Sinonasal inverted papilloma (SNIP) is one of the most common benign sinonasal tumors demonstrating a high recurrence rate after surgery, and sometimes presents malignant tendency or coexists squamous cell carcinoma. Therefore, it is essential to achieve complete surgical resection, especially the original location of SNIP. In this paper, we evaluated the predictability of preoperative CT and magnetic resonance imaging (MRI) for localization of SNIP origin.
Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Nose Neoplasms ; diagnosis ; pathology ; surgery ; Papilloma, Inverted ; Paranasal Sinus Neoplasms ; diagnosis ; pathology ; surgery ; Prognosis ; Tomography, X-Ray Computed

OBJECTIVE: To evaluate the efficacy and safety of a short course of nebulized budesonide via transnasal inhalation in chronic rhinosinusitis with nasal polyps. METHOD: Fifty patients with severe eosinophilic nasal polyps were randomized devided into study group (n = 25) and control group (n = 25). The study group received budesonide inhalation suspension (1 mg twice daily) via transnasal nebulization for one week and the control group received oral prednisone (24 mg QD). Visual analogue scales (VAS) of nasal symptoms, endoscopic polyp scores (kennedy scores) and morning serum cortisol concentrations were assessed in both groups pre- and post-treatment. Operation time and surgical field bleeding were evaluated. RESULT: Four subjects dropped out in control group. Budesonide transnasal nebulization caused a significant improvement in all nasal symptoms especially nasal obstruction (baseline: 8.25 ± 0.53; after treatment: 4.97 ± 0.97, P < 0.01) and reduced polyp size significantly (baseline: 4.64 ± 0.63; after treatment: 3.40 ± 0.76, P < 0.01) compared to pre-treatment. The patients treated with oral prednisone, however, showed more obvious improvement in nasal symptoms and polyp size, shorter operation time and better surgical field than budesonide group. Additionally, the morning serum cortisol concentration was mildly decreased after one week treatment in budesonide group [baseline (17.18 ± 2.83) μg/dl, after treatment (16.24 ± 2.93) μg/dl, P > 0.05], but all values were still located in normal range (normal range: 5-25 μg/dl). Conversely, the morning serum cortisol concentration in oral prednisone group was lower than normal limit [baseline (18.19 ± 2.81) μg/dl, after treatment (2.26 ± 0.70) μg/dl, P < 0.01]. CONCLUSION Twice daily budesonide transnasal nebulization is an effective and safe treatment as evidenced by significant improvements in nasal symptoms and reduction in polyp size, coupled with an absence of hypothalamic-pituitary-adrenal axis suppression, which is safer than the systemic corticosteroids. Budesonide transnasal nebulization offers a viable treatment option for CRSwNP before operation.
Administration, Inhalation ; Budesonide ; administration & dosage ; therapeutic use ; Chronic Disease ; Humans ; Hydrocortisone ; blood ; Hypothalamo-Hypophyseal System ; Nasal Obstruction ; Nasal Polyps ; complications ; drug therapy ; Pituitary-Adrenal System ; Prednisone ; therapeutic use ; Rhinitis ; complications ; drug therapy ; Sinusitis ; complications ; drug therapy ; Suspensions

Objective To compare the incidences of biliary complication after adult living donor liver transplantation (ALDLT) using Roux-en-Y hepaticojejunostomy (R-Y HJ) with duct-to-duct hepaticocholedochostomy (D-D HC).Methods A meta-analysis was conducted by searching the Medline-PubMed,EMBASE,Scielo-LILACS,and Cochrane Databases.A comparison using 95％ confidence intervals was performed on different biliary reconstruction techniques in liver transplantation with regard to occurrence of biliary complications.Results According to our predetermined inclusion and exclusion criteria,seven clinical studies were selected to compare D-D HC with R-Y HJ.The overall biliary comphcation rates,biliary stricture rates and biliary leakage rates were compared.The overall biliary complication rate and the biliary stricture rate of R-Y HJ were significantly less than D-D HC,but the biliary leakage rate of R-Y HJ was similar with the D-D HC (overall biliary complication rate P ＜ 0.05,OR =0.35,95％ CI:0.15 ～ 0.81,I2 =28％ ; biliary stricture rate P ＜ 0.05,OR =0.43,95％ CI:0.29 ～ 0.65,I2 =49％ ; biliary leakage rate P=0.05,OR=1.62,95％ CI:1.01 ～2.60,I2 =19％).Conclusions The meta-analysis showed that biliary reconstruction in ALDLT should be performed using R-Y HJ.

Objective To investigate the expression characteristics of Golgi phosphoprotein 3(GOLPH3)in human hepatocellular carcinoma (HCC)and explore its clinicopathological significance. Methods The expressions of GOLPH3 protein was detected in 132 cases of paired paraf-fin embedded HCC specimens and pericarcinoma tissues using immunohistochemical staining ,and the relation of the expression of GOLPH3 to clinicopathologic features was analyzed. Meanwhile,the expression and distribution of GOLPH3 in HCC cells was observed by laser confocal mi-croscopy. Results The positive expression rates of GOLPH3 in HCC and pericarcinoma tissues were 70.0%(92/132)and 42.4%(56/132) (P<0.001),respectively. The incidence of portal vein tumor thrombus in high and low GOLPH3 expression groups of HCC were 21.2%(14/66) and 6.1%(4/66)(P<0.05),respectively. The expression rate of GOLPH3 in HCC was significantly higher than that in pericarcinoma tissues, and the expression of GOLPH3 in HCC was positively related to portal vein tumor thrombus. In addition ,GOLPH3 was mainly expressed in cyto-plasm of HCC cells,and there was also scattered distribution in the nucleus. Conclusion GOLPH3 acts as an oncogene and may play vital roles in the carcinogenesis and development of HCC.

0.05). CONCLUSION BDP do not cause adrenal suppression on therapeutic doses of 400 microgram/day after 4 weeks of use.

Anaphylaxis ; diagnosis ; therapy ; Humans

[ABSTRACT]OBJECTIVETo observe the anatomic relationship between the middle and distal section of bony nasolacrimal duct and anterior wall of maxillary sinus. METHODS206 cases of sinus CT without maxillary disorders were enrolled. The middle and distal section of bony nasolacrimal duct and anterior wall of maxillary sinus is divided into fusion type and separation types, and the angle between the anterior and medial wall of the maxillary sinus is divided into frontal and lateral types in relation to the middle and distal section of bony lacrimal duct.RESULTSThe fusion type accounted for 40.05%, and the separate type was 59.95%. There was no statistical difference between male and female.The proportion of inconsistency on both sides was 16.02%. The frontal type of the angle between the anterior and medial wall of the maxillary sinus accounted for 64.08%, meanwhile the proportion of the lateral type was 35.92%. The lateral type was 84.24% out of the cases of fusion type, whereas the frontal type was15.76%. In the separate type, the frontal type accounted for 97.17%, and the lateral type was 2.92%. CONCLUSIONThe anatomic relationship between the middle and distal section of bony nasolacrimal duct and anterior wall of maxillary sinus shows different type, which is helpful to choose operative strategy.

Objective To explore the influence of abnormal donor hepatic artery on hepatic artery and biliary complications after liver transplanta?tion,and summarize the hepatic artery reconstruction procedures during transplantation. Methods The clinical data of 210 cases of liver transplan?tation conducted in our hospital from May 2005 to April 2015 were retrospectively searched for the study,including 42 with abnormal donor hepatic artery. Results Among the 210 liver transplantation,42 cases exhibited abnormal donor hepatic artery,and the aberration rate was 20.0%. Mean volume of blood flow of abnormal group and normal group was 4.7±95.1 mL/min and 190.9±101.6 mL/min,respectively. There was no statistic differ?ence(P=0.519). Twelve cases had arterial complications,the incidence rate was 5.71%,and there was no statistic difference between each group (χ2=0.72,P>0.05). Twenty five cases got biliary complications,the incidence rate was 11.9%,and there was no statistic differences between each group(χ2=0.05,P>0.05). Conclusion There was no statistic difference of mean volume of blood flow after arterial reconstruction between two groups. Liver transplantation with abnormal arterial reconstruction will not increase the incidence rate of arterial and biliary complications.

Objective To establish a simple method to extract the methylated ctDNA in urine using magnetic beads as solid phase adsorption carri?er with a specific design reagent system and extraction process,and evaluate its application feasibility for methylated gene detection in urine sample . Methods Fourty cases of methylated ctDNA were extracted in urine using magnetic beads. After methylated modification,the concentration and pu?rity of DNA was determined by ultraviolet spectrophotometer. Results The extraction of 50 mL urine can gain 61?200 ng/mL methylated ctDNA, and the OD260/280 was 1.8 ± 0.05. Conclusion There are methylated ctDNA exist in the urine which can be extracted by magnetic beads. The estab?lished extraction method is simple,effective,and with high purity.

OBJECTIVE To evaluate the clinical outcome of submucosal inferior turbinectomy and outfracture surgery of inferior turbinates. METHODS All patients receiving two different operations were measured by acoustic rhinometry and questionnaire of QOL at preoperative 1 week and postoperative 12 months, seperately. RESULTS Forty-seven patients with inferior turbinate hypertrophy were enrolled in this study. Evaluation of SNOT-20 discovered both surgeries could improve patients' QOL with similar outcome. Preoperative '5 important items' in patients with inferior turbinate hypertrophy were 'lack of a good night's sleep', 'need to blow nose', 'thick nasal discharge', 'fatigue' and 'dizziness'. Postperative '5 important items' were 'postnasal discharge', 'runny nose', 'sneezing', 'reduced concentration' and 'reduced productivity'. Both surgeries could make acoustic rhinometry parameters change obviously, such as minimal cross-sectional area, 0-5 cm nasal volume(NV) and 2-5 cm NV. Furthermore, submucosal inferior turbinectomy produced more volume in nasal cavity than outfacture surgery, (7.28±2.01)cm3 vs (6.01±1.22)cm3, (5.99±1.87)cm3 vs (4.23±1.08)cm3(P<0.05), seperately. There was no correlation between the data of SNOT-20 and acoustic rhinometry. CONCLUSION We recommend outfracture surgery of inferior turbinate as the preferred surgical choice for patients with mild inferior turbinate hypertrophy.