OBJECTIVE: To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal. METHOD: Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed. RESULT: There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later. CONCLUSION Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.
Carcinoma, Adenoid Cystic ; diagnosis ; surgery ; Carcinoma, Basal Cell ; diagnosis ; surgery ; Carcinoma, Squamous Cell ; diagnosis ; surgery ; Ear Canal ; pathology ; Ear Neoplasms ; diagnosis ; surgery ; Humans ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Parotid Gland ; pathology ; Prognosis ; Retrospective Studies ; Temporal Bone ; surgery

OBJECTIVE: To investigate the clinical features of labyrinthine fistula and obtain the diagnosis, treatment and prognosis of different types of fistula. METHOD: A retrospective analysis of 42 cases (43 ears) with labyrinthine fistula in our hospital from January 2007 to November 2014 was conducted. Data of preoperative clinical manifestation, auditory function, CT image, operative findings, treatment and postoperative recovery were collected and statistically analysed. RESULT: Thirty-nine cases (40 ears) of the 42 cases (43 ears) which were diagnosed as labyrinthine fistula according to operative findings occurred in the lateral semicircular canal, 1 case occurred in the posterior semicircular canal, 1 case occurred in the superior semicircular canal, and 1 case occurred both in lateral and posterior semicircular canal. Before operation, 24 ears (55.8% ) experienced vertigo and 14 ears (32.6%) showed impaired bone conduction hearing threshold. According to Dornhoffer classification standard, 22 cases (23 ears) were diagnosed as type I fistula, 9 cases as type II fistula and 11 cases as type III fistula. There was no statistical difference among the 3 groups on type of hearing loss, vertigo, CT, facial nerve canal damage before operation and bone conduction hearing threshold, vertigo after operation. CONCLUSION An accurate diagnosis of labyrinthine fistula relies on the operative findings rather than preoperative clinical manifestation, auditory function or CT The surgical intervention should be individualized. There is no significant difference on postoperative recovery among different types of labyrinthine fistula.
Bone Conduction ; Cholesteatoma, Middle Ear ; complications ; Deafness ; Facial Nerve Injuries ; Fistula ; etiology ; Humans ; Labyrinth Diseases ; etiology ; Otitis Media ; complications ; Postoperative Period ; Prognosis ; Retrospective Studies ; Vertigo

OBJECTIVE: To explore the clinical characteristics, diagnosis method and treatment of petrous apex cholesteatoma. METHOD: A retrospective analysis was taken with respects to the clinical characteristics, diagnosis and surgical management of 38 patients who underwent surgery for petrous apex cholesteatoma in our department. RESULT: (1)31 patients had unilateral hearing loss and facial paralysis of different degree, 27 patients were firstly characterized with hearing loss, and followed by facial paralysis. 6 cases had facial paralysis as the main performance. (2)17 patients had syndrome of tinnitus, and 15 patients had syndrome of vertigo and 4 cases of severe pain of ear. (3)All patients had petrous bone destroy with high resolution CT scan, while MRI suggests the presence of pathological changes in petrous apex. (4)All patients were taken surgeries to remove the lesion, and translabyrinth approach was chosen for 23 patients, middle cranial fossa approach is 12, while 3 case has choose endoscopic approach. 8 cases were operated with facial nerve decompression. 7 cases was taken end to end anastomosis. 3 cases of great auricular nerve transplantation. There is no recurrence in follow-up of 1 years to 2 years. CONCLUSION The clinical manifestations of petrous apex cholesteatoma lack specificity, and high resolution CT and MRI has important value in the diagnosis of petrous apex cholesteatoma. The strategy of surgical operation should be taken according to the classification, location of petrous apex cholesteatoma as well as hearing level and facial nerve function with patients.
Cholesteatoma ; pathology ; surgery ; Cranial Fossa, Middle ; Decompression, Surgical ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Hearing Loss, Unilateral ; Humans ; Magnetic Resonance Imaging ; Petrous Bone ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: To construct and obtain ideal protein delivery vectors by researching the delivery efficiency and cytotoxicity to Hela cells using mPEG-PLGA-BSA-FITC-NPs. METHOD: The mPEG-PLGA nanoparticle was obtained through surface modification of PLGA with PEG, and deliver BSA-FITC into Hela cells in vitro. The positive cells were counted by Laser scanning confocal microscopy and the survival rate of Hela cells was calculated by MTT assay at different time points. RESULT: mPEG-PLGA-BSA-FITC-NPs shows the classic nanometer size, and the encapsulation efficiency reached 51. 2%. At the same time, the nanoparticles possess characteristics of slow release. By optimizing the delivery conditions, the highest efficiency of mPEG-PLGA-BSA-FITC-NPs was above 65.2%, and the cellular viability was about 85.7%. CONCLUSION mPEG-PLGA-BSA-FITC-NPs nanoparticles can successfully carry the target protein into cells as safe and effective as novel delivery materials of protein in vitro, and has shown slow release characteristics. The mPEG-PLGA-BSA-FITC-NPs provide ideal delivery vector for future application in clinical treatment of disease using nano-materials.
Drug Carriers ; Fluorescein-5-isothiocyanate ; analogs & derivatives ; HeLa Cells ; Humans ; Nanoparticles ; Particle Size ; Polyesters ; Polyethylene Glycols ; Serum Albumin, Bovine

Objective To explore the risk factors of early traumatic coagulation(TIC)in elderly patients with chest trauma.Methods The data of 113 elderly patients with chest trauma admitted in a hospital from January 2016 to January 2022 were retrospectively analyzed.Patients were divided into TIC group and non-TIC group according to whether they had early TIC.The risk factors of early TIC in elderly patients with thoracic trauma were analyzed by single factor and multi factor methods.Analysis of the predictive value of early TIC in elderly patients with thoracic trauma using multifactor model.Result Of all the patients included in the study,27 were determined as TIC,and the rest 86 were non-TIC.The results of univariate analysis showed that there were statistically significant differences in the data of shock index,platelet count at admission and plasma fibrinogen at admission between patients in TIC group and non-TIC group(P＜0.05).Multivariate analysis showed that the shock index at admission,platelet count at admission,and plasma fibrin at admission were all independent influencing factors of early TIC in elderly patients with chest trauma(all P＜0.05).The P value of multivariate model and independent variables predict the early TIC of elderly patients with chest trauma.The Yoden index is 36.95％,42.89％,75.58％and 78.85％respectively.Conclusion The shock index,platelet count and plasma fibrin at the time of admission can affect the early occurrence of TIC in elderly patients with chest trauma.

This study aimed to establish characteristic chromatogram and content determination method for Chan Taoren formula granules,evaluate the production processes of Chan Taoren formula granules based on the correlation of characteristic chromatogram and the transfer rate of D-amygdalin,and clarify the key control points. The optimized analytical method was carried out on a Waters CORTECS C18 column(4. 6 mm×150 mm,2. 7 μm) with acetonitrile-0. 1% phosphoric acid aqueous solution as the mobile phase at a flow rate of 0. 6 m L·min-1. The detection wavelength was 207 nm,and the column temperature was 20 ℃ ． As compared with the standard decoction of Chan Taoren,there were five characteristic peaks in the decoction pieces,extracts,concentrates,spray-dried powders and formula granules,basically consistent in relative retention time and peak pattern; in addition,the transfer rate of D-amygdalin from Chan Taoren pieces to the formula granules was within the transfer rate range of standard decoction. The average transfer rate of D-amygdalin was 56.65%,72.85%,94.58% and 99.29% respectively in the extraction,concentration,spray drying and granulation processes. Therefore,the factors affecting D-amygdalin in the extraction process were further studied. The results showed that D-amygdalin was easily converted to L-amygdalin in the water extraction process,leading to a low transfer rate of D-amygdalin in this process.D-amygdalin was unstable under alkaline conditions and prone to isomerization. Both liquid to solid ratio and extraction time had significant effects on the extraction rate of D-amygdalin. In this study,the key links in the production process of Chan Taoren formula granules was clarified based on the characteristic chromatogram and the quantity transmission of D-amygdalin,which provided a theoretical basis for production and quality control.
Amygdalin ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Quality Control ; Water

Objective: To analyze the clinical characteristics of hand, foot and mouth disease (HFMD) caused by coxsackievirus A6 (CV-A6) in different age groups. Methods: From January 2015 to December 2017, throat swabs were collected from children with or suspected of having HFMD then quantitative real-time PCR was performed to detect enterovirus nucleic acid. HFMD cases caused by CV-A6 were divided into different groups according to age for comparison. Results: In total, there were 467 cases of HFMD caused by CV-A6 with the age ranging from 3 months to 16 years. There were 273 cases in the infants and young children group (< 3 years old), 131 cases in the pre-school group (3-6 years old), and 63 cases in the school-age group (> 6 years old). The peak incidence was found between May and November.Fever was the common symptom, and the rate of fever in infant group was the highest (220/273, 80.5%); The proportion of cases with leucocyte elevation in the infant group was the highest (127/273, 46.5%) than that in the school-age group (17/63, 27.0%) with a statistical significance. The skin erythra of the HFMD caused by CV-A6 were diverse in forms. Over two forms of skin erythra accounted for 53.9% (257/476) of all cases, and the cases in the infant group showing more forms of skin erythra (163/273, 59.7%). The oral herpes were mainly distributed in the upper palate and pharyngeal isthmus, but the school age group had the least number of distribution sites (0.89±0.86). The cases in the infant group showed higher incidence of skin rash at the elbow joint (109/273, 39.9%), knee (88/273, 32.6%), thigh (112/273, 41%), buttock (122/273, 44.7%) than the other two groups, However, the school age group showed lower incidence of skin rash in the lower leg (0/63, 0%) and thigh (6/63, 9.5%) than the other two groups. The differences between groups were statistically significant. All cases were cured clinically, no severe cases occurred. Among the 288 cases followed up for 6 months, 33 (33/288, 11.5%) suffered from nail exfoliation. Conclusions Different age groups of HFMD caused by CV-A6 had different clinical manifestations. In the infant group, more cases had fever and the erythra were more diverse in forms and wider in distribution. In addition, the increased leukocytes in routine blood test was also more common in the infant group.