Clinical characteristics and genetic analysis of three children with Congenital chlorine diarrhea / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics and genetic basis for three children with Congenital chlorine diarrhea (CCD).@*METHODS@#Three children with CCD who attended the Affiliated Children's Hospital of Capital Pediatric Institute from June 2014 to August 2020 were selected as the research subjects. Peripheral blood samples of the three children and their parents were collected for genetic testing. And the results were verified by Sanger sequencing.@*RESULTS@#The clinical manifestations of the three children have included recurrent diarrhea, with various degrees of hypochloremia, hypokalemia and refractory metabolic alkalosis. Genetic testing revealed that the three children have all carried variants of the SLC26A3 gene, including homozygous c.1631T>A (p.I544N) variants, c.2063_1G>T and c.1039G>A (p.A347T) compound heterozygous variants, and c.270_271insAA(p.G91kfs*3) and c.2063_1G>T compound heterozygous variants. Sanger sequencing confirmed that all of the variants were inherited from their parents.@*CONCLUSION@#The variants of the SLC26A3 gene probably underlay the CCD in these children. Above finding has enriched the spectrum of SLC26A3 gene variants.

Predicting the prognosis of patients with cardiogenic acute stroke based on the nomogram model / 国际外科学杂志

Objective:A nomogram model was constructed to predict poor prognosis and death risk of mechanical thrombectomy in patients with cardiogenic acute stroke.Methods:Selected 276 patients with cardiogenic acute stroke who were treated by Jiangyin Hospital of Traditional Chinese Medicine from January 2016 to June 2020 who underwent mechanical thrombectomy as the research objects, and recorded their general information and laboratory test results. On the 90th day, the subjects were divided into a good prognosis group ( n=122) and a poor prognosis group ( n=154) according to whether the prognosis was poor or not; according to whether they died, the subjects were divided into the survival group ( n=208) and the death group ( n=68). The differences in patient related data were compared, Logistic regression analysis was used to screen for risk factors for poor prognosis and death, the line chart prediction model was established, and the ability of the column chart model to predict poor prognosis and death was evaluated by using the subject work characteristic (ROC) curve. The independent factors selected by multivariate regression analysis were used as predictors to construct a nomogram model to predict the prognosis of mechanical thrombectomy surgery in patients with cardiogenic acute stroke. The degree of calibration and validity of the nomogram model established in this study Make an evaluation. The measurement data that obey the normal distribution were represented by the Mean ± standard deviation ( ± s), and the two independent sample t test was used for the comparison between groups; The comparison of enumeration data between groups adopted chi-square test. Results:Multivariate logistic regression analysis showed age ( OR=1.165; 95% CI: 1.046-1.284; P=0.001), diabetes ( OR=1.123; 95% CI: 1.021-1.225; P<0.001), hemorrhage transformation ( OR= 2.394; 95% CI: 1.857-2.931; P=0.001), recanalization ( OR=0.418; 95% CI: 0.410-0.552; P=0.001), NIHSS score ( OR=1.502; 95% CI: 1.373-1.631); P=0.001), neutrophil count (NEUT) ( OR=1.024; 95% CI: 1.009-1.139; P=0.001), NEUT/lymphocyte count (NLR) ( OR=1.235; 95% CI: 1.112-1.358; P=0.001), D-dimer ( OR=1.939; 95% CI: 1.328-2.551; P=0.001) was an independent risk factor for poor prognosis in patients with cardiogenic acute stroke; age ( OR=1.153; 95% CI: 1.080-1.226; P<0.001), hemorrhage transformation ( OR=6.330; 95% CI: 4.904-7.754; P=0.001), recanalization ( OR=0.418; 95% CI: 0.323-0.514; P=0.001), NIHSS score ( OR=2.051; 95% CI: 1.784-2.338; P=0.001), NEUT ( OR=1.399; 95% CI: 1.275-1.523; P=0.001), NLR ( OR=1.528; 95% CI: 1.414-1.642; P=0.001), D-dimer ( OR=2.391; 95% CI: 1.948-2.834; P=0.001) was an independent predictor of death in patients with cardiogenic acute stroke. The established nomogram model predicted poor prognosis and the area under the ROC curve of death were 0.814 (95% CI: 0.800-0.828) and 0.842 (95% CI: 0.828-0.857). Conclusions:Age, hemorrhage transformation, recanalization, NIHSS score, NEUT, NLR, and D-dimer are all important for the prognosis of patients with cardiogenic acute stroke by mechanical thrombectomy. Diabetes only has a suggestive effect on poor prognosis. The nomogram model established based on these factors can effectively help clinicians evaluate the prognosis of patients, formulate reasonable treatment plans for them, and improve the prognosis.

Implication of enhanced recovery after surgery in the surgical management of hypopharyngeal squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the safety and efficacy of enhanced recovery after surgery (ERAS) in the clinical management of hypopharyngeal squamous cell carcinoma (HSCC). Methods: In this retrospective study, a total of 168 patients with pyriform sinus carcinoma in Qilu Hospital of Shandong University from January 2015 to January 2019 were divided into two groups, based on the different perioperative interventions that patients received, i.e. the ERAS group (n=64) and the conventional group (n=104), including 164 males and 4 females, whose ages ranged from 42 to 84 years old. The difference between two groups in the operative time, postoperative nutritional status, incidences of postoperative complications and postoperative hospitalization time were compared using the student's t test, Chi-squared test or Fisher's exact test. Results: Compared with the conventional group, patients in the ERAS group had significantly shorter operative time [(166.8±58.2) min vs. (183.3±39.9) min,t=-2.72, P=0.031], higher levels of postoperative serum albumin [(38.3±4.2) μmol/L vs. (36.6±3.3) μmol/L, t=2.73, P=0.007] and more body weight [(65.4±9.4) kg vs. (62.1±9.4) kg, t=2.22, P=0.028], lower incidences of postoperative subcutaneous infection [7.8% (5/64) vs. 20.2% (21/104), χ²=4.64, P=0.03] and severe pneumonia [4.7% (3/64) vs. 15.4% (16/104), χ²=4.52, P=0.03], and shorter postoperative hospitalization time [(16.5±3.9) d vs. (18.2±4.3) d, t=-2.65, P<0.05]. Conclusion: ERAS is effective and safe in the surgical management of HSCC, with benefits in reducing the operative stress via saving operation time, shortening the hospitalization time, ameliorating nutritional status and decreasing the incidences of complications.

Prognostic value of free triiodothyronine in patients with dilated cardiomyopathy / 中华医学杂志(英文版)

BACKGROUND@#The association between free triiodothyronine (FT3) and long-term prognosis in dilated cardiomyopathy (DCM) patients has not been evaluated. The purpose of this study was to determine whether the level of FT3 could provide prognostic value in patients with DCM.@*METHODS@#Data of consecutive patients diagnosed with DCM were collected from October 2009 to December 2014. FT3 was measured by fluoroimmunoassay. Other biochemical markers, such as free thyroxin (FT4), thyroid-stimulating hormone, red blood cell, hemoglobin, blood urea nitrogen, and serum creatinine, were tested at the same time. Follow-up was performed every 3 months. The primary endpoint was all-cause mortality. Pearson analysis was used to evaluate the correlation of FT3 and other lab metrics with DCM patients' prognosis. The association of long-term mortality in DCM and FT3 was compared using Cox hazards model.@*RESULTS@#Data of 176 patients diagnosed with DCM were collected. Of them, 24 patients missed FT3 values and six patients were lost to follow-up. Altogether, data of 146 patients were analyzed. During the median follow-up time of 79.9 (53.5-159.6) months, nine patients lost, 61 patients died (non-survival group), and 85 patients survived (survival group). FT3 was significantly lower in non-survival group than that in survival group (3.65 ± 0.83 pmol/L vs. 4.36 ± 1.91 pmol/L; P = 0.003). FT3 also showed a significantly positive correlation with red blood cell and hemoglobin, negatively correlated with age, blood urea nitrogen and serum creatinine (P < 0.05), respectively. Patients in the group of lower FT3 levels (FT3 ≤3.49 pmol/L) suffered from a higher risk of all-cause mortality (P for log-rank = 0.001). In multivariate Cox regression analysis, FT3 level was significantly associated with all-cause mortality (hazard ratio: 0.70, 95% confidence interval 0.52-0.95, P for trend = 0.021).@*CONCLUSION@#Low levels of FT3 were associated with increased all-cause mortality in patients with DCM.

Surgical treatment in 184 patients with supraglottic carcinoma at a single institute / 中华耳鼻咽喉头颈外科杂志

Objective@#To summarize clinical experience in surgical treatment of supraglottic carcinoma and reconstructive techniques.@*Methods@#Medical files of 184 patients (173 men, 11 women) were collected and retrospectively analyzed, who underwent surgeries between January 2008 and December 2012 at Qilu Hospital of Shandong University. Among them, T1, T2, T3 and T4 staging tumors accounted respectively for 14.1% (26/184), 41.9%(77/184), 31.5%(58/184) and 12.5%(23/184). Cervical metastasis was histologically identified in 86 cases (98 for N0, 31 for N1 and 55 for N2). Advanced cases (56 cases at stage Ⅲ and 67 at stage Ⅳ), early cases (22 at stage Ⅰ and 39 at stage Ⅱ) accounted respectively for 66.8% and 33.2%. Supraglottic horizontal laryngectomy or total laryngectomy was performed to allow for tumor excision without compromising margins and the tongue flap or sternohyoidmyofascial flap was subsequently used for repairing the defect after removal of tumor. Survival rates were analyzed by the Kaplan-Meier method.@*Results@#Patients receiving conservation laryngeal surgery accounted for 75.5% (139/184). The 3-year and 5-year survival rates for all cases were 84.2% and 70.7%, respectively. Log-rank test demonstrated that cervical lymph node metastasis, primary tumor staging and clinical TNM staging were significantly associated with prognoses of patients (P=0.003, 0.010, 0.035). Dysphagia was not observed in any case and speech function was maintained in petients with partial laryngectomy.@*Conclusion@#Adequate pre-operative evaluation, individualized treatment, and comprehensive application of flaps for repair are critical to precise tumor excision and reconstruction of laryngeal functions.

Comprehensive treatment of 335 patients with pyriform sinus carcinoma by surgery via the paraglottic space approach / 中华耳鼻咽喉头颈外科杂志

Objective@#To report the experience in comprehensive surgical treatment of pyriform sinus carcinoma via the paraglottic space approach.@*Methods@#Three hundred and thirty-five cases with pyriform sinus carcinoma (according to UICC 2012 criteria, stage Ⅰ, 12 cases; Ⅱ, 36; Ⅲ, 79; Ⅳ, 208; T1, 26; T2, 139; T3, 121; T4, 49; cN0, 83; cN1, 61; cN2a-b, 118; cN2c, 71; cN3, 2) treated between 2006 and 2013 were retrospectively reviewed. There were 323 males and 12 females. Age aged from 36 to 80 years old with a median of 60 years old. There was no case with distant metastasis. All patients received modified neck dissection, including unilateral in 240 patients and bilateral in 95 patients. Pharyngoesophageal defects were reconstructed with directly suture in 246 cases, pectoralis major musculocutaneous flaps in 74 cases, and laryngotracheal flaps in 15 cases. Three hundred and nineteen patients received postoperative radiotherapy (55-65 Gy).@*Results@#The overall 3 and 5 year survival rates were 68.6% (230/335) and 52.1%(139/267), respectively. The cervical lymph node metastases were found in 265 (79.1%) patients. Pathologic findings showed that all patients had squamous cell carcinoma. Laryngeal functions (voice, respiration and deglutition) were completely restored in 277 (82.7%) patients.@*Conclusions@#The oncological efficacy of surgery via the paraglottic space approach is sure for pyriform sinus carcinoma, especially suitable for the early and medium-term lesions. The function of the larynx can retain after surgery, with the decreased incidences of cough and pharynx fistula.

Siblings with congenital adrenal cortex hyperplasia (17-α-hydroxylase deficiency) and literature review / 临床儿科杂志

Objective To report clinical characteristics and genetic results of two sisters suffered from congenital adrenal cortex hyperplasia (17-α-hydroxylase deficiency), and relevant literatures were reviewed. Methods Clinical manifestation and laboratory examination data of two sister cases of 17-α-hydroxylase deficiency enrolled in Capital Institute of Pediatrics in March 2016 were analyzed. Sanger sequencing and MLPA for CYP17A1 genes were performed and the parents' genes were also verified. Results The two patients were four years and 10 years old, both suffered from hypokalemia after infections, and hypergonadotrophin gonad hypofunction. One case was with slightly high blood pressure. Laboratory test results showed potassium fluctuation tendency in 1.9~4.0 mmol/L, 17-OHP and DHEA was decreased. Enhanced CT showed different degree of adrenal gland enlargement. Chromosome examination of the older sister is 46, XY. Both sisters demonstrated heterozygous mutation of CYP17A1 gene. The molecular genetic analysis suggested a c.985_987delTACinsAA from father and a deletion spanning exons 1-7 of the CYP17A1 gene from mother. Conclusion 17-α-hydroxylase enzyme deficiency can be diagnosed before adolescence. Clinical hypokalemia with unknown reason and high blood pressure may indicate the disease. The diagnosis can be confirmed with gene sequencing of CYP17A1.

Schimke immuno-osseous dysplasia ( SIOD):A case report and review of literatures / 中华内分泌代谢杂志

Objective A 10-years-old girl with Schimke immuno-osseous dysplasia ( SIOD ) was reported and a literature review presented to provide clinical and genetic information of this rare disease. Methods Retrospective analysis of a case of SIOD in Capital Institute of Pediatrics was reported. The patient and her parents' DNA were extracted from blood for detecting SMARCALl gene mutation. Literatures of the disease were reviewed. Results The patient was a ten-years-old girl who admitted because of slow growth in height for 3 years. Herstaturewas123cm(T(p.Q149X)andc.1933C>T(p.R645C)compound heterozygous mutation. A novel nonsense c.445C>T(p. Q149X)was found. One reported missense mutations c. 1933C>T(p. R645C) was detected. We reviewed literatures and found that there were 4 confirmed cases in China including this one. All the 4 cases had the characteristic of short stature, special facial features, osseous dysplasia, pigmentations in body, and proteinuria. However the severity of the disease and genetic changes are not the same. Conclusion When a patient was admitted because of short stature, diagnosis of SIOD should be suspected if he or she also had special facial feature, osseous dysplasia, café-au-lait spots, and proteinuria. Gene test is a tool to help us to make a definite diagnosis of SIOD.

Homozygous ectonucleotide pyrophosphatase/phosphodiesterase 1 variants in a girl with hypophosphatemic rickets and literature review / 中华儿科杂志

Objective@#To investigate the clinical features and genetic characteristics of patients with ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) gene variants.@*Method@#The clinical data of a patient with ENPP1 homozygous variants from Capital Institute of Pediatrics was collected, the related literature was searched from China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, National Center from Biotechnology Information and PubMed by using search term "ENPP1" , "hypophosphatemic rickets" . The literature retrieval was confined from 1980 to February 2017. The clinical manifestations, bone metabolism examinations, X-RAY and genotypes were reviewed.@*Result@#Our patient was an 11 years old girl, with 7 years history of lower limb malformation. She showed significant valgus deformity of the knee (genu valgum). Metabolic examination revealed reduced level of plasma phosphate (0.86 mmol/L), a normal level of plasma calcium (2.30 mmol/L) and an elevated alkaline phosphatase level of 688 IU/L. The calcium-phosphorus product was 25.9. A homozygous nonsense variants of ENPP1 gene, c.783C>G (p.Tyr261X) in exon 7 was identified in the patient. Both parents were heterozygous carriers. Literature review identified 3 Chinese patients from one publication and 17 cases from twenty one publications around the world. None of the patients was found PHEX variants which is the most common variants among hypophosphatemic rickets patients. The disease onset age was 11 months to 10 years. Eight patients had short stature, five patients had the history of generalized arterial calcification of infancy. Four suffered from deafness, three showed localized calcifications of arteries, three patients manifested pseudoxanthoma elasticum and two suffered from ossification of posterior longitudinal ligament. Nine missense variants, six splicing variants and 4 nonsense variants were reported among these twenty patients. c.783C>G was found in two Chinese patients.@*Conclusion@#ENPP1 gene mutation was a cause of patient with hypophosphatemic rickets. Comorbid features included generalized arterial calcification of infancy, early onset hearing loss, pseudoxanthoma and ossification of posterior longitudinal ligament. ENPP1 gene testing should be performed on hypophosphatemic rickets patients without PHEX gene variants. Long-term follow up is recommended. The most common types of ENPP1 gene variants were nonsense/splicing variants. The gene c.783C>G was the most common variants in Chinese patients.

Comparison of domestic infantile type video intubationscope and stethoscope in positioning of double-lumen endobronchial tube / 中国内镜杂志

Objective To compare the effect of the domestic infantile type video intubationscope (VIS) and stethoscope in positioning of double-lumen endobronchial tube (DLT). Methods 100 cases of patients underwent elective thoracic surgery requiring single lung ventilation were randomly divided into two groups: domestic infantile type video intubationscope group (group V) and stethoscope group (group S), with 50 cases in each. After intubating with a DLT, the positions of DLT were judged and adjusted by VIS (group V) and stethoscope (group S) respectively, and then reviewed by fiberoptic bronchoscopy (FOB), the positioning time and accuracy were recorded. Results Comparing with the group S, the positioning time of DLT was significantly shorter and the total positioning accuracy of DLT was significantly higher in group V (P < 0.05). Conclusion It is easy and quickly, high accuracy with domestic infantile type video intubationscope in positioning of DLT, which is worthy of clinical popularization and application.

Comparison of domestic infantile type video intubationscope and stethoscope in positioning of double-lumen endobronchial tube / 中国内镜杂志

Objective To compare the effect of the domestic infantile type video intubationscope (VIS) and stethoscope in positioning of double-lumen endobronchial tube (DLT). Methods 100 cases of patients underwent elective thoracic surgery requiring single lung ventilation were randomly divided into two groups: domestic infantile type video intubationscope group (group V) and stethoscope group (group S), with 50 cases in each. After intubating with a DLT, the positions of DLT were judged and adjusted by VIS (group V) and stethoscope (group S) respectively, and then reviewed by fiberoptic bronchoscopy (FOB), the positioning time and accuracy were recorded. Results Comparing with the group S, the positioning time of DLT was significantly shorter and the total positioning accuracy of DLT was significantly higher in group V (P < 0.05). Conclusion It is easy and quickly, high accuracy with domestic infantile type video intubationscope in positioning of DLT, which is worthy of clinical popularization and application.

The molecular diagnosis and their detailed clinical presentations in 5 cases of maturity-onset diabetes of the young / 中华实用儿科临床杂志

Objective To analyze the genetic changes and detailed clinical presentations of 5 maturity-onset diabetes of the young (MODY) cases in order to enhance the knowledge about MODY in children.Methods Seventy-eight patients initially diagnosed as diabetes mellitus between January 1 and December 31,2015 in Capital Institute of Pediatrics were retrospectively studied.Nine of them were suspected of MODY,and 5 patients were diagnosed as MODY through gene test.Clinical informations were collected including age,gender,main complaint,family history,body mass index (BMI),fasting blood glucose,fasting blood insulin,2-hour blood glucose and insulin after oral glucose tolerance test and glycosylated hemoglobin.The blood glucose was monitored dynamically in 2 patients.Targeted capture panel was designed to capture the 16 genes related to MODY,including 12 genes from MODY1 to MODY13 type and 4 genes with weak evidence of MODY according to Human Gene Mutation Database Exome capture,and Next-Generation sequencing on a HiSeq2000 (Illumina) was performed.After bioinformatics analysis,all prioritized variants detected in patients were validated by Sanger sequencing,including the probands and their parents.Results Five patients were confirmed as MODY by molecular diagnosis,accounting for 6.4％ of all the 78 patients in 2015.The ratio of male to female was 2 ∶ 3.The ages at diagnosis ranged from 2 to 11 years old,and the median age was 3 years old.Two cases were found to have abnormal blood glucose in physical examination.The rest 3 cases were discovered with abnormal blood glucose during hospitalization because of pneumonia (1 case)or diarrhea (2 cases).In 4 cases,their mothers had gestational diabetes history,in 1 case the father suffering from diabetes.BMI ranged 15.68-23.40 kg/m2.Fasting blood glucose was 6.3-7.2 mmol/L.Fasting blood insulin was 0.5-8.0 IU/L.Glucose tolerance test results showed that blood glucose of the patients was 8.6-10.8 mmol/L after 2 hours.The level of glycosylated hemoglobin was 5.5％-6.7％.Blood glucose was 3.9-13.0 mmol/L.All the 5 confirmed patients were caused by GCK gene mutation (MODY2 type).The mutations detected were located at Exon7 (2 cases),Exon4 (1 case),Exon5 (1 case),and Exon10 (1 case).Conclusions All the confirmed MODY patients were identified either through medical exam or infectious disease,and all had positive family history.Their BMI ranged widely.Fasting blood glucose was slightly elevated and glycosylated hemoglobin was normal or slightly elevated,but fasting blood insulin was normal in all the patients.Abnormal glucose tolerance test results were found in all 5 patients.Glycosylated hemoglobin was normal or slightly elevated.MODY2 was the only subtype detected in this group,which indicated that the common type in children was different from that in adults.

Congenital nephrogenic diabetes insipidus：2 cases report of brothers and review / 临床儿科杂志

Objective Congenital nephrogenic diabetes insipidus (CNDI) is a rare disease, the aim of this article is to help better understanding of this disease. Methods The clinical features, genetic analysis and treatments of two siblings with CNDI were retrospectively analyzed, and related literatures were reviewed. Results Both brothers had polydispia, polyuria and low concentrate urine continuously, and they both had a mutation in AQP 2 conifrmmed with Sanger sequencing. This novel frame shift mutation caused arginine of 254 to histidine, and prolonged AQP 2 protein. Conclusions Gene analysis can help diagnosis of CNDI. Amiloride is useful option for treatment.

Surgical treatment of differentiated thyroid carcinoma with laryngeal or tracheal invasion / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical characters, surgical treatments and prognosis of differentiated thyroid carcinoma (DTC) with laryngeal or tracheal invasion.@*METHOD@#Forty-six cases including 33 papillary and 13 follicular were retrospectively reviewed. Thirty-four cases with tracheal invasion received conservative resection (17), window resection (11) and sleeve resection (6). One case with subglottic invasion was performed subglottic partial laryngectomy. Eleven cases with trachea-laryngeal invasion received total laryngectomy(4), 3 shave technique and 4 preservative laryngectomy.@*RESULT@#Complications included infections and hypocalcaemia, 15 patients got permanent fistula. 5-year survival rate in cases of tracheal shave resection was 88.2%, while 63.6% in those of window resection and 83.3% in those of sleeve resection. Survival rate within 5 years of patients received preservative laryngectomy was 62. 5%. Conclusion: With meticulous preoperative examination and positive surgical treatment, both survival rate and quality of life could be improved in patients of DTC with laryngeal or tracheal invasion.

Clinical analysis of 91 cases of primary parapharyngeal space tumors / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To summarize and analyze the clinical features, diagnosis methods, surgical approaches and treatment outcomes of patients with primary parapharyngeal space tumors.</p><p><b>METHODS</b>A retrospective review of 91 cases with primary parapharyngeal space tumors treated from January 1999 to December 2011 was performed. All patients underwent preoperative enhanced CT scan and postoperative histopathologic examination. Intraoperative frozen section biopsies were performed in 36 of 91 cases. The surgical approaches included trans-cervical approach in 73 cases, trans-parotid approach in 5 cases, trans-oral approach in 5 cases, and mandibulotomy in 8 cases.</p><p><b>RESULTS</b>The postoperative pathological diagnoses consisted of 29 variants, including 20 for benign tumors and 9 for malignant tumors. Of the 80 cases with benign tumors, 6 cases were lost to follow-up and 74 cases were followed up for 31-84 months with no recurrence. Eleven cases with malignant tumor were followed up for 8-51 months (median 29 months), of them 7 cases died and 1 case was lost to follow-up. The post-operative complications included Horner syndrome in 3 cases, hoarseness in 2 cases, hypoglossal nerve palsy in 1 case, accessory nerve palsy in 1 case, upper airway obstruction in 1 case, and internal carotid artery cavernous sinus fistula in 1 case.</p><p><b>CONCLUSIONS</b>Parapharyngeal space tumors are rare, with atypical clinical manifestation, and have pathological types of diversification. CT or MRI is helpful to evaluate the tumor size, location and possible sources, and to make operation scheme. Surgery is the first choice for parapharyngeal space tumors. Trans-cervical approach can be applied to most tumors. Parapharyngeal benign tumors have good prognosis, but malignant tumors have poor prognosis.</p>

Surgical treatment of advanced laryngeal cancer with preservation of laryngeal function / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the surgical methods for advanced laryngeal cancer and long term effects of laryngectomy.</p><p><b>METHODS</b>Two hundred and thirty-eight cases of laryngeal cancer at different stages, including 103 cases with supraglottic cancer, 118 cases with glottic cancer, 3 cases with subglottic cancer, and 14 cases with recurrent cancer, underwent different kinds of operation from 2000 to 2010. The TNM classifications were as follows: T3 168 cases, T4 70 cases. Stage III 145 cases, Stage IV 93 cases. N0 134 cases,N1 64 cases,N2 38 cases, and N3 2 cases. The effects of operation, especially with the preservation of laryngeal function, was analyzed. The disease-free survival rate was calculated by Kaplan-Meier methods.</p><p><b>RESULTS</b>Partial laryngectomy was performed on 142 of the 238 cases (59.7%). Total laryngectomy was performed on 96 cases. In 142 patients who received partial laryngectomy with preservation of laryngeal function, the trachea cannula was extracted in 90 patients, with the decannulation rate as 63.4%. The nasal feeding tube was removed and peroral feeding was recovered in all patients. The patients undergoing partial laryngectomy succeeded in phonation. The 3 years and 5 years disease-free survival rates in all patients were 81.4% and 59.5%. The 3 years and 5 years disease-free survival rate of partial laryngectomy were 82.9% and 64.3%. The 3 years and 5 years disease-free survival rates in total laryngectomy were 79.2% and 52.4%. There was no significantly different between the two groups (χ(2) = 2.478, P = 0.115).</p><p><b>CONCLUSION</b>For the advanced laryngeal cancer, it is possible to preserve the laryngeal function without compromising the remote survival rate by detailed pre-operational estimation, properly selected operation and skilled surgical practice.</p>

Study on the corrosion resistance of Cr ahoy in the artificial saliva with different pH value / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the effect on the corrosion resistance of Cr alloy in the artificial saliva with different pH value in vitro.</p><p><b>METHODS</b>Compared to Ti alloy, electrochemical technique was used to measure the electric potential of corrosion (E(corr)), current density of corrosion (I(corr)) Cr alloy in the artificial saliva with different pH value. The corrosion and corrosion resistance mechanism on Cr alloy in the artificial saliva with different pH value had been investigated by the EIS curves.</p><p><b>RESULTS</b>The corrosion resistance of Co-Cr alloy was better than Ti alloy. The value of I(corr) was lower and the value of R(p) was larger than Ti alloy. The corrosion resistance of Ni-Cr alloy was worse than Ti alloy. The value of I(corr) was larger and the value of R(p) was lower than Ti alloy. The pH value in the artificial saliva was decreased, the I(corr) value of three types of alloy increased, the R(p) value of three types of alloy decreased. But the changes of Co-Cr alloy was smaller than that of Ti alloy or Ni-Cr alloy.</p><p><b>CONCLUSION</b>The corrosion resistance of Co-Cr alloy was superior to that of Ni-Cr alloy and Ti alloy. In the acid artificial saliva, the corrosion resistance of three types of alloy descended evidently.</p>

Characterization of Calreticulin Expression in Mouse Endometrium during Embryo Implantation

Calreticulin (CRT), a Ca2+-binding storage protein and chaperone in the endoplasmic reticulum, modulates cell adhesiveness and integrin-dependent Ca2+ signaling. However, the role of CRT during implantation remains poorly understood. In the present study, we characterized the expression of CRT mRNA and the protein in mouse endometria from pregnancy DI to D7. Real-Time PCR and in situ hybridization results showed that the levels of CRT mRNA in the endometria of pregnant mice were significantly higher than those of non-pregnant mice (P<0.05), and increased gradually from pregnancy DI to D4, reaching the máximum level on D4, followed by a plateau from D4 to D7. Using immunofluorescence histochemistry and western blot, changes of CRT expression in the endometria of pregnant mice were consistent with the expression of CRT mRNA. Furthermore, antisense CRT oligodeoxynucleotide was injected into the uterus horns of pregnant mice (D3) to investígate its effect on embryo implantation. The result showed that the number of implanted embryos markedly decreased in the side of uterine horns receiving antisense CRT oligodeoxynucleotide(í><0.05). These findings suggest that CRT may play an important role in embryo implantation in mice.