Metastasis is one of the main complaints of nasopharyngeal carcinoma. After radiotherapy and chemotherapy, residual and recurrent lymph nodes in the neck are still partially seen. Neck dissection is an important salvage treatment to improve survival and life quality. The present review summarizes the distribution of residual and recurrent lymph nodes, the applications of different salvage surgeries and outcomes.

OBJECTIVETo study the reliability and validity of Chinese version of International Physical Activity Questionnaire (IPAQ) and to provide an instrument for physical activity measurement in Chinese-spoken population.

METHODSTest-retest reliability was systemically assessed in 94 participants sampled from college students. Questionnaires were completed twice with a three-day interval. The validity was established in 39 volunteers by Caltrac accelerometer monitoring and 24-hour activity recording for seven consecutive days.

RESULTSBoth long vision (LV) and short vision (SV) had intraclass correlation coefficients above 0.7 for physical activity. The total energy expenditure measured by LV, SV and PA records were 264.5 +/- 260.9, 185.4 +/- 128.9 (compared with activity records, P < 0.05) and 250.5 +/- 141.2 MET-min/d respectively. Energy expenditure of moderate physical activity were 81.7 +/- 165.4, 32.0 +/- 42.5 (compared with activity record, P < 0.05) and 61.3 +/- 72.0 MET-min/d. Caltrac accelerometer was moderately correlated with LV (r = 0.50) and SV (r = 0.63) while SV measured total daily energy expenditure was lower than activity records. When participants were categorized into two groups according to their time spent in physical activity above or below the target level, proportions of agreement of questionnaires and 24-hour activity records were high, including vigorous physical activity above 90% and moderate physical activity above 70%. LV, SV and activity records were measured during sedentary condition at an approximate level.

CONCLUSIONSBoth LV and SV of IPAQ appeared to have acceptable reliability and validity, compared to other physical activity instruments that were used in various large epidemiological studies. The total or physical energy expenditures were similar between LV and activity records. For activity levels, the proportion of agreement were similar between activity records and LV or SV. However, SV underestimated the energy expenditure of total and moderate physical activity.

Adult ; China ; Exercise ; Female ; Humans ; Internationality ; Language ; Male ; Reproducibility of Results ; Surveys and Questionnaires ; standards

BACKGROUNDDetermining the nerve of origin for vestibular schwannoma (VS), as a method for predicting hearing prognosis, has not been systematically considered. The vestibular test can be used to investigate the function of the superior vestibular nerve (SVN) and the inferior vestibular nerve (IVN). This study aimed to preoperatively distinguish the nerve of origin for VS patients using the vestibular test, and determine if this correlated with hearing preservation.

METHODSA total of 106 patients with unilateral VS were enrolled in this study prospectively. Each patient received a caloric test, vestibular-evoked myogenic potential (VEMP) test, and cochlear nerve function test (hearing) before the operation and 1 week, 3, and 6 months, postoperatively. All patients underwent surgical removal of the VS using the suboccipital approach. During the operation, the nerve of tumor origin (SVN or IVN) was identified by the surgeon. Tumor size was measured by preoperative magnetic resonance imaging.

RESULTSThe nerve of tumor origin could not be unequivocally identified in 38 patients (38/106, 35.80%). These patients were not subsequently evaluated. In 26 patients (nine females, seventeen males), tumors arose from the SVN and in 42 patients (18 females, 24 males), tumors arose from the IVN. Comparing with the nerve of origins (SVN and IVN) of tumors, the results of the caloric tests and VEMP tests were significantly different in tumors originating from the SVN and the IVN in our study. Hearing was preserved in 16 of 26 patients (61.54%) with SVN-originating tumors, whereas hearing was preserved in only seven of 42 patients (16.67%) with IVN-originating tumors.

CONCLUSIONSOur data suggest that caloric and VEMP tests might help to identify whether VS tumors originate from the SVN or IVN. These tests could also be used to evaluate the residual function of the nerves after surgery. Using this information, we might better predict the preservation of hearing for patients.

Adult ; Female ; Hearing ; Humans ; Male ; Neuroma, Acoustic ; pathology ; physiopathology ; Vestibular Nerve ; physiology

OBJECTIVETo evaluate the clinical manifestations of laryngeal tuberculosis and its laryngoscopic characteristics.

METHODClinical analysis of 36 laryngeal tuberculosis cases confirmed pathologically was carried out retrospectively.

RESULTSThe patients' ages ranged from 19 to 78 years old (median 39.5 years old). The male to female ratio was 1.8 to 1. The most frequent chief complaint was hoarseness (83.3%). The true vocal cord and the false vocal cord were usually found involved by fibrolaryngoscope observations. The lesions appearances were mainly the proliferation such as nodules or granules. The laryngostroboscopy demonstrated that the wave of the mucosa and vibration of the involved vocal cords were markedly reduced or disappeared. Among 24 patients with multiple lesions in the larynx, 19 (79.2%) had active pulmonary tuberculosis,while 9 (75.0%) had normal lung status among 12 patients with single lesions in the throat. All the patients received a full course of antituberculosis treatment. The results of the antituberculous medication was satisfactory in all 26 cases patients who can be followed up, while 10 cases were lost for the follow-up.

CONCLUSIONSThe local clinical manifestations of laryngeal tuberculosis is nonspecific, while the whole manifestation is not apparent. The lesions commonly involve the true vocal cord and the false vocal cord. It can even occur without pulmonary tuberculosis.

Adult ; Aged ; Female ; Humans ; Laryngoscopy ; Larynx ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Laryngeal ; diagnosis ; pathology ; therapy ; Young Adult

Objective To calculate the electric field intensity and transmembrane voltage of spherical cells and ellipsoi -dal red blood cells ( RBC) in an extremely low frequency electromagnetic field .Through this calculation , we can provide reference to the search for interaction targets and mechanics between the extremely low frequency electromagnetic field and organisms.Methods The Finite Element Method was used in the numerical computation for the spherical cell model and the ellipsoidal RBC model .Results The electric field intensity of the two types of cells on the cellular membrane was both significantly higher than the applied electric field strength , and the values of the induced field strength and transmembrane voltage varied with the direction of the electric field periodically .Conclusion The cell shape and direction of the applied electric field are not the main determinants of the cellular membrane electric field intensity and the transmembrane voltage compared with electromagnetic parameters .The distribution of the electric field intensity and transmembrane voltage are re-lated to the direction of the applied electric field.

Background Leber hereditary optic neuropathy (LHON)is a common inherited eye disease,which generally affects young adults with bilateral loss of central vision.Mutation frequency of Leber hereditary has not been fully clarified. Objective This study was to investigate the mutation frequency of mitochondrial NDI gene associated with LHON in Chinese population. Methods The proposal of the study was approved by Ethic Committee of Wenzhou Medical College.Written informed consent was obtained from each subject initial of this trial.Eight hundred and ninety-four LHON patients and 134 normal subjects were collected.Genomic DNA was extracted from peripheral blood leukocytes of the all participants.Polymerase chain reaction (PCR) was used to amplify and sequence analysis of the mitochondrial ND1 gene was performed and aligned with revised Cambridge Reference Sequence(rCRS) of mitochondrial DNA.Then mutated gene frequency was screened and analyzed. Results Mutational analysis of mitochondrial ND1 gene in 894 LHON patients revealed the presence of G3316A,T3394C,G3460A,C3497T,G3635A,G3733A,and T4216C.11.19％ LHON patients (100/894 ) were found to be associated with the gene mutations mentioned above,and 3.24％ patients (29/894) showed the co-occurrence of three primary mutations.Mutation frequencies in LHON patients were 2.57％,2.23％,1.45％,3.80％,0.67％,0.11％,0.34％,respectively,and G3316A,T3394C,C3497T and T4216C also were detected in 134 normal controls with the mutation frequencies of 4.48％,2.99％,4.48％ and 1.49％,respectively.Mutation frequency analysis showed an insignificant difference in the mutations of G3316A,T3394C,C3497T and T4216C between LHON patients and normal controls (x2 =0.926,P=0.336;x2 =0.052,P=0.820; x2 =0.142,P=0.707;P=0.129).G3376A,G3496T,G3700A,A4136G,T4160C and C4171A were absent in Chinese LHON patients. Conclusions Mitoehondrial ND1 gene in LHON is a mutational hotspot in Chinese population,11.19％ (100/894)associated with LHON was caused by ND1 gene mutation.G3635A,G3733A may be rare pathological mutation in Chinese population.However,G3316A,T3394C,C3497T and T4216C are insufficient to produce the clinical phenotype,but they may play a synergic role for penetrance and phenotypic manifestation in LHON.

AIM To establish an HPLC method for the simultaneous content determination of gallic acid,protocatechuic acid,morroniside,loganin,sweroside,paeoniflorin,hypericin,astragalin,salvianolic acid B,salvianolic acid A,epimedin C and icariin in Bushen Huoxue Sanjie Capsules.METHODS The analysis was performed on a 30℃thermostatic Agilent 5 TC-C18 column(250 mm×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1%phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 240 nm.RESULTS Twelve constituents showed good linear relationships within their own ranges(r≥0.999 8),whose average recoveries were 97.11%-101.14%with the RSDs of 0.60%-2.65%.CONCLUSION This simple,accurate and reproducible method can be used for the quality control of Bushen Huoxue Sanjie Capsules.

Objective To summarize the medication law of TCM in the treatment of chronic bronchitis;To provide reference for clinical medication.Methods Medical records of patients with chronic bronchitis who were hospitalized in the Respiratory Department of the First Affiliated Hospital of Henan University of Chinese Medicine from January 1,2016 to December 31,2021 were extracted based on HIS electronic medical record data.After screening,the TCM prescriptions used by patients with chronic bronchitis were input into Excel 2019 to establish a database.Based on the software Lantern 5.0,the latent structure model was learned,hidden variables and explicit variables were obtained,and the model was interpreted.SPSS Modeler 18.0 was used to establish model points with Apriori algorithm for Chinese materia medica with a frequency greater than 6%,to obtain the association rules between drugs,and to analyze the medication law of TCM in treating chronic bronchitis.Results A total of 3 410 cases were included,involving 423 kinds of Chinese materia medica,with a cumulative frequency of 82 766 times.Among them,109 kinds of Chinese materia medica with a frequency of>6 % had a cumulative frequency of 69 845 times.The top five commonly used medicines were Fritillariae Cirrhosae Bulbus,Poria,Atractyodis Macrocephalae Rhizoma,Asteris Radix et Rhizoma,Citri Reticulatae Pericarpium,mainly with medicines of reducing cough and phlegm,antiasthmatic medicine,tonifying deficiency,clearing heat,relieving superficies,promoting blood circulation and removing blood stasis.The medicinal properties were warming,cold and mild,and the main tastes were bitter,sweet and pungent,and the meridians were mainly lung,spleen,liver and stomach meridians.Through analysis of latent structure,49 hidden variables and 149 hidden classes were obtained.Combined with professional knowledge,10 comprehensive clustering models and 21 core formulas were deduced,such as Sangbaipi Decoction,Xuefu Zhuyu Decoction,Xiaoqinglong Decoction,Erchen Decoction,Shashen Maidong Decoction,Liuwei Dihuang Pills,Yinqiao Powder,Zhisou Powder,Yupingfeng Powder,Xuefu Zhuyu Decoction combined with Daotan Decoction,etc.It was concluded that the chronic bronchitis syndrome included phlegm-heat stagnation lung syndrome,qi stagnation blood stasis syndrome,cold fluid attacking lung syndrome,phlegm-dampness accumulation lung syndrome,lung qi and yin deficiency syndrome,kidney yin deficiency syndrome,wind heat attacking lung syndrome,wind cold attacking lung syndrome,lung qi and spleen deficiency syndrome,phlegm stasis interjunction syndrome.A total of 41 strong association rules were screened in the analysis of association rules,including 5 strong association rules for two and 36 strong association rules for three.The high confidence rules were Saposheikovize Radix + Angelicae Sinensis Radix →Atractyodis Macrocephalae Rhizoma,Saposheikovize Radix + Codonopsis Radix → Atractyodis Macrocephalae Rhizoma,Codonopsis Radix + Citri Reticulatae Pericarpium → Atractyodis Macrocephalae Rhizoma;the higher degree of improvement were Bupleuri Radix + Mori Cortex → Scutellariae Radix,Perillae Fructus + Belamcandae Rhizoma → Fritillariae Cirrhosae Bulbus,Armeniacae Semen Amarum + Pinelliae Rhizoma → Citri Reticulatae Pericarpium,etc.Conclusion In the treatment of chronic bronchitis,TCM is mainly used to reduce phlegm,relieve cough and asthma,and the method of promoting blood circulation and removing blood stasis is commonly used to help eliminate phlegm.In addition,TCM pays attention to the application of methods such as tonifying lung and securing the exterior,invigorating spleen and benefiting qi.

BACKGROUND: Jefferson fracture associated with unstable odontoid fracture is rare, and little reported.Occipito-cervical fusion is the commonly used treatment method, but it causes a severe loss of the motion of cervical vertebrae, which affects the patients' quality of life, so the curative effect is poor.OBJECTIVE: To evaluate the feasibility and therapeutic efficacy of atlantoaxial transpedicular screw fixation for Jefferson fracture associated with unstable odontoid fracture, so as to avoid occipito-cervical fusion and preserve the motion of the atlanto-occipital joint.METHODS: Fifteen patients with Jefferson fracture associated with unstable odontoid fracture from March 2010 to August 2015, were treated with atlantoaxial transpedicular screw fixation. There were 13 cases of Anderson type II and 2 cases of Anderson shallow type lll odontoid fracture, as well as 5 cases combined with transverse atlantal ligament rupture. All patients underwent skull traction after admission, as well as three-dimensional CT was applied preoperatively to determine the atlas pedicle screw trajectory and chose suitable screws. Atlantoaxial transpedicular screw was placed and atlantoaxial joint was reduced under general anesthesia. Bone graft fusion of atlantoaxial joint was applied only for the transverse atlantal ligament.The pain and neurologic function were evaluated by the Visual Analog Scale and the American Spinal Injury Association Impairment Scale before and after operation. The range of motion of the atlanto-occipital joint was observed during follow-up.RESULTS AND CONCLUSION: (1) The mean operation time was (150±41) minutes (120-270 minutes). The mean blood loss was (246±95) mL (160-500 mL). (2) Atlantoaxial transpedicular screws were successfully placed in all patients. No spinal and nerve root injury, or vertebral artery injury occurred intraoperatively. The atlantoaxial achieved good reduction. (3) The follow-up time was 12-36 months. There were nine cases of incomplete spinal cord injury, and 7 cases of obviously improved neurologic function. The visual analog scale scores were significantly improved at 1 year postoperatively, from preoperative (8.15±0.62) to postoperative (1.2±1.4) (P < 0.05). (4) All fractures and bone grafts were healed without loosening or rupture of the screws. The range of motion of the atlanto-occipital joint was (14.6±2.8)° postoperatively. (5) To conclude, atlantoaxial transpedicular screw fixation is effective for Jefferson fracture combined with unstable odontoid fracture, which not only exhibits a high rate of bone healing and stable fixation, but also avoids the occipital-cervical fusion and preserves occipito-atlantal motion.

Purpose: The aim of this study was to compare the efficacy of liver transplantation (LT) and liver resection (LR) for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) and to investigate risk factors affecting prognosis. Materials and Methods: A total of 94 HCC patients with PVTT type I (segmental PVTT) and PVTT type II (lobar PVTT) were involved and divided into LR (n=47) and LT groups (n=47). Recurrence-free survival (RFS) and overall survival (OS) were compared before and after inverse probability of treatment weighting (IPTW). Prognostic factors for RFS and OS were explored. Results: Two treatment groups were well-balanced using IPTW. In the entire cohort, LT provided a better prognosis than LR. Among patients with PVTT type I, RFS was better with LT (p=0.039); OS was not different significantly between LT and LR (p=0.093). In subgroup analysis of PVTT type I patients with α-fetoprotein (AFP) levels >200 ng/mL, LT elicited significantly longer median RFS (18.0 months vs. 2.1 months, p=0.022) and relatively longer median OS time (23.6 months vs. 9.8 months, p=0.065). Among patients with PVTT type II, no significant differences in RFS and OS were found between LT and LR (p=0.115 and 0.335, respectively). Multivariate analyses showed treatment allocation (LR), tumor size (>5 cm), AFP and aspartate aminotransferase (AST) levels to be risk factors of RFS and treatment allocation (LR), AFP and AST as risk factors for OS. Conclusion LT appeared to afford a better prognosis for HCC with PVTT type I than LR, especially in patients with AFP levels >200 ng/mL.