Endoscopy-Assisted 1-Stage Correction of the Crooked Nose Airway Function and Aesthetic Morphology.

OBJECTIVES: The aims of the study were to explore the application of endoscopy in the correction of septal deviation and nasal skeletal deviation in crooked nose deformity and, using multiple evaluation methods, to investigate the effect of endoscopy-assisted 1-stage surgery in restoring crooked nose airway function and aesthetic morphology. METHODS: From March 2015 to March 2018, 45 patients with nasal septum and skeletal deviation were treated with endoscopy-assisted septoplasty simultaneously with rhinoplasty. The follow-up period was at least 8 months. Treatment effects were evaluated both objectively and subjectively using various methods. RESULTS: All cases showed certain degree of airway function and nose morphology improvement. In patients with abnormal nasal ventilation, the volume and minimal cross-sectional area increased significantly after the surgery (t = 2.470 and 3.134, respectively, P < 0.05). External nose deviation distance measured on 3-dimensional models decreased significantly from 3.230 ± 1.661 mm to 1.997 ± 1.037 mm after the surgery (t = 3.772, P < 0.05). Patients visual analog scale score of nasal patency and nose morphology were significantly improved (t = 5.795 and 7.187, respectively, P < 0.05). Overall patient satisfaction was 100%, and no complication (nasal septal perforation, nasal cavity synechia, etc) was reported. CONCLUSIONS: Septal deviation combined with external nose deflection can be corrected by endoscopy-assisted rhinoplasty and septoplasty simultaneously, to achieve 1-stage improvement of crooked nose morphology and nasal airway function. This approach has the advantages of minimal invasion, clear surgery vision, less pain, and shorter recover time. It has fewer complication and better outcomes and worth clinical promotion and application.

The effect of Fu's subcutaneous needling in treating knee osteoarthritis patients: A randomized controlled trial.

BACKGROUND: Fu's subcutaneous needling (FSN) is an acupuncture technique for the treatment of soft tissue diseases. Knee osteoarthritis often involves lower limb muscles. This study aimed to observe and compare the clinical efficacy of Fu's subcutaneous acupuncture and electroacupuncture in the treatment of patients with knee osteoarthritis. METHODS: 62 patients with early or medial stage of knee osteoarthritis were randomly divided into the FSN therapy group or the electroacupuncture(EA) therapy group (1:1). The Lysholm score, range of motion, and equilibrium function were observed over a 3-month follow-up period. A total of 60 participants completed the study. RESULTS: Over the 3 months of follow-up, both treatment regimens showed equally favorable results on all prognostic measures compared with their respective baseline data (P<0.05). Compared with the EA group, the FSN group had a significantly greater improvement in claudication, joint stability, swelling, pain, and ROM after treatment (P<0.05). At 3 months after treatment, the FSN group revealed better scores of claudication, joint stability, swelling, walking up stairs, squatting, pain, ROM, and equilibrium function (forward and backward movement speed, left and right movement speed, movement ellipse area, movement length) compared to the EA group (all P<0.05). CONCLUSIONS: This study showed that FSN can significantly improve the pain symptoms, joint stability, and joint function of patients with knee osteoarthritis, and the clinical efficacy can be maintained at least 3 months after treatment.

Negligible risk of surface transmission of SARS-CoV-2 in public transportation.

BACKGROUND: Exposure to pathogens in public transport systems is a common means of spreading infection, mainly by inhaling aerosol or droplets from infected individuals. Such particles also contaminate surfaces, creating a potential surface-transmission pathway. METHODS: A fast acoustic biosensor with an antifouling nano-coating was introduced to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on exposed surfaces in the Prague Public Transport System. Samples were measured directly without pre-treatment. Results with the sensor gave excellent agreement with parallel quantitative reverse-transcription polymerase chain reaction (qRT-PCR) measurements on 482 surface samples taken from actively used trams, buses, metro trains and platforms between 7 and 9 April 2021, in the middle of the lineage Alpha SARS-CoV-2 epidemic wave when 1 in 240 people were COVID-19 positive in Prague. RESULTS: Only ten of the 482 surface swabs produced positive results and none of them contained virus particles capable of replication, indicating that positive samples contained inactive virus particles and/or fragments. Measurements of the rate of decay of SARS-CoV-2 on frequently touched surface materials showed that the virus did not remain viable longer than 1-4 h. The rate of inactivation was the fastest on rubber handrails in metro escalators and the slowest on hard-plastic seats, window glasses and stainless-steel grab rails. As a result of this study, Prague Public Transport Systems revised their cleaning protocols and the lengths of parking times during the pandemic. CONCLUSIONS: Our findings suggest that surface transmission played no or negligible role in spreading SARS-CoV-2 in Prague. The results also demonstrate the potential of the new biosensor to serve as a complementary screening tool in epidemic monitoring and prognosis.

[Surgical techniques and efficacies of deep brain stimulation in the treatment of essential tremor].

OBJECTIVE: To explore the surgical techniques and efficacies of deep brain stimulation (DBS) in the treatment of the patients with essential tremor (ET). METHODS: A total of 6 ET patients from January 2004 to June 2011 at Department of Neurosurgery, Beijing Tiantan Hospital were recruited to receive DBS at ventral intermediate nucleus of thalamus (Vim-DBS) (n = 5) and subthalamic nucleus (STN-DBS) (n = 1). All underwent stereotactically guided DBS procedures utilizing atlas of neuroanatomy and neurophysiology, pre-operative magnetic resonance imaging (MRI), microelectrode recording and intra-operative testing for target-locating. Postoperative computed tomography (CT) and/or MRI scan were performed after implantation. Such stimulation parameters as stimulus voltage, frequency, pulse width and polarity configuration were adjusted postoperatively to optimize tremor control and maximize battery life. The patients were followed by further consultations or telephone for a comprehensive evaluation of their therapeutic efficacies. RESULTS: All patients showed typical electrical signal and relief of tremor symptoms with significant tremor control. No severe adverse events, such as infection, hemorrhage, paresthesia, dysarthria, cognitive deficits, imbalance and diplopia, appeared after the implantation of DBS electrodes. CONCLUSION: Vim-DBS and STN-DBS are both safe and effective for the controls of unilateral and bilateral tremors.

Bilateral subthalamic nucleus stimulation in the treatment of neurodegeneration with brain iron accumulation type 1.

BACKGROUND: Neurodegeneration with brain iron accumulation type 1 (NBIA1), previously called Hallervorden-Spatz disease, is a rare neurodegenerative condition with abnormal brain iron accumulation. There have been some reports of deep brain stimulation (DBS) in the treatment of NBIA1. However, the target was usually the globus pallidus internus or thalamus. OBJECTIVES/METHODS: We present a case of NBIA1 in a 16-year-old male who was treated with bilateral subthalamic nucleus (STN)-DBS and explored its efficacy in the treatment of NBIA1. The patient presented with severe generalized dystonia and marked dysarthria and had previously had unsuccessful ablation surgery. MRI confirmed the diagnosis of NBIA1. RESULTS: He had significant improvement postoperatively, and the benefit of surgery was maintained for 3 years during follow-up. Burke-Fahn-Marsden Dystonia Rating Scale score was 114/120 preoperatively, and dropped to 60/120 at 14 days, 35/120 at 1 month, 28/120 at 3 months, 14/120 at 1 year and 18/120 at 3 years postoperatively. CONCLUSIONS: Our results suggest that bilateral STN-DBS might be considered as an effective treatment for selective NBIA1 patients.

Antineutrophil cytoplasmic antibody-negative pauci-immune crescentic glomerulonephritis associated with rheumatoid arthritis: An unusual case report.

Clinically relevant renal lesions in rheumatoid arthritis (RA) are not common. More often renal involvement is related to complications of therapy than the disease itself. The most common forms of primary renal disease in RA are membranous glomerulonephropathy and a pure mesangial proliferative glomerulonephritis. Some studies have described the association between crescentic glomerulonephritis (crescentic GN) and RA, but they were all found to be perinuclear antineutrophil cytoplasmic antibody (p-ANCA) positive. However, RA associated with ANCA negative pauci-immue crescentic GN has not been reported. This is a case report of a 37-year-old female with RA who initially presented with general oedema and acute deterioration of renal function. The renal biopsy revealed ANCA negative pauci-immune crescentic GN. The patient was treated with steroid pulse and plasmapheresis, but not cyclophosphamide because of severe urosepsis. Despite the use of aggressive therapy, her renal function was not improved and she underwent maintenance haemodialysis thereafter. Because ANCA negative crescentic GN may occur in RA patients without frank systemic vasculitis, but with severe clinical manifestation, a heightened suspicion for a relatively 'silent' crescentic GN would have led to the correct diagnosis and appropriate treatment.

Primary hyperparathyroidism in multiple endocrine neoplasia type 1: individualized management with low recurrence rates.

BACKGROUND: To evaluate the outcomes in different surgical modalities for primary hyperparathyroidism in multiple endocrine neoplasia type 1 (MEN1) patients, intraoperative findings from a single surgeon were studied to investigate a potentially improved modality of parathyroidectomy (PTx). METHODS: All 22 patients had PTx by a single surgeon in the past 21 years. Three modalities of PTx were used, depending on the operative findings, after all parathyroids and the thymus were identified. If fewer than three glands were enlarged, selective removal of the enlarged glands with or without biopsy of a normal-appearing gland was performed (selective PTx); if all glands were enlarged, either a subtotal PTx leaving a 50-mg remnant in situ or a total PTx with autotransplantation (TPTx + AT) was performed. RESULTS: There were 7 men and 15 women, aged 22 to 67 years (average, 43 years). Sixteen had familial and six had sporadic MEN1. They underwent 23 operations, including 11 selective PTx, 6 subtotal PTx, and 6 TPTx + AT. On follow-up for 1 to 19 years, only one patient (4.6%) had recurrent hyperparathyroidism 5.5 years after subtotal PTx. Others had either normocalcemia (n = 14; 63.6%) or hypocalcemia (n = 7; 31.8%). Those who had either a subtotal PTx or TPTx + AT had a significantly higher rate of postoperative hypocalcemia than those who had a selective PTx (9.9% vs. 54.5%; P = .032; Fisher's exact test). CONCLUSIONS: Primary hyperparathyroidism in our MEN1 patients was less aggressive than that reported in the literature. Selective PTx according to the intraoperative findings achieved optimal outcomes.