RESUMO
Objective: To analyze the subjective and objective results and the correlation of nasal obstruction because of nasal structural variation pre and post operation, and to provide clinical evidence for surgery and curative effect. Methods: Three groups were included in this study: group 1 were 78 patients with structural rhinitis, group 2 were 72 patients with chronic sinusitis (without nasal polyp) and group 3 were healthy controls of 75 cases. Assessment of nasal obstruction was achieved by visual analog scale (VAS), and objective measurement was achieved by rhinomanometry and acoustic rhinometry. The first two minimum cross-sectional area of nasal cavity (MCA1, MCA2), their distances from the nostrils (MD1, MD2) and the nasal volume of 5 cm depth from the nostril (NV5) were recorded. The ratio of the parameters of the two sides of the nasal cavity was calculated respectively. Nasal resistance total (RT) and calculated right-left nasal resistance ratio (Rlr) were recorded. Patients of group 1 and group 2 accepted endoscopic surgery and received the above evaluation again at three months after surgery. Three groups were compared with statistical test. Results: The preoperative values of three groups (MCA1, MD1, MCA2, MD2, NV5, RT) showed no statistical significance (F value was 0.945, 0.245, 1.380, 0.036, 0.866, 1.651, respectively; all P>0.05), while their ratio had statistical differences except MD1 (F value was 5.242, 1.726, 4.882, 4.005, 5.066, 5.316; P=0.013, 0.199, 0.019, 0.024, 0.018, 0.011, respectively). Statistical results between the ratio of values (MCA1, MD1, MCA2, MD2, NV5, RT) and VAS of nasal obstruction of group 1 and group 2 showed significant positive correlations pre operation(r of group 1 value was 0.471, 0.418, 0.260, 0.324, 0.305, 0.459, respectively; r of group 2 value was 0.373, 0.403, 0.288, 0.366, 0.402, 0.249, respectively; all P<0.05). VAS scores pre and post operation of group 1 had statistically difference (t=35.122, P<0.05). Postoperative value of MD1, MD2 and RT among three groups had no statistical difference (F value was 0.178, 0.582, 0.905, respectively; all P>0.05). Postoperative value of MCA1, MCA2, NV5 among three groups had statistical difference (F value was 4.010, 5.126, 4.901, respectively; all P<0.05). Postoperative ratio of MCA1, MD1, NV5 and Rlr among three groups had no statistical difference (F value was 1.023, 0.944, 0.524, 0.996, respectively; all P>0.05). Postoperative ratio of MCA2 and MD2 among three groups had statistical difference (F value was 4.859, 4.357, respectively; all P<0.05). Conclusion: Severity of nasal obstruction is related to structural variation of nasal cavity and the purpose of surgery is to restore structural symmetry of bilateral nasal cavity.
Assuntos
Obstrução Nasal/diagnóstico , Resistência das Vias Respiratórias , Estudos de Casos e Controles , Endoscopia , Feminino , Humanos , Masculino , Cavidade Nasal/patologia , Obstrução Nasal/etiologia , Obstrução Nasal/fisiopatologia , Obstrução Nasal/cirurgia , Pólipos Nasais/complicações , Nariz/patologia , Nariz/cirurgia , Período Pós-Operatório , Rinite/diagnóstico , Rinomanometria , Rinometria AcústicaRESUMO
Objective:To explore the long-term effect of rhinoplasty of nasal cavity improving nasal obstruction in patients with structural variation. Method:One hundred and six patients with structural rhinitis included this study whose assessment of nasal obstruction were achieved by visual analogue scale(VAS), and were divided into two groups: group1(n=56,VAS score >5), group 2(n=48,VAS score <5).They were measured by rhinomanometry and acoustic rhinometry recording the minimum cross-sectional area of nasal cavity(MCA), the distances from the nostrils(MD) and the nasal volume of 5 cm,2-5 cm,5-7 cm from the nostril(V5,V2-5,V5-7),then we calculated the ratio of the parameters of the two sides of the nasal cavity respectively, recorded nasal resistance and calculated Rlr. All patients were performed endoscopic rhinoplasty of nasal cavity and re-evaluated one-year later. Two groups were compared with statistical test.Result: The symptoms of twoîgroup patients improved satisfactorily after surgery. VAS scores and ratio of pre-operation of two groups had statistical differences except MD,V5-7,and group1 had more structural abnormalities compared with group 2.VAS scores and ratio of pre- and post-operation of group1 had statistically difference. Conclusion:Severity of nasal obstruction is related to structural variation of nasal cavity and the nasal plasty has certain clinical application value as its good long-term curative effects,the purpose of surgery is to restore symmetry of nasal cavity.
RESUMO
In this work, the expression conditions of fusion protein thioredoxin (Trx)-soluble B lymphocyte stimulator (sBLyS) in shake flask and bioreactor from the recombinant Escherichia coli BL21 (DE3) with a pET system encoding the fusion protein gene of Trx-sBLyS and the purification method of the sBLyS were optimized to effectively obtain the bioactive protein sBLyS with a high purity. A yield of about 250 mg Trx-sBLyS/g DWC (1686 mg Trx-sBLyS/L) and expression level of about 38.5% in soluble Trx-sBLyS were obtained in a 30 1 bioreactor after optimization of the fermentation conditions. After the completion of the optimized purification procedure in order of affinity chromatography, enzymatic cleavage with enterokinase and DEAE ion exchange chromatography, about 200 mg sBLyS per liter fermentation broth was obtained with a purity of about 95% and a yield of near 30%, respectively. Furthermore, the molecular weight (MW) and the isoelectric point (pI) of the purified sBLyS were determined by 2-D gel electrophoresis and SDS-PAGE analysis and estimated to be over 16 kDa and about pH 4.15, respectively. In addition, the bioactivities of the soluble Trx-sBLyS in fermentation broth and the purified sBLyS were tested by two kinds of analytical methods of bioactivity. The good fermentation yield and the satisfied, purified sBLyS product with high purity, yield and bioactivity demonstrated the sBLyS production procedure was promising in industry.