Objective To explore the clinical effect of video supported laryngoscopy surgery for the diagnosis and treatment of vocal nodules and vocal polyps in our hospital.Method A retrospective study was conducted on 125 patients with vocal nodules and vocal polyps who underwent surgical treatment in our hospital from January 2020 to June 2022.They were divided into vocal nodules,localized vocal polyps,and diffuse vocal polyps according to the morphology of electronic laryngoscopic tumors,and were treated with daytime center surgery under general anesthesia video laryngoscope.Result The effective rate of video laryngoscopy surgery was 98.4％,with significant therapeutic effects;There was a significant improvement in voice indicators before and after surgery,with a statistically significant difference(P＜0.05);There was a significant improvement in quality of life before and after surgery,as well as a significant improvement in scores of physiological/psychological function/mental health factors before and after surgery,with a statistically significant difference(P＜0.05);The total incidence of surgical adverse events was 4.8％.Conclusion Video assisted laryngoscopy is effective in the diagnosis and treatment of vocal nodules and vocal polyps,which can significantly improve the patient's hoarseness symptoms.Fine surgical procedures can help reduce complications,and postoperative vocal cord rest and oral anti reflux drugs can help reduce recurrence and improve the quality of the patient's voice.

Objective To analyze the clinicopathological features of primary hyperthyroidism complicated with thyroid carcinoma. Methods From January 2010 to July 2018,418 patients complicated with thyroid cancer underwent thyroidectomy in the First Affiliated Hospital of Xiamen University were retrospectively analyzed.According to thyroid function,418 patients were divided into two group:A group ( n =39 ) had hyperthyroidism with thyroid carcinoma,and B group(n=379) had normal thyroid function.The clinicopathological features of the two groups were analyzed and compared.Results There were no statistically significant differences in age,sex,tumor stage and tumor diameter between the two groups(all P>0.05).The lymph node metastasis rate in A group was 17.9%(7/39), which was higher than that in B group[6.1%(23/379)] (χ2 =5.814,P=0.016).The incidence rate of temporary hypoparathyroidism in A group was 28.2%(11/39),which was higher than that in B group[13.2%(50/379)] (χ2 =6.394,P＜0.05).The local recurrence rate in A group was 5.1%(2/39),which was higher than that in B group[2.4%(9/379)],but there was no statistically significant difference(χ2 =0.248,P=0.619).The 5 -year disease-free survival rate in A group was 84. 6%( 33/39 ), which was lower than that in B group [ 95. 8%(363/379)]( χ2 =6.740,P＜0.05).Conclusion Hyperthyroidism complicated with thyroid carcinoma has high aggressive behavior and should be treated actively.

目的:分析探讨儿童鼾症临床治疗方法和临床治疗效果.方法:选取2015年5月-2016年5月在笔者所在医院就诊治疗的鼾症患儿100例作为此次的研究对象,采用双盲法将研究对象分为试验组和对照组,对照组采用药物保守治疗,试验组采用鼻内镜下腺样体扁桃体等离子射频消融手术治疗,比较两组患儿的临床治疗效果.结果:对照组总有效例数为34例,总有效率为68.00％;试验组总有效例数为47例,总有效率为94.00％,术后未发生术后出血、鼻咽部粘连等并发症;比较分析两组患儿临床治疗效果,对照组治疗总有效率明显低于试验,比较差异有统计学意义(P<0.05).结论:手术治疗比药物保守治疗临床效果显著,针对症状较轻的患儿可优先考虑药物保守治疗,对药物保守治疗不佳的患儿的需及时进行手术治疗,腺样体扁桃体等离子射频消融术手术效果良好,治疗微创,值得推广应用.

目的 观察甲状腺乳头状癌手术治疗效果、 术后并发症情况、 中央区淋巴结转移情况及术后进一步碘131治疗、甲状腺激素药物抑制治疗情况,以指导临床.方法 回顾性分析我院2013年3月—2014年3月术中冰冻及术后常规病理确诊为甲状腺乳头状癌患者60例的病历资料,患者均接受Focus超声刀手术治疗.根据患者具体情况对于原发灶采用甲状腺腺叶+峡部切除术或双侧甲状腺全切除术.均行患侧中央区淋巴结清扫,注意保留甲状旁腺及其血供,探查并保护喉返神经.探讨该病的临床治疗效果.结果 患者术后均无出血,均无感染.1例暂时性声嘶,经营养神经治疗症状消失;3例暂时性低钙血症,经补钙对症治疗后症状缓解消失;16例患者术后中央区淋巴结病理确诊为转移,中央区淋巴结转移率为26.67％,中央区淋巴结转移与患者临床分期有相关性;9例患者于术后1个月进一步行碘131治疗.所有患者均予甲状腺激素药物长期口服抑制治疗,术后1年内促甲状腺激素(TSH)控制在0.1 mU/L以下.术后随访24个月未发现患者死亡,未出现远处转移,无术后局部复发,手术效果及术后控制治疗效果良好.结论 甲状腺癌规范化超声刀手术治疗效果良好,术后并发症少,术后碘131治疗及TSH抑制疗法能有效防止甲状腺癌复发,改善患者生存质量,具有积极的临床意义.

The Wnt/β-catenin pathway serves important roles in cancer development. The expression and function of Chibby (Cby), as a direct antagonist of β-catenin, in nasopharyngeal carcinoma (NPC) has not been fully investigated. The present study revealed that the mRNA and protein expression of Cby was significantly lower in NPC tissue than in the adjacent normal tissue. Low expression of Cby was significantly associated with the tumor and the clinical staging. Furthermore, Cby overexpression inhibited the proliferation of human NPC SUNE1 cells and induced cell cycle arrest. In addition, Cby overexpression also significantly enhanced the susceptibility of SUNE1 cells to apoptosis. These results indicated that Cby might serve as an anti-oncogenic gene in the development of NPC and could represent a potential therapeutic target for the human NPC therapy.

目的：研究鼻咽癌放疗后大出血的急救与伦理沟通。方法本文收集37例经病理证实的鼻咽癌治疗后鼻咽大出血患者，急救方法主要包括预防性气管切开、前后鼻孔填塞、数字减影动脉造影栓塞术，同时与患者家属进行合理的伦理沟通。结果8例气管切开术后行血管栓塞成功，半年后随访只有2例存活。患者家属均无异议。结论鼻咽癌放疗后大出血死亡率高，伦理沟通可获家属理解。

目的 探讨下咽肉瘤样癌的临床及病理学特点,为下咽肉瘤样癌的诊治提供参考依据,提高对肉瘤样癌的诊断、治疗及其预后的认识.方法 分析2010年1月-2014年9月我院治疗的5例下咽肉瘤样癌患者的临床资料,包括诊疗过程、病理特征等.结果 5例患者均经过不同的手术方式,其中咽后壁扩大切除1例,梨状窝扩大切除2例,全后、全下咽、全食管切除2例;肉瘤样癌肉瘤样成分与癌成分共存,且之间有一定的移行,CK、vimentin均表达阳性,P63阳性4例.5例患者均定期随访.结论 下咽肉瘤样癌有其特殊的生物学行为及病理学特点,是一种不同于其他类型的恶性肿瘤,具有自身病理特征,预后情况各不相同,外科手术仍是首选治疗方法,术后辅助放化疗.

The aberrant expression of retinoic acid receptor-α (RARα) has been reported in various types of cancer. However, its association with the prognosis and development of laryngeal squamous cell carcinoma (LSCC) has not yet been determined. Therefore, the present study aimed to examine the expression and function of RARα in patients with LSCC. The expression of RARα in LSCC tissues was investigated using immunostaining. An MTT assay and flow cytometry analysis were also performed to investigate the function of RARα in the proliferation and cell cycle of LSCC cells. The expression of RARα was significantly elevated in LSCC tissues compared with adjacent noncancerous tissues (78.1 vs. 6.3%, P<0.05). The overexpression of RARα was associated with poorly differentiated features of LSCC (P<0.05). Furthermore, the downregulation of RARα inhibited the proliferation of LSCC cells, and arrested the cell cycle at the G1 phase via upregulation of cyclin dependent kinase inhibitor 1A, which may be associated with inhibition of the protein kinase B signaling pathway. Therefore, the overexpression of RARα may contribute to the development of LSCC through the regulation of the cell cycle. The results of the present study provide evidence that RARα serves an important function in LSCC development and may be a potential therapeutic target or prognostic predictor for LSCC.

目的:分析下咽鳞状细胞癌患者外周血T淋巴细胞亚群和NK细胞活性情况,旨在为相关研究工作提供参考资料.方法:择取2011年6月-2016年5月本院收治的95例下咽鳞状细胞癌病患为病例组,另取此期间内来本院接受健康检查的72例志愿者为正常组.使用流式细胞仪对病患开展相关检查,分析病例组与正常组的淋巴细胞亚群、NK活性情况以及不同临床分期的下咽癌病患外周血T淋巴细胞亚群以及NK细胞活性之间的关系.结果:与正常组相比,病例组的NK细胞、总B淋巴细胞、总T淋巴细胞、辅助/抑制T细胞、辅助T细胞偏低(P<0.05),活化T细胞以及抑制T细胞偏高(P<0.05).Ⅰ～Ⅱ期病患外周血总T淋巴细胞比Ⅲ～Ⅳ期者稍低(P>0.05).Ⅰ～Ⅱ期病患辅助T淋巴细胞比Ⅲ～Ⅳ期者略高(P>0.05).Ⅰ～Ⅱ期病患抑制T淋巴细胞值比Ⅲ～Ⅳ期者低(P<0.01).Ⅰ～Ⅱ期病患辅助/抑制T淋巴细胞值比Ⅲ～Ⅳ期者高(P<0.01).Ⅰ～Ⅱ期病患外周血总B淋巴细胞值比Ⅲ～Ⅳ期者高(P<0.05).Ⅰ～Ⅱ期病患的活化T细胞和Ⅲ～Ⅳ期者相近(P>0.05).Ⅰ～Ⅱ期病患外周血NK细胞数比Ⅲ～Ⅳ期者略高(P>0.05).结论:下咽鳞状细胞癌病患的免疫功能异常,且随着疾病的进展,细胞免疫和体液免疫均有所降低,证实免疫功能紊乱在疾病进展中发挥了一定作用.经流式细胞设备对外周静脉血淋巴细胞亚群以及NK细胞活性情况检测,可实现动态化检测癌症病患某阶段细胞免疫功能变化详情,此法方便简单,在指导治疗方案制定以及监测疾病预后方面,均体现出了一定效果,值得进一步推广.

目的：探讨甲状腺乳头状癌（PTC）患者中央区淋巴结（CLN）转移的临床病理特征。方法回顾性分析86例行甲状腺全切除术或甲状腺腺叶切除术及预防性双侧 CLN 清扫术的 PTC 患者的临床病理资料。结果行甲状腺全切除术及预防性双侧 CLN 清扫术52例，行甲状腺腺叶切除术及预防性双侧 CLN 清扫术34例。86例患者中＜45岁、男性，肿瘤直径≤0．5 cm、＞0．5～＜1．0 cm，侵及甲状腺被膜、突出腺体 CLN 转移阳性率与≥45岁、女性，肿瘤直径≥1．0 cm，未侵及甲状腺被膜、未突出腺体比较差异均有统计学意义（均 P ＜0．05）。86例患者＜45岁、男性、肿瘤直径≥1．0 cm 与 CLN 转移均呈正相关（r＝0．605、0．374、0．600，均 P ＜0．05），双侧转移、多灶、侵及甲状腺被膜、突出腺体与 CLN 转移均无相关性（r＝0．005、0．006、0．068、0．108，均 P ＞0．05）。结论对 PTC 患者首次手术在切除原发灶的同时应行预防性 CLN 清扫术，＜45岁、男性、肿瘤直径≥1．0 cm 易出现 CLN 转移。

Objective:To investigate the application value of nano carbon for the protection of parathyroid glands in thyroid carci-noma surgery.Methods:88 cases of patients with thyroid carcinoma were randomly divided into the nano carbon group and the con-trol group.The control group underwent the resection of thyroid gland and thyroid,the nano carbon group underwent the resection of thyroid gland and thyroid after lymph nodes staining black using nano carbon.Results:There was no parathyroid glands removed incorrectly in the nano carbon group and the incorrect removed rate of parathyroid glands in the control group was 20.5%,the dif-ference was statistically significant(P<0.05).The dissection of lateral cervical lymph nodes in the nano carbon group were (10± 5) and the dissection of central neck lymph nodes were (10±4),the dissection of lateral cervical lymph nodes in the control group were (6±4) and the dissection of central neck lymph nodes were (6±3),the difference was statistically significant(P<0.05).Con-clusion:Nano carbon could display the parathyroid glands clearly and avoid the intraoperative parathyroid glands incorrect re-moved,which had better clinical effect to protect the parathyroid glands.

Objective:To provide the reference for the clinical diagnosis of nasopharyngeal carcinoma.Methods: 153 patients with nasopharyngeal carcinoma were selected from January 2013 to July 2014.We analyzed the first presentation auxiliary examination results of them.Results:VCA-IgA antibody test in 10 cases,magnetic resonance imaging(MRI) examination in 15 cases,CT scan in 23 cases,cervical lymph node biopsy in 6 cases,30 cases of nasal endoscopy,54 cases of nasopharyngeal mirror,5 cases of PET/CT. Conclusion:The first hint of auxiliary examination of nasopharyngeal carcinoma is diversity.It has very important significance to the diagnosis and treatment as soon as possible.

Objective To explore the different effect of unciform process excision with back biting rongour or cickle knife on endoscopic operation of noninvasive fungal nasosinusitis.Methods 128 patients with monolateral noninvasive fungal ball maxillary sinusitis were divided into two groups at random.Whose the middle part of unciform processes of 64 patients(group A) were bited by back biting rongeur while the unciform processes of other 64 patients(group B) were excised by sickle knife.Then the opening of maxillary sinus was enlarged foreward and backward.And the secretion in maxillary sinus was cleaned out through enlarging opening.Results Comparing with excising the unciform process by sickle knife,biting the unciform by back biting rongour before opening the maxillary sinus may result in curing earlier,and the incidence of narrow again of the maxillary sinus opening lower.Conclusion The endoscopic operation of maxillary sinus by back biting rongour can reduce tissue damage,advance recovery and preserve sinus mucous membrane in good condition.

目的 探讨桥本甲状腺炎的诊断和外科治疗时机及方法.方法 回顾分析2003～2010年本科手术治疗的桥本甲状腺炎93例临床资料,总结分析本病的诊断程序、外科治疗适应征、手术方法及治疗效果.结果 术后病理检查结果显示,桥本甲状腺炎34例,桥本甲状腺炎合并结节性甲状腺肿55例,合并甲状腺乳头状癌4例,合并甲亢2例.所有患者无近期并发症发生.随访72例,随访时间5月～7年,均无肿瘤复发,但有7例出现比较明显的甲状腺功能减退.结论 对有恶性病变可能及甲状腺重度肿大而产生压迫症状、药物治疗无效的桥本甲状腺炎病人,应积极手术治疗.术中根据冰冻病理切片结果决定手术方式,应尽量保留足够的甲状腺组织.

目的 探讨喉接触性肉芽肿的治疗方法.方法 回顾分析10例病理确诊的喉接触性肉芽肿的治疗,包括手术、手术联合药物治疗、配合语音治疗、纠正不良习惯等.结果 单纯手术治疗,术后复发率高达90%,配合制酸、吸人类固醇激素、配合语音疗法、纠正不良习惯明显提高治愈率,降低复发率.结论 喉接触性性肉芽肿单纯手术治疗复发率高.先手术,术后病理明确诊断.术后必须根据可能的病因尽可能采用综合治疗,如制酸、吸人类固醇激素、配合语音疗法、纠正不良习惯等,才能取得满意疗效。

<正>随着我国企业信息化建设工作的深入开展,汽车维修企业信息化管理作为提升汽车维修行业竞争力的重要手段,正日益受到汽车维修各界人士的广泛关注。过去,由于汽车维修企业规模较小,人才素质也不高,

目的 观察显微镜支撑喉镜下CO2激光治疗早期声门型喉癌的临床疗效及安全性.方法 回顾分析26例早期声门型喉癌的治疗,其中Tis 6例,T1a 12例,T1b 7例,T2 1例.均采用显微镜支撑喉镜下CO2激光切除治疗,术后定期复查、随访3年.结果 23例1次手术治愈,3例局部复发,Tis 0/6,T1a 2/12,T1b 1/7,T2 0/1,各组间复发率比较差异无统计学意义(P＞0.05).3例复发者均第二次行显微镜支撑喉镜下CO2激光切除治疗,再次复发率0(0/3).随访结果,1年生存率100%(26/26).随访3年,24例存活良好,2例失访(按死亡计算),3年生存率92.3%.结论 显微镜支撑喉镜下CO2激光治疗早期声门型喉癌疗效可靠,能较好地保留喉部结构和功能,避免气管切开及颈部手术瘢痕.同时具有住院时问短、费用低、创伤小、恢复快等优点。

目的 探讨喉接触性肉芽肿的治疗方法.方法 回顾分析10例病理确诊的喉接触性肉芽肿的治疗,包括手术、手术联合药物治疗、配合语音治疗、纠正不良习惯等.结果 单纯手术治疗,术后复发率高达90%,配合制酸、吸人类固醇激素、配合语音疗法、纠正不良习惯明显提高治愈率,降低复发率.结论 喉接触性性肉芽肿单纯手术治疗复发率高.先手术,术后病理明确诊断.术后必须根据可能的病因尽可能采用综合治疗,如制酸、吸人类固醇激素、配合语音疗法、纠正不良习惯等,才能取得满意疗效。

OBJECTIVE To investigate the clinical value of exposure of recurrent laryngeal nerve and conservation of thyroid arteries during thyroidectomy.METHODS The clinical data of 247 patients who underwent thyroidectomy were studied. There were 26,29,and 192 cases underwent total, near total and partial thyroidectomy respectively. The recurrent laryngeal nerve was exposed and the superior and inferior thyroid arteries were conserved in all the cases.Blood calcium and parathyroxin were measured and laryngoscopy was carried out perioperatively.RESULTS All of the 247 cases were very well after operation.No vocal cord paralysis, bleeding,convulsion and numbness occurred.The level of blood calcium and parathyroxin was normal after followed up for 4 to 36 months.CONCLUSION It is a safe and effective way to expose recurrent laryngeal nerve and conserve thyroid arteries during thyroidectomy.

<正>随着我国企业信息化建设工作的深入开展,汽车维修企业管理信息化作为提升维修行业竞争力的重要手段,正日益受到汽车维修界人士的广泛关注。本文主要探讨汽车维修企业管理软件的发展历程及趋势。