Improvement of liraglutide release from PLGA microspheres by a porous microsphere-gel composite system.

In the current work, we aimed to prepare a liraglutide-loaded porous microsphere-gel composite system. By employing polyethylene glycol (PEG) as a porogenic agent and poly (lactic-co-glycolic acid) copolymer (PLGA) as a carrier, the liraglutide microspheres were prepared and dispersed in a temperature-sensitive gel made of poloxamer 407 (F-127) and poloxamer 188 (F-68), which served as the gel matrix, to construct the composite system. The porous microsphere-gel composite system demonstrated prolonged and steady drug release, with a reduction to 4.7% in the initial release within 1 d, according to data from in vitro release tests. The drug release from the porous microspheres decreased from 53% to 29% during the rapid release phase as the PEG concentration increased and the release rate slowed down. In vivo experiments in rats revealed that the composite system prolonged the release period by about 10 d. The pharmacokinetic parameter AUC0-1 was decreased by 24.78 ng/ml*h, the initial burst release was decreased, and the blood drug concentration fluctuation was lessened. The construction of a porous microsphere-gel composite matrix offers a novel approach to the systems with a sustained, long-lasting release that utilizes rational design.

[The speed CT measurement of the airway in obstructive sleep apnea-hypopnea syndrome].

OBJECTIVE: To measure the upper airway of obstructive sleep apnea-hypopnea syndrome by speed CT. We can predict the airway obstruction plane with the airway plane data and compliance in OSAHS patients. Through this measurement, we can provide assistance for clinical diagnosis and treatment. METHOD: This study randomly selected 82 patients diagnosed with OSAHS and 45 cases non-snoring healthy people as control group by the PHILIPS 256-slice CT. The zone volume, sagittal diameter, coronary diameter and cross-sectional area of the narrowest plane in nasopharyngeal area, velopharyngeal area, glossopharyngeal area, hypopharynx area in two groups of quiet respiration and Müller's status were measured. RESULT: In the OSAHS group underwent quiet breathing and Müller movement during CT scanning, the two states about nasopharyngeal coronary diameter, the hypopharynx sagittal diameter and cross-sectional area showed no significant difference, while other groups showed differences between the parameters (P<0.05). There was significant difference (P<0.01) in the velopharyngeal volume, tongue sagittal diameter and volume. Under Müller movement in the OSAHS group and the control group, the hypopharynx volume showed no significant difference. The nasopharyngeal coronary diameter and volume, velopharyngeal cross-sectional area and tongue sagittal diameter were different (P<0.05). The remaining set of parameters showed significant differences (P<0.01). Compared the airway compliance (Müller phase) of the OSAHS group and the control group,the parameters of each group were different (P<0.05), of which the nasopharyngeal sagittal diameter, velopharyngeal volume showed significant difference (P<0.01). Meanwhile, in the same plane, coronary diameter was greater than sagittal diameter (P<0.05) in both the OSAHS group and the control group. The pharyngeal volume measurement was basically consistent to the fiber endoscopy. CONCLUSION: The obstruction plate of OSAHS patients is mostly in the velopharyngeal area and glossopharyngeal area measured with a high speed CT. The volume measurement of upper airway with speed CT can predict airway obstruction plate in patients with OSAHS.

[Significance expression and relationships with endothelin-1, matrix metalloproteinase-9 in the laryngeal carcinoma].

OBJECTIVE: To evaluate the expression of endothelin-1(ET-1) and matrix metalloproteinase-9 (MMP-9) in laryngeal carcinoma and their correlations with clinical features. METHOD: The expression of ET-1 and MMP-9 was detected by immunohistochemical method in 58 specimens of laryngeal carcinoma, 28 specimens of polyps of vocal cord and 19 specimens of normal laryngeal tissues. RESULT: The expressions of ET-1, MMP-9 in laryngeal carcinoma were remarkably higher,compared to polyps of vocal cord and normal laryngeal tissues (P < 0.05). The expression of ET-1, MMP-9 was associated with clinical stage, T stage and lymph node metastasis. Expression levels of ET-land MMP-9 correlated significantly with each other (r(s) = 0.693, P < 0.05). CONCLUSION: The expression of ET-1 and MMP-9 may be the vital indexes in laryngeal carcinoma.

Spontaneous otogenic pneumocephalus presenting with occipital subcutaneous emphysema as primary symptom: could tension gas cause the destruction of cranial bones?

The authors report, to the best of their knowledge, the first case of a spontaneous tension pneumocephalus with subcutaneous emphysema. Hyperpneumatization of the cranium and mechanical compression contributed jointly to the formation of a fistula, and air pressure caused a subsequent disruption of the suture and air leakage into the subcutaneous space. A minimally invasive otological procedure proved efficacious for resolution.

[Expression of transforming growth factor beta1 in human vocal fold polyps].

OBJECTIVE: To analyze the expression of transforming growth factor-beta1 (TGF-beta1) in human vocal fold polyps, and explore the pathogenesis of vocal fold polyp. METHOD: The expression of TGF-beta1 were detected in 37 examples of vocal fold polyps and 11 healthy vocal folds by immunohistochemical staining (SP method). Meanwhile, the positive results were compared. RESULT: The percent of positive expression of TGF-beta1 was 56.76% and the number of positive cells was 22.55 +/- 27.31 in vocal fold polyps, both of which were significantly increased compared with the percent of positive expression of TGF-beta1 (18.18%) and the number of positive cells (2.53 +/- 3.75) in healthy vocal folds (P<0.05). The positive expression of TGF-beta1 in stroma cells of vocal cord polyps was significantly higher than that in the healthy vocal cords. There was no significant difference of TGF-beta1 between the vocal fold polyps of male and female (P>0.05). CONCLUSION: TGF-beta1 may participate in some pathologic changes in vocal cord polyps, such as extracellular matrix accumulation, local fibrosis and formation and development of vocal cord polyps. Manipulating the TGF-beta1 expression in vocal cord polyps may supply a new treatment method.

[Study of the relationship between obstructive sleep apnea syndrome and obesity and serum resistin level].

OBJECTIVE: To investigate the serum resistin level in healthy volunteers and patients with obstructive sleep apnea syndrome (OSAHS), and study the relationship between OSAHS and obesity, serum resistin level. METHOD: All body's height, weight and calculate body mass index (BMI) were precisely measured. According to the BMI, 35 OSAHS patient were divided into two groups: One group was normal weight patients (BMI:18.5-24.9, 14 cases)and the other group was overweight patients(BMI > or =25, 21 cases). There were 40 healthy volunteers in control group. The blood pressure, fasting levels of plasma glucose (FPG), total cholesterol (TC) and triglyceride (TG), and test resistin level in plasma were detected. The apnea-hypopnea index (AHI), the average oxygen saturation and the minimum oxygen saturation in 35 OSAHS patients were examined with Polysomnography. RESULT: (1) Compared with healthy volunteers, serum resistin level, BMI, TG, systolic blood pressure (SBP) and diastolic blood pressure (DBP) in OSAHS patients were all enhanced (P < 0.05); (2) In OSAHS patients, the indexes of BMI, SBP, DBP and AHI for overweight group were notably higher than those for normal weight group (P < 0.05). (3) In OSAHS patients, BMI was positively correlated with AHI and SBP, and negatively correlated with the average oxygen saturation and the minimum oxygen saturation. (4) Serum resistin level was positively correlated with TG, FPG and DBP. Multiple stepwise regression analysis revealed that serum resistin level was associated with TG and FPG. CONCLUSION: In OSAHS patients, serum resistin level is enhanced and accompany with the disorder of blood pressure and serum lipid. Obesity or abdomen obesity may aggravate the hypoxia in OSAHS patients. Serum resistin level is positively correlated with TG, FPG and DBP. TG and FPG are important factors in serum resistin level, which indicate that the resistin is highly associated with lipid metabolism and glycometabolism, and possibly connect with diastolic blood pressure (DBP).

[Expression of vascular permeability factor in human vocal cord polyps].

OBJECTIVE: This study aimed to analyse the expression of vascular permeability factor (VPF) in human vocal fold polyps. Meanwhile, we studied the pathogenesis of vocal cord polyp further. METHOD: The expression of VPF were detected with immunohistochemical staining in the 37 cases with vocal cord polyps and 11 healthy vocal folds tissues (SP method). Meanwhile,the positive results were contrasted. RESULT: The percent of positive expression of VPF was 51.35 in vocal cord polyps. This expression tended not to be increased greatly compared with the percent of positive expression of VPF (18.18%) in healthy vocal fold (P > 0.05). But,the percent of positive vascular counts of VPF in the vocal cord polyps (56.66 +/- 25.48) %was higher than that in the healthy vocal fold tissues (37.11 +/- 29.52)% (P < 0.05). In the vocal cord polyps , there was no significant difference in the expression of VPF between the male and female( P > 0.05). CONCLUSION: The VPF may play a key role in the formation of heavy edema of vocal cord polyps. The VPF may be involved in the formation and development of vocal cord polyps . If we can control the produce of VPF in the vocal cord polyps, we may find a new way to treat it.

[Study on the relationship among the projective positions of interior laryngeal structure on thyroid ala].

OBJECTIVE: To provide anatomic basis of locations of laryngeal interior structures for laryngeal operating through lateral laryngeal approaches in clinic. METHOD: Thirty cadavers laryngeal cartilage specimens (19 male and 11 female) was collected. Using pin pierced method under direct vision to locate the projections of muscle process of arytenoids cartilage and vocal fold on thyroid ala, then to observe their relationships. RESULT: The projection of vocal fold is the line that connecting a little bit superior of the middle point of anterior commissure of thyroid cartilage and the point on the crosspoint of superior 3/4 and inferior 1/4 of the posterior edge of thyroid cartilage ala. The angle of the line and anterior commissure of thyroid cartilage is sixty-five degrees. The projection of muscle process is locating on the projective line of vocal fold. The projection of pyriform fossa is locating at the posterior superior portion of thyroid cartilage ala. CONCLUSION: The interior structures of larynx have a intact relationship of projective position on thyroid cartilage ala,which providing anatomic references for clinical surgeries relating to vocal fold through laryngeal framework.

[Roles of CD45RO, CD20 and local IgE in the pathogenesis of vocal fold polyps].

OBJECTIVE: To investigate the roles of CD45RO, CD20 and local IgE in the pathogenesis of vocal fold polyps. METHOD: Thirty cases of vocal fold polyps and ten cases of normal vocal folds were used in present study by immunohistochemical method to detect the CD45RO, CD20 and IgE cells. A mean numbers of positive cells per high power field(X 400) were counted. All data were analyzed with t-test and correl-test by SPSS10.0 software. RESULT: The number of CD45RO+ cells, CD20+ cells and local IgE cells in vocal fold polyps was significantly more than in normal vocal folds (P < 0.01). The expression of CD45RO+ cells, CD20+ cells and local IgE+ cells in vocal fold polyps was no connection relations. The expression of CD45RO+ cells, CD20+ cells and local IgE cells between male and female vocal fold polyps was no significant(P > 0.05). CONCLUSION: There were active cellular immunity and humoral immunity in vocal fold polyps. Local allergy may play a role in the pathogenesis of vocal fold polyps.