Objective:To compare and analyze the efficacy of bilateral and unilateral posterior vocal cord resection with CO 2 laser under endoscopy in the treatment of bilateral vocal cord paralysis. Methods:This case series study retrospectively analyzed the data of 110 patients with bilateral vocal cord paralysis who underwent endoscopic CO 2 laser posterior cordotomy at the Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Naval Medical University, from October 2016 to January 2023. The cohort consisted of 36 males [mean age (45.5±9.1) years, range 24-72 years] and 74 females [mean age (47.2±10.1) years, range 22-67 years]. Among them, 47 patients underwent simultaneous bilateral posterior cordotomy (bilateral cordotomy group), while 63 patients underwent unilateral posterior cordotomy (unilateral cordotomy group). Pre-and postoperative indicators, including swallowing function, glottal size, and vocal function (subjective and objective assessments), were compared between the two surgical approaches. The Wilcoxon signed-rank test was used to analyze changes in swallowing function, glottal size, and vocal function (subjective and objective assessments) within each group before and after surgery, whereas the Mann-Whitney U test was utilized to assess differences between groups. Results:Postoperative follow-up was 1-5 years [median follow-up time was 1.6 (1.3, 2.0) years].The one-time extubation rate was 71.4%(45/63)in the unilateral posterior vocal cord resection group and 87.2%(41/47)in the bilateral posterior vocal cord resection group, significantly higher in the bilateral group ( χ2=3.94, P<0.05). One week after surgery, the swallowing function score of unilateral cordotomy group was 2 (1, 2.5) points, which was significantly better than that of bilateral cordotomy group [2 (1.5, 3) points, Z=-2.118, P<0.05], and the swallowing function score of both groups returned to normal 3 months after surgery. There were no significant differences in preoperative glottic closure during inhalation, auditory perceptual evaluation (GRBAS), objective voice analysis, and Voice Handicap Index-10 (VHI-10) between the two groups ( P>0.05). Postoperatively, the maximum transverse diameter of the posterior glottis during inspiration in the unilateral cordotomy group was 4.49 (4.24, 4.77) mm, significantly smaller than that in the bilateral cordotomy group, which was 5.05 (4.52, 5.62) mm ( Z=-4.103, P<0.05). Among the GRBAS parameters, G (grade of hoarseness), B (breathiness), and A (asthenia), as well as VHI-10 scores and objective voice analysis parameters [jitter, shimmer, harmonic-noise ratio (HNR), and maximum phonation time (MPT)], were significantly better in the unilateral cordotomy group compared to the bilateral cordotomy group, with statistically significant differences ( P<0.05). Conclusions:Unilateral posterior vocal cord resection using CO 2 laser is simple and feasible for the treatment of bilateral vocal cord paralysis, with shorter recovery time, maximal preservation of laryngeal phonatory function, and fewer complications compared to bilateral resection. However, the one-time extubation rate is higher with bilateral resection, reducing the need for a second surgery and associated patient discomfort. This study offers guidance for clinical decision-making in the surgical management of bilateral vocal cord paralysis.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective:To compare and analyze the efficacy of bilateral and unilateral posterior vocal cord resection with CO 2 laser under endoscopy in the treatment of bilateral vocal cord paralysis. Methods:This case series study retrospectively analyzed the data of 110 patients with bilateral vocal cord paralysis who underwent endoscopic CO 2 laser posterior cordotomy at the Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Naval Medical University, from October 2016 to January 2023. The cohort consisted of 36 males [mean age (45.5±9.1) years, range 24-72 years] and 74 females [mean age (47.2±10.1) years, range 22-67 years]. Among them, 47 patients underwent simultaneous bilateral posterior cordotomy (bilateral cordotomy group), while 63 patients underwent unilateral posterior cordotomy (unilateral cordotomy group). Pre-and postoperative indicators, including swallowing function, glottal size, and vocal function (subjective and objective assessments), were compared between the two surgical approaches. The Wilcoxon signed-rank test was used to analyze changes in swallowing function, glottal size, and vocal function (subjective and objective assessments) within each group before and after surgery, whereas the Mann-Whitney U test was utilized to assess differences between groups. Results:Postoperative follow-up was 1-5 years [median follow-up time was 1.6 (1.3, 2.0) years].The one-time extubation rate was 71.4%(45/63)in the unilateral posterior vocal cord resection group and 87.2%(41/47)in the bilateral posterior vocal cord resection group, significantly higher in the bilateral group ( χ2=3.94, P<0.05). One week after surgery, the swallowing function score of unilateral cordotomy group was 2 (1, 2.5) points, which was significantly better than that of bilateral cordotomy group [2 (1.5, 3) points, Z=-2.118, P<0.05], and the swallowing function score of both groups returned to normal 3 months after surgery. There were no significant differences in preoperative glottic closure during inhalation, auditory perceptual evaluation (GRBAS), objective voice analysis, and Voice Handicap Index-10 (VHI-10) between the two groups ( P>0.05). Postoperatively, the maximum transverse diameter of the posterior glottis during inspiration in the unilateral cordotomy group was 4.49 (4.24, 4.77) mm, significantly smaller than that in the bilateral cordotomy group, which was 5.05 (4.52, 5.62) mm ( Z=-4.103, P<0.05). Among the GRBAS parameters, G (grade of hoarseness), B (breathiness), and A (asthenia), as well as VHI-10 scores and objective voice analysis parameters [jitter, shimmer, harmonic-noise ratio (HNR), and maximum phonation time (MPT)], were significantly better in the unilateral cordotomy group compared to the bilateral cordotomy group, with statistically significant differences ( P<0.05). Conclusions:Unilateral posterior vocal cord resection using CO 2 laser is simple and feasible for the treatment of bilateral vocal cord paralysis, with shorter recovery time, maximal preservation of laryngeal phonatory function, and fewer complications compared to bilateral resection. However, the one-time extubation rate is higher with bilateral resection, reducing the need for a second surgery and associated patient discomfort. This study offers guidance for clinical decision-making in the surgical management of bilateral vocal cord paralysis.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective:To explore the efficacy of ansa cervicalis anterior root-recurrent laryngeal nerve (RLN) anastomosis in the treatment of unilateral vocal fold paralysis (UVFP) and to analyze the effect of different pathogenic factors on efficacy.Methods:From January 2010 to January 2022, 428 patients (187 males and 241 females) at Changhai Hospital with UVFP who underwent ansa cervicalis anterior root-RLN anastomosis due to thyroid surgery, thoracic surgery, idiopathic vocal ford paralysis or high cranial base injury were analyzed. The course of nerve injury ranged from 6 to 24 months. Videostroboscopy, auditory perceptual evaluation parameters (GRBAS including Grade, Roughness, Breathiness, Asthenia, Strain), Voice Handicap Index (VHI-10), acoustic analysis including Jitter, Shimmer and noise to harmonic ratio (NHR), maximum phonation time (MPT) and laryngeal electromyography were used to evaluate the surgery efficacy, and the therapeutic difference of the above 4 different etiology patients receiving the operation was compared. Data processing was performed using SPSS 26.0 statistical software, and Wilcoxon signed rank test was used. Kruskal Wallis one-way ANOVA was used for those with equal variance.Results:At 12 months after operation, the affected vocal ford position, vocal ford edge, glottal closure, symmetry and regularity of vocal ford vibration were significantly improved in all four groups ( P<0.01). G, R, B, A, S, VHI-10, Jitter, Shimmer and NHR were significantly lower than those before operation, while, MPT was significantly longer ( P<0.01). Also, the maximum voluntary motor unit recruitment (VMUR) in the affected thyroarytenoid muscles and posterior cricoarytenoid muscles was significantly improved after surgery ( P<0.01). However, the results of thyroid surgery group, thoracic surgery group and idiopathic vocal ford paralysis group were better than those of high cranial base injury group respectively, and the differences were statistically significant ( P<0.05). Conclusion:Ansa cervicalis anterior root-RLN anastomosis has an obvious efficacy on the recovery of phonatory function in UVFP patients with different causes, but the high cranial base injury is significantly worse than that of vocal ford paralysis caused by other causes.

Objective To investigate the current status of liver and gallbladder diseases and analyze the influencing factors of fatty liver based on the ultrasound examination results of officers and soldiers on a certain island.Methods The data of physical examination from 377 officers and soldiers on a certain island in 2021 were retrospectively analyzed.Age,gender,living habits,abdominal ultrasound results,and liver function test results were collected,and the incidence of liver and gallbladder diseases were investigated.Univariate and multivariate logistic regression analyses were used to screen the influencing factors of fatty liver disease.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of influencing factors for fatty liver disease.Results A total of 103 officers and soldiers were diagnosed with liver and gallbladder diseases.The top three were fatty liver(63.11%,65/103),gallbladder polyps(19.42%,20/103),and liver hemangioma(8.74%,9/103),accounting for 91.27%(94/103)of the subjects with liver and gallbladder diseases and 24.93%(94/377)of all the subjects undergoing physical examination.There were significant differences in the age,body mass index(BMI),the habit of mid night snacks,liver function indexes(alanine aminotransferase[ALT],aspartate aminotransferase[AST],total bilirubin[T-Bil],direct bilirubin[D-Bil],gamma-glutamyltransferase[γ-GT]),glucose(Glu),and triglyceride(TG)between the officers and soldiers with fatty liver(65 cases)and without fatty liver(312 cases)(all P<0.01).Multivariate logistic regression analysis showed that ALT,Glu,TG,BMI and the habit of midnight snacks were independent influencing factors of fatty liver(all P<0.05).The area under the ROC curve values of ALT,Glu,TG,BMI,the habit of midnight snacks and their combination in prediction of fatty liver were 0.776,0.621,0.764,0.828,0.637 and 0.866,respectively.Conclusion There is a high prevalence of fatty liver in officers and soldiers on a certain island(17.24%,65/377).ALT,Glu,TG,BMI and the habit of midnight snack can be used as a combined diagnostic model of fatty liver.The diet,exercise and training methods should be systematically and comprehensively managed to control related risk factors.Risk factor intervention and treatment should be carried out for high-risk population to effectively improve the physical and mental health of officers and soldiers on the island.

With the rapid development of implant techniques and digital technology,intraoral digital impressions have become a commonly used impression method in implant restoration.At present,the accuracy of intraoral digital impressions directly applied to implant-supported prostheses in edentulous jaw remains inadequate.This is due to the high accuracy requirement of full-arch implant impressions,while there are still technical challenges in intraoral digital impressions about recognition and stitching.In this regard,scholars have proposed a variety of scanning strategies to improve the accuracy of intraoral scans,including mucosal modifications,auxiliary devices and novel scan bodies.At the same time,as a new digital impression technique,stereo photogrammetry has been developing steadily and exhibits promising accuracy.This article reviews the research progress on the accuracy of edentulous full-arch implant impressions and techniques which can improve the accuracy of intraoral digital impressions thus providing a reference for clinical application.

Objective:To explore the efficacy of ansa cervicalis anterior root-recurrent laryngeal nerve (RLN) anastomosis in the treatment of unilateral vocal fold paralysis (UVFP) and to analyze the effect of different pathogenic factors on efficacy.Methods:From January 2010 to January 2022, 428 patients (187 males and 241 females) at Changhai Hospital with UVFP who underwent ansa cervicalis anterior root-RLN anastomosis due to thyroid surgery, thoracic surgery, idiopathic vocal ford paralysis or high cranial base injury were analyzed. The course of nerve injury ranged from 6 to 24 months. Videostroboscopy, auditory perceptual evaluation parameters (GRBAS including Grade, Roughness, Breathiness, Asthenia, Strain), Voice Handicap Index (VHI-10), acoustic analysis including Jitter, Shimmer and noise to harmonic ratio (NHR), maximum phonation time (MPT) and laryngeal electromyography were used to evaluate the surgery efficacy, and the therapeutic difference of the above 4 different etiology patients receiving the operation was compared. Data processing was performed using SPSS 26.0 statistical software, and Wilcoxon signed rank test was used. Kruskal Wallis one-way ANOVA was used for those with equal variance.Results:At 12 months after operation, the affected vocal ford position, vocal ford edge, glottal closure, symmetry and regularity of vocal ford vibration were significantly improved in all four groups ( P<0.01). G, R, B, A, S, VHI-10, Jitter, Shimmer and NHR were significantly lower than those before operation, while, MPT was significantly longer ( P<0.01). Also, the maximum voluntary motor unit recruitment (VMUR) in the affected thyroarytenoid muscles and posterior cricoarytenoid muscles was significantly improved after surgery ( P<0.01). However, the results of thyroid surgery group, thoracic surgery group and idiopathic vocal ford paralysis group were better than those of high cranial base injury group respectively, and the differences were statistically significant ( P<0.05). Conclusion:Ansa cervicalis anterior root-RLN anastomosis has an obvious efficacy on the recovery of phonatory function in UVFP patients with different causes, but the high cranial base injury is significantly worse than that of vocal ford paralysis caused by other causes.

Objective:To analyze clinical characteristics and genetic characteristics of children with ATP sensitive potassium passage (K ATP-HI). Methods:Forty-five children with genetically confirmed K ATP-HI and their families admitted to Beijing Children′s Hospital of Capital Medical University between February 2002 and December 2018 were selected as the study subjects. A detailed retrospective analysis of the patient's clinical characteristics, diagnosis and treatment process, disease-causing gene carrying status and later follow-up data was performed. ABCC8/KCNJ11 gene was sequenced by second-generation sequencing technology. Results:Among 45 children with K ATP-HI, 34 cases (75.6%) were neonatal onset, the first symptoms of 21 cases (46.7%) were convulsions. 39 cases had been treated with diazoxide, including 12 cases (30.8%) with good efficacy, 16 cases (41%) with poor efficacy and 11 cases with uncertain efficacy. Octreotide was further applied in 18 patients with uncertain or ineffective efficacy after diazoxide treatment, and 13 cases (72.2%) were effective, 3 cases were ineffective, and 2 cases were uncertain. 10 CHI patients who were ineffective to drug treatment or had clearly focal lesions confirmed by 18F-dopa positron emission by computed tomography ( 18F-DOPA PET) scans had undergone surgical treatment, 8 of which underwent partial pancreatectomy and blood glucose returned to normal after the operation; the other 2 cases underwent subtotal pancreatectomy and both had secondary diabetes after operation. Among 45 children with K ATP-HI, 1 case carried both ABCC8 and KCNJ11 mutations, 10 cases carried ABCC8 compound heterozygous mutations, and the remaining 34 cases carried ABCC8/KCNJ11 single genetic mutation. Among them, 21 cases had paternal inheritance, and 3 cases had maternal inheritance, 6 cases were identified with de novo mutations. Conclusions:Diazoxide treatment was ineffective for most K ATP-HI children, but octreotide had a higher effective rate. Partial pancreatectomy for focal type patients had a higher cure rate, and there was a risk of secondary diabetes after subproximal pancreatectomy, so it was very important to clarify the histological type of children before surgery. ABCC8 gene mutations and KCNJ11 gene mutations were the main pathogenic genes of K ATP-HI. Among patients carrying mutations in single ABCC8 or KCNJ11 gene mutation, K ATP-HI inherited by paternity were the majority. Some K ATP-HI children can relieve the hypoglycemia symptoms by themselves.

Objective: To evaluate the efficacy and safety of 0.05% atropine eye drops for retarding myopia progression and ocular axial elongation in school children,and to provide a reference for the relevant prevention and control measures of myopia. Methods: A total of 188 children with myopia were randomly assigned to the experimental group(93) or to the control group(95). During the phase (first 24 months) I,children received treatment in each eye once a day. During the phase II (from 25th to the 36th month),no treatment was given. Standardized eye examinations including spherical equivalent(SE),axial length(AL),intraocular pressure(IOP) and potential atropine-related side effect assessment were performed every 6 months. Results: In phase I, the annual progression rates of equivalent spherical degree [(-0.35±0.21)D/year] and axial length [(0.11±0.07)mm/year] in the experimental group were significantly lower than those in the control group [(-0.83±0.26)D/year and (0.37±0.22)mm/year] (P<0.05). After withdrawal of atropine eye drops (phase II), the equivalent spherical degree progression rate [(-0.40±0.29)D/year] and axial length progression rate [(0.10±0.04)mm/year] in the experimental group were significantly lower than those in the control group [(0.73±0.40)D/year and (0.30±0.11)mm/year]. No serious adverse events associated with atropine were found during the follow up period. After the withdrawal of atropine, the pupil size, near visual acuity and adjustment gradually returned to the pre-treatment level. Conclusion 0.05% atropine eye drops may not only maintain the efficacy and reduce potential side effects of atropine but also significantly increase the compliance of children,0.05% atropine is a safe and effective treatment for retarding myopic progression in moderate myopia.