Traffic-related air pollution and allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

Exposure to traffic-related air pollutants(TRAP)has been implicated in airway allergic diseases.Recent findings include epidemiologic and mechanistic studies that shed new light on the impact of TRAP on allergic rhinitis(AR)and the biology underlying this impact.These studies have found that oxidative stress induced by TRAP could affect the axis of epithelial cell-dendritic cell-T cell towards a T-helper 2 immune response,which is the major mechanism between TRAP and AR.Further,epigenetics and microRNA might be involved in this process.Our review will summarize the most recent findings in each of these areas.

A prospective multicenter clinical trial of medical and surgical treatment for chronic rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To demonstrate the clinical outcomes of maximal medical therapy(MMT) and functional endoscopic sinus surgery+ maximal medical therapy (FESS+MMT) for moderate to severe chronic rhinosinusitis without nasal polyps (CRSsNP) in China, to provide clinical evidence for treatment recommendation.</p><p><b>METHODS</b>A prospective multicenter case control study consisting of 90 strictly selected CRSsNP patients were carried out by ENT Hospital of SUN Yet-sen university and 7 other university affiliated hospitals across China from March 2011 to October 2012. All patients were selected to MMT group or FESS+MMT group followed by 3 months treatment and 6 months follow up. Treatment efficacy evaluation indicators included improvement of visual analogue scale (VAS) score, quality of life, CT score and post-operative nasal endoscopic evaluations. SPSS16.0 software was used to analyze the data.</p><p><b>RESULTS</b>All patients enrolled complied with moderate to severe CRSsNP evaluation criteria. There were no significant differences found in the baseline data between two groups (P > 0.05). (1) At the 3 time points (pre-treatment, 3 months and 6 mongths after treatment) , VAS overall symptom score in MMT group were 6.52 ± 2.61, 2.66 ± 2.10, 2.40 ± 1.56, significant differences were found among them (t value were 2.083 and 2.295, both P < 0.05); in FESS+MMT group the values were 6.99 ± 2.70, 0.95 ± 0.84, 0.60 ± 0.81, significant differences were found among them (t value were 3.582 and 5.196, both P < 0.05); SNOT-20 score in MMT group were 38.61 ± 17.36, 18.59 ± 14.04, 18.40 ± 8.91, significant differences were found among them (t value were 2.737 and 2.657, both P < 0.05); in FESS+MMT group the values were 38.21 ± 19.61, 5.94 ± 5.01, 2.65 ± 2.31, significant differences were found among them (t value were 3.247, 3.319, both P < 0.05). (2) FESS+MMT group relative to the MMT group in VAS overall symptom score and quality of life improvements appeared earlier and were more pronounced. (3) Overall treatment efficacy showed that in MMT group: complete control 14 cases (30.4%), partially control 31 cases (67.4%), uncontrolled 1 cases (2.2%); In FESS+MMT group: complete control 17 cases (38.6%), partially control 26 cases (59.1%), uncontrolled 1 cases (2.3%). (4) Patients' satisfaction survey showed that the number of the patients who were very satisfied with the efficacy in the FESS+MMT group were 2 times higher than the MMT group.</p><p><b>CONCLUSIONS</b>(1) For moderate to severe CRSsNP, both MMT and FESS+MMT treatment can effectively control the overall symptoms and classified symptoms, reduce CT scores and significantly improve the quality of life, the ineffective rate is less than 5%. (2) FESS+MMT group in terms of improving symptoms and the onset time are better than MMT group, especially in improving the stuffy nose, head and face fullness, and mental and physical symptoms are better than MMT group. (3) FESS+MMT group showed better results in patient satisfaction survey compared to the MMT group. Therefore for moderate to severe CRSsNP patients, FESS+MMT therapy could be recommended as the preferred treatment.</p>

Clinicopathologic study of 9 patients with neuroendocrine carcinoma of the larynx / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinic manifestation, therapy and prognosis of neuroendocrine carcinoma of the larynx.</p><p><b>METHODS</b>Nine cases with neuroendocrine carcinoma of the larynx treated between May 2005 and June 2011 were analyzed retrospectively.</p><p><b>RESULTS</b>There were six males and three females, with a median age of 58 years (ranging from 35 to 65 years). Five cases were treated by only operation, and four cases by combined treatment (surgery followed by radiotherapy and chemotherapy). Two patients with typical carcinoid tumor had not any recurrence with following up of 28 and 30 months, respectively. Of three patients with atypical carcinoid tumor, one patient recurred in 36 months after the first operation and followed by re-operation, with no recurrence by further 30 month follow-up, and the other two patients did not recur 15 and 20 month follow-up, respectively. Of three patients with small cell neuroendocrine carcinoma, two died after 11 and 14 months, respectively, and another patient was followed up for 18 months, with no recurrence. One patient with paraganglioma showed no recurrence with a follow up of 32 months.</p><p><b>CONCLUSIONS</b>Neuroendocrine carcinoma in larynx included typical carcinoid tumor, atypical carcinoid tumor, small cell neuroendocrine carcinoma and paraganglioma. Accurate diagnosis relies on histopathologic and immunohistochemical examination. There is no standard treatment plan and based-surgery combined treatment should be adopted to laryngeal neuroendocrine carcinoma. The prognosis is dependent on tumor types.</p>

Treatment of allergic rhinitis with nasal mometasone furoate / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the effects of nasal mometasone furoate on moderate to severe allergic rhinitis.</p><p><b>METHODS</b>Patients with moderate to severe allergic rhinitis were enrolled and received mometasone furoate nasal spray 200 microg once daily for four weeks. Four hundreds and sixty-three patients completed the study. We weekly interviewed the patients to evaluate the symptoms, and the affection of disease on night sleep and daily life. Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life.</p><p><b>RESULTS</b>The individual and total symptomatic scores of week 1, week 2 and week 4 decreased compared with baseline. The scores of Mini-RQLQ and NRQLQ of week 1, week 2 and week 4 decreased compared with baseline too. The scores of the next visit were significantly lower than those of the previous visit (P < 0.01).</p><p><b>CONCLUSIONS</b>A four-week administration of mometasone furoate nasal spray can effectively treat allergic rhinitis.</p>

Study on interference therapy induced by epidermal growth factor receptor-antisense cDNA in signal transduction of laryngeal squamous cell carcinoma / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate effect of interference therapy induced by epidermal growth factor receptor (EGFR)-antisense cDNA in signal transduction of Hep-2 laryngeal squamous cell carcinoma in vitro.</p><p><b>METHODS</b>AdEasy Vector System was used to construct the recombinant adenovirus vector sense/antisense-pAdEasy-EGFR. The recombinant adenovirus vector introduced EGFR-sense/antisense cDNA fragment into HEK293 cell. The purified recombinant adenovirus sense/antisense-pAdEasy-EGFR transfected Hep-2 cells in vitro. The inhibition of EGFR protein expression and proliferation of Hep-2 cells, the changes of cell cycle and DNA content in Hep-2 cells were examined by MTT, Western blot analysis, flow cytometry essay, and immunocytochemistry respectively.</p><p><b>RESULTS</b>The higher titre sense and antisense mRNA expression recombinant adenovirus containing 1,032 bp EGFR-cDNA was constructed and prepared successfully. When antisense-pAdEasy-EGFR was transferred into Hep-2 cells the inhibition of cell proliferation and EGFR protein expression in Hep-2 cells were investigated effectively.</p><p><b>CONCLUSION</b>The antisense-pAdEasy-EGFR effectively interfere the Hep-2 signal transduction pathway and induce apoptosis which results in inhibiting proliferation of laryngeal squamous cell carcinoma.</p>

Microsurgical anatomy of epiglottic artery and its clinical implications / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the microsurgical anatomy of human epiglottic blood vessel to provide exact and reliable data and morphological properties for further studies of laryngeal transplantation, reconstruction and other epiglottis-related diseases.</p><p><b>METHODS</b>Thirty Chinese adult cadavers (27 males and 3 females) were examined for the present study. The cadavers were dissected under magnification along the anatomic planes from skin down to vertebral column. The anterior neck was exposed by a midline incision and extended laterally along the angle of mandible superiorly, and on clavicle inferiorly. After the visualization of laryngeal prominence of thyroid cartilage, strap muscles were resected and superior laryngeal artery and epiglottic blood vessel were exposed under an operating microscope ( original magnification 7 -30). The epiglottic artery was named for the first time.</p><p><b>RESULTS</b>The diameter of superior laryngeal artery was (1. 06+/-0. 16) mm( male: 1. 09 mm+/-0. 12 mm). The diameter of origin epiglottic artery was (0. 79+/-0. 13) mm (male: 0. 81 mm+/-0. 11 mm). The vertical distance between origin epiglottic artery and superior horn of thyroid cartilage was (27. 16+/-3. 85) mm. Epiglottic artery loop was observed in all the cadavers, which could be M-, N-, omega-, or U-shaped and mixed under the thyrohyoid membrane or in the epiglottic vallecula.</p><p><b>CONCLUSIONS</b>These findings could improve the application of epiglottis in laryngeal functional reconstruction after partial laryngectomy, as well as in the prevention of epiglottic artery loop injuries during the operation.</p>

Anatomic study of pterygopalatine fossa under endoscope / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To provide endoscopic anatomic bony structures of pterygopalatine fossa for skull base surgery.</p><p><b>METHODS</b>The bony structures of the pterygopalatine fossa were observed in ten dry skulls under endoscope.</p><p><b>RESULTS</b>The pterygopalatine fossa showed a long and narrow cleft composed of the body and pterygoid process of sphenoid bone, the lamina perpendicular of palatine bone, and the posterior wall of maxillary sinus. The pterygopalatine fossa is (21.4 +/- 0.8) mm x (5.2 +/- 0.3) mm x (3.2 +/- 0.3) mm, with seven paths communicating with nasal cavity, mouth cavity, pharynx, orbit, infratemporal fossa and middle cranial fossa. Under endoscope,the whole pterygopalatine fossa could be observed.</p><p><b>CONCLUSIONS</b>Endoscopic anatomic study of the pterygopalatine fossa is important to endoscopic endonasal skull base surgery. Under endoscope,the whole pterygopalatine fossa can be observed.</p>

Construction of recombinant adenovirus vector carrying cell cycle controlling gene-p14ARF / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The recombinant adenovirus vector carrying p14ARF gene was constructed for using in the interference therapy in signal transduction of laryngeal squamous cell carcinoma.</p><p><b>METHODS</b>The total cDNA fragment of p14ARF was cloned into the shuttle plasmid pAdTrack-CMV, with the resultant plasmid and the backbone plasmid pAdEasy-1, the homologous recombination took place in the E.Coli BJ5183 and the recombinant adenoviral plasmid was generated. The adenoviruses were packaged and amplified in the 293 cells. Then the viral titer was checked by GFP.</p><p><b>RESULTS</b>The recombinant adenovirus vector carrying p14ARF was constructed successfully. The viral titer was 2.3 x 10(9).</p><p><b>CONCLUSION</b>The recombinant adenovirus vector could introduce p14ARF gene into the laryngeal squamous cell carcinoma line or tumor tissue effectively, which would provide experimental basis for the mechanisms and further study of the interference therapy in signal transduction of laryngeal squamous cell carcinoma.</p>

Clinical analysis of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the clinical character, diagnosis and treatment of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica.</p><p><b>METHODS</b>The clinical character, diagnosis and treatment of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica of 46 cases were investigated retrospectively.</p><p><b>RESULTS</b>Lateral and bilateral neck infection cases were 38 and 8 respectively. 30 cases formed primary pyogenic infection in cervical part with pneumatosis of vomica, and 16 did from adjacent sites. Besides the characters of the acute infection, gas storage in deep cervical part abscess was notable. CT and B Ultrasonic examination provided useful informations such as sizes, shapes, capacity, extents of abscess and the relationship between the abscess and vessel or vital organ. Diagnosis puncture and germiculture were performed before and after operation. The results showed that 25 of 46 cases were infected by staphylococcus or streptococcus, and 21 cases did by other bacterium. Exploration and drainage treatments were performed. All cases were cured except 2 died.</p><p><b>CONCLUSION</b>Diagnostic puncture, CT and/or B Ultrasonic examination are essential for diagnosis and presurgical planning. Germiculture provides reliable evidence for finding pathogeny and therapy. The most possibilities of pyogenic infection with pneumatosis of vomica in cervical part are the action of aerogenic bacterium, infection both in cervical part and chest or swallowing movement of pharynx.</p>

Repair of large area of tracheal wall defects with silastic framework:an experimental study / 中华创伤杂志

Objective To explore the feasibility of artificial silastic framework(SF)in repair of large area of tracheal wall defects.Methods Twenty healthy adult dogs with tracheal defects for 2.5 cm?6.0 cm-3.0 cm?6.0cm were randomly and equally divided into experimental group(repaired with SF combined with sternohyoid fasciae)and control group(repaired with T-silastie tubule combined with sternohyoid fascial flap).After the operation,the animals were sacrificed at the 4th,8th,16th,24th, and 48th weeks respectively for harvesting the tracheae that were used for tracbeoscopically observing in- flammatory reaction of the repaired defect area and light microscopically observing epithelium healing on the repaired defect area.Results In the experiment group,the repaired trachea was smooth,without proliferation of granulation;and at the 8th week,the repaired defect area was covered with epithelial cells,with good functional recovery of respiration,phonation and deglutition.In the control group,there was obvious proliferation of granulation on the tracheal surface near anterior and posterior ends of T-silas tic tubule.The animals were under asphyxia to die with extraction of T-silastic tubule.Conclusions SF has excellent tracheal skeletal function.In the meantime,SF combined with sternohyoid fasciae is a simple but effective method for repair of large area of tracheal wall defects.