Biomechanical Analysis on NiTi Memory Alloy Stent for Lumbar Interbody Fusion / 医用生物力学

Objective To evaluate biomechanical properties of the nickel-titanium (NiTi) memory alloy stent and its in vitro biomechanical properties for lumbar interbody fusion. Methods The mechanical properties of the NiTi memory alloy stent were tested on mechanical testing machine. Moreover, lumbar interbody fusion was simulated on fresh lumbar specimens, and biomechanical properties of the NiTi memory alloy stent with matching bone graft for used for lumbar interbody fusion were analyzed and compared with the traditional box-shape cage. Results The maximum compressive strength of the NiTi memory alloy stent was ( 12 964 ± 962) N. The maximum deformation within the effective range of memory characteristics was (4. 68±0. 03) mm. The recovery rate of the NiTi memory alloy stent was up to 99. 86% . Compared with the intact lumbar model, the stability of the operative segment after the simulated lumbar interbody fusion using NiTi memory alloy stent alone was increased in the direction of anterior flexion, posterior extension, lateral flexion and rotation, which was equivalent to the box shape cage group (P>0. 05). After the combined use of autogenous bone granule and absorbable bone cement the ROM of the operative segment was further reduced (P0. 05). The pull-out strength of the NiTi memory alloy stent with matching bone graft group was significantly stronger than that of the box-shape cage group (P<0. 05). Conclusions The NiTi memory alloy stent in this study was designed with a matched bone granule-absorbable bone cement graft,which provided a new idea for the further optimization and development of lumbar interbody fusion. With excellent support and deformation properties, this NiTi memory alloy stent is biomechanical equivalent to the traditional box shape cage for lumbar interbody fusion, and can greatly improve the stability of surgical segment and the pull-out strength of implants after the combined use of autogenous bone granule and absorbable bone cement.

Effect of traditional Chinese medicine on portal vein thrombosis in patients with liver cirrhosis and its medication characteristics / 临床肝胆病杂志

Objective To investigate the therapeutic effect of traditional Chinese medicine (TCM) on portal vein thrombosis (PVT) in patients with liver cirrhosis and its medication characteristics. Methods A retrospective analysis was performed for 89 patients with liver cirrhosis and PVT who were hospitalized and treated in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and according to whether TCM treatment was applied in combination, they were divided into TCM group with 59 patients and control group with 30 patients. Related data were collected for the two groups, including demographic data, laboratory examination, radiological examination, gastroscopy, history of surgery, portal hypertension-related complications, medication, and follow-up data. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. An ordinal polytomous Logistic regression analysis was used for multivariate analysis. TCM Inheritance Computing Platform (V3.0) was used to perform a drug effect cluster analysis of TCM prescriptions. Results The multivariate logistic regression analysis showed that esophageal and gastric varices (odds ratio [ OR ]=3.144, 95% confidence interval [ CI ]: 1.221-8.094), PVT involving the portal vein (PV) and the superior mesenteric vein (SMV) ( OR =51.667, 95% CI : 3.536-754.859), PVT involving PV+spleen vein (SV)+SMV ( OR =13.271, 95% CI : 2.290-76.928), cavernous transformation of the portal vein ( OR =11.896, 95% CI : 1.172-120.696), and TCM intervention ( OR =0.348, 95% CI : 0.129-0.938) were influencing factors for the outcome of PVT in liver cirrhosis. Follow-up results showed that compared with the control group, the TCM group had a significantly lower progression rate (16.95% vs 56.67%, P < 0.001) and a significantly lower incidence rate of variceal rupture and bleeding (8.47% vs 33.33%, P < 0.001). Effective TCM drugs with a relatively high frequency of use included deficiency-tonifying drugs (359 times, 34.6%), blood-activating and stasis-resolving drugs (202 times, 19.5%), and diuresis-inducing and dampness-draining drugs (180 times, 17.3%); the TCM drugs with a relatively high frequency of use included Astragalus membranaceus (57 times, 8.7%), Angelica sinensis (50 times, 7.6%), and leech (48 times, 7.3%); TCM drug combinations with a relatively high frequency of use included Astragalus membranaceus+Angelica sinensis, Astragalus membranaceus+leech, Angelica sinensis+leech, and Astragalus membranaceus+Angelica sinensis+leech. Conclusion Qi-tonifying, blood-activating, and stasis-breaking drugs, such as Astragalus membranaceus, Angelica sinensis, and leech, can promote the stabilization or recanalization of PVT in liver cirrhosis and reduce the incidence rate of bleeding events due to portal hypertension.

Integrated traditional Chinese and Western medicine diagnosis and treatment of liver cirrhosis with diabetes / 临床肝胆病杂志

Hepatogenous diabetes (HD) is a common complication of liver cirrhosis and can reduce survival rate and increase the risk of other complications. It differs from type 2 diabetes in terms of etiology, pathogenesis, and diagnostic methods. There are currently no guidelines for HD treatment in China and globally. Although the understanding of HD in traditional Chinese medicine is gradually deepened, no consensus has been reached on its etiology, pathogenesis, and syndrome differentiation. This article reviews the traditional Chinese and Western medicine research on HD in recent years, so as to provide a reference for clinicians to develop individualized traditional Chinese and Western medicine diagnosis and treatment strategies.

Efficacy of open-door laminoplasty for cervical hyperextension injury accompanied with or without spinal cord-canal mismatch / 中华创伤杂志

Objective:To explore the clinical efficacy of open-door laminoplasty in treatment of cervical spinal hyperextension injury accompanied with or without spinal cord-canal mismatch.Methods:A retrospective case-control study was performed to analyze the clinical data of 42 patients with cervical spine hyperextension in Shanghai Ninth People’s Hospital，Shanghai Jiaotong University School of Medicine from January 2016 to June 2019. There were 31 males and 11 females at age range of 40-78 years［（59.7 ± 9.9）years］. All patients underwent open-door laminoplasty.Preoperative Japanese Orthopaedic Association score（JOA）was（10.2 ± 3.8）points，and American Spinal Injury Association（ASIA）spinal cord injury score was（260.4 ± 47.5）points. Those with spinal cord occupation rate（SCOR）equal to or more than 70% were classified as spinal cord-canal mismatched group（n=21），and those with SCOR less than 70% were classified as spinal cord-canal matched group（n=21）. ASIA total score，ASIA upper and lower limb motor scores，ASIA sensory score，JOA score，surgical improvement rates and complications were compared between the two groups before operation，at postoperative one week and at the latest follow-up.Results:All patients were followed up for 12-26 months［（19.1 ± 2.3）months］. Both groups had significantly improved ASIA total score at postoperative one week and at the latest follow-up，compared with that before operation（ P < 0.05）. The two groups showed no significant difference in ASIA total score at postoperative one week（ P > 0.05）. ASIA total score in unmatched group was（307.6 ± 9.9）points at the latest follow-up，significantly lower than that in matched group［（315.4 ± 8.7）points］（ P < 0.01）. ASIA upper limb motor score in mismatched group was（29.1 ± 7.0）points and（36.6 ± 6.5）points at postoperative one week and at the latest follow-up，significantly lower than that in matched group［（42.0 ± 5.7）points，（47.4 ± 2.5）points］（ P < 0.01），while there was no significant difference in ASIA lower limb motor score and sensory score between the two groups（ P > 0.05）. Both groups showed significantly improved JOA score at postoperative one week and at the latest follow-up，compared with that before operation（ P < 0.05）. JOA score in mismatched group was（11.5 ± 3.0）points and（12.5 ± 3.0）points at postoperative one week and at the latest follow-up，significantly lower than that in matched group［（13.5 ± 2.4）points，（15.0 ± 2.0）points］（ P < 0.01）. Postoperative improvement rate in matched group was 95%（20/21），and was 85%（18/21）in mismatched group（ P < 0.05）. Cervical axial pain occurred in 3 patients in each group and C 5 nerve root palsy in 2 patients in matched group，all of which were relieved after conservative treatment. No implant loosening or breakage occurred during follow-up. Conclusions:Open-door laminoplasty can improve part of the nerve function of patients with cervical hyperextension injury. However，the overall improvement degree of nerve function especially recovery of upper limb motor function in patients with spinal cord-canal mismatch is inferior to those in spinal cord-canal matched patients.

Effect of glucagon-like peptide-1 receptor agonist in treatment of nonalcoholic fatty liver disease and related mechanism / 临床肝胆病杂志

The incidence rate of nonalcoholic fatty liver disease (NAFLD) continues to rise around the world, and due to its complex pathogenesis, there is still a lack of effective treatment drugs. If NAFLD is not treated in time, it may increase the risk of related metabolic diseases such as diabetes and hyperlipidemia and even lead to liver fibrosis and liver cirrhosis. Glucagon-like peptide-1 is a hormone secreted by L-shaped cells of the small intestine and can regulate glucose-dependent stimulation of insulin secretion, reduce gastric emptying, and inhibit food intake. This article reviews the effect of glucagon-like peptide-1 receptor agonist in the treatment of NAFLD and related mechanism.

Finite Element Analysis of Lumbar Interbody Fusion with Stent-Bone Granule-Absorbable Bone Cement / 医用生物力学

Objective To evaluate the biomechanical properties of lumbar interbody fusion with NiTi memory alloy stent-autogenous bone granule-absorbable bone cement. Methods The normal L3-5 segment finite element model (M0), L4-5 intervertebral fusion model with box fusion cage (M1), L4-5 intervertebral fusion model with NiTi memory alloy stent (M2) and L4-5 interbody fusion model with bone granule-absorbable bone cement for casting bone graft (M3) were constructed, respectively. The models were applied with mechanical loading to analyze the mechanical stability and the peak stress of L4 interior endplate. Results The range of motion (ROM) of L4-5 segment in M1 and M2 models was significantly lower than that of M0 model under flexion, extension, lateral flexion and axial rotation. In M3 model, the stability of the surgical segment was further improved and the peak stress of L4 interior endplate was much smaller than that of M1 and M2 models. Conclusions NiTi memory alloy stent and traditional box fusion cage have biomechanical equivalence when used alone in lumbar interbody fusion, and application of bone granule-absorbable bone cement for casting bone graft can further improve the stability and reduce the stress of endplate.

Clinical effect of Fuzheng Huayu tablets combined with entecavir in the treatment of chronic hepatitis B liver fibrosis / 临床肝胆病杂志

ObjectiveTo investigate the efficacy and safety of Fuzheng Huayu tablets (FZHY) combined with entecavir (ETV) in the treatment of chronic hepatitis B (CHB) liver fibrosis. MethodsA total of 52 patients with CHB liver fibrosis with an Ishak stage of ≥F3 who were treated in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine and Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from April 2011 to January 2013 were enrolled and divided into FZHY combined with ETV group (combination group) and placebo combined with ETV group (control group), with 26 patients in each group, and the course of treatment was 48 weeks for both groups. Liver biopsy was performed before and after these treatment; clinical outcome was determined based on the reversal rate of Ishak stage for liver fibrosis and the improvement rate of histological activity index (HAI) for inflammation grade, and safety was evaluated based on electrocardiographic findings. Three datasets (full analysis set, per-protocol set, and safety dataset) were identified for analysis; the t-test or the Wilcoxon test was used for comparison of continuous data between two groups, and the CMH chi-square test, the chi-square test, or the Fisher’s exact test was used for comparison of categorical data between groups. ResultsOf all 52 patients, 46 underwent the two liver biopsies before and after treatment, with 22 in the combination group and 24 in the control group. At week 48 of treatment, there was a significant difference in the proportion of patients with Ishak stage reduced by ≥1 stage between the combination group and the control group (81.8% vs 54.2%, χ2=5.297, P=0.021). There was also a significant difference in the improvement rate of HAI grade between the combination group and the control group were (59.1% vs 25.0%, χ2=6.822, P=0.009). There were no significant differences between the two groups in the incidence rates of adverse events and serious adverse events, the safety analysis of vital signs, and laboratory safety indicators (all P＞0.05). ConclusionFZHY combined with ETV has significant advantages over ETV alone in improving liver fibrosis and inflammation, and antiviral therapy combined with anti-fibrosis therapy can bring better hepatic histological improvement for CHB patients. FZHY combined with ETV has good safety in the treatment of patients with CHB liver fibrosis.

Chinese Society of Allergy and Chinese Society of Otorhinolaryngology-Head and Neck Surgery Guideline for Chronic Rhinosinusitis

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.

Research progress of cirrhosis with portal vein thrombosis / 中华肝脏病杂志

Portal vein thrombosis refers to the formation of a thrombus in the trunk of the portal vein and /or its branches due to various causes, and is one of the common complications of cirrhosis. Synthesizing the existing evidence, this paper summaries the cirrhosis with portal vein thrombosis in terms of epidemiology, etiology, pathophysiology, risk factors, definition and classification, clinical manifestations and complications, diagnosis and screening, treatment, follow-up and prognosis, prospects and problems.

Effects of endogenous glucocorticoid deprivation on immune response of allergic rhinitis in mice / 中华耳鼻咽喉头颈外科杂志

Objective@#To study the effect of dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis on the pathogenesis of allergic rhinitis (AR) by the mouse model of decreased endogenous glucocorticoid (GC) after adrenalectomy, and further explore the mechanism of neural-endocrine regulation.@*Methods@#According to literatures, adrenalectomized (ADX) mice and AR model were established. Eighty mice were randomly divided into four groups (n=20 per group) including control group, AR group of normal mice (AR group), AR group of bilateral ADX (bilateral ADX/AR group) and AR group of unilateral ADX (unilateral ADX/AR group). In order to assess the model of ADX, adrenal gland tissue was assayed by HE staining and the plasma adrenocorticotropic hormone (ACTH) and cortisol (CORT) concentrations were measured by enzyme-linked immunosorbent assay (ELISA). The behavioral observation, OVA-sIgE assessments and count of eosinophils/mast cells by the HE/Toluidine Blue staining of nasal septum mucosa tissue were performed to evaluate the AR model. The expression of peripheral blood CD4+ IL4+ T cells (Th2 cells) and CD4+ IFN-γ+ T cells (Th1 cells), splenocytes of CD4+ CD25+ Treg cells (Treg cells) were measured by flow cytometry to study the influence of endogenous GC on immunological indexes in different groups of mice. SPSS 16.0 software was used to analyze the data.@*Results@#The concentrations of OVA-sIgE in control group, AR group, bilateral ADX/AR group and unilateral ADX/AR group mice were (28.86±3.62) ng/ml, (76.27±16.47) ng/ml, (48.37±8.89) ng/ml, (49.86±7.19) ng/ml, respectively. There was statistically significant difference between control group and AR group (t=7.09, P<0.05), AR group and bilateral ADX/AR group (t=4.81, P<0.05), AR group and unilateral ADX/AR group (t=5.21, P<0.05). The level of Th2 cells in different four groups were (0.71±0.24)%, (7.03±1.95)%, (2.44±2.06)%, (3.20±1.21)%, respectively. There was statistically significant difference between control group and AR group (t=-2.93, P<0.05), AR group and bilateral ADX/AR group (t=-4.67, P<0.05), AR group and unilateral ADX/AR group (t=-3.61, P<0.05). The expression of Th2 in bilateral ADX/AR group is lower than that in unilateral ADX/AR group without significant difference (t=4.39, P>0.05). Meanwhile, the level of Th1 cells in different four groups was (0.58±0.76)%, (0.57±0.59)%, (0.72±0.34)%, (1.03±0.32)%, respectively, with no significant difference among these groups. The proportion of Treg cells was (11.10±2.18)%, (4.10±1.07)%, (7.15±0.92)%, (4.58±1.05)%, respectively, with significant difference between control and other groups (t value was -7.171, -8.273, -8.360, respectively, all P<0.05). Compared with AR group, Treg cells increased significantly in bilateral ADX/AR group (t=-2.607, P<0.05). In addition, lower expression of eosinophil and mast cell were detected in the local nasal tissue of bilateral ADX/AR group, and mast cell degranulation wasn′t be observed.@*Conclusion@#Unilateral or bilateral ADX leads to HPA axis dysfunction and endogenous GC deprivation, possibly regulating the mechanism of AR through Th1/Th2 immune bias and Tregs cell′ activity.

Effect of Fuzheng Huayu capsules on survival rate of patients with liver cirrhosis / 中华肝脏病杂志

Objective@#To investigate the effect of Fuzheng Huayu capsules on the survival rate of patients with liver cirrhosis.@*Methods@#A retrospective analysis was performed for the clinical data of the patients with various types of liver cirrhosis who were hospitalized in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1, 2006 to December 31, 2008. The data collected for these patients included their basic information, diagnosis and treatment, and results of laboratory examination. The Kaplan-Meier method was used to analyze the effect of Fuzheng Huayu capsules on the survival rate of patients with liver cancer. The starting point of observation was the first day of the patient’s admission and the ending point of follow-up observation was the date of death or the end of follow-up April 1, 2014. The cut-off value was obtained if the patient did not experience any outcome event (death) at the end of follow-up. With reference to the outcome, the time when the outcome occurred, and the cut-off value, the life-table method was used to calculate survival rates and survival curves were plotted. The Kaplan-Meier product-limit method was used to calculate the arithmetic mean of survival time and median survival time, and the log-rank test was used to compare the survival data.@*Results@#A total of 430 patients with liver cirrhosis were enrolled, among whom 191 died and 239 survived or were censored. The average constituent ratio of death was 55.6% and the average constituent ratio of survival was 44.4%. The life-table method showed that the half-, 1-, 2-, and 5-year survival rates were 70%, 64%, 58%, and 48%, respectively. The median survival time was 112.1 weeks for the patients who did not take Fuzheng Huayu capsules and 351.6 weeks for those who did, and there was a significant difference in survival rate between the two groups (P = 0.000). Among 313 patients who had an etiology of hepatitis B, 164 did not take Fuzheng Huayu capsules and had a median survival time of 195.9 weeks and a 5-year survival rate of 44%, and 149 took Fuzheng Huayu capsules and had a median survival time of 336.9 weeks and a 5-year survival rate of 59%; there was a significant difference in survival rate between the two groups (P = 0.038). Among 117 patients who did not have hepatitis B, 68 did not take Fuzheng Huayu capsules and had a median survival time of 78.1 weeks and a 5-year survival rate of 32%, and 49 took Fuzheng Huayu capsules and had a median survival time of 277.4 weeks and a 5-year survival rate of 53%; there was a significant difference in survival rate between the two groups (P = 0.013). Among 92 patients with compensated liver cirrhosis, 47 did not take Fuzheng Huayu capsules and had a 5-year survival rate of 65%, and 45 took Fuzheng Huayu capsules and had a 5-year survival rate of 82%; both groups of patients had a median survival of 440 weeks; there was a significant difference in survival rate between the two groups (P = 0.027). Among 338 patients with decompensated liver cirrhosis, 185 did not take Fuzheng Huayu capsules and had a median survival time of 60.3 weeks and a 5-year survival rate of 33%, and 153 took Fuzheng Huayu capsules and had a median survival time of 267.7 weeks and a 5-year survival rate of 51%; there was a significant difference in survival rate between the two groups (P = 0.001).@*Conclusion@#Fuzheng Huayu capsules can improve the prognosis of patients with liver cirrhosis and increase their survival rates and have good long-term efficacy.

Endoscopic removal of a dental foreign body from maxillary sinus via anterior prelacrimal recess approach: a case report / 临床耳鼻咽喉头颈外科杂志

We present a rare case of dental foreign body from maxillary sinus in a 21-year woman who was hospitalized because of oral cavity and nasal sinus leak for 3 months when doing cheek-bulging action. Admission diagnosis :dental maxillary sinus"foreign body" (left); chronic maxillary sinusitis (left). Computed tomographic scan showed irregular high density shadow in the left maxillary sinus. The "foreign body" was removed via anteri- or prelacrimal recess approach, which was supposed to be the iatrogenic foreign body - alveolar bone.

Analysis of cage migration after lumbar interbody fusion and Revision strategies / 中华骨科杂志

Objective To investigate cause analysis and treatment strategy of cage migration after lumbar interbody fusion.Methods Retrospective study was performed on 9 cases with cage migration after lumbar interbody fusion from January 2009 to February 2015 in our hospital.There were 4 males and 5 females,and mean age was 61.6 years (rang,38-75 years).The types of cage included Titanium metal cage used in 3 cases,cylindrical thread cage in 1 case and PEEK cage in the other cases.Bilateral instrumented posterior lumbar interbody fusion was found in 7 cases,and unilateral fixation in 2 cases.Analyze the risk factors of cage migration and the strategies of revision surgery,and evaluate the radiological outcomes and clinical efficacy of revision surgery.Results Risk factors of cage backward migration are as follows:nucleus pulposus left too much in 6 cases,poor cartilage endplate resection in 4 cases,small size of cage selection in 5 cases,unsatisfied cage placement in 2 cases,and improper operation in 1 case.Follow-up survey was fulfilled in all patients,the follow-up time was 6 to 32 months,and bony union was detected in all patients.No cage re-migration,non-fusion,or loosen pedicle screw was found during follow-up period.Clinical symptoms were all improved after revision.Conclusion The causes of cage migration after bilateral or unilateral instrumented transforaminal lumbar interbody fusion were complicated.Risk factors of cage migration may be poor intervertebral space preparation,small cage size,and improper cage placement,which may be not associated with unilateral fixation.Excellent or good radiological outcomes and clinical efficacy depend on a reasonable revision surgery.

An in vitro study on substance P-stimulated neuro-immune mechanism of mast cell degranulation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The goal of this study was to study the mechanism of substance P (SP)-mediated the neural control of mast cell (MC) degranulation.@*METHOD@#Bone marrow mast cells from mice were cultured with stem cell factor (SCF), IL-3 and IL-4 (group A) and SCF, IL-3 (group B) for four weeks. Then the cells were harvested and reserved for studies. Western Blot hybridization technique was used to detect the expression of FcεR I α and NK-1R on MCs from the two groups. Then such cells were activated with SP (0, 0. 01, 0. 10, 1. 00, 10. 00 µg/ml, respectively) for 30 min. The histamine released into the supernatant and stored in the protoplasm was quantified by enzyme linked immunosorbent assay (ELISA). And the percentage of histamine release was calculated as a percent of total histamine content.@*RESULT@#The expressions of FcεR I α and NK-1R on these mast cells in group A were statistically higher than in group B (P<0. 05). The MCs from two groups can be actived when stimulated by SP, but the level of MC degranulation in group A was higher than group B (P<0. 05).@*CONCLUSION@#Neuropeptide may stimulate MC degranulation through immunological and non-immunological pathways. In summary, the current study provides us with better understanding of the mechanism of neuropeptide-controlled MC deranulation, and this should be helpful for the further research involved in the mechanism and treatmemt of airway hyper-reactivity.

A case report of endoscopic assisted unilateral infraorbital nerve decompression / 临床耳鼻咽喉头颈外科杂志

Patients of infraorbital nerve injury often appear in the sensory abnormalities of corresponding position, such as numbness or pain. We present a case with numbness of the left cheek because of the injury. The patient were treated by endoscopic assisted on the left infraorbital nerve decompression through the approach of the canine fossa. The symptom shows improvement after the operation. The patient feels numbness significantly ease on 4 months after the operation.

Application of endoscopic nasal lateral wall dissection in lesions of the maxillary sinus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the application of endoscopic nasal lateral wall dissection in lesions of the maxillary sinus.@*METHOD@#Ten hospitalized patients with the maxillary sinus lesions were treated with the endoscopic nasal lateral wall dissection.@*RESULT@#All 10 patients were unilateral invasion. Among them, 7 cases were inverted papilloma, 2 cases were recurrent antrochoanal polyps, 1 case was sinusal tooth. The tumors and antrochoanal polyps originated from the every part of the maxillary sinus wall during operation, especially from the anterior and media wall. During 10-62 months follow-up,epithelization of nasal occured and the shape of inferior turbinate was well. All of them had no epiphora.@*CONCLUSION@#Endoscopic nasal lateral wall dissection can remain the function of nasal lacrimal duct and nasal cavity,and may provide a new minimally invasive approach for complete resection of lesions of nasal cavity and the maxillary sinus.

Dynamic observation on the short-term change of xerostomia after intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To dynamically analyze the change of xerostomia in patients with nasopharyngeal carcinoma after radiotherapy by DW MRI.</p><p><b>METHODS</b>Twenty-three nasopharyngeal carcinoma patients confirmed by pathology were enrolled. Male/Female: 19/4. The age was from 37 to 69 years. The patients were divided into two groups: G1, Dmean<26 Gy, G2, Dmean ≥ 26 Gy. All patients underwent salivary glands examination by DW MRI before IMRT, at the end of IMRT, 6 months and 12 months after IMRT, at the same time the ADC value of salivary glands were calculated. According to the RTOG/EORTC salivary gland injury grading standard and referring the subjective index, the degree of xerostomia was assessed. SPSS 13.0 and SAS 8.2 software were used to analyze the data.</p><p><b>RESULTS</b>At the end of IMRT, the change tendency of ADC in parotid and submandibular glands value was different in patients with different degree of xerostomia (F = 11.52, P < 0.01). At the end of IMRT, a significant difference for degree of xerostomia could be found in patients within different irradiation dose groups (Z = -3.622, P < 0.01). Clinical stage, treatment mode and age had no significant effect on the degree of xerostomia for patients at the end of IMRT (Z value was -0.791, -0.949, 2.488, all P > 0.05). A significant difference of xerostomia degree in patients was found at the various follow-up time after IMRT (χ(2) = 19.59, P < 0.01).</p><p><b>CONCLUSIONS</b>There is good correlation between the function of salivary gland and subjective rating of xerostomia in patients with nasopharyngeal carcinoma after radiotherapy. The degrees of salivary gland function and dry mouth in patients with nasopharyngeal carcinoma damage evaluate with illuminated dose increases. The function of salivary gland gradually restored and the degree of dry mouth gradually reduce with the extension of time after radiotherapy.</p>

Study on DWMRI in evaluating the influence of intensity modulated radiotherapy on salivary gland function of nasopharyngeal carcinoma patients / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the dynamic change of salivary gland function in patients with nasopharyngeal carcinoma (NPC) before and after intensity modulated radiotherapy (IMRT) by DWMRI.</p><p><b>METHODS</b>Twenty-three NPC patients confirmed by pathology were enrolled. Male/Female: 19/4. The age was from 37 to 69 years. All cases underwent salivary glands examination by DWMRI before IMRT, at the end of IMRT, 6 months and 12 months after IMRT, at the same time the ADC value of salivary glands were calculated. The patients were divided into two groups: G1, Dmean < 26 Gy, G2, Dmean ≥ 26 Gy. SPSS 13.0 and SAS 8.2 software was used to analyze the date.</p><p><b>RESULTS</b>The ADC values of parotid in two group patients at rest were not significantly different between 6 months after and at the end of IMRT (t value was 0.732, 1.405, all P > 0.05). The ADC values of parotid in two group patients at rest were significantly lower in the 12 months after IMRT than at the end of IMRT (t value 2.621, 3.417, all P < 0.05). During the period of acid stimulation, A significant change of ADC in parotid was found in G1 (all P < 0.05) and no significant change of ADC in parotid was found in G2 at the various follow-up time after IMRT (all P > 0.05). At the various follow-up time after IMRT, the average ADC values of parotid were significantly higher in G2 than G1 in the same time points of acid stimulation (all P < 0.05). The ADC values of submandibular glands at rest were significantly higher at the various follow-up time after IMRT than before IMRT (t value was -9.782, -8.963, -7.722, all P < 0.05). During the period of acid stimulation no significant change of ADC in submandibular glands was found after IMRT (F = 1.124, P = -0.348).</p><p><b>CONCLUSIONS</b>The changes of salivary function can be well reflected by ADC values. There is a good clinical application value of DWMRI for evaluating radiation-induced salivary glands functional changes and observing salivary function recovery during the follow-up period after IMRT.</p>

A preliminary study on the role of substance P in histamine-nasal-spray-induced allergic conjunctivitis in guinea pigs / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of the non adrenergic non cholinergic nerve (NANC) and substance P (SP) in allergic rhinoconjunctivitis by observing histamine nasal provocation induced conjunctivitis in guinea pigs.</p><p><b>METHODS</b>Forty male guinea pigs were randomly divided into five groups with each group consisting of eight guinea pigs. All anesthetized guinea pigs were exposed either to histamine (0.2%, 5 µl) (group B~E) or saline (5 µl, group A) via unilateral nostril. No pretreatment was done in group A and B while pretreatment was done in groups C~E through injection into the unilateral common carotid artery with cholinergic nerve inhibitor (atropine, 1 mg/kg, group C), cholinergic nerve inhibitor plus adrenergic nerve inhibitors (atropine, 1 mg/kg, phentolamine, 1 mg/kg plus Esmolol, 1 mg/kg, group D) and cholinergic nerve inhibitor, adrenergic nerve inhibitors plus SP receptor antagonist (the same treatment with group D plus D-SP 10(-6) mol/L, 1 µl/g, group E), respectively. To assess the ipsilateral conjunctival inflammatory reaction, conjunctiva leakage with Evans blue dye assessments and HE staining of conjunctival tissues were performed. The SP expression in ipsilateral conjunctival tissue in different groups of guinea pigs were assessed by immunofluorescence and RT-PCR. The activity of eosinophils was assessed by eosinophil major basic protein 1 (MBP1) with RT-PCR, meanwhile, the activity of mast cells was assessed by tryptase with RT-PCR. SPSS 17.0 software was used to analyze the data.</p><p><b>RESULTS</b>At 30 min after nasal application of histamine, ipsilateral conjunctivitis was successfully induced as shown by the change of conjunctiva leakage and histology. The content of Evans blue in ipsilateral conjunctival tissue of group A~E was (13.78 ± 2.48), (29.62 ± 3.31), (19.03 ± 1.47), (18.42 ± 2.52), (14.83 ± 2.14) µg/ml, respectively. There was statistically significant difference between group A and B (t = -10.66, P < 0.05), group B and C (t = 7.97, P < 0.05), group C and E (t = 4.51, P < 0.05). PT-PCR assays showed the relative expression of SP mRNA in ipsilateral conjunctival tissues of group A~E was (1.00 ± 0.04), (1.61 ± 0.09), (1.26 ± 0.03), (1.27 ± 0.06), (1.08 ± 0.05), respectively. There was statistically significant difference between group A and B (t = -22.04, P < 0.05), group B and C (t = 12.93, P < 0.05), group C and E (t = 11.85, P < 0.05). The expression of tryptase of ipsilateral conjunctiva was (1.00 ± 0.01), (1.01 ± 0.05), (1.02 ± 0.17), (1.00 ± 0.14), (1.01 ± 0.20), and the expression of MBP1 was (1.00 ± 0.03), (1.02 ± 0.15), (0.94 ± 0.08), (1.01 ± 0.07), (0.98 ± 0.13) in A~E groups. There was not statistically significant difference among five groups (F value was 1.93, 0.57, both P > 0.05).</p><p><b>CONCLUSIONS</b>Histamine nasal provocation induced allergic inflammatory response of ipsilateral conjunctiva in guinea pigs. Neural factors including NANC nerves and its medium SP participated this nose-ocular reflex process. These data help to develop a more scientific clinical treatment strategy.</p>

Analysis on the elements of teaching ability in the field of traumatology and orthopedics of TCM / 中华医学教育探索杂志

Teaching ability is the comprehensive embodiment of expertise and personal cultivation,and it is closely related to teaching results.The teaching ability of teachers in the field of traumatology and orthopedics of TCM is developed in their practice of clinical work and teaching practice,which reflects the efficiency and quality of their classroom teaching and clinical teaching.The elements of teaching ability in the field of traumatology and orthopedics of TCM should be strengthened by approaches such as professionalism,the ability of teaching design,the expertise of modem educational technology and professional dedication.