A case report of primary extubation by partial cricotracheal resection for severe subglottic stenosis / 临床耳鼻咽喉头颈外科杂志

This patient suffered from severe subglottic stenosis(grade Ⅳb). During partial cricotracheal resection, we cut through the cricothyroid membrane and the cricoid arch along the line from the lower edge of the thyroid cartilage to 5 mm of the inferior thyroid cartilage corner anteromedially. This can protect the cricothyroid joint, effectively protect the recurrent laryngeal nerve, and also support the airway. Strictly adhere to airway separation, avoid excessive separation of scars, and combine with reasonable postoperative management to achieve a safe extubation.

Establishment and preliminary evaluation of a fluorescent recombinase-aided amplification/CRISPR-Cas12a system for rapid detection of Plasmodium falciparum / 中国血吸虫病防治杂志

Objective To establish a fluorescent assay for rapid detection of Plasmodium falciparum based on recombinaseaided amplification (RAA) and CRISPR-Cas12a system,and to preliminarily evaluate the diagnostic efficiency of this system.. Methods The 18S ribosomal RNA (rRNA) gene of P. falciparum was selected as the target sequence, and three pairs of RAA primers and CRISPR-derived RNA (crRNA) were designed and synthesized. The optimal combination of RAA primers and crRNA was screened and the reaction conditions of the system were optimized to create a fluorescent RAA/CRISPR-Cas12a system. The plasmid containing 18S rRNA gene of the P. falciparum strain 3D7 was generated, and diluted into concentrations of 1 000, 100, 10, 1 copy/μL for the fluorescent RAA/CRISPR-Cas12a assay, and its sensitivity was evaluated. The genomic DNA from P. vivax, P. malariae, P. ovum, hepatitis B virus, human immunodeficiency virus and Treponema pallidum was employed as templates for the fluorescent RAA/CRISPR-Cas12a assay, and its specificity was evaluated. Fifty malaria clinical samples were subjected to the fluorescent RAA/CRISPR-Cas12a assay and nested PCR assay, and the consistency between two assays was compared. In addition, P. falciparum strain 3D7 was cultured in vitro. Then, the culture was diluted into blood samples with parasite densities of 1 000, 500, 200, 50, 10 parasites/μL with healthy volunteers’ O-positive red blood cells for the RAA/CRISPR-Cas12a assay, and the detection efficiency was tested. Results The Pf-F3/Pf-R3/crRNA2 combination, 2.5 μL as the addition amount of B buffer, 40 min as the RAA reaction time, 37 °C as the reaction temperature of the CRISPR-Cas12a system were employed to establish the fluorescent RAA/CRISPR-Cas12a system. Such a system was effective to detect the plasmid containing 18S rRNA gene of the P. falciparum strain 3D7 at a concentration of 1 copy/μL, and presented fluorescent signals for detection of P. falciparum, but failed to detect P. ovum, P. malariae, P. vivax, T. pallidum, hepatitis B virus or human immunodeficiency virus. The fluorescent RAA/CRISPR-Cas12a system and nested PCR assay showed completely consistent results for detection of 50 malaria clinical samples (kappa = 1.0, P < 0.001). Following 6-day in vitro culture of the P. falciparum strain 3D7, 10 mL cultures were generated and the fluorescent RAA/CRISPR-Cas12a system showed the minimal detection limit of 50 parasites/μL. Conclusion The fluorescent RAA/CRISPR-Cas12a system is rapid, sensitive and specific for detection of P. falciparum, which shows promising value for rapid detection and risk monitoring of P. falciparum.

Clinical observation of supplementing catheter balloon dilation therapy with transcranial magnetic stimulation in the treatment of swallowing dysfunction caused by cricopharyngeal muscle dysfunction after stroke / 中华物理医学与康复杂志

Objective:To observe the clinical efficacy of combining catheter balloon dilation therapy with transcranial magnetic stimulation in the treatment of stroke survivors with swallowing dysfunction caused by cyclopharyngeal muscle dysfunction.Methods:Ninety stroke survivors with swallowing dysfunction caused by cyclopharyngeal muscle dysfunction were randomly divided into a balloon dilation group, an rTMS group and a combination treatment group, each of 30. The groups received balloon dilation therapy, repetitive transcranial magnetic stimulation or both respectively for 4 weeks. A water swallowing test and the Standardized Swallowing Assessment were administered before and after the treatment.Results:After the treatment there was a significant decrease in the average scores of all three groups on both tests, but the improvement in the combination treatment group was significantly greater than in the other two groups. The total effectiveness rate of the combination treatment was 96.7%, significantly higher than the 70.0% of the balloon dilation treatment and the 63.3% with magnetic stimulation alone.Conclusion:Combining catheter balloon dilation therapy with repetitive transcranial magnetic stimulation can significantly improve the swallowing function of stroke survivors caused by cyclopharyngeal muscle dysfunction.

Application potential of bacterial flagellin in treatment of autoimmune rheumatic diseases with Treg epitope peptides / 中华微生物学和免疫学杂志

Immunization with regulatory T cell ( Treg ) epitope peptides to activate and induce Tregs, by which to suppress pathological autoimmune responses and reconstitute a new homeostasis, is a promising therapeutic regimen for autoimmune rheumatic diseases. However, it is usually hard to induce po-tent peptide-specific immune responses in vivo with small molecular peptides. Bacterial flagellin is one of the agonists triggering innate immune responses. When used as carrier, it shows strong adjuvant activity to its conjugated antigens. In some particular situations, bacterial flagellin can also activate and induce Tregs. Thus if Treg epitope peptides are covalently conjugated to a bacterial flagellin, the conjugates should be able to effectively enhance the Treg-based immune responses via flagellin itself and the adjuvanticity of flagellin to Treg epitope peptides, and thereby enhance the immunotherapeutic effects on autoimmune rheumatic diseases.

Application potential of bacterial flagellin in treatment of autoimmune rheumatic diseases with Treg epitope peptides / 中华微生物学和免疫学杂志

Immunization with regulatory T cell (Treg) epitope peptides to activate and induce Tregs, by which to suppress pathological autoimmune responses and reconstitute a new homeostasis, is a promising therapeutic regimen for autoimmune rheumatic diseases. However, it is usually hard to induce potent peptide-specific immune responses in vivo with small molecular peptides. Bacterial flagellin is one of the agonists triggering innate immune responses. When used as carrier, it shows strong adjuvant activity to its conjugated antigens. In some particular situations, bacterial flagellin can also activate and induce Tregs. Thus if Treg epitope peptides are covalently conjugated to a bacterial flagellin, the conjugates should be able to effectively enhance the Treg-based immune responses via flagellin itself and the adjuvanticity of flagellin to Treg epitope peptides, and thereby enhance the immunotherapeutic effects on autoimmune rheumatic diseases.

The significance of circulating tumor cells in head and neck squamous cell carcinoma: a preliminary study / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the significance of circulating tumor cells (CTC) in squamous cell carcinoma of the head and neck (HNSCC).@*Methods@#Twenty-four patients with HNSCC treated between October 2016 and July 2017 in our department were selected (experimental group), including 23 males and 1 females, aged 47-81 years. There were 14 cases of squamous cell carcinoma of larynx and 10 cases of hypopharynx, including I-Ⅱ stage (5 cases) and Ⅲ- Ⅳ stage (19 cases). All patients were primary and/or relapsed after treatment. Nine healthy volunteers were selected as control group. A novel in vivo capture technique (CellCellector system) was used to detect CTC. SPSS23.0 was used for statistical analysis.@*Results@#The total capture rate of CTC in patients with HNSCC before treatment was 70.8% (17/24), with 40% (2/5) for patients at I-Ⅱ stage, and 78.9% (15/19) for patients at Ⅲ- Ⅳ stage, and was 0 in patients of control group. The total capture rate of CTC in patients with HNSCC after treatment was 50% (8/16). There was no significant correlation between CTC and age, sex, location of tumor or lymph node metastasis (P>0.05). CTC was related to tumor staging and tumor differentiation (P<0.05). The positive rate of EGFRVⅢ in CTC was 26.3% (5/19).@*Conclusions@#The CellCollector system is a very efficient way of detecting CTC, and CTC plays an important role in the occurrence, progression and metastasis of HNSCC.

Thyroid operation after the discussion on drainage technology / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the possibility of thyroidectomy/lobectomy without drainage after surgery.@*METHOD@#Eighty-eight consecutive cases with thyroid mass have been underwent operations including: lobectomy group(42 cases), thyroid lobectomy with contralateral partial thyroidectomy group (17 cases) and total thyroidectomy group (29 cases) from 2013. 06 to 2014. 06 in Nanjing Tongren Hospital. FIfteen patients with thyroid operation in other hospital were collected from 2014. 01 to 2014. 06, the recovery of postoperative incision were compared.@*RESULTS@#Eighty-four cases were smoothly discharged from hospital except 4 thyroidectomy cases suffered from a small amount of effusion in surgical cavity. Our postoperative wound recovery were more in line with the principle of cosmetology compared with other hospital operation group.@*CONCLUSION@#Drainage following thyroidectomy is not essential, if the thyroid surgery is meticulous in each step of the surgery, and can increase the effect of beauty.

Preliminary report on meticulous operation of thyroid lobectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Thyroid lobectomy can be programmed to operate as "step by step". Each step must be performed meticulously with quality control, so as to minimize the complications of surgery.</p><p><b>METHODS</b>From May 2013 to Auguest 2014, the meticulous thyroid operation was conducted in 72 cases (144 lobectomies). Pre- and post-operative evaluations by strobe laryngoscopy, parathyroid hormone (PTH), and blood calcium examinations were conducted in all cases.</p><p><b>RESULTS</b>Four cases (5.6%) had transient recurrent laryngeal nerve paralysis after surgery, but no permanent recurrent laryngeal nerve paralysis. There was no transient or permanent superior laryngeal nerve paralysis. Transient hypoparathyroidism occurred in 10 cases, with no permanent hypoparathyroidism. No case presented with postoperative bleeding or infection.</p><p><b>CONCLUSIONS</b>"Meticulous operation of thyroid lobectomy" may minimize effectively the complication of surgery.</p>

Preservation of parathyroid during the thyroidectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the protection of the parathyroid in the total thyroidectomy to avoid the postoperative permanent hypoparathyroidism.</p><p><b>METHODS</b>Forty-three consecutive cases underwent total thyroidectomy from June 2013 to June 2014 in Nanjing Tongren Hospital were reviewed. Of them 26 cases with malignant and 17 cases with benign thyroid diseases.</p><p><b>RESULTS</b>Intraoperatively, all 4 parathyroid glands were identified in 27 cases, 3 parathyroids in 10 cases and 2 parathyroids in 6 cases. Intraoperative parathyroid transplantation was performed in 6 cases, including 5 cases with 1 parathyroid transplantation and 1 case with 2 parathyroid transplantation. With the follow-up of 1-3 months after surgery, 10 cases presented with transient hypocalcemia, 8 cases with temporary hypoparathyroidism and no case with permanent hypoparathyroidism.</p><p><b>CONCLUSION</b>Accurate identification and conservation in situ or auto-transplantation in total thyroidectomy could be effective for prevention of postoperative permanent hypoparathyroidism.</p>

Clinical Application of Multiplanar Reformatted Images of Multislice Spiral CT in Chronic Suppurative Otitis Media / 实用放射学杂志

Objective To evaluate the clinical application value of multislice spiral CT (MSCT) in diagnosis andclinical treatment of the chronic suppurative otitis media(CSOM). Methods Multislice spiral CT with direct axial plane and saggitalmultiplanar reformation(MPR) were performed in 61 cases including 76 ears.The results from those images were comparedwith that of operations. Results The sagittal MPR images preferably could delineate the anatomical details of the temporal bone and theadjacent relationship,and could display the tympanicand mastoid segment of the facial nerve,sigmoid sinus plate and the glomusjugular better.On the sagittal MPR images,the disruption of the ossicular chain and bony erosion in the tympanic cavity and antrum weredisplayed in 38 ears.The destruction of the facial nerve canal was severe in the type of cholesteatoma compared with the type of granuloma of chronic suppurative otitis media.The congenital abnormities were showed in 8 ears of the sigmoid sinus plate and 2 ears of the glomus jugular.Conclusion CT sagittal MPR images are of significant clinical value in showing the degree and location of destruction of the canal of facial nerve , and the relation between around structures in chronic suppurative otitis media.