OBJECTIVE: To evaluate the preemptive analgesia effects of both the parecoxib sodium and the pentazocine in patients undergoing nasal endoscopic surgery. METHOD: In the randomized, double blind, controlled study, 120 patients undergoing septoplasty were divided into 3 groups (n = 40): group A received parecoxib 40 mg by muscle injection 30 min before the operation; group B received pentazocine 30 mg; group C received an equal volume of saline. The preemptive analgesia effect was evaluated with VAS scores which recorded at different time points. The proportion of participants using rescue analgesia after the operation were recorded as additional measures of preemptive analgesia. RESULT: Intra-operative as well as the postoperative pain scores were less in the group A and group B than in the control group. Fewer participants required rescue medication after operation with parecoxib as well as pentazocine than placebo. However there were no difference in the preemptive effects between the group A and group B. CONCLUSION Administration of both the parecoxib and pentazocine before the nasal endoscopic surgery can provide preemptive analgesia without serious adverse side effects that deserves popularization in the clinic.
Analgesia ; methods ; Analgesics ; therapeutic use ; Double-Blind Method ; Endoscopy ; adverse effects ; Humans ; Isoxazoles ; therapeutic use ; Nasal Surgical Procedures ; adverse effects ; Nose ; Pain ; prevention & control ; Pain, Postoperative ; prevention & control ; Pentazocine ; therapeutic use

OBJECTIVE: To evaluate the perioperative analgesic effects of parecoxib sodium in patients undergoing nasal endoscopic surgery. METHOD: In the randomized, double blind, controlled study, 120 patients undergoing septoplasty were divided into 3 groups (n = 40): A group received parecoxib at a dose of 40 mg by muscle injection 30 min before the operation followed by saline at the same volume every 24 h for 48 h; B group received parecoxib at a dose of 40 mg by muscle injection 30 min before the operation followed by 40 mg every 24 h for 48 h; C group received an equal volume of 0.9% saline at the same time points. Patients were assessed with respect to pain score (VAS), rescue analgesia requirement and the side effects during the operation as well as at 3, 24, 48 h after the surgery. RESULT: Intra-operative as well as the postoperative pain scores were less in the A group and B group than in the.control group. Compared with group A, group B had significantly lower VAS score at 24 h after the operation, however there were no significant difference on other time points. Fewer participants of both the A and B groups required rescue medication after operation. CONCLUSION Administration of parecoxib can provide ideal analgesic effects without serious adverse side effects at the perioperative period for patients who received nasal endoscopic operation. Intramuscular parecoxib (40 mg 30 min before the operation followed 40 mg qd for 48 h) designed as preoperative analgesia mode resulted in sufficient perioperative analgesia that deserves popularization in the clinical works.
Analgesia ; methods ; Double-Blind Method ; Endoscopy ; Humans ; Isoxazoles ; administration & dosage ; therapeutic use ; Nasal Surgical Procedures ; methods ; Pain, Postoperative

Objective: Surfactant protein A (SP-A) is protein that appears to play an important role in mammalian first-line host defense. The objective of this study was to immunolocalize SP-A in human sinonasal tissue. Method:Eleven cases of allergic rhinitis, fifteen cases of polyp and seven cases of normal middle turbinate were studied with immunohistochemistry and immunofluorescence method to detect the expression of SP-A. Result:The expression of SP-A in allergic rhinitis and polyp were dramatically higher than that in controls(P<0.05), and there was no remarkable difference in the expression of SP-A between allergic rhinitis and polyp(P>0.05). The result demonstrated that SP-A was positivly correlated with eosinophils within the basement membrane of epitheli-um(R=0.81,0.55). In the result of immunofluorescence, there was significantly higher expression SP-A in nasal mucosa of allergic rhinitis and nasal polyp than that in control group(P<0.05). Conclusion:SP-A is likely to play key roles in the inflammatory reaction process of allergic rhinitis and polyp. Its secretion in the upper airway indicates that future studies may allow manipulation of this protein and development of novel treatments for sinonasal pathology.

OBJECTIVE:To analysis outcomes of patients with knee osteoarthritis treated by mini-incision knee replacement accompanied by early rehabilitation. METHODS:Outcomes of 28 knee osteoarthritis patients (46 knees) who were treated by joint replacement from 2005 June to August were retrospectively analyzed. Sixteen patients were served as experimental group,including 4 males and 12 females,aged 59-77 (65.3?5.3) years,and the course of disease was 10-15 (13.4?4.3) years. These patients were received mini-incision knee replacement,accompanied by specified early rehabilitation procedure. Early rehabilitation procedure comprised psychological treatment,training before knee replacement,muscle strength training after knee replacement,and correction of poor gait,joint position sense training and exercise for coordination after knee replacement,early quadriceps femoral muscle active extension knee exercises especially emphasized. Another 12 patients were served as control group,including 5 males and 7 females,aged 60-75 (67.5?4.7) years,with course of disease 8-18 (12.8?4.9) years,they were received normal knee replacement. Pain severity,joint motion ranges and functional situations were evaluated. RESULTS:Twenty-eight patients stayed in hospital for (13.2?2.7) days (ranging from 10 days to 16 days). All the patients were followed up 9 to 12 months. There were no significantly differences in pain severity,joint motion ranges and functional scores on admission between two groups. Pain,joint motion and joint functions were improved greatly after knee replacement. The joint motion ranges and functional scores were higher on discharge and the last follow-up in the experimental group than that of the control group. CONCLUSION:The program that consists of Mini-incision knee replacement,which protected quadricep muscle intactness and diminished surgical injury,accompanied by psychological treatment,preoperational preparation,postoperational training,correction of gait,training in articular position sensation and all the body coordination,can improve the outcomes of the knee osteoarthritis patients with knee replacement.

OBJECTIVE: To summarize the clinical features of epistaxis in the posterior fornix of inferior meatus and its comprehensive treatment measures. METHOD: We collected and retrospectively analyzed the clinical data of 212 cases of epistaxis hospitalized in our department, among which 23 cases were diagnosed as epistaxis in the posterior fornix of inferior meatus. They underwent nasal endoscopic exploration and coagulation surgery with one case under general anesthesia and the other 22 under local anesthesia. The bleeding from olfactory cleft, spheno-ethmoidal recess and the middle nasal meatus were excluded for all the patients during the surgery. After shifting the inferior turbinate inward by fracture, the active bleeding was found in the posterior fornix of inferior meatus, which was stopped immediately by bipolar coagulation. The areas of coagulation and nasal mucosa erosion were packed with nasopore after operation. RESULT: For all the patients, bleeding spots were definitely located during the operation and successfully coagulated. None of them suffered from recurrent-bleeding within 1 week postoperatively. Followed up for 6 to 12 months, there was no epstaxis recurrence or nasal cavity adhesion at the bled side in all patients. CONCLUSION For intractable epistaxis patient, after excluding the bleeding in olfactory cleft, sphenoethmoidal recess and the middle nasal meatus, it should be considered that the bleeding might come from posterior fornix of inferior meatus. It is the key point to thoroughly expose the posterior fornix of inferior meatus by shifting the inferior turbinate inward by fracture and explore for the bleeding spot carefully.
Adult ; Aged ; Epistaxis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective:To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid(CSF)rhinorrhea.Method:Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Janu 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery.Result:Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery,and no relapse case was found. The 18 cases under surgery included endoscopic approach(12 cases), extra-nasal approach(4 cases), transnasal approach under microscope(2 cases).Conclusion:It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.

OBJECTIVE: To analyze the results of serum in allergic rhinitis and investigate the specific clinic allergen and serum immunoglobulin E (IgE) levels. METHOD: Allergy Screen method was used to detect the specific allergen and total serum IgE level of 134 cases of Allergic rhinitis. RESULT: The dust mite was the most common allergen in inhalation group in 134 cases of allergic rhinitis, the positive rates was 90%; then were donly, feline and scurfy fungus, the positive rates were 16%, 9%. The positive rates of total IgE was 54%. The serum IgE levels between 100 to 200 kU/L, there was 21 cases together, but there existed 7 negative cases. There were 51 cases' IgE levels more than 200 kU/L, the rates was 70.8%, but there still existed 4 negative cases. CONCLUSION Allergy screen method can find relevant allergen and provide basis for the prevention and treatment of allergic disease.
Adult ; Allergens ; blood ; immunology ; Animals ; Antigens, Dermatophagoides ; analysis ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Mites ; immunology ; Passive Cutaneous Anaphylaxis ; Pollen ; immunology ; Rhinitis, Allergic, Perennial ; diagnosis ; immunology

OBJECTIVE: To explore the effect of a comprehensive surgical approach of hyoid suspension with Repose system plus uvulopalatopharyngoplasty (UPPP) on the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: Twelve patients with severe OSAHS (AHI > 40) diagnosed by polysomnography, were determined for the obstruction in both the velo-pharyngeal and the hypopharynx by preoperative physical examination, fiberoptic pharyngo-laryngoscopy. Two cases were given continuous airway pressure via nose, seven days before operation and then were performed hyoid suspension plus UPPP. The follow up was 3 months postoperatively. The pair T test was used to compare the preoperative and postoperative results by SPSS11.0 for windows. RESULT: At postoperative 3 month, there were statistically significance between preoperative and postoperative measurement in all. Mean AHI decreased from preoperative 69.28 +/- 6.50 to postoperative 19.77 +/- 9.23, lowest mean oxygen saturation increased from 65.25 -/+ 3.14 to 90.17 +/- 2.86. Snoring and sleep apnea disappeared or lessened, with the disappearance or decrease of lethargy at daytime. No severe complication occurred. CONCLUSION Comprehensive surgical approach of hyoid suspension with Repose system plus UPPP is effective surgical approach for patients with severe OSAHS who suffered from oropharyngeal and hypopharyngeal obstruction in short- term result.
Adult ; Female ; Humans ; Hyoid Bone ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome ; Uvula ; surgery ; Young Adult

PURPOSE: Maternal influences contribute to the origin of allergic diseases, but the mechanisms are not clear. The current literature prompted the role of epigenetics in the development of allergic diseases. We sought to investigate the roles of regulatory T (Treg) cells and Forkhead box p3 (Foxp3) DNA methylation in the process of maternal transmission of allergic rhinitis (AR) susceptibility. METHODS: BALB/c female mice (AR mother) were sensitized by intraperitoneal injection of Dermatophagoides pteronyssinus (Der p) 1 on day 1 and 7. Then they mated with normal male mice on day 8. From day 21 to 28, the female mice were intranasal challenged with Der p 1 continuously. The normal controls were given with normal saline in the same way. On postnatal day 3, Female mice and their offspring were sacrificed to detect their histopathology in nasal mucosae, cytokines in sera of mother and spleen homogenates of offspring, Treg cells count, Foxp3 mRNA expressions, and Foxp3 DNA methylation levels in spleens. RESULTS: Compared with the normal controls, neonatal offspring of Der p 1-stimulated female mice (AR offspring) showed the elevation of interleukin (IL)-4 (P<0.01) and IL-17 (P<0.01), the submission of IL-10 (P<0.01) in spleen homogenates. Further, Treg cells count in AR offspring decreased remarkably compared with the normal offspring (P<0.01). Though the difference of Foxp3 DNA methylation level between AR offspring and normal control offspring was not obvious, correlation analysis demonstrated that there was significantly positive correlation between Foxp3 DNA methylation level of mother and that of offspring (r=0.803, P<0.01). CONCLUSIONS: Under the influence of Maternal AR, their neonatal offspring develop into T-helper type 2 (Th2) dominant immune state, which is closely associated with the recession of Treg cells. Foxp3 DNA methylation may be a mechanism responsible for that maternal effect but still need more studies to ensure.
Animals ; Cytokines ; Dermatophagoides pteronyssinus ; DNA Methylation ; Epigenomics ; Female ; Humans ; Injections, Intraperitoneal ; Interleukin-10 ; Interleukin-17 ; Interleukins ; Male ; Mice ; Mothers ; Nasal Mucosa ; Rhinitis, Allergic* ; RNA, Messenger ; Spleen ; T-Lymphocytes, Regulatory*

OBJECTIVE: To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid (CSF) rhinorrhea. METHOD: Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Jan 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery. RESULT: Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery, and no relapse case was found. The 18 cases under surgery included endoscopic approach (12 cases), extra-nasal approach (4 cases), transnasal approach under microscope (2 cases). CONCLUSION It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.
Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; diagnosis ; etiology ; surgery ; Child ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Retrospective Studies ; Young Adult