Application of high‑density polyethylene implants in adult cleft lip and palate nasal deformity and dysfunction北大核心CSCD

Objective Through the use of high‑density polyethylene implants in adults with cleft lip and palate nasal deformities and abnormal functions, to evaluate the clinical effect of postoperative patients on improving nasal shape and symptoms. Methods A retrospective study of 12 patients with nasal deformities after cleft lip and palate surgery in the Shanghai Ninth People′s Hospital Affiliated to Shanghai JiaoTong University School of Medicine from January 2018 to January 2022 was completed, including 7 males and 5 females, with the age ranging from 18 to 29 years. All the patients underwent nasal deformity correction, and nasal septum correction was performed if necessary. High‑density polyethylene implants (MEDPOR/Su‑Por) were used intraoperatively. Follow‑up for at least 6 months was performed to measure the relevant appearance indicators and subjective Visual Analog Scale (VAS) scores, and to compare the clinical effects before and after surgery. SPSS 22.0 software was used for statistical analysis. Results Before and after surgery, the average VAS score of nasal obstruction decreased by (4.83±0.94) points; the average VAS score of appearance satisfaction increased by (3.92±1.08) points; the height of nasal columella was increased by (1.79±0.78)mm; the height of nasal tip was increased by (2.79±1.50)mm; the height of ipsilateral nostril was increased by (1.83±0.62)mm; the width of the ipsilateral nasal floor was reduced by (0.42±0.47)mm. All of above were statistically significant (all P<0.05). Conclusion High‑density polyethylene implants can effectively improve the shape and function of the nose in operations related to cleft lip and palate nasal deformity and abnormal functions, and are an ideal synthetic material. © 2023 Authors. All rights reserved.     

Comparison of the application methods and effects of skin flaps in the repair of defects in different parts of the nose according to the concept of aesthetic nosesubunits北大核心CSCD

Objective To analyze the difference of application methods and effects of local flap in small and medium‑sized defects of different aesthetic subunits of nose, in order to provide reference for clinical work. Methods A retrospective analysis was made on 59 patients with external nasal masses and scars who underwent surgical treatment in the Department of Aesthetic Plastic Surgery of the Affiliated Hospital of Qingdao University from July 1, 2021 to January 30, 2022, including 27 females and 32 males, aged 15 to 69 years. Using Likert scale, the repair methods and effects of local flap for nasal soft tissue defects were evaluated and summarized from three aspects of texture, flatness and scar concealment. GraphPad Prism 5.0 software was used for data statistics and analysis. Results The use of skin flaps to repair small and medium‑sized areas of the nose could achieve satisfactory results. For patients with different subunits, in terms of skin flatness and scar concealment degree in the operation area, patients′ satisfaction with the dorsal and lateral nasal areas was higher than that of the alar and tip areas, respectively (F=6.40, P=0.001; F=10.57, P<0.001). For patients with different skin flap repair methods, the satisfaction of patients with Z‑plasty and Dufourmentel skin flap was higher than that of other skin flap repair methods (F=4.38, P=0.002), and the satisfaction of patients with Dufourmentel skin flap was the highest in the degree of scar concealment (F=2.57, P=0.038). Conclusions In the small and medium‑sized defects of the nose, the use of multiple local flaps can achieve good cosmetic effects and functional recovery. The operator should select the appropriate flap repair method according to the characteristics of different aesthetic subunits of the nose. © 2023 Authors. All rights reserved.     

Transoral robotic nasopharyngectomy for local recurrent nasopharyngeal carcinoma北大核心CSCD

Objective To investigate the safety, efficacy, locally control and survival results of transoral Da Vinci robotic surgery for salvage treatment of locally recurrent nasopharyngeal carcinoma. Methods This retrospective study included 33 patients with locally recurrent nasopharyngeal carcinoma (stage rT1‑2, partial rT3) underwent transoral Da Vinci robotic surgery between October 2017 and January 2020. There were 20 males and 11 females, with an average age of (47.9±10.5) years. The lesions were localized in nasopharyngeal cavity in 14 cases, with extending to parapharyngeal space in 6 cases and the floor of sphenoid sinus in 13 cases. Transnasal endoscopy was used to assist surgery if necessary. SPSS 25.0 statistical software was used for statistical analysis. Results Transoral robotic nasopharyngectomy was successfully performed in all cases without conversion to open surgery, of which 13 cases were combined with transnasal endoscopic surgery. The average operation time was (126.2±30.0) min, ranging from 90 to 180 min. The postoperative pathological margin was R0 (31 cases) and R1 (2 cases), with no tumor residue. Complications of surgery mainly included symptoms of headache, nasal dryness and velopharyngeal insufficiency without nasopharyngeal hemorrhage. Follow‑up time was from 3 to 54 months. One case had tumor recurrence 11 months after operation, 1 case had ipsilateral cervical lymph node metastasis 27 months after operation, 2 cases had distant metastasis and 1 case died of nasopharyngeal hemorrhage 3 months after operation. The 1‑year, 2‑year and 3‑year overall survival rates were 97.0%, 96.0% and 92.9%, respectively and the local recurrence free rates were 97.0%, 95.7% and 91.7%, respectively. Conclusion Transoral robotic nasopharyngectomy is safe and feasible for local recurrent nasopharyngeal carcinoma in selected patients, with higher local control rate and quality of life. © 2022 Chin J Otorhinolaryngol Head Neck Surg. All rights reserved.     

Postoperative rehabilitation effect and influence factors of adult prelingual deafness with cochlear implant北大核心CSCD

Objective To investigate whether pre‑lingual deafness adult caused by inadequate auditory compensation in childhood can benefit from cochlear implants and the related influencing factors. Methods A total of 26 prelingual deafness as experimental group [11 males and 15 females, the age of operation was (24.5±5.7) years] and 13 postlingual deafness as control group [5 males and 8 females, the age at the time of operation was (42.2±11.4) years] were recruited. Objective assessment included hearing threshold and speech recognition rate tests while wearing cochlear implants. Subjective assessment used Nijmegen Cochlear Implant Questionnaire to assess hearing‑related quality of life of subjects. The changes of hearing ability in the prelingual deafness group before and after operation and the differences with the postlingual deafness group were compared, and the correlation between speech recognition ability and the age diagnosed as severe or profound deafness, the age of hearing aid invalid, and duration of wearing cochlear implant were analyzed as factor indicators. All statistical results were analyzed by SAS 9.4 software. Results In terms of objective indicators, the speech recognition rate of pre‑lingual deafness was significantly lower than that of post‑lingual deafness [(35.4±28.0)% vs (80.9±8.0)%, t=7.67, P< 0.001], while there was no statistical difference in hearing threshold between the two groups [(34.8± 4.0) dB HL vs (33.1±3.7) dB HL, t=1.30, P>0.05]. The indicators in the subjective questionnaire showed that the prelingual deafness group was only weaker in advanced sound perception, confidence and total mean score than the post‑lingual deafness group (P<0.05), and there was no significant difference in other aspects(P>0.05), meanwhile, all indicators of the prelingual deafness group were significantly improved compared with the preoperative level (P<0.001). There was a moderate positive correlation between the hearing quality and the speech recognition rate in the prelingual deafness group(r=0.51, P=0.008). The regression analysis showed that the invalid age of hearing aid was the exact influencing factor of speech recognition rate. Conclusions Certain prelingual deaf adults can adapt to cochlear implants and obtain different degrees of auditory assistance. Compared with the improvement of objective auditory ability assessment, the patient who received cochlear implantation gain more improvement in auditory related quality of life subjectively. The ineffective age of preoperative hearing aid is an important factor, which needs to be aroused sufficient preoperative attention. © 2022 The Author(s).     

Different forms of free radial collateral artery perforator flaps for reconstruction after removal of oral tumors北大核心CSCD

Objective To investigate the efficacies of different forms of free radial collateral artery perforator flaps in repairing the defects after oral tumor surgeries. Methods From May 2016 to March 2021, 28 patients (22 males, 6 females, aged 35 ⁃ 62 years) with oral tumors admitted by Hunan Cancer Hospital received the reconstructive surgeries with the free radial collateral artery perforator flaps after removal of oral tumors, including 24 cases of tongue cancer (11 cases of tongue marginal cancer, 9 cases of tongue belly cancer and 4 cases of tongue cancer involved in the floor of the mouth) and 4 cases of buccal and oral cancer. Four forms of radial collateral artery perforator flaps were used: single perforator flaps for 6 cases, double perforators flaps for 7 cases, flaps without perforator visualization for 10 cases and chimeric perforator myocutaneous flaps for 5 cases. The recipient vessels were the superior thyroid artery and superior thyroid vein, and if second concomitant vein available, it was anastomosed with internal jugular vein in end‑to‑side fashion. SPSS 20.0 statistical software was used to analyze the data. Results The mean length of flaps was (9.7±0.4) cm, mean width (4.4±0.3) cm and mean thickness (1.1±0.4) cm. The mean length of the vascular pedicles was (7.1±0.6)cm (6.0-8.0 cm), the mean diameter of the radial accessory arteries was (1.1±0.3)mm (0.8-1.3 mm). Eleven cases(39.3%) had respectively one accompanying vein and 17 cases(60.7%) had respectively two accompanying veins, with the mean diameter of (1.1±0.3) mm (0.8-1.3 mm). All the 28 flaps survived, the donor and recipient wounds healed in one stage, the appearances of the flaps were satisfactory, only linear scars remained in the donor sites, and the upper arm functions were not significantly affected. Follow up for 12‑43 months showed that the flaps were soft with partially mucosalization, the reconstructed tongue and buccal cavity were in good shape, and the swallowing and language functions were satisfactory. The swallowing and language functions were retained to the greatest extent in 3 cases with near total tongue resection, although the functions were still significantly affected. There was no local recurrence of the tumor during follow‑up. One case had regional lymph node metastasis, and further lymph node dissection and comprehensive treatment were performed, with satisfactory outcomes. Conclusions The vascular pedicle of the radial collateral artery perforator flap has a constant anatomy, which can be prepared in different forms to improve the safety of the operation and minimize the donor site damage. It is an ideal choice for the repair of small and medium‑sized defects after oral tumor surgery. © 2023 Authors. All rights reserved.     

Electromyographic signals and the starting threshold voltage of orbicularis oris muscle in healthy rhesus monkeys北大核心CSCD

Objective To investigate the characteristics of electromyography (EMG) signals and the starting threshold voltages of the orbicularis oris muscles (OOM) in healthy rhesus monkeys under different muscle movement conditions. Methods The EMG signals and the starting threshold voltages at different time points in 4 healthy rhesus monkeys were acquired and recorded with EMG device and evoked potentiometer. The voltage amplitude variation of EMG signals was analyzed, and the voltage amplitude range of EMG signals at the beginning of OOM contraction was established. The data were statistically analyzed by one‑way ANOVA. Results The EMG of OOM in healthy monkeys in the quiet, natural and continuous mouth‑closed state was linear and relatively stable, and the absolute value fluctuated between 15 and 50 μV. The EMG waveform increased rapidly during the natural lip contraction movement, and its amplitude fluctuated greatly, with the highest absolute value of the peak value reaching hundreds of microvolts. The amplitude of EMG induced by continuous mouth closure was more than thousands of microvolts. There was no significant difference in EMG amplitudes of OOM in the healthy rhesus monkey under quiet and continuous lip closure at different time points (P>0.05). There was no significant difference in threshold voltages in the state of natural lip contraction of bilateral OOM at different time points (average range: 57.17-57.47 μV) in the healthy rhesus monkeys (P>0.05). There was no significant difference in threshold voltages of OOM induced by bilateral OOM at different time points(average range: 55.38-55.99 μV) in the healthy rhesus monkeys(P>0.05). There were significant differences in the absolute values of EMG amplitudes of OOM between the three lip movement modes: (30.67± 8.72) μV in quiet and natural continuous lip closure (475.12±54.72) μV in natural lip contraction, and (921.22±312.79) μV in the induced persistent lip closure, with t values of -8.48, -9.35 and -5.01 respectively, all P<0.001. Conclusions The EMG signals of OOM show different characteristics under different muscle movement conditions, which can be used as a basis for computer to judge and recognize the movement conditions of OOM. The upper limits of the EMG threshold voltage values of OOM under different motion states are 55‑60 μV. ©2021 Japanese Society of Allergology.     

Expression of COX-2 and transcription factor CCAAT enhancer binding proteinβin refractory sinusitis with nasal polyps and its significance

Objective To study the expression and significance of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps,and to explore the relationship between them and the recurrence of sinusitis with nasal polyps.Methods The protein expression of COX-2 and C/EBP-βin 20 cases of refractory sinusitis with nasal polyps,20 cases of sinusitis with nasal polyps and 20 cases of normal nasal mucosa were detected by western blot,and the relationship between the two was compared.Results The expression levels of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps were significantly different from those in refractory sinusitis with nasal polyps(P<0.05);The expression levels of COX-2 and C/EBP-βin sinusitis tissues with nasal polyps were significantly different from those in normal nasal mucosa tissues(P<0.05);The expression levels of COX-2 and C/EBP-βin each group were significantly correlated(P<0.05).Conclusions The high expression of COX-2 and C/EBP-βmay be closely related to postoperative recurrence of sinusitis patients with nasal polyps.Both may be used as objective indicators to judge the postoperative follow-up and recurrence tendency of patients with sinusitis with nasal polyps..     

A comparative study for the efficacies of transaxillary non-inflatable endoscopic surgery versus traditional surgery for papillary thyroid carcinoma北大核心CSCD

Objective To compare the efficacies between open surgery and axillary non‑inflatable endoscopic surgery in papillary thyroid carcinoma (PTC). Methods A retrospective analysis was performed on 343 patients with unilateral PTC treated by traditional open surgery (201 cases) and transaxillary non‑inflating endoscopic surgery (142 cases) from May 2019 to December 2021 in the Head and Neck Surgery of Sichuan Cancer Hospital. Among them, 97 were males and 246 were females, aged 20-69 years. 1∶1 propensity score matching (PSM) was performed on the enrolled patients, and the basic characteristics, perioperative clinical outcomes, postoperative complications, postoperative quality of life (Thyroid Cancer‑Specific Quality of Life), aesthetic satisfaction and other aspects of the two groups were compared after successful matching. SPSS 26.0 software was used for statistical analysis. Results A total of 190 patients were enrolled after PSM, with 95 cases in open group and 95 cases in endoscopic group. Intraoperative blood losses for endoscopic and open groups were [20 (20) ml vs. 20 (10) ml, M (IQR), Z=-2.22], postoperative drainage volumes [170 (70)ml vs. 101 (55)ml, Z=-7.91], operative time [135 (35)min vs. 95 (35)min, Z=-7.34], hospitalization cost [(28 188.7±2 765.1)yuan vs. (25 643.5±2 610.7)yuan, x̄ ± s, t=0.73], postoperative hospitalization time [(3.1±0.9)days vs. (2.6±0.9)days, t=-3.24], and drainage tube placement time [(2.5±0.8) days vs. (2.0±1.0)days, t=-4.16], with statistically significant differrences (all P<0.05). There was no significant difference in surgical complications (P>0.05). There were significant diffferences between two groups in the postoperative quality of life scores in neuromuscular, psychological, scar and cold sensation (all P<0.05), while there were no statistically significant differences in other quality of life scores (all P>0.05). In terms of aesthetic satisfaction 6 months after surgery, the endoscopic group was better than the open group, with statistically significant difference (χ2=41.47, P<0.05). Conclusion Endoscopic thyroidectomy by a gasless unilateral axillary approach is a safe and reliable surgical method, which has remarkable cosmetic effect and can improve the postoperative quality of life of patients compared with the traditional thyroidectomy. © 2023 Authors. All rights reserved.     

Distribution and relative activity of matrix metalloproteinase-2 in human coronal dentin

The presence of matrix metalloproteinase-2 (MMP-2) in dentin has been reported, but its distribution and activity level in mature human coronal dentin are not well understood. The purpose of this study was to determine the MMP-2 distribution and relative activity in demineralized dentin. Crowns of twenty eight human molars were sectioned into inner (ID), middle (MD), and outer dentin (OD) regions and demineralized. MMP-2 was extracted with 0.33 mol·L -1 EDTA/2 mol·L -1 guanidine-HCl, pH 7.4, and MMP-2 concentration was estimated with enzyme-linked immunoabsorbant assay (ELISA). Further characterization was accomplished by Western blotting analysis and gelatin zymography. The mean concentrations of MMP-2 per mg dentin protein in the dentin regions were significantly different (P=0.043): 0.9 ng (ID), 0.4 ng (MD), and 2.2 ng (OD), respectively. The pattern of MMP-2 concentration was OD>ID>MD. Western blotting analysis detected ～66 and ～72 kDa immunopositive proteins corresponding to pro-and mature MMP-2, respectively, in the ID and MD, and a ～66 kDa protein in the OD. Gelatinolytic activity consistent with MMP-2 was detected in all regions. Interestingly, the pattern of levels of Western blot immunodetection and gelatinolytic activity was MD>ID>OD. The concentration of MMP-2 in human coronal dentin was highest in the region of dentin that contains the dentinoenamel junction and least in the middle region of dentin. However, levels of Western blot immunodetection and gelatinolytic activity did not correlate with the estimated regional concentrations of MMP-2, potentially indicating region specific protein interactions.     

鼻内镜下108例鼻腔扩容术疗效分析

目的 探讨鼻内镜下鼻腔扩容术的疗效.方法 选择108例鼻中隔偏曲和慢性肥厚性鼻炎患者,根据具体病情分别行个性化手术,如鼻中隔偏曲行鼻内镜下鼻中隔成形术或三线减张鼻中隔矫正术;慢性肥厚性鼻炎行鼻内镜下下鼻甲外移术酌情联合下鼻甲等离子消融术或下鼻甲黏膜下切除术及下鼻甲部分切除术等.结果 术后随访3～12个月,有效率为97.2%,患者无头痛,鼻干等并发症发生.结论 鼻内镜下鼻腔扩容术处理鼻中隔偏曲和慢性鼻炎疗效确实.

Abstract：

Objective To investigate the efficacy of endoscopic nasal cavity enlarging surgery for the alleviation of nasal obstruction.Methods One hundred and eight patients with deviation of the nasal septum ( DNS) and chronic hypertrophic rhinitis ( CHR) were included in this study.Individualized operations were performed.DNS patients were treated by three line tension relaxing correction or nasal septum plasty.CHR patients were treated by inferior turbinate outfracture in combination with plasma radiofrequency ablation for reducing the volume of nasal soft tissue,sub-mucoperiosteal partial resection of the inferior turbinate or partial inferior turbinectomy.Results All patients were followed for 3-12 months after surgry with an effective improvement in 97.2%.Symptoms of headache or complications of rhinitis sicca were not found.Conclusions Being careful to keep the physiological function of nasal mucosa,the integrity of the nasal septum,appropriate expansion of the nasal cavity volume,and restore ventilation with bilateral symmetry of the nasal cavity,satisfactory relief of nasal obstruction can be achieved.     

鼻中隔矫正术或联合下鼻甲骨折外移术对鼻腔模拟气流场及气道结构影响的分析

目的 探讨鼻中隔矫正术或联合下鼻甲骨折外移术对鼻腔气流场及气道结构的影响.方法 对2006-2009年诊治的6例"C"型鼻中隔偏曲患者行鼻中隔矫正术或联合下鼻甲骨折外移术,术前及术后分别行鼻CT检查,根据CT分别对手术前后鼻腔气道结构进行表面三维重建,设定边界条件并求解Navier-Stokes方程.对比分析手术前后通气量为12 L/min时气流场、气道结构变化.采用SPSS 12.0软件进行非参数秩和检验.结果 术前气道总面积、总鼻道中、下部面积宽敞侧分别为(1.61±0.18)、(0.40±0.10)、(0.40±0.14)cm2,狭窄侧分别为(1.30±0.18)、(0.33±0.05)、(0.36±0.10)cm2,双侧对比差异无统计学意义(Z值分别为1.782、1.363、0.526,P值均＞0.05);气道总流量、总鼻道中、下部流量、下鼻甲厚度宽敞侧分别为(361±68)、(131±25)、(100±28)ml,(0.93±0.10)cm,狭窄侧分别为(178±33)、(59±26)、(59±18)ml,(0.58±0.12)cm,双侧对比差异均有统计学意义(Z值分别为2.207、2.201、2.201、2.214,P值均＜0.05);双侧气流形式均紊乱.术后气道总面积宽敞侧、狭窄侧分别为(2.55±0.44)、(2.20±0.72)cm2,术后狭窄侧总鼻道中、下部面积分别为(0.58±0.13)、(0.81±0.26)cm2,术后宽敞侧下鼻甲厚度为(0.73±0.08)cm,与术前对比差异均有统计学意义(Z值分别为2.201、2.201、2.201、2.201、2.264,P值均＜0.05);双侧气流形式稳定.术后气道阻力[(0.16±0.01)kPa·L-1·s-1]较术前[(0.41±0.03)kPa·L-1·s-1]明显减小,差异有统计学意义(Z=-2.207,P=0.027).结论 鼻中隔偏曲患者术前鼻腔气道呈失代偿性改变,通气功能减退;行鼻中隔矫正术或联合下鼻甲骨折外移术后通气功能好转,但气道结构仍有继发性、自适应性改变.

Abstract：

Objective To explore the effect of septoplasty or in combination with outfracture of the inferior turbinate in patients with nasal septum deviation on the airflow field and the nasal airway structure.Methods Six patients with nasal septum deviation underwent spiral CT imaging scans before surgery and during the follow-up.The 3D finite element meshes of the nasal airway were developed from the above CT scans.Given three preconditions,the nasal airflow fields were described by the Navier-Stokes and continuity equations at the inspiratory flow rate of 12 L/ min. The whole airflow patterns were obtained and then compared with the airflow filed and airway structure changes before and after surgery.SPSS 12.0 software was used to analyze the data.Results Before surgery,area of the common airway and the middle and ventral medial regions in the concave side were (1.61 ± 0.18),(0.40 ± 0.10),(0.40 ± 0.14) cm2 respectively,and those of convex side were (1.30 ±0.18),(0.33 ±0.05),(0.36 ±0.10) cm2 respectively.The differences between both sides were of no statistical significance (Z value was 1.782,1.363,0.526 respectively,all P ＞ 0.05).Airflow of the above airways were (361 ± 68),(131 ± 25),(100 ±28) ml respectively in concave side and (178 ± 33),(59 ± 26),(59 ± 18) ml respectively in convex side, which differences were significant statistically (Z value were 2.207,2.201,2.201respectively,all P ＜ 0.05＝.The inferior turbinate in concave side [(0.93 ± 0.10) cm] was statistically (Z=2.214,P＜0.05＝ bigger than that in convex side[(0.58 ±0.12)cm] before surgery.The airflow fields were in disorder in both ill-airways.After surgery,area of the common airway was (2.55 ±0.44) cm2in concave side and (2.20 ± 0.72)cm2 in convex side respectively,and area of the middle and ventral medial regions in the convex side were (0.58 ± 0.13),(0.81 ± 0.26)em2 respectively,which differences were of significance statistically when comparing to areas before surgery (Z value were 2.201,2.201,2.201,2.201,P ＜0.05＝.The airflow passed through nasal airway orderly in both sides.But the thickness of inferior turbinate was (0.73 ±0.08)cm in concave side after surgery,which difference was significant statistically in comparison to that before surgery (Z = 2.264,P ＜ 0.05＝.Consequently,nasal resistance decreased from (0.41 ± 0.03) k Pa · L- 1 · s - 1 to (0.16 ± 0.01) kPa · L -1 · s - 1 after surgery,the difience was significantly(Z = -2.207,P = 0.027).Conclusion Septoplasty or in combination with outfracture of the inferior turbinate,followed by the self-adaptation consecutively,could improve the airway and breathing capacity of the nose.     

Role and mechanism of the expression of matrix metalloproteinase 9 and tumor necrosis factor α in upper and lower respiratory tract inflammation in rats

Objective To investigate the role and mechanism of matrix metalloproteinase 9(MMP-9) and tumor necrosis factor α (TNF-α) in the pathogenesis of allergic rhinitis (AR) and asthma (AS). Methods The rat models of AR and AS were made by injecting ovalbumin. The infiltration of eosinophils and mast cells were detected by hematoxylin-eosin (HE) staining and toluidine blue staining respectively, and the expression of MMP-9 and TNF-α in nasal mucosa and lung tissue were examined by immunohistochemical staining ( SP method). The relationship of their expression with upper and lower respiratory tract inflammation was analyzed. SPSS 13.0 software was used to analyze the data. Results The numbers of MMP-9 positive inflammatory cells in nasal mucosa and lung tissue of AR were ( 154.8±12.0)and (124. 0 ±8.2), (43. 2 ±7.6) and (34. 5 ±5.0) in the control groups, the difference was significant (t value were 24. 260, 29. 525 respectively, all P＜0.05). The numbers of MMP-9 positive inflammatory cells in nasal mucosa and lung tissue of AS were (149.9±11.7)and(120.1±7.3), (48.6 ± 7. 6) and (39.1±5.2)in control groups, the difference was significant (t value were 22. 929 and 28. 530respectively, all P＜0.05).The numbers of TNF-α positive inflammatory cells in nasal mucosa and lung tissue of AR were (188.8±17.0), and (134.8±7.9), (57.6±23.3)and(40. 3 ± 8. 2 ) in control groups, the difference was significant (t value were 13. 836 and 26. 220, all P ＜0.05). The numbers of TNF-α positive inflammatory cells in nasal mucosa and lung tissue of AS were (179. 2 ± 15.4 ) and ( 153. 5 ± 10. 1 ), (70. 5 ±33. 1 ) and ( 33.8 ± 14. 0) in control groups, the difference was significant ( t value were 9. 412 and 21. 858, all P ＜0. 05). There was a correlation between the expression of MMP-9 and TNF-α in nasal mucosa and lung tissue of AR ( r values were 0. 893 and 0. 700 respectively, P values were 0. 001 and 0. 024, respectively ) and AS ( r values were 0. 692 and 0. 644 respectively, P values were 0. 027and 0. 044 respectively) groups. Conclusions The inflammation is similar between AR and AS. The MMP9 and TNF-α may play an important role in the pathogenesis of upper and lower respiratory tract inflammation.     

转录因子RORC2和白细胞介素17的表达与变应性鼻炎症状关系的研究

目的 探讨变应性鼻炎(allergic rhinitis,AR)患者转录因子维甲酸相关孤儿受体(retinoic acid-related orphan receptor variant 2,RORC2)和白细胞介素(interleukin,IL)17的表达与过敏症状的关系.方法 取23例AR患者和16例健康人鼻黏膜、鼻分泌物和静脉血,采用免疫组化、实时荧光定量反转录聚合酶链反应和酶联免疫吸附试验检测其中RORC2和IL-17的表达.对AR患者进行症状评分.采用SPSS 13.0软件对变应性鼻炎组与健康对照组各检测指标进行统计学分析.结果 AR组鼻黏膜中RORC2和IL-17免疫组化染色的阳性细胞率分别为0.17±0.05(-x±s,以下同)和0.72±0.13,高于健康对照组的0.05±0.02和0.27±0.11,差异有统计学意义(t值分别为9.51和11.92,P值均＜0.05).AR组鼻黏膜和外周血RORC2 mRNA的相对表达量为0.063±0.011和0.452±0.031,高于对照组的0.029±0.009和0.239±0.027,差异有统计学意义(t值分别为6.51和3.35,P值均＜0.05).AR组IL-17在鼻黏膜、鼻分泌物和外周血中的水平分别为(70.28±10.69)、(45.32±8.55)、(6.76±1.18)pg/ml,高于对照组的(18.43±8.34)、(6.83±1.31)、(0.74±0.05)pgml,差异有统计学意义(t值分别为7.92、17.66和15.43,P值均＜0.05).AR组鼻过敏症状评分为(9.43±1.27)分,分别与鼻黏膜、外周血RORC2 mRNA的表达以及鼻黏膜、外周血IL-17的表达水平呈正相关(r值分别为0.820、0.746和0.629、0.841,P值均＜0.05).结论 RORC2和IL-17参与了AR的炎性反应,可作为判断病情严重程度的指标之一.

Abstract：

Objective To evaluate the relationship between allergic symptoms and retinoic acid related orphan receptor variant 2 (RORC2) and interleukin(IL) 17 in patients with allergic rhinitis(AR).Methods Blood sample,nasal secretion and nasal mucosa were taken from 23 patients with AR and 16 health individuals.The expression of RORC2 and IL-17 were detected by immunohistochemistry and quantitative real-time fluorescence reverse polymerase chain reaction.The allergic symptoms in patients were graded.Results The rate of positive cells of RORC2 and IL-17 in AR group were 0.17 ±0.05 and 0.72 ±0.13,higher than the 0.05 ± 0.02 and 0.27 ± 0.11 of health controls,the difference was statistically significant(t were 9.51 and 11.92 respectively,all P ＜0.05＝.The expression level of RORC2 mRNA in nasal mucosa and peripheral blood of AR group were 0.063 ± 0.011 and 0.452 ± 0.031,higher than the 0.029 ±0.009 and 0.239 ±0.027 of health controls,the difference was statistically significant (t were 6.51and 3.35 respectively,all P ＜0.05＝.The concentrations of IL-17 in the nasal mucosa,nasal secretions and serum levels of AR group were (70.28 ± 10.69) ,(45.32 ± 8.55) and (6.76 ± 1.18) pg/ml,compared with (18.43 ± 8.34),(6.83 ± 1.31) and (0.74 ±0.05) pg/ml of controls,the difference was statistically significant(t were 7.92,17.66 and 15.43 respectively,all P ＜ 0.05＝.The allergy symptom scores of AR group were 9.43 ± 1.27.There were correlations between the allergic symptom and the expression of RORC2 mRNA and IL-17 in nasal mucosa and peripheral blood (r value were 0.820,0.746,0.629,0.841 respectively,all P ＜ 0.05＝.Conclusion RORC2 and IL-17 involved in the inflammatory response of AR and can be used as an indicator to judge the severity.     

基质金属蛋白酶及组织金属蛋白酶抑制剂在鼻腔鳞状细胞癌中的表达及意义

Objective To study the expression and significance of matrix metalloproteinase (MMP)2, MMP-9, tissue inhibitor of metalloproteinase (TIMP) 1 and TIMP-2 in nasal cavity squamous cell carcinoma and their signification. Methods Fifty cases of epithelial carcinoma tissue and 50 cases of normal nasal tissue were detected for MMP-2, MMP-9, TIMP-1, TIMP-2 by immunohistochemistry technique (S-P), and their relationship between the expression of MMP-2, MMP-9, TIMP-1, TIMP-2 and some clinical symptoms were analyzed. The SPSS 12. 0 software was used to analyze the data. Results The positive ratio of expression of MMP-2 in 50 cases of epithelial carcinoma was 52. 0% (26/50), which was significantly higher ( x2 = 6. 00, P ＜0. 05 ) than those [28.0% (14/50)] in the normal nasal tissue. The positive ratio of expression of MMP-9 in 50 cases of epithelial carcinoma was 58.0% (29/50), which was significantly higher ( x2 = 12. 8, P ＜ 0. 05 ) than those [10. 0% (5/50)] in the normal nasal tissue. The positive ratio of expression of TIMP-1 in two groups was 74. 0% (37/50), 56. 0% (28/50) respectively.There was no difference between two groups ( x2 = 0. 51, P ＞ 0. 05 ). The positive ratio of expression of TIMP-2 in two groups was 26. 0% ( 13/50), 20% (10/50) respectively. There was no difference between two groups( x2 = 3.35, P ＞ 0. 05). Conclusions There was a close relationship between pathogenesis and development of nasal epithelial carcinoma and the expression of MMP-2, MMP-9 in the epithelial carcinoma tissues. Both MMP and TIMP, especially the unbalance of MMP and TIMP, have prognostic value in nasal cavity squamous cell carcinoma.     

鼻腔筛窦鳞状细胞癌146例治疗分析

Objective To evaluate the treatment outcome of different therapeutic modalities for squamous cell cacinoma of the nose and ethmoid sinus and prognostic factors. Methods One hundred and forty-six cases of squamous cell carcinoma of the nose and ethmoid sinus treated from 1990 to 2007 were reviewed. Of the 146 cases,28 were at stage Ⅰ or Ⅱ ;46 stage Ⅲ ;72 stage Ⅳ. Forty-one patients were treated with preoperative radiation plus surgery( R + S) ,22 patients with surgery plus postoperative radiation ( S + R), 5 patients with surgery alone ( SA ), 78 patients with radiotherapy alone (RA). Results The overall 5 year survival rate of 146 patients with squamous cell carcinoma of the nose and ethmoid sinus was 49. 1%. The 5 year survival rate of the patients at stage Ⅰ and Ⅱ was 95. 7% ,while the rate was 59. 8% in the patients at stage Ⅲ and 28. 2% in the patients at stage Ⅳ ( x2 = 24. 15, P < 0. 05). The 5 year survival rate was 57.7% in R+S group,60.4% in S+R group, 100% in SA group,and 38.8% in RA group,respectively(P >0. 05). The 5 years survival rate of N + patients was lower than that of NO( x2 = 12. 326,P < 0. 05). Local recurrence and distant metastasis were main causes of death. Cox analysis showed TNM stage and differentiation of tumor were independent significant prognostic factors. Conclusions The higher survival rate of patients with squamous cell carcinoma of the nose and ethmoid sinus was obtained from combined therapy R + S or S + R. SA gave ideal results for early lesions(stage Ⅰ and Ⅱ ).     

鼻腔筛窦鳞状细胞癌146例治疗分析

Objective To evaluate the treatment outcome of different therapeutic modalities for squamous cell cacinoma of the nose and ethmoid sinus and prognostic factors. Methods One hundred and forty-six cases of squamous cell carcinoma of the nose and ethmoid sinus treated from 1990 to 2007 were reviewed. Of the 146 cases,28 were at stage Ⅰ or Ⅱ ;46 stage Ⅲ ;72 stage Ⅳ. Forty-one patients were treated with preoperative radiation plus surgery( R + S) ,22 patients with surgery plus postoperative radiation ( S + R), 5 patients with surgery alone ( SA ), 78 patients with radiotherapy alone (RA). Results The overall 5 year survival rate of 146 patients with squamous cell carcinoma of the nose and ethmoid sinus was 49. 1%. The 5 year survival rate of the patients at stage Ⅰ and Ⅱ was 95. 7% ,while the rate was 59. 8% in the patients at stage Ⅲ and 28. 2% in the patients at stage Ⅳ ( x2 = 24. 15, P < 0. 05). The 5 year survival rate was 57.7% in R+S group,60.4% in S+R group, 100% in SA group,and 38.8% in RA group,respectively(P >0. 05). The 5 years survival rate of N + patients was lower than that of NO( x2 = 12. 326,P < 0. 05). Local recurrence and distant metastasis were main causes of death. Cox analysis showed TNM stage and differentiation of tumor were independent significant prognostic factors. Conclusions The higher survival rate of patients with squamous cell carcinoma of the nose and ethmoid sinus was obtained from combined therapy R + S or S + R. SA gave ideal results for early lesions(stage Ⅰ and Ⅱ ).     

鼻息肉患者鼻腔淋巴系统核素显影的初步研究

目的 探讨鼻腔黏膜淋巴引流障碍在鼻息肉患者鼻黏膜中的表现.方法 应用核素显影技术对25例鼻息肉患者(试验组,又分为Malm-1、Malm-2、Malm-3级3个亚组)和需行前哨淋巴结核素检查且经鼻内镜检查鼻腔结构正常的6例甲状腺腺癌、喉癌等患者(对照组)的鼻腔黏膜特定部位进行核素注射,通过影像结果分析鼻腔黏膜淋巴引流状况.结果 试验组及对照组注射部位均未见到明显的淋巴显影及引流征象,但试验组注射点周围存在显影剂滞留现象.试验组、对照组感兴趣区(region of interest,ROI)内放射性计数比值((x)±s,以下同)分别为29.33 ±6.34、20.66 ±1.89,差异有统计学意义(t=3.275,P＜0.05).试验组中Malm-1、Malta-2、Malm-3级3个亚组ROI内放射性计数比值分别为24.40 ±3.19、29.31±3.39、39.21±3.15,3个亚组比较,差异有统计学意义(F=38.980,P＜0.05).结论 鼻息肉患者鼻黏膜淋巴引流存在功能紊乱.

Abstract：

Objective To explore the role of nasal mucosal lymphatic drainage in the pathogenesis of nasal polyps.Methods There were 25 cases in the experimental group who had nasal polyps ( which was further divided into Malm-1,Malm-2,Malm-3 level 3 subgroups)and 6 cases in the control group,including thyroid cancer and laryngeal cancer patients who had normal nasal structure.The nasal polyps in the experimental group and the middle turbinate in the control group were injected with a radionuclide and a radionuclide imaging technique was used to image the nasal mucosal lymphatics.The lymphatic drainage status of the nasal mucosa through the imaging results was analysed.Results The T/NT ratio ( radioactivity counting) of the region of interest( ROI) was 20.66 ± 1.89 in the control group and 29.33 ± 6.34 in the experimental group.The difference was significant (t =3.275 ,P ＜0.05 ) .The T/NT ratio of the ROI was 24.40 ±3.19 in the Malm-1 level group,29.31 ± 3.39 in the Malm-2 level group,39.21 ± 3.15 in the Malm-3 level group.The differences of qualitative analysis were significant ( F = 38.980,P ＜0.05 ) .The quantitative analysis showed that at the injection site,signs of lymphatic development and drainage were not found in the control group or experimental group,but the phenomenon of contrast media retention existed at the injection site in the experimental group.Conclusion Lymphatic drainage dysfunction exists in patients with nasal polyps,and it may play a role in the pathogenesis of nasal polyps.     

Functional and patient-reported outcomes of bone-anchored hearing aids (BAHA): A prospective case series study

Objective: The purpose of this study was to evaluate the functional and patient-reported outcomes, and their correlation, after percutaneous bone-anchored hearing aid(BAHA) implantation.Methods: A prospective study was conducted between January 2018 and December 2020 in a tertiary care center. All adult patients who were implanted with a percutaneous BAHA device during this evaluation period were included in the study. Complete auditory function and patients reported outcome measures(PROMs) were...     

神经导航及内镜辅助下经鼻蝶显微切除无功能性 垂体大腺瘤的近期疗效分析

ObjectiveTo investigate the short term effect of neuronavigator and endoscope assisted endonasal trans sphenoidal surgery for patients with nonfunctioning pituitary macroadenomas.MethodsClinical data of 62 patients with nonfunctioning pituitary macroadenomas received surgical treatment in our department from Jan 2013 to Sept 2014 were retrospectively analyzed. 62 patients were divided into two groups by whether to use neuronavigator and endoscopic technology or not, i.e. study group (32 cases) and control group (30 cases). Pituitary adenoma resection was performed with assistance of endoscope and neuronavigation in the study group. The indexes including surgery time, postoperative hospitalization duration, postoperative complications, changes of serum endocrinology, MRI, the residual and recurrence rates in the two groups were recorded and analyzed.ResultsThe time of hospital stays (6.6±0.7 d) in the study group was significantly less than that in control group (8.1±0.8 d). The postoperative complication rate (including transient diabetes insipidus, cerebrospinal fluid rhinorrhea, electrolyte disturbances, postoperative bleeding in the tumor cavity,hypopituitarism) in study group was also significantly lower than that in the control group (P<0.05). The postoperative remission rate of study group was significantly higher than that of the control group. The residual (2 cases) and recurrence (0 cases) rates in the study group were significantly lower than those in the control group (9 cases and 5 cases). According to the Knosp grade, the residual rate of the patients with Knosp grade=2 in the study group was lower than that of the control group, and the difference was statistically significant (P<0.05).ConclusionThe neuronavigator and endoscopic technology contribute to decrease the occurrence of the postoperative complications, to reduce residual and recurrence rate, and to improve the gross total resection of tumor, is therefore effective for the treatment for patients with nonfunctioning pituitary macroadenomas.     

自体筋膜加脂肪声带注射术治疗声门闭合不全的疗效观察

Objective To evaluate the effect of combination of autologous fascia and fat injection into vocal fold for the treatment of patients with unilateral vocal fold paralysis and to observe the long-term effectiveness of this procedure. Methods A total of 26 unilateral vocal fold paralysis patients underwent vocal fold injection under general anesthesia, meanwhile, the mucosa of the injected point was sutured through laryngoscope under direct vision. There were 6 patients underwent autologous fat injection into vocal fold ( group A), and 20 patients underwent autologous anterior rectus sheath fascia and fat injection ( group B). Therapeutic efficacy were evaluated by videostroboscopy, voice-related parameters analysis and voice evaluation before and after treatment. Clinical analysis of this procedure was retrospectively performed in this serial of patients. Results All patients were followed up for 24 months. On the third day after operation,there was an acute inflammatory reaction induced by the graft. This reaction disappeared three months later.In all 20 eases, videolaryngostroboscopy showed significant improvement of the glottic closure, the improvement in acoustical parameters was statistically significant ( P ＜ 0. 01 ). Perceptual evaluation of GRBAS scale showed significant improvement of phonatory function on G, B, A scale. The results remained stable 6 -24 months after operation and were not changed by the length of follow-up. And in the 6 cases,videolaryngostroboscopy showed significant improvement of the glottic closure at 3 months compared with preoperative observation, a little spindle-shaped disclosure. The improvement in acoustical parameters was significant statistically at 3, 6 and 24 months (P ＜ 0. 05 or ＜ 0. 01 ), the voice quality decreased significantly at 6 and 24 months compared with 3 months (P ＜0. 05 or ＜0. 0l ). The significant differences were not observed between 6 and 24 months (P ＞ 0. 05 ). No complications were observed in all patients perioperatively or during the follow-up period. Voice-related parameters jitter, normalized noise energy and maximum phonation time showed significant differences between Group A and Group B on 24 months ( P ＜0. 05 or ＜ 0. 01 ). Conclusion The combination of autologous fascia and fat vocal fold injection is an effective procedure for the treatment of unilateral vocal fold paralysis, and the stable results can be achieved during the follow-up period for 24 months.