[ABSTRACT]OBJECTIVETo study the clinical effect of CO2 laser in the treatment of hypertrophic ventricular dysphonia.METHODSFrom December 2011 to December 2013, 40 patients with hypertrophic ventricular dysphonia were treated in our department. Conservative treatment had no valid for all of them. All the patients were examined with strobolaryngoscope and voice analysis (including fundamental frequency, jitter, shimmer and harmonic to noise). After general anesthesia, the hypertrophic ventricular cords were excised with CO2 laser under suspension laryngoscope.RESULTS The Hoarseness were better in all the patients after operation. The ventricular cord and mucosal waves of the vocal cord were normal. The jitter and shimmer were lower than that before operation, but the fundamental frequency and harmonic to noise were higher than that before operation. There were no complications. CONCLUSIONThe treatment of hypertrophic ventricular dysphonia with CO2 laser under suspension laryngoscope is safe, reliable and practical.

OBJECTIVE To analyze the complications of the CO2 laser-assisted laryngeal microsurgery for laryngeal tumors. METHODS The clinical data of 520 patients who underwent CO2 laser assisted laryngeal microsurgery for laryngeal tumors were retrospectively analyzed. The complications were recorded. RESULTS Complications caused by CO2 laser were found in 61 case(11.73 %) and those caused by suspended laryngoscope in 71 case(13.65 %). CONCLUSION The complications of the CO2 laser-assisted laryngeal microsurgery for laryngeal tumors may be caused by CO2 laser or suspended laryngoscope.

Objective To investigate the aerodynamic characteristics of vocal polyps and vocal nodules.Methods Aerodynamic parameters of 58 patients with vocal polyps or vocal nodules and 30 normal adults were measured by Aerophone Ⅱ Voice Function Analyzer.The mean airflow rate,intraoral pressure,glottal resistance,glottal efficiency were compared among different group.Results The mean airflow rate,glottal resistance and glottal efficiency of vocal polyps,vocal nodules and normal adult were 254.50±36.02 ml/s,33.55±4.63 cmH_2O/(L·S),2.46±1.49,177.45±25.93 ml/s,38.83±8.88 cmH_2O/(L·S),7.75±3.71,118.44±29.98 ml/s,53.04±8.64 cmH_2O/(L·S),9.17±3.87,respectively.The difference between them was significant(P＜0.01).The difference of intraoral pressure between vocal polyps (8.97±1.36 cmH_2O) and normal adult (6.24±0.99 cmH_2O) was significant (P＜0.01).The mean airflow rate,glottal resistance,glottal efficiency were significantly different between vocal polyps and vocal nodules(P＜0.01).Conclusion The degree of vocal fold adduct and the effciency of voice production in vocal polyps is worse than that of vocal nodules.The aerodynamic parameters can make quantifiable,objective assessment in voice function of vocal polyps and vocal nodules.

Objective To explore the clinic value of the vocal acoustics on voice evaluation in larynx leukoplakia pa?tients. Methods Dr. Speech software was used to perform voice acoustic analysis and deduce EGG parameters in 48 sub?jects with larynx leukoplakia and 50 normal subjects. Voice acoustic analysis parameters (Jitter, Shimmer, NNE, HNR, SNR, MPT), EGG parameters ( EGG-Jitter、EGG-Shimmer、EGG-NNE、EGG-HNR、EGG-SNR, CQP,CIP) and EGG wave?form were compared between two groups. Results For voice acoustic analysis, Jitter, Shimmer, NNE in larynx leukoplakia group were higher than those in normal group while HNR, SNR in larynx leukoplakia group were lower than those of normal group. What’s more,MPT in larynx leukoplakia group was obviously shorter than that in normal group with, statistically sig?nificant difference (P<0.05). For EGG analysis, EGG-Jitter, EGG-Shimmer, EGG-NNE were higher in larynx leukoplakia group than those in normal group with significant difference (P<0.05). EGG-HNR and EGG-SNR in larynx leukoplakia group were lower than those in normal group. Furthermore, CQP and CIP in larynx leukoplakia group were higher than those normal group with statistically significant difference (P<0.05). Most patients’(72.9%) EGG waveform showed gradually ac?celerate phase velocity and fast close phase, which represent a spike-like shape. Conclusion Voice acoustic analysis com?bined with EGG provide objective indicators to assess degree of hoarseness, and to provide sonic evidences for prevention, recurrence, assessment and pronunciation correction of the larynx leukoplakia.

The teaching reform on functional experiment is an attractive problem of the medical teaching development at present. Our school has opened the course of functional experiment according to integrating and recombining with physiology, pathologic physiology and pharmacology, which brought into playing a positive role in enhancing the medical students' capability of practice, the comprehensive application of knowledge and the consciousness of innovation. However, some problems still exist and further practice is needed for more improvement.

Objective To investigate the effect of neuropeptide Y (NPY) on the osteoblastic differentiation of murine MC3T3-E1 cells and its mechanism related to the Wnt signaling pathway.Methods The murine MC3T3-E1 cells were divided into 4 groups according to the stimulators added:phosphate buffered saline (PBS) (control) and different concentrations of NPY (10-8 mol/L,10-10 mol/L and 10-12 mol/L).The cellular proliferation was detected with MTT assay after 1,3,5,7 and 9 days.The cells were identified with cell immunochemistry and Western Blot to find out the most effective concentration of NPY at different time points under osteoblastic condition.The cells were then divided into 4 groups:PBS,NPY,NPY + NPY receptor antagonist,and NPY + DKK1.Western blot was used to determine the expression of β3-catenin and p-GSK-3β in each group.Nuclear signaling activity of β3-catenin was observed using immunofluorescence staining.Results NPY significantly improved the proliferation of MC3T3-E1 cells at 7 and 9 days (P ＜0.05).NPY (10s mol/L and 10-10 mol/L) groups and NPY (10-10 mol/L and 10-12 mol/L) groups significantly improved the ALP activity at 4 and 14 days respectively (P ＜ 0.05).At 4 days,the expression of ALP protein was significantly decreased in the NPY + DKK1 group and the NPY + NPY receptor antagonist group compared with that in the NPY group (P ＜ 0.05).Although the expression levels of [β-catenin and p-GSK-3β protein were uninfluenced in either case,NPY significantly stimulated the nuclear signaling activity of β3-catenin.Conclusions NPY may significantly increase the expression of ALP protein in MC3T3-E1 ceils during osteoblastic differentiation.This effect might be mediated through the canonical Wnt signaling pathway.

Objective To evaluate the clinical efficacy of coaxial micro-incision phacoemulsification for intraoperative floppy iris syndrome (IFIS) during cataract surgery.Methods A prospective randomized control study was conducted in 80 patients (80 eyes) taking tamsulosin more than two weeks with age-related cataract from October 2014 to October 2016.All cases were randomly divided into microincision group (MICS group) and standard incision group (SICS group),40 cases in each group.Coaxial 1.8 mm microincision cataract surgery was performed in the MICS group,and coaxial 2.6 mm standard incision cataract surgery was performed in the SICS group.The incidence and the degree of IFIS and complications were recorded during the operation.The uncorrected visual acuity (UCVA) was compared at 1 day,1 week,1 month after surgery.Results At postoperative 1 day,1 week and 1 month,UCVA was 0.83 ± 0.12,0.86 ±0.10,0.89 ±0.11 in the MICS group,and was 0.71-±0.12,0.75 ±0.11,0.83 ±0.12 in the SICS group,there were statistical differences (all P ＜ 0.05),the UCVA of MICS group was better than that of SICS group.The incidence of IFIS was 60.0％ in the MICS group,and 82.5％ in the SICS group,there was statistical difference (P ＜ 0.05).There was statistical difference on degree of IFIS between two groups (P ＜ 0.05),the degree of IFIS in the MICS group was lower than that in the SICS group.Conclusion The coaxial microincision phacoemuisification is a safe and effective surgery for the patients with cataract and high risk of IFIS.

OBJECTIVE To investigate the effect of obstructive sleep apnea hypopnea syndrome(OSAHS) on the quality of voice. METHODS Electroglottography (EGG) method was used for detecting the vocal cords vibration, waveforms of electroglottography and voice parameters such as Jitter, Shimmer, normalized noise energy (NNE), contact quotient(CQ), contact index (CI), contact quotient perturbation(CQP), contact index perturbation(CIP), and the in 82 OSAHS patients and 53 healthy subjects. The voice parameters were analyzed with Dr.Speech software, RESULTS While in normal pronunciation, the Jitter, Shimmer, NNE, CQP and CIP were (1.037±1.493)%, (5.627±1.872)%, (-16.109±1.719)dB, (2.638±0.633)% and (166.789±30.492)% in 22 mild OSAHS patients, (1.578±0.362)%, (8.478±1.635)%, (-11.517±1.614)dB, (6.043±0.936)% and (255.210±91.224)% in 24 moderate OSAHS patients, and (2.138±1.384)%, (14.888±4.089)%, (-7.677±2.151)dB, (11.749±7.164)% and (431.233±259.266)%in 36 severe OSAHS patients respectively. They were all higher than those in 53 normal subjects as (0.517±0.303)%, (3.299±2.196)%, (-21.933±5.477)dB, (1.322±0.942)% and (58.834±131.849)%. The regularity of vocal fold vibration in all patients with OSAHS was seriously out of whack. EGG waveform was irregular. CONCLUSION The OSAHS patients have structural changes in their upper airway, it will cause non-physiological breathing and lead dry of the vocal cord mucosa and weak elasticity. Their EGG parameters will get higher and vibration will be irregular seriously. We should pay attention to the voice qualities of the OSAHS patients and let them receive treatment as early as possible.

Objective To assess the feasibility of gastroscopy training with AccuTouch(R) Endoscopy Simulator for novice endoscopists. Methods The novice endoscopists ( n = 8 ) were divided into 2 groups to receive training with the simulator ( group A, n = 4) or with traditional method ( group B, n = 4). After the training, we compared the success rate of independent performance, success rate with aids and failure rate for the first 10 cases between 2 groups. Results There were no significant differences between 2 groups in terms of age, gender, educational background and experience of practice. The group A showed higher independent success rate and success rate with aids, and lower failure rate. Conclusion The simulator, decreasing the learning fees and improving learning efficiency, is applicable to endoscopist training.

OBJECTIVE: To explore the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carcinoma. METHOD: Retrospectively study 91 patients with glottic carcinoma (9 Tis, 45 pT1a, 25 pT1b, 12 pT2) treated in our department from October 1999 to August 2004. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society in 2000. RESULT: According to the Kaplan-Meier method, the probability of remaining free of local recurrence 5 years after primary surgery alone was 100.00% for the Tis, 93.33% for the T1a, 84.00% for T1b and 75.00% for the T2 respectively, without statistical significance of various groups by the Log-Rank tests (P > 0.05). The probability of remaining free of local recurrence 5 years after primary surgery alone was 78.57% (6/28) of tumors offended the anterior commissure, versus 93.65% (4/63) with no involvement of anterior commissure, have statistical significance (P < 0.01). The 5 year overall survival and the disease free survival were 92.72% and 84.62% respectively. Perceptive evaluation was performed with the "GRBAS" evaluation system 6 month after laser operation. All patients in the group of type I and type II had an normal voice or mild dysphonia. The patients treated with type III, type IV and type V had a mild or moderate vocal disease. CONCLUSION According to the present series, endoscopic CO2 laser surgery is an effective treatment for early glottic cancer.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Lasers, Gas ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Vocal Cords