[Objective] To compare the clinical efficacy and safety of flexible ureteroscope lithotripsy (FURL) combined with flexible vacuum-assisted urethral access sheath (FV-UAS) and traditional UAS in the treatment of 1-2 cm lower renal calyceal stones, so as to provide reference for clinical practice. [Methods] Clinical data of 157 patients with 1-2 cm lower renal calyceal stones treated with FURL during Mar.2021 and Oct.2023 were retrospectively analyzed, including 80 treated with traditional UAS, and 77 with FV-UAS.General and clinical information of the two groups were compared. [Results] The immediate stone-free rate (SFR) (84.4% vs.67.5%, P=0.013) and final SFR (88.3% vs. 75.0%, P=0.032) of the FV-UAS group were significantly higher than those of the traditional UAS group, with significant difference.The incidence of postoperative complications such as fever, renal colic, and perirenal hematoma was significantly higher in the traditional UAS group than in the FV-UAS group (15.0% vs.5.2%, P=0.042). After treatment with anti-infective and analgesic drugs, both groups were improved, and no severe sepsis or septic shock occurred after surgery.The hospitalization expenses of the FV-UAS group were significantly lower than those of the traditional UAS group [ (18 341±1519)yuan vs.(19 152±1826)yuan, P=0.003]. [Conclusion] Compared to the traditional UAS, the combination of FURL and FV-UAS for the 1-2 cm lower renal calyceal stones has a high SFR and low incidence of complications.Patients experience less pain, recover faster and spend less.It's a new treatment option for inferior calyceal calculi.

Objective:To retrospectively analyze the efficacy and feasibility of surgical management in patients with cervical dysphagia secondary to Diffuse idiopathic skeletal hyperostosis(DISH)of the cervical spine.Methods:A retrospective analysis was conducted on 6 patients who presented with dysphagia as the primary symptom, were diagnosed with cervical DISH, and underwent surgical treatment in the Department of Otorhinolaryngology Head and Neck Surgery of The Second Xiangya Hospital of Central South University from January 2018 to February 2024. There were 5 males and 1 female, aged from 65 to 78 years (70.2±4.7 years). The duration of dysphagia prior to admission was 13 to 18 months (14.7±2.2 months). All patients had the symptom of dysphagia, and at least one other clinical manifestation of cervical DISH (dyspnea, restricted neck mobility, sleep apnea, odynophagia). One patient had undergone tracheotomy due to laryngeal obstruction before surgery. Surgical intervention was performed after failure of conservative management in all patients. All patients underwent anterior cervical osteophyte resection via the Smith-Robinson approach without concomitant spinal fusion. In the patient with prior tracheotomy for airway obstruction, epiglottoplasty and right arytenoidectomy were performed simultaneously. The swallowing function was evaluated by water swallow test, FEES, M. D. Anderson Dysphagia Inventory. Clinical and imaging evaluations were conducted for follow-uppostoperatively. Preoperative and 30-day post operative data were statistically analyzed using paired samples t-test.Results:Cervical computed tomography revealed osteophyte involvement from C2 to T1 with a median of 4 vertebral segments affected. The most frequently involved vertebral segments were C4-C6 (all 6 patients were involved). The anteroposterior diameter of the most prominent osteophyte was 12.0 to 20.0 mm (16±3.1 mm). The time to resumption of a regular diet was 6 to 20 days(12.7±5.3 days), and the time to remove the nasogastric tube was 8 to 25 days(15.2±6.2 days). In the patient with prior tracheotomy, the tracheostomy tube was successfully decannulated 30 days after initial tube capping following conversion to a metal tube. All cervical DISH-related symptoms except for limited neck mobility improved postoperatively. Both water swallow test and the Rosenbek Penetration-Aspiration Scale showed significant improvement postoperatively. At 30 days postoperatively, MDADI scores significantly improved in all domains: l global (73.33±10.33), emotional (85.56±8.35), functional (83.33±5.89), and physical (82.08±6.60). No major perioperative complications occurred. and the length of hospital stay was 7 to 10 days (7.8±1.2 days). The follow-up time was 12 to 84 months (43.7±27.2 months). All patients maintained sustained symptom relief, with no evidence of osteophyte recurrence during follow-up.Conclusion:Cervical DISH is an under-recognized causes of dysphagia in elderly patients and warrants attention from otolaryngologists. For patients erefractory to conservative treatment, anterior resection of cervical osteophytes via the Smith-Robinson approach is a safe, minimally invasive procedure with favorable short-and long-term outcomes in improving swallowing function.

Objective:To retrospectively analyze the efficacy and feasibility of surgical management in patients with cervical dysphagia secondary to Diffuse idiopathic skeletal hyperostosis(DISH)of the cervical spine.Methods:A retrospective analysis was conducted on 6 patients who presented with dysphagia as the primary symptom, were diagnosed with cervical DISH, and underwent surgical treatment in the Department of Otorhinolaryngology Head and Neck Surgery of The Second Xiangya Hospital of Central South University from January 2018 to February 2024. There were 5 males and 1 female, aged from 65 to 78 years (70.2±4.7 years). The duration of dysphagia prior to admission was 13 to 18 months (14.7±2.2 months). All patients had the symptom of dysphagia, and at least one other clinical manifestation of cervical DISH (dyspnea, restricted neck mobility, sleep apnea, odynophagia). One patient had undergone tracheotomy due to laryngeal obstruction before surgery. Surgical intervention was performed after failure of conservative management in all patients. All patients underwent anterior cervical osteophyte resection via the Smith-Robinson approach without concomitant spinal fusion. In the patient with prior tracheotomy for airway obstruction, epiglottoplasty and right arytenoidectomy were performed simultaneously. The swallowing function was evaluated by water swallow test, FEES, M. D. Anderson Dysphagia Inventory. Clinical and imaging evaluations were conducted for follow-uppostoperatively. Preoperative and 30-day post operative data were statistically analyzed using paired samples t-test.Results:Cervical computed tomography revealed osteophyte involvement from C2 to T1 with a median of 4 vertebral segments affected. The most frequently involved vertebral segments were C4-C6 (all 6 patients were involved). The anteroposterior diameter of the most prominent osteophyte was 12.0 to 20.0 mm (16±3.1 mm). The time to resumption of a regular diet was 6 to 20 days(12.7±5.3 days), and the time to remove the nasogastric tube was 8 to 25 days(15.2±6.2 days). In the patient with prior tracheotomy, the tracheostomy tube was successfully decannulated 30 days after initial tube capping following conversion to a metal tube. All cervical DISH-related symptoms except for limited neck mobility improved postoperatively. Both water swallow test and the Rosenbek Penetration-Aspiration Scale showed significant improvement postoperatively. At 30 days postoperatively, MDADI scores significantly improved in all domains: l global (73.33±10.33), emotional (85.56±8.35), functional (83.33±5.89), and physical (82.08±6.60). No major perioperative complications occurred. and the length of hospital stay was 7 to 10 days (7.8±1.2 days). The follow-up time was 12 to 84 months (43.7±27.2 months). All patients maintained sustained symptom relief, with no evidence of osteophyte recurrence during follow-up.Conclusion:Cervical DISH is an under-recognized causes of dysphagia in elderly patients and warrants attention from otolaryngologists. For patients erefractory to conservative treatment, anterior resection of cervical osteophytes via the Smith-Robinson approach is a safe, minimally invasive procedure with favorable short-and long-term outcomes in improving swallowing function.

[Objective] To explore the efficacy of disposable flexible ureteroscopic lithotripsy (FURL) with flexible vacuum-assisted ureteral access sheath (FV-UAS) in the treatment of 2-3 cm upper urinary tract stones, so as to provide reference for the treatment selection. [Methods] Clinical data of 178 patients with upper urinary tract stones who received FURL or minimally invasive percutaneous nephrolithotomy (MPCNL) at our hospital during Apr. 2022 and Oct. 2023 were retrospectively analyzed. The patients were divided into FV-UAS group (n=90, received FV-UAS combined with diaposable FURL treatment) and MPCNL group (n=88, received MPCNL). The general information, perioperative data, and postoperative stone-free rate (SFR) of the two groups were compared. [Results] All operations were successfully completed. The operation time was significantly longer in the FV-UAS group than in the MPCNL group [(66.5±6.7) min vs. (63.9±7.4) min, P=0.015]. However, the intraoperative hemoglobin reduction [(7.3±3.1)g/L vs.(11.4±5.9)g/L], postoperative hospital stay (P<0.001) [(2.2±0.7)d vs.(5.4±1.3)d], and visual analogue score (VAS) [(2.7±0.9)vs.(5.6±1.1)] were significantly lower in the FV-UAS group than in the MPCNL group (P<0.001). The incidence of persistent gross hematuria was significantly higher in the MPCNL group than in the FV-UAS group (12.5% vs. 3.3%, P=0.023). The FV-UAS group had a similar postoperative immediate (83.3%) and final SFR (95.6%) to those of the MPCNL group (89.8%, 96.6%, P>0.05). [Conclusion] The combination of FURL with FV-UAS for 2-3 cm upper urinary tract stones has a higher SFR and a lower complication rate.Patients experience endurable pain and fast recovery, which is worth promoting and applying in clinical practice.

【Objective】 To explore the application value of scrotoscopy in the treatment of testicular hydrocele. 【Methods】 The clinical data of 27 patients with testicular hydrocele who were successfully treated with minimal hydrocelectomy with the aid of scrotoscope (MHS group) and 32 patients with traditional open surgery (TH group) during Dec.2017 and Dec.2021 were retrospectively analyzed and compared. 【Results】 Compared with TH group, the MHS group needed shorter average operation time [(32.22±5.25) min vs.(57.34±8.71) min, P<0.01], shorter incision length [(0.95±0.15) cm vs.(5.09±0.55) cm, P<0.01], shorter hospital stay [(3.63±0.97) d vs.(4.72±0.89) d,P<0.01] and lower postoperative incision visual analogue scale (VAS) (P<0.01), and milder degree of edema on the 3rd and 7th day after operation (P<0.05), but higher recurrence rate (14.81% vs.3.13%, P=0.256) 24 weeks after operation. 【Conclusion】 Scrotoscopy is safe in the treatment of testicular hydrocele, which has the advantages of short operation time, small incision, mild postoperative incision pain, mild scrotal edema and short hospital stay, but the recurrence rate tends to be higher than that of traditional open surgery.

Objective: To observe the clinical effect of massage combined with warm acupuncture and moxibustion on primary frozen shoulder. Methods: From April 2018 to April 2019, 30 patients with primary frozen shoulder admitted and treated in Wenzhou Hospital of Traditional Chinese Medicine were selected in theresearch.According to different admission time, they were divided into observation group and control group, with 15 patients in each group.The control group was treated with warm acupuncture and moxibustion, while the observation group was combined with massage.The total effective rate and VAS pain score after treatment were compared and observed. Results: The total effective rate in the observation group was 93.33%, which was higher than 73.33% in the control group (χ²=3.294, P<0.05). The VAS score of the observation group was (1.05±0.22)points after treatment, which was lower than (3.13±0.43)points of the control group, the difference between the two groups was statistically significant(t=2.493, P=0.000). Conclusion Massage combined with warm acupuncture and moxibustion in the treatment of primary frozen shoulder is more effective than the single treatment method, which can relieve the pain of patients and is a safe and effective treatment.

Objective: To investigate blood pressure and vascular remodeling of OSAS by establishing the chronic-intermittent hypoxia model in rat. Methods: Experiments were performed on 35 adult male Sprague-Dawley rats. Animals were randomly divided into four groups: unhandled control group (with 5 rats in it), CIH group at 9/6/3 weeks (with 10 ratsin each group). Rats in CIH group went through 8-hour intermittent hypoxia everyday, and those in control group were raising normally. After 9-week experiment, blood pressure was measured. The changes of the following indexes were observed: pathological changes of aorta and the middle aorta thickness (HE staining), the collagen of aorta wall (Masson staining). The experimental data were analyzed by SPSS 24.0 statistical software. The variance was analyzed by one-way analysis of variance, and the irregularity was selected using the calibration t test. Results: The systolic and diastolic blood pressures of the CIH9, 6, and 3 weeks groups and the control group were: (127±13) and (79±9), (124±11) and (81±7), (101±11) and (75±9), (91±10) and (65±9) mmHg (1 mmHg=0.133 kPa). The systolic blood pressure and diastolic blood pressure of the rats in the week of CIH 9 and 6 weeks were significantly higher than the control group (F=14.64, P=0.000; F=6.81, P=0.000). There was no significant difference in the mean blood pressure between the three groups of CIH and the control group. Membrane thickness in CIH9, 6 and 3 weeks and control group were: (20±2), (19±2), (14±2), (13±3) μm. Compared with the control group, the aortic pathology and thickness of the middle layer of the CIH9 and 6 weeks group were significantly thicker (F=20.24, P=0.000), but there was no significant difference between the CIH3 week group and the control group; the collagen deposition was unchanged compared with the control group. Conclusion Intermittent hypoxia for 6 weeks or more in rats resulted in the increasement of blood pressure, morphological changes of aorta and vascular remodeling in thickened media.

Objective To evaluate the efficacy of lumbar discectomy,radiofrequency ablation and annuloplusty performed with Disc-FX system under the guidance of C-arm in treatment of discogenic low back pain.Methods Twenty-eight patients with discogenic low back pain,with VAS score greater than 7,aged 27-73 yr,underwent lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system under the guidance of C-arm.The patients were followed up for 2 months after surgery and pain was assessed using VAS score.VAS scores were recorded before surgery,and at 7 and 14 days and 1 and 2 months after surgery.The effective analgesia was recorded according to VAS scores.The therapeutic effect was evaluated according to Macnab standard 2 months after surgery.Results VAS scores were significantly lower at each time point after surgery than before surgery (P ＜ 0.05).The rate of effective analgesia was 93 % at 2 months after surgery.The excellent and good rate of the therapeutic effect evaluated was 93 %.One female patient developed injury to lumbar venous plexus,and no patients developed infection of intervertebral disk,nerve root injury or spinal cord injury.Conclusion The excellent and good rate is 93 % when lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system is used for treatment of discogenic low back pain under the guidance of C-arm,with fewer side effects.

OBJECTIVE: To study the correlation of CD44 with epithelial-mesenchymal transition(EMT) and metastasis in nasopharyngeal cancer cells, and explore the possible mechanism of CD44 regulates EMT and metastasis in nasopharyngeal cancer cells. METHOD: The CD44 and EMT-associated proteins in 5-8F and 6-10B nasopharyngeal cancer cell lines were assayed by Western blotting. The erasion trace test was performed to observe the migratory ability of 5-8F and 6-10B nasopharyngeal cancer cells. Using lipid-mediated DNA transfection technique, the low metastatic nasopharyngeal cancer cells 6-10B were transfected in vitro with plasmid which contained CD44 gene, and then new nasopharyngeal cancer cells were obtained. The CD44 and EMT-associated proteins in 6-10B, empty vector transfected and CD44-transfected cells were assayed by Western blotting. The erasion trace test was performed to observe the alteration of migratory ability of nasopharyngeal cancer cells before and after CD44 transfection. RESULT: The expression of CD44 and EMT-associated protein MMP-9 in 5-8F was higher than that in 6-10B, but EMT-associated protein E-Cadherin in 5-8F was lower than that in 6-10B. The migratory ability of 5-8F was higher than that of 6-10B. The expression of CD44 and MMP-9 were significantly higher in the CD44-transfected nasopharyngeal cancer cells than in the control groups. Compared with control groups, the migratory ability of CD44-transfected nasopharyngeal cancer cells was significantly increased. CONCLUSION CD44 positively regulates the metastatic ability of nasopharyngeal cancer cells, which is relevant to the process of EMT.
Carcinoma ; Cell Line, Tumor ; Epithelial-Mesenchymal Transition ; Humans ; Hyaluronan Receptors ; genetics ; metabolism ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Neoplasm Metastasis ; Transfection