We reported a case of children's OSAHS caused by the huge fibrolipoma in pharynx nasalis. The patient was a 10-years-old child who went to the hospital with the chief complaint of "Snoring and mouth breathing during sleep for 10 years". Imaging tests found one huge tumor in pharynx nasalis before the operation. The tumor was resected totally. The postoperative pathological diagnosis was fibrolipoma. No recurrence was noted during the follow-up visit one year postoperatively. The clinical features, diagnosis, treatment, pathology and prognosis were reviewed herein.
Child ; Humans ; Lipoma ; complications ; surgery ; Neoplasm Recurrence, Local ; Pharynx ; pathology ; Prognosis ; Sleep Apnea, Obstructive ; etiology ; Snoring

Objective To explore the clinical application of digital chair?side immediate all?ceramic restoration system,design and fabricate inlays and onlays to restore the large?defected molars,and to analyze and evaluate the efficacy of this clinical restoration. Methods Totally 84 inlays and 65 onlays were fabricated with IPS e.max CAD series ceramic blocks by using Cerec AC system to conduct immediate all?ceramic restorations of 149 teeth for 108 patients. The inlays and onlays were applied and cemented to the prepared teeth with dual?cured resin luting agent. The restored molars were re?examined by two dentists after six months. The analysis standard was based on the United States Public Health Service(USPHS criteria) and the results were statistically analyzed(α=0.05). Results There was no statistically significant difference in the case numbers of grade A and grade B for each index comparing the immediate condition to the condition after 6 months. Over 90 percent of ceramic inlays and onlays were quali?fied to be grade A. The restorations were well in the aspects of anatomic morphology,marginal integrity,color match,marginal discoloration,reten?tion,gingival health and secondary caries. Conclusion Computer aided design/computer aided manufacture(CAD/CAM)system combined with machinable glass ceramics can achieve a favorable result in restoration of large?defected teeth. Digital chair?side immediate all?ceramic restoration technique is an ideal solution for large?defected tooth restoration.

Retinopathy of prematurity (ROP) as a leading cause of blindness in children in both developed and developing countries, is a type of proliferative retinopathy that occurs in preterm and low birth mass infants.Early treatment can effectively save the visual function of the children.With the continuous study of the pathogenesis of ROP, the treatment is constantly changing.Due to its feasibility and complications, cryotherapy is not the priority.Laser therapy is still the golden standard, while there are inevitable complications.The efficacy of anti-vascular endothelial growth factor (VEGF) drugs among the numerous factors related to ROP is a satisfactory.Nowdays, the selection of drugs and the optimal injection dose are the key points.Meanwhile, the occurrence of systemic adverse events remains urgent.ROP pathogenesis, the advantages and disadvantages of several treatment methods were briefly described and summarized to providing references for the ROP treatment.

Objective To assess the feasibility and curative effects of laser surgery in treatment of early-stage glottic carcinoma under self-retaining laryngoscope with nasal endoscopic assistance.Methods Thirteen cases of glottic carcinoma(TisN0M0:2 cases;T1aN0M0:7 cases;T1bN0M0:3 cases;T2N0M0:1 case) extirpated with Nd:YAG laser or Diomed laser from June 1999 to March 2003 were retrospectively analyzed.Because of the poor glottic exposure with self-retaining laryngoscope under general anesthesia,various angular nasal endoscopes were used.The tumor was distinctly displayed on monitor screen with nasal endoscopic assistance and were completely removed through vapourization or removed with Nd:YAG laser or Diomed laser.Results The follow-up period was three to five years.Two patients were found to have local recurrence.One patient received treatment with Nd:YAG laser surgery under electronic laryngoscope with local and superfacial anesthesia,and the patient was followed up for three years without showing recurrence.The other patient underwent vertical hemilaryngectomy and was followed up for three and half years without showing recurrence.All 13 cases were followed up for three years,and all of them were alive.Three-year survival rate was 100%(13/13).When they were followed up for five years,one patient lost track(counted as death),therefore the five-year survival rate was 92.3%(12/13).Conclusions With the assistance of various angular nasal endoscope,the glottic tumors can be exposed distinctly under self-retaining laryngoscope and removed completely.Nd:YAG laser or Diomed laser is an effective and safe procedure with minimal invasion for the treatment of early-stage glottic carcinoma.The advantages of this technique include lower complication rate and high rate of preservation of laryngeal functions,avoidance of tracheotomy and the sequela of laryngeal fissure.

Objective:To summarize the characteristics of genetic variation and prenatal diagnosis in pedigrees with X-linked adrenoleukodystrophy (X-ALD) and elucidate the value of prenatal diagnosis in preventing the birth of children with X-ALD.Methods:Twenty pedigrees, clinically diagnosed with X-ALD in Peking University First Hospital from November 2012 and March 2019, were included in this retrospective study. Genomic DNA was extracted from peripheral blood and amniotic fluid or chorionic villi samples of probands and their families for detecting variants in ATP-binding cassette subfamily D member 1 ( ABCD1) gene using polymerase chain reaction (PCR)-Sanger sequencing. Linkage analysis was also performed on five microsatellite markers near ABCD1 gene to exclude maternal contamination. Characteristics of ABCD1 gene variants and prenatal diagnosis of X-ALD pedigrees were summarized by descriptive statistics. Results:Twenty ABCD1 gene variants were identified in the 20 pedigrees. The variants in three probands that were not detected by next-generation sequencing were identified by PCR-Sanger sequencing. Among the mothers of the 20 probands, 17 carried ABCD1 variants and three did not. We performed 24 prenatal diagnoses on 20 pregnancies (24 fetuses) and identified eight fetuses with variants who were finally terminated. The 16 cases without variants were born alive. The validation results obtained after termination or delivery were consistent with those performed prenatally. Conclusions:No hotspot variants in ABCD1 gene are detected in these X-ALD patients and most variants are maternally inherited. PCR-Sanger sequencing is an effective method for detecting ABCD1 variants. Prenatal diagnosis for mothers who had a body with X-ALD could prevent another one from birth.

Objective To summarize the experience and technique of complex transradial percutaneous coronary intervention ( PCI) using a 4F KIWAMI ST01 catheter with Mother-Child technique for patients with coronary heart disease. Methods Retrospectively analyzed the data from 30 patients who had received PCI using a 4 F catheter with Mother-Child method. Results PCI were performed on a total of 30 patients with complex lesions. Angiographic success was achieved in 100% of lesions. 19 patients were found to have moderate-to-severe calcified lesions, 13 patients had chronic total occlusion ( CTO ) , 11 patients had moderate-to-severe tortuous lesions, and 6 patients had moderate-to-severe angulated lesions. Four patients suffered from in-stent restenosis. 4 F catheter with Mother-Child method was used in all patients, and all 4F catheters successfully passed through the target lesions with all stents implanted in place along the 4 F catheter. There were no 4 F catheter-related complications in all patients. Conclusions Use of 4F catheter with Mother-Child method is safe and effective for patients where stent delivery is difficult by the conventional method.

Objective:To investigate the cleaning status of silicone oil attached ophthalmic surgical instruments in China, so as to provide reference and suggestions for the standard cleaning process of silicone oil attached ophthalmic surgical instruments.Methods:61 hospitals in 22 provinces (regions, municipality) in China were selected as the objects of investigation. The on-site treatment, pretreatment and routine cleaning of silicone oil attached ophthalmic surgical instruments were investigated by questionnaire from November 2019 to January 2020.Results:18.033% (11/61) hospitals had mixed silicone oil attached ophthalmic surgical instruments and other instruments intraoperatively, 11.475% (7/61) hospitals didn′t wipe silicone oil and other visible contaminants postoperatively. 18.033% (11/61) hospitals didn′t carry out pretreatment and 4.000% (2/50) hospitals used saline as pretreatment solution; 54.098% (33/61) hospitals were involved in ultrasonic cleaning. 32.787% (20/61) hospitals had water temperature 31-37 ℃ and 4.918% (3/61) hospitals had water temperature>37 ℃during the cleaning process; During pretreatment and routine cleaning, 38.000% (19/50) hospitals and 54.902% (28/51) hospitals selected enzymatic detergent respectively, the contact time between instruments and detergent in specialized hospital was more standardized than that in general hospital ( P<0.001); In flushing, rinsing and final rinsing, there were 29.412% (15/51) hospitals, 11.765% (6/51) hospitals and 3.922% (2/51) hospitals used water that didn′t meet the requirements. 17.647% (9/51) hospitals, 13.725% (7/51) hospitals and 13.725% (7/51) hospitals didn′t record the time of flushing, rinsing and final rinsing. Conclusions:There are still some problems in the cleaning of silicone oil attached ophthalmic surgical instruments in specialized and general hospitals, such as no on-site treatment and pretreatment, improper control of cleaning parameters, and difficulty in ensuring water quality and water time. It is necessary to formulate the cleaning process specification of silicone oil attached ophthalmic surgical instruments as soon as possible to ensure the cleaning quality and avoid the occurrence of postoperative eye complications.

OBJECTIVETo analyze the characteristics of germline mutations of adenomatous polyposis coli (APC) gene in pedigrees affected with familial adenomatous polyposis (FAP).

METHODSGenomic DNA was extracted from peripheral blood samples from members of the 13 FAP pedigrees. Multiplex ligation-dependent probe amplification (MLPA) was used to detect large fragment deletions of the APC gene. Subsequently, potential mutation was screened from all exons of the APC gene with PCR amplification and direct sequencing.

RESULTSGermline mutations have been identified in 5 FAP pedigrees, which included c.3184_3187delCAAA, c.5432C>T, c.3925_3928delAAAA and c.3925_3929del AAAAG(in two pedigrees). Small deletional mutations were found primarily in the area of AAAAG tandem repeat sequences.

CONCLUSIONC.3925_3929 located in AAAAG tandem repeats is probably the hot spot for APC gene mutations, which are mostly deletional mutations, especially the 5 bp base deletion at codon 1309.

Adenomatous Polyposis Coli ; genetics ; Adenomatous Polyposis Coli Protein ; genetics ; Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Female ; Humans ; Male ; Molecular Sequence Data ; Pedigree ; Sequence Deletion

Objective:To investigate the risk factors for early complications after laparoscopy-assisted gastrectomy in patients with gastric cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 196 patients who underwent laparos-copy-assisted radical gastrectomy at Peking Union Medical College Hospital from March 2016 to March 2019 were collected. There were 144 males and 52 females, aged (61±10)years. Observation indicators: (1) early complications after laparoscopy-assisted radical gastrectomy and treatment; (2) analysis of risk factors for early complications after laparoscopy-assisted radical gastrectomy.Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( P25,P75). Count data were represented as absolute numbers. Univariate analysis was conducted using the t test, Mann-Whitney U test or chi-square test. Multivariate analysis was conducted using the Logistic regressional model. Results:(1) Early complications after laparoscopy-assisted radical gastrectomy and treatment: 51 of 196 patients had early postoperative complications, including 7 cases of grade Ⅰ according to Clavien-Dindo classi-fication system, 32 cases of grade Ⅱ, 9 cases of grade Ⅲa, 3 cases of grade Ⅲb. There was no grade Ⅳ or Ⅴ complication. There were 25 cases with abdominal complications, 7 cases with thoracic complications, 3 cases with internal/catheter related complications and 16 cases with other unclassified complications. All patients with complications were improved after symptomatic and supportive treatments. (2) Analysis of risk factors for early complications after laparoscopy-assisted radical gastrectomy: results of univariate analysis showed that the lymphocyte count, neutrophil-to-lymphocyte ratio, radiotherapy, operation time, volume of intraoperative blood loss, T stage, lymph node metastasis were related factors for early complications after laparoscopy-assisted radical gastrectomy in patients with gastric cancer ( Z=?2.048, χ2=6.385, 4.168, 8.068, 6.336, 12.497, 7.522, P<0.05). Results of multivariate analysis showed that the neutrophil/lymphocyte ratio ≥1.96, operation time ≥222 minutes, and lymph node metastasis were independent risk factors for early complica-tions after laparoscopy-assisted radical gastrectomy in patients with gastric cancer ( odds ratio=2.279, 2.245, 2.226, 95% confidence interval as 1.149-4.519, 1.116-4.517, 1.125-4.402, P<0.05). Conclusions:The abdominal complications are the most common early complications after laparoscopy-assisted radical gastrectomy. The neutrophil-to-lymphocyte ratio ≥1.96, operation time ≥222 minutes, and lymph node metastasis are independent risk factors for early complications after laparoscopy-assisted radical gastrectomy in patients with gastric cancer.

Background In the process of greenhouse working, labor intensity is high and repetitive work involves multiple body parts such as limbs, neck, upper back, and lower back. The prevalence and comorbidity of work-related musculoskeletal disorders (WMSDs) in greenhouse workers are worthy of attention. Objective This study is conducted to investigate the prevalence and comorbidity, as well as potential influencing factors of WMSDs in greenhouse workers. Methods A total of 722 greenhouse workers were selected as the subjects for a cross-sectional epidemiological survey. Through questionnaire survey and physical examination, basic information of the subjects and the prevalence of WMSDs were collected. The participants were divided into low, medium, and high cumulative exposure groups by cumulative exposure index matrix. Chi-square test was used to analyze the difference of prevalence among different cumulative exposure levels, the correlation between the prevalence of WMSDs in paired sites was calculated as prevalence ratio (PR) by using the log-binomial model, the prevalence of multi-site WMSDs in each group was compared by Wilcoxon rank sum test, and the influencing factors of multi-site WMSDs were evaluated by multi-classification logistic regression model. Results The prevalence rate of WMSDs in the greenhouse workers was 78.7% (568/722). The main affected sites of body were lower back, legs, neck, and shoulders, and associated prevalence rates were 47.6%, 46.0%, 27.1%, and 23.8%, respectively. By constructing a cumulative exposure index matrix, the low, medium, and high cumulative exposure groups contained 121, 196, and 405 workers respectively. The prevalence rates of WMSDs in lower back, legs, or shoulders were significantly different among groups with different exposure levels (P<0.05), and the prevalence rates increased with higher cumulative exposure levels (lower back, \begin{document}${χ} _{{{\rm{trend}}}} ^2$\end{document}=11.144, P<0.05; legs, \begin{document}${χ} _{{{\rm{trend}}}} ^2$\end{document}=6.767, P<0.05; shoulders, \begin{document}${χ} _{{{\rm{trend}}}} ^2$\end{document}=15.666, P<0.05). The results of log-binomial model found that lower back and legs (PR values were 1.57 and 1.43, respectively) as well as neck and shoulders (PR values were 2.00 and 2.07, respectively) among the main affected parts have a strong association with comorbidities. The prevalence of multi-site WMSDs showed that 50.4% of the workers had comorbidity of two or more sites of WMSDs. The results of multi-classification logistic regression analysis indicated that the influencing factors of WMSDs in two sites involved high-level cumulative exposure (OR=2.41, 95%CI: 1.34-4.33) and female (OR=3.27, 95%CI: 2.07-5.16); the influencing factors of WMSDs in three or more sites also included medium-level cumulative exposure (OR=3.78, 95%CI: 1.70-8.39), high-level cumulative exposure (OR=7.34, 95%CI: 3.41-15.80), and female (OR=5.66, 95%CI: 3.48-9.22). Conclusion In this study, the prevalence rates of WMSDs in lower back, legs, neck, and shoulders are high among selected solar greenhouse workers, and WMSDs comorbidity of lower back-legs and neck-shoulders are identified. Greenhouse workers with high cumulative exposure level and female workers report more WMSDs comorbidities in two or more sites.