Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology最新文献

Objective: To assess the clinic efficacy of compound induced hypotension during functional endoscopic sinus surgery.

Method: Sixty patients with chronic sinusitis and nasal polyps were divided into three groups: Sodium nitroprusside (SNP) group (A), diltiazem+SNP group (B), labetalol+SNP group (C). We started induced hypotension with beginning of functional endoscopic sinus surgery. Mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI) and ejection fraction (EF) were recorded during induced hypotension. Sugar and lactic acid in arterial and venous blood were also assayed. Then we calculate rate-pressure product (RPP), arteriovenous difference in blood glucose [D(v-a) BG], blood glucose extraction rate (BGER), arteriovenous difference in lactate [L(v-a)] and lactate produce rate (LPR).

Result: The dose of SNP applied in group B and C are fewer than group A ( P <0. 05). The cardiovascular functions and body metabolism of the patients in group B and C were stable and the anesthetic effect was satisfactory. Few adverse reaction of the drug was found in present study.

Conclusion: Induced hypotension with SNP compound of diltiazem or labetalol is an ideal way in clinical use and produce satisfied synergistic effect.

Objective: To evaluate the method and treatment effect of endoscopic sinus surgery for chronic sphenoid sinusitis.

Method: Fifty cases, 84 sides of chronic sphenoid sinusitis patients were treated with endoscopic sinus surgery.

Result: In the follow-up of 6-12 months, 61 sides (72.62%) were cured; 13 sides (15.48%) were mended; 10 sides (11.90%) were ineffective; 74 sides were effective, the effectiveness rate were 88.10%.

Conclusion: Treatment with endoscopic sinus surgery is a safe, effective method with little pain for chronic sphenoid sinusitis.

Objective: To investigate the cytokine level in the supernatants of spleen cell stimulated with different stimulus of allergic rhinitis model at different time, compared the effect of the two stimulus to the cytokine, and its secrete status.

Method: We sensitized and challenged the BALB/c mice with ovalbumin (OVA), in the control group normal sodium instead of OVA was used. After the last challenge we cultured the spleen mononuclear cell (SMNC) and stimulated with OVA or concanavalin A (ConA), then got the supernatants of the SMNC cultures at 24 h, 48 h and 72 h respectively to measure the concentration of cytokine IL-4, IL-5 and IFN-gamma.

Result: Production of IL-4, IL-5 and IFN-gamma by ConA-stimulated SMNC from sensitized mice increased significantly (P < 0.05); the concentration of IL-4 and IL-5 by OVA-stimulated SMNC from sensitized mice also increased, inversely the production of IFN-gamma resulted suppression. The level of IL-4 was increased obviously in 72 hours, IL-5 and IFN-gamma were increased significantly in 48 hours, and slow down from 48 to 72 hours.

Conclusion: The T cells of the experimental allergic rhinitis mice were generally activated. Production of cytokines from Th2 cells by OVA or ConA increased significantly, but Th1 cells and its cytokines were suppressed. The result was more obvious in the ConA-stimulated group. The levels of cytokines increased persistently within 72 hours.

Objective: To inquire into the feasibility of transnasal endoscopic surgery for the diagnosis and treatment of cerebrospinal rhinorrhea caused by transsphenoidal meningo encephalocele.

Method: Three cases of cerebrospinal rhinorrhea caused by transsphenoidal meningo encephaloceles were managed by transnasal endoscopic surgery. Different repair materials such as muscle, fascia, artificial dural material were applied into the defect site.

Result: All cases were successful treated, 1 of them complicated with meningitis, the others were cured without any complication. One reoccurred after 6 months and was successful repaired after second surgery during 1-3 year follow-up.

Conclusion: The treatment of transnasal endoscopic surgery for cerebrospinal rhinorrhea caused by transsphenoidal cephalocele is a feasible, mini-wound and safe approach.

Objective: To survey the effects of TNF-alpha and IL-8 in the pathogenesis of allergic rhinitis.

Method: The serum levels of TNF-alpha and IL-8 in 102 cases of seasonal or non-seasonal allergic rhinitis were detected pre and post specific immunotherapy (SIT), and the results were statistically analyzed.

Result: The levels of TNF-alpha and IL-8 in experiment group were significant higher than that in the health control. And the levels of TNF-alpha and IL-8 significantly decreased post SIT in the experiment group.

Conclusion: TNF-alpha and IL-8 play important roles in the pathogenesis of allergic rhinitis.

Objective: To investigate the expression and clinical significance of anti-apoptosis gene Survivin and tumor suppressor gene PTEN in laryngeal squamous cell carcinomas (LSCC) METHOD: The expression of Survivin and PTEN protein were detected by immunohistochemistry Envision method in 71 specimens of LSCC, and 10 specimens of vocal cord polyp as control.

Result: No Survivin was detected in polyp of vocal cord. However, it was detected in 53 of 71 (74. 6%) specimens from the patients with LSCC. The Survivin expression was unrelated to the age and sex of patients or the size of tumors ( P >0.05) ,but related to the tumor site, clinical stage, histological grade, lymphatic metastasis and tumor prognosis ( P <0. 05). PTEN had the expression in all specimens of vocal cord polyp. However, it was detected in 33 of 71 (46. 5%) specimens of laryngeal carcinoma. The PTEN expression was unrelated to the clinical data including age, gender, tumor size and site ( P >0. 05), but related to the clinical stage, pathological grade, lymph node metastasis and prognosis ( P <0. 05). There was a negative correlation between Survivin expression and PTEN expression ( P <0. 05).

Conclusion: The abnormal expression of Survivin and PTEN gene may be related to carcinogenesis, tumor progress and prognosis. The Survivin and PTEN gene may act as markers predicting biological behavior of LSCC. The coexpression of Survivin and PTEN gene have the synergism in carcinogenesis and tumor progress of LSCC.

Objective: To test non-mandarin native-speaker of normal hearing with MHINT.

Method: Eighty-two non-native Mandarin speakers with normal hearing were included. The test were done under four test conditions by HINT for Windows V6.1. The results were compared between non-mandarin native-speakers' with mandarin native-speakers'. The results were analyzed statistically.

Result: Three hundred and twenty-eight results of the subjects were gained. There was evident significantly difference between mandarin and non-mandarin native speakers (P < 0.01), and between non-mandarin native speakers with high educational level and low educational level ( P < 0.01), but there was no difference when compared with their age, time of use Mandarin in the results (P > 0.05).

Conclusion: Non-mandarin native-speakers' results are lower than mandarin native-speakers'. The primary factor affect MHINT results are native language and educational experiences.

Objective: To investigate the relationship among angiogenesis, spontaneous apoptosis and clinicopathological parameters in laryngeal squamous cell carcinoma (LSCC).

Method: The intratumor microvessel density (IMVD), apoptotic index (AI) and vascular endothelial growth factor (VEGF) expression were detected by immunohistochemistry SABC and terminal uridine deoxynucleotidyl transferase mediated nick end labeling(TUNEL) methods in 34 LSCC patients.

Result: The average IMVD was (21.50 +/- 8.87), and median of AI was 1.15%. The average IMVD in positive and negative cervical lymphatic metastasis was (26.33 +/- 9.70) and (17.68 +/- 6.06) respectively, and the IMVD with positive lymphatic metastasis tumors was statistical significantly higher than those with negative cervical lymphatic metastasis tumors (P < 0.01). The average IMVD had statistical difference in histological grading (P < 0.01), and analysis by one to one, the average IMVD had statistical difference between high and median grading. Expression of VEGF had a significantly positive correlation with IMVD (r = 0.51, P < 0.01). Statistical analysis revealed a significantly inverse correlation between AI and IMVD (r = -0.53, P < 0.01). We failed to find the statistical difference between IMVD and tumor T-stage in LSCC.

Conclusion: IMVD may be an important indicator to predict cervical lymphatic metastasis in LSCC. VEGF might be an important angiogenic factor, and could promote tumor angiogenesis in LSCC. Tumor angiogenesis might contribute to tumor malignant progression by inhibiting spontaneous apoptosis in LSCC.

Objective: To investigate the feasibility and subject range of endoscopic transnasal surgery for anterior skull base lesions.

Method: Six patients affected with anterior skull base diseases in recent years were studied. The lesions were included 3 cases of cen encephalocele, 2 of cerebrospinal rhinorrhea and one of left retrobulbar tumor. All 6 patients received endoscopic transnasal surgery under general anesthesia.

Result: All patients had accepted successful one-stage surgeries without any complications.

Conclusion: Endoscopic transnasal surgery for some anterior skull base lesions has the advantages of tiny injuring, quick recovery and few complications. But surgical indications must be controlled seriously. The operator must hold skillful anatomic intelligence, surgical technique and experiences as well as advanced surgical apparatuses.

Objective: To investigate the characteristics of chronic frontal sinusitis and to improve the clinical therapeutic efficacy.

Method: Sixty-eight patients (130 sides) who underwent endoscopic frontal sinus surgery in our department were randomly divided into three groups: Group 1 included 23 patients (43 operations) underwent endonasal sinus surgery with the frontal sinus opened and drained by two pipes of silicone for 6 months. Group 2 included 24 patients (45 operations) treated as group 1 but added injection of beclomethasone (approximately 1 cc, 94 mcg/100 microliters). Group 3 included 21 patients (42 operations) with only frontal sinus opened.

Result: After an average follow-up of 18 months, the cure rate in group 1, group 2 and group 3 was 93%, 93% and 71% respectively.

Conclusion: The ultimate success or failure of frontal sinus surgical procedures, whether they are endonasal or external, depends on the restenosis of the frontal sinus outflow tract or neo-ostium postoperatively. Long-term stenting for a period of several months will significantly reduce the possibility of restenosis. We recommend that this type of management be considered in difficult revision cases and before performing an external operation.