OBJECTIVE To recognize the frontal recess cells and analyze their distributional characteristics during image navigation assisted endoscopic sinus surgery. METHODS 20 cases(39 sides)of chronic sinusitis with nasal polyps were observed in this study. The fontal recess cells and frontal sinus were opened under the endoscope and the distributional characteristics were observed and recorded, and then confirmed by the image navigation system. RESULTS Centred on frontal sinus ostium, frontal recess cells were divided into three areas: the agger nasi cell(ANC)and frontal cells(FC)are located in front of frontal sinus ostium(FS); frontal septum cells(IFSSC)and terminal cells(RT)are located at the same plane of FS; supra-ethmoidal bulla recess(SBR), frontal bulla cell(FBC)and super-obital cells(SOEC)are in the posterior area. The coincidence of identification for ANC, FCI and II, SBR, FBC and IFSSC under endoscope and image navigation is 100%, the coincidence of identification for FS is 89.7%, SOEC 80%, RT 71.4% and FC III and IV 60%. CONCLUSION The distribution of the frontal recess cells around the frontal ostium showed a fixed pattern.It would well benefit the orientation of frontal ostium and the opening of frontal sinus. Furthermore, it is significant for the orientation and opening of the frontal recess cells.

OBJECTIVE To investigate the effects of continuous positive airway pressure (CPAP) on patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) who underwent the revised uvulopalatopharyngoplasty (UPPP). METHODS 18 cases of severe OSAHS patients (therapy group) were selected for CPAP treatment in the 2nd week of postoperation. The average time of CPAP treatment was 34.3 days. The other 20 cases (control group) onlyunderwent operation. All patients were monitored with PSG before operation and in the 6 months postoperatively. RESULTS Compared with the result of pre-operative PSG, apnea hypopnea index (AHI) and Lowest SaO2 (LSaO_2) was improved (P＜0.001) in two groups. Compared with control group, LSaO_2 of the therapy group in the sixth month postoperatively was improved (P＜0.001), but the decreasing of AHI was not significant (P＞0.05). Contrast to the control group, the length of stage 1 and 2 decreased and that of REM increased. (P＜0.05). CONCLUSION For severe OSAHS patients who underwent uvulopalatopharyngo plasty, CPAP treatment for one month postoperatively could improve the hypoxia of patients, and prolong REM stage, shorten the stage 1 and 2 sleep. CPAP treatment in short time would be helpful for the severe OSAHS patients with revised UPPP.

OBJECTIVE: To study the laryngeal electromyography (LEMG) behaviors of recurrent laryngeal nerve (RLN) paralysis at different time and severity level. METHOD: Eighty-seven cases with RLN paralysis were divided into seven groups according to their paralysis time. Their LEMG behaviors were investigated, and compared with normal. RESULT: (1) Fibrillation potentials and positive sharp wave could be found in injuries thyroarytenoid muscles(TA), posterior cricoarytenoid muscles(PCA), lateral cricoarytenoid muscles(LCA) as early as five days after the onset of paralysis. The denervation potentials increased, and reinnervation potentials appeared from two weeks to three months after the onset. The former became less and the latter increased from 3 months, and the denervation potentials vanished after three years. (2) The recruitment patterns of paralyzed muscles were weak and even there was no interference patterns in them. The amplitude and turns significantly decreased compared with normal control, and the decrease of the turns was more significant. The recruitment potentials of other normal laryngeal muscles increased right after the onset of disease. (3) Evoked potentials (EP) of most paralyzed laryngeal muscles vanished only in some patients, in others there were small and weak EPs, which had a longer latent period and small amplitude. CONCLUSION LEMG is important for the diagnosis and differentiation of RLN paralysis. The denervation potentials and reinnervation potentials are important marks of RLN injury, and closely correlated with the degree and time of RLN injury. The abnormal EP of paralyzed laryngeal muscles could suggest the degree of injury.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Electromyography ; Evoked Potentials ; Female ; Humans ; Male ; Middle Aged ; Recurrent Laryngeal Nerve ; physiopathology ; Vocal Cord Paralysis ; diagnosis ; physiopathology ; Young Adult

Objective To investigate the effect of different premolar extraction patterns on Bolton index and occlusal relationship of skeletal Class Ⅱmalocclusion.Methods The plaster models of 62 patients with skeletal ClassⅡmalocclusion were selected and con-verted into digital models by iTeroElement scanner.Each model was simulated by the four premolar extraction pattrens,and tooth ar-rangement test was performed after tooth extraction.The Bolton index before and after tooth extraction was calculated,and the occlusal relationship after tooth arrangement was evaluated to explore its law.Results All the four premolar extraction patterns resulted in a significant decrease in the Bolton index over-all ratio in skeletal ClassⅡpatients,and compared with the extraction patterns of 4/4 and 4/5,the patterns of 5/4 and 5/5 resulted in a greater decrease in the Bolton index over-all ratio(P＜0.001).For skeletal classⅡmal-occlusion,the tooth arrangement test was conducted on the basis of establishing the neutral relationship of first molar.The average value of anterior teeth over-jet obtained by patterns of 4/4 and 4/5 was within the normal range(＜3 mm).The average value obtained by pat-terns of 5/4 and 5/5 was greater than the normal range(＞3 mm),and the difference was statistically significant(P＜0.001).Conclu-sion The premolar extraction patterns of 4/4 and 4/5 are more conducive to normalizing the Bolton index over-all ratio and establis-hing the better occlusal relationship for skeletal Class Ⅱ malocclusion.

Objective To explore the effects of positive psychological intervention based on PERMA model of wellbeing on stigma,adaptation to ostomy and quality of life in patients with permanent enterostomy.Methods A total of 83 patients with permanent enterostomy were recruited from October 2022 to September 2023 in a tertiary hospital in Liaoning Province.They were randomly divided into an experimental group and a control group.While the control group received routine nursing,the experimental group received nursing intervention based on PERMA.The intervention lasted 8 weeks,and data were collected before and after the intervention.The scores of the Social Impact Scale(SIS),Ostomy Adjustment Inventory-20(OAI-20)and Stoma Quality of Life(Stoma-QOL)in the 2 groups were compared.Results Experimental group and control group were 40 cases each completed the study.After the intervention,the SIS score of the experimental group was(44.70±9.10),which was significantly lower than(62.15±12.43)of the control group,and the difference between 2 groups was statistically significant(t=-7.163,P＜0.001).The OAI-20 score of the experimental group was(52.28±5.80),which was significantly higher than(41.53±9.00)of the control group,and the difference between the 2 groups was statistically significant(t=6.349,P＜0.001).The Stoma-QOL score of the experimental group was(54.08±8.29),which was significantly higher than(42.95±9.19)of the control group,and the difference between the 2 groups was statistically significant(t=5.688,P＜0.001).Conclusion Nursing interventions based on PERMA are beneficial in reducing stigma of patients with permanent enterostomy,improving their ostomy adjustment and postoperative quality of life.

OBJECTIVE: To test the acute and chronic toxicity of topical application of 0.5% podophyllotoxin-loaded nanostructured lipid carriers (POD-NLC) to the vaginal mucosa. METHODS: Twelve New Zealand rabbits were randomized into 3 groups and subjected to daily topical applications of normal saline (control group), 0.5% podophyllotoxin tincture (POD-T) or 0.5% POD-NLC on the vaginal mucosa for 10 consecutive days, and the pathological changes in the mucosa were graded using the Eckstein scoring system.The acute toxicity of POD-NLC was tested in 20 SD female rats, which received intravaginal administration of POD-NLC or vehicle for 3 times within 24 h; After 14 days of continuous observation, the rats were dissected for calculating the viscera coefficient.For testing the chronic toxicity of POD-NLC, 80 SD female rats were randomized into 4 groups and subjected to daily intravaginal administration of the vehicle or POD-NLC at low, moderate or high doses for 13 consecutive weeks.The rats were weighed once a week and at the end of the experiment, 2/3 of the rats from each group were sacrificed to collect blood samples, calculate the viscera coefficient, and examine the pathological changes in the liver.The remaining 1/3 rats were observed for another 2 weeks without further drug treatment and the same examinations were performed. RESULTS: In the rabbits, 0.5% POD-NLC elicited only mild irritation while POD-T caused moderate irritation of the vaginal mucosa.In the acute toxicity test, the organ coefficients were comparable between the rats treated with the vehicle and POD-NLC (>0.05).Long-term intravaginal administration of POD-NLC did not produce significant changes in the behavior, activity, body weight, blood biochemical profiles or organ coefficient as compared with the vehicle control group (>0.05). CONCLUSIONS Intravaginal administration of 0.5% POD-NLC causes very mild irritation without obvious acute or chronic toxicity to the vaginal mucosa in rabbits and rats.
Administration, Intravaginal ; Animals ; Female ; Liposomes ; Mucous Membrane ; drug effects ; Nanostructures ; toxicity ; Podophyllotoxin ; administration & dosage ; toxicity ; Rabbits ; Random Allocation ; Rats ; Vagina ; drug effects

BACKGROUNDAnterior glottic web is one type of laryngeal stenosis. Previous surgical methods had some drawbacks, such as large surgical trauma, long postoperative recovery time, and multiple-stage surgery. This study aimed to explore better treatment to repair anterior glottis web.

METHODSWe performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs. All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with selfretaining laryngoscope.

RESULTSAll 32 patients completed surgery in one stage, without postoperative laryngeal edema, difficulty in breathing, or other complications. After the surgery, the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however, in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords, accompanied by scar appearance of bilateral vocal cords. The GRB score, voice handicap index scores, and maximum phonation time score significantly improved in all patients after the surgery. There was no evidence of recurrent laryngeal webbing in the 6-month follow-up.

CONCLUSIONVocal cords mucosal flap repair surgery has the advantages of less trauma, quick recovery, and significant improvement of the voice in the treatment of laryngeal webs.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Laryngeal Diseases ; surgery ; Male ; Middle Aged ; Surgical Flaps ; Suture Techniques ; Vocal Cords ; surgery ; Young Adult

OBJECTIVE：To investigate the effects of dihydroartemisinin （DHA）on the metabolism of amino acid metabolites in human hepatocellular carcinoma cells Huh 7 and BEL- 7402，and to provide theoretic basis for clarifying the mechanism of DHA regulating the metabolism of hepatocellular carcinoma cells. METHODS ：CCK-8 method was taken to detect the effect of different concentrations of DHA （12.5，25，50，100 µmol/L）treating for 24，48，72 h on the two kinds of cells. Two kinds of cells were divided into control group and administration group （DHA，25 µmol/L），and then cultured with drug-free or drug-containing medium for 24 h，operated in parallel for three times. After derivatization of cell samples in each group ，GC-MS method was used to detect the content of amino acid metabolites ，combined with SIMCA-P software analysis and compound library comparison ，the differential metabolites in two kinds of cells were screened out. The pathway enrichment analysis of differential metabolism was conducted with Metaboanalyst 4.0 software. RESULTS ：Compared with control group ，the contents of glutamine ，glutathione， phenylalanine，fumaric acid and taurine were trending down in Huh 7 or BEL- 7402 cells. There were 28 and 29 differential metabolites obtained from the above two kinds of cells ，and 10 of them were common differential metabolites ，including glutamine，glutathione，taurine，fumaric acid ，phenylalanine，etc. The differential metabolites were enriched in 8 and 6 pathways respectively. The common enrichment pathways were amino acid-tRNA biosynthesis ，aspartate-alanine-glutamate metabolism ， nitrogen metabolism ，phenylalanine metabolism and pentose phosphate pathway ，etc. CONCLUSIONS ：DHA can significantly reduce the activities of Huh 7 cells and BEL- 7402 cells，and the contents of glutamine ，glutamic acid ，glutathione and phenylalanine，etc. It may regulate the growth of the two kinds of cells by influencing the mechanism of aspartic acid- alanine-glutamate metabolic pathway ，etc.