BACKGROUND: Hyperbaric oxygen therapy has been considered as an effective therapy for prevention and cure of cerebral infarction traditionally.However, some scholars suggested that hyperbaric oxygen therapy could also result in cerebral infarction, although the mechanism is unclear.OBJECTIVE: To investigate the cause of cerebral infarction due to hyperbaric oxygen therapy.DESIGN: Case-control trial with patients as subjects.SETTING: Department of Hyperbaric Oxygen, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA.PARTICIPANTS: From December 1996 to March 1998, 192 inpatients receiving hyperbaric oxygen therapy were recruited into the trial from the Department of Hyperbaric Oxygen, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA. There were 127 males and 65 females aged 9-78 years. Patients admitted to the department of hyperbaric oxygen were eligible if they had hypoxia or ischemia induced disease and had no contraindication to hyperbaric oxygen therapy. Patients were recruited into the study regardless of the gender, and all patients and their family gave informed consent before enrollment. Patients were excluded if they did not receive hyperbaric oxygen therapy. According to the Diagnosis and Curing Criteria of Clinical Diseases, 6 patients developed into cerebral infarction during hyperbaric oxygen therapy, 3 males and 3 females, at the age of 51-76 years.METHODS: Patients were exposed to oxygen at 0.2 MPa in hyperbaric chamber used for many persons, and inhaled oxygen with a facemask once a day for 80 minutes with an interval of 10 minutes at the 40th minute. Ten days was considered as one course. Background and risk factors were analyzed in 6patients with cerebral infarction and 186 patients without cerebral infarction.MAIN OUTCOME MEASURES: Analysis of distribution of risk factors among cerebral infarction patients, and risk factor levels in patients without cerebral infarction.RESULTS: Among the 6 patients with cerebral infarction, hyperlipidemia was in all 6 cases, hypertension in 5 cases, primary cerebral infarction or hemorrhage in 5 cases, ≥ 60 years old or hyperviscosity in 4 cases, and diabetes mellitus in 1 case. Risk factor aggregation existed in the patients with over four risk factors. Of the 6 patients with cerebral infarction due to hyperbaric oxygen therapy, 5 cases had 4 risk factors and 1 had 5 risk factors. Of the 186 patients without cerebral infarction, 25 cases had 4 risk factors, and no case had 5 risk factors. The risk factor aggregation was relatively impossible (x2 = 54. 37, P ＜ 0. 05 ).CONCLUSION: Risk factor aggregation was found in all cerebral infarction patients, which is closely associated with the probability of cerebral infarction resulting from hyperbaric oxygen therapy.

Head and Neck Neoplasms ; surgery ; Humans ; Imaging, Three-Dimensional ; Reconstructive Surgical Procedures

Computer-Aided Design ; Head ; pathology ; surgery ; Humans ; Neck ; pathology ; surgery ; Printing, Three-Dimensional ; Reconstructive Surgical Procedures

Adenocarcinoma ; Carcinoma, Papillary ; Estrogens ; metabolism ; Humans ; Receptors, Estrogen ; metabolism ; Thyroid Neoplasms ; metabolism

Objective To compare the differences in recurrence rates and surgical complications between thyroidectomy alone and thyroidectomy combined with central neck dissection as initial treatments to differentiated thyroid cancer and evaluate the clinic significance of central neck dissection for these patients.Methods The literatures published in 1998-2013 were searched in Wanfang database,Chongqing VIP database,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,Pubmed,Medline and Beijing Kangjian foreign medical journal full text service.According to the inclusion and deletion criteria,30 articles were included.Of them 26 articles involved in complications,hypocalcemia and recurrent laryngeal nerve palsy as two major complications were involved in 26 articles and 24 articles respectively,and 26 articles involved in recurrence rate.RevMan5.0 software package was used to perform meta-analysis.Results Total complication rate in experimental group (plus central neck dissection) was 13.08％ higher than that in control group (thyroidectomy only),the odds ratio (OR) [95％ confidence interval (95％ CI)] was 2.32 [2.02,2.67],Z value was 11.80,P ＜ 0.01.Hypocalcemia in the experimental group was 11.80％ higher than that in control group,OR value [95％ CI] was 2.58[2.21,3.02],Z was 11.98,P ＜ 0.01.The rates of recurrent laryngeal nerve paralysis were low in both experimental group (5.26％) and control group(3.95％),and OR value [95％ CI] was 1.22 [0.94,1.58],Z was 1.48,P =0.14.Recurrence rate in experimental group was 2.23％ lower than that in control group,OR value [95％CI] was 0.78 [0.63,0.97],Zwas 2.35,P=0.03.Conclusion Central compartment dissection as initial treatment to differentiated thyroid cancer may reduce the risk of recurrence,but increases the incidence of total complications and hypocalcemia,and has no significant effect on the rate of the recurrent laryngeal nerve paralysis.

Objective To investigate the factors associated with oral infections in patients with oral cancer undergoing radiotherapy.Methods Clinical data of 241 patients with oral cancer undergoing radiotherapy between March 2012 and May 2014 in sichuan cancer hospital were reviewed.Univariate and multivariate analyses were performed to determine the factors related to oral infection occurring in the patients.SPSS 17.0 software was used to analyze the data.Results Ninety-three (38.59％) of 241 cases had oral infection.Among the 93 cases,49 (52.69％) cases presented with fungal infections,44 (47.31％) cases with bacterial infection,and 38 (40.86％) cases with mixed infection.Oral infection occurred since the fifth week after radiotherapy in 55 (59.14％) patients.Multivariate Logistic regression analysis showed that the risk factors for oral infection after radiotherapy were the late stage of cancer,poor oral health habits,the coexistence of multiple treatments,city dwellers and surgical history (all P ＜0.05).Conclusions Oral infections commonly occur in the late period of radiotherapy.The late stage of cancer,poor oral health habits,the coexistence of multiple treatments,city dwellers and surgical history are key risk factors for oral infection in patients with oral cancer undergoing radiotherapy.

Thyroid cancer is a common head and neck malignant tumor,it has become a malignant tumor of the highest incidence in young women in China.The treatment of thyroid cancer is a surgery-based comprehensive therapy,and the protection of the parathyroid gland during surgery has always been a major problem for clinicians.The methods for protection of parathyroid glands are in situ preservation or immediate parathyroid autotransplantation according to whether or not the blood supply can be maintained.To identify the parathyroid gland is the key issue of the protection during thryoidectomy.This article reviews the recent progress of the identification and protection of parathyroid glands at home and abroad.

Objective To analyze and summarize the perioperative care of double flap repair of free tissue for head and neck tumors patients with multiple sites defect. Methods From January 2014 to March 2017, 8 head and neck tumors patients with multiple sites defect who underwent the double flap repair of free tissue were selected as the research objected. We established the medical and nursing integrated management group care in perioperative period to care the patient including preoperative scientific and systematic evaluation, careful preoperative preparation, intraoperative cooperation and postoperative target nutrition management, fine management, special oral management, diverse tube nursing, individual nursing care, functional exercise and observation in disease. Results Through meticulous nursing management, 8 patients were successfully discharged from hospital. Conclusions Patients with multiple site defects in head and neck tumors are rare. The features of this kind of patient included high risk of surgery, serious traums, more complications, long time for healing. Targeted perioperative care is the key to successful recovery of patients.

The TNM staging system is an essential standard for cancer treatment and evaluation, and is used to assess a patient''s prog-nosis. Therefore, every update made to the system is of great significance. According to the recently released edition of the American Joint Committee on Cancer (AJCC) Staging Manual, several major changes to head and neck cancer staging have been made. In this pa-per, we analyze the advantages and disadvantages of these amendments and offer a direction for making future amendments. Our goal is to provide a brief introduction of recent research on head and neck cancers, which can be used as a reference by clinicians.