0.05). The total serum IgE lev-els in allergic rhinitis patients were compared with those of the controls. The total serum IgE levels of the pa-tients were much higher than those of the controls (geometric mean of the patients and the controls were 224 IU/ml and 50 IU/ml respectively,P

Humans ; Maxilla ; Maxillary Sinus ; surgery ; Paranasal Sinuses

Endoscopy ; adverse effects ; Humans ; Nasal Surgical Procedures ; adverse effects ; Paranasal Sinuses ; surgery ; Postoperative Complications ; prevention & control ; therapy

OBJECTIVETo investigate the prevalence and psychopathological characteristics of anxiety and depression in patients with chronic rhinosinusitis (CRS) and to find the risk factors leading to psychological problems.

METHODSBetween August 2013 and April 2014, 117 consecutive patients with the diagnosis of CRS who had been scheduled for endoscopic sinus surgery were prospectively enrolled. Somatic and psychological symptoms were evaluated using a series of questionnaire instruments. The instruments included symptom checklist-90 (SCL-90), self-rating depression scale (SDS), self-rating anxiety scale (SAS) and the visual analogue scale (VAS) and the sinonasal outcome test 20 (SNOT-20) and Lund-Mackay computed tomography score. The results of SAS, SDS, SCL-90 were compared with the standard, obtained from healthy Chinese population. Multivariate Logistic regression was used to analyze the factors that might cause anxiety and depression. SPSS 19.0 software was used to analyze the data.

RESULTSThe scores of SAS and SDS (39.40 ± 11.55, 54.05 ± 10.96) were significantly higher than those of our country's normal standard (29.78 ± 10.46, 41.88 ± 10.57, t equals 5.648, 7.529, all P < 0.01). The SCL-90 scores were significantly higher than those of the normal standard population, including dimension of somatization, anxiety, depression, psychosis and total average score of the factors ( all P < 0.01), the result of somatization, anxiety, depression had positive correlation with the scores of SAS and SDS (r equals 0.681, 0.781, 0.531, 0.866, 0.674, 0.557, all P < 0.05). Multivariate Logistic regression showed that gender and CRS complicated with asthma or allergic rhinitis (AR) and the symptom of nasal obstruction were related to the incidence of anxiety depression comorbid. In addition, the gender and concurrent asthma had positive correlation with incidence of any anxiety or depressive disorder. To compare the abnormal psychological state group and healthy group, the SNOT-20 scores had no statistical significance (all P > 0.05).

CONCLUSIONSHigh prevalence of anxiety and depression was found in CRS patients. Such factors as gender, nasal obstruction and concurrent with asthma or AR are high risk factors for anxiety and depression in patients with CRS.

Anxiety ; epidemiology ; Chronic Disease ; Depression ; epidemiology ; Endoscopy ; Humans ; Pain Measurement ; Prevalence ; Prospective Studies ; Rhinitis ; epidemiology ; surgery ; Sinusitis ; epidemiology ; surgery ; Surveys and Questionnaires ; Tomography, X-Ray Computed

Objective To evaluate the efficacy of the intensity modulated radiotherapy in early stage cervical cancer with vaginal stump recurrence after surgery.Methods A retrospective concurrent comparative study included 60 patients with vaginal recurrence after surgery in early stage cervical cancer.30 cases of the experimental group were treated with intensity-modulated radiotherapy (IMRT),and 30 cases of the control group were treated with conventional radiotherapy.The efficacy and complications between two groups were compared after 3 treatment cycles.Results Of 30 patients in experimental group,22 patients achieved complete remission,7 had partial and 1 progressed.But in the control group,14 had complete remission,5 reached partial remission,7 were stable and 4 progressed.The effective rates were 96.67 ％ (29/30) and 63.33 ％ (19/30),respectively,in the experimental and control group,which showed statistical significance (P =0.009).In the experimental group,there were 1 case with grade 1 radiation cystitis and 1 case with grade 1 radiation proctitis.In the control group,there were 3 cases of vaginal-rectal fistula,1 case of grade 3 radiation proctitis,2 cases of grade 2 radiation cystitis and 2 cases of grade 1 radiation proctitis.Conclusions IMRT for treating vaginal recurrence of early cervical cancer achieves satisfactory short-term effect.In comparison with conventional radiotherapy,IMRT has higher efficacy but less side effects.

Objective To investigate the role of three-dimensional speckle tracking echocardiography (3D-STE) in providing a novel approach to assessing myocardial viability in patients with myocardial infarction (MI).Methods The subjects from the Department of Cardiology and the Department of Cardiac Surgery admitted from April 2010 through December 2012 were diagnosed as MI by electrocardiogram,myocardial enzymes and angiography.The clear imaging of angiography was selected out and collected.All patients had different degrees of segmental wall motion abnormalities,and some already had percutaneous transluminal coronary angioplasty and coronary stenting or coronary artery bypass grafting.Patients with diabetes,heart disease and severe valvular disease of heart were excluded.A total of 45 MI patients were checked with routine echocardiography,two-dimensional speckle tracking echocardiography (2D-STE) and 3D-STE.Then,radionuclide myocardial perfusion/metabolic imaging was served as a golden standard to distinguish the viable from nonviable myocardium in each patient within a day.In order to determine the most sensitivity and specificity threshold values of circumferential peak-systolic strain (Cs),longitudinal peak-systolic strain (Ls),radial peak-systolic strain (Rs),3D strain and area strain for viability detection from 3D-STE,the receiver operating characteristic curve was used to investigate the sensitivity and specificity of the detection of viable myocardium with strain parameters in the study.Comparisons between viable and non-viable groups were carried out with t test.Data were expressed as the mean value ± standard deviation (-x ± s).Results The ventricular wall motion abnormality by visual assessment was observed in 368 segments from 720 segments in 45 patients.Furthermore,204 segments were confirmed to be viable by radionuclide myocardial perfusion/metabolic imaging whereas the rest 164 segments were identified as nonviable among 368 abnormal segments.There were no significant differences in circumferential peaksystolic strain (Cs),longitudinal peak-systolic strain (Ls) and radial peak-systolic strain (Rs) by 2D-STE between viable and nonviable group.Compared with those in viable group,there wasn' t any difference in Cs,but Rs and Ls decreased significantly by 3D-STE in nonviable group.The 3D strain and area strain in absolute value decreased in nonviable group compared with viable group.According to 3D-STE,when Rs higher than 11.1％,the sensitivity was 95.1％ and the specificity was 53.4％ for identification of viable myocardium,whereas Ls higher than 14.3％ resulted in sensitivity of 65.2％ and a specificity of 65.7％.Besides,3D strain higher than 17.4％ had a sensitivity of 70.6％ and a specificity of 77.2％ for detection of viable myocardium,while area strain higher than 23.2％ allowed a sensitivity of 91.5％ and a specificity of 78.8％.Conclusions The 3D-STE might have potential reliability of myocardial viability detection in the patients with left ventricular dysfunction after MI.

OBJECTIVE: To discuss endoscopic surgical treatment and its effect on structural rhinitis. METHOD: Eighty-four patients with structural rhinitis were treated by endoscopic rhinoplasty of nasal cavity, include: (1) inferior turbinoplasty with three segment method, (2) middle turbinoplasty, (3) functional resection of ostiomeatal complex, (4) endoscopic submucous septoplasty. To achieve organic combination of the above surgery methods according to the patient's symptom and the different results of the CT scan, the surgical procedure were designed individually. RESULT All patients were followed-up for 8 to 12 months, average 10 months. The rate of fully recovered without serious complication was 95.24%. CONCLUSTION: Structural rhinitis is a sort of functional disease as a result of multi-abnormality of nasal cavity structure. Endoscopic rhinoplasty is an effective treatment by means of reconstructing the balance of bilateral nasal cavity and improving its function.
Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Rhinitis ; surgery ; Rhinoplasty ; methods ; Young Adult

Objective To detect the serum levels of CC chemokine receptor 2(CCR2)and C-reactive pro-tein(CRP)in stroke patients,and analyze their relationship with the severity of stroke associated pneumonia and their clinical significance.Methods A total of 78 patients with stroke associated pneumonia who were di-agnosed and treated in the hospital from October 2022 to February 2023 were collected as the study group,ac-cording to the severity of pneumonia,the study group was divided into mild group(31 cases),moderate group(29 cases),and severe group(18 cases),78 stroke patients who did not develop pneumonia were included into control group.Pearson method was applied to analyze the correlation between serum CCR2 and CRP levels in stroke associated pneumonia patients.Multivariate Logistic regression was applied to analyze the factors influ-encing the occurrence of stroke associated pneumonia.Receiver operating characteristic(ROC)curve was ap-plied to analyze the diagnostic value of serum CCR2 and CRP for stroke associated pneumonia.Results The National Institute of Health stroke scale(NIHSS)score,serum CCR2,and CRP levels in the study group were obviously higher than those in the control group(P<0.05).The levels of serum CCR2 and CRP increased with the aggravation of pneumonia(P<0.05).The levels of serum CCR2 and CRP in the study group were positively correlated(r=0.799,P<0.05).NIHSS score,CCR2,and CRP levels were risk factors for stroke associated pneumonia in stroke patients(P<0.05).The area under the curve(AUC)for the diagnosis of stroke associated pneumonia using serum CCR2 and CRP alone was 0.873 and 0.888,respectively,and the AUC for the combined detection of the two was 0.936,the combined detection of the two was superior to the individual detection of serum CCR2 and CRP(Zcombination-CCR2=1.987,Zcombination-CRP=1.832,P=0.041,0.047).Conclusion Serum CCR2 and CRP are closely related to the severity of stroke associated pneumonia,and their combined detection has high diagnostic value for stroke associated pneumonia.

OBJECTIVETo explore the feasibility of the extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach.

METHODSEight patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach for maxillary sinus lesions. The indications, surgical management and outcomes of the surgery were presented.

RESULTSThere were 2 cases of maxillary dentigerous cyst with oroantral fistula, 2 cases of antrochoanal polyp, 2 cases of maxillary sinus inverted papillomas, 1 case of odontogenic maxillary sinusitis with oroantral fistula, and 1 case of maxillary sinus mucocele. All patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach without intraoperative complication, with good access to the lesions. Complete resection could be achieved through this approach, no postoperative complications occurred except one patient had a delayed wound healing of inferior turbinate, all patients were free of recurrence with the average postoperative follow-up of 7.8 months (range 4-12 months).

CONCLUSIONThe extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach is recommended for some maxillary pathology owing to its good access to the lesions and complete resection.

Cysts ; Dentigerous Cyst ; Humans ; Maxilla ; Maxillary Sinus ; surgery ; Maxillary Sinus Neoplasms ; Maxillary Sinusitis ; Mucocele ; Nasal Polyps ; Papilloma, Inverted ; Paranasal Sinus Diseases ; surgery ; Postoperative Complications ; Turbinates ; surgery

〓 Objectives: To analyze the pathological and clinical features of nasal respiratory epithelial adenomatoid hamartoma（REAH）, and summarize the diagnostic points, to improve the experience of diagnosis and treatment. Methods:The clinical data of 16 patients with REAH were analyzed retrospectively. The clinical manifestations, pathological features, imaging features, surgical treatment and prognosis were summarized. Results:16 cases of REAH were studied, 10 cases（62.50%） were associated with sinusitis, 1 case（6.25%） was associated with inverted papilloma, 1 case（6.25%） was associated with hemangioma. 5 cases（31.25%） had a history of nasal sinus surgery, including 1 case with 3 times of nasal sinus surgery, 1 case with 2 times of nasal sinus surgery, 3 cases with 1 time of nasal sinus surgery; 10 cases（62.50%） occurred in the bilateral olfactory cleft, 2 cases（12.50%） in the unilateral olfactory cleft, 3 cases（18.75%） in the unilateral middle turbinate, 1 case（6.25%） in the nasopharynx. All 16 patients were pathologically diagnosed as REAH. In the patients with lesions located in bilateral olfactory fissures, symmetrical widening of olfactory fissures and lateral displacement of middle turbinate were observed on preoperative sinus CT. The average width of bilateral olfactory fissures was （9.9±2.70） mm. The ratio of wide to narrow olfactory cleft was 1.21 ± 0.19. There was no significant difference in Lund-Mackay score between the two sides（P>0.05）. All patients underwent surgery under general anesthesia and nasal endoscopy. The follow-up period ranged from 1 to 66 months, and no recurrence occurred. Conclusion:Preoperative diagnosis of REAH is facilitated by the combination of clinical manifestations and endoscopic and imaging features. Endoscopic complete resection can achieve a good therapeutic effect.
Humans ; Nasal Polyps/complications* ; Retrospective Studies ; Paranasal Sinuses/pathology* ; Adenoma ; Endoscopy/methods* ; Hamartoma/surgery*