BACKGROUND: A number of clinical trials addressing olfactory ensheathing cells for the treatment of chronic spinal cord injury have been conducted in the world, but the efficacy and safety are still controversial. OBJECTIVE: To evaluate the safety and efficacy of olfactory ensheathing cell transplantation for chronic spinal cord injury, and to further compare its short-and long-term efficacy. METHODS: PubMed, Cochrane Library, EMBASE, CNKI and WanFang databases were searched at July 23, 2018 for retrieval of clinical trials addressing olfactory ensheathing cells in the treatment of chronic spinal cord injury. Types and cases of adverse events during the safety trial should be recorded in detail. In the enrolled studies, American Spinal Injury Association scale was used to assess the motor, light touch, and pinprick scores of spinal cord injury patients before and after cell transplantation. The follow-up time was recorded. Systematic evaluation of efficacy data was performed using Review Manager 5.3. RESULTS AND CONCLUSION: Both short-and long-term follow-up data showed that the neurological function of patients was significantly improved after olfactory ensheathing cell transplantation (P < 0.05) , and the results were homogeneous (I2 < 50％ and P> 0.1). However, the long-term efficacy was not as good as the short-term efficacy, which may be related to chronic rejection and olfactory ensheathing cell survival. The overall adverse event rate was 8.99％, and no complications associated with olfactory ensheathing cells occurred. These findings show that olfactory ensheathing cell transplantation is effective and safe in the treatment of chronic spinal cord injury, but it is still necessary to explore more minimally invasive approaches to reduce surgical complications. In addition, a large number of high-quality experiments and clinical trials are warranted to confirm factors affecting the long-term efficacy of olfactory ensheathing cell transplantation.

Objective To explore the effect of Four Flavor Elimination Decoction on treatment of brain metastases.Methods Sixty patients with brain metastases,admitted to our hospital from January 2015 to January 2017,were selected.According to the willing of the patients,they were divided into observation group and control group (n=30).The patients from control group were given conventional medicines,and the patients from observation group were supplemented with Four Flavor Elimination Decoction on the basis of control group.The clinical efficacy of the two groups after treatment,and scores of Kamofsky performance status scale (KPS) and changes of T lymphocyte subsets and tumor markers before treatment and on 7th,14th,21th and 28th d of treatment were observed.Results The total effective rate of the observation group after treatment was 100％,which was significantly higher than that of the control group (50％,P＜0.05).KPS scores of the observation group were significantly higher than those of the control group on 21st and 28th d of treatment (P＜0.05).The levels of CD3+,CD4+ and CD8+ in the observation group were significantly higher than those of the control group after treatment (P＜0.05).The levels of carcino-embryonic antigen,carbohydrate antigen (CA)50 and CA125 in the observation group were significantly lower than those of the control group (P＜0.05).Conclusion Four Flavor Elimination Decoction is efficient in treatment of brain metastases,which can improve quality of life and immune indexes,and is worth of clinical application.

Objective To discuss the effectiveness and safety of Ommaya sar implantation through neuronavigation in treatment of intracranial cysts. Methods Twenty-eight patients with intracranial cysts (cystic glioma, cystic metastases, radioactive encephalopathy cystic necrosis), admitted to our hospital from January 2007 to December 2014, were chosen in our study; these patients accepted Ommaya sar implantation through neuronavigation. The clinical data, disease courses, CT scan results, operation efficacies and postoperative complications of these patients were retrospectively analyzed. Results In the 8 patients with cystic gliomas, improvement of clinical symptoms and activity of daily living was noted in 6 patients; imaging re-check indicated focus shrink<50%in 6 patients, enjoying an effective rate of 75%. In the 12 patients with cystic metastases, the improvement of clinical symptoms and activity of daily living was noted in 9 patients; imaging re-check indicated focus shrink<50% in 9 patients, enjoying an effective rate of 75%. In the 8 patients with radioactive encephalopathy cystic necrosis, the improvement of clinical symptoms and activity of daily living was noted in 7 patients;imaging re-check indicated focus shrink<50%in 7 patients, enjoying an effective rate of 87.5%. No antidromic intracranial infection was noted in these 28 patients. Conclusion Implantation of Ommaya sar through neuronavigation is an effective treatment in intracranial cysts, enjoying minimally invasiveness.

Objective To investigate the changes of uvulopalatopharyngoplasty on the auditory function in adult patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS).The possible mechanism of hypoxemia was analyzed,and hypercapnia might affect auditory function and the effect of operation to hearing was improved.Methods A total of 82 adult patients who were made a diagnosis by polysomnography (PSG) with severe OSAHS had been diagnosed by pure tone audiometry,tympa-nometry,auditory brainstem responses (ABR),and otoacoustic emissions (OAE) before and 6 months after surgical treatments.The control group included 43 non-snoring healthy people through the same line of the above test.Results (1)Among 82 patients who underwent uvulopalatopharyngoplasty,symptoms were resolved in 51 patients,significantly improved in 24 patients,and somewhat improved in7 patients at 6 months followed-up,yielding a total effective rate of 100％.(2)There were no significant differences in hearing threshold across 250 to 4 000 Hz on pure tone audiometry between OSAHS and control groups (P ＞ 0.05),although hearing thresholds at high frequencies showed significant differences (P ＜ 0.05).(3)The latencies of ABR waves Ⅰ and Ⅴ in the OSAHS group were significantly longer than control group (P ＜ 0.05).The interpeak lantency intervals of wave Ⅲ ～ Ⅴ in patients with OSAHS were longer than that in the control group (P ＜ 0.05).No significant difference was showed before and after surgery (P ＞ 0.05).(4)Distortion product otoacoustic emission (DPOAE) detection rate and amplitudes at all frequencies were poorer in OSAHS group before surgery compared with the control group (P ＜ 0.05),and significant changes were found after surgical treatments (P ＜ 0.05).Conclusions OSAHS can impair auditory function,probably from chronic hypoxia,which can be improved by surgical treatment in adult patients with severe OSAHS.

Objective To analyze the related factors,and discuss the causes and prevention measures of pharyngocutaneous fistula caused by total laryngectomy.Methods The complete chnical data of 118 patients underwent laryngeal ancer surgery were analyzed retrospectively.Analyzed the relationship between pharyngocutaneous fistula and the factors of sex,age,pre-operative nutrition states,preoperative radiotherapy,prior tracheotomy,neck dissection,tumor position,clinical stage of tumor,patho-staging,post-operative infection comobidity with analysis of single factor.Results Among the 118 cases of laryngeal carcinoma,17 cases were pharyngocutaneous fistula after operation,the incidence was 14.4％ (17/118).According to the statistical analysis results,the predominant influencing factors in the causation of pharyngocutaneous fistula were:pre-operative nutrition states,pre-operative radiotherapy,clinical stage of tumor and post-operative infection.Concusion Pharyngocutaneous fistula after total laryngectomy is related to many factors,avoiding the above mentioned factors can reduce the rate of fistula and improve the life quality.

Objective To compare the efficacies between nasal packing and no nasal packing after endoscopic sinus surgery for chronic sinusitis,and explore the feasibility of no nasal packing after endoscopic sinus surgery.Methods Eighty-two type 1 or type 2 chronic sinusitis patients who received endoscopic sinus surgery under general anesthesia were divided into no nasal packing group (44 cases,75 sides) and nasal packing group (38 cases,65 sides) by random digits table method.The patients in 2 groups were taken preoperative anti-inflammatory and regulation blood pressure treatment.The volume of bleeding,postoperative pain (visual analogue score,VAS),degree of mucosal edema,efficacy and postoperative complications between 2 groups were compared.Results There were no statistical difference in volume of bleeding and efficacy between 2 groups (P ＞ 0.05).The postoperative VAS in no nasal packing group was significantly lower than that in nasal packing group [(2.46 ± 0.54) scores vs.(5.49 ± 1.26) scores],there was statistical difference (P＜ 0.01).There was no statistical difference in mucosal edema score postoperative 1 week and 6 months between 2 groups (P ＞ 0.05),but the mucosal edema score postoperative 1 month in no nasal packing group was significantly lower than that in nasal packing group [(1.32 ±0.63) scores vs.(3.52 ±0.72) scores],there was statistical difference (P ＜ 0.01).Postoperative comphcations in nasal packing group were significantly more than those in no packing group.Conclusion No nasal packing can be performed for type 1 or type 2 chronic sinusitis patients who has no significant bleeding after endoscopic sinus surgery under general anesthesia,it is actually beneficial of relieving distress of the patient and reducing postoperative complications.

Objective To investigate the effect of common diseases by the Charlson weighted index of comorbidities(WIC) in predicting 1-year survival rate of older patients with rectum cancer.Methods Retrospective analyzed 160 patients with rectum cancer who were admitted in general surgery of Beijing Chaoyang Hospital Affiliated to Capital Medical University from Jun.2011 to May 2012.The patients were divided into two groups according to 1-year survival status:survival group (n =123) and death group (n =37).The data were recorded including age,gender,cancer diagnosis,underlying diseases,operation mode (laparoscopic or open) The WIC and the Acute physiology and chronic health Ⅱ (APACHE Ⅱ) score were calculated.Logistic regression analysis was used to determine the independent predictors for 1-year survival rate.Receiver operating characteristics(ROC) curve was used to evaluate the value of WIC in predicting 1-year survival rate.Results Of the 160 patients,123 cases survived,37 cases died at 1 year after treatment.WIC score and APACHE score in death group were (2.2 ± 1.3) and (11.5 ± 5.1),higher than those of survival group (1.3 ± 1.2,9.5 ± 4.3 ;P =0.021,0.014).Multivariate Logistic regression analysis indicated that age,mode of operation,WIC score and APACHE score were related to the 1-year survival status of patients with rectal cancer(OR(95％ CI):1.053 (1.018-1.178,1.021 (1.011-1.906),1.786 (1.203-2.235),1.019 (1.004-1.628).ROC curve area of forecasting of death of the WIC score,APACHE Ⅱ score and the combination of the two are 0.731,0.828,0.959.Conclusion The WIC scoring system can be a good evaluation method for 1-year survival rate in old patients with rectum cancer.

ObjectiveTo explore the prognosis and relationship between soluble differentiation antigen of cluster designation 14 (sCD14) and the injury severity score (ISS) of casualties with multiple injuries.Methods A total of 86 casualties with multiple injuries were enrolled from October 2009 to March 2010,and the severity of trauma of casualties were assessed in ISS score within the first 24 hours after accident,and the patients were divided into survival and non-survival groups as per the outcomes in 28 days after accident. Another 20 healthy subjects served as control group. In multiple injuries group,sCD14 concentrations were detected and APACHE Ⅱ scores were calculated on the 1st,3rd,5th and 7th days after accident.The related coefficient between sCD14 and ISS was calculated and then the values of sCD14 in predicting prognosis were analyzed by ROC curve. ResultsCompared with control group, sCD14 concentrations were obviously higher in casualties of multiple injuries group at all observation intervals ( P ＜0.01). Compared with survival group, casualties of non-survival group had more higher sCD14 concentrations and APACHE Ⅱ scores ( P ＜ 0.05 ).The sCD14 concentration was correlated with ISS and the related coefficient was 0.469 ( P ＜ 0.01 ). ROC curve analysis suggested sCD14 had values in predicting prognosis of casualties with multiple injuries and area under ROC curve was 0.820.Conclusions The concentration of sCD14 is correlated with ISS and can be used for predicting the prognosis of casualties with multiple injuries.

Objective To use tri-operator breast blood oxygen imaging in diagnosis of early stage breast cancer.Methods To analysis and diagnosis eighty cases with the technology of breast blood oxygen imaging.Results The accurate rate of the diagnosis made by technology of breast blood oxygen imaging was 93.75%,the sensitivity of diagnosis was 90.63%,the specificity was 95.83%.Conclusions The technology of breast blood oxygen imaging without the radiation may be a better methods to diagnosis the breast diseases,which has the higher sensitivity than infrared rays examination on breast cancer diagnosis.

Objective To study the efficacy of microvascular decompression in treating cranial nerve diseases. Methods 156 patients were treated with microvaseular decompression,of whom 119 were with trigeminal neuralgia,34 with hemifacial spasm and three with glossopharyngeal neuralgia.Rusults The overall effective rate was 96.8%(151/156) and the corresponding effective rate for the above three conditions were 94.2%,97.1% and 66.7%. Conlusions Mierovaseular decompression iS an effective treatment for cranial nerve diseases.