A young male patient presented with a rapidly growing mass on the left ear. Histopathologic and immunohistochemical findings were consistent with nodular fasciitis. The disease is rare in the ear, without obvious clinical features. The diagnosis mainly relies on the postoperative pathological findings.
Adult ; Ear, External ; pathology ; Fasciitis ; Humans ; Male

Objective:To explore the feasibility and clinical efficacy of stratified suture of lateral pharyngeal wall(SSLPW) combined with soft palate radiofrequency coblation in the treatment of the patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:The clinical data of 21 severe OSAHS patients underwent lateral pharyngoplasty(LP) combined with soft palate radiofrequency coblation (LP group) and 39 severe OSAHS patients underwent SSLPW combined with soft palate radiofrequency coblation (SSLPW group) were selected.The apnea hypopnea index(AHI),lowest SaO2(LSaO2),Epworth sleepiness scale(ESS) scores,and related postoperative complications of the patients in two groups were analyzed before and after operation.The successful rates of operation of the patients in two were compared.Results:In LP group,1 patient was cured (5%),19 patients were improved markedly (90%),1 patient was effective (5%),and no patient was invalid;the successful rate was 95.2%(20/21).In SSLPW group,2 patients were cured (5.1%),33 patients were improved markedly (84.6%),4 patients were effective (10.3%),and no patients was invalid;the successful rate was 89.7%(35/39);there was no statistical difference in the successful rate of operation of the patients between two groups (P>0.05).There was statistically significant improvement of the subjective symptoms.All the patients returned to normal subjective swallowing functions without nasal pharyngeal reflux and dysphagia in one month follow-up after operation.Compared with before operation,the AHI and ESS scores of the patients in two groups after operation were decreased(P<0.05);the LSaO2 scores were increased(P<0.05).Conclusion:The AHI,LSaO2 and ESS scores are significantly improved in the OSAHS patients after treated with SSLPW combined with soft palate radiofrequency coblation.The method is a valid option for the severe OSAHS patients.

Objective To observe the clinical efficacy of moxibustion in treating perimenopausal syndrome (PMS).Method Totally 108 PMS patients of yang deficiency or yin deficiency constitution were randomized into a treatment group of 56 cases and a control group of 52 cases. The treatment group was intervened by moxibustion, while the control group was by medication. The modified Kupperman Index (KI), Hamilton Anxiety Scale (HAMA), Symptom Checklist-90 (SCL-90), and Self-rating Depression Scale (SDS) were observed before and after treatment for comparison.Result The KI score, HAMA score, SCL-90 total score, and SDS score were significantly changed in both groups after intervention (P<0.01,P<0.05). After treatment, the KI score, HAMA score, SCL-90 total score, and SDS score in the treatment group were significantly different from that in the control group (P<0.01,P<0.05).Conclusion Moxibustion is effective in treating PMS, and it can improve the anxiety and depression symptoms of the patients.

Objective:To investigate the application effects of non-invasive ultrasound cardiac output monitoring (USCOM) in fluid resuscitation guidance and hemodynamic evaluation of patients with sepsis.Methods:A total of 80 patients with sepsis who were treated in The Second Hospital of Jiaxing from January 2021 to December 2022 were included in this single-blind randomized controlled study. These patients were randomly divided into a control group ( n = 40) and an observation group ( n = 40). In the control group, continuous cardiac output indicated by pulse waveform monitoring was used to guide fluid resuscitation and monitor hemodynamic status, while in the observation group, USCOM was used to guide fluid resuscitation and monitor hemodynamic status. The fluid intake and outflow at 24, 48, and 72 hours after admission to the ICU were compared between the two groups. The changes in arterial blood lactate and oxygenation index at 1, 2, 3, 5, and 7 days after admission to the ICU were compared between the two groups. The time of admission to ICU, the length of ICU stay, and changes in hemodynamic indicators were compared between the two groups. The incidence of death within 28 days after admission to the ICU was compared between the two groups. Results:The liquid intake and output in the observation group at 24, 48 , and 72 hours after admission to the ICU were (4 178.13 ± 327.19) mL, (7 763.63 ± 324.08) mL, and (10 501.38 ± 376.74) mL, respectively, which were significantly lower than (4 527.35 ± 276.84) mL, (8 778.15 ± 361.42) mL, and (11 589.12 ± 413.27) mL in the control group ( t = 5.15, 13.22, 12.30, all P < 0.001). The arterial blood lactate levels in the observation group were significantly lower than those in the control group at 1, 2, 3, 5, and 7 days ( t = 5.73, 6.73, 9.98, 12.25, 14.47, all P < 0.001). There was no significant difference in oxygenation index between the two groups on the 1 st day ( P > 0.05). The oxygenation index in the observation group at 2, 3, 5 and 7 days was significantly higher than that in the control group ( t = -4.31, -8.19, -5.28, -9.44, all P < 0.05). The time of admission to ICU and the length of ICU stay in the observation group were (10.15 ± 2.43) days and (16.51 ± 1.36) days, respectively, which were significantly shorter than (12.75 ± 2.87) days and (17.68 ± 1.59) days in the control group ( t = 4.37, 3.54, both P < 0.05). After 24 hours of resuscitation, cardiac output, stroke output, and cardiac index in the observation group were (5.89 ± 0.51) L/min, (57.71 ± 3.82) mL, and (3.31 ± 0.35) L·min -1·m -2, respectively, which were significantly higher than (5.30 ± 0.37) L/min, (50.06 ± 3.25) mL, and (2.85 ± 0.34) L·min -1·m -2 in the control group ( t = -5.92, -9.65, -5.96, all P < 0.001). There was no significant difference in the 28-day mortality rate between the two groups ( P > 0.05). Conclusion:The guidance of USCOM on fluid resuscitation and hemodynamic status assessment in sepsis patients has an obvious effect, which can promote the improvement of patient oxygenation index, and shorten the time of admission to the ICU and the length of hospital stay.

Objective : To investigate the mechanism of sertoli/spermatogenic injury induced by cigarette smoke extract(CSE) based on ROS/NLRP3 signaling pathway. Methods : The sertoli/spermatogenic of rat were cultured in vitro , and they were divided into control group , cigarette Smoke extract (CSE) group and CSE + NLRP3 inflammosome inhibitor MCC950 group. Cell viability was detected by CCK⁃8 assay; Lactate dehydrogenase ( LDH) was used to detect cell membrane damage ; reactive oxygen species ( ROS) production was used to detect oxidative stress level ; Hoechst/PI fluorescent staining was used to detect cell pyroptosis. Real⁃time quantitative PCR ( RT⁃qPCR) was used to determine the mRNA level of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18. Western blot was used to determine the protein level of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18. Results: CCK⁃8 assay showed that cell viability decreased in CSE group (P < 0. 001) , LDH leakage rate (P < 0. 001) and ROS (P < 0. 001) production increased. Compared to the CSE group , cell viability increased (P < 0. 001) , LDH leakage rate (P < 0. 01) and ROS (P < 0. 001) production decreased in CSE + MCC950 group. The number of PI staining cells in CSE group was more than that in control group and CSE + MCC950 group , but staining cells in CSE + MCC950 group was less than that in CSE group. RT⁃qPCR and Western blot results showed that the expression levels of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18 increased in CSE group but decreased in CSE+ MCC950 group. Conclusion The oxidative stress and inflammation of sertoli/spermatogenic induced by ciga⁃ rette smoke may be related to the activation of ROS/NLRP3 signaling pathway.

Background Occupational stress has become one of the main factors affecting people's physical and mental health, and there are many sources of occupational stress in petrochemical enterprises. Objective To evaluate the current situation of occupational stress and its related factors among employees in a petrochemical enterprise, and to provide a scientific basis for reduing the risk of occupational stress among employees in petrochemical enterprises. Methods In June 2022, a cross-sectional questionnaire survey was conducted in a petrochemical enterprise in Hainan, including a general information questionnaire for basic information, the Effort-Reward Imbalance (ERI) for occupational stress, and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Chi-square test was used to compare differences in positive occupational stress by demographic characteristics, occupational characteristics, behavior, and occupational disease hazards. Logistic regression was employed to evaluate factors associated with occupational stress. Results Of the 1129 questionnaire distributed, a total of 999 valid questionnaire were returned,with a valid recovery rate of 88.5%. The positive rate of occupational stress among employees in the petrochemical enterprise was 29.5%. There were statistically significant differences in the positive rate of occupational stress among the employees grouped by gender, age, marital status, body mass index (BMI), monthly income, length of service, smoking, weekly working hours, type of work, working mode, sleep quality, noise exposure, and high temperature exposure (P<0.05). In terms of positive occupational stress among subcategories: workers being male (vs. female), working ＞40 h per week (vs. ≤40 h per week), regular day shift (vs. shift work), smoking (vs. not smoking), with exposure to noise and heat (vs. without such exposure), and having poor sleep quality (vs. good sleep quality) reported higher positive occupational stress rates (P＜0.05). The results of pairwise comparison showed that the positive rate of occupational stress in divorced (50.0%) or married (32.0%) workers was higher than that in single (27.1%) workers, and higher in operation workers (30.6%) than in other types of work (20.5%) (P＜0.05). The trend chi-square results showed that the positive rate of occupational stress increased linearly with the increase of age, length of service, BMI, or monthly income (P＜0.05). The results of logistic regression analysis after adjustment showed that workers who worked ＞40 h a week had a higher risk of occupational stress than those who worked ≤40 h a week, and the OR (95%CI) was 1.909 (1.135, 3.211); the workers of other types of work had a lower risk of reporting occupational stress than operation workers, and the OR (95%CI) was 0.513 (0.272, 0.968); the workers with noise exposure had a higher risk of occupational stress than the workers without, and the OR (95%CI) was 2.457 (1.070, 5.642). Conclusion The positive rate of occupational stress among employees in this petrochemical enterprise is high. Among them, operators, working hours per week＞40 h, and noise exposure may increase the incidence of occupational stress. The enterprise should actively take measures to reduce the occurrence of occupational stress among employees.