Objective:To analyze the clinical characteristics and risk factors of postoperative first bite syndrome（FBS） after parapharyngeal space surgery, and to provide evidence-based recommendations for the diagnosis and management of this complication. Methods:A retrospective analysis was conducted on 142 patients undergoing parapharyngeal space surgery from March 2016 to November 2024, including 12 cases of postoperative FBS. Univariate analysis compared differences in tumor location, pathological type, and surgical approach between FBS and non-FBS groups. Multivariate logistic regression identified independent risk factors. A systematic literature review evaluated the preventive value of transoral endoscopic surgery for FBS, followed by proposed clinical optimization strategies. Results:The incidence of FBS was 8.45%（12/142）. Univariate analysis revealed significant associations with: Superior parapharyngeal space tumors（OR=3.21, 95%CI 1.12-9.21, P=0.029）; Schwannoma pathology（OR=4.05, 95%CI 1.35-12.18, P=0.013）; Traditional lateral cervical approach（OR=5.67, 95%CI 1.89-17.02, P=0.002）. Multivariate analysis confirmed lateral cervical approach（aOR=4.98, 95%CI 1.62-15.31, P=0.005） and schwannoma（aOR=3.75, 95%CI 1.22-11.51, P=0.021） as independent risk factors. Literature review suggested lower FBS rates with transoral endoscopic approaches. The overall effect of the drug on FBS is poor. Conclusion:FBS is a frequent complication of parapharyngeal space surgery, significantly associated with tumor location, pathology, and surgical approach. Transoral endoscopic surgery can effectively reduce the risk of FBS through precise anatomical dissection that minimizes sympathetic nerve injury. Minimally invasive approaches are recommended for eligible cases.
Humans ; Retrospective Studies ; Postoperative Complications/etiology* ; Risk Factors ; Endoscopy ; Parapharyngeal Space/surgery* ; Male ; Female ; Adult ; Middle Aged ; Neurilemmoma/surgery*

Objective:To investigate the relationship between clinicopathological features and lymph node metastasis(LNM)of early gastric cancer(EGC), so as to provide and theoretical guidance for the normative treatment of EGC.Methods:A retrospective analysis was performed on 128 patients with EGC who received surgical treatment from January 2016 to December 2019 in Anhui Medical University Affiliated Anqing hospital.Results:The total LNM ratio of EGC was 10.1% (13/128). Univariate analysis showed that the LNM ratio was 18.0% in patients with the largest diameter of >2 cm, higher than 5.1% in patients with the largest diameter of ≤2 cm. The LNM ratio of submucosal carcinoma (T 1b) was 21.6%, higher than 2.6% of intramucosal carcinoma (T 1a). The LNM ratio of patients with vascular invasion was 71.4%, higher than 6.7% of patients without vascular invasion. The LNM ratio was 13.1% in the total dissected lymph node group ≥15, higher than 0 in the total dissected lymph node group <15. The difference between the these groups was statistically significant( χ2=5.532, 12.101, 23.778, 4.239, P<0.05). There was no significant difference in the correlation between age, gender, tumor site, general type, degree of differentiation, and the LNM of EGC ( P>0.05). Multivariate analysis showed that submucosal carcinoma(RR=10.688, 95% CI: 1.714-66.651, P=0.011) and vascular infiltration(RR=27.209, 95% CI: 3.749-197.450, P=0.001) were the independent risk factor for the LNM of EGC. Conclusions:Patients of EGC with tumor infiltration to submucosa(T 1b), maximum diameter of lesion >2 cm, and vascular infiltration have a higher risk of LNM. Standardized D1+ or D2 lymph node dissection (≥15) should be performed for EGC patients.

Objective To estimate the curative effect of non-gastrointestinal decompression in laproscopic colorectal surgery. Methods By using the single-blind-random test and prospective study, 55 patients were divided into two groups, experimental group and matched group. The difference of operating time, gastrointestinal function recovery time, adverse effect, complication, average length of hospital stay between two groups were observed and evaluated. Results The difference of operating time, gastrointestinal function recovery time, adverse effect, complication, average length of hospital stay between two groups were not statistically significant(P>0.05). The incidence rate of sore throat and cough and expectoration difficulty after operation was significantly lower in the experimental group (the rate was respectively 16.0% vs 77.7% and 8.0% vs 50.0, P<0.05). However, The incidence rate of nausea and vomiting, abdom-inal distension was not statistically significant(P>0.05). Conclusion In the perioperative period of laproscopic colorectal surgery, non-gastrointestinal decompression appears to be security and feasible.

Hepatic stellate cell (HSC-T) was cultured in medium containing different concentrations of recombinant human augmenter of liver regeneration (hALR),and cells were collected at different incubation period. Total RNA of HSC was isolated and collagenⅠ and Ⅲ gene expression levels were measured with reverse transcription polymerase chain reaction. The results showed that, collagen Ⅰ gene expression levels of HSC in high(0 2ng/L),middle (0 02ng/L) and low (0 002ng/L) concentrations of three hALR groups were much lower than those of control group after exposure to hALR at 8h, 24h, 48h and 72h. Collagen Ⅰ gene expression levels of HSC in high dose group were also significantly lower than those of middle and low dose groups . Collagen Ⅲ gene expression levels of HSC in middle and low dose hALR group were much lower than those of control group at 24h,48h and 72h, Collagen Ⅲ gene expression levels in high dose group were significantly lower than those of control group at 8h, 24h, 48h and 72h, and were also much lower than those of middle and low dose groups. It suggested that hALR could inhibit collagen Ⅰ and Ⅲ gene expression in hepatic stellate cells.

To investigate the influence of recombinant human augmenter of liver regeneration (hALR) on stromelysin 1 gene expression in rats with fibrotic liver. CCl 4 or albumin induced liver fibrosis in rats was established, and different dosages of recombinant human augmenter of liver regeneration were given to rats with liver fibrosis.Liver specimens were obtained at different intervals of treatment , total RNA of liver tissues were isolated and stromelysin 1 gene expression was measured by reverse transcription polymerase chain reaction (RT PCR) . The results showed that in both rat models of experimental liver fibrosis , stromelysin 1 gene expression levels were significantly higher in hALR treated rats than those without the treatment at various intervals. Stromelysin 1 gene expression levels in high dose hALR treatment group were significantly higher than that in low dose hALR treatment group. It suggested that recombinant human augmenter of liver regeneration may enhance stromelysin 1 gene expression in rats with fibrotic liver.