We reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach. Case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma. The tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary. The two patients were followed up for 26 and 18 months respectively, and no recurrence was noted without postoperative chemotherapy or radiotherapy. To the best of our knowledge, this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma. Our experience revealed that not only for the early recurrent nasopharyngeal carcinoma, the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma.
Adenocarcinoma* ; Drug Therapy ; Endoscopes ; Humans ; Nasopharyngeal Neoplasms ; Radiotherapy ; Recurrence

BACKGROUNDPlantar pressure serves as a key factor for predicting ulceration in the feet of diabetes patients. We designed this study to analyze plantar pressure changes and correlating risk factors in Chinese patients with type 2 diabetes.

METHODSWe recruited 65 patients with type 2 diabetes. They were invited to participate in the second wave 2 years later. The patients completed identical examinations at the baseline point and 2 years later. We obtained maximum force, maximum pressure, impulse, pressure-time integral, and loading rate values from 10 foot regions. We collected data on six history-based variables, six anthropometric variables, and four metabolic variables of the patients.

RESULTSOver the course of the study, significant plantar pressure increases in some forefoot portions were identified (P < 0.05), especially in the second to forth metatarsal heads. Decreases in heel impulse and pressure-time integral levels were also found (P < 0.05). Plantar pressure parameters increased with body mass index (BMI) levels. Hemoglobin A1c (HbA1c) changes were positively correlated with maximum force (β = 0.364, P = 0.001) and maximum pressure (β = 0.366, P = 0.002) changes in the first metatarsal head. Cholesterol changes were positively correlated with impulse changes in the lateral portion of the heel (β = 0.179, P = 0.072) and pressure-time integral changes in the second metatarsal head (β = 0.236, P = 0.020). Ankle-brachial index (ABI) changes were positively correlated with maximum force changes in the first metatarsal head (β = 0.137, P = 0.048). Neuropathy symptom score (NSS) and common peroneal nerve sensory nerve conduction velocity (SCV) changes were positively correlated with some plantar pressure changes. In addition, plantar pressure changes had a correlation with the appearance of infections, blisters (β = 0.244, P = 0.014), and calluses over the course of the study.

CONCLUSIONSWe should pay attention to the BMI, HbA1c, cholesterol, ABI, SCV, and NSS changes in the process of preventing high plantar pressure and ulceration. Some associated precautions may be taken with the appearance of infections, blisters, and calluses.

Adult ; Aged ; Asian Continental Ancestry Group ; Diabetes Mellitus, Type 2 ; physiopathology ; Diabetic Foot ; diagnosis ; physiopathology ; Female ; Foot ; physiopathology ; Humans ; Male ; Middle Aged ; Pressure ; Prospective Studies ; Risk Factors

Objective: Jiaotaiwan is a classic prescription in traditional Chinese medicine for insomnia. Modern clinical research has proved its anti-diabetes effect by "the same treatment for different diseases" theory, so it is necessary to study its pharmacological mechanism for anti-diabetes effect. Method: In this study, the integrative pharmacology platform of traditional Chinese medicine (TCMIP) was used to explore the potential target and mechanism of Jiaotaiwan, and construct its core target network for diabetes. Then the enrich analysis of GO and KEGG on key targets was conducted to build the visual multilayer association network of "Jiaotaiwan-active composition-core target-key pathway". Result:28 active ingredients were obtained from Jiaotaiwan in this study. Its anti-diabetes effect was relevant to 187 core targets,including 15 known disease targets such as vasopressin V2 receptor (AVPR2), receptor activity-modifying protein 1 (RAMP1), receptor activity-modifying protein 3 (RAMP3), insulin receptor (INSR), and insulin-like growth factor 1 receptor (IGF1R); as well as 71 predictive drug targets such as cyclin-dependent kinase 9 (CDK9), glucokinase (GCK), NF-kappa-B inhibitor alpha (NFKBIA), NF-kappa-B p100 subunit (NFKB2), and hypoxia inducible factor-1 alpha (HIF1A). Conclusion:The anti-diabetes mechanism of Jiaotaiwan may be associated with activation of adenylate cyclase activity, cellular response to glucagon stimulus, activation of mitogen-activated protein kinase (MAPK) activity, endocrine system, gonadotropin-releasing hormone (GnRH) signaling pathway, Chemokine signaling pathway, phosphatidylinositol 3-kinase-serine/threonine kinases (PI3K-Akt) signaling pathway and other related biological processes and pathways. This study provides a scientific evidence for further study of the anti-diabetes mechanism of Jiaotaiwan.

In Taiwan, high-risk patients have been identified and tested for preventing community spread of COVID-19. Most sample collection was performed in emergency departments (EDs). Traditional sample collection requires substantial personal protective equipment (PPE), healthcare professionals, sanitation workers, and isolation space. To solve this problem, we established a multifunctional sample collection station (MSCS) for COVID-19 testing in front of our ED. The station is composed of a thick and clear acrylic board (2 cm), which completely separates the patient and medical personnel. Three pairs of gloves (length, 45 cm) are attached and fixed on the outside wall of the MSCS. The gloves are used to conduct sampling of throat/nasal swabs, sputum, and blood from patients. The gap between the board and the building is only 0.2 cm (sealed with silicone sealant). ED personnel communicate with patients using a small two-way broadcast system. Medical waste is put in specific trashcans installed in the table outside the MSCS. With full physical protection, the personnel conducting the sampling procedure need to wear only their N95 mask and gloves. After we activated the station, our PPE, sampling time, and sanitization resources were considerably conserved during the 4-week observation period. The MSCS obviously saved time and PPE. It elevated the efficiency and capacity of the ED for handling potential community infections of COVID-19.
Betacoronavirus ; Clinical Laboratory Techniques ; Coronavirus Infections ; diagnosis ; epidemiology ; Emergency Service, Hospital ; organization & administration ; Humans ; Mass Screening ; methods ; Pandemics ; Personal Protective Equipment ; supply & distribution ; Pneumonia, Viral ; diagnosis ; epidemiology ; Taiwan ; epidemiology