This case reports of nasopharyngeal embryonal rhabdomyosarcoma mainly for a stuffy nose, runny nose with blood, and without typical clinical manifestations. Electronic laryngoscopy tip: nasopharyngeal neoplasm. MRI tip: nasopharyngeal carcinoma. By pathological and immunohistochemical examinations, it finally was diagnosed with nasopharyngeal embryonal rhabdomyosarcoma.
Carcinoma ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; diagnosis ; Rhabdomyosarcoma, Embryonal ; diagnosis

Using the weight-average molecular weight 50 000 polylactic acid (PLA) as a carrier, and a certain proportion of erythromycin (EM) and prednisone acetate (PNA) to mixed prepare the compound erythromycin sustained release preparation (sustained-release tablets). Using ultraviolet spectrophotometry and high performance liquid chromatography (HPLC) to detect separately the release amount of EM and PNA in vitro medium. The sustained-release tablets release for about 21 days, the average content of EM is 99.7 mg/table, RSD = 0.82%; and the average content of PNA is 10.03 mg/table, RSD = 0.93%. Within 21 days, the cumulative releases of EM and PNA are 86.1% and 78.3%, respectively. The drug release is steady and slow after 5 days, the burst release phenomenon in early stage is more significant. The results showed that the sustained-release tablet preparation method is feasible, the release performance is good and the clinical efficacy is significant.

Background: Risk perception plays a crucial role in workers' unsafe behaviors. However, little research has explored why workers generate biased risk perceptions, namely underestimating or overestimating the risks of unsafe actions. Cognitive biases in risk perception arise from uncertainties about the dangers of unsafe behaviors. As a typical heuristic strategy, the anchoring effect is critical in decision-making under uncertain conditions. Consequently, this study empirically analyzed the influence of anchoring effects on workers' risk perception. Methods: In 2022, a survey was conducted with 1,418 coal mine workers from Shanxi Province, China. The survey instruments assessed workers' risk perception of unsafe behavior, anchoring effects, need for cognition, and safety knowledge. Multivariable linear regression models were employed to analyze the associations among these variables. Results: The findings verified the proposed anchoring effects. Specifically, experimenter-provided high-risk anchors led workers to overestimate unsafe behavior risks, thus reducing their tendency to engage in such behavior. In contrast, experimenter-provided low-risk anchors and accident-injury experiences (self-generated anchors) decreased workers' risk perception, increasing their propensity to engage in unsafe behavior. Additionally, workers' safety knowledge and need for cognition significantly affected anchoring effects. Conclusion This research enhances workplace safety studies by applying the anchoring effect from psychology to risk perception research. Suggestions for improving risk perception encompass implementing hazard warnings, fostering safety education, and providing training. Furthermore, managers should give special attention to workers with accident-injury experience and promptly correct their accident fluke mentality, thereby improving overall risk awareness.

Background: Risk perception plays a crucial role in workers' unsafe behaviors. However, little research has explored why workers generate biased risk perceptions, namely underestimating or overestimating the risks of unsafe actions. Cognitive biases in risk perception arise from uncertainties about the dangers of unsafe behaviors. As a typical heuristic strategy, the anchoring effect is critical in decision-making under uncertain conditions. Consequently, this study empirically analyzed the influence of anchoring effects on workers' risk perception. Methods: In 2022, a survey was conducted with 1,418 coal mine workers from Shanxi Province, China. The survey instruments assessed workers' risk perception of unsafe behavior, anchoring effects, need for cognition, and safety knowledge. Multivariable linear regression models were employed to analyze the associations among these variables. Results: The findings verified the proposed anchoring effects. Specifically, experimenter-provided high-risk anchors led workers to overestimate unsafe behavior risks, thus reducing their tendency to engage in such behavior. In contrast, experimenter-provided low-risk anchors and accident-injury experiences (self-generated anchors) decreased workers' risk perception, increasing their propensity to engage in unsafe behavior. Additionally, workers' safety knowledge and need for cognition significantly affected anchoring effects. Conclusion This research enhances workplace safety studies by applying the anchoring effect from psychology to risk perception research. Suggestions for improving risk perception encompass implementing hazard warnings, fostering safety education, and providing training. Furthermore, managers should give special attention to workers with accident-injury experience and promptly correct their accident fluke mentality, thereby improving overall risk awareness.

Background: Risk perception plays a crucial role in workers' unsafe behaviors. However, little research has explored why workers generate biased risk perceptions, namely underestimating or overestimating the risks of unsafe actions. Cognitive biases in risk perception arise from uncertainties about the dangers of unsafe behaviors. As a typical heuristic strategy, the anchoring effect is critical in decision-making under uncertain conditions. Consequently, this study empirically analyzed the influence of anchoring effects on workers' risk perception. Methods: In 2022, a survey was conducted with 1,418 coal mine workers from Shanxi Province, China. The survey instruments assessed workers' risk perception of unsafe behavior, anchoring effects, need for cognition, and safety knowledge. Multivariable linear regression models were employed to analyze the associations among these variables. Results: The findings verified the proposed anchoring effects. Specifically, experimenter-provided high-risk anchors led workers to overestimate unsafe behavior risks, thus reducing their tendency to engage in such behavior. In contrast, experimenter-provided low-risk anchors and accident-injury experiences (self-generated anchors) decreased workers' risk perception, increasing their propensity to engage in unsafe behavior. Additionally, workers' safety knowledge and need for cognition significantly affected anchoring effects. Conclusion This research enhances workplace safety studies by applying the anchoring effect from psychology to risk perception research. Suggestions for improving risk perception encompass implementing hazard warnings, fostering safety education, and providing training. Furthermore, managers should give special attention to workers with accident-injury experience and promptly correct their accident fluke mentality, thereby improving overall risk awareness.

Background: Risk perception plays a crucial role in workers' unsafe behaviors. However, little research has explored why workers generate biased risk perceptions, namely underestimating or overestimating the risks of unsafe actions. Cognitive biases in risk perception arise from uncertainties about the dangers of unsafe behaviors. As a typical heuristic strategy, the anchoring effect is critical in decision-making under uncertain conditions. Consequently, this study empirically analyzed the influence of anchoring effects on workers' risk perception. Methods: In 2022, a survey was conducted with 1,418 coal mine workers from Shanxi Province, China. The survey instruments assessed workers' risk perception of unsafe behavior, anchoring effects, need for cognition, and safety knowledge. Multivariable linear regression models were employed to analyze the associations among these variables. Results: The findings verified the proposed anchoring effects. Specifically, experimenter-provided high-risk anchors led workers to overestimate unsafe behavior risks, thus reducing their tendency to engage in such behavior. In contrast, experimenter-provided low-risk anchors and accident-injury experiences (self-generated anchors) decreased workers' risk perception, increasing their propensity to engage in unsafe behavior. Additionally, workers' safety knowledge and need for cognition significantly affected anchoring effects. Conclusion This research enhances workplace safety studies by applying the anchoring effect from psychology to risk perception research. Suggestions for improving risk perception encompass implementing hazard warnings, fostering safety education, and providing training. Furthermore, managers should give special attention to workers with accident-injury experience and promptly correct their accident fluke mentality, thereby improving overall risk awareness.

OBJECTIVETo compare the oncology outcomes and anal function among laparoscopic partial, subtotal and total intersphincteric resection(ISR) for low rectal cancers.

METHODSFrom June 2011 to February 2016, a total of 79 consecutive patients with low rectal cancers underwent laparoscopic ISR with hand-sewn coloanal anastomosis at our department. According to the distal tumor margin, partial ISR (internal sphincter resection at the dentate line) was used to treat tumors with distance <1 cm from the anal sphincter (n=28), subtotal ISR was adopted for the tumors locating between the dentate line and intersphincteric groove (n=34), and total ISR (resection at the dentate line) was applied in the treatment of intra-anal tumors (n=17). Anal function was evaluated by a standardized gastrointestinal questionnaire, Wexner incontinence score and Kirwan's classification. Metaphase oncological results and postoperative anal function were compared among three groups, and.

RESULTSOther than the distance of tumor low margin to dentate line (P=0.000) and serum CEA level (P=0.040), no significant differences were noted in baseline data among 3 groups (all P>0.05). The median follow up was 21(8-61) months. The 3-year disease-free survival rates in laparoscopic partial, subtotal and total ISR groups were 91.1%, 88.9%, 88.2% (P=0.901) and the 3-year local relapse-free survival rates were 91.1%, 72.9%, 80.2%(P=0.658), whose all differences were not significant. Thirty-eight patients who did not receive neoadjuvant chemoradiotherapy and underwent ileostomy closure for at least 24 months completed the evaluation of anal function, including 14 cases in partial group, 15 cases in subtotal group and 9 cases in total group. Of 38 patients, 73.7%(28/38) was classified as good function (Wexner incontinence score ≤10) and no patient adopted a colostomy because of severe fecal incontinence(Kirwan classification=grade 5). Furthermore, there were no significant differences in Wexner incontinence score and Kirwan classification among 3 groups (all P>0.05). However, patients with chronic anastomotic stoma stenosis showed worse anal function than those without stenosis [Wexner incontinence score: 18(9-20) vs 6(0-18), P=0.000; Kirwan grading: 3(2-4) vs. 2(1-4), P=0.002].

CONCLUSIONSAs the ultimate sphincter-saving technique, laparoscopic ISR can result in better oncologic outcomes and better anal function for patients with low rectal cancers. The different procedures of ISR may not affect the efficacy, but chronic anastomotic stoma stenosis deteriorates incontinence status.

OBJECTIVETo summarize the perioperative and postoperative complications follow laparoscopic intersphincteric resection (LapISR) in the treatment of low rectal cancer and their management.

METHODSAn observational study was conducted in 73 consecutive patients who underwent LapISR for low rectal cancer between June 2011 and February 2016 in our hospital. The clinicopathological parameters, perioperative and postoperative complications, and clinical outcomes were collected from a prospectively maintained database. Perioperative and postoperative complications were defined as any complication occurring within or more than 3 months after the primary operation, respectively.

RESULTSForty-nine(67.1%) cases were male and 24(32.9%) were female with a median age of 61(25 to 79) years. The median distance from distal tumor margin to anal verge was 4.0(1.0 to 5.5) cm. The median operative time was 195 (120 to 360) min, median intra operative blood loss was 100 (20 to 300) ml, median number of harvested lymph nodes was 14(3 to 31) per case. All the patients underwent preventive terminal ileum loop stoma. No conversion or hospital mortality was presented. The R0 resection rate was 98.6% with totally negative distal resection margin. A total of 34 complication episodes were recorded in 21(28.8%) patients during perioperative period, and among which 20.6%(7/34) was grade III(-IIII( according to Dindo system. Anastomosis-associated morbidity (16.4%,12/73) was the most common after LapISR, including mucosa ischemia in 9 cases(12.3%), stricture in 7 cases (9.6%, 4 cases secondary to mucosa necrosis receiving anal dilation), grade A fistula in 3 cases (4.1%) receiving conservative treatment and necrosis in 1 case (1.4%) receiving permanent stoma. After a median follow up of 21(3 to 60) months, postoperative complications were recorded in 12 patients (16.4%) with 16 episodes, including anastomotic stenosis (8.2%), rectum segmental stricture (5.5%), ileus (2.7%), partial anastomotic dehiscence (1.4%), anastomotic fistula (1.4%), rectovaginal fistula (1.4%) and mucosal prolapse (1.4%). These patients received corresponding treatments, such as endoscopic transanal resection, anal dilation, enema, purgative, permanent stoma, etc. according to the lesions. Six patients (8.2%) required re-operation intervention due to postoperative complications.

CONCLUSIONAnastomosis-associated morbidity is the most common after LapISR in the treatment of low rectal cancer in perioperative and postoperative periods, which must be strictly managed with suitable methods.

Adult ; Aged ; Anal Canal ; surgery ; Anastomosis, Surgical ; adverse effects ; Blood Loss, Surgical ; statistics & numerical data ; Colectomy ; adverse effects ; Constriction, Pathologic ; etiology ; therapy ; Digestive System Surgical Procedures ; adverse effects ; Female ; Humans ; Ileostomy ; adverse effects ; Intestinal Mucosa ; pathology ; Ischemia ; etiology ; Laparoscopy ; adverse effects ; Lymph Node Excision ; statistics & numerical data ; Male ; Margins of Excision ; Middle Aged ; Necrosis ; etiology ; Operative Time ; Postoperative Complications ; etiology ; therapy ; Rectal Neoplasms ; complications ; surgery ; Rectovaginal Fistula ; etiology ; therapy ; Surgical Stomas ; Treatment Outcome

ObjectiveTo investigate the optimal ratio of goat horn replacing antelope horn in Fufang Lingjiao Jiangya pills and the blood pressure-lowering mechanism of this medicine. MethodsThe blood pressure-lowering efficacy of Fufang Lingjiao Jiangya pills with varying proportions of goat horn replacing antelope horn was evaluated on spontaneous hypertensive rats （SHR）. In this experiment， 50 SHR rats were randomly grouped as follows： model （n=8）， captopril （0.01 g·kg^-1） （n=6）， low-dose blank Fufang Lingjiao Jiangya pills （0.342 g·kg^-1） （n=6）， high-dose blank Fufang Lingjiao Jiangya pills （0.684 g·kg^-1） （n=6）， low-dose antelope horn-containing Fufang Lingjiao Jiangya pills （0.378 g·kg^-1） （n=6）， high-dose antelope horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1） （n=6）， low-dose goat horn-containing Fufang Lingjiao Jiangya pills （0.378 g·kg^-1） （n=6）， and high-dose goat horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1） （n=6）. Additionally， 8 WKY rats were used as the normal group. Drugs were administered by gavage for 4 weeks while an equal volume of distilled water was administered for the normal and model groups. Blood pressure was measured before administration， 3 h post administration， and biweekly thereafter. In the experiment for Fufang Lingjiao Jiangya pills with goat horn replacing antelope horn in different proportions， 48 SHR rats were randomly grouped as follows： model， blank Fufang Lingjiao Jiangya pills （0.684 g·kg^-1）， antelope horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1）， 2× goat horn-containing Fufang Lingjiao Jiangya pills （0.824 g·kg^-1）， 4× goat horn Fufang Lingjiao Jiangya pills （0.969 g·kg^-1）， and 6× goat horn Fufang Lingjiao Jiangya pills （1.112 g·kg^-1）. The normal group included 8 WKY rats， and the normal group and model group received an equal volume of distilled water. The treatment lasted for 2 weeks， and blood pressure was recorded at various time points （pre-administration， 3 h post administration， and on days 4， 7， 10， and 14 of administration）. Serum levels of angiotensin-converting enzyme （ACE）， angiotensin Ⅱ（Ang Ⅱ）， renin， and interleukin-6 （IL-6） were measured by enzyme-linked immunosorbent assay. Histopathological changes in the heart， kidney， and thoracic aorta were observed by hematoxylin-eosin staining. The protein levels of ACE2， angiotensin Ⅱ type 1 receptor （AT1R）， and angiotensinogen （AGT） in the kidney tissue were determined by Western blot， while the expression of nuclear factor （NF）-κB p65 and Toll-like receptor 4 （TLR4） in the thoracic aorta tissue was assessed by immunohistochemistry. ResultsCompared with the model group， all treatment groups showed lowered blood pressure （P<0.05， P<0.01）， and the 6× goat horn-containing Fufang Lingjiao Jiangya pills group showed consistent blood pressure-lowering effect with the antelope horn-containing Fufang Lingjiao Jiangya pills group. Compared with the normal group， the model group showed elevated serum levels of ACE， Ang Ⅱ， renin， and IL-6， while the elevations were declined in the Fufang Lingjiao Jiangya pills groups （P<0.05， P<0.01）. Pathological changes in the heart， kidney， and thoracic aorta were alleviated in all the treatment groups， with the 6× goat horn- and antelope horn-containing Fufang Lingjiao Jiangya pills groups exhibited the best effect. Western blot and immunohistochemistry results showed that all the treatment groups exhibited down-regulated protein levels of AT1R， AGT， NF-κB p65， and TLR4 and up-regulated protein levels of ACE2 （P<0.05， P<0.01） compared with model group， with the 6×goat horn- and antelope horn-containing Fufang Lingjiao Jiangya pills groups showcasing the best effect. ConclusionReplacing antelope horn with 6×goat horn in Fufang Lingjiao Jiangya pills can achieve consistent blood pressure-lowering effect with the original prescription. The prescription may exert the effect by inhibiting the renin-angiotensin-aldosterone system （RAAS） and TLR4/NF-κB signaling pathways.