1.Clinical study of carbon dioxide laser tonsillectomy
Zhenhua JIANG ; Jie WANG ; Chuan DONG ; Chuanyu LIANG ; Qihong FU ; Guoqi LIU ; Jianping YIN ; Zhen ZHANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(3):119-121
Objective:To investigate the therapeutic effect of carbon dioxide laser tonsillectomy.Method:In this prospective,randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectom,and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar.Result:Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2±2.1)ml, while control group have hemorrhage in operation (92.0±35.0)ml. Laser group have pseudomembrane early but desquamate late.Conclusion:Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time ,it's an safe , efficient and mini-trauma operation.
2.The effect of uvulopalatopharyngoplasty by radio frequency plasma
Mengling WEI ; Lingbo LI ; Huanhua QIN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(3):116-118
Objective:To study the effect of uvulopalatopharyngoplasty(UPPP) by using radio frequency plasma on obstructive sleep apnea-hypopnea syndrome(OSAHS) with Velopharyngeal obstruction.Method:Eighty-one cases that were diagnosed as OSAHS with Velopharyngeal obstruction were randomized into two groups, UPPP group and radio frequency plasma Velopharynoplasty group. Result:Six months after operation, the effects in both groups were similar.Conclusion:Radio frequency plasma Uvulopalatopharyngoplasty is safe, time saving, less hemorrhage with good effects.
3.Clinical observation on obstructive sleep apnea-hypopnea syndrome cases in snoring children
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(3):111-113
Objective:To explore the necessity of monitoring polysomnography (PSG ) in snoring children.Method:The PSG were monitored in 162 children with snoring or apnea.Acording to results of PSG,162 cases were separated into two groups:group obstructive sleep apnea hypopnea syndrome(OSAHS) and group primary snoring(PS),monitoring data including:apnea hypopnea index(AHI),snoring index(SI),lowest oxygen saturation(LSaO_2) and time of SaO_2<0.9,all data were undertaked statistical analysis. Result:In all 162 snoring cases,150 cases(92.6%) belong to group OSAHS,12 cases(7.4%) belong to group PS;Differences of data of age,sex and body mass index(BMI) are not significant but that of AHI,SI,LSaO_2 and time of SaO_2<0.9 are significant(P<0.05).Conclusion:It's necessary to monitor PSG in snoring children for early diagnosis and correct treatment to avoid disadvantage of OSAHS.
4.Research on apoptosis changes of tensor veli palatini in patients with obstructive sleep apnea-hypopnea syndrome
Hongxun GONG ; Xianming CHEN ; Xian ZHANG ; Fengfang LIU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(3):108-111
Objective:To explore apoptosis changes of dilator muscles in the upper airway by detecting the expression of Bax, Bcl-2 in tensor veli palatini in patients with OSAHS.Method:The expression of Bax and Bcl-2 were detected in tensor veli palatini in 30 cases with OSAHS and 10 cases chronic tonsillitis without OSAHS by immunohistochemistry and image analytical system, and the results were analyzed.Result:①The expression levels of Bax in the OSAHS group increased significantly compared to control group(P<0.05), but there were no significant differences of Bcl-2 expression between two groups, the ratio of Bax/Bcl-2 increased significantly(P<0.05). ②There were positive correlations between AHI and the expression levels of Bax(r=0.697,P<0.01) respectively in the test group.Conclusion:The results indicate that apoptosis occurred in tensor veli palatini in patients with OSAHS, and the more severity of OSAHS , the more apoptosis.
5.Recent progress on diagnosis and treatment of benign symmetric lipomatosis
Yingnan KAN ; Ping YAO ; Weihong XIN ; Qianqian CHEN ; Jun WANG ; Jian YUE ; Jiajing ZHU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(3):105-107
Objective:To introduce recent progress on diagnosis and treatment of benign symmetric lipomatosis(BSL).Method:Detailed clinical data of 6 patients with BSL were reviewed and analyzed.We present a summary of the clinical symptoms,physical sign,diagnosis and therapeutic methods of BSL. And related literatures were discussed together.Result:All of 6 patients have excessive subcutaneous fat deposit predominantly around neck.One patients had upper extremity localizations. Six patients had the complication of left ventricular diastolic function changes,glucose intolerance or diabetes mellitus, chronic hepatopathy, hyperuricemia and sleep apnea syndrome in one or more. One patients with several symptoms occur simultaneously, another one female patient was accompanied by all symptoms but chronic hepatopathy. Five male patient were alcohol abusers. Tatal neck lipentomy and abstinence from alcohol were performed on 5 patients. One patient refused treatment.During a follow-up of 3 months to 4 years, one patients was relapsed again,and no recurrence was seen in another 4 patients. All pathological results were nonencapsulated fat. Conclusion:BSL is a lipodystrophy caused by diffuse fatty tissue, symmetry deposition in the neck and shoulder subcutaneous fascia space or deep fascial space .The highest incidence favors to middle-aged man who is alcoholist. Chronic alcohol addiction and typical clinical symptoms help to diagnosis BSL. Lipectomy represents a successful procedure in treating BSL.
6.Expression and significance of COX-2 and S-100positive dendritic cell in laryngeal carcinoma
Gang QIN ; Zhuoping LIANG ; Ling YU ; Zuyao CHEN ; Wenjun LIU ; Wanrong LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(3):101-104
Objective:To explore the expression of cyclooxygenase-2(COX-2) and S-100 positive dendritic cell in laryngeal carcinoma tissue and their clinical significance.Method:Sixty-five samples of laryngeal carcinoma and thirty-four biopsies of adjacent noncancerous tissue were obtained. Immunohistochemical technique(SP method) was used to detect the expression of COX-2 and S-100 positive dendritic cell, and the relationship of their expression with clinical pathological parameters and prognosis was analyzed.Result:The rates of COX-2 expression were 63.08%(41/65)and 14.70%(5/34)in laryngeal carcinoma and control group, respectively. The difference was significant(P<0.05).The positive expression of COX-2 was correlated with T and clinical stage in laryngeal carcinoma(all P<0.05).The rates of S-100 positive dendritic cell expression were 61.54%(40/65)and 0 in laryngeal carcinoma and control group, respectively. The difference was significant(P<0.05).S-100 positive dendritic cells showed significant differences between early and late clinical stage and lymph node metastasis (all P<0.05).Kaplan-Meier survival analysis showed that patients with positive expression of COX-2 and S-100 positive dendritic cell had worse disease-free and overall survival(P<0.05).Cox regression analysis showed that S-100 positive dendritic cell was indicated as an independent prognostic factor for survival(P<0.05).Conclusion:COX-2 and S-100 positive dendritic cell are highly expressed in laryngeal carcinoma tissue. It suggests that the expression of COX-2 and S-100 positive dendritic cell is related to the process of carcinogenesis and may be the important indicators in laryngeal carcinoma for prognosis.
7.Clinical features and treatment of closed rupture of cervical trachea
Youzhong LI ; Yongde LU ; Xinming YANG ; Weijing WU ; Jingjia LI ; Xiangbo HE
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(3):97-100
Objective:To study the clinical manifestations and treatments of closed injuries of the cervical trachea.Method:We carried out a retrospective study of the clinical manifestations, diagnosis and treatment of patients with closed injuries of the cervical trachea that have been treated in our hospital over the last ten years. We analyzed commonly occurring clinical problems, key points of surgical treatment, and postoperative recovery. Fourty-one patients with acute closed injuries of the cervical trachea underwent emergency tracheotomy or anesthesia orotracheal intubation and surgical repair of the trachea within 24 to 48 hours. Twenty six patients had their tracheotomy tubes extubated after surgery and had their anesthesia orotracheal tubes extubated within 48 hours postoperatively; tracheotomy tubes remained in the airway in 15 patients postoperatively, and of them, 12 had extubation successfully in 2 weeks postoperatively, while the remaining 3 were left intubated due to laryngotracheal stenosis. Among the 3, 2 underwent further surgical repair and recovery, and 1 had a stent inserted.Result:Twenty-eight patients fully recovered postoperatively. Ten patients mostly recovered postoperatively exception for hoarseness, and their fundamental phonation function recovered within 2 to 3 months but with poor movement of the vocal cords. The breathing and swallowing function of the other 3 patients recovered after the surgery, but they suffer from hoarseness.Conclusion:In the treatment of closed disruption of the cervical trachea, prompt diagnosis and timely surgical repair of the structure and function of the trachea are key to saving the patients' lives and avoiding tracheal stenoses.
8.GluR2 expression in the developing rat inferior colliculus and the relationship with development of synapse
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(4):173-176
Objective:To observe the GluR2 expression in rat inferior colliculus (IC) in different developmental stages , and to investigate its developmental change and relationship with the synapse development.Method: The expression of GluR2 and synaptophysin(SYP) in IC were detected by double immunofluorescence method.Result:①All sorts of neurons in IC expressed GluR2 in every postnatal groups, and the GluR2 expression in P6w groups was higher than that in other groups .②The expression of GluR2 were different in different subnucleus of IC.③All sorts of neurons in IC expressed SYP in every postnatal groups, and the SYP expression in P6w groups was higher than others. ④The expressions of GluR2 consistented with the expression of SYP in IC.Conclusion:The developmental changes of GluR2 and SYP expression in the rat IC may be involved in the development and plasticity of auditory center.
9.Study on the relationship between TK gene regulated by enhanced suicide gene vector and telomerase activity in nasopharyngeal carcinoma cells
Congxiang SHEN ; Zhong WEN ; Yuhong QIAN ; Shaofeng MU ; Xiaofang GUAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(4):168-173
Objective:To explore the relationship between TK gene expression regulated by enhanced suicide gene vector and telomerase activity in nasopharyngeal carcinoma cells.Method:The reformed reconstructed enhanced vector, pGL3-basic-EGFP-TK-hTRETp-CMV enhancer, and hTERT mono-promoter vector, pGL3-basic-EGFP-TK-hTRETp(as controls), were transfected into telomerase(+) nasopharyngeal carcinoma 5-8F cell lines,telomerase(+) human breast cancer MCF-7 cell lines and telomerase(-) normal vascular endothelium cell lines respectively. TK gene green fluorescent protein was observed by fluorescence microscope. The expression of TK gene mRNA was measured by the real-time fluorescent quantified PCR and the telomerase activity was determined by the method of TRAP argentation in maligment tumour cells pre- and post-transfected by enhanced vector . Meanwhile the relationship beteewn TK and telomerase was analyzed.Result:①A strong TK gene fluorescent show and TK mRNA expression were displayed after the enhanced suicide gene vector was transfected into nasopharyngeal carcinoma 5-8F cell lines and human breast cancer MCF-7 cell line, which were more stronger than those of mono-promoter group,pGL3-basic-EGFP-TK-hTRETp,and ECV cells transfected by enhanced suicide gene vector. Meanwhile,real-time fluorescent quantified PCR showed that the A value of enhanced vector group was higher than that of controls. ②Telomerase activity after transfection of enhanced vector and GCV was lower than those before by the method of TRAP argentation in nasopharyngeal carcinoma cell lines,but no change in normal control cells after transfection of enhanced vector and GCV.③ After adding GCV, the obvious inhibitory effect of tumour cells growth induced by pGL3-basic-EGFP-TK-hTRETp-CMV enhancer were observed in nasopharyngeal carcinoma 5-8F cell lines and human breast cancer MCF-7 cell line, which was higher than those of mono-promoter, pGL3-basic-EGFP-TK-hTRETp,pGL3-basic-EGFP3 and blank controls, but without inhibitory effect in ECV cells transfected by enhanced vector. Conclusion:TK gene expression is regulated by hTERT promoter and CMV enhancer, and then the telomerase activity is reduced and the cancer cells are specifically killed.But it is unclear how the telomerase are down-regulated by TK gene.
10.Cause analysis of radical mastoidectomy failure
Guiping LIU ; Lei ZHU ; Hongjun XIAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(4):166-167
Objective:To investigate the common reasons for the failure of radical mastoidectomy in order to improve the result of treatment and obtain a dry ear.Method:Twenty-eight cases,who achieved no dry ear after radical mastoidectomy,underwent secondary surgery.Result:All cases obtained dry ear without vertigo or facial paralysis after operation and postoperative dressing.Conclusion:The reasons for the failure of radical mastoidectomy result from the incomplete clearance of lesions, the insufficient ventilation of mastoid cavities, the inappropriate postoperative dressings or the residual foreign bodies in surgical cavity.It is the key points to achieve skeletonization adequately, to eliminate the pathological tissues thoroughly under microscope, and to ensure unobstructed drainage of surgical cavities for preventing secondary surgery.