Analysis on the efficacy of hypertonic sugar local injection in the treatment of lymphatic leakage after cervical lymph node dissection for thyroid cancer / 中国实用外科杂志

OBJECTIVE: To investigate the effect of hypertonic glucose injection on patients with chylous leakage after neck dissection.METHODS: The clinical data of 9 patients with postoperative chylous fistula after the lymph node dissection of thyroid cancer from February 2017 to December 2018 in the Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University were collected and analyzed.RESULTS: As for 9 patients with intractable chylous fistula,8 patients were finally cured and had the drainage tube removed.Three patients decreased significantly by over 50% on next day after hypertonic glucose injection.Four patients decreased significantly by over 50% on next two daysafter hypertonic glucose injection.One patient had to have another one operation to cure chylous fistula.CONCLUSION: In patients with chylous fistula after thyroid cancer surgery,local injection of hypertonic glucose seems to be more effective in shortening time of drainage tube remining,which would promote wound healing and release pains.

Analysis of chloroplast genome and its characteristics of medicinal plant Sophora flavescens / 药学学报

In order to explore the chloroplast genome characteristics of Sophora flavescens and the phylogenetic relationship of the genus, this study used high-throughput sequencing technology to sequence and functionally annotate the chloroplast genome of Sophora flavescens. The results showed that the full length 154 165 bp of Sophora flavescens chloroplast genome showed a typical four-stage structure. The chloroplast genome contains 123 genes, including 77 protein-coding genes, 38 tRNA genes and 8 rRNA genes. Sequence analysis revealed 104 SSR loci, most of which consisted of A and T. In addition, the chloroplast genome codon preference is weak, and the coding region is biased towards the use of A and T bases. A comparative analysis of two different regions of Sophora flavescens chloroplast genome revealed four differential genes. Based on the maximum likelihood method (ML) for phylogenetic analysis of Sophora flavescens and 16 other leguminous, it was found that the relationship between Sophora flavescens and the genus Sophora alopecuroides is the closest. This study provides an important theoretical basis for the genetic variation, breeding and phylogenetic analysis of Sophora flavescens, and has certain reference value.

Repair of deep wound on the head due to high-voltage electrical burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the methods for repairing deep wound on the head due to high-voltage electrical burn (HEB).</p><p><b>METHODS</b>Twenty-six patients with deep wounds on the head due to HEB were hospitalized from June 2002 to May 2012. They were all injured by high-voltage (voltage ranged from 380 V to 300 kV) electric current, involving head and several other parts over the body. The total burn area ranged from 1% to 75% TBSA, and the depth ranged from deep partial-thickness to full-thickness (including muscle or even bone). Scalp defect area ranged from 3 cm×2 cm to 20 cm×18 cm, and the maximum size of skull exposure was 12 cm×9 cm and the maximum size of skull defect was 7 cm×6 cm. The wounds of 26 patients were repaired with 7 local advance flaps, 4 bilateral rotation flaps, 18 local rotation flaps combined with thin split-thickness skin grafts in donor site, and 3 free anterolateral thigh flaps with vascular anastomosis. In four of the 26 patients, expander was used in the early stage after burn and 5 after wound healing (with thin split-thickness grafts).</p><p><b>RESULTS</b>All flaps and skin grafts survived, except for one flap which was complicated by wound infection, and it was healed after dressing and secondary suturing. The implanted expander expanded smoothly. Patients were followed up for 15 days to three years after surgery. Satisfactory results were obtained, and wounds of 15 patients were repaired completely.</p><p><b>CONCLUSIONS</b>Deep wound on the head due to HEB should be repaired with suitable flap combined with skin graft in donor site, and implantation of expander according to the injury area and condition of patient.</p>

Methylation and expression of RUNX3 gene promoter in papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the relationship between status of methylation of human runt-related transcription factor 3 (RUNX3) gene promoter in papillary thyroid carcinoma (PTC).</p><p><b>METHODS</b>Methylation-specific PCR and immunohistochemical SP technique were used to detect the methylation of RUNX3 gene promoter and expression of its protein in 56 cases of PTC and their matched adjacent non-carcinous epithelium (NCE).</p><p><b>RESULTS</b>In NCE, there was no methylation of RUNX3 gene promoter, while in PTC the methylation rate was 35.7%(20/56), which was related to the tumor TNM stage, pathological grade and lymph node metastasis (P < 0.05). The positive rates of RUNX3 protein expression in NCE and PTC were 100.0% and 60.7%, respectively, with a significant difference (χ(2) = 27.378, P < 0.05). In PTC, the positive rates of RUNX3 protein expression in gradeI and grade II were 70.0% and 37.5%, respectively (P < 0.05); the rates were 46.7% and 76.9% in lymph node metastasis group and no metastasis group, respectively (P < 0.05). Moreover, there was a distinct correlation between methylation of RUNX3 gene promoter and expression of its protein (χ(2) = 21.62, P < 0.01).</p><p><b>CONCLUSIONS</b>Methylation of promoter might be one of the important factors of inactivation of RUNX3 gene, and might play an important role in carcinogenesis and progression of PTC.</p>

Expression of Piwil2 and its relationship with tumor invasion and metastasis in papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the expressions of Piwil2 protein and mRNA in papillary thyroid carcinoma (PTC) and the relationship between Piwil2 and the invasion and metastasis of PTC.</p><p><b>METHODS</b>Immunohistochemistry and in situ hybridization were used to detect the expression of Piwil2 protein and mRNA in 60 cases of PTC with the matched adjacent non-cancerous epithelium (NCE).</p><p><b>RESULTS</b>The positive rates of Piwil2 protein expression in PTC and NCE were 88.3% (53/60) and 10.0% (6/60) respectively, with significant difference (χ² = 73.654, P < 0.01). The positive rates of Piwil2 mRNA expression in PTC and NCE were 85.0% (51/60) and 6.7% (4/60) respectively, also with significant difference (χ(2) = 74.148, P < 0.01). Up-regulated expressions of Piwil2 protein and mRNA were related to the invasion and metastasis of PTC (P < 0.05).</p><p><b>CONCLUSIONS</b>Piwil2 may play a role in the invasion and metastasis of PTC.</p>

Microsurgical treatment for giant and irregular pituitary adenomas in a series of 54 consecutive patients.

The aim of this investigation was to evaluate the clinical significance of the various optional surgical approaches for giant and irregular pituitary adenomas and to summarize the optimal surgical protocols for the adenomas in terms of different growth morphologies. Fifty-four cases with giant and irregular pituitary adenomas were treated by studying their clinical features and image examinations, designing the specific surgical protocols, and choosing the optimal approaches according to the various growth morphologies. Neuro-endoscope and neuronavigation-assisted techniques were applied intraoperatively. Postoperative MRI and endocrine function were re-examined routinely to judge the therapeutic efficacy of various single approaches, combined approaches and staged operations. Application of the six protocols resulted in total removal of the tumours in 18 cases, subtotal removal in 28 cases, partial removal in five cases and three deaths. The most appropriate surgical approaches, which were adopted after comprehensive analyses of the morphological characteristics presented in image examinations, those involving anatomical spaces and the clinical symptoms, can achieve the improved therapeutic results and reduce injuries to the vital anatomic structures. The tumour removal rate can be increased with the help of neuro-endoscope, neuronavigation techniques and intraoperative MRI.

Effect of the Traditional Chinese Medicine Combined with Traction and Physical Therapeutic on Lumbar Intervertebral Discprolapse / 中国康复理论与实践

@#ObjectiveTo observe the curative effect of the Chinese traditional medicine combined with traction and physical therapeutic on lumbar intervertebral discprolapse (LIDP).Methods95 LIDP patients were randomly divided into the treatment group (50 cases) and control group (45 cases). Patients of the treatment group were treated by Chinese traditional medicine, traction and physical therapy. Patients of the control group were treated by traction and physical therapy only.ResultsThe total clinical effective rate of the treatment group was 100%, but that of the control group was 75.6%, there was a significant difference between two groups (P<0.05).ConclusionChinese traditional medicine therapeutics is an effective non-surgical therapeutics for LIDP.

Application of virtual reality technique in preoperative planning of neurosurgery / 中华显微外科杂志

Objective To evaluate the usefulness of virtual reality technique in preoperative planning of neurosurgery.Methods Multiple medical imaging data including magnetic resonance imaging,magntic rsonanc angiograph,magnetic resonance venography and computed tomography collected from 26 patients who suffered craniocerebral diseases,were transfered to Dextroscope system.A stereoscopic 3-D object displayed after merging,extracting,dissecting the data with the Radiodexter software in virtual reality environment.A suite of 3-D tools accessible inside the Dextroscope workspace enabled users to obtain measurement and simu- lated intraoperative viewpoint about the lesion and adjacent anatomic structure.A preoperative plan was de- fined and compared with real operation.Results 3-D stereoscopic virtual reality images of 26 cases were re- constructed successfully,and of coincidence with real situation in operations.Conclusion VR technique in Dextroscope system can integrat multiple medical imaging data quickly,intuitively and overall,offer a compre- hensive information about the lesions and related local anatomy,give a hand to optimizing the operative project and might be possible potentially to increase the safety of operation and the resecting rate of the lesion.

The clinical evaluation of patients with pituitary adenomas undergone transsphenoidal microsurgery / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the overall effect of transsphenoidal microsurgery for pituitary adenomas in recent 5 years and to discuss the surgical technique, application of new technology and postoperative follow-up results.</p><p><b>METHODS</b>The clinical presentation, image characteristics, endocrinal findings, pathological types, tumor removal percentage, postoperative complication and follow-up of 1 462 patients with pituitary adenomas who underwent the transsphenoidal microsurgery from 1997 to 2002 were analysed retrospectively.</p><p><b>RESULTS</b>Total rate of tumor removal for the patients achieved 97.0% in the patients with Hardy I adenomas, 95.2% with Hardy II, 90.5% with Hardy III, and 47.4% with Hardy IV respectively. A significant postoperative improvement both in clinical symptoms and endocrinal parameters was achieved. The tumor recurrence rate was 0.3%.</p><p><b>CONCLUSIONS</b>With the improvement of microsurgical technique and application of novel technology, the indication of transsphenoidal microsurgery for pituitary adenomas was increasingly extended. Endoscope and(/or) neuronavigation-assisted microsurgery via transsphenoidal approach should be of the first choice for the treatment of pituitary adenomas. The routine postoperative radiotherapy is not required for patients with total tumor removal.</p>