OBJECTIVE To evaluate theclinical characteristics and its significance of individualized management of middle turbinate, and to discuss the efficacy of individualized management of middle turbinopathy in endoscopic sinus surgery. METHODS The clinical data of 68 patients with middle turbinopathy, chronic sinusitis and nasal polyp were analyzed retrospectively. By means of study of the shapes, pathological types and lesion extent of middle turbinate, and the relationship of middle turbinate with nasal sinuses, middle meatus, uncinate process, nasal septum, the efficacy of individualized management of middle turbinate after endoscopic sinus surgery was evaluated. RESULTS Among 68 cases, there were 23 cases with concha bullosa, 5 cases with paradoxical curve of the middle turbinate, 25 cases with mucosal polyp of middle turbinate, 6 cases with polyp of middle turbinate, and 9 cases with hypertrophy of bilateral middle turbinate. All of the cases with different extent obstruction of middle turbinate. All the cases were followed up for 6 to 12 months after operation. The nasal adhesion occurred in 19 cases (19/68, 28 %) at 2 to 4 weeks, 11 cases (11/68,16 %) at 5 to 8 weeks, 8 cases (8/68,12 %) at 9 to 12 weeks, 4 cases (4/68, 1.8 %) at 6 to 12 months. The location of nasal adhesion were adhesion with external lateral of nasal cavity in 30 cases, adhesion with inferior turbinate in 9 cases, adhesion with nasal septum in 3 cases. In all of the cases, the cure rate was 72 % (49/68), the improved rate was 26 %(18/68), the ineffective rate was 1.8 %(1/68). CONCLUSION It is necessary that management of different extent and type ofmiddle turbinopathy individualize in endoscopic sinus surgery. Middle turbinate anaplasty is probably benefit for recovering the function of middle turbinate and improving clinical efficacy.

Objective To evaluate the effect of “flying kite” technique and detachable balloon on embolization of carotid-cavernous fistulas (CCF). Methods 9 cases of CCF were treated by using“flying kite”technique, and 6 cases of CCF were treated by using detachable balloon. Results In “flying kite” treatment group, 8 cases were completely cured, and 1 case was partly cured. In detachable ballon treatment group, all 6 cases were completely cured once. Conclusion The“flying kite”technique was simple method for embolization of CCF, which didn't need special instruments and materials, and was easy to use in the basic hospitals, but it could obstruct carotid artery and lead to CCF recurrence. The embolization of CCF by using detachable balloon had a higher curative rate and recurred rarely, but it needed special instruments and skills. Detachable balloon embolization of CCF is a reliable method for the treatment of CCF. [

Objective To explore the effects of embolizing intracranial ruptured aneurysm in early stage using Guglielmi Detachable Coil (GDC). Methods 10 intracranial ruptured aneurysms including 8 cases of the first ruptured and 2 cases of the second ruptured were studied. The locations of aneurysm were as following: 1 case in anterior cerebral artery, 1 case in middle cerebral artery, 5 cases in anterior communicating artery, 2 cases in posterior communicating artery, and 1 case of multianeurysm in anterior and posterior communicating artery. Hunt-Hess grade was as following: 2 cases of gradeⅠ,4 cases of gradeⅡ, 2 cases of gradeⅢ, 1 case of grade Ⅳ, and 1 case of grade Ⅴ. Fisher CT scale was as following: 2 cases of gradeⅠ, 6 cases of gradeⅡ,and 2 cases of grade Ⅲ. Embolization of intracranial ruptured aneurysm was performed in early stage using GDC, 7 cases in 3 days after ruptured, and 3 cases in 6 days after ruptured. Results Among 11 aneurysms in 10 cases, 8 cases were 100% embolization, 2 cases≥95%, and 1 case≥90%. Followed-up from 1 month to 2 years after operation 1 case was dead, 7 cases recovered well, 1 case was in vegetable state, and 1 case occurred subarachnoid hemorrhage again. Conclusions GDC early embolization is preferable technique for treating intracranial ruptured aneurysm.

OBJECTIVE To discuss the preoperative locating diagnosis and transnasal endoscopic surgery for cerebrospinal fluid rhinorrhea in sella turcica region.METHODS All of the 22 patients with cerebrospinal fluid rhinorrhea had been located the position of leakage by means of high resolution computed tomography(HRCT),magnetic resonance imaging(MRI)and/or computed tomography cisternography(CTC)techniques,and then the skull base defects were repaired with fascia via transnasal endoscopic surgery.All the patients were followed up for 6 to 51 months.RESULTS Nineteen cases were successfully repaired by operation once and another patient was cured through reoperation.Two cases refused reoperation after failure of the operation and lost follow-up.No complications such as intra-cranial infection and hemorrhage were found during the perioperative period and follow-up.The main failure causes of operation were the necrosis of the repairing fascia,missing the real leakage,and the recurrence of malignant tumor.CONCLUSION It is a key step to locate leakage accurately before operation by means of CT and MRI.Transnasal endoscopic technique is the optimal choice for management of cerebrospinal fluid rhinorrhea in sella turcica region.

OBJECTIVE To investigate the significance,indication,operation experience and complication of biopsy for middle skull base neoplasms under nasal endoscope.METHODS A total of 48 patients with middle skull base neoplasms underwent biopsy under nasal endoscope with local or general anesthesia.RESULTS Biopsy was successfully done in 95.8%patients.Two patients failed to the procedure because of bleeding.Forty two patients were diagnosed pathologically through the biopsy at the first time,and 4 patients were diagnosed through the biopsy at the second time.The positive rates of the biopsy near and in the lesions were 82.6%and 97.8%respectively. The positive rates were significantly different between those two different biopsy sites(P=0.02).Blood loss was less than 50ml in 85.4%patients.Only one patient had the complication of leakage of cerebrospinal fluid.CONCLUSION Biopsy of middle skull base neoplasms under nasal endoscope can identify the pathological nature of the lesions with minimal invasion and less complication,and it is a reliable method.The pathological positive rate is relative to the sites of the biopsy.Serial biopsies can increase the positive rate.

OBJECTIVE: To analyse the causes of nasal sinus mucoceles after sinus surgery or trauma and explore operative therapy and methods of avoiding mucoceles recurrence. METHOD: Retrospective analysis were made in 22 cases of nasal sinus mucoceles after sinus surgery or trauma. RESULT: All the cases underwent endoscopic mucosectomy. There is one recurrent frontal mucocele in follow-up one year later after surgery and coherency of the lateral nasal cavity with the middle nasal concha in two cases. CONCLUSION Sinus surgery or trauma can induce nasal sinus mucoceles. So it is necessary to fix the sinus fracture site and replace the mucosa as possible, keep the the middle nasal concha stability and healthy sinus mucosa in endoscopic surgery,and take long term follow-up for reducing mucoceles recurrence.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mucocele ; etiology ; pathology ; Paranasal Sinus Diseases ; etiology ; pathology ; Paranasal Sinuses ; surgery ; Postoperative Complications ; Retrospective Studies ; Wounds and Injuries ; complications ; Young Adult

OBJECTIVE: To explore the relationships between the sphenoid-sinus-o-tumoropathy and local anatomy, as well as the characteristics of invasive damages of nerve system in sphenoid-sinus-o-tumoropathy, and emphasize that it is crucial of early diagnosis and surgery for sphenoid-sinus-o-tumoropathy. METHOD: Retrospective analysis of the characteristics of invasive damages of nerve system in 13 patients with sphenoid-sinus-o-tumoropathy, and follow-up the outcomes of nerve system after transnasal endoscopic surgery. RESULT: 1) The majority clinical manifestations of invasive damages in nerve system are cranial nerves, there are 9 cases optic nerve, 7 cases oculomotorius nerve, 4 cases trochlear nerve, 4 cases abducent nerve and 1 cases trigeminal nerve have been found damage at different levels in this group, and the secondly are 3 cases dysfunction of pituitary and 2 cases central nerve damage. 2) The improvement of invasive damages in nerve system after transnasal endoscopic surgery are as follow: at the day of operation or the next day, there are 4 cases to be reported that the symptoms of headache and eyes relieve very well; during 3 to 7 days after operation there are 9 cases to be reported that the symptoms of headache and eyes relieve or disappear significantly; 2 weeks after operation, there are 8 cases to be reported that the optical sights recovery at different levels, and there are many symptoms such as headache (9 cases), visual diplopia (1 cases), ptosis (2 cases), fixation of eyeball (1 cases), exophthalmoptosis (2 cases), face pain (2 cases), orbital paralysis (2 cases) disappeared completely. No complications of cerebrospinal fluid rhinorrhea, brain edema and hemorrhage to be found during the period of operation and follow-up. CONCLUSION The majority clinical characteristics of invasive damage in nerve system with sphenoid-sinus-o-tumoropathy are cranial nerve manifestations, and the second manifestation is dysfunction of pituitary. Transnasal endoscopic surgery could inhibit the invasive damages in cranial nerves of sphenoid-sinus-o-tumoropathic patients effectively.
Adolescent ; Adult ; Aged ; Child ; Cranial Nerves ; pathology ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Paranasal Sinus Neoplasms ; pathology ; surgery ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Young Adult

Objective Investigation of the significance for applying the percentage of neutrophils, neutrophil to lymphocyte ratio combined with contrast enhanced ultrasonography in the diagnose of coronary artery disease through examining the percentage of neutrophils, neutrophil to lymphocyte ratio on peripheral blood. Methods 130 patients with acute coronary syndrome (ACS group) , 90 patients with stable angina (SAP group) and 50 nonCAD patients (control group were observed. The neutrophils counts of all the patients were detected and Neut％, NLR were calculated; all the patients were asked to examine enhanced carotid contrast echocardiography. The plaque enhancement (DE) , and luminal enhancement ratio (Ratio) were recorded. The differences in neut％, NLR and CEUS were compared among the three groups. The Pearson correlation analysis was used to analyze the correlation between Ratio and Neut％, NLR. Multivariate logistic regression analysis was used to evaluate the predictive value of Neut％, NLR and CEUS for ACS. Results (1) The value of Neut％, NLR of the peripheral blood, DE, and Ratio in both ACS group and SAP group were higher than those in control group, and the value of ACS group was higher than that in SAP group (P < 0.05 or P < 0.01); (2) The analysis of Linear correlation showed that the ratio of CEUS in ACS patients was positively correlated with Neut％ (r = 0.422, P = 0.001) and NLR (r = 0.407, P = 0.001). (3) The ROC results showed that circulating Neut％, NLR and DE, Ratio play a significant role in the diagnose of unstable plague in CAD patients; (4) Multivariate logistic regression analysis showed that Neut％, NLR, DE, Ratio were independent indicators of the ACS patients (P< 0.05 or P < 0.01).Conclusions Contrast enhanced carotid examination combined with leukocyte analysis on peripheral blood were useful to detect plaque instability and inflammatory response in CAD patients, and it also provide lots of objective evidence for predicting and intervening unstable plaque in CAD patients.

Objective To investigate the expression and potential role of heterogeneous nuclear ribonucleo?protein A2B1 (HNRNPA2B1) in mouse cerebellar development and the significance of HNRNPA2B1 in human medulloblastoma. Methods The data of HNRNPA2B1 RNA expression in mouse and human cerebella were obtained from databases. Western blot and immunohistochemical staining were performed to detect the protein level of HNRNPA2B1 in mouse cerebella at different ages. The expression level of HNRNPA2B1 in control human cerebellum and medulloblastoma was detected by immunohistochemical staining. m6A?IP?qPCR method was applied to confirm whether HNRNPA2B1 RNA in Daoy cells was modified with m6A.Western blot was used to detect the effect of MG132 treatment on the HNRNPA2B1 protein level in Daoy cells. Results The level of HNRNPA2B1 protein in postnatal mouse cerebella was higher than that in adult mouse cerebella, with weak HNRNPA2B1 staining in external granular cells while strong staining in mature Purkinje cells and molecular layer. Compared with control normal human cerebella, the RNA expression level of HNRNPA2B1 increased in medulloblastoma, while immunohistochemical staining showed that the mean intensity of HNRNPA2B1 decreased in medulloblastoma. HNRNPA2B1 RNA in medulloblastoma and Daoy cells was modified by m6A. The HNRNPA2B1 protein level in Daoy cells increased upon MG132 treatment. Conclusions HNRNPA2B1 is dynamically expressed during mouse cerebellar development. Compared with normal human cerebella, HNRNPA2B1 is significantly up?regulated at transcriptional level but obviously down?regulated at translational level in medulloblastoma. These results indicate that HNRNPA2B1 may be involved in cerebellar development process and medulloblastoma tumorigenesis. The m6A methylation in HNRNPA2B1 transcript and protein ubiquitin?proteasome pathway may account for the down?regulation of HNRNPA2B1 at protein level.

Objective: To investigate the expression and potential role of heterogeneous nuclear ribonucleo-protein A2B1 (HNRNPA2B1) in mouse cerebellar development and the significance of HNRNPA2B1 in human medulloblastoma. Methods: The data of HNRNPA2B1 RNA expression in mouse and human cerebella were obtained from databases. Western blot and immunohistochemical staining were performed to detect the protein level of HNRNPA2B1 in mouse cerebella at different ages. The expression level of HNRNPA2B1 in control human cerebellum and medulloblastoma was detected by immunohistochemical staining. m6A-IP-qPCR method was applied to confirm whether HNRNPA2B1 RNA in Daoy cells was modified with m6A.Western blot was used to detect the effect of MG132 treatment on the HNRNPA2B1 protein level in Daoy cells. Results: The level of HNRNPA2B1 protein in postnatal mouse cerebella was higher than that in adult mouse cerebella, with weak HNRNPA2B1 staining in external granular cells while strong staining in mature Purkinje cells and molecular layer. Compared with control normal human cerebella, the RNA expression level of HNRNPA2B1 increased in medulloblastoma, while immunohistochemical staining showed that the mean intensity of HNRNPA2B1 decreased in medulloblastoma. HNRNPA2B1 RNA in medulloblastoma and Daoy cells was modified by m6A. The HNRNPA2B1 protein level in Daoy cells increased upon MG132 treatment. Conclusions HNRNPA2B1 is dynamically expressed during mouse cerebellar development. Compared with normal human cerebella, HNRNPA2B1 is significantly up-regulated at transcriptional level but obviously down-regulated at translational level in medulloblastoma. These results indicate that HNRNPA2B1 may be involved in cerebellar development process and medulloblastoma tumorigenesis. The m6A methylation in HNRNPA2B1 transcript and protein ubiquitin-proteasome pathway may account for the down-regulation of HNRNPA2B1 at protein level.