methods of sacral fractures. There were 10 males and 2 females with an average age of 36.3±1.2 years in the orthopaedic robot group. According to Dennis classification, there were 4 type I and 8 type II fractures. Two patients were associated with nerve injuries (Gibbons II 1 case, III 1 case). In traditional posterior-midline open fixation group, there were 11 males and 1 female with an average age of 38.2±1.6 years. According to Dennis classification, there were 3 type I and 9 type II fractures. Three patients were associated with nerve injuries (Gibbons II 2 cases, III 1 case). The clinical data of two group patients were collected and compared statistically. T test was used to compare the operation time, intraoperative bleeding, intraoperative fluoroscopy times, Majeed function assessment which was to evaluate the patients' clinical prognosis and healing time of fracture. χ2 test was used to compare the healing rate of fracture, accuracy assessment of fixation insertion, and Mears radiological assessment which was applied to evaluate the reduction quality of fractures. The rank sum test was used to compare Gibbons score which was applied as the index of neurological deficiency recovery. The Fisher exact test was used to compare the infection rate. Results:All patients were followed up continuously for an average time of 21.2±3.2 months. The average operation time of robot group was 100.3±14.5 minutes, meanwhile the open fixation group was 202.0±18.5 min. The average intraoperative bleeding of robot group was 180.0±17.4 ml, meanwhile the open fixation group was 850.0±15.2 ml. The average intraoperative fluoroscopy time of robot group was 23.3±4.5 s, meanwhile the open fixation group was 90.0±7.7 s. All fractures were healed and no loss of reduction or fail of fixation occurred in both groups. The healing time of fracture of robot group was 8.5±1.9 months, meanwhile the open fixation group was 12.8±2.4 months. The satisfaction rates of reduction which was based on Mears-Velyvis radiological criterion of both groups were 91.7%. The accuracy rate of fixation insertion of robot group was 100% meanwhile the open fixation group was 77.78%. Majeed function assessment score of robot group was 86.2±3.4, meanwhile the open fixation group was 84.2±2.7. There was no infection occurred in robot group, meanwhile 3 patients infected in open fixation group. The Gibbons score of one patient changed from II preoperative to I postoperative and one case changed from III preoperative to II postoperative in robot group, meanwhile two patients changed from II preoperative to I postoperative and one case changed from III preoperative to II postoperative in open fixation group. The healing rate of fracture, infection rate, Majeed function assessment, Mears-Velyvis radiological evaluation criterion and Gibbons score of two groups had no significant statistical difference ( P >0.05), meanwhile the operation time ( t=14.99), intraoperative bleeding ( t=100.46), intraoperative fluoroscopy time ( t=32.13), healing time of fracture ( t=4.87) and accuracy rate of fixation insertion ( χ2=9.00) of orthopedic robot group were better than traditional open group and had the significant difference ( P< 0.05). Conclusion:The minimal-invasive triangular fixation with orthopedic robot for unilateral unstable sacral fracture had the advantages of less operation time, less intraoperative bleeding and less times of fluoroscopy, more accurate of fixation insertion and less healing time of sacral fractures compared to traditional open fixation method and should be recommended as an effective and advanced choice.

Objective:To explore the efficacy of posterior iliac screw rod for unilateral unstable Denis I and II sacral fractures.Methods:Data of 50 patients with unilateral unstable Denis I, II sacral fractures treated from March 2016 to October 2018 were retrospectively analyzed. According to fixation methods, the patients were divided into posterior iliac screw rod group (Iliac screw rod group) and robot-assisted iliosacral screw group (Iliosacral screw group). There were 20 patients in the Iliac screw rod group, 13 males and 7 females, with an average age of 41.10±14.07 years (range, 22-76 years), and there were 5 cases of Denis type I and 15 cases of type II sacral fractures. All of them had anterior pelvic ring injuries, and according to pelvic Tile classification, there were 2 B1 type, 12 B2 type, 6 C1 type, and 3 cases of Gibbons grade II sacral nerve injuries. There were 30 patients in the Iliosacral screw group, 18 males and 12 females, with an average age of 44.70±13.35 years (range,16-78 years), and there were 6 cases of type I and 24 cases of type II sacral fractures. There were 2 cases of type B1, 20 cases of B2, 8 cases of C1 pelvic fractures, 4 cases combined with sacral nerve injuries including 3 cases of Gibbons grade II and 1 case of grade III. The patients’ age, operation time, amount of bleeding, times of fluoroscopy, postoperative Majeed score were compared by the independent t test. The quality of fracture reduction was compared by Chi-square test, and the postoperative Gibbons grade was compared by the rank sum test.Results:All patients were followed up for 22.8 months (range, 12-40 months). In the Iliac screw rod group, the operation time was 41.40±7.30 min, intraoperative blood loss 105.00±61.94 ml, intraoperative times of fluoroscopy 19.10±7.33, and according to Mears and Velyvis valuation criterion, there were 9 cases of anatomical reduction, 10 cases of satisfactory reduction, and 1 case of unsatisfactory reduction, with the Majeed score of 84.25±8.29. There were 3 cases with Gibbons grade II sacral nerve injury, and 2 of them recovered to grade I. In the Iliosacral screw group, the operation time was 18.27±5.89 min, intraoperative blood loss 33.00±17.54 ml, intraoperative times of fluoroscopy 14.93±4.49, and according to Mears and Velyvis valuation criterion, there were 15 cases of anatomical reduction, 13 cases of satisfactory reduction and 2 cases of unsatisfactory reduction, with the Majeed score of 86.43±7.43. There were 3 cases with Gibbons grade II sacral nerve injury, and 2 of them recovered to grade I, and 1 case with grade III recovered to grade II postoperation. Compared to Iliosacral screw group, the Iliac screw rod group has longer operation time ( t=-12.36, P<0.001), more blood loss ( t=-6.04, P<0.001) and more intraoperative times of fluoroscopy ( t=-2.50, P=0.016). There were no statistical differences for quality of fracture reduction ( χ2=0.23, P=0.89), Majeed score ( t=0.97, P=0.34), and the Gibbons grade ( Z=-0.224, P=0.82) between the two groups. In the Iliac screw rod group, 1 patient had a unilateral superficial wound infection and 1 patient complained of discomfort because of the nail. In the Iliosacral screw group 1 patient had iatrogenic S 1 neurological injury. Conclusion:For the unstable sacral fractures, who are not suitable for iliosacral screw fixation, posterior iliac screw rod fixation is an effective alternative with similar clinical effect as robot assisted iliosacral screw fixation.

Objective: To explore the treatment outcome of triangular osteosynthesis (TOS) for the treatment of unilateral Isler type II lumbosacral junction injuries (LSJIs). Methods: Data of sixteen patients with unilateral Isler type II LSJIs surgically who were treated in our Hospital from March 2015 to February 2017 were retrospectively analyzed. There were 13 males and 3 females with an average age of 35.5 years (range, 24-61 years). Seven patients were multiple injuries including head, thoracic, musculoskeletal and nerve injuries. According to Isler classification of LSJIs, there were 5 cases of type IIa, 9 of type IIb and 2 of type IIc. All the LSJIs combined with ipsilateral sacral fractures. The sacral fractures were classified by Denis classification with 1 case of zone I, 13 cases of zone II and 2 cases of zone III. According to Tile classification of pelvic fractures, there were 3 cases of type B2, 11 of type C1 and 2 of type C3. There were 3 cases combined with sacral nerve injury among which there were 2 cases of grade II and 1 case of grade III according to Gibbons classification of neurologic deficits. All cases were surgically treated with triangular osteosynthesis. There were 14 cases combined with iliosacral screws fixation in S₁ and 2 cases combined with posterior locking plates. Results: All patients were followed up for 20.6 months (range, 16-30 months). CT scan was conducted 12 to 24 months after surgery which showed all the sacral fractures were union, and 2 cases achieved bony fusion in L₅S₁ facets while the other 14 didn’t. According to Majeed’s pelvic injury evaluation, clinical outcomes were rated with excellent in 12 cases, good in 2 cases, fair in 2 cases. The excellent and good rate was 87.5% (14/16) . According to Mears-Velyvis evaluation criterion, there were 14 cases with anatomical reduction and 2 cases with satisfactory reduction. Among the 3 cases with sacral nerve injury, 2 cases were improved from Gibbons grade II to grade I and the other 1 case was improved from Gibbons grade III to grade II, still feeling numbness on the lateral foot. There were no intraoperative complications in all patients such as neurovascular injuries. No incision infection, fat liquefaction and other incision related complications occurred postoperatively. Irritation and pain in iliac spine about prominent implant occurred in 1 case and lumboscaral stiffness in 1 case, in which the symptom relieved and disappeared after implants removal. Conclusion Triangular osteosynthesis can provide enough stabilization for Isler type II LSJIs and achieve satisfactory outcomes.

OBJECTIVE: To compare the effect of rehabilitation of prelingual deaf children who used a cochlear implant (CI) in one ear and a hearing aids in the opposite ear while the hearing level of the opposite ears are different. Hearing ability, language ability and learning ability was included in the content. The aim of this research is to investigate better style of rehabilitation, and to offer the best help to the prelingual deaf children. METHOD: Accord ing to the hearing level of the ear opposite to the one wearing a cochlear implant and whether the opposite ear wear a hearing aid or not, 30 prelingual deaf children were divided into three groups, including cochlear implant with opposite severe hearing loss and hearing aid ear (CI+SHA), cochlear implant with opposite profound hearing loss and hearing aid ear (CI+PHA), cochlear implant only (CI). The effect of rehabilitation was assessed in six different times (3,6,9,12,15 and 18 months after the cochlear implants and hearing aids began to work). RESULT: The longer time the rehabilitation spends, the better the hearing ability,language ability and the learning ability were. The hearing ability of CI+SHA was better than those of CI+PHA (P<0.05) and CI (P<0.05). The language ability and learning ability of CI-SHA was nearly equal to those of the other two groups. CONCLUSION The prelingual deaf children should take much more time on rehabilitation. The effect of rehabilitation for prelingual deaf children who used cochlear implant in one ear and hearing aid in the other depend on the residual hearing level of the other ear. If a prelingual deaf children still has any residual hearing level in the ear opposite to the cochlear implant ear, it is better for him/her to wear a hearing aid in the ear.
Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Deafness ; physiopathology ; rehabilitation ; Female ; Hearing Aids ; Humans ; Male ; Persons With Hearing Impairments ; rehabilitation ; Sound Localization ; Speech Perception ; Treatment Outcome