Objective:To explore the therapeutic strategy for laryngeal cysts in infants. Methods:A retrospective analysis of the clinical data of 19 children with laryngeal cysts treated in Kunming Children's Hospital from January 2020 to January 2023. All patients were diagnosed through electronic laryngoscopy examination. Twelve neonates were admitted to the neonatal intensive care unit. Five of them received mechanical ventilation with tracheal intubation before surgery due to severe respiratory distress, and seven received oxygen therapy with a head mask. The remaining seven children were admitted to Department of Otolaryngology Head and Neck Surgery, of which three cases were treated with oxygen therapy through a mask during sleep due to frequent shortness of breath during sleep. All patients underwent low-temperature plasma radiofrequency ablation under general anesthesia to remove the cysts. Results:Three newborns were unable to have their tracheal tubes removed due to complications with pneumonia after surgery, while the rest of the children were able to have their tubes successfully removed after complete anesthesia, and no gastric tubes were placed. All postoperative respiratory difficulties in the children disappeared, and there were no complications such as bleeding, hoarseness, or laryngeal stenosis. Five pediatric patients had incomplete relief of laryngeal ringing symptoms one month after surgery, and electronic laryngoscopy diagnosed laryngeal softening. Regular follow-up is recommended. One child relapsed 4 months after surgery and underwent a follow-up surgery six months later without recurrence. Conclusion:Endoscopic low-temperature plasma radiofrequency ablation is an effective surgical method for treating laryngeal cysts, with a low postoperative recurrence rate. Laryngeal cysts may be accompanied by laryngeal softening, which may be a possible reason for the postoperative symptoms not improving.
Humans ; Retrospective Studies ; Cysts/surgery* ; Laryngeal Diseases/surgery* ; Infant ; Laryngoscopy ; Infant, Newborn ; Male ; Female ; Radiofrequency Ablation

Objective: To investigate the influence of extending the waiting time on tumor regression after neoadjuvant chemoradiology (nCRT) in patients with locally advanced rectal cancer (LARC). Methods: Clinicopathological data from 728 LARC patients who completed nCRT treatment at the First Affiliated Hospital, Naval Medical University from January 2012 to December 2021 were collected for retrospective analysis. The primary research endpoint was the sustained complete response (SCR). There were 498 males and 230 females, with an age (M(IQR)) of 58 (15) years (range: 22 to 89 years). Logistic regression models were used to explore whether waiting time was an independent factor affecting SCR. Curve fitting was used to represent the relationship between the cumulative occurrence rate of SCR and the waiting time. The patients were divided into a conventional waiting time group (4 to <12 weeks, n=581) and an extended waiting time group (12 to<20 weeks, n=147). Comparisons regarding tumor regression, organ preservation, and surgical conditions between the two groups were made using the t test, Wilcoxon rank sum test, or χ² test as appropriate. The Log-rank test was used to elucidate the survival discrepancies between the two groups. Results: The SCR rate of all patients was 21.6% (157/728). The waiting time was an independent influencing factor for SCR, with each additional day corresponding to an OR value of 1.010 (95%CI: 1.001 to 1.020, P=0.031). The cumulative rate of SCR occurrence gradually increased with the extension of waiting time, with the fastest increase between the 9^th to <10^th week. The SCR rate in the extended waiting time group was higher (27.9%(41/147) vs. 20.0%(116/581), χ²=3.901, P=0.048), and the organ preservation rate during the follow-up period was higher (21.1%(31/147) vs. 10.7%(62/581), χ²=10.510, P=0.001). The 3-year local recurrence/regrowth-free survival rates were 94.0% and 91.1%, the 3-year disease-free survival rates were 76.6% and 75.4%, and the 3-year overall survival rates were 95.6% and 92.2% for the conventional and extended waiting time groups, respectively, with no statistical differences in local recurrence/regrowth-free survival, disease-free survival and overall survival between the two groups (χ²=1.878, P=0.171; χ²=0.078, P=0.780; χ²=1.265, P=0.261). Conclusions: An extended waiting time is conducive to tumor regression, and extending the waiting time to 12 to <20 weeks after nCRT can improve the SCR rate and organ preservation rate, without increasing the difficulty of surgery or altering the oncological outcomes of patients.

The aim of this study was to investigate the regulatory role of retinoid X receptor (RXR)-mediated oxidative stress pathway in rat pulmonary ischemia/reperfusion injury (PIRI) and the underlying mechanism. Seventy-seven male Sprague-Dawley (SD) rats were randomly divided into 7 groups (n = 11): control group, sham group, sham+9-cis-retinoid acid (9-cRA, RXR agonist) group, sham+HX531 (RXR inhibitor) group, ischemia/reperfusion (I/R) group, I/R+9-cRA group, and I/R+HX531 group. The unilateral lung I/R model was established by obstruction of left lung hilus for 30 min and reperfusion for 180 min in vivo. The rats in I/R+9-cRA and I/R+HX531 groups were given intraperitoneal injection of 9-cRA and HX531 before thoracotomy. After reperfusion, the left lung tissue was taken to evaluate the lung tissue injury, and the oxidative stress-related indexes of the lung tissue were detected by the corresponding kits. The lung tissue morphology and the ultrastructure of the alveolar epithelial cells were observed by HE staining and transmission electron microscope, respectively. The protein expression of RXR in lung tissue was observed by immunofluorescence labeling method, and the expression level of nuclear factor E2-related factor (Nrf2) protein was detected by Western blot. The results showed that, compared with the sham group, the I/R group exhibited obviously injured lung tissue, decreased SOD activity, increased MDA content and MPO activity, and down-regulated expression level of Nrf2 protein. Compared with the I/R group, the I/R+9-cRA group showed alleviated lung tissue injury, increased activity of SOD, decreased MDA content and MPO activity, and up-regulated expression levels of RXR and Nrf2 protein. The above-mentioned improvement effects of 9-cRA were reversed by HX531 treatment. These results suggest that RXR activation can effectively protect the lung tissue against I/R injury, and the mechanism may involve the activation of Nrf2 signaling pathway, the enhancement of antioxidant level and the reduction of oxidative stress response.
Animals ; Lung ; physiopathology ; Male ; NF-E2-Related Factor 2 ; physiology ; Oxidative Stress ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; Retinoid X Receptors ; physiology ; Signal Transduction

OBJECTIVETo evaluate the efficacy and safety of tiotropium in treatment of severe persistent asthma.

METHODSReports of randomized controlled trials (RCTs) describing tiotropium for treatment of severe persistent asthma published from January 1946 to February 2015 were searched in Cochrane Library, ClinicalTrials.gov, PubMed, Ovid Medline, CNKI, and CSJD. The data of the included RCTs were extracted and the data quality was evaluated. Meta-analyses were performed with Revman 5.3 software.

RESULTSFive RCTs including 1433 patients were analyzed. Meta-analysis of the data showed that compared with the placebo group, tiotropium treatment significantly improved the patients' peak forced expiratory volume in one second (FEV1) [weighted mean difference (WMD): 0.13 L, 95% confidence interval (CI): 0.10-0.16 L, P<0.00001], trough FEV1 (WMD: 0.09 L, 95%CI: 0.06-0.12 L, P<0.00001), peak forced vital capacity (FVC) (WMD: 0.10 L, 95%CI: 0.06-0.14 L, P<0.00001), trough FVC (WMD: 0.12 L, 95%CI: 0.08-0.17 L, P<0.00001), morning peak expiratory flow (PEF) (WMD: 9.21 L/min, 95%CI: 4.2-14.23 L/min, P=0.0003), evening PEF (WMD: 22.06 L/min, 95%CI 13.05-31.08 L/min, P<0.00001). The scores of asthma control questionnaire (ACQ) (WMD: 0.01, 95% CI: -0.07-0.09, P=0.86) or asthma quality of life questionnaire (AQLQ)(WMD: 0.06, 95% CI:-0.18-0.06, P=0.33) were not affected by tiotropium. No significant difference with adverse events between tiotropium group and placebo group were reported in these included studies (P>0.05).

CONCLUSIONSTiotropium for severe persistent asthma treatment can improve FEV1, FVC, and PEF but may not improve the quality of life of the patients. Tiotropium is well tolerated and can be an add-on therapy for severe persistent asthma.

Asthma ; Bronchodilator Agents ; Humans ; Quality of Life ; Tiotropium Bromide

OBJECTIVETo summarize the clinical features of diffuse panbronchiolitis (DPB).

METHODWe retrospectively analyzed the clinical data of 35 patients who had been admitted to Peking Union Medical College Hospital from December 1996 to July 2014 due to DPB,which was confirmed basing on the diagnostic criteria proposed in 1998 by a working group of the Ministry of Health and Welfare of Japan or histopathological examination.

RESULTSThe average age of these 35 patients (20 men and 15 women,with a sex ratio of 1.33 to 1) was (42.2<15.6) years,mainly distributed in the 40-49 age group. The average clinical history was (8.4<8.5) years. The main symptoms and signs of DPB included chronic cough (n=35,100%),copious purulent sputum production (n=31,88.6%),exertional dyspnoea (n=24,68.6%),end-inspiratory crackles (n=28,80.0%). Also,26 patients (74.3%) had a history of sinusitis. Cold agglutination test in 15 out of 15 patients were negative. Pseudomonas aeruginosa and Haemophilus influenza were isolated from 22 patients (73.3%,22/30),and 26 patients (83.9%,26/31) had hypoxemia. The mean values of forced expiratory volume in the first second/forced vital capacity,residua volume/total lung volume,maximum forced expiratory volume of 50% lung volume,and maximum forced expiratory volume of 25% lung volume were 60.5%,53.8%,25.9%,and 31.2%,respectively. The most common CT findings from this cohort of patients were bronchiectasis and bronchiolitis,with nodular shadows distributed in a centrilobular pattern. Finally,29 patients were misdiagnosed as other conditions such as pulmonary infection and bronchiectasis.

CONCLUSIONSDPB in Chinese populations have different presentations compared to that Japanese populations:for instance,the serum cold agglutination test always shows negative results,which is often inconsistent with the pathogens in sputum. DPB usually is misdiagnosed. Clinicians should take DPB into consideration when patients had pulmonary infection and sinusitis.

Adult ; Beijing ; Bronchiectasis ; Bronchiolitis ; Chronic Disease ; Cough ; Female ; Haemophilus Infections ; Humans ; Inpatients ; Lung Diseases ; Male ; Retrospective Studies ; Sputum

Objective To understand the developmental effects induced by CdSe /ZnS quantum dots(QDs)on zebrafish embryos.Methods Zebrafish embryos were exposed to 0,0.5,1,2,4,8 and 16 nmol/L of CdSe /ZnS QDs,and the typical toxicological indexes were recorded at five time points respectively (24 hours post fertilization (hpf),48 hpf, 72 hpf,96 hpf,120 hpf).Results The results showed that the median lethal concentration (LC50 )for zebrafish embryos after 120 hpf was 21.38 nmol/L(95% CI =17.21 -26.57).The frequency of spontaneous movement in 60 seconds after 24 hpf,the frequency of heart beat in 60 seconds after 48 hpf,the hatching rate and the mortality rate were obviously affected by CdSe /ZnS QDs.Several abnormalities and toxic symptoms caused by CdSe /ZnS QDs at 8 nmol/L and 16 nmol/L were observed including pericardial edema,liver atrophy,non -depleted yolk,intestinal abnormal development and muscle degeneration after 120 hpf.Conclusion High level of CdSe /ZnS QDs (more than 8 nmol/L)could induce toxic effects on zebrafish embryonic development.

OBJECTIVETo explore the characteristics, diagnosis and treatment on traumatic dislocation.

METHODSFrom April 2000 to August 2010, 12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification, 8 cases were the anterolateral dislocation, 2 were posterior-medial dislocation, and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee, fibular head prominent, fibular head pain, floating feeling in head of fibula. One case was treated by conservative treatment, and the remaining 11 cases by surgical treatment.

RESULTSAll patients were followed-up for 10 months to 3 years (means 18 months). Evaluation by Lysholm scoring,the total scores were 95.08 +/- 2.02, involving limbing 4.92 +/- 0.28, support 4.92 +/- 0.28, interlocking 15.00 +/- 0.00, instability 24.58 +/- 0.79, pain 22.50 +/- 1.24, swell 8.50 +/- 0.90, climbing stairs 9.75 +/- 0.62, squatting 4.92 +/- 0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation.

CONCLUSIONThe diagnosis of traumatic dislocation is easy misseddiagnosis, surgery is the main treatment method, the prognosis is good.

Adolescent ; Adult ; Arthrography ; Female ; Fibula ; Humans ; Joint Dislocations ; diagnostic imaging ; therapy ; Joints ; injuries ; Male ; Middle Aged ; Tibia ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the effect of computer assisted navigation system in the treatment of unilateral zygomatic complex fractures.

METHODSFive patients with unilateral zygomatic complex fractures were included in this study.Preoperative design, intraoperative real-time navigation and postoperative evaluation with chromatogram were executed in the unaffected and affected side.

RESULTSUsing computer assisted navigation system, the position and direction of the affected side of the unilateral zygomatic complex fracture were confirmed and shown real-time on the screen. The global maximal deviation was less than 2 mm between the affected side and the mirror side of the healthy side with chromatogram.

CONCLUSIONSComputer assisted navigation system can instruct the treatment of unilateral zygomatic complex fractures effectively. The global comparison with chromatogram is more objective for the unilateral zygomatic complex fractures.

Adult ; Female ; Humans ; Male ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; Young Adult ; Zygomatic Fractures ; diagnostic imaging ; surgery

OBJECTIVETo explore the therapeutic efficacy and safety of batroxobin in patients with primary hepatic carcinoma (PHC) and the advantages of transcatheter arterial perfusion of batroxobin combined with transcatheter arterial chemoembolization (TACE).

METHODS40 patients with PHC were randomized into experimental group (transcatheter arterial perfusion of batroxobin combined with TACE treatment, 20 patients) and control group (TACE alone group, 20 patients). The patients were followed up and the data were recorded, compared and analyzed.

RESULTS(1) Compared with the control group, the FIB level in the experimental group was significantly decreased at the first month after treatment (P < 0.05). (2) The baseline of the tumor was shortened in both groups after the treatment. There was a significant difference between the two groups at different time intervals (P < 0.05). (3) After the treatment, there was a significant difference of PFS levels between the two groups (t = 2.877, P < 0.05).(4) The incidence of metastasis were 5.0% (1/20) in both groups at 6 months after treatment, and that after one year was 10.0% (2/20) in the experimental group and 25.0% (5/20) in the control group. However, the difference was not significant (chi(2) = 0.693, P > 0.05).

CONCLUSIONBatroxobin can rapidly and effectively decrease the FIB level. Therefore it may be used as an effective and safe adjuvant drug for the the treatment of primary hepatic carcinoma. Transcatheter arterial perfusion of batroxobin combined with TACE therapy has advantages in comparison with TACE alone. It could be taken as a new therapeutic regimen in the PHC treatment.

Adult ; Aged ; Batroxobin ; therapeutic use ; Carcinoma, Hepatocellular ; blood ; pathology ; therapy ; Chemoembolization, Therapeutic ; methods ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Fibrinogen ; metabolism ; Fibrinolytic Agents ; therapeutic use ; Follow-Up Studies ; Humans ; Liver Neoplasms ; blood ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Metastasis

Objective To investigated the related factors which affecting the severity degrees of post-traumatic stress disorder(PTSD) in trailsferred casualty after Wenchuan Earthquake.Methods Taking PTSD symptoms self-assessment scale(PCL-C) to involve 386 wounded who sufiered 40 days after the earthquake disaster,from 11 hospitals and were transferred to Chongqing city.Multi-stage cluster sampling method was used.354 valid questionnaires were recovered to explore the relevant factors affecting the severity on the symptoms of PTSD.Results This survey contains 354 subjects,with male 154(43.6%),female 200(56.4%),age 43.76±21.22,nation alities:Han people 236(66.7%),Qiang people 114(32.2%),others4(1.1%),and marriage status as unmarried 92(26.1%),married 253(71.7%),others 9(2.2%).The wounded women PTSD have more seriotis symptoms than men,and there were differences between them in repeated and disturbing dreams of this stressful experience(t=2.46,P=0.014),a strong sense of psychological suffering annoyance (t=2.02,P=0.044),having difficulty concentrating(t=2.04,P=0.042),being"super-alert"(t=2.465,P=0.014) etc,also in the total scores(t=2.489.P=0.013)(P<0.05).The PTSD symptoms of wounded degree in who had been buried in Earthquake were more serious than those not been buried.There were significant difierences between them in the iterns as:avoid thinking about or talking about a stressful experience(t=2.661,P=0.008),avoid activities or situations that could fecall the stressful experience(t=2.705,P=0.007),trouble remembering important parts of a stressful experience (t=2.775,P=0.006),feeling emotionally numb or being unable to have loving feelings for those close to you(t=3.017,P=0.003),feeling as if your future will somehow be cut short(t=2.979,P=0.003) and total scores(t=3.175,P=0.002).The wounded that witnessed someone be buried or died in earthquake,in PTSD symptoms,were more serious than those without.In the items of feeling distant or cut off from other people,feeling emotionally numb or being unable to have loving feelings for those close to you,feeling irritable or having angry outbursts, there were significant difference(P<0.05-0.01).There were significant difrerences among the average score of the three core symptoms(F=3.350,P<0.001),among the three core symptoms as well as between the three core symptoms and total score respectively.Conclusion There were differences in the severity degrees of PTST in transferred casualty under difrerent exposed conditions.Correlations were also found between each of the symptoms.