Objective To explore the risk factors of perioperative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic surgery,and construct a nomogram predic-tion model.Methods A retrospective analysis was conducted on the clinical data of 262 patients who un-derwent the nasal endoscopic surgery from January 2021 to May 2023.The patients were divided into two groups according to perioperative blood transfusion or not:non-transfusion group and transfusion group.Uni-variate and multivariate logistic regression were conducted to identify independentrisk factors of perioperative blood transfusion,and a nomogram prediction model was developed.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated.Results The incidence of blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic surgery was 46(17.6％).Multivariate logistic regression analysis revealed that preoperative hemoglobin level 70 to＜100 g/L(OR=6.178,95％CI 2.271-16.805,P＜0.001),preoperative albumin level 25 to＜35 g/L(OR=2.126,95％CI 1.021-4.424,P=0.044),and classification of surgery grade Ⅲ or Ⅳ (OR=4.725,95％CI 1.634-13.584,P=0.004)were independent risk factors for predicting perioper-ative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic sur-gery.The AUC of the nomogram model was 0.769(95％CI 0.701-0.838),the sensitivity was 67.6％,and the specificity was 76.1％.Conclusion Preoperative hemoglobin level 70 to＜100 g/L,preoperative albumin level 25 to＜35 g/L,and classification of surgery grade Ⅲ or Ⅳ are independent risk factors of perioperative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endo-scopic surgery.The nomogram model established based on the above risk factors has good predictive ability for perioperative blood transfusion.

Because of its high degree of malignancy and complicated anatomy,the malignant tumors of liver and pancreas have always been the difficult and important point in the field of surgery.As an interdisciplinary subject in the field of rapid development and medical surgery,3D printing technology has shown great application potential in surgical field because of its unique advantages of individualized medical treatment.3D printing technology has been gradually applied to clinical work by clinicians through the development of auxiliary surgical programs,improving the accuracy of surgery,and facilitating communication between doctors and patients.This article reviews the new application and new technology of this technique in the surgical treatment of liver disease and pancreatic disease.

Objective: To explore the clinical efficacy in patients who underwent endoscopic nasopharyngectomy for primary advanced nasopharyngeal carcinoma (NPC). Methods: Forty-five patients who underwent endoscopic nasopharyngectomy for primary advanced NPC encountered between Aug. 2007 and Sep. 2015 were retrospectively reviewed. Twenty-seven patients were male (60.0%), and 18 patients were female (40.0%), the ratio of male to female was 3∶2. The median age was 53 years old (ranged from 13 to 75 years old). The median onset time was 5 months (ranged from 1 to 72 months). TNM stage: 16 cases were at stage Ⅲ (35.6%), 29 at stage Ⅳ (64.4%); T3 16 cases (35.6%), T4 29 cases (64.4%); N0 38 cases (84.4%), N2 7 cases (15.6%). No patients were found to have distance metastasis. All patients underwent endoscopic resection of lesions. Postoperatively all the patients were treated with radiotherapy or chemoradiotherapy. Using SPSS 19.0 software, Kaplan-Meier and Log-rank test were done for the assessmen of survival rate; Cox proportional hazards model was used for the univariate analysis of prognostic factors. Results: The median follow-up was 36 months (ranged from 6 to 97 months), with 36 cases surviving (80.0%), 9 cases died (20.0%); 15 cases relapsed (33.3%). The overall 1 year survival rates (SR), 3 year SR, 5 year SR was 90.6%, 81.0%, 76.0%, respectively. The survival univariate analysis indicated the recurrence and metastasis were correlated with the survival (χ² value was 16.644, 6.451, respectively, all P<0.05). Conclusion The patients who undergo endoscopic nasopharyngectomy for primary advanced NPC have better survival rate with lower recurrent rate and metastatic rate.

[ABSTRACT]OBJECTIVEThis study aims to explore the molecular mechanism and expression of Wnt/β-catenin signaling pathway and tumor marker CD44 in nasopharyngeal carcinoma cells after transfection withβ-Catenin when the Wnt/β-catenin signaling pathway was blocked.METHODSSP cells and CD44+SP cells isolated from the nasopharyngeal carcinoma cell line CNE-2 by flow cytometry were identified. Changes in the number and biological characteristics of CNE-2 and CD44+SP cells in vitro were investigated after the Wnt/β-catenin signaling pathway was blocked through siRNA.RESULTSSP cells accounted for 2.3% of nasopharyngeal carcinoma CNE-2 cells, andCD44+SP cells accounted for 36.5% of the SP cells. CD44+SP cells showed significantly higher in vitro proliferation and resistance to chemotherapy (P<0.05). After transfection withβ-Catenin siRNA, the proliferation, cloning efficiency, and tolerance to chemotherapeutic drugs of the cells were found statistical differences compared with those before transfection ofβ-Catenin siRNA. CONCLUSIONWnt/β-catenin signaling pathway abnormalities are closely related to the biological behavior of nasopharyngeal carcinomaCD44+SP cells. Interference of this pathway can change the characteristics of nasopharyngeal carcinoma stem cells.

Objective:To understand the characteristics and the treatment methods of the Salvage endoscopic surgery for residual or recurrent nasopharyngeal carcinoma（rNPC）with different rT grading after irradiation failure, and to explore the effect of different endoscopic procedures on the prognosis of the diseases.Method:Ninety-six patients who underwent endoscopic salvage nasopharyngectomy for rNPC in our department between June 2009 and March 2015 were retrospectively reviewed.All the patients underwent the corresponding salvage endoscopic surgery under general anesthesia according to the different rT grading and the patients with cervical metastasis received the radical neck dissection at the same time.Result:The number of the patients whose lesions were completely removed was 44(Total removal rate 45.8%),and the number of subtotal removal was 52(subtotal removal rate 45.8%),respectively.Postoperative follow-up continued until April 2015，the median follow-up was 19 months(1-57 months),the number of overall survival patients was 62(64.6%),the number of death was 34（35.4%）. The overall 1 year survival rate(SR),2 year SR,3 year SR were 83%,68%,63%,respectively.The median survival time was 43 months.Conclusion:The patients who underwent salvage endoscopic surgery for rNPC could have a good survival rate,and the different rT grading made the different methods to resect the lesions by the endoscopy. The use of frozen pathological examination during the operation to determine the negative rate of the surgical margins is the key to ensure the operation curative effect.

Objective To investigate the clinical efficacy of endoscopic surgery for extensive osteoradionecrosis (ORN) of skull base in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.Methods Seventeen patients diagnosed as ORN of skull base after radiotherapy for NPC and underwent endoscopic surgery were retrospectively studied with their clinic data.Results Based on the CT and endoscopic examination,all patients had large skull base defects with bone defects averaged 7.02 cm2 (range,3.60-14.19 cm2).Excepting for curetting the sequestra,endoscopic surgery was also used to repair the wound or to protect the internal carotid artery with flap in 12 patients.No bone reconstructions were conducted in all patients with the bone defects of skull base.CT examinations were taken after endoscopic surgery when required.The postoperative follow-up ranged from 8 months to 6 years (average,14 months).Aside from 1 patient with delayed cerebrospinal fluid (CSF),others had no related complications.Conclusions The patients with extensive ORN can be treated with endoscopic surgery to curette the necrotic bone of skull base,and endoscopic reconstruction provides an alternative technique.It may not be necessary to reconstruct the bone defects at skull base,however,the exposed important structures of skull base,such as internal carotid artery,need to repair with soft tissue such as flap.

Endoscopy ; Humans ; Myosarcoma ; diagnosis ; surgery ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; surgery ; Paranasal Sinuses ; Skull Base ; Skull Base Neoplasms ; diagnosis ; surgery

OBJECTIVE: To assess the long-term clinical efficacy of endoscopic surgery of primary sinonasal malignant neoplasms and find out the potential postoperative prognostic factors. METHOD: Forty-three clinical cases of primary sinonasal malignant neoplasms treated under endoscopy were analyzed retrospectively. RESULT: Fifteen patients died. The 1-year, 2-year, 3-year and 5-year survival rates were 83. 7% (36/43), 74. 4% (32/43), 69. 8% (30/43) and 65. 1% (28/43), respectively. Kaplan-Meier single-variable analysis showed that gender, T grade, TNM stage and pathological types of olfactory neuroblastoma were statistically significant prognostic factors (P< 0. 05). COX Pro-Portional hazard models showed that TNM stage was an independent prognostic factors. CONCLUSION Endoscopic surgery for primary sinonasal malignant neoplasms is a safe and effective minimally invasive surgical treatment, and it is an important supplement to the traditional surgery. Gender, T grade, TNM stage and pathological types of olfactory neuroblastoma might be significant prognostic factors.
Endoscopy ; Esthesioneuroblastoma, Olfactory ; surgery ; Humans ; Nasal Cavity ; pathology ; surgery ; Nose Neoplasms ; surgery ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVE: Discussion of expression and its significance of CD44 in SP cells of nasopnaryngeal carcinoma. METHOD: Flow cytometry was used to sort cultured CNE-2 cells of nasopharyngeal carcinoma for obtaining CD44-SP and CD44+SP cells. Biological differences of CNE-2, CNE-2 SP, CNE-2 NSP, CNE-2 CD44+SP and CNE-2 CD44-SP cells were statistically analyzed by experiments such as cell migration experiments, plate clone formation assay, cell cycle analysis and sensitivity tests to chemotherapeutics. RESULT: Two point 3 perent of SP cells were extracted from CNE-2 cells of nasopharyngeal carcinoma, among which 36.5% was CD44+SP cells. Abilities of proliferation, cell migration and plate clone of CD44+SP cells were significantly higher than other cells (P < 0.01), and its tolerance to chemotherapeutics was significantly higher too (P < 0.01). CONCLUSION The proportion of SP cells in nasopharyngeal carcinoma cells was small, but SP cells had strong activeness in the aspect of cell proliferation with a "seed" characteristic of tumor cells. As CD44+SP cells played an important role in proliferation and chemotherapy resistance of nasopharyngeal carcinoma, it indicated that CD44 can be one of the surface markers of SP cells of nasopharyngeal carcinoma.
Biomarkers, Tumor ; metabolism ; Carcinoma ; Cell Cycle ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Flow Cytometry ; Humans ; Hyaluronan Receptors ; metabolism ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism

OBJECTIVE: To investigate the influential factors associated with the long-term effect of allergic rhinitis (AR) specific immunotherapy (SIT). METHOD: Retrospective analyzed the following visual analog scale(VAS) before and after the specific immunotherapy of 219 patients with allergic rhinitis. Logistic regression and pair t-test were used to explore the key factors influencing the prognosis. RESULT: (1) The gender and the VAS before specific immunotherapy (P < 0.05) were associated with the long-term effect of allergic rhinitis specific immunotherapy, while family history, the age of specific immunotherapy, number of allergens and stitches and with other allergic diseases (P > 0.05) were not associated with the long-term effect of specific immunotherapy; (2) Compared VAS of different endpoints with VAS before the treatment,there were significant differences. The primary endpoints were the time following no more than half a year (total effective rate: 50.0%), half a year to 1 year (total effective rate: 51.7%), 1 to 2 year (total effective rate: 47.1%), 2 to 3 year (total effective rate: 54.5%) and over 3 year (total effective rate: 40.7%). CONCLUSION Apart from the gender and the VAS before specific immunotherapy,genetic and other factors can not significant influence the long-term effect of specific immunotherapy. The effect of specific im- munotherapy seems to last for 3 years at least. Increasing stitches can not improve long-term effect of SIT,but it can consolidate the effect. The long-term effect of specific immunotherapy tends to drop off with fluctuations over time and the higher of VAS before SIT,the better effect of long-term SIT. Further more, the long-term effect of SIT of male is worse than female. In consequences, we speculate epigenetics related to the interaction between environmental factors and genetic factors plays an important role in the long-term effect of allergic rhinitis specific immunotherapy.
Allergens ; Female ; Humans ; Hypersensitivity ; Immunotherapy ; Male ; Retrospective Studies ; Rhinitis, Allergic ; therapy ; Sex Factors ; Time Factors