Endoscopic sinus surgery is effective to nasal sinus mucocele with eye symptoms as main manifestation. It is very importment to raise the awareness of the disease and to prompt imaging examination. Three cases were reviewed. One mucocele was found in the frontal sinus ethmoid sinus,1 in the fronto-ethmoid sinus and 1 in the spheno-ethmoid sinus. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. Nasal sinus mucocele with eye symptoms as main manifestation should be early diagnosed. Endoscopic sinus surgery is a safe and effective method for the treatment of nasal sinus mucocele,and could be the primary choice for it. All cases were treated by nasal endoscopic sinus surgery. The majority of symptoms, such as exophthalmos, epiphora and diplopia, disappeared in all patients. However, vision recovery was observed only in some patients.
Diplopia ; complications ; Endoscopy ; Ethmoid Sinus ; pathology ; Exophthalmos ; complications ; Frontal Sinus ; pathology ; Humans ; Lacrimal Apparatus Diseases ; complications ; Magnetic Resonance Imaging ; Mucocele ; complications ; diagnosis ; Paranasal Sinus Diseases ; complications ; diagnosis

Adolescent ; Adult ; Aged ; Endoscopy ; Epistaxis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nasal Surgical Procedures ; Young Adult

Objective · To observe the vascular structure before autogenous arteriovenous fistula (AVF) construction in patients with end-stage renal disease (ESRD) and analyze the risk factors of the pre-existing venous neointimal hyperplasia. Methods · The 8 vein samples were screened from 20 ESRD patients at their first time of the AVF construction (non-stenosis group), and the other 8 vein samples were screened from 15 ESRD patients at their at least second time of the AVF repair operation (stenosis group). Sections were prepared and stained with hematoxylin & eosin (H-E) or Masson's trichrome for observation. The intimal thickness was measured by the cellSens software, and its correlation with patients' renal function, calcium-phosphorus metabolism, iron metabolism and inflammatory reaction in the non-stenosis group were analyzed. Results · In the non-stenosis group, there were varying degrees of intimal hyperplasia in 5 (62.5%) cases, loss of endothelial cell layer in 3 (37.5%) cases, and vascular wall replacement by collagenous with atrophy or loss of muscle layer in 5 (62.5%) cases. In the stenosis group, almost all vein samples showed general thickening of the wall and 2 (25.0%) totally lost the muscle layer. Avg It of those two groups were statistically significant (P<0.01). In the non-stenosis group, both of average I/M thickness and average I/M area were negatively related to glomerular filtration rate (GFR) (P<0.05) and positively related to serum phosphorus and calcium-phosphorus product (P<0.05). Conclusion · Some apparently normal vein of ESRD patients showed varying degrees of intimal hyperplasia before AVF construction. The intimal hyperplasia had a remarkable correlation with GFR or calcium-phosphorus metabolism. Early intervention of the intimal hyperplasia prior to AVF construction may be a new prevention and control means.

OBJECTIVE: To investigate the feasibility and efficacy of endoscopic sinus surgery for sinonasal malignancy. METHOD: Clinical data of 40 cases of sinonasal malignancy treated in our hospital from January 2007 to December 2011 were retrospectively analyzed. The pathological types encountered were: 5 cases of malignant transformation of sinonasal inverted papilloma, 2 cases of maxillary sinus carcinoma, 3 cases of ethmoid sinus carcinoma, 11 cases of mucosal melanoma, 7 cases of olfactory neuroblastoma, 2 cases of neuroendocrine carcinoma, 4 cases of myoepithelial carcinoma, 3 cases of adenoid cystic carcinoma, 1 case of malignant hemangiopericytoma. These patients were operated on either by an exclusive endoscopic surgery or endoscopic surgery with a complementary external approach. Thirty-two patients received adjuvant radiotherapy and/or chemotherapy. RESULT: All the patients were followed up for a period of 1 to 5 years after operation, of which 18 cases survived for more than three years. Four cases recurred after six months to two years, but the result was satisfactory after revision endoscopic sinus surgery. Three cases occurred cervical lymph node metastasis, of which 2 cases received neck dissection and 1 case received chemotherapy and radiotherapy due to no surgical indications. Four cases occurred distant metastasis. Eight cases died of tumor until the last follow-up. The other 21 cases occurred no recurrence and metastasis during follow-up period. CONCLUSION Endoscopic sinus surgery is an effective method for sinonasal malignancy. Appropriate indication must be carefully selected for malignant tumor. Combined treatment based on surgery should be adopted to it.
Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Nose Neoplasms ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Retrospective Studies ; Young Adult

OBJECTIVE: To investigate the diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body and to make a better solution for the disease. METHOD: Twenty-four cases with esophageal perforation and neck abscess induced by esophageal foreign body treated in our department were surgery under general anesthesia. The foreign bodies were removed via esophagoscope in 14 cases, thorocomy in 3 eral neck incision in 5; and no foreign bodies were found in 2 cases. RESULT: There were 16 cases complicated by abscess. Among these complications,there were 10 cases of periesophageal abscess,4 cases of neck abscess and 1 case of mediastinal abscess. In 24 patients, 21 cases cured and one died. One case was sent to the department of endocrinology because of hyperglycaemia and two cases were sent to the department of thoracic surgery for further treatment. CONCLUSION Early diagnosis and treatment is the key to the management of esophageal perforation induced by esophageal foreign body. Thin-section CT has a high value for the diagnosis and differential diagnosis in such patients. Once deep neck abscess is diagnosed, an early abscess surgical drainage, an appropriate antibiotics and a nutrition supporting treatment are effective for the patients.
Abscess ; etiology ; surgery ; Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Drainage ; Esophageal Perforation ; etiology ; surgery ; Esophagus ; Female ; Foreign Bodies ; complications ; surgery ; Humans ; Male ; Middle Aged ; Neck ; pathology ; Young Adult

OBJECTIVE: To investigate the efficacy of endoscopic nasal cavity expansion surgery on obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal obstruction. METHOD: Clinical data of 48 OSAHS patients with structural abnormality in nasal cavity treated in our department were retrospectively analysed. These patients received endoscopic nasal cavity expansion surgery and were observed for the relief of both subjective and objective symptoms. RESULT: PSG was reexamined 12 months postoperatively. Of all the patients, 29 cases (60.4%) showed complete recovery, 10 cases (20.8%) showed remarkable improvement of the symptoms, 4 cases (8.3%) exhibited curative effect and 5 cases (10.4%) were of no effect, respectively. The symptoms of apnea, hypopnea, LSaO2 and somnolence were significantly improved in all patients,and nasal congestion was obviously relieved. The improvement of snore was not evident. CONCLUSION Endoscopic nasal cavity expansion surgery is effective and safe for the treatment of OSAHS mainly due to nasal obstruction. Operation should be performed to correct structural abnormality in nasal cavity and adjust symmetric distribution of nasal airflow on both sides in order to maintain normal ventilation function. The procedure is applicable to OSAHS patients accompanied by nasal congestion and upper airway resistance syndrome and personalized adjustment is beneficial for better clinical efficacy according to the condition of different patients.
Adult ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Nasal Obstruction ; complications ; pathology ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; etiology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE:To establish the quality creteria of Dendrobium denneanum cultivated in Sichuan.METHODS: The reference substance had been isolated and identified.HPLC and TLC were applied for determination and identification respectively.RESULTS: The coumarin control had been successfully isolated and the TLC spots were clear.The linear range of coumarin was 0.096～0.480 ?g with an average recovery of 99.1%(RSD=1.44%,n=6).CONCLUSION: The results can overall reflect the internal quality of D.denneanum cultivated in Sichuan and provide basis for quality evaluation and development of D.denneanum from Sichuan.

OBJECTIVE:To study the chemical constitutes of Ligusticum chuanxiong and to establish the method for the content determination of ligustilide. METHODS:The compounds were extracted and percolated by ethanol. Then the samples were separated using silica gel and identified by 1H-NMR,13C-NMR data.HPLC was used to assay the contents of ligustilide. RESULTS:Three compounds were isolated and their structures were identified as Z-ligustilide,Z-6,8',7,3'-diligustilide and Z,Z'-6,6',7,3'a-diligustilide. The contents of ligustilide were no less than 0.70%.CONCLUSION:The separation method can be used to prepare high-purity ligustilide reference substance. And the determination method can be used for quality control of L. chuanxiong.

BACKROUND:Previous studies have confirmed that radiofrequency ablation(RFA)has not only efficiently killed tumor cells,but also improved immune suppression of organism.Antigen presenting cells play an important role during anti-tumor immune reaction.Dendritic cells are most powerful antigen presenting cells.OBJECTIVE:To study the influence of RFA on OX-62,OX-6 and CD86 expression of rat peripheral blood mononuclear cells.DESIGN,TIME AND SETTING:The randomized controlled animal observation was performed at the School of Oncology of Peking University from June 2005 to March 2006.MATERIALS:A total of 12 Sprague Dawley rats were equally and randomly assigned into control and 1 -week radiofrequency groups.METHODS:2 mL peripheral blood was extracted from rats of the control group following rats were sacrificed.The left lobe of rat liver was exposed,inserted with acicular electrodes at tilted position.The acicular electrodes were spread out.The action time was 4 minutes.After RFA,the rats were given anti-infective therapy.2 mL peripheral blood was taken out after they were put to death 1 week after RFA.MAIN OUTCOME MEASURES:The following parameters were measured:pathomorphological observation on the liver of normal rats after RFA;OX-62,OX-6 and CD86 expression of peripheral blood mononuclear cells before and after RFA.RESULTS:Pathologyical examination after RFA showed the characteristic that coagulation necrosis and cellular degeneration and granulation tissue forming appeared from target center to peripheral of the target.Positive expression rate of OX-62 in rat peripheral blood in the 1-week radiofrequency group[(0.70±0.16)%]was significantly higher than in the control group [(0.34±0.08)%,P ＜0.05].No significant difference in positive expression rate of OX-6 and CD86 in the peripheral blood mononuclear cells between both groups(P＞0.05).CONCLUSION:RFA can promote the increased number of precursor Dendritic cells in rat peripheral blood,which may be contributed to improve the ability to angtigen presentation during immune response.Dai Wei-de,Doctor,Associate chief physician,Department of Ultrasound,Beijing Hospital of Ministry of Public Health,Beijing 100730,China dai.weide@126.com

Objective To evaluate the value of MR spectroscopy (MRS) in the differential diagnosis between recurrence and radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma (NPC). Methods Muhi-voxel proton MRS was performed on 50 patients with NPC, who were suspected of intracalvarium tumor recurrence or radiation encephalopathy after radiotherapy by conventional MRI,including 44 males and 6 females. Among the 50 patients, 26 cases were finally diagnosised as basicranial tumor recurrence and 24 cases as radiation encephalopathy by clinical and MRI follow-up. The following metabolites, such as Cho, NAA, Cr, lactate and lipid, were analyzed comparatively between basicranial tumor recurrence and radiation encephalopathy(RE), and between the lesions and the relative normal brain tissue. Wilcoxon's rank sum test was used to analyze the data. Results The median of Cho/Cr, Cho/NAA,LI/Cr in tumor recurrence group were 2. 22, 2. 13, and 1.77, respectively, and 1.40, 1.31, and 0. 57,respectively, in RE group. The difference of Cho/Cr, Cho/NAA, and LL/Cr between the two groups were statistically significant (P < 0. 01). Those in tumor recurrence group were higher than in RE group. The median of Cho, Cr, NAA in tumor recurrence group and in RE group were 3366. 00, 1023.00, 1930. 00 and 2469.50, 1864.50, 1734.00. There were no significant difference of Cho, Cr, and NAA between the two groups (P > 0. 05). In the 14 cases whose normal brain tissue were compared with the recurrent tumor tissue in tumor recurrence group, the median of Cr, NAA, LL, Cho/Cr, Cho/NAA, LL/Cr of recurrent tumor tissue and normal brain tissue were 1023.00, 1930.00, 2090.00, 3.76, 2. 13, 3.39 and 2370.00, 3012.00, 1680.00, 1.64, 1.17, 0.75,The difference of Cr, NAA, LL, Cho/Cr, Cho/NAA, LL/Cr between the normal tissue and recurrent tumor tissue were significant (P <0.05). LL, Cho/Cr, Cho/NAA, LL/Cr of recurrent tumors were higher than those of the normal brain tissue,while NAA and Cr of recurrent tumors were lower than those of the normal brain tissue. In the 12 cases whose normal brain tissue were compared with the RE tissue in RE group, the median of Cho, Cr, NAA, LL, Cho/Cr, IX,/Cr of RE tissue and normal brain tissue were 390.00, 217.50, 427.50, 39.00, 1.30, 0.40 and 680.00, 360.00, 610.00, 30.00, 1.54, 0. 09. The difference of above-mentioned parameters between RE tissue and normal tissue were significant. Cho, Cr, NAA, Cho/Cr of RE were lower than those of normal tissue (P <0. 05) ,while LL and LL/Cr of RE were higher than those of normal tissue (P < 0. 05). Conclusion The changes of the metabolites in recurrent lesions and RE lesions were different on MRS. Parameters such as Cho/Cr, Cho/NAA and LL/Cr, which were higher in recurrent lesions than those of RE, were valuable for the differential diagnosis between basicranial tumor recurrence and radiation encephalopathy after radiotherapy for NPC.