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ObjectiveTo investigate the efficacy of Bushen Shengxue prescription and Yiqi Yangxue prescription in the treatment of chronic aplastic anemia and the effect on T cell subsets and the expression of T-box expressed in T cells （T-bet） and GATA binding protein 3 （GATA3）. MethodA total of 585 patients with chronic aplastic anemia who were treated in 19 hospitals in China from May 2018 to June 2021 were enrolled. With the prospective， double-blind and randomized control methods， the patients were randomized into three groups： kidney deficiency group， Qi and blood deficiency group， and control group. The three groups were respectively treated with Bushen Shengxue prescription granule， Yiqi Yangxue prescription granule， and Placebo （half the dose of Bushen Shengxue formula granules）. In addition， all of them were given oral cyclosporin and androgen. The treatment lasted 6 months， with 3 months as a course. The blood routine indexes， T cell subsets， and fusion genes T-bet and GATA3 before and after treatment were analyzed， and the safety indexes were monitored. ResultDuring the observation， a total of 75 cases dropped out and 18 were rejected. Finally， 161 cases in the kidney deficiency group， 164 in the Qi and blood deficiency group， and 167 in the control group were included. After 6 months of treatment， the total effective rate was 98.8% （159/161） in the kidney deficiency group， which was higher than the 79.9% （131/164） in the Qi and blood deficiency group （χ2=30.135， P<0.01） and the 61.7% （103/167） in the control group （χ2=70.126， P<0.01）. The total effective rate was higher in the Qi and blood deficiency group than in the control group （χ2=13.232， P<0.01）. After treatment， the hemoglobin （HGB） content increased significantly in three groups （P<0.05） as compared with that before treatment， particularly the kidney deficiency group （P<0.01）. After treatment， the white blood cell （WBC） count and platelet （PLT） count in the kidney deficiency group and the control group increased compared with those in the Qi and blood deficiency group （P<0.01）. There was no specific difference in neutrophils （ANC） after treatment among the three groups. At the same time point， the level of T helper type 1 （Th1） cells， Th1/Th2 ratio （P<0.05）， level of CD4+， and CD4+/CD8+ ratio （P<0.05） were significantly low in the kidney deficiency group among three groups. There was no significant difference in CD19-， HLA/DR+， and CD25+ between the kidney deficiency group and the other two groups， but the T-bet of the kidney deficiency group and the control group was lower than that of the Qi and blood deficiency group （P<0.05）. ConclusionBushen Shengxue prescription exerts therapeutic effect on the aplastic anemia by improving the immunoregulatory mechanism， inhibiting the activity of immune system， modulating T cell subsets， suppressing Th1 and CD4+， and promoting bone marrow hematopoiesis. Moreover， it is safe with little side effects， which is worthy of further promotion.
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Objective To compare and analyze the clinical effect of two different surgical treatment of comminuted fracture of clavicle fracture combined with coracoclavicular ligament injury by internal fixation and artificial ligament repair.Methods Eighty-four patients with comminuted clavicle fracture and coracoclavicular ligament injury who were admitted to the Department of Acute Traumatic Surgery,Dongfeng General Hospital Affiliated to Hubei University of Medicine from February 2015 to February 2016 were selected as the experimental subjects by prospective research methods.The patients were divided into two groups according to the random number table primciple.The 42 cases in the control group were treated with clavicular plate,while the other 42 cases in the observation group were treated with artificial ligament.The clinical effects of the two surgical methods were evaluated according to the operation time,intraoperative blood loss,fracture healing time,hospitalization time,functional score and the incidence of postoperative complications.Measurement data were expressed as ((x) ± s).Comparison between groups using t test.Counting data were expressed as percentage (％) and compared by Chi-square.Results After operation,the operation time,intraoperative blood loss,fracture healing time and hospital stay in the observation group were (37.5 ± 22.0) minutes,(101.2 ± 24.1) ml,(11.2 ± 3.1) months and (19.4 ± 6.1) days,respectively.In control group,there were (53.5 ± 35.4) minutes,(200.1 ± 55.3) ml,(18.4 ± 7.8) months and (32.4 ± 7.2) days,respectively.The difference was statistically significant (P ＜ 0.05).The functional scores of two groups of patients were compared,the observation group was significantly better than the control group,the difference was statistically significant (P ＜ 0.05).The two groups of patients with complications were compared,the incidence of the observation group was 4.8％,while in the control group was 21.4％,the observation group was significantly lower than the control group,the difference was statistically significant (P ＜ 0.05).Conclusion The application of artificial ligament surgical treatment to patients with comminuted clavicle fracture and coracoclavicular ligament injury has the advantages of simple operation and good therapeutic effect,which is conducive to the recovery of shoulder joint function and less postoperative complications,which is worthy of clinical application.
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Objective To investigate the clinical features,diagnosis and treatment of medullary thyroid microcarcinoma (MTMC).Methods The clinical data of 14 patients with MTMC from Mar.2012 to Sep.2016 were retrospectively reviewed.All cases were treated with surgery and pathologically proved to be MTMC.Results All patients were sporadic MTMC.Calcitonin and CEA levels were measured before surgery in 11 patients.The median values were 81.61 (3.36-1187) pg/ml and 7.42 (0.81-90.75) ug/ml,respectively.All patients were followed up postoperatively.During a median follow-up of 24 months (8-63 months),no death happened.Regional lymph node metastasis occurred in 8 patients (57.14％),and lateral lymph node metastasis in 5 cases (35.71％).The rate of postoperative calcitonin abnormal was significantly higher in patients with lateral lymph node metastasis (P＜0.01).6 cases (42.86％) had abnormal postoperative calcitonin,among whom 5 cases had preoperative baseline calcitonin level higher than 100 pg/ml.Patients having abnormal postoperative calcitonin suffered from higher calcitonin and CEA baseline (P＜0.05).The tumor size was similar in two groups (P＞0.05).Conclusions For patients with thyroid nodules,preoperative screen of calcitonin can effectively detect MTC.Patients with elevated CEA also need to exclude the possibility of MTC.Compared with tumor size,calcitonin baseline is more important to surgical options and postoperative outcomes.Lateral lymph node metastasis,baseline calcitonin ＞100 pg/ml indicates abnormal postoperative calcitonin.
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Objective To evaluate the risk factors for postoperative hypoparathyroidism.Methods Tolally 200 patients with thyroid diseases undergoing total thyroidectomy at Department of General Surgery,Ruijin Hospital from Sep 2012 to Oct 2015 were followed up.The related risk factors were analyzed.x2 test and Fisher's exact test were used to analyze the correlation between hypoparathyroidism after total thyroidectomy and the other clinical factors.Multiple logistic regression analysis was performed to identify these risk factors.We analyzed the receiver operating characteristic (ROC) curve and calculated the area under the curve (AUC).The highest accuracy cutoff levels of intact parathyroid hormone (iPTH) level at 1 day after thyroidectomy (iPTH 1 d) and ％ iPTH decline were determined from the ROC curves.Results Of the 200 patients,66.5％ developed hypoparathyroidism on the first day,6.5％developed hypoparathyroidism in 6 months after surgery.That was 3.5％ in 1 year.The femaleness(OR =2.966,95％ CI:1.480-5.945,P =0.002),age (OR =0.972,95％ CI:0.946-0.999,P =0.039),and bilateral center lymph node dissection (OR =5.508,95％ CI:1.693-17.923,P =0.005) were independently correlated with postoperative hypoparathyroidism.The parathyroid hormone concentration on postoperative day 1 (OR =0.738,95％ CI:0.556-0.979,P =0.035) and 131I remnant ablation therapy (OR =12.887,95％ CI:3.434-48.367,P =0.000) were independent risk factors for postoperative hypoparathyroidism in 6 month.Both iPTH ＜ 3.05 pg/ml and ＞ 92.5％ iPTH decline on post-op dl could accurately predict significant hypoparathyroidism postoperative 6 month with accuracy of 82.1％ and 78.2％.Conclusions Bilateral center lymph node dissection and 131I remnant ablation therapy are risk factors for postoperative hypoparathyroidism,the iPTH1 d and ％ iPTH decline can predict hypoparathyroidism in postoperative 6 month.
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Objective To evaluate the role of cabon nanoparticles for dissecting lymph nodes and preserving parathyroid glans in patients with differentiated thyroid carcinoma undergoing total thyroidectomy plus bilateral central neck dissection.Metheds From Sep.2015 to Feb.2016,100 patients in Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine with thyroid carcinoma undergoing primarily total thyroidectomy plus bilateral central neck dissection were randomly divided into carbon nonoparticle group and the contol group.The numbers of total dissected lymph nodes,the lymph node posterior to fight recurrent laryngeal nerve,metastasized lymph nodes,inadvertent parathyroidectomy,the parathyroid hormone and serum total calcium were measured.Results The average counts of lymph nodes in carbon nonoparticle group (10.96±5.43)were more than those in the control group at (8.22±4.40)lymph nodes,(t＝2.78,P＝0.01).The average counts of lymph node posterior to fight recurrent laryngeal nerve in carbon nonoparticle group (1.62±1.95)were more than those in the control group at (0.76±1.21)lymph nodes,(t＝2.66,P＝0.01).The numbers of metastasized lymph nodes was 2.02±2.40 in carbon nonoparticle group and 1.84±2.61 in the control group.The difference had no statistical significance(t＝0.36,P＞0.05).The amount of PTH and the decrease of PTH discrepancy one day after surgery between the two groups had no statistical difference (t＝0.23,P＞0.05),(t＝l.04,P＞0.05).The carbon nonoparticle group had 2％(1/50)mistakenly parathyroid gland removed incidence,on contrary,the control group had 6％(3/50)mistakenly removed incidence.The difference had no statistical significance(x2＝0.26,P＞0.05).Conclusion Carbon nonoparticle can improve the central lymph node detection rate,but the protection of the parathyroid glands is more likey to depend on the experience of the operator and the vascular protection.
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Objective To investigate the relation of synovial anti-citrullinated epitope peptide(CCP)expression and peptidyl arginine deiminase 4 (PADI4)gene in the rheumatoid arthritis patient.Methods From February 2013 to 2015 in Dongfeng General Hospital Affiliated to Hubei University,selected 110 patients with rheumatoid arthritis as the observation group, and selected 110 healthy people at the same period in this hospital for medical examination as the control group,both groups were given the synovial CCP expression positive rate and PADI4 gene expression detecting and correlation analysis.Results The synovial anti-CCP expression positive rates in the observation group and the control group were 70.9% and 9.1% re-spectively,and the observation group were significantly higher than the control group (P<0.05).The PADI4-104 genotype expression frequency compared between the observation group and control group,the difference were statistically significant (P<0.05).The G/G expression was more in the observation group,while the control group was more wit the C/G expres-sion.Pearson correlation analysis showed that in the observation group,synovial CCP positive expression were significant correlated to the expression of genotype PADI4-104 (r=0.344,P<0.05).Logistic regression analysis showed PADI4-104 genotype frequency were the main factors for the synovial CCP epitope expression (P<0.05).Conclusion The rheumatoid arthritis was more with synovial anti-CCP positive expression.There were also PADI4 polymorphism disorder expression, and clear correlation between the two.Thus impact the incidence of rheumatoid arthritis.
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OBJECTIVE@#This article summarizes the matters warranting consideration in adult cochlear implants before and after operation with different deafness causes and investigates the impact of etiological variables that affect hearing and speech ability rehabilitation after cochlear implantation.@*METHOD@#We retrospectively reviewed the preoperative data of 30 adults who have received cochlear implantation, switch on, and periodical post operative mapping. 'Nijmegen Cochlear Implant Questionnaire' was used for every patient during follow-up and test their hearing thresholds at one year after switched-on. The average score of every patient in the six aspects of questionnaire, along with the average hearing threshold, has been gathered.@*RESULT@#The average hearing threshold of every patient is lower than 35 dBHL. The average score of 28 patients is more than or equal to 75 in the basic sound perception, advanced sound perception as well as self-esteem. The average score of 26 patients is more than or equal to 75 in capacity for action. Besides, as for sociability and speech ability, the average score of 22 patients is more than or equal to 75.@*CONCLUSION@#Auditory perception can be greatly improved regardless of deafness causes, on the premise that appropriate candidate is selected. The primary disease should be brought under control before and after the operation. The influence of various causes to the language ability rehabilitation largely depends on the development of the language center at deafness onset. Self-esteem and social identity can be significantly enhanced after cochlear implantation in adult patients, particularly those with acquired deafness.
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Adolescent , Adult , Aged , Humans , Middle Aged , Young Adult , Auditory Perception , Cochlear Implantation , Psychology , Follow-Up Studies , Retrospective Studies , Self Concept , Social Identification , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate the expressions of high mobility group box B1 protein (HMGB1), matrix metalloproteinases-2(MMP-2) and matrix metalloproteinases-9 (MMP-9) in human laryngeal carcinoma and study their relationships with clinicopathological characteristics and prognosis.@*METHOD@#The expressions of HMGB1, MMP-2 and MMP-9 proteins were examined with the EnVision immunohistochemical method in 61 cases of laryngeal carcinoma. The expressions of HMGB1, MMP-2 and MMP-9 mRNA were detected by real-time quantitative RT-PCR method in 30 cases of laryngeal carcinoma.@*RESULT@#The positive expression rates of HMGB1, MMP-2 and MMP-9 proteins were significantly higher in laryngeal carcinoma than those in adjacent tissue (chi2=44.934, 49.923 and 36.054, P<0.01). The relative expression levels of HMGB1, MMP-2 and MMP-9 mRNA in laryngeal carcinoma were significantly higher than those in adjacent tissue (t=5.940, 7.005 and 7.664, P<0.01). The high level expression of HMGB1, MMP-2, MMP-9 proteins was closely associated with T stage, clinical stage and the status of lymph node metastasis (P<0.05 or P<0.01). There was a positive correlation between the expression of HMGB1 and MMP-9 protein (r=0.381, P<0.01). Univariate analysis indicated that the overall survival rate was lower in patients with a positive expression of HMGB1 and MMP-9 than those with negative expression (chi2= 4.974, 6.418, P<0.05). Multivariate analysis showed that HMGB1 was a risk predictor. A higher expression of HMGB1 was associated with a shorter survival time.@*CONCLUSION@#HMGB1, MMP-2 and MMP-9 play a role in invasion and metastasis of laryngeal carcinoma; Also there is a synergistic effect between HMGB1 and MMP-9; Moreover HMGB1 may be a independent prognostic factor.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carcinoma, Squamous Cell , Metabolism , Pathology , HMGB1 Protein , Metabolism , Laryngeal Neoplasms , Metabolism , Pathology , Matrix Metalloproteinase 2 , Metabolism , Matrix Metalloproteinase 9 , Metabolism , PrognosisABSTRACT
Objective We will discuss the related factors affecting the rehabilitation efficacy after the opera-tion of adults cochlear implantation .Methods Nijmegen Cochlear Implant Questionnaire'was adopted .There were questionnaire surveys on 29 adult patients with cochlear implantation .The individual scores and total scores of all subjects were collected together with the personal information ,including age ,bilateral effects and other factors . They were grouped in accordance with different grouping standards of different affecting factors .Results Compared to the communication manner of long -term hearing loss ,the rehabilitation efficacy of the group using lip -reading preoperatively was greater than the group using sign language or writing ;the rehabilitation efficacy of the group with the aggregate time of using CIs more than two years was superior to that similar group of less than two years , and the average P within the group of these two factors was 0 .05 .Conclusion Ages ,the bilateral deafness ,and auditory dep-rivation have no obvious effects on the rehabilitation efficacy after the operation .The patients with postlingual deafness can improve their hearing with proper rehabilitation .Lip-reading preoperatively has positive effects on the rehabilitation effica-cy after the operation ;the length of using CIs has become the major factor affecting the rehabilitation efficacy .
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OBJECTIVE@#Our previous study revealed many genes differentially expressed in human laryngeal squamous cell carcinoma tissues (LSCC) and related adjacent normal tissues. We verificated the differentiated expressions of target genes, possibly related to LSCC. And these results can be foundations of further study of these target genes function.@*METHOD@#SENP1, CD109, Laminin alpha 2, Laminin alpha 3 were selected according to the cDNA microarray results. The expression of these genes mRNA and protein were detected by RT-PCR and Western blot in 12 cases of LSCC and related adjacent normal tissues.@*RESULT@#The mRNA expression of SENP1, CD109 and Laminin alpha 3 were significantly higher while Laminin alpha 2 were significantly lower in LSCC tissues than in corresponding adjacent normal tissues by Semiquantitative RT-PCR. Western blot analysis revealed SENP1, CD109 protein expression were significantly higher in LSCC tissues than in corresponding adjacent normal tissues.@*CONCLUSION@#SENP1, CD109, Laminin alpha 2 and Laminin alpha 3 may correlated with tumorigenesis and development of LSCC and can provide beneficial clue for study pathogenesis of LSCC in molecular level.
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Antigens, CD , Genetics , Carcinoma, Squamous Cell , Genetics , Cysteine Endopeptidases , Endopeptidases , Genetics , GPI-Linked Proteins , Genetics , Gene Expression Regulation, Neoplastic , Laminin , Genetics , Laryngeal Neoplasms , Genetics , Neoplasm Proteins , Genetics , Oligonucleotide Array Sequence AnalysisABSTRACT
OBJECTIVE@#This study was to investigate the expression and significance of Integrins subunits in laryngeal squamous cell carcinoma (LSCC).@*METHOD@#The expression of Integrins subunits was detected by cDNA microarray in 4 cases of primary LSCC tissues and corresponding adjacent normal tissues. Semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) were used to identify the different expression of Integrins subunits in 24 cases of primary LSCC tissues and corresponding adjacent normal tissues.@*RESULT@#A cDNA microarray analysis revealed significant changes in the expression of Integrins subunits, with IntegrinalphaV, Integrinbeta8 being up-regulated and Integrinalpha8 being down-regulated. The result of RT-PCR was consistent with that of cDNA microarray. The mRNA levels of IntegrinalphaV and Integrinbeta8 were significantly higher in LSCC tissues than that in corresponding adjacent normal tissues (1.0131 +/- 0.4780 vs 0.7591 +/- 0.4678 for IntegrinalphaV, P<0.05, 1.7362 +/- 1.3849 vs 1.2267 +/- 0.9363 for Integrinbeta8, P<0.05). The mRNA levels of Integrinalpha8 were significantly lower in LSCC tissues than that in corresponding adjacent normal tissues (0.2646 +/- 0.2622 vs 0.5457 +/- 0.3827, P<0.05).@*CONCLUSION@#The expression of IntegrinalphaV, Integrinbeta8, Integrinalpha8 were significantly up-regulated or down-regulated in laryngeal squamous cell carcinoma, which may relate to tumorigenesis and development of laryngeal squamous cell carcinoma.
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Carcinoma, Squamous Cell , Metabolism , Pathology , Integrin alpha Chains , Genetics , Metabolism , Integrin alphaV , Genetics , Metabolism , Integrin beta Chains , Genetics , Metabolism , Laryngeal Neoplasms , Metabolism , Pathology , Neoplasm Proteins , Metabolism , Neoplasm StagingABSTRACT
OBJECTIVE@#To explore the characteristic of formant-a very important parameter in the spectrogram of three types of artistic voice (western mode; Chinese mode; Beijing opera).@*METHOD@#We used MATLAB software to make the short-time Fourier transform and spectrogram analysis on the homeostasis vowel examples of the three types.@*RESULT@#The western mode had different representation "singer formant" (Fs) based on the voice part; the Chinese mode's notable features were that F1, F2, F3, were continuous and the energy of them changed softly; the Beijing opera had the common representation which was a very wide formant and there was soft transition between formants and various harmonic, besides it showed a similar component like the "Fs" (two formants connected normally).@*CONCLUSION@#Different artistic voice showed their own characteristics of the formant parameter in the spectrogram, which had important value on the identification, objective evaluation and prediction.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Music , Spectroscopy, Fourier Transform Infrared , Voice QualityABSTRACT
OBJECTIVE@#To confirm the expression and distribution of aquaporin 5 (AQP5) in nasal polyps.@*METHOD@#AQP5 were studied in 20 samples nasal polyp without AR (Group NAR) and 16 samples with AR (Group AR) with immunochemistric staging and its integrated light intensity and its grey step.@*RESULT@#(1) Hematoxylin and eosin staining showed that there was obvious inflammation reaction, a large quantity of glands hyperplasia and acidophils soaked in nasal polyps, especially those with allergic rhinitis. (2) Immunofluorescence technique showed that the distribution of AQP5 in the two groups was in accordance with that in nasal polyps on the whole. AQP5 expressed mainly in the membrane and cytoplasm of the epithelium of the glands, ducts and cilia. (3) The statistical analysis of the immunohistochemical staining showed that the integrated light intensity of AQP5 in Group AR (0.1675+/-0.006536) was obviously higher than that in the Group NARs nasal polyps (0.09343+/-0.001816). There was statistical significance between the two groups (t = -12.00, P<0.01). (4) The statistical analysis of the immunohistochemical staining showed that the grey step of AQP5 in Group AR (175.6+/-2.471) was obviously lower than that in the Group NAR's nasal polyps (206.2+/-0.9649). There was statistical significance between the two groups (t=12.46, P<0.01).@*CONCLUSION@#AQP5 is expressed in nasal polyp. Combined with the research before, it was conferred that the hypersecretion of glands and its character has a relationship with the high expression of AQP5 in nasal polyps, and nasal polyp with different symptom has different mechanism.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Aquaporin 5 , Metabolism , Nasal Mucosa , Metabolism , Nasal Polyps , Metabolism , Rhinitis, Allergic, Perennial , MetabolismABSTRACT
Objective To investigate the effectiveness of microresection combined with radiofrequency ablation under laryngoscope and rigid telescope for laryngeal precancerosis. Methods Fifty-one patients with laryngeal precancerosis, which was diagnosed pathologically, were treated with microresection combined with radiofrequency ablation under laryngoscope and rigid telescope. The patients were followed up for over 6 months. Results During a mean of 26-month follow-up (6 months to 4.5 years), 7 of the patients had recurrence (vocal cord leukoplakia in 3, atypical hyperplasia in 2, and laryngeal papilloma in 2); 4 had carcinomatous change (vocal cord leukoplakia in 1, atypical hyperplasia in 2, and laryngeal papilloma in 1);and 2 patients developed laryngeal web after surgical treatment for bilateral vocal cord leukoplakia. One month after the operation, the Jitter, Shimmer, and NNE were decreased significantly (P
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Objective To investigate the outcome of powered laryngeal shaver for papilloma of the larynx in children by laryngeal endoscopy. Methods Thirty-nine children with papilloma of the larynx were treated by powered laryngeal shaver under a laryngeal endoscope. Twenty-seven of the patients who had an extensive tumor received radiofrequency to avoid hemorrhage and adhesion of the surgical surface. Results The mean operation time was (11.2?2.6) min, and the blood lose was less than 30 ml. Three months after the operation, 28 of the patients were fond of their voice quality. Among the 39 patients, 37 were followed up for 2-5 years, during which 3-year recurrence rate was 51% (19/37). In the children with primary patients, the rate of recurrence was 30% (3/10), and in those with recurrent tumor, the rate was 59% (16/27). Conclusions By using powered laryngeal shaver under a laryngeal endoscope, papilloma of the larynx can be accurately resected with low blood loss, short operation time and short hospital stay and confirmed effectivenss.