Development of a Serum-Free Culture Method for Endothelial Cells of the Stria Vascularis and Their Pro-Inflammatory Secretome Changes Induced by Oxidative Stress

Objectives@#. Reactive oxygen species in the stria vascularis (SV) of the cochlea may be involved in the pathogenesis of sensorineural hearing loss. However, the effects of oxidative stress on SV endothelial cells (SV-ECs) remain largely unknown, and no feasible in vitro cell culture model exists for the functional study of SV-ECs. @*Methods@#. We isolated primary SV-ECs from the SV of neonatal mice. The apoptosis-reducing effects of fibronectin in SV-ECs cultured with serum-free medium were determined using β-galactosidase staining and flow cytometry. SV-ECs incubated in serum-free medium were treated with various H2O2 concentrations to evaluate the effects of H2O2 on their viability. The secretome of SV-ECs treated with or without H2O2 (100 μM or 500 μM) was analyzed using high-resolution mass spectrometry. The function of the SV-EC secretome was evaluated by a macrophage assay. @*Results@#. We successfully isolated and characterized the SV-ECs. Treatment with H2O2 at concentrations up to 500 μM for 2 hours and further incubation with serum-free medium in plates precoated with fibronectin showed no significant effect on apoptosis. Compared to the control SV-ECs, the amount of differential proteins in the secretome of SV-ECs stimulated with 500 μM H2O2 was much higher than in those treated with 100 μM H2O2. Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analyses suggested that the proteins differentially expressed in SV-ECs treated with 500 μM H2O2 were involved in the regulation of multiple signaling pathways and cellular processes. The secretome of H2O2-stimulated SV-ECs exhibited significant pro-inflammatory effects on macrophages. @*Conclusion@#. We successfully established an in vitro serum-free culture method, identified the differential proteins released by oxidative stress-induced ECs and their functions, and revealed the pro-inflammatory effects of the secretome of H2O2-stimulated SV-ECs. Therefore, SV-ECs might elicit immunoregulatory effects on bystander cells in the microenvironment of oxidative stress-induced cochlea, especially cochlear macrophages.

Tailor-made Complex Sound Alleviates both Residual-Inhibition Positive and Negative Tinnitus Patients with Normal Hearing Audiogram / 中山大学学报(医学科学版)

[Objective] To evaluate the efficacy of sound therapy and provide a kind of treatment for tinnitus patients with normal audiogram.[Methods] From the database of the Audiometric Center of the First Affiliated Hospital,Sun Yat-sen University,we identified 46 outpatients with normal hearing thresholds in the conventional pure-tone audiometry suffering subjective tinnitus over 3 months.The clinical information were collected with respect of age,gender,tinnitus severity,pitch,laterality and duration,comorbid symptoms.All the patients received the tinnitus test,including loudness and frequency of the tinnitus and residual inhibition,Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) scores pre-and post-complex sound therapy.The complex sound were remixed with natural sounds and music materials,while the masking frequency of natural sounds is consistent with the tinnitus frequency of patients and the main frequency of music materials covers the tinnitus frequency.[Results] 32 of the 46 patients showed residual inhibition (RI) positive.The average THI score before treatment was 33.38±16.23 and the VAS score was 4.38±1.62.The THI score decreased to 21.75±11.67 and the VAS score was 2.97±1.06 after sound therapy.The rest 14 patients were residual inhibition (RI) negative.The THI score were 29.86±20.15 and 23.43±16.29 pre-and post-complex sound therapy,while the VAS score were 3.93±1.69 and 3.36±1.2.The THI and VAS scores were significantly decreased after the treatment in both RI positive and negative patients.The RI positive group showed better results than RI negative group.[Conclusions] Both RI positive and negative tinnitus with normal audiometry shown adaptation with complex sound therapy,RI positive patients acquired more benefits from tailor-made complex sound therapy.

Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors: A Randomized Controlled Trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up.</p><p><b>METHODS</b>A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method.</p><p><b>RESULTS</b>Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) (P < 0.001); total economic cost in WFU group (RMB 90 Yuan) was much lower than that in TFU group (RMB 196 Yuan). Lost-to-follow-up rate in the WFU group was 7.02% (4/57) compared with TFU group, 9.80% (5/51), while no significance was observed (95% confidence interval [CI]: 0.176-2.740; P = 0.732). The overall satisfaction rate in WFU group was 94.34% (50/53) compared with 80.43% (37/46) in TFU group (95% CI: 0.057-0.067; P = 0.034).</p><p><b>CONCLUSIONS</b>The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions.</p><p><b>TRIAL REGISTRATION</b>Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613.</p>

Numerical simulation study on effects of ambient temperature on airflow in the nasal cavity / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the aerodynamics of the normal human nasal cavity under different ambient temperatures.</p><p><b>METHODS</b>Based on CT scanning, a model of a healthy adult's nasal cavity was established using computational fluid dynamics software from Fluent. Airflow in this model was simulated and calculated at ambient temperatures of 0 °C, 24 °C, and 37 °C during periodic breathing.</p><p><b>RESULTS</b>Ambient temperature only had an impact on the temperature in the nasal cavity during the inspiratory phase, and the temperature distribution was not symmetrical in the inspiratory acceleration and deceleration phases. The ambient temperature significantly affected airflow speed in main nasal passages during the inspiratory process, but had little impact on flow status (proportion and streamline of airflow in different nasal passages). Temperature differences increased the irregular air movement within sinuses. The anterior nasal segment, including the area between the valve and the head of the middle turbinate, was the most effective part of the nasal airway in heating the ambient air.</p><p><b>CONCLUSIONS</b>Our findings describe the effects of ambient temperature on airflow parameters in the nasal cavity within a single respiratory cycle. This data is more comprehensively and accurately to determine the relationship between nasal cavity aerodynamics and physiological functions.</p>

A comparative study on numerical simulation of the normal nasal airflow during periodic breathing and steady-state breathing / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To compare the characteristics of normal nasal airflow during periodic breathing and steady-state breathing.</p><p><b>METHODS</b>Fluent software was used to simulate the nasal cavity and paranasal sinus structures following CT scanning of a normal adult subject. Air flow velocity, pressure, distribution and streamlines were calculated and compared during periodic breathing and steady-state breathing.</p><p><b>RESULTS</b>The same flux, the performance of nasal airflow on 15.600 s of periodic breathing and steady-state expiratory (entrance flow was 697.25 ml/s) were as follows: air flow in the common and middle meatus accounted for more than 50% and 30% of total nasal cavity flow during two respiratory status. Flow velocity and pressure of nasal cavity and each paranasal sinus were extremely similar. The flow trace during two respiratory status in the inferior and lower part of the common meatus were predominately straight in form.Flow were parabolic in the middle and superior meatus and the middle and upper parts of the common meatus. The flow trace of nasal airflow on 16.495 s of periodic breathing had wide areas vortex in nasopharynx and limen nasi, the average speed was 0.0706 m/s, while the entrance flow 7.62 ml/s stable state of the left nasal expiratory, the average speed was 0.0415 m/s, the flow trace was similar to 697.25 ml/s.</p><p><b>CONCLUSION</b>The same flow, except in the junction of the respiratory cycle, the performance of normal nasal airflow during periodic breathing and steady-state breathing were similar.</p>

Damage of nasal mucociliary movement after intensity-modulated radiation therapy of nasopharyngeal carcinoma / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Radiation usually results in paranasal sinusitis in patients with nasopharyngeal carcinoma (NPC), which influences patients' quality of life. This study aimed to determine the relationships between dose distribution in the nasal cavity and nasal mucous injury in patients with NPC treated by intensity-modulated radiation therapy (IMRT), and to find the tolerable radiation dose for the nasal mucous.</p><p><b>METHODS</b>Sixty-six patients with NPC treated by IMRT between October 2006 and November 2008 were enrolled. The irradiation dose in the nasal cavity was determined by the computer with the IMRT work platform. Mucociliary transport rate (MTR) was detected by modified saccharine test before IMRT, at the end of IMRT, and at 3, 6, and 12 months after IMRT.</p><p><b>RESULTS</b>The data were available for 129 nasal cavities. The cavities receiving a mean dose below or equal to 37 Gy showed substantial preservation of nasal mucous after IMRT. The MRT decreased to (62.82 ± 38.59)%, (56.78 ± 37.79)%, (64.05 ± 39.37)%, and (71.13 ± 39.55)% of pre-IMRT value at 4 time points after IMRT, with significant differences among the data (P < 0.05). In contrast, when the cavities received a mean dose higher than 37 Gy, no significant differences in MTR among the time points were observed. At 3 months after IMRT, the MTR was the lowest (38.27% of pre-RT value).</p><p><b>CONCLUSIONS</b>A mean radiation dose of ≤ 37 Gy for the nasal cavity is an optimal dose to protect the nasal cavity function.</p>

Influence of uncinate process on aerodynamic characteristics of nasal cavity and maxillary sinus / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>This study aimed to investigate the influence of uncinate process on air flow velocity, trace, distribution, air pressure, as well as the air flow exchange of nasal cavity and paranasal sinuses.</p><p><b>METHODS</b>Fluent software was used to simulate two nasal cavity and paranasal sinus structures following CT scanning, one had normal nasal cavity, the another had the nasal cavity with uncinate process removed. Air flow velocity, pressure, distribution and trace lines were calculated and compared by Navier-Stokes equation and numerically visualized between two models.</p><p><b>RESULTS</b>Air flow of two models in the common and middle meatus accounted for more than 50% and 30% of total nasal cavity flow. Flow velocity of two models were maximal in the common meatus, followed by the middle meatus. The maximal velocity existed on the left nasal district between limen nasi and head of inferior turbinate. The flow traces of two models were similar. In the normal model, the air flow velocity of the district around uncinate process was almost the same in inhale and exhale. In the model with the uncinate process removed, the air flow velocity of the district around uncinate process was faster, the air flow velocity in expiratory phase was quicker. Compared with the normal nasal cavity, there was more exchange of maxillary sinus in the model with cut uncinate process.</p><p><b>CONCLUSIONS</b>In the view of flow dynamics, the uncinate process effects the air flow velocity of the district around uncinate process and the exchange of maxillary sinus, the contribution of nasal flow is connected with the morphosis of the uncinate process.</p>

Effect of endoscopic sinus surgery on airflow of the nasal cavity and paranasal sinuses: a computational fluid dynamics study / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the airflow velocity, trace, distribution, pressure, as well as the airflow exchange between the nasal cavity and paranasal sinuses in a computer simulation of nasal cavity pre and post virtual endoscopic sinus surgery (ESS).</p><p><b>METHODS</b>Computational fluid dynamics (CFD) technique was applied to construct an anatomically and proportionally accurate three-dimensional nasal model based on a healthy adult woman's nasal CT scans. A virtual ESS intervention was performed numerically on the normal nasal model using Fluent 6.1.22 software. Navier-Stokes and continuity equations were used to calculate and compare the airflow characteristics between pre and post ESS models.</p><p><b>RESULTS</b>(1) After ESS flux in the common meatus decreased significantly. Flux in the middle meatus and the connected area of opened ethmoid sinus increased by 10% during stable inhalation and by 9% during exhalation. (2) Airflow velocity in the nasal sinus complex increased significantly after ESS. (3) After ESS airflow trace was significantly changed in the middle meatus. Wide-ranging vortices formed at the maxillary sinus, the connected area of ethmoid sinus and the sphenoid sinus. (4) Total nasal cavity resistance was decreased after ESS. (5) After ESS airflow exchange increased in the nasal sinuses, most markedly in the maxillary sinus.</p><p><b>CONCLUSIONS</b>After ESS airflow velocity, flux and trace were altered. Airflow exchange increased in each nasal sinus, especially in the maxillary sinus.</p>