Clinical efficacy of GnRH-a combined with LNG-IUS in the treatment of refractory adenomyosis by magnetic resonance-guided high intensity focused ultrasound / 中国医师杂志

Objective To explore the clinical effects of Gonadotropin releasing hormone agonist (GnRH-a) combined with levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of refractory adenomyosis by magnetic resonance-guided high intensity focused ultrasound (MRgHIFU).Methods 80 patients with refractory adenomyosis admitted to our hospital from April 2015 to June 2017 were randomly divided into observation group and control group.They were treated with MRgHIFU as observation group.LNS-IUS was placed after the third injection of GnRH-a as control group.The uterine volume,pain score,menstrual volume and adverse reactions were compared between the two groups at 3 and 6 months after treatment.Results After 6 months of treatment,the uterine volume of the observation group [(100.23 ±4.65) cm3] was significantly lower than that of the control group [(145.46 ± 10.23) cm3],with statistically significant difference (t =6.01,P ＜ 0.05).After 6 months,the degree of dysmenorrhea in the observation group was significantly lower than that in the control group [(2.12 ± 0.24) point vs (0.27 ± 0.09) point],with statistically significant difference (t =5.21,P ＜ 0.05).At 3 and 6 months after treatment,the menstrual volume of the observation group was significantly lower than that of the control group [(64.67 ± 10.12) point vs (96.45 ± 15.12) point,(42.46 ± 11.18) point vs (66.26 ± 12.48) point],with statistically significant difference (t =4.51,P ＜ 0.05;t =3.58,P ＜ 0.05).The adverse reactions such as vaginal bleeding,hot flashes and night sweats were significantly lower than those in the control group (x2 =3.967,P ＜ 0.05).Conclusions As a new non-invasive and refractory treatment of adenomyosis,high intensity focused ultrasound guided by magnetic resonance is safe and effective with less adverse reactions,which is worthy of clinical application.

Clinical effect of improved mesh in the treatment of severe pelvic organ prolapse / 中国综合临床

Objective To discuss the clinical effect of improved pelvic floor mesh implantation in the treatment of severe pelvic organ prolapse. Methods From January 2016 to April 2018, eighty-four patients with severe pelvic organ prolapse admitted to Harbin First Hospital were randomly divided into observation group and control group with 42 cases in each group. The control group was treated with traditional pelvic floor reconstruction,which used two meshes to reconstruct front and back of pelvic cavity. 42 cases of the observation group were treated with improved mesh-augmented vaginal reconstructive surgery, which used only one mesh to reconstruct total pelvic reconstruction by changing the location of puncture. The therapeutic effects of the two surgical methods were compared,including general condition of the whole body, perioperative period,operative period and follow-up. Results The amount of blood loss in the observation group were significantly lower than that in the control group((65. 32±20. 39) ml vs. (86. 52±30. 23) ml), and the difference was statistically significant ( t＝ 4. 56, P＜0. 05 ) . The average operation time in the observation group were significantly lower than that in the control group ((40. 35±12. 41) min vs. (57. 83± 17. 54) min),and the difference was statistically significant (t＝6. 56,P＜0. 05). The medical fees in the observation group were significantly lower than that in the control group ((10 600±1 012)yuan vs. (20 200 ±1 123)yuan),and the difference was statistically significant (t＝25. 38,P＜0. 05). After one year follow-up,there were 1 case (2. 4%,1/42) of mesh erosion,2 cases (4. 8%,2/42) of sexual discomfort and 2 cases (4. 8%) of recurrence in the observation group. In the control group,there were 3 cases (7. 1%) of mesh erosion,4 cases (9. 5%) of sexual discomfort and 3 cases ( 7. 1%) of recurrence. The complications caused by mesh in the observation group were significantly lower than those in the control group (2. 4%(1/42) vs.7.1%(3/42),4.8%(2/42) vs.9.5%(4/42)) (χ2 ＝3.98,3.46,P＜0.05).There was no significant difference in the time of catheter placement,the time of exhaust after operation and the recurrence rate between the two groups (t＝0. 08,0. 48,0. 05,P＞0. 05). Conclusion The improved mesh-augmented vaginal reconstructive surgery is an effective minimally invasive surgery,which has small trauma and fewer complications,faster recovery after surgery, can save medical costs, and has broad prospects for clinical application.

Clinical effect of MR-guided high intensity focused ultrasound and gonadotropin releasing hormone agonist combined with levonorgestrel-releasing intrauterine system in the treatment of recurrent uterine fibroids / 中国综合临床

Objective To explore the clinical effects of magnetic resonance guided high intensity focused ultrasound ( MRgHIFU ) and gonadotropin releasing hormone agonist ( GnRH-a ) combined with levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of recurrent uterine fibroids. Methods Eighty patients of recurrent uterine fibroids from April 2015 to June2017 in the First Hospital of Harbin were collected and randomly divided into the observation group and control group. MRgHIFU was used in the observation group were employed,and patients in the control group were treated with ING-IUS after first injecting GnRH-a. The tumor volume,hemoglobin level,menstrual quantity and adverse reactions were compared before and at 3 months,6 months after treatment. Results After 6 months,the size of the uterine myoma in the observation group was ((80. 23 ± 4. 35) cm3 ),significantly lower than that of the control group (( 135. 46 ±9. 25) cm3 ),and the difference was statistically significant ( t = 6. 01,P < 0. 05) . At 3 and 6 months after treatment,the amount of menstruation in the observation group was significantly lower than that of the control group( (66. 37 ± 12. 12) points vs. (40. 46 ± 10. 15) points; (98. 42 ± 14. 12) points vs. ( 68. 26 ± 11. 38) points). The difference was statistically significant (t at 3 months after treatment= 4. 52,P<0. 05,t at 6 months after treatment= 3. 53,P<0. 05). After 6 months of treatment,the hemoglobin value of the observation group was significantly higher than that of the control group (( 142. 12 ± 4. 24) g/ L vs. ( 108. 27 ± 3. 09) g/ L), the difference was statistically significant (t= 5. 02,P<0. 05),while the adverse reactions such as vaginal bleeding, hot flashes and night sweats were lower than those of the control group (2. 5% (1/ 40) vs. 7. 5% (3/ 40)) (χ2= 3. 99,P<0. 05). Conclusion Magnetic resonance guided high intensity focused ultrasound was considered as safe and effective in treating uterine fibroids,which is a new and noninvasive therapeutic methed,

Expression and significance of MTDH and MMP-9 in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the expression changes of metadherin (MTDH) and matrix metalloproteinase-9 (MMP-9) in the laryngeal squamous cell carcinoma tissues and to investigate the significance.@*METHOD@#The expression of MTDH and MMP-9 in 54 cases of laryngeal squamous cell carcinoma tissues(observation group) and 30 cases of para-carcinoma tissues (control group) was examined by immunohistochemical method, the correlation between them and their correlations with the clinicopathological parameters were analyzed.@*RESULT@#The positive expression rates of MTDH in the observation group and control group were 64.8% (35/54) and 6.7% (2/30), respectively; the positive expression rates of MMP-9 in the observation group and control group were 70.4% (38/ 54) and 13.3% (4/30), respectively; and there was a statistically significant difference between two groups (all P < 0.01). In the laryngeal squamous cell carcinoma tissues, the expression of MTDH protein was related with degree of differentiation, lymph-node metastasis and TNM stage (all P < 0.05); and the expression of MMP-9 protein was related lymph-node metastasis and TNM stage (all P < 0.05). The expression of MTDH was positively correlated with MMP-9 in the laryngeal squamous cell carcinoma tissues (r = 0.371, P < 0.01).@*CONCLUSION@#The high expression of MTDH and MMP-9 was closely related to the occurrence, development and metastasis of laryngeal squamous cell carcinoma, joint detection of the two proteins was valuable for early diagnosis and prognosis of laryngeal squamous cell carcinoma.

The expression of BUB1 in laryngeal squamous cell carcinoma and its clinical significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and clinical significance of BUB1 protein in laryngeal squa mous cell carcinoma (LSCC) tissues.@*METHOD@#The expression of BUB1 protein was measured by immunohistochemistry (EliVision two steps) in 55 cases of LSCC tissues,30 cases of adjacent normal laryngeal mucosa tissues, the relationship of BUB1 expression with clinical pathologic factors in LSCC was also analyzed.@*RESULT@#The positive rate of BUB1 protein in LSCC tissues (50.9%, 28/55) was significantly lower than that in adjacent normal laryngeal mucosa tissues (83.3%, 25/30), P 0.05, respectively).@*CONCLUSION@#The low expresssion of BUB1 protein is closely related to the tumorigenesis and development of LSCC, and can be a molecular marker for prognosticating metastasis and prognosis of LSCC.

Efficacy evaluation of specific immunotherapy with standardized house dust mite allergen preparation for allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of specific immunotherapy (SIT) with standardized house dust mite allergen preparation for allergic rhinitis (AR).@*METHOD@#Fifty-five patients with allergic rhinitis caused by house dust mites were selected in this self-control study. Clinical efficacy was evaluated by symptom and sign score after two years of specific immunotherapy and compared with pre-treatment scores.@*RESULT@#After completing the study, a clinically significant reduction in symptom and sign score in these patients was noted, compared with that of pretreatment. And the difference was statistically significant (P < 0.01).@*CONCLUSION@#Standardized house dust mite allergen preparation is an effective treatment in patients suffering from allergic rhinitis due to house dust mites.

Comprehensive traditional Chinese medicine intervention for perimenopausal syndrome in women: a community study / 中西医结合学报

As perimenopausal syndrome is a particularly disturbing condition to the patient, it is practical and necessary to establish a program of comprehensive traditional Chinese medicine therapy for women with perimenopausal syndrome.

The expression of oncogene AKT2 in laryngeal squamous cell carcinoma and its clinical significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and clinical significance of oncogene AKT2 in laryngeal squamous cell carcinoma (LSCC).@*METHOD@#The expression of AKT2 protein was measured with immunohistochemistry (Elivision two steps) in 60 cases of LSCC tissue, 28 cases of peri-cancer tissue and 16 cases of normal laryngeal epithelium, the relationship between AKT2 expression and clinical pathologic factors in LSCC was also analyzed.@*RESULT@#The positive rates of AKT2 protein expression in LSCC and peri-cancer tissue were 56.7% (34/60), 14.3% (4/28) respectively. There was no expression of AKT2 in normal laryngeal epithelium. The positive rate of AKT2 protein expression in LSCC was significantly higher than that in peri-cancer tissue and normal laryngeal epithelium (P 0.05, respectively).@*CONCLUSION@#AKT2 might play an important role in the tumorigenesis and development of LSCC, and it was suggested that AKT2 could be a useful marker for predicting tumorigenesis, invasion and metastasis potential of LSCC.

Treatment of thoracolumbar burst fractures / 中国矫形外科杂志

Thoracolumbar burst fractures account for more than half of all thoracolumbar fractures,which often result in neurologic deficit,kyphosis deformity and significant disability.The management of thoracolumbar burst fractures differ with the types.Nowadays,the accepted methods of treatment of thoracolumbar burst fractures include conservative therapy,posterior reduction and instrumentation,anterior decompression and instrumentation,combined anterior-posterior approach and minimally invasive approach.Howerer,the optimal technique is not always evident.There is no precise classification system to determine which surgical procedure is the best.The following review summarizes the recent advances in treatment of thoracolumbar burst fractures.Recent clinical evidence shows that there is no significant difference between conservative therapy and surgical treatment for thoracolumbar burst fractures without neurologic deficit,and that surgical treatment should be considered for unstable fractures with neurological injuries.Some other clinical evidence shows that short segment combined fractured vertebra plasty with various manners has gained popularity,because it can reconstruct anterior column and decrease the failure of internal fixation and the occurrence of long-term spinal kyphosis deformity.In accordance with the principles of biomechanics and taking into account the occurrence of degeneration of adjacent segment,surgeons gradually applied non-fusion technology in clinical practice,and yet its long-term results need to be confirmed by further studies.