Dacryocystorhinostomy ; Endoscopy ; Humans ; Nose

OBJECTIVE: To investigate the perioperative treatments of endoscopic sinus surgery for nasal diseases in patients with coronary heart disease after PCI. METHOD: Clinical data of 12 cases of endoscopie-assised surgery such as nasal tumors resection,functional sinus surgery,correction of deviated nasal septum,low-temperature plasma hemostasis in patients with coronary heart disease after PCI were analyzed retrospectively. RESULT: Serious bleeding did not take place with the 12 cases during surgery, and surgery progressed smoothly; one of patients had heavy nosebleed after surgery, however her condition was stable when received active treatment. Follow-up 3 months to 2 years, nasal diseases of 12 patients recovered well and symptoms were relieved; cardiovascular events such as hemorrhage, thrombosis and so on did not occur. CONCLUSION Due to physiological function of the heart dysfunction in patients with coronary heart disease after PCI,they often accompany a number of trouble issues such as medical disorders, oral antiplatelet drugs, surgery affordability loss and increase surgical risk. Correct and effective perioperative treatments, strictly surgical indications are really necessary which can keep patients safe through perioperative period.
Coronary Disease ; Endoscopy ; Epistaxis ; Humans ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; Nose Deformities, Acquired ; Nose Neoplasms ; surgery ; Paranasal Sinuses ; Percutaneous Coronary Intervention ; Retrospective Studies ; Treatment Outcome

Objective:To evaluate the effects of perioperatively administrated enteral immunonutrition in gastrointestinal cancer patients on immune and inflammatory responses,nutrition states and postoperative morbidity.Methods:Sixty patients with gastrointestinal cancer were divided randomly into two groups.Two groups perioperatively(from preoperative day 5 to postoperative day 7) received an supplemented diet with arginine,RNA,and ?-3fatty acids(immunonutrition group;n=30) or an isoenergetic and isonitrogenous standard diet (standard-nutrition group;n=30).All variables of immune and inflammatory responses,nutrition states and postoperative morbidity were measured on preoperative day 5 and postoperative day 1,4 and 8.Results:On postoperative day 4 and 8,most immune variables and prealbumin in the immuno-group were significantly higher than those in the standard-group(P0.05),and inflammatory variables as CRP in the immunonutrition group were significantly lower than those in the standard group.In the immunonutrition group,there were significantly fewer patients who experienced postoperative complications and shorter days of hospital stay compared with standard group(P0.05).Conclusion:The perioperative administration of enteral immunonutrition in gastrointestinal cancer patients can significantly modulate the postoperative immunosuppressive and inflammatory responses at the early postoperative day,can significantly decrease the occurrence of infectious and overall postoperative complications as well as the length of hospital stay.

ObjectiveTo explore the value of conventional echocardiography and transthoracic real-time three-dimensional echocardiography (RT3DE) in diagnosis of Ebstein anomaly.MethodsWe investigated the morphology and function of right ventricle (RV) as well as the structure, morphology and regurgitation of tricuspid valve in 61 adult patients with Ebstein anomaly before surgery by using conventional echocardiography and transthoracic RT3DE. Twenty normal adults were enrolled as control group. ResultsThe surface of the tricuspid leaflets, the morphology of the tricuspid annulus as well as the three-dimensional structure of the tricuspid valve were displayed stereoscopically by RT3DE. Complete RV volume data could be acquired in 32 patients of Ebstein anomaly. The apex or part of RV could not be contained in the remaining 29 patients. Thirty-four (55.7%) patients with Ebstein anomaly had severe tricuspid regurgitation,
16 (26.2%) patients had moderate to severe regurgitation, and 11 (18.1%) patients had moderate regurgitation. Compared with the normal adults, patients of Ebstein anomaly showed higher RV end-diastolic volume (EDV), end-systolic volume (ESV), end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume (SV), RV anterior-posterior diameter (RV), tricuspid valve annular transverse diameter (TV-R), and lower RV ejection fraction(EF) [(273.5±77.7) mlvs (74.3±15.9) ml, (187.1±96.8) mlvs (31.1±9.2) ml, (177.4±53.6) ml/m2vs (43.4±8.2) ml/m2, (121.7±65.5) ml/m2vs (18.4±5.1) ml/m2, (95.9±20.2) ml vs (43.6±8.8) ml, (48.1±13.3) ml/m2vs (19.0±1.9) ml/m2, (56.4±8.9) ml/m2vs (28.5±4.3) ml/m2, (38.3±12.8) %vs (59.3±5.1) %, allP<0.05). The tricuspid regurgitant orifice flow cross-sectional area (EROA) were correlated positively with RV anterior-posterior diameter (r=0.691), ratio of RV and LV anterior-posterior diameter (RV/LV) (r=0.6471).ConclusionTransthoracic RT3DE is a feasible method in addition to conventional two-dimensional echocardiography in evaluation of tricuspid valve mophology and function, as well as RV volume and EF in adult patients with Ebstein anomaly.

Objective:To preliminarily study the characteristics of ventricular synchronicity in patients of idiopathic pulmonary arterial hypertension (IPAH) with different heart function.
Methods:Our research included in 2 groups:IPAH group, n=40 patients intermittently collected in our hospital from 2010-10 to 2014-12 and Control group, n=23 normal subjects from the same period of time. Tissue Doppler echocardiography was conducted to compare interventricular systolic and diastolic time to peak (Ts and Te), their differences (Te-Ts) and (Te-Ts) of left ventricle (LV), right ventricle (RV), interventricular septum (IVS) between 2 groups.
Results:Ts and Te of RV were longer than Ts and Te of LV and IVS in both groups, P<0.05. Compared with Control group, by heart function reducing, IPAH group showed different Ts and Te of LV and IVS, P<0.05 and Ts was gradually prolonged, Te was gradually shorter;while Te of RV became longer firs tand then became shorter thereafter. In IPAH group, the patients with heart function grade IV had the longer Ts of LV and IVS than those with heart functionII, III;the patients with heart function IV had the shorter Te of LV, RV and IVS than those with heart function II, III, all P<0.05. In IPAH group with different heart function, Te between RV-IVS and RV-LV were different from Control group, all P<0.05;Te between LV-IVS in heart function IV patients had the largest difference from Control group, P<0.05. Compared with Control group, IPAH group had gradually decreased Te-Ts of LV and IVS by heart function reducing asgrade II>III>IV, all differences had statistic meaning.
Conclusion:IPAH patients with different right heart function may have interventricular systolic and diastolic de-synchronicity;by reduced heart function, interventricular Te-Ts could be specifically shortened.

Objective To observe the efficacy and adverse reaction of Durogesic (thansdermal fenfanul) for analgesia in patients with malignant tumors, who occur moderate or severe pain from mucosal response during radiochemotherapy. Methods 50 patients were divided into two groups randomly. The treatment group received Durogesic and normal therapy, the contrast group received normal therapy. The analgesic effects, the quality of life and the side effects after medicine were observed. Results The pain remission rates of treatment group and control group were 100 % (25/25) and 52 % (13/25), respectively (χ2 =15.78, P ＜ 0.01)[(9.66±0.35), (10.01±0.34) min]and[(18.12±0.46), (14.68±0.19) min].The quality of life in treatment group was improved significantly (t = 8.11, P ＜0.01).The main adverse reactions of Durogesic included constipation, itch of skin, drowsiness, nausea, vomiting and so on. All of adverse reactions were tolerable. Conclusion Durogesic for analgesia have high curative effect and slight adverse effects in pain of oral cavity and laryngeal pharynx in patients with malignant tumors during radiochemotherapy which make patients complete radiochemotherapy successfully.

Objective To observe the effect of DNA-PKCS antisense oligodeoxynucleotides (ASODN) on the radiosensitivity of lung cancer cell line A549 through transfecting DNA-PKcs ASODN into A549 cells.Methods DNA-PKCS ASODN and unrelated ODN were transfected into A549 cells (testing group and control group).These cells were irradiated with 0,0.5,1.0,2.0,4.0,6.0 or 8.0 Gy X-ray.Clo nogenic assay was performed to determine the survival fraction.The parameters Do,Dq and N for the multi target single-hit model,as well as the parameters a,13 and SF2 for the linear-quadratic model,were calculated to evaluate cell radiesensitivity.ResultsIn the control group and testing group,the α value was 0.14 and O.31 ,The βvalue was 0.030 and 0.018 ,the SF2 was 0.63 and 0.41 ,the Do was 2.38 and 2.09 ,the Dq was 1.43 and 0.60 ,respectively.In the testing group,the α value of A549 cells was increased,but the β value, SF2,DO and Dq were decreased.Conclusions DNA-PKCS ASODN can enhance the radiosensitivity of A549 cells and is a potential target in treating lung cancer.

Objective: To observe the therapeutic efficacy of astragalus polysaccharide (APS) in combination with three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with non-small cell lung cancer (NSCLC). Methods: A total of 80 elderly patients with I～IV stage NSCLC were randomly divided into two groups. The 40 patients in the therapeutic group received radiotherapy in combination with APS. The 40 patients in the control group received radiotherapy alone. Both groups received 3D-CRT with a total dose of 50～ 70Gy, 2.0Gy/fraction, once a day, 5 times per week. The patients in the therapeutic group were treated with radiotherapy combined with injection of APS (250mg in 5% glucose) or normal saline (500 mL) intravenously once a day until the end of radiotherapy. The short-term efficacy and patients' quality of life were evaluated. The T-lymphocyte subpopulation and peripheral blood leukocyte count were also measured after treatment. Results: The short-term effective rates of the therapeutic group and the control group were 87.5% and 72.5%, respectively, without significant difference between the two groups (P＞0.05). The decrease of peripheral blood leukocyte count after treatment in the control group was significant (P＜0.05). In the therapeutic group, the T-lymphocyte subsets CD8 and CD4/CD8 were improved after treatment, with a significant difference (P＜ 0.05). But in the control group, no significant changes in T-lymphocyte subsets CD8 and CD4/CD8 were observed after treatment (P＞0.05). Patients' quality of life in the therapeutic group was superior to that in the control group, with a significant difference (P＜0.05). Conclusion: APS in combination with 3D-CRT can reduce the side effects of radiation and improve the quality of life of elderly patients with NSCLC.

Objective: To investigate the predictors of death after endovascular mechanical thrombectomy (EMT) in patients with acute vertebrobasilar occlusive stroke (VBOS). Methods: Patients with acute VBOS treated with EMT in Wuhan No. 1 Hospital were enrolled retrospectively. The demographic and clinical data were collected. According to whether the patients died at 90 d after procedure, they were divided into survival group and death group. The demographic and clinical data were compared between the two groups. Multivariate logistic regression analysis was used to determine the independent risk factors for death at 90 d after EMT. Results: A total of 47 patients were enrolled. The median age was 62 years, 34 were males (72.3%), the median baseline National Institutes of Health Stroke Scale (NIHSS) score was 16, 42 patients (89.4%) had recanalization (modified Thrombolysis in Cerebral Infarction[mTICI] 2b/3 grade), and 12 (25.5%) died within 90 d after procedure. Univariate analysis showed that the baseline NIHSS score (26 [21-28]vs. 12 [5-23]; Z=-3.165, P=0.002), percentage of neutrophil (81.61% ±11.82% vs. 72.20% ±12.09%; t=-2.137, P=0.033), neutrophil/lymphocyte ratio (10.54±7.17 vs. 4.98±3.57; t=-2.393, P=0.017), and incidence of sICH (25.0% vs. 2.9%; χ²=5.627, P=0.018) in the death group were significantly higher than those in the survival group, while the percentage of lymphocyte (12.00%±9.04% vs. 20.67%±10.39%; t=-2.429, P=0.015) was significantly lower than that of the survival group. Multivariate logistic regression analysis showed that high baseline NIHSS score (odds ratio [OR] 1.243, 95% confidence interval [CI] 1.046-1.318; P=0.038), high neutrophil/lymphocyte ratio (OR 1.278, 95% CI 1.002-1.630; P=0.049) and symptomatic intracranial hemorrhage (OR 5.088, 95% CI 1.065-38.718; P=0.046) were the independent predictors for death. Conclusion High baseline NIHSS score, high neutrophil/lymphocyte ratio and symptomatic intracranial hemorrhage are the independent predictors for death within 90 d after EMT in patients with acute VBOS.

In view of the current teaching status of Traditional Rehabilitation Methodology for rehabilitation medicine specialty in higher medical colleges and universities,combining with the knowledge of some acupoints taught in this course,we put forward some suggestions for the teaching of this course.In teaching process of acupoints knowledge,while emphasizing the importance of its anatomical location,we should also attach importance to elaborating the name of acupoints and the rich cultural contents contained in the naming process.At the same time,paying attention to induction learning and finding memory rules,combining theoretical knowledge with classmates' hands-on practice,and encouraging students to participate early in clinical practice activities,we can develop students' practical work ability.