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Investigation of intranasal bacteriological character and pH value in patients with chronic rhinitis treated by Budesonide aqueous nasal spray.

Wei-ping WEN ; Hui-wen ZHUANG ; Geng XU ; Jian-bo SHI ; Hong-yan JIANG ; Li-jing HU

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):917-921.

OBJECTIVETo investigate the bacteriological character and pH value in nasal cavity and observe the efficacy following 8 week treatment with Budesonide aqueous nasal spray in chronic nonallergic rhinitis.

METHODSForty-two patients with chronic nonallergic rhinitis were treated with Budesonide aqueous nasal spray (256 microg once daily intranasal) for 8 weeks. Bacteriological character was measured before and 8 weeks after treatment All the swab specimens were obtained from the inferior meatus, bacteriologic outcome was determined by general cultures. Nasal pH value was measured by using a probe sited under the inferior turbinate before and after treatment. Efficacy was evaluated by measurement of nasal symptom scores and sign scores before and 8 weeks after treatment.

RESULTSThe bacterial growth was present in 37 of 42 cases (88%) before the treatment (group 1), including 53 aerobic bacteria. The bacterial growth was present in 38 of 42 cases (90.47%) 8 weeks after treatment (group 2), including 46 aerobic bacteria. There was no significant difference in the bacterial distribution between group 1 and group 2 (chi2 = 0.416, P > 0.05). Budesonide aqueous nasal spray reduced pH value from 7.90 +/- 0.39 to 7.70 +/- 0.23 (t = 2.72, P < 0.05). All the parameters of symptoms were improved after treatment, including nasal obstruction, nasal secretions, itchy feeling of the nose, closed rhinolalia and headache.

CONCLUSIONSGlucocorticoid aqueous nasal spray could be used safely for eight weeks and does not increase the risk of aerobes and fungi infection and reduce the pH in chronic nonallergic rhinitis. It is effective in relieving symptoms of patients with chronic nonallergic rhinitis.

Administration, Intranasal ; Adult ; Aged ; Budesonide ; administration & dosage ; therapeutic use ; Chronic Disease ; Female ; Humans ; Hydrogen-Ion Concentration ; Male ; Middle Aged ; Nasal Cavity ; microbiology ; Rhinitis ; drug therapy ; microbiology ; physiopathology

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Anatomical and computed tomographic analysis of the interaction between uncinate process and agger nasi cells.

Luo ZHANG ; De-min HAN ; Wen-tong GE ; Bing ZHOU ; Jun-fang XIAN ; Zhong-yan LIU ; Kui-ji WANG ; Fei HE

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):912-916.

OBJECTIVETo investigate the anatomical interaction between uncinate process and agger nasi cell to better understand the anatomy of the frontal sinus drainage pathway by endoscopy, spiral computed tomography (CT) and sectioning.

METHODSTwenty-one skeletal skulls (forty-two sides) and one cadaver head (two sides) were studied by spiral CT together with endoscopy and collodion embedded thin sectioning at coronal plane. The sections with the thickness of 100 microm were stained with hemotoxylin and eosin.

RESULTSUnder endoscopy, a leaflet of bone to the middle turbinate, which is given off by uncinate process, forms the anterior insertion of the middle turbinate onto the lateral nasal wall. The middle portion of the uncinate process attached to the frontal process of the maxilla in all of the skeletal nasal cavities, as well as the lacrimal bone in 78.6% of the skeletal nasal cavities. On CT scans, the agger nasi cell is present in 90.5% of the skeletal nasal cavities. While the lateral wall of the agger nasi cell is formed by lacrimal bone, the medial wall of the agger nasi cell is formed by uncinate process. And the anterior wall is formed by the frontal process of the maxilla. The superior portion of the uncinate process forms the medial, posterior and top wall of the agger nasi cells. The superior portion of the uncinate extends into the frontal recess and may insert into lamina papyracea (33.3%), skull base (9.5%), middle turbinate, combination of these (57.2%).

CONCLUSIONSThe agger nasi cell is the key that unlocks the frontal recess.

Adult ; Frontal Sinus ; anatomy & histology ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Nasal Cavity ; anatomy & histology ; diagnostic imaging ; Tomography, Spiral Computed ; Turbinates ; anatomy & histology ; diagnostic imaging

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Expression of T-bet and its relation with IgE and eosinophil cationic protein in patients with allergic rhinitis.

Shen-hong QU ; Tian-ying LI ; Zhi-ying OU ; Zhi-bin LIN ; Yan-qiu CHEN ; Geng XU

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):908-911.

OBJECTIVETo investigate the expression of T-bet mRNA in peripheral blood mononuclear cells (PBMC) as well as its relations with total IgE (TIgE), eosinophil cationic protein (ECP) in serum and nasal allergic symptoms in patients with allergic rhinitis (AR).

METHODSThe allergen, TIgE and ECP in serum of patients with AR were detected by Unicap CAP system. Blood sample was taken from 8 healthy individuals and 22 patients with allergic rhinitis. PBMC was isolated by density gradient centrifugation and one part of them was cultured with 50 microg/ml mite allergen. PBMC was subjected to analysis of T-bet mRNA expression using semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR).

RESULTSThe ratio of T-bet to beta-actin mRNA levels was 0.381 +/- 0.099 in patients and 0.750 +/- 0.067 in normal individuals, the difference was significantly (P <0.01). The expression intensity of T-bet mRNA had no relation to varying severity of allergic symptoms and concentration of ECP and the correlation coefficient was 0.187 and -0.165 (all P > 0.05). However, there was an inverse correlation between expression intensity of T-bet mRNA and TIgE concentration (r = -0.525, P < 0.05). Mean mRNA level (x +/- s) of T-bet expression before and after being stimulated by allergen was 0.381 +/- 0.099 and 0.365 +/- 0.104 respectively, which indicated no significant differences (P > 0.05).

CONCLUSIONSAmong allergic patients whose allergen was mite, there was a down-regulated expression of T-bet mRNA, which had no relation to ECP concentration and allergic symptoms, but was one of important links in mechanisms of imbalance of Th1/Th2 in AR. There was no effect of specific allergen on T-bet mRNA in patients with AR T-bet was one of indirect factors that affected the level of IgE.

Adolescent ; Adult ; Case-Control Studies ; Child ; Child, Preschool ; Eosinophil Cationic Protein ; blood ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Rhinitis, Allergic, Seasonal ; blood ; T-Box Domain Proteins ; blood ; Young Adult

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Vascular cell adhesion molecule-1, eotaxin and vascular endothelial growth factor in nasal polyps after endoscopic surgery.

Hai-qing HU ; Ling-xiang LI ; Qin-nuan SUN

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):903-907.

OBJECTIVETo study the different expression of VCAM-1, eotaxin and VEGF in nasal polyp tissues and in the nasal mucosa of the operative cavity after endoscopic surgery and its significance.

METHODSParaffin sections of nasal polyps and the nasal mucosa of the operative cavity were studied with immunohistochemical technique and HE staining.

RESULTS(1) Abundant eosinophils were observed in the nasal polyps, however, it was rarely seen in the nasal mucosa of the operative cavity (t = 2.891, P <0.05). (2) The positive expression of VCAM-1 and eotaxin was in nasal polyps and nasal mucosa of operative cavity, and both of the positive area were not statistically significant (t = - 2.051, P > 0.05), but their average density of light was decreased in the nasal mucosa of the operative cavity (t = 3.670, P = 0.05). The positive glandular of eotaxin were increased after endoscopic surgery (t = -2.899, P < 0.05). (3) Expression of VEGF was similar in both groups (t = - 0.037, 0.825, P > 0.05, respectively).

CONCLUSIONS(1) It is suggested that the nasal mucosa of the operative cavity was different from the nasal polyps. (2) The positive expression of VCAM-1 and eotaxin in the nasal mucosa of the operative cavity after endoscopic surgery indicates that eotaxin may up-regulate the expression of VCAM-1 in vessel endothelium and promote adhesion and migration of eosinophils, as a result, to lead to the recurrence of nasal polyps. The glandulous expression of eotaxin may play a key role in the early stage. (3) The expression of VEGF in nasal mucosa after surgery may contribute to the growth of blood vessel and induce increasing of vascular permeability and tissue edema. This may be an important factor in the process of nasal polyp recurrence.

Adolescent ; Adult ; Aged ; Chemokine CCL11 ; metabolism ; Child ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; metabolism ; Nasal Polyps ; metabolism ; Vascular Cell Adhesion Molecule-1 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

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Expression and significance of interleukin-17 and its receptor in nasal polyps.

Xin WANG ; Zhen DONG

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):899-902.

OBJECTIVETo detect the expression and distribution of interleukin-17 and interleukin 17 receptor (IL-17R) in nasal polyps and to probe into their significance in the pathology of nasal polyps.

METHODSThe methods of immunohistochemical staining and western blot were used to detect IL-17 and IL-17R in nasal polyps and controls.

RESULTSIn nasal polyp tissues, IL-17 expressed mainly in cytoplasm of plasm cell, less in prickle-cell layer of the epithelium and the acinus of the serous gland. In turbinates, IL-17 also expressed in the cytoplasm of the plasm cell, the prickle-cell layer of the epithelium and the acinus of the serous gland. The expression of IL-17 between nasal polyps and turbinates differed significantly (t = 2.237, 2.176, 2.246, P < 0.05, respectively). Both IL-17 and IL-17R displayed specific bands in nasal polyps and turbinates, but the bands of IL-17 and IL-17R in nasal polyps were stronger than those in turbinates.

CONCLUSIONSIL-17 may have an important role in the occurrence of nasal polyps by specific combination with IL-17R and over-expression in nasal polyps.

Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Interleukin-17 ; metabolism ; Male ; Middle Aged ; Nasal Polyps ; metabolism ; pathology ; Receptors, Interleukin-17 ; metabolism

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Effect of plumbism on auditory brainstem response of children.

Wei-guo WANG ; Yi-ming WANG ; Lian-dong FENG

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):896-898.

OBJECTIVETo observe the injury of plumbism to the nerve system in children.

METHODSOne hundred children with plumbism which had no masculine body sign of nerve system were divided into two groups. Fifty of them were as controls, while others were treated by calcium. Fifty age and gender matched healthy children were selected as the normal group in order to compare with plumbism group. All of their auditory brainstem response (ABR), pure tone and distortion product otoacoustic emission (DPOAE) were examined.

RESULTSLatency period of wave V of the plumbism groups was longer than that of normal group. The difference between them was significant statistically (t =3.21, P <0.01). The interval between wave I and wave III of plumbism group was longer than that of normal group, but there was no difference between them (former: t = 2.06, P > 0.05; later: t = 1.64, P > 0.05). The interval between wave III and wave V and the interval between wave I and wave V of plumbism group was longer than that of normal group, and their difference was significant statistically (former: t = 7.30, P <0.01; later: t = 3.14, P < 0.01). The interval between wave I and wave III of plumbism group was longer than that of normal group, but there was no difference between them (t = 0.91, P > 0.05). The amplitude of wave I, wave III and wave V of plumbism group was lower than that of normal group, and their difference was significant statistically (I: t =3.20, P < 0.01; III: t=3.31, P < 0.01; V: t=3.41, P < 0.01). The auditory brainstem response, pure tone and DPOAE in all three groups had no obvious change after six months treatment (P >0.05).

CONCLUSIONSPlumbism may have potential clinical injury to nerve system. There has no obvious change of ABR after treatment by calcium. ABR may be a forepart examination to find the injury of plumbism to the nerve system.

Case-Control Studies ; Child ; Evoked Potentials, Auditory, Brain Stem ; drug effects ; Humans ; Lead Poisoning ; physiopathology

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Clinical classification and relationship with conductive deafness of congenital middle ear malformations.

Hu YUAN ; Qiu-ju WANG ; Dong-yi HAN

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):893-895.

OBJECTIVETo investigate the clinical classification and relationship with conductive deafness of congenital middle ear malformations.

METHODSFrom 1995 to 2004, 64 patients (82 ears) with single congenital middle ear malformations were operated in the ENT department of the General Hospital of Chinese People's Liberation Army. According to the histology and embryology of middle ear and the findings of surgical exploration, the clinical classification was performed. Statistical analysis was used to judge the differences of hearing loss in different type of congenital middle ear malformations.

RESULTSAccording to the embryologic development of the structures in middle ear, congenital middle ear malformations were classified 4 types. Type A: congenital ossicular chain anomalies; type B: congenital fusion of stapes; type C: congenital hypoplasia or atresia of oval/round widows. Hearing loss of three types on language frequency have no obvious difference (P = 0.1617), but there were statistical difference on high frequency ( > 2 kHz) between type A with type B and type C (P <0.05). Furthermore, descension of bone conduction and mixed deafness were familiar in type B and C.

CONCLUSIONSAccording to embryologic development, it was rational that congenital middle ear malformations were classed 3 types mentioned above. Hearing loss due to middle ear malformations could be distinguished by descension of bone conduction and air conduction on high frequency ( >2 kHz).

Adolescent ; Adult ; Child ; Child, Preschool ; Congenital Abnormalities ; classification ; diagnosis ; Ear Ossicles ; abnormalities ; Ear, Middle ; abnormalities ; Female ; Hearing Loss, Conductive ; classification ; congenital ; diagnosis ; Humans ; Male ; Retrospective Studies ; Young Adult

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Role of titanium mesh coated with silk fibroin in rabbit tracheal reconstruction.

Yu-su NI ; Xia ZHAO ; Liang ZHOU ; Wen-hong YAN ; Zheng-zhong SHAO ; Xin CHEN ; Zheng-bing CAO

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):887-892.

OBJECTIVETo Compare the curative effects between titanium mesh coated with or without silk fibroin and in the treatment of larger trachea circumferential defects. To explore the merits of titanium mesh coated with silk fibroin in promoting mucous healing and decreasing related complications.

METHODSTwenty-five New Zealand white rabbits were chosen , divided randomly as follows: group one: titanium mesh coated with silk fibroin (n = 12), group two: pure titanium mesh without silk fibroin (n = 12); Titanium mesh coated with silk fibroin and those titanium without silk fibroin were embedded in the anterior of 7-12th tracheal rings respectively, in 2 weeks we removed the anterior and lateral wall of 7-12th tracheal rings about 8 mm x 6mm (more than half ring) and used the two different materials to reconstruct tracheal defects. All these rabbits were euthanized in 4, 8 and 12 weeks and tracheal CT scan, tracheal endoscopy, histopathological examination and scanning electron microscopic examinations were performed. All complications such as death, local inflammation, tracheal stenosis were documented. Group three, leave one normal rabbit as controlled study , removed the anterior and lateral wall of 7-12th tracheal rings, and histopathological examination, scanning electron microscopy were performed as controlled study.

RESULTSThe CT scan, tracheal endoscopy of those with silk fibroin showed there was no apparent tracheal stenosis. Histopathological examination showed there was no obvious granulation tissue and scar. The mucous membrane and cilia grow normally. The silk fibroin was not entirely absorbed and the remains showed good biocompatibility. The scanning electron microscopy showed that the cilia grew better and more orderly than that of group two, and in 12 weeks, the cilia became normal. In group two, there were 5 rabbits died in succession from suffocation in 4, 5, 7, 17, 60 days after surgery. All rabbits had local or general subcutaneous emphysema. The CT scan, tracheal endoscopy and pathological examination showed that there were apparent granulation tissue, scar hypertrophy, and tracheal stenosis. The mortality of group two (41.7%) for suffocation compare to that of group one (0), the incidence rate of subcutaneous emphysema in group two (100%) to that of group one (25.0%) and the average cross section stenosis area in group two (18.15 +/- 7.85) mm2 to that of group one (3.15 +/- 1.58) mm2, there are significant statistically differences in these postoperative complications (P <0.05) and stenosis degree (P <0.05) between the two groups. In addition, there was one rabbit died of diarrhea in each group except group three.

CONCLUSIONSSilk fibroin and titanium mesh coated with silk fibroin showed good biocompatibility. Titanium mesh coated with silk fibroin used in tracheal reconstruction of rabbits can promote agglutination of mucous membrane and decrease postoperative complications, such as subcutaneous emphysema, tracheostenosis. It may be a prospective biomaterial which can be used in clinical circumferential trachea defect reconstruction.

Animals ; Biocompatible Materials ; Fibroins ; chemistry ; Male ; Rabbits ; Reconstructive Surgical Procedures ; methods ; Surgical Mesh ; Titanium ; chemistry ; Trachea ; surgery ; Tracheal Stenosis ; surgery ; Wound Healing

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Adeno-associated virus-mediated gene transfer of endostatin for inhibiting growth and metastasis of human nasopharyngeal carcinoma in nude mice.

Xiao-hua LI ; Ying PENG ; Xiang-ping LI ; Xiong LIU ; Gang LI

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2005;40(12):881-886.

OBJECTIVETo investigate the inhibitory effect on growth and metastasis of human nasopharyngeal carcinoma in nude mice by adeno-associated virus-mediated gene transfer of human endostatin.

METHODSThe infectious efficiency of recombinant adeno-associated virus (rAAV) in vitro was detected. The endostatin expressed in human umbilical vein endothelial cell ECV304 was detected by immunofluorescence staining. MTT was used to assay inhibitory effect of the infecting supernatant of recombinant adeno-associated viral vectors carrying human endostatin gene (rAAV-hEndo)on ECV304 cell. Heterotopic implantation model of human nasopharyngeal carcinoma cell C666-1 in nude mice was established. rAAV-hEndo or rAAV-EGFP or PBS were injected into the tail vein of tumor bearing mice. Three weeks after implantation, the volumes of tumor, inhibition rate, the percentage of lung metastases, microvessel density (MVD) and apoptotic index (AI) were evaluated respectively.

RESULTSThe infectious efficiency of rAAV was 98% in vitro. Immunofluorescence staining showed the humam endostatin protein was expressed mainly in cytoplasm. ECV304 cell proliferation was obviously inhibited by the infecting supernatant of rAAV-hEndo. The inhibitory rate was 67.3% when the supernatant was used 72 h later. Compared with PBS group, the restrained percentage of tumor in hEndo group was 70.7%. The percentage of lung metastases in hEndo group, EGFP group and PBS group was 0.0%, 50.0% and 66.7% respectively. The average MVD of hEndo group (3.67 +/- 1.63) was significantly lower than that of EGFP group (19.67 +/- 2.16) and PBS group (22.50 +/- 3.02) (P < 0.01). The apoptotic index increased significantly in hEndo group(28.83 +/- 5.27)% versus EGFP group (6.17 +/- 2.79)% and PBS group (4.50 +/- 2.17)% (P < 0.01). The survival time of tumor bearing mice in hEndo group (36.50 +/- 8.46) d was significantly longer than EGFP group (24.00 +/- 5.66) d and PBS group (21.17 +/- 3.92) d (P < 0.01).

CONCLUSIONSThe gene transfer of human endostatin mediated by adeno-associate virus can inhibit the growth and metastasis of human nasopharyngeal carcinoma in nude mice effectively. The mechanism may be due to the effect of antiangiogensis and inducement of tumor cell apoptosis.

Animals ; Cell Line, Tumor ; Dependovirus ; genetics ; Endostatins ; genetics ; pharmacology ; Genetic Therapy ; Genetic Vectors ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Nasopharyngeal Neoplasms ; genetics ; pathology ; Neoplasm Transplantation

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TNM of laryngeal cancer and partial laryngectomy.

Wei SHEN ; Jing ZHU ; Shi-jun QIAN

Chinese Journal of Otorhinolaryngology Head and Neck Surgery.2006;41(5):390-391.

Contraindications ; Humans ; Laryngeal Neoplasms ; classification ; pathology ; surgery ; Laryngectomy ; methods ; Neoplasm Staging

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