Objective:This study aims to investigate the therapeutic efficacy of staged endoscopic surgery for Shin-Ⅲ stage external auditory canal cholesteatoma. Methods:A retrospective analysis was conducted on the clinical data of 25 patients diagnosed with Shin-Ⅲ cholesteatoma of the external auditory canal, who were admitted to the Otology Center of the First People's Hospital of Foshan City from May 2020 to October 2024. All patients initially underwent endoscopic cholesteatoma removal. Based on the outcomes of the first-stage postoperative follow-up, patients were categorized into two groups: the repair type and the non-repair type. The non-repair type was further subdivided into simple and complex types. Of the total cases, 10 patients were of the repair type, with 9 requiring no further surgical intervention. The non-repair type comprised 15 patients, of which 8 were classified as simple type and underwent either tympanoplasty type Ⅰ or external auditory canal wall reconstruction during the second stage. The remaining 7 patients, identified as complex type, received open mastoidectomy or tympanotomy in the second stage, with or without ossicular chain reconstruction. Results:All patients were monitored for a minimum of six months postoperatively. The incidence of dry ear was observed in 22 patients, corresponding to a dry ear rate of 88.0%. Four cases experienced primary complications. Conclusion:Endoscopic phased operation for managing Shin-Ⅲ stage cholesteatoma of the external auditory canal can ensure that the surgical options match the severity of the lesions, reducing unnecessary surgical trauma and achieving good efficacy.
Humans ; Retrospective Studies ; Ear Canal/surgery* ; Endoscopy/methods* ; Cholesteatoma/surgery* ; Male ; Tympanoplasty ; Female ; Treatment Outcome ; Adult ; Middle Aged ; Cholesteatoma, Middle Ear/surgery* ; Mastoidectomy

Objective To summarize the clinical efficacy of robotic-assisted left thoracic small-incision minimally invasive direct coronary artery bypass grafting(MIDCAB).Methods A retrospective analysis was conducted on the procedures and treatment outcomes of robotic-assisted MIDCAB in the Army Medical Center of PLA from October 2016 to June 2023.Baseline clinical information,MIDCAB-related data,perioperative conditions and data during follow-up were collected and analyzed.Results There were 23 patients subjected,including 21 males and 2 females,with a mean age of 58.17±7.49 years,and a body mass index(BMI)of 23.99±3.25 kg/m2.All of them experienced angina pectoris,and 1 had a history of myocardial infarction,1 had dilated cardiomyopathy,2 patients had chronic obstructive pulmonary disease(COPD),and 10 had a history of percutaneous coronary intervention(PCI).Robotic-assisted MIDCAB procedure was successfully completed.No internal mammary artery injury or transformation of the procedure occurred in these cases,and excellent bridging vessel flow was achieved after anastomosis of the internal mammary artery to left anterior descending branch.The incision length in the left chest was 8(8,8)cm,the operation time was 380(300,465)min,the intraoperative bleeding volume was 300(100,400)mL,the length of ICU stay was 3(2,3)d,the amount of thoracic drainage was 780(525,1 040)mL,and the postoperative length from surgery to discharge was 11.17±2.38 d.No mortality was observed during or within 30 d of hospitalization,and 1 patient was readmitted due to pericardial effusion within 30 d,and was discharged after symptomatic treatment including pericardiocentesis and drainage.No deaths,major adverse cardiovascular and cerebrovascular events(MACCE),or re-revascularization occurred in all patients during outpatient and telephone follow-up.Conclusion Robotic-assisted internal mammary artery dissection is a delicate and safe technique,and coronary artery bypass grafting in minimally invasive small-incision off-pump is effective,safe and feasible,with satisfactory short-and mid-term outcomes.The technique is suitable for minimally invasive coronary artery disease surgery and is worthy of popularization and application.

【Objective】 To investigate the effect of sinomenine hydrochloride （SH） on angiogenesis and the underlying mechanism in breast cancer. 【Methods】 The 4T1 orthotopic tumor model of breast cancer was utilized， and mice were treated with different dosage of SH to investigate the effect of SH on tumor growth. IHC staining of CD31 was used to evaluate angiogenesis within tumors under different treatment. ELISA was performed to measure the bFGF level within tumor extracellular fluid （TEF） and tumor cells to analyze the effect of SH on bFGF secretion and production. RT-qPCR was utilized to evaluate the effect of SH on the mRNA expression of bFGF in tumor cells. Kaplan-Meier Plotter was analyzed online to investigate the relationship between bFGF expression and the survival of patients with breast cancer. 【Results】 SH at 100 mg/kg could inhibit 4T1 orthotopic tumor growth compared with saline （P<0.05）， but SH showed little cytotoxicity in vitro under the tested concentrations. SH at 100 mg/kg suppressed the vessel area compared with saline （P<0.01）， and the concentration of angiogenic factor bFGF in TEF and tumor cells was decreased by SH treatment （P<0.05）， while the mRNA expression of bFGF in tumor cells was also downregulated by SH treatment （P<0.05）. Kaplan-Meier Plotter online analysis showed that elevated mRNA expression of bFGF in the primary tumor was associated with poorer OS， RFS and DMFS in patients with breast cancer （P<0.01）. 【Conclusion】 SH inhibits breast cancer growth by suppressing bFGF-induced angiogenesis， which enriches the pharmacological effects of this traditional Chinese medicine.

Objective To observe the clinical efficacy of ozone injection combined with extracorporeal shock wave in treatment of arthritis of perishoulderr.Methods 120 patients with arthritis of perishoulderr and treated were choiced,they were randomly divided into two groups.Patients in group C were performanced extracorporeal shock wave treatment.Patients in group H were performanced with ozone injection combined with extracorporeal shock wave.Visu-al analogue score(VAS)and rane of motion(ROM)were used to evaluate the therapeutic effect.Results There was no significant difference between the two groups preoperation.Then significant difference of VAS in the two groups for 1week,1 month,3 months and 6 months after treatment showed respectively as (4.56 ±0.27)points vs.(2.49 ± 0.25)points,t =43.57,(3.96 ±0.23)points vs.(1.86 ±0.29)points,t =43.95,(3.36 ±0.20)points vs.(1.79 ± 0.25)points,t =36.51,(3.98 ±0.23)points vs.(2.09 ±0.27)points,t =41.29,P <0.05;The ROM data were respectively(55 ±18)points vs.(67 ±16)points,t =3.86,(60 ±20)points vs.(72 ±18)points,t =3.45,(56 ±19) points vs.(78 ±15),t =7.04,(46 ±18)points vs.(77 ±14)points,t =10.53,P <0.05.Patients feeled pain eased significantly in group H was significantly higher than group C in 6 month postoperativeiy.(χ2 =38.90,P <0.01;χ2 =8.91,P <0.05).Conclusion There is significant effect in patients with arthritis of perishoulderr treated by com-bined ozone injection with extracorporeal shock wave.