目的：分析口咽部B細胞來源非霍奇金淋巴瘤(NHL)的CT表現、特征，初步探討不同病理類型B細胞來源NHL的CT表現特點，為臨床診斷和治療提供更為準確的信息。方法：對18例經病理證實的口咽部B細胞來源非霍奇金淋巴瘤的CT表現進行回顧性分析。結果：18例中，彌漫大B細胞淋巴瘤13例，占72.2%(13/18)，濾泡性淋巴瘤3例，占16.7%(3/18)，套細胞淋巴瘤1例，占5.6%(1/18)，結外邊緣區淋巴瘤(MALT淋巴瘤)1例，占5.6%(1/18)。病變分布為：扁桃體NHL9例(彌漫大B細胞淋巴瘤8例、套細胞淋巴瘤1例)；舌根8例(彌漫大B細胞淋巴瘤5例、濾泡性淋巴瘤3例)；軟腭1例，為結外邊緣區淋巴瘤(MALT淋巴瘤)。18例病變均表現為腫塊型。同時有淋巴結受累者12例(66.7%)，其中雙側受累者3例。結論：口咽B細胞來源NHL多發生于扁桃體及舌根。病理類型以彌漫大B細胞淋巴瘤為主，主要表現為腫塊。 CT對于B細胞來源NHL的鑒別診斷和病變范圍的判斷具有重要作用。
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.
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 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.