Objective:This paper aims to demonstrate the maxillary mucosa restoration after operation to the nasal fungal sinusitis. Methods Observation by microscopic, transmission electron microscopic and scanning electron microscopic was done to the same parts in the maxillary mucosa 3-4 months before and after the endoscopic sinus surgery in the 24 cases of the nasal fungal sinusitis during 2003-2005. Result: Before the operation, all the cases demonstrated epithelia shedding, proliferation, squamous metaplasia, glandular and fibrous tissue proliferation and lymphocytes infiltration. The microtubule was abnormal and mitochondria diminished,3-4 months after operation, the cavity was clear and smooth and the epithelia complete. The cilia average increased and the cilia lined in the same direction. The structure of microtubules was clear. The mitochondria was elongated and dense. Conclusion: There was no significant difference in the damage on ultramicrostructure of the maxillary mucosa between the chronic nasal sinusitis and chronic nasal fungal sinusitis. It is crucial in the successful recovery that the operation gives a thorough clean to the fungal clot and sinus aeration, and that good cleaning and sinus aeration are maintained after the operation. The ultramicrostructure restoration and the function recovery of mucosa will be achieved after careful cleaning for 3-4 months after operation.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; instrumentation ; Sleep Initiation and Maintenance Disorders ; diagnosis

Objective:To explore the possibility of repairing partial nasal alar defects with individualized design of localized skin flaps.Methods:The clinical data of 38 patients with nasal alar region tumor from October 2015 to June 2019 in Dalian Municipal Central Hospital were retrospectively analyzed, including 5 cases with intradermal nevus, 8 cases with junction nevus, 21 cases with basal cell carcinoma, 3 cases with trichoepithelioma, and 1 case with nasal alar sulcus fistula combined with infection. Surgical treatment with local anaesthesia was applied, and intraoperative freezing pathology was used to confirm the diagnosis and determine the safe margin. There was no nasal alar cartilage infiltration in all patients. The defect areas after resection of nasal alar lesions ranged from 1.0 cm × 1.0 cm to 3.0 cm × 2.5 cm. Local skin flap was aesthetically designed in accordance with the location and size of the nasal alar defect to primarily repair the defect. Among them, 15 cases were repaired with pedicled nasolabial groove flap, 10 cases with modified rhomboid flap, 6 cases with rotatory nasolabial groove flap, 5 cases with V-Y push flap, and 2 cases with double lobe flap.Results:One case had blood transportation obstacle after operation caused by compression and bandaging, 1 case had postoperative infection. Healing of the two cases delayed after treatment, and other patients healed properly. All the flaps survived without facial deformity, and the cosmetic effect was good.Conclusions:The primary repair of the nasal alar defect needs to follow the aesthetic requirements of the nose and face, which varies with diseases and experience of doctors. Flap selection should be individualized to achieve both the purpose of repairing defects and beauty.

Objective To explore the feasibility and safety of early ambulation in patients with acute deep ve-nous thrombosis. Methods The literatures about early ambulation for acute venous thrombosis were collected and the quality of the literature was evaluated by two investigators independently. Results Thirteen published studies were recruited for systematic review,including 10 RCTs and 3 CCTs. The meta-analysis showed that compared with bed rest,early ambulation did not increase the incidence of secondary pulmonary embolism in patients with acute DVT[early activity:22/1408;bed rest:34/1417;RR=0.62,95%CI(0.37,1.03),and the incidence of DVT progression [early activity:48/1523;bed rest:45/1525;RR=0.85,95%CI(0.58,1.24)]. There were no statistically significant differ-ences in mortality,swelling,and pain relief in acute DVT patients. Conclusion Early ambulation did not increase the incidence of thrombus progression and secondary pulmonary embolism in patients with acute DVT compared with bed rest. Besides,early ambulation cannot relieve symptoms of swelling and pain in DVT patients. However,it can relieve the acute pain of DVT patients with moderate to severe pain.

OBJECTIVE: To investigate the result of child-type micro-sensitive mattress sleep monitor on obstructive sleep apnea-hypopnea syndrome in children. METHOD: The PSG and child-type micro-sensitive mattress sleep monitor were synchronously performed on 58 cases of children with OSAHS. The breathing and sleep metrics were compared. RESULT: By PSG monitoring, 41 cases were diagnosed as mild OSAHS, 14 cases were moderate and 3 cases were severe. The results of mattress system monitoring showed mild OSAHS in 37 cases, 16 cases of moderate and severe OSAHS in 5 cases. Seven patients diagnosed as mild OSAHS monitored by PSG were classified as moderate by mattress system monitoring; three cases diagnosed as mild OSAHS by mattress system monitoring system were diagnosed as moderate by PSG. Among 14 cases of children diagnosed as moderate by PSG, three cases were diagnosed as mild by mattress system monitor and two cases as severe. Children diagnosed as severe by PSG got the same result by mattress system monitor. Two kinds of sleep monitoring methods were compared and there were no statistically significant difference in AHI (t = 2.316, P > 0.05), deep and shallow sleep constituent ratio (t = 2.280, t = 2.388, PF > 0.05). while there was significant difference in REM period Sleep constituent ratio (t = 3.135, P < 0.01). CONCLUSION Child-type micro-sensitive mattress is in good agreement with the PSG for diagnosing OSAHS in children, which can be used as a monitoring method in clinical work.
Child ; Child, Preschool ; Female ; Humans ; Male ; Polysomnography ; instrumentation ; methods ; Sleep Apnea, Obstructive ; diagnosis

OBJECTIVE: To investigate the sleep monitoring feature of the MSMS in elderly patients with OSAHS. METHOD: One hundred and ninety patients diagnosed with OSAHS were divided into elderly group and non elderly group according to age, then the results of MSMS were analyzed. RESULT: Majority elderly patients were with mild to moderate OSAHS. The nocturnal mean blood oxygen and the lowest oxygen were higher than non elderly group, coupled with higher percentage of the total oxygen saturation < 90% monitoring time (TS90). There was no significant difference in sleep structure between two groups, but the total sleep time of elderly group is lower than the non elderly group, the difference is statistically significant. CONCLUSION The elderly patients with OSAHS were less severe in nature, but the nocturnal hypoxia last longer in the elderly group. There is no significant difference in the sleep structure between the two groups. But the total sleep time decrease in elderly group. With smaller interference, the MSMS is closer to the natural sleep stustus of the subjects.
Aged ; Humans ; Hypoxia ; diagnosis ; Oxygen ; physiology ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; diagnosis

Objective To evaluate the effect of robot-assisted gait training on the walking ability of hemiplegic patients.Methods Sixty hemiplegic patients were randomly divided into a control group and a treatment group,each of 30.Both groups were given traditional rehabilitation and drug therapy.The control group was additionally provided with the traditional gait training,while the treatment group additionally received robot-assisted gait training.The gait training lasted 30 minutes a day,5 days per week.Before and after 8 weeks of training,the time parameters,phase parameters,the joint angles of the lower limbs,and the peak ground reaction forces of both groups were evaluated using a three-dimensional gait analysis system.Results After the intervention,the walking velocity,stride frequency and stride length had increased in the treatment group,while stride width had decreased.Significant improvement was observed in the treatment group in terms of the percentage of swing phase on the paretic side,the percentage of stance phase on the paretic side,the single support time ratio,the percentage of double support phase,the range of motion of the hip and knee joints,and the peak vertical and forward ground reaction force as a percentage of body weight.The improvements were significantly greater than those observed in the control group.Conclusions Compared with traditional walking training,robot-assisted gait training can be more effective in improving the walking ability of hemiplegic patients.

OBJECTIVE: This paper aims to demonstrate the maxillary mucosa restoration after operation to the nasal fungal sinusitis. METHOD: Observation by microscopic, transmission electron microscopic and scanning electron microscopic was done to the same parts in the maxillary mucosa 3-4 months before and after the endoscopic sinus surgery in the 24 cases of the nasal fungal sinusitis during 2003-2005. RESULT: Before the operation, all the cases demonstrated epithelia shedding, proliferation, squamous metaplasia, glandular and fibrous tissue proliferation and lymphocytes infiltration. The microtubule was abnormal and mitochondria diminished, 3-4 months after operation, the cavity was clear and smooth and the epithelia complete. The cilia average increased and the cilia lined in the same direction. The structure of microtubules was clear. The mitochondria was elongated and dense. CONCLUSION There was no significant difference in the damage on ultramicrostructure of the maxillary mucosa between the chronic nasal sinusitis and chronic nasal fungal sinusitis. It is crucial in the successful recovery that the operation gives a thorough clean to the fungal clot and sinus aeration, and that good cleaning and sinus aeration are maintained after the operation. The ultramicrostructure restoration and the function recovery of mucosa will be achieved after careful cleaning for 3-4 months after operation.
Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Fungi ; Humans ; Male ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Middle Aged ; Mycoses ; pathology ; surgery ; Nasal Mucosa ; pathology ; surgery ; ultrastructure ; Sinusitis ; microbiology ; pathology ; surgery ; Young Adult

OBJECTIVE: Duloxetine hydrochloride is a selective serotonin (5-hydroxytryptamine) and norepinephrine reuptake inhibitor. It is approved for effective treatment for major depressive disorder. The pharmacokinetics (PK) of duloxetine has been studied, but few pharmacokinetics properties in Chinese subjects are available. This study explored the dose proportionality and determined duloxetine levels in human plasma by comparing the PK properties after administration of single or multiple doses in healthy volunteers. METHODS: Thirty-six subjects were divided randomly into three groups and received a single dose of 15, 30, or 60 mg duloxetine. Those who received 30 mg continued on to the multiple-dose phase and received 30 mg daily for 7 days. Liquid chromatography/mass spectroscopy was applied to determine concentrations. The PK properties were calculated and included maximum plasma concentration (Cmax), time when maximum plasma concentration was reached (Tmax), time when half-maximum plasma concentration was reached (t1/2), area under the plasma concentration-time curve from time zero to the last measurable concentration (AUC0-t), mean concentration levels (AUC0-infinity), and apparent total clearance of the drug from plasma after oral administration (CL/F). RESULTS: The standard calibration curve was linear in the concentration range 0.11-112 ng/ml (r>0.992). Linear PK properties were found at doses of 15-60 mg. The Cmax and AUC were proportional to dose, but the Tmax and t1/2 did not increase with increasing dose. CONCLUSION: No significant differences in the PK parameters were found among the three groups during the single-dose phase. The AUC and Cmax were greater in the multiple-dose phase, indicating duloxetine accumulation following multiple-dose administration.
Administration, Oral ; Area Under Curve ; Asian Continental Ancestry Group ; Calibration ; Depressive Disorder, Major ; Humans ; Norepinephrine ; Plasma ; Serotonin ; Spectrum Analysis ; Tablets, Enteric-Coated ; Thiophenes ; Duloxetine Hydrochloride

OBJECTIVE: Differentiating unicystic ameloblastomas from keratocystic odontogenic tumors (KCOT) is necessary for the planning of different treatment strategies; however, it is difficult based on conventional CT and MR sequences alone. The purpose of this study was to investigate the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADCs) in the differentiation of the two tumors. MATERIALS AND METHODS: We prospectively studied 40 patients with odontogenic cysts and tumors of the maxillomandibular region using conventional MR imaging and DWI. ADCs were measured using 2 b factors (500 and 1000). RESULTS: Unicystic ameloblastomas (n = 11) showed free diffusion on DWI and a mean ADC value of 2.309 ± 0.17 × 10-3 mm2/s. KCOT (n = 15) showed restricted diffusion on DWI with a mean ADC value of 0.923 ± 0.20 × 10-3 mm2/s. The ADC values of unicystic ameloblastomas were significantly higher than those of KCOT (p < 0.001, Mann-Whitney U-test). An ADC cut-off value of 2.0 × 10-3 mm2/s to differentiate KCOT and unicystic ameloblastomas resulted in a 100% sensitivity and 100% specificity. Dentigerous cysts (n = 3) showed restricted diffusion on DWI and similar ADC values (1.257 ± 0.05 × 10-3 mm2/s) to those of KCOT. CONCLUSION: Diffusion-weighted imaging and ADC determination can be used as an adjuvant tool to differentiate between unicystic ameloblastomas and KCOT, although the ADC values of dentigerous cysts overlap with those of KCOT.
Ameloblastoma ; Dentigerous Cyst ; Diffusion ; Humans ; Magnetic Resonance Imaging ; Odontogenic Cysts ; Odontogenic Tumors ; Prospective Studies ; Sensitivity and Specificity