Root canal therapy combined with endoscopic sinus surgery for odontogenic sinusitis:Efficacy comparison in a cohort study

BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need for a multidisciplinary diagnostic and treatment approach.AIM To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal the-rapy in the treatment of severe odontogenic maxillary sinusitis caused by peria-pical periodontitis.METHODS The clinical data,diagnosis,and treatment of 200 patients with severe odonto-genic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively.Among them,63 patients were treated with simple root canal therapy as the control group,and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group.The therapeutic effect,Lund-Kennedy endoscopic score,paranasal sinus Lund-Mackay score,complication rate,recurrence rate,and patient satisfaction were compared between the two groups.RESULTS First,we compared the effective rates:23 cases were cured,22 were improved,and 8 were ineffective in the control group,yielding a total effective rate of 84.90%.Meanwhile,97 cases were cured,34 improved,and 6 were ineffective in the observation group,resulting in a total effective rate of 95.62%.The observation group had a higher total effective rate compared with the control group(P<0.05).Second,we compared the Lund–Kennedy endoscopic score.Before treatment,no significant difference(P>0.05)was observed in this score between the two groups.After treatment,the Lund–Kennedy endoscopic score decreased in both groups.The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group(P<0.05).Third,we compared the Lund–Mackay score of paranasal sinuses.Before treatment,there was no significant difference in this score between the two groups(P>0.05).After treatment,the Lund–Mackay scores of paranasal sinuses decreased in both groups.The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group(P<0.05).Fourth,we compared the incidence and recurrence rate of complications.Three months after treatment,no significant difference was found in the incidence and recurrence rate of complications between the observation group(6.56%)and the control group(9.52%)(P>0.05).However,6 mo after treatment,the incidence and recurrence rate of complications in the observation group(2.91%)was significantly higher compared to that of the control group(12.69%)(P<0.05).Fifth,we compared patient satisfaction.Six months after treatment,the patient satisfaction of the observation group(93.43%)was significantly better than that of the control group(84.12%)(P<0.05).CONCLUSION Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis,and it can reduce the injury of maxillary sinus mucosa and bone,and significantly reduce the incidence of complications and recurrence rate.Meanwhile,it has high patient satisfaction and remarkable therapeutic effect,which is suggested to be popularized and applied in clinic.

基于实时同步和全文搜索技术的方剂学多维实训平台

针对中医方剂学存在的数据量大、类型多样、学习识记困难等问题,提出一种改进的基于实时同步和全文搜索算法的方剂学多维实训平台(MTPF)。分析MTPF系统需求并搭建基础框架,采用Canal同步数据和ElasticSearch提供全文搜索服务,以保证业务应用的效率和性能;结合MTPF业务领域问题,提出针对具体业务的可配置和过滤的同步算法,构建面向搜索的自定义分词词典优化算法。通过系统应用及对比实验,验证了改进算法能够满足MTPF的需求;通过与其他框架的对比实验,证明了改进算法在同步时延、资源消耗、搜索速度等方面均取得了良好的效果,保障了业务数据信息在传输、存储、同步、搜索等环节的性能。

Peat properties of a tropical forest reserve adjacent to a fire-break canal

Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit greenhouse gases and particles contributing to haze,and prevention by constructing fire-break canals to reduce fire spread into forest reserves is crucial.This paper aims to determine peat physical and chemical properties near a fire-break canal at different fire frequency areas.Peat sampling was conducted at two forest reserves in Malaysia which represent low fire frequency and high fire frequency areas.The results show that peat properties were not affected by the construction of a fire-break canal,however lignin and cellulose content increased significantly from the distance of the canal in both areas.The study concluded that fire frequency did not significantly influence peat properties except for porosity.The higher fibre content in the high frequency area did not influence moisture content nor the ability to regain moisture.Thus,fire frequency might contribute differently to changes in physical and chemical properties,hence management efforts to construct fire-break canals and restoration efforts should protect peatlands from further degradation.These findings will benefit future management and planning for forest reserves.

Endodontic irrigants from a comprehensive perspective

This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and shaping.It reviews commonly used endodontic irrigant,namely sodium hypochlorite(NaOCl),herbal extracts,chlorhexidine(CHX),and chelating agents,highlighting their properties,applications,and potential drawbacks.NaOCl,a key antimicrobial agent,demonstrates effectiveness against various microorganisms but poses challenges such as high cytotoxicity.Herbal extracts,gaining recognition in endodontics,present an alternative with potential advantages in preserving dentin integrity.CHX,known for its broad-spectrum antimicrobial activity,is discussed in both liquid and gel formulations,emphasizing its role in reducing smear layer formation and preserving hybrid layer durability.Chelating agents,specifically ethylenediaminetetraacetic acid and citric acid,play a vital role in removing the smear layer,enhancing dentin permeability,and facilitating the penetration of antimicrobial agents.The review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic procedures.It serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.

Primary thoracolumbar intraspinal malignant melanoma:A case report

BACKGROUND Primary intraspinal malignant melanoma is a very rare tumor that most often occurs in the cervical,thoracic,or thoracolumbar segment.CASE SUMMARY A rare case of primary thoracolumbar malignant melanoma is described.A 45-year-old female patient complained of low back pain with numbness and fatigue in both lower limbs.MR revealed an intradural space-occupying lesion at the thoracic 12 to lumbar 1 level.The tumor was partially excised,and a malignant melanoma was confirmed by histopathology.CONCLUSION Primary intraspinal malignant melanoma has rarely been reported,and surgical resection and related characteristics and diagnoses have been discussed.

Steel bar penetrating cervical spinal canal without neurological injury:A case report

BACKGROUND We report a rare case of cervical spinal canal penetrating trauma and review the relevant literatures.CASE SUMMARY A 58-year-old male patient was admitted to the emergency department with a steel bar penetrating the neck,without signs of neurological deficit.Computed tomography(CT)demonstrated that the steel bar had penetrated the cervical spinal canal at the C6–7 level,causing C6 and C7 vertebral body fracture,C6 left lamina fracture,left facet joint fracture,and penetration of the cervical spinal cord.The steel bar was successfully removed through an open surgical procedure by a multidisciplinary team.During the surgery,we found that the cervical vertebra,cervical spinal canal and cervical spinal cord were all severely injured.Postoperative CT demonstrated severe penetration of the cervical spinal canal but the patient returned to a fully functional level without any neurological deficits.CONCLUSION Even with a serious cervical spinal canal penetrating trauma,the patient could resume normal work and life after appropriate treatment.

Surgical approach for lower postoperative anal stenosis

After anorectal surgery,hemorrhoids frequently lead to chronic issues,partic-ularly in patients with mixed hemorrhoids.Liu et al investigated the outcomes of staple removal at the 3-and 9-o’clock positions following modified stapled hemorrhoidopexy(SH)in patients with grade III or IV hemorrhoids.This study included patients who underwent standard or modified SH between January 1,2015,and January 1,2020.Key metrics assessed included hospital stay duration,blood loss,operation time,and the incidence of minor or major complications.The findings indicated that the modified SH technique is a safe option for advanced-grade hemorrhoids,resulting in a lower rate of postoperative anal stenosis compared to standard SH.Notably,this technique also showed reduced anal stenosis rates in patients with prior hemorrhoid treatments.While the modified SH demonstrates immediate benefits,further research is necessary to evaluate long-term effects.Despite its advantages,the study’s limited sample size restricts the generalizability of the findings,underscoring the need for larger,long-term studies to validate these results.Clinically,the modified SH method appears to significantly reduce the incidence of postoperative anal stenosis,a common concern following typical surgeries.If confirmed by larger trials,this procedure may become the preferred surgical approach for hemorrhoids.In conclusion,the work of Liu et al signifies a meaningful advancement in hemorrhoid surgery,enhancing patient safety and outcomes.

Modified stapled hemorrhoidopexy for lower postoperative stenosis: A five-year experience

BACKGROUND Stapled hemorrhoidopexy(SH)is currently a widely accepted method for treating the prolapse of internal hemorrhoids.Postoperative anal stenosis is a critical complication of SH.A remedy for this involves the removal of the circumferential staples of the anastomosis,followed by the creation of a hand-sewn anastomosis.Numerous studies have reported modified SH procedures to improve outcomes.We hypothesized that our modified SH technique may help reduce complications of anal stenosis after SH.AIM To compare outcomes of staple removal at the 3-and 9-o’clock positions during modified SH in patients with mixed hemorrhoids.METHODS This was a single-center,retrospective,observational study.Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015,and January 1,2020,were included.The operation time,blood loss,length of hospital stay,and incidence of minor or major complic-ations were recorded.RESULTS Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015 and January 1,2020,were included.Operation time,blood loss,length of hospital stay,and incidence of minor or major complications were recorded.We investigated 187 patients(mean age,50.9 years)who had undergone our modified SH and 313 patients(mean age,53.0 years)who had undergone standard SH.In the modified SH group,54%of patients had previously undergone surgical intervention for hemorrhoids,compared with the 40.3%of patients in the standard SH group.The modified SH group included five(2.7%)patients with anal stenosis,while 21(6.7%)patients in the standard SH group had complications of anal stenosis.There was a significant relationship between the rate of postoperative anal stenosis and the modified SH:0.251(0.085-0.741)and 0.211(0.069-0.641)in multiple regression analysis.The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH.CONCLUSION The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH.

Feasibility of Transferring Drinking Water from the Senegal River in the East (Backel) to the West Center (Fatick) in Senegal

Every year, 24 billion m3 of fresh water are thrown into the sea by the Senegal River, while most of the country’s populations do not have permanent access to drinking water. Also, agricultural land, which extends as far as the eye can see, is only used during winter periods, thus slowing down the development of agriculture. It is in this context that this article studies the feasibility of transferring drinking water from the Senegal River in the east of the country to the center-west through a transfer canal to meet the drinking water needs of the populations. In addition, we intend to flood the fossil valleys from this canal and recharge the aquifers. The watershed resulting from the juxtaposition of the two watersheds which dominate central Senegal has a slightly descending profile from Bakel to Fatick. This promotes gravity flow of water over 542 km. This analysis is carried out by the Glabal Mapper software and SRTM1 images. We report that all water needs have been estimated at approximately 70 m3/s based on the ANDS census in 2023, the distribution of arable land and groundwater recharge areas in the country. The waters flowing in the canal have depths (draft) not reaching 4.6 m. These results are obtained by applying the Manning Strickler equation, on a channel with a straight cross-section in the shape of a trapezoid and lined with sand concrete. The canal thus designed will bring water to populations and arid zones in the central and central-western regions of the country where problems persist. However, it will be necessary to overcome a difference in altitude of 96 m over 30 km to raise the water from the river to the threshold of the canal in order to ensure the flow in the latter. We have retained two calculation variants (Canal + Pumping or Single Pumping) whose pumping stations will be powered by solar fields. Due to the heavy investments, the installations upstream of the canal will be modular over time. Consequently, the central canal project will be constructed in six (6) phases of ten (10) years.

Evaluation of the Spatial Quality of the Greenway on the Tonghui River in Beijing

This study organized the current status of tangible cultural heritage along the Tonghui River.The spaces along the Tonghui River were classified according to the farmland,suburban areas,urban residential areas,and urban center areas.Spatial analysis of the current situation was conducted through Baidu Street View images,with a focus on evaluating the spatial environment around the tangible cultural heritage.Negative factors affecting the reuse of cultural heritage were analyzed,such as poor appearance of buildings and low accessibility of transportation along the Tonghui River.

The Millennia-Old Canal Takes on a New Look Nihao!China——2024 China's Grand Canal Tourism Overseas Promotion Season

On the occasion of the 10th anniversary of the Grand Canal's application for the World Heritage status in 2024,with the strong support of the Department of International Cooperation of the National Radio and Television Administration and the International Tourism Alliance of Silk Road Cities.

Results Analysis of Surveys Made to Stakeholders in the Pacific Ports in the Panama Canal:A Study Focused to Improve the Efficiency of Loading/Discharging Operations

This research aims to analyze the communication process between the different participating actors in the port of Balboa,in the Panamanian Pacific.The starting hypothesis begins with the normal operation of the port itself.Considering which strategic actions have potential development and which specific strategic actions are proposed for their improvement,the article begins with a discussion of the nature of ports in Panama and their relationships with the Panama Canal,followed by a literary review of all the effects that climate change may have on navigation on the Panamanian Pacific coast.Next,the implication between the coordination and cooperation between the port,the Panama Canal pilots,and the other actors involved with the arrival and departure of vessels from the port will be analyzed.In a third part,the results of the perception of a significant sample of these actors who were surveyed,which are related to the process,are presented.The document concludes with recommendations on how the Panamanian Pacific port can improve its individual interests through the application of improvements derived from the results of the surveys,for more efficient inter-institutional coordination and cooperation.

Clinico-Investigational Profile and Surgical Outcomes of Pediatric Cholesteatoma: A Case Series

Pediatric cholesteatoma causes extensive destruction within the middle ear and adjacent structures. Despite advancements in surgical techniques, the management of pediatric cholesteatoma remains controversial due to the varied presentations and its rapid progression. This study aims to evaluate the presentation of symptoms, otoscopic findings, surgical outcomes, and functional results in a series of pediatric cholesteatoma patients at our institution. A total of 18 patients, aged 5 - 14 years, underwent canal wall down (CWD) or intact canal wall (ICW) surgery based on the extent of disease as assessed intraoperatively. The study focused on the sites involved by cholesteatoma, the surgical challenges encountered, and the techniques employed. Outcomes measured included the incidence of residual and recurrent cholesteatoma, as well as hearing function at follow-up. Our results indicated a 69% improvement in the air-bone gap (ABG) among patients, with residual perforation observed in 4% of cases and no recurrences during the follow-up period. The increased selection of the CWD technique correlated with the extensive nature of the disease presentation. This study underscores the necessity for individualized treatment plans in pediatric cholesteatoma management, considering the aggressive nature of the disease and the need for a balance between eradication and hearing preservation.

Surgical Management of Lumbar Spinal Canal Stenosis with Instrumentation at the Yaounde Central Hospital: Comparison of Unilateral versus Bilateral Pedicle Screw Fixation Combined with Transforaminal Lumbar Interbody Fusion

Introduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed comparing the clinical effectiveness of unilateral versus bilateral fixation in the surgical management of lumbar spinal canal stenosis. Objective: Evaluate the impact on quality of life and clinical efficacy of unilateral spondylodesis compared to bilateral spondylodesis in the surgical management of lumbar spinal canal stenosis at the Yaounde Central Hospital. Methods: This was a retrospective descriptive cross-sectional study for a period of 4 years, from June 2015 to June 2019. It involved all patients operated for lumbar canal stenosis and who underwent spondylodesis or spinal fusion at the neurosurgery department of the Yaounde Central Hospital. Results: A total of 68 participants were recruited during our study period. 32 (47%) of the study population were in the 50 - 60 age group, with a mean age of 56.98 years ranging from 41 to 75 years. Females, housewives and farmers were the most affected. In our study, 72% of patients had unilateral spondylodesis and 28% had bilateral fusion. Preoperatively, 71% of patients had insurmountable pain, refractory to medical treatment. At 3 months postoperatively, 73.7% of patients with bilateral setup had moderate pain compared to 69% of those with unilateral setup. At 6 months postoperatively, 79% of patients with bilateral fusion had mild pain compared to 82% of patients with unilateral setup. At 1 year postoperatively, all patients had mild pain. Preoperatively, 66.2% of patients were unable to walk and 19.1% of patients were bedridden according to the Oswestry score. At 3 months postoperatively, 10.2% of patients with unilateral setup were unable to walk compared to 10.5% of patients with bilateral fixation, while 67.3% of patients with unilateral fixation had moderate disability compared to 52.6% of patients with bilateral fixation. At 6 months postoperatively, 51% of patients with unilateral setup had moderate disability compared to 47.4% of patients with bilateral fixation, while 42.9% of patients with unilateral fixation had mild disability compared to 42.1% of patients with bilateral fixation. At 1 year postoperatively, 81.6% of patients who underwent unilateral fixation had only mild disability compared to 73.7% of patients with bilateral fixation. Conclusion: The assessment of quality of life according to the set-up used shows similar results at 3 months, 6 months and 1 year, with no statistically significant differences. Single-sided pedicle screw fixation combined with transforaminal lumbar interbody fusion or mounting has the advantage of being faster, with less bleeding and is less expensive compared to bilateral fixation.

Corporate Social Responsibility and Shipping Supply Chain Risks

This study aims to investigate whether Corporate Social Responsibility(CSR)activities reduce supply chain disruptions by examining the impact of the Suez Canal obstruction on the Ever Given container ship in March 2021.This study conclude that the more responsible companies have higher returns and are less affected by this event than the less responsible companies;the less responsible companies have lower returns.The companies with better CSR have a lower impact on their supply chains when faced with disruptions in the supply chain.

制霉素片治疗外耳道真菌病

外耳道真菌病是耳鼻咽候科常见病,致病的真菌种类甚多,以曲霉菌、青霉菌及念珠菌等引起者较常见。当外耳道进水或积存分泌物,长期用抗生素液滴耳等情况下,都易受真菌感染。2003年4月～2006年6月间有效统计我科门诊共治疗外耳道真菌病患者258耳。用制霉素片和本院配制的4％水杨酸乙醇滴耳液（治疗组）与曲安奈德益康唑乳膏薄涂外耳道（对照组）比较观察两组药物治疗效果。

外耳道真菌病的病原学特征以及三种不同治疗方案的疗效分析

目的剖析外耳道真菌病的病例特征、病原菌分布以及不同治疗方案的疗效。方法回顾性分析97例外耳道真菌感染患者的临床资料,根据症状、外耳道分泌物镜检、真菌培养结果进行诊断,分别采用硝酸咪康唑乳膏、醋酸曲安奈德益康唑乳膏、3%硼酸洗液联合醋酸曲安奈德益康唑乳膏治疗,治疗周期2~4周。比较不同方案的临床疗效、不良反应及复发情况。结果97例外耳道真菌病中以≥51岁患者居多,男性多于女性。110侧真菌感染患耳中曲霉菌所占比例最大。3种治疗方案临床有效率比较,差异有统计学意义(χ^(2)=13.1996,P<0.05),联合用药组疗效最好,醋酸曲安奈德益康唑组次之。3个组不良反应发生率、疾病复发率均无明显差异(P>0.05)。结论外耳道真菌病与不良生活习惯关系密切,病原菌以曲霉菌最为常见,使用3%硼酸洗液联合醋酸曲安奈德益康唑乳膏治疗效果显著,且安全性好。

自制外耳道冲洗器在外耳道疾病诊治中的应用

外耳道耵聍或异物是耳鼻咽喉头颈外科门急诊中常见疾病,对于一些简单的外耳道耵聍和外耳道异物,能够配合的成人患者,可以予耵聍钩及镊予以取出。对于耵聍硬、完全阻塞难以取出者,可予5%碳酸氢钠溶液滴耳待耵聍软化后再取出或冲洗取出。

外耳道骨瘤临床分析

外耳道骨瘤患者临床少见，肿瘤生长缓慢，症状表现不典型，部分为体检时发现，病因尚不明确。我科自2004年1月～2015年6月共收治外耳道骨瘤患者17例，经手术治疗效果良好。

200例外耳道炎病原菌的培养与耐药性分析

目的通过探讨外耳道炎症病原菌培养与耐药性结果,指导临床用药。方法采用回顾性分析方法,总结我科门诊近2年收集的175例(200耳),外耳道炎患者病原菌培养及微生物敏感性试验的临床资料。结果 200耳外耳道分泌物标本中,病原菌阳性率占85.00%(170/200),其中革兰氏阳性菌中以金黄色葡萄球菌多见(28/42),革兰氏阴性菌中以铜绿假单胞菌多见(12/35)。真菌占比最高(93/200)。微生物敏感性试验结果以左氧氟沙星、莫西沙星和伊曲康唑耐药率较低。结论外耳道炎症病原谱分布及耐药性不断变化,治疗上应根据药敏结果合理用药,以提高临床疗效。