Present situation and progress of surgical treatment for laryngeal clefts / 临床耳鼻咽喉头颈外科杂志

At present, there is no unified gold standard for the treatment of laryngeal clefts. Type Ⅰ laryngeal clefts with mild symptoms can be treated conservatively, such as thick diet feeding and using proton pump inhibitor to control reflux, while Ⅱ-Ⅳ laryngeal clefts mostly requires surgical intervention.There are many different surgical methods for the treatment of laryngeal clefts, including injection laryngoplasty, endoscopic surgical repair of laryngeal clefts and open laryngoplasty through anterior cervical approach. How to choose a more suitable surgical plan for children is a problem worth discussing. This article will review the literature on the surgical treatment of laryngeal clefts both domestically and internationally, and summarize the current situation and challenges of surgical treatment of laryngeal clefts.

Application of peroral endoscopic-assisted laryngeal microsurgery in children with laryngeal neurofibromas / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the clinical manifestations and the effect of peroral endoscopic-assisted laryngeal microsurgery for children with laryngeal neurofibroma, and to provide clinical reference for the diagnosis and treatment of this disease. Methods:The clinical data of 4 children with laryngeal tumors admitted to the Department of Otorhinolaryngology, Children's Hospital of Chongqing Medical University from January 2021 to June 2023 were retrospectively analyzed. Laryngeal tumors were removed by peroral endoscopic-assisted laryngeal microsurgery. One case underwent tracheotomy at the same time, and one case was simultaneously performed with laryngeal T tube placement and tracheotomy. Results:Surgical resection is the best treatment for laryngeal neurofibroma, and laryngeal microsurgery should be actively used for patients with surgical indications.This surgical method has the advantages of good efficacy, minimal invasion, aesthetics and preservation of laryngeal function, which not only ensures safety, but also improves the quality of life after surgery, and has the value of development and promotion.

Application of endoscopic surgical repair through bracing laryngoscope in children with type Ⅲ laryngeal clefts / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the efficacy of endoscopic surgical repair in the treatment of type Ⅲ laryngeal clefts and to explore the feasibility of the treatment for type Ⅲ laryngeal clefts. Methods:The clinical data of 6 children with type Ⅲ laryngeal clefts who underwent endoscopic surgical repair in our department from June 2018 to January 2023 were analyzed retrospectively. The operation was performed under combined intravenous and general anesthesia,preserving the spontaneous breathing of the children. With the assistance of 4 mm/0° endoscope, radiofrequency knife or laryngeal scissors were used to make fresh wounds along the edge of laryngeal clefts,and cotton pads infiltrated with adrenaline （1:10 000） were used to compress the wound. 6-0 PDP suture was used to suture 3-6 stitches according to the extent of laryngeal clefts. Modified barium swallowing test （MBS） was performed 3 months after operation. Results:All the children were successfully treated with endoscopic surgical repair. After surgery, 2 cases were transferred to pediatric intensive care unit （ICU） for 7 days of monitoring, and the rest were transferred back to the general ward. There were no postoperative complications. The symptoms of dysphagia, laryngitis and recurrent pneumonia were improved in all children. According to the follow-up results of postoperative MBS,no aspiration was found in all children, and 2 children had intermittent cough when drinking large amounts of water. During the follow-up, there were 2 cases of recurrence, and the cracks were completely repaired after the second endoscopic surgical repair treatment,and no recurrence has been observed so far. Conclusion:Endoscopic surgical repair can be applied to some children with type Ⅲ laryngeal clefts with less intraoperative bleeding and fewer operative complications. It can significantly improve the symptoms such as swallowing dysfunction and recurrent pneumonia. It is a safe and effective surgical treatment.

The preliminary analysis of the endoscopic holistic rhinoplasty—report of 52 cases / 中华整形外科杂志

Objective@#To analyze the clinical effect of the endoscopic holistic rhinoplasty in order to improve its clinical application and safety.@*Methods@#The patients with external nasal deformities and complained nasal congestion were assessed before operation and undergoing endoscopic holistic rhinoplasty from January 2015 to June 2017. Therefore, the internal nasal plasty and external nasal plasty were performed simultaneously, so as to correct the abnormalities of internal and external nasal structures, restore nasal ventilation function, and achieve the purpose of external nose cosmetology. The nasal congestion, visual analog scale, rhinomanometry and acoustic rhinometry and patient satisfaction were used to assess the efficacy. SPSS 21.0 was used for statistical analysis. Paired sample t test was used for preoperative and postoperative comparison, and P<0.05 was taken as statistically significant difference.@*Results@#All the patients were followed up from one month to one year without complications. Postoperative nasal obstruction VAS score (1.63±0.76) was significantly lower than preoperative(6.35±0.65) (t=6.315, P<0.001). The minimum nasal cross-sectional area was (0.38±0.29) cm2 preoperatively and (0.52±0.14) cm2 postoperatively, which was significantly higher than that before the operation (t=9.732, P<0.001). Postoperative nasal volume (9.21±3.23) cm3 was significantly higher than preoperative (6.44 ± 1.04) cm3 (t=9.559, P<0.001), and postoperative nasal resistance (0.26 ± 0.07) kPa·s/L was lower than preoperative (0.65±0.21) kPa·s/L(t=7.524, P<0.001). The postoperative satisfaction survey result were very satisfactory in 41 cases (78.85%), accounted satisfaction in 11 cases (21.15%).@*Conclusions@#The application of the endoscopic holistic rhinoplasty has a good clinical effect and a high degree of satisfaction.

Guidine role of sunjective and objective assessment in chronic rhinosinusitis patient with nasal congestion during perioperative period / 中国耳鼻咽喉头颈外科

OBJECTIVE To assess the guideline role of preoperative subjective and objective assessment on nasal obstruction in chronic rhinosinusitis(CRS) patient during perioperative period. METHODS The patients with CRS who's chief complaint was nasal obstruction were divided into experimental group and control group according to different doctors. Visual analog scale, rhinomanometry and acoustic rhinometry were used to assess subjective and objective nasal obstruction, and nasal endoscopy and sinus CT examination were applied to evaluate the condition of nasal cavity and nasal sinuses. Patients were taken corresponding appropriate strategies in experimental group, but conventional empirical measures in control group during perioperative period. Postoperative follow-up were performed in 6 months and 1 year. SPSS21.0 was used for statistical analysis. RESULTS There was no statistical difference in nasal obstruction symptom score, total rhinomanometry before operation between experimental group and control group(P>0.05). There were statistical difference between the 2 groups after operation in nasal obstruction symptom score, total rhinomanometry. At the 2 postoperative time points (6 months, 1 year after operation) compared with preoperative period, significant differences were found in the parameters evaluated between the two groups(P<0.05). The curative effect in different postoperative time showed statistical significance(P<0.05). CONCLUSION Preoperative subjective and objective assessment for nasal obstruction can be used not only in the evaluation of severity and treatment effect, but also in the guideline of perioperative treatment for CRS combined with nasal endoscopy and sinus CT examination, which can improve nasal obstruction and the treatment effect of CRS.

Epidemiologic investigation and analysis of children allergic rhinitis in Chongqing City / 重庆医学

Objective To investigate the epidemic features of pediatric allergic rhinitis (AR) in Chongqing City .Methods The children aged 2 to 12 years old from 11 kindergartens and primary schools in Chongqing City were randomly extracted as the study subjects .The AR questionnaire was designed and conducted the epidemiologic survey and statistical analysis .Results The self-reported AR prevalence rate among children in Chongqing City was 28 .5% (334/1170) .The clinical diagnosis rate was 18 .1%(212/1170) and definite diagnosis rate was 17 .3% (202/1170);intermittent AR accounted for 36 .6% (74/202) and persistent AR accounted for 63 .4% (128/202) .Among the nasal symptoms in AR children patients ,nasal itch occupied the highest proportion (70 .7% ) ,followed by nasal discharge(59 .3% ) ,nasal obstruction(56 .3% ) and continuous sneezing (45 .5% );complicating ocular symptoms accounted for 34 .1% ,those with cough symptom accounted for 56 .9% .Eczema was the most common concomitant dis-ease for children with AR(37 .7% ) ,followed by allergic conjunctivitis (27 .5% ) ,nasosinusitis(26 .9% ) ,epistaxis(25 .1% ) ,asthma (19 .2% ) and secretory otitis media (6 .6% ) .Conclusion The self-reported morbidity rate of children AR in Chongqing City is higher and persistent AR is more common than intermittent AR .

Efficacy of nucleoside analogues antiviral therapy on clinical outcome for HBV-related primary hepatic carcinoma patients after hepatectomy / 实用医学杂志

Objective To evaluate the efficacy of nucleoside analogues (NAs) antiviral therapy on clinical outcome for hepatitis B virus (HBV)-related primary hepatic carcinoma patients after hepatectomy. Methods The clinical data of 156 HBV-related primary hepatic carcinoma patients after hepatectomy were retrospectively analyzed..According to whether accepted postoperative antiviral treatment, all patients were divided into control group (n = 80)and observation group (n = 76). The serum HBV DNA capacity, recurrence-free survival (RFS)and overall survival (OS)were compared between two groups. Results One week, 1 month, 2 months and 3 months after operation , the serum HBV DNA capacity of observation group was significantly lower than that of control group(P < 0.05). One year, 3 years and 5 years after operation, intergroup comparison of RFS rate of both groups showed statistical significance (P < 0.05) and 1 year, 3 years and 5 years after operation, the difference of OS rate of both groups indicated statistical significance (P < 0.05). Conclusion Standard NAs antiviral treatment for HBV-related primary hepatic carcinoma patients after hepatectomy ,can improve prognosis and prolong survival time. The inhibition the HBV copy active may be its mechanism.

Expression and significance of interleukin-6 in children with chronic rhinosinusitis / 重庆医学

Objective To evaluate the expression of interleukin-6 (IL-6) on peripheral blood and adenoid in children with chronic rhinosinusitis (CRS) and adenoidal hypertrophy ,to investigate the mechanism of IL-6 on the occurrence and development of CRS .Methods A total of 216 cases of hypertrophic adenoids were collected ,including 95 CRS children with hypertrophic adenoid (CRS group) ,70 children with allergic rhinitis and hypertrophic adenoid (AR group)and 51 children with hypertrophic adenoid (control group) .The plasma IL-6 concentrations were detected by ELISA ,and the expression and distribution of IL-6 in adenoid tissue was detected by immunohistochemistry .Results The plasma IL-6 level in CRS group was (49 .8 ± 8 .3)pg/mL ,significantly higher than that of in control group (33 .6 ± 6 .9)pg/mL and in AR group (35 .9 ± 5 .6)pg/mL ,differences had statistic significance ( P 0 .05) .Conclusion Among children with CRS ,expression of IL-6 whether in peri-plasma or in focal tissue was higher than those without CRS ,demonstrating that IL-6 may play an important role in the pathogenesis and developemnt of CRS in chil-dren .

Bacterial culture and drug susceptibility observation of children with chronic rhinosinusitis in Chongqing city / 重庆医学

Objective To investigate the distribution of pathogenic bacteria in children with chronic rhinosinusitis (CRS) and their susceptibility to commonly used antibacterial drugs .Methods 95 cases of CRS complicating adenoidal hypertrophy were per-formed adenoidectomy .The secretion of maxillary sinus ostium and posterior ethmoid sinus ostium was collected during endoscopic adenoidectomy by the disinfected cotton swab for conducting the bacterial culture and the drug sensitivity test .Results 89 speci-mens showed the bacterial growth ,the positive rate of bacterial culture in all culture specimens was 93 .7% ,86 strains of aerobic bacteria ,28 strains of anaerobic bacteria .Among 95 patients ,81 cases of aerobic infection ,52 cases of anaerobic infection ,44 cases of mixed infection .The drugs susceptibility test in vitro displayed that amoxicillin and clavulanate potassium had the higher antibacte-rial activity to aerobic bacteria and metronidazole had the higher antibacterial activity to anaerobic bacteria .Conclusion Children CRS is dominated by the aerobic bacterial infection .The bacterial infection plays a larger role in children CRS .Antibacterial drugs have better effect for treating CRS .

The high-risk factors and audiology characteristics analysis of 952 cases of neonatal failed hearing screening / 重庆医学

Objective To analyze the related factors in new born failed in hearing screening and its audiological characteristics . Methods From May 2009 to Febrary 2012 ,952 infants within the 3 to 6-month-old with detailed birth records and hearing screen-ing records were reviewed in the study .They were born in Chongqing and surrounding areas ,but failed in the first and second hear-ing screening .They were tested by auditory brainstem response (ABR) ,distortion product otoacoustic emissions (DPOAE) ,tympan-ometry and stapedius reflex .Results The normal ratio of tympanogram ,normal group(74 .25% ) was higher than the high-risk group(69 .61% )(P30 dBnHL was 55 .80% ,60 .36% in high-risk group .High-risk group′s hearing abnormality rate was significantly higher than the normal group (P<0 .05);In normal group ,mean threshold of ABR was (47 .64 ± 22 .86)dBnHL .While it was(50 .58 ± 25 .02)dBnHL in high-risk group .The threshold was higher in normal group than high-risk group(P<0 .05) .Conclusion premature birth ,low birth weight(<1 500 g) ,hyperbilirubinemia ,neonatal asphyxia ,pal-ace the virus infection ,mechanical ventilation ≥ 5 days ,≥ 2 high-risk factors are risk factors for hearing loss .Newborn hearing screening is a long and arduous task ,We should enhance screening efforts in infant with high risk factors ,and actively prevent and treat neonatal perinatal risk factors and reduce the incidence of hearing loss .

Comparation of therapeutic effects of early enteral nutrition and delayed enteral nutrition on severe acute pancreatitis / 实用医学杂志

Objective To compare the therapeutic effects of early enteral nutrition and delayed enteral nutrition on severe acute pancreatitis. Methods Sixty-four patients of severe acute pancreatitis were enrolled into two groups: early enteral nutrition group was used as the treatment group and delayed enteral nutrition was used as the control group. Two weeks after the treatment, Variables of TP, ALB, CRP, APACHEⅡscore, hospital stay and recovery time of blood and urine amylase were compared between the two groups. Results The TP and ALB of the treatment group were significantly higher than those in the control group (P<0.05). The CRP and APACHEⅡscore of the treatment group were significantly lower than those in the control group (P<0.05). Compared with the control group, the recovery time of blood amylase, urine amylase and hospital stay were significantly shorter in the treatment group (P<0.05). Conclusion Using early enteral nutrition treatment in patients with severe acute pancreatitis is efficient, worthy of clinical use.

A Study of the inhibitory effect of a recombinant CEA vaccinia virus inocnlation on mouse CEA positive tumor / 细胞与分子免疫学杂志

Aim To explore antitumor mechanism of a recombinant vaccinia virus containing the human CEA-cDNA (rV-CEA). Methods C57/BL mice were immunized three times with rV-CEA. Six weeks later, the macrophages(MΦ s)and splenocytes from rV-CEA-immunized donors were transferred to CEA＋ -HePa tnmor-bearing recipients,Meanwhile, the antitumor effects of these donor's MΦ s and splenocytes and that of the recipient's splenocytes were detected in vitro. Results The MΦ s and splenocytes from rV-CEA-immunized donors possessed strong antitumor activity in CEA-positive tumor-bearing recipients. The in vitro antitumor effect of splenocytes from mice inoculated with MΦ s from rV-CEA-immunized donors were markedly stronger than those from W-VV-immunized donors. However,the in vitro antitumor effect of the MΦ s from rV-CEA-immunized donors was the same as those from W-VV-immunized donors. Conclusion It is demonstrated that antitumor activity induced with rV-CEA may be mediated mainly by antigen present cells (the MΦ s), which activated tumor-specific T cells to kill tumor cells.