[Observation of liver indexes in patients with relapsed/refractory multiple myeloma treated with CAR-T-cells based on BCMA].

Objective: To observe the characteristics of the evolution of liver indexes in patients with relapsed/refractory multiple myeloma (RRMM) treated with CAR-T-cells based on BCMA. Methods: Retrospective analysis was performed of patients with RRMM who received an infusion of anti-BCMA CAR-T-cells and anti-BCMA combined with anti-CD19 CAR-T-cells at our center between June 1, 2019, and February 28, 2023. Clinical data were collected to observe the characteristics of changes in liver indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and direct bilirubin (DBIL) in patients, and its relationship with cytokine-release syndrome (CRS) . Results: Ninety-two patients were included in the analysis, including 41 patients (44.6%) in the group receiving a single infusion of anti-BCMA CAR-T-cells, and 51 patients (55.4%) in the group receiving an infusion of anti-BCMA combined with anti-CD19 CAR-T-cells. After infusing CAR-T-cells, 31 patients (33.7%) experienced changes in liver indexes at or above grade 2, which included 20 patients (21.7%) with changes in one index, five patients (5.4%) with changes in two indexes, and six patients (6.5%) with changes in three or more indexes. The median time of peak values of ALT and AST were d17 and d14, respectively, and the median duration of exceeding grade 2 was 5.0 and 3.5 days, respectively. The median time of peak values of TBIL and DBIL was on d19 and d21, respectively, and the median duration of exceeding grade 2 was 4.0 days, respectively. The median time of onset of CRS was d8, and the peak time of fever was d9. The ALT, AST, and TBIL of patients with CRS were higher than those of patients without CRS (P=0.011, 0.002, and 0.015, respectively). CRS is an independent factor that affects ALT and TBIL levels (OR=19.668, 95% CI 18.959-20.173, P=0.001). The evolution of liver indexes can be reversed through anti-CRS and liver-protection treatments, and no patient died of liver injury. Conclusions: In BCMA-based CAR-T-cell therapy for RRMM, CRS is an important factor causing the evolution of liver indexes. The evolution of liver indexes after CAR-T-cell infusion is transient and reversible after treatment.

[Clinical and genetic characteristics of patients with newly diagnosed acute promyelocytic leukemia: a single-center retrospective of 790 cases].

Objective: To retrospectively analyze the data of Chinese patients with newly diagnosed acute promyelocytic leukemia (APL) to preliminarily discuss the clinical and cytogenetic characteristics. Methods: From February 2004 to June 2020, patients with newly diagnosed APL aged ≥ 15 years who were admitted to the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College were chosen. Clinical and laboratory features were retrospectively analyzed. Results: A total of 790 cases were included, with a male to female ratio of 1.22. The median age of the patients was 41 (15-76) years. Patients aged between 20 and 59 predominated, with 632 patients (80%) of 790 patients classified as low and intermediate risk and 158 patients (20%) of 790 patients classified as high risk. The white blood cell, platelet, and hemoglobin levels at diagnosis were 2.3 (0.1-176.1) ×10(9)/L, 29.5 (2.0-1220.8) ×10(9)/L, and 89 (15-169) g/L, respectively, and 4.8% of patients were complicated with psoriasis. The long-form type of PML-RARα was most commonly seen in APL, accounting for 58%. Both APTT extension (10.3%) and creatinine>14 mg/L (1%) are rarely seen in patients at diagnosis. Cytogenetics was performed in 715 patients with newly diagnosed APL. t (15;17) with additional chromosomal abnormalities were found in 155 patients, accounting for 21.7%; among which, +8 was most frequently seen. A complex karyotype was found in 64 (9.0%) patients. Next-generation sequencing was performed in 178 patients, and 113 mutated genes were discovered; 75 genes had an incidence rate>1%. FLT3 was the most frequently seen, which accounted for 44.9%, and 20.8% of the 178 patients present with FLT3-ITD. Conclusions: Patients aged 20-59 years are the most common group with newly diagnosed APL. No obvious difference was found in the ratio of males to females. In terms of risk stratification, patients divided into low and intermediate risk predominate. t (15;17) with additional chromosomal abnormalities accounted for 21% of 715 patients, in which +8 was most commonly seen. The long-form subtype was most frequently seen in PML-RARα-positive patients, and FLT3 was most commonly seen in the mutation spectrum of APL.

Prognostic value of the platelet-to-lymphocyte ratio for outcomes of stroke: a systematic review and meta-analysis.

OBJECTIVE: The current study aimed to conduct a systematic literature search and pool data from individual studies to assess the relationship between platelet-lymphocyte ratio (PLR) and functional outcomes and mortality in stroke patients. MATERIALS AND METHODS: The databases of PubMed, Embase and Google Scholar were searched for relevant studies up to 21st August 2021. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for the association between PLR and poor functional outcomes and mortality. RESULTS: Sixteen studies were included in the systematic review and nine in the meta-analysis. On analysis of eight studies, we noted no statistically significant relationship between PLR and poor functional outcomes in patients with stroke (OR: 1.00 95% CI: 1.00, 1.00 I2=80% p=0.30). Data on mortality was reported by just two studies. Pooled analysis indicated no statistical relationship between PLR and mortality in patients with stroke (OR: 1.49 95% CI: 0.56, 3.98 I2=76% p=0.43). Descriptive analysis of the remaining studies demonstrated conflicting results for the relationship between PLR and early neurological deterioration (END) and functional outcomes. CONCLUSIONS: Our results indicate that PLR may not be a useful prognostic marker to predict functional outcomes after AIS. Evidence on the predictive power of PLR for mortality and END after stroke is scarce and contrasting. There is a need for further studies assessing the role of PLR in predicting outcomes of stroke patients while taking into account important confounders like baseline stroke severity and treatment modality.

[Preliminary study of the changes in blood system in pyrrolizidine alkaloid-related liver damage].

Objective: To preliminary explore the changes in blood system in pyrrolizidine alkaloids (PAs)-related liver damage. Methods: General situation, liver function, biochemical blood test, routine blood test, coagulation function markers, etc., of 77 cases with drug-induced liver damage admitted to the Zhongshan Hospital Affiliated to Fudan University from 2012 to 2019 were retrospectively analyzed. Patients' were divided into PA group, other traditional Chinese medicine group and Western medicine group according to their medication history. Simultaneously, the changes in liver function were observed in the established mice model of monocrotaline-induced liver damage. Liver tissues HE staining and blood routine indexes were observed. Results: 24 cases received PA, 24 cases received other traditional Chinese medicine, and 29 cases received western medicine. Alanine aminotransferase was lower in PA group than the other two groups (P < 0.05), and the total bilirubin and direct bilirubin were significantly lower than the other traditional Chinese medicine group (P < 0.05). The peripheral platelet count of the PA group was (84.11 ± 26.91) ×10(9)/L, which was significantly lower than the lower limit of normal, and had statistically significant difference with other traditional Chinese medicine and western medicine group (P < 0.01). Thrombocytocrit, mean platelet volume and platelet indices of PA group were statistically different from the other two groups (P < 0.05). The D-dimer level in patients with PA group was (2.62 ± 1.93) mg/L, which was higher than the upper limit of normal, and significantly higher than the D-dimer level of the other two groups of patients (P < 0.01). Meanwhile, prothrombin time was longer in PA group than that of the other two groups (P < 0.01), and platelets count were decreased significantly in the mouse model of monocrotaline-induced liver damage after alanine aminotransferase and aspartate aminotransferase elevation (P < 0.01). Conclusion: PA-related liver damage has lower peripheral platelet counts, and the peripheral platelet counts of these patients are lower than other types of drug-induced liver damage. In addition, increased D-dimer in patients with PA-related liver damage indicate a potential risk of thrombosis.

[Influence of prognostic nutritional index and controlling nutritional status on the prognosis of patients with multiple myeloma].

Objective: To explore the influence of prognostic nutritional index (PNI) and controlling nutritional status (CONUT) on the prognosis of patients with multiple myeloma. Methods: Data of 157 patients with multiple myeloma (MM) at the affiliated hospital of Xuzhou medical university from January 2014 to December 2018 were retrospectively evaluated. The operating characteristic (ROC) curve analysis was adopted as the optimal cut-off point. PNI and CONUT were grouped based on the cut-off points of 44.45 and 3.5, respectively, and the differences between age, gender, serum calcium, ß(2)-microglobulin, serum creatinine, lactate dehydrogenase, and hemoglobin were analyzed. The prognostic factors were analyzed via univariate and Cox multivariate regression analyses. Results: The level of PNI and CONUT is the influencing factor of OS time. The univariate analysis revealed that age, LDH, plasma cell ratio, ß(2)-microglobulin, ISS stage, PNI, and CONUT were the risk factors for the prognosis of patients with MM. The multivariate analysis revealed that age (HR=1.636, 95%CI 1.014-2.640) , plasma cell ratio (HR=1.953, 95%CI 1.232-3.096) , and PNI (HR=0.513, 95%CI 0.287-0.917) were the independent prognostic risk factors of patients with MM. Conclusion: Low PNI in patients with MM indicates a poor prognosis, which is an independent prognosis risk factor.

[Application strategy and effect of cuffed tracheostomy tube with inner cannula in the treatment of postoperative complications of laryngeal or hypopharyngeal cancer].

Objective: To Investigate the application strategy and effect of cuffed tracheostomy tube with inner cannula in the treatment of postoperative complications of laryngeal and hypopharyngeal cancer. Methods: A total of 60 patients with laryngeal and hypopharyngeal cancer occurred serious postoperative complications, including 31 cases of severe postoperative neck infection, 8 cases of dyspnea, 5 cases of massive hemorrhage and 16 cases of seriously intractable aspiration. The tracheal cannula with inner cannula and outer cuff was immediately worn on these patients and the cuff was inflated. Different treatments were carried out according to different complications. The outer cuffs were inflated for patients with severe neck infections to prevent a large amount of neck secretions inhaled to the trachea. Patients with dyspnea immediately received ventilator-assisted ventilation. For those with massive hemorrhage on the wound, doctors should prevent bleeding and stop bleeding under general anesthesia. Patients with severely coughing should perform eating training to prevent food aspiration. The inner cannula was regularly replaced once a month for all of these patients. Results: Through targeted treatment, the complications of 60 patients with cuffed tracheostomy tube with inner cannula were effectively controlled. After dressing change, the neck wounds of 31 patients with neck infection were shrunk or healed. Finally, all of the patients were replaced with metal tracheal tubes. Eight cases with dyspnea were rescued with the symptomatic and related special treatment, and finally replace by metal tracheal tube. Five cases with massive bleeding in the neck wound were successfully rescued and replaced with metal tracheal cannula. Thirteen patients among 16 cases with intractable aspiration were removed the tracheal cannula and other 3 cases of old and severely ill were replaced with metal tracheal cannula. Conclusions: The cuffed tracheostomy tube with inner cannula is of great value in the treatment of severe postoperative complications of laryngeal or hypopharyngeal cancer. It is strongly recommended that the operators should fully understand and use it reasonably after the operation of laryngeal or hypopharyngeal cancer.

Bone marrow mesenchymal stem cells repair brachial plexus injury in rabbits through ERK pathway.

OBJECTIVE: To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) on repairing brachial plexus injury in rabbits and their influence on expression of the extracellular signal-regulated kinase (ERK) pathway. MATERIALS AND METHODS: With big-ear rabbits as the objects, the BMSCs were first isolated, and the cluster of differentiation (CD)45- and CD90+ BMSCs were sorted out via flow cytometry. BMSCs were transfected with red fluorescent protein (RFP), and the transfection effect was detected. Then, the big-ear rabbits were subjected to brachial plexus root avulsion injury (BPAI) to establish injury Model group and sham-operation group (Sham group). Later, the BMSCs were transfected with RFP to construct RFP-BMSCs. The RFP-BMSCs (5×106, Treat group) and normal saline (Model group) were intraperitoneally injected, and the recovery rate of wet weight of the upper limb muscle was measured by weighing. The injured nerve tissues were embedded for hematoxylin and eosin (HE) staining and observation of pathological changes. The electrophysiological measurement of the compound muscle action potential (CMAP) on the injured side was conducted for the rabbits to be sacrificed immediately using an electromyogram instrument, and the CMAP amplitude and latency were applied to evaluate the recovery of upper limb muscle. Finally, the location of RFP-BMSCs in the nerve tissues was traced by a fluorescence microscope, and the protein expression levels of phosphorylated ERK (p-ERK) and phosphorylated mitogen-activated protein kinase (p-MAPK) in the injured nerve tissues were determined by means of Western blotting. RESULTS: Persistently expressed red fluorescence was observed in CD45- and CD90+ BMSCs sorted via flow cytometry under the fluorescence microscope, indicating that the RFP-BMSCs were constructed successfully. Compared with Sham group, Model group had a remarkably decreased recovery rate of wet muscle weight (p<0.05), while Treat group exhibited a notably increased recovery rate of wet muscle weight in comparison with Model group. The CMAP amplitude was reduced markedly (p<0.05), while the CMAP latency was prolonged significantly (p<0.05) in Model group compared with those in Sham group. Moreover, Treat group had distinctly higher CMAP amplitude and evidently shorter CMAP latency than Model group (p<0.05). It was discovered under the fluorescence microscope that RFP-BMSCs were visibly arranged on both sides of nerve fibers in Treat group. The expressions of p-MAPK and p-ERK were raised prominently in Model group in comparison with those in Sham group (p<0.05), and they were lowered apparently in Treat group compared with those in Model group (p<0.05). CONCLUSIONS: BMSCs can repair the impaired brachial plexus neurons and restore their physiological functions, and the protective effect of the BMSCs on the neurons is associated with the mediated MAPK/ERK pathway.

MicroRNA-142 promotes the development of nasopharyngeal carcinoma through targeting PTEN.

OBJECTIVE: To elucidate whether microRNA-142 could regulate the development of nasopharyngeal carcinoma (NPC) by mediating gene of phosphate and tension homology deleted on chromosome ten (PTEN) expression. PATIENTS AND METHODS: The microRNA-142 expression in NPC tissues and paracancerous tissues was detected by the quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Correlation between the microRNA-142 expression and the prognosis of NPC patients was analyzed. MicroRNA-142 expression in NPC cell lines was determined as well. By transfection of microRNA-142 inhibitor or negative control, biological performances of NPC cells were accessed through cell counting kit-8 (CCK-8), colony formation, wound healing, and transwell assay. Dual-luciferase reporter gene assay was conducted to verify the binding condition between microRNA-142 and its target gene PTEN. Rescue experiments were carried out by co-transfection of microRNA-142 inhibitor and si-PTEN, followed by detecting the invasive capacity of NPC cells. Protein expressions of relative genes in the PI3K/AKT pathway after the microRNA-142 knockdown in NPC cells were determined by Western blot. RESULTS: MicroRNA-142 was highly expressed in NPC tissues than that of paracancerous tissues, which was correlated with poor prognosis of NPC patients. MicroRNA-142 was also highly expressed in NPC cells. Downregulated microRNA-142 inhibited proliferative, migratory, and invasive capacities of NPC cells. Dual-luciferase reporter gene assay verified that microRNA-142 could directly bind to PTEN. Knockdown of PTEN could reverse the inhibitory effect of microRNA-142 on invasive capacity of NPC cells. Finally, Western blot results demonstrated that the microRNA-142 knockdown inhibited the PI3K/AKT pathway in NPC cells. CONCLUSIONS: MicroRNA-142 is highly expressed in NPC. MicroRNA-142 enhances the proliferative and invasive capacities of NPC cells by inhibiting PTEN expression, thus promoting NPC development.

[Clinical manifestations of erythrocyte membrane protein coding gene mutations in hereditary spherocytosis].

Objective: To investigate the relationship between the erythrocyte membrane protein gene mutations and the clinical severity of hereditary spherocytosis (HS). Methods: Targeted sequencings were performed on 25 HS patients, correlation between HS mutations and patients' clinical characteristics were evaluated. Results: A total of 25 HS patients were enrolled, including 13 males and 12 females with median age of 20 (4-55) years, including 9 compensatory hemolysis patients, 9 patients with mild anemia, 3 patients with moderate anemia and 4 patients with severe anemia. Of them, 18 patients (72%) harbored HS-related mutations, including ANK1 mutation in 6 cases, SLC4A1 mutation in 6 cases, SPTB mutation in 5 cases and 1 case with EPB41 mutation. Seven patients (28%) didn't carry common HS mutations. SPTB and SLC4A1 mutations mainly affected male patients. There was no significant difference between the age of diagnosis (P=0.130) and HGB level (P=0.585) in patients with HS mutation and those without mutation, however, the EMA binding fluorescence intensity (P=0.015), AGLT50 (P=0.032) and EOF minimal hemolytic concentration (P=0.027) were significantly different in these two groups of HS patients. Conclusion: To screen erythrocyte membrane protein coding gene mutations could favor the diagnosis of HS, and patients without mutations have mild clinical phenotype.

[Study on the immune functions of dendritic cells regulated by histone deacetylase inhibitor Belinostat].

Objective: To explore effects of histone deacetylase inhibitor Belinostat on the immunologic function of dendritic cells (DC) and its possible mechanism. Methods: Cultured mouse bone marrow-derived DC from C57BL/6 mouse in vitro. The experiments were divided into 0, 50, 100 nmol/L Belinostat + immature DC (imDC) group, and 0, 50, 100 nmol/L Belinostat mature DC (mDC). The changes of the ultrastructure of DC were observed by transmission electron microscope (TEM). Immunophenotype and CCR7 expression rate were detected by FCM, and the migration rate was observed by chemotaxis assay. The proliferation of lymphocytes stimulated by different DC was detected by mixed lymphocyte culture reaction. The cytokines in the culture supernatant, including TNF-α, IL-12 and IL-10, were examined by ELISA. RQ-PCR was used to examine the relative expression of mRNA in RelB. Results: Successful cultured and identified the qualified imDC and mDC. Belinostat decreased the expression of CCR7 on imDC [(25.82±7.25)% vs (50.44±5.61)% and (18.71±2.00)% vs (50.44±5.61)%], meanwhile increased the rate on mDC [(71.14±1.96)% vs (64.90±1.47)%]. Chemotaxis assay showed that the migration rate of Belinostat+imDC and Belinostat+mDC group were both decreased, but the difference in imDC was not significant. T lymphocyte proliferation rate stimulated by 100 nmol/L Belinostat+imDC group was lower than imDC group in condition irritation cell∶reaction cell=1∶2 [(227.09±13.49)% vs (309.49±53.69)%]. Belinostat significantly suppressed the secretion of cytokines TNF-α, IL-12 and IL-10 (all P<0.01). The relative expression of mRNA in RelB was slightly decreased in Belinostat+imDC and Belinostat+mDC group (all P<0.05). Conclusion: Belinostat could effectly suppress DC maturation and regulate immune tolerance of DC, which may be due to the down-regulation of mRNA level of RelB in DC.

[Effects of perforator flaps combined with muscle flaps for repairing grade â £ pressure ulcers in ischial tuberosity of elderly patients].

Objective: To explore effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients. Methods: Nine elderly patients with grade Ⅳ pressure ulcers in ischial tuberosity were hospitalized in our burn ward from April 2014 to April 2017. Size of wounds ranged from 5 cm×3 cm to 12 cm×7 cm, and depth of sinus ranged from 6 to 22 cm. After admission, emergency debridement or debridement in selective time was performed. After debridement, the wounds were treated with continuous vacuum assisted closure therapy. After the treatment for 1 to 2 weeks, tissue flaps repair operations were performed. Four patients were repaired with inferior gluteal artery perforator flaps combined with long head of biceps femoris muscle flaps. Three patients were repaired with inferior gluteal artery perforator flaps combined with semimembranous muscle flaps. One patient was repaired with inferior gluteal artery perforator flap combined with gracilis muscle flap. One patient was repaired with femoral profound artery perforator flap combined with gluteus maximus muscle flap, and the distal area of femoral profound artery perforator flap of the patient which showed intraoperative cyanosis of 6 cm×4 cm was thinned to medium thickness skin to cover the muscle flap. The other eight patients showed no abnormality during operation. Size of perforator flaps ranged from 7 cm×5 cm to 14 cm×12 cm, and size of muscle flaps ranged from 11 cm×4 cm to 24 cm×6 cm. The donor sites of flaps were all sutured directly. Results: The tissue flaps and skin graft of all patients survived well after operation. During follow-up of 8 to 35 weeks, operative area of all patients showed good shape and texture, with no local diabrosis or recurrence of pressure ulcers. Conclusions: The combination of perforator flaps and muscle flaps is effective in repairing and reducing recurrence of grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients.

The effect of somatostatin retained enema in the treatment of pancreatic ileus.

OBJECTIVE: To analyze the therapeutic effects of somatostatin retained enema in the treatment of pancreatic ileus in the clinic. PATIENTS AND METHODS: 79 patients randomly divided into 41 cases in the observation group and 38 cases in the control group were analyzed. The control group applied basic treatment plan. The observational group applied the same treatment combined with somatostatin retained enema, conducted twice every day and at least 30 minutes every time. Every 7 days' treatment made a course. The clinical therapeutic effects were compared. RESULTS: The levels of the hemo diastase and urinary amylase in both groups were decreased prominently after treatment. The levels of blood calcium were prominently increased (p<0.05) with even more improvement in the observation group (p<0.05). The relief times of the abdominal ache and distention, the recovery time of bowel sound and the first defecation time in the observation group were shorter (p<0.05) than those in the control group. The levels of blood serum IL-6 and TNF-α in the two groups were prominently decreased (p<0.05) after treatment, with even more obvious improvement in the observation group. The therapeutic effective rate of the observational group was prominently higher (p<0.05) than that in the control group. The occurrence rate of the complications was lower. CONCLUSIONS: The application of somatostatin retained enema in the treatment of pancreatic ileus is preferably safe and effective, and it deserves clinical promotion and application.

[Current situation and thinking of diagnosis and treatment in some types of thyroid cancer].

As arising incidence of thyroid cancer, the treatment for thyroid carcinoma is becoming increasingly standardized. But there are different opinions on the treatment for some types of thyroid cancers, including the determination of operative opportunity, surgical method, and follow-up observation plan. There are mainly two categories of patients, namely the patients diagnosed as familial thyroid cancer mutation carriers through family screening, including medullary thyroid carcinoma and familial nonmedullary thyroid carcinoma, and the patients with thyroid microcarcinoma that can be observed after diagnosed by fine needle biopsy cytology. We will discuss current situation for the diagnosis and treatment of these patients.

[The relationship between incidence of secretory otitis media and passive smoking in children].

Children with secretory otitis media are often the result of multiple factors. Recent epidemiological studies on its incidence have mentioned the effects of passive smoking on its incidence. This article explores the potential links between the two by summarizing relevant literatures.

[Analysis of association of human 8-oxoguanine giycosylase 1 polymorphism with the susceptibility of laryngeal cancer].

Objective: To study the association between human 8-oxoguanine giycosylase 1 (hOGG1) gene polymorphisms and the risk of laryngeal carcinoma. Methods: A total of 86 patients with laryngeal carcinoma treated in The Air Force General Hospital and the Bozhou People's Hospital of Anhui Province from Jan 2010 to Dec 2014 were included in experimental group, and 86 healthy adults were selected as control group. The hOGG1 gene polymorphisms of subjects in two group were detected with by polymerase chain reaction amplification and gene sequencing technology, the differences in hOGG1 gene polymorphisms between two groups were analyzed. Results: The frequencies of hOGG1 gene heterozygous type (Ser/Cys) and mutant type (Cys/Cys) in experimental group were higher than those in control group(P<0.05). Compared to individuals with hOGG1 gene Ser/Ser, individuals with hOGG1 gene Ser/Cys had a 2.97-fold increased risk of laryngeal carcinoma, and individuals with hOGG1 gene Cys/Cys had a 8.09-fold increased risk of laryngeal carcinoma. Stratified by smoking or not, it was found that the proportion of heterozygous type or mutant type in smokers was higher significantly than non-smokers (P<0.05). Conclusion: Individuals with hOGG1 gene heterozygous type (Ser/Cys) or mutant type (Cys/Cys) have a higher risk of laryngeal carcinoma, with interaction between these gene types and smoking, and the gene types could be used as predictors for the occurrence of laryngeal carcinoma.

[The diagnosis and treatment progress of vocal fold leukoplakia].

Vocal fold leukoplakia is a descriptive diagnosis, and can be divided into simple hyperplasia, precancerous lesions(with atypical hyperplasia) and invasive carcinoma according to pathological types. Because of a close relationship with the laryngeal carcinoma, knowing the risk factors and treatment methods of vocal fold leukoplakia has grate significance in preventing the malignant change and recurrence. This paper summarizes the recent progress in clinical diagnosis and treatment of vocal cord leukoplakia, mainly including risk factors, means of examination, treatment and prognosis.

[The influence on the peeling off time of the tunica albuginea after 4-8℃ cool water was applied to children's low temperature plasma-assisted tonsillectomy].

Objective:The aim of this study is to discuss the influence on the peeling off time of the tunica albuginea after 4-8℃ cool water was applied to children 's low temperature plasmaassisted tonsillectomy.Method:One hundred and seventeen benign hypertrophy of tonsil patients were recruited,the 56 cases of them were served as experimental group,who were treated with plasma tonsillectomy using 4-8℃ normal saline as medium,while the 61 cases were served as control group,who were treated with plasma tonsillectomy using 22-25℃ normal saline as medium.Then,we analyzed the peeling off time of the tunica albuginea between experimental and control group.Result:The difference of formation time between experimental group and control group was not statistically significant(P >0.05).The average peeling off time of the tunica albuginea was (11.32±2.51) days in experimental group,while time was(15.03±4.12) days in control group.There was a statistical difference between them.Conclusion:The use of 4-8℃ cold water in children's low temperature plasma-assisted tonsillectomy can reduce the peeling off time of the tunica albuginea,and it indicate that the ice water medium can reduce the heat injury caused by the plasma operation.