Histopathologic changes after tracheal reconstruction with a scraped partial mucosa jejunal autograft / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the histopathological changes of the new trachea reconstruction with a scraped partial mucosa jejunal autograft hy microscope and transmission electron microscope.@*METHOD@#Eight canine models of extensive circumferential tracheal defects with revascularized jejuna combined with NiTi alloy mesh tube were established. Operations were performed on these dogs under general anesthesia by intravenous ketamine. A 6.5 cm length of segment of the jejunum was resected. The graft was prepared by scraping the partial mucosa with operating knife blade and dry gauze. During the resecting course, micro-vascular anastomoses were done between the mesenteric artery and the right common carotid artery,and the mesenteric vein with the right common carotid vein. The silicone intraluminal stent was placed in the lumen of the jejunal segment and was removed the fourth week after operation. A Ni-Ti alloy prothesis was placed over the jejunal segment, with the mesenteric vascular supply egressing through the longitudinal defect of the mesh tube. Then the free jejunum was used to reconstruct the tracheal defects. Biopsy were performed and recorded at the 1 at, 2nd, 3rd and 4th postoperative months. All specimens were observed by microscope and transmission electron microscope examinations.@*RESULT@#Eight dogs postoperative all survived expected time. One month after operation, the tracheointestinal snastomosis showed smooth and was covered by continuous internal lining. The mucosa of the jejunum was slightly atrophied. Two months after operation, examination of the jejunal mucosa of the autografts demonstrated obviously thinned. The lumen of the reconstructed trachea was covered by squamous epithelium entirely at 3 months postoperatively. The partial squamous epithelium has transformed ciliated columnar epithelium at 4 months postoperatively.@*CONCLUSION@#A free scraped partial jejunum reconstructed trachea can accelerated the atrophying process of mucous epithelization and promoted mucosal metaplasia of the jejunum. The reconstructed tracheal lumen has completely transformed squamous epithelium at 3 months postoperatively and partial squamous epithelium has transformed ciliated columnar epithelium at 4 months postoperatively.

Chiral Separation and Determination of Four Lurasidone Hydrochloride Enantiomers by HPLC / 中国药师

Objective:To establish the determination method for four lurasidone hydrochloride enantiomers by HPLC. Methods:Lurasidone hydrochloride enantiomers were separated on a CHIRALPAK AD-H column (250 mm × 4. 6 mm, 5μm). The mobile phase consisted of hexane-ethanol-diethylamine ( 90∶10∶0. 1) at a flow rate of 1. 0 ml·min-1 and the column temperature was at 40℃. The detection wavelength was 230nm. Results:The resolution of lurasidone hydrochloride enantiomers was above 2. 0. The linear calibra-tion curves were obtained over the range of 5-120 μg· ml-1 for all the enantiomers (r=0. 999 9). The recovery was above 99. 0%with RSD below 0. 5%. The detection limits were 5ng. Conclusion:The method is simple, accurate and rapid, and suitable for the de-termination and quality control.

A case report with esophageal foreign body of muskmelon / 临床耳鼻咽喉头颈外科杂志

A male patient, 41 years old, swallowed a chunk of muskmelon because his attention was not centralized. Odynophagia and dysphagia were the two main clinical manifestations. The esophagus barium swallow examination showed a foreign body in the upper esophagus. The patient did the rigid esophagoscope examination in the operating room under general anesthesia. There was a chunk of muskmelon in the upper esophagus and could not take it out from the esophagus by using foreign body forceps because the muskmelon was very crisp. In the end the muskmelon was sent in the stomach. The patient's symptoms were alleviated after operation.

Clinical classification of osteoradionecrosis of temporal bone and the treatment of massive osteonecrosis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the effective treatment regimen for osteoradionecrosis of temporal bone.@*METHOD@#Twenty-seven patients with massive osteoradionecrosis in temporal bone were included and retrospectively analyzed, in which, 15 cases received surgery and the other 12 cases adopted non-surgical treatment.@*RESULT@#In the surgery group, three cases died one year postoperatively and died of massive hemorrhage due to internal carotid blowout. One case died four years after surgery without clear cause of death, and two cases were lost to follow up. Out of the nine survivors, the follow up period ranged from four months to eight years (one was followed up eight years, one was followed up over four years, four were followed up two-three years, one was followed up over one year, one was followed up nine months, and one was followed up four months, respectively). Patients classified as the type III received best outcome, and patients of type V and IV without invasion of the internal carotid artery received good surgical effects, while patients classified as the type IV with internal carotid artery invasion presented low survival rate. Two cases in the non-surgical group died of internal carotid rupture, and the other ten cases presented with repeated infection and expansion of the osteoradionecrosis lesion.@*CONCLUSION@#The new classification criteria is helpful in diagnosis of location of lesions,and can serve as a guide for clinical therapy. Massive osteoradionecrosis in temporal bone responded unfavorably to conservative treatment, compared to that, surgery can effectively control the expansion of the lesion and markedly improve patient quality of life. Long-term follow up is necessary because of the slow development of osteoradionecrosis after surgery.