Efficacy of magnetic traction hyoid suspension surgery in the animal model of OSAHS / 西安交通大学学报(医学版)

【Objective】 To explore the effectiveness of creating the obstructive sleep apnea hypopnea syndrome (OSAHS) animal model of glossocoma using the botulinum toxin type A in white rabbits, and to explore the effectiveness and safety of magnetic traction hyoid suspension operation in the OSAHS animal model of glossocoma. 【Methods】 A total of 12 adult male experimental white rabbits were randomly divided into two groups. The animals in the experimental group were injected with 0.4 mL (10 U) of botulinum toxin type A in the genioglossus muscle to construct the OSAHS animal model of glossocoma. The animals in the control group were injected with 0.4 mL of normal saline. We designed and 3D printed a polyacrylate shell that could be loaded with inner and outer neodymium iron boron (NdFeB) magnets. After the modeling, a polyacrylate shell with the inner magnet device was fixed on the hyoid bone of the animals in the experimental group. All animals in the experimental group wore the polyacrylate orthotic neck brace containing the outer magnet 10 days after the operation. The arterial blood oxygen detector was used to record the oxygen saturation (SaO2) of the femoral artery, and multi-slice CT plain scan was used to measure the diameter of the narrowest part of the upper airway. 【Results】 The animals in the experimental group gradually showed decreased activity, labored breathing, blue lips and ear margins and other manifestations of hypoxemia 5 days after intramuscular injection of botulinum toxin type A in the genioglossus, and their body weight dropped from (3.72±0.21)kg to (3.40±0.20)kg, the average SaO2 of the femoral artery decreased from (93.84±5.14)% to (84.00±3.35)%, and the diameter of the narrowest part of the upper airway decreased from (4.83±0.47)mm to (3.52±0.83)mm (P<0.05). In the control group, the animals’ weight, the average SaO2 of the femoral artery, and the diameter of the narrowest part of the upper airway did not significantly change before and after injection of normal saline into the genioglossus muscle (P>0.05). The animals in the experimental group completed the magnetic traction hyoid suspension surgery. After wearing the orthotic neck brace containing an external magnet for hyoid magnetic traction, the food intake and activity of the animals in the experimental group increased, the color of the lips changed from purple to pink, the SaO2 of the femoral artery increased significantly to (90.44±5.95)%, and the diameter of the narrowest part of the upper airway increased significantly to (4.42±0.15)mm (P<0.05). 【Conclusion】 The genioglossus muscle injection of botulinum toxin type A in white rabbits could successfully establish the OSAHS animal model of glossocoma. Magnetic traction hyoid suspension surgery in the treatment of OSAHS animal model could effectively correct the upper airway stenosis related symptoms and hypoxemia caused by glossocoma.

Clinicopathological study of 12 cases of salivary myoepithelial carcinoma / 临床与实验病理学杂志

Purpose To study the clinical features,pathological manifestation and immunohistochemical phenotype and improve the diagnosis and treatment of myoepithelial carcinoma in salivary glands.Methods Histomorphology and immunohistochemical phenotype were analyzed after the sections were stained with routine HE and immunohistochemical methods,and the relevant literatures were reviewed.Results The tumours were predominantly composed of pale-stained clear cells.In some cases,plasma-like cells,epithelioid cells and spindle cells were also seen.The cells were arranged in nest,solid or cords.Mitosis was easily seen,cytological atypia was obvious and necrosis existed in 4 cases.The results of immunohistochemical staining showed that CK was expressed in all cases.EMA was expressed in 8 cases.p63 and CK5/6 were expressed in 11 cases.S-100 was expressed in 10 cases.vimentin was expressed in 4 cases.Calponin was expressed in 2 cases.SMA was expressed in one case.The proliferation index of Ki-67 was 5％ to 40％.Conclusion The histological changes of myoepithelial carcinoma cells are diverse,and pathological and immunohistochemical methods are helpful for improving the rate of right diagnosis.Sugery is the main treatment for myoepithelial carcinoma.

Effects of high flexion total knee prosthesis treatment of senile knee osteoarthritis in elderly / 中国基层医药

Objective To investigate the elderly knee osteoarthritis high-flexion total knee prosthesis re-placement therapy clinical efficacy .Methods 68 patients(68 knees) were randomly divided into two groups in ac-cordance with the order of treatment ,each group was treated with high flexion total knee prosthesis replacement therapy and the general treatment of posterior stabilized prosthesis ,compared before and after surgery in March and after a in HSS,WOMAC knee function , maximum knee flexion and knee activity before the pain incidence .Results Two groups of patients HSS and WOMAC after treatment ,3 months,1 year compared with before treatment ,the differences were statistically significant(t=6.28,7.36,all P<0.05),the control group after treatment,3 months and 1 year compared with before treatment,there was statistically significant(t=5.23,7.35,all P<0.05);HSS in observation group after 1 year compared with the control group ,the difference was statistically significant (t=4.69,P<0.05), WOMAC after 3 months compared with the control group,the difference was statistically significant (t =6.49,P<0.05);Two groups of patients knee activity after treatment ,3 months,1 year compared with before treatment , the differences were statistically significant (t=5.24,4.66,all P<0.05),the control group after treatment ,3 months and 1 year compared with before treatment ,the differences were statistically significant (t=5.81,4.64,all P<0.05);ob-servation group after 1 year maximum flexion and range of motion and control group ,the difference were statistically significant(t=6.64,5.33,all P<0.05).The incidence of postoperative anterior knee pain of observation group and control were 2.94%,14.71%,there was statistically significant difference (χ2 =5.23,P<0.05).Conclusion Eld-erly high flexion knee osteoarthritis total knee prosthesis replacement therapy can improve long -term postoperative knee function and range of motion ,which also can reduce knee pain occur .

Endoscope thyroid lobectomy through subclavicular approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical applications of endoscopic thyroid lobectomy through subclavicular approach and to summarize the surgical experiences.@*METHOD@#Thirty-five cases were subjected to endoscopic thyroid lobectomy through subclavicular approach. Briefly, operative cavities were established by automatic retractors and the affected lobes were dissected and removed using suction dissectors combined with the harmonic scalpels. The inferior thyroid artery was used as the mark to locate the recurrent laryngeal nerve.@*RESULT@#All the operations achieved successfulness with no complication. 33 out of 35 were intraoperatively diagnosed by frozen-pathology as goiter and the last two cases were diagnosed as papillary thyroid carcinoma. There were no postoperative swelling, numbness or other kinds of uncomfortableness with benign patients and they were satisfied with the cosmetic outcomes.@*CONCLUSION@#Endoscopic thyroid lobectomy through subclavicular approach for thyroid benign lesions has the advantages of minimal invasion, high safety, easy manipulation and good cosmetic outcomes, which are worth of wide applications.

Research on social part transformation of postoperative patient of laryngeal carcinoma / 中国医学伦理学

Objective Through studying the change of life style and social part constractly on patients of laryngeal carcinoma with different modus operandi.To elevate the living quality through combined treatment of laryngeal carcinoma.Methods One hundred and thirty two patients of laryngeal carcinoma were divided into two groups: total laryngectomy and partial laryngectomy.Through investigation of questionnaire to analyse the living quality between the different modus operandi.Results There has significant difference between two groups of total and partial laryngectomy on living state and mental state(P