Objective: To search for sensitive indicators for the voice assessment of patients with larynx leukoplakia and to analyze the clinical relevance of voice assessment in diagnosis of larynx leukoplakia. Methods: Sixty-three patients with larynx leukoplakia (including 47 males and 16 females) were subjected to voice assessment by Dr. Speech software and the values of Jitter, Shimmer, normalized noise energy (NNE), harmonics-to-noise ratios (HNR), and fundamental frequency (Fo) were calculated. The results of the 47 male leukoplakia patients and 16 females were compared with those of normal controls (male 30, female 30) and of patients with vocal cord polyp (male 30, female 30). Results: The Jitter and Shimmer values of male leukoplakia patients were obviously higher than those of normal controls and patients with vocal cord polyp; their HNR value was lower than those of normal controls and higher than those of patients with vocal cord polyp; their NNE value was lower than those of normal controls and patients with vocal cord polyp (all P<0.05); and their Fo value was similar to those of normal controls and patients with vocal cord polyp. Female leukoplakia patients had a similar result to the male ones. Conclusion: The Jitter, Shimmer, NNE, and HNR values can be used as sensitive indicators for voice assessment of patients with larynx leukoplakia; among them the Jitter and Shimmer values have the strongest sensitivity and can be used as indicators for diagnosis and prognosis of larynx leukoplakia.

China ; Humans ; Immunohistochemistry ; standards ; Pathology, Clinical ; methods ; Quality Control

Objective To evaluate the effect and safety of low or medium heparinization in porcine model for coronary artery restenosis and investigate the rational dose of unfractionated heparin.Methods According to the doses of unfractionated heparin given to the animal models 24 porcines were randomized into low heparinization group(100 U/kg) and medium heparinization group(150 U/kg).We took blood samples from each porcine and measured the ACT value before intravenous injection of unfractionated heparin and 5 minutes,20 minutes,30 minutes and 60 minutes after heparinization.We compared the effects of anticoagulation,compression hemostasis and the occurance of adverse events.Results Both low and medium heparinization groups achieved the ACT peak value(245.3?93.64 s vs.241.0?37.29 s,P=0.824) 5 minute after intravenous injection of heparin and maintained high ACT value(191.8?53.06 s vs.184.6?42.82 s,P=0.707) within 20 minutes.The ACT value of medium heparinization group was higher than low heparinization group 30 minute later(193.9?58.95 s vs.154.0?28.20 s,P=0.005).The compression time for hemostasis in medium heparinization group was longer than low heparinization group(17.7?2.96 mins vs.14.3?4.44 mins,P=0.042).No peri-operation adverse events were found in both groups.Conclusion Low heparinization can provide adequate anticongulation for a 20-minute-operation and at the same time reduce the compression time for hemostasis in the porcine model for coronary artery restenosis.

Objective To evaluate the efficacy and safty of Polymer-free sirolimus eluting-stents(PFSES) in preventing restenosis in porcine coronary model.Methods Bare metal stents(BMS)(n=13),polymer-free bare metal stents(PFBMS)(n=13),polymeric sirolimus-eluting stents(PSES)(n=13) and PFSES(n=13) were implanted in left anterior descending coronary arteries(n=26) and left circumflex coronary(n=26) of 27 swines randomly.Coronary angiography was performed 28 days and 90 days after the procedure.Twelve animals were sacrificed for histomorphologic analysis after 90 days.Results The 28-day(n=24) and 90-day(n=12) outcome by quantitative coronary angiography(QCA) showed significant reduction in luminal loss(LL) in PFSES(LL:0.69?0.49 mm vs 1.27?0.36 mm,P=0.041;0.77?0.44 mm vs 1.33?0.29 mm,P

Objective To evaluate the efficacy and safty of bioabsorbable polylactic acid sirolimus eluting-stents(BPSES) in inhibiting neointimal hyperplasia in porcine coronary model.Methods Bare metal stents(BMS)(n=18),mere bioabsorbable polylactic acid polymer coated stents(BPOS)(n=18) and BPSES(n=18) were implanted in left anterior descending(n=18),left circumflex coronary(n=18) and right coronary artery(n=18) of 18 swines in random.Coronary angiography was performed 28 days and 90 days after the stenting procedure and histomorphologic analysis was done in a certain number of animals after 7 days(n=4),18 days(n=6) and 90 days(n=6),respectively.Results The 28-day(n=6) and 90-day(n=6) outcome by quantitative coronary angiography(QCA) showed significant reduction in luminal loss(LL) in BPSES(28-day-LL: 0.54?0.45 mm vs 1.11?0.45mm,P=0.048;90-day-LL:0.42?0.34 mm vs 0.96?0.41 mm,P=0.024)compared with BMS.With similar injury scores,histomorphologic analysis on day 28 showed there was a significant reduction in neointimal tissue proliferation with BPSES compared with BMS control(average neointimal area: 0.90?0.40 mm2 vs 1.88?0.71 mm2,P=0.015).High magnification histomorphologic examination revealed similar inflammation score and endothelialization score between BPSES and BMS.Conclusion Bioabsorbable polymeric sirolimus-eluting stents showed reduction in neointimal hyperplasia with good biocompatibility in porcine coronary model.

Purpose There is no agreement for contrast enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant thyroid nodules. This paper aims to evaluate the diagnostic value of the conventional and contrast-enhanced ultrasonography in the diagnosis of thyroid nodule by meta analysis. Materials and Methods Literature search was performed in PubMed, CNKI and Wanfang databases to identify relevant English and Chinese literatures by using pathological results as the gold standard from January 1990 to September 2014. The quality of each selected study was evaluated by QUADAS. The pooled weighted sensitivity, specificity and the corresponding 95% CI were calculated. Summary receiver operating characteristic curves (SROC), area under curve (AUC) and the Q* index were also calculated. Results A total of 14 literatures (1970 nodules) were included, the pooled weighted sensitivity and specificity of conventional ultrasonography were 0.74 and 0.70; those of contrast-enhanced ultrasonography were 0.86 and 0.82. The AUC by using the two methods were 0.84 and 0.93, respectively, and the Q* index were 0.77 and 0.86, respectively. Conclusion In the diagnosis of thyroid nodule, the accuracy of contrast-enhanced ultrasonography is better than conventional ultrasound; however, both of them have high clinical value in the diagnosis of thyroid nodule, thus they are helpful in avoidance of unnecessary surgical treatment in patients with thyroid disease.

BACKGROUND: The proliferation and differentiation of mesenchymal stem cells (MSCs) lack of regulatory functions. Following combining with suitable vectors, MSCs cannot highly effectively proliferate and differentiate, which are keys to prevent MSCs entering the clinic. It is of great importance to effectively regulate the differentiation of stem cells into osteoblasts using pulse electromagnetic field.OBJECTIVE: To investigate the differentiation of mouse MSCs into osteoblasts in vitro following stimulation of pulse electromagnetic field.DESIGN, TIME AND SETTING: The cytological in vitro controlled study was conducted at the Laboratory of Department of Orthopaedics, Puai Hospital of Tongji Medical College, Huazhong University of Science and Technology from May 2004 to October 2007.MATEIRALS: Totally 20 BALB/C mice were supplied by the Experimental Animal Center of Tongji Medical College. Pulse electromagnetic field deviser was designed and made by the Department of Electric Machine, Naval University of Engineering.METHODS: Mouse bilateral femur was sterilely isolated. BMSCs were harvested by the Percoll density gradient centrifugation,and purified and proliferated by the adherent method. Cells at the third passage (2×10~7/L) were incubated in a 6-well plate, and then divided into 4 groups. Cells in the blank control group were incubated in the complete medium. Cells in the pulse electromagnetic field underwent pulse electromagnetic field radiation of 50 Hz, sinusoidal wave, and 1 mT, twice a day, once 30 minutes, with an interval of 12 hours, totally 10 days. Cells in the osteogenic induction group were incubated in the complete medium, supplemented with dexamethasone, sodium glycerophosphate and VitC. Cells in the pulse electromagnetic field + osteogenic induction group were subjected to the same pulse electromagnetic field radiation and then incubated in the complete medium.MAIN OUTCOME MEASURES: The differentiation of BMSCs was measured.RESULTS: Results of alkaline phosphatase staining showed that cells were negative in the blank control group, but weakly positive in the pulse electromagnetic field group, positive in the osteogenic induction group, and strongly positive in the pulse electromagnetic field + osteogenic induction group 10 days following intervention. Compared with the blank control group,absorbance value of type I collagen immunohistochemistry was significantly greater in the osteogenic induction group, pulse electromagnetic field + osteogenic induction group (P < 0.05, P < 0.01).CONCLUSION: Pulsed electromagnetism fields of 50 Hz, waves of sine, with the intensity of 1 mT could promote alkaline phosphatase and type I collagen expression and enhance the differentiation of mouse BMSCs into osteoblasts in vitro.

Objective To compare the clinical effects of intramedullary nails and locking compression plate in the treatment of femur shaft fracture.Methods The clinical data and follow-up records of 43 patients with femur shaft fracture treated by intramedullary nails and locking compression plate were retrospectively reviewed.Including 31 males and 12 females with an average age of 40.07 years(25 to73).According to AO classification:5 cases were type A,24 cases were type B,14 cases were type C.26 patients in group A treated by intramedullary nails and 17 patients in group B treated by locking compression plate.Operation time,fracture union time,blood loss and complications were compared between the two groups.The Karlstrom and Olerud result were compared and analyzed.Results All patients were followed up at an average of 15 months(range 5-24) after surgery.According to Karlstrom and Olerud score system,the excellent and good rate of group A was 88.4％,higher than the group B 82.3％.But there was no significant difference between the two groups.In group A:the operation time (113.77 ±20.14)min,the blood loss in the operation (386.74 ± 65.16) ml,clinical bone healing (15.52 ± 1.77) weeks.All these outcomes were better than group B (P ＜ 0.01).One case in group A appeared screw loose,but X-ray showed the nail stable,the bone wasn't displacement.One case in group B appeared broken plate 1 month after operation,and received twice operation,the clinical outcome was good as well.Another 1 case with fracture delayed union in group B,after internal fixation removed,we check the X-ray showed bone union.Conclusion Two methods of treatment femur shaft fracture can all reach the above requirement.Fixation of intramedullary interlocking nail is the preferred surgery than locking compression plate.

Objective To establish a sensitive,specific,simple and high-throughput method for detection of the epidermal growth factor receptor (EGFR) mutation in the plasma samples of patients with non-small cell lung cancer (NSCLS) by the use of mutant-enriched liquid chip (MEL) assay.Methods The specific probes for the EGFR exon19 E746-750 deletion,exon 21 L858R mutation and wild-type sequence were designed and coupled to the microspheres coding with different fluorescent dye.The probe coupling efficiency was verified by crossing hybridization test with biotin-labeled reverse sequence.A blood-based MEL approach which integrates a sensitive mutant-enriched PCR and quantitative high throughput liquid chip assay for assessment of EGFR mutations was developed.The sensitivity and specificity of MEL was further evaluated using the mixture with different copy numbers of mutant and wild-type plasmids as template.The mutations of exon 19 and 21 of EGFR gene in plasma samples from 201 patients with stage ⅢB or Ⅳ NSCLC who enrolled in the First Affiliated Hospital of Guangzhou Medical College from September 2008 to April 2010 were analyzed by both the MEL and the mutant-enriched PCR assay.The result comparison was made between direct sequencing and MEL in 50 cases whose EGFR gene type had been tested by MEL and mutantenriched PCR.The correlation of EGFR gene mutation and the response to the Geftinib treatment was analyzed in 16 patients with lung adenocarcinoma as well.Results The probes were successfully coupled to the microspheres encoding with different fluorescent dye,and could be specifically recognized by the corresponding target sequence.The MEL was capable of detecting as few as 10 copies of EGFR mutants (sensitivity was 0.1％).Among the enrolled 201 cases of advanced NSCLC,the detection rate of the EGFR exon19 E746-750 del and exon 21 L858R was 55.7％ (112/201) by MEL assay.Conpared with mutantenriched PCR[58.2％ (117/201)],the coincidence rate was 97.5％ (196/201).There was no statistically significant difference between the results of mutant-enriched PCR and MEL (x2 =3.20,P ＞ 0.05).The mutations detection rate was 22.0％ (11/50) by directing sequencing,which was significantly lower than by MEL[50.0％ (25/50),x2 =12.07,P ＜ 0.05].Among the 16 patients treated with Gefitinib,9 cases who had EGFR mutation showed a higher response rate(P =0.041)and prolonged progression-free survival (x2 =6.76,P =0.009) after the treatment compared to those 7 who without EGFR mutation.Conclusions A new method of MEL with accuracy,specificity,fast and high-throughput is established for the detection of EGFR 19 E746-750 deletion and exon 21 L858R mutations in plasma from advanced NSCLC patients.It has the ability to provide the most direct and valuable guidance for clinicians to make decision on EGFR tyrosine kinase inhibitors therapy in the advanced NSCLC paticnts.

Objective To evaluate the effectiveness and safety of terazosin in the treatment of benign prostatic hyperplasia (BPH)patients with concomitant hypertension.Methods A singlecenter prospective clinical observational study was conducted from March,2006 to March,2010 in our center.The main endpoints were the changes of IPSS total score,diastolic and systolic blood pressures at the end of 4 weeks and 3 monthes compared with the baseline,The second endpoints were Qmax value at the end of 4 weeks and 3 monthes compared with the baseline,Safety was assessed by adverse events.Results There were 212 patients in the study recruited,and 189 patients completed the study.All patients had BPH combined with hepertension.All patients were randomly devided into two statistical analysis group,blood pressure well controled and not well controled group,In the well controlled group,the IPSS socre reduced from 22.31 ± 5.18 at baseline to 15.64 ±3.91 at the end of the 4th weeks and 13.16 ± 3.53 at the end of 3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).The Qmax were improved significantly from (7.87 ± 2.41 ) ％ at baseline to (14.19 ±2.64)％ at the end of the 4th weeks and (15.69 ±2.77)％ at the end of3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).Terazosin had moderate effect in blood pressure decreasing (P ＜ 0.05 ),and all patients were within normal blood pressure range.In the uncontrolled group,the IPSS socre reduced from 21.55 ± 4.82 at baseline to 15.44 ± 3.66 at the end of the 4th weeks and 12.96 ± 3.11 at the end of 3rd monthes in the blood pressure well controled group populatin (P ＜ 0.01 ).The Qmax were improved significantly from ( 8.27 ± 2.27 ) ％ at baseline to ( 14.26 ± 2.87) ％ at the end of the 4th weeks and ( 15.51 ±2.92) ％ at the end of 3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).Terazosin decreased BPH patient blood pressure with controlled patients and unctrolled patients additionaly to other blood pressure medicine (P ＜ 0.05 ),and no severe side effect occured.At the end of the study,all patients were taking drug continuously and were followed.Conclnsion Terazosin can significantly improve the symptoms and quality of life in BPH patients with hypertension with good safety and compliance.