Bleomycin ; analogs & derivatives ; therapeutic use ; Humans ; Injections ; Larynx ; blood supply ; drug effects ; pathology ; Pharynx ; blood supply ; drug effects ; pathology ; Vascular Malformations ; drug therapy

OBJECTIVE: To provide anantomical basis for the endoscope-assisted partial superficial parotidectomy via retroauricular hairline approach (EASPRHA) and assess its feasibility and safety. METHOD: The surgical anatomy of retroauricular hairline region and parotid gland region were observed in 15 fresh human cadavers (30 halves). The EASPRHA was performed on 5 human cadavers (10 halves). After the procedure, the related vascular and neural structures were evaluated. RESULT: The retroauricular hairline region extends between superficial musculoaponeurotic system and superficial cervical fascia. On the superficial surface of the upper sternocleidomastoid lie the lesser occipital nerve, the great auricular nerve and the external jugular vein. The bifurcation of great auricular nerve is(22.85 ± 2.01) mm from the bottom of earlobe. The parotid gland region extends between parotidomassteric fascia and parotid gland parenchyma. The facial nerve emerging from the stylomastoid foramen runs across the superficial surface of base of styloid process, passes through the interspace between cartilage of external acoustic meatus and posterior belly of digastric muscle, and enters the parotid gland. The bifurcation of facial nerve trunk is (19.10 ± 3.10)mm from the mastoidale and (39.49 ± 5.78) mm from the mandibular angle. Above the posterior belly of digastric muscle, the posterior auricular artery arises from the posterior wall of the external carotid artery with its main stem running over the superficial surface of facial nerve trunk. In all endoscope-assisted operations, the partial superficial parotidectomy was successful without the need for an additional incision. No major neurovascular damage wasobserved. CONCLUSION A thorough knowledge of the surgical anatomy of retroauricular hairline region and parotid gland region is an essential requirement in performing the safe and feasible EASPRHA.
Cranial Nerves ; anatomy & histology ; Endoscopes ; Endoscopy ; methods ; Facial Nerve ; anatomy & histology ; Fascia ; Feasibility Studies ; Humans ; Male ; Neck Muscles ; anatomy & histology ; Parotid Gland ; anatomy & histology ; surgery

OBJECTIVE: To evaluate the modified rhytidectomy incision in superficial parotidectomy. METHOD: Thirty-five patients with superficial parotid tumor were included in this study. A modified rhytidectomy incision often used in facial plastic surgery was used for superficial parotidectomy and subtotal superficial parotidectomy with preservation of facial nerve and great auricular nerve. The follow-up study included the exposed region, the cosmetic effect of this approach and the rate of complication. RESULT: All patients healed without salivary fistula, and were satisfied with this modified approach. Temporary paralysis of the marginal mandibular branch of facial nerve were found in five patients, and six patients felt insensible around earlobe after operation. They all recovered in 1 to 3 months after surgery, no recurrence was happened during follow-up in 36 to 60 months (median follow-up period was 48 months). CONCLUSION The modified rhytidectomy incision provided good exposure, had less complication and better cosmetic outcome.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; surgery ; Rhytidoplasty ; methods ; Young Adult

OBJECTIVE: To assess the feasibility, risks and advantages of endoscope-assisted second branchial cleft cyst (SBCC) resection via the retroauricular hairline approach (RHA) by comparing with conventional trans cervical approach. METHOD: Using prospective clinical controlled study, in twenty five patients with SBCC, 13 cases underwent endoscope-assisted resection via the RHA, 12 cases underwent conventional transcervical approach resection. Preoperatively, the sizes, locations and adjacency of all lesions were evaluated by ultrasonography, CT or MRI. Pathologic diagnoses of all cases were identified as SBCC using fine needle aspiration biopsy. Two groups were compared at length of incision, operation time, bleeding, incision cosmetic result, complication etc. RESULT: All 25 operations were successfully performed. Length of incision and operation time in endoscopic group were significantly longer than that of the transcervical group (P < 0.05). After three months, the mean subjective satisfaction score of incision scar in the endoscopic group was significantly higher than that of transcervical group (P < 0.01). In endoscopic group, 1 cases (7.7%) with temporary numbness of earlobe and 1 case (7.7%) with a darkened color change of the flap margin at the incision angle were found postoperatively. However, they were recovered within 1 month. All the 25 patients were disease free with a follow-up from 18 to 36 months (median follow-up: 26 months). CONCLUSION Endoscope-assisted SBCC resection via RHA is feasible and safe for the treatment of SBCC. In comparison with the transcervical approach, this method can provide an invisible incision and better cosmetic re suits without significant complications.
Adolescent ; Adult ; Branchioma ; surgery ; Endoscopy ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Young Adult

Objective To investigate the image features of congenital pyriform sinus fistula (CPSF). Methods We retrospectively analyzed the clinical features and preoperative images of 80 patients with confirmed diagnosis of CPSF by surgical and pathological outcome in Guangdong general hospital from January 2007 to December 2014. At least one of the following imaging examinations were performed for all the patients, including Barium swallow X-ray (BSX), CT and MRI. Among them, 63 patients were examined with BSX, while 42 patients underwent plain and enhanced CT scans, wherein 40 of them were exanimated shortly after BSX. Thirty-two patients underwent plain and enhanced MRI scans. Patients were divided into two groups according to their age, young age group (≤14 years old) and older age group (>14 years old). Furthermore, they were also grouped based on inflammatory or quiescent stage clinically. The images of BSX, CT, and MRI from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ2 tests. Results For the patients examined with BSX, sinuses in 35 of 63 were depicted from pyriform and fistulas in 9 of 63 were depicted from the pyriform. The overall PDR of BSX was 74.6%(47/63),wherein 46.2%(12/26)in young age group , 94.6%(35/37)in older age group, 52.9%(9/17) in inflammatory stage group ,and 82.6%(38/46)in quiescent stage group. The inter-group differences were statistically significant (χ2 were 18.911 and 5.766,both P<0.05). The PDR of CPSF with CT was 85.7%(36/42), MRI was 84.4%(27/32), BSX+CT was 87.5%(35/40). The courses of fistula or sinus were showed on CT and MRI. The presence of air bubbles at the inferomedial edge of cricothyroid joints or around the upper lobe of the thyroid gland, the changes of the morphology of thyroid grand as well as the inflammatory change along the fistula region were detected much clearly on CT and MRI. There was no statistical difference between CT and MRI groups(P>0.05).Conclusions BSX could be a screening method for suspected cases of CPSF in quiescent stage. However, the PDR could be affected by many factors (age and inflammation). CT and MRI could provide valuable information for diagnosis. An examination combined BSX and CT is preferred to improve the positive detective rate of CPSF.

OBJECTIVE To study the relationship of the expression of PLOD2 protein in laryngeal carcinoma and the clinicopathological features of patients. METHODS The expression of PLOD2 in paraffin-embedded specimens of 114 patients with laryngeal carcinoma was detected by immunohistochemistry. The relationship between the expression of PLOD2 and clinicopathological features was analyzed by χ2 t est, s urvival a nalysis b y K aplan-Meier method, and multivariate analysis of Cox proportional hazard model. The fresh frozen specimens of 8 patients randomly selected from the patients were detected by realtime quantitative polymerase chain reaction and Western blotting for the expression of PLOD2 in tumor tissues and adjacent normal tissues. RESULTS PLOD2 protein was associated w ith c linical s tage a nd T s tage(P <0.05). The expression level of PLOD2 protein in laryngeal squamous cell carcinoma was higher than that in adjacent normal tissue(P <0.05). Kaplan-Meier survival analysis showed that low expression of PLOD2 was associated with patient survival rate(χ2=12.484, P <0.001). Multivariate Cox regression analysis showed that PLOD2 protein expression and M stage were independent risk factors for laryngeal cancer growth (P value, both <0.05). CONCLUSION The level of POLD2 protein expression was positively correlated with clinical stage and T stage. PLOD2 protein is an independent risk factor for the growth of laryngeal cancer. The higher the expression of PLOD2 protein, the lower the prognosis of patients. PLOD2 protein expression may play an important role in the growth and prognosis of laryngeal cancer, and may be a new molecular marker for judging the growth and prognosis of laryngeal cancer.

Objective:To evaluate the safety and feasibility of cancer tissue specimen delivery through a preventive ostomy incision during laparoscopic radical resection of rectal cancer .Methods:A total of 155 patients undergoing laparoscopic radical rectal cancer combined with prophylactic ileostomy at Peking University Third Hospital from Oct 2016 to Sep 2021 were retrospectively divided into two groups according to where the specimens were delivered through prophylactic colostomy incision (46 cases) or through newly made suprapubic incision (109 cases).Results:The by prophylactic colostomy incision delivery group had shorter surgery time [(243±66) min vs. (281±73) min, t=3.003, P<0.01] and shorter postoperative hospital stay [(7.5±2.2) d vs. (8.8±4.3）d， t=2.516， P<0.05], while there were no significant differences in intraoperative blood loss, intraoperative blood transfusion, postoperative first time of flatus, surgery-related complications and ostomy-related complications between the two groups (all P>0.05). Though the ostomy size in the prevention colostomy group was larger ( P<0.01), but there were no significant differences in the ostomy related complications between the two groups ( P>0.05). Conclusions:Laparoscopic radical resection of rectal cancer with specimen delivery through a preventive ostomy incision is of more aesthetic advantages without causing higher postoperative complications.

The nursing experience of intimal hyperplasia at buttonhole puncture site in a patient with autogenous arteriovenous fistula was reported.The key points of nursing:to formulate a scientific and reasonable internal fistula puncture plan,to establish and maintain the buttonhole tunnel,to regularly monitor the use of arteriovenous fistula,to replace the traditional internal fistula steel needle(hereinafter referred to as the steel needle)with the hemodialysis trocar needle(hereinafter referred to as the trocar needle)for buttonhole puncture,to treat with far infrared ray during each dialysis,and to guide the patient to apply hirudoid cream on the arm of the fistula side.After careful nursing,the intimal hyperplasia at the buttonhole puncture site disappeared,and there was no recurrence after 6 months of follow-up.

OBJECTIVE: To study the mRNA expression of muscle phenotype and collagen of soft palate and pathology in obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: We used the Real-time PCR to test the mRNA expression of soft palate muscle myosin heavy chain (MyHC) phenotype and collagen in 12 OSAHS patients and 8 control patients. We also distinguished the muscle isoforms I , II with ATPase staining, then counted the numbers of isoforms muscle fiber. RESULT: The mRNA expression of OSAHS group was more than control group in II A MyHC phenotype (P<0.01). The number of OSAHS group muscle fibre I isoform was less than control group with pH4. 3 ATPase staining (P<0.05). CONCLUSION Compare to control group, the enhancement happened in the mRNA expression of II A MyHC phenotype which can increase the velocity and power but de crease the enduring quality of muscle in OSAHS, and the reduce be in the I MyHC isoform of muscle fiber that can cause muscle velocity become slower and persistency become longer in OSAHS patients.
Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Muscle Fibers, Skeletal ; metabolism ; pathology ; Myosin Heavy Chains ; metabolism ; Palate, Soft ; metabolism ; pathology ; Phenotype ; Protein Isoforms ; metabolism ; RNA, Messenger ; genetics ; Sleep Apnea, Obstructive ; metabolism ; pathology

Objective:To explore the observation of the short-term recanalization rate and safety of acute thrombosis of arteriovenous fistula by dual-channel urokinase thrombolysis.Methods:A total of 52 dialysis patients with acute thrombosis of arteriovenous fistula in the Department of Nephrology, Shenzhen Hospital of Southern Medical University from January 2017 to January 2020 were selected. They were divided into control group and observation group by random number table. Twenty-seven cases in the test group used inflow arterial puncture and venous thrombosis, hereinafter referred to as dual channel, and bolus injection of urokinase for thrombolysis. Twenty-five cases in the control group were treated with tradi) ional peripheral intravenous bolus injection of urokinase for thrombolysis, and the recanalization time of internal fistula, adverse reactions and safety of thrombolysis were compared between the two groupsResults::The early (2 hours) reopening rate of the test group was 92.6% (25/27), which was higher than that of the control group by 44.0% (11/25) ( χ2 value was 14.389, P<0.05), which was statistically significant. The embolization site of the two groups of patients ( χ2 value was 2.989, P>0.05), the access situation of the two groups of patients ( χ2 value was 0.277, P>0.05), no statistical significance. There was no statistical significance in subcutaneous ecchymosis ( χ2 value was 0.088, P>0.05), bleeding at the puncture point ( χ2 value was 0.003, P>0.05), and puncture injury ( χ2 value was 0.944, P>0.05) in both groups. Conclusions:The double-channel urokinase thrombolysis method has the characteristics of high (2 hours) early recanalization rate, safe and effective in the treatment of acute arteriovenous fistula thrombosis.