A 67-year-old male patient was admitted because of "the right side nasal obstruction repeatedly for 4 years". He got nasal obstruction 4 years ago, especially for the right side nasal cavity, sometimes got blood in his nasal discharge, then the symptom relieved after accepting treatment in local hospital. During the 4 years, the symptom repeatedly occurrence. Three days before hospitalization, the CT examination indicated abnormal things in his nasal cavity and the bone of his nasal sinus had been destroyed. Some abnormal organism were sent to pathological examination, and the report indicated it is acinic cell carcinoma of salivary gland. During the nasal endoscope surgery, a red goiter was found in his nose with its surface crude and brittle. Then we cut the goiter by nasal endoscope, during the operation we find the bottom of the goiter is on the nasal septum. Two weeks after the operation, the patient received the radiation therapy. One year after the operation he doesn't get the abnormal symptom and the nasal MRI not found recidivation.
Aged ; Carcinoma, Acinar Cell ; surgery ; Endoscopy ; Humans ; Magnetic Resonance Imaging ; Male ; Nasal Cavity ; pathology ; Nasal Obstruction ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; Paranasal Sinuses ; pathology ; Salivary Gland Neoplasms ; surgery ; Salivary Glands ; pathology

[ABSTRACT]OBJECTIVETo study the deposition of suspended particles in the respiratory tract during human breathing.METHODSBased on CT data, three dimensional finite element model of an anatomically accurate respiratory tract, including the nasal cavity, oral cavity, pharynx, larynx, trachea and parts of tracheobronchial tree, is established. Numerical analysis for the deposition of suspended particles in the respiratory tract was conducted. RESULTSThe velocity and pressure distributions of airflow in the respiratory tract were obtained, as well as the particles path and their deposition law.CONCLUSION Respiratory tract plays an important role in filtering suspended particles in the air during breathing. The main deposition sites of the particles were at the front of the inferior turbinate and the posterior pharyngeal wall.

[ABSTRACT]OBJECTIVETo explore the basic characters of the airflow-field in Chinese people's nasal cavity by computational fluid dynamics.METHODSThe three-dimensional, finite-element mesh were developed from Spiral CT imaging scans of nose of the 40 healthy Chinese people. Given the following spatial boundaries of the flow field: no-slip condition was imposed at the surface of the nasal airway walls; a standard atmosphere pressure condition was established at the inlet; a velocity vector was specified at the outlet (nasopharynx), which was obtained under the condition of aspiratory flow rate (12 L/min), the full Navier-Stokes and continuity equations were solved to obtain the airflow pattern.RESULTS1. The airflow passed mainly through left or right side of the nasal airway in the whole 40 cases (left 33, right 7),and the volume of air through the main-side is (320±28) ml while non-main-side (180±45) ml. 2. Airflow velocity: airflow of anterior nostrils, internal nostrils, the middle and inferior parts of the total meatus in the main-side were (5.01±2.12) m/s, (7.00±1.75) m/s, (5.08±1.55) m/s, (4.12±1.40) m/s respectively, and those in non-main-side were (2.01±0.94) m/s, (2.40±0.34) m/s, (1.99±1.0) m/s, (2.01±0.65) m/s respectively, which differences between the both sides were of statistical significance (allP<0.05); airflow of middle meatus, inferior meatus and olfactory cleft in the main-side were (2.08±0.43) m/s, (1.60±0.95) m/s, (1.64±0.80)m/s respectively, and those in non-main-side were (1.89±0.52) m/s, (1.49±0.89) m/s, (1.50±0.75) m/s respectively, which differences were significant statistically (allP>0.05); 3. The airflow form appeared to be linear in the middle and inferior parts of the nasal cavity. 4. Velocity in maxillary sinus cavity was almost 0 m/s.CONCLUSIONThe airflow passes mainly through the middle and inferior parts of the meatus with higher velocity in laminar form and airflow of middle meatus, inferior meatus and olfactory cleft are low and the velocity were slow. Besides, airflow in maxillary sinus cavity diffuses free mainly.

Objective To investigate the effect of silicone oil on the corneal endothelium in experimental animal models,while the silicone oil in the anterior chamber of the experimental animals will be taken out so as to explore their corneal changes.Methods Forty healthy white rabbits were randomly divided into three groups : silicone oil in the anterior chamber group (SIG),silicone oil in and out of the anterior chamber group (SIOG) and control group(CG).The cornea of rabbit was investigated at different times by slit-lamp,corneal thickness instrument,endothelial cell count instrument,histology and electromicroscopy.The time of silicone oil in the anterior chamber without keratpathy and the pathological changes of cornea with taking out of the silicone oil were observed.Results The density of the corneal endothelium in SIOG and SIG decreased more obviously by endothelial cell count instrument from 8 weeks to 16 weeks compared with control group (P

OBJECTIVE To evaluate the effect of intravenous infusion of methylprednisolone on postoperative recovery and complications after coblation tonsillectomy.METHODS Eighty three patients who were scheduled for coblation tonsillectomy from December 2015 to December 2016 were included in this study.Firstly,they were divided into 2 groups,i.e.,the younger group (＜12 years) and the older group (≥12 years old).Secondly,these two groups were further divided into experimental group and control group by the prospective,double-blind and randomized method.The experimental group was treated with methylprednisolone and antibiotics for 3 days.Then,the postoperative reactions such as the pain,activity,pharyngeal edema,body condition,exfoliation time of the tunic albuginea,post-tonsillectomy hemorrhage were observed.RESULTS 1.From the third day to fifth day,using methylprednisolone can alleviate pain (Z=4.42,P=0.00),increase the activity(Z=2.64,P=0.00)and reduce pharyngeal edema(Z=2.84,3.10,all P=0.00) in younger group.2.After operation,in the younger group,the incidence rate of gastrointestinal discomfort in control group was higher than that in experimental group(x2=4.97,P=0.03).In the older group,the incidence rate of gastrointestinal discomfort(x2=5.24,P=0.02) and sleep disturbance(x2=5.03,P=0.03) in control group was higher than those in experimental group.3.In the older group,exfoliation average time of the tunic albuginea in experimental group was longer than that in control group(t=2.16,P=0.04).4.Secondary bleeding rate was not statistically significant in the two groups(x2=1.29,P=0.26).CONCLUSION Intravenous infusion of methylprednisolone after coblation tonsillectomy is beneficial,especially in the relief of pain,gastrointestinal discomfort and pharyngeal edema.

OBJECTIVE: To investigate the nasal airflow-field in relation with the structure and function of the human nose. METHOD: The 3-D finite-element mesh is developed from Spiral- CT imaging scans of the 25 healthy volunteers' noses. Given three preconditions, the nasal air-flow is described by the Navier-Stokes and continuity equations at the inspiratory flow rate of 10 min, then the whole airflow patterns are obtained for further analysis. RESULT: (1) In 5 cases, the airflow passes mainly through the middle medial region in both sides in the nasal airway. In remaining 20 cases, the airflow passes mainly through the middle and ventral medial regions in one side in the nasal cavity while little air passes through middle medial regions in another the other side through which little air passes. (2) The differences of velocity in the nasal valve, middle and ventral medial regions of the nasal airway between mainly side and non maingnot-mainly side are of statistical significance, while those in the olfactory split, middle and inferior meatuses in both sides are of no statistical significance. (3) In the mainly side, the most rapid air speed occurred in the nasal valve , the second rapid velocity in the middle medial region and the third in the ventral medial regions, the slowest velocity in the olfactory split, middle and inferior meatuses. In notion- mainly side, the velocity in all regions is slow without statistical significance. CONCLUSION (1) At the inspiratory flow rate of 10 L/min, the middle and ventral medial regions act as the main airways in nasal cavity. (2) The airflow in nasal cavity can be directed effectively and reasonably by nasal valve, inferior turbinate, middle turbinate in turn, which may be consistent with the nasal cycle functionally.
Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Models, Biological ; Nasal Cavity ; diagnostic imaging ; Pulmonary Ventilation ; Tomography, X-Ray Computed

Patients with cardiovascular diseases have poor medication adherence, which seriously affects the prognosis of their diseases. This article reviewed the prediction model of medication compliance for patients with cardiovascular diseases, analyzed its predictive factors, model efficacy and application, and put forward opinions on the construction of relevant prediction models, which could provide reference for the clinical development of targeted intervention programs.

Background: Job performance is known as an essential reflection of nursing quality. Colleague solidarity, positive emotion, and turnover intention play effective roles in a clinical working environment, but their impacts on job performance are unclear. Investigating the association between nurses’ colleague solidarity and job performance may be valuable, both directly and through the mediating roles of positive emotion and turnover intention. Methods: In this cross-sectional study, a total of 324 Chinese nurses were recruited by convenience sampling method from July 2016 to January 2017. Descriptive analysis, Spearman’s correlation analysis, and the structural equation model were applied for analysis by SPSS 26.0 and AMOS 24.0. Results: A total of 49.69% of participants were under 30 years old, and 90.12% of participants were female. Colleague solidarity and positive emotion were positively connected with job performance. The results indicated the mediating effects of positive emotion and turnover intention in this relationship, respectively, as well as the chain mediating effect of positive emotion and turnover intention. Conclusions In conclusion, dynamic and multiple supportive strategies are needed for nurse managers to ameliorate nursing job performance by improving colleague solidarity and positive emotion and decreasing turnover intention based on the job demand-resource model.

OBJECTIVE: To investigate the safety of laparoscopic pancreaticoduodenectomy (LPD) in elderly patients and the related risk factors admitted to the intensive care unit (ICU) after LPD. METHODS: The perioperative data of patients who underwent LPD in Tianjin Medical University General Hospital from February 2017 to June 2023 were retrospectively collected, including basic data, preoperative laboratory indicators, intraoperative and postoperative indicators, pathological results (tumor size, lymph node dissection and pathological type), postoperative complications, ICU postoperative management and prognosis. The patients were divided into the elderly group (≥ 65 years) and the non-elderly group (< 65 years) according to age. Perioperative data between two groups were compared. Kaplan-Meier survival curve was drawn to analyze the survival rate of the elderly group and the non-elderly group, and the pancreatic head carcinoma group and other type of tumors group after LPD. Logistic regression was used to analyze the risk factors of ICU stay (length of ICU stay > 1 day) after LPD in elderly patients. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of this risk factor for ICU stay after LPD in elderly patients. RESULTS: A total of 160 patients were enrolled, including 57 cases in the elderly group (17 cases of vascular reconstruction) and 103 cases in the non-elderly group (40 cases of vascular reconstruction). All patients underwent R0 resection and were transferred to the comprehensive ICU for treatment. The follow-up time of patients with malignant tumors was 43 (6, 72) months. The elderly group had significantly longer surgery time, postoperative hospital stay and oral feeding time than the non-elderly group, and the incidence of delayed gastric emptying (DGE) was significantly higher than that in the non-elderly group. There were no significant differences in intraoperative blood transfusion rate, intraoperative blood loss, pathological results, short-term and severe postoperative complications, reoperation rate and 90-day mortality between the two groups. In patients with vascular resection reconstruction, the intraoperative blood loss in the elderly group was significantly higher than that in the non-elderly group, and the operation time and postoperative hospital stay were significantly longer. During ICU, the acute physiology and chronic health evaluation II [APACHE II: 12 (9, 14) vs. 8 (7, 10)], sequential organ failure assessment [SOFA: 6 (4, 8) vs. 3 (2, 5)] within 24 hours after admission to ICU were significantly increased in the elderly group (both P < 0.05), the time of mechanical ventilation [hours: 12 (10, 15) vs. 9 (5, 13)] and the length of ICU stay [days: 2 (1, 2) vs. 1 (1, 1)] were significantly increased in the elderly group (both P < 0.05), and the proportion of multi-disciplinary team (MDT) was also significantly increased in the elderly group (33.3% vs. 17.4%, P < 0.05), there were no significant differences in the levels of hemoglobin (Hb), albumin, and blood lactic acid between the two groups. Logistic regression analysis showed that the APACHE II score was an independent risk factor for ICU stay after LPD in elderly patients (β = 1.737, P = 0.028). ROC curve showed that the prediction performance was the best when the APACHE II score was 13, with the sensitivity of 72.41% and the specificity of 96.43%, and the area under the ROC curve (AUC) of 0.884. The Kaplan-Meier survival curve showed that there were no significant difference in median survival time (months: 24.1 vs. 24.7) and 5-year survival rate (19.01% vs. 19.02%) between the elderly group (52 cases) and the non-elderly group (92 cases) among the 144 patients with malignant tumors (both P > 0.05). The median survival time in the pancreatic head carcinoma group was significantly shorter than that in the other tumors group (63 cases; months: 20.2 vs. 40.1, P < 0.05), 5-year survival rate was significantly lower than that in the other tumors group (21.98% vs. 30.91%, P < 0.05). CONCLUSIONS LPD is a safe and feasible treatment for elderly patients. APACHE II score has a certain predictive value for ICU stay after LPD in elderly patients.
Humans ; Aged ; Middle Aged ; Sepsis/therapy* ; ROC Curve ; Pancreaticoduodenectomy/adverse effects* ; Retrospective Studies ; Blood Loss, Surgical ; Prognosis ; Pancreatic Neoplasms/surgery* ; Postoperative Complications ; Intensive Care Units

Objective:To compare and analyze the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic assisted surgery (LAS) in the treatment of advanced gastric cancer.Methods:Articles of the efficacy comparison of HALS and LAS in D2 radical gastrectomy for gastric cancer from 2000 to 2019 published in PubMed, Cochrane library, EM-BASE, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu, Chinese full-text database of Chinese Sci-Tech journals, Chinese biomedical literature database were retrieved, and the literatures were screened according to the pre-established inclusion and exclusion criteria. The quality of the two groups was evaluated, and the short-term indexes and complications for meta-analysis of the two groups were analyzed by using Revman 5.3 software.Results:A total of 1277 patients were included in 10 articles, including 629 in the HALS group and 648 in the LAS group. The results of the meta-analysis showed that compared with the LAS group, the operation time was shorter in the HALS group (WMD=24.02, 95% CI: -40.41--7.62, P=0.004), but the auxiliary incision was slightly longer (WMD=0.27, 95% CI: 0.06-0.47, P=0.01), and there were no statistically significant difference in the remaining number of lymph node dissections (WMD=0.58, 95% CI: -1.22-2.39, P=0.53), intraoperative blood loss (WMD=-7.94, 95% CI: -16.21-0.33, P=0.06), gastrointestinal tract recovery time (WMD=0.00, 95% CI: -0.03- 0.04, P=0.85), total length of hospital stay (WMD=-0.14, 95% CI0: -0.36-0.09, P=0.23) and postoperative complications ( OR=0.89, 95% CI: 0.58-1.37, P=0.61). Conclusions:Compared with the LAS for D2 radical surgery of advanced gastric cancer, HALS has significantly shorter operation time and is easier to perform than LAS, but the incision length is slightly increased. Physicians can choose the appropriate operation method according to the specific conditions of the operation and themselves.