Objective: To develop a narcissistic personality questionnaire for non-clinical Chinese people. Methods: The questionnaire was developed on the basis of data from open questionnaire, interview and Narcissistic Personality Inventory. Six hundred and twelve participants finished a Narcissism Questionnaire, Self-Esteem Scale, Trait Anxiety Inventory, and Satisfaction with Life Scale. Results: ①An exploratory factor analysis revealed three factors labeled authority, superiority, and selfadmiration; and a confirmatory factor analysis suggested that the goodness-of-fit indexes of this three-factor model was satisfactory; ②Cronbach alpha coefficients of narcissism questionnaire and its three factors ranged from 0.796 to 0.929; ③Consistent with previous studies, males were more narcissistic than females; ④Narcissism was pos- itively correlated with self-esteem, negatively correlated with anxiety and was not associated with satisfaction of life; selfesteem mediated the relationship between narcissism and anxiety. Conclusion: The self developed questionnaire illustrated satisfactory internal consistency reliability, construct validity, and criterion-related validity.

OBJECTIVE: To study the effectiveness of repairing nearly circumferential defect with the submental flaps after resection of laryngeal function unpreserved hypopharyngeal cancer. METHOD: All the cases were treated with the submental flaps after resection of hypopharyngeal cancer with laryngeal function unpreserved. RESULT: All 13 flaps were alive. Hypopharyngeal fistula occurred in 2 cases. All patients had normal swallowing function. The patients were followed up 6-42 months. Of 13 cases,3 had recurrence at neck Lymph node, but no local hypopharyngeal recurrence was found. Seven cases were followed up more than 3 years, and only 3 of them survived. CONCLUSION Submental flap is an ideal tissue flap submental flap in repairing of approaching circumferential defects after hypopharyngeal cancer ablation with laryngeal function unpreserved for the repairment of after approaching circumferential defects after hypopharyngeal cancer ablation with laryngeal function unpreserved, For it is close to the defect region, safe, easy-to-obtain and easy-to-survive.
Fistula ; pathology ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Hypopharynx ; pathology ; surgery ; Larynx ; Lymphatic Metastasis ; Neck ; Neoplasm Recurrence, Local ; Reconstructive Surgical Procedures ; Surgical Flaps

OBJECTIVE: To explore the clinical characteristic, the CT, MRI features, diagnosis and treatment of low grade myofibroblastic sarcoma in head and neck. METHOD: Six cases of low grade myofibroblastic sarcoma in head and neck were diagnosis and reviewed retrospectively. Routine preoperative CT and MRI examination were performed. RESULT: All cases were operated one case with radiotherapy before operation was given with a total dose of 60 Gy. The patients were follow-up for 6 months to 5 year and no recurrence was found. No complications occurred in 6 cases. CONCLUSION It has been confirmed in this research that LGMS is a low-grade malignangt tumor. It was difficult to make early diagnosis through frozen section. The final diagnosis depend on paraffin section and immunohistochemisty. Extended local excision with tumor-free margin is the treatment of choice.
Adult ; Aged ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Myosarcoma ; diagnosis ; surgery ; Retrospective Studies ; Young Adult

Objective To probe into the psychological resilience and its influencing factor among parents of children with cancer.Methods A total of 125 parents were investigated by self-designed general information questionnaire,Connor-Davidson psychological resilience scale (CD-RISC),Chinese version of Parents' Perception Uncertainty in Illness Scale (PPUS),Social Support Rating Scale (SSRS),self-rating depression scale (SDS) and self-rating anxiety scale (SAS).Results The total score of psychological resilience was (54.86±12.88) and the illness uncertainty score was (91.52±14.66).The social support score was moderate with a total score of (39.86±7.99).The anxiety and depression among parents got a total score of (40.08±7.19) and (44.61±7.38) respectively.Psychological resilience was negatively correlated with illness uncertainty and depression,and was positively correlated with the social support.The depression,illness uncertainty,residence,children's age,clinical diagnosis entered into the multiple linear regression equation of psychological resilience,predicting 30.1％ of total variation in psychological resilience.Conclusions Social support,illness uncertainty and depression are the important factors which affect psychological resilience among parents of children with cancer.Nurses should assess the social support that parents receive,the level of depression and the disease feeling of the parents,and provide targeted interventions to relieve it,help to establish effective coping style and improve their psychological state.

Objective To assess reconstructive options for critical limb ischaemia in infrapopliteal arteries. Methods A retrospective review of all CLI patients who underwent infrapopliteal reconstruction was carried out. Patient history, demographics, procedure details, complications, and follow-up information were collected and analyzed. Patency, limb salvage rate was determined by Kaplan-Meier analysis. Results During the period (from December 2003 to January 2008 ), 123 CLI patients with arteriosclerosis occlusions were treated on an intention-to-treat basis with infrapopliteal percutaneous transluminal angioplasty (PTA).Thirty-three thromboangiitis obliterans and twenty-three arteriosclerosis occlusions suffering CLI were treated by infrapopliteal bypass procedures. Primary patency and limb salvage rate of infrapopliteal PTA at 6, 12 and 24 months was 67%, 54%, 49% and 91%, 85%, 78% respectively, Primary patency and limb salvage rate of infrapopliteal surgical bypass at 6, 12 and 24 months was 90%, 83%, 79% and 92%,87%, 80% respectively, the patency of infrapopliteal PTA was lower than infrapopliteal surgical bypass (P ＜0. 01 ), but the limb salvage rate of infrapopliteal PTA and open surgery was no significant difference (P ＞ 0. 05 ). Conclusion Endovascular treatment (PTA) in patients with infrapopliteal arteriosclerosis occlusions and critical ischaemia is safe, effective. Infrapopliteal PTA can be used as the choice of therapy and surgical bypass reserved in those endovascular treatment failed. While in CLI patients with thromboangiitis obliterans infrapopliteal artery bypass remains the best treatment option.

OBJECTIVE: To investigate the expression of SOX2 in laryngeal carcinoma and analyze the relation of SOX2 and clinical factors. METHOD: We measured the expression of SOX2 protein in 45 laryngeal carcinoma fresh samples and 45 paracarcinoma tissues (cutting margin > 0.5 cm) with flow cytometer (Epics-XL II), 20 normal laryngeal mucosa samples were also studied as controls. RESULT: The quantitative and qualitative expression of SOX2 protein in laryngeal carcinoma tissues was obviously higher than those in paracarcinoma and in normal laryngeal mucosa tissues respectively (P < 0 05). There was no significant difference between the expression of paracarcinoma and normal laryngeal mucosa tissues. In laryngeal carcinoma, the expression of SOX2 protein wasn't significantly related to patients' clinical classification, tumor size, smoking history, patients' age and sex but related to metastasis, pathological grade and clinical stage. CONCLUSION The high expression of SOX2 may contribute to the carcinogenesis and development of laryngeal carcinoma. It is an important index of judging metastasis and staging and prognosis of laryngeal carcinoma to measure the expression of SOX2 protein.
Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma ; metabolism ; pathology ; Female ; Flow Cytometry ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; SOXB1 Transcription Factors ; metabolism

Retrospective analysis was performed on 1 child with silent inactivation (SI) of asparaginase (ASNas) who was diagnosed with acute lymphoblastic leukemia (ALL) and treated in the First Affiliated Hospital, Sun Yat-Sen University in October 2019.The patient was a 9 years and 3 months old boy who was diagnosed as ALL accompanied with late bone marrow relapse.After pegylated Escherichia coli-Asparaginase (PEG-ASNase) was given, he did not have the expected treatment-related adverse reactions, including hyperammonemia, hypofibrinogenemia, and the low activation of antithrombin Ⅲ (ATⅢ). The plasma asparagine (ASN) concentration failed to meet the depletion criteria and the ASNase activity was 64.5 U/L.Therefore, the SI of ASNase was confirmed.Erwinase was used to replace PEG-ASNase, the lowest level of ATⅢ was 33%, and the lowest level of fibrinogen was 1.20 g/L.Hyperammonemia and decreased ASN were also observed, and the ASNase activity was 1 813.0 U/L.All the above suggested that when, SI occurred, the replacement by Erwinase was effective.The ASNase activity should be monitored in ALL patients who were treated with ASNase.Monitoring the treatment-related adverse reactions such as hyperammonia and coagulation disorders closely has important implications to the SI of ASNase when the detection of ASNase activity was unavailable.

Objective To evaluate the application value of diode laser in situ fenestration in the thoracic endovascular aortic repair (TEVAR) for the treatment of aortic arch disease.Methods The retrospective crosssectional study was conducted.The clinical data of 110 patients with aortic arch disease who underwent TEVAR using diode laser in situ fenestration in the Ninth People's Hospital of Shanghai Jiaotong University School of Medicine from January 2014 to June 2017 were collected.TEVAR using diode laser in situ fenestration was performed according to the lesion involving the three branches of aortic arch.Observation indicators:(1) surgical and intraoperative situations;(2) follow-up.All patients were followed up by outpatient examination,inpatient examination and telephone interview up to May 2017.CT angiography was performed to evaluate the patency of the stents and presence of endoleak at 3,6,and 12 months postoperatively.Measurement data with normal distribution were represented as x ±s.Results (1) Surgical and intraoperative situations:106 of 110 patients underwent successful TEVAR using diode laser in situ fenestration.Intraoperative digital subtraction angiography (DSA) showed that primary aortic dissection incisions were completely closed,with a patency of all stents and no fenestration-related endoleaks.The surgical success rate was 96.36％ (106/110).Two patients died of intraoperative pericardial tamponade and 2 received chimney stent implantation after complex anatomic configuration of the aortic arch inducing to failure of the innominate artery fenestration.Of 106 patients,70 received left subclavian arterial fenestration,30 received 3 aortic branches fenestration and 6 received both left subclavian arterial and left common carotid arterial fenestrations.The operation time and dose of contrast agent in 110 patients were respectively (140±9)minutes and (185±-5)mL.Four patients had postoperative complications,1 died of severe pulmonary infection and 3 with cerebral infarction were improved by anti-platelet,brain nerve nutrition and other symptomnatic treatment.Other patients had no transient ischemic attack,stroke,brain infarction,myocardial infarction or other neurological complications.Duration of hospital stay of the 110 patients was (15 ± 7)days.(2) Follow-up:99 of 107 patients were followed up for 2-17 months,with a median time of 10 months.During the follow-up,there were patencies of all stents,and endoleaks of 4 patients occurred and were closely followed up and observed.Conclusion The diode laser in situ fenestration is safe and feasible in the TEVAR for the treatment of aortic arch disease,with satisfactory short-term outcomes.

With the continuous development of endovascular surgery, thoracic endovascular aortic repair (TEVAR) has gradually replaced traditional open surgery and has become the preferred treatment strategy for Stanford type B aortic dissection. However, the disadvantage of the short proximal landing zone greatly limited the indication of TEVAR surgery and affected the prognosis. In recent years, many strategies such as hybrid surgery, in vitro fenestrated and branched aortic endo-graft, chimney technique, in-situ fenestration technique, etc., have been developed, which greatly broadens the TEVAR indication and improved the prognosis.