We report a rare case of pleomorphic adenoma arising from the nasal septum. A 37-year-old woman presented with a 1-year-history of right-sided occasional epistaxis. Computed tomographic scans revealed an oval mass in the right nasal cavity. The tumor was removed endoscopically with endonasal approach. The microscopic finding showed numbers of myoepithelial cells and duct-like structures consisting of loose myxoid stroma. This lesion had histological characteristics of a pleomorphic adenoma, and this was confirmed by immunohistochemical expression of cytokeratin, S-100 protein and SMA. Her post-operative course was uneventful, and she is currently free from the disease 1.5 years after surgery.
Actins ; metabolism ; Adenoma, Pleomorphic ; diagnosis ; surgery ; Adult ; Endoscopy ; Epistaxis ; Epithelial Cells ; Female ; Humans ; Keratins ; metabolism ; Nasal Septum ; pathology ; Nose Neoplasms ; diagnosis ; surgery ; S100 Proteins ; metabolism

AIM: To investigate the changes of ultrastructure in early diabetic rat cornea and the pathogenesis of diabetic keratopathy. METHODS: 20 Sprague-Daxley rats were sacrificed 6, 8, 10 and 12 weeks after induction of diabetes mellitus by streptoxotocin. 20 untreated rats at the same age were used as normal controls and were sacrificed at the same intervals. The ultrastructures of cornea were observed with transmission electronic microscopy and scanning electron microscopy. RESULTS: During the experimental period, the corneal ultrustructure of diabetic rats showed that epithelial and endothelial cells were swollen, the mitochondrions in the cytoplasm were swollen and increased. The collagen fibers appeared in disarrangement 10 weeks after streptoxotocin treatment. The endothelial of cornea was damaged from the periphery to the center gradually. CONCLUSION: The ultrastructural changes of cornea leads to dysfunction in streptoxotocin-induced diabetic rats, which may be related to the abnormal metabolism in hyperglycemia condition.

Objective To investigate the effect of ischemic preconditioning (IPC) on the expression of a disintegrin and metalloprotease with thrombospondin type 1 motifs (ADAMTS-1), and to study whether the application of small interfering (si)RNA specifically targeting ADAMTS-1 would help to recover IPC protection in the aged heart. Methods The 32 young (4 months) and 32 aged(24 months) male Sprague-Dawley (SD) rats were assigned randomly to IPC group (n=20) and sham operated group (n= 12) respectively. Myocardial samples from the ischemic-reperfused region were harvested for detecting the ADAMTS-1 expression. In addition, the 110 aged SD rats were assignedrandomly to ADAMTS-1 siRNA group and control group (n=55, each). The effects of ADAMTS-1siRNA transfcction on the expression of ADAMTS-1 protein, myocardial infarction survival rate,heart function and myocardial infarction size after IPC were observed.Results Twenty-four hours after IPC, the ADAMTS-1 protein expression increased significantly in iscbemic-reperfused region both in young and aged rats (P＜0. 05), and the protein expression was higher in aged rats than in young rats (P＜0.05). In young-IPC group, the absorbency showed ADAMTS-1 protein expression at 0 hrs and 24 hrs after IPC were 0. 05±0.01 and 0.12±0.03 by immunohistochemical staining, and were 0.68±0. 16 and 1. 17±0.21 by Western blots respectively. In aged-IPC group, the absorbency showed ADAMTS-1 protein expression at 0 hrs and 24 hrs after IPC were 0.07±0. 03 and 0.21 ±0.04 by immunohistochemical staining, and were 0. 76±0. 21 and 1. 48±0. 17 by Western blots. In the aged rats, ADAMTS-1 siRNA transfection inhibited ADAMTS-1 protein expression (0. 66±0. 19and 0.78±0.21, by Western blots at 0 hrs and 24 hrs after IPC, P＞0.05), but didn't improve myocardial infarction survival rates [ADAMTS-1 siRNA group and sham operated group: 14.3% (5/35) vs. 17.1 %(6/35), P＞0.05], left ventricular fractional shortening [(14.0±3.2)% vs. (13.0±2.9)%, P＞0.05] and myocardial infarction size[(39.0±4.1)% vs. (38.0±5.3)%, P＞0.05].Conclusions ADAMTS-1 expression induced by IPC increases significantly in aged versus in young rats. ADAMTS-1 knockdown by siRNA inhibits ADAMTS-1 protein expression but cannot recover the age-associated loss of IPC protection.

Objective To explore the effects of bundle care on improving the tolerance of enteral nutrition (EN) in postoperative patients with gastric carcinoma. Methods Totally 180 patients who received laparoscopic surgery for gastric carcinoma in the Department of Gastrointestinal Surgery of Anhui Provincial Hospital from May 2016 to January 2017 were equally divided into a control group and an observation group according to the random number table. Patients in the control group received conventional nursing with enteral nutrition, while patients in the observation group received bundle care on the basis of conventional nursing. The time of first anal exhaust, time of oral intake, incidence of gastrointestinal complications, completion of daily EN consumption, duration of hospital stays, hospital expenses and satisfaction after surgery were then compared between the patients in the two groups. Results The time of first anal exhaust and oral intake of the patients in the observation group was (62.77±17.29) and (62.77±10.11)h, respectively, earlier than that of the patients in the control group, [(68.30±23.11) and (67.29±17.92)h; t=2.03, 2.08; P< 0.05]. The incidence of sickness or emesis, abdominal distension and diarrhea of the patients in observation group was (4.44%, 11.11%, 5.56%), lower than that of the patients in the control group, [(13.33%, 22.22%, 5.56%); χ2=4.39, 4.72, 4.77; P<0.05]. The completion rate of daily EN consumption of the patients in the observation group was (98.74±1.07)%, better than that of the patients in the control group [(93.71±1.24)%, t=27.57,P< 0.01]. The average duration of hospital stays of the patients in the observation group was(7.12±1.36) days, shorter than that of the patients in the control group [(9.02±2.21) days; t=6.95,P<0.01]. The hospital expense of the patients in the observation group was (38 100±11 200) RMB, less than that of the patients in the control group, [(41 200±10 900) RMB; t=2.25,P< 0.05]. The patients in the observation group showed higher satisfaction 3 days after surgery and at discharge than the patients in the control group (P<0.05). Conclusions Bundle care can help to improve the EN tolerance, shorten the time of anal exhaust and the duration of hospital stays, reduce hospital expenses, and enhance patients' satisfaction in the process of early enteral nutrition after surgery.

OBJECTIVE To investigate the positive rates and distribution of multiple allergens in children aged 6 to 14 with allergic rhinitis(AR) in the Chaozhou area,and to explore whether health education plays a positive role in these patients. METHODS A random sample of 100 school-age children diagnosed with AR at the outpatient department of Chaozhou Central Hospital from January to May 2024 was selected for allergen testing. Additionally,100 school-age children diagnosed with AR at the outpatient department of Chaozhou Central Hospital from January to May 2024 were surveyed before and after intervention using the same self-made questionnaire,and the effectiveness of the intervention was evaluated. RESULTS Among school-age children with AR in Chaozhou area,the top three positive rates of allergens were house dust mites/dust mites(42％),milk(29％) and egg(23％),and the top three strong positive rates were also house dust mites/dust mites(27％),milk(18％) and egg(17％). After health education,the correct response rate to questions on how to reduce AR attacks increased compared to before the intervention. The overall awareness of AR health knowledge was 31.7％,which significantly increased to 91.4％ after the intervention,with a statistically significant difference. CONCLUSION Understanding the positive rates and distribution of allergens in the Chaozhou area is very important for diagnosing and managing allergic symptoms,which can help physicians and patients better cope with AR. Health education can significantly improve school-age children's understanding of AR,promote the formation of good hygiene habits and lifestyles,and has a positive impact on the prevention and treatment of AR in school-age children.

Objective To explore the effect of angiogenesis in carotid atherosclerotic plaque.Methods From Jan 2016 to Aug 2016,Carotid artery plaque was abtained in 52 cases after carotid endarterectomy at the Department of Cardiovascular Surgery of China-Japan Friendship Hospital.Patients were divided into symptomatic group and asymptomatic group.Specimens were stained with HE and Movat,and the density,size,distribution and morphology of neovascularization were counted.Results The density of neovascularization in the symptomatic group and the asymptomatic group were 5.27 ± 0.46 and 2.30 ±0.29,respectively (P ＜ 0.001),the average cross-sectional area of neovascularization in the symptomatic group was (2.26±0.21) mm2 and (1.00 ±0.48) mm2 in the asymptomatic group (P=0.02).In the distribution,the symptomatic group and the asymptomatic group were 3.37 ± 0.46/ mm2,1.32 ±0.16/mm2 in basal part,3.71 ±0.42/mm2,1.56 ±0.20/mm2 in the shoulder part,3.48 ±0.44/mm2,1.55 ± 0.21/ mm2 in the fibrous cap,respectively (P ＜ 0.001).Conclusion The density and cross-sectional area of neovascularization in the symptomatic group were larger than those in the asymptomatic group,irregular branching vessels were dominant.

Objective:To investigate the diagnosis, classification and treatment of pancreatic duct stones (PDS) .Methods:Clinical data and prognosis of 32 patients with PDS treated in our hospital from Jan. 2010 to Dec. 2019 were retrospectively analyzed. The treatment methods were summarized.Results:All 32 cases were diagnosed with PDS by imaging examinations such as B ultrasonography, CT, endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP) . The diagnosis accuracy was 81.3% (26/32) for B-ultrasound, 86.2% (25/29) for CT, 90.4% (19/21) for MRCP, and 100% (8/8) for ERCP. According to the location of stones and intraoperative exploration, the 32 patients were divided into 3 groups: Type I, 17 patients, the stones were located in the main pancreatic duct; TypeⅡ, 11 patients, the stones were located in both main and branch pancreatic duct; Type Ⅲ, 4 patients, the stones were located in the branch pancreatic duct. Different treatment methods were employed according to the different types. No patient died in the perioperative period. 11 (34.3%) patients had postoperative complications. 3 (9.3%) patients had postoperative residual stones. 32 cases were followed up for a period of 6 to 60 months. The abdominal pain and steatorrhea disappeared or significantly improved postoperatively. 2 patients complicated with pancreatic cancer died 12 to 35 months after operation.Conclusions:The treatment and diagnosis of the PDS still remains complicated. Imaging examinations are the main methods for diagnosis of PDS. The accurate classification and individual treatment are important. Surgery is the most commonly used method for PDS.

Objective To evaluate diagnostic method and treatment strategy for free floating thrombus in carotid artery.Methods From Ju12016 to Oct 2017,7 patients with free floating thrombus in carotid artery was diagnosed at our department.The medical history,symptoms,diagnosis,treatment strategy and prognosis of those patients were analyzed retrospectively.Results Among 7 patients,4 were symptomatic;4 patients were concomitant with severe carotid artery stenosis and 3 with mild to moderate stenosis.3 received carotid endarterectomy and patch angioplasty.4 received carotid artery stenting with distal cerebral protection divice.There was no perioperative and 30-day stroke,myocardial infarction,death or hyperperfusion syndrome occurred.The 12-month follow up showed no restenosis,no free floating thrombus recurrence and no ischemic cerebrovascular event.Conclusion Free floating filling defect in carotid artery is a typical sign for unstable plaque.Both carotid endarterectomy and carotid artery stenting can be used for the treatment of free floating thrombus.

A case of pituicytoma was observed in a Han-Wistar rat from the control group of a 2-year carcinogenicity study. No obvious abnormality were found in clinical observation and necropsy. Hematoxylin and Eosin (HE) staining results showed that nodular hyperplasia in the pars nervosa of the pituitary, which was well demarcated and compressed the adjacent normal tissue. The tumor cells were similar to the glial cells with round or oval nuclei, cytoplasm rich in eosinophilic or vacuole. The tumor cells differentiated well, with no obvious cell pleomorphism and visible mitotic figures. Some tumor cells were arranged in a pseudorosette formation. Immunohistochemical staining (IHC) analysis confirmed positive expression of Glial fibrillary acidic protein (GFAP) and S-100 protein. The tumor was diagnosed as the spontaneous benign pituicytoma combining the HE and IHC staining results.

Objective     To identify the preoperative risk factors for prolonged mechanical ventilation (PMV) after pulmonary thromboendarterectomy (PTE). Methods    The clinical data of patients who underwent PTE from December 2016 to August 2021 in our hospital were retrospectively analyzed. The patients were divided into two groups according to the postoperative mechanical ventilation time, including a postoperative mechanical ventilation time≤48 h group (≤48 h group) and a postoperative mechanical ventilation time>48 h (PMV) group (>48 h group). Univariable and logistic regression analysis were used to identify the preoperative risk factors for postoperative PMV. Results    Totally, 90 patients were enrolled in this study. There were 40 patients in the ≤48 h group, including 30 males and 10 females, with a mean age of 45.48±12.72 years, and there were 50 patients in the >48 h group, including 29 males and 21 females, with a mean age of 55.50±10.42 years. The results showed that in the ≤48 h group, the median postoperative ICU stay was 3.0 days, and the median postoperative hospital stay was 15.0 days; in the >48 h group, the median postoperative ICU stay was 7.0 days, and the median postoperative hospital stay was 20.0 days. The postoperative PMV was significantly correlated with tricuspid annular plane systolic excursion (TAPSE) [OR=0.839, 95%CI (0.716, 0.983), P=0.030], age [OR=1.082, 95%CI (1.034, 1.132), P=0.001] and pulmonary vascular resistance (PVR) [OR=1.001, 95%CI (1.000, 1.003), P=0.028]. Conclusion    Age and PVR are the preoperative risk factors for PMV after PTE, and TAPSE is the preoperative protective factor for PMV after PTE.