Objective To investigate the expression of phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt) and their role in pathogenesis in laryngeal squamous cell carcinoma. Methods Immunohistochemical S-P method was used to detect the expression of PI3K and p-Akt in 40 paraffin-embedded human laryngeal squamous cell carcinoma, 20 cases of polyp of vocal cords and 20 cases of laryngeal papilloma. All the samples were stained by HE method to confirm their pathologic characteristics. Positive rates of PI3K and p-Akt were evaluated by microscopy. Results PI3K and p-Akt showed low expression in the polyp tissues of vocal cords, while they were of significantly higher expression in laryngeal squamous cell carcinoma (P

0.05). ③All of the OSAHS patients suffered seri-ous lipid metabolic disorders. CONCLUSION ① Fatty infiltration in the pharyngeal tissue may lead to collapse of the pharyngeal airway during sleep. ②The epithelial cells of mucosa,endothelial cells of small vessels and glandular cells of minor salivary glands can potentially produce leptin. Leptin existing with Ob-Rb shows the peripheral action of leptin. The positive ex-pression of leptin and Ob-Rb had no significant differ-ence between the two groups, which may explain theectopic accumulation of lipid. ③ Disordered lipid me-tabolism may not be the determinant factor in the patho-genesis of OSAHS. ④ Endogenous hyperleptinemia may be the protective response to respiratory distur-bance and disordered lipid metabolism, and is also as-sociated with the continuous hypersympathetic activity. The level of leptin in plasma has a positive correlation with the severity of OSAHS.

To explore the characteristics and treatment of temporal bone fractures and its complications, clinical data of 48 cases of temporal bone fracture admitted to our hospital from January 1989 to November 1999 were retrospectively analyzed. The results showed that in these 48 patients temporal bone fracture caused by traffic accidents accounted for 66 67%. Forty three cases survived (89 58%) and 5 died (10 41%). Middle inner ear or craniocerebral injury held 77 08% and hearing loss or tinitus held 48%; The incidences of CSF otorrhea and facioplegia were 36 7% and 3%, respectively for the longitudinal fracture, while for the transversal fracture they were 25% and 37 5%, respectively. Our conclusions are: (1) Traffic injury is the most dangerous factor of temporal bone fracture; (2) The dangerous complication is injury to cranium and brain, or multiple organs, resulting in death; (3) Middle inner ear injury is the commonest complication in temporal bone fracture; (4) CSF otorrhea is common in the longitudinal fracture and facioplegia is common in the transversal fracture.

0.05),but had positive relationship with the clinical stages and lymphatic metastasis of the tumor. Conclusion Livin ? is highly expressed in the tissues and peripheral blood cell from the patients of laryngeal squamous carcinoma,which is closely related to the clinical stages and lymphatic metastasis of the tumor.

Objective To investigate the effect of cisplatin ototoxicity on apoptosis of spiral ganglion cells(SGC), and relation between signal transportation of Caspase-3 and apoptosis of SGC.Methods Forty guinea pigs were randomly divided into 4 groups, and injected cisplatin (1, 2, 4 day group and control group). ABR and AERP (40 Hz Auditory Event Related Potentials) were tested every day after the injection, to find out the threshold changes of guinea pigs. Apoptosis was detected by terminal deoxynucleotidyl transferase(TdT)-mediated deoxyuridine triphosphate(d-UTP) nick end labeling method (TUNEL), and immunohistochemistry method was used to detect Caspase-3 p20 segment of SCGs.Results It was observed that the more cisplatin injected, the worse hearing guinea pigs got, and the damnification of threshold on 8KHz was significantly higher than that on 1 kHz. At the same time, TUNEL staining and the expression of Caspase-3p20 segment rose up gradually, and significant difference was observed compared with control group ( P

Objective This study is to study the age related changes of the expression of caspase-3 and the apoptosis states of neurons in primary auditory cortex of 15 young C57BL/6J mice(2 months, 15～20 g) and 15 old C57BL/6J mice(10 months, 50～60 g) and to determine probable physical effects underlying these changes. This paper also discusses the relationship of caspase-3 and apotosis states in primary auditory cortex, the possible role of caspase-3 in primary auditory cortex and the pathogenesis of presbycusis. Methods The immunohistochemical methods were applied to explore the differences of the expression of caspase-3 and the apoptosis states determined by TUNEI. method in the primary auditory cortex between young and old C57BL/6J mice. Results The expression of caspase-3 and apoptosis in Al of old C57BL/6J mice was significantly higher than that in the counterpart of young C57BL/6J mice. Conclusion The results presented a direct morphological evidence for the strengthening of caspase-3 in the primary auditory cortex in old C57BL/6J mice. This method has an important role in the formation and development of presbycusis. The expression of caspase-3 participated in the regulatory procedure of apoptosis and may be a possible factor of the etiologies of presbycusis.

BACKGROUND: Acellular dermalmatrix (ADM), as a new material, is generally applied to tissue repair after head and neck tumorectomy. However, hypopharyngeal carcinoma surgery always involves in repair and functional reconstruction of defected tissue; therefore, the application effect of ADM needs to be further studied for repairing laryngopharynx defect. OBJECTIVE: To evaluate the clinical effect of ADM in repairing laryngopharynx defect following tumorectomy. DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Otolaryngology-Head and Neck Surgery, Institute of Battle Surgery, Daping Hospital, the Third Military Medical University of Chinese PLA from May 2005 to June 2006.PATICIPANTS: A total of 25 male cases aged 45-68 years including 22 patients with tumor in the lateral wall of the unilateral piriform fossa and 3 patients with in the posterior wall of laryngopharynxat were finally diagnosed as squamous cell carcinoma. METHODS: According to clinical stages, patients underwent partial or complete laryngopharyngectomy. ADM was used to repair oropharynx mucosa following the laryngopharyngectomy. However, ADM alone was used to repair piece-shaped oropharynx mucosa, limiting by being unable to complete reconstruction of spatial structure. Therefore, myocutaneous flap or other materials combined with ADM was beneficial for reconstruction of laryngopharyngeal cavity following complete laryngopharyngectomy. MAIN OUTCOME MEASURES: The effect of ADM on functional reconstruction of swallowing, breathing, and pronouncing. RESULTS: A total of 25 patients were included in the final analysis. No patients suffered with the pharyngeal fistula. Only one case encountered the subcutaneous infection at day 20 after surgery, but recovering after regular change of dressing and treatment of antibiotics. About 15 patients who accepted the surgery of partial laryngopharyngectomy suffered with bucking, but after 30-60 days, the symptom relieved, even disappeared, in spite of 3 cases still bucking when they swallowed liquid diet. Breathing function was recovered, and tracheal cannula was removed 6-12 months after surgery. Ten of them who accepted total laryngopharyngectomy had resumption of normal oral diet after 20 days. The follow-up periods after the surgery lasted 12-30 months. The allograft became normal mucosa finally, without rejection or scar formation. The follow-up of 10 patients lasted more than 24 months, one case had relapse of tumor, still alive after the second surgery. CONCLUSION: ADM with perfect histocompatibility and easy operability, can be applied to repair deletion of laryngeal or pharyngeal tissue and recover functions of pronouncing, breathing, and swallowing after tumorectomy. The combined use of ADM and musculo-cutaneous flap was effective and satisfactory.

Objective To evaluate the efficacy and safety of desloratadine for the treatment of allergic rhinitis. Methods A total of 50 cases of chronic or acute allergic rhinitis confirmed clinically were randomized into control and experimental groups for double blind study. Scoring of clinical symptoms, examinations of the nasal cavity, blood and urine routine examination, functions of liver and kidney and electrocardiogram (ECG) were conducted on day 14 before and after the experiment. The collected data were analyzed statistically. Results The clinical data of the two groups were comparable. The effective rate of desloratadine was significant in allergic rhinitis, being 95.45%. No remarkable adverse effect was noted in this experiment. Conclusion Desloratadine is more effective and safe than loratadine in the treatment of allergic rhinitis and it may be feasible for clinical application.

Objective To investigate the relationship of impact stress distribution and stress wave dissemination with temporal bone fracture. Methods Twelve donated fresh corpse were selected and impacted with driving force of 800 kPa, 1 200 kPa and 1 400 kPa to establish the model of impact temporal bone fractures. With aid of three-dimensional stereochemical structure image of 64-slice CT, the vitodynamic distribution and dissemination of impacted temporal bone was calculated by using computer simulation. Results (1) The instant velocity, acceleration and energy of impact as well as displace-ment scope of the hammer increased with higher driving force in the tempus. (2) Instantaneous impact of the temporal bone resulted in Von Mises stress concentration area around the impact point. The stress was weakened suddenly in the skull-brain tissue coupling place but later accumulated in the skull base. (3) Only ipsilateral linear fracture occurred when the driving force of impact was 800 kPa. While impact dif-ferent degrees of depressed fractures could be seen and one case showed secondary fracture of the opposite side when the driving force of impact was 1 200 kPa. The impact with driving force for 1 400 kPa begot complex ipsilateral fractures, secondary fracture of the opposite side and skull basal fracture. (4) Frac-ture line of the temporal bone accorded with impact stress concentration area. Conclusions All pa-rameters, stress distribution and dissemination of impact are in accordance with temporal bone fracture during impaet process of the temporal bone, which is of vital significance for diagnosis and protection of impact temporal bone fractures.

OBJECTIVE To explore the outcomes of CO2 laser assisted stapedotomy with artificial stapes prostheses in the treatment of advanced otosclerosis. METHODS Between January 2010 and January 2014, 15 patients (16 ears) diagnosed as advanced otosclerosis accepted CO2 laser assisted stapedotomy with artificial stapes implantation in our department. The averaged preoperative air conduction threshold of the speech frequency was 70.21 dB HL, the averaged bone conduction threshold was 38.49 dB HL, the averaged air-bone gap (ABG) was 31.72 dB HL. All cases were followed up for more than 6 months after operation. RESULTS All cases accepted auditory follow up after 6 months postoperatively. The speech frequency average air conduction threshold was 43.7 dB HL, the average bone conduction threshold was 28.95 dB HL, the average ABG was 14.75 dB HL. The ABG≤20 dB was achieved in 9 ears (56.3%) and ABG closure (≤10 dB) was achieved in 6 ears (37.5%). No cases appeared intractable vertigo, sensorineural hearing loss, secondary facial paralysis and other serious complications. CONCLUSION CO2 laser assisted technique reduced the probability of serious complications of stapedotomy, most patients with hearing level improved significantly. It's a safe, practical, relatively economical choice for advanced otosclerosis.