OBJECTIVE To explore the prognostic significance of the prognostic nutrition index(PNI)in patients with hypopharyngeal cancer undergoing surgical treatment.METHODS Clinical and pathological data of 117 patients with hypopharyngeal carcinoma who underwent surgical treatment at the center of Otolaryngology Head and Neck Surgery of Beijing Friendship Hospital,Capital Medical University from May 2014 to June 2022 were collected.The prognostic significance of hematological indicators such as PNI and neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and systemic immune inflammation index(SⅡ)were investigated.The time-dependent receiver operating characteristic(tROC)curves were used to analyze the sensitivity and specificity of various hematological indicators and to determine their optimal cutoffvalues.The Kaplan-Meier method was used to plot the postoperative survival curve,and the Cox regression model was used to analyze the correlation between PNI and overall survival(OS)and disease-free survival(DFS).RESULTS 117 patients were enrolled in this cohort,of which 109 were clinically classified as advanced stage(Ⅲ-Ⅳ).63 cases underwent surgery to preserve laryngeal function.The 5-year OS is 46.07％.According to the analysis of the tROC curve,the optimal cutoffvalue for PNI is 46.75.PNI is correlated with tumor T staging,NLR,PLR,and SⅡ.Kaplan Meier univariate analysis showed that PNI was significantly correlated with OS and DFS(P<0.05).In addition,tumor N-stage,postoperative complications,adverse pathological prognostic factors,NLR,PLR,and SⅡ were all significantly correlated with OS(P<0.05).Tumor N-stage,laryngeal preservation,postoperative complications,NLR,and SⅡ were significantly correlated with DFS(P<0.05).The Cox multivariate analysis results indicated that PNI,tumor N-stage,and postoperative complications were independent factors affecting OS and DFS.CONCLUSION Preoperative PNI,tumor N-stage,and postoperative complications are independent risk factors for OS and DFS in patients with hypopharyngeal carcinoma.PNI,as a prognostic indicator for predicting hypopharyngeal cancer patients,is superior to other hematological indicators.

Ripple structure is widely used in space suits,and the predicted trajectory motion is realized according to its large deformation behavior.Due to the complexity of irregular bellows structure,the existing researches are mostly based on the display dynamic method,and lack the systematic analysis of geometric nonlinearity and the effect of shell section thickness under the framework of statics.This study combines statics and arc length method(Riks),introduces linear buckling mode defects,and analyzes the ultimate bending behavior of irregular bellows with different shell thicknesses.It is concluded that the thick-shell model exhibits higher apparent deformation tolerance due to geometric softening effect,and the contact force distribution between ripples can be accurately extracted by static analysis,which provides a basis for the inversion of external force loads.The deformation mode of bellows after introducing defects based on statics-Riks is proposed,and the control mechanism of shell section thickness on deformation path is revealed.

Aiming at the problem that the amount of Oxygen remaining and available time can not be accurately predicted while an astronaut conducting extravehicular activities(EVAs)in EVA spacesuit.Research the oxygen consumption process of EVA spacesuit.The model and algorithm of oxygen consumption are established by the gas state equation including compressibility and temperature coefficient,combined with human metabolism and micro leakage characteristics of spacesuit.Experimental data show that the orecast model and algorithm hasing high accuracy and practicability.

Objective:To systematically sort out and cluster the existing indicators of key issues in the quality of postgraduate clinical degree education based on the bibliometric study, so as to build a multidimensional quality assessment index system that integrates scientificity, rationality and representativeness, and to provide a scientific measurement tool for assessing clinical professional postgraduate education in China.Methods:By mining the related functions of UCINET6 network analysis integration software and its one-dimensional and two-dimensional data analysis NetDraw program, the social network analysis (SNA) method was used to extract and cluster the education quality problem set of clinical professional degree postgraduates.Results:A three-dimensional evaluation index system was constructed. The first dimension concluded such 8 key issues in the quality of postgraduate education in clinical medicine as ability assessment, teaching system, teaching quality assurance system, professional cognition and career prospects, assessment and evaluation system and organization, and the pulse taking and diagnosis.Conclusion:The clinical graduate education quality evaluation index system is an effective measurement tool for education quality improvement, based on a multidimensional perspective, with key issues as priority areas for intervention, providing an effective evidence-based basis for ensuring the development of professional graduate education efforts from 2020-2025.

OBJECTIVE: To explore the possibility of far-lateral retro-condylar approach in an attempt to apply endoscope. METHOD: For anatomical information, the microneurosurgical anatomical dissection, observation and measurement had been performed under microscope and endoscope by mimicking the far-lateral retro-condylar approach on 10 adult cadaver heads and 10 adult dry skulls. RESULT: The complex relationship exists between the osseous jugular foramen and its adjacent structures. The exposed anatomic structures of jugular foramen region were observed under microscope and endoscope without drilling occipital condyle and jugular tubercle. CONCLUSION With the technology of modern microsurgery and endoscope, several diseases in jugular foramen region can be operated via far-lateral retro-condylar approach without drilling occipital condyle and jugular tubercle.
Adult ; Endoscopy ; Female ; Humans ; Jugular Veins ; anatomy & histology ; Male ; Occipital Bone ; anatomy & histology ; surgery