Clinical features and management analysis of 11 cases of laryngocele / 中华耳鼻咽喉头颈外科杂志

Objective: To summarize clinical features and our experience of the diagnosis and treatment of laryngocele. Methods: Clinical data of 11 laryngocele patients in department of Otorhinolaryngology Head and Neck Surgery of the Second Affiliated Hospital of Shanxi Medical University from January 2012 to December 2021 were retrospectively reviewed, including 9 men and 2 women, aged from 12 to 75 years, with median age of 56 years. Electronic laryngoscope was performed in 10 of all patients, laryngeal CT in 10 and cervical color ultrasound in 5 before operation.All the operations were performed under general anesthesia, and the external cervical approach was used for external and combined laryngocele. The internal laryngocele was resected by low temperature plasma through transoral endoscopy. Patients were followed up regularly after operation to evaluate the effect. Clinical feature, types of lesions, imaging findings, surgical approaches and follow-up results were analyzed through descriptive statistical method. Results: Eleven laryngocele patients were divided into mixed type (n=6), internal type (n=4) and external type (n=1).Nine patients presented with hoarseness or dysphonia, 7 with cervical mass and 1 with airway obstruction. Surgical resections were done through external cervical approach (n=7)or transoral endoscopic approach (n=4). All the operations were successful and no complication occurred. All cases were followed up from 17 to 110 months. No recurrence was encountered. Conclusions: Laryngocele is a rare lesion with atypical clinical presentation. Preoperative imaging including CT scan and electronic laryngoscope is essential to evaluate the location, and extent of the lesion, and to make the surgical plan.Complete surgical excision is required. Surgical resection is the only effective method for the treatment of laryngocele.

Acute- and Long-term Outcomes of Rotational Atherectomy followed by Cutting Balloon versus Plain Balloon before Drug-Eluting Stent Implantation for Calcified Coronary Lesions / 中华医学杂志(英文版)

Background@#Coronary calcification is a major determinant of stent underexpansion and subsequent adverse events. This study aimed to evaluate the acute- and long-term outcomes of rotational atherectomy (RA) followed by cutting balloon (CB) versus plain balloon before drug-eluting stent implantation for calcified coronary lesions.@*Methods@#From June April 2013 to March 2016, a total of 127 patients with moderately or severely calcified coronary lesions were treated with RA. Patients were divided into two groups according to the balloon type after RA: RA+CB group (n = 75) and RA+plain balloon group (n = 52). Minimal lumen diameter and acute lumen gain were analyzed by quantitative coronary angiography. In-hospital and long-term (>1 year) outcomes were recorded. Multivariate Cox regression analysis was performed to determine the independent predictors of in-stent restenosis.@*Results@#The mean age of the patients was 65.5 years, and 76.4% were men. Total lesion length and minimal lumen diameter at baseline were similar in the two groups. After RA and balloon dilation, the lumen diameter was significantly larger in the RA+CB group than in the RA+plain balloon group (1.57 ± 0.46 mm vs. 1.10 ± 0.40 mm, t = 4.123, P 1 year) in-stent restenosis (hazard ratio: 0.136, 95% confidence interval: 0.020-0.936, P = 0.043).@*Conclusions@#In patients with moderately or severely calcified lesions, a strategy of RA followed by CB before stent implantation can increase lumen diameter and acute lumen gain. This strategy is safe with lower risk of long-term in-stent restenosis.

Effects of cool restrain stress on eosinophils and interleukin 2 and 6 in nasal mucosa of rats with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the effects of cool restrain stress on the accumulation of eosinophils and expression of Th cytokines in rat nasal mucosa with allergic rhinitis model.</p><p><b>METHODS</b>Fifty healthy female rats were randomly divided into 5 groups: control group, allergic rhinitis (AR) group, AR plus stress group, stress plus AR group and simultaneous stress-AR group. Cool restrain stress, AR model and simultaneous stress-AR were made. Nasal mucosa of septum from rats of five groups were stained routinely by haematoxylin eosin (HE) and immunohistochemistry respectively. The density of eosinophils and expression of interleukin (IL)2, IL-6 were observed by using software of image analysis systems under microscope.</p><p><b>RESULTS</b>The density of eosinophiles and IL-6 in the nasal mucosa of stress-AR group were significantly higher than those in AR [(14.1 +/- 3.2) for eosinophiles, and (15.3 +/- 4.8) for IL-6 ] and were also significantly higher than those in control groups [(2.3 +/- 1.4) for eosinophiles, and (4.9 +/- 2.4) for IL-6)], and the differences reached statistical significance. (F were respectively 7.06, 7.14, 8.54, 8.20, P were respectively < 0.05 or < 0.01), but no significant differences of the three groups (AR plus stress, stress plus AR and simultaneous stress-AR groups) were found (F were respectively 2.90 and 3.20, P > 0.05). The expression of IL-2 in nasal mucosa of stress-AR group was significantly reduced compared with AR and control groups (F were respectively 7.27, 7.32, P were respectively < 0.05 or < 0.01). But there were also no significant differences of the three groups (AR plus stress, stress plus AR and simultaneous stress-AR groups, F = 3.12, P > 0.05).</p><p><b>CONCLUSIONS</b>The abnormal infiltration and accumulation of eosinophiles and the differences in expression of IL-2 and IL-6 which represented Th1 and Th2 cytokines in rats nasal mucosa varied in different groups. The eosinophiles and IL-6 were rarely expressed in control group and moderately expressed in AR group, but significantly expressed in cool restrain groups. The IL-2 representing Th1 cytokines were reduced in cool restrain stress gruops. All these results indicated that cool restrain stress might play a role in inducing rat allergic rhinitis.</p>

Study on the prevalence of diabetes mellitus among acute coronary syndrome inpatients in a multi-provincial study in China / 中华流行病学杂志

Objective To demonstrate the current prevalence and treatment status of diabetes mellitus (DM) among inpatients with acute coronary syndrome (ACS) in China. Methods Sixty-four hospitals, including 32 secondary hospitals and 32 tertiary hospitals were selected for baseline survey. Fifty inpatients diagnosed with ACS were recruited consecutively from hospitals participated in this study. This paper focused on the prevalence and treatment status of DM among inpatients with ACS. Results (1)Clinical data of 3223 inpatients (average age 65±11 ) with ACS were collected during baseline survey,including 2183(67.7%) males and 1040(32.3%) females. Among them,39.8% were diagnosed as ST-segment elevation myocardial infarction ( MI), 9.2% as non-ST-segment elevation MI, 51.0% as unstable angina,and 27.1% with ACS history. (2) DM was found in 22.6% ACS patients. The prevalence rate of DM was higher in female (26.3%) patients than that in males (20.8%). The rate of DM was the highest(28.0%) in northeast area and lowest (17.7%) in southwest among 7 geographic districts (north, east,south,central,northeast,northwest and southwest parts of the country). Significant difference was observed among these areas. (3) Rate of awareness on DM was 73.1% among patients with DM, with significant differences among various areas. Treatment rate was 62.1% among patients with DM, with the highest(88.6%) seen in northwest and the lowest (78.4%) in central part of China. (4) Rates of prevalence(27.1%), awareness (82.3%) and treatment (86.7%) of DM were higher in recurrent ACS patients than in those without ACS history, Conclusion Nearly one-forth of the ACS inpatients were having DM, and 15% of the patients with known DM were not on anti-diabetic treatment. It is essential to pay more attention on the treatment of DM for the purpose of secondary prevention on cardiovascular disease.