Objective To investigate the effect of outpatient nursing intervention in patients with chronic rhinosinusitis(CRS)on the aspects of clinical efficacy, quality of life and nursing satisfaction after medical therapy. Methods The clinical efficacy according to the judgment standard for clinical effect was valued. Medical outcome study short-form 36-items health survey (SF-36) was used to assess the quali?ty of life of the subjects. Satisfaction Questionnaire was used to evaluate the satisfaction scale of patients. Eighty subjects with CRS were randomly divided into the control group (40 cases) and the trial group (40 cases). The trial group was given nursing intervention on basis of usual nursing. In three months after treat?ment, the data and statistics analysis was purely descriptive by SPSS 20.0. Results Clinical efficacy:in the group, nineteen subjects were cured,fourteen subjects were improved and inefficacy occurred in seven subjects. The effective rate was 77.5%(31/40). In the trial group, twenty-six subjects were cured,twelve subjects were improved and inefficacy occurred in two subjects. The effective rate was 95.0%(38/40). There were differences in general data between the two groups (χ2=5.165,P=0.023). Quality of life:the average score of the control group was 58.10±5.04, while the average score of the trial group was 72.22±5.63, the average score of quality of life in the trial group was significantly higher than that in the control group(t=3.08,P=0.025). Nursing satisfaction:there were significant differences in nursing satisfaction between the control group and the trial group (u=-7.048,P=0.000). Conclusions Outpatient nursing intervention can improve the effect of patients with chronic nasal sinusitis after medical therapy, improve the quality of life and improve nursing satisfaction.

Objective To investigate the relationship between bacteria biofilm and bacterial culture in patients with chronic rhinosinusitis (CRS). Methods Ninety patients with CRS were enrolled in the study. Five patients with deviation of nasal septum and 10 healthy subjects served as controls. Mucosa of uncinate process or near the ostium of the maxillary sinus was obtained during endoscopic sinus surgery. All specimens were processed for bacterial culture and scanned by electron microscopy. Pearson test was performed to analyze the relationship between the presence of bacterial biofilm and the results of bacteria culture. Results The scanning electron microscopy showed bacterial biofilms in 64 (71.1%) out of 90patients with CRS, while the positive rate of bacteria culture in the study group was 66.7% (60/90). No bacterial biofilm and bacterium was detected in the control group and 26 culture-negative individuals in study group. Pearson correlation analysis showed a statistically association between bacterial biofilm and bacterial culture in CRS ( r = 0. 901, P = 0. 000). Conclusion Positive results of bacteria culture are highly correlated with the presence of bacterial biofilm in CRS patients.

Objective To evaluate the efficacy of low-dose and long-term clarithromycin in treatment of chronic rhinosinusitis with positive bacterial biofilms.Methods Seventy-seven patients with chronic rhinosinusitis and positive bacterial biofilms underwent functional endoscopic sinusitis surgery between January 2008 and December 2009 in department of otolaryngology of Jinhua Central Hospital.Fortytwo patients were treated with clarithromycin 250 mg/d orally for at least 3 months (trial group).At the end of 3 months patients received endoscopic examination,for patients with mucosal epithelialization the clarithromycin therapy was stopped; for those with mucosal edema,granulation or polyoid formations the clarithromycin treatment was continued,but no longer than 5 months.Thirty-five patients in control group were not given clarithromycin.All patients were assessed by visual analogue scale (VAS) and nasal endoscopic examination (Lund-kennedy score) 6 months after surgery,the results were compared between two groups.Results Two patients in the trial group did not complete the protocol.VAS score and Lundkennedy score in trial group were 8.0 ± 0.8 and 3.6 ± 1.3 at 6 month after surgery respectively,while those in the control group were 7.3 ± 0.7 and 4.5 ± 1.7,and the differences were of statistical significance (t =5.311 and-3.187,P ＜ 0.01).Conclusion Low-dose and long-term oral administration of clarithromycin has positive impact on the prognosis of bacterial biofilms positive patients with chronic rhinosinusitis.

Objective To observe the bacterial biofilm in patients with chronic rhinosinusitis (CRS), and to investigate the possible relationship between biofilm and clinical factors. MethodsSixtynine patients with CRS ( study group), 15 patients with nasal septum deviation and 10 patients with nasal bone fracture (control group) were enrolled in the study. Mucosa specimens of uncinate process or ethmoid near the ostium of the maxillary sinus were obtained during endoscopic sinus surgery. The specimens were subjected to scanning electron microscopy. All patients were evaluated by questionnaire of chnical factors based on sino-nasal outcome test-20. SPSS 10. 0 was used for statistical analysis, and the relationship between bacterial biofilm and clinical factors was evaluated by Chi-square test. ResultsBacterial biofilms were found in 49 patients ( 71.0％ ) with CRS. A marked destruction of the epithelium and cilia was observed in all samples of study group. No bacterial biofilm was found in the control group, and scanning electron microscopy showed normal epithelium and cilia in those specimens. Chi-square test showed that bacterial biofilm was not associated with clinical factors (gender, staging, course, nasal obstruction, phlegm, nasal discharge with stinking smell, headache, bloody nasal discharge and olfactory degeneration) in CRS. ConclusionsBacterial biofilms and destruction of the epithelium and cilia can be obscrved in CRS patients, which may be involved in the pathogenesis of CRS, but the formation of bacterial biofilm is not correlated with the clinical factors in CRS.

Objective To investigate the clinical effect and safety of endoscopic inlay butterfly cartilage tympanoplasty(BCT)by day surgery mode.Method 120 patients with tympanic membrane perforation from June 2021 to June 2022 were randomly divided into two groups,the observation group of 60 patients underwent endoscopic inlay BCT,the control group of 60 patients underwent endoscopic tympanic membrane repair with tragus cartilage membrane.Both groups of patients completed all preoperative examinations in the outpatient department and completed the steps of admission,surgery,and discharge within 24 h.The surgical conditions(operation time and intraoperative blood loss),pure tone average(PTA)after 6 months,air-bone gap(A-B gap)after 6 months,tympanic membrane healing rate,and complications were compared between the two groups.Results There was no statistical significance in the operation time and intraoperative blood loss between the observation group and the control group(P>0.05).After 6 months,the PTA and A-B gap of both groups were lower than those before the surgery(P<0.01),the observation group had a significantly lower PTA(23.40±4.40)dB HL and A-B gap(9.11±3.13)dB HL than the control group(29.12±3.33)dB HL and(14.86±3.20)dB HL,with statistically significant differences(P<0.05).There was no statistical significance in the tympanic membrane healing rate between the two groups after surgery(P>0.05),but the incidence of complications in the observation group was 5.0%(3/60),significantly lower than that in the control group(21.7%,13/60),with a statistically significant difference(P<0.05).Conclusion Endoscopic inlay BCT is safe and effective in the treatment of tympanic membrane perforation,with better hearing recovery than tragus cartilage membrane repair surgery,fewer complications,and more suitable for day surgery mode.It is worthy clinical application.

OBJECTIVE: To investigate the expression and clinical pathological significance of PDCD4 in laryngocarcinoma tissue and its potential significance to clinic. METHOD: Western-blotting and immunohistochemistry ana lyse to measure the protein expression of PDCD4 in 54 cases of laryngocarcinoma tissues (studying group) and their paraneoplastic normal tissues (control group). The correlations of PDCD4 with clinical pathological parameters were analyzed. RESULT: PDCD4 protein was positively expressed in paraneoplastic normal tissue while which was lost or decreased in laryngocarcinoma tissue by Western blot and immunohistochemistry. Immunohistochemistry assay showed the location of PDCD4 protein in cells was different between the studying group and the control group. The expression level of PDCD4 was related to the pathological grades of the laryngocarcinoma. It's higher in the well-differentiated tumor group than that in the poorly differentiated ones. But the expressions of PDCD4 were no differences among other clinical parameters including sex, age, clinical classification, clinical stage and the cervical lymphonodus who had been metastases or not. CONCLUSION PDCD4 gene is anti-oncogene. It may play an important role in the pathogenesis and development of laryngeal carcinoma and it may be a new target of therapy for laryngo carcinoma.
Adult ; Aged ; Aged, 80 and over ; Apoptosis Regulatory Proteins ; metabolism ; Female ; Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; RNA-Binding Proteins ; metabolism

Objective:To explore the effects of nursing intervention based on cognitive behavioral therapy (CBT) in patients with laryngeal cancer.Methods:Totally 88 patients with laryngeal cancer admitted to Department of Otolaryngology-Head and Neck Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine from October 2018 to October 2020 were selected by convenient sampling and divided into a control group and an observation group according to the random number table, with 44 patients in each group. Patients in the control group received routine nursing, while patients in the observation group underwent CBT-based nursing intervention on this basis. The psychological status, quality of life, and nursing satisfaction were compared between the two groups of patients.Results:After intervention, the scores of Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS) in the observation group were lower than those in the control group, and the differences were statistically significant ( P< 0.01) ; the patient satisfaction in the observation group was higher than that in the control group, with a statistically significant difference ( P< 0.01) ; the total score and all aspects of the quality of life of the observation group were higher than those of the control group, and the differences were statistically significant ( P< 0.01) . Conclusions:CBT-based nursing intervention can alleviate the anxiety and depression and improve the quality of life of patients with laryngeal cancer.

Immunoglobulin (IgG) glycosylation affects the effector functions of IgG in a myriad of biological processes and has been closely associated with numerous autoimmune diseases, including systemic lupus erythematosus (SLE), thus underlining the pathogenic role of glycosylation aberration in autoimmunity. This study aims to explore the relationship between IgG sialylation patterns and lupus pregnancy. Relative to that in serum samples from the control cohort, IgG sialylation level was aberrantly downregulated in serum samples from the SLE cohort at four stages (from preconception to the third trimester of pregnancy) and was significantly associated with lupus activity and fetal loss during lupus pregnancy. The type I interferon signature of pregnant patients with SLE was negatively correlated with the level of IgG sialylation. The lack of sialylation dampened the ability of IgG to suppress the functions of plasmacytoid dendritic cells (pDCs). RNA-seq analysis further revealed that the expression of genes associated with the spleen tyrosine kinase (SYK) signaling pathway significantly differed between IgG- and deSia-IgG-treated pDCs. This finding was confirmed by the attenuation of the ability to phosphorylate SYK and BLNK in deSia-IgG. Finally, the coculture of pDCs isolated from pregnant patients with SLE with IgG/deSia-IgG demonstrated the sialylation-dependent anti-inflammatory function of IgG. Our findings suggested that IgG influences lupus activity through regulating pDCs function via the modulation of the SYK pathway in a sialic acid-dependent manner.
Humans ; Pregnancy ; Female ; Lupus Erythematosus, Systemic/pathology* ; Signal Transduction ; N-Acetylneuraminic Acid/metabolism* ; Immunoglobulin G ; Dendritic Cells/pathology*