Severe Streptococcus pneumoniae-associated red blood cell T-polyagglutination and plasma exchange strategy / 中国输血杂志

【Objective】 To identify and propose blood transfusion suggestions for 3 children suspected to have red blood cell T polyagglutination. 【Methods】 According to the RBC reactions with phytohemagglutinin, adult serum and cord blood serum, aggregation test with polybrene reagent and MN antigen phenotype test were carried out on 3 children to confirm the presence of T polyagglutination. The donor serum with negative or weak reactions was selected by minor cross matching for the 3 children who needed therapeutic plasma exchange(TPE). 【Results】 Three cases of RBC T polyagglutination were caused by bacterial infection, with transient appearance of MN antigen; the samples were reactive to peanut agglutinin, soybean agglutinin, adult serum but nonreactive to cord blood serum, and didn′t aggregate after adding polybrene reagent. After receiving timely TPE, the T polyagglutination gradually disappeared. 【Conclusion】 Some bacteria, such as Streptococcus pneumoniae, may cause polyagglutination of red blood cells. The patients with suspected T polyagglutination should be diagnosed in time. For T polyagglutination patients, the minor matched plasma should be used for avoiding the random plasma with anti-T antibody transfusion.

Drug treatment of laryngeal granuloma after hypothermic plasma radiofrequency surgery for early glottic carcinoma / 中国医师进修杂志

Objective:to investigate the efficacy of drugs in the treatment of laryngeal granuloma after hypothermic plasma radiofrequency surgery in early glottic carcinoma.Methods:Thirty-two cases of laryngeal granulomacoming from 289 patients with early glottic carcinoma treated by plasma radiofrequency surgery under endoscope-supported laryngoscopefrom January 2011 to January 2021 in Dalian Municipal Central Hospital were enrolled. All patients were given oral treatment of zinc gluconate tablets (70 grams per tablet, containing 10 grams of zinc). The usage was 3 tablets each time, twice a day. If the granulation was located in the vocal cord, 20 mg of esomeprazolec was added twice a day, and taken orally on an empty stomach. The total course of treatment was 6-12 weeks.Results:Follow-up and reexamination of electronic laryngoscope showed that the granulation of all patients began to become smaller after 3 weeks of drug treatment and gradually disappeared after 6-12 weeks. After the granulation disappeared, the drug was stopped, and there was no recurrence.Two patients developed nausea and epigastric discomfort after oral administration of zinc gluconate tablets for 3 weeks, and the discomfort disappeared after reducing the dose.Conclusions:Oral administration of zinc gluconate tablets alone or in combination with esomeprazoleis an effective, safe and low recurrence method for laryngeal granuloma after hypothermic plasma radiofrequency ablation in early glottic carcinoma.

Application value of flexible endoscopic examination of swallowing in acute stroke patients with dysphagia / 中国医师进修杂志

Objective:To study the application value of flexible endoscopic examination of swallowing(FEES) for the aspiration screening, the diagnosis of dysphagia and evaluation of the therapeutic effectin acute stroke patients with dysphagia.Methods:Three hundred and seventy-three patients with acute stroke who hospitalized from October 2015 to January 2020 in Dalian Municipal Central Hospital Affiliated of Dalian Medical University and underwent FEES for analyzing the characteristic performance were enrolled, and 11 cases of them were examined by video fluoroscopic swallowing study (VFSS). The results of the reliability of diagnosis dysphagia of the two methods were compared. The results of FEES for assessing the recovery effect after treatment were evaluated.Results:In 373 patients, the FEES revealed 268 cases(71.85%) of aspiration (99 cases) were recessive aspiration, which was better than that in water swallow test (50.94%, 190/373). Patients with potential cricopharyngeus achalasia got the same results through both of VFSS and FEES. FEES could provide more positive indicators and guide clinical rehabilitation treatment and objective assessment of rehabilitation effectiveness.Conclusions:Acute stroke patients with dysphagia have characteristic laryngeal performance. FEES is simple to operate and has high application value.

Effect of cognitive rehabilitation training assisted by hearing on patients with hearing loss and dementia / 中国医师进修杂志

Objective:To investigate the clinical effect of hearing aid combined with cognitive rehabilitation training in the treatment of dementia with hearing loss.Methods:Forty-six cases of dementia patients with hearing loss in Dalian Municipal Central Hospital Affiliated of Dalian Medical University from September 2019 to September 2020 were divided into two groups by random number table method. The treatment group received cognitive rehabilitation training assisted by sound amplifier, while the control group only received cognitive rehabilitation training for 7 weeks. Before and after treatment, questionnaires were used to evaluate the training effect of patients, including MMSE, HAMA, HAMD and ADL, and satisfaction questionnaire was used to evaluate the satisfaction of caregivers.Results:After treatment, the MMSE score of the treatment group was significantly higher than that of the control group: (20.22 ± 3.38) scores vs. (19.89 ± 3.10) scores ( P<0.05), and HAMA and HAMD were significantly lower than those of the control group: (11.43 ± 5.07) scores vs. (11.83 ± 4.79) scores, (8.39±3.37) scores vs. (9.67 ± 5.34) scores ( P<0.05); there was no difference in activities of daily living between the treatment group and the control group ( P>0.05); the caregiver satisfaction of the treatment group was significantly improved, compared with that of the control group ( P<0.05). Conclusions:Hearing assisted cognitive training can improve the cognitive function of patients with hearing-impaired dementia, promote mental and emotional stability, and improve the feelings of caregivers; we emphasize the importance of hearing evaluation for the elderly with dementia, and the importance of cognitive rehabilitation training with hearing assistance.

Application of individualized selection of local skin flaps for primary repair of partial nasal alar defects / 中国医师进修杂志

Objective:To explore the possibility of repairing partial nasal alar defects with individualized design of localized skin flaps.Methods:The clinical data of 38 patients with nasal alar region tumor from October 2015 to June 2019 in Dalian Municipal Central Hospital were retrospectively analyzed, including 5 cases with intradermal nevus, 8 cases with junction nevus, 21 cases with basal cell carcinoma, 3 cases with trichoepithelioma, and 1 case with nasal alar sulcus fistula combined with infection. Surgical treatment with local anaesthesia was applied, and intraoperative freezing pathology was used to confirm the diagnosis and determine the safe margin. There was no nasal alar cartilage infiltration in all patients. The defect areas after resection of nasal alar lesions ranged from 1.0 cm × 1.0 cm to 3.0 cm × 2.5 cm. Local skin flap was aesthetically designed in accordance with the location and size of the nasal alar defect to primarily repair the defect. Among them, 15 cases were repaired with pedicled nasolabial groove flap, 10 cases with modified rhomboid flap, 6 cases with rotatory nasolabial groove flap, 5 cases with V-Y push flap, and 2 cases with double lobe flap.Results:One case had blood transportation obstacle after operation caused by compression and bandaging, 1 case had postoperative infection. Healing of the two cases delayed after treatment, and other patients healed properly. All the flaps survived without facial deformity, and the cosmetic effect was good.Conclusions:The primary repair of the nasal alar defect needs to follow the aesthetic requirements of the nose and face, which varies with diseases and experience of doctors. Flap selection should be individualized to achieve both the purpose of repairing defects and beauty.

Progress of immunotherapy for multiple myeloma / 白血病·淋巴瘤

The clinical application of biological immunotherapy such as chimeric antigen receptor T cells (CAR-T) and novel targeted therapy has explored a new therapy for multiple myeloma (MM) treatment. Targeting B-cell maturation antigen (BCMA), allogeneic CAR-T, antibody-drug conjugate (ADC) and bispecific antibody targeting BCMA have achieved remarkable efficacy and safety in many clinical studies. This article introduces the latest immunotherapy for MM at the 62nd American Society of Hematology (ASH) Annual Meeting.

Effect of small interfering RNA silencing high mobility group box 1 expression on the biological characteristics of hep-2/v resistant cell line of human laryngeal squamous cell carcinoma / 中国医师进修杂志

Objective:To study the effect of small interfering RNA (siRNA) silencing high mobility group box 1 (HMGB1) on the biological characteristics of hep-2/v resistant cells line of human laryngeal squamous cell carcinoma (HSCC).Methods:In Dalian Municipal Central Hospital, siRNA-HMGB1 was transfected into Hep-2/v cells. The expression of HMGB1 and MDR1 protein were detected by Western blot and cell immunofluorescence, cell proliferation activity was detected by CCK-8, and cell cycle was detected by flow cytometry.Results:Compared with that of the negative control group and the blank control group, the proliferation ability of the positive control group decreased by 20.18% at 24 h ( P<0.01) and 21.92% at 48 h ( P<0.05). The proportion of G 1 cells increased obviously. The expression of HMGB1 protein decreased 41.38% ( P<0.01), the expression of HMGB1 protein decreased 26.77% ( P<0.05). Conclusions:Reduction of HMGB1 expression in hep-2/v cells can inhibit cell proliferation and reduce drug resistance.

Venetoclax and low-dose cytarabine induced complete remission in a patient with high-risk acute myeloid leukemia: a case report / 医学前沿

Conventional combination therapies have not resulted in considerable progress in the treatment of acute myeloid leukemia (AML). Elderly patients with AML and poor risk factors have grave prognosis. Midostaurin has been recently approved for the treatment of FLT-3-mutated AML. Venetoclax, a BCL-2 inhibitor, has been approved for the treatment of relapsed and/or refractory chronic lymphoid leukemia. Clinical trials on applying venetoclax in combination with cytarabine and other agents to treat various hematological malignancies are currently underway. Here, we present a case of a male patient with poor performance status and who developed AML following allogeneic hematopoietic stem cell transplant for high-risk myelodysplasia. The patient with high risk AML achieved complete response to the combined treatment regimen of low-dose cytarabine and venetoclax. Furthermore, we reviewed current clinical trials on the use of venetoclax for hematological malignancies.

Content Determination of Paeonol in Cynanchum paniculatum by Three-dimensional Fluorescence Coupled with ATLD Algorithm / 中国药房

OBJECTIVE:To determine the content of paeonol in Cynanchum paniculatum by three-dimensional fluorescence coupled with ATLD algorithm. METHODS:The trilinear model was established. The principle of least square was used for ATLD. The component value was fitted by core consistency diagnosis,and inner filter effect was corrected by mathematical correction method. Fluorescence scanning condition included excitation wavelength of 250-400 nm,emission wavelength of 410-600 nm, wavelength interval of 5 nm,slit width of 5.0/5.0 nm,scanning speed of 1200 nm/min. Determination and absorption spectrum condition included scanning wavelength of 250-600 nm,scanning speed of 600 nm/min;Al(Ⅲ)was used as the sensitizer to in-crease the fluorescence intensity of paeonol. The content of paeonol was determined by HPLC. RESULTS:The linear range of pae-onol was 0.132-1.188 μg/mL(r=0.9999). RSDs of precision,stability and reproducibility tests were less than 3.0%. The recover-ies were 100.1%-104.7%(RSD=2.39%,n=6). The analysis spectrum of paeonol was almost completely overlapped with the actu-al spectrum. The results of HPLC method are very similar to those of ATLD algorithm. CONCLUSIONS:The three-dimensional fluorescence coupled with ATLD algorithm is simple,rapid,efficient and accurate,and can be used for the qualitative and quantita-tive analysis of complex system.

Progress of Synthesis α-Substituted Propanoic Acids Drugs by Transition Metal-catalyzed Asymmetric Hydrogenation / 现代生物医学进展

Optically pure α-substituted propanoic acids and their derivatives represent as an important kind of organic building blocks and key intermediates,which has been widely used in the synthesis of chiral drugs.Some of them have been used directly as nonsteroidal anti-inflammatory drugs (NSAIDs),such as ibuprofen,naproxen,ketoprofen and so on.Dihydroartemisinic acid (DHAA),the same structure as the α-substituted propanic acids,is a key intermediate for the synthesis of artemisinin,the most effective and current used anti-malarial drug.Therefore,the asymmetric synthesis of α-substituted propanoic acids is always a hot topic for chemical scientists.Asymmetric catalytic hydrogenation attracts more and more attentions because of its atom economy and efficiency.This dissertation will disclose the asymmetric synthesis of α-substituted propanoic acids using transition metal-complex as a chiral catalyst.

Advances in treatment of congenital posterior choanal atresia / 临床耳鼻咽喉头颈外科杂志

Congenital posterior choanal atresia is a rare congenital deformity. Due to the influence of nose and face and intellectual development, its preferred surgical treatment. But surgical treatment methods and technology are in dispute. The using of high resolution display systems combine with micro tools can effectively reduce postoperative scarring and adhesion formation which is the key point to prevent restenosis. There is also the focus of controversy whether should place an expansive tube after operation. Currently nasal endoscopic approach has become the first choice for otolaryngologist treating congenital posterior choanal atresia.

Coblation-channelling for the tongue / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of Coblation-channelling for the tongue(CCT) treatment of tongue hypertrophy.@*METHOD@#The 31 patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) combining tongue hypertrophy staged as Friedman ll or N were performed CCT after nasal septum surgery, coblation channelling of bilateral inferior turbinate and coblation-assisted UPPP. While the vertical channelling in the base and the body of the tongue, the tilted one parallel side edge and posterior to the tongue were combined. The intraoperative and postoperative complications such as bleeding were observed. The 12 months postoperative follow-up were done by MRI of the tongue.@*RESULT@#The retrolingual space were expanded postoperatively. The 2 bleedings occurred immediately after channellings in the tongue body, and they were stopped by local compression. No postoperative tongue paralysis, no tongue hematoma and abscess happened. The tongue sizes changed from preoperative III or IV degree to postoperative I to II degrees. One case received three CCT sessions.@*CONCLUSION@#CCT treatment tongue hypertrophy is a individually safe, effective and minimally invasive treatment.

Clinical observation of coblation under endoscopy on epiglottis cyst / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effect of the coblation under endoscopy on epiglottis cyst.@*METHOD@#One hundred and ninety-three patients with epiglottis cyst were treated with coblation under endoscopy. Follow-up study was performed from 1 month to 6 months after treatments.@*RESULT@#All 193 cases with epiglottis cyst were primary cured without serious complication and the cure rate was 100%. Moreover, the minor hemorrhage (1-5 ml) was observed.@*CONCLUSION@#The coblation under endoscopy on epiglottis cyst was safe, effective and minimally invasive.

Lingual thyroglossal duct cyst treatment by low temperature coblation on endoscope / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the treatment for lingual thyroglossal duct cyst by low temperature coblation on endoscope.@*METHOD@#Eleven cases of lingual thyroglossal duct cyst were treated by low temperature coblation on endoscope,to observe the curative effect and complication.@*RESULT@#Eleven cases of lingual thyroglossal duct cyst were satisfied after operation, without serious complication. There were no recurrence during a followed up for 1-3 years after operation.@*CONCLUSION@#The operation for lingual thyroglossal duct cyst by low temperature coblation on endoscope was easy,safe and effective.

Coblation-assisting uvulopalatopharyngoplasty combining coblation-channeling of the tongue for patients with severe OSAHS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the therapeutic efficacy of coblation-assisting uvulopalatopharyngoplasty (CAUPPP) combining with coblation-channeling of the tongue (CCT) for patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHOD@#A retrospective analysis was made on patients with severe OSAHS treated by CAUPPP combining with CCT. The adult with severe OSAHS were involved in the study and the apnea-hypopnea index (AHI) were beyond 40/h and lowest arterial oxygen saturation (LSaO2) were under or equal to 80%. Surgical approach: The UPPP was performed to decrease the size of soft palate with coblation and coblation-channeling in the soft palate and decrease the size of tongue by CCT. All patients were followed up for 6 to 12 months and underwent polysomnography (PSG).@*RESULT@#Subjective symptoms of patients improved more significantly than that of preoperation. The function of soft palate is normal without significant nasopharyngeal regurgitation. Compared with the preoperative data, AHI values were significantly decreased (P<0.01) and the lowest oxygen saturations increased significantly (P<0.01) and the effective rate was 91.7%.@*CONCLUSION@#There are usually multiple obstruction levels in patients with severe OSAHS and the traditional surgical treatment is not ideal. This study demonstrated that with the assistance of coblation, combining CAUPPP with CCT for patients with severe OSAHS is an effective surgical method. It has less blood loss, minimally invasive, retained the normal function of the soft palate, etc., should be widely applied.

Low-temperature plasma assisted via mouth for surgery treating styloid process syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the low-temperature plasma assisted way and the traditional method in surgery treating styloid process syndrome.@*METHOD@#The clinical data from 23 patients who have a typical syndrome and need surgery treating, thirteen patients had been treated by low-temperature plasma way and the left cases by traditional one. Comparing operation time, amount of bleeding, degree of pain,time of the fake membrane falling and effort estimating.@*RESULT@#The difference of operation time,amount of bleeding and degree of pain between low-temperature plasma and tradition in the two operation procedures is significant (P 0.05). And one patient who used the traditional operation bled when he was at home.@*CONCLUSION@#The two operation procedures are both effective. The low-temperature plasma assisted via mouth for surgery treating elongated styloid process has a big advantage in operation time, amount of bleeding and degree of pain. For the more, it reserves the function and morphology of tonsil; which is more simple, convenient, safe and tiny wound.

Preliminary clinical investigation of coblation-assisted functional endoscopic sinus surgery for chronic sinusitis and nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical efficacy of coblation-assisted FESS (CAFESS) by observing the patients intraoperatively and postoperatively.@*METHOD@#Thirty patients with chronic sinusitis or/and with nasal polyps were selected. The subjective symptoms and objective changes were observed 6 to 9 months after CAFESS.@*RESULT@#The sense of nasal congestion, headache and face pain, purulent rhinorrhea, postnasal drip, and other symptoms were relieved. The scores of SNOT-20 reduced from preoperative (22.53 +/- 6.26) to (7.80 +/- 3.63) 6 months postoperatively, and the difference was statistically significant (t = 16.741, P < 0.05). The scores of Lund-Kennedy decreased from (4.30 +/- 1.15) preoperatively to (1.17 +/- 0.83) 6 months postoperatively, and the difference was statistically significant (t = 19.947, P < 0.05). The observation under endoscope illustrated that epithelization commenced at 6w postoperatively and completed until 12 week after CAFESS.@*CONCLUSION@#CAFESS is a new technique for treatment of chronic sinusitis and nasal polyps, and postoperative clinical results were satisfactory. It's a good method for the treatment of chronic sinusitis and nasal polyps.

Modulation of histone acetylation and induction of apoptosis in SMMC-7721 cells by phenylhexyl isothiocyanate / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effect of phenylhexyl isothiocyanate (PHI) on histone acetylation and apoptosis in hepatocellular carcinoma cell line (SMMC-7721) in vitro.</p><p><b>METHODS</b>The viability of SMMC-7721 cells was determined by trypan blue exclusion. Apoptotic cells were assessed by TUNEL assay. The proteins of Bcl-2, Procaspase-9, Procaspase-8, Procaspase-3, caspase-9, caspase-3, histone acetylated H3 and H4 were detected by Western blot.</p><p><b>RESULTS</b>Compared with the vehicle control, PHI at 5, 10, 20, 40 and 80 µmol/L reduced the cell viability of SMMC-7721 cells in a concentration-dependent manner. PHI induced apoptosis in SMMC-7721 cells. An increased amount of apoptotic cells was detected after 7 hours exposure to PHI at 10, 20, and 40 µmol/L, 6.9% ± 2.4%, 17.5% ± 4.2% and 54.5% ± 5.4%, respectively, while that of the vehicle control was 4.5% ± 2.3% (P < 0.05). Along with the prolongation of time and increase of dose, the expressions of bcl-2, procaspase-9, procaspase-3 were decreased, that of caspase-9 and caspase-3 was increased. In contrast, alteration of procaspase-8 was not significant at those concentrations. PHI accumulated acetylated histone H3 and H4. After 3 hours exposure to PHI at 10, 20 and 40 µmol/L, the level of histone acetylated H3 was 1.87-, 2.43-, 3.67-fold increased and histone acetylated H4 was 1.29-, 1.45-, and 2.25-fold increased, compared with that of the vehicle control. The protein of histone acetylated H3 and H4 was significantly accumulated after 7 hours exposure.</p><p><b>CONCLUSION</b>PHI is a new histone deacetylation inhibitor. It may induce accumulation of histone acetylation H3 and H4, inhibit cell growth and induce apoptosis in SMMC-7721 cells via the mitochondrial pathway.</p>

Coblation for benign hyperplasia of tongue base under endoscope / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the feasibility and efficacy of coblation on benign hyperplasia of tongue base under endoscopy.@*METHOD@#Fifty cases with benign hyperplasia at tongue root including tonsillar hypertrophy, lymphangioma and papillary epithelioma were treated with coblation under endoscopy and analyzed retrospectively. The post-operative Hemorrhage and pain and therapeutic effect were observed. And the follow-up was 16 to 32 months.@*RESULT@#All the tumors were resected completely. The postoperative pain was mild. The patients could eat on the day of surgery without dysfunction of pronunciation and respiratory. The VAS score of foreign body sensation in pharynx was decreased from 81.5 +/- 9.6 to 13.5 +/- 3.9 after surgery (P < 0.01). The recovery rate was 96%, excellence rate was 4% and total effective rate was 100%. Besides, there was no recurrence.@*CONCLUSION@#Coblation is a safe, effective and minimally invasive way to treat benign hyperplasia of tongue base under endoscopy.

Investigation of reoperation after failure of UPPP / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the surgical ways of reoperation of the UPPP.@*METHOD@#Fifteen failed cases of OSAHS after UPPP were reviewed and analyzed. The reoperations were performed with modified laser assistant, ablation assistant UPPP combining ablation of tongue base. The follow-up was done after 1 year.@*RESULT@#The AHI decreased from (38.56 +/- 11.23)/h to (4.87 +/- 1.59)/h and the lowest SpO2 increased from (61.5 +/- 8.5)% to (79.9 +/- 9.7)% of the patients. The statistical difference was significant (P<0.01) in 1 year after the reoperation. The total validity ratio was 100% and the recovery rate was 96%. No complications happened.@*CONCLUSION@#The shortcomings of UPPP could be made up with ablation, and the ablation could help the UPPP more minimal damage and effective therapy.