1.Clinical significance of microcalcification in patients with thyroid micropapillary carcinoma
Long JIN ; Chunsong CHENG ; Yifan CHEN ; Min JIANG ; Xiaohong CHEN
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):345-348
OBJECTIVE To investigate the clinical significance of microcalcification under high resolution ultrasonography in predicting thyroid micropapillary carcinoma(PTMC) and cervical lymph node metastasis. METHODS The clinical data of 388 patients with papi l lar y thyroid microcarcinoma were analyzed retrospectively in Beijing Tongren Hospital from Jan 2013 to Jun 2017, which included patients' clinical ultrasonographic features and pathological results in this study. Pearson correlation analysis and data fitting modeling were used to analyze the microcalcification, the maximum diameter of the tumor and the cervical lymph node metastasis in the central region. RESULTS The incidence of microcalcification in PTMC patients was closely related to the maximal diameter of the tumor. The tumor diameter of PTMC was related to the lymph node metastasis rate in the central region of the neck, and it was not found that microcalcification was associated with lymph node metastasis in the central region of the neck. CONCLUSION The weight of microcalcification in the diagnosis of PTMC is related to the maximum diameter of the nodule. Furthermore, patients with thyroid nodules having a tumor diameter of less than 1 cm, with the larger diameter of tumor nodules, the greater the risk of PTMC, the more recommended fine needle biopsy.
2.Clinical analysis of AIDS-related Kaposi's sarcoma in head and neck
Jing HOU ; Gaoli FANG ; Lisong ZHANG ; Huiyu SUN ; Chengshuo WANG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):349-352
OBJECTIVE To summarize the clinical features of the acquired immunodeficiency syndrome-related Kaposi's sarcoma(AIDS-KS) in head and neck. METHODS The clinical data of 20 inpatients with AIDS-KS in head and neck from June 2009 to September 2016 in Beijing Ditan Hospital were retrospectively analyzed. RESULTS All 20 patients were male, median age 38.50±10.98. One case was Manchu, 1 case was of Uygur, and others were Han nationality. There were 7 cases with homosexuality history, 2 cases with blood transfusion history, and 1 case with prostitution history. Mass in head and face was the first symptom in 10 cases. The head and neck skin and mucosa were involved, including 2 cases with nasal mucosa involvement, 4 cases with auricle skin involvement, 8 cases with oral mucosal involvement, 3 cases with facial skin involvement, 1 case with neck skin involvement, 1 case with eyelid conjunctiva involvement. Four cases had disseminated lesions. When diagnosed, the CD4+T lymphocyte were 52.55±47.87/mm3. The CD4+T were less than 200/mm3 in all of the patients, including CD4+T<50/mm3 in 15 cases(75%). After treatment with highly active antiretroviral therapy combined with or without chemotherapy, 12 cases were discharged. Eight cases died due to respiratory failure or septic shock or other reasons. CONCLUSION Kaposi's sarcoma of the head and neck might be the first visit of AIDS patients. Some of the patients get partial remission after highly active antiretroviral therapy and the overall prognosis is poor.
3.Clinical analysis of benign paroxysmal positional vertigo
Hui LENG ; Qi ZHANG ; Haibo SUN
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):353-357
OBJECTIVE To observe the clinical characteristics and curative effect inpatients with benign paroxysmal positional vertigo(BPPV). METHODS The data of 1000 BPPV patients were retrospectively analyzed. RESULTS 1. There was no significant difference in age between men and women; There was significant difference in incidence between men and women; 2. The single semicircular canal was involved in 993 cases, 2 semicircular canals were involved in 7 cases, canalolithiasis in 818 cases, cupulolithiasis in 175 cases; 3. The posterior semicircular canalwas involved in 587 cases, horizontal semicircular canal in 402 cases, anterior semicircular canal in four cases. The incidence of the right side was significantly higher than that of the left side; 4. The average treatment times of canalolithiasis and cupulolithiasiswere statistically different; 5. BPPV canalolithiasis and cupulolithiasisonetimerepositi on cure rate is 62.5% and 42.3% respectively; 6. There was no correlation between nystagmus velocity,affected sideand reposition times in horizontal BPPV. CONCLUSION BPPV has the following characteristicscs. First of all, popularin the middle-aged, elderly population and more common in women, single semicircular canal involve predominantly. Second, most of BPPV involve posterior semicircular canal, horizontal semicircular canal lesion take the second place and anterior semicircular canal lesion was least. Most of BPPV occur in the right side andiscanalolithias type. Thirdly, the average treatment times of BPPV of cupulolithiasis type is more than that of canalolithiasistype.
4.Estimation of spectral oscillatory power of resting-state EEG in subjective tinnitus
Yuexin CAI ; Jiahong LI ; Haidi YANG ; Ling CHEN ; Yingfeng SUN ; Xiayin HUANG ; Hao XIONG ; Suijun CHEN ; Xiaoting CHEN ; Guisheng CHEN ; Yanhong CHEN ; Yiqing ZHENG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):358-362
OBJECTIVE To explor e the characteristics of spectral oscillatory power of resting-state electroencephalography(EEG) in subjective tinnitus patients and to lay the foundation for study of central mechanism of tinnitus.METHODS 31 subjects(15 subjects with subjective tinnitus and 16 age matching healthy subjects) underwent a 128-channel resting-state EEG analyses. After a series of preprocessing, data were segmented into 8 frequency bands, including δ(0.5~3.5 Hz), θ(4~7.5 Hz), α1(8~10 Hz), α2(10~12 Hz), β1(13~18 Hz), β2(18.5~21 Hz), β3(21.5~30 Hz) and γ(30.5~44 Hz). The group differences of spectral power were analyzed by independent t test. Correlation between spectral power of each frequency band and tinnitus subjective symptoms were also analyzed. RESULTS Significant higher spectral power of the α1, β and γ bandwere found in the left and right temporal areas of tinnitus group compared with that of normal group.Tinnitus subjects also had higher spectral powerof the δ and θ band in temporo-parietal areas than that of the normal group. There was no significant difference of spectral power in other frequency bands. Moreover, signif icant positive cor relation were found between tinnitus loudness and spectralpower of right anterior lateral(R=0.66, P =0.007) and right anterior medial(R=0.58, P =0.031) areas. CONCLUSION Tinnitus subjects have higher spectral oscillatory power on right and left temporal lobe and temporo-parietal area. A positive correlation exsit between tinnitus loudness andspectral power of right anterior lateral and medial areas in tinnitus subjects, whichindicate that central reorganizationexsit in tinnitus reorganization andγ band maybe considered as a possible biomarkerforthe tinnitus subjective symptom.
5.Role of Wnt/β-catenin signaling in zebrafish lateral line hair cell regeneration
Xiaoxiao MI ; Jian YAN ; Yuan LI ; Junping SHI
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):363-366
OBJECTIVE To explore the role of Wnt/β-catenin signaling in hair cell regeneration using zebrafish lateral line system. METHODS Zebrafish larval were incubated in cisplatin solution to induce lateral line hair cells loss and then regenerated for 48 hrs. Supporting cells were sorted, and QPCR was taken to detect the expression change of Wnt/β-catenin signaling factors. Whole mount in situ hybridization was used to show the expression pattern of dkks. Wnt/β-catenin signalinginhibitors(FH535 and XAV939) and enhancer(BIO) was added to the medium to observe the influences on hair cell regeneration. RESULTS RT-PCR and Q-PCR showed that the expressions of wnt2, wnt3a and ctnnb1 in sorting supporting cells were elevated(P<0.05). Whole mount in situ hybridization showed that the expression of dkk1a and dkk2 in lateral lines sub-supporting cellsreduced. The addition of Wnt/β-catenin signaling inhibitors reduced the regenerated hair cells to 40% of normal, and even to 10% when the concentration of inhibitor was elevated.And the first 12 hrs Wnt/β-catenin signaling inhibition also led to the reduced regenerated hair cells(P<0.001). However, regeneratedhair cells have no significant change compared between BIO-treated and nontreated group(P>0.05). CONCLUSION Wnt/β-catenin signaling is necessary whilenot sufficient for zebrafish lateral line hair cell regeneration.
6.Assessment of postoperative vital signs by nasal packing versus transseptal suturing techniques after septoplasty
Guanhui HUANG ; Yuanyuan HAO ; Tingliang WANG ; Baoshu CHEN ; Guifang WANG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):367-369
OBJECTIVE To evaluate the affection to heart rate, blood pressure and breathing rate by nasal packing versus transseptal suturing techniques during patients undergone septoplasty. METHODS Eighty patients with deviation of nasal septum were included in this study. The patients were allocated into two groups: packing group and suturing group. The heart rates, blood pressure and breathing rates pre-and post-operations were collected, and the ascending range of these between two groups were assessed. The post-operative complications were observed. RESULTS The ascending range of the heart rates, blood pressure and breathing rates were smaller in suturing group than in packing group patients(P <0.05). There is no significant differences in post-operative complications between 2 groups. CONCLUSION Nasal suturing techniques during septoplasty might be a valid substitution for packing with more stable vital signs, smaller burden on the cardiovascular system and the same complication rates.
7.Study of fractional exhaled nitric oxide concentrations in healthy school children of Beijing, Tianjin, Hebei province
Chengyao LIU ; Xiangdong WANG ; Ming ZHENG ; Zhongyan LIU ; Feifei CAO ; Wei XIONG ; Luo ZHANG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):370-374
OBJECTIVE To investigate the normal range of fraction exhaled nitric oxide(FeNO) in healthy schoolchildren in Beijing, Tianjin and Hebei Province. METHODS A total of 337 schoolchildren(161 males and 176 females) in Beijing, Tianjin and Hebei Province were selected randomly in our outpatient clinic and met the health standards. FeNO values were measured using NIOX. Age, height, weight and body mass index(BMI) were investigated. At the same time, skin prick tests were performed on children with suspected atopy. RESULTS Geometric mean of FeNO value in healthy schoolchildren in Beijing, Tianjin and Hebei Province was 13 ppb(part per billion, ppb), and the 95% Confidence Interval(CI, bias distribution) was 5-23 ppb, which was related to the gender of schoolchildren(P <0.001). There was no signif icant cor relation between age, height, weight, body mass index(BMI) and regional differences(P all>0.05). FeNO values were no significant difference among the three regions(P >0.05); the geometric mean of FeNO values were 13 ppb in Beijing, 13 ppb in Tianjin, and 14 ppb in Hebei; 95%CI was 5 to 21 ppb, 5 to 21 ppb, 5 to 23 ppb, respectively. CONCLUSION FeNO values of healthy schoolchildren in Beijing, Tianjin and Hebei provinces are only significantly correlated with gender. However, FeNO values are highest among schoolaged girls in Hebei, and 23 ppb is the 95% normal range of FeNO in healthy schoolchildren in Beijing, Tianjin and Hebei province. Gender and regional factors must be considered when FeNO values are evaluated.
8.Predictive value of ventilatory steability in determining positive airway pressure efficacy in patients with obstructive sleep apnea
Yanru LI ; Xiu DING ; Fei GAO ; Qingwen YANG ; Xiaoyi WANG ; Wen XU ; Demin HAN
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):375-379
OBJECTIVE We hypothesized that unstable ventilatory control(high loop gain, LG) could predict the short-term efficacy of positive airway pressure therapy in patients with obstructive sleep apnea(OSA). METHODS 42 adult patients with OSA, M/F=39/3, were studied. The stability of the ventilatory control system(LG) was quantified by fitting a simplified mathematical model to the spontaneous ventilatory pattern obtained via polysomnography. LG, pulmonary function test results, and other PSG parameters were analyzed in patients who had post-treatment AHI≥10 events/hr(non-responders) using auto-positive airway pressure therapy. RESULTS The subjects aged(40±8) years, apnea-hypopnea index(AHI) were 68.2[42.9,81.0]events/hr). Nine patients(34.6%) were non-responders. Twenty pat ients(47.6%) had residual AHI<5 events/hr. Loop gain and pre-treatment mixed apnea index were higher in the non-responders versus responders(0.74 [0.62, 0.82] vs 0.49[0.37, 0.77], P =0.035) and(11.0[4.3, 22.9] vs 2.0[0.2, 5.3], P =0.004). In the 26 patients with LG>0.6, nine(34.9%) had posttreatment 5 events/hr≤AHI<10 events/hr. And all of the non-responders had LG(n=9, 34.9%). The difference was signif icant between the LG>0.6 a nd LG<0.6 group(P =0.007). CONCLUSION Loop gain and mixed apnea index was higher in patients with residual AHI>10 events/hr after short-term auto-PAP therapy. Ventilatory control stability evaluation might have predictive value for PAP treatment efficacy in OSA patients.
9.Study on the correlation between sleep snoring and intelligence level in 4-6 years old children
Jinghong TIAN ; Jing ZHAO ; Guixiang WANG ; Hua WANG ; Jishui ZHANG ; Li ZHENG ; Zhifei XU ; Jie ZHANG ; Xin NI
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):380-383
OBJECTIVE Aim to evaluate the mental level in 4-6 years old children with obstructive sleep apnea hypopnea syndrome(OSAHS). METHODS Children who were diagnosed as OSAHS with a whole night PSG monitor in the sleep center between January 2015 and August 2016, and 30 healthy children were included in the study. Intelligent levels were evaluated at the enrollment day. The following intelligent levels evaluation questionnaires were used: Wechsler Intelligence Scale for children and infants. Intelligent levels were compared between the patient and healthy control groups. RESULTS The 60 children, including 30 children with OSAHS(patient group) and 30 healthy children(control group) were enrolled. Comparison of the patient versus the control groups revealed that total intelligence quotient(FIQ) was 96.59±12.60 vs 102.53±8.44; language capability(VIQ) was 94.00±13.24 vs 101.03±9.41; comprehension test was 5.96±2.5 vs 7.57±2.14; visual analysis was 8.85±2.32 vs 10.3±1.93. All the 4 values in the patient group were significantly lower than those in the control group(all P <0.05). The accumulated time of SO2<90% correlated with PIQ negatively and significantly. CONCLUSION The intelligent level of children with OSAHS was in the normal range, but lower than that of healthy group. Snoring affects the IQ level of 4-6 years old children, and the influence on PIQ is closely related to the accumulated time of SO2<90% in total sleep time.
10.Diagnosis and treatment of the cartilaginous subglottic web in children
Lingxiang HU ; Mingliang XIANG ; Qi HUANG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2018;25(7):385-388
OBJECTIVE To explore the methods of preoperative diagnosis, evaluation and surgical treatment of the subglottic web in children. METHODS We analyzed the clinical manifestations, electronic laryngoscopy results, tracheal endoscopy and airway CT results of 4 children cases with congenital laryngeal cartilaginous subglottic web (1 case of type IV and 3 cases of type III) from August 2014 to March 2018. All of the 4 patients underwent a laryngofissure plus submucosal resection of cartilage web and short-term stenting. RESULTS Two cases underwent preoperative tracheotomy at 13 month old, 1 case at 6 month old. One case underwent tracheotomy at the same time of laryngoplasty. Two children indwelled the stents for 7 days and 11 days after operation and removed the stent by themselves. Other 2 cases removed the stent by the doctor at 14 day after operation. After removing the stents, the 4 cases underwent a pluging of the tracheotomy instantaneously. After 3 to 5 months of continuously pluging of the tracheotomy, all cases successfully removed the tracheal cannula. CONCLUSION For children with congenital laryngeal cartilaginous subglottic web of type III or type IV, the operation of laryngofissure plus submucosal resection of cartilage web and short-term stenting is the good choice with a high extubation rate and no complications.