RESUMO
Objective:To analyze the clinical characteristics and influencing factors on postoperative emotional and cognitive function for elderly versus non-elderly male patients with laryngeal carcinoma.Methods:The patients with laryngeal cancer hospitalized in the Department of Otorhinolaryngology-Head and Neck Surgery were selected for a questionnaire survey in two Grade III-A Hospital in Shanxi Province from January 2018 to December 2019.There were 105 patients with laryngeal cancer, including 60 in the elderly and 45 in the non-elderly group.Negative emotion and cognitive function were investigated by using Self-rating Anxiety Scales(SAS), Self-rating Depression Scale(SDS), and Montreal Cognitive Assessment(MOCA)before surgery, 10 days after surgery, and 1 year after surgery, respectively.The clinical characteristics of the elderly versus non-elderly groups were analyzed and compared.Results:One year after surgery, there were 52 cases(86.7%)and 27 cases(45.0%)of depression and cancer-related cognitive impairment(CRCI)in the elderly group, which were higher than 30 cases(66.7%)and 4 cases(8.9%)in the non-elderly group, with statistically significant difference( χ2 = 6.013, χ2 =16.115 and P<0.05, P<0.01). The elderly group showed much more anxiety and CRCI 10 days after surgery(60.50±4.31 vs.55.84±3.81, 27.47±1.08 vs.28.31±1.08, P<0.01)and showed much more depression and CRCI(57.20±5.66 vs.62.60±5.37, 27.36±1.37 vs.26.08±1.42, P<0.01)than did the non-elderly group 1 year after surgery.The results of multiple linear regression analysis in the elderly group showed that the mode of operation and the pronunciation one year after surgery significantly affected their anxiety; the marriage and the educated level significantly affected their depression; the marriage, the educated level and operation mode significantly affected their cognitive function.Clinical stage of tumor significantly affected anxiety and depression, the educated level significantly affected cognitive function in the non-elderly group. Conclusions:Postoperative negative emotion and cognitive function in patients with laryngeal cancer continues to deteriorate after surgery, which were affected by many factors, especially in elderly patients.It is necessary to conduct active and effective interventions as soon as possible.
RESUMO
Summary@#Vertical nystagmus is a vertical nystagmus caused by structural abnormalities and/or dysfunction of the central vestibular system and observed in situ in the center of the eyeball. There are two kinds of nystagmus （UBN） and downbeat nystagmus （DBN） according to the direction of nystagmus. The diagnosis of UBN is mainly made by naked eye or electronystagmography/viewer. It is a common neuro-ophthalmologic sign in the field of vestibular medicine. In this paper, the mechanism of vertical nystagmus formation and the location of lesions were briefly introduced, in order to provide help for the diagnosis and treatment of Vertigo.
RESUMO
Objective@#Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT).@*Methods@#We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software.@*Results@#A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01).@*Conclusions@#SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.
RESUMO
Vertical nystagmus is a vertical nystagmus caused by structural abnormalities and/or dysfunction of the central vestibular system and observed in situ in the center of the eyeball. There are two kinds of nystagmus （UBN） and downbeat nystagmus （DBN） according to the direction of nystagmus. The diagnosis of UBN is mainly made by naked eye or electronystagmography/viewer. It is a common neuro-ophthalmologic sign in the field of vestibular medicine. In this paper, the mechanism of vertical nystagmus formation and the location of lesions were briefly introduced, in order to provide help for the diagnosis and treatment of Vertigo.
RESUMO
Surgical margin principle is one of the central surgical principles for head and neck cancers. Negative surgical margin is the primary purpose of surgery for head and neck cancers. This paper is based on the current clinical application of surgical margins of head and neck cancers, and it is proposed that surgical margins of head and neck cancers may be classified into three types: surface margin, deep margin, and tissue interface margin in consideration of surgical exposure of tumors. The classification of surgical margins can make the clinical application and the research of surgical margins of head and neck cancers more systematic and clear.
RESUMO
Most of the common dizziness/vertigo diseases in otology clinic are peripheral vertigo diseases, and while about 20% -30% of all vertigo diseases are caused by central nervous system diseases. Pseudo vestibular neuritis, acute ischemic stroke with audiovestibular loss, and central paroxysmal positional vertigo are the three types of central "malignant vertigo" diseases which are most easily misdiagnosed by otologists. This article described the clinical characteristics and bedside physical performance of these three diseases, and summarized the differential diagnosis points for clinical reference.
RESUMO
Early intervention contributes to improving patient experience and doctor-patient relationship in the case of non-psychiatric outpatients with psychological problems.The authors studied the psychological assessment and hierarchical management for non-psychiatric inpatients at a general hospital. Measures taken include establishing multi-disciplinary and inter-department teams, building an intra-hospital joint-action system, and implementing the psychological assessment and hierarchical management for non-psychiatric inpatients.These efforts explored ways for a general hospital in psychological counseling, offering humanistic service, and transformation of medical pattern.
RESUMO
Objective@#To investigate the prevalence and psychosocial characteristics in inpatients with head and neck cancer before surgery.@*Method@#From September 2015 to December 2016, 237 consecutive inpatients with head and neck cancer who had been scheduled for surgery were prospectively enrolled in Department of Head and Neck Surgery of Shanxi Provincial Tumor Hospital. Mental health symptoms were systematically investigated using three psychological instruments: symptom checklist-90 (SCL-90), Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS). SPSS 17.0 software was used to analyze the data. And he results of SCL-90, SAS and SDS were compared with the Chinese norm. For all statistical analyses, a P value <0.05 was considered statistically significant.@*Result@#Of 237 patients, 228 (96.2%) completed all the questionnaire. The scores of SCL-90 (1.60±0.44), SAS (46.67±8.51)and SDS(47.50±11.43)in patients with head and neck cancer were significantly higher than those of Chinese norm (t=3.093, t=17.29, t=4.29 respectively and P=0.003, P=0.001, P=0.001 respectively). Positive proportion identified by three measure tools are 32.9%, 35.5% and 36.8% respectively. And 42 patients (18.4%) suffered from both anxiety and depression. The SCL-90 scores were significantly higher than those of the normal standard population, including dimension of somatization obsessive-compulsive, anxiety, hostility, phobic-anxiety and psychoticism (t=4.47, 3.04, 2.87, 2.58, 5.46, 4.15 respectively, all P<0.05).@*Conclusions@#This study offers important information regarding psychological status in inpatients with head and neck cancer before surgery. Identifying these patients using proper screening instrument is of great important clinical implications for the early detection, management, and reduction of the distress associated with head and neck cancer.
RESUMO
OBJECTIVE To investigate the effect of music relaxation imagination training(MRIT) on mood and pain in patients with chronic rhinosinusitis(CRS). METHODS A total of 120 patients were divided into experimental group(60 cases) and control group(60 cases). The intervention group received routine nursing care and MRIT, while the control group received routine nursing care. RESULTS The scores of each dimension of the brief mood scale in intervention group after intervention were lower than that in control group, and the degree of pain was significantly lower too at 6 h, 12 h, 24 h 48 h, 72 h after operation. The differences were statistically significant(P<0.05). CONCLUSION MRIT can improve the postoperative mood of patients underwent CRS nasal endoscopic surgery and reduce the degree of postoperative pain.
RESUMO
The lymphatic system plays an important role in human health and disease. In addition to a role in the immune response, the lymphatics can also serve as a pathway for cancer metastasis.Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers.In the case where the primary focus has been controlled, cervical lymph node metastasis is one of the most important factors affecting the prognosis of head and neck cancer.Thus, understanding the anatomy of the lymphatic system is of paramount importance in predicting cancer metastasis and to perform proper lymph node dissection in cancer patients.The objective of this review is to summarize current imaging approaches that facilitate both basic science and clinical investigations of lymphatic vasculature.Mutation analysis of the laryngeal lymphatic system may provide a theoretical basis for the diagnosis and treatment of HNSCC.
RESUMO
Objective To analyze and discuss the clinical effect of the four-hands technique mode of doctor-nurse collaboration in endoscopic sinus surgery. Methods Convenient sampling method was used to select 50 cases of patients with nasal endoscopic surgery who met the inclusion criteria and agreed to participate in this study in the period between January to May in 2016. Designing one side of the nasal cavity of patients with traditional surgery mode, the other side of the nasal cavity to carry out the four-hands operation mode. The operation time and amount of bleeding were recorded. Results The operation time, amount of bleeding of traditionalsingle hand operationside and the other side of four-hands operation respectively were (39.30 ± 21.96) min, (143.86 ± 15.01) ml and (31.60 ± 19.27) min, (102.98 ± 12.85) ml, with significant differences between the two groups (t=2.096, 14.625, P<0.01). Conclusions The four-hands technique of doctor-nurse collaboration can significantly reduce the operation time, reduce the amount of bleeding and get a better surgical field, clinical nurse and doctor′s cooperation is more closely and also improve the quality of patient care.
RESUMO
3D reconstruction technologies have been widely used in medical diagnostic assist, surgical simulation, anatomy teaching, etc. The resolution of traditional imaging data such as computed tomography (CT) and magnetic resonance imaging (MRI) cannot meet the needs of life science research. Continuous sectioning technology can provide accurate and high-resolution information for the vast majority of tissues, which make it become a valuable method in the research and exploration of microstructures studies. With the development of microscopy and image processing techniques, significant advances have been made in the small-scale serial sections-based 3D reconstruction technologies. This enables the analysis of sample morphology and tissue function, as well as a more complete assessment of the structure of the tissue. Therefore, this technology has led to profound changes in the fields of cell and tissue biology. In this paper, the common small-scale serial sections-based 3D reconstruction technologies were compared and reviewed.
RESUMO
Objective To investigate the relationships of tone burst -ABR Thresholds and the pure -tone audiograms in normal hearing adults .Methods The response thresholds of Tone burst -ABR and the pure -tone audiogram were recorded from 34 adult(68 ears) at 0 .5 ,1 .0 ,2 .0 ,and 4 .0 kHz .The results were statistically ana-lyzed .The correlation of the response thresholds of tone burst -ABR and the pure-tone audiogram were studied . Results At 0 .5 ,1 .0 ,2 .0 ,4 .0 kHz ,the averages of the response thresholds of tone burst -ABR were 27 .43 ± 3 .29 ,25 .98 ± 2 .76 ,16 .78 ± 2 .37 ,and 12 .42 ± 2 .64 dB nHL ,respectively .The averages of the pure -tone audio-gram were 12 .23 ± 3 .99 ,11 .82 ± 2 .56 ,9 .58 ± 3 .23 ,and 9 .92 ± 2 .59 dB nHL ,respectively .The differences between the response thresholds of tone burst -ABR and the pure-tone audiogram were 12 .13 ± 4 .51 ,11 .43 ± 3 .66 ,7 .61 ± 2 .43 ,and 7 .17 ± 1 .32 dB ,respectively .At 0 .5 ,1 .0 ,2 .0 ,and 4 .0 kHz ,Pearson correlation coefficients were 0 .69 ,0 .79 ,0 .84 ,0 .89 ,respectively .Conclusion The tone burst -ABR and the pure -tone audiogram thresholds were a highly correlated with each other ,especially at 2 .0 kHz and 4 .0 kHz .Tone burst -ABR has the frequency specificity ,which can response the hearing level better .
RESUMO
Objective To explore the curative effectiveness of comprehensive voice training methods on teachers' voice disorders patients by using subjective and objective assessment. Methods Forty-seven teachers' voice disorders patients suffering from voice symptoms without organic disease and complete follow-up data as the research object were treated with a three-month comprehensive voice training program. Training content included relieving laryngeal muscle tension, improving the throat vocal cord movement and reconstruction methods of pronunciation. The use of voice acoustic analysis and voice handicap index(VHI) were compared before and after training. Results The jitter and shimmer were significantly decreased after comprehensive voice training from 1.06(0.79,1.38)％and 2.71(2.16,3.24)％to 0.78 (0.59, 0.99)％ and 1.64(1.03,2.45)％, the differences were significant (Z=3.249,-4.121, P<0.05). Maximum phonation time and dysphonia severity index were significantly increased obviously from (9.87 ± 2.61)s and-2.23±0.75 to (12.81±1.97)s and-0.43±1.65 respectively, the differences were significant (t=-6.057,-5.273, P<0.05). After the training, the VHI score of voice disorder index decreased from (37.41±4.96)points to (26.31± 4.29) points after the comprehensive voice training. In addition to emotional function, the difference was statistically significant(t=12.715, 5.881, 11.483, P<0.05). Conclusions Voice training can reduce the degree of voice disorders effectively, increase the power of the respiratory system, therefore improve the voice quality of teachers with voice disorders. The subjective and objective combination assessment can evaluate the quality of the patient′s voice more thoroughly and evaluate the clinical efficacy of voice training further.
RESUMO
OBJECTIVE@#Comparative analysis of the clinical curative effect of manipulative reduction and TRV- CRP treatment of BPPV, comfort degree during reset and quality of life improvement.@*METHOD@#One hundred and thirty-two patients with BPPV were randomly divided into two groups ,one group underwent the traditional manip- ulative reduction, the other group with TRV-CRP. DRI and VAS was evaluated in the pre and after treatment and evaluation of the efficacy was conducted. The results of two groups were compared.@*RESULT@#The effective rate of manipulative reduction after a week treatment was 89. 23% and TRV-CRP.was 98. 51%, which was higher in TRV-CRP group than that of the manipulation reduction group(P0. 05), the score of the two groups were decreased after a week of reduction, but the improvement of TRV-CRP group was higher than that of manipulation reduction group(P<0. 05).@*CONCLUSION@#The success rate of TRV-CRP was higher than that of manipulative reduction,but manipulative reduction comfort degree was higher than TRV-CRP, the two methods can both improve the quality of life of patients with BPPV. TRV-CRP has many advantages over manipulative reduction, but manipulative reduction is simple with low cost, and the effect is still a great advantage. In clinical work, we should reasonable combine the two methods,so as to improve the cure rate of RPPV.
Assuntos
Humanos , Vertigem Posicional Paroxística Benigna , Terapêutica , Posicionamento do Paciente , Qualidade de Vida , Resultado do TratamentoRESUMO
To report one case of postoperative reconstruction of facial squamous cell carcinoma by cervicotho-racic flap and temporal flap in our hospital. Clinical symptoms of the patient are facial mass and tumor ulceration.The patient had chronic bronchitis. On admission, the right side of the patient face was found to have a mass of about 6. 5 cm X 5. 0 cm, and the middle is about 2. 5 cm X 2. 5 cm X 1. 0cm ulcer, the neck has no swollen lymphnodes by palpation. After imaging and pathological examination,the patient was diagnosed as right facial squamouscell carcinoma and chronic bronchitis.
Assuntos
Humanos , Carcinoma de Células Escamosas , Cirurgia Geral , Face , Patologia , Cirurgia Geral , Período Pós-Operatório , Procedimentos de Cirurgia Plástica , Retalhos CirúrgicosRESUMO
Because of minimal donor site morbidity, adequate tissue, excellent clinical and functional results, the anterolateral thigh flap has become one of the most important tissue flaps which are used to repair the defects of head and neck. Generally, anterolateral thigh flap is mainly used to repair the maxillofacial defects in head and neck surgery. However, the anterolateral thigh flap is a better tissue flap for reconstruction of hypopharyngeal and cervical esophageal defects.
Assuntos
Humanos , Esôfago , Cirurgia Geral , Cabeça , Cirurgia Geral , Hipofaringe , Cirurgia Geral , Pescoço , Cirurgia Geral , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Coxa da PernaRESUMO
OBJECTIVE@#To investigate the expression of Bax and PHF20 in laryngeal squamous cell carcinoma (LSCC)and to discuss their relevance and the roles in carcinogenesis and development in LSCC.@*METHOD@#The expressions of Bax and PHF20 in the LSCC tissues and normal mucosa tissues adjacent to carcinoma were detected by SP immunohistochemistry assay. The relationship between the expressions of Bax and PHF20 and the clinicopathological characteristics including clinical stage, pathological type, histological grade and lymph node metastasis in LSCC were analyzed according to the clinical data.@*RESULT@#(1) The expressions of Bax and PHF20 were both significantly lower in the LSCC tissue than that in the normal laryngeal tissue (P 0.05). In histological differentiation grouping, the quantity and positive rate of Bax and PHF20 expressions decreased significantly in poorly differentiated LSCC compared with the well and moderately differentiated LSCCs (P < 0.01, P < 0.05, respectively). In T stage grouping, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in T1 + T2 compared with T3 +T4 (both P < 0.01). In addition, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in LSCC with lymph node metastasis compared to that without lymph node metastasis (both P < 0.01).@*CONCLUSION@#The lack of Bax and PHF20 might contribute to the carcinogenesis and development in LSCC. The positive expression of Bax and PHF20 maybe relative to T term degree, differentiation degree and lymphamatic metastasis of LSCC.
Assuntos
Humanos , Antígenos de Neoplasias , Metabolismo , Biomarcadores Tumorais , Metabolismo , Carcinoma de Células Escamosas , Metabolismo , Neoplasias de Cabeça e Pescoço , Metabolismo , Imuno-Histoquímica , Neoplasias Laríngeas , Metabolismo , Metástase Linfática , Prognóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço , Proteína X Associada a bcl-2 , MetabolismoRESUMO
OBJECTIVE@#To systematically analyze the local recurrence of CO₂ laser surgery for early glottic cancer and without anterior commissure involvement.@*METHOD@#By searching CBM, CNKI, wanfang, weipu, PubMed, Embase, OVID, and Springer database, the retrospective clinical studies were included according to inclusion and exclusion criteria. Meta analysis of extracted data was carried out by RevMan 5.0 software.@*RESULT@#By analyzing the 1900 cases from 14 retrospective studies using Meta analysis, it was indicated that local recurrence rate of AC+ group was significantly higher than that of AC- group [OR = 3.00, 95% CI (2.31, 3.89), P < 0.01] for early glottic cancer. Local recurrence rates between AC+ group and AC- group for glottic cancer of Tis and T₁b stage showed no statistically significant difference, while those for glottic cancer of T₁a and T₂ stage showed statistically significant difference.@*CONCUSION@#Local recurrence rate of CO₂laser surgery for early glottic cancer was related with anterior commissure involvement.
Assuntos
Humanos , Dióxido de Carbono , Bases de Dados Factuais , Glote , Patologia , Neoplasias Laríngeas , Cirurgia Geral , Terapia a Laser , Recidiva Local de Neoplasia , Estudos RetrospectivosRESUMO
OBJECTIVE@#To investigate the presence of vasculogenic mimicry in laryngeal squamous cell carcino- ma and explore its clinical significance.@*METHOD@#The presence of vasculogenic mimicry and expression of endotheli- um-dependent vessel in 138 laryngeal squamous cell carcinomas cases were detected by the immunohistochemistry and tissue microarray. Metlab software was used to evaluate the relationship among vasculogenic mimicry, mi- crovessel density and clinic pathological parameters in laryngeal carcinoma.@*RESULT@#We found vasculogenic mimicry in 32 (26.23%) of 122 laryngeal carcinoma samples. The mean of microvessel density is 12.61 per high-power field. The vasculogenic mimicry and expression of endothelium-dependent vessel were not significantly related to patient age or gender, tumor location, pathology grade, T stage or N stage (P > 0.05). However, the vasculo- genic mimicry and the mean of microvessel density were a little higher in patients older than 60, with poorly differ- entiated and patients with N₁₋₃ stage. Vasculogenic mimicry was positively correlatedwith microvessel density (r = 0.1927, P < 0.05).@*CONCLUSION@#Vasculogenic mimicry can occur in laryngeal carcinoma. Moreover, vasculogenic mimicry may be associated with recurrence and metastasis in laryngeal carcinoma.