[Clinical analysis of endoscopic sinus surgery on patients with chronic sinusitis with nasal polyps complicated and asthma].

OBJECTIVE: To investigate the efficacy of the treatment of endoscopic sinus surgery on patients dignosed as chronic sinusitis with nasal polyps(CRSwNP) complicated and asthma. METHOD: Data of 45 patients with CRSwNP complicated asthma were analyzed retrospectively. RESULT: All cases were followed up for a period of 1 to 3 years after operation. In the 45 cases treated with ESS, 32 cases were cured, 9 cases were improved and 4 cases were inefficient by the treatment. The cure rate was 91.1% (41/45). The asthma symptoms were improved in 16 patients compared to 4 before the surgery. CONCLUSION: With ESS based on combined therapy,it can significantly improve the condition of CRSwNP, asthma symptoms and pulmonary function. Meanwhile, sufficient perioperative period preparation should be made to ensure the safety of the operation.

[Clinical analysis of revision endoscopic sinus surgery for recurrent chronic rhinosinusitis].

OBJECTIVE: To investigate the therapeutic effect of revision endoscopic sinus surgery for recurrent chronic rhinosinusitis. METHOD: Clinical data of 45 cases of recurrent rhinosinusitis treated in our hospital were retrospectively analyzed. Revision endoscopic sinus surgery was performed in all the patients. RESULT: All the patients were followed up for a period of 1 to 2 years after operation. No serious complication occured. The cure rate was 75.6% (34 cases), 8 cases (17.8%) improved, while other 3 cases (6.6%) were of no effect. CONCLUSION: Recurrent rhinosinusitis is closely related with medical treatment before the surgery, adhesion in nasal cavity after the surgery, deviation of nasal septum, treatment of superior turbine and inferior turbine and regular medicament management after the surgery. Revision endoscopic sinus surgery is an effective method for recurrent recurrent rhinosinusitis. The efficacy of revision endoscopic sinus surgery can be greatly improved by reasonable perioperative management, skilled operation and regular follow-up postoperatively.

[Clinical analysis of imflammatory myofibroblastic tumor of the nasal cavity and paranasal sinus].

OBJECTIVE: To investigate the clinical features, therapeutic methods and therapeutic efficacy of imflammatory myofibroblastic tumor(IMT)of the nasal cavity and paranasal sinuses. METHOD: Clinical data of 14 cases diagnosed as IMT by pathology were retrospectively analyzed. There were 8 males and 6 females,age ranging from 18 to 77 years. 12 cases of them were treated by surgery while 2 cases received postoperative radiotherapy. RESULT: All cases were operated. All the patients were followed up for a period of 1 to 7 years after operation and two cases were proved low grade IMT pathologically. Eight cases survived with no recurrence until the last follow-up and 6 cases relapsed, of which 4 cases died and 2 were alive with tumor. CONCLUSION: IMT of the nasal cavity and paranasal sinuses is very rare. The diagonosis of IMT is based on pathology and immunohistochemistry. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures. Radical excision is still the first choice of treatment for IMT of the nasal cavity and paranasal sinuses. Chemotherapy and radiotherapy may not be helpful to prevent recurrence after operation. Due to high recurrence rate, long-term follow up is necessary after operation.

[Clinopahological analysis of sinonasal mucosal malignant melanoma].

OBJECTIVE: To investigate the clinopathological characteristics, differential diagnosis, therapy and prognosis of sinonasal mucosal malignant melanoma. METHOD: Clinopathological data of 18 cases which were diagnosed by pathology and immmunohistochemistry were analyzed retrospectively. All cases were proved by pathology and immmunohistochemistry. All cases were performed operations. 5 underwent single surgery. 4 underwent surgery plus adjuvant radiotherapy. 4 underwent surgery plus adjuvant radiotherapy chemotherapy. 5 underwent surgery plus adjuvant chemoradiation. RESULT: All cases were followed up for a period of 1 to 7 years after operation. Twelve patients died of tumor until the last follow-up, meanwhile 6 patients stayed alive. In Six cases recurrence occurred. In five casescervical lymph node metastasis occurred, of which 3 cases received neck dissection and 2 cases received chemotherapy and radiotherapy due to no surgical indications. In three cases distant metastasis oc- curred. CONCLUSION: Sinonasal mucosal malignant melanoma is rare and highly heterogenous. Current diagnosis depends on clinical characteristics and immunohistochemical examination. It still should be differentially diagnosed from other tumors. CT and MRI image examination can provide some helpful information to understand the extent and nature of lesions. The treatment of nasal endoscopic or the surgery under endoscopy has become to be a safe, viable and reasonable alternative to open resection. Appropriate indication must be carefully selected for these lesions.

[Endoscopic resection of benign fibro-osseous lesions of naso-sinuses with different surgical choice].

OBJECTIVE: To explore and discuss the characteristics of benign fibro-osseous lesion of naso-sinuses and the features and indications of different surgical choice with endoscope. METHOD: Fourteen patients with benign fibro-osseous lesion of naso-sinuses were treated through endoscopic surgery, of which 9 cases underwent endonasal endoscopic surgery simply, 2 cases were operated with a superciliary arch incision through endoscope, 1 case underwent endoscopic caldwell-luc' surgery, 1 case was operated with endoscopic surgery through frontal recess of tears, and 1 case was operated with Draf II surgery under endoscope. RESULT: In all of patients, 2 cases relapsed, 2 cases had residual lesions, 4 cases had complications including numbness and scar of incision, no relapse and no complications in other 6 cases. CONCLUSION: Endoscopic resection of benign fibro-osseous lesion of naso-sinuses with different surgical choice was of special advantages, but the exactly indications, relapse rate and complications should be observed and reckoned deeply.

PI3K-like kinases restrain Pim gene expression in endothelial cells.

Pim kinases contribute to tumor formation and development of lymphoma, which shows enhanced DNA replication, DNA recombination and repair. Endothelial cells^(ECs) express all the three members of Pim kinase gene family. We hypothesized that DNA repair gene would regulate Pim expression in ECs. Human umbilical vein endothelial cells (HUVECs) were isolated and maintained in M199 culture medium. The cellular distribution of Pim-3 in ECs was determined by immunofluorescent staining. The siRNA fragments were synthesized and transfected by using Lipofectamine LTX. The total cellular RNA was extracted from the cells by using Trizol reagent. cDNAs were quantified by semi-quantity PCR. The effects of LY294002 and wortmannin on RNA stability in ECs were also examined. Our data showed that LY294002 and wortmannin, phosphatidylinositol 3-kinase (PI3K) and PI3K-like kinase inhibitors, increased Pim mRNA expression in ECs without altering the mRNA stability. RNA interference (RNAi) targeting DNA-dependent protein kinase catalytic subunit (DNA-PKcs) and ataxia telangiectasia mutated (ATM) increased mRNA expression of Pim-3 and Pim-1, respectively. Silencing of Akt decreased Pim-1 instead of Pm-2 and Pim-3 gene expression in ECs. But etoposide, a nucleoside analogue, which could activate DNA-PKcs and ATM, increased Pim expression in ECs. Our study indicates that the expression of Pim kinases is physiologically related to DNA-PKcs and ATM in ECs.

Ischemia-reperfusion injury up-regulates Pim-3 gene expression in myocardial tissue.

This study examined the effect of ischemia-reperfusion injury on the expression of Pim-3 gene in myocardial tissues and their underlying mechanism. Rat models of myocardial ischemia-reperfusion injury were established by ligating the left anterior descending coronary artery of the rats. A total of 30 SD male adult rats were randomly divided into 5 groups: group A (sham operation, n=6); group B (in which the rats were subjected to 15 min of ischemia by ligation of the left anterior descending coronary artery, n=6); group C (in which the rats received 30 min of ischemia, n=6), group D and group E (in which the left anterior descending coronary artery of the rats were ligated for 30 min and then reperfused for 30 min or 120 min, n=6 in each). The left ventricular tissues were removed immediately after the ischemia-reperfusion injury. Neonatal cardiomyocytes were cultured and treated with different concentrations of H(2)O(2) (0, 5, 10, 20 µmol/L) or tumor necrosis factor-α (TNF-α, 0, 1, 5, 10 ng/mL). The mRNA and protein expression of Pim-3 gene was determined by using RT-PCR, western blotting and immunohistochemistry. Additionally, neonatal cardiomyocytes were transfected with Pim-3 siRNA, and induced to develop apoptosis by using H(2)O(2). The results showed that normal myocardial tissues expressed a quantity of Pim-3 gene mRNA and protein. Ischemia-reperfusion injury could up-regulate the mRNA and protein expression of Pim-3 gene in myocardial tissues. Furthermore, H(2)O(2) but not TNF-α up-regulated the Pim-3 gene expression in cultured cardiomyocytes. And Pim-3 silencing failed to strengthen the H(2)O(2)-inducing apoptosis in cardiomyocytes. It was concluded that ischemia-reperfusion injury up-regulated the Pim-3 gene expression through oxidative stress signaling pathway in myocardial tissues.