Objective To observe the changes in blood glucose,albumin/creatinine ratio and isletβcell function,after calcitriol therapy was used on patients with type 2 diabetes mellitus and microalbuminuria.Methods Sixty patients with type 2 diabetic microalbuminuria were randomly divided into experimental group and control group,each had 30 cases.Patients in the experimental group were given calcitriol 0.25ug once a day for three months,the changes of blood glucose,glycosylated hemoglobin,albumin/creatinine ratio,islet βcell function were observed.Results After the intervention,the albumin/creatinine ratio level in the experimental group was lower than that in the control group ((127.48±139.94) mg/g vs.(151.02±96.25) mg/g,P=0.04).The insulin resistance index in the experimental group was lower than that in the control group ((2.99±1.24) vs.(3.72±2.58),P=0.233),the difference was not statistically significant.Conclusion Calcitriol can reduce microalbuminuria in patients with type 2 diabetes.Calcitriol may be helpful in improving insulin resistance in patients with type 2 diabetes mellitus.

Objective To explore the relationship between different treatment methods of hiatus sinus maxillaris during nasal endoscope paranasal sinuses operation and prognosis.Methods Eighty patients with chronic rhinosinusitis and rhinopolyp were divided into observation group and control group byrandom digits table method with 40 cases each.Expanding hiatus sinus maxillaris were given according to the modality of hiatus sinus maxillaris and lesion of maxillaris sinus in observation group.The patients in control group were given expanding hiatus sinus maxillaris.The opening rate of hiatus sinus maxillaris and postoperative complication were observed.Results All the patients were followed up ≥ 1 year.The opening rate of hiatus sinus maxillaris in observation group (97.5％,39/40) was significantly higher than that in control group (77.5％,31/40),the rate of postoperative complication in observation group (5.0％,2/40) was significantly lower than that in control group (27.5％,11/40),and there were statistical differences (P ＜ 0.01).Conclusion Whether or not to enlarge hiatus sinus maxillaris during nasal endoscope paranasal sinuses operation should base on intraoperative specific situation,and it can reduce intraoperative injury,prevent the shutting of sinus and postoperative complication.

Objective To explore the clinical effect of nasal endoscope antrostomy treatment of maxillary sinus cyst through two approaches. Methods Eighty patients with maxillary sinus cyst were selected. The patients were divided into experiment group and control group according to the treatment method. Experiment group (40 cases) was treated through windowing middle meatus maxillary sinus associated with antrostomy of inferior nasal meatus approach. Control group (40 cases) was treated through antrostomy of inferior nasal meatus approach. On the basis of the review, the local state of the nasal endoscope and the CT examination of the sinus and the nasal sinuses, the patients were evaluated comprehensively. Results The recovery rate in experiment group was significantly higher than that in control group:97.5%(39/40) vs. 77.5% (31/40), and the complication rate in experiment group was significantly lower than that in control group:10.0%(4/40) vs. 35.0%(14/40). And there were statistical differences ( P<0.01). Conclusions The approach of windowing middle meatus maxillary sinus associated with antrostomy of inferior nasal meatus in the treatment of maxillary sinus cyst in nasal endoscope has wide field and no dead ends. Moreover, the lesions can be cleared completely. The procedure can reduce the recurrence. The complication rate is lower than the antrostomy of inferior nasal meatus approach.

Objective:To explore the dynamic changes of three-dimensional morphology of laryngeal soft tissue and its clinical value in the unilateral vocal fold paralysis (UVFP) patients through dynamic CT scanning during the process from inspiration to phonation.Methods:From October 2017 to July 2019, a retrospective study was performed in 18 patients with UVFP (10 males and 8 females with the range of age from 29 to 75 years old) and 10 normal subjects (5 males and 5 females with the range of age from 25 to 58 years old) in Department of Voice-Otolaryngology Head and Neck Surgery, Section Two, Zhongshan Hospital Xiamen University. The laryngeal dynamic computed tomography (CT) of cine mode was performed. Ten dynamic sequence images of vocal folds movements were obtained during the process from inspiration to phonation. Based on the dynamic changes of glottic area and the displacement of cricoid cartilage. The above dynamic sequence images were divided into inspiratory phase and phonation phase as well as open phase and closed phase. The soft tissue parameters were measured respectively, including vocal folds length, width, thickness and subglottal convergence angle. Independent-sample t test was used to analyze between UVFP group and control group. Results:During the process from inspiration to phonation, the morphology of vocal folds in control group was relatively stable at inspiratory phase and closed phase in phonation. When open phase and closed phase of phonation were switching, the morphology of vocal folds changed obviously. The length of vocal folds became longer (1.19±0.10) mm, the width became wider (2.19±0.17) mm, the thickness became thinner (2.66±0.56) mm, and the subglottal convergence angle decreased (31.45±4.78)°. Compared with the controll group, in the open phase, the thickness and width of the vocal fold on affected side in the UVFP group were thinner ( t=10.25, P<0.001) and wider ( t=5.25, P<0.001).While in the closed phase, the subglottal convergence angle was larger ( t=4.41, P=0.001).The width of the healthy side vocal fold in the UVFP was wider ( t=2.54, P=0.026) than that in the control group. The differences in other parameters were not statistically significant. Conclusions:Dynamic laryngeal CT scanning provides a simple and non-invasive method for the objective and quantitative measurement of the dynamic changes of laryngeal morphology from inspiration to phonation. Compared with the control group, the characteristic dynamic changes among UVFP were observed during this particular process, which included changes of subglottal convergence angle and thickness of vocal muscle due to denervation. In addition, in UVFP group, the width of the vocal fold healthy side in the closed phase may be used to assess its compensatory function.