1.Analysis of short-term efficacy and safety of transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in resection of benign orbital apex lesions
Qiang ZUO ; Zhidi ZHANG ; Jichao ZHOU ; Hailing JIANG ; Yi WANG ; Yinghong ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(9):1070-1077
Objective:To evaluate the early efficacy and safety of the exclusively transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in the resection of benign orbital apex lesions.Methods:A retrospective analysis was conducted on 51 patients who underwent transnasal endoscopic resection of benign lesions in the orbital apex at Peking University Third Hospital from May 2021 to December 2024. The study population was composed of 17 males and 34 females, with the age of (39.4±12.4) years (range: 4 to 65 years). Pathology diagnoses were identified as orbital cavernous hemangioma (OCH, n=38), schwannoma ( n=8), solitary fibrous tumor ( n=1), mucocele ( n=1), optic nerve sheath meningioma ( n=1), pseudotumor ( n=1), and organized hematoma ( n=1). Two surgical approaches were compared as the exclusively transnasal endoscopic resection ( n=27) and the combined transconjunctival-endoscopic approach (combined approach, n=24). Preoperative and postoperative evaluations were conducted for the best corrected visual acuity (BCVA), visual field, intraocular pressure (IOP), and exophthalmos before and after surgery. Demographic characteristics, tumor features, and postoperative complications were analyzed between the two surgical groups. Differences in Orbital Resection by Intranasal Technique (ORBIT) stage between the two surgical approaches were analyzed. SPSS 27.0 software was used for statistical analysis. Results:Among the 51 patients, 3 schwannomas underwent intracapsular resection (1 via exclusively transnasal endoscopic approach, and 2 via combined approach), and the remaining 48 patients underwent complete tumor resection. Significant postoperative improvements were observed in BCVA, visual field, IOP and exophthalmos ( t value was 2.96, 4.34, 4.85, and 4.63, respectively, all P<0.05). The combined approach required longer operative time but showed comparable intraoperative blood loss. Tumors resected via the combined approach were larger in volume, though not statistically significant. Postoperative complications (e.g., diplopia, mydriasis) were more frequent in the combined approach group but resolved within a short-term period. There was no significant difference in ORBIT stage between the two groups ( P=0.178). Conclusions:Both exclusively transnasal and combined transconjunctival-endoscopic approaches prove safe and effective for benign orbital apex lesions resection. The combined approach ensures complete tumor removal.
2.Endoscopic endonasal surgery for ORBIT stage Ⅲ orbital cavernous hemangioma: a preliminary experience of 20 cases
Zhidi ZHANG ; Yi WANG ; Jichao ZHOU ; Yali DU ; Qiang ZUO ; Hailing JIANG ; Yinghong ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(3):321-329
Objective:To evaluate the early efficacy and safety of transnasal endoscopic surgical resection of orbital cavernous hemangioma (OCH) at orbital resection by intranasal technique (ORBIT) stage Ⅲ.Methods:A retrospective study was conducted on 20 patients (20 eyes) who underwent nasal endoscopic surgery to remove ORBIT stage Ⅲ OCH at the Third Hospital of Peking University from July 2021 to July 2024. The cohort were included 10 males and 10 females, aged from 25 to 59 years, with a mean follow-up time of (5.10±4.51) months. Preoperative symptoms included visual field defects in 19 patients (95%), decreased visual acuity in 18 patients (90%), exophthalmos in 2 patients (10%), diplopia in 2 patients (10%), headache in 2 patients (10%), ocular pain in 2 patients (10%), and color vision abnormalities in 1 patient (5%). Data on patient demographics, medical history, imaging data, surgical approach, and postoperative outcomes were collected. Pre-and post-surgical outcomes including best corrected visual acuity (BCVA), visual field, proptosis, and intraocular pressure were compared. Surgical approaches included transnasal endoscopic OCH resection (12 cases, 60%) and transnasal endoscopic combined conjunctival approach OCH resection (8 cases, 40%). The results of the postoperative 2-week review were used as the postoperative short-term efficacy data, and those at 3 months were used for postoperative therapeutic efficacy analysis. SPSS 26.0 statistical software was applied for statistical analysis.Results:In 20 patients, all OCH were completely resected, and the BCVA, visual field, and exophthalmos were significantly improved post-operatively. The differences were statistically significant before and after surgery ( t values were 3.169, 5.127, and 3.350, respectively, all P<0.05). There were no serious complications in the short term after surgery. The short-term complications after endoscopic surgery alone were mainly new-onset diplopia in 1 case (1/12), and the short-term complications after combined approach were new-onset diplopia in 5 cases (5/8) and pupil dilation in 2 cases (2/8). All short-term complications recovered within 3 months, and no serious or permanent complications occurred in the long-term follow. Conclusion:The endoscopic transnasal surgery is a safe and effective approach for complete resection of ORBIT stage Ⅲ OCH, with promising early results.
3.Construction of supportive care program for patients treated with CAR-T immunotherapy for lymphoma
Zhidi ZHANG ; Meihua CHEN ; Huizhen ZHANG ; Xinyan YU
China Modern Doctor 2025;63(16):1-4
Objective Based on the needs of supportive care,a supportive care program for patients treated with lymphoma chimeric antigen receptor T cell(CAR-T)immunotherapy was constructed.Methods A questionnaire for supportive care program was initially constructed through a literature review and semi-structured interviews,and then refined through two rounds of Delphi method.Results The response rates for two rounds of questionnaires were both 100%.The expert authority coefficients were 0.89 and 0.90 respectively,and the Kendall's coefficient of concordance was 0.253 and 0.262 respectively.The final program included five primary categories(health information support,physiological symptoms and daily living support,psychological support,care and emotional support,and safety support),20 secondary categories,and 50 tertiary categories.Conclusion The supportive care program developed in this study for patients receiving CAR-T immunotherapy for lymphoma has certain scientific and feasibility.
4.Construction of supportive care program for patients treated with CAR-T immunotherapy for lymphoma
Zhidi ZHANG ; Meihua CHEN ; Huizhen ZHANG ; Xinyan YU
China Modern Doctor 2025;63(16):1-4
Objective Based on the needs of supportive care,a supportive care program for patients treated with lymphoma chimeric antigen receptor T cell(CAR-T)immunotherapy was constructed.Methods A questionnaire for supportive care program was initially constructed through a literature review and semi-structured interviews,and then refined through two rounds of Delphi method.Results The response rates for two rounds of questionnaires were both 100%.The expert authority coefficients were 0.89 and 0.90 respectively,and the Kendall's coefficient of concordance was 0.253 and 0.262 respectively.The final program included five primary categories(health information support,physiological symptoms and daily living support,psychological support,care and emotional support,and safety support),20 secondary categories,and 50 tertiary categories.Conclusion The supportive care program developed in this study for patients receiving CAR-T immunotherapy for lymphoma has certain scientific and feasibility.
5.Analysis of short-term efficacy and safety of transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in resection of benign orbital apex lesions
Qiang ZUO ; Zhidi ZHANG ; Jichao ZHOU ; Hailing JIANG ; Yi WANG ; Yinghong ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(9):1070-1077
Objective:To evaluate the early efficacy and safety of the exclusively transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in the resection of benign orbital apex lesions.Methods:A retrospective analysis was conducted on 51 patients who underwent transnasal endoscopic resection of benign lesions in the orbital apex at Peking University Third Hospital from May 2021 to December 2024. The study population was composed of 17 males and 34 females, with the age of (39.4±12.4) years (range: 4 to 65 years). Pathology diagnoses were identified as orbital cavernous hemangioma (OCH, n=38), schwannoma ( n=8), solitary fibrous tumor ( n=1), mucocele ( n=1), optic nerve sheath meningioma ( n=1), pseudotumor ( n=1), and organized hematoma ( n=1). Two surgical approaches were compared as the exclusively transnasal endoscopic resection ( n=27) and the combined transconjunctival-endoscopic approach (combined approach, n=24). Preoperative and postoperative evaluations were conducted for the best corrected visual acuity (BCVA), visual field, intraocular pressure (IOP), and exophthalmos before and after surgery. Demographic characteristics, tumor features, and postoperative complications were analyzed between the two surgical groups. Differences in Orbital Resection by Intranasal Technique (ORBIT) stage between the two surgical approaches were analyzed. SPSS 27.0 software was used for statistical analysis. Results:Among the 51 patients, 3 schwannomas underwent intracapsular resection (1 via exclusively transnasal endoscopic approach, and 2 via combined approach), and the remaining 48 patients underwent complete tumor resection. Significant postoperative improvements were observed in BCVA, visual field, IOP and exophthalmos ( t value was 2.96, 4.34, 4.85, and 4.63, respectively, all P<0.05). The combined approach required longer operative time but showed comparable intraoperative blood loss. Tumors resected via the combined approach were larger in volume, though not statistically significant. Postoperative complications (e.g., diplopia, mydriasis) were more frequent in the combined approach group but resolved within a short-term period. There was no significant difference in ORBIT stage between the two groups ( P=0.178). Conclusions:Both exclusively transnasal and combined transconjunctival-endoscopic approaches prove safe and effective for benign orbital apex lesions resection. The combined approach ensures complete tumor removal.
6.Endoscopic endonasal surgery for ORBIT stage Ⅲ orbital cavernous hemangioma: a preliminary experience of 20 cases
Zhidi ZHANG ; Yi WANG ; Jichao ZHOU ; Yali DU ; Qiang ZUO ; Hailing JIANG ; Yinghong ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(3):321-329
Objective:To evaluate the early efficacy and safety of transnasal endoscopic surgical resection of orbital cavernous hemangioma (OCH) at orbital resection by intranasal technique (ORBIT) stage Ⅲ.Methods:A retrospective study was conducted on 20 patients (20 eyes) who underwent nasal endoscopic surgery to remove ORBIT stage Ⅲ OCH at the Third Hospital of Peking University from July 2021 to July 2024. The cohort were included 10 males and 10 females, aged from 25 to 59 years, with a mean follow-up time of (5.10±4.51) months. Preoperative symptoms included visual field defects in 19 patients (95%), decreased visual acuity in 18 patients (90%), exophthalmos in 2 patients (10%), diplopia in 2 patients (10%), headache in 2 patients (10%), ocular pain in 2 patients (10%), and color vision abnormalities in 1 patient (5%). Data on patient demographics, medical history, imaging data, surgical approach, and postoperative outcomes were collected. Pre-and post-surgical outcomes including best corrected visual acuity (BCVA), visual field, proptosis, and intraocular pressure were compared. Surgical approaches included transnasal endoscopic OCH resection (12 cases, 60%) and transnasal endoscopic combined conjunctival approach OCH resection (8 cases, 40%). The results of the postoperative 2-week review were used as the postoperative short-term efficacy data, and those at 3 months were used for postoperative therapeutic efficacy analysis. SPSS 26.0 statistical software was applied for statistical analysis.Results:In 20 patients, all OCH were completely resected, and the BCVA, visual field, and exophthalmos were significantly improved post-operatively. The differences were statistically significant before and after surgery ( t values were 3.169, 5.127, and 3.350, respectively, all P<0.05). There were no serious complications in the short term after surgery. The short-term complications after endoscopic surgery alone were mainly new-onset diplopia in 1 case (1/12), and the short-term complications after combined approach were new-onset diplopia in 5 cases (5/8) and pupil dilation in 2 cases (2/8). All short-term complications recovered within 3 months, and no serious or permanent complications occurred in the long-term follow. Conclusion:The endoscopic transnasal surgery is a safe and effective approach for complete resection of ORBIT stage Ⅲ OCH, with promising early results.
7.Factors influencing dyadic coping in young and middle-aged patients with lymphoma
Qian ZOU ; Meihua CHEN ; Zhidi ZHANG
China Modern Doctor 2024;62(35):1-5
Objective To investigate and analyze the level of dyadic coping and its influencing factors in young and middle-aged lymphoma patients.Methods A total of 90 young and middle-aged lymphoma patients and spouses in the Internal Medicine of Lymphoma,Zhejiang Cancer Hospital from March 2023 to May 2024 were selected for the study using convenience sampling method.The general information questionnaire,dyadic coping inventory,dyadic adjustment scale,and functional assessment of cancer therapy-lymphoma were selected for questionnaire survey,and influencing factors of dyadic coping in young and middle-aged lymphoma patients were explored using univariate analysis,correlation analysis,and multiple linear regression analysis.Results Differences in dyadic coping scores were not statistically significant when comparing different ages,living environments,types and stages of lymphoma,types of health insurance,and patients'and spouses'knowledge of the disease(P>0.05),and in comparison of dyadic coping scores for patients with different levels of genders,literacy levels,cycles of chemotherapy,and average monthly household incomes,the difference was statistically significant(P<0.05).Young and middle-aged lymphoma patients had dyadic coping score of(124.022±22.924)points,marital quality score of(119.156±18.821)points,and functional assessment of cancer therapy-lymphoma score of(120.811±20.170)points,and correlation analyses showed that the three were positively correlated.Multiple regression analysis showed that patients'average monthly family income and marital quality were main factors affecting their dyadic coping.Conclusion The dyadic coping ability of young and middle-aged lymphoma patients is at an intermediate level,and there is still room for further improvement.The work should focus on young and middle-aged lymphoma patients in the early stages of disease treatment,with low family financial income,low literacy levels,unstable marital status and poor quality of life,assisting them to develop appropriate intervention strategies from the perspectives of symptom management of the disease and dyadic relationships between the couples,To enhance their dyadic coping skills.
8.Factors influencing dyadic coping in young and middle-aged patients with lymphoma
Qian ZOU ; Meihua CHEN ; Zhidi ZHANG
China Modern Doctor 2024;62(35):1-5
Objective To investigate and analyze the level of dyadic coping and its influencing factors in young and middle-aged lymphoma patients.Methods A total of 90 young and middle-aged lymphoma patients and spouses in the Internal Medicine of Lymphoma,Zhejiang Cancer Hospital from March 2023 to May 2024 were selected for the study using convenience sampling method.The general information questionnaire,dyadic coping inventory,dyadic adjustment scale,and functional assessment of cancer therapy-lymphoma were selected for questionnaire survey,and influencing factors of dyadic coping in young and middle-aged lymphoma patients were explored using univariate analysis,correlation analysis,and multiple linear regression analysis.Results Differences in dyadic coping scores were not statistically significant when comparing different ages,living environments,types and stages of lymphoma,types of health insurance,and patients'and spouses'knowledge of the disease(P>0.05),and in comparison of dyadic coping scores for patients with different levels of genders,literacy levels,cycles of chemotherapy,and average monthly household incomes,the difference was statistically significant(P<0.05).Young and middle-aged lymphoma patients had dyadic coping score of(124.022±22.924)points,marital quality score of(119.156±18.821)points,and functional assessment of cancer therapy-lymphoma score of(120.811±20.170)points,and correlation analyses showed that the three were positively correlated.Multiple regression analysis showed that patients'average monthly family income and marital quality were main factors affecting their dyadic coping.Conclusion The dyadic coping ability of young and middle-aged lymphoma patients is at an intermediate level,and there is still room for further improvement.The work should focus on young and middle-aged lymphoma patients in the early stages of disease treatment,with low family financial income,low literacy levels,unstable marital status and poor quality of life,assisting them to develop appropriate intervention strategies from the perspectives of symptom management of the disease and dyadic relationships between the couples,To enhance their dyadic coping skills.
9.Analysis of the efficacy of transnasal endoscopic annulus of zinn area decompression in the treatment of dysthyroid optic neuropathy
Zhidi ZHANG ; Yi WANG ; Jichao ZHOU ; Yali DU ; Weini HU ; Chiyu XU ; Yinghong ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(12):1198-1205
Objective:To evaluate the early efficacy and safety of transnasal endoscopic decompression in the annulus of zinn (AZ) region for refractory dysthyroid optic neuropathy (DON) and to preliminarily analyze the correlated factors of postoperative visual function outcome.Methods:From July 2021 to January 2023, 35 patients (56 eyes) with DON who received AZ area decompression in Peking University Third Hospital were included retrospectively, including 9 males (13 eyes) and 26 females (43 eyes), aging (52.2±12.0) years. Among them, 35 eyes underwent two-wall (medial and inferior) orbital decompression using an endonasal endoscopic approach, while 21 eyes received three-wall (medial, lateral, and inferior) orbital decompression through a combined approach. Key parameters such as best corrected visual acuity (BCVA), visual field (MD value), eyeball prominence, intraocular pressure, and complications were recorded. Postoperative data were collected one month after surgery. The statistical analysis was performed using paired t-test and Spearman correlation analysis. Results:Significant outcomes were observed post surgery in BCVA, visual field, intraocular pressure and proptosis ( t value was 8.37, 6.17, 4.50, and 9.20, respectively, all P<0.001). The reduction in proptosis was statistically significant between the 2-wall and 3-wall orbital decompression groups ( t=-2.82, P=0.007). Changes in BCVA, visual field, and intraocular pressure before and after surgery was greater in the 3-wall orbital decompression group compared to 2-wall orbital decompression group, although the difference was not statistically significant (all P>0.05). Change in postoperative visual acuity and visual field was significantly positively correlated with preoperative visual acuity and preoperative visual field (all P<0.001). Similarly, change in intraocular pressure and proptosis was positively correlated with preoperative intraocular pressure and preoperative protrusion (all P<0.001). Preoperative diplopia was reported in seven patients (20.0%), and two new cases (5.7%) were noted post-operation, which resolved within 3 months after surgery. Conclusions:Endoscopic endonasal decompression of the AZ area is a safe and effective surgical treatment for DON, with notable improvements in BCVA. Furthermore, three-orbital wall decompression seems to yield better outcomes in terms of eye retraction.
10.Chemotherapy combined with immunotherapy in treatment of middle and advanced stage non-small cell lung cancer
Jiangang ZHANG ; Zhifeng YE ; Ling HUANG ; Ting HUANG ; Zhidi ZHANG
Chinese Journal of Endocrine Surgery 2015;(6):504-507
Objective To study the efficacy of chemotherapy combined with immunotherapy in treatment of middle and advanced stage non-small cell lung cancer and improvement of patients'life quality.Methods 140 patients with middle and advanced stage non-small cell lung cancer treated from Mar .2012 to Mar.2014 were in-cluded and they were randomly divided into two groups:the observation group(70 cases)and the control group(70 cases).The observation group took chemotherapy combined with immunotherapy , while the control group took chemotherapy treatment alone .Patients'life quality , treatment effects and changes in immune indexes were co-mared between the two groups .Results The improvement rate of life quality of the observation group (90.0%) was significantly higher than that of the control group (58.6%), and the difference had satistical significance (P<0.05).The response rate of the observation group (88.6%) was significantly higher than that of the control group(70.0%), and the difference had statistical significance (P<0.05).The increasement rate of CD3 +, CD4 +, CD8 +cells, as well as CD4 +/CD8 +cells was significantly higher in the observation group than in the control group, and the difference had statistical significance (P<0.05).Conclusion Chemotherapy combined with immunotherapy in teatment of patients with middle and advanced non-small cell lung cancer has obvious effect, high safety, and high clinical value .

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