Rejected

The aim of this study is to analyze the application value of NBI endoscopy in finding the concealed primary lesions of misdiagnosis of oropharyngeal cancer. The clinical data of patients with missed oropharyngeal cancer treated in the Department of Otolaryngology Head and neck surgery, the Second Affiliated Hospital of Xi'an Jiaotong University from May 2018 to June 2021, were retrospectively studied, and the missed diagnosis was also analyzed combined with results of NBI endoscopy. In 31 cases of misdiagnosis of oropharyngeal cancer patients, including 25 males and 6 females, there was no significant difference in age, BMI index, course of disease and TNM stage （> 0.05）, and the pharyngeal or cervical symptoms were the first clinical manifestations of them, containing pharyngeal pain in 17 cases（54.8%） , pharyngeal foreign body sensation in 4 cases（12.9%） and unilateral cervical mass in 10 cases （32.3%）. No laryngoscopy was performed （21 cases） or no primary lesion was found by laryngoscopy （10 cases） at initial diagnosis. Among them, "inflammatory lesions" were given anti-inflammatory treatment with ineffective results or surgical resection was explored for suspicious lesions （17 cases）, or imaging examination （9 cases, including 6 cases with CT and MRI, 3 cases with PET-CT） and cervical lymph node biopsy （5 cases） were carried out for further diagnosis. According to these results, they were given ordinary laryngoscope （2 cases） or NBI endoscopy （29 cases） subsequently, finally they were confirmed as oropharyngeal squamous cellcarcinoma after localized biopsy at the suspicious lesions, indicating that the accuracy of NBI endoscopy in finding the concealed primary lesions of oropharyngeal cancer （93.55%） is significantly higher than that of ordinary electronic laryngoscope （6.45%）（²=43.613, <0.01）. NBI endoscopy has unique advantages in finding oropharyngeal cancer in concealed parts such as tonsil, root of tongue, soft palate and lateral wall of oropharynx, which could reduce misdiagnosis of oropharyngeal cancer.

Epilepsy is a pathological condition characterized by seizures of muscle tension and convulsions in which the patient is unable to control himself, resulting in various complications and injuries. In this paper we talk about a rare case that combines a shoulder dislocation with a fracture of the surgical neck of the humerus after an epileptic seizure. The patient came to the hospital with clinical symptoms directed at dislocating the shoulder after an epileptic seizure, but careful examination and radiography revealed the presence of a fracture of the surgical neck of the humerus, so the management needed experience to repair two serious traumatic injuries. In the light of the foregoing, the need for clinical knowledge regarding such injuries in terms of diagnosis and methods of management and treatment is very necessary especially that neglect or wrong diagnosis will lead to very bad results, the most important of which are chronic pain, disability and stiffness.

The aim of this study is to examine the effect of preoperative conservative treatment on the success of high-grade bursal/articular-sided partial rotator cuff repair.

The combination in a fixed dose of two or more active pharmaceutical ingredients in the same pharmaceutical dosage form is an approach that has been used successfully in the treatment of several pathologies, including pain. In the preclinical development of a topical fixed-dose combination product with analgesic and anti-inflammatory activities for pain management, the main objective is to establish the nature of the interaction between the different active pharmaceutical ingredients while obtaining data on the medicinal product safety and efficacy. Despite the improvement of in vitro assays, animal models remain a fundamental strategy to characterise the interaction, efficacy and safety of active pharmaceutical ingredients at the physiological level, which cannot be reached by in vitro assays. Thus, the main goal of this review is to systematise the available animal models to evaluate the efficacy and safety of a new fixed-dose combination product for topical administration indicated for pain management. Particular emphasis is given to animal models that are accepted for regulatory purposes.

Given the risk of postoperative pain and specifically neuropathic gluteal pain after a sacrospinous ligament suspension, we conducted a randomized trial to compare a 2-week course of gabapentin versus placebo on postoperative pain after a sacrospinous ligament fixation.

In the USA, spinal cord injury (SCI) occurs in 40 people per million every year due to events such as car accidents, falls, violence, or sports injury. Secondary complications that arise from SCI are life-threatening and should be treated as early as possible. In some cases, it is not completely obvious what complication a patient may have until it is too late. Therefore, biomarkers are required to assess the levels of secondary complications after SCI. As there are several complications that pose different warning signs, different biomarkers may be beneficial in early detection, maintenance, and long-term care for patients with SCI.

To explore the diagnostic performance of cardiac magnetic resonance imaging (CMR) with T1 mapping and T2 mapping for detection of acute phase of ischemic cardiomyopathy.

Cutaneous T-cell lymphomas (CTCL) are malignant lymphoproliferative disorders accompanied by persistent pruritus. Pruritogenic role of interleukin-31 (IL-31) has been studied extensively and was proven in atopic dermatitis (AD), while its role in CTCL is still rather vague.

Pseudotumor cerebri syndrome (PTCS) is a condition caused by an abnormal elevation of intracranial pressure (ICH), which may be primary (idiopathic intracranial hypertension) or because of an identifiable secondary cause. We present a rare case of an obese male who complained of gradual bilateral vision loss for one year without headaches and tinnitus. On fundoscopy, he had high-grade bilateral papilledema and, on lumbar puncture, he had an elevated intracranial pressure of 260 mmH2O. Cerebrospinal fluid (CSF) was unique for eight restricted oligoclonal bands while extensive other demyelinating workup was negative. He was started on acetazolamide initially and subsequently proceeded with bilateral optic nerve sheath fenestration (ONSF) with mild improvement in the right eye and no improvement in the left eye. Although the causative mechanism of PTCS is a matter of debate, immune-mediated processes are one of the proposed mechanisms that may play a role in the pathophysiology of PTCS, evidenced by the presence of oligoclonal bands (OCBs) and pro-inflammatory markers in CSF. PTCS diagnosed in men and patients with OCBs poses an increased risk of vision loss as this case and literature documented. Therefore, prompt treatment through therapeutic lumbar punctures, acetazolamide therapy concurrently with weight loss, and surgical intervention in severe or refractory cases are necessary.

Below-knee surgeries are among the most commonly performed orthopedic or plastic and reconstructive procedures. They are associated with significant postoperative pain despite the use of systemic analgesics. The regional analgesia (RA) technique has been proven beneficial for better patient outcomes when used as an adjunct to multimodal analgesia in the early postoperative period. However, apprehension of an acute compartment syndrome (ACS) can limit the administration of appropriate RA techniques in such surgeries, leading to more opioid consumption to meet the increasing analgesic demands. Many modifications in the RA related to techniques and the local anesthetic type, concentration, and volume have been described to tackle such situations. The ideal RA technique should provide procedure-specific analgesia below the knee joint without affecting motor power and/or causing any delay in diagnosing or treating ACS. The high-volume proximal adductor canal (Hi-PAC) block is a novel RA technique described as motor-sparing and procedure-specific for the below-knee surgeries. The Hi-PAC block, a single-injection technique, is administered in the proximal adductor canal targeting the saphenous nerve and depositing local anesthetics (LA) adjacent to the femoral artery below the vasoadductor membrane (VAM). By directly blocking the saphenous nerve and indirectly the sciatic nerve, it covers the entire innervation of the pain-generating components involved in the below-knee surgeries. This article describes the anatomical and technical considerations of the Hi-PAC block and provides background knowledge of the relevant anatomy and sonoanatomy for a better understanding of its intricacies.