Central South University began to implement the eight-year medical education in 2004, and has accumulated rich experience in the pre-medical education through continuous reform and improvement. Since 2012, Central South University has made a series of reformation, which is more conducive to the all-round development of medical students , on the pre-medical education . Through adding freshman courses, humanities courses, bilingual teaching courses, and applying aca-demic adviser institution, early scientific research training and open courses during the pre-medical education, Central South University has exercised and strengthened students' scientific research ability, the humanistic quality, English level, and made the pre-medical comprehensive examination for the shunt selection of students. Thus Central South University has improved the eight-year medical students' comprehensive quality, and provided an example of the reformation for medical education.

OBJECTIVE: To discuss the feasibility of endoscopic frontal sinus surgery in the nasal septum median path. METHOD: (1) Sixty adult cadaveric heads fixed with formalin were CT scanned,and were three dimensional reconstruction. (2) Thirty adult cadaveric heads were sawn along the sagittal line close to the side of the nasal septum, then the important anatomic marks were observed and measured. (3) Combined with CT and anatomical data, thirty adult cadaveric heads were operated in different degree, and the damage of nasal septum and fila olfactoria were detected in the same time. RESULT: (1) The roots of middle nasal concha were simulated in the endoscopic frontal sinus surgery. The operation time, operative procedures, markers foundation, endoscopic back of posterior border of frontal sinus foundation and attached to the symphysis with cribriform plate and the top of ethmoidal sinus were recorded. (2) The intersection point formed by the level of middle nasal concha and the vertical of middle nasal concha corresponded with the nasal septum was called the M point. The distance from the M point to the horizon of the nasal bone was (20.07 +/- 6.21) mm, the distance from the M point to the first fila olfactoria was (24.38 +/- 7.68) mm, the distance from the first fila olfactoria to the posterior edge of frontal sinus was (9.57 +/- 2.73) mm, the distance from the root of the middle nasal concha to posterior edge of frontal sinus was (5.38 +/- 1.23) mm, the anteroposterior diameter of frontal sinus fundus was (7.62 +/- 2.45) mm, the transverse diameter of frontal sinus fundus was (9.41 +/- 3.37) mm, the seesaw diameter of frontal sinus partition was (16.97 +/- 3.23) mm, the anteroposterior diameter of frontal sinus partition was (12.34 +/- 2.23) mm. (3) The operation time through the nasal septum path was 105 minutes which combined with CT and anatomical measurements. 0 degrees endoscopy could be used to observe the frontal part of the lateral, posterior and top wall, while nasal septum remove should be finished with 30 degree endoscopy. The bottom of frontal sinus can be exposed and removed with 0 degree endoscopy. 3 cases of cadaveric frontal sinus lateral wall can not be observed with 70 degree endoscopy. 30 cases of cadaveric frontal sinus,some of the top and the lateral wall, anterior and posterior wall could be observed with 70 degree endoscopy, nasal septum damage range was about 2.23 cm x 2.59 cm, and no fila olfactoria damage was found. CONCLUSION Endoscopic frontal sinus surgery in the nasal septum median path is a good way to find frontal sinus.
Endoscopy ; methods ; Feasibility Studies ; Frontal Sinus ; diagnostic imaging ; surgery ; Humans ; Nasal Bone ; diagnostic imaging ; surgery ; Nasal Septum ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

AIM:To comprehensively evaluate the efficacy and safety of rituximab(RTX),tocilizumab(TCZ),and teprotumumab(TMB)in the treatment of thyroid-associated ophthalmopathy(TAO).METHODS:A systematic search was conducted in PubMed,Embase and Cochrane Library databases for systematic reviews/meta-analyses on TAO treat-ment,with the search time limited to January 2024.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 state-ment,Assessment of Multiple Systematic Reviews(AMSTAR)2 tool,and Grading of Recommenda-tions,Assessment,Development,and Evaluation(GRADE)were used to assess the reporting quality,methodological quality,and evidence quality of the included studies.RESULTS:The current systematic reviews on the three monoclonal antibodies in TAO treatment exhibited deficiencies in reporting quali-ty,methodological quality,and evidence quality.Di-rect comparative evidence between the three monoclonal antibodies is still lacking.Based on indi-rect comparative evidence,TCZ appears to be the most promising treatment option,followed by TMB and RTX.In terms of efficacy,TCZ and TMB signifi-cantly reduced the Clinical Activity Score(CAS),pro-ptosis,and improved quality of life.TCZ also signifi-cantly reduced the incidence of diplopia.RTX signif-icantly reduced disease response,while RTX and TCZ both significantly improved disease inactiva-tion rates.RTX showed no significant difference in diplopia,lid fissure changes,NOSPECS score and quality of life.The conclusions regarding safety are inconsistent,with TCZ and TMB potentially increas-ing the incidence of adverse events,while RTX showed no significant difference in safety com-pared to glucocorticoids or placebo.CONCLUSION:This study provides evidence-based insights for the selection of three monoclonal antibodies in the treatment of TAO.While TCZ may have advantages in efficacy,considering the limitations of existing evidence,more high-quality studies are needed to further verify and compare the efficacy and safety of different monoclonal antibodies in TAO treat-ment.