OBJECTIVE TTo evaluate the clinical manifestations of the laryngeal amyloidosis and its laryngoscopic characteristics.METHODS The clinical data of 11 cases with laryngeal amyloidosis confirmed pathologically was studied retrospectively. RESULTS There were 4 males and 7 females in this study.The age of the patients ranged from 16 to 64 years old (average 43.36?4.16).The duration of symptoms was 4 months to 10 years (average 2.85?0.87 years).Hoarseness presented in 10 patients (90.90%) and dyspnea in 4 patients.The false vocal cord was involved in 8 patients,laryngeal ventricle in 6 patients,true vocal cord in 5 patients and subglottic area in 3 patients observed with fibrolaryngoscope. The appearance of the lesions was mainly described as waxy yellow or yellow-gray submucosal plaques and nodules without ulceration of the overlying mucosa.The laryngostroboscopy demonstrated that the wave of the mucosa and vibration of the involved vocal cords were adynamic or disappeared.CONCLUSION The chief complaint of the laryngeal amyloidosis was hoarseness. Laryngeal amyloidosis is a slowly progressive disease. The lesions commonly involve the false vocal cord, laryngeal ventricle,true vocal cord and subglottic area.

Objective To evaluate the applicable value of two - dimensional speckle tracking imaging on assessing the local function and coronary collateral circulation of acute myocardial ischemia in dogs.Methods Open-chest model to induce acute myocardial ischemia in 10 dogs was established by ligating their anterior descending coronary artery(LAD). Two-dimensional dynamic gray- scale images of two standard left ventricular short axis views at the levels of mitral annulus and papillary muscle were acquired for the off -line comparative analysis before the operation and 0, 30, 60, 120, 240 and 360 minutes after the operation respectively. Peak systolic circumferential strain(CS), peak systolic radial strain(RS) and left ventricular fraction shortenting(LVFS) of 12 segments at the levels of mitral annulus and papillary muscle were analyzed with QLAB software. After the lab experiment,the fresh hearts of dogs were dyed by TTC.Results ①Compared with the preoperative value , the peak systolic CS and RS of ischemia myocardial regions(anteroseptum,anterior and lateral) in left ventricular short-axis decreased significantly( P ＜0. 05)during 30 to 60 minutes after ligating LAD. Sixty minutes later, the peak systolic CS and RS had a tendency to return to the level before the operation,although the statistical difference was existing. The peak systolic RS and CS also decreased in certain nonischemic regions (inferolateral and inferior). But CS and RS in inferoseptal regions didn't alter significantly. ②Compared with the preoperative value,LVFS in the ischemia regions were significantly decreased( P ＜0.05), while nonischemic regions had no significant difference. ③The results of TTC dyeing showed that the infarcted regions in left ventricular short-axis were anteroseptum, anterior and lateral with blood supplied by LAD, which were consistent with the results of RS and CS. Conclusions RS and CS,as the parameters of myocardial strain may reflect the range and extent of acute myocardial ischemia,and the strain changes of local myocardial segments after the construction of coronary collateral circulatory.

OBJECTIVE: To study the anatomic characteristics of recurrent laryngeal nerve during thyroid surgery. METHOD: A retrospective review of surgical data of 307 patients undertook thyroid surgery was conducted. RESULT: Total 342 recurrent laryngeal nerves were identified during the surgery(184 on the right side, left 158). 215 (62.9%) nerves were deep to the inferior thyroid artery, 106(31.0%)were superficial to the artery, 21(7.5%) were between the arterial branches. A nerve bifurcation was found in 203(59.4%). None of nerve bifurcation was found in 136(39.8%). 3(0.9%)were confirmed to hold non-recurrent laryngeal nerves during operations. No patient showed permanent laryngeal recurrent nerve paralysis postoperatively. CONCLUSION The careful dissection and protection of the recurrent laryngeal nerve was an effective method to prevent its injury during thyroid surgery.
Arteries ; Cranial Nerve Diseases ; etiology ; prevention & control ; Dissection ; Humans ; Postoperative Period ; Recurrent Laryngeal Nerve ; Retrospective Studies ; Thyroid Gland ; surgery ; Thyroidectomy ; Vocal Cord Paralysis

OBJECTIVE: To explore the effect of a comprehensive surgical approach of hyoid suspension with Repose system plus uvulopalatopharyngoplasty (UPPP) on the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: Twelve patients with severe OSAHS (AHI > 40) diagnosed by polysomnography, were determined for the obstruction in both the velo-pharyngeal and the hypopharynx by preoperative physical examination, fiberoptic pharyngo-laryngoscopy. Two cases were given continuous airway pressure via nose, seven days before operation and then were performed hyoid suspension plus UPPP. The follow up was 3 months postoperatively. The pair T test was used to compare the preoperative and postoperative results by SPSS11.0 for windows. RESULT: At postoperative 3 month, there were statistically significance between preoperative and postoperative measurement in all. Mean AHI decreased from preoperative 69.28 +/- 6.50 to postoperative 19.77 +/- 9.23, lowest mean oxygen saturation increased from 65.25 -/+ 3.14 to 90.17 +/- 2.86. Snoring and sleep apnea disappeared or lessened, with the disappearance or decrease of lethargy at daytime. No severe complication occurred. CONCLUSION Comprehensive surgical approach of hyoid suspension with Repose system plus UPPP is effective surgical approach for patients with severe OSAHS who suffered from oropharyngeal and hypopharyngeal obstruction in short- term result.
Adult ; Female ; Humans ; Hyoid Bone ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome ; Uvula ; surgery ; Young Adult

OBJECTIVE: To analyze the characteristic of chronic paranasal sinusitis CT scans and discuss the relationship between the anatomic variations in ostiomeatal complex (OMC) and the incidence of chronic sinusitis. METHOD: One hundred and ninety-seven cases diagnosis as sinusitis were selected and analyzed,whose age ranged between 4 and 74 years old. Several common anatomical abnormalities in ostiomeatal complex were evaluated through the observation of the coronal and axial plane CT scans of the paranasal sinusitis. RESULT: The incidence of anatomic variations in OMC concentrated in the age between 11-20. The incidence of chronic sinusitis also concentrated in the age between 11-20. Deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy were observed between the chronic sinusitis group and the none chronic sinusitis group,the correlation between deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy and chronic sinusitis were significant (P<0.05). CONCLUSION The occurrence of OMC variation is common. The anatomic variations may be one of the causes of chronic paranasal sinusitis, especially deviation of nasal septum, uncinate variations and inferior-turbinate hypertrophy. If these abnormalities were altered,it will have a great significance for the preservation and treatment of chronic paranasal sinusitis.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; diagnostic imaging ; Paranasal Sinuses ; diagnostic imaging ; Sinusitis ; diagnostic imaging ; Tomography, Spiral Computed ; Young Adult

Objective To investigate the changes of heart rate deceleration capacity(DC)in patients with unstable angina pectoris(UAP)and its correlation with the scope and severity of coronary artery disease. Methods From September 2016 to January 2017,one hundred and nine patients with UAP and 52 with non-coronary artery disease were diagnosed in the department of cardiology in the Third Affiliated Hospital of Anhui Medical University. They were all measured with 24h dynamic electrocardiogram and the corresponding analysis software was used to analyze the results,and the difference in deceleration capacity between the two groups was compared. The severity and the number of coronary artery lesions were compared with different deceleration capacity in UAP patients. The relationship between deceleration capacity and the number of coronary artery stenosis, the scope and severity of coronary artery lesions were then analyzed. Results The deceleration capacity value of UAP group was significantly lower than that of the control group((5.10 ± 1.34)vs.(6.03 ±1.40),t=-3.775,P<0.01). The number of coronary artery lesions and Gensini score in group deceleration capacity>4.5 ms were smaller than those in group deceleration capacity ≤4.5 ms((1.67± 0.77)branches vs. (26.76±25.31)branches;(21.27±5.541)points vs.(42.69±8.61)points)(t= -3.910,-2.277,P<0.05). The deceleration capacity value was negatively correlated with the number of coronary artery stenosis(r=-0.206,P<0.01)and the Gensini score(r=-0.358, P<0.01)in patients with UAP. Conclusion Deceleration capacity decreased in patients with UAP and it was closely associated with the severity and the scope of coronary artery lesions.

OBJECTIVE To analyze the clinical manifestation,diagnosis and treatment of cervical lymph node tuberculosis.METHODS The clinical data of 100 patients with cervical lymph node tuberculosis admitted in our hospital from 2007 to 2015 were retrospectively analyzed.RESULTS Most of the patients with cervical lymph node tuberculosis presented with cervical mass alone,only 8 cases associated with fever,night sweats,fatigue and other systemic symptoms of poisoning.Ninety five patients were diagnosed by postoperative pathological examination,while 15 patients were diagnosed with fine needle aspiration preoperatively.Ninety five patients received surgical treatment with postoperative systemic anti-tuberculosis treatment for 6 months,the remaining 5 patients given standard antituberculosis treatment.All of the patients got satisfactory results.There were three operative methods:simple cervical lymph node resection(31 cases),cervical lymph node dissection(53 cases),and abscess incision debridement(ll cases).All patients had no recurrence.CONCLUSION The clinical manifestation of cervical lymph node tuberculosis are complicated,the positive rate of fine needle aspiration biopsy is low.Postoperative pathological examination can help to further confirm the diagnosis.Surgical treatment combined with postoperative systemic standard anti-tuberculosis therapy can be used to cervical lymph node tuberculosis.

Objective To compare the efficacy of sound therapy and conventional medical treatment in the treatment of chronic tinnitus.Methods CNKI,Wanfang database,Weipu database (VIP),Chinese biomedical literature database (CBM),Pubmed,Embase,OVID,SciVerse ScienceDirect and Cochrane library were used.The data were retrieved up to May 2017,and the relevant literature was screened according to the inclusion and emission standards.The quality of the literatures were analyzed and the data was extracted.Meta analysis was carried out by using Revman 5.2 software with total effective rate,tinnitus handicap inventory(THI) value and visual analogue scale(VAS) value.Results A total of 16 articles (1 594 patients) were included in the literature,including 14 articles in Chinese and 2 articles in English.The total effective rate in the sound therapy group were 86.42 ％ (by patients) and 80.50％ (by ears),while in conventional medical treatment group were 60.62％ (by patients),and 48.10％ (by ear),respectively[P＜0.01 (by patients),P＜0.01 (by ear)].The changes of THI value were analyzed before and after treatment,the difference was statistically significant(P＜0.01).The changes of VAS value were analyzed before and after treatment,the difference was statistically significant (P＜0.05).Conclusion Compared with conventional medical treatment,sound therapy can significantly improve the clinical efficacy of tinnitus treatment and reduce the symptoms in tinnitus patients.

OBJECTIVE：To esta blish a sc ientific and objective post competency evaluation index system for the drug registration specialist. METHODS ：By searching the competency model literature of drug registration and registration related documents，combined with Spencer ’s Competency Dictionary and Hay ’s Competency Dictionary ，post competency evaluation index system for drug registration specialist was formulated preliminarily. Through two rounds of Delphi expert consultation ，experts in related fields of drug registration were consulted by letter ，the evaluation indexes were screnned and revised ，and the weight of the indexes was calculated by using the superior order diagram method. Based on questionnaire survey ，232 drug registration personnel were selected as research objects ，and then exploratory factor analysis ，confirmatory factor analysis and internal consistency reliability analysis were used to test the constructed evaluation index system. RESULTS ：The post competency evaluation system of drug registration specialist covered 4 core dimensions （registered professional ability ，relationship management ability ，professional development ability ，personal comprehensive quality ），11 sub-scales，and 41 measurement items ；the weight of the index was confirmed. The establishment process of the evaluation system showed that the expert consultation had high enthusiasm and good coordination；exploratory factor analysis and confirmatory factor analysis had proved the scientific rationality of the index system. CONCLUSIONS：The post competency evaluation index system for drug registration specialist is comprehensive ，integrated and scientific，can provide reference for evaluation and management of the drug registration specialist practice.