Five patients with primary malignancies in the pterygopalatine fossa (PPF) and infra temporal fossa (ITF) were enrolled in this retrospective study between January 2012 and January 2018. After malignancies proven by biopsy and evaluation with CT and MRI scan, all patients received modified maxillary swing (MMS) approach for extirpation of malignant tumors in the PPF and ITF under general anesthesia. En bloc resection with wide surgical margins was successfully performed in all cases. Negative margins were observed in 4 cases and positive margins were found in one patient with adenoid cystic carcinoma who received postoperative radiotherapy. The most common complication was facial numbness. During the follow-up period (range 12 to 57 months), one patient suffered from recurrence while others did not. The advantages of MMS include wide surgical field, full exposure and easy manipulation. The MMS approach is expected to become an standard method for monobloc resection of malignancies in the PPF and ITF.

Objective To study the clinical manifestations and antibiotic sensitivity features of early-and late-onset invasive infections caused by group B Streptococcus (GBS). Methods A total of 96 infants with invasive GBS infections were enrolled prospectively from seven tertiary hospitals of GBS Infection Research Cooperative Group in southwest Fujian, such as Xiamen Maternal and Child Care Hospital, etc., from January 2016 to June 2018. According to the onset time of infection after birth, they were divided into early-onset GBS disease (GBS-EOD) group (<7 d, n=67) and the late-onset GBS disease (GBS-LOD) group (7-89 d, n=29). Clinical manifestations, disease spectrum, complications and outcomes of the two groups were compared. Drug sensitivity test was carried out using disk diffusion test. Chi-square or Fisher's exact test, two independent sample t-test or Mann-Whitney U tests were used for statistical analysis. Results (1) The average ages at onset in GBS-EOD and GBS-LOD groups were (15.8±6.7) h (0.5-142.0 h) and (25.0±8.1) d (9-89 d), respectively. The incidence of tachypnea, pallor, fever and convulsion were noted in 68.7% (46/67) vs 44.8% (13/29), 52.2% (35/67) vs 17.2% (5/29), 23.9% (16/67) vs 65.5% (19/29) and 7.5% (5/67) vs 48.3% (14/29) of GBS-EOD and GBS-LOD groups with χ2 values of 6.282, 10.199, 15.146 and 21.237 (all P<0.05). The main clinical manifestations of GBS-EOD were tachypnea and pallor, while most of the patients in the GBS-LOD group developed fever and convulsions. (2) The incidence of pneumonia, sepsis, meningitis, sepsis complicated by septic joints, pneumonia complicated by sepsis, sepsis complicated by meningitis and pneumonia complicated by sepsis and meningitis were noted in 43.3% (29/67) vs 20.7% (6/29), 9.0% (6/67) vs 17.2% (5/29), 0.0% (0/67) vs 3.4% (1/29), 0.0% (0/67) vs 6.9% (2/29), 31.3% (21/67) vs 13.8% (4/29), 6.0% (4/67) vs 31.0% (9/29) and 10.4% (7/67) vs 6.9% (2/29) of GBS-EOD and GBS-LOD groups. There was a statistically significant difference in the disease spectrum between the two groups (Fisher's exact test, all P<0.001). Compared with the GBS-LOD group, the GBS-EOD group had a higher incidence of pneumonia [85.1% (57/67) vs 41.4% (12/29), χ2=19.116, P<0.001] and a lower incidence of meningitis [16.4% (11/67) vs 41.4% (12/29), χ2=6.922, P=0.009]. Complications such as acute respiratory distress syndrome (ARDS), pulmonary hemorrhage, shock and persistent pulmonary hypertension of the newborn (PPHN) occurred much more in the GBS-EOD group than the GBS-LOD group [28.4% (19/67) vs 6.9% (2/29), 13.4% (9/67) vs 0.0% (0/29), 11.9% (8/67) vs 10.3% (3/29), 4.5% (3/67) vs 0.0% (0/29), χ2=13.683, P<0.001]. (3) Among the 96 patients, 23 (24.0%) had meningitis and 73 (76.0%) developed pneumonia and sepsis. Meningitis resulted in a higher fatality rate [17.4% (4/23) vs 4.1% (3/73), χ2=4.564, P=0.035] and longer average hospital stay [(37.2±12.6) vs (14.1±5.3) d, t=7.831, P<0.001] than pneumonia and sepsis. Seven out of the 19 meningitis survivors developed intracranial complications. (4) The overall fatality rate in this study was 7.3% (7/96) and no significant difference was found between GBS-EOD and GBS-LOD group [7.5% (5/67) vs 6.9% (2/29), χ2=0.010, P=0.982]. Among the 67 GBS-EOD infants, 58 (86.6%) occurred within 24 h and five of them died, but no death was reported in the other nine cases occurred after 24 h. (5) Totally 96 strains of GBS were isolated with 100% sensitivity to penicillin, ampicillin, cefazolin and meropenem, and 97% to vancomycin. Around 79.3%-91.0% of GBS isolates were resistant to clindamycin and erythromycin. Conclusions Clinial features vary greatly in GBS-LOD and GBS-EOD cases. Infants with meningitis have poor prognosis. The drug resistance rate of GBS to erythromycin and clindamycin are relatively high.

Objective To explore the influence of network intervention on lifestyle and behaviors habit of the middle -aged patients with hypertension.Methods All 300 middle -aged patients with hypertension were randomly assigned into the study group and the control group.Each group had 150 cases.All patients in the both two groups were given hypotensive drugs according to treatment specification of hypertension.The patients in the study group received a network intervention for 2 years,while the patients in the control group received an outpatient service follow-up.The difference of lifestyle and behaviors habit of the patients in the two groups were observed and compared. Results There were no significant differences with all items of the lifestyle and behaviors habit of the patients between the two groups before intervention(P >0.05 ).In the 12th end of month after intervention,there were no significant differences between the two groups with the items of smoking control,working and resting regularly,hobby and psychological balance(P >0.05),but other items in the study group were significantly better than those in the control group(Z =-3.062,-2.509,-2.239,-2.056,-2.126,-2.045,-2.023,all P <0.05).In the 24th end of month after intervention,all items in the study group were significantly better than those in the control group (Z =-4.078,-3.792,-2.080,-2.098,-1.985,-2.478,-2.173,-2.478,-3.290,-2.514,-2.730,all P <0.05 ).Conclusion The network intervention can significantly improve lifestyle and behaviors habit of the middle -aged patients with hypertension.Its effect is much better than that of outpatient service follow -up.

OBJECTIVETo investigate the clinicopathologic features and differential diagnoses of non-involuting congenital hemangioma (NICH) in children.

METHODSThe clinical, morphologic and immunophenotypic characteristics of 22 cases of NICH were retrospectively analyzed.

RESULTSThe mean patients' age at diagnosis was 4.2 years, with a male to female ratio of 1.75:1. The tumors were located in the head and face (5 cases), neck (3 cases), body (6 cases), upper limbs (5 cases), and lower limbs (3 cases). Histologically, the tumor was dominated by rather large lobules of small vessels that were mostly rounded, curved, small and thin-walled, and were lined by endothelial cells surrounded by one or more layers of pericytes. The center of the lobules was occupied by one or more thin or thick walled vessels, which were surrounded by fibrous and fatty tissue, which contained abnormal arterial and venous structures. At the edge of the lobules there were lymphatic vessels. Immunohsitochemical study showed that tumor cells in NICH were positive for CD34 (22/22), CD31 (22/22), SMA (22/22), vimentin (22/22) and Glut1 (0/22). D2-40 expression was located at the edge of the capillary lobules.

CONCLUSIONSNICH is a benign lesion. Clinically and pathologically, it needs to be differentiated from rapidly involuting congenital hemangioma, infantile hemangiomas, tufted angioma, vascular malformation, and others.

Biomarkers, Tumor ; Child, Preschool ; Diagnosis, Differential ; Female ; Hemangioma, Capillary ; congenital ; diagnosis ; Humans ; Male ; Retrospective Studies

The traditional approach to accessing healthcare information restricts the further development of healthcare services,thus unable to meet the growing needs of individual healthcare.The flexible sensor technology has emerged along with the development of new materials,machinery and manufacturing technology.As a result,textiles,accessories,human skin and even internal body organs can be integrated with various sensors.The popularization of flexible sensors provides new methods for monitoring health,improving therapeutics,investigating disease status and building the human-machine in-terface.Through a systematic investigation of literature,this paper reviews the applications of flexible sensors in health-care,discusses the key technologies,and introduces the common materials and manufacturing technology.

OBJECTIVE: This study aimd to evaluate the application and clinical effect of improved submental island flap in hypopharyngeal cancer reserved laryngeal function surgery. METHOD: A retrospective review of clinical data was performed on 38 patients of hypopharyngeal cancer reserved laryngeal function using sumental island flaps, by the way of improving in design of vascular pedicle, reconstructive mode of laryngeal and hypopharyngeal function and closing of wound of neck following hypopharyngeal cancer resection. Meanwhile, the effect and prognosis was comprehensively assessed on patients with hypopharyngeal cancer reserved laryngeal function using improved submental island flaps. RESULT: The submental flaps kept alive in all 38 cases. During the follow-up period, 18 cases were dead, and of them, 7 cases died of the second primary carcinoma, included 4 cases of esophagus cancer, 1 case of cancer of soft palate, 2 cases of nasopharyngeal carcinoma; and 5 cases died of cervical or parapharyngeal lymph nodes recurrence; 2 cases died of hepatic metastasis; and 4 cases died of pulmonary metastasis. The overall 5-years survival rate was 52.6%. CONCLUSION Improved submental island flap repairing postoperative defect of hypopharyngeal cancer reserved laryngeal function has many advantages including higher success rate, more security, easy and simple to operate as well as good clinical effects, and is worth to widespread using.
Humans ; Hypopharyngeal Neoplasms ; surgery ; Hypopharynx ; surgery ; Larynx ; Neck ; surgery ; Neoplasm Recurrence, Local ; Prognosis ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps ; Survival Rate

Objective To investigate the clinicopathologic features and differential diagnoses of non-involuting congenital hemangioma ( NICH ) in children.Methods The clinical , morphologic and immunophenotypic characteristics of 22 cases of NICH were retrospectively analyzed.Results The mean patients′age at diagnosis was 4.2 years, with a male to female ratio of 1.75∶1.The tumors were located in the head and face (5 cases), neck (3 cases), body (6 cases), upper limbs (5 cases), and lower limbs (3 cases).Histologically, the tumor was dominated by rather large lobules of small vessels that were mostly rounded, curved, small and thin-walled, and were lined by endothelial cells surrounded by one or more layers of pericytes.The center of the lobules was occupied by one or more thin or thick walled vessels , which were surrounded by fibrous and fatty tissue , which contained abnormal arterial and venous structures.At the edge of the lobules there were lymphatic vessels.Immunohsitochemical study showed that tumor cells in NICH were positive for CD34 ( 22/22 ) , CD31 ( 22/22 ) , SMA ( 22/22 ) , vimentin ( 22/22 ) and Glut1 (0/22).D2-40 expression was located at the edge of the capillary lobules.Conclusions NICH is a benign lesion.Clinically and pathologically , it needs to be differentiated from rapidly involuting congenital hemangioma ,infantile hemangiomas ,tufted angioma ,vascular malformation ,and others.

ObjectiveTo investigate the relationship between enhanced CT examination and acute kidney injury in patients with acute pancreatitis.MethodsThe clinical data of 162 acute pancreatitis patients were analyzed retrospectively.Acute kidney injury was diagnosed and graded by RIFLE criterion.The patients were divided into two groups according to enhanced CT examination:enhanced CT group and non-enhanced CT group.ResultsEnhanced CT group had 85 cases,and non-enhanced CT group had 77 cases.The increased creatinine level in enhanced CT group was higher than that in non-enhanced CT group [(59 ± 13 ) μ mol/L vs.(38 ± 11 ) μ mol/L],and there was significant difference between two groups (P ＜0.01 ).The incidence of acute kidney injury in enhanced CT group was higher than that in non-enhanced CT group [30.6％ (26/85) vs.15.6％ (12/77)],and there was significant difference between two groups (P ＜0.01 ).Enhanced CT examination increased the risk of acute kidney injury occurrence (OR =1.293,95％ CI1.089-1.443).After adjusted by diabetes and APACHE Ⅱ score,enhanced CT examination was still anindependent risk factor of acute kidney injury (OR =1.282,95％ CI 1.185-1.377 ).ConclusionsEnhanced CT examination is a potential risk factor of acute kidney injury in acute pancreatitis patients.The time of enhanced CT examination is worthy of further study.

Objective To determine the value of ERCP and EST after Billroth gastroenterostomy. Methods ERCP was used in 31 patients after Billroth- Ⅰ gastroenterostomy, 12 of whom received EST. It was in 137 patients after Billroth-Ⅱ gastroenterostomy, of the 34 received EST and 4 EPBD.Results Billroth- Ⅰ gastroenterostomy ERCP was successfully performed in 28 out of the 31 patients and EST in 11 out of the 12 patients. Billroth- Ⅱ gastroenterostomy ERCP was successfully performed in 109 out of the 137 patients and EST in 31 out of the 38 patients. There were no serious complications in patients receiving endoscopic treatments. Concluasion The success rates of ERCP and EST are high in patients with bile duct lithiasis after Billroth-gastroenterostomy. Endoscopic treatment or cholangioduodenostomy has good therapeutic effects.

OBJECTIVE: To investigate the prevalence of otitis media with effusion (OME) of kindergarten children in Wuhan City. METHOD: The study subjects were 3-6-year-old children in some kindergarten children in Wuhan City . All subjects were assessed with routine otorhinolaryngologic examination, otoscopic examination and tympanometry. Chi-square test were used to analyse the difference of data. RESULT: The prevalence of children of some kindergarten in Wuhan City is 6.67%. There was no statistical difference were found between sexuality. The prevalence of OME in 3 years old group is obviously higher than that in 4-6 years old group. Previous acute otitis media episodes, feeding, high-arched palate, and nasal obstruction are risk factors of OME. CONCLUSION Children with previous acute otitis media episode and nasal obstruction should be suggested to have otorhinolaryngologic examination regularly. It is necessary to have routine otoscopic examination and tympanometry in children of kindergarten.
Child ; Child, Preschool ; China ; epidemiology ; Humans ; Otitis Media ; epidemiology ; Prevalence ; Schools, Nursery