Objective To study significance of anicteric biliary tract dilatation in early diagnosis and treatment of patients with periampullary carcinoma.Method Review the resection rate and survival rate of 16 periampullary carcinoma patients with anicteric biliary tract obstruction found out by B-ultrasound,CT or PTC during 13 years(1986-1999).Result The operative resection rate was 87.50%(14/16) ,5-year survival rate was 43.75%(7/16),3-year survival rate was 62.50%(10/16).Conclusions Biliary tract dilatation existed before icterus occurred,while syndromes such as upset of upper abdomen,reclusion, epigastralgia distention and anorexia, may occur 1-3 months ahead of icterus occurred in patients with periampullary carcinoma. If the patient has syndromes mentioned above, more than 40 years of age and biliary tract dilatation found by B-ultrasound, CT,PTC or ERCP, periampullary carcinoma should be considered. The patients should be checked by operation,so as to raise the operative resection rate and survival rate.

OBJECTIVE Exploring the expression levels of serum miR-124-3p and miR-202-5p levels in patients with allergic rhinitis(AR) and their clinical significance. METHODS One hundred and seventy-three patients with AR admitted to our hospital during the period from January 2022 to December 2022 were selected as the observation group,and another 63 healthy people who underwent physical examination in our hospital during the same period were selected as the control group. RESULTS In the control,mild,and severe groups,serum miR-124-3p(1.02±0.29 vs. 0.79±0.21 vs. 0.63±0.18) levels gradually decreased and miR-202-5p(1.01±0.25 vs. 1.39±0.29 vs. 1.62±0.33) levels gradually increased,with statistically significant differences between the two comparisons(P<0.05);Pearson correlation analysis showed a significant negative correlation between serum miR-124-3p levels and miR-202-5p levels in AR patients(r=-0.437,P<0.001);Serum miR-124-3p level[OR(95％CI)=0.651(0.508-0.835)],duration of symptom onset[OR(95％CI)=1.671(1.088-2.567)],asthma[OR(95％CI)=1.571(1.029-2.399)],and serum miR-202-5p level[OR(95％CI)=2.053(1.020-4.133)]were influential factors in patients with severe AR(P<0.05);the combined prediction of serum miR-124-3p and miR-202-5p was superior to the prediction of serum miR-124-3p(Z=2.385,P=0.017) and miR-202-5p(Z=2.466,P=0.014) alone. CONCLUSION Serum miR-124-3p is lowly expressed and miR-202-5p is highly expressed in AR patients,which is closely correlated with the severity of the patient's disease and is expected to be a potential biomarker.

OBJECTIVETo investigate the efficacy of operations of acquired middle ear cholesteatoma.

METHODSRetrospectively analyzed clinical data of 102 patients whom received tympanoplasty with CWU or CWD with mastoid obliteration in our hospital between January 2014 and December 2014. Patients were divided into different groups according to types of the cholesteatoma as well as the different surgical procedures. Patients were followed up for 12-24 months, the pre and post-operative PTA was performed and evaluated. The post-operative hearing was assessed in terms of average ABG.

RESULTSThe average dry ear time was (5.4±1.7)weeks. The dry ear time of patients of attic cholesteatoma was shorter than those of tensa cholesteatoma[(4.9±1.7)weeks vs(6.1±1.5)weeks, t=-3.52, P=0.001]; the dry ear time of patients underwent CWU was shorter than those underwent CWD with mastoid obliteration[(2.3±0.5)weeks vs(5.8±1.4)weeks, t=-8.43, P=0.000]. Mean pre and post-operative air bone gaps in 93 ears underwent ossiculoplasty were (34.2±11.8)dB and (19.0±5.5)dB respectively and these differences were statistically significant. Both the pre and post-operative air bone gaps of ears of attic cholesteatoma were smaller than those ears of tensa cholesteatoma(P<0.05). In the patients who underwent ossiculoplasty with CWD with mastoid obliteration, the post-operative air bone gaps of attic cholesteatoma were smaller than those of tensa cholesteatoma(P<0.05). Both the pre and post-operative air bone gaps of ears underwent CWU were smaller than those underwent CWD with mastoid obliteration(P<0.05). The post-operative air bone gaps of ears underwent PORP with CWD with mastoid obliteration were smaller than those underwent TORP with CWD with mastoid obliteration(P<0.05).

CONCLUSIONSBoth the hearing loss and the outcome of tensa cholesteatoma are worser than attic cholesteatoma. The outcome of PORP is better than TORP. The patients who will accept CWU should be selected more carefully and be followed up regularly.

Cholesteatoma, Middle Ear ; classification ; surgery ; Ear, Middle ; pathology ; Hearing ; Hearing Loss ; Humans ; Mastoid ; surgery ; Postoperative Period ; Retrospective Studies ; Treatment Outcome ; Tympanoplasty