[Clinical observation on perioperative complications of minimally invasive Ivor-Lewis and minimally invasive McKeown esophagectomy].

Objective: To compare and analyze the perioperative clinical effects of minimally invasive Ivor-Lewis esophagectomy (MIE-Ivor-Lewis) and minimally invasive McKeown esophagectomy (MIE-McKeown). Methods: A total of 147 patients who underwent endoscopic esophageal cancer surgery from April 2018 to August 2019 were selected, including 85 patients undergoing MIE-McKeown surgery and 62 patients undergoing MIE-Ivor-Lewis surgery. The measurement data were expressed as (x±s), the comparison of normally distributed measurement data was performed by independent sample t-test, and the comparison of count data was performed by χ(2) test or Fisher's exact test. Results: The operation time of McKeown (M) group and Ivor-Lewis (IL) group were (219.2±72.4) minutes and (225.8±65.3) minutes. The mediastinal lymph node dissection number of M and IL groups were 13.3±4.8 and 11.6±6.5, respectively. The number of left recurrent laryngeal nerve lymph node dissection were 3.5±1.2 and 3.1±1.4, respectively. The intraoperative blood loss were (178.3±41.3) ml and (163.2±64.1) ml, respectively. The number of patients reoperated for postoperative bleeding were 1 and 0, respectively. The number of patients with postoperative gastric bleeding were 0 and 1, respectively. The postoperative chest tube retention time were (2.8±1.3) days and (3.1±1.2) days, respectively. The number of patients with anastomotic leakage were 7 and 1, respectively. The number of patients with lung infection were 13 and 5, respectively, and with chylothorax were 2 and 1, respectively, without statistically significant difference (P>0.05). The number of patients with hoarseness were 11 and 3, respectively. The total incidence of complication were 41.2% (35/85) and 17.7% (11/62), and the postoperative hospital stay were (14.7±6.5) days and (12.3±2.3) days, with statistical difference (P<0.05). Conclusion: MIE-Ivor-Lewis and MIE-McKeown are safe and effective in treating esophageal cancer, but the complication of MIE-Ivor-Lewis is less than that of MIE-Mckeown, and the perioperative clinical effect of MIE-Ivor-Lewis is better than that of MIE-McKeown.

[The application of extended high frequency audiometry in detecting the early hearing loss for polycystic ovarian syndrome].

Objective:To preliminarily explore the clinical significance of extended high frequency audiometry in evaluating the early hearing loss in patients with polycystic ovarian syndrome（PCOS）. The results were statistically analyzed. Method:The hearing threshold of forty young women diagnosed as PCOS and 20 healthy controls were obtained by using conventional audiometry（0.25-8.00 kHz） and extended high frequency（10-20 kHz） pure tone audiometry. Result:The hearing thresholds of the two groups were similar at conventional frequencies of 0.25，0.50，1.00，2.00 and 4.00 kHz（P>0.05）. The hearing threshold of PCOS group at 8-20 kHz frequency was significantly higher than that of the control group, and the difference was statistically significant（P<0.05）. The expanded high-frequency detectable rate was lower in PCOS group than that in control group, especially at 16 and 18 kHz （P<0.05） and the differences were statistically significant. Conclusion:The early hearing impairment of PCOS patients starts from the extended high frequency, which is more sensitive than the conventional pure tone audiometry in the early hearing impairment assessment of PCOS patients.

[Transnasal endoscopic surgery of communicating neoplasm outside cerebral dura mater and orbital fasciae].

Objective:This paper is intend to observe the feasibility of surgical approach with which communicating neoplasm outside cerebral dura mater and orbital fasciae was removed by transnasal endoscopic surgery.Method:Nine patients suffered from communicating neoplasm in the area of naso-orbital-cranio complex were treated with transnasal endoscopic surgery. The size of skull base bone defect was from 1.25 cm×1.13 cm to 3.25 cm×2.69 cm. No eye enucleation was done. No reconstructions of skull base and medial wall of orbital cavity were done. Iodoform gauze was packed in paranasal sinuses fourteen days. Patients with malignant tumor were treated radiation therapy and chemical therapy after surgical treatment. The degree of resection, complications of intracranial and orbital cavities, survival condition were the focus of this study.Result:The tumor were completely removed and all operations were successfully completed by trasnasal endoscopic surgery. Only one patient was required blood transfusion due to seriously bleeding from tumor during the operation. There was no orbital, intracranial, and vascular complications. The defect of bone at skull base and lamina papyracea were automatic reconstructed. Three patients have showed recurrence of neoplasm, and two of them died during two years of following up time.Conclusion:Transnasal endoscopic surgery is a safe, reliable and effective approach to treat communicating neoplasm in the area of naso-orbital-cranio complex, of which main part of tumor exists in the sinunasal cavity.

[Analysis of deafness-related gene mutations in 23 nonsyndromic hearing impairment families in Guangxi Zhuang Autonomous Region].

Objective:To investigate the genetic characteristics of the mutations responsible for nonsyndromic hearing loss in Guangxi Zhuang Autonomous Region, and analyze the deafness-related gene mutations in nonsyndromic hearing impairment families in this region.Method:In 23 nonsyndromic hearing impairment families,66 patients or their families were enrolled as family history group and 167 patients or their families without family histiory as control group, respectively. Deafness gene mutations were determined with deafness-related gene mutations detection kits. The mutation rates among the deafness probands, the hearing impairment patients and their audibility relatives were analyzied. Whole length sequences of the deafness-related gene were detected if there was mutation by the kits, to explore Guangxi region-specific mutation-sites.Result:Common deafness-related gene mutation rate in family history group(31.82%) was higher than that in control group(11.38%), including those that in GJB2 homozygous(21.21%), SLC26A4 homozygous (9.09%), both were higher than the control group (GJB2 homozygous 5.99%, SLC26A4 homozygous 3.59%) . The rate of common deafness-related gene mutations in the deafness probands was 34.78%, in the hearing impairment patients was 30.56%, in their audibility relatives was 29.63%, all of which were higher than those in the control group. We found three rarely seen mutations, SLC26A4 IVS11+47T>C, 1548insC and GJB2 109 A>G, by detecting the whole-length sequences of the deafness-related gene.Conclusion:The results indicated that GJB2 and SLC26A4 were the most frequent mutant genes in Guangxi region. Analysis of the individual family were helpful to linkage the mutations and the deafness.

[Analysis of the SLC26A4 mutation from 230 deafness patients in Guangxi region].

Objective:To investigate the mutation characteristics of SLC26A4 gene from 230 hearing loss patients in Guangxi region.Method:Two hundred thirty patients with hearing loss were enrolled in the study. Eight mutation sites in SLC26A4 gene were tested; the types of gene mutation and the inner ear CT features of the mutationpositive patients were analyzed.Result:Among 230 deafness patients,the total mutation rate of SLC26A4 gene is 2.61%(6/230). The types of gene mutation include SLC26A4 IVS7-2A> G heterozygous in 2 case(0.87%).1226G> A homozygous in 1 cases(0.43%),IVS7-2A>G，IVS11+47T>C and 1548insC mutations in 2 cases(0.87%).Conclusion:The mutation rate of SLC26A4 gene in Guangxi region is lower than the national average level. The main mutation type in Guangxi region is SLC26A4 IVS7 2A>G. In this study, two gene mutations (SLC26A4 IVS11+47T> C and 1548insC) are firstly found, suggesting that some rare mutation types of SLC26A4 may exist in patients living in Guangxi region.