Objective:To compare the effects of different surgical treatment of chronic rhinitis-sinusitis difference,and its impact on transport function of maxillary sinus mucociliary,provide a clinical-surgical sinusitis preferably reference about the treatment of chronic nasal formulation for.Methods:From 2013.9-2014.12,otorhinolaryngology clinic in our hospital,160 cases were diagnosed as chronic nose-as research subjects were randomly divided into four groups of patients with sinusitis were treated from 1 to 4,60 cases in each group;treatment groupl receiving the maxillary sinus ostium augmentation,treatment group 2 received fenestration,treatment group 3 through tears crypt before maxillary sinus surgery,treatment 4 group receiving the maxillary sinus balloon dilatation;after covering the nasal mucosa observed and compared four groups of patients about edema,vesicle formation,bone exposure,scarring,etc.,as well as internal maxillary sinus secretions traits,volume situation,and compared patients after four groups line maxillary sinus cavity and perioral saccharin test biopsy cases three months and six months.Results:The four groups were made after surgery better clinical efficacy,and group efficacy 4 with the other three groups,the effect is most significant (all P ＜0.05),the difference was statistically significant,and after three months and six months,group 4 compared with other surgical group,the Lund-Kernedy score were also lower,MMT time were also lower,the difference was more significant (all P ＜0.05);in the maxillary sinus biopsy aspects:the number of postoperative inflammatory cells and dendritic cells and glandular cell morphology and submucosal edema improved submucosal structures also in the group of four most significant (P＜0.05).Conclusion:Maxillary sinus balloon dilatation treatment chronic nasal sinusitis curative effect is higher,which can effectively improve the cell and submucosal gland cell morphology and sinus mucosa edema,sinus unobstructed drainage effect,and high safety.

Purpose To analyze the multimodal imaging manifestations of phosphaturic mesenchymal tumor.Materials and Methods A retrospective analysis was performed on ten patients with phosphaturic mesenchymal tumor confirmed by pathology and molecular imaging from November 2012 to June 2022 in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology.The imaging features of CT in four cases,of MRI in seven cases,and of nuclear medicine in ten cases were reviewed,along with the clinical characteristics of all patients.Results The main clinical symptoms of ten patients,eight cases had pain,four cases had weakness,and nine cases had multiple fractures.Laboratory tests results:ten cases showed decreased blood phosphorus,six cases showed decreased blood 25-hydroxyvitamin D and ten cases showed elevated blood alkaline phosphatase.The lesions were heterogeneous in four cases on CT scans and in six cases on MRI scans.Calcification was common,and some had cysts and fatty components.After enhancement,seven cases showed moderate to obvious uneven enhancement.99Tcm-MDP SPECT showed increased uptake of multiple bones and joints in eight cases,18F-FDG PET/CT showed no or slight increase in lesion metabolism in eight cases,68Ga-DOTATATE PET/CT showed significantly high uptake at the lesion site in ten cases.Conclusion Phosphaturic mesenchymal tumor patients typically present with pain,fractures and hypophosphatemia.The conventional imaging features are characterized by small and concealed lesions and complex components.Particularly,68Ga-DOTATATE PET/CT imaging exhibits high sensitivity for the tumor detection.

Objective:To investigate the independent risk factors for postoperative severe pulmonary infection (SPI) in patients with severe traumatic brain injury (sTBI) and evaluate their predictive value.Methods:A retrospective cohort study was conducted to analyze the clinical data of 163 sTBI patients admitted to Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from April 2021 and March 2023, including 101 males and 62 females, aged 20-80 years [53.0(46.0, 59.0)years]. The surgical procedures involved decompressive craniectomy, subdural hematoma removal, epidural hematoma removal, and intracranial hematoma removal. The patients were divided into SPI group ( n=62) and non-SPI group ( n=101) according to whether they had SPI postoperatively. The following data of the two groups were collected, including gender, age, preoperative Glasgow coma scale (GCS), elevated blood glucose, abnormal liver function, abnormal renal function, hemoglobin level, anemia, albumin level, hypoproteinemia, white blood cell count, neutrophil count, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI) and serum lactate dehydrogenase (LDH) level. All the hematological tests were performed on venous blood samples collected preoperatively before anti-inflammatory treatment. Independent risk factors for predicting the postoperative occurrence of SPI in sTBI patients were identified through univariate analysis and multivariable stepwise regression analysis. The predictive value of separate indicator or indicators combined was assessed by calculating the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results:Univariate analysis demonstrated that preoperative GCS, albumin level, lymphocyte count, NLR, PNI and serum LDH level in both groups were significantly correlated with the postoperative occurrence of SPI ( P<0.05), while gender, age, elevated blood glucose, abnormal liver function, abnormal renal function, hemoglobin level, anemia, hypoproteinemia, white blood cell count, neutrophil count, platelet count, dNLR and PLR were not correlated with the postoperative occurrence of SPI in sTBI patients ( P>0.05). Multivariable stepwise regression analysis revealed that low lymphocyte count (95% CI -0.337, -0.013, P<0.05), high NLR (95% CI -0.023, -0.005, P<0.01), low PNI (95% CI 0.007, 0.026, P<0.01), and high serum LDH (95% CI -0.002, -0.001, P<0.01) were independent risk factors for SPI in sTBI patients ( P<0.05). ROC curve analysis indicated that low lymphocyte count, high NLR, low PNI and high serum LDH level could predict SPI in sTBI patients postoperatively, with the combination of PNI and serum LDH showing the highest predictive ability (AUC=0.78, 95% CI 0.70, 0.85). Conclusion:Low lymphocyte count, high NLR, low PNI, and high serum LDH level are independent risk factors for postoperative SPI in patients with sTBI, and the combination of PNI and serum LDH possesses a high predictive value for postoperative SPI in sTBI patients.

Objective To explore the risk factors of frozen shoulder,and to provide the basis for the prevention of frozen shoulder.Methods A total of 114 patients with frozen shoulder who were hospitalized in the First Affiliated Hospital of Zhejiang Chinese Medical University from January 2020 to August 2022 were included in case group,and 114 physical examination patients with no history of frozen shoulder were included in control group.The clinical data of two groups were collected and the risk factors of frozen shoulder were analyzed by multivariate Logistic regression.Results There were statistically significant differences in cervical radiculopathy,type 2 diabetes mellitus,hepatitis,chronic non-atrophic gastritis,lumbar disc herniation,osteoporosis and thyroid sarcoidosis between two groups(P<0.05).Multivariate Logistic analysis showed that cervical radiculopathy(OR=6.114,95%CI:1.458-25.642)and type 2 diabetes mellitus(OR=24.069,95%CI:4.023-144.007)were independent risk factors for the onset of frozen shoulder.Conclusion Patients with type 2 diabetes mellitus and cervical radiculopathy have a higher risk of frozen shoulder,and should pay attention to early prevention.