Objective:To explore the effect of revision endoscopic sinus surgery (RESS) on quality of life in the patients with chronic rhinosinusitis with nasal polypsis (CRSwNP).Method:To survey and evaluate 60 cases of RESS patiens (treatment group) and 120 normal ones with physical examination (Control group) through the medical outcomes survey short form questions (MOS SF-36) and the Sino-Nasal Outcome Test-20 (SNOT-20), and comparison and analysis of the two groups results which we got were carried out.Result:With SF-36 scales for evaluation of quality of life, the results show that: the scores of CRSwNP patients (treatment group) without surgical treatments with RESS were significantly lower than that of the control group(P<0.05); while use of SNOT-20 scales in evaluation of the properative treatment group patients, the results were significantly higher than that of the control group(P<0.05). While the CRSwNP patients with surgical treatments with RESS for 6 monthes, not only with SF-36 scales but also with SNOT-20 scales,there was no significant difference between the two groups(P>0.05 ).Conclusion:RESS may obviously improve the clinical symptom of CRSNP patients. The SF-36 and SNOT-20 assessment scales could reflect the patient's QoL change.

A method for simultaneous determination of 20 Perfluorinated alkyl substances ( PFAS) in animal liver using QuEChERs and HPLC_MS/MS technique was developed. The samples were extracted with 0. 1%hydrochloric acetonitrile and cleaned up with C18 , N_Propylethylendiamine ( PSA ) and graphitized carbon blacks ( GCB ) . The analytes were separated by a reversed phase C18 column and gradiently eluted with a mixed solution of 5 mmol/L ammonium acetate methanol and 5 mmol/L ammonium acetate. The samples were quantified using isotope internal standard and external standard with the matrix matched standard calibration curve method. Good linearity was obtained for all the 20 PFAS at the concentration of 0. 1-10 μg/L with the linear correlation coefficients more than 0. 9995. The limits of detection (LOD) and the limits of quantification ( LOQ) for PFAS were 0. 05-0. 2 μg/kg and 0. 4-0. 5 μg/kg, respectively. The recoveries at three different concentration levels ( 0 . 5 , 2 and 5 μg/kg ) were in the range of 70 . 3% -108 . 1%. The repeatability expressed as relative standard deviations (RSD) was ranged from 2. 1% to 11. 9% (n=6).

Objective To establish an IT-based follow-up platform, and to explore its application effect in patients with ischemic stroke.Methods By constructing a follow-up model and a recurrence risk warning model for ischemic stroke patients, such a follow-up platform was established.Thanks to the retrospective comparative and analysis method, we built a study group comprising ischemic stroke patients discharged since the platform and a control group comprising 228 such patients discharged prior to the platform.These two groups were followed up by means of IT-based manner and traditional paper-based manner respectively at the first,third,sixth,ninth,and twelfth months since their discharge.These patients were analyzed in terms of their medication adherence,activities of daily living and recurrence rate.Results One year after the follow-up,32 cases were lost of contact in the study group and 42 cases from the control group.Medication adherence of the study group was higher than that of the control group at the sixth month (2.72 ±0.62), ninth month(2.86 ±0.37)and twelfth month(2.83 ±0.40)after discharge, with the differences being statistically significant(P <0.05).The recurrence rate of the study group at the ninth months(6.38%)and twelfth months(10.21%)after follow-up was lower than that of the control group,a difference being statistically significant(P<0.05).The difference of BI scores between the two groups was not statistically significant(P>0.05).Conclusions The IT-based follow-up platform could improve the medication adherence of ischemic stroke patients,and reduce the recurrence rate of ischemic stroke,but the effect of improving activities of daily living was still not significant.

OBJECTIVE: To explore the effect of revision endoscopic sinus surgery (RESS) on quality of life in the patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). METHOD: To survey and evaluate 60 cases of RESS patients (treatment group) and 120 normal ones with physical examination (Control group) through the medical outcomes survey short form questions (MOS SF-36) and the Sino-Nasal Outcome Test-20 (SNOT-20), and comparison and analysis of the two groups results which we got were carried out. RESULT: With SF-36 scales for evaluation of quality of life, the results show that: the scores of CRSwNP patients (treatment group) without surgical treatments with RESS were significantly lower than that of the control group(P < 0.05); while use of SNOT-20 scales in evaluation of the preoperative treatment group patients, the results were significantly higher than that of the control group (P < 0.05). While the CRSwNP patients with surgical treatments with RESS for 6 months, not only with SF-36 scales but also with SNOT-20 scales, there was no significant difference between the two groups (P > 0.05). CONCLUSION RESS may obviously improve the clinical symptom of CRSNP patients. The SF-36 and SNOT-20 assessment scales could reflect the patient's QoL change.
Adolescent ; Adult ; Case-Control Studies ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinuses ; surgery ; Quality of Life ; Reoperation ; Sinusitis ; surgery ; Young Adult

Objective To explore the clinical efficacy of metoprolol on elderly patients with chronic heart failure (CHF)and its influence on serum interleukin-12 (IL-12)and brain natriuretic peptide (BNP)levels.Methods A total of 86 patients with CHF served as study objects and ran-domly divided into observation group and control group,43 cases for each.Routine medicines were given to control group while observational group added with metoprolol for 12 weeks.Clinical effica-cy and changes of serum IL-12 and BNP levels were observed.Results Total response rate in obser-vation group was 93.02%,evidently higher than in control group (P <0.01),and there were sig-nificant differences before and after treatment and between two groups in blood pressure,heart rate and left ventricular ejection fraction (LVEF)(P <0.01).Conclusion Basic therapies concomitant with metoprolol have better clinical efficacy than single application of basic therapies,and can more effectively regulate serum IL-12 and BNP expressions and improve the internal environment of body of elderly patients with CHF.

Objective To explore the clinical efficacy of metoprolol on elderly patients with chronic heart failure (CHF)and its influence on serum interleukin-12 (IL-12)and brain natriuretic peptide (BNP)levels.Methods A total of 86 patients with CHF served as study objects and ran-domly divided into observation group and control group,43 cases for each.Routine medicines were given to control group while observational group added with metoprolol for 12 weeks.Clinical effica-cy and changes of serum IL-12 and BNP levels were observed.Results Total response rate in obser-vation group was 93.02%,evidently higher than in control group (P <0.01),and there were sig-nificant differences before and after treatment and between two groups in blood pressure,heart rate and left ventricular ejection fraction (LVEF)(P <0.01).Conclusion Basic therapies concomitant with metoprolol have better clinical efficacy than single application of basic therapies,and can more effectively regulate serum IL-12 and BNP expressions and improve the internal environment of body of elderly patients with CHF.

Objective:To investigate the surgical method and clinical value of free medial sural artery perforator (MSAP) flap for repairing the wound of toe.Methods:The patients with isolated toe skin defects admitted to the Department of Trauma Microsurgery of No.988 Hospital of Joint Logistics Support Force were treated with MSAP flap for wound repair from June 2014 to December 2018. All the donor site were closed primarily. After the operation, the appearance, texture, hair growth and functional recovery of donor and recipient sites were observed through regular follow-up in outpatient or WeChat.Results:A total of 11 cases were enrolled, including 7 males and 4 females, aged from 19 to 44 years, with an average of 31.3 years. The wound sites were located at the first toe in 8 cases, the second toe in 2 cases, and the fourth toe in 1 case. The size of the skin defects was from 2.2 cm×1.8 cm to 5.7 cm×3.8 cm, the primary repair was performed in 4 cases and secondary repair in 7 cases, and the flaps ranged from 2.6 cm×2.1 cm-6.1 cm×4.2 cm. Ten cases survived successfully, and the wounds healed primarily. One case had local necrosis at the distal end of the flap, the wound healed after secondary repair surgery. All patients were followed-up from 6 to 18 months. The appearance of flaps was good in 9 cases and slightly swollen in 2 cases. All flaps had good texture, no discomfort of wearing shoes, no obvious influence on walking, and linear scar remained in the donor area. Three cases were treated with laser hair removal because of the flap hair growth.Conclusions:The method of using a free MSAP flap to repair the small toe wound can restore its appearance to satisfaction and achieve a good aesthetic repair effect.

Objective To investigate the clinicopathologic features and associated risk factors for bilateral neck node metastasis ( BNM ) in head and neck squamous cell carcinoma ( HNSCC ).Methods Two hundred eighty-six cases with HNSCC were retrospectively studied , including 83 cases of oral tongue cancers, 101 cases of hypopharyngeal cancers and 102 cases of supraglottic laryngeal cancers.All patients had unilateral or bilateral cervical lymph node metastasis confirmed by postoperative pathologic examinations .The following factors were evaluated to determine the risk for BNM in HNSCC: T staging, size, location, trans-midline condition, growth pattern, pathologic grading and infiltration of primary tumors;N staging;the size, number and extracapsular spread (ECS) of ipsilateral metastatic nodes;the number of involved levels on the ipsilateral neck.Chi-square test and logistic regression test were used for statistical analysis.Results BNM was found in 86 (30.1%) of 286 patients with HNSCC, including 52 (18.2%) cases of contralateral occult neck node metastasis.The incidence of BNM was 35.6% ( 36/101 ) in hypopharyngeal cancer , 31.4% (32/102) in spuraglottic laryngeal cancer and 21.7%(18/83) in oral tongue cancer , respectively.N staging, the number and ECS of ipsilateral metastatic nodes , and the number of involved levels on the ipsilateral neck were important factors contributing to BNM.Multiple logistic regression analysis revealed that midline passing of primary tumor was associated with BNM in oral tongue cancer.The midline passing and ECS of ipsilateral metastatic node were key factors for BNM in hypopharyngeal and supraglottic laryngeal cancers.T staging, size and midline passing of primary tumor were closely related to BNM in oral tongue cancer.T staging and midline passing were associated with BNM in hypopharyngeal cancer.Midline passing was an important factor related to BNM in supraglottic laryngeal cancer.Conclusion Midline passing of primary tumor is the most important factor determining BNM in hypopharyngeal , supraglottic laryngeal and oral tongue cancers , whereas ECS of ipsilateral metastatic node is the most important factor impacting BNM in hypopharyngeal and supraglottic laryngeal cancers.

Objective To investigate the clinicopathologic factors associated with neck control and distant metastasis in patients with neck metastases in head and neck squamous cell carcinoma (HNSCC)after postoperative radiation as adjuvant treatment.Methods Clinicopathologic data of 208 pathologic N + (pN +) patients with HNSCC initially treated with neck dissection and postoperative radiation in Bethune International Peace Hospital of China from January 2004 to December 2009 were reviewed.The clinicopathologic factors,includeding age,sex,primary tumor site,pathologic T and N stage,tumor growth pattern,histological grade,tumor resection margin,size and number of positive lymph node,number of levels with positive lymph node,and extracapsular nodal spread (ECS),were evaluated for their association with neck control and distant metastasis in patients with HNSCC after postoperative radiation.Univariate x2 test and multiple stepwise logistic regression model were used for the analysis.Results Overall 5-year neck control rate after postoperative radiotherapy was 72.6％ (151/208),with 84.0％ (63/75) for SND,72.9％ (78/107) for MRND,and 38.5％ (10/26) for RND,respectively.Univariate analysis showed that neck control after postoperative radiation was related with following factors:primary tumor site,pathologic N stage,size of positive node,number of levels with positive node,number of positive node,and ECS.Pathologic N stage and number of levels with positive lymph node were associated with distant metastasis.Multivariate analysis indicated that ECS was the most significant risk factor for neck metastasis after surgery and postoperative radiotherapy and the number of levels with positive node was the most significant risk factor for distant metastasis.Conclusions ECS is the most important pathologic factor in planning postoperative adjuvant treatment for pN + patients with HNSCC,therefore ECS should be evaluated routinely after neck dissection.The value of postoperative radiotherapy in controlling the ECS-related recurrence after surgery is limited.Postoperative concurrent chemoradiotherapy and targeted therapy can be considered in HNSCC patients with ECS.

Objective:To investigate the surgical method and clinical value of free medial sural artery perforator (MSAP) flap for repairing the wound of toe.Methods:The patients with isolated toe skin defects admitted to the Department of Trauma Microsurgery of No.988 Hospital of Joint Logistics Support Force were treated with MSAP flap for wound repair from June 2014 to December 2018. All the donor site were closed primarily. After the operation, the appearance, texture, hair growth and functional recovery of donor and recipient sites were observed through regular follow-up in outpatient or WeChat.Results:A total of 11 cases were enrolled, including 7 males and 4 females, aged from 19 to 44 years, with an average of 31.3 years. The wound sites were located at the first toe in 8 cases, the second toe in 2 cases, and the fourth toe in 1 case. The size of the skin defects was from 2.2 cm×1.8 cm to 5.7 cm×3.8 cm, the primary repair was performed in 4 cases and secondary repair in 7 cases, and the flaps ranged from 2.6 cm×2.1 cm-6.1 cm×4.2 cm. Ten cases survived successfully, and the wounds healed primarily. One case had local necrosis at the distal end of the flap, the wound healed after secondary repair surgery. All patients were followed-up from 6 to 18 months. The appearance of flaps was good in 9 cases and slightly swollen in 2 cases. All flaps had good texture, no discomfort of wearing shoes, no obvious influence on walking, and linear scar remained in the donor area. Three cases were treated with laser hair removal because of the flap hair growth.Conclusions:The method of using a free MSAP flap to repair the small toe wound can restore its appearance to satisfaction and achieve a good aesthetic repair effect.