Objective:To explore the effect, postoperative mucosal pathological changes and molecular biological changes of reboot operation for type 2 inflammation chronic rhinosinusitis with nasal polyps（CRSwNP） patients, and to provide theoretical basis for the clinical application of this kind of operation. Methods:We collected 29 patients who were diagnosed with CRSwNP with type 2 inflammatino response and underwent Reboot surgery from June 2022 to August 2023, and 27 patients who were diagnosed with deviated septum and underwent simple submucosal resection of the septum as the control group. We conducted nasal symptom scoring, endoscopic sinusitis scoring, and CT scanning of the sinuses before and after surgery, as well as HE staining, immunohistochemical staining, and detection of inflammatory factors using Elisa kits at the time of surgery, 1, 3, and 6 months postoperatively. We also observed the ultrastructural changes using transmission electron microscopy and scanning electron microscopy, and performed proteomic analysis of the mucosa in the ethmoid sinus area of the sinusitis patients at the time of surgery and 6 months postoperatively. Results:After 6 months of postoperative follow-up, CT scores of the nasal cavity and sinuses had gradually decreased compared with the preoperative period. The VAS score of main symptoms, SNOT-22 score and Lund-Kennedy endoscopic score were decreased after 12 months follow-up. The histological morphology of the mucosa in the area of the screen was significantly improved compared with the preoperative period, with a reduction in the number of eosinophils. The levels of inflammatory factors such as IL-4 and IL-5 et al. in the mucosa of the area of the screen were gradually reduced compared with the preoperative period. The histological morphology, ultrastructure, and cilia structure of the mucosa in the area of the screen were gradually improved compared with the preoperative period, though not recovered completely. The number of CD4⁺T and CD8⁺T cells not changed significantly before and after the surgery yet. By conducting proteomic analysis of the ethmoidal sinus mucosa before and after surgery, differential proteins were selected, and bioinformatics analysis was conducted on the differentially expressed proteins. By using cytoHubba to identify hub genes and intersecting them with the genes related to chronic sinusitis, we found that MMP9 expression increased in non-type 2 CRS and type 2 CRS in sequence, while ACTC1 expression decreased in non-tpye 2 CRS and type 2 CRS in sequence. Conclusion:Reboot surgery can improve the postoperative symptoms and signs of patients, improve the pathological morphology of the mucosa, and influence the expression of protein after surgery. However, the surgery may not have a significant impact on the distribution of T cell subpopulations and inflammation signal pathway in the nasal mucosa.
Humans ; Sinusitis/metabolism* ; Nasal Polyps/metabolism* ; Nasal Mucosa/ultrastructure* ; Chronic Disease ; Rhinitis/complications* ; Inflammation ; Male ; Female ; Postoperative Period ; Adult ; Interleukin-5/metabolism* ; Interleukin-4/metabolism* ; Middle Aged ; Proteomics ; Rhinosinusitis

Objective:To investigate the clinical outcome of endovascular treatment vs. drug treatment in patients with symptomatic non-acute long-segment occlusion of the internal carotid artery. Methods:Based on prospective cohort registration research data, patients with symptomatic non-acute long-segment occlusion of internal carotid artery were retrospectively included. They were divided into a drug treatment group and an endovascular treatment group according to the actual treatment received. The latter was further divided into a successful recanalization group and an unsuccessful recanalization group. The endpoint events included ipsilateral ischemic stroke, any stroke, and all-cause death. Multivariate logistic regression analysis was used to compare the endpoint events between groups during the perioprocedural period (within 30 days), and multivariate Cox proportional hazards model was use to compare the endpoint events between the groups during the long-term follow-up. Results:A total of 684 patients were included, of which 570 (83.33%) were male, median aged 63 years (interquartile range, 56-70 years). Three hundred and fifty-three patients (51.6%) received drug treatment; 331 (48.4%) received endovascular treatment, of which 161 (48.6%) had successful recanalization. The median follow-up time was 1 223 days (interquartile range, 646.5-2 082 days), with 109 patients (15.9%) experiencing stroke recurrence events (including 87 ipsilateral ischemic stroke) and 78 (11.4%) experiencing all-cause mortality. The risk of any stroke during the perioprocedural period in the successful recanalization group was significantly higher than that in the drug treatment group (odds ratio 3.679, 95% confidence interval 1.038-13.036; P=0.044), but the risk of ipsilateral ischemic stroke recurrence (risk ratio 0.347, 95% confidence interval 0.152-0.791; P=0.012) and all-cause mortality (risk ratio 0.239, 95% confidence interval 0.093-0.618; P=0.003) during the long-term follow-up were significantly lower than those in the drug treatment group. Conclusions:In patients with symptomatic non-acute long-segment occlusion of the internal carotid artery, endovascular treatment can increase the risk of stroke recurrence within 30 days, but successful recanalization can reduce the risks of long-term ipsilateral ischemic stroke recurrence and all-cause mortality.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.