OBJECTIVE: Systematic reviews and Meta-analysis were conducted to assess the efficacy and security of adenoidectomy for the treatment of otitis media with effusion in children. METHOD: Based on the principles and methods of Cochrane systematic reviews, literature was searched in PubMed, Medline, Elisevier, Ovid, CBM, CNKI, VIP and Wanfang datebases. Randomized controlled trials about treatment of otitis media with effusion in children using adenoidectomy were included. Meta-analysis was performed for the result of homogeneous studies using RevMan 5.2 software. RESULT: Adenoidectomy (combined with myringotomy or puncture) was superior to non-surgical (combined with myringotomy or puncture) treatment in reducing the incidence of acute otitis media and removing the middle ear effusion. Adenoidectomy combined with tympanostomy tube was superior to tympanostomy tube alone in the removal of the middle ear effusion and improvement of hearing level. Three trials described some postoperative complications including haemorrhage, incipient malignant hyperthermia, postoperative pneumonia and velopharyngeal insufficiency. CONCLUSION Our research shows a benefit of adenoidectomy in the removal of middle ear effusion in children with OME. Adenoidectomy combined with tympanostomy tube was superior to tympanostomy tube alone in improving hearing level. At present, there is no evidence of serious postoperative complications after adenoidectomy.
Adenoidectomy ; Child ; Humans ; Middle Ear Ventilation ; Otitis Media with Effusion ; surgery ; Postoperative Complications

Background and purpose:Surgical operation is the main method in the treatment of laryngeal carcinoma, but different patients have different impacts on the survival time and the quality of life with different type of operation. This study was to analyze the methods of surgical treatment and its long-term effect of laryngeal carcinoma, to increase survival rates, laryngeal function reservation and reconstruction and improve life quality.Methods:A total mumber of 424 patients of laryngeal carcinoma treated with surgical treatment during between Jan. 2002 and Dec. 2012 were researched by clinical follow-up and data analysis. Surgical method: CO2 laser-assisted laryngeal microsurgery for laryngeal tumors for 50 cases, frontal partial laryngectomy or modiifed thyroid cartilage window partial laryngectomy without tracheostomy for 42 cases, vertical frontolateral partial laryngectomy for 119 cases, horizontal partial laryngectomy and extended subtotal laryngectomy for 22cases, anastomosis of pharynx and trachea for 4 cases, supra cricoid partial laryngectomy for 129 cases (CHEP of them for 103 cases, CHP for 26 cases), total laryngectomy for 58 cases, cervical lymph node dissection at the same term for 121 cases.Results:Partial laryngectomy without tracheostomy for 92 cases (21.7%), total laryngectomy for 58 cases (13.7%); decannulation rate was 86.5%, vertical frontolateral partial laryngectomy of them for 93.2%, horizontal partial laryngectomy of them for 90.9%,supra cricoid partial laryngeal of them for 82.2%; laryngeal function reservation rate for 86.3%; all patients did outpatient review and telephone follow-up, 9 cases loss to follow-up, a total of tumor recurrence, cervical lymph node metastasis and distant metastasis were 41 cases, mostly occurred in 1 year after surgery; death for 57 cases, relapse of them for 8 cases, cervical metastasis for 13 cases, pulmonary metastasis for 5 cases, hepatic metastases for 2 cases, brain metastases for 1 case, esophagus metastases for 1 case, pulmonary infection for 6 cases, acute renal failure for 2 cases, unknown reason for 19 cases, according to Kaplan-Meier to count survival rate, 3-year and 5-year survival rate were 90.7% and 84.1%, relapse and metastasis were the main causes of death.Conclusion:Surgical treatment is the main therapy mode of laryngeal carcinoma. We choose individualized surgical methods for patients according to tumor staging, invasion site, age, occupation and education background of patient, health condition and so on. On the premise that tumor is completely cut off, we always advocate function surgery and minimally invasive surgery, and adopt comprehensive treatment at the same time, in order to increase survival rates, lesson suffering and improve life quality as far as possible.

OBJECTIVE: To evaluate the efficacy and safety of vasodilators for sudden sensorineural hearing loss. METHOD: Based on the principles and methods of Cocharne Systematic Reviews, we searched the cochrane central register of controlled trials, PubMed, Embase, ISI, the China biological medicine datebase, VIP, CNKI and Wangfang database. Randomized controlled trials about using vasodilators to treat sudden sensorineural hearing loss were included. Meta-analysis was performed for the results of homogeneous studies using RevMan software. RESULT: Twenty eight randomized control trials met the inclusion criteria. Seven studies showed vasodilators was not more effective than placebo. From 14 studies comparing vasodilators with vasodilators and 9 studies comparing vasodilators with other drugs, no definite conclusion could be drawn. CONCLUSION The evidence currently available does not support the use of vasodilators in the treatment of sudden sensorineural hearing loss. Further randomized, double-blind, placebo-controlled trials are needed in order to define the efficacy and acceptability of vasodilators in the treatment of sudden sensorineural hearing loss.
Hearing Loss, Sensorineural ; drug therapy ; Hearing Loss, Sudden ; drug therapy ; Humans ; Randomized Controlled Trials as Topic ; Vasodilator Agents ; therapeutic use

Objective To investigate the effect of chaihu-shugan-san ( CSS) on the behaviors and Notch1 signal pathway in depression model rats. Methods Thirty-two SD rats with similar behavioral scores were divided into control group (CON),model group (CUMS),positive control group (FLU) and interven-tion group (CSS).The depression model was established by stimulating with chronic unpredictable mild stress (CUMS),and the behaviors evaluation was assessed by sugar water consumption and forced depression.Im-munofluorescence was used to detect the proliferation of hippocampus neurons in rats,at the same time,real- time PCR and Western blot were used to detect the mRNA and protein expression levels of each factor (Notch1,Hes1,Hes5 and Jagged1) of Notch1 signal pathway respectively. Results Compared with CON group,the percentage of sugar water preference and swimming length of rats decreased significantly in CUMS group (P＜0.05 and P＜0.01).Compared with CUMS group,the percentage of sugar water preference and swimming length of rats increased significantly in CSS group(P＜0.05).Compared with CON group,there was a significant increase in the inactivity length of rats between CUMS group,FLU group and CSS group,and the difference was statistically significant (P＜0.01).Compared with CUMS group,the swimming length of rats in CSS group was significantly reduced,and the difference was statistically significant (P＜0.01).Compared with CON group((750.00±27.51)/mm2),the number of BrdU positive cells in the substratum or granulocyte lay-er of the hippocampus dentate gyrus of rats in CUMS group ((338.75±29.61)/mm2),FLU group ((545.00 ±17.73)/mm2) and CSS group ((529.38±13.74)/mm2) was significantly reduced(P＜0.01).Compared with CUMS group ((338.75±29.61)/mm2),there was a significant increase in the number of BrdU positive cells in the substratum or granulocyte layer of the hippocampus dentate gyrus of rats in CSS group ((529.38 ±13.74)/mm2),and the difference was statistically significant (P＜0.01).Compared with CON group,the mRNA and protein expression levels of Notch1,Hes1,Hes5,and Jagged1 in the hippocampus of rats in CUMS group were significantly reduced(P＜0.05 or P＜0.01).Compared with CUMS group,the mRNA and protein ex-pression levels of Notch1,Hes1,Hes5 and Jagged1 in the hippocampus of rats in FLU group and CSS group were significantly increased,and the differences were statistically significant (P＜0.05 or P＜0.01). Conclu-sion Notch1 signal pathway may be related to the obstacle during the hippocampus nerve regenerating in the model rat under chronic unpredictable mild stress.CSS may play an anti-depressant role by regulating Notchl to improve hippocampus nerve regeneration.

ObjectiveTo explore the effect of serum containing Zhenwutang on myocardial mast cell apoptosis induced by angiotensin Ⅱ （AngⅡ） and the mechanism of the correlation between apoptosis and mitochondrial autophagy. MethodsIn this experiment， AngⅡ and serum containing Zhenwutang with different concentrations were used to interfere with H9C2 cardiomyocytes for 24 h， and the survival rate of H9C2 cardiomyocytes was detected by cell counting kit-8 （CCK-8） to screen the optimal concentration for the experiment. Enzyme-linked immunosorbent assay （ELISA） was used to detect the content of B-type natriuretic peptide （BNP） in cell culture supernatant， and immunofluorescence was used to detect the cell surface area to verify the construction of the myocardial mast cell model. Subsequently， the experiment was divided into a blank group （20% blank serum）， a model group （20% blank serum + 5×10^-5 mol·L^-1 AngⅡ）， low-， medium-， and high-dose （5%， 10% and 20%） serum containing Zhenwutang groups， an autophagy inhibitor group （1×10^-4 mol·L^-1 3-MA）， and autophagy inducer group （1×10^-7 mol·L^-1 rapamycin）. The apoptosis level of H9C2 cells and the changes of mitochondrial membrane potential were detected by flow cytometry. The lysosomal probe （Lyso Tracker） and mitochondrial probe （Mito Tracker） co-localization was employed to detect autophagy. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect Caspase-3， Caspase-9， B-cell lymphoma 2 （Bcl-2）， Bcl-2-related X protein （Bax）， and cytochrome C （Cyt C） in apoptosis-related pathways and the relative mRNA expression of ubiquitin ligase （Parkin）， phosphatase and tensin homolog （PTEN）-induced kinase 1 （PINK1）， and p62 protein in mitochondrial autophagy-related pathways. Western blot was used to detect cleaved Caspase-3， cleaved Caspase-9， Bax， Bcl-2， and Cyt C in apoptosis-related pathways， phosphorylated ubiquitin ligase （p-Parkin）， phosphorylated PTEN-induced kinase 1 （p-PINK1）， p62， and Bcl-2 homology domain protein Beclin1 in mitochondrial autophagy-related pathways， and the change of microtubule-associated protein 1 light chain 3 （LC3） Ⅱ/Ⅰ ratio. ResultsCCK-8 showed that when the concentration of AngⅡ was 5×10^-5 mol·L^-1， the cell activity was the lowest， and there was no cytotoxicity. At this concentration， the surface area of cardiomyocytes was significantly increased （P<0.01）， and the content of BNP in the supernatant of culture medium was significantly increased （P<0.05）. Therefore， AngⅡ with a concentration of 5×10^-5 mol·L^-1 was selected for the subsequent modeling of myocardial mast cells. Compared with the blank group， the model group and the autophagy inhibitor 3-MA group had a significantly increased apoptosis rate （P<0.01） and significantly decreased mitochondrial membrane potential （P<0.01）. The results of immunofluorescence co-localization showed that compared with the blank group， the model group had a significantly decreased number of red and green fluorescence spots. The results of Real-time PCR showed that compared with that in the blank group， the relative mRNA expression of Bax， Caspase-3， Caspase-9， Cyt C， and p62 in the model group was significantly up-regulated （P<0.01）， while the relative mRNA expression of Bcl-2， Parkin， and PINK1 was significantly down-regulated （P<0.01）. In addition， the relative protein expression of Bax， cleaved Caspase-3， cleaved Caspase-9， Cyt C， and p62 was significantly up-regulated （P<0.01）. The LC3Ⅱ/Ⅰ was significantly decreased， and the relative protein expression of Bcl-2， p-Parkin， p-PINK1， and Beclin1 was significantly down-regulated （P<0.01）. Compared with the model group， the serum containing Zhenwutang groups and the autophagy inducer group had significantly decreased apoptosis rate （P<0.01）， and the decrease ratio of mitochondrial membrane potential is significantly lowered （P<0.01） in a dose-dependent manner. Additionally， both red and green fluorescence spots became more in these groups. In the 3-MA group， the number of red and green fluorescence spots decreased significantly. The relative mRNA expression of Bax， Caspase-3， Caspase-9， Cyt C， and p62 was significantly down-regulated （P<0.05， P<0.01）， while that of Bcl-2， Parkin， and PINK1 was significantly up-regulated （P<0.01）. In the serum containing Zhenwutang groups， the relative protein expression levels of Bax， cleaved Caspase-3， cleaved Caspase-9， Cyt C， and p62 were significantly down-regulated （P<0.05，P<0.01）. The LC3Ⅱ/Ⅰ was significantly increased， and the relative protein expression levels of Bcl-2， p-Parkin， p-PINK1， and Beclin1 were significantly up-regulated （P<0.01）. ConclusionThe serum containing Zhenwutang can reduce the apoptosis of myocardial mast cells and increase mitochondrial autophagy. This is related to the inhibition of intracellular Bax/Bcl-2/Caspase-3 apoptosis pathway and regulation of Parkin/PINK1 mitochondrial autophagy pathway.