BACKGROUND:A great development has been achieved in essential research on tissue engineered cartilage. However, its real application in otolaryngology has been rarely reported. It is faced with the topic to explore the simple and convenient method of repairing laryngeal cartilage by tissue engineering technique. OBJECTIVE:To compare the effect of porous spongy poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) seeded with chondrocytes or using senior tissue engineered cartilage in repairing al ogenic thyroid cartilage defects.METHODS:Chondrocytes at passage 3 were harvested from infant rabbits within 3 days. Porous spongy poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) seeded with chondrocytes composites were made by tissue engineering technique. The chondrocyte-poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) composites were co-cultured in vitro to form junior tissue engineered cartilage. And then respectively used for repairing the thyroid cartilage defects and directly transplanted with junior tissue engineered cartilage (experimental group A, n=5), or firstly the junior tissue engineered cartilage to be implanted subcutaneously for a period of time to further maturity for relative senior tissue engineered cartilage and secondly to be transplanted (experimental group B, n=5) into adult New Zealand white rabbits. Simple poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) sponge scaffold (control group A, n=4) and chondrocyte suspensions(control group B, n=4) were used as reparative materials in defect areas as control groups. Final y, the reparative effect was respectively studied grossly and histological y at 4 weeks (experimental group B) and 8 weeks (experimental group A, control group A and control group B) after transplantation. RESULTS AND CONCLUSION:The cartilage defects were wel repaired in the experimental groups. It was smooth between the reparative area and original cartilage without dents and defects. Both were similar grossly. But few chondrocytes at interfacial region between the reparative area and original cartilage and poor matrices were observed in the experimental group A. A Few chondrocytes and more matrices were observed in the experimental group B. Inflammatory cellinfiltration was not obvious in two experimental groups. Control groups showed soft tissue of dark-red color accompanied with local concave in gross specimens. Histological examination and special staining showed there were no cartilage-like structure and secretion of matrix components. The results showed that it is possible to repair thyroid cartilage defect using junior tissue engineered cartilage directly or junior tissue engineered cartilage after in vitro implantation in al ograft rabbits with immunity, and the immunoreaction is not obvious;in the same period, the repairing effect of mature tissue engineered cartilage is better than that of junior tissue engineered cartilage. However, application of junior tissue engineered cartilage directly can save time, costs, workload and operational link, and avoid the pain from secondary skin surgery, which is one of the more practical approaches.

Objective To investigate the early diagnosis value of MR by detecting spinal inflammatory lesions in ankylosing spon-dylitis (AS).Methods Forty patients were involved in this study,including 20 cases with short inflammatory back pain (IBP)histo-ry (duration ≤18 months)and 20 cases with long IBP history (duration ≥24 months).MR images were analyzed retrospectively. Results Patients with a short history of IBP had 7 lesions in vertebral bodies (anterior/posterior spondylitis and spondylodiscitis) and 33 lesions in posterior spinal structures (arthritis of costovertebral joints,costotransversal joints,zygapophyseal joints and en-thesitis of spinal ligaments).Patients with a long history of IBP had 27 lesions in vertebral bodies and 24 lesions in posterior spinal structures.Patients with a short history of IBP had significantly more lesions in posterior spinal structures than in vertebral bodies with 82.5% (33/40)vs 1 7.5% (7/40),respectively (P <0.01).In contrast,patients with a long history of IBP had significantly more inflammation in vertebral bodies with 79.4% (27/34)vs 20.6% (7/34),respectively (P <0.01).Conclusion Inflammatory spinal lesions in patients with a short history of IBP are seen more often in the posterior structures.Early detection of inflammatory spinal lesions by MRI is useful for early diagnosis of AS.

Objective: To investigate the clinical effect of modified Graeb criteria score and Glasgow coma score (GCS) in individualized treatment of intraventricular hemorrhage. Methods: 113 patients with intraventricular hemorrhage admitted to the department of neurosurgery of Second Affiliated Hospital of Guangxi Medical University from June 2014 to February 2018 were enrolled, and they were divided into 13-15, 9-12, and 3-8 groups according to GCS score at admission, and modified Graeb criteria score was classified as grade Ⅰ, Ⅱ and Ⅲ at the same time. In GCS 9-12 and 3-8 groups, patients with modified Graeb criteria score grade Ⅲ were treated with bilateral extra ventricular drainage, patients with modified Graeb criteria score grade Ⅱ were treated with bilateral extra ventricular drainage or lumbar cistern drainage (GCS 9-12 group was more prior to lumbar cistern drainage, 3-8 group was given priority to extra ventricular drainage), and patients with modified Graeb criteria score grade Ⅰ were treated conservatively. In GCS 13-15 group, bilateral extra ventricular cerebral drainage or lumbar cistern drainage was performed if the modified Graeb criteria score grade was Ⅲ, lumbar cistern drainage or conservative treatment was performed if the modified Graeb criteria score grade was Ⅱ, and conservative treatment was performed if the modified Graeb criteria score grade was Ⅰ. The changes in GCS score at 1 month after individualized treatment and the favourable prognosis rate at 6 months after treatment were observed [favourable prognosis was defined as Glasgow outcome score (GOS) Ⅳ-Ⅴ] as well as the basic clearance time of intraventricular hematomas, and the occurrence of complications such as intracranial infection, pulmonary infection and hydrocephalus were recorded. Results: 113 patients with intraventricular hemorrhage were enrolled in the final analysis, including 39 patients in GCS 13-15 group, 27 in 9-12 group, and 47 in 3-8 group; 21 patients with the first grade of modified Graeb criteria score, 42 with the second grade and 50 with the third grade. At 1 month after individualized treatment, the GCS scores in GCS 13-15 and 9-12 groups were significantly higher than those at admission (14.8±0.2 vs. 13.7±0.8, 13.1±1.7 vs. 10.7±1.1, both P < 0.05). When comparing the GCS score of the same patient at admission with that of 1 month after treatment, the GCS scores of the three groups were significantly improved, indicating that the consciousness of patients with different coma levels at admission had been significantly improved after individualized treatment. The basic clearance time of intracerebroventricular hematomas in patients with the second grade of modified Graeb criteria score was (7.0±2.8) days, in patients with the third grade was (6.1±2.0) days. At 6 months after individualized treatment, among 113 patients, GOS score was grade Ⅰ in 7 patients (6.2%), grade Ⅱ in 13 patients (11.5%), grade Ⅲ in 28 patients (24.8%), grade Ⅳ in 27 patients (23.9%), and grade Ⅴ in 38 patients (33.6%), with the favourable prognosis rate of 57.5% (65/113). Among 113 patients, intracranial infection occurred in 5 patients (4.4%), pulmonary infection in 22 patients (19.5%), hydrocephalus in 2 patients (1.8%) and rebleeding in 4 patients (3.5%). In 83 patients with lumbar cistern drainage, 1 patient had post-drainage infection (1.2%), 3 patients had plugging (3.6%), 6 patients had accidental drop of drainage tube (7.2%), and none of them had occipital macroforamen hernia after drainage. Seven of the 113 patients died including 2 patients died of cerebral hernia caused by rebleeding, 5 patients died of severe pneumonia or automatic discharge from hospital. Conclusion The combination of modified Graeb criteria score and GCS score can individualize treatment for patients with intraventricular hemorrhage and effectively improve the prognosis of patients with intraventricular hemorrhage.

Objective To explore the application disturbance coefficient (DC) value of noninvasive brain edema monitoring in patients after traumatic brain injury.Methods A total of 54 cerebral injury patients were performed by non-invasive brain edema monitoring from June to November 2016.The essential information,DC,intracranial pressure (ICP),and 6-month-later glasgow outcome score (GOS) were collected.Results DC was negatively correlated with ICP (r=-0.779 5,P＜0.01),and it was positively correlated with glasgow coma scale (GCS) and GOS (r=0.667 5,P＜0.01;r=0.630 6,P＜0.01).The mean of DC with good prognosis patients was 106.99±4.09,and that of the poor prognosis patients was85.26±4.45,the difference was statistically significant (P＜0.05).Conclusion DC has a good clinical application value.

Obsjective To analyze the inflammation characteristics and changes of small airway function in patients with eosinophil and neutrophil asthma, and provide evidence for individualized treatment of asthma. Methods:Using a cross-sectional study, 46 patients with eosinophilic asthma and 42 patients with neutrophilic asthma confirmed by cytology of induced sputum were recruited from July 1, 2017 to June 30, 2019 at the respiratory Department of Respiratory Medicine,Jinshan Branch of the Sixth People's Hospital of Shanghai. Patients were divided by asthma category into eosinophilic asthma group and neutrophilic asthma group.The severity of acute attack, the score of asthma control test (ACT) and the concentration of serum C-reactive protein (CRP) were compared between the two groups The fraction of exhaled nitric oxide (FeNO), related cytokines(interleukin-4(IL-4), interleukin-5(IL-5), interleukin-13(IL-13), interleukin-17(IL-17) and interferon γ(IFN-γ)) in peripheral blood and induced sputum supernatant and lung function indicators (forced exhalation volume in one second (FEV1)% percent predicted (%pred), maximal mid-expiratory flow (MMEF)% pred, forced expiratory flow (FEF) 75% pred, forced expiratory flow at 50% of FVC exhaled (FEF50%) pred were detected. Independent sample t-test was used for the comparison between measurement data groups comforming to normal distritution, rank sum test was used for the comparison between measurement data groups not conforming to normal distribution, and χ 2 test was used for the comparison of counting data. Results:There were no significant differences in the general data and ACT scores between the two groups (all P>0.05). The ratio of severe and critical degree (52.38%(22/42)), uncontrolled and partially controlled patients (59.52%(25/42)), CRP level (24.6(7.1, 35.0) mg/L) in neutrophil asthma group were higher than those in eosinophilic asthma group(30.43% (14/46), 36.96% (17/46), and 8.5 (2.0, 12.0) mg/L, respectively) (χ 2=4.37, χ 2=4.48, Z=4.76; P=0.036, P=0.034, P<0.001). The concentration of FeNO was higher in eosinophilic asthma group (76(54,93) ppb) than that in neutrophil asthma group(27(15,41) ppb),and the differences was statistically significant ( Z=6.52, P<0.001). The values of FEV1% pred ((56.13±21.51)%), MMEF% pred ((62.03±23.97)%), FEF75% pred ((54.42±20.49)%), FEF50% pred ((66.89±26.47)%) in neutrophil asthma group were lower than those in eosinophilic asthma group ((68.53±29.81)%, (72.16±23.05)%, (65.38±25.46)% and (79.86±27.61)%), and the difference between the two groups was statistically significant( t values were 2.25, 2.02, 2.21, 2.24; P values were 0.027, 0.046, 0.030, 0.027). The concentrations of serum IL-4((49.42±24.46) ng/L), IL-5((104.89±43.91) ng/L) and IL-4((44.49±19.12) ng/L), IL-5((95.45±28.58) ng/L) in induced sputum supernatant were higher than neutrophilic asthma group((32.29±14.19), (50.35±22.30), (33.33±15.08), (55.61±26.41) ng/L). The difference between the two groups was statistically significant ( t values were 4.06, 7.44, 3.02, 6.77, P values were <0.001, <0.001, 0.003, <0.001). In eosinophilic asthma group, the concentrations of serum IL-13 ((76.18±20.62) ng/L), IL-17 ((31.32±9.32) ng/L), IFN-γ ((18.27±5.56) ng/L) and IL-13((71.08±20.08) ng/L), IL-17((26.29±6.70) ng/L), and IFN-γ((17.61±5.94) ng/L) in induced sputum supernatant were lower than those in neutrophilic asthma group((153.83±44.53 ) ng/L, (55.27±18.89) ng/L, (26.46±10.08) ng/L, (120.32±28.41) ng/L, (44.99±12.66) ng/L, (23.91±7.66) ng/L). The difference between the two groups was statistically significant ( t values were 10.33, 7.43, 4.66,9.31,8.54,4.33, respectively; all P<0.001). Conclusion:Eosinophilic asthma and neutrophil asthma have different inflammation, small airway function characteristics and different response to treatment. The small airway function changes in early stage of neutrophil asthma are more obvious.