Objective:To investigate the clinical effect of "ladder reduction method" in the treatment of iliac fracture combined anterior dislocation of sacroiliac joint.Methods:The retrospective analysis was performed on 10 cases of iliac fracture combined anterior sacroiliac joint dislocation admitted to the Affiliated Hospital of Yunnan University from February 2010 to January 2022, among which 5 cases were males and 5 cases were females, aged ranging from 22 to 52 years, with an average age of 38.8 years. All patients were injured in car accidents including 5 cases of C1.2, 3 cases of C2, and 2 cases of C3 fractures according to Tile classification. All patients were treated with the "ladder reduction method" with plate and screw fixation. In the first step, 1-2 Schanz pins were inserted into the iliac crest to control the ilium, and the Schanz pins were appropriately pulled laterally; in the second step, the periosteal stripper was used to pry the reduction between the sacrum and ilium; in the third step, for the patients who still could not be reduced, a 2.5 mm diameter Kirschner wire was placed on the sacrum close to the iliac crest, and a periosteal stripper was inserted between the sacrum and iliac crest, with its tip against the Kirkner wire, and the iliac crest as the fulcrum for pry pulling to separate the two. In the fourth step, the pry was maintained, and then another 2.5 mm diameter Kirschner wire was placed on the sacrum close to the internal margin of the iliac bone. The periosteal stripper was continued to pry between the sacrum and the iliac bone, and the operation was repeated. At the same time, the anterior dislocation of the sacroiliac joint was reduced with traction of the lower limb. Postoperatively, the quality of reduction was evaluated by the Matta score, and the degree of functional recovery after pelvic fracture was evaluated by the Majeed score.Results:Four patients completed the reduction through the first and second steps, and 6 cases of refractory sacroiliac joint anterior dislocation were successfully reduced through the first to fourth steps. The fracture reduction time of 6 patients with refractory anterior sacroiliac joint dislocation was 39.67±3.09 min (range, 35-44 min), with intraoperative blood loss of 300.00±141.42 ml (range, 150-600 ml); in the other 4 cases, the fracture reduction time was 36.75±4.38 min (range, 30-42 min), and the intraoperative blood loss was 225.00±44.30 ml (range, 200-300 ml). All 10 patients were followed up for 12.9±3.7 months (range, 9-20 months). The anterior and posterior pelvic ring fractures were healed in all patients, and the fracture healing time was 12.77±1.62 weeks (range, 10.71-15.28 weeks). At the last follow-up, Matta evaluation was excellent in 5 cases, good in 1 case, and excellent in the other 4 cases. The Majeed scores of 6 cases were 86.50±6.08 points (range, 74-92 points), of which 5 cases were excellent and 1 case was good. The other 4 cases were 81.5±9.39 scores (range, 71-94), of which 2 were excellent and 2 were good.Conclusion:The "ladder reduction method" is a safe, effective and easy-to-operate method for the treatment of iliac fracture combined anterior dislocation of the sacroiliac joint, especially for refractory anterior dislocation of the sacroiliac joint, which can still obtain satisfactory curative effects.

Objective To establish a druggability evaluation method for new targets of anti-tumor drugs by analyzing the mutation genes of common tumors in the digestive system. Methods We collected the mutant gene data of the five common tumors of the digestive system (esophageal cancer, gastric cancer, colorectal cancer, liver cancer and pancreatic cancer) in the Integrative Onco Genomics database, and screened out the genes with higher mutation rates in each tumor. We evaluated the druggability of these genes or their encoded proteins, and discovered the potential targets for the new anti-tumor drugs. Results A total of five tumors, 35 cohorts and 5445 tumor samples were collected in this study. The top 10 mutation genes were selected for further analysis. The canSAR database was used to analyze the druggability of unpublished mutant genes or their encoded proteins, and a total of 17 potential therapeutic drug targets were screened out. Conclusion A method for evaluating druggability of targets based on mutant genes or their encoded protein is established in this study. The application of this method can provide a reference for discovering new anti-tumor therapeutic target, saving the cost and time of target screening in new drug development.

OBJECTIVE To explore the outcomes of CO2 laser assisted stapedotomy with artificial stapes prostheses in the treatment of advanced otosclerosis. METHODS Between January 2010 and January 2014, 15 patients (16 ears) diagnosed as advanced otosclerosis accepted CO2 laser assisted stapedotomy with artificial stapes implantation in our department. The averaged preoperative air conduction threshold of the speech frequency was 70.21 dB HL, the averaged bone conduction threshold was 38.49 dB HL, the averaged air-bone gap (ABG) was 31.72 dB HL. All cases were followed up for more than 6 months after operation. RESULTS All cases accepted auditory follow up after 6 months postoperatively. The speech frequency average air conduction threshold was 43.7 dB HL, the average bone conduction threshold was 28.95 dB HL, the average ABG was 14.75 dB HL. The ABG≤20 dB was achieved in 9 ears (56.3%) and ABG closure (≤10 dB) was achieved in 6 ears (37.5%). No cases appeared intractable vertigo, sensorineural hearing loss, secondary facial paralysis and other serious complications. CONCLUSION CO2 laser assisted technique reduced the probability of serious complications of stapedotomy, most patients with hearing level improved significantly. It's a safe, practical, relatively economical choice for advanced otosclerosis.

BACKGROUND: Acellular dermalmatrix (ADM), as a new material, is generally applied to tissue repair after head and neck tumorectomy. However, hypopharyngeal carcinoma surgery always involves in repair and functional reconstruction of defected tissue; therefore, the application effect of ADM needs to be further studied for repairing laryngopharynx defect. OBJECTIVE: To evaluate the clinical effect of ADM in repairing laryngopharynx defect following tumorectomy. DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Otolaryngology-Head and Neck Surgery, Institute of Battle Surgery, Daping Hospital, the Third Military Medical University of Chinese PLA from May 2005 to June 2006.PATICIPANTS: A total of 25 male cases aged 45-68 years including 22 patients with tumor in the lateral wall of the unilateral piriform fossa and 3 patients with in the posterior wall of laryngopharynxat were finally diagnosed as squamous cell carcinoma. METHODS: According to clinical stages, patients underwent partial or complete laryngopharyngectomy. ADM was used to repair oropharynx mucosa following the laryngopharyngectomy. However, ADM alone was used to repair piece-shaped oropharynx mucosa, limiting by being unable to complete reconstruction of spatial structure. Therefore, myocutaneous flap or other materials combined with ADM was beneficial for reconstruction of laryngopharyngeal cavity following complete laryngopharyngectomy. MAIN OUTCOME MEASURES: The effect of ADM on functional reconstruction of swallowing, breathing, and pronouncing. RESULTS: A total of 25 patients were included in the final analysis. No patients suffered with the pharyngeal fistula. Only one case encountered the subcutaneous infection at day 20 after surgery, but recovering after regular change of dressing and treatment of antibiotics. About 15 patients who accepted the surgery of partial laryngopharyngectomy suffered with bucking, but after 30-60 days, the symptom relieved, even disappeared, in spite of 3 cases still bucking when they swallowed liquid diet. Breathing function was recovered, and tracheal cannula was removed 6-12 months after surgery. Ten of them who accepted total laryngopharyngectomy had resumption of normal oral diet after 20 days. The follow-up periods after the surgery lasted 12-30 months. The allograft became normal mucosa finally, without rejection or scar formation. The follow-up of 10 patients lasted more than 24 months, one case had relapse of tumor, still alive after the second surgery. CONCLUSION: ADM with perfect histocompatibility and easy operability, can be applied to repair deletion of laryngeal or pharyngeal tissue and recover functions of pronouncing, breathing, and swallowing after tumorectomy. The combined use of ADM and musculo-cutaneous flap was effective and satisfactory.

OBJECTIVE: To explore the effects of c-Met-siRNA on the proliferation, movement and invasion of laryngeal carcinoma Hep-2 cells in vitro. METHOD: Firstly, the pSilencer 2.0/c-Met-shRNA recombinant plasmid was transfected into laryngeal carcinoma Hep-2 cells with transfecting agent of cationic liposome Lipofectamine 2000. Secondly,the transfection efficacy was tested by RT-PCR and Western-Blot, then the most inhibitive c-Met-siRNA sequence was elected. Cell proliferation, movement and invasion were detected with MTT, cell migration assay and cell invasion assay, respectively. RESULT: After the transfection of pSilencer 2.0/c-Met-shRNA recombinant plasmid into laryngeal carcinoma Hep-2 cells, the expression of mRNA and protein of c-Met decreased significantly in Hep-2 cells, and ability of the proliferation, movement and invasion of laryngeal carcinoma Hep-2 cells were also inhibited. CONCLUSION The results indicated that c-Met-siRNA can down-regulated the expression of c-Met and markedly inhibited laryngeal carcinoma Hep-2 cell proliferation, movement and invasion. It may have the potential as a therapeutic modality to treat human laryngeal carcinoma.
Apoptosis ; genetics ; Carcinoma, Squamous Cell ; genetics ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Laryngeal Neoplasms ; genetics ; pathology ; Liposomes ; Proto-Oncogene Proteins c-met ; genetics ; RNA, Messenger ; genetics ; RNA, Small Interfering ; genetics ; Transfection

Objective This study is to study the age related changes of the expression of caspase-3 and the apoptosis states of neurons in primary auditory cortex of 15 young C57BL/6J mice(2 months, 15～20 g) and 15 old C57BL/6J mice(10 months, 50～60 g) and to determine probable physical effects underlying these changes. This paper also discusses the relationship of caspase-3 and apotosis states in primary auditory cortex, the possible role of caspase-3 in primary auditory cortex and the pathogenesis of presbycusis. Methods The immunohistochemical methods were applied to explore the differences of the expression of caspase-3 and the apoptosis states determined by TUNEI. method in the primary auditory cortex between young and old C57BL/6J mice. Results The expression of caspase-3 and apoptosis in Al of old C57BL/6J mice was significantly higher than that in the counterpart of young C57BL/6J mice. Conclusion The results presented a direct morphological evidence for the strengthening of caspase-3 in the primary auditory cortex in old C57BL/6J mice. This method has an important role in the formation and development of presbycusis. The expression of caspase-3 participated in the regulatory procedure of apoptosis and may be a possible factor of the etiologies of presbycusis.

Objective To investigate the relationship of impact stress distribution and stress wave dissemination with temporal bone fracture. Methods Twelve donated fresh corpse were selected and impacted with driving force of 800 kPa, 1 200 kPa and 1 400 kPa to establish the model of impact temporal bone fractures. With aid of three-dimensional stereochemical structure image of 64-slice CT, the vitodynamic distribution and dissemination of impacted temporal bone was calculated by using computer simulation. Results (1) The instant velocity, acceleration and energy of impact as well as displace-ment scope of the hammer increased with higher driving force in the tempus. (2) Instantaneous impact of the temporal bone resulted in Von Mises stress concentration area around the impact point. The stress was weakened suddenly in the skull-brain tissue coupling place but later accumulated in the skull base. (3) Only ipsilateral linear fracture occurred when the driving force of impact was 800 kPa. While impact dif-ferent degrees of depressed fractures could be seen and one case showed secondary fracture of the opposite side when the driving force of impact was 1 200 kPa. The impact with driving force for 1 400 kPa begot complex ipsilateral fractures, secondary fracture of the opposite side and skull basal fracture. (4) Frac-ture line of the temporal bone accorded with impact stress concentration area. Conclusions All pa-rameters, stress distribution and dissemination of impact are in accordance with temporal bone fracture during impaet process of the temporal bone, which is of vital significance for diagnosis and protection of impact temporal bone fractures.

0.05). ③All of the OSAHS patients suffered seri-ous lipid metabolic disorders. CONCLUSION ① Fatty infiltration in the pharyngeal tissue may lead to collapse of the pharyngeal airway during sleep. ②The epithelial cells of mucosa,endothelial cells of small vessels and glandular cells of minor salivary glands can potentially produce leptin. Leptin existing with Ob-Rb shows the peripheral action of leptin. The positive ex-pression of leptin and Ob-Rb had no significant differ-ence between the two groups, which may explain theectopic accumulation of lipid. ③ Disordered lipid me-tabolism may not be the determinant factor in the patho-genesis of OSAHS. ④ Endogenous hyperleptinemia may be the protective response to respiratory distur-bance and disordered lipid metabolism, and is also as-sociated with the continuous hypersympathetic activity. The level of leptin in plasma has a positive correlation with the severity of OSAHS.

0.05),but had positive relationship with the clinical stages and lymphatic metastasis of the tumor. Conclusion Livin ? is highly expressed in the tissues and peripheral blood cell from the patients of laryngeal squamous carcinoma,which is closely related to the clinical stages and lymphatic metastasis of the tumor.

Objective To investigate the expression of phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt) and their role in pathogenesis in laryngeal squamous cell carcinoma. Methods Immunohistochemical S-P method was used to detect the expression of PI3K and p-Akt in 40 paraffin-embedded human laryngeal squamous cell carcinoma, 20 cases of polyp of vocal cords and 20 cases of laryngeal papilloma. All the samples were stained by HE method to confirm their pathologic characteristics. Positive rates of PI3K and p-Akt were evaluated by microscopy. Results PI3K and p-Akt showed low expression in the polyp tissues of vocal cords, while they were of significantly higher expression in laryngeal squamous cell carcinoma (P