Expert consensus on odontogenic maxillary sinusitis multi-disciplinary treatment

Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion. Due to the lack of unique clinical features, OMS is difficult to distinguish from other types of rhinosinusitis. Besides, the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis. Its current diagnosis and treatment are thus facing great difficulties. The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS. However, this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality. Based on systematically reviewed literature and practical experiences of expert members, our consensus focuses on characteristics, symptoms, classification and diagnosis of OMS, and further put forward multidisciplinary treatment decisions for OMS, as well as the common treatment complications and relative managements. This consensus aims to increase attention to OMS, and optimize the clinical diagnosis and decision-making of OMS, which finally provides evidence-based options for OMS clinical management.

Effect of nursing intervention on rehabilitation of patients with chronic sinusitis and nasal polyps after nasal endoscopy

BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.

Coinfection with hepatic cystic and alveolar echinococcosis with abdominal wall abscess and sinus tract formation:A case report

BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this unique presentation,discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.CASE SUMMARY A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis,accompanied by abdominal wall abscesses and sinus tract formation.Initial conventional imaging examinations suggested only hepatic cystic echinococcosis,but intraoperative and postoperative pathological examination revealed the coinfection.Following radical resection of the lesions,the patient’s condition improved,and she was discharged soon thereafter.Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing.Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare,the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.CONCLUSION Lesions involving the abdominal wall and sinus tract formation,may require radical resection.Long-term prognosis includes albendazole and follow-up examinations.

Socioeconomic Status Impacts the Prognosis of Chronic Rhinosinusitis Treated by Endoscopic Sinus Surgery:An Observational Cohort Study in Northeast China

Objective To explore the association between socioeconomic status(SES)and postoperative outcomes in patients with chronic sinusitis(CRS)after functional endoscopic sinus surgery(ESS).Methods We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS.Discharged patients were followed up to 72 weeks for all-cause recurrence events.Baseline SES was established based on occupation,education level,and family income of the patients 1 year before the operation.Kaplan–Meier method was used to calculate the recovery rate after ESS,and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis.Results Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES;24-week overall recovery rate was 90.4%[95%confidence interval(CI):89.6%–91.2%]in patients of middle SES,13.5%(95%CI:12.8%–14.2%)in patients of low SES,and 31.7%(95%CI:30.7%–32.7%)in patients of high SES(both log-rank P<0.001).After adjustment for covariates,hazard ratios(HRs)were7.69(95%CI:6.17–9.71,Ptrend<0.001)for all-cause recurrence for low SES versus middle SES,and 6.19(95%CI:4.78–7.93,Ptrend<0.001)for middle SES versus high SES.Conclusion Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES.

无线紫外光MIMO通信系统信道容量估算方法

无线紫外光通信系统易受大气散射等因素的影响,导致通信信道容量估算准确率较低。为此,提出一种无线紫外光多入多出(Multiple-Input Multiple-Output, MIMO)通信系统信道容量估算方法。根据信道特征,构建无线紫外光MIMO通信系统的信道容量估计模型,获取无线紫外光的单次散射传输特性,利用符号补码式的方法改进空时编码,设定高级检测器中符号的接收能耗,使每个符号保持在标准功率数值范围内,完成通信系统信道检测式编码。根据不同发射角和接收角计算无线紫外光通信的路径损耗比,通过泊松随机分布获得最终通信系统信道容量的估算结果。实验结果表明,所提方法的传输速率可高达8 Mbps,误码率始终低于10-3bit/s,估算准确率在90%以上,估计时间低于4 ms,估算效果好,可为通信行业发展提供理论依据。

STEMI患者外周血单个核细胞中MAPK通路与炎症反应及PCI后无复流的关系

目的 研究ST段抬高型心肌梗死(STEMI)患者外周血单个核细胞(PBMCs)中丝裂原活化蛋白激酶(MAPK)通路与炎症反应及经皮冠状动脉介入术(PCI)后无复流的关系。方法 选取郑州市第七人民医院2021年2月至2022年10月进行PCI治疗的STEMI患者和同期进行体检的健康志愿者,分别作为STEMI组(n=92)和对照组(n=100)。采用荧光定量PCR法检测PBMCs中p38MAPK、JNK的表达水平,根据中位数将STEMI组患者分为p38MAPK、JNK高表达和低表达。检测STEMI患者血清ICAM-1、TNF-α、IL-6含量,评估STEMI患者心肌损伤程度及无复流情况。结果 STEMI组患者PBMCs中p38MAPK、JNK的表达水平高于对照组,差异有统计学意义(t=5.386、5.126,P<0.05);STEMI组中p38MAPK、JNK高表达患者的CK-MB峰值、cTnT峰值及ICAM-1、TNF-α、IL-6含量均高于p38MAPK、JNK低表达患者,差异有统计学意义(t=7.143、4.999、9.528、6.805、6.890、6.226、8.132、7.807、7.162、7.588,P<0.05);STEMI组中无复流患者PBMCs中p38MAPK、JNK的表达水平高于血流正常患者,差异有统计学意义(t=5.208、4.240,P<0.05);经ROC曲线分析,PBMCs中p38MAPK、JNK的表达水平对STEMI患者PCI后无复流具有预测价值(P<0.05)。结论 STEMI患者MAPK通路中p38MAPK、JNK的高表达与炎症反应激活、PCI后无复流有关。

Association of Comorbid Asthma and the Efficacy of Bioabsorbable Steroid-eluting Sinus Stents Implanted After Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyps

Objective To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery(ESS)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP.Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation:sex,serum eosinophil levels,history of prior surgery,endoscopic scores,and comorbid conditions(asthma and allergic rhinitis).The primary outcome was the rate of post-operative intervention on day 30,and the secondary outcome was the rate of polypoid tissue formation(grades 2–3)on days 14,30,and 90.Results A total of 151 patients with CRSwNP were included in the post-hoc analysis.Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30,with an odds ratio of 23.71(95%CI,2.81,200.16;P=0.004)for the need for post-operative intervention and 19(95%CI,2.20,164.16;P=0.003)for moderate-to-severe polypoid tissue formation.In addition,the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30.Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation.Conclusion Comorbid asthma,but not blood eosinophil level,impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.

miR-494在阿霉素诱导大鼠心肌细胞损伤中的作用及机制研究

目的探讨mi R-494在阿霉素(DOX)诱导大鼠心肌细胞损伤中的作用及机制。方法将大鼠H9C2细胞分为4组:对照组、DOX组、DOX+阴性对照(NC)模拟物组、DOX+mi R-494模拟物组;除对照组,其余3组均采用5μmol/L DOX与细胞共孵育法构建心肌细胞损伤模型;后两组分别进行NC模拟物、mi R-494模拟物转染。采用细胞计数试剂盒8法检测细胞活力,实时荧光定量聚合酶链反应检测mi R-494、磷酸酶和张力蛋白同系物(PTEN)m RNA表达水平,原位末端转移酶标记染色法检测细胞凋亡率,蛋白质印迹法检测B淋巴细胞瘤-2(Bcl-2)、Bcl-2关联X蛋白(Bax)、PTEN、磷酸化磷脂酰肌醇3-激酶(p-PI3K)、磷酸化蛋白激酶B(p-Akt)蛋白表达水平,酶联免疫吸附试验检测乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)含量;采用双荧光素酶报告基因实验验证mi R-494与PTEN的相互作用。结果与对照组比较,DOX组H9C2细胞凋亡率、Bax蛋白表达水平以及LDH、CK-MB含量均明显升高(均P<0.01),而细胞活力、Bcl-2蛋白表达水平均明显降低(均P<0.01);与DOX+NC模拟物组比较,DOX+mi R-494模拟物组H9C2细胞凋亡率、Bax蛋白表达水平以及LDH、CK-MB含量均明显降低(均P<0.01),而细胞活力、Bcl-2蛋白表达水平均明显升高(均P<0.01)。PTEN与mi R-494存在结合位点;PTEN-WT的荧光素酶活性被mi R-494模拟物明显抑制(P=0.010),而PTEN-MUT的荧光素酶活性不受mi R-494模拟物影响(P=0.707)。与对照组比较,DOX组H9C2细胞中p-PI3K、p-Akt蛋白表达水平均明显降低(均P<0.01);与DOX+NC模拟物组比较,DOX+mi R-494模拟物组H9C2细胞中p-PI3K、p-Akt蛋白表达水平均明显升高(均P<0.01)。结论mi R-494可能通过靶向抑制PTEN表达来调控PI3K/Akt信号通路,以改善DOX诱导的心肌细胞损伤。

HFACS-MI改进模型在危险化学品仓储事故人因分析中的应用

为了研究危险化学品仓储事故的关键人因,通过人因分析与分类系统-煤矿(Human Factors Analysis and Classification System-Mine,HFACS-MI)改进模型从员工的不安全行为、影响不安全行为的前提条件、监督行为、组织影响和企业外部因素5个层次系统地分析65起危险化学品仓储事故,并运用卡方检验和让步比分析了产生不安全行为的原因和各层次间的内在关系。结果表明,外部管理、组织过程、监督不充分、个人因素、技能差错和违规是导致危险化学品仓储事故发生的重要因素。HFACS-MI改进模型上下层级的人为因素间存在显著的因果关系,且主要的危险化学品仓储事故致因路径共有5条,其中“外部管理因素—组织过程漏洞—监督不充分—个人因素—违规”是最关键的致因路径。改进的HFACS-MI模型可以有效分析危险化学品仓储事故人因因素。

基于互信息和MiniRocket网络的CFST脱空识别

为提高钢管混凝土(concrete filled steel tube,CFST)脱空检测的效率和精度,本文提出了一种基于快速傅里叶变换(fast fourier transform,FFT)、互信息(mutual information,MI)和MiniRocket神经网络的智能识别方法。首先,采用FFT将待测CFST敲击声波时域信号转换为频域信号;其次,采用MI建立频域信号与脱空状态的相关性,提取相关性最大的前30个特征建立数据集,避免了复杂的数学运算和冗余信息;建立MiniRocket深度学习网络,通过使用更少的参数量和更小的特征尺寸,提高分类的速度和精度。最后,考察了模型的噪音鲁棒性,并与其他算法、特征提取方法和识别方法进行对比。结果表明,在不同脱空深度和脱空宽度下,所提的方法在100次重复试验中获得了100%的平均预测精度。在高信噪比下,该方法受影响较小。此外,与其他算法、特征提取方法和识别方法相比,本方法具有更好的预测性能。因此,所提出的方法在未来实际CFST结构的智能脱空识别中具有较大的应用潜力。

基于多重生物信息学数据库分析Mis18β在膀胱癌组织中的表达及其临床意义

目的:探讨Mis18β基因在膀胱癌组织中的表达、临床意义及在疾病过程中的作用。方法:通过癌症基因组图谱(The Cancer Genome Atlas, TCGA)数据库获得膀胱癌患者Mis18β mRNA测序数据及临床资料数据,通过基因表达综合(Gene Expression Omnibus, GEO)数据库获得膀胱癌Mis18β表达数据,分析Mis18β在膀胱癌组织和癌旁组织中mRNA表达差异及与患者临床病理参数的相关性并进行生存分析,利用基因本体论(Gene Ontology, GO)功能分析以及京都基因与基因组百科全书(Kyoto Encyclopedia of Gene and Genomes, KEGG)通路富集分析探索Mis18β在膀胱癌发生发展中可能的信号通路。收集膀胱癌患者及健康对照者外周血标本,RT-PCR方法验证Mis18β mRNA表达水平的差异。结果:TCGA数据库和GEO数据库分析显示膀胱癌组Mis18β的表达量明显高于对照组(P<0.05)。生存分析提示Mis18β高表达组膀胱癌患者的总生存期明显低于低表达组(P<0.05)。功能富集分析显示Mis18β主要参与细胞有丝分裂,调控细胞周期及DNA复制等过程。膀胱癌患者外周血有核细胞中Mis18β的含量明显高于对照组(P<0.05)。结论:Mis18β在膀胱癌中呈高表达,其表达水平与患者年龄、病理类型、总生存期等临床病理特征存在相关性,为揭示膀胱癌发生发展的分子机制及寻找新的诊断、预后标志物提供了理论基础。

膀胱癌组织中MIS18BP1的表达及临床意义

目的探讨MIS18BP1在膀胱癌中的表达、与临床病理参数相关性及临床意义。方法TCGA、GEO数据库分析MIS18BP1在肿瘤和对照组中mRNA表达并经qRT-PCR验证;UALCAN在线数据库分析MIS18BP1表达及与临床病理参数、免疫细胞浸润程度相关性;免疫组织化学分析MIS18BP1在膀胱癌中的表达及与临床病理特征的关系;ROC曲线评价MIS18BP1 mRNA对膀胱癌的诊断价值。结果生物信息学分析及qRT-PCR结果显示,与对照组相比较,MIS18BP1 mRNA在膀胱癌中表达增加(P<0.05);免疫组织化学结果表明膀胱癌MIS18BP1蛋白阳性率显著增高(P<0.05),且与肿瘤临床分期、浸润深度及淋巴结转移相关(P<0.05);免疫浸润分析显示MIS18BP1与膀胱癌中免疫细胞浸润相关。结论MIS18BP1基因和蛋白在膀胱癌中表达水平增高,可能通过影响免疫细胞浸润调控膀胱癌的发生发展。

对MIS结构热弛豫时间的分析计算

对MIS(金属-绝缘层-半导体)结构从深耗尽过渡至强反型状态所需的热弛豫时间进行了研究。通过建立较教科书更精确的模型,对热弛豫时间τth与深耗尽时耗尽区宽度x d0、强反型时耗尽区最大宽度x dm、耗尽区内少子净产生率G和掺杂浓度N D等关键物理量之间的关联进行了推导,并基于MEDICI平台对推导结果完成了仿真验证,从而加强了学生对半导体表面效应的理解,也利于他们未来从事半导体方面的创新研究。

血清miR-590联合粪便钙卫蛋白对溃疡性结肠炎的诊断价值及其与内镜下疾病活动度的相关性

目的 探究血清miR-590联合粪便钙卫蛋白(FC)对溃疡性结肠炎(UC)的诊断价值及与内镜下疾病活动度的相关性。方法 选择2021年1月至2023年2月滨州市人民医院消化内科收治的84例UC患者设为研究组,另选择同期在该院体检的56名健康志愿者设为对照组。分别采用实时荧光定量PCR法和ELISA法检测2组的血清miR-590和FC水平。采用Pearson相关性分析法探究血清miR-590与溃疡性结肠炎内镜下严重程度指数(UCEIS)的相关性,采用Spearman秩相关性分析法探究FC与UCEIS的相关性。采用ROC曲线分析血清miR-590联合FC对UC的诊断价值及与内镜下疾病活动度的相关性。结果 研究组的血清miR-590表达水平较对照组显著降低,FC水平较对照组显著升高,差异均有统计学意义(P均<0.05)。血清miR-590联合FC诊断UC的敏感度、特异度、曲线下面积(AUC)分别为95.48%、76.85%、0.914,两者联合的诊断效能均高于单一指标(P均<0.05)。与缓解期UC患者相比,活动期UC患者的血清miR-590表达水平较低,且血清miR-590表达水平与内镜下疾病活动度呈负相关(P<0.05)。与缓解期UC患者相比,活动期UC患者的FC水平较高,且FC水平与内镜下疾病活动度呈正相关(P<0.05)。UC患者的血清miR-590表达水平与UCEIS评分呈显著负相关(r=-0.791,P=0.000),FC水平与UCEIS评分呈显著正相关(r=0.884,P=0.000)。血清miR-590联合FC评估UC内镜下疾病活动度的敏感度、特异度、AUC分别为97.31%、78.42%、0.946,两者联合的评估效能均高于单一指标(P均<0.05)。结论 血清miR-590联合FC有助于提高UC诊断的敏感度,并可作为辅助指标评估内镜下疾病活动度,具有临床推广价值。

具有低噪声及高线性度的高性能MOCVD-SiN_(x)/AlN/GaN毫米波MIS-HEMTs

文章在超薄势垒AlN/GaN异质结构上采用金属有机化学气相沉积(MOCVD)原位生长SiN_(x)栅介质,成功制备了高性能的SiN_(x)/AlN/GaN金属-绝缘体-半导体高电子迁移率晶体管(MIS-HEMTs)。深能级瞬态谱(DLTS)技术测试SiN_(x)/AlN的界面信息,显示其缺陷能级深度为0.236 eV,俘获截面为3.06×10^(-19)cm^(-2),提取的界面态密度为10^(10)~10^(12)cm^(-2)eV^(-1),表明MOCVD原位生长的SiN_(x)可以有效降低界面态。同时器件表现出优越的直流、小信号和噪声性能。栅长为0.15μm的器件在2 V的栅极电压(Vgs)下具有2.2 A/mm的最大饱和输出电流,峰值跨导为506 mS/mm,最大电流截止频率(fT)和最大功率截止频率(fMAX)分别达到了65 GHz和123 GHz,40 GHz下的最小噪声系数(NFmin)为1.07 dB,增益为9.93 dB。Vds=6 V时对器件进行双音测试,器件的三阶交调输出功率(OIP3)为32.6 dBm,OIP3/Pdc达到11.2 dB。得益于高质量的SiN_(x)/AlN界面,SiN_(x)/AlN/GaN MISHEMT显示出了卓越的低噪声及高线性度,在毫米波领域具有一定的应用潜力。

Study on the Impact of Cognitive Nursing Model on Postoperative Quality of Life in Patients Undergoing Chronic Sinusitis Surgery

Objective:To explore effective nursing programs for surgical patients with chronic sinusitis(CS).Methods:62 CS surgery patients were randomly divided into a research group and a control group with 31 cases in each group.The patients in the research group received cognitive nursing care,while the patients in the control group received routine nursing care.The nursing effects of the two groups were compared.Results:The postoperative quality-of-life scores,health behavior scores,complication rates,and nursing satisfaction scores of the patients in the research group were all better than those of the control group(P<0.05).Conclusion:The cognitive nursing model significantly improves the condition of CS surgery patients,thus it should be popularized.

Low-grade myofibrosarcoma of the maxillary sinus:Two case reports

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.

Use of MLC901 in cerebral venous sinus thrombosis:Three case reports

BACKGROUND Cerebral venous sinus thrombosis(CVT)is rare cause of cerebrovascular disease.The incidence is 0.5%of all stroke.The majority of affected patients are young adults(mean age:35-40 years)with mild to moderate disabilities.Poor outcome with severe disability is seen in 13%of cases.Early diagnosis and treatment are important for good outcomes and preventing complications.Treatment options are limited and mostly based on consensus.NeuroAiD II™(MLC901;Moleac Pte,Ltd,Singapore)has a potential beneficial role in post-stroke recovery,by aiding the natural brain recovery process.CASE SUMMARY MLC901 consists of nine natural herbal ingredients.Studies have shown its safety profile and aid in post stroke recovery.The aim of this case series was to demonstrate the potential role of MLC901 in stroke recovery of patients with cerebral venous sinus thrombosis(CVST)who received MLC901 in addition to standard of care.The prescribed dose of MLC901 is 400 mg/cap two capsules,three times a day.Data from these patients were prospectively collected at baseline and at monthly visits,for a duration of 3 mo.Outcome measures included adherence to therapy,side effects,National Institutes of Health Stroke Scale,Glasgow Coma Scale,modified Rankin Scale,and the Short Orientation-Memory-Concentration Test.MLC901 was well tolerated and no side effects were reported.All patients were stable with improved condition.CONCLUSION This case series highlights the potential therapeutic effects of MLC901 on CVST and provides support for further studies.

Sinonasal teratocarcinosarcoma involving the nasal cavity,unilateral paranasal sinuses,and intracranial invasion:A case report

BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses.Typically,it exhibits an invasive behavior towards adjacent structures;however,in exceptional instances,it may infiltrate the intracranial compartment.Due to the tumor's rarity and lack of distinctive features on computed tomography(CT)and magnetic resonance imaging(MRI)images,SNTCS is often misdiagnosed.CASE SUMMARY In this study,we present a case of SNTCS in a 56-year-old patient who exhibited unexplained cognitive impairment before admission.CT and MRI scans revealed the presence of a mass in the right nasal cavity,with lesions extending to the right ethmoid sinus and right frontal region.Subsequently,the patient underwent pathological examination for confirmation and received surgical intervention to excise the tumor.The future advancement in our understanding of this disease will significantly contribute to the precise diagnosis and treatment of SNTCS.CONCLUSION SNTCS is an exceptionally rare malignant tumor that originates from the nasal cavity and paranasal sinuses,presenting a diagnostic challenge due to its nonspecific imaging findings.MRI accurately delineates the location,morphological characteristics,size,internal structure,extent of surrounding involvement,and metabolic information of the lesion.These aspects play a pivotal role in the precise localization and qualitative assessment of SNTCS.Nevertheless,a definitive diagnosis still requires a pathological biopsy.

Invasive Fungal Sinusitis in Immunocompromised Patients: A Multicenter, University Hospital Experience in Shiraz

Objective: It is to determine the causes of invasive fungal sinusitis in patients of Shiraz University hospitals, Iran. Methods: This cross-sectional study was conducted during 18 months (from 21 March 2009 till 22 September 2010) in three Shiraz University Hospitals. Thirty-six patients with sings of invasive fungal sinusitis were enrolled, and tissue samples were investigated for histopathology, culture and antifungal susceptibility test. The laboratory results with host factor and sinus computed tomography scan were evaluated for classification of patients as proven, probable and possible invasive fungal sinusitis. Results: Thirty-five patients have involved with at least one risk factor (immune compromised disease, diabetes mellitus, or use of immune suppressed drugs). Radiological findings of parasinus invasion or necrosis were present in 20 patients. By histopathology, 21 patients were considered as proven, from these, 17 samples had positive growth. The culture aetiology agents were 4 Candida, 8 Aspergillus, and 5 Mucor. All positive culture samples were matched with histopathology findings. Significant associations were considered for radiologic finding and histopathology and culture (p 0.05). From 8 patients with mucormycosis histopathology, 6 suffered from diabetes mellitus. None of the antifungal agents were effective on these three types of infections. Conclusion: DM is the most common predisposing factor for IFS followed by ALL and AML. The most common aetiology of IFS was found to be Aspergillus fumigant followed by Mucormycosis and Candida. None of antifungal agents could successfully cover all the species.