Objective To investigate the assembl ing and cl inical appl ication of the video output system util izing teaching sight glass of surgical microscope. Methods Between June 2009 and April 2010, 10 patients with craniocervical junction malformation were treated by the method of transoral-transpharyngeal approach with the microscope and videooutput system under the direct vision. There were 6 males and 4 females with an average age of 32 years (range, 13-52 years). Three cases had the history of injury and 7 cases had no history of definite injury. The disease duration was from 10 months to 12 years (median, 5 years). The main cl inical symptoms were brevicoll is or torticoll is; 2 patients had malformation appearance and 4 patients had occi put-cervical pain. The physical examination showed that all patients had the symptoms that upper cervical cord was damaged; the imaging examination showed that all patients had basilar invagination, atlantoaxial dislocation, and ossification. Before and after operations, the functions of nerve were evaluated by Japanese Orthopaedic Association (JOA) scoring, the improvement rate was calculated to evaluate the efficacy. Results By the video output system assembly, 15.1 mill ion pixels high-definition images could be collected and reached 1 920 × 1 080 pixels video camera, so assistants or medical students could watch the cl inical operation directly. All patients had no neural injury or cerebrospinal fluid leakage during operation. Basilar invagination and atlantoaxial dislocation were corrected. Infection at incision occurred in 1 patient; other incisions healed by first intention without early compl ication. All patients were followed up 6-16 months (mean, 13.5 months). The average JOA score was increased from 10.2 preoperatively to 15.5 at 6 months postoperatively with an improvement rate of 77.9%. At 12 months after operation, bony fusions were achieved. Conclusion The miscroscope and video output system can improve the effectiveness of the original surgical microscope. It makes visual fields much clearer and operations more accuratewith a few compl ications.
目的：分析口咽部B细胞来源非霍奇金淋巴瘤(NHL)的CT表现、特征，初步探讨不同病理类型B细胞来源NHL的CT表现特点，为临床诊断和治疗提供更为准确的信息。方法：对18例经病理证实的口咽部B细胞来源非霍奇金淋巴瘤的CT表现进行回顾性分析。结果：18例中，弥漫大B细胞淋巴瘤13例，占72.2%(13/18)，滤泡性淋巴瘤3例，占16.7%(3/18)，套细胞淋巴瘤1例，占5.6%(1/18)，结外边缘区淋巴瘤(MALT淋巴瘤)1例，占5.6%(1/18)。病变分布为：扁桃体NHL9例(弥漫大B细胞淋巴瘤8例、套细胞淋巴瘤1例)；舌根8例(弥漫大B细胞淋巴瘤5例、滤泡性淋巴瘤3例)；软腭1例，为结外边缘区淋巴瘤(MALT淋巴瘤)。18例病变均表现为肿块型。同时有淋巴结受累者12例(66.7%)，其中双侧受累者3例。结论：口咽B细胞来源NHL多发生于扁桃体及舌根。病理类型以弥漫大B细胞淋巴瘤为主，主要表现为肿块。 CT对于B细胞来源NHL的鉴别诊断和病变范围的判断具有重要作用。
ObjectiveTo systematically review the effect of selective oropharyngeal decontamination (SOD) on the prevention of ventilator-associated pneumonia (VAP). MethodsWe electronically searched PubMed, EMbase, CBM, Wanfang, CNKI and Cochrane Central Register of Controlled Trials from the date of its establishment to September 2013. We also hand-searched some relevant references of included studies. Two independent reviewers screened the studies for inclusion, extracted data, and assessed trial quality. Meta-analysis was performed using the Cochrane Collaboration's RevMan 5.1 software. ResultsTen randomized controlled trials involving 2 791 patients were included. Results of meta-analysis showed that, compared with control group, SOD could reduce the incidence of VAP[RR=0.53, 95% CI (0.43, 0.65), P<0.000 01]. No statistical differences between the two groups were found for all cause mortality, average duration of receiving mechanical ventilatory assistance or length of stay in intensive care unit. No severe adverse event related to study participation was identified. ConclusionSOD can reduce the occurrence of VAP effectively and safely. Consequently, it may be considered as a good choice in the prevention of VAP.
Objective This study aims to investigate the changes of inflammatory markers of oropharynx and its correlation with prognosis in the stable phase of chronic obstructive pulmonary disease (COPD). Methods Sixty-two patients with COPD in stable stage were divided into smoking and non-smoking groups, and 31 healthy persons were selected as controls. The pharyngeal swabs were collected to determine tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), collagen type Ⅳ (COL-4), and fibronectin (FN) by an enzyme-linked immunosorbent assay. Meanwhile, eosinophil count and C-reactive protein (CRP) in peripheral blood were measured. The correlations between the above metrics and COPD and the prognosis of the patients were analyzed. Results TNF-α, IL-8, COL-4, FN and CRP levels in patients with COPD were significantly higher compared with control groups (P<0.05), and there were significant differences between smoking and non-smoking groups in inflammatory markers such as TNF-α, IL-8, FN, CRP (P<0.05). The forced expiratory volume in one second (FEV1) and FEV1%pred of patients with COPD were significantly lower than the control group (P<0.05). The smoking index of patients with COPD in smoking group was significantly higher than that in smoking control group (P<0.05). TNF- α and IL-8 were positively associated with blood CRP in patients with COPD. Conclusion The inflammatory markers of oropharynx in patients with COPD are different from those in healthy persons and smoking may promote the increase of inflammatory markers of oropharynx in patients with COPD; the non-invasive detection of paired pharyngeal inflammatory markers may be helpful in determining acute onset and prognosis.