Background The inferior turbinate (IT) and nasolacrimal duct (NLD) are often sacrificed while managing the diffuse lesion of maxillary sinus (MS).We report a new approach to MS without ablation of NLD and IT.Methods This retrospective study enrolled 19 hospitalized patients (aged from 42 to 68 years) who underwent endoscopic sinus surgery between 2003 and 2008.Twelve patients had inverted papilloma (IP),two had nasal polyps,two had Kubo's postoperative cyst of MS,one had recurrent bone cyst of maxilla,one had dentigerous cyst and one had bleeding of internal maxillary artery secondary to Caldwell-Luc operation respectively.Two IP patients were excluded from this group since the follow-up time was less than 12 months.The NLD was dissected after removing the anterior bony portion of nasal lateral wall.The prelacrimal recess approach (PLRA) to MS was established when IT-NLD flap was raised medially.The flap was repositioned when MS lesion was removed.Results All the 17 patients had unilateral lesions.Ten MS IP patients were at the T3 Krouse stage.The follow-up ranged from 7 to 60 months.No recurrence was seen in 16 patients.Only one IP patient had a local recurrence in MS.All of them had no any complications.Conclusion The diffuse or severe diseases of MS may be the potential indications for PLRA.

Abstract: Due to the continued emergence of multiple variants of SARS-CoV-2, the ongoing pandemic has resulted in severe mortality over the past two years. After the Alpha, Beta, Gamma and Delta variants, the most recent new variant of concern (VOC) strain to emerge is Omicron (B.1.1.529), which evolved as a result of the accumulation of a large number of mutations. The Omicron variant, which has a much higher transmission rate than the Delta variant, soon replaced the Delta variant and others, is now the dominant variant worldwide. The emergence of Omicron poses new challenges for the prevention and control of COVID-19 and has raised a number of concerns worldwide. Recently, cases of Omicron infection have been reported in several parts of China, and therefore this paper provides a comprehensive analysis and summary of the epidemiology and immune escape mechanisms of the Omicron variant. We also suggest some therapeutic strategies against the Omicron variant, including rapid diagnosis, genome analysis of emerging variants, ramping up of vaccination drives and receiving booster doses, updating the available vaccines, designing of multivalent vaccines able to generate hybrid immunity, up-gradation of medical facilities and strict implementation of adequate prevention and control measures need to be given high priority to handle the on-going COVID-19 pandemic successfully.

This experiment was performed to establish a qualitative analysis on chemical composition in water extract of Paeoniae Radix Alba by HPLC-ESI-Q-TOF-MS. The analysis was conducted on a C18 (Hanbon Lichrospher, 4.6 mm x 250 mm, 5 microm) column with methanol-0.1% formic acid as the mobile phase for gradient elution; ESI ion source was used for mass spectra, and data were collected in both positive and negative modes. The results showed that eleven compounds from water extract of Paeoniae Radix Alba had been identified by analyzing positive and negative ion mass data including element composition and by comparing with data from literatures. Since efficient separation of HPLC and the high sensitive detection of MS was used, this experiment, it will provide evidences for elucidation of the effective substance in the water extract of Paeoniae Radix Alba.
Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Paeonia ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; methods ; Tandem Mass Spectrometry ; methods

Seven compounds were isolated from the leaves of Panax japonicus var. major by chromatographic methods including silica gel, Sephadex LH-20, ODS and semi-preparative HPLC. Their structures were elucidated by their physical and chemical properties and spectral data analysis as 5, 7-dihydroxy-8-methoxyl flavone (1), ginsenoside Rs2 (2), quinquenoside R1 (3), ginsenoside Rs1 (4), notoginsenoside Fe (5), ginsenoside Rd2 (6) and gypenosiden IX (7). Among them, compound 1 was obtained from the Panax genus for the first time, and compounds 2-7 were isolated from this plant for the first time.
Chromatography, High Pressure Liquid ; Flavones ; analysis ; chemistry ; isolation & purification ; Ginsenosides ; analysis ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Panax ; chemistry ; Plant Leaves ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Ten compounds were isolated from the leaf of Eucommia ulmoides by means of recrystallization and chromatographic techniques such as D-101 macroporous resin, MCI resin, ODS gel, Sephadex LH-20 and Rp-HPLC. Their structures were identified by NMR spectral analyses as kaempferide 3-O-beta-D-glucoside (1), quercetin-3-O-beta-D-glucoside (2), quercetin (3), quercetin-3-O-beta-D-xylosyl-(1-->2)-beta-D-galactoside (4), kaempferol-3-O-alpha-L-rhamnosyl-(1-->6)-beta-D-glucoside (5), (2S,3S)-taxifolin 3-O-beta-D-glucoside (6) ,4-hydroxy cinnamic acid (7), (+)-cycloolivil (8), pinoresinol beta-D-glucoside (9), squalene (10). Among them compounds 1,5-7,10 were isolated from the Eucommia genus for the first time. In the DPPH free radical scavenging assay, compound 2 exhibited significant activity (IC50 13.7 micromol x L(-1)), compared with vitamin C (IC50 59.9 micromol x L(-1)); compounds 1, 3 and 9 showed moderate activity (IC50 161,137, 214 micromol x L(-1)), compared with 2,6-di-tert-butyl-4-methylphenol (IC50 236 micromol x L(-1)); compound 4 and 6 showed weak activity (IC50 264, 299 micromol x L(-1)).
Antioxidants ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Eucommiaceae ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Leaves ; chemistry

Objective To investigate the clinical application of global osteitis score system(GOSS)in patients with chronic rhinosinusitis(CRS).Methods Three hundreds and thirty-four patients with CRS were enrolled prospectively in a large tertiary referral center.The paranasal sinus bone Hounsfield unit (Hu),thickness,scope were measured by PHILIPS MxLiteView software.Nasal endoscopy Lund-Kennedy score was analyzed in all patients.Sinus CT scans of all patients were analyzed for Lund-Mackay score and for osteitis using the GOSS.Association between GOSS and Lund-Mackay,Lund-Kennedy was analyzed by SPSS 16.0 software.Results The incidence of osteitis in patients with CRS was 53.9％(180/334).The incidence of osteitis(more than grade 2)in patients with CRS was 33.8％(113/334).Average GOSS score of osteitis was 7.51 ± 7.27.The highest incidences of osteitis were in the maxillary and anterior ethmoid sinuses.The left anterior ethmoid sinuses was 37.2％.The right anterior ethmoid sinuses was 32.8％.The left maxillary sinuses was 46.1％.The right maxillary sinuses was 42.2％.GOSS score were significantly correlated with Lund-Mackay and Lund-Kennedy scores(r value were 0.497 and 0.409 respectively,all P ＜ 0.001).Conclusion GOSS can define and evaluate the extent and the severity of osteitis in patients with CRS by using CT,and can also reflect the extent and the severity of CRS.

Objective To summarize the follow-up outcomes of Draf Ⅱ b frontal sinusotomy and it's modified procedures,and to discuss the surgical indications and prognostic factors.Methods Thirty-two patients treated between 2004 and 2010 were enrolled in this study.There were 15 patients for recurrent frontal inverted papilloma ( IP),6 for mucocele,4 for recurrent frontal sinusitis,3 for osteoma,2 for meningoeneephalocele with cerebrospinal fluid rhinorrhea,1 for meningoencephalocele alone and 1 for acute frontal sinusitis.All patients underwent preoperative paranasal sinus computed tomography (CT) scans.Patients with tumor accepted magnetic resonance imaging (MRI).The patients with meningoencephalocele and cerebrospinal fluid rhinorrhea recieved magnetic resonance cistemography (MRC).The Draf Ⅱ b frontal sinusotomy and it's modified Draf Ⅱ b-1 -3 procedures were applied endoscopically under general anesthesia mainly by high speed bur and power system.The postoperative CT scan was obtained as a base line for follow-up 1 week after the operation.Postoperative follow-up was performed under endoscope.Results Among 19 cases of Draf Ⅱ b,12 were recurrent IP of frontal sinus,4 were mucocele,2 were recurrent frontal sinusitis and 1 were osteoma.Five cases received Draf Ⅱ b-1,2 for each recurrent IP of frontal sinus and recurrent frontal sinusitis and 1 for osteoma. Six cases received Draf Ⅱ b-2, 3 for meningoencephalocele,1 for each IP,acute frontal sinusitis and osteoma.Two cases received Draf Ⅱ b-3 were mucocele.The follow-up ranged from 8 to 73 months.Twenty-two cases of the frontal neoostium were widely opened,7 were stenosis and 3 were closed.Revision surgery was seen in 2 cases with IP.All of them had no complications.Conclusions The Draf Ⅱ b frontal sinusotomy and it's modified procedures are suitable for complex frontal sinus disease,which can be selected according to pathological and anatomical features,and have a good prospect for clinical application.

Objective To sum up the follow-up outcomes of endoscopic modified Lothrop procedure (EMLP) and retrospectively analyze the indications,methods and prognostic factors of EMLP.Methods The collected data of 73 cases who received EMLP with frontal sinus diseases were analyzed in this paper.The mean age was 45.6 (ranging from 14 to 72 years).There were 52 males and 21 females.Only patients with follow-up time greater or equal to 6 months were included.Paranasal sinus CT scan was adopted for all cases and MRI for tumor patients.All patients were followed under endoscope.Results There were 21 inverted papilloma in the frontal sinus,16 chronic sinusitis with asthma,12 frontal sinusitis,9 chronic sinusitis with or without polyps,7 osteoma of the frontal sinus,4 frontal mucocele,3 allergic fungal sinusitis and 1 congenital encephalocele.Sixty-one cases had prior surgical history ( 1.8 times on the average).Their mean follow-up was 25.0 months,(ranging from 6 to 122 months).At the end of follow-up,44 cases (60.3％ ) had well opened frontal drainage pathway.Twenty-five (34.2％ ) was re-stenosed and 4 (5.5％)closed.Seven cases (9.6％ ) underwent revision surgeries.There were no surgical complications.Conclusions EMLP is an effective and salvage procedure in dealing with tumor of frontal sinus and recurrent frontal sinusitis.Combined with medical treatment,EMLP will have a better results for chronic sinusitis with or without polyps and asthma.The degree of diseases,mucosal loss,anatomic variability and prior surgeries are important prognostic factors.

BACKGROUNDThe inferior turbinate (IT) and nasolacrimal duct (NLD) are often sacrificed while managing the diffuse lesion of maxillary sinus (MS). We report a new approach to MS without ablation of NLD and IT.

METHODSThis retrospective study enrolled 19 hospitalized patients (aged from 42 to 68 years) who underwent endoscopic sinus surgery between 2003 and 2008. Twelve patients had inverted papilloma (IP), two had nasal polyps, two had Kubo's postoperative cyst of MS, one had recurrent bone cyst of maxilla, one had dentigerous cyst and one had bleeding of internal maxillary artery secondary to Caldwell-Luc operation respectively. Two IP patients were excluded from this group since the follow-up time was less than 12 months. The NLD was dissected after removing the anterior bony portion of nasal lateral wall. The prelacrimal recess approach (PLRA) to MS was established when IT-NLD flap was raised medially. The flap was repositioned when MS lesion was removed.

RESULTSAll the 17 patients had unilateral lesions. Ten MS IP patients were at the T3 Krouse stage. The follow-up ranged from 7 to 60 months. No recurrence was seen in 16 patients. Only one IP patient had a local recurrence in MS. All of them had no any complications.

CONCLUSIONThe diffuse or severe diseases of MS may be the potential indications for PLRA.

Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged ; Papilloma, Inverted ; surgery ; Retrospective Studies

BACKGROUNDRecombinant human parathyroid hormone (1-34) (rhPTH (1-34)) is the first agent in a unique class of anabolic therapies acting on the skeleton. The efficacy and safety of long-term administration of rhPTH (1-34) in Chinese postmenopausal women had not been evaluated. This study compared the clinical efficacy and safety of rhPTH (1-34) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China.

METHODSA total of 453 postmenopausal women with osteoporosis were enrolled in an 18-month, multi-center, randomized, controlled study. They were randomized to receive either rhPTH (1-34) 20 µg (200 U) daily for 18 months, or elcatonin 20 U weekly for 12 months. Lumbar spine (L1-4) and femoral neck bone mineral density (BMD), fracture rate, back pain as well as biochemical markers of bone turnover were measured. Adverse events were recorded.

RESULTSrhPTH (1-34) increased lumbar BMD significantly more than did elcatonin after 6, 12, and 18 months of treatment (4.3% vs. 1.9%, 6.8% vs. 2.7%, 9.5% vs. 2.9%, P < 0.01). There was only a small but significant increase of femoral neck BMD after 18 months (2.6%, P < 0.01) in rhPTH groups. There were larger increases in bone turnover markers in the rhPTH (1-34) group than those in the elcatonin group after 6, 12, and 18 months (serum bone-specific alkaline phosphatase (BSAP) 93.7% vs. -3.6%; 117.8% vs. -4.1%; 49.2% vs. -5.8%, P < 0.01; urinary C-telopeptide/creatinine (CTX/Cr) 250.0% vs. -29.5%; 330.0% vs. -41.4%, 273.0% vs. -10.6%, P < 0.01). rhPTH (1-34) showed similar effect of pain relief as elcatonin. The incidence of clinical fractures was 5.36% (6/112) in elcatonin group and 3.2% (11/341) in rhPTH (1-34) group (P = 0.303). Both treatments were well tolerated. Hypercaluria (9.4%) and hypercalcemia (7.0%) in rhPTH (1-34) group were transient and caused no clinical symptoms. Pruritus (8.2% vs. 2.7%, P = 0.044) and redness of injection site (4.4% vs. 0, P = 0.024) were more frequent in rhPTH (1-34). Nausea/vomiting (16.1% vs. 6.2%, P = 0.001) and hot flushes (7.1% vs. 0.6%, P < 0.001) were more common in elcatonin group.

CONCLUSIONSrhPTH (1-34) was associated with greater increases in lumbar spine BMD and bone formation markers. It could increase femoral BMD after 18 months of treatment. rhPTH could improve back pain effectively. The results of the present study indicate that rhPTH (1-34) is an effective, safe agent in treating Chinese postmenopausal women with osteoporosis.

Aged ; Bone Density ; drug effects ; Calcitonin ; analogs & derivatives ; therapeutic use ; China ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; drug therapy ; Parathyroid Hormone ; therapeutic use ; Treatment Outcome