[The imaging presentations of the fallopian canal cerebrospinal fluid leaking].

Objective: To summarize the imaging presentations of the fallopian canal cerebrospinal fluid leaking (FCCFL). Methods: The high resolution CT (HRCT)and MRI materials of 4 patients (4 ears) with FCCFL confirmed by surgery between August 2016 to November 2023 were retrospectively analyzed. Among these, there were 2 males and 2 females, their ages ranged from 6 to 69 years. Results: All of the FCCFL were unilateral, including 2 on the left and 2 on the right.Clinically, the patients with FCCFL suffered from clear nasal fluid flow, ear tightness, and hearing loss. On CT, all of the affected ears were depicted markedly dilatation of the proximal portion of fallopian canal(FC), the labyrinthine segment and geniculate fossa were involved in 4 cases, and involvement of tympanic segment in 1 case at the same time. The geniculate fossa in the affected side were significantly enlarged, protruding upwards into the tympanic cavity, with one case simultaneously involving the cochlea. On MRI, the hyposignal on T1WI and hypersignal on T2WI or water sequence like cerebrospinal fluid (CSF) were shown in the enlargement FC, without diffusion restriction, and non-enhancing with administration Gadolinium contrast.CSF-like signal effusion was shown in all of the affected tympanum, of which, the CSF-like signal effusion was demonstrated in the area along the superficial petrosal nerve, the right pterygopalatine fossa and the parapharyngeal space. The adjacent intracranial meninges were presented thickening in 3 cases. Conclusion: The imaging appearances of FCCFL present some characteristics:on HRCT, the proximal portions of the affected FC depicts markedly enlargement,especially the geniculate fossa.While they present CSF-like signal, no diffusion restriction, and no enhancement administration, Gadolinium contrast on MRI, accompanying the CSF-like signal effusion in the affected tympanum.

[The application value of concept of enhanced recovery after surgery in patients with colorectal carcinoma after natural orifce specimen extraction surgery].

Objective: To discuss the role of enhanced recovery after surgery (ERAS) in patients with colorectal carcinoma after natural orifce specimen extraction surgery (NOSES). Methods: From March 2017 to May 2018, 86 patients diagnosed with colorectal carcinoma and received NOSES at Tangshan Gongren Hospital were randomized to the control group and the observation group. Doctors utilized traditional interventions in the control group. In the observation group were orally administered with electrolyte solution for 12 hours before surgery, without gastrointestinal decompression tube routinely. Patients were fasting for 6 hours before surgery, 2 hours of water inhalation, and oral administration of 10% glucose 3 hours before surgery. During surgery, patients received intraoperative warming and controlled infusion volume. After operation, no drainage tube was placed, and multi-mode analgesia was used. The patient was given a fluid diet on the first day after surgery, and gradually transitioned to a normal diet. The intraoperative blood loss, number of lymph node dissection, operation time, hospitalization time, hospitalization expenses, first drinking time after surgery, diet time, exhaust time, time to get out of bed, pre-and post-operative self-rating anxiety scale (SAS) and self-rating depression scale (SDS) score, postoperative Barthel index and complication were compared between the two groups. Results: The intraoperative blood loss, number of lymph node dissection, and operation time were almost the same between the two groups (all P>0.05). The hospitalization time (6.8±1.2 d versus 8.5±1.5 d) and expenses (58±10 thousand Yuan versus 69±12 thousand Yuan) were significantly reduced in The first drinking time after surgery(1.31±0.35 d versus 2.28±0.24 d), diet time(1.8±0.4 d versus 3.0±0.4 d), exhaust time(2.4±0.5 d versus 2.9±0.6 d), and time to get out of bed (12.0±2.4 d versus 16.8±2.5 d) were all earlier in the observation group (all P<0.05). The SAS and SDS score before the operation were similar between the two groups (all P>0.05), while post-operative SAS (57±7 versus 69±8) and SDS (57±4 versus 62±9) score were significantly decreased in the observation group (all P<0.05). The incidence rates of complication after surgery was 7.0%(3/43) in the observation group, which was significantly lower than the control group (27.9%, 12/43, P=0.011). Conclusion: The combination of NOSES and EARS could reduce stress response, complications, recovery time and expense after surgery, while improving the quality of life in these patients.

Association between ERCC5 gene polymorphisms and gastric cancer risk.

We investigate the role of ERCC5 gene polymorphisms (rs17655 and rs751402) in the development of gastric cancer in a Chinese population. A total of 142 gastric cancer patients whose diagnoses were confirmed by pathology, and 274 control subjects were recruited from Tangshan Gongren Hospital between March 2013 and March 2015. Genotyping of ERCC5 rs17655 and rs751402 polymorphisms was performed by polymerase chain reaction-restriction fragment length polymorphism. Compared with the control subjects, we found that gastric cancer patients were more likely to be older, smoke tobacco, drink alcohol, and suffer from Helicobacter pylori infection. Using a chi-square test, a significant difference was observed in the distribution ofERCC5 rs751402 genotypes between patient and control groups (chi-square = 7.79, P = 0.02). In addition, unconditional multiple logistic regression analysis revealed that the AA genotype of rs751402 significantly increased gastric cancer risk compared to the GG genotype [odds ratio (OR) = 2.61, 95%CI = 1.23-5.49; P = 0.005]. Moreover, we found that the AA genotype correlated with elevated risk of gastric cancer when compared to the GG+AG genotype under a recessive model (OR = 2.21, 95%CI = 1.11-4.39; P = 0.01). In conclusion, we suggest that the ERCC5 rs751402 polymorphism is associated with development of gastric cancer.

[A serological study on the immunization schedule at first dose of domestic BRD II strain rubella vaccine].

In order to develop a valid immunization schedule on the initial vaccination at different age of domestic BRD II strain rubella vaccine, a total number of 268 children at the age of 6 to 18 months from Yantai city of Shandong Province, China were selected for the serological study on hemagglutination inhibition (HI) antibody level against rubella from August to October, 1995. The results showed that the negative rates of HI antibody among children of 6, 7, 8, 9, 12 and 18 month olds before inoculation with rubella vaccine were 100.00%, 95.56%, 93.02%, 96.36%, 97.96% and 93.94% with geometric mean titers (GMTs) 0.00, 1.17, 1.21, 1.12, 1.07 and 1.13, respectively. After one month of immunization with rubella vaccine, the positive rates and GMTs of HI antibody were 97.67%, 95.56% 97.67%, 98.18%, 97.96%, 96.67% and 110.17, 197.02, 155.32, 177.63, 192.92, 142.17, respectively. There was no significant difference on immuno-response to rubella vaccine in children regardless the previous titers. Taking these results together with the current vaccine immunization schedule for expanded programme on immunization (EPI) in China into consideration, the author recommended that the immunization schedule at first vaccination for BRD II strain rubella vaccine should be started at 8 month olds.