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以咽部肿物为典型表现的巨大食管肿物临床上罕见，本文报道山东大学齐鲁医院（青岛）耳鼻咽喉头颈外科收治的3例巨大食管肿物均来源于环后区，随着肿瘤生长，向食管管腔内延伸。我们分别采用咽侧切开和经口直达喉镜的方法给予切除，病理为错构瘤及脂肪瘤，术后随访2~20个月，未见并发症及肿瘤复发。针对此类病变手术的关键及难点在于肿瘤根蒂部的识别、显露及周围重要解剖结构的保护。.

过去二十年，我国甲状腺癌的诊疗呈现出共识与争议相伴、进步与瓶颈共存的局面。由于尚缺乏足够的循证医学证据，早期、低危甲状腺癌的手术指征和治疗方式，中晚期甲状腺癌的手术范围和治疗选择等问题，仍然困扰着广大的临床医生，限制着甲状腺癌整体诊疗水平的进步。未来，在深入基础研究与完善前瞻性临床研究的基础上，推动甲状腺癌向分型手术规范化、治疗策略个性化方向发展，将成为实现我国甲状腺癌诊疗技术突破和总体水平提升的重要着力点。.

浆液黏液腺错构瘤（seromucinous hamartoma，SMH）是一种罕见的鼻腔鼻窦良性腺体增生性病变，目前国内外文献仅报道了40余例。本文报道1例山东大学齐鲁医院（青岛）耳鼻咽喉头颈外科收治的发生于蝶筛隐窝的SMH病例，并结合文献复习，介绍鼻腔SMH的临床和影像学特点、诊治及预后。.

头颈部恶性肿瘤的评估是其诊疗过程中最重要的环节之一，是成功施治的前提和关键。评估内容不仅包含原发灶和转移灶的位置、范围，也应同时涵盖器官功能状态以及治疗方案的合理性，并贯穿术前、术中及术后随访的全过程。本文论述了头颈部常见恶性肿瘤围手术期的评估方法，着重强调在规范化的前提下对不同肿瘤、不同病例进行精准化、个体化的评估，以达到全面认识肿瘤并合理、精准施治的目的。.

FibroTouch (FT) has been used widely in clinic. Studies of the FT diagnostic efficiency and influencing factors of liver stiffness measurement (LSM) of liver fibrosis in autoimmune liver diseases (AILD) have shown that FT has a good diagnostic efficiency and accuracy, especially in AIH. However, for patients with primary biliary cholangitis and overlap syndrome of autoimmune hepatitis, FT results should be vigilant. In addition, the diagnostic efficiency of FT. Notably, when using FT to diagnose AILD, the value of elastic stiffness depends on five influencing factors, such as, age, total bile acid, international standardized ratio, FIB-4 index, and prothrombin time.FibroTouch（FT）已被广泛投入临床使用，在研究FT对自身免疫性肝病（AILD）肝纤维化的诊断效能及分析影响肝脏硬度值（LSM）的因素中发现，FT对AILD肝纤维化具有良好的诊效效能，尤其对AIH肝纤维化具有良好的诊断准确性，但用于原发性胆汁性胆管炎及其与自身免疫性肝炎重叠综合征患者时，需谨慎对待结果。与血清学模型比较，FT的诊断效能与Forns指数相当。FT用于诊断AILD时，其弹性硬度值受年龄、总胆汁酸、凝血酶原时间标准化比值、纤维蛋白原指数、凝血酶原时间5个因素影响。.

加速康复外科（enhanced recovery after surgery，ERAS）因其能促进患者术后快速康复，减少围手术期并发症以及良好的卫生经济学效益，具有广阔的临床应用前景。但ERAS在耳鼻咽喉头颈外科的实践起步较晚，尚缺乏系统的、推广性强的指南和管理方法，应用受到制约。本文从概括ERAS在围手术期各阶段的应用原则入手，结合耳鼻咽喉头颈外科的具体特点，探究其在耳鼻咽喉头颈外科领域的实施细则和发展方向，以期ERAS能更好地服务于临床。.

随着医疗技术的发展进步和患者对生存质量要求的日益提高，喉癌的治疗呈现出以肿瘤根治为核心，以功能保全为治疗重点，多种治疗手段和治疗模式并存的特点。然而，丰富的选择也给治疗的规范化和合理化提出了很大的挑战。本文对喉癌现有的各种治疗手段和模式进行评述和总结，从对喉癌综合治疗认知和理念的角度出发，以期寻找个体化、合理化的治疗策略，从而全面提高喉癌患者的生存率和生活质量。.

下咽癌在头颈部恶性肿瘤中预后较差，正确认识其特殊的生物学规律，科学准确评估患者及肿瘤情况，有效制定个性化的诊疗方案，有利于我们实现并推动下咽癌整体诊疗策略的规范化开展，以提高患者的生存期和生活质量。.

On April 26, 2018, a 55-year-old male patient with severe phenol burn complicated with acute poisoning was admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine. The patient quickly developed the symptoms of central nervous system including blurred consciousness and restlessness, anuria, and respiratory failure. After self-rescue before admission and a series of measures in hospital including wound decontamination to reduce phenol absorption, rapid massive infusion and hemodialysis+ hemoperfusion, continuous renal replacement therapy for speeding up phenol excretion and organ function maintenance, the poisoning symptoms were effectively alleviated, and the patient was finally rescued successfully and discharged on post injury day 29. This case suggests that early hemodialysis combined with hemoperfusion and continuous renal replacement therapy are effective methods for treating severe phenol burn complicated with acute poisoning.2018年4月26日，浙江大学医学院附属第二医院收治1例经外院转入的严重苯酚烧伤合并急性中毒的55岁男性患者。该患者伤后很快出现意识模糊、躁动等中枢神经症状及无尿、呼吸功能衰竭，经院前自救及院内创面洗消减少酚吸收、快速大量补液及血液透析＋血液灌流、连续性肾脏替代治疗加快酚排泄、脏器功能维护等一系列措施，中毒症状得到有效缓解，最终得以成功救治，于伤后29 d出院。本病例提示，早期血液透析联合血液灌流及连续性肾脏替代治疗是救治严重苯酚烧伤合并急性中毒的有效手段。.

The 2019 novel coronavirus (2019-nCov) has caused increasing number of infected cases globally. This study was performed to analyze information regarding the transmission route and presence of viral nucleic acids on several clinical samples. Confirmed 2019-nCov-infected cases were identified in Dongyang and were treated according to guidelines for the diagnosis of 2019-nCov infection released by the National Health Commission. Information regarding the contacts that the infected people had was collected to determine whether it caused clustered cases. A series of successive nucleic acid examination of feces, oropharyngeal swabs, and sputum was also performed, and the results were analyzed. A total of 19 confirmed cases of 2019-nCov infection were identified in Dongyang, Zhejiang Province, China. Five cases showed severe symptoms, and the remaining ones showed mild manifestations. Ten cases infected from two asymptomatic individuals were clustered into two groups. Among 14 cases with consecutive nucleic acid test results, four patients showed positive results in feces after their negative conversion in oropharyngeal swabs. Asymptomatic individuals with the virus could cause 2019-nCov clustered cases, and the clustered cases may differ from sporadic cases on age and length of hospitalization. In addition, nucleic acids in feces last longer than those in oropharyngeal swabs.

Laryngeal cancer is one of the most common malignancies in the head and neck. With the development in clinical research of multimodality therapy for recent years, the treatment strategies for laryngeal cancer, especially for advanced cases, have changed significantly. The management for laryngeal cancer needs the adequate assessments of the primary tumor and the general condition of patient, the comprehensive application of multiple treatment modalities including surgery, radiation, chemotherapy and biotherapy, and the design of individualized regimens. The goal is to eradicate the tumor completely with maximal reconstruction and preservation of laryngeal functions, and to improve patient's quality of life without reduction in survival rate.喉癌是头颈部常见的恶性肿瘤。近年来，随着综合治疗临床研究的深入，喉癌的治疗尤其是中晚期喉癌的治疗策略发生了较大改变，需要充分评估患者肿瘤及全身情况后，综合运用手术、放疗、化疗、生物治疗等手段，制定个体化的治疗方案。在彻底切除肿瘤的同时，尽可能重建及保留喉功能，在保证生存率的前提下提高患者的生活质量。.

Warm laser shock peening (WLSP) is a thermomechanical strengthening technique with tempering treatment during laser shock peening (LSP) to optimize the mechanical properties of a metallic material. In WLSP, processing temperature plays a key role in regulating the final product’s mechanical properties. In this work, Ti6Al4V titanium alloy is used to evaluate effect of temperature on mechanical properties during warm laser shock peening. The compressive residual stress (CRS) generated by WLSP at different temperature was measured by X-ray diffraction (XRD) and the surface hardness was investigated to reveal the surface strength features under different heat treatments as well. It was found that regardless of which temperature applied during the WLSP process, the treated specimens all displayed high-amplitude CRS on the surface or in depth, but the surface peak CRS decreases gradually as temperature increases. Specially, when the WLP temperature exceeded 250°C, the decreasing slope raised. The CRS affected width increased first, and then decreased with the increases of temperature. The maximum CRS affected width was about 6.25 mm, appearing at a temperature of 250 °C. For the affected depth of CRS, firstly, as the temperature increases from 20 to 250 °C, the thickness of affected layer rises with temperature. However, when the temperature exceeds 300°C, the affected depth of CRS sharply declines. In addition, the WLSP technology could improve the hardness of Ti6Al4V titanium alloy from 389 HV at room temperature to 418 HV at 350 °C

Skin perfusion pressure (SPP) is the perfusion pressure at the skin level, and it can serve as an index of microcirculation in skin and subcutaneous tissue. SPP can be measured simply, with less injury and high reproducibility in a short time, without interfering vascular calcification. It has been widely used in various fields, including evaluation of critical limb ischaemia and effect of vascular surgery, selection of proper level of amputation, and prediction of wound healing. So far, there is no relevant reports about the application of SPP in China. This article reviews the clinical application of SPP abroad.

Ground-based observations of the polarization properties of aerosol particles using a polarization optical particle counter (POPC) were performed from October 2013 to January 2015 at a suburban site in the Kyushu area of Japan. By conducting an analysis of online measurements of aerosol composition, we investigated size-dependent polarization characteristics for three typical aerosol types (anthrop ogenic pollutants, dust, and sea salt). We found that, for supermicron particles, its depolarization ratio (DR, the fraction of s-polarized signal in the total back ward light scattering signal) generally increased with the particle size, and a threshold value of 0.1 could be used to identify the irsphericity. In summer, air pollution was less serious, and the DR of aerosol particles was relatively small due to the influence of spherical sea salt particles in high humidity conditions. This study indicated that air masses were transported across the Asian continent and contained not only anthropogenic pollutants, but also large amounts of non-spherical particles (i.e., dust), which could impact on the air quality in western Japan, especially in winter and spring. The variation of number fraction of spherical particles did not correlate with relative humidity averaged along the trajectories of air parcels, indicating the coexistence of hydrophobic substances (e.g., mineral dust and organics), although the sulfate and nitrate mass concentrations were high.

The effect of rare earth metals (REMs) on the microstructure and segregation during solidification in a highly alloyed Ni based superalloy was investigated. Rare earth metals considerably decrease the amounts of coarse columnar grains and increase the amounts of equiaxed grains. They are segregated to the interdendritic regions mainly as the precipitate of Ni5Ce. Both the dimension and distribution of γ′ particles and MC carbide are modified by REM. Eutectic (γ+γ′), Laves phase, δ phase and σ phase are precipitated in the interdendritic regions because of the serious segregation of niobium and titanium aggravated by REM. The differential thermal analysis indicates that the precipitation temperature of phases and the solidification sequence of the superalloy can be changed due to the additions of REM.

Mesoporous spinel membranes as ultrafiltration membranes were prepared through a novel sol-gel technique. By in situ modification of the sol particle surface during the sol-gel process, control of the material structure on a nanometer scale from the earliest stages of processing was realized. Nano-particles with a chocolate-nut-like morphology, i.e. spinel MgAl2O4 as a shell and g-Al2O3 as a core, were first revealed by HRTEM results. The formation of the spinel phase was confirmed by X-ray diffraction (XRD). N2 adsorption‐desorption results showed that the mesoporous membranes had a narrow pore size distribution. © 2001 Elsevier Science B.V. All rights reserved.

Understanding the relationship between black carbon (BC) and carbon monoxide (CO) will help improve BC emission inventories and the evaluation of global/regional climate forcing effects. In the present work, the BC (PM1) and CO mixing ratio was continuously measured at a~high-altitude background station on the summit of Mt Huangshan between 2006 and 2009. Annual mean BC concentration was 654.6 ± 633.4 ng m−3 with maxima in spring and autumn, when biomass was burned over a large area in Eastern China. The yearly averaged CO concentration was 446.4 ± 167.6 ppbv, and the increase in the CO concentration was greatest in the cold season, implying that the large-scale domestic coal/biofuel combustion for heating has an effect. The BC–CO relationship was found to have different seasonal features but strong positive correlation (R > 0.8). Back trajectory cluster analysis showed that the ΔBC/ΔCO ratio of plumes from the Yangtze River Delta region was 6.58 ± 0.96 ng m−3 ppbv−1, which is consistent with result from INTEX-B emission inventory. The ΔBC/ΔCO ratios for air masses from Northern, Central Eastern and Southern China were 5.2 ± 0.63, 5.65 ± 0.58 and 5.21 ± 0.93 ng m−3 ppbv−1, respectively. Over the whole observation period, the ΔBC/ΔCO ratio had unimodal diurnal variations and had a maximum during the day (09:00–17:00 LST) and minimum at night (21:00–04:00 LST) in spring, summer, autumn and winter, indicating the effects of the intrusion of clean air mass from the high troposphere. The case study combined with measurements of urban PM10 concentrations and satellite observations demonstrated that the ΔBC/ΔCO ratio for a plume of burning biomass was 12.4 ng m−3 ppbv−1 and that for urban plumes in Eastern China was 5.3 ± 0.53 ng m−3 ppbv−1. Transportation and industry were deemed as controlling factors of the BC–CO relationship and major contributions to atmospheric BC and CO loadings in urban areas. The loss of BC during transportation was also investigated on the basis of the ΔBC/ΔCO–RH relationship along air mass pathways, and the results showed that 30–50% BC was lost when air mass traveled under higher RH conditions (>60%) for 2 days.

This study investigates the effects of the total solar eclipse of 22 July 2009 on surface ozone and other photo-oxidants over central China using the WRF-Chem model. Chemical and meteorological observation data were used to validate the model, and results suggest that the WRF-Chem model can capture the effects of the total solar eclipse well. The maximum impacts of the eclipse occur over the area of totality, with a decrease in surface temperature of 1.5 °C and decrease in wind speed of 1 m s−1. In contrast, the maximum impacts on atmospheric pollutants occur over parts of north and east China where emissions are greater, with an increase of 5 ppbv in NO2 and 25 ppbv in CO and a decrease of 10 ppbv in O3 and 3 ppbv in NO. This study also shows the effects of the solar eclipse on surface photo-oxidants in different parts of China. Although the sun was obscured to a smaller extent in polluted areas than in clean areas, the impacts of the eclipse in polluted areas are greater and last longer than they do in clean areas. The change in radical concentrations during the eclipse reveals that nighttime chemistry dominates in both polluted and clean areas. In contrast to the effects on atmospheric pollutants, the change in radical concentrations (OH, HO2 and NO3 in clean areas is much larger than in polluted areas mainly because of the limited sources of radicals in these areas. In addition, since solar eclipse does provide a natural opportunity to test our understanding more thoroughly on atmospheric chemistry, especially on photolysis-related chemistry, a comprehensive experimental campaign is highly recommended during solar eclipses in future.

Macroporous α-Al2O3 hollow fibers are used as supports for thin dense Pd membranes; these membranes show a high and stable H2 flux in permeance studies.

We investigated aerosol hygroscopic growth property and its influence on scattering coefficient using M9003 nephelometers in coupling with a relative humidity controlled inlet system at a rural site near Beijing mega-city (Jingjintang) from 24th April to15th May 2006. Inlet relative humidity was controlled in an increasing range of 40%–90% while the aerosol hygroscopic growth factor, f(RH=80%), varied in a range of 1.07–2.35 during the measurement. Estimated periodic mean values of aerosol hygroscopic growth factors are 1.27–1.34, 1.17–1.23, 1.55–1.59 and 2.33–2.48 for clean, dust, urban pollution and mixed pollution periods respectively. An examination of chemical composition of daily filter samples highlighted that aerosol hygroscopicity was generally enhanced with the increasing ratio of ammonium sulfate (AS) to organic matter (OMC). Furthermore, strong hygroscopic organic aerosols were observed on 11th (f(RH=80%)=2.23) and 15th (f(RH=80%)=2.21) of May with organic carbon proportions of PM2.1 reaching 42.3% and 43.0% respectively. Back-trajectory analysis indicated that solar radiation and vertical convective movement along the air mass pathway might strongly influence the hygroscopic properties of organic matter.

To sequence and analyze the complete nucleotide sequence of the Japanese encephalitis virus (JEV) strain 02-76, newly isolated in 2002 in China and to provide information for the genomic structure of JEV and the characteristics of virulence.Overlapping primers were designed according to the full-length genomes from GenBank. RT-PCR was used to amplify the fragments, sequencing was performed and all the nucleotides were connected to acquire the full-length genome. Computer software was used to analyze the nucleic acid data, deduced amino acid sequence and phylogenetic trees including Clustal X(1.8), DNASTAR, GENEDOC(3.2).The result of sequence analysis showed that the genome of 02-76 strain was 10,977 nucleotides long. An open reading frame from 95 to 10,391 including 10,296 bases was found capable of coding for a 3432 amino acid polyprotein. Compared with the Beijing 1 strains isolated in 1949 in China, there was a 248 nucleotide divergence and 16 amino acid divergence. Comparison of the complete genome sequences of different JEV isolates showed a 0.6%-15.1% nucleotide sequence divergence among them, which resulted in 0.2%-4.6% amino acid sequence divergence. Phylogenetic analysis through PrM/C,E,3'NTR and full-length genome showed that the 02-76 strain belonged to genotype 3.Analysis based on the complete genome sequences of different JEV isolates showed that the 02-76 isolate in 2002 belonged to genotype 3 and was close to the old Chinese isolates SA-14.

Oridonin, an extract from the Chinese herb Rabdosia rubescens, is currently one of the most important traditional Chinese herbal medicines. Recently oridonin has been reported to have anti- tumor effects in a large variety of malignant diseases. In this study, we investigated the apoptotic inducing effect of oridonin in leukemia K562 cells and its mechanism. Cell growth inhibition was measured using a microculture tetrazolium assay, apoptosis was measured by flow cytometry and electron microscopy as well as by DNA fragmentation analysis. Telomerase activity was measured by TRAP-enzyme- linked immunosorbent assay, and the expression of Bcl-2 and Bax proteins was detected by western blot analysis. The results showed that oridonin could inhibit the proliferation and induce apoptosis on leukemia K562 cells remarkably. Telomerase activity as well as Bcl-2 expression was down- regulated, while Bax expression was up-regulated concurrently, when apoptosis ocurred. We therefore conclude that oridonin demonstrated anti-proliferative and apoptosis-inducing effects on K562 cells in vitro, and that changes in bcl-2 and bax protein levels as well as telomerase activity may play an important role in its mechanism of action.

To improve the curative effects of hypopharyngoesophageal stenosis.35 patients treated for hypopharyngoesophageal stenosis were retrospectively reviewed. The curative methods were selected on the stage of stenosis, including drug, dilatation, reconstruction of hypopharynx and oesophagus.33 patients resumed a normal oral diet, no stenosis of anastomosis occurred.For the early mild lesions, using of steroids, antibacterial and dilatation is considered to be the procedure of choice, for those severe lesions, reconstruction of hypopharynx and oesophagus with selected appropriate materials can obtain good results.

The aims of the present study were to find electroencephalographic parameters that appropriately represent the microstructure of electroencephalograms (EEG) in different sleep states and to find quantitative criteria for an automatic system of sleep-state classification in preterm infants.Continuous 24 h EEG was performed in 14 normal preterm infants for whom 26 EEG records were obtained. Based on respiratory activity, body movements and rapid eye movements, the different sleep states were determined visually in 30 s epochs. Seven EEG parameters, Minimum Akaike Information Criterion (Min-AIC), total power (TP), component powers (delta, theta, alpha and beta), and the discontinuity were calculated by means of autoregressive and component analyses in 30 s epochs. The student's t test was performed independently for each parameter. Four of the seven parameters (Min-AIC, TP, delta component power and the discontinuity) showed significant differences in different sleep states. The results of multivariate discriminant analysis revealed that the combination of Min-AIC, TP, delta component power and the discontinuity of EEG defined the EEG sleep states well.The combination of Min-AIC. TP, delta component power and the discontinuity of EEG defined the EEG sleep states well and might be used to predict sleep state changes in preterm infants of conceptional ages of more than 30 weeks.

Macroporous α-Al2O3 hollow fibers are used as supports for thin dense Pd membranes; these membranes show a high and stable H2 flux in permeance studies.

A comparative study of the soft x‐ray appearance potential spectra of various pure rare‐earth metals has been carried out with a specially designed sealed‐off analyzer tube. It is shown that for lanthanide elements with even number of 4f‐electrons (except Eu) no spectrum is found in a region of accelerating potential from 50 to 1400 V. The most sensitive peaks are M5 (3d5/2) and M4 (3d3/2), which can serve as ’’finger prints’’ to identify the rare‐earth metals. The ratio of the M5/M4 peak heights might be classified into three groups, according to their various values. Satellite peaks also exist, although no satisfactory explanation has yet been given. The purity of most samples is checked by a Mattauch–Herzog type mass spectrometer or by the proton‐induced x‐ray emission (PIXE).

Various samples of Y-Ba-Cu-O system have been studied by Rutherford backscattering (RBS). At least within the selvage layer of 0.2 micron thickness, the real composition usually differs from its nominal composition, unless Y:Ba:Cu = 1:2:3. Surface infrared reflectance (SIR) under different temperatures from 4.2 K to 200K has been used for measuring energy gaps. Many electron spectroscopies are also measured under room temperature, but it is difficult to get reproducible and reliable results. Some preliminary results, however, are discussed.