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OBJECTIVE To study the clinical efficacy of voice training on voice recovery in patients with vocal cord polyps during perioperative period.METHODS A total of 72 patients with vocal cord polyp were chosen in this study and they were randomly divided into study group and control group. After operation, the control group received routine treatment, and the study group received voice training on the basis of routine treatment. The results of voice acoustic analysis in the two groups were compared at 8 weeks after operation.RESULTS After 8 weeks, the maximum phonation time(MPT), dysphonia severity index (DSI) and the highest frequency(F0-High) of the study group were significantly higher than that of control group (P0.05).CONCLUSION Voice training in the early postoperative period of vocal cord polyps was helpful to the recovery of the voice.
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Objective To investigate the application value of continuous irrigation and vacuum suction by subcutaneous drainage tube for prevention of abdominal type Ⅳ incision infection.Methods A prospective,single-blind, randomized, controlled study was conducted based on the clinical data of 123 patients with abdominal type Ⅳ incision infection who were admitted to the First People's Hospital of Foshan between January 2008 and July 2014.Patients were divided into the experimental group and the control group based on the random number table and received open surgery.Patients in the experimental group were placed subcutaneous drainage tube with postoperative continuous irrigation and vacuum suction, while patients in the control group adopted the method of traditional abdominal closure without subcutaneous drainage tube.The levels of preoperative hemoglobin (Hb) and albumin (Alb), severity grading according to the American Society of Anesthetheologists (ASA), levels of Hb and Alb at postoperative day 1, 3, 7 were recorded and postoperative incision infection and bacteria culture were observed.Patients received bi-weekly regular return visit by outpatient evamination after discharged up to 3 months after suture removal.Measurement data with normal distribution were presented as x-± s and comparison between groups was analyzed by t test.Measurement data with skew distribution were presented as M (Qn) and comparison between groups were analyzed by rank sum test.Repeated measures data were analyzed by the repeated measures ANOVA.Count data were analyzed by the chi-square test.Results One hundred and twenty-three patients were screened for eligibility, and 65 were allocated into the experimental group and 58 into the control group.The levels of Hb and Alb at postoperative day 1, 3, 7 were (111 ± 15) g/L, (107 ± 18) g/L, (108 ± 13) g/L and 30 g/L (26 g/L,32 g/L), 31 g/L(28 g/L,33 g/L), 35 g/L(32 g/L,37 g/L) in the experimental group and (112 ± 13)g/L, (106 ±16)g/L, (106 ± 12)g/L and 30 g/L(25 g/L,32 g/L), 32 g/L(29 g/L,33 g/L), 37 g/L (32 g/L,38 g/L) in the control group, with no significant difference in the changing trends of the above indexes between the 2 groups (F =0.124, 0.007, P ＞ 0.05).There were 4 patients with incision infection in the experimental group and 12 patients in the control group, showing a significant difference (x2=2.723, P ＜ 0.05).The infections occurred at postoperative 4-6 days confined to subcutaneous tissues and unreached to muscular and below layers, and then were cured by incision open drainage without recurrence.Patients without incision infection were removed the stitches at postoperative 7-9 days.Incision bacteria cultures showed that Escherichia coli was detected in 8 cases (including 1 complicated with Enterococcus faecalis and 1 complicated with Klebsiella pneumonia and Pseudomonas aeruginosa), Pseudomonas aeruginosa in 1 case, Klebsiella pneumonia in 2 cases, Acinetobacter baumanii in 1 case, Enterobacter cloacae in 1 case and no bacteria in 3 cases.All the patients were followed up for 3 months after incision healing and survived well without recurrence and complications such as incision split and incision fistula.Conclusion Continuous irrigation and vacuum suction by subcutaneous drainage tube can be operated easily and effectively reduce the postoperative infection rate in abdominal type Ⅳ incision.
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Objective To investigate the practicability and safety of laparoscopic anatomical hepatectomy.Method 40 patients with space occupying lesions in the liver underwent laparoscopic anatomical hepatectomy between Jan.2008 and Mar.2012.The diagnoses were hepatocellular carcinoma (HCC) (n=13),recurrent HCC (n =1 ),cholangiocarcinoma ( n =1 ),metastatic cancer ( n=6),hepatolithiasis (n=10),hemangioma (n=7),FNH (n=1) and liver cell adenoma (n =1).Intraoperative ultrasound was routinely performed to locate lesions and intrahepatic structures.Selective hemihepatic vascular occlusion was applied during resection. High frequency cautery,CUSA and Ligasure were used to transect liver parenchyma. Hemolocks were applied when large blood vessels and bile ducts were encountered.Endo-GIA was used if necessary.The operations included right hemihepatectomy (n =3),left hemihepatectomy (n =10),resections of segment Ⅴ and Ⅵ (n=5),segment Ⅴ (n=3),segment Ⅵ (n =4),and segment Ⅳb (n =1).Result34 hepatectomics were performed laparoscopically.6 patients were converted to open surgery.There was no perioperative death. The operating time was 250.21±50.94 min,and intraoperative blood loss was 420.20± 120.10 ml.Bile leakage was diagnosed in 2 patients after operation.Conclusion With careful patient selection,and improvement in surgical technique and apparatus,laparoscopic anatomical hepatectomy has become safe and practicable.The operation has the advantages of minimal invasion and rapid recovery. It can be regarded as a standard procedure for selected benign and malignant lesions.
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Objective To investigate the safety and long-term therapeutic results of anatomical hepatectomy for hepatocellular carcinoma (HCC).Methods 90 patients underwent anatomical hepatectomy from January,2003 to January,2010.The tumor size was ≤5 cm in 38 patients,and ＞5 cm in 52 patients.The tumor number was a single lesion in 58 patients,and multiple lesions in 32 patients.Cirrhosis was present in 46 patients (55.42％); cancer embolus was present in 34 patients (37.78％).There were 64 patients in Child-Pugh A and 26 patients in B.The operating time,blood loss and blood transfusion were recorded and analyzed.Complications and liver function were monitored after surgery.The Kaplan-Meier method was used to calculate the survival rates.Log-rank test was used to analyze factors associating with postoperative recurrence.Independent factors influencing tumor-free survival and overall survival were analyzed by Cox-model logistic regression.Result There was no perioperative death.The incidence of complications was 31.1％ (28/90).The recurrence rate was 51.1％ (46/90).The 1-,3-,5 year tumor-free survivals were 92.2％,67.3％ and 49.7％％00,respectively.Positive resection margin and satellite nodule were independent factors for recurrence (RR19.22,95 ％ confidence interval 5.85～63.17).The 1-,3-,5-year overall survivals were 94.4％,80.0％ and 60.0％,respectively.Positive resection margin and TNM were independent factors for overall survival (RR 2.013,95％ confidence interval 1.28～3.17).Conclusions Anatomical hepatectomy was a safe and efficacious procedure to treat HCC.Positive resection margin and TNM were independent factors associated with overall survival.Anatomical hepatectomy had the advantages in ensuring a lower rate of negative resection margin.
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OBJECTIVE@#To survey the etiology of sensorineural hearing loss with unknown reason and the incidence of the mutation of SLC26A4 2168A > G in Henan province.@*METHOD@#The evaluation of hearing loss, etiologic survey, the molecular genetic analysis and temporal bone CT examination for genes common to hereditary hearing disorders were performed in 95 hearing-impaired patients in Henan province.@*RESULT@#In the deafness group, the incidence of large vestibular aqueduct syndrome (LVAS) which correlates with SLC26A4 2168A > G is 6.32%. The incidence of the gene diagnosis conformed to the clinical one is 83.3%.@*CONCLUSION@#There is a high incidence of SLC26A4 2168 A > G mutation in sensorineural hearing loss with unknown reason. Molecular genetic screening for these mutations and genetic counseling are effective methods to prevent the occurrence of hereditary hearing loss.
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Humans , Base Sequence , China , Epidemiology , Genetic Testing , Hearing Loss, Sensorineural , Epidemiology , Genetics , Membrane Transport Proteins , Genetics , Mutation , Sulfate Transporters , Vestibular AqueductABSTRACT
Objective To investigate the clinical feature and treatment on rhypenous unilateral exophthalmoses and increase their correctness of diagnosis and treatment. Methods One hundred and thirty-seven rhypenous unilateral exophthalmoses patients' clinical data were analyzed. Results There were 39malignant tumors(28.5%)and 98 benign diseases(71.5%)in the 137 patients. All 137 cases underwent surgical operation. Eighty-three patients were treated through intranasal endoscopic surgery and 15 patients were treated through the outside of nose approach in 98 benign diseases. Ninty-two patients with exophthalmoses cured and 6 patients recovered incompletely after operation. After more than 1-year follow-up, no recurrence happened. The eyeballs of 32 cases were kept in 39 malignant tumors being used by operation combined with radiotherapy. Conclusions Rhypenous unilateral exophthalmoses has their clinical features. CT is an effective method for diagnosis of rhypenous unilateral exophthalmoses. Intranasal endoscopic surgery is the important method for benign rhypenous unilateral exophthalmoses.Patients with rhypenous unilateral exophthalmoses resulted from malignant tumors should be taken different measures according to different circumstances.
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Objective To investigate the surgical procedure of restoring stenosed hilar bile duct by gallbladder lamella with cystic artery.Methods Based on extensive incising and hilar cholangioplasty,stenosed hilar bile duct was restored by gallbladder lamella with cystic artery.Results Among all the 12 pa tients,including 10 intrahepatic bile duct calculi patients,1 right hepatic duct injury and 1 left intrahepatic chaolangiocarcinoma,no cystic fistula,reflexed cholangitis and recurrent stone were noticed by post operative follow-up.Conclusion This procedure is a ideal method by remaining the normal function of Oddis sphincter while removing stenosis.
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OBJECTIVE@#To investigate the available operation method of special type tracheobronchial foreign bodies removal.@*METHOD@#Sixty one patients of special type tracheobronchial foreign bodies were extracted with some special instruments and methods depend on foreign body types. The features of operation on different kinds of foreign bodies were analyzed.@*RESULT@#All patients were operated successfully by using foreign body hook (31 cases), pencil or writing screw brush extracted (11 cases), foreign body cage (13 cases), slender inverse claw esophagus foreign body clamp (3 cases) and so on. No complications and died cases were found. Only 5 patients were undertaken trachea incision before operation.@*CONCLUSION@#Suitable instruments and technique chose for every individual cases is the key to successful operation.
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Bronchi , Bronchoscopy , Methods , Foreign Bodies , General Surgery , Trachea , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To establish a serum-free culture system of dendritic cells (DCs) from chronic myeloid leukemia (CML) cells so that DCs vaccine may be applied to the adoptive immunotherapy of CML in the near future.</p><p><b>METHODS</b>Fetal calf serum, serum-free medium and autologous serum were used for culture of DCs. The usage of cytokines was classified into two groups: group A (stem cell factor, granulocyte/macrophage colony-stimulating-factor, tumor necrosis factor-alpha and interleukin-4) and group B (granulocyte/macrophage colony-stimulating-factor, tumor necrosis factor-alpha and interleukin-4). The phenotypes of DCs were analyzed by using indirect immunofluorescence and flow cytometry. Mixed leukocyte responses were performed by methyl thiazolyl tetrazolium (MTT) assay. Chromosome analysis of DCs can be achieved by displaying G banding. T cells from CML patients were stimulated with autologous DCs and T-cell cytotoxicity was measured by (MTT) assay.</p><p><b>RESULTS</b>CD34(+) cells or mononuclear cells were obtained from peripheral blood or bone marrow samples of eight patients of chronic-phase CML. Group A of serum-free medium was better than group B in expansion of total cell numbers and the rate of DCs. These results of serum-free medium were not significantly different from those of fetal calf serum medium, but the results of autologous serum medium were inferior to two groups above. The expression of major histocompatibility complex class II antigen on the surface of DCs was notable (> 50%), but the expression of CD83 and the costimulatory molecules CD86 was not noticeable (10% - 50%). Although CD1a(+)/CD14(-) DCs were potent stimulators of allogeneic lymphocytes, expansion of T cells from normal volunteers were not significant (average 27.2 fold at DCs: T cells ratio of 1:10). At day 12, CD1a(+) cells from three patients were studied by displaying G banding and Ph(+) cells in these populations were 100%, 98% and 60%, respectively. At an effector: target ratio of 40:1, 32% to 45% cytotoxicity was noted with DC-stimulated T cells against autologous leukemia cells.</p><p><b>CONCLUSIONS</b>A stable serum-free culture system of CML-DCs was established. The expression of CD83 and CD86 on the surface of CML-DCs and DCs' potent stimulation of allogeneic lymphocytes were not notable. DCs in CML patients can be derived from the malignant clone and these malignant DCs could induce anti-leukemic reactivity in autologous T lymphocytes without the necessity for additional exogenous antigens.</p>
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Humans , Cells, Cultured , Culture Media, Serum-Free , Cytotoxicity, Immunologic , Dendritic Cells , Physiology , Immunotherapy, Adoptive , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Allergy and Immunology , Therapeutics , T-Lymphocytes , Allergy and ImmunologyABSTRACT
Objective: To overview the experience of postoperative nutritional management in live transplant patients. Methods: Postoperative nutritional therapy and nutritional status assessment in 18 liver transplantation (2 patients undergone retransplantation) were retrospectively analyzed. During the first 3 days after operation, patients were supported with total parenteral nutrition (TPN) and supplied with human albumin. On the 4th and 5th days after operation, patients were provided with parenteral nutrition (PN) and enteral nutrition (EN). And on days 6～10 after operation, patients were gradually transferred to total enteral nutrition and they restored the oral intake completely on days 12～18 after operation. Recombinant human growth hormone was postoperatively injected for 4～7 days. Results: Despite 3 cases who died from brain hemorrhage, respiratory failure and acute rejection respectively, other 13 cases recovered fluently. Conclusions: Appropriate postoperative nutritional therapy facilitated the recovery of liver transplant patient.
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Objective To induce human mononuclear cell of cord blood into CD 3 activating killing (CD 3AK) cells with anti-CD 3 monoclonal antibody (CD 3McAb) and recombinant human interleukin-2 (rhIL-2), so that their proliferative activity, activity of killing action, phenotypes and level of secretory cytokines can be observed dynamically. Methods The increase of the number of cells was counted by Tapan-blue staining. The killing action can be measured by using methyl -thiazolyl-tetrazolium-array. The phenotypes of cells were analysed by using indirect immunofluorescence assay. The levels of IL-6, interferon-? (IFN-?) and tumor necrotic factor-? (TNF-?)in culture supernatants were analysed by using enzyme-linked irnmunosorbent assay(ELISA). Results The increase of the number of CD 3AK cells from cord blood was the highest amounting to 78.56 times in the second week. The killing action reached the peak on day 12, and all target cells (malignant cell lines) could be killed significantly. The heterogeneous phenotypes of CD 3AK cells showed that the number of cells with CD 3+, CD 8+, CD 25+, CD 38+, CD 16+ and CD 56+ increased significantly on day 7,14 compared with those of pre-culture (P