OBJECTIVE: To investigate the causes, clinical manifestation and treatment principles of frontal sinus tract after the frontal approach craniotomy. METHOD: The clinic data of 13 patients with frontal skin sinus tract after the frontal approach craniotomy were retrospectively analyzed. All of them were described in the clinical record to have undergone frontal sinus mucosa pushing down or shaving and bone wax filling in the frontal sinus during the surgery, of whom 3 cases had history of frontal abscess incision drainage. All patients were performed endoscopic frontal sinus surgery and forehead skin sinus tract excision and suture. RESULT: All of the patients successfully recovered after one-stage operation, and the frontal skin sinus tract was healed. CONCLUSION The frontal approach craniotomy with postoperative frontal sinus tract was related with the improper use of bone wax tamponade and sealing of frontal sinus. The treatment principles were to remove bone wax, remove inflammatory granulation tissue around the sinus tract, and to open frontal sinus and promote frontal sinus drainage.
Craniotomy ; methods ; Drainage ; Endoscopy ; Forehead ; Frontal Sinus ; surgery ; Granulation Tissue ; surgery ; Humans ; Palmitates ; Retrospective Studies ; Waxes

OBJECTIVE: To Summarize and analyze the clinical characteristics and treatment of patients with spontaneous cerebrospinal fluid rhinorrhea, and to explore the related factors of recurrence. METHOD: Retrospective- ly analyze the clinical data of 58 patients of spontaneous cerebrospinal fluid rhinorrhea from July 2002 to July 2012, combined with its clinical characteristics, and statistically analyze the related recurrence factors. RESULT: Fifty-eight cases were accepted the nasal endoscopic repairment of cerebrospinal fluid rhinorrheak, follow-up 3 years, 20 cases (34.5%) recurred, 1 case recurred in half a year after operation. In the first year, there were 10 cases recurred. In the second year there were 9 cases recurred, and 1 case recurred in the third year. Through multiariable analysis it was found that higher BMI, empty sella and skull base bone defect were the independent risk factors influencing the recurrence of spontaneous cerebrospinal fluid rhinorrhea (P < 0.05). CONCLUSION The recurrence rate of spontaneous cerebrospinal fluid rhinorrhea is high, needing long-term follow-up. Higher BMI, empty sella, skull base bone defect are independent risk factors of recurrence of the disease, and the treatment should be individualized.
Cerebrospinal Fluid Rhinorrhea ; pathology ; surgery ; Empty Sella Syndrome ; pathology ; Endoscopy ; adverse effects ; Humans ; Nose ; Recurrence ; Retrospective Studies ; Risk Factors ; Skull Base ; pathology

BACKGROUND: Studies have demonstrated that intervention material retention for a period of time in vivo causes pathogenic bacteria surface attachment, proliferation even forming biofilm to become potential source of high polymer catheter-associated infection. Inhibition of biofilm formation significantly reduces infection.OBJECTIVE: To evaluate the antimicrobial effect of anti-infective polyethylene material and its inhibiting effect to biofilm on the surface.DESIGN, TIME AND SETTING: Single sample observation was performed at the National Engineering Research Center for Engineering Plastics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences from June 2008 to May 2009, and the antimicrobial test was performed at the General Hospital of General Staff Headquarters of PLA in March 2009.MATERIALS: Organic antibacterial agent2,4,4'-trichloro-2'-hydroxydiphenyl ether; IONPURE~(R) Silver-Inorganic anti-microbialreagent; low-density polyethylene (LDPE).METHODS: LDPE was respectively blended with organic antibacterial agent and inorganic antibacterial agent, and the LDPE slice was prepared by injection molding process.MAIN OUTCOME MEASURES: The antimicrobial efficacy of anti-infective polyethylene was determined by the plate counting method. The ultrasonic-plate method and scanning electron microscopy were introduced to observe the biofilm formation.biofilm maturation. The propagation of microbe was found to be depressed remarkably on the surfaces of modified samples with organic antibacterial agent, and the formation of biofilm was prevented. The observation of SEM confirmed that no biofilm was formed on the surfaces of PE added organic antibacterial agent. The results showed that a large amount of bacteria and extracellularpolysaccharide matrix adhered on the surfaces of PE added inorganic antibacterial agent and untreated PE.CONCLUSION: Anti-infective polyethylene added organic antibacterial agent possesses excellent antimicrobial performance against S. aureus and E coli, and it can inhibit the formation of biofilm on the surfaces, which provides a promising approach to prevent catheter-related infections.

Objective: To investigate the changes of osteoprotegerin ( OPG) and receptor activator of nuclear factor kappa B ligand ( RANKL) level in perio-implant crevicular fluid ( PICF) and to monitor the development of the stability of Straumann ? tissue-level implants by resonance frequency analysis ( RFA) during the early phases of healing .Methods: A total of 35 implants ( length 10 mm ) were placed.PICF samples were collected with filter paper strips at baseline , 1, 2, 3, 4, 6, 8, and 12 weeks post-surgery, respectively.The OPG, RANKL levels were determined by ELISA method .At the same time points, the implant stability quotient (ISQ) values were determined with Osstell TM mentor.Results:During healing , PICF-OPG levels increased significantly 2 weeks after surgery when compared with the 4th-, 6th-, 8th-and 12th-week reevaluation (P<0.05).The OPG/RANKL ratio in PICF was significantly higher ( P<0 .05 ) than that in gingival crevicular fluid at 1 week post-surgery .ISQ slightly fluctuated within the first 4 weeks after installation .Following this, the ISQ values increased steadily for all the implants and up to 12 weeks.Significant differences were noted between the mean ISQ values at the 12th-week and other observation time points .Conclusion: The PICF-OPG levels may be effective in monito-ring the process of osseointegration .All the ISQ values indicated the stability of Straumann ? implants over a 12-week healing period .RFA is a reliable and effective assistant to monitor implant stability .

Objective:To evaluate the differences of clinical parameters and putative periodontal patho-gens in sites of different probing depth ( PD) reduction after non-surgical periodontal treatment in patients with aggressive periodontitis ( AgP ) .Methods: Clinical examinations including plaque index , probing depth (PD), attachment level (AL) and bleeding index (BI), and full-mouth periapical photographs were collected from 20 patients with AgP .All the patients received non-surgical periodontal treatment , including oral hygiene instruction , supra-gingival scaling , subgingival scaling and root planing ( SRP ) and were followed up for 6 months post-therapy.Gingival crevicular fluids (GCF) were collected at 1 site in each quadrant before and at the end of 6 months post-therapy .Six kinds of putative periodontal patho-gens and 6 kinds of short chain fatty acids ( SCFAs ) were detected in the GCF samples .Results: The baseline clinical parameters of PD , AL and BI , the baseline concentration of succinic acid , acetic acid , propionic acid and butyric acid , and the prevalence of Treponema denticola were significantly higher in sites with PD reduction more than 2 mm sites compared with PD reduction no more than 2 mm sites [(7.7 ±1.2) mm vs.(5.1 ±1.8) mm, (6.3 ±1.9) mm vs.(4.5 ±2.2) mm, 3.8 ±0.4 vs.3.3 ± 0.8, 1.66 mmol/L vs.1.10 mmol/L, 31.67 mmol/L vs.17.78 mmol/L, 3.31 mmol/L vs.1.95 mmol/L, 84.6%vs.56.1%, P<0.05].However, there were no significant differences in the clinical param-eters, the 6 kinds of putative periodontal pathogen detection and SCFAs concentration between the 2 groups at the end of 6 months post-treatment.In sites with PD>5 mm at the end of 6 months post-thera-py , all were found with red complex bacteria infection .Conclusion:The baseline clinical parameters are important factors in predicting PD reduction after non-surgical periodontal treatment in patients with AgP . In sites with deep pockets after non-surgical periodontal treatment , the active control of red complex bac-teria is recommended .

Objective:To analyze the serum IgG titers to Aggregatibacter actinomycetemcomitans ( Aa ) and associated factors in patients with aggressive periodontitis (AgP).Methods:Venous blood samples were collected from 62 AgP patients and 45 periodontal healthy controls , unstimulated whole saliva and pooled subgingival plaque samples of AgP patients were also collected for the detection of Aa ( PCR method) .Serum IgG titers to Aa serotype c were measured by enzyme-linked immunosorbnent assay ( ELISA) .Results:The detection rates of serum IgG to Aa serotype c in the AgP patients and the healthy controls were both 100%.The AgP patients exhibited significantly higher IgG titers to Aa serotype c than the healthy controls (11.1 ±1.9 vs.9.1 ±1.8, P<0.01).There was no significant difference in serum IgG levels to Aa serotype c and in the prevalence of high-responding patients to Aa serotype c between the incisor-first molar type AgP patients and generalized AgP patients .Serum IgG titers to Aa serotype c in the Aa-positive AgP patients ( the patients who were Aa-positive in subgingival plaque or saliva ) were sig-nificantly higher than those of the Aa-negative patients (11.9 ±1.3 vs.10.7 ±2.1, P<0.05).Con-clusion:Serotype c was the main serotype of Aa in Chinese patients with AgP .Serum IgG responses in generalized AgP patients were comparable to those in incisor-first molar type AgP patients .

Objective: To evaluate the feasibility of full-mouth debridement ( subgingival scaling and root planning , SRP) by 2 times within 1 week and compare the clinical effects of different sequences of debridement-antibiotic usage in patients with severe chronic periodontitis ( CP ) .Methods: A double-blinded, placebo-controlled, randomized clinical trial was conducted in 30 severe CP patients (14 males and 16 females, 40.5 ±8.4 years old on average from 35 to 60 ) receiving 3 different sequences of debridement-antibiotictherapy:Group A, antibiotic usage (metronidazole, MTZ, 0.2 g, tid, 7 d;amo-xicillin, AMX 0.5 g, tid, 7 d) was started together with SRP ( completed by 2 times in 7 d);Group B, antibiotic usage (MTZ 0.2 g, tid, 7 d;AMX 0.5 g, tid, 7 d) was started 1 d after SRP(completed by 2 times in 7 d);Group C, SRP alone[probing depth (PD), bleeding index (BI) and tooth mobility] was examined .The average full-mouth probing depth , the average full-mouth proximal probing depth ( pPD) , the percentage of sites with PD >5 mm ( PD>5 mm%) , the percentage of sites with proximal PD>5 mm ( pPD>5 mm%) , the average bleeding index ( BI) and the percentage of sites with bleeding on probing ( BOP%) were calculated .Clinical examinations were performed at baseline and 2 months post therapy .Results:(1) Compared with baseline conditions , all the subjects showed clinical improve-ments in all the parameters evaluated 2 months post therapy , P<0 .05 .( 2 ) Significant difference were observed in the average PD changes between Group A [(2.15 ±0.42) mm], Group B [(1.76 ±0.29) mm] and Group C [(1.57 ±0.33) mm], P<0.05.No significant difference was observed in the aver-age PD changes between Group B and Group C , P=0.354.Significant differences were observed in the average pPD changes between Group A [(2.45 ±0.43)mm] and Group C[(1.90 ±0.48) mm], P<0.05.No significant difference was observed in BI and BOP% changes between Group A ,Group B and Group C.Conclusion: For patients with severe chronic periodontitis , it is safe and feasible to receive full-mouth SRP by 2 times within 1 week.The short-term ( 2 months ) advantages in PD changes are observed in patients receiving SRP and antibiotic usage at the same time comparing with patients using antibiotics after SRP or SRP alone .

Objective: To explore the association of the single nucleotide polymorphisms (SNPs) in N-formylpeptide receptor (FPR) gene with the susceptibility of aggressive periodontitis (AgP). Methods: A total of 94 AgP patients and 73 healthy controls were entered into the study. Peripheral blood sample was obtained from each subject by venepuncture. Genomic DNA was isolated from each sample.The target fragment of FPR gene was amplified by PCR. The SNPs in FPR gene were detected by denature high performance liquid chromatography ( DHPLC) combined with DNA sequencing. Results: There were two non-synonymous SNPs in the 370 bp FPR gene fragment;289C/A and 301G/C. The 289C/Awas a novel SNP. No variation in nucleotides 329 and 378 was detected. There were no statistically significant differences in distributions of the genotypes and alleles for FPR289 and FPR301 between AgP patients and healthy controls. Using multivariate logistic regression (adjusted for age and gender) , it was showed that the adjusted Ors of AgP for the C~+ genotype and allele C of FPR301 combined with smoking were 5.74 and 5.20 respectively. Conclusion: The presence of the C~+ genotype/allele C of FPR301 together with smoking conferred a higher risk for AgP. The result suggests that the SNPs in FPR gene may not be associated with the susceptibility of AgP in Chinese.

Objective To investigate the changes of the cervical spinal cord in patients with relapsing-remitting multiple sclerosis (RRMS) and relapsing neuromyelitis optica (RNMO) using diffusion tensor imaging (DTI) and to analyze its correlations with clinical disability scores.Methods Thirty patients with MS (MS group),28 patients with NMO (NMO group) and 20 healthy volunteers were imaged using DTI on a 3.0 Tesla scanner.DTI indices of cervical spinal cord from all participants were measured,including mean diffusivity (MD) and fractional anisotropy (FA),and the correlations between the DTI metrics and the expanded disability status scale (EDSS) scores were assessed.One-way ANOVA,Dunnett-t test and Spearman correlation analysis were used for statistics.Results (1) The values of MD among three groups were different at C3 level for left lateral and dorsal columns,C4 level for the central gray substance and dorsal columns,and C5-C6 level for all structures.There were significant differences among them (F =4.006-36.814,P ＜ 0.05).The values of FA were significantly different at all levels (F =5.561-98.128,P ＜0.05).(2) Compared with the control group,the values of MD were increased and FA were decreased for both MS and NMO groups,there were significant differences among them (t =-0.320-3.138,P ＜0.05).In MS and NMO groups,there were no significant differences of MD (t =-1.183-0.069,P ＞0.05),while the FA at C4-C6 levels (including the central gray substance,dorsal columns,right lateral columns and left lateral columns) for NMO group were 0.57 ± 0.09,0.56 ± 0.11,0.54 ±0.10,0.57±0.09,0.55 ±0.11,0.52 ±0.13,0.55 ±0.11,0.54 ±0.13,0.54±0.10,0.54±0.11,0.53 ±0.13,0.52 ±0.11 ;and for MS group were 0.67 ±0.10,0.68 ±0.10,0.68 ±0.10,0.70 ±0.12,0.68 ±0.11,0.69±0.10,0.68 ±0.11,0.69 ±0.12,0.67 ±0.14,0.68 ±0.15,0.69 ±0.14,0.69 ±0.16,and there were significant differences between two groups (t =-0.011-0.169,P ＜ 0.05).(3)Univariate correlations between DTI measures and the average EDSS scores were assessed.The MD at all levels showed significant positive correlations with disability scores (r =0.324-0.541,P ＜ 0.05),and FA significant negative correlated with disability scores (r =-0.632--0.294,P ＜ 0.05),except C4 level for lateral columns and C2 level.Conclusions DTI metrics are sensitive to cervical spinal cord damage in demyelinating diseases,providing an important way of distinguishing MS from NMO,and can be potentially useful quantitative biomarkers for monitoring the evolution of demyelinating diseases.

Objective To evaluate the effcacy of electron-beam chest-wall irradiation in patients with breast cancer after mastectomy.Methods From June 1999 to December 2007,280 women with localized breast cancer received postmastectomy radiotherapy using electron beam to chest wall.The effcacy and toxicity of these 280 women was compared with 118 women treated during the same period using tangential field with photon beam.Results The follow-up rate was 93.2%.140 patients had a minimum followed up time of 5 years and 12 patients had a minimum follow up time of 10 years.The 5-year and 10-year chest wall recurrence rates were 6.8%and 5.0%.14.8%and 10.1%for patients irradiated with electron and photon(X2=1.12,P=0.290).The corresponding 5-year and 10-year disease-free survival rates were 60.6%and 65.5%,47.6%and 57.3%(X2=0.97,P=0.325).The 5-year and 10-year overall survival rates were 77.5%and 79.6%,48.4%and 53.3%(X2=0.37,P=0.545).Grade Ⅱ or more acute skin toxicity occurred in 10.4%and 16.9%of patients irradiated with electron and photon(X2=3.34.P=0.090).Pulmonary fibrosis developed in 28.8%and 22.1% of patients irradiated with electron and photon(X2=1.27,P=0.300).Conclusion Electron-beam chest-wall irradiation is as effective as photon-beam irradiation in breast cancer after mustectomy.