Objective To explore the effect of ginkgo biloba injection combined with alprostadil to hearing recovery,immunoglobulin level and hemorheology indexes of patients with sudden deafness.Methods 82 cases of sudden deafness patients collected in the first affiliated hospital of Wenzhou medical university from September 2015 to July 2014 were divided into control group(n=41) and experimental group(n=41) according to the random number table method.Control group were treated with 10μg alprostadil injection, added to 100 mL 0.9% saline infusion, intravenous drip, one time per day.Experimental group was given ginkgo biloba injection 20 mL, added to 500 mL 5% glucose intravenous drip on the basis of control group, one time per day.The clinical curative effect and hearing degree of recovery of two groups were observed after two weeks.Serum immunoglobulin A ( IgA ) , immunoglobulin G( IgG) , immunoglobulin M( IgM) levels were tested by automatic biochemical analyzer.The whole blood viscosity, plasma viscosity, red cell pressure product and red cell aggregation index were tested by blood viscosity analyzer.Results Two weeks after treatment, the total effective rate of experimental group was 92.68%, higher than 70.73% of the control group(χ2 =6.609,P=0.010).The tinnitus, aural fullness, vertigo and hearing recovery in experimental group was significantly higher than that of the control group, and the pure tone hearing threshold in experimental group was lower than the control group(P <0.05).After treatment, serum IgA, IgG and IgM levels were all decreased, and those indexes of experimental group were all significantly lower than those of control group(P<0.05).The whole blood viscosity, plasma viscosity, red blood cell hematocrit and red blood cell aggregation index were decreased, and those indexes of experimental group were all significantly lower than that of the control group( P <0.05).Conclusion The therapy of ginkgo biloba injection combined with alprostadil can reduce the tone of sudden deafness hearing threshold, promote the recovery of hearing, decreased in patients with immune globulin protein and hemorheology indexes, and improve clinical curative effect.

Objective To evaluate the effects of different treatments to middle turbinate by endo-scopic sinus surgery (ESS) on olfaction in patients with chronic sinusitis and nasal polyps. Methods ESS was performed on 74 cases of chronic sinusitis and nasal polyps. Proper treatments divided into the group of retaining middle turbinate, the group of forming middle turbinate and the group of partial endonasal middle turbinectomy which were applied to different pathological changes of middle turbinates. The olfactory function of the 74 patients was tested through the CCCRC olfactory testing method pre-operation and twenty-four weeks post-operation. The results were analyzed by analysis of variance. Results The olfaction after treat-ment of the three groups was significantly better than that of pre-operation (P < 0.05), but there was no sig-nificant difference among the three groups (P>0.05). Conclusion Different treatments to middle turbinate by ESS is no obvious effects on olfaction.

Objective To evaluate the influence of endoscopic sinus surgery on olfactory disorder caused by chronic sinusitis and nasal polyps by testing the olfactory function of fifty-two patients with chronic sinusitis and nasal polyps before and after endoscopic sinus surgery and then confirming the olfactory rehabilitation of the patients.Methods The olfactory function of the fifty-two patients with chronic sinusitis and nasal polyps was tested through the CCCRC olfactory testing method pre-operation and four weeks,twelve weeks,twenty-four weeks post-operation.The results were analyzed by matched t-test.Results All results of olfactory function after treatment were significantly better than that of pre-operation(P0.05).Conclusion Olfactory function of above patients was significantly improved within the first month post-operation.There was no further improvement in the following five months compared with the first month post-operation.

Objective To explore the effect of azelastine hydrochloride nasal spray combined with desloratadine to inflammatory factors, cell function and IgE of patients with allergic rhinitis.Methods 92 cases of allergic rhinitis patients treated in the first affiliated hospital of wenzhou medical college hospital from June 2014 to December 2015 were divided into experimental group(n=46) and control group(n=46) according to the random number table method.The control group was given oral loratadine tablets, one piece per time, one time per day, while the experimental group was given azelastine hydrochloride nasal spray on the basis of the control group,each nostril one spray, one time in the morning and night.The clinical efficacy of two groups of patients would be observed after 4 weeks,ELISA would be used to detect serum levels of IFN-γ, IL-4, IL-8 and IgE level, and IFN-γ/IL-4 was the value of Thl/Th2,flow cytometry instrument was used to the determination of T cell subgroup CD4 +,CD8 + cells.Results 4 weeks after treatment,stuffy nose, nasal itching, runny nose, sneezing and nasal cavity change points are lower than before the treatment in both the two groups.Experimental group obviously lower than the control group, the difference was statistically significant ( P <0.05 ).The total effective rate of treatment group is higher than the control group,the difference was statistically significant(χ2 =4.389,P=0.036).The serum level of IFN-γis higher than before treatment in both the two groups.IL-4, IL-8 inflammatory factor levels were lower than before treatment,the experimental group was better than control group,the difference was statistically significant(P<0.05).CD4 +,CD8 +of T cells and Thl/Th2 values are higher than before the treatment in both the two groups,the experimental group was higher than control group, the difference was statistically significant ( P<0.05 ).Serum IgE levels were lower than before the treatment in both the two groups,the experimental group was lower than control group,the difference was statistically significant (P<0.05).Conclusion The therapy of azelastine hydrochloride nasal spray combined with desloratadine can improve the clinical effect of the treatment of allergic rhinitis,reduce inflammation,strengthen the body's immune function, improve thelevel of serum IgE.

OBJECTIVE: To investigate the factors influence in the operational therapeutic efficacy for sinusitis. METHOD: Logistic regression analysis was performed for sex, age, clinical stage of sinusitis, used nasal decongestant preparation, recurrence of sinus surgery, allergic rhinitis, extensive postoperative treatments in 210 patients. RESULT: Age, used nasal decongestant preparation, recurrence of sinus surgery, allergic rhinitis, extensive postoperative treatments were the important factors influenced the operation therapeutic efficacy. CONCLUSION Independent prognostic factors for patients with sinusitis after endoscopic sinus surgery are age, used nasal decongestant preparation, recurrence of sinus surgery, allergic rhinitis, extensive postoperative treatments. What's more, extensive postoperative treatments are one of the important factors to improve the operational therapeutic efficacy for chronic rhinosinusitis.
Adolescent ; Adult ; Aged ; Chronic Disease ; Endoscopy ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sinusitis ; diagnosis ; surgery ; Young Adult

OBJECTIVE To determine the distribution of allergens in patients with allergic rhinitis in Wenzhou area. METHODS Patients with AR symptoms from January 2013 to December 2014 were given skin prick test (SPT). The clinical data about SPT was retrospectively colleceted to analyze SPT results. RESULTS 1. Among 2991 individuals, the total positive rate of SPT was 82.0%, with Dermatophagoides farinae (Der. f) and Dermatophagoides pteronyssinus (Der.p) as the most common allergens; the positive rate of inhalant allergen was obviously higher than that of ingestive ones, with significantly statistical difference(χ2=2006.557,P<0.01). Most of patients were allergic to double allergens; the intensity of Der.f and Der.p mainly presented as (++++), with no significant difference(Z=-0.391, P=0.696). 2. There was significant difference of variation with seasons(χ2=34.254, P<0.01). 3. No significant difference of positive rate were observed in different AR-courses(χ2=16.102, P<0.01). 4. Significant difference of positive rate was found among different age-groups; The positive rate was increased along with growing age, got peak at group of 10-12 years old, and then got down after that. CONCLUSION Dust mite was the main allergen coursed AR in Wenzhou area. Seasons and age were two important factors effecting on positive of SPT and onset of AR. The positive rate of allergens was related to age.

OBJECTIVE: To evaluate the efficacy of combined modality therapy for advanced hypopharyngeal carcinoma in order to improve the curative effect of hypopharyngeal carcinoma. METHOD: Seventy-six male patients with the stage III - IV hypopharyngeal carcinoma were treated with postoperative combined modality. Of all the 76 cases, 44 were treated with postoperative radiotherapy, and the other 32 treated with chemoradiotherapy concurrently. RESULT: Kaplan Meier analysis indicated that the overall 5 survival rates of patients treated with postoperative radiotherapy was 25.9%, and that of patients treated with postoperative chemoradiotherapy was 27.8%. There was no significant difference between the two groups (P>0.05). Three and five years relapse-free survival rates of the patients treated with postoperative radiotherapy were 36.0%, 22.5%, and those of the patients treated with postoperative chemoradiotherapy were 68.0%, 45.3%. Significant difference was calculated between the two groups (P<0.05). According to the NCI CTC3.0 criteria, the toxicities on grade 3 or above of the two groups showed no significant difference (P>0.05). CONCLUSION For advanced hypopharyngeal carcinoma, postoperative chemoradiotherapy yielded satisfactory relapse free survival and laryngeal function preservation rate which was superior to that of postoperative radiotherapy. Also the treatment toxicities were not increased.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; mortality ; surgery ; therapy ; Chemoradiotherapy ; Combined Modality Therapy ; Humans ; Hypopharyngeal Neoplasms ; mortality ; surgery ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Survival Rate

OBJECTIVETo validate the discharge, inflammation, polyps/edema (DIP) scoring system for the assessment of endoscopic sinus surgery (ESS) outcomes in patients with chronic rhinosinusitis (CRS).

METHODSThirty patients with CRS were included in this prospective study. All patients were evaluated before and 2 months after surgery. Baseline measures and postoperative outcomes were evaluated using sino-nasal outcome test-20 (SNOT-20), visual analogue scale (VAS) symptom score and Lund-Mackay CT score (in baseline only). All endoscopic videos were recorded before surgery and in the end of follow-up. All videos were scored blindly by two rhinologistis using the DIP and Lund-Kennedy system for investigating the inter-rater and test-retest reliability, as well as the correlations with the existing subjective and objective scoring systems.SPSS17.0 software was used to analyze the data.

RESULTSThe average scores of VAS, SNOT-20, Lund-Kennedy, and DIP before and after surgery were listed below. Baseline, 29.73 ± 13.05, 24.43 ± 13.76, 7.70 ± 3.25 and 32.67 ± 13.48. Post-surgical, 13.60 ± 8.67, 10.40 ± 7.45, 5.03 ± 2.04 and 16.97 ± 8.37. All scores were declined significantly from baseline (t value were 7.43, 6.49, 6.88 and 10.93, all P < 0.001). The DIP system showed a higher inter-rater and rest-rest reliability than Lund-Kennedy system (interclass coefficient,ICC > 0.75). The Pearson analysis revealed that VAS scores were significantly correlated with SNOT-20 scores both in baseline and post-surgical assessments (r = 0.518 6, P = 0.003, and r = 0.546 7, P = 0.000). Before surgery, Lund-Kennedy scores were significantly correlated with DIP and Lund-Mackay CT scores (r = 0.937 5, P = 0.000 and r = 0.748 0, P = 0.000). DIP scores were significantly correlated with Lund-Mackay CT scores (r = 0.712 2, P = 0.000). After surgery,DIP scores were significantly correlated with Lund-Kennedy scores (r = 0.869 6, P = 0.000). But there were no significant correlations between subjective scores (VAS and SNOT-20) and objective scores (Lund-Kennedy, DIP and Lund-Mackay CT), (all P > 0.05).

CONCLUSIONSThe DIP scoring system shows substantial inter-rater and test-retest reliability.It is also significantly correlated with existing objective scoring parameters. It is suitable and reliable to use.

Chronic Disease ; Edema ; Endoscopy ; Female ; Humans ; Inflammation ; Male ; Nasal Polyps ; diagnosis ; Paranasal Sinuses ; Polyps ; Postoperative Period ; Prospective Studies ; Reproducibility of Results ; Rhinitis ; diagnosis ; Sinusitis ; diagnosis

OBJECTIVETo study the expression of succinate dehydrogenase subunit B (SDHB) in the tissues of locally recurrent nasopharyngeal carcinoma (rNPC) and the correlation with the clinicopathological factors and prognosis of rNPC.

METHODSImmunohistochemistry was used to detect the expression of SDHB in the tissues of primary and locally recurrent nasopharyngeal carcinoma. The relationship between SDHB expression and clinicopathological features was analyzed using the Chi-square test, and Kaplan-Meier method and Log-rank test were used for survival analysis. The independent prognostic factors of rNPC were analyzed by Cox regression model.

RESULTSLow SDHB expression was showed in 76.5% (39/51) of the patients with rNPC, significantly higher than 57.1% (24/42) of primary nasopharyngeal carcinoma (χ(2) = 4.098, P < 0.05). Low expression of SDHB strongly was correlated with T classification, clinical stage and cranial nerve palsy. Patients with low SDHB expression had a shorter survival time and a lower 3 or 5 year survival rate compared to the patients with high SDHB expression. Multivariate analysis showed that low SDHB expression was an independent predictor for overall survival of patients with rNPC (P < 0.05).

CONCLUSIONThe low SDHB expression is an independent indicator for poor prognosis of rNPC and may play an important role in the recurrence of rNPC.

Biomarkers, Tumor ; metabolism ; Carcinoma ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Nasopharyngeal Neoplasms ; diagnosis ; metabolism ; Prognosis ; Succinate Dehydrogenase ; metabolism ; Survival Analysis

Objective: Vascular endothelial growth factor A (VEGFA) was investigated as the key protein which might promote the specific metastasis progress of nasopharyngeal carcinoma. Methods: Sixteen specimens of pulmonary metastasis carcinoma and counterparts in primary nasopharyngeal carcinoma tissue were collected from patients. The expression of VEGFA through immunohistochemistry was investigated.VEGFA was knocked down by siRNA in two cell lines of nasopharyngeal carcinoma (CNE-1 and 5-8F), MTT and Transwell test were used to explore the role of VEGFA in praxiology. Then shRNA was used to cultivate the stable CNE-1 cell line with down-regulated-expression of VEGFA. The nude mice models were built through tail vein injection of specific nasopharyngeal carcinoma cells, and lungs were collected to perform further metastasis analysis. Results: Previous genetic studies showed that VEGFA had higher expression in metastasis tissue, and the result was validated in the present study using immunohistochemistry. The percentage of positive cells was 84.8% in pulmonary metastasis group, 51.5% in primary tissue group (t=8.639, P<0.05), average optical density was 0.154 in pulmonary metastasis group, 0.061 in primary tissue group (t=18.791, P<0.05). Low expression of VEGFA inhibited cell viability of optical density value of CNE-1 in siRNA gourp was 0.715, 0.902 in control group (t=7.274, P<0.05); 5-8F in siRNA group was 0.715, 0.935 in control group (t=7.751, P<0.05). Number counting suppressed migration of CNE-1 in siRNA group was 52 per high-power lens, 124 per high-power lens in control group (t=29.380, P<0.05), 5-8F in siRNA group was 65 per high-power lens, 155 per high-power lens in control group (t=18.181, P<0.05). Number counting invasion of CNE-1 in siRNA gourp was 38 per high-power lens, 86 per high-power lens in control group (t=27.665, P<0.05), 5-8F in siRNA group was 52 per high-power lens, 116 per high-power lens in control group (t=40.972, P<0.05) in vitro. Furthermore, knock-down of VEGFA in nasopharyngeal carcinoma reduced the pulmonary metastasis in vivo. Number counting of tumor volumes in shRNA group was 2.4, and 11.0 in control group (t=6.143, P<0.05); average optical density of immunohistochemistry in shRNA group was 0.033, and 0.176 in control group (t=15.734, P<0.05). Conclusions Results above reveal the overexpression of VEGFA in nasopharyngeal carcinoma can facilitate the pulmonary metastasis. Targeting VEGFA may provide a new biomarker of clinical study.