Increased perihematomal neuron autophagy and plasma thrombin-antithrombin levels in patients with intracerebral hemorrhage: An observational study.

Animal studies have demonstrated that autophagy was involved in neuronal damage after intracerebral hemorrhage (ICH). Several studies showed thrombin-antithrombin (TAT) plasma levels were elevated in patients with ICH. In this study, we aimed to evaluate if autophagy occurred in patients with ICH; and the relationship between the severity of brain injury and plasma TAT levels.A novel tissue harvesting device was used during hematoma removal surgery to collect loose fragments of tissue surrounding the affected brain area in 27 ICH patients with hematoma volumes of >30 mL in the basal ganglia. Control tissues were obtained from patients who underwent surgery for arteriovenous malformation (n = 25). Transmission electron microscopy (TEM) and immunohistochemistry for autophagy-related proteins were used to evaluate the ultrastructural and morphologic cellular characteristics; and the extent of autophagy in the recovered tissue specimens. Stroke severity was assessed by using the Glasgow Coma Scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS). An enzyme-linked immunosorbent assay (ELISA) was used to measure plasma TAT levels.Transmission electron microscopy showed autophagosomes and autolysosomes exist in neurons surrounding the hematoma, but not in the control tissues. The number of cells containing autophagic vacuoles correlated with the severity of brain injury. Immunohistochemistry showed strong LC3, beclin 1, and cathepsin D staining in ICH tissue specimens. Plasma TAT levels correlated positively with autophagic cells and ICH severity (P < .01).Autophagy was induced in perihematomal neurons after ICH. Autophagy and plasma TAT levels correlated positively with severity of brain injury. These results suggest that autophagy and increased plasma TAT levels may contribute to the secondary damage in ICH patients.

[Application of CO2 laser and T tube in the treatment of the laryngeal stenosis].

OBJECTIVE: To introduce a new method for treating laryngeal stenosis of both children and adults using silicon T tube and CO2 laser. METHODS: Twenty-two cases stenosis of adults and children were treated with silicon T tube and CO2 laser. The tracheotomy were enlarged upward, the laryngeal cavity scar was removed by using CO2 laser and the laryngeal cavity was exposed by distending laryngoscope under general anesthesia. The follow up time is between 1 to 3 years. RESULTS: The 22 cases were successfully decanulated postoperatively in 12 to 24 months. Silicon 4 cases's T tube were either too high or too low and had second operation. CONCLUSION: The method for treating laryngeal stenosis of both children and adults using silicon T tube and CO2 laser are effective, easy to operate, less invasive and have a short recovery interval.

[Application of endoscopic telescope in the treatment of the juvenile onset recurrent respiratory papillomatosis].

OBJECTIVE: To evaluate the treatment methods of the juvenile onset recurrent respiratory papillomatosis. METHOD: Twelve patients with juvenile onset recurrent respiratory papillomatosis were treated from 1995 to 1999 by using endoscopy. RESULT: Among the 12 cases, 3 cases had no recurrence within one year follow-up and were decannulated,the other 9 cases had recurrence postoperatively, but the recurrence period got longer. CONCLUSION: It is demonstrated that endoscopic surgery is an ideal therapy for the treatment of juvenile onset recurrent respiratory papillomatosis.

[Evaluate the curative effect of CO2 laser in treatment of glottic carcinoma].

OBJECTIVE: To evaluate the curative effect of CO2 laser in treatment of glottic carcinoma. METHODS: Retrospective analysis of 217 cases of early glottic laryngeal carcinoma treated with laser surgery were carried out. Among these cases, Tis were 22 cases, T1a 108 cases, T1b 38 cases, T2 46 cases, T3 3 cases. 1 case being applied vocal cord excision due to failure of tumor exposure. The follow-up period was 3 to 9 years. RESULTS: Relapse were detected in 21 out of 217 cases of glottic laryngeal carcinoma after CO2 laser surgery under self-retaining laryngoscope. The recurrent rate was 9.7% (21/217). Recurrent ratio of T1a, T1b, T2, T3 were 5.6% (6/108), 21% (8/38), 13.0% (6/46), 1/3 respectively, with significant differences among groups (chi 2 = 6.102, P < 0.01). The recurrent rate was 21.6% of tumors offended the anterior commissure, versus 5.1%(8/157) with no involvement of anterior commissure (chi 2 = 13.64, P < 0.01). 217 cases received laser surgery as the only treatment, 201 cases were still alive. 4 failed to be followed-up(taken into dead number), 12 cases were dead. 3 year survival rate was 97.2%(211/217), 5 year survival rate was 89.4%(118/132). CONCLUSION: It was reliable to use laser surgery in treatment of early glottic laryngeal cancer. The advantages of it included lower complication rate and vocal function was well retained.