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The hemodynamics of children with congenital heart disease (CHD) often changes during the perioperative period. Unfortunately, the evaluation of cardiac function in children with CHD is mainly focused on the left ventricle. With the further understanding of cardiac hemodynamics, the monitoring of RV function has gradually become an important part of cardiac intensive care department. We totally searched five databases including Pubmed, Embase, Cochrane, Wanfang Med, as well as China National Knowledge Infrastructure (CNKI) and reviewed the clinical research progress of the application of TAPSE in the evaluation of RV systolic function in children with CHD to provide a theoretical basic for the monitoring of RV function before and after operation in children with CHD.
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Objective:To summarize the evidence-based practice of a steroid-resistant patient with severe acute skin graft-versus-host disease caused by donor lymphocyte reinfusion.Methods:Clear the clinical problems of patients, through the development of a rigorous search strategy, according to the "6S" Pyramid model from the top to the bottom of the relevant literature in turn, after the evaluation of evidence level to determine the best clinical evidence.Combined with team experience and patient's actual situation, the acute graft-versus-host disease of steroid-resistant patients was treated while infection was strictly prevented. The non-invasive method of wet healing by topical high concentration tacrolimus smearing and sterile dressing sealing was compared with the invasive optical separation replacement therapy in vitro, which avoided puncture and sterile dressing. A series of possible complications of phototherapy.Results:The patient was relieved of swelling and pain 5 days after treatment, and was discharged on the 15th day of this hospitalization.Conclusions:Local high concentration tacrolimus smear plus aseptic dressing to seal wet healing is a noninvasive method that can relieve and treat severe acute graft-versus-host disease symptoms of steroid resistant patients. It is useful for similar clinical cases.
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The aim of this study is to explore the application and advantages of combined intrathecal and extrathecal hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in OSA children. We retrospectively reviewed 726 cases who were diagnosed as OSA. All patients were divided into two groups according to the surgical method: 320 cases by total tonsillectomy and 406 cases by combined extracapsular and intracapsular tonsillectomy. The intro operative bleeding volume, post operative haemorrhage data as time, location and degree in the two groups were compared. There was no statistical difference in the intro operative bleeding volume in the two groups [（9.3±4.6） mL]vs [（7.6±3.5） mL], =12.687, =0.235. Two patients who underwent combined extracapsular and intracapsular tonsillectomy presented with post operative haemorrhage, the total post operative haemorrhage rate was significantly decreased that in the total tonsillectomy group（14 cases）（χ²=10.779, =0.001）. The 2 patients in combined extracapsular and intracapsular tonsillectomy group were secondary haemorrhage, with location in the upper pole and medium, grade A haemorrhage; while in the 14 cases in in the total tonsillectomy group, there were 2 cases presented with primary haemorrhage and 12 cases with secondary haemorrhage; with regard to location of haemorrhage, 1 in the upper pole, 2 in the medium, 11 in the lower pole; 5 cases presented with grade A haemorrhage, 8 with grade B haemorrhage and 1 with grade C haemorrhage. The haemorrhage rate at 7 days after surgery （χ²=5.697, =0.017）, at the lower pole（χ²=11.961, =0.001） and grade B（χ²=8.097, =0.004） were all significantly decreases in the combined extracapsular and intracapsular tonsillectomy group. Plasma tonsillectomy combined with intrathecal and extrathecal hypothermic tonsillectomy is a safe and effective method, which has obvious advantages in reducing the postoperative hemorrhage, especially the secondary hemorrhage of Subtonsillar Pole.
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The aim of this study is to investigate the effect of fibreoptic endoscopic of sallowing （FEES） in the assessment of pharyngeal dysphagia in post-irradiated patients with nasopharyngeal carcinoma. Fifty-three NPC patients with post-irradiated underwent FEES and video fluoroscopy（VF）.The results were analyzed using the Bolus Residue Scale and Rosenbek's penetration aspiration scale. The agreement in the detection of penetration and aspiration between FEES and VF of liquid（κ=0.56, 95% 0.38-0.73） and porridge（κ=0.64, 95% 0.43-0.81） was "fair". The detection rates of penetration on FEES with liquid and porridge were 60% and 51%, the detection rates of aspiration on VF with liquid and porridge were 70% and 53%. There were no statistical differences. The agreement in the detection of pharyngeal residue between FEES and VF of liquid （κ=0.38, 95%0.12-0.62） and porridge （κ=0.66, 95% 0.44-0.86） was "fair". The detection rates of pharyngeal residue on FEES and VF with porridge were 43% and 45%, the difference was not statistically significant. The detection rates of pharyngeal residue on FEES and VF with liquid were 44% and 24%, and the difference was statistically significant. FEES is an effective and valuable tool for evaluating pharyngeal dysphagia in post-irradiated patients with nasopharyngeal carcinoma.
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Objective@#The aim of this study is to investigate the effect of fibreoptic endoscopic of sallowing （FEES） in the assessment of pharyngeal dysphagia in post-irradiated patients with nasopharyngeal carcinoma.@*Method@#Fifty-three NPC patients with post-irradiated underwent FEES and video fluoroscopy（VF）.The results were analyzed using the Bolus Residue Scale and Rosenbek's penetration aspiration scale.@*Result@#The agreement in the detection of penetration and aspiration between FEES and VF of liquid（κ=0.56, 95%CI 0.38-0.73） and porridge（κ=0.64, 95%CI 0.43-0.81） was "fair". The detection rates of penetration on FEES with liquid and porridge were 60% and 51%, the detection rates of aspiration on VF with liquid and porridge were 70% and 53%. There were no statistical differences. The agreement in the detection of pharyngeal residue between FEES and VF of liquid （κ=0.38, 95%CI0.12-0.62） and porridge （κ=0.66, 95%CI 0.44-0.86） was "fair". The detection rates of pharyngeal residue on FEES and VF with porridge were 43% and 45%, the difference was not statistically significant. The detection rates of pharyngeal residue on FEES and VF with liquid were 44% and 24%, and the difference was statistically significant.@*Conclusion@#FEES is an effective and valuable tool for evaluating pharyngeal dysphagia in post-irradiated patients with nasopharyngeal carcinoma.
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Objective@#The aim of this study is to explore the application and advantages of combined intrathecal and extrathecal hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in OSA children. @*Method@#We retrospectively reviewed 726 cases who were diagnosed as OSA. All patients were divided into two groups according to the surgical method: 320 cases by total tonsillectomy and 406 cases by combined extracapsular and intracapsular tonsillectomy. The intro operative bleeding volume, post operative haemorrhage data as time, location and degree in the two groups were compared. @*Result@#There was no statistical difference in the intro operative bleeding volume in the two groups [（9.3±4.6） mL]vs [（7.6±3.5） mL], t=12.687, P=0.235. Two patients who underwent combined extracapsular and intracapsular tonsillectomy presented with post operative haemorrhage, the total post operative haemorrhage rate was significantly decreased that in the total tonsillectomy group（14 cases）（χ²=10.779, P=0.001）. The 2 patients in combined extracapsular and intracapsular tonsillectomy group were secondary haemorrhage, with location in the upper pole and medium, grade A haemorrhage; while in the 14 cases in in the total tonsillectomy group, there were 2 cases presented with primary haemorrhage and 12 cases with secondary haemorrhage; with regard to location of haemorrhage, 1 in the upper pole, 2 in the medium, 11 in the lower pole; 5 cases presented with grade A haemorrhage, 8 with grade B haemorrhage and 1 with grade C haemorrhage. The haemorrhage rate at 7 days after surgery （χ²=5.697, P=0.017）, at the lower pole（χ²=11.961, P=0.001） and grade B（χ²=8.097, P=0.004） were all significantly decreases in the combined extracapsular and intracapsular tonsillectomy group. @*Conclusion@#Plasma tonsillectomy combined with intrathecal and extrathecal hypothermic tonsillectomy is a safe and effective method, which has obvious advantages in reducing the postoperative hemorrhage, especially the secondary hemorrhage of Subtonsillar Pole.
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Objective:To observe the changes of abdominal aortic calcification and biochemical indicators after parathyroidectomy (PTX) in the maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism (SHPT).Methods:The MHD patients with SHPT who were followed up for 2 years were analyzed retrospectively and divided into PTX surgery group ( n=26) and non-surgery group ( n=18) according to whether they underwent PTX, and then the abdominal aortic calcification score (AACS), intact parathyroid hormone (iPTH), blood calcium and phosphorus after 2 years were observed in the two groups. The PTX surgery group was divided into advanced group and non-advanced group according to whether abdominal aortic calcification had progressed or not 2 years after the operation. Indicators such as age, dialysis age, iPTH, blood calcium, blood phosphorus, calcium and phosphorus product were compared between the two groups to analyze the possible factors related to the development of abdominal aortic calcification. Results:A total of 44 patients meeting the inclusion criteria were included, with 26 in the PTX surgery group and 18 in the non-surgery group. The baseline data of the PTX surgery group and the non-surgery group showed statistical difference in the age of dialysis ( P<0.05), but no statistical differences in gender, age and history of hypertension. Compared with preoperative indicators, postoperative iPTH, blood calcium and phosphorus significantly reduced (all P<0.05), and there was no significant difference in AACS. There were 8 cases (30.77%) of accelerating progress of calcification, 8 cases (30.77%) of improvement in calcification, 10 cases (38.46%) of calcification stability. After 2 years, iPTH value of non-advanced group was significantly lower than advanced group [(20.62±6.44) ng/L vs (132.72±76.83) ng/L], while the preoperative AACS progress was higher in non-advanced group [(13.11±2.71) vs (2.00±1.41)] (all P<0.05). In non-surgery group, AACS was significantly higher after 2 years [(10.44±1.65) vs (8.05±1.26)], blood phosphorus and the product of blood calcium and phosphorus significantly decreased (all P<0.05) , and the levels of iPTH and blood calcium did not significantly change. Pearson correlation analysis showed that the decreased value between preoperative AACS and 2-year postoperative AACS was positively correlated with the decreased value of iPTH ( r=0.534, P=0.012), blood calcium ( r=0.643, P=0.004), blood phosphorus ( r=0.897, P<0.001) and calcium-phosphorus product ( r=0.568, P=0.021) , and negatively correlated with preoperative AACS ( r=-0.647, P=0.014). Conclusions:Small sample data shows that PTX can correct parathyroid hormone, calcium and phosphorus for long term, and prevent abdominal aortic calcification progression, even reverse vascular calcification. Whether abdominal aortic calcification improves or not may be associated with the decrease of iPTH, calcium, phosphorus and the product of blood calcium and phosphorus.
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Hematopoietic stem cell transplantation (HSCT) patients undergo tremendous psychological stress during the long course of treatment, which affected the quality of life and the prognosis of the disease. This paper reviews the psychological state of HSCT patients in recent years,to provide a basis for psychological support in appropriate time. The psychological status of HSCT patients is mainly manifested as anxiety, depression, loneliness and post-traumatic stress disorder. The main influencing factors of bad psychological status include: gender, personality, physical function, family and social support, coping style; Intervention measures are: health education, music therapy, comprehensive nursing intervention, palliative care.
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Objective@#To explore the clinical manifestation and treatment strategy for descending necrotizing mediastinitis (DNM).@*Methods@#A total of 27 cases diagnosed as DNM from January 2010 to August 2018 in the First People’s Hospital of Foshan were reviewed. There were 16 males and 11 females, age ranged from 16 to 84 years. The clinical data were collected. SPSS 16.0 software and chi square test were used for statistical analysis.@*Results@#ALL 27 cases were diagnosed as DNM by contrast-enhanced CT scan of the neck and chest. Among the 27 cases, 13 cases resulted from peritonsillar abscess, 8 cases from esophageal foreign body perforation, 5 cases from parapharyngeal and retropharyngeal space abscess, and one case from infection of oral cavity. These 27 cases were divided into three subtypes according to the sites of mediastinitis, including 11 cases for typeⅠ, 5 cases for type ⅡA and 11 cases for type ⅡB. Of 27 cases, 20 cases underwent transcervical drainage for DNM, of which 5 cases with tracheotomy and 6 cases with thoracic drainage, and finally 19 of the 20 patients were cured, and one patient died of bacteremia; 7 cases refused to received surgery and were routinely treated with antibiotics, of which, one case was cured and 6 cases died. The curative rate in patients underwent surgery was significantly higher than that in patients treated with medication (χ2=13.638, P<0.001). Among the 20 cured cases, 4 cases were combined with diabetes mellitus and 6 cases with necrotizing fasciitis, while in the 7 died cases, 5 cases were combined with diabetes mellitus and 6 cases with necrotizing fasciitis. The comorbidity rates of diabetes mellitus (χ2=4.074, P=0.044) and necrotizing fasciitis (χ2=4.457, P=0.035) in died cases were significantly higher than those in cured cases.@*Conclusion@#DNM is a serious infection, with high mortality especially in patients with diabetes and necrotizing fasciitis. Timely cervical and chest enhanced CT scan play vital role in its diagnosis. DNM can be treated effectively with transcervical drainage.
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Hematopoietic stem cell transplantation (HSCT) patients undergo tremendous psychological stress during the long course of treatment, which affected the quality of life and the prognosis of the disease. This paper reviews the psychological state of HSCT patients in recent years,to provide a basis for psychological support in appropriate time. The psychological status of HSCT patients is mainly manifested as anxiety, depression, loneliness and post_traumatic stress disorder. The main influencing factors of bad psychological status include: gender, personality, physical function, family and social support, coping style; Intervention measures are: health education, music therapy, comprehensive nursing intervention, palliative care.
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Objective@#To investigate the factors associated with the anastomotic leakage after anterior resection in rectal cancer.@*Methods@#From January 2014 to January 2017 471 patients underwent Dixon procedure for rectal cancer in The Affiliated Hospital of Qingdao University. The data of those patients was collected and reviewed retrospectively. Inclusion criteria included: 1) rectal cancer confirmed by preoperative electron colonoscopy; 2) the standard of total mesorectal excision followed by the surgeon during the surgery; and 3) elective surgery. Exclusion criteria included multi-primary rectal cancer, secondary surgery for tumor recurrence, palliative surgery, Miles procedure, Hartmann procedure, hormone drugs used, presence of rheumatic and immune diseases, and distant metastasis of rectal cancer. The variables, including demograpic characteristics, ASA score, diabetes mellitus, preoperative radiochemotherapy, histopathologic grade, pathological T stage, laparoscopic or open surgery, distance of the tumor from the anal verge ≤5 cm, were analyzed to identify the risk factors for anastomotic leakage.@*Results@#Of 471 patients, 285 and 186 were men and women, respectively, with a mean age of 61 years (range, 31-92) years. Symptomatic clinically anastomotic leakage occurred in 31 patients (6.6%, 31/471) after Dixon procedure for rectal cancer. On univariate analysis, the occurrence of anastomotic leakage was associated with diabetes (χ2 = 10.972, P = 0.001) , serum albumin level < 35 g/L (χ2 = 9.784, P = 0.002) , neoadjuvant chemoradiotherapy (χ2 = 6.867, P = 0.009) , distance ≤5 cm between the tumor and anal edge (χ2 = 5.993, P = 0.014) , preventive colostomy (χ2 = 5.630, P = 0.018) , and the use of double-perfusion cannula for abdominal flushing (χ2 = 4.232, P = 0.040) . Multivariate analysis revealed that diabetes (OR = 3.632, 95%CI: 1.620-8.145, P = 0.002) , neoadjuvant chemoradiotherapy (OR = 3.177, 95%CI: 1.283-7.867, P = 0.012) and distance ≤5 cm between the tumor and anal edge (OR = 2.444, 95%CI: 1.172 - 5.059, P = 0.017) were independent risk factors for anastomotic leakage, while preventive colostomy (OR = 0.138, 95%CI: 0.056 - 0.345, P = 0.000) and the use of double-perfusion cannula for abdominal flushing (OR = 0.223, 95%CI: 0.086 - 0.575, P = 0.002) were independent protective factors for anastomotic leakage.@*Conclusions@#For patients with rectal cancer with diabetes, undergoing neoadjuvant chemoradiotherapy, or distance ≤5 cm between the tumor and anal edge, anastomotic leakage after anterior resection of rectal cancer must be paid attention. When necessary, preventive colostomy or use of double-perfusion cannula for abdominal flushing should be considered.
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Objective To investigate the efficacy of laparoscopic assisted and open surgery for right colectomy.Methods 230 patients underwent right colectomy were selected,and they were randomly divided into laparoscopic group and laparotomy group according to the digital table,each group in 115cases.The laparoscopic group was treated with laparoscopic assisted operation.The laparotomy group was treated with open surgery.The complications after operation,the quality of life and follow up were compared between the two groups.Results The operation time,number of lymph node dissection and total cost of the laparoscopic group were (120.75 ± 28.20) min,(15.89 ± 3.83),(4.5 1 ±0.72) million,respectively,which of the l aparotomy group were (110.44 ± 23.58) min,(11.14 ± 4.01),(3.71 ±0.69) million,respectively,the differences were statistically significant (t =3.008,9.186,8.603,all P ＜ 0.01).The intraoperative blood loss and incision length of the laparoscopic group were (91.23 ± 14.85) mL and (5.85 ± 2.32) cm,respectively,which were significantly lower than those of the laparotomy group [(121.63 ± 12.32) mL,(15.05 ±7.72)cm,t =16.895,12.238,all P ＜ 0.01].The bowel exhaust time,fluid time,postoperative drainage time,postoperative analgesia time,postoperative catheterization time and hospitalization time of the laparoscopic group were (3.47 ± 1.55)d,(4.80 ±2.12)d,(6.31 ±3.21)d,(5.01 ± 1.75)h,(3.25 ± 1.07)d,(15.37 ±4.41)d,respectively,which were significantly shorter than those of the laparotomy group [(4.62 ± 1.68) d,(7.43 ± 2.58) d,(7.67 ±2.80)d,(9.51 ±3.54)h,(6.20 ±2.33) d,(22.62 ±5.39)d,t =16.895,12.238,5.395,8.446,3.424,12.220,12.338,11.163,all P ＜ 0.01].The incidence rate of complication in the laparoscopic group was 1.74％,which was significantly lower than 14.78％ in the laparotomy group(x2 =12.908,P ＜0.01).The scores of quality of life in the laparoscopic group were significantly higher than those in the laparotomy group(all P ＜ 0.01).The two groups were followed up for 9 months,the local recurrence,metastasis and other differences were not statistically significant (all P ＞ 0.05).Conclusion Laparoscopic assisted right colectomy has less wounded in patients,faster recovery after operation,lower incidence of complications,higher quality of life,but relatively expensive medical expenses.
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Objective To study the effcts of total parathyroidectomy with autotransplantation (tPTX+AT) on fibroblast growth factor-23 (FGF-23) in maintenance hemodialysis (MHD) patients with severe secondary hyperparathyroidism (SPTH). Methods Maintenance hemodialysis patients with severe SPTH treated in our hospital from 2014 to 2016 were enrolled and divided into two groups:tPTX+AT group and non-surgical group. Two groups' biochemical indexes and FGF-23 level before and after 6 months treatment were compared. Results A total of 48 patients were included in the study, including 22 in the tPTX+AT group and 26 in the non-surgical group. Age, duration of dialysis, primary disease, rate of hypertension, parathyroid hormone (iPTH), FGF - 23, cholesterol (TCH), triglyceride (TG), albumin (ALB), and hemoglobin (HGB) level showed no significant difference between the two groups (P>0.05); but serum calcium and alkaline phosphatase (ALP) of that tPTX+AT group were significantly higher than those of the non-surgical group (P<0.01). After 6 months the blood iPTH, calcium, phosphorus and the calcium-phosphorus product level of tPTX+AT group were significantly lower than those of non-surgical group (P<0.05). Blood lipids, propagated, HGB, and ALP level had no statistical differences in the two groups (P>0.05); serum FGF-23 progressive declined after 1 week, 1 month, 3 month and 6 month in tPTX+AT patients, and after 6 months, the level of FGF-23 was significantly lower than that of non-surgical patients[1462.9(903.7, 5826.9) ng/L vs 12627.9(5488.9, 16844.4) ng/L, P<0.01]. Conclusion tPTX+AT can significantly alleviate calcium and phosphorus metabolism disorders and in 6 months gradually reduce FGF-23 level in patients receiving MHD.
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Objective To determine low-concentration clenbuterol in edible meat based on the solidphase extraction coupled with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS).Method The homogenated sample was acidized to remove proteins,and purified using the liquid-liquid extraction and MCX Oasis solid prepared extraction column,then further treated with gradient elution with the mobile phase of ammonium formate (10 mmol/L and pH 3.5) and acetonitrile.The clenbuterol was completely separated on Eclipse C18 (1.8 μm,4.6×100 mm) column and detected in multiple reaction monitoring (MRM) mode.Results A good linearity was achieved for clenbuterol in the arrange of 0.01～0.2 μg/kg based on the internal standard calibration of D9-clenbuterol,with the linearity correlation coefficient greater than 0.99 and the detection limit of 0.005 μg/kg.The relative recovery of target compounds spiked in blank sample at three levels ranging from 78.8 to 114.8％,with the relative standard deviations less than 10％.Conclusion The method in this research is simple,rapid,reliable and suitable to confirm low-concentration clenbuterol in edible meat.
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Objective@#To study the clinical outcome of transoral CO2 laser surgery for glottic cancer involving the anterior commissure.@*Methods@#Thirty-two cases of glottic cancer involving the anterior commissure treated by transoral CO2 laser surgery between March 2009 and December 2013 were retrospectively reviewed. Among these cases, 27 were T1bM0M0, 5 were T2N0M0. All cases were followed-up for more than 3 years.@*Results@#All the 32 cases were successfully treated. Perioperative complications included injuries in the soft palate mucosa(13/32, 40.63%), loose incisors(3/32, 9.38%) and subcutaneous emphysema in the neck(2/32, 6.25%). During the follow-up period, granulation was found in all cases. Three cases had local recurrence. Two patients treated by a secondary transoral CO2 laser surgery and the other case had total laryngectomy, all three cases were followed up for 5 years without recurrence. Two cases had regional recurrence but no primary site recurrence. One patient was treated by neck dissection, and followed up for 5 years without recurrence. The other patient died of supraclavicular and mediastinal lymph node metastasis and lung metastasis 40 months after operation. The overall 5-year survival rate was 90.6%. There was no significant difference in survival rate between T1bN0M0(92.6%) and T2N0M0(80.0%) (Log Rank χ2=0.788, P=0.375). The overall 5-year local regional control rate was 84.4%. In T1bN0M0 lesions, the 5-year local regional control rate was 92.6%, which was significantly higher than that in T2N0M0 lesions(40.0%) (Log Rank χ2=9.504, P=0.002).@*Conclusion@#With appropriate surgical indication, detailed preoperative evaluation, good surgical skill, transoral CO2 laser surgery may achieve satisfactory outcome in the treatment of glottic cancer involving the anterior commissure.
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<p><b>OBJECTIVE</b>To evaluate the effect of cervical esophagostomy for the treatment of patients with dysphagia induced by radiotherapy, in order to improve the therapeutic effects.</p><p><b>METHODS</b>A retrospective study was performed on 53 nasopharyngeal carcinoma (NPC) patients with dysphagia, who received cervical esophagostomy. The nutritional status of these patients was measured at five given time before and after operation. The occurrence of pneumonia and reflux esophagitis before and after operation was recorded, and the quality of life based on SF-36 quality of life (QOL) scale was studied.</p><p><b>RESULTS</b>After operation, the nutritional status of these patients improved substantially, including the weight, levels of hemoglobin, total protein, albumin and transferring (P<0.05). The pneumonia-infection decreased from 60.38% (32/53) before operation to 15.22% (7/46) after operation (χ(2)=21.04, P<0.01). The incidences of reflux esophagitis decreased from 26.42% (14/53)without operation to 6.52% (3/46) after operation (χ(2)=5.00, P<0.01). Meanwhile, the status of physical health, mental health as well as physical function and social function of these patients were improved significantly at 1 month, 6 months, 1 year and 2 years after operation (P<0.05).</p><p><b>CONCLUSION</b>Cervical esophagostomy can improve the life quality of patients with dysphagia induced by radiotherapy for nasopharyngeal carcinoma.</p>
Subject(s)
Humans , Carcinoma , Deglutition Disorders , General Surgery , Esophagitis, Peptic , Esophagostomy , Incidence , Nasopharyngeal Neoplasms , Radiotherapy , Pneumonia , Quality of Life , Radiotherapy , Retrospective StudiesABSTRACT
Objective To analyze the expressions and clinical significance of human epidermal growth factor receptor-2 (C-erbB-2) protein in sinonasal squamous cell cancer cells.Method Immunohistochemical and RT-PCR methods were used to detect the expression of C-erbB-2 in 62 cases of sinonasal squamous carcinoma tissues,30 cases of nasal polyps and 25 cases with normal nasal mucosa.The relationships between the expression of C-erbB-2 in sinonasal squamous carcinoma tissues and clinical pathological characteristics were analyzed.Results There was significant difference in the expression of C-erbB-2 in sinonasal squamous carcinoma tissues, nasal polyps and normal nasal mucosa tissues(P <0.05).The expression of C-erbB-2 was positively correlated with the clinicopathologic stage, tumor classification and lymph node involvement(P<0.05).Conclusion The expression of C-erbB-2 is correlated with tumorigenesis,invasion and metastasis of sinonasal squamous cell carcinoma.It can be used as an auxiliary diagnostic and prediction maker as well as a new therapeutic target of sinonasal squamous cell cancer.
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Objective The objective was to discussing the difference between the Pemberton osteotomy and Salter osteot?omy which performed in patients between the ages of 2 and 3 years who suffered from developmental dislocation of the hip (DDH). Methods A retrospective review of the results of operation treatment for DDH in 59 children (84 hips) from January 1998 to De?cember 2008 was conducted. There are 10 boys (14 hips) and 49 girls (70 hips). The age of the patients was between 2-3 years old at the time of treatment 2.5±0.4 years. Surgery consist of open reduction of the hip, capsulorraphy, shortening and derotational oste?otomy of proximal femur, and innominate osteotomy which include Pemberton osteotomy (33 hips), Salter osteotomy (51 hips). McKay and Severin modified criteria were used to assess the function and radiographic results of the hip. Results The average follow?up time was 5.6±3.5 years ranging from 2 to 16 years. According to Severin criteria at final follow?up, 78 hips (93%) had ex?cellent and good results;4 hips were fair and 2 hips poor result. The radiology results in Salter osteotomy were better than Pember?ton osteotomy (rate of excellent and good results 100%vs. 82%,χ2=7.43, P=0.003). According to the McKay criteria Salter osteoto?my and Pemberton osteotomy have no significant difference in latest follow?up (the satisfactory rate 100%vs. 97%,χ2=1.56, P=0.39). 18 hips (21%) had proximal femoral growth disturbance which 10 hips in Pemberton group, 8 hips in Salter group. There is no significant difference (χ2=2.54, P=0.17). Conclusion Open reduction, innominate osteotomy and proximal femoral osteotomy were effective procedures for the treatment of DDH in children between 2-3 years old. More attention should be taken in Pember?ton osteotomy to prevent the acetabular bony edge absorption.
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<p><b>OBJECTIVE</b>To investigate the effects of periacetabular osteotomy (PAO) for developmental dysplasia of the hip in adolescent.</p><p><b>METHODS</b>Twelve hips in 9 adolescent patients who underwent a Bernese periacetabular osteotomy for symptomatic or asymptomatic developmental dysplasia of the hip were analyzed. The average age of the patients at the time of surgery was 12.9 years(11-14 years). The Harris hip score and overall patient satisfaction with surgery were used to assess hip function and clinical results. Plain radiographs were used to assess the correction of the deformity and to observe progression of degenerative changes.</p><p><b>RESULTS</b>The average duration of clinical follow-up was 88.5 (60-136) months. The mean Harris hip score increased from 89 ± 6 preoperatively to 97 ± 3 at the time of the most recent follow-up (t = -6.754, P = 0.000). All patients (12 hips) had an excellent clinical result. The lateral center-edge angle of Wiberg increased from 4° ± 13° preoperatively to 36° ± 7° at the time of the most recent follow-up (t = -11.677, P = 0.000). The acetabular roof obliquity decreased from 28° ± 10° preoperatively to 2° ± 8° at the time of the most recent follow-up (t = 9.038, P = 0.000). The acetabular-head index increased from 54% ± 11% preoperatively to 89% ± 13% at the time of the most recent follow-up (t = -11.137, P = 0.000). The hip center was translated medially. Improvement of cystic degeneration of the acetabulum were found in 4 hips. Remodeling of aspherical uncongruence were found in 5 cases. Crossing sign were found in 2 hips postoperatively without symptoms of impingement.</p><p><b>CONCLUSIONS</b>PAO can provide comprehensive deformity correction and improve hip function in treatment of developmental dysplasia of the hip in adolescence. Some of the patients have improvement of cystic degeneration and remodeling of the hip.</p>
Subject(s)
Adolescent , Child, Preschool , Humans , Acetabulum , Pathology , Disease Progression , Hip Dislocation , General Surgery , Hip Dislocation, Congenital , Osteotomy , Postoperative PeriodABSTRACT
OBJECTIVE@#To investigate the effect of operation on Benign thyroid nodules with hoarseness as primary symptom.@*METHOD@#Twelve patients were underwent the operation of subtotal thyroidectomy and exposing of recurrent laryngeal nerve. We evaluating the effect by fibrolaryngoscope and voice acoustic analysis before and after operation.@*RESULT@#All the 12 patients underwent surgery successfully. The hoarseness improved obviously and vocal cords were reactivate. Jitter, shimmer and dysphonia severity index showed significant difference pre and one month after surgery.@*CONCLUSION@#Benign thyroid nodules could also cause vocal cord paralysis and hoarseness, the effect can be satisfying by subtotal thyroidectomy and exposing of recurrent laryngeal nerve if it can be early diagnosed.