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Objective To analyze the clinical effect of ostimeatal complex surgery on chronic sinusitis under nasal endoscope.Methods A total of 270 patients with chronic sinusitis treated in Huzhou Central Hospital from March 2014 to May 2017 were selected.The patients were randomly divided into control group and observation group according to the digital table,with 135 cases in each group.The observation group received ostimeatal complex surgery under nasal endoscope.The control group was treated with local excision,local glucocorticoid injection,and maxillary sinus puncture and irrigation. The patients were followed up for 6 months after surgery, the clinical effect was observed.The life quality of patients was evaluated with 36-items short form health survey (SF-36) and sino-nasal outcome test-20 (SNOT-20).Results At the last follow-up,the cure rate of the observation group was 84.4% , the improvement rate was 13.3% , the cure rate of the control group was 45.2% , and the improvement rate was 20.0%.The clinical efficacy of the observation group was significantly better than that of the control group ( Z =7.291,P<0.001).Three months after treatment,the physiological role score[(69.5 ± 14.1) points] and general health score [(62.9 ± 11.4) points], the total score of 20 items [( 15.5 ± 3.4 ) points] and 5 items [( 8.1 ± 3.7)points] of SNOT-20 scale in the observation group were significantly improved (t=4.881,5.102,20.283, 14.360,all P<0.05).The scores of physiological function,physiological role,body pain,vigor,social function,emotional role,mental health and general health in the observation group were (86.8 ± 11.5) points,(81.0 ± 12.1) points, (82.8 ± 12.7)points,(70.4 ± 11.0)points,(84.5 ± 13.0) points,(73.4 ± 11.6) points,(87.0 ± 12.4)points and (68.7 ± 16.4)points,which were significantly better than those in the control group [(83.8 ± 11.4)points,(69.5 ± 12.4)points,(78.5 ± 13.1) points,(68.4 ± 11.9) points,(74.4 ± 11.7) points,(67.4 ± 11.9) points,(78.9 ± 12.3)points and (64.3 ± 12.9) points],the differences were statistically significant (t =2.153,7.712,2.738, 2.012,6.710,4.195,5.388,2.450,all P<0.05).There were no statistically significant differences in the score of 20 general items and the score of 5 items compared with those at 3 months (all P>0.05).Conclusion The clinical effect of ostimeatal complex surgery on chronic sinusitis under nasal endoscope is satisfactory.The overall symptoms and quality of life of the patients returned to normal,but the 5 major problems such as nasal mucus,mucus nose,bad sleep at night,nasal discharge backstreaming and inattention have not been solved thoroughly.
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OBJECTIVE To explore the expression of Maspin in invasive fungal rhinosinusitis (IFRS) and the value of Maspin in the diagnosis of IFRS. METHODS Forty two cases of fungal rhinosinusitis (FRS) were set as the experimental group, which included 12 cases of IFRS and 30 cases of noninvasive fungal rhino-sinusitis (NIFRS). At the same time, 30 cases of chronic rhino-sinusitis were set as control group. Immunohistochemistry (IHC) was used to detect the expression of Maspin. RESULTS Compared with the control group, the expression of Maspin in FRS group decreased statistically (t=-3.367, P<0.05). The IFRS group, compared with other two groups, had the lowest expression of Maspin (t=-3.390, P<0.05; t=-4.143, P<0.05). By using Maspin score of 5.70 as the cut-off point, the sensitivity and specificity for the diagnosis of IFRS was 91.7% and 88.3% respectively. CONCLUSION The expression of Maspin is very low in IFRS group. Down-regulation of Maspin expression may be a potential indicator for diagnosis of IFRS.
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Objective To review the research advancement of multimodal therapy for advanced gastric carcinoma.Methods The literatures on multimodal therapy for advanced gastric carcinoma in recent years were collected and reviewed.Results The multimodal therapy,such as preoperative chemotherapy,preoperative adjuvant chemoradiotherapy,preoperative interventional chemoradiotherapy for advanced gastric carcinoma was effective because it could increase the rate of R0 resection for the patients with advanced gastric carcinoma.And it can decrease the mortality rate after operation,extend the overall survival time and improve patients' life quality.Conclusion Multimodal therapy is a promising method for the treatment of advanced gastric carcinoma and it should be further developed.