Background: Coughing and hemodynamic fluctuations during emergence from anesthesia after a craniotomy can result in serious complications. This study evaluated whether the ultrasound-guided superior laryngeal nerve block (SLNB) attenuates these tracheal tube-related responses. Methods: Eighty patients scheduled for elective craniotomy were randomized into the control (Group C, 2 ml 0.9% saline per side) and SLNB (Group S, 2 ml 1% lidocaine per side) group. The primary outcome was the incidence of coughing during the recovery period. Secondary outcomes included the severity of coughing, hemodynamic fluctuations, need for rescue interventions, anesthesia-related parameters, and complications. Results: Compared to controls, the patients in Group S experienced a significantly reduced incidence (78.9% vs. 48.6%; P = 0.006) and severity (P < 0.001) of coughing during emergence. The mean arterial pressure and heart rate were also more stable during and after extubation in Group S than in Group C. Furthermore, Group S required a significantly lower dose of nicardipine during the emergence period (P = 0.032), and both the incidence of and visual analog scale scores for postoperative sore throat at 6 h after extubation were markedly reduced (P = 0.035). No significant differences were noted between the groups in terms of propofol consumption, emergence agitation, extubation time, post-anesthesia care unit stay duration, or complications. Conclusions The SLNB significantly suppressed extubation-related responses during anesthetic emergence after craniotomy by reducing coughing and attenuating hemodynamic fluctuations, thereby contributing to a smoother emergence profile.

【Objective】 To investigate the protective effects of aflexible sleeve penile protection device on reducing postoperative pain and wound edema in patients after circumcision. 【Methods】 A total of 54 patients who underwent circumcision at Yan’an Branch of Peking University Third Hospital during Feb.1 and May 31, 2023 were enrolled.The patients were randomly divided into the experimental group and control group, with 27 patients in either groups.Patients in the experimental group were treated with a flexible sleeve penis protection device after surgery, and patients in the control group were treated with traditional gauze bandage after surgery.Postoperative pain, wound edema and complications were compared between the two groups. 【Results】 In terms of pain, the visual analogue scale of the experimental group was significantly lower at 6 hours [(1.7±0.9) vs.(3.3±1.9), P<0.001] and 2 days [(2.0±1.3) vs.(3.3±1.3), P<0.001] after surgery than that of the control group, but there were no statistically significant differences between the two groups on the 4th and 7th postoperative days (P>0.05).In terms of edema, the edema score of the experimental group was significantly lower than that of the control group on the 2nd postoperative day [(2.0±1.0) vs.(4.0±0.8), P<0.001] , the 4th postoperative day [(1.5±1.2) vs.(2.6±0.9), P<0.001] , and the 7th postoperative day [(0.9±1.3) vs.(2.3±1.5), P<0.001] .There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). 【Conclusion】 The flexible sleeve penile protection device has significant effects of reducing early postoperative pain and reducing edema in patients undergoing circumcision.

Objective:To establish an automatic colorimetric method for determination of iodine in drinking water by enzyme-labeled instrument (hereinafter referred to as this method).Methods:The water iodine was measured in the range of 0 - 10 μg/L and 0 - 100 μg/L, experiments were carried out on linear relationship, detection limit, precision and accuracy of this method. And the results were compared with the National Reference Laboratory for Iodine Deficiency Disorders recommended arsenic cerium catalytic spectrophotometry method.Results:In the range of 0 - 10 μg/L and 0 - 100 μg/L, all│ r│ > 0.999 0, the detection limits were 0.6 and 1.1 μg/L (samples were 200 and 100 μl), respectively; the relative standard deviation ( RSD) of water samples of low, medium and high iodine mass concentrations were < 3%, the recovery rates ranged from 92.5% to 108.3% and 93.2% to 108.9%, with a total average recovery of 100.0% and 100.3%, respectively. This method and arsenic cerium catalytic spectrophotometry method were used to detect 40 water samples in the range of 0 - 10 μg/L and 0 - 100 μg/L, there was no significant difference in water iodine content between the two methods ( t = 0.99, P > 0.05). Conclusion:This method has good linear curve relationship for determination of water iodine content, good precision and high accuracy, and it is suitable for wide application.

Objective To explore the iodine nutritional status of people after adjusting iodine content in iodized salt in Anhui Province. Methods In 2014, 30 counties (cities, districts) were selected in Anhui Province according to the probability ratio sampling method (PPS), and one school was selected in each county (city, district), and 50 children aged 8 - 10 years were selected in each school. Urine and household salt samples were collected, urine and salt iodine levels were tested, and thyroid was examined using B-ultrasound. In the township where the school was located, 20 pregnant women's urine samples and household salt samples were collected for urine and salt iodine detection. The salt iodine level was measured by direct titration, Chuan salt and other fortified salt iodine levels were determined by arbitration method (GB/T 13025.7-2012). Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry (WS/T 107-2006). Results A total of 1575 children's household salt samples were collected, the median salt iodine was 23.77 mg/kg, the qualified iodized salt consumption rate was 93.65％(1475/1575); 600 household salt samples were collected from pregnant women, the salt iodine median was 23.50 mg/kg, the consumption rate of qualified iodine salt was 96.33％( 578/600 ) . A total of 1575 urine samples were collected from children, the median urinary iodine was 242.20 μg/L; six hundred urine samples were collected from pregnant women, and the median urinary iodine was 158.15μg/L, 43.33％(13/30) of the counties (cities, districts) pregnant wowen median urinary iodine < 150 μg/L. A total of 1575 thyroid glands were examined in children aged 8 to 10 years, and the thyroid enlargement rate was 3.75％ (59/1575). Conclusion The iodine nutrition of children aged 8 - 10 years in Anhui Province is higher than the appropriate level, but the iodine is not in the excessive state, and the iodine nutrition of pregnant women in some counties (cities, districts) is insufficient.

Objective: To observe the clinical effects of intranasal excision on nasal vestibular cyst under nasal endoscopy. Methods: Forty-two cases of nasal vestibular cyst diagnosed in the Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Third Central Hospital between Feb. 2011 and Jan. 2016 were treated by intranasal excision under nasal endoscope. Results: All the 42 patients were cured without any complication. The rate of complete stripping was 78.6% (33/42), with operating time of (21.31±4.04) min and bleeding amount of (10.26±2.13) ml. During follow-up ranged from 6 months to 5 years, with the median follow-up time being 19.6 months, no post-operative recurrence and complication were found. Conclusion Intranasal excision for nasal vestibular cyst under nasal endoscopy is an effective method, which can be widely used in hospitals.

Objective To compare the biomechanical characteristics of lengthened sacroiliac screw and long sacroiliac screw fixated in different ways for the treatment of central vertical sacral fractures to provide reference for clinical practice.Methods A finite element model with three dimensions of Tile type C pelvic ring injury (central type Denis Ⅲ fracture of sacrum) was produced.The central sacral fractures were fixated with lengthened sacroiliac screw or long sacroiliac screw in 7 types of models respectively as follows.(1) One long sacroiliac screw was fixated in S1 segment from the right (C1);(2) One long sacroiliac screw was fixated in S2 segment from the right (C2);(3)Two long sacroiliac screws were fixated in S1 and S2 segments respectively from the right (C12);(4) One long sacroiliac screw was fixated in S1 segment from the right and one long sacroiliac screw was fixated in S2 segment from the left (C12hybrid);(5) One lengthened sacroiliac screw was fixated in S1 segment from the right (J1);(6) One lengthened sacroiliac screw was fixated in S2 segment from the right (J2);(7)Two lengthened sacroiliac screws were fixated in S1 and S2 segments respectively from the right (J12).The shift and angle displacement of the central superior surface of sacrum in the case of standing on both feet were measured and compared.The maximum Von Mises stresses in different positions were measured.And various mechanical indices (including stresses of various parts and stress distribution of screws and pelvis,etc) were also quantified and compared.Results The stability of the posterior ring-screw complex was optimal when the sacrum was fixated with S1 & S2 lengthened sacroiliac screws.The maximum Von Mises stresses of screw were affected by sacral segments,namely,S1 ＞ S2 ＞ S1& S2.The maximum Von Mises stress of screws in S1 and S2 segments were similar.The maximum stress of the lengthened sacroiliac screw was lower than that of the long sacroiliac screw.The maximum Von Mises stress of bilateral sacroiliac joints in the lengthened sacroiliac screw fixation model was similar to that of normal pelvis.The maximum stress in the left sacroiliac joint of the long sacroiliac screw fixation model was larger than that of the normal pelvis.The maximum Von Mises stress of screw-bone interface of the long sacroiliac screw fixation model was larger than that of the lengthened sacroiliac screw fixation model.The screw stress distribution of the lengthened sacroiliac screw was superior to that of the long sacroiliac screw,and the screw stress distribution of the double segment fixation was superior to that of the single segment fixation.There was relatively less difference between the pelvic stress distribution of double segment fixation model and that of the normal pelvic model.Conclusion The fixation of S1 & S2 lengthened sacroiliac screws utilized in central sacral fractures of Tile C pelvic ring injury results in a more stable posterior pelvic ringscrew complex,more dispersed screw stress and better pelvic stress distribution which is closed to normal,and can also reduce the risk of internal fixation failure as well as lower back pain.

Objective To investigate the clinical features and treatment of residual gallbladder lesions after cholecystectomy.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 83 patients with residual gallbladder lesions after cholecystectomy who were admitted to the Affiliated Hospital of Inner Mongolia Medical University between January 2009 and April 2016 were collected.Among the 83 patients,74 had residual gallbladder (41 combined with bile duct stones and 33 with simple residual gallbladder)and 9 had simple residual bile duct stones.Patients received laboratory and imaging examinations,and then selected suitable surgery according to residual lesions.Observation indicators included:(1) clinical features:medical history,clinical manifestation,features of laboratory and imaging examinations;(2) surgical and postoperative situations:surgical procedure,operation time,volume of intraoperative blood loss,time of drainagetube removal,postoperative complications and duration of postoperative hospital stay;(3) postoperative pathological examination;(4) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect survival of patients and recurrence of lesions using abdomen color Doppler ultrasound up to October 2016.Measurement data with normal distribution were represented as ~ ±s.Results (1) Clinical features:① medical history:all the 83 patients had histories of cholecystectomy,including 57 with emergency operation and 26 with selective operation.② Clinical manifestation:initial clinical manifestation occurred at 1-324 months postoperatively,with an average time of 96 months.Of 83 patients,49 had right upper abdominal colic associated with right shoulder or back rediating pain,fever,nausea and vomiting,24 had jaundice as the main symptoms,8 had gradually worse conditions,with right upper quadrant abdominal pain,chills and fever associated with jaundice in the advanced stage and 2 had abdominal discomfort associated with incomplete intestinal obstruction.③ Laboratory examination:elevated alanine transaminase (ALT) and aspartate transaminase (AST) levels were detected in 48 patients,elevated total bilirubin (TBil) level in 28 patients and elevated serum and urinary amylase level in 4 patients,respectively.④ Imaging examination:of 83 patients,77 had positive results of magnetic resonanced eholangio-pancreatography (MRCP),43 had positive results of abdominal color Doppler ultrasound and 39 (4 combined with pancreatitis) had positive results of abdominal computed tomography (CT).(2) Surgical and postoperative situations:all the 83 patients underwent surgery.Of 74 patients with residual gallbladder,72 underwent residual gallbladder resection (of 41 combined with bile duct stones,35 undergoing residual gallbladder resection + bill duct exploration and removing the stone + T-tube drainage,6 initially undergoing endoscopic sphincterotomy for removing bile duct stones and then residual gallbladder resection and 31 undergoing simple residual gallbladder resection),1 combined with residual gallbladder cancer underwent residual gallbladder resection + common bile duct resection + hepatic duct-jejunum internal drainage and 1 combined with residual gallbladder cancer and common bile duct space-occupying lesion underwent palliative biliary-enterostomy.Nine patients with simple residual bile duct stones underwent endoscopic sphincterotomy for removing bile duct stones.Operation time,volume of intraoperative blood loss,time of drainage-tube removal and duration of postoperative hospital stay were (92±39)minutes,(63±12)mL,(5±4)days and (9±5)days in 74 patients with residual gallbladder,respectively.There was no severe postoperative complication.Operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were (57±33)minutes,(25±9)mL and (5 ± 3) days in 9 patients with simple residual bile duct stones,respectively.No severe complication was occurred in 9 patients.(3) Postoperative pathological examination:the length of residual cystic duct in 74 patients with residual gallbladder was (2.8 ± 1.0) cm,combining with stones.Of 74 patients,simple hyperplasia of residual gallbladder were detected in 54 patients,dysplasia in 14 patients,tumor-like hyperplasia and benign tumor in 4 patients and adenocarcinoma in 2 patients.(4) Follow-up situation:all the 83 patients were followed up for 6-71 months,with a median time of 33 months.Eighty-one patients were healthy survival,without recurrence of lesions.One patient had recurrence of bile duct stones at 34 months postoperatively,and then was cured by choledochojejunostomy,without recurrence up to the end of follow-up.One patient with residual gallbladder cancer complicated with common bile duct space-occupying lesion died at 9 months postoperatively.Conclusions Patients have recurrent right upper abdominal colic associated with right shoulder or back rediating pain,fever and jaundice after cholecystectomy,and lesions of residual gallbladder or bile duct stones should be considered.Reoperation is safe and feasible for patients,with a good clinical outcome.

Adenoma, Pleomorphic ; diagnosis ; pathology ; Humans ; Trachea ; pathology ; Tracheal Neoplasms ; diagnosis ; pathology

Objective To study the impact of changes in the pharynx on the vocal functions and resonance functions to evaluate the effects of UPPP on voice and in order to provide a reference for the selection of UPPP sur‐gery population .Methods The 30 male adult patients who underwent UPPP surgery were recorded pre-surgery ,1-week post-surgery and 3-month post-surgery speech .Then the multi-dimensional voice program (MDVP) , linear prediction coding (LPC) ,the Nasometer Ⅱ(model 6450) were used to evaluate the vocal functions ,the oral resonance functions and the nasal resonance function .Results F0 ,jitter ,shimmer ,and NHR were unchanged from the pre-surgery to the post-surgery condition .One week after the surgery ,F1 ,F2 of /a/,/i/and /u/were un‐changed (P>0 .05) .Three months after surgery ,F1 ,F2 of the vowel /a/and F1 of the vowel /u/were remained essentially unchanged (P>0 .05);while the frequency of F1 ,F2 of the vowel /a/and of F2 of the vowel /u/were significantly higher compared to pre-surgery values (P<0 .05) .One week after the surgery ,the nasalance scores of the oral sentence ,the oranasal sentence ,and the nasal sentence were unchanged (P>0 .05) .Three months after surgery ,the nasalance scores of the oral sentence and the oranasal sentence were unchanged (P>0 .05);while the nasalance scores of the nasal sentence were significantly higher compared to pre-surgery values (P<0 .05) .Conclu‐sion UPPP doses not affect the vocal function .But it might have a certain effect on resonance function ,demonstra‐ted by the change of several formant frequency and nasalance .UPPP in all professional voice users should be cau‐tious .Such patients who want to undergo UPPP must be informed of this potential modification of the voice after sursery .

Objective Xiangqingzhitong spray ( XQ spray) is a kind of class V new Chinese drugs .This paper studied the anti-inflammatory and analgesic effects of XQ spray to provide experiment evidence for clinical application . Methods Mice were divided into blank control A group , yunnan baiyao aerosol A group , voltaren A group and low , middle and high dose A group of XQ spray.Analgesic effects were studied by observing effect of XQ spray for pain threshold in electrical stimulation test .Mice were divided into blank control B group , yunnan baiyao aerosol B group , voltaren B group and low , middle and high dose B group of XQ spray .Analgesic effects were studied by observing the effects of XQ spray for pain threshold in tail pain tenderness test .Mice were divided into blank control C group , yunnan baiyao aerosol C group , voltaren C group and low,middle and high dose C group of XQ spray .Anti-inflammatory effects were observed by the models of ear swelling induced by xylene in mice.Rats were divided into blank control D group , yunnan baiyao aerosol D group , voltaren D group and low, middle and high dose D group of XQ spray .Anti-inflammatory effects were observed by the models of paw edema induced by carrageenin in rats . Results Electrical stimulation test showed that middle and high dose A group of XQ spray could enhance the pain threshold and the analgesia percentage reached 90%after the administration of 15 min and 30 min.Compared with control group , significant difference was found in medium and high dose A group (P<0.05).High dose B group of XQ spray could enhance pain threshold in tail pain tenderness test markedly after the administration of 15 min and 30 min and the difference was significant compared with control group ( P<0.01).Middle dose C group could inhibit the ear swelling induced by xylene in mice and the difference was significant compared with control group ([4.41 ±4.55]mg vs [9.15 ±3.94]mg,P<0.05).High dose C group could inhibit the ear swelling induced by xylene in mice and significant difference was found compared with control group ([3.62 ±3.56]mg vs [9.15 ±3.94] mg,P<0.01). High dose D group could inhibit the paw edema induced by carrageenin in rats after the administration of 30 min and there was signifi-cant difference compared with control group ([1.19 ±0.94]mg vs [2.54 ±1.28]mg,P<0.01). Conclusion XQ spray has sig-nificant anti-inflammatory and analgesic effects .