This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Chronic myeloid leukemia (CML) is a clonal hematologic malignancy. In recent years, its treatment mainly involves the application of tyrosine kinase inhibitors (TKI) targeting the BCR::ABL fusion gene, but some patients still develop drug resistance or drug intolerance during TKI treatment and enter into the advanced stages (include accelerated phase and blast crisis phase). This article reviews the research progress of novel TKI drugs, TKI combined regimens and other targeted drugs for treatment of advanced stages of CML.

Objectives:To observe the exercise tolerance and cardiopulmonary function characteristics of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) combined with cardiovascular disease,in order to assess the cardiorespiratory reserve and health status of untreated OSAHS,and to provide a clinical evidence for the phase Ⅱ cardiac rehabilitation. Methods:This retrospective analysis included 134 cardiovascular disease patients who attended the Cardiac Rehabilitation Center of Fuwai Hospital,Chinese Academy of Medical Sciences from November 2021 to April 2024 and received home sleep apnea monitoring (HSAT).According to the apnea hypopnea index (AHI),the patients were divided into the non-OSAHS (AHI<5 times/h) group (n=24),the mild-OSAHS (5 times/h ≤AHI<15 times/h) group (n=65),and moderate-to-severe OSAHS (AHI ≥15 times/h) group (n=45),and the body composition,pulmonary function characteristics,exercise tolerance,and ventilatory response to exercise were compared among the three groups. Results:A total of 110 (82.1％) patients had comorbid OSAHS,with a higher proportion of male patients (80.0％).Height,weight,body mass index,lean body mass,skeletal muscle mass,body water content,and basal metabolic rate increased progressively with increasing OSAHS severity in three groups (all P<0.05),while cardiovascular disease comorbidity was similar.Static lung function,exercise tolerance and ventilatory function at maximal exercise were similar between the patients in the mild OSAHS group and the moderate-severe OSAHS group as compared to the non-OSAHS group (all P>0.05).With the increase in the severity of OSAHS,the cardiorespiratory fitness showed a decreasing trend among patients in the three groups,and the forced vital capacity and the maximum vital capacity of patients in the moderate-severe OSAHS group were significantly higher than that of the mild OSAHS group,while peak O2 pulse％pred was significantly lower than that of the mild OSAHS group (all P<0.05).Multivariate analysis showed that the body fat mass (β=0.307,95％CI:0.263-0.823,P<0.001),minute ventilation at rest (β=0.259,95％CI:0.429-1.785,P=0.002) were the independent influencing factors of AHI. Conclusions:The prevalence of OSAHS is high in patients with cardiovascular disease,and patients with moderate-to-severe OSAHS have reduced cardiorespiratory fitness,OSAHS is not associated with additional cardiac impairment and ventilatory function impairment in patients with cardiovascular disease.Weight loss should be the primary rehabilitation goal in patients with OSAHS combined with cardiovascular disease.

Objective:To investigate the value of 18F-FDG PET/CT combined with conventional imaging modalities in the evaluation of the depth of tumor invasion, regional lymph node metastasis, distant organ and lymph node metastasis (TNM staging), and the adjacent structure invasion of rectal cancer. Methods:Fifty-four patients (28 males, 26 females, age (65.8±11.0) years) with pathologically confirmed rectal cancer admitted to the Affiliated Qingdao Central Hospital of Qingdao University between September 2019 and June 2021 were retrospectively analyzed. 18F-FDG PET/CT examination, conventional imaging modalities including high-resolution MRI (HR-MRI), chest CT plain scan, upper abdominal MRI or CT plain scan+ enhanced examination were performed within 2 weeks before or after the rectal cancer being confirmed. The TNM staging and adjacent structural invasions including circumferential resection margin (CRM), extramural vascular invasion (EMVI), anal sphincter complex involvement were evaluated by 18F-FDG PET/CT and conventional imaging modalities separately or in combination, and those results based on imaging were compared with the pathological results or clinical follow-up results. χ2 test was used to compare the differences of diagnostic sensitivity, specificity and accuracy between the 18F-FDG PET/CT or conventional imaging modalities and combined examination. Results:The accuracy for T staging and the sensitivity and accuracy for N staging of the combined examination were 96.30%(52/54), 98.65%(73/74) and 93.91%(185/197), respectively, which were significantly higher than those of 18F-FDG PET/CT (85.19%(46/54), 66.22%(49/74), 81.73%(161/197); χ2 values: 3.97, 26.88, 13.66, all P<0.05). The specificity (91.06%, 112/123) and accuracy of the combined examination for N staging were higher than those of the conventional imaging modalities (77.24%(95/123), 83.76%(165/197); χ2 values: 8.81, 10.23, both P<0.05). The sensitivity and accuracy of the combined examination for M staging were higher than those of the conventional imaging modalities (97.01%(65/67) vs 73.13%(49/67), 95.95%(71/74) vs 68.92%(51/74); χ2 values: 15.05, 18.66, both P<0.001). The sensitivities of the combined examination in evaluating CRM and EMVI were 100%(22/22) and 95.00%(19/20), and the accuracies were 98.15%(53/54) and 96.30%(52/54), all of which were higher than those of 18F-FDG PET/CT (CRM: 54.55%(12/22), 74.07%(40/54); EVMI: 30.00%(6/20), 74.07%(40/54); χ2 values: 12.94, 13.08, 18.03, 10.56, all P<0.01). The accuracy of the combined examination in evaluating EMVI was higher than that of the conventional imaging modalities (85.19%(46/54); χ2=3.97, P=0.046). Conclusion:18F-FDG PET/CT combined with conventional imaging modalities can improve the diagnostic efficacy for TNM staging and assessment of adjacent structural invasion in rectal cancer.

The rational use of medical consumables in clinical practice is of great significance for improving medical quality and controlling medical costs. In June 2023, a tertiary hospital established a management organization system, formulated a list of key monitored medical consumables, built supporting information system and database, and established a warning mechanism, to explore the rationality evaluation path for clinical use of medical consumables through in-depth analysis of the entire hospital-department-disease-surgical procedure. This evaluation path achieved good results. Taking absorbable hemostatic gauze as an example, through implementing this evaluation path, problems with the clinical use of this consumable were promptly identified, and targeted improvements were made. After rectification, the number of absorbable hemostatic gauze used in the third quarter of 2023 (209.0 pieces) had decreased compared to the second quarter of the same year (254.0 pieces), and clinical use was more reasonable and standardized. This evaluation path achieved refined control over key monitored medical consumables, which could provide references for other hospitals to carry out the management of clinical rational use of medical consumables.

Objective:To explore the relevance of a new comprehensive respiratory mechanics parameter, elastic power, to the 28-day prognosis of ARDS patients.Methods:Patients with ARDS hospitalized for at least 48 h with invasive mechanical ventilation in five intensive care units in three local hospitals in Lianyungang City from June 2018 to June 2022 were included in the study. Their baseline data and respiratory mechanics parameters were collected. Elastic power, mechanical power, driving pressure and lung compliance are calculated according to the corresponding formulae. The prognostic risk factors of ARDS patients were analysed using COX multi-factor regression, and the predictive value of EP/Cst on the 28-day prognosis of ARDS patients was evaluated based on ROC curve analysis and Kaplan-Meier survival curve.Results:There was no significantly difference in tidal volume and PEEP settings between the patients in the ARDS survivor and death groups ( P> 0.05). However, the differences in respiratory rate, plateau pressure, driving pressure, lung compliance, mechanical work, elastic work, EP/cst and MP/cst between the two groups were significantly different (all P< 0.01). Multifactorial COX regression analysis showed that EP/cst ( HR=1.211, 95% CI:1.091-1.323) and RR ( HR=1.209, 95% CI:1.046-1.339) were strongly associated with a more severe degree of illness and a worse prognosis in ARDS. And the cumulative survival rate at 28 d was significantly lower in the high Cst-EP group than in the low Cst-EP group (50.00% vs. 82.40%, P < 0.01). Conclusions:The new respiratory mechanics parameters EP and EP/Cst can assess the severity of ARDS with a good predictive effect on patient prognosis at 28 days.

Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.

Objective:To evaluate the heart hemodynamics in fetuses with premature ductus arteriosus constriction or closure using fetal heart quantification (FHQ).Methods:The clinical data of 50 singleton fetuses with ductus arteriosus constriction ( n=35) or ductus arteriosus closure ( n=15) who underwent echocardiography in Department of Ultrasound, Beijing Anzhen Hospital were retrospectively analyzed, from May 2013 to January 2020. Fifty healthy singleton fetuses were randomly selected as the control group. The ductus arteriosus diameter (DA), pulsatility index (PI), diameter of the left atrium(LA) and right atrium(RA), diameter of the left ventricle (LV) and right ventricle (RV), tricuspid regurgitation/right atrium area ratio (TR/RA Ratio), pressure gradient of tricuspid regurgitation (PG of TR), and heart/chest ratio were measured using conventional fetal echocardiography; the correlations among the parameters were analyzed. Speckle-tracking analysis was used to analysis and compute the LV and RV global spherical index (GSI), fractional area change (FAC) and global strain (GS), the LV ejection fraction(EF) and stroke volume (SV). These variables and their correlations were compared and analyzed. Results:Compared with the control group, the GS and FAC of the LV and RV in the ductus arteriosus constriction or closure groups were lower ( P<0.05) while the LV-SV was higher ( P<0.05). The FAC, GS, and EF values of the LV were higher in the premature ductus arteriosus closure group than in the ductus arteriosus constriction group ( P<0.05), while the RV-FAC was lower ( P<0.05), the RV-GS and LV-SV showed no significant changes ( P>0.05). Correlation analyse showed that the PI was positively correlated with DA( r=0.364, P<0.05); the PG of TR was negatively correlated with DA( r=-0.414, P<0.05); the TR/RA Ratio was negatively linearly correlated with PI( r=-0.388, P<0.05), and positively correlated with RV/LV Ratio ( r=0.369, P<0.05); the other parameters were not significantly correlated with the DA or PI ( P>0.05). Conclusions:Fetal heart hemodynamics in the premature ductus arteriosus constriction or closure groups change significantly, FHQ can provide valuable information for the evaluation of the fetal heart with ductus arteriosus constriction or closure.

OBJECTIVE：To optim ize ethanol extraction technology of Mongolian medicine Naru- 3. METHODS ：The L 9（34） orthogonal design was used to optimize ethanol extraction technology of Mongolian medicine Naru- 3 with solid-liquid ratio ，ethanol volume fraction and extraction time as factors ，using comprehensive scores for the contents of benzoylaconitine ，benzoylneoaconitine， benzoylhypoaconitine，aconitine，neoaconitine，hypoaconitine，piperine and gallic acid as indexes. RESULTS ：The optimal ethanol extraction technology was that solid-liquid ratio of 1∶10（g/mL），ethanol volume fraction of 75％，extracting for 1.5 h. After 3 times of validation tests ，average contents of above 8 components in ethanol extract from Naru- 3 were 1.69，1.48，14.69，0.28， 0.05，0.08，26.01，17.33 mg/g（RSDs were 0-4.96％，n＝3），respectively. Average comprehensive score was 19.03（RSD＝1.42％， n＝3）. CONCLUSIONS ：The optimal ethanol extraction technology of Mongolian medicine Naru- 3 is stable and feasible.

Objective:To establish a method for rapid determination of iodine in whole blood by direct alkali dilution inductively coupled plasma mass spectrometry (ICP-MS).Methods:Totally 0.50 ml whole blood sample was collected, and 2% ammonia and 0.01% Triton X-100 solution were added to constitute a total volume of 10.0 ml. After shaking to uniformity, 1.0 μg/ml rhodium and 20% isopropanol were used as on-line internal standard solution. The flow ratio of internal standard solution to the solution to be measured was 1∶16. The sample was quantitatively determined by ICP-MS. The linear range, limit of detection (LOD), accuracy and precision of the method were evaluated.Results:Iodine in whole blood could be determined and had a good linear relationship within the range of 0-200 μg/L, with correlation coefficient ( r) > 0.999. The LOD of the method was 0.1 μg/L, the limit of quantitation (LOQ) was 0.3 μg/L, the recovery rate of iodine in whole blood was 88.5%-106.1%, and the relative standard deviation was 2.2%-4.7% ( n=7). Conclusions:A method for rapid determination of iodine in whole blood by direct alkali dilution ICP-MS is successfully established. This method is accurate, simple, rapid, and highly automatic, and it can be widely applied in determination of iodine in whole blood.