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Objective:To determine the technical feasibility,intraoperative safety,and efficacy of endoscopic thyroidectomy using the gasless unilateral axillary approach.Methods:We analyzed 11 patients diagnosed with papillary thyroid carcinoma who underwent an endoscopic thyroidectomy between February and April 2017 using a gasless unilateral axillary approach at the Department of Head and Neck Surgical Oncology,Zhejiang Cancer Hospital.Additionally,we compared the clinical features,early surgical outcomes,surgi-cal complications and postoperative satisfaction of endoscopic thyroidectomy with those of 11 patients who underwent conventional open thyroidectomies during the same period.Result:In the endoscopic group,the mean age of patients((35.6±2.6)years was young-er than that of the open thyroidectomy group[(48.5±2.3)years,(P=0.002)].The endoscopic thyroidectomy(unilateral lobectomy)pro-cedure was successfully completed in all patients. The rate of central compartment neck dissection was not different between the groups[(2.4±1.7)vs.(2.8±1.6),P>0.05].The operative time was longer and the amount of drainage was higher in the endoscopic than in the open group[(123.9±28.1)min vs.(48.6±9.8)min,P<0.01;(145.9±81.8)mL vs.(87.7±18.9)mL,P<0.01].Everage length of hospi-talizntion was 1 day longer in the endoscopic group. The complication rate was not statistically significantly different between the groups.The postoperative pain score of the neck and anterior chest was not different between the groups except the anterior chest pain score at day 3 after operation.The cosmetic satisfaction was greater in the endoscopic group(P<0.01).Conclusions:Endoscopic thyroidectomy using a gasless unilateral axillary approach for the management of selected patients presenting with papillary thyroid carcinoma is a safe,feasible,and cosmetically superior procedure.
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Objective To evaluate the efficacy of endoscopic nasopharyngectomy in the management of recurrent nasopharyngeal cancers (NPC) and to identify the prognostic factors.Methods Between september 2010 and october 2016,31 patients who received endoscopic nasopharyngectomy in our hospital for recurrent NPC were retrospectively reviewed.The clinical and pathological features of the patients,such as sex,age,T stage,pathological type,recurrence location,operation time,bleeding volume,perioperative complications,postoperative recurrence time,location and survival were recorded and analyzed,and the prognosis was observed.Results All patients underwent endoscopic resection of nasopharyngeal carcinoma locally,and no 1 cases received external nasal route surgery.All patients underwent successful endoscopic nasopharyngectomy.No patient was transferred to open approach.The mean operative time was (108.55 ± 34.36)min.The average blood loss was (23.05 ± 16.11)rnl.No serious postoperative complications occurred,no surgical deaths,and 1 cases had positive edge.Postoperative follow-up time was 3-82 months.During follow-up,29 cases survired,including that 9 patients survived with disease,1 patient concurrent oropharyngeal carcinoma,1 patient lost and 1 patient died.There were 6 cases of local recurrence,1 cases of liver metastasis and 2 cases of cervical lymph node metastasis after operation,2 patients with recurrent postoperative received endoscopic nasopharyngectomy and no recurrence of postoperative follow-up.One-year overall survival rate,disease-free survival rate and no local recurrence survival rate were 96.67％,80.00％ and 86.67％ respectively.Five-year disease-free survival rate was 61.80％.The progression free survival time was 2-82 (31.87 ± 23.26) months.Multivariate analysis showed that sex,age,first diagnosed T stage,and tumor necrosis were not the independent prognostic factor for survival in recurrent nasopharyngeal carcinoma patients.Conclusions Endoscopic nasopharyngectomy is a safe and effective procedure for the treatment of recurrent nasopharyngeal carcinoma.
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Mucosal malignant melanoma of the head and neck is one of the rarely malignant diseases. The standard therapy for mucosal melanoma of the head and neck is radical surgery associated with adjuvant radiation. The immunotherapy and chemotherapy are confirmed effective in some degree. Molecular staging and targeted therapy will be the new tendency in the future.
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This study examined the corneal permeability of topical eye drop solutions added with various corneal penetrating accelerators and gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) by nuclear magnetic resonance imaging (MRI). Twenty-four New Zealand rabbits were randomly divided into 3 groups according to the random digits table: Gd-DTPA group, in which the rabbits received 23.45% Gd-DTPA; hyaluronic acid group, in which 23.45% Gd-DTPA plus 0.2% hyaluronic acid was administered; azone group, in which 23.45% Gd-DTPA with 0.2% azone was given. Fifty microliters of the eye drops was instilled into the conjunctive sac every 5 min, for a total of 6 applications in each group. Contrast medium signals in the cornea, anterior chamber, posterior chamber, and vitreous body were scanned successively by MRI. The morphology and cell density of the corneal endothelium were examined before and 24 h after the treatment. The results showed that the residence time of Gd-DTPA in the conjunctival sac in the hyaluronic acid and azone groups was longer than that in the Gd-DTPA group. The signals in the anterior chamber of the Gd-DTPA and hyaluronic acid groups were increased slightly, and those in the azone group strengthened sharply. The signal intensity continuously rose over 80 min before reaching plateau. The strengthening rate of signals in the anterior chamber was 19.63% in the Gd-DTPA group, 53.42% in the sodium hyaluronate group, and 226.94% in the azone group. No signal was detected in the posterior chamber or vitreous body in all the 3 groups. Corneal morphology and cell density did not show any significant changes after the treatment in all the 3 groups. It was concluded that azone can significantly improve the corneal permeability of drugs that are similar to Gd-DTPA in molecular weight and molecular size, and MRI is a noninvasive technique that can dynamically detect eye drop metabolism in real time.
Subject(s)
Animals , Female , Male , Rabbits , Azepines , Pharmacokinetics , Contrast Media , Pharmacokinetics , Cornea , Metabolism , Gadolinium DTPA , Pharmacokinetics , Magnetic Resonance Imaging , Ophthalmic Solutions , PermeabilityABSTRACT
This study examined the corneal permeability of topical eye drop solutions added with various corneal penetrating accelerators and gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) by nuclear magnetic resonance imaging (MRI). Twenty-four New Zealand rabbits were randomly divided into 3 groups according to the random digits table: Gd-DTPA group, in which the rabbits received 23.45% Gd-DTPA; hyaluronic acid group, in which 23.45% Gd-DTPA plus 0.2% hyaluronic acid was administered; azone group, in which 23.45% Gd-DTPA with 0.2% azone was given. Fifty microliters of the eye drops was instilled into the conjunctive sac every 5 min, for a total of 6 applications in each group. Contrast medium signals in the cornea, anterior chamber, posterior chamber, and vitreous body were scanned successively by MRI. The morphology and cell density of the corneal endothelium were examined before and 24 h after the treatment. The results showed that the residence time of Gd-DTPA in the conjunctival sac in the hyaluronic acid and azone groups was longer than that in the Gd-DTPA group. The signals in the anterior chamber of the Gd-DTPA and hyaluronic acid groups were increased slightly, and those in the azone group strengthened sharply. The signal intensity continuously rose over 80 min before reaching plateau. The strengthening rate of signals in the anterior chamber was 19.63% in the Gd-DTPA group, 53.42% in the sodium hyaluronate group, and 226.94% in the azone group. No signal was detected in the posterior chamber or vitreous body in all the 3 groups. Corneal morphology and cell density did not show any significant changes after the treatment in all the 3 groups. It was concluded that azone can significantly improve the corneal permeability of drugs that are similar to Gd-DTPA in molecular weight and molecular size, and MRI is a noninvasive technique that can dynamically detect eye drop metabolism in real time.
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Objective Our previous research demonstrated that trkA and p75 receptors of nerve growth factor(β-NGF) are expressed in human pterygium fibroblasts(HPF), and trkA is expressed only in conjunctiva. The purpose of present study was to investigate the effects of β-NGF on proliferation of HPF and analyse the pathogenesis mechanism of pterygium. Methods The HPF specimen was obtained from Union Hospital of Tongji Medical College, Huazhong University of Science and Technology during the surgery. Explant culture technique was used for the primary culture of HPF tissue. The cells of confluenting 80% were collected and digested using 0. 25% tripsin + 0. 02% EDTA (1:1) and the third to fifth generation of cells were utilized in the experiment. Different concentrations of β-NGF was added in medium. Cultured cells were identified using vimentin, keratin and α-SMA. MTT was used to determine the proliferation of HPF after addition of β-NGF. The expression of trkA and p75 in HPF was detected by immumofluorescence method. Cell proliferation also was semi-quantitatively analyzed by detect of expressions of PCNA protein and mRNA in HPF using Western blot and RT-PCR. Results Cultured HPF cells showed the positive responses for vimentin, α-SMA, trkA and p75 but absent reaction for keratin. MTT revealed that the OD value of HPF cells was gradually enhanced with the increase of β-NGF concentration in 12, 24, 48, 72 and 96 hours after β-NGF action with the maximum stimulation at 48 hours. The expression of PCNA protein and mRNA in HPF was significantly different among various concentrations of β-NGF groups(F_(protein) = 24. 980, P = 0. 000; F_(mRNA) = 64. 490, P = 0. 000) and increased from 5 ng/mL β-NGF group through 50 ng/mL β-NGF group in comparison with 0 and 1 ng/mL β-NGF group (P ＜ 0. 05) . Conclusion The findings demonstrate the potential proliferative effect of β-NGF binding to trkA and p75 on HPF.
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Objective To study the effects of Ziyin Bushen Pill on Aristolochia acid A in Aristolochia fangchi,and preliminary study on reducing poisonous effects of Ziyin Bushen Pill to Aristolochia fangchi.Methods Absorption of Aristolochhia acid A in the mingled decoction of Aristolochia fangchi and Ziyin Bushen Pill by HPLC,and the change of Aristolochia acid A was observed.Results Aristolochia acid A content of Aristolochia fangchi was markedly decreased after Ziyin Bushen Pill was added.Conclusion Ziyin Bushen Pill can markedly decreased Aristolochhia acid A content of Aristolochia fangchi.
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Objective:To study the effects of Naoling tablet on Aristolochia acid A from Aristolochia fangchi,preliminary explore the deintoxication of Aristolochia fangchi.Methods:Absorption value of Aristolochhia aicd A was determined by HPLC after Aristolochi fangchi decocted with Naoling tablet,the change of content of Aristolochia acid A was observed .Results:the content of Aristolochia acid A from Aristolochia fangchi was markedly decreased after Naoling tablet was added.Conclusion:Naoling tablet can markedly decreased the content of Aristolochhia aicd A from Aristolochia fangchi.