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Objective:To investigate the correlation of central compartment lymph node metastasis(CLNM) in stage T 1a solitary papillary thyroid carcinoma (PTC) with the clinicopathological characteristics, sonographic features and the number of lymph node dissection, and to analyze the risk factors of CLNM. Methods:The data of 218 patients with stage T 1a solitary PTC who underwent thyroid cancer surgery from January 2017 to May 2021 in Tangshan Union Medical College Hospital were retrospectively analyzed. All patients were divided into CLNM positive group and CLNM negative group according to CLNM. The age, gender, preoperative sonographic features, pathological type, the number of lymph node dissection and the number of metastasis were recorded. Logistic regression was used to analyze the risk factors of CLNM. Results:Among 218 patients, there were 71 cases (32.6%) in CLNM positive group and 147 cases (67.4%) in CLNM negative group. There were statistically significant differences in age, tumor diameter, capsular invasion in thyroid or not, tumor blood supply or not, and the number of lymph node dissection between two groups (all P < 0.05). There were no statistically significant differences in gender, clear tumor boundary or not, tumor shape, tumor aspect ratio, calcification, nodular goiter and Hashimoto's thyroiditis or not (all P > 0.05). Multivariate binary logistic regression analysis showed that age < 55 years ( OR = 2.995, 95% CI 1.228-7.307), capsular invasion in thyroid ( OR = 5.297, 95% CI 2.494-11.248) and the number of lymph node dissection ≥6 ( OR = 4.085, 95% CI 2.059-8.104) were independent risk factors of CLNM (all P < 0.05). Conclusions:Patients with stage T 1a solitary PTC, age < 55 years and capsular invasion in thyroid are prone to CLNM; sufficient number of lymph node dissection can get more accurate CLNM rate.
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Objective:To evaluate the feasibility, safety and efficacy of uncut Roux-en-Y anastomosis, Roux-en-Y anastomosis and Billroth Ⅱ plus Braun anastomosis in laparoscopic-assisted distal gastrectomy for distal gastric cancer.Methods:In the retrospective cohort study, 71 cases of laparoscopic-assisted distal gastrectomy for distal gastric cancer from May 2016 to October 2019 in Tangshan Union Medical College Hospital were selected as the study subject. According to the different reconstruction methods of digestive tract, they were divided into: non disconnected Roux-en-Y anastomosis group (Uncut RY group, 29 cases); Roux-en-Y anastomosis group (RY group, 24 cases); Billroth Ⅱ-braun anastomosis group (B Ⅱ-Braun group, 18 cases). The operation time, digestive tract reconstruction time, intraoperative blood loss, the time to flatus, length of hospital stay, incidence of complication and the changes of nutritional index 1 year after surgery were observed. SPSS 18.0 software was used process the data, the measurement data conforming to normal distribution by Kolmogorov-Smirnov test was expressed by xˉ± s deviation, the measurement data dose not meet the normal distribution was expressed by the median (interquartile range) ( M( Q1, Q3)).Analysis of variance was used to compare the measurement data of normal distribution; Nonparametric rank sum test was used for the comparison between measurement data groups with non normal distribution; Count data were expressed in cases (%), and χ 2 test or Fisher exact probability method was used for composition comparison between groups. Results:In Uncut group, RY group and B Ⅱ-Braun group, the operation time were (196.0±28.8) min, (201.0±28.5) min and (186.4±26.1) min, respectively, the digestive tract reconstruction time were (56.2±13.9) min, (57.8±12.9) min and (51.5±10.0) min, respectively,the intraoperative blood loss were (285.2±85.4) mL, (280.1±78.4) mL and (273.3±79.6) mL, respectively, the time to flatus were (52.5±14.4) h,(53.9±14.6) h and (46.2±9.4) h, respectively, the length of hospital stay were (12.6±2.8) d, (12.1±3.0) d and (12.8±2.6) d, respectively, there were no significant differences among the three groups ( F values were 1.41, 1.33, 0.12, 1.89 and 0.35, respectively; P values were 0.251, 0.271, 0.890, 0.158 and 0.709, respectively). Postoperative complications in Uncut group, RY group and BⅡ-Braun group: The number of cases of anastomotic leakage was 0, 1 and 1, respectively. The number of cases of abdominal bleeding was 1, 1 and 0, respectively. The number of cases of bile reflux gastritis was 2, 1 and 5, respectively, and the number of cases of anastomotic ulcer was 0, 0 and 1, respectively. There were no significant differences among the three groups (Fisher's exact test, P values were 0.510,1.000, 0.063 and 0.254, respectively). The number of cases of Roux-en-Y retention syndrome was 0, 6 and 0, respectively. There were significant differences among the three groups (Fisher's exact test, P=0.001). Nutritional index: the weight loss were 4.00 (2.00, 5.50) kg, 3.00 (1.25,4.75) kg and 3.00 (1.75,4.25) kg respectively, decreases of hemoglobin level were (5.62±8.20) g/L, (6.63±6.84) g/L and(5.33±7.79) g/L, respectively, decreases of albumin level were 1.00 (-2.50, 7.00) g/L, 3.00 (-1.25, 6.75) g/L and 6.00 (-3.25,7.50) g/L, respectively. There were no significant differences among the three groups (Statistic value were χ 2=1.42, F=0.18 and χ 2=2.43, respectively, P values were 0.492,0.839 and 0.297, respectively). Conclusion:As a digestive tract reconstruction method for radical resection of distal gastric cancer, uncut Roux-en-Y anastomosis can reduce the incidence of Roux-en-Y retention syndrome without increasing the operation risk and affecting the postoperative nutritional status. It is a safe and feasible gastrointestinal tract reconstruction method.
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Objective:To investigate the effect of uncut Roux-en-Y anastomosis in laparoscopic assisted radical gastrectomy for distal gastric cancer.Methods:The clinical data of 53 patients with distal gastric cancer treated by surgery in Tangshan Union Medical College Hospital from May 2016 to October 2019 were analyzed retrospectively.The operation method was laparoscopic assisted radical gastrectomy for distal gastric cancer.The anastomosis methods were uncut Roux-en-Y anastomosis in 29 cases (uncut group) and Roux-en-Y anastomosis in 24 cases (traditional group). The operation time, digestive tract reconstruction time, the time to flatus, length of hospital stay, incidence of complication and one year followed up results were compared between the two groups.Results:The operation time was (196.0±28.8) min, anastomotic time was (56.1±13.8) min, postoperative exhaust time was (52.5±14.4) h, postoperative hospital stay was (12.5±2.8) d in the uncut group, and (201.0±28.5) min, (57.8±12.9) min, (53.9±14.6) h, (12.0±3.0) d in the traditional group.There was no significant difference between the two groups ( P values were 0.534, 0.664, 0.717 and 0.557, respectively). Postoperative complications: anastomotic leakage was 0(0/29), abdominal bleeding was 3.4% (1/29), alkaline reflux gastritis was 6.9% (2/29) in the uncut group and 4.2% (1/24), 4.2% (1/24) and 4.2% (1/24) in the traditional group respectively.There was no significant difference between the two groups ( P values were 0.453, 1.000 and 1.000, respectively). The incidence of Roux-en-Y stasis syndrome was 0 (0/29) in the uncut group and 25.0% (6/24) in the traditional group.There was significant difference between the two groups ( P=0.006). One case in the uncut group was found recanalization 8 months after operation, the patient underwent reoperation, the method of anastomosis was changed to traditional Roux-en-Y anastomosis.The patient′s symptoms of reflux and hearburn improved significantly after operation. Conclusion:As a digestive tract reconstruction method for radical gastrectomy of distal gastric cancer, uncut Roux-en-Y anastomosis is safe and feasible, and can avoid Roux-en-Y stasis syndrome.
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Objectives@#To discuss the clinical and radiological features of IgG4-related rhinosinusitis.@*Methods@#In this retrospective research, the clinical data of 16 patients diagnosed with IgG4 related rhinosinusitis, who were enrolled in Beijing Tongren Hospital from November 2013 to September 2017, were collected. The clinical features, laboratory findings, radiological findings, histological features, treatment and prognosis were all summarized.@*Results@#There were 12 males and 4 females among 16 patients, and male-to-female ratio was 3︰1. The age was between 30 to 70 years old, with median age of 52 years old. The chief nasal complaints were nasal obstruction and hyposmia, complicated with proptosis and eyelid swelling in 11 patients (11/16). Serum IgG4 levels were elevated in all patients and the value was over 1.44 g/L, and one patient serum IgG4 level was up to 49.70 g/L. Computed tomography (CT) showed the mainly affected sinuses were bilateral ethmoid sinus and olfactory cleft. The classic feature of CT scans was thickening of the involved bilateral ethmoid sinus mucous membrane with ethmoid bone absorption, which was mainly at midline. Histological features were severe inflammation of the mucosal tissue with mass of neutrophils and plasma cell infiltration. All patients were treated by methylprednisolone combined with cyclophosphamide or methotrexate. Remission of symptoms was detected in all patients.@*Conclusion@#The clinical features of IgG4-related rhinosinusitis are often accompanied by orbital tissue involvement, elevated IgG4 serum concentration, associated sinus imaging changes, and sensitive glucocorticoid and immunosuppressive therapy.
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Anatomy and surgery teaching has always been a difficulty in clinical medical education. In particular, the anatomy and surgery teaching under the endoscope is more difficult to learn and under-stand because of the visual differences with the direct vision. If the students misunderstand, it may lead to the severe surgical complications. We applied the image-guidance technology in the teaching of rhinology endoscope surgery, which can help teachers to teach the sinonasal anatomical structure and give an accurate explanation of surgical procedures. According to the questionnaire survey, 96.23% (51/53) of the students thought the method was effective and clear, and 98.11% (52/53) of them thought the method was better than the traditional teaching method of nasal endoscope. By this technology, the students can acquire a deeper understanding of the anatomy and surgery procedure. It especially fits the surgery teaching of the sinonasal occupying lesion.
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Objective To investigate the characteristics and feasibility of genipin-crosslinked amniotic membrane(AM) as bio-scaffold.Methods Human umbilical cord mesenchymal stem cells (hUCMSCs) were isolated from fresh umbilical cord and cultured by adherent method.The expressions of PE-CD34,PE-CD45,PE-CD90,FITC-105 and FITC-Oct-4,the markers of hUCMSCs,were detected by flow cytometry.Alizarin red and oil red O staining were performed to identify the cells after adipogenesis and osteogenesis induction on the third-generation cells.Human AMs were treated at 37 ℃ and 45 ℃ by 0.5％ and 1％ genipin solution for 24,36 and 48 hours respectively,and the mechanical properties of AM in each group were measured and compared.The hUCMSCs were divided into only hUCMSCs culture group,fresh AM group,crosslinked AM group,gelatin group and crosslinked AM+gelatin group,and the cells were cultured in the corresponding medium.The content of hydroxyproline among the groups was detected with hydroxyproline kit,and proliferation of the cells (absorbance) was assayed by MTT method to evaluate the biological compatibility of crosslinked AM.Results The maximum tensile displacement of the crosslinked-AM by 0.5％ and 1％ genipin was (8.31±0.43)mm and (4.49±0.37)mm respectively,and those after crosslinked with 0.5％ genipin under the 37 ℃ and 45 ℃ for 24 hours was (9.89±1.09)mm and (5.39±0.59)mm,respectively,showing a significant difference between them (t =6.389,P＜0.05).The maximum tensile displacement of the crosslinked-AM was gradually decreased as the lapse of crosslinking time,and an insignificant difference was found among 24,36 and 48 hours after 0.5％ genipin treatment under the 37 ℃ (P＞0.05).The loading force of the crosslinked-AM was significantly higher in the 1％ genipin treated group than that in the 0.5％ genipin treated group (P＜0.05),and the loading force of the AM was significantly increased in 45 ℃,0.5％ genipin,24 hours crosslinked group compared with the 37 ℃,0.5％ genipin,24 hours crosslinked group (t =5.528,P＜0.05).The content of hydroxyproline in the AM was (1.28±0.36),(2.03 ±0.49) and (2.11 ±0.10) mg/g in the 1％ genipin crosslinked AM group,0.5％ genipin crosslinked AM group and fresh AM group,respectively,and the content of hydroxyproline in the AM in the 1％ genipin group was significantly lower than that in the 0.5％ genipin group in the fresh AM group (both at P＜0.05).The proliferative values of the hUCMSCs were significantly lower in the only hUCMSCs culture group,fresh AM group and gelatin group were significantly reduced in comparison with the crosslinked AM group and crosslinked AM+gelatin group (all at P＜0.05).There was no significant difference in the proliferative values of the hUCMSCs between crosslinked AM group and crosslinked AM+gelatin group (P＞0.05).Conclusions Different crosslinked temprature,crosslinking period and concentration of genipin impact the mechanical properties of AM.Crosslinked AM with genipin is feasible as a carrier scaffold of artificial cornea because of less tissue toxicity and better plasticity.
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OBJECTIVE To analyze the value of modified sinus CT score in olfactory function evaluation before and after functional endoscopic sinus surgery in chronic rhinosinusitis with nasal polyps(CRSwNP). METHODS Fifty-four patients who underwent functional endoscopic sinus surgery for CRS with nasal polyps were enrolled in this prospective study by inclusion criteria and exclusion criteria. T&T methods and olfactory function VAS were used to analyze the subjective olfactory function and were performed preoperatively and at 6 months after surgery. In modified sinus CT score, middle turbinate and superior turbinate associated olfactory cleft areas were used to evaluate the anterior olfactory cleft score(AOCS) and posterior olfactory cleft score(POCS). Sinus CT scans Lund-Mackay scores were also collected before surgery. The correlation between the status of the olfactory cleft on CT, Lund-Mackay score and the preoperative and postoperative olfactory results were investigated.RESULTS Among 54 patients, there were 36 male and 18 female, with average age of 47.9 years old(from 24 to 67 years). There were 30 patients followed 6 months after surgery. The findings of olfactory cleft opacification and the CT Lund-Mackay scores had a positive correlation with preoperative olfactory results(P<0.001). The olfactory cleft opacification showed a stronger correlation with the preoperative olfactory results than the CT Lund-Mackay score. The AOCS was more significantly correlated with the postoperative olfactory results than the other parameters.CONCLUSION Preoperative CT findings, especially the anterior portion of the olfactory cleft had a statistically significant association with the postoperative olfactory results in patients with CRS with nasal polyps.
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OBJECTIVE@#To evaluate the prognosis of Draf II b surgery in treating fontal sinus inverted papilloma.@*METHOD@#A retrospective study was carried out among 15 patients diagnosed as fontal sinus inverted papilloma, which had underwent endoscopic Draf II b surgery. The clinical success rate and surgical success rate were calculated by survival analysis.@*RESULT@#In all patients, there were 1 (6.67%) recurrence,1 (6.67%) stenosis, 4 (26.67)% complete closure, and 1 (6.67%) mucocele cyst. The 3-year clinical success rate was 93.3%, and the 3-year surgical success rate was 65.0%.@*CONCLUSION@#Draf II b surgery is feasible when the frontal sinus inverted papilloma is involved in the area of the pupil center line, and the frontal neo-ostium stenosis or complete closure is a common complication after surgery. Thus a close follow-up is recommended during the first year after the surgery. Further study is necessary to find a better way to reduce the complication rate.
Subject(s)
Humans , Constriction, Pathologic , Pathology , Endoscopy , Frontal Sinus , Pathology , Mucocele , Pathology , Nasal Surgical Procedures , Methods , Neoplasm Recurrence, Local , Papilloma, Inverted , General Surgery , Paranasal Sinus Neoplasms , General Surgery , Postoperative Complications , Pathology , Prognosis , Retrospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
[ABSTRACT]OBJECTIVETo evaluate the curative effect of endoscopic sinus surgery from the viewpoint of biomechanics analysis.METHODSWe select one case undergoing nasal endoscopic surgery for chronic sinusitis patients, after half year follow-up and collect preoperative and postoperative spiral CT data to build a numerical model of nasal cavity and paranasal sinuses with computer numerical simulation (CFD) research methods, to explore nasal airflow distribution and flow field characteristics of value changes before and after the operation. Patients undergo subjective assessments: nasal obstruction of VAS score, olfactory VAS score, SNOT-20, objective assessment: Lund Kennedy score, Lund Mackay score, saccharin test time and acquisition clinical efficacy data to verify the credibility of the analysis method is feasible and the results. RESULTSThe nasal resistance after endoscopic sinus surgery in nasal cavity and paranasal sinuses numerical simulation decreased, middle meatus of nose and nasal air flow velocity decreased, the pressure change slightly;nasal threshold region, middle turbinate head end section in maxillary sinus ostium section, after nearly sieve horizontal cross-section average velocity decreased, nasal airflow for the mucosa of the shear stress reduced. The volume of the nasal cavity and the area of the mucosa was increased, the volume ratio was decreased, the subjective and subjective assessment of the patients was improved, and the objective assessment was lighten.CONCLUSIONAerodynamic rules are presented through the calculation of numerical simulation of fluid mechanics which is invisible before. Better understanding of changes in the nasal airflow distribution and the changes of flow field characteristics can be useful to establish nasal endoscopic surgery in numerical analysis of offshore platform,which provides a new research tool for the understanding of the pathophysiology of chronic sinusitis by endoscopic sinus surgery.
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[ABSTRACT]OBJECTIVETo compare the aerodynamic differences before and after nasal cavity ventilation expansion techniques in patients with OSAHS. METHODSA total of 30 adult patients with OSAHS were included in this study. Pre-operative upper airway CT of each subject was acquired. Each subject underwent surgery. Postoperative upper airway CT was obtained at least 3 months later. By means of CFD simulation method, numerical simulation was performed to calculate the airflow dynamic indexes of the upper airway. The pre-and post-operative aerodynamic characteristics were compared. RESULTSAfter operation, post-operative negative pressure nephogram of the nasal cavity indicated more smooth variation of pressure gradient, post-operative velocity nephogram of nasal cavity indicated slower airflow velocity. Proper values of flow field indicated the volume of nasal cavity increased significantly (t=4.025,P<0.01), the total nasal airway resistance decreased significantly (t=-2.065,P<0.01). The total negative pressure of the upper airway decreased significantly (t=-2.659,P<0.01) after operation. However, the proper values of flow field increased in 5 patients. CONCLUSIONNasal cavity ventilation expansion effectively increase the volumes of nasal cavity, improve the nasal ventilation, and reduce the air flow velocity of both nasal cavity and pharynx in OSAHS patients, those reduce the pharyngeal negative pressure and the pharyngeal collapse. However, for patients with its narrowest segment at the velopharyngeal level, operation cannot do anything or even aggravate the pharyngeal collapse. Operation should be performed individually.
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<p><b>BACKGROUND</b>Aberrant epithelial repair has been observed in chronic rhinosinusitis (CRS) patients; however, the mechanism of epithelial cell repair regulation is unclear. Epidermal growth factor (EGF) plays an important role in regulating epithelial cell repair in lower airway and may be a critical factor in the remodeling processes of CRS. The objective of our research is to evaluate the differences between CRS and normal subjects and between chronic rhinosinusitis without nasal polys (CRSsNP) and chronic rhinosinusitis with nasal polys (CRSwNP) in the regulation of EGF pathways and the regulating proliferative position of classic Ras/Raf/MEK/ERK pathways.</p><p><b>METHODS</b>We evaluated the proliferation rates of ethmoidal mucosal cells before and after stimulation with EGF, epidermal growth factor receptor (EGFR) kinase inhibitor AG1478, and extracellular signal-regulated kinase 1/2 (ERK1/2) inhibitor PD98059 using MTT assays. We also analyzed the sinonasal epithelial cells collected from control subjects and patients with CRS subtypes CRSsNP and CRSwNP for the expression of ERK1/2, phosphorylated ERK1/2, P21, P15, and P27 using western blotting analyses.</p><p><b>RESULTS</b>The proliferation rates of sinonasal epithelial cells before and after EGF stimulation were lower in CRS patients than in the controls. AG1478 or PD98059 inhibitor treatment of control epithelial cells did not result in a significant difference in proliferation. Although, AG1478 and PD98059 inhibited the proliferation of CRS cells, the degree of proliferation inhibition was markedly different in CRSsNP. AG1478 suppressed the proliferation of CRSwNP epithelial cells, whereas PD98059 had no effect. The ratio of ERK1/2 phosphorylation in CRS cells was lower than that of the control cells. Cyclin-dependent kinase inhibitors were highly expressed in CRS cells compared with that of control cells. ERK1/2 and P27 showed differential expression in CRSsNP and CRSwNP.</p><p><b>CONCLUSIONS</b>Differences existed in EGF pathways in CRS patients and normal subjects as well as in CRSsNP and CRSwNP. Classical Ras/Raf/MEK/ERK pathway may assume absolute superiority in control cells. Ras/Raf/MEK/ERK classical pathway and other pathways might be active at the same time to stimulate epithelial cell proliferation in CRSsNP. The function of Ras/Raf/MEK/ERK classical pathway was weaker in CRSwNP than in CRSsNP and when the classical pathway was blocked in CRSwNP, some other pathway could have completely compensated the proliferation induced by the Ras/Raf/MEK/ERK pathway.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cell Proliferation , Cells, Cultured , Epidermal Growth Factor , Pharmacology , Epithelial Cells , Cell Biology , Nasal Mucosa , Cell Biology , Sinusitis , MetabolismABSTRACT
Objective To study the rationality in the use of proton pump inhibitors (PPI) to stress ulcer(SU) prophylaxis in pa-tients receiving aseptic-contaminative and contaminative incision operation .Methods A retrospective analysis was performed on the use of PPI to SU ,which taken from surgical patients received aseptic-contaminative and contaminative incision operation and hospi-talized from January 2013 to April 2013 .Results Among 1 745 patients in the study ,540(30 .95% ) received a stress ulcer prophy-laxis with PPI .The rate of prophylaxis to ICU ,general surgery ,urology ,thoracic surgery and neurosurgery was higher than other departments(except for between ICU ,thoracic surgery ,neurosurgery and orthopedic) .A total of 232 patients had risk factors , 72 .41% of the patients who received prophylaxis .A total of 1 513 patients did not have risk factors ,24 .59% of the patients who received prophylaxis ,the rate of prophylaxis to general surgery ,thoracic surgery and urology was higher than other departments (except for ICU ,and between thoracic surgery with orthopedics ) .In prevention of SU ,the usage rate of Lansoprazole was higher than that of Omeprazole and Pantoprazole .Preoperative prophylactic usage rate was 14 .44% .Excessive dosage was 0 .93% .Preven-tive medicine treatment longer accounted for 12 .78% .Conclusion The phenomenon such as non-risk factors ,inappropriate of medi-cation time and long course of treatment are existed ,when physicians use the PPI for SU prophylaxis in surgical patients receiving aseptic-contaminative and contaminative incision operation .Therefore ,treatment recommendations for SU prophylaxis are needed to restrict PPI use for justified indications .
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<p><b>OBJECTIVE</b>To examine the effects of continuous and intermittent exercises on obesity and fatty liver in rats fed with high-fat diet.</p><p><b>METHODS</b>Wistar rats were randomly assigned into routine diet (R) and high-fat diet (H) groups, and each group were subdivided into sedentary group (S), continuous exercise (CE) group, and intermittent exercise (IE) group (n=8). In the CE group, the rats were forced to swim continuously for 90 min once daily, and those in the IE group swam for 30 min for 3 times (at a 4-h interval) daily. Both the CE and IE groups exercised for 5 days a week for 8 consecutive weeks. After the experiment, the retroperitoneal, epididymal, and visceral white and brown adipose tissues, the liver, and the gastrocnemius muscle of the rats were weighed. The lipogenesis rate was determined by incorporation of (3)H(2)0 into saponified lipids, and the blood lipid profiles were analyzed. The body weight and food intake of the rats were recorded daily.</p><p><b>RESULTS</b>IE appeared to be more efficient than CE in reducing the adverse effects of high-fat diet and sedentarism. Compared with CE, IE resulted in an improved lipid profile with reduced food intake, body weight gain, visceral and central adiposity, and fatty liver. The effect of high-fat diet and different exercises on weight gain, adiposity, fatty liver, and lipid profile in rats was associated to the manner of exercise, time of each session, age, gender, and length of observation period.</p><p><b>CONCLUSION</b>Intermittent exercise is an important nonpharmacological strategy to control obesity and the related complications.</p>
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Animals , Male , Rats , Diet, High-Fat , Fatty Liver , Therapeutics , Obesity , Therapeutics , Physical Conditioning, Animal , Methods , Rats, WistarABSTRACT
OBJECTIVE@#To summary the preliminary experience of fat bath-plug technique in endoscopic transnasal approach for repairing anterior skull base cerebrospinal fluid rhinorrhea (CSF) and meningoencephalocele.@*METHOD@#Using fat bath-plug technique repair 1 case meningoencephalocele (traumatic) and 5 cases cerebrospinal fluid rhinorrhea (1 traumatic, 4 spontaneous). The analysis index included: preoperative localization, intraoperative position, surgical procedures, perioperative symptoms, follow-up. etc.@*RESULT@#CT and MRI techniques were used for location of the fistula preoperative. The location of the fistulas were exploration during the operation and were consist with the imaging studies. All 6 fistulas were repaired during the first operation. No fever and no intracranial infection occurred postoperatively. All the patients discharged 7 days postoperatively with an iodoform nasal packing. Three to 4 weeks later the patients were reviewed to clean up the nasal cavity. All patients were recovered well with good epithelial mucosa in the 3 and 6 months endoscopic follow-ups. No CSF leak and intracranial infection happened in the 3-year telephone follow-up.@*CONCLUSION@#The fat bath-plug technique in endoscopic transnasal approach for repairing anterior skull base small fistula, especially in cribriform ethmoid roof, is effective, safe and simple.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Adipose Tissue , General Surgery , Cerebrospinal Fluid Rhinorrhea , General Surgery , Endoscopy , Nasal Cavity , General Surgery , Skull Base , General SurgeryABSTRACT
Objective To evaluate how functional endoscopic sinus surgery(FESS)modifies patients symptom profiles and the quality of life and analyze the influential factors.Methods During 2010 to 2012,90 cases were investigated to evaluate the quality of life of different age groups to use SNOT-20.Results The quality of life after the surgery of different age groups were significantly higher than it before the surgery(P<0.05).The juvenile group:first dimension(nasal congestion,70%),the second dimension (memory,30%),the third dimension(worried about the condition,30%)and the fourth dimension(social influence,40%).The young aged group:first dimension(nasal congestion,73.3%),the fourth dimension(social influence,43.3%),second dimension (quality of sleep,20.0%)and the third dimension(irritability,16.7%).The middle and old aged group:first dimension(nasal con-gestion,66.7%),the third dimension(trepidation,20%),the second dimension(quality of sleep,20.0%)and the fourth dimension (financial burden,40.0%).Preoperative QOL related factors:complications,age,gender,disease duration and urban-rural;Postop-erative QOL related factors:complications,disease duration,age,perioperative management,gender and urban-rural.Conclusion The quality of life of different ages after FESS is improved in different aspects.To increase the level of perioperative compliance can improve the quality of life.
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OBJECTIVE@#Analyzing the prognostic factors in endoscopic surgery of juvenile nasopharyngeal angiofibromas (JNA).@*METHOD@#Forty-seven records of JNA, treated with the endoscopic, from 2002 to 2008 were reviewed retrospectively. Previous surgery in other hospitals, sites involved, whether selective embolization was performed before surgery, feeding vessels, operative techniques and follow-up results were recorded. Evaluated factors include previous surgery for resection of JNA, vascular supply from carotid artery, surgery after selective embolization, involvement of cavernous bone in the root of pterygoid process, greater wing of sphenoid bone, interpterygoid fossa, infratemporal fossa and orbit. Chi-square test was used.@*RESULT@#Operations were done under general anesthesia. The follow-up time was 12 to 87 month (median 35 month). During follow up, six patients presented recurrent lesions. Chi-square test showed that deep invasion of the cavernous bone in the root of pterygoid process was related to recurrence (P<0.05). There was no statistically significant difference between other factors and recurrence. Imaging examination showed that recurrent tumor was around the root of pterygoid process.@*CONCLUSION@#Deep invasion of the cavernous bone in the root of pterygoid process which was related to recurrence deserve close attention before and after endoscopic surgery.
Subject(s)
Adolescent , Adult , Child , Humans , Male , Middle Aged , Young Adult , Angiofibroma , Diagnosis , Pathology , General Surgery , Endoscopy , Nasopharyngeal Neoplasms , Diagnosis , Pathology , General Surgery , Prognosis , Recurrence , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To establish a molecular technique of internal transcribed spacer (ITS) sequencing to identify pathogenic fungi species from the fungal sinusitis tissues. Methods Total 270 sinusitis tissues samples were collected by endoscopic surgery from 2006 to 2008. The histopathology, organize spring clip culturation and ITS region (ITS region region of fungal rRNA, including ITS1-5. 8S rRNA-ITS2) sequencing were employed simultaneously. And then to evaluate the ITS sequencing as the tool for identification of pathogenic fungi directly from clinical samples. Results Of the 270 samples, histopathology positive rate was 80.0% (216/270) , organize spring clip positive rate was 80.0% (216/ 270), fungal culturation positive rate was 53.0% (143/270) , ITS region sequencing positive rate was 63. 0% [ (134 +28 +8)/270], There were 22 species and 6 genera identified by fungal culturation, and 32 species identified by ITS region sequencing. Conclusion ITS region sequencing will become a applicable tool in clinical laboratory in future.
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OBJECTIVE@#To evaluate the effect of resection of frontal ethmoid sinus osteomas with nasal endoscopy.@*METHOD@#Eighteen cases of frontal ethmoid sinus osteoma from 2005 to 2008 were enrolled in our study, including 8 cases of frontal sinus osteomas, 6 cases of ethmoid osteomas and 4 cases of frontal sinus osteomas extending to ethmoid sinus. Seventeen cases were treated by an endoscopic approach alone, and one case treated by a combined endoscopic and an external approach.@*RESULT@#All cases were resected completely without complications. The preoperative symptoms disappeared without recurrence within the follow-up periods, ranging from 6 months to 3 years.@*CONCLUSION@#Most frontal ethmoid sinus osteomas can be resected with nasal endoscopy aided by extra nasal incision in some cases.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Ethmoid Sinus , Frontal Sinus , Osteoma , General Surgery , Paranasal Sinus Neoplasms , General Surgery , Retrospective StudiesABSTRACT
Objective:To evaluate the effect of resection of frontal ethmoid sinus osteomas with nasal endosco-py. Method: Eighteen cases of frontal ethmoid sinus osteoma from 2005 to 2008 were enrolled in our study, including 8 cases of frontal sinus osteomas, 6 cases of ethmoid osteomas and 4 cases of frontal sinus osteomas extending to ethmoid sinus. Seventeen cases were treated by an endoscopic approach alone, and one case treated by a combined endoscopic and an external approach. Result: All cases were resected completely without complications. The preoperative symptoms disappeared without recurrence within the follow-up periods , ranging from 6 months to 3 years. Conclusion: Most frontal ethmoid sinus osteomas can be resected with nasal endoscopy aided by extra nasal incision in some cases.
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OBJECTIVE@#To evaluate the expression of eosinophil major basic protein (MBP) in chronic rhinosinusitis (CRS) and discuss the role of MBP in the pathogenesis in CRS.@*METHOD@#Thirty-eight nasal mucus obtained from CRS patients were used to detect the expression of MBP by Elisa assay. Thirty nasal mucus samples from health people were used as control.@*RESULT@#The expression of MBP of nasal mucus obtained from CRS patients was obviously higher than that of nasal mucus obtained from control. There was significant statistical difference (P < 0.01).@*CONCLUSION@#MBP was involved in the formation of CRS.