目的:探讨鼻内窥镜下下鼻甲成形术加骨折外移术治疗慢性肥厚性鼻炎的临床应用价值。方法: 对符合慢性肥厚性鼻炎的56例患者在00内窥镜下骨折下鼻甲,切除下鼻甲增生肥厚部分外侧面黏膜及其下肥大骨质,内侧的黏膜瓣保留并覆盖在下鼻甲创面上形成新下鼻甲。随访1到2年。结果: 56例中,治愈42例(75.0%),有效13 例(23.2%),无效1例(1.8%),总有效率98.2%,无并发症发生。结论: 鼻内窥镜下下鼻甲成形术加骨折外移术是治疗慢性肥厚性鼻炎较为理想的手术方法。
Influenza A is an acute infectious respiratory disease caused by influenza A virus, with typical signs and symptoms of upper and / or lower respiratory tract involvement, and symptoms of systemic disease such as fever, headache, myalgia and fatigue. Although it is a self-limited disease in the general population, it is associated with increased morbidity and mortality in some high-risk populations and often leads serious complications, such as severe acute lung injury, acute respiratory distress syndrome, as well as other extrapulmonary injuries. The exploration of the mechanisms of lung injury caused by influenza A infection could be helpful to understand the pathogenic mechanisms of other viral pneumonias, such as coronavirus disease 2019.
目的 探讨乳腺癌改良根治术中保留肋间臂神经（ICBN）的临床效果。方法 笔者所在医院2005年3月至2009年3月期间行乳腺癌改良根治术54例，其中保留ICBN 39例，未能保留者15例，术后严密追踪观察。结果 保留ICBN和未能保留ICBN患者术后1个月皮肤感觉异常者分别为5例（12.8%）和13例（86.7%），两者差异有统计学意义（P＜0.01）；保留ICBN感觉异常者均在术后2～3个月内恢复正常，未保留ICBN感觉异常者3个月后症状稍有改善，有7例6个月后仍未恢复。全部病例均获随访，随访时间6～36个月，平均22个月，无复发。结论 保留ICBN能减少乳腺癌患者术后上肢感觉障碍的发生，提高其生活质量。
目的 探讨进展期胃癌联合脏器切除的指征和临床效果。方法 回顾性分析我院1998年6月至2008年6月期间施行联合脏器切除的43例进展期胃癌患者的临床资料，并与同期行姑息性手术的29例进展期胃癌患者相比较。结果 术后1、3及5年生存率联合脏器切除患者分别为65.1% （28/43）、30.2% （13/43）及18.6%（8/43），姑息性手术患者分别为41.4% （12/29）、10.3% （3/29）及0 （0/29），前者明显高于后者（P＜0.05）。联合脏器切除组并发症发生率为14.0% （6/43），而姑息性手术组并发症发生率为13.8% （4/29），二者比较差异无统计学意义（P＞0.05）。结论 进展期胃癌实施联合脏器切除联合术中腹腔内温热化疗等综合治疗，可提高术后生存率。
ObjectiveTo elucidate the latest research progress of Yes-associated protein (YAP) / transcriptional coactivator with PDZ-binding motif (TAZ) in regulating tumor drug resistance. MethodThe relevant literature on YAP/TAZ in regulating tumor cell chemotherapy, immunotherapy, and targeted therapy resistance was reviewed and summarized in the databases such as PubMed, CNKI, and so on. ResultsThe YAP/TAZ was involved in the resistance regulation of chemotherapy, immunotherapy, and targeted therapy in various human tumors. The YAP/TAZ could interact with various proteins to induce the occurrence of tumor resistance. The imbalance of YAP/TAZ signaling might lead to an important mechanism of tumor cell resistance. ConclusionsThere is a close relation between YAP/TAZ and tumor cell resistance. Studying the mechanism of YAP/TAZ regulating tumor resistance can provide new strategies and targets for addressing tumor resistance.
目的 探讨复发性结节性甲状腺肿再手术中喉返神经损伤的预防方法。方法 回顾性分析笔者所在单位1996年7月至2009年7月期间再次手术治疗的56例复发性结节性甲状腺肿患者的临床资料，术中行喉返神经解剖31例，未行喉返神经解剖25例。 结果 未行喉返神经解剖者中有3例出现暂时性喉返神经损伤，损伤率为12.0%；行喉返神经解剖者中无一例出现喉返神经损伤，损伤率为0；两者之间差异有统计学意义（χ2=3.931，P＜0.05）。 结论 复发性结节性甲状腺肿再手术时解剖喉返神经有助于降低喉返神经的损伤；术中精细的操作和细致的解剖是避免喉返神经损伤的关键。
ObjectiveTo investigate the effect of anterior chest wall depression on the cardiac function and the effectiveness of minimally invasive surgery for pectus excavatum by comparing cardiac function and morphology between pre- and post-operation. MethodsBetween August 2009 and December 2010, 102 adult patients with pectus excavatum were treated with minimally invasive surgery, including the primary operation in 95 cases and the reoperation in 7 cases. There were 84 males and 18 females, aged 18-57 years (mean, 23.4 years). The haller index (HI) was 4.59 ± 1.51. Of 102 patients, 59 were classified as pectus excavatum type I and 43 as type II; 42 had clinical symptoms and 19 had the physical sign of heart. The preoperative chest CT examination showed cardiac compression in all patients and heart displacement in 74 patients. The left ventricular ejection fraction (LVEF) was 68.9% ± 6.2%. ResultsThe procedure was successful in all patients, and no death or serious complication occurred. The patients were followed up 12-28 months (mean, 21 months). The clinical symptoms and cardiac physical sign of the patients disappeared after operation. HI was 2.70 ± 0.33 at 12 months after operation, showing significant difference when compared with preoperative HI (t=5.83, P=0.00). According to Nuss’s evaluation method, the results were excellent in 99 patients and good in 3 patients. CT examination showed complete relief of cardiac compression in 101 patients and mild cardiac compression in 1 patient; the heart position was normal at 12 months after operation. Electrocardiogram returned to normal in 4 patients having abnormal electrocardiogram. LVEF was 70.5% ± 4.8% after operation, showing no significant difference when compared with preoperative LVEF (t=1.08, P=0.30). ConclusionThe main effects of pectus excavatum in adults on heart are compression and displacement. Cardiac compression may be relieved efficiently and the patient’s clinical symptoms can be abated by minimally invasive surgery.
ObjectiveTo explore the application value of multidisciplinary collaborative team (MDT) model in retroperitoneal tumors involving large vessels.MethodsThree cases of retroperitoneal tumors involving great vessels admitted to Xiang’an Hospital of Xiamen University in 2019 were retrospectively analyzed. With the support of 3D visual reconstruction and virtual reality (VR) technology, we performed MDT discussion and three cases received treatment of surgery, intervention, and targeted therapy.ResultsCase 1 was discussed by MDT and concluded that, based on CT examination, 3D reconstruction, and VR virtual image results, the tumor on the right side was determined to be completely resectable. The left tumor was judged to be unresectable, and the proposed treatment plan was right metastatic tumor resection + left metastatic tumor radiofrequency ablation. After surgery case 1 had been followed up for 6 months. The symptoms of diarrhea were significantly improved. CT reexamination showed that liver lesions and left retroperitoneal lesions were the same size and the condition was stable. After discussion by MDT, radiofrequency ablation around the tumor was proposed for case 2. This case was followed up for 3 months after surgery, and CT reexamination showed no new lesion in retroperitoneum. After MDT discussion, we concluded that arteriovenous fistula of case 3 had no indications for surgery, and proposed interventional combined with targeted therapy. After treatment, the tumor was found to be smaller after reexamination in 8 months than before treatment, and the efficacy was evaluated as partial remission. The follow-up was continued.ConclusionThe future development trend of retroperitoneal tumor therapy involving great vessels is to evaluate each patient’s condition under the MDT mode by using 3D visual reconstruction and VR technology, and to formulate the individualized treatment plan of operation combined with other treatments.