Objective To explore the clinical efficacy of high-frequency electric snare device under elec-tronic laryngoscope in the treatment of epiglottic cyst.Methods A total of 100 patients with definitely diag-nosed epiglottic cyst receiving outpatient operation treatment in the First Affiliated Hospital of Gannan Medi-cal University from April 2021 to March 2023 were selected as the research subjects and included into the ob-servation group and control group according to the visiting order,50 cases in each group.The observation group was treated with high-frequency electric snare for epiglottic cyst resection under electronic laryngo-scope,and the control group was treated with laryngeal tissue forceps under electronic laryngoscope for uncov-ering operation of epiglottic cyst.The operation time,intraoperative blood loss volume,pain degree within postoperative 24 h,pain duration,complete resection rate and recurrence rate in postoperative 3 months were compared between the two operation methods.Results The operation time,intraoperative blood loss volume,VAS score within postoperative 24 h and pain duration in the observation group were significantly less than those in the control group,the complete resection rate was significantly higher than that in the control group,and the differences were statistically significant (P<0.05).The two groups were followed up for 3 months. Only 2 cases in the control group relapsed,which were epiglottic multiple cyst,and the recurrence rate had no statistical difference between the two groups (P>0.05).No dyspnea,massive bleeding and epiglottic adhesion appeared.Conclusion The high-frequency electric snare device under electronic laryngoscope for treating epi-glottic cyst has the advantages of short operation time,less blood loss,postoperative light pain and high com-plete resection rate.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

OBJECTIVE：To stud y the effects of different processed products of Whitmania pigra on hemorheology and coagulation indexes in acute blood stasis model rats. METHODS ：SD rats were randomly divided into blank group ，model group ， aspirin group ，W. pigra hang-dried product low- ，medium- and high-dose groups ，W. pigra talcum powder-ironed product low- ， medium- and high-dose groups ，W. pigra wine bran-processed product low- ，medium- and high-dose groups ，with 6 rats in each group. Except for blank group ，other groups received subcutaneous injection of epinephrine hydrochloride and ice water bath for 15 d to induce acute blood stasis model. From the 8th day of modeling ，rats in aspirin group were given aspirin 0.2 g/kg intragastrically. Rats in each dose group of W. pigra processed products were given relevant medicine 0.35，1.4，3.5 g/kg intragastrically（calculated by crude drug ）. Rats in blank group and model group were given constant volume of normal saline intragastrically， once a day ， for consecutive 8 days. Hemorheology indexes as whole blood viscosity （high， medium and low shearrate ），plasma viscosity ，erythrocyte com deformation index ，erythrocyte aggregation index ，hematocrit， and blood coagulation indexes as prothrombin time （PT）， mail：wcl19960125@163.com activated partial prothrombin time （APTT），thrombin time （TT）were determined. RESU LTS：Compared with blank group ，whole blood viscosity under different shear rates ，plasma viscosity ， erythrocyte aggregation index and hematocrit of model group were increased significantly ，while erythrocyte deformation index was significantly decreased ，PT，TT and APTT were significantly shortened （P＜0.01）. Compared with model group ，whole blood viscosity under different shear rates ，plasma viscosity ，erythrocyte aggregation index and hematocrit of aspirin group and W. pigra hang-dried product ，talcum powder-ironed product ，wine bran-processed product high-dose groups were decreased significantly ， while erythrocyte deformation index were significantly increased ，and PT （only W. pigra talcum powder-ironed products high-dose group），APTT（except for W. pigra hang-dried products high-dose group ）and TT were prolonged significantly. The whole blood viscosity of W. pigra hang-dried product medium-dose group under low shear rate ，and those of W. pigra talcum powder-ironed product low-dose ，wine bran-processed product medium-dose groups under low and medium shear rates were decreased significantly. Erythrocyte deformation index of W. pigra talcum powder-ironed product medium-dose group was increased significantly ，while erythrocyte aggregation index was decreased significantly ，and PT ，TT were prolonged significantly. APTT of W. pigra hang-dried product medium-dose group was prolonged significantly. Hematocrit of W. pigra wine bran-processed product low-dose group was decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ： W. pigra hang-dried， talcum powder-ironed and wine bran-processed product can effectively improve hemorheology indexes and prolong blood coagulation time.

Objective To establish a quality standard of yinqiao xiaozhen mixture. Methods Preparation of Forsyth-ia,Arctium lappa L.,and Honeysuckle were identified by TLC method.The concentration of baicalin in yinqiao xiaozhen mixture was determined by HPLC method. Results The qualitative identification method can detect Forsythia,Arctium lappa L.,and Honeysuckle.TLC spots were clear.TLC method has strong specificity.The linear range of baicalin was 0.122 5-1.531 2 μg,r=0.999 9,the average sample recovery rate was 99.42%,RSD was 2.19%,respectively. Conclusion The method is simple,ac-curate and repeatable,which can be used for quality control of Qinqiao xiaozhen mixture.

Objective To explore the efficiency of the ABC-HOME in the rapid identification and assessment of potential donors.Methods We developed a submit system and a rapid assessment method of ABC-HOME for potential donors at 2013.They were on trial in service area hospitals of Guangzou General Hospital Organ Procurement Organization (GHOPO) from February,2015.We reviewed medical records of potential donors occurring in the intensive unit at 2014,from February to December 2015 and 2016,respectively.We examined data on the number of potential donors,actual donors and beds of ICU,and calculated the number of potential donors and actual donors per bed per year.The reasons for donation failure were analyzed.Results 19,38 and 50 organ donations were realized in 243,474 and 513 potential donors in 2014,from February 2015 to December 2015 and 2016,respectively.The growth rate of organ donation and the number of actual donors per bed per year was 95.0%,8.2% and 0.45,0.89 and 0.96,respectively.The conversion rate in these potential donors was 8.92% from February 2015 to December 2016.The reasons for donation failure included the family and social factors,doctor-patient relationship and communication factor and illness condition of donors' factors.Conclusion ABC-HOME is a convenient assessment method for potential donors,which can help to promote the identification of potential donors and to increase the number of potential donor information.

Objective: To compare the efifcacy of direct and pre-dilated atherectomy (RA) for treating the patients with calciifed coronary lesions. Methods: A total of 137 coronary artery disease (CAD) patients received RA treatment in our hospital from 2010-04 to 2014-09 were retrospectively studied. The ischemic related lesions were all deifned as calciifed coronary lesions. The patients were divided into 2 groups: Direct RA group,n=81 and Pre-dilated RA group, the patients received balloon dilatation followed by RA,n=56. The procedural features, complications, in-hospital and 1 year occurrence rates of major cardiaccerebral vascular events (MACCE) were compared between 2 groups. Results: Compared with Pre-dilated RA group, Direct RA group had the less pre-stent balloon application,P=0.000 and the higher maximum post-dilatationpressure,P=0.004; lower rate of in-operative complication (14.8% vs 32.1%),P=0.016; higher rate of acute lumen gain (128.52±75.77) % vs (77.12±27.01) %,P=0.004; lower MACCE occurrencerate(7.3% vs 23.6%) at 1 year period,P=0.006.Cox regression analysis presented that the following indexes were related to MACCE occurrence within 1 year of RA treatment: balloon dilatation before RA (HR=8.166, 95% CI 1.872-35.614,P=0.005), left main disease (HR=13.649, 95% CI 2.983-62.440,P=0.001), minimum post-operative lumen area (HR=0.583, 95% CI 0.378-0.879,P=0.010), post-dilatation (HR=0.066, 95% CI 0.013-0.332,P=0.001) and EF>40% (HR=0.019, 95% CI 0.002-0.158, P=0.000). Conclusion: Direct RA had the lower MACCE occurrence rate at 1 year period, this might be related to less operative complication and the optimal lumen gain.

Objective To summarize the experiences and protocol of extracorporeal membrane oxygenation (ECMO) technique in donors with brain death and unexpected cardiac arrest.Method We described here the organ donation of one case of brain death complicated with hemodynamic instability and cardiac arrest,and the corresponding recovery of the receptor liver.A 50-year old female developed brain death due to brain aneurysmal hemorrhage.He was given two kinds of high-dose vasopressor,but hemodynarnic instability was not improved.After ECMO support,the hemodynamics turned to stable,but unexpected cardiac arrest happened.The total operating time of ECMO was 5 h,including 4 h after cardiac arrest.The liver was transplanted into a 65-year old female with hepatocellular carcinoma (diagnosed by Hangzhou Criteria) by classic orthotopic liver transplantation with end-to-end anastomosis.Result One liver and two kidneys were obtained successfully,and all the receptors recovered uneventfully.The post-operative ALT and AST levels reached the peak at 169 U/L and 365 U/L respectively,and returned to normal two weeks later.Conclusion ECMO can be used to support brain death complicated with hemodynamic instability and unexpected cardiac arrest.It can save precious time for organ donation,and preserve the function of liver and kidney as well.

Objective To study the diagnosis and treatment of non-anastomotic biliary stricture (NABS) after liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation in the past 10 years in our department were analyzed retrospectively,compared different methods to find out the most appropriate method in the diagnosis and management of NABS.Results NABS occurred in 13 out of 403 patients (3.2％),almost the same incidence as in patients who received DCD donor livers (4.16％,2/48).The clinical signs of NABS were frequent cholangitis and high TBil,r-GT and AKP (P ＜0.01).All these cases were finally diagnosed by cholangiography and they could be classified into 3 types:hepatic bile duct stricture (4 patients,type Ⅰ),multiple extrahepatic and intrahepatic biliary strictures (7 patients,type Ⅱ),intrahepatic biliary strictures (2 patients,type Ⅲ).NABS were mainly treated by interventional therapy,Roux-en-Y anastomosis and retransplantation in our centre.All type Ⅰ patients were successfully managed with interventional therapy/ERCP and Roux-en-Y anastomosis,but 44.4％ (4/9) of type Ⅱ and Ⅲ patients required retransplantation.The TBIL,r-GT and AKP decreased significantly in 12 patients (P ＜ 0.05) and the total curative rate of NABS was 92.3％ (12/13) with one patient who died after retransplantation.Conclusions Cholangiography was an effective way to diagnose NABS which is common among patients after liver transplantation.Interventional therapy/ERCP,Roux-en-Y anastomosis and retransplantation were our 3 ways to treat this problem.We proceeded from easy to difficult and chose a suitable way to deal with NABS according to the different types of biliary stricture from cholangiography.Type Ⅰ patients had much better prognosis than Type Ⅱ and Ⅲ patients who should receive retransplantation if interventional therapy/ERCP failed.

Objective To investigate the application and clinical value of donation after citizens death (DCD) in salvage liver transplantation (SLT).Method The clinical data of 12 recipients who underwent SLT from DCD of 12 donors at the Guangzhou General Hospital of Guangzhou Military Area from October 2010 to December 2013 were retrospectively analyzed.Of the donors,there was one case of type of China-Ⅰ,2 cases of the type of China-Ⅱ and 9 cases of the type of China-Ⅲ.Extracorporeal membrane oxygenation (ECMO) was applied to donation after brain and cardiac death to avoid warm ischemia.Of the recipients,6 met the Milan criteria,3 UCSF(The University of California,San Francisco) criteria and 3 Hangzhou criteria respectively.Orthotopic liver transplantation was performed on recipients.Eleven recipients received end-to-end anastomosis of the bile duct and followed up regularly.Result Liver transplantation was successfully performed on all recipients.No mortality during operation,no recovering delay and non-function of the transplanted liver occurred.Postoperative complications occurred in 4 cases,2 patients died,and 2 patients recovered and discharged after the second surgery.Ten recipients had a long-term survival.Two cases of hepatocellular carcinoma (HCC) recurrence were still alive after active treatment.The longest survival time was 42 months.All of them had no long-term complications such as biliary stricture.Conclusion The role and status of SLT in the treatment of HCC has become increasingly,and there will be more and more use of DCD donor in SLT.To ensure the DCD donors safely and effectively applied in SLT,we should grasp the characteristics of SLT,choose the appropriate DCD donor according to recipients,and rationally use the ECMO to protect the graft quality.

OBJECTIVE: To construct expression vector for the SEA-EGF fusion gene. METHOD: Clone the SEA gene and the EGF gene segment with PCR and RT-PCR independently, and connect this two genes by the bridge PCR. Insert the fusion gene EGF-SEA into the expression vector PET-44. Induced the secretion of the fusion protein SEA-EGF by the antileptic. RESULT: The gene fragment encoding EGF and SEA mature peptide was successfully cloned. The fusion gene EGF-SEA was successfully constructed and was inserted into expression vector. CONCLUSION The new recombinant expression vector for fusion gene EGF-SEA is specific for head and neck cancer, laid the foundation for the further study of fusion protein SEA-EGF targeting immune therapy in head and neck tumors.
Enterotoxins ; genetics ; Epidermal Growth Factor ; genetics ; Genetic Vectors ; Head and Neck Neoplasms ; drug therapy ; Humans ; Molecular Targeted Therapy ; Recombinant Fusion Proteins ; biosynthesis ; genetics