Methodology in Conventional Head and Neck Reconstruction Following Robotic Cancer Surgery: A Bridgehead Robotic Head and Neck Reconstruction

PurposeRobotic head and neck surgery is widespread nowadays. However, in the reconstruction field, the use of robotic operations is not. This article aimed to examine methodologies for conventional head and neck reconstruction after robotic tumor surgery in an effort to obtain further options for future reconstruction manipulations.Materials and MethodsA retrospective review of all patients who received head and neck robot surgery and conventional reconstructive surgery between October 2016 and September 2021.ResultsIn total, 53 cases were performed. 67.9% of the tumors were greater than 4 cm. Regarding defect size, 47.2% of the lesions were greater than 8 cm. In terms of TNM stage, stage 3 disease was recorded in 26.4% and stage 4 in 52.8%. To make a deep and narrow field wider, we changed the patient’s posture in pre-op field, additional dissection was done. We used radial forearm flap mostly (62.2%).ConclusionConventional head and neck reconstruction after robotic ENT cancer surgery is possible. One key step is to secure additional space in the deep and narrow space left after robotic surgery. For this, we opted for a radial forearm flap mostly. This can be performed as a bridgehead to perform robotic head and neck reconstruction.     

美国毕业后医学教育的评鉴与认可

毕业后医学教育是医学教育连续统一体中的重要组成部分,是目前进一步完善我国医学教育体系的关键环节之一。本文介绍了美国毕业后医学教育评鉴与认可的组织实施情况,包括最新的发展趋势,并针对我国毕业后医学教育改革与发展的情况归纳了四点值得借鉴之处。     

A pilot investigation of e‐cigarette use and smoking behaviour among patients with chronic airway disease or respiratory symptoms

BackgroundThis pilot study aimed to investigate the current status of e‐cigarettes (ECs) use patterns among patients with chronic airway disease or chronic respiratory symptoms and the effects of ECs use on respiratory and mental health.MethodsA cross‐sectional survey was conducted at the outpatient clinic of eight teaching hospitals in South Korea between November 2019 and December 2019. All adult ECs users (19 years and above) who visited the outpatient clinic as a patient with chronic airway disease or chronic respiratory symptoms were eligible to participate in this study.ResultsA total of 51 subjects responded to the survey. Most of the participants were male (92.2%) and the mean age was 41.8 years. Dominant airway diseases were asthma and chronic obstructive pulmonary disease. Most of the subjects had a history of cigarette smoking, and 19 subjects were dual users of current cigarettes and ECs. Most of the subjects started ECs use due to health‐related reasons. When comparing exclusive ECs users and dual users, St. George''s respiratory questionnaire (SGRQ) scores, the proportion of cases with moderate to severe depressive symptoms, and average Fagerstrom test for nicotine dependence scores for ECs were higher in dual users than exclusive ECs users (mean 4.64 vs. 2.38, p = 0.006), respectively.ConclusionMost of the subjects started ECs use due to health concerns, but dual users have more respiratory symptoms and higher nicotine dependence in this pilot study. One hypothesis that comes from these results is that greater nicotine dependence may influence behaviours, habits, and views about ECs. These preliminary observations need confirmation in a large cohort.     

必止咳胶囊制剂工艺研究

采用正交设计,以苦杏仁中指标成分苦杏仁甙的含量为指标,对必止咳胶囊的制剂工艺条件进行试验考察,优选出最佳生产工艺路线及提取工艺条件.     

Cumulative Recurrence Rate and Risk Factors for Recurrent Abdominal Wall Endometriosis after Surgical Treatment in a Single Institution

PurposeThis study aimed to evaluate the cumulative recurrence rate and risk factors for recurrent abdominal wall endometriosis (AWE) after surgical treatment.Materials and MethodsA retrospective cohort study was conducted at a single gynecological surgery center between January 2004 and December 2020. Patients who were surgically treated and followed up for at least 6 months after surgery were selected.ResultsEighteen patients with pathologically diagnosed AWE were included in this study. The median follow-up duration was 22.5 months (range, 6–106). The median age was 37 years (range, 22–48), and 33.3% of the patients were nulliparous. Among the patients included in our study, 55.6% complained of a mass with cyclic pain, and 27.8% had a palpable mass. In addition, 22.2% of patients experienced recurrence with 17.5±9.7 months of mean time to recurrence. The cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were 23.8% and 39.1%, respectively. There were no statistically significant risk factors for the recurrence of AWE, including postoperative medical treatment.ConclusionThe recurrence rate of AWE appears to be correlated with the follow-up duration. There was no statistically significant risk factor for the recurrence of AWE. Unlike ovarian endometriosis, postoperative hormonal treatment does not seem to lower the recurrence of AWE. The findings of the current study may help healthcare providers in counselling and managing patients with AWE.     

农村妇儿肺通气功能免疫水平的配对分析

用配对比较的方法,探讨厨房位置和燃料不同对农村妇儿肺通气功能免疫水平的影响规律,结果是家庭月耗煤多的妇儿FEV1.0％、儿童唾液溶菌酶、血清IgG含量偏低;炉灶置宅内耗煤多的家庭儿童IgA含量偏高。说明合理布局厨房位置、设置排烟道及精选燃料,可大大改善室内空气质量,保护妇儿健康。     

妇科失血性急腹症患者凝血功能障碍分析

目的探讨妇科失血性急腹症患者凝血功能障碍及相关的危险因素。方法选择在我院进行治疗的妇科失血性急腹症患者100例为研究对象,根据患者是否存在休克、低体温、酸中毒、低血红蛋白等情况进行相应分组．行患者凝血功能障碍相关的危险因素分析。结果休克组门、APTT、TT时间显著长于非休克组（P〈0．01或Pl〈0．05）。低体温组PT、APT、TT时间显著长于非低体温组（P〈0.01或P〈0．05）。酸中毒组PT、APT、TT时间显著长于非酸中毒组（P〈0．01或P〈0．05）。低蛋白血症组PT、AFTT、TT时间显著长于非低蛋白血症组（P〈0．01或P〈0．05）。结论对于妇科失血性急腹症患者,如果出现休克、酸中毒、低体温、低蛋白血症,患者更容易出现凝血功能障碍。