Atlantoaxial dislocation treated by posterior atlantoaxial lateral mass interarticular release,posterior screw reduction and fusion with bone graft / 中国组织工程研究

BACKGROUND:Atlantoaxial dislocation is often facilitated by interlaminar bone grafting.However,there are relatively few reports on the treatment of complex atlantoaxial dislocation with posterior atlantoaxial lateral mass interarticular release and fusion. OBJECTIVE:To explore the safety and effectiveness of atlantoaxial dislocation treated by simple posterior atlantoaxial lateral block interarticular release and fusion. METHODS:We retrospectively analyzed the clinical data of 30 patients with atlantoaxial dislocation who were treated from January 2017 to July 2021,all of whom suffered from reducible atlantoaxial dislocation.Posterior atlantoaxial lateral mass interarticular release and fusion were performed in all patients.During the surgery,patented instruments were used to release the atlantoaxial lateral mass joint,and posterior screw reduction and fixation were used with bone grafting in the lateral mass joint space.The postoperative follow-up period was 6 to 24 months,mean(13.0±5.4)months.During the follow-up period,cervical MRI was reviewed to observe the decompression of the upper cervical spine.X-ray films and CT scans were reviewed to observe the reduction of the upper cervical spine,as well as the internal fixation for looseness and breakage.CT scans were reviewed to assess interlateral block implant fusion.The Japanese Orthopaedic Association score was used to evaluate the improvement of spinal cord function.The neck disability index and the quality of life scale were used to assess the improvement of daily life function.The atlanto-anterior interspace and atlanto-planar spinal effective space were used to evaluate atlantoaxial repositioning and decompression. RESULTS AND CONCLUSION:(1)The surgery of 30 patients went smoothly,and no serious complications such as spinal nerve and vertebral artery injuries occurred during the operation.Postoperative review of cervical MRI showed that the spinal cord compression was lifted.X-ray film and CT showed that the atlanto-anterior gap was significantly reduced;the effective space of atlantoaxial spinal cord was significantly increased,and neurological dysfunctional symptoms were significantly reduced.(2)During the follow-up period,X-ray film and CT showed that the internal fixation was solid;no broken nails or rods occurred,and there was no recurrence of atlantoaxial dislocation.(3)The Japanese Orthopaedic Association scores,neck disability index,and quality of life scores were significantly improved at the last follow-up compared with the preoperative period(P<0.05).The average improvement rate of Japanese Orthopaedic Association scores at the last follow-up was 73.1%.The average neck disability index was 8.80%.All of the patients had a continuous bone-scalp connection between atlantoaxial lateral block joints to achieve osseous fusion.(4)These findings indicate that the use of simple posterior atlantoaxial lateral block interarticular release and fusion for the treatment of atlantoaxial dislocation can significantly increase the fusion rate and shorten the fusion time.

Causes of ABO forward and reverse grouping discrepancy: 75 cases / 中国输血杂志

【Objective】 To analyze the causes and solutions of ABO forward and reverse grouping discrepancy, and to ensure the safety of blood transfusion in clinical. 【Methods】 Samples from 75 patients with discrepancy between forward and reverse grouping in December 2019 and March 2022 were tested and analyzed in combination with saline method(forward and reverse grouping), direct antiglobulin test, antibody screening, antibody identification, increasing plasma volume, incubation enhancement test at 4℃, absorption-eluation test and molecular biological tests. 【Results】 Causes for abnormal reverse typing were as follows : weak antibody in 11 cases(14.67%), unexpected antibody in 19 cases(25.33%), inverted albumin and globulin ratios in 9 cases(12.00%), increased white blood cells in 3 cases(4.00%), inadequate anticoagulation in 3 cases(4.00%), bone marrow transplantation in 2 cases(2.67%), multiple myeloma in 4 cases(5.33%), acute gastrointestinal bleeding in 3 cases(4.00%). Causes for abnormal forward typing were as follows: self-coagulating in 1 case(1.33%), acute leukemia in 7cases(9.34%), post-transplantation in 1 case(1.33%). Causes for abnormal forward/reverse typing: acute leukemia in 1 case(1.33%), condensin syndrome in 1 case(1.33%), autoimmune hemolytic anemia in 6 cases(8.00%), subtype in 4 cases(5.33%). Results of genotying in 7 cases were as follows: B(A) 04 for 1 case, B(A)02 2 cases, AB3 1case, A1 2 cases, and 1case with new genotype. 【Conclusion】 For patients with forward and reverse typing discrepancy for ABO blood group, several studying methods, such as clinical/serological tests inquiring, absorption-eluation tests and molecular biological tests, should be combined to ensure blood transfusion safety.

Correlation between hemolysis degree and antibody IgG subtypes contained in infant serum and erythrocyte eluates / 中国输血杂志

【Objective】 To analyze the effects of IgG subtypes(IgG 1 and IgG3) of antibodies contained in infant serum and erythrocyte eluates on hemolytic disease of the newborn(HDN), so as to provide reference for its early clinical diagnosis and treatment. 【Methods】 49 newborns with HDN in our hospital from June 2019 to March 2020 were detected for three hemolytic tests(direct antiglobulin test, elution test and indirect antiglobulin test), as well as the components of IgG1 and IgG3 in eluates. The correlation analysis was conducted by combining birth hours (physiological jaundice) and hemolytic degrees (total bilirubin, indirect bilirubin, and hemoglobin). 【Results】 In the 44 cases of IgG1 and IgG3 subtype detection of infant RBC eluates, regression equations could be established between total bilirubin, indirect bilirubin and birth hours, and between hemoglobin and elution test, and linear regression relationships were found (P<0.05). In the 28 cases of IgG1 and IgG3 subtype detection of infant serum, regression equations could be established between total bilirubin, indirect bilirubin, birth time and IgG3 subtype, and between hemoglobin and IgG1 subtype (P<0.05), and linear regression relationships were found (all P<0.05). Three infants, presenting IgG1 and IgG2 subtypes(+ ) and three hemolysis tests(-), were all second pregnancy, constituted by Rh-HDN of 2 case and other-system-HDN 1. 【Conclusion】 The degree of HDN is directly related to IgG1 and IgG3 antibodies in infant blood plasma. In addition to the total bilirubin and indirect bilirubin, the changes of IgG3 antibodies in infant plasma and IgG1 antibody in anemic infants should be monitored. If IgG1 and IgG3 antibodies are yielded even with all negative ABO-HDN hemolysis tests, non-ABO-HDN should be considered in time to achieve accurate diagnosis and treatment.

The effect of uvulopalatopharyngoplasty by radio frequency plasma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the effect of uvulopalatopharyngoplasty(UPPP) by using radio frequency plasma on obstructive sleep apnea-hypopnea syndrome(OSAHS) with velopharyngeal obstruction.@*METHOD@#Eighty-one cases that were diagnosed as OSAHS with Velopharyngeal obstruction were randomized into two groups, UPPP group and radio frequency plasma Uvulopalatopharyngoplasty group.@*RESULT@#Six months after operation, the effects in both groups were similar.@*CONCLUSION@#Radio frequency plasma Uvulopalatopharyngoplasty is safe, time saving, less hemorrhage with good effects.

The effect of uvulopalatopharyngoplasty by radio frequency plasma / 临床耳鼻咽喉头颈外科杂志

Objective:To study the effect of uvulopalatopharyngoplasty(UPPP) by using radio frequency plasma on obstructive sleep apnea-hypopnea syndrome(OSAHS) with Velopharyngeal obstruction.Method:Eighty-one cases that were diagnosed as OSAHS with Velopharyngeal obstruction were randomized into two groups, UPPP group and radio frequency plasma Velopharynoplasty group. Result:Six months after operation, the effects in both groups were similar.Conclusion:Radio frequency plasma Uvulopalatopharyngoplasty is safe, time saving, less hemorrhage with good effects.

Clinical analysis of solitary sphenoid sinus disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical characters and treatment on solitary sphenoidal sinus disease thus improve the initial diagnosis accuracy and curative rate together with avoiding severe complications.@*METHOD@#Forty-six cases were included in the study. The clinical manifestations, medical imaging characteristics and type of pathology and surgical treatment efficacy were analyzed retrospectively.@*RESULT@#The main symptoms were headache and visual lesion. Medical image showed pace occupying lesion and partial destruction of bone. Pathological exams showed 8 cases with sphenoiditis, 19 cases with fungal infection, 10 cases with cysts and 9 cases with polyposis. All the patients underwent open sphenoidal surgery with nasal endoscope. After a follow-up of over 6 months, most of the patients' symptoms had been obviously relieved. And the entrance to sphenoid was patent with smooth sinus wall and no secretion in sinus cavity.@*CONCLUSION@#There is no specificity with solitary sphenoidal sinus disease. Pre-operation diagnosis rate can be improved with the help of nasal endoscope and CT or MRI. Nasal sinus surgery with nasal endoscope may be the first choice for treatment.

Clinical study of microwave ablation in treating snoring and obstructive sleep apnea hypopnea syndrome / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the clinical efficacy of microwave ablation in treating snoring and obstructive sleep apnea hypopnea syndrome(OSAHS). METHODS Eight patients with snores and 48 with OSAHS were included in the study. They all received micro-surgeries including plastic operations on the uvula and soft palate,tonsil ablation and tonsillectomy,inferior nasal concha and adenoid ablation,and de-volume of the tongue root. Symptoms six months before and after surgery were monitored by Polysomnography(PSG). RESULTS In 56 cases, the patients’ throats were widened. The mean values of the apnea hypopnea index(AHI), the lowest saturations (LSaO2) and the snoring index were significantly different before and after surgery(P

Tonsillectomy for peritonsillar abscess / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the best timing of tonsillectomy for peritonsillar abscess (PTA).METHODS The clinical data of 326 cases with PTA were reviewed.Among them,167 cases (group 1) underwent tonsillectomy in the period of abscesses,the other 159 cases (group 2) underwent elective tonsillectomy.RESULTS In group 1,the mean unilateral bleeding was (10?2.3)ml during operation,postoperative bleeding rate was 3.0%, mean operation time was (10?1.2)min and mean hospitalization period was (8?1.1)d.While in group 2,the mean unilateral bleeding was (21?2.1)ml during operation,postoperative bleeding rate was 6.9%,mean operation time was (20?1.5)min and mean hospitalization period was (16?1.3)d.There were significant differences between the two groups in the bleeding amount,operation time,postoperative bleeding rate and hospitalization period (P0.05). CONCLUSION For patients with good general conditions and no contradiction for operation, tonsillectomy implemented 3-4 days after drainage of abscess shows obvious advantages than elective operation.

Screening of TACE Peptide Inhibitors from Phage Display Peptide Library / 华中科技大学学报（医学）（英德文版）

To obtain the recombinant tumor necrosis factor-α converting enzyme (TACE) ectodomain and use it as a selective molecule for the screening of TACE peptide inhibitors, the cDNA coding catalytic domain (T800) and full-length ectodomain (T1300) of TACE were amplified by RTPCR, and the expression plasmids were constructed by inserting T800 and T1300 into plasmid pET28a and pET-28c respectively. The recombinant T800 and T1300 were induced by IPTG, and SDSPAGE and Western blotting analysis results revealed that T800 and T1300 were highly expressed in the form of inclusion body. After Ni2+-NTA resin affinity chromatography, the recombinant proteins were used in the screening of TACE-binding peptides from phage display peptide library respectively. After 4 rounds of biopanning, the positive phage clones were analyzed by ELISA, competitive inhibition assay and DNA sequencing. A common amino acid sequence (TRWLVYFSRPYLVAT) was found and synthesized. The synthetic peptide could inhibit the TNF-α release from LPS-stimulated human peripheral blood mononuclear cells (PBMC) up to 60.3 %. FACS analysis revealed that the peptide mediated the accumulation of TNF-α on the cell surface. These results demonstrate that the TACE-binding peptide is an effective antagonist of TACE.

Study of the effects of LPS on the TACE gene expression and its function / 华中科技大学学报（医学）（英德文版）

In order to investigate the effects of LPS on the TACE gene transcription and expression and its regulating effect on the TM-TNF secretion, in vitro studies were carried out on HL-60 cells stimulated by LPS. TACE, TNF-alpha mRNA levels were detected by Dot-Elisa and the distribution of membrane molecules determined by flow cytometry assay and indirect immunofluorescence. The results showed that: (1) TACE was detected in or on HL-60 cells and it is predominantly localized on cell surface and to a perinuclear compartment. (2) LPS induced a time dependent increasement of TNF-alpha mRNA and enhanced TNF conversion with decreasing distribution of TNF in cell surface and increasing secretion of TNF protein. Such conversion could be inhibited by TACE ODN. (3) LPS also induced time-dependently increased expression of TACE gene and activation of its function. On the other hand, TACE protein in cell lysate and on cell surface was decreased. It was suggested that TACE molecular structure might change following its mediating membrane-anchored molecular secretion.

Empirical study of titration of IgG antibody against blood group in pregnant women by using domestic microcolumn gel Coombs'test / 中国免疫学杂志

Objective:To compare microcolumn gel Coombs test and test tube Coombs test for IgG anti-A and anti-B titre in serum of pregnant women with blood type O.The critical titre for IgG anti-A and anti-B should be established in domestic microcolumn gel Coombs' test.Methods:524 blood samples of pregnant women with blood type O,whose husbands were of blood type A or B,were detected simultaneously by domestic microcolumn gel Coombs' test and test tube Coombs test.The results were analyzed using paired "t " test,"?2 " test and regression analysis.Results:IgG anti-A mean titres determined by the two methods separately were 249.98 and 120.85,and IgG anti-B mean titre were 156.98 and 76.38.IgG anti-A and anti-B titration in domestic microcolumn gel Coombs'test showed significantly higher titres(mean 2.07 fold and mean 2.06 fold) than in test tube Coombs test in all samples studied(t=19.64,P