OBJECTIVE: To explore the clinical manifestations and treatments of retro-esophageal space abscess. METHOD: The clinical data of 27 cases with retro-esophageal space abscess were analyzed retrospectively. Twenty-one cases (77. 78%) were secondary to acute injury of esophageal meatus caused by foreign bodies. 2 cases (7. 41%)were secondary to old foreign body infection in retro-esophageal space, 3 cases (11. 11%) after secondary to pharyngeal abscess, and 1 case (3. 70%) was unknown to etiology. All patients were confirmed by sectional medicalimageology. Six cases(Conservation group, C group) were treated conservatively and 6 cases (Oropharyngeal incision group, OI group) were performed with oropharyngeal incision drainage. 15 cases(Extra-neck incision group, ENI group)were performed with extra-neck incision and vacuum sealing drainage. RESULT: In C group, 6 cases were cured with conservative therapy and the average hospital stay was 15. 6 days. In OI group, 5 cases were healed with oropharyngeal drainage but aspiration pneumonia complicated with septic shock occurred in 2 cases, and 1 case dead from septic shock secondary to mediastinum and lung abscess. The average hospital stay was 18. 8 days. In ENI group, 15 patients were cured with extra-neck drainage without complication and the average hospital stay was 9. 5 days. CONCLUSION The main causes of retro-esophageal space abscess are foreign body injury of upper esophagus and remnant of retro-esophageal space. Sectional medicalimageology can be of important value of diagnosis and treatment for displaying the retro-esophageal space abscess and other deep cervical fascia space sufficiently. Incision and vacuum sealing drainage via extra-neck is an effective therapy while oropharyngeal drainage is less effective and is not advocated as a primary treatment because of aspiration pneumonia complication . Conservative cure is a choice for patients without dyspnoea and background diseases, and it is necessary to recognize and treat severe complications early.
Abscess ; etiology ; therapy ; Drainage ; Esophagus ; Foreign Bodies ; complications ; Humans ; Neck ; Pharyngeal Diseases ; Retrospective Studies

[ABSTRACT]OBJECTIVETo investigate the treatment choice and curative effect of stage III external auditory canal cholesteatoma (EACC) with different degrees of damage to the posterior wall of external auditory canal and mastoid.METHODS44 patients (45 ears) diagnosed with III type external auditory canal cholesteatoma and treated with different surgeries were collected: 27 ears with damages of mastoid which did not involve tympanic antrum (group A) underwent simple mastoid repair+external auditory canal plasty+conchoplasty (in necessity). 18 ears with damages of mastoid which involve the tympanic antrum (group B) underwent mastoidectomy+mastoid filling+external auditory canal plasty+conchoplasty. RESULTSAll patients were followed up for 1 to 2 years postoperatively. There was no recurrence of cholesteatoma, no external auditory canal collapse, stricture or atresia,and hearing improved to different degrees. The postoperative dry ear rate of group A and group B was 100% and 94.4% respectively. The mean duration of dry ear in group A and B was (12.1±2.3) and (28.1±3.5) days respectively. The cases with smooth external auditory canal and good self-purification in group Aand B accounted for 100% and 88.9%respectively.CONCLUSIONType III external auditory canal cholesteatoma can be treated with different surgical methods according to different damages of mastoid. The cases in which damages of mastoid did not involve tympanic antrum can be treated with simple mastoid repair+external auditory canal plasty+conchoplasty (in necessity). The cases in which damages of mastoid involved tympanic antrum can be treated with mastoidectomy+mastoid filling+external auditory canal plasty+conchoplasty.

[Objective] To summarize the clinical experience on treating frozen shoulder by using transcutaneous electrical nerve stimulation, TENS. [Method] By col ecting clinical cases and record of Pro. Fang Jianqiao clinical experience to sort and analyze the methodology of Pro. Fang Jianqiao's clinical y used TENS and warm acupuncture to treatment frozen shoulder. [Result] Professor Fang Jianqiao applies the theory of anatomy and muscle along meridians in his diagnosis and treatment on frozen shoulder, which is based on its origin theory of aseptic inflammation. Treatment with transcutaneous electrical nerve stimulation, TENS, combined with local Ashi warm acupuncture to clear the meridians, qi and blood circulation and relieve pain. [conclusion] Professor Fang Jianqiao has great innovation on treatment of frozen shoulder and the combination of Transcutaneous electrical nerve stimulation, TENS on frozen shoulder has noninvasive, economy, safe and significant effect in clinic. This clinical method is worthy promotion to public.

Objective To investigate the clinical effect of myringoplasty with double flaps in treatment of large tympanic membrane perforaton.Methods Ninety-five patients (112 ears) with large tympanic membrane perforation were enrolled in this study,48 patients (54 ears) were performed myringoplasty with double flaps (double flaps method group) and 50 patients (58 ears) were performed myringoplasty with underlay method (underlay method group).The air conduction (AC) and air bone gap (ABG) were measured before operation and 6 months after operation.The clinical efficacy of two groups was compared.Results The successful rate in double flaps method group was 96.3％ (52/54) and 91.4％ (53/58) in underlay method group,there was no significant difference (P ＞0.05).The effective rate in double flaps method group was 92.6％ (50/54) and 77.6％ (45/58) in underlay method group,there was significant difference (P ＜ 0.01).Conclusions Myringoplasty with double flaps in treatment of large tympanic membrane perforation can effectively mould tympanic membrane and improve hearing.The operation is worthy of spreading.

Objective To study the effect of nursing intervention on postural hypotension of aged with heart disease.Methods Nursing intervention were gived to the 68 aged patients with heart disease and postural hypotension.The effect of nursing intervention on postural hyporension and hypotension associated symptoms were observed.Results The postural hypotension was improved and the incidence of hypotension associated symptoms were reduced after nursing intervention.Differences were statistically significant(P＜0.01).Conclusion Nursing intervention was effective on the improvement of postural hypotension.

Objective To investigate the anti-inflammatory effects and mechanism of durian peel extracts (DPE). Methods The in vivo anti-inflammation effects of DPE were examined by carrageenin-induced mice paw edema test and allergic contact dermatitis test induced by 2, 4-DNFB. And the in vitro anti-inflammation effects of DPE were evaluated with methyl thiazolyl tetrazolium ( MTT) assay in RAW 264.7 cell model of inflammation induced by lipopolysaccharide (LPS). Results The results of animal experiments showed that DPE groups could markedly relieve mice paw edema induced by carrageenin ( P<0.01 or P<0.001 compared with blank group). DPE could effectively inhibit the allergic contact dermatitis induced by 2, 4-DNFB in mice, showing good dose-effect relationship. The results of in-vitro test showed that DPE at the given concentrations had no influence on RAW 264.7 cell proliferation. Tumor necrosis factor alpha ( TNF-α) , interleukin 6 ( IL-6) , interleukin 1 beta (IL-1β), nitric oxide (NO) and nuclear factor kappaB (NF-кВ ) were observably inhibited, and anti-inflammatory cytokine IL-10 was enhanced by 25 and 50 mg/L of DPE. Conclusion DPE exert potential anti-inflammation effect, and the mechanism might be related to its inhibition of NF-кВsignal pathway.

Purpose:To study the role of ovarian cancer tumor suppressor genes (OCTSGs) and to determine the relationship between 3p loss of heterozygosity (LOH) and the pathogenesis of ovarian cancer. Methods:50 cases of epithelial ovarian tumor, including 40 cases with malignant tumors and 10 cases with benign tumors, were examined by polymerase chain reaction (PCR) with D3S1228 and D3S1038 microsatellite polymorphic markers at 3p. Results:Thirty two of the 40 cases (80%)with ovarian cancer showed either LOH at 3p14 or at 3p25, but only one of 10 cases (10.0%)with bengin ovarian tumor there occured 3p LOH. Among them, 24 cases (60.0%) had LOH at 3p14 and 16 cases (40.0%) at 3p25, as well as 8 cases (20.0%) there was co deletion on both at 3p14 and 3p25. According to FIGO staging, the rate of LOH at 3p in ovarian cancer patients with Ⅲa , Ⅲb was higher than that in patients with stage Ⅰ, Ⅱ ( P 0.05). Conclusions:Since 3p14 and 3p25 LOH are related to the staging of ovarian cancer as well as the common occurrence of 3p LOH in epithelial ovarian cancer, it is suggested that there are some candidate ovarian TSGs harbored at 3p regions and the detection of 3p LOHs may be used as a genetic marker for monitoring the development of ovarian cancer.

Purpose To investigate the genetic changes of ALK gene in sporadic neuroblastoma in China, and to explore its role in neuroblastoma. Methods Total 56 cases of NB with overexpressed ALK protein were studied by fluorescence in situ hybridization ( FISH) , using interphase Vysis LSI ALK dual-color and break apart rearrangement probes. Literature under the subject was searched through PubMed. Results Of the 56 cases, ALK gain was found in 9 (16%) cases, ALK amplification was found in 1 (1. 8%) case only. No alterations of ALK were detected in the remaining 46 cases. Conclusion As a major predisposition gene as well as a poten-tial therapeutic target for neuroblastoma, the frequency of aberrant copy numbers of ALK gene in Chinese NB patients is closely similar with previously published results.

Objective To determine the concentration of soluble PD-1 (sPD-1) in the sera of patients with recurrent genital herpes (RCH), and to explore the significance of abnormal expression of sPD-1 in RCH. Methods Serum samples were obtained from 88 healthy blood donors, 74 patients with RCH including 34 cases of outbreak-stage RCH and 40 cases of stable-stage RCH. The serum level of sPD-1 was measured by monoclonal antibody labeling and enzyme linked immunosorbent assay (ELISA). Results A significant difference was observed in the serum level of sPD-1 between the patients with RGH and the blood donors (33.06 ± 17.5 μg/L vs. 53.07 ± 26.3μg/L, P < 0.01) and between the patients with outbreak-stage RGH and those with stable-stage RGH (27.47 ± 12.9 μg/L vs. 37.71 ± 19.6 μg/L, P< 0.01). Conclusions There is a low expression of sPD-1 in patients with RGH, which may be one of the mechanisms underlying the escape of HSV- Ⅱ from immunologic surveillance and development of immunological tolerance.

Objective To investigate right ventricular(RV) dyssynchrony in patients with pulmonary hypertension(PH)by strain imaging.Methods Sixty PH patients were divided into three groups according to the pulmonary artery systolic pressure(PASP),20 healthy volunteers served as control group.RV structures parameters included RV end-diastolic area(RVEDA),end-systolic area(RVESA),the ratio of RV diameter and LV diameter(RVTD/LVTD).RV function parameters included RV fractional area change (RVFAC)and Tei index.RV strain parameters included the maxmal differences of the peak systolic strain(Max-ΔPST)and the maxmal differences of the time to peak systolic strain(Max-ΔT_(Q-S))of each segment.Results Compared with control group, Max-ΔT_(Q-S) and Max-ΔPST of PH groups were significantly larger (P<0.01).Max-ΔT_(Q-S) had strong correlations with PASP and RV structure and function parameters(P<0.01).Max-ΔPST had good correlations with PASP and Tei-index(P<0.05,P<0.01).Conclusions PH patients exhibit right ventricular dyssynchrony which correlates with right ventricular function and structure parameters.Right ventricular dyssynchrony parameters could evaluate right ventricular function in PH patients early by strain imaging.