[ABSTRACT]OBJECTIVETo investigate the methods of diagnosing and treating congenital middle ear cholesteatoma
and causes of misdiagnosis.METHODSThis was a retrospective review of 9 cases of congenital middle ear cholesteatoma in this hospital.RESULTS9 patients all received operative treatment and definite diagnosis was made by histopathologic investigation. The ossicular reconstruction was performed to 6 patients. All of the cases were followed-up for 3 months-2.5 years. A-B gap was 20 dB. After 1 year, no residual or recurrence of cholesteatoma was found in CT scan. All patients had been misdiagnosed. Misdiagnosis rate was 100%.CONCLUSIONCongenital middle ear cholesteatoma is a clinically rare and diagnosis is usually delayed in clinical practice due to the silent nature of the disease in its early stage. Preoperative diagnosis may be based on Levenson diagnostic criteria and CT imaging. Early surgical treatment can obtain a good effect of hearing reconstruction. To avoid misdiagnosis and incorrect treatment, radiological evaluation and careful local examination are really important, which may also avoid serious complications.

[ABSTRACT]OBJECTIVETo evaluate the effectiveness of low temperature radiofrequency ablation on tongue cancer in early stage (<2 cm T1 stage) .METHODS High differentiated tongue squamous cell carcinoma(<2 cm T1 stage) were removed with radiofrequency ablation in 11 patients and with high-frequency electrotome in 20 patients from 2009 to 2014 in our hospital. All the patients underwent elective neck dissection(I,Ⅱ,Ⅲ regions). Intraoperative blood loss, VAS ratings of post-operative pain, post-operative bleeding rate and the recurrence rate of tongue cancer or lymph node metastasis were compared between the two groups.RESULTSIn the radiofrequency ablation group, the mean intraoperative blood loss was 13.82±7.40ml, the VAS ratings of post-operative pain were 3.8±1.3 (day 1), 2.5±0.7 (day 3) and 1.8±0.6(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in one case at 6 month after operation. In the high-frequency electrotome group, the mean intraoperative blood loss was 40.55±12.03ml, the VAS ratings of post-operative pain were 6.8±1.3(day 1), 4.4±1.1(day 3) and 2.3±0.7(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in 3 cases at 6 month to one year after operation. The intraoperative blood loss and post-operative pain in radiofrequency ablation group were significantly lower and less than that in the high-frequency electrotome group.CONCLUSIONRadiofrequency ablation is a promising method for early stage tongue cancer with less blood loss, invasiveness and complications.

Objective To investigate the prevalence of sinusitis in poorly controlled asthma children.Methods Asthmatic children from the Asthma Specialist Department of Hunan Provincial People's Hospital were selected as the study cases,of which 107 children coughing for more than 4 weeks after treatment were allocated to the research group and 105 newly diagnosed asthmatic children were selected as the control group.Results 1.The CT confirmed sinusitis prevalence was 81.3％ (87/107 cases) in research group and 51.4％ (54/105 cases) in the control group,respectively.The 2 groups were significantly different (x2 ＝ 21.242,P ＜ 0.05).2.The patient complained nasal obstruction in sinusitis group was 80.5％ (70/87 cases) compared to 50.0％ (10/20 cases) in non sinusitis group,and the difference between 2 groups was statistically significant (x2 =7.997,P ＜ 0.05).3.In the research group,69.2％ (74/107 cases) suffered from maxillary sinusitis,61.7％ (66/107 cases) ethmoid sinusitis,14.0％ (15/107 cases) frontal sinusitis,and 30.8％ (33/107 cases) sphenoid sinusitis.All the 4 nasosinus involved was 10.3％ (11/107 cases).The frequency of allergic rhinitis symptoms in 4 groups of sinuses had no significant difference (P ＞ 0.05).Conclusions Chronic cough in poorly controlled asthma children is related to sinusitis and upper airway cough syndrome.

OBJECTIVE: To explore the relationship of the expression of thymic stromal lymphopoietin (TSLP) in nasal polyps tissues and the Th2 inflammatory response. METHOD: Sixty patients with nasal polyps were collect ed. The immunohistochemical staining method was used to detect the expression of TSLP in nasal polyps tissues and ELISA method to the expression of IL-4, IL-5, IFN-gamma, IL-13 and analyzed the correlation between them. RESULT: The expression of TSLP in nasal polyp tissues was higher than that in normal inferior turbinate mucosa (P < 0.05). The expression level of IL-4, IL-5, IFN-gamma and IL-13 in nasal polyps tissues were significantly higher than those in control group (P < 0.05). TSLP staining was a statistically significant positive correlation with IL-4, IL5 and IL-13 (r = 0.475, 0.594 and 0.582, respectively, P < 0.01), while inverse correlation with IFN-gamma (r = -0.614, P < 0.01). CONCLUSION The high expression of TSLP might promote T cell differentiation towards Th2, and participated in the occurrence/development of nasal polyps, aggravated the nose Th2 inflammatory response.
Adult ; Cytokines ; metabolism ; Female ; Humans ; Interferon-gamma ; metabolism ; Interleukin-13 ; metabolism ; Interleukin-4 ; metabolism ; Interleukin-5 ; metabolism ; Male ; Nasal Polyps ; immunology ; metabolism ; Th2 Cells ; immunology ; Young Adult

Transoral laser microsurgery (TLM) has developed more than 40 years in the treatment of laryngeal cancer. TLM is especially important in the minimally invasive surgery of laryngeal carcinoma. Compared with the traditional open surgery, it is a major breakthrough, which has the significant advantages such as safety, effectiveness, low rate of local recurrence and high rate of larynx preservation. Not only can cure early laryngeal cancer, but also more and more the use of TLM in advanced supraglottic and glottic laryngeal cancer were reported. This article will review the characteristics, indications, superiority, surgical options and efficacy of the TLM in laryngeal carcinomas.
Carcinoma, Squamous Cell ; Glottis ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Laser Therapy ; Microsurgery ; Neoplasm Recurrence, Local ; Organ Sparing Treatments ; Otorhinolaryngologic Surgical Procedures

Objective To investigate the value of FDG PET-CT in the outcome assessment and prognostic evaluation for recurrent nasopharyngeal carcinoma (rNPC).Methods From January 2008 to December 2013,92 rNPC patients were treated in our center,who were histologically or radiologically diagnosed and re-staged according to the 2008 clinical staging system for nasopharyngeal carcinoma in China.The numbers of patients in stage Ⅰ,stage Ⅱ,stage Ⅲ,and stage Ⅳ were 8,11,39,and 34,respectively.According to the recurrent T stage (rT),the numbers of patients in rT1,rT2,rT3,and rT4 were 10,11,38,and 33,respectively.Twenty-eight patients had recurrence in the neck lymph nodes.All patients underwent pretreatment FDG PET-CT for the whole body or head/neck,and treated by radiotherapy with or without chemotherapy.The relationship of maximum standard uptake value (SUVmax) and clinical factors with clinical outcomes was analyzed.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),local recurrence-free survival (LRFS),regional recurrence-free survival (RRFS),and distant metastasis-free survival (DMFS).The log-rank test was used for survival difference analysis and univariate prognostic analysis.The Cox model was used for multivariate prognostic analysis.Results The 3-year OS,DFS,LRFS,RRFS,and DMFS were 33.6％,32.1％,32.8％,31.8％,and 33.7％,respectively.The median SUVmax was 8.35 (2.7-21.5).The SUVmax of 7.0 was taken as the optimal cut-off value for all patients.Patients with SUVmax ≤7.0 had a significantly higher 3-year OS rate than those with SUVm ax ＞7.0 (42.0％ vs.28.3％,P=0.019).The univariate analysis revealed that patient age,SUV and rN were significantly associated with OS (P=0.023,0.019,and 0.002).The multivariate analysis showed that SUVmax and rN were significant influencing factors for OS,DFS,and DMFS (HR=1.68,P=0.045 and HR=2.23,P=0.003;HR=1.67,P=0.042 and HR=2.39,P=0.001;HR=1.77,P=0.025 and HR=2.40,P=0.001).Conclusions SUVmax may be one of the useful prognostic factors for OS,DFS,and DMFS in rNPC patients.

As induction chemotherapy goes on,target volume,dose distribution in the surrounding organs at risk (OARs),and target dose conformity all change.Therefore,the question is how to develop reasonable radiotherapy plans in clinical practice.Induction chemotherapy followed by radiotherapy is commonly used around the world,but it is recommended to delineate the target volume based on the gross tumor volume before induction chemotherapy and not to reduce the dose.This point of view lacks the basis of evidence-based medicine.The experts and scholars in China clarify the advantages of radiotherapy plans after induction chemotherapy from the aspects of reducing the target volume,reducing the volume of high-dose region in the target volume,increasing the uniform dose coverage in target volume,reducing dose to OARs,and increasing dose conformity.However,at present,there are no objective data on its long-term efficacy and benefit.Besides,no consensus has been reached on how to delineate the target volume and determine the dose distribution after induction chemotherapy,and further studies are needed.

18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) is the integration of functional imaging and anatomic information,which is found to be particularly valuable in TNM staging,tumor volume delineating,post-treatment assessment,identification of recurrent and residual nasopharyngeal carcinoma (NPC).The combination of 18F-FDG PET-CT with other image technologies,different tracer agents,and specific molecular biomarkers can improve the application value of 18F-FDG PET-CT in NPC.

AIM: To elucidate the effects of losartan on the expression ofmatrix metalloproteinases-2, JNK1/2 and proliferation in cardiac fibroblast. METHODS: Neonatal rat cardiac fibroblasts were cultured. The cells proliferation was determined by MTT. To determine effects of AngⅡ on JNK1/2 activity, cells were incubated (for 0, 2, 5, 10, 30, 60, 120 min) in serum-freemedia with AngⅡ, and the other group fibroblasts were exposed to serum-free media with or without AngⅡ and losartan (AngⅡ 100 nmol/L, AngⅡ 100 nmol/L+losartan 100 nmol/L, losartan100 nmol/L, losartan for 45 min before). Cells protein was collected with MBST buffer. The relative abundance of MMP-2, JNK1/2 and p-JNK1/2 in cells was determined by immunoblotting. The secretion of MMP-2 in media of cell culture was determined by ELISA. RESULTS: AngⅡ increased the proliferation of CFB in a dose-dependent manner, whereas losartan decreased the proliferation of CFB stimulated by AngⅡ in a dose-dependant manner, too (P＜0.05). The relative abundance of JNK1/2 was highest in AngⅡ of the 2-min-stimulated group. AngⅡincreased expression of JNK1/2 and MMP-2 protein (P＜0.05), on the contrary, losartan inhibited JNK1/2 and MMP-2 protein expression.CONCLUSION: AngⅡ induce the increase of proliferation of CFB, expression of JNK1/2 and MMP-2 in CFB, and losartan inhibits these effects of AngⅡ.

OBJECTIVE: As a subtype membrane receptor of tumor necrosis factor alpha, not much is known about the link between the soluble TNF receptor-I and obstructive sleep apnea hypopnea syndrome. We hypothesized that the TNF receptor might play an important role in the inflammation in patients with OSAHS, moreover this study was undertakan to investigate the effects of multimodality therapies on its periphery blood level. METHOD: Seventy-seven adults with habitual snoring and mean age of 34.9 +/- 11 years old consented to participate in the study. All participants were studied with overnight polysomnography, physical examination and a blood crew at baseline. According to the severity of OSAHS, they were categorized into three groups and one control group. Moderate and severe OSAHS groups returned for a repeat test of polysomnography and a blood crew at 3 months after the ENT surgery or continuous positive airway pressure (CPAP). serum levels were measured by using an immunoluminometric assay kit. RESULT: (1) Compared with control non-OSAHS group, serum sTNF-R I levels prior to treatment in OSAHS groups were significantly greater, with a mean serum levels at (742 +/- 258 & 340 +/- 102) pg/ml (P < 0.05), respectively. (2) Plasma solube tumor necrosis factor receptor-I responsed sensitively to the effect of comprehensive therapies when we compared its prior treatment levels with post ones. (3) Analysis was used to assess the associations adjusting for age, gender, BMI and weight ,a positive assosiation were found between apnea-hypopnea index (AHI) and sTNF-R I (r = 0.646, P < 0.01) a negative assosiation were found between lowest nadir oxygen saturation (LSaO2) and (r = 0.522, P < 0.01). CONCLUSION ln summary, independent of age, gender, BMI and weight ,our datas suggest a relationship can be found between the the severity of OSAHS and periphery blood level of soluble TNF receptor-I. Comprehensive therapies is effective in changing sTNF-R I. sTNF-R I may be recommended as a Inflammation factor of OSAHS.
Adult ; Biomarkers ; blood ; Continuous Positive Airway Pressure ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; Receptors, Tumor Necrosis Factor ; blood ; Sleep Apnea, Obstructive ; blood ; therapy ; Snoring ; blood ; Tumor Necrosis Factor-alpha