Objective To investigate the three-dimensional spatial relationships of the sphenopalatine foramen ( SPF) , vidian canal ( VC ) , and foramen rotundum ( FR ) with regard to an endoscopic endonasal approach to the pterygopalatine fossa(PPF)using three-dimensional reconstruction of high resolution computed tomography (HRCT) scans. Methods The HRCT scans of 17 patients and a cadaver specimen were retrospectively evaluated .The morphology of the SPF, VC, and FR as well as the spatial relationship between the SPF and VC were measured on the image of three -dimensional CT reconstruction.Results The mean diameters of the SPF, VC, and FR were(6.26 ±1.59)mm,(2.35 ± 0.77)mm and(2.75 ±0.77)mm, respectively.The mean distance between the VC and posteroinferior margin of SPF was (4.03 ±1.15) mm.The mean vertical and horizontal distances on the image of three-dimensional CT reconstruction were between the VC and FR were(4.94 ±1.35)mm and(9.22 ±3.07)mm, respectively.The whole or partial margin of the VC was above the inferior margin of the SPF in 92%(33/36) of the VC and lateral to the posterior margin of the SPF in 97%(35/36) of the VC.Conclusion The endoscopic endonasal approach to the PPF is performed with greater safety through comprehension of the spatial relationships between the SPF , VC, and FR.

Objective To study the clinical effect of specific immune therapy for children with allergic rhini-tis(AR)and its influence on the level of serum IL -17 and IL -35.Methods 174 children with AR were chosen as the research group,who were used specific immune therapy for 24 months.In same period,110 cases of healthy chil-dren were selected as the control group.Curative effect was evaluated by rhinitis symptoms total score(TRSS)points rate.quality of life was evaluated by nasal conjunctivitis related quality of life questionnaire(RQLQ)score.Pulmonary function before and after treatment,serum Eos counting,IL -17,IL -35 were detected.Results (1 )In research group,the total effective rate after treatment of 2 years was 89.66%,which was significantly higher than 71.26% after treatment of 1 year,there was statistically significant difference(χ2 =18.716,P <0.05).(2)In the research group, TRSS score and RQLQ score after treatment of 1 year and 2 years were lower than that before treatment(t =28.360, 42.850,7.749,42.850,all P <0.05 ),and the data after treatment of 2 years were less than that after treatment 1 year(t =19.207,10.558,all P <0.05).(3)In the research group,FEV1 /predictive value after treatment of 1 year and 2 years elevated compared to that before the treatment,the airway resistance value /forecast and Eos count were lower than that before the treatment(t =15.972,27.811,48.780,62.211,10.930,62.211,all P <0.05).FEV1 /pre-dicted value after treatment of two years was higher than that after treatment of 1 year,airway resistance value /forecast and Eos counts were less than that after treatment of 1 year(t =8.728,14.707,16.488,all P <0.05 ).(4)In research group,serum IL -17 after treatment of 1 year and 2 years reduced,while IL -35 rose (t =9.162,14.522, 10.235,14.522,all P <0.05).And IL -17 after treatment of 2 years was lower than that after treatment of 1 year,IL-35 was higher than after treatment of 1 year(t =5.795,7.731,all P <0.05).(5)Correlation analysis showed that the serum IL -35 and the level of IL -17 showed a negative correlation(r =-0.36,P <0.05).Conclusion Effect of specific immune treatment on children with allergic rhinitis is better,specific immune treatment can improve the clinical symptoms,inhibit IL -17,promote IL35 and improve lung function and quality of life of patients.

Objective To investigate the prognosis correlation factors of sudden hearing loss.Methods A retrospective analysis was performed in 137 cases (149 ears) of sudden hearing loss.The relationships between the age,prehospital delay time,type of hearing loss,degree of hearing loss,and whether with dizziness,tinnitus,diabetes mellitus,high blood pressure and therapeutic effect were observed.Results The total effective rates in ＜ 45 years,45-59 years and ＞ 59 years patients were 86.36％(38/44),77.78％ (56/72) and 57.58％ (19/33) respectively.There were statistical differences in the total effective rate between ＜ 45 years,45-59 years patients and ＞ 59 years patients (x2 =8.128,P =0.004; x2 =4.525,P =0.033).The total effective rates in patients who were treated ≤7 d,8-14 d and ≥ 15 d were 83.52％ (76/91),76.67％(23/30) and 50.00％(14/28) respectively.There were statistical differences in the total effective rate between patients who treated ≤7 d,8-14 d and patients who were treated ≥ 15 d (x2 =13.050,P =0.000; x2 =4.459,P =0.035).The total effective rates in low-mid frequency type,all frequency type,total deafness type and mid-high frequency type were 89.66％ (52/58),84.44％ (38/45),7/12,47.06％ (16/34) respectively.There were statistical differences in the total effective rate between low-mid frequency,all frequency type and total deafness type,mid-high frequency type (P ＜ 0.05).The total effective rates in hearing loss mild degree,middle degree,severe degree,extremely severe degree and total deafness were 87.23％ (41/47),86.11％ (31/36),61.90％ (13/21),7/15 respectively.There were statistical differences in the total effective rate between mild degree,middle degree and severe degree,extremely severe degree and total deafness (P ＜ 0.05).The hearing loss prognosis with the dizziness,diabetes mellitus,high blood pressure was worse.Conclusions It is considered that the age,prehospital delay time,type of hearing loss,degree of hearing loss,and whether with dizziness,high blood pressure,diabetes mellitus are related to the total effective rate.The prognosis of hearing loss can be estimated according to these correlation factors.

OBJECTIVE: To evaluate the safety of the circular round window and discus anatomic landmarks of posterior wall of internal auditory canal by investigating the microscopic anatomy of internal auditory canal area of the retrosigmold approach, which can provide the anatomical basis for acoustic neutrinomas surgery. METHOD: Fifteen adult cadaver heads (30 sides) fixed with formalin were used in the study. The retrosigmold approach operations were imitated to dissect the blood vessels and nerves in internal auditory canal area by opening round bony window and removing posterior wall of internal auditory canal. RESULT: Fifteen specimens of 30 sides circular bone window were opened without injury with transverse sinus and sigmoid sinus. The vertical distance between the highest point of bone window margo superior and the lowest point of transverse sinus margo inferior was (4.02 ± 0.32) mm. The vertical distance from the most anterior point of bone window leading edge to the most posterior point of sigmoid sinus trailing edge was (6.31 ± 0.43) mm. The internal auditory canal tubercle located in the anterior superior position of internal auditory canal. The vertical distance from the highest point of internal auditory canal tubercle to the upper margin of internal auditory canal was (2.31 ± 0.32) mm. To expose the whole internal auditory canal, the length and width of the internal auditory canal posterior wall removal was (7.29 ± 0.32) mm, (4.12 ± 0.29) mm. Within this removal range, no case of cochlea, semicircular canal or venous was injured in 30 specimens. CONCLUSION The method of opening round window through retrosigmold approach is simple, practial and convenient. With little variation and easiness of location, the sinternal auditory canal tubercle can be used in the identification of the internal auditory canal. When exposing the whole internal auditory canal, the removal scope of the posterior wall should be paid more attention to, in order to avoid the damage of cochlea, semicircular canal and jugular bulb.
Adult ; Cranial Sinuses ; Ear Canal ; Ear, Inner ; Humans ; Round Window, Ear ; anatomy & histology ; Semicircular Canals ; anatomy & histology ; Temporal Bone

OBJECTIVE: To investigate the accuracy and clinical application of multi-slice spiral CT imaging on optic canal area. METHOD: Forty intact specimens of human corpse head were tested with three dimensional reconstruction of multi-slice spiral CT imaging. The results of radiology and anatomy were compared on adjacent structures of optic canal interior wall and its developmental relationship with sphenoid sinus. RESULT: (1) The high spatial resolution of integrity could be obtained with dimensional processing technique. The anatomical structure of optic canal and its surrounding area could be demonstrated clearly. (2) With the technique of virtual endoscopy, the interior reconstruction of optic canal could demonstrate the inner topography of optic canal, the reconstruction image of which was identical to that of the control subjects. (3) There was no significant difference between the data of multi-slice spiral CT imaging and that of anatomy (P > 0.05). CONCLUSION Associated application of dimensional processing technique and virtual endoscopy, not only can the subtle structures of optic canal be demonstrated and measured, but also the detailed information on spatial relationships of optic canal area can be provided for operation.
Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Optic Nerve ; anatomy & histology ; diagnostic imaging ; Tomography, Spiral Computed

OBJECTIVE: To observe the value of induced hypotension in nasal endoscopic surgery with local anesthesia. METHOD: Sixty Patients were randomly divided into two groups. Group I : induced hypotension group; Group II: control group. MAP, HR, SaO2 amount of blood loss, clear visual field of operation and the operation time were observed and compared between two groups. RESULT: The difference of MAP, HR, SaO2 data between two groups showed no statistic difference with anatomical measurement (P >0.05). The difference of amount of blood loss, the operation time and clear visual field of operation between two groups was significant (P <0.05). CONCLUSION The induced hypotension with local anesthesia can produce time of operation and amount of blood loss decreased. It can safely applied to the in clinical practice.
Adolescent ; Adult ; Anesthesia, Local ; Endoscopy ; methods ; Female ; Humans ; Hypotension, Controlled ; Male ; Middle Aged ; Nose ; surgery ; Young Adult

The anoikis resistance confers the ability of cancer cells to survive and metastasize in the blood circulation without adhesion,but its effect and mechanism in intrahepatic and distant metastasis of hepatocellular carcinoma has not been fully elucidated.Recent studies have shown that certain factors or drugs may inhibit anoikis of hepatoma cells through some signaling pathways.These signaling pathways are not completely separated,they are interconnected to promote metastasis of hepatocellular carcinoma.Liver is the metabolic center of many substances,and many related factors can promote metastasis of hepatocellular carcinoma through inhibiting anoikis.In this review,we summarized the signaling pathways of anoikis resistance of hepatocellular carcinoma.

OBJECTIVE: To explore a method of demonstrating the facial nerve anatomical landmarks under transmastoid and epitympanum approach with multi-slice CT using double oblique multi-planar reconstruction (MPR). METHOD: Two temporal bone of a corpse were dissected, under transmastoid and epitympanum approach, to observe the anatomical landmarks of facial nerve. Based on that, the anatomical landmarks of facial nerve under transmastoid and epitympanum approach in 30 (60 ears) normal temporal bones of adult corpses were reconstructed using double oblique MPR in multi-slice CT. The achievement ratio was calculated and the differences among transverse plane, coronal plane, sagittal plane and double oblique were compared. RESULT: The different part of facial nerve, such as mastoid segment, tympanum segment, pyramid segment, geniculate ganglion and the outer labyrinthine segment could be exposed clearly with the main anatomical landmarks, such as horizontal semicircular canal, epitympanic recess and cochleariform process through transmastoid and epitympanum approach. The image of anatomical landmarks could be showed in the same sections by double oblique multi-planar reconstruction. The double oblique multi-planar reconstruction to show the landmarks of facial nerve displaying on the same imaging is better than transverse plane, coronal plane and sagittal plane. The achievement ratio of every section is 100%. CONCLUSION Double oblique MPR is a new method to demonstrate anatomical landmarks through transmastoid and epitympanum approach in one slice. Combined with the operative approach and purpose, the reconstructive images with double oblique MPR can provide valuable information for operation.
Adult ; Ear, Middle ; diagnostic imaging ; surgery ; Facial Nerve ; diagnostic imaging ; surgery ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Mastoid ; diagnostic imaging ; surgery ; Tomography, Spiral Computed

Primary sclerosing cholangitis (PSC) is a common autoimmune liver disease,and the diversity of its treatment methods has been hotly discussed by scholars in various countries.As the best treatment,end-stage liver transplantation (LT),due to the related diseases,such as postoperative complications greatly limits its wide application in clinical practice.Early assessment and intervention can reduce the risk of concomitant disease and reduce the occurrence of postoperative complications.In this paper,the status of LT indications,timing and related disease management,postoperative complications and other aspects of PSC patients were reviewed.

OBJECTIVETo study the effect of gene transfection of full length spleen tyrosine kinase (Syk (L)) on the biological behavior of malignant cancer cells.

METHODSEukaryotic expression vector pIRES2-EGFP-Syk (L) was constrauted and sequenc. Laryngeal carcinoma cell line Hep-2 were transfected with pIRES2-EGFP-Syk (L) vectors or blank vectors. The expressions of mRNA and protein were examined by real time fluorescence quantitative polymerase chain reaction (Q-RT-PCR) and Western blot analysis. CCK-8 method was used for evaluating cell proliferation, Transwell for cell invasion capacity in vitro, and tumor formation in nude mice for in vivo tumorigenicity.

RESULTSpIRES2-EGFP-Syk (L) vectors were successfully construct and transfected to Hep-2 cells. Q-PCR showed that mRNA expression level in Hep-2 cells transfected with Sky (L) (28.395 ± 0.067) was higher than those in Hep-2-neo cells transfected with blank vectors (3.891 ± 0.021) and Hep-2 cells with no transfection (1.005 ± 0.012), with statistically significant difference (F = 104.02, P < 0.01). Western blot showed that protein expression level of transfected-Sky (L) cells (0.821 ± 0.047) was significantly higher than those of Hep-2-neo cells (0.558 ± 0.031) and Hep-2 cells (0.468 ± 0.031), and the difference was statistically significant (F = 112.32, P < 0.01) ; CCK-8 assay showed OD value (1.390 ± 0.067) of transfected-Sky (L) cells was lower than those of Hep-2-neo cells (1.830 ± 0.067) and Hep-2 cells (1.920 ± 0.040), and the difference was statistically significant (F = 107.64, P < 0.01). Transwell assay showed average cell number per field of transfected-Sky (L) cells (176.04 ± 22.32) was higher than those of Hep-2-neo cells (301.02 ± 21.45) and Hep-2 cells (336.04 ± 26.01) with statistically significant difference (F = 123.46, P < 0.01). The volume (250.77 ± 34.83) mm(3) tumor formed from transfected-Sky (L) cells in nude mice, was less than those from Hep-2-neo cells (750.77 ± 40.83) mm(3) and Hep-2 cells (770.77 ± 30.83) mm(3), with statistically significant difference (F = 165.78, P < 0.01).

CONCLUSIONDown-regulation of Syk in Hep-2 cells is associated with the malignant biological behaviors of the cells. Syk (L) may be a potential target in gene therapy for laryngeal squamous cell carcinoma.

Animals ; Carcinoma, Squamous Cell ; Cell Line, Tumor ; Cell Proliferation ; Down-Regulation ; Epithelial Cells ; Genetic Therapy ; Genetic Vectors ; Head and Neck Neoplasms ; Humans ; Intracellular Signaling Peptides and Proteins ; metabolism ; Laryngeal Neoplasms ; metabolism ; Larynx ; Larynx, Artificial ; Mice ; Mice, Nude ; Neoplasms, Second Primary ; Protein-Tyrosine Kinases ; metabolism ; RNA, Messenger ; RNA, Small Interfering ; Syk Kinase ; Transfection