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Objective:To compare the clinical effect of surgical treatment of congenital preauricular fistulas in children during the local infection period and static inflammatory period. Methods:Forty children with congenital preauricular fistula infection treated in our hospital from January 2020 to December 2022 were selected as the experimental group, and 39 children with congenital preauricular fistula inflammation at static period were selected as the control group. The fistula of the two groups of children aged between 1-14 years old was located in front of the foot of the ear wheel or the foot of the ear wheel, and all were unilateral fistulas. The postoperative follow-up was 6 months to 2 years, and the efficacy of the two groups was compared. Results:There was no significant difference in the healing rate of stage Ⅰ and stage Ⅱ between the two groups（P>0.05）. There was no significant difference in fistula recurrence rate and satisfaction with the preauricular scar between the two groups after treatment（P>0.05）. There was no significant difference in postoperative hospital stay between the experimental group and the control group（P>0.05）. Conclusion:The effect of surgical treatment of congenital preauricular fistula in the infected period is similar to that of surgical treatment in the static period of inflammation, and it can reduce the pain of dressing change under local anesthesia in children, avoid the second operation in children, and reduce the economic cost. This treatment method is worthy of clinical promotion. Appropriate incision and resection method were designed according to the fistula and infection sites.
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Humans , Child , Infant , Child, Preschool , Adolescent , Fistula/surgery , Inflammation , Craniofacial Abnormalities/surgery , Cicatrix , Treatment OutcomeABSTRACT
Objective@#To understand lunch satisfaction and leftovers of Changsha compulsory education schools under different supply modes served by school canteens and specialized enterprises,and to provide scientific basis for the government to formulate school lunch improvement policies.@*Methods@#Multistage stratified cluster sampling method was used to random select 2 203 students from 8 primary and secondary schools in Changsha who were administered with questionnair survey in April to May of 2018.@*Results@#For school lunch, the overall rate of satisfaction was 78.8%.The overall lunch satisfaction of female and primany school students were higher than that of male and junior high school students respectively,and the difference was statistically significant(P<0.05). Totally 76.0% of students had the highest satisfaction in food hygiene and the lowest satisfaction rate was 60.0% in food taste. By comparing different supply modes, the overall satisfaction rate of meal quantity was higher (47.8%) under school canteens, and that of dining environment was relatively high (43.7%) under specialized enterprises. "Don-t like some food" (63.8%) was the main reason for students leftovers under the two supply modes. The lunch leftover rate of specialized enterprises (37.8%) was significantly higher than that of school cafeteria (30.6%)(χ 2=12.81，P<0.05).@*Conclusion@#The satisfaction of food taste and the rate of lunch leftovers need to be further improved. School canteens environment and management should be strengthened, as well as the flexibility and communication under specialized enterprises and family-school communication. The joint efforts by school and family are needed for healthy eating education.
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Objective To explore the clinical features and treatment of thyroid carcinoma in children. Method The clinical data of 19 children under 14 years old with thyroid carcinoma diagnosed and treated from January 2003 to January 2014 were retrospectively analyzed. Results In 19 cases (12 males and 7 females), there were 18 cases of papillocarcinoma and one case pf follicular carcinoma. Unilateral lobectomy plus isthmectomy was performed in 6 cases, subtotal thyroidectomy in 4 cases and total thyroidectomy in 9 cases. Unilateral cervical lymph node dissection was performed in 5 cases and bilateral in 11 cases. After the operation, multiple lesions were confirmed by pathology in 9 cases, thyroid capsular invasion in 14 cases, lymphatic metastasis in 15 cases and distant metastasis in 5 cases. All the patients were treated with TSH, and 10 cases were treated with 131I after operation. The median follow-up time was 63 months. There was no death in all cases, while local residual tumor recurrence was found in 2 cases and cervical lymph node metastasis in 2 cases and distant metastasis in one case. Conclusion Thyroid carcinoma in children is mostly well-differentiated, so the overall prognosis is better. However, children who have extracapsular invasion, multiple lesions in bilateral thyroid, cervical lymph node metastasis and distant metastasis are at high risks and should be treated with comprehensive therapy that includes total thyroidectomy.
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Metformin as a cheap,safe and effective diabetes drug,has been used for many years. Recently,many studies have shown its variety inhibition of tumor cells. Its antitumor mechanism is not entirely clear;may be related to glucose metabolism and protein kinase or inflammatory cytokines mediating tumor kill-ing. Metformin has different cytotoxic effects to various tumor cell,as well as playing some auxiliary roles on other antitumor methods.
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OBJECTIVE@#To explore the cause and the methods of reoperation for recurrent thyroid carcinoma.@*METHOD@#The clinicopathologic data of 87 cases were retrospectively analyzed. The diagnosis on recurrent thyroid carcinoma were confirmed after reoperative pathology.@*RESULT@#Forty-three cases (49.4%) were confirmed as residual carcinoma by pathology. Among 87 cases, 65 cases (74.7%) had lymph node metastasis in group VI and 42 cases (48.3%) had lateral neck lymph nodes metastasis, 3 cases were in the presence of recurrent laryngeal nerve injury temporarily, 1 case was in the presence of recurrent laryngeal nerve injury permanently, 5 cases were convulsed by hypocalcemia.@*CONCLUSION@#The nonstandard surgical procedure in the first operation is the main cause for the reoperation of thyroid carcinoma. Increased cognitive level of thyroid carcinoma and appropriate surgical technique may be the important keys to avoid reoperating. It is necessary to protect the parathyroid and recurrent laryngeal nerve in reoperation.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Lymph Nodes , Pathology , Lymphatic Metastasis , Pathology , Neoplasm Recurrence, Local , General Surgery , Reoperation , Retrospective Studies , Thyroid Neoplasms , Pathology , General SurgeryABSTRACT
Objective To explore the incidence and factors of paranasal sinusitis among nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods Retrospectively evaluated the clinical data of 144 NPC patients without paranasal sinusitis before radiotherapy, including 82 cases in T1/T2 stage and 62 cases in T3/T4 stage treated in the First Affiliated Hospital of Bengbu Medical College from 2000 to 2005. MRI images before and after radiotherapy were compared. The incidence and factors of paranasal sinusitis were analyzed. There were 58 cases of nasal invasion. Nasopharyngeal carcinoma was given at face-neck joint portal with 6 MV X-ray fractionated irradiation 68-78 Gy during 6-8 weeks. The number of patients who received radiotherapy with less than or equal to 70 Gy, more than 70 Gy radiation doses were 89 and 55, respectively. Cervical part were treated with high-energy electron beam, patients with positive neck lymph nodes and with negative neck lymph nodes received 64-74 Gy doses during 6-8 weeks and 50-54 Gy during 4-5 weeks, respectively. Results Among the 144 NPC patients 86.8%(125/144) developed paranasal sinusitis after radiotherapy, the incidence rates of paranasal sinusitis (IRPS) was higher among stage T3 + T4 patients than that among stage T1 + T2 patients (94% vs 82% ,x2=4.32, P ＜0.05). Among patients who were given radiotherapy with more than 70 Gy,less than or equal to 70 Gy radiation doses on the nasopharynx, the IRPS were 95% and 82.0% (x2 = 4.65, P ＜ 0.05 ). The IRPS in patients with nasal cavity infringement was higher than that in others (95% vs. 81% , x2 = 5.46,P ＜0.05). The IRPS at 3, 6, 12 months, and more than 1 year after radiotherapy were 13.6% ,31.2% ,48.8% and 6.4%, respectively (x2 = 70.48, P ＜ 0.001 ). Conclusions The incidence of paranasal sinusitis in NPC patients after radiotherapy was very high, and reached a peak in one year. It was influeneed by invasion of nasal cavity or not, the dose of radiotherapy and T stage.
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Objective To explore the microanatomy of the horizontal segment of the facial nerve (FN)in temporal bone and its adjacent structures,in order to provide microanatomical datag for the clinical works.Methods In 20 adult wet skull specimens(40 temporal bones),horizontal segment of FN and their adjacent structures in temporal bones were observed according to operational layers by simulating transmagtoid approach.Results The lenglh of the horizontal segment was[(8.85±1.01)(7.10～11.25)]mm;The diameter of the horizontal segment wag[(1.88±0.65(1.55～1.90)]mm;The angle opening towards anterior direction between horizontal segment and vertical segment wag[(115.5±6.89)(109.5～128.6)]..The ansh towards posterior direction between horizontal segment of FN and tympanic tegmen wag [(28.5±3.66)(25.8～31.5)°;The vertical distance from the cochlear form process to the horizontal segment of the FN wag[(1.89±0.58)(0.90～3.05)]mm;The vertical distance from the head of the stapes to the horizontal segment of the FN wag[(2.30±0.85)(1.97～3.11)]mm;The distance between the summit of pyramidal segment of FN and the apex of shor limb of incus wag 2.55±0.21(2.10-2.90)mm;The distance between the summit of pyramidal segment of FN and the eminence of the lateral semicircuiar canal wag[(2.86±0.31)(2.23～3.56)]mm;No branching or dislocated nerve of the horizontal segment of the FN wag found in all 40 cases.Five percent(2/40)distal part of the horizontal segment of FN tracks forward lateral to the eminence of the literal semicircular canal.Conclusion Geniculate ganglion,cochlearform process,stapes,tympanic tegmen,lateral semicircular canal,incus are important landmarks by which horizontal segment of FN might be located in manipulation of mastoid;The relations of horizontal segment of FN and its adjacent structures are complicated,compact.It will be good that the manipuliter absorb a great deal of anatomical knowledge about landmarks that can be used in locating horizontal segment of FN.