OBJECTIVE To establish a method to detect the blood concentration of ibrutinib and apply it to the clinic. METHODS Using zanubrutinib as internal standard， the concentration of ibrutinib was detected by high performance liquid chromatography （HPLC） after plasma samples were processed by solid-phase extraction. The separation was performed on an Agilent 5 TC-C18（2） column with acetonitrile-0.5% potassium dihydrogen phosphate solution （43∶57， V/V） as the mobile phase at a flow rate of 1 mL/min， a detection wavelength of 260 nm， a column temperature of 40 ℃ ， a sample size of 20 μL， and a run time of 25 min. The concentration of ibrutinib was measured in the plasma of 9 patients with non-Hodgkin’s lymphoma 2 h after drug administration on the 30th day by the above method. RESULTS The linear range of the assayed mass concentration of ibrutinib was 10-500 ng/mL （R 2＝0.998 9）， the lower limit of quantification was 10 ng/mL， and the RSDs of the intra-batch and inter-batch precision tests were not higher than 12.77%. The recoveries of the extraction were 74.80% and 97.70%， with both RSDs＜2.90%， and the RSDs of the stability tests were not higher than 7.10%. The peak plasma concentrations of 9 patients were 15.341-279.628 ng/mL. CONCLUSIONS The established HPLC method is simple and rapid， and can be used for the determination of ibrutinib concentration in plasma samples.

Objective:To explore the diagnosis, treatment and aeromedical assessment of parotid pleomorphic adenoma for civil pilot.Methods:The diagnosis, treatment and aeromedical assessment of a class I pilot with parotid pleomorphic adenoma were analyzed. Related literatures were reviewed.Results:The 54-year-old male pilot was found a mass behind the right earlobe in the routine annual physical examination. B-ultrasound examination showed solid nodule in the right parotid gland. The mass and superficial parotid glands were removed and the facial nerve was dissected. Pathology showed pleomorphic adenoma of the right parotid gland. No complications were found in physical examination 2 months after the operation. The masticatory function and facial nerve function were good and CT showed no obvious abnormalities. The pilot was finally qualified for flying. No tumor recurrence or other complications were found 5 months after returning flight. B-ultrasound showed changes after partial resection of the right parotid gland and no other abnormalities were found.Conclusions:Parotid pleomorphic adenoma may be ignored easily at its early stage. The pilot with proper treatment and good postoperative recovery can be qualified to flight.

Objective:To explore the diagnosis, treatment and aeromedical assessment of parotid pleomorphic adenoma for civil pilot.Methods:The diagnosis, treatment and aeromedical assessment of a class I pilot with parotid pleomorphic adenoma were analyzed. Related literatures were reviewed.Results:The 54-year-old male pilot was found a mass behind the right earlobe in the routine annual physical examination. B-ultrasound examination showed solid nodule in the right parotid gland. The mass and superficial parotid glands were removed and the facial nerve was dissected. Pathology showed pleomorphic adenoma of the right parotid gland. No complications were found in physical examination 2 months after the operation. The masticatory function and facial nerve function were good and CT showed no obvious abnormalities. The pilot was finally qualified for flying. No tumor recurrence or other complications were found 5 months after returning flight. B-ultrasound showed changes after partial resection of the right parotid gland and no other abnormalities were found.Conclusions:Parotid pleomorphic adenoma may be ignored easily at its early stage. The pilot with proper treatment and good postoperative recovery can be qualified to flight.

Objective:To investigate the value of CT findings of childhood hepatoblastoma (HB) in predicting preoperative tumor risk stratification.Methods:Totally 46 children with HB confirmed by surgery and pathology were retrospectively enrolled from October 2010 to October 2019 in Shenzhen Children′s Hospital and Xuzhou Children′s Hospital. The preoperative abdominal plain CT and three-phasic contrast-enhanced CT with complete clinical files were evaluated. According to the clinical risk stratification established by the multidisciplinary diagnosis and treatment consensus for children with HB, the HB children were divided into high-risk group and non-high-risk group with 16 and 30 cases respectively. The maximum diameter of tumor, relative tumor volume index, cystic change or necrosis, bleeding, calcification, fibrous septations, tumor rupture, liver capsule retraction and subcapsular effusion were evaluated. Enhancement percentage and enhancement index on arterial, venous and delayed phases of each tumor were measured and calculated. Pearson′s χ 2 test or Fisher′s exact test were used to compare the differences in gender and lesion morphological characteristics between the high-risk group and the non-high-risk group. Two independent sample t test or Mann-Whitney U test were used to compare the differences in age, gestational age, birth weight, α-fetoprotein, platelets, maximum diameter of tumor, relative tumor volume index and CT parameters of the lesion between the two groups. Statistically significant features were included in the binary logistic regression analysis and independent predictors related to high-risk group were obtained. The ROC curve was used to determine the critical value of the high-risk group. Results:There were statistically significant differences in age, maximum diameter of tumor, relative tumor volume index and tumor rupture between the high-risk group and the non-high-risk group (all P<0.05). The logistic regression analysis showed that the maximum diameter of tumor (OR=1.906, P=0.004) and tumor rupture (OR=16.558, P=0.005) were risk factors of the high-risk group. Based on ROC curve, the optimum cut-off point of maximum diameter of tumor to predict high-risk group was 10.5 cm. Tumor rupture, maximum diameter of tumor and maximum diameter of tumor combined with tumor rupture for predicting the incidence of high-risk group resulted in the area under the curve of 0.744, 0.807 and 0.879, respectively. The sensitivity and specificity of maximum diameter of tumor combined with tumor rupture were 75.0% and 96.7%, respectively. Conclusion:The age of onset in high-risk group is relatively older. The maximum diameter of tumor greater than 10.5 cm accompanied by tumor rupture can be regarded as a high-risk sign.

Objective:To improve the level of aeromedical assessment by analyzing the otolaryngological diseases those were diagnosed in the physical reexamination of flying candidates by the medical specification.Methods:Otolaryngological reexamination of 2 012 flying candidates was performed from August to November of 2019. Comprehensive assessment was made according to Medical Specification for Recruitment of Civil Aviation Airman Trainees (issued in 2017), and the results were compared with that in 2017.Results:Ten out of 2 012 flying candidates (0.5%) were not conformed to the medical specification, which included 4 ear cases, 4 nose cases, 1 larynx case and 1 oral maxillofacial case. Compared with the results in 2017, there was no statistical difference in the elimination rate and the distribution of disease sites (P>0.05).Conclusions:The elimination rate of the otolaryngology in the physical reexamination of flying candidates is stable. The diseases that were not conformed to the medical specification covers many organs, but mainly concentrated in the ear and nose. In the physical examination of flying candidates, we should take more careful examination, grasp specification requirements, and try to avoid missed diagnosis.

Objective:To improve the level of aeromedical assessment by analyzing the otolaryngological diseases those were diagnosed in the physical reexamination of flying candidates by the medical specification.Methods:Otolaryngological reexamination of 2 012 flying candidates was performed from August to November of 2019. Comprehensive assessment was made according to Medical Specification for Recruitment of Civil Aviation Airman Trainees (issued in 2017), and the results were compared with that in 2017.Results:Ten out of 2 012 flying candidates (0.5%) were not conformed to the medical specification, which included 4 ear cases, 4 nose cases, 1 larynx case and 1 oral maxillofacial case. Compared with the results in 2017, there was no statistical difference in the elimination rate and the distribution of disease sites (P>0.05).Conclusions:The elimination rate of the otolaryngology in the physical reexamination of flying candidates is stable. The diseases that were not conformed to the medical specification covers many organs, but mainly concentrated in the ear and nose. In the physical examination of flying candidates, we should take more careful examination, grasp specification requirements, and try to avoid missed diagnosis.

OBJECTIVE: To investigate the electrophysiological characteristics and pathological changes in different recurrent laryngeal nerve injury models. METHOD: Twenty dogs were divided into different models of recurrent laryngeal nerve injury. Electrophysiological changes of animal models and histopathological changes in laryngeal muscles were investigated at different time. RESULT: Amplitude of MUP in TA decreased at first and then increased a little, while duration of MUP keeps decreased. The latent periods of the evoked potential in the incomplete injury group increased at first and then went down. In animal histopathological investigation, the lighter of the muscle injuries and the bigger of the diameter of muscle fibers and fascicles, and the smaller of the number of cellular nucleolus per square inch. In the early periods after injury, the correlation among the standard amplitude, threshold amplitude, maximum amplitude of EP and the diameter of fascicles were positive; while in the late period, the correlation among the amplitude, duration, area of MUP and nucleolus number was positive. CONCLUSION The physiological characteristics of laryngeal nerves and muscles could be known. LEMG was an important method in diagnosis of laryngeal nerve and muscle diseases.
Animals ; Disease Models, Animal ; Dogs ; Electromyography ; Evoked Potentials ; Laryngeal Muscles ; innervation ; physiopathology ; Recurrent Laryngeal Nerve Injuries