One case of intracardiac ectopic thyroid / 中华内分泌外科杂志

Ectopic thyroid gland is a kind of congential deformity which occurs during thyroid embryo development. Combined with this case, our study introduced the diagnosis, treatment process and the postoperative outcome of "intracardiac ectopic thyroid" in the case, discussed the causes of this kind of disease from the perspective of tissue and embryo, and summarized the basic characteristics of this disease. Through the research and analysis of our study, we come to the conclusion and wish to offer some suggestions: although this disease is relatively rare, it should also be paid attention to to avoid misdiagnosis and mistreatment if encountered middle-age female patients with the intracardiac mass located in the right ventricle outflow tract.

One case of intracardiac ectopic thyroid / 中华内分泌外科杂志

Ectopic thyroid gland is a kind of congential deformity which occurs during thyroid embryo de-velopment. Combined with this case, our study introduced the diagnosis, treatment process and the postoperative outcome of "intracardiac ectopic thyroid" in the case, discussed the causes of this kind of disease from the per-spective of tissue and embryo, and summarized the basic characteristics of this disease. Through the research and analysis of our study, we come to the conclusion and wish to offer some suggestions: although this disease is rela-tively rare, it should also be paid attention to to avoid misdiagnosis and mistreatment if encountered middle-age female patients with the intracardiac mass located in the right ventricle outflow tract.

Study on expression of Smad1 in gastric adenocarcinoma and its effect on migration ability of gastric cancer cells / 中国免疫学杂志

Objective:To investigate the expression of Smad1 in gastric carcinoma and the influence on the migration ability of gastric cancer cells.Methods:Collected the protein from the gastric cancer tissues and corresponding adjacent tissues,the expression level of Smad1 was detected by Western blot.In HGC-27 gastric cancer cells as the research object,the carrier cells transfected with overexpression of Smad1 (p-EGFP-C1/Smad1) and Smad1 small interfering RNA (Smad1 siRNA),while transfection of p-EGFP-C1 and siRNA control as control.MTT to detect cell proliferation.Cell migration ability was detected with cell scratch test.The expression levels of MMP-9,MMP-2,p-Akt and Akt in ceils were detected by Western blot.Akt signal pathway inhibitor LY294002 (20 μg/ml) in gastric adenocarcinoma ceils,MTT for cell proliferation,cell scratch assay for cell migratior.The expression levels of MMP-9,MMP-2,p-Akt,Akt were detected by Western blot.Results:Smadl in gastric carcinoma was significantly lower than the adjacent tissues (P＜ 0.01).The cell survival rate and migration rate of p-EGFP-C1/Smad1 group were significantly lower than that of p-EGFP-C1 group (P＜0.01).The cell survival rate and migration rate of Smad1 siRNA group were significantly higher than those in the siRNA control group (P＜0.01).The expression levels of Akt protein in P-EGFP-C1,p-EGFP-C1/Smad1,Smad1 siRNA,siRNA control cells did not change.The expression levels of MMP-9,MMP-2 and p-Akt in p-EGFP-C1/Smad1 group were significantly lower than that in p-EGFP-C1 group (P＜0.01).The expression levels of MMP-9,MMP-2 and p-Akt in Smad1 siRNA group were significantly higher than that in control siRNA (P＜0.01).The cell proliferation and migration trends in gastric cancer cells effected by Akt signaling pathway inhibitor consistent with the p-EGFP-C1/Smadl group.Conclusion:Low expression of Smad1 in gastric cancer tissue.Smad1 can inhibit the proliferation and migration of gastric cancer cells,the mechanism of action is related to the Akt signaling pathway.

Diffusion-weighted imaging combined with dynamic contrast-enhanced MRI in parotid gland tumors / 中国医学影像技术

Objective To explore the value of DWI combined with dynamic contrast-enhanced MR imaging (DCE MRI) in differential diagnosis of benign and malignant parotid gland tumors.Methods DWI and DCE-MRI was performed in 90 patients with parotid gland tumors (94 lesions),included 75 benign tumors and 19 malignant tumors.The ADCs were measured,and the type of time-intensity curve (TIC) was assessed.ROC curve was used to analyze the diagnostic efficacy of ADC values,TIC types and combination of the two methods in diagnosing benign and malignant tumors.Results The ADC values of malignant tumors ([1.02 ± 0.25] × 10a mm2/s) were significantly smaller than that of benign tumors ([1.38±0.44] × 10-3 mm2/s;t=5.170,P＜0.001).The sensitivity was 0.62 and specificity was 0.92,when type A (persistent),B (washout),and D (flat) tumors regarded as benign and type C (plateau) tumors regarded as malignant.Sensitivity and specificity were significantly improved in diagnosis of malignant tumors when combined type C and ADC＜1.36× 10-3mm2/s,which were 0.92 and 0.95,respectively.Conclusion Due to an overlap within benign and malignant parotid tumors,the diagnosis should not be addressed on the basis of ADC values alone.The TIC manifestations type A,B or D on DCE-MRI indicates benign parotid tumors,and type C indicates malignant diseases.When the TIC shows type C,combining ADC value can elevate the differential diagnostic efficacy of benign and malignant parotid tumors.

Viral infection and ear diseases / 临床耳鼻咽喉头颈外科杂志

The association of viral infection to ear disease has triggered a great deal of interests. In the present paper, we provide a critical review of the viral hypothesis of ear diseases. Detection of viral antigen and antibody or RNA and DNA in the patients serum, endolymphatic fluid or surgical pathology specimens reveals that virus may have relevance to certain kinds of ear diseases, such as Meniere's disease, idiopathic sudden sensorineural hearing loss, otosclerosis. Bell's palsy and otitis media. The most appealing is the herpesvirus, which can cause latent infection in the neurons, and its reactivation may be the mechanism of recurrent attacks of ear diseases. Currently, antiviral drug treatment plus supportive therapy are the most effective managements dealing with viral infection. Although antiviral vaccine will become a promising preventive strategy in the future.

Intranasal immunization with chitosan-DNA nanoparticles expressing pneumococcal polyamine transport protein D(PotD) protects mice against Streptococcus pneumoniae nasopharyngeal colonization / 中华微生物学和免疫学杂志

Objective To prepare the chitosan-potD nanoparticles and to evaluate its protective efficacy against pneumococcal nasopharyngeal colonization. Methods potD gene was amplificated from pneumococcal genome and was inserted into pVAX1 expression vectors to construct pVAX1-potD recombinant plasmid which was then transfected into 293T cell using LipofectAMINE 2000 to analyze transient potD gene expression in vitro by RT-PCR and Western blot. Chitosan-potD nanoparticles were freshly prepared by coacervation methods at each time and the characterizations of the nanoparticles were then evaluated. BALB/c mice were immunized with chitosan-potD, naked potD DNA or pVAX1 for 4 times at two-week intervals. Anti-PotD IgG, IgG1 and IgG2a levels in serum and IgA levels in nasal washes, bronchoalveolar lavage fluids (BALF) and middle ear lavages(MEL) were detected by indirect enzyme-linked immunosorbent assay (ELISA). IL-17A, IL-4 and IFN-γ levels in splenocytes were determined by double sandwich ELISA. Mice were intrannsally challenged with Streptococcus pneumoniae ATCC6303, and Pneumococci were recovered from the nasopharyngeal niche at the fifth day after challenge. Results potD gene was successfully amplificated by PCR and the sequence was confimed to be consistent with that in the Genbank. The pVAX1-potD recombinant plasmid was successfully constructed and was expressed in eukaryocytes in vitro. The mean size and zeta potential of chitosan-potD nanoparticles was 430 nm and + 20.5 mv, respectively. Chitosan-potD nanoparticles were not digested by DNase Ⅰ , while naked potD DNA was completely digested. The levels of antibodies inculding IgG, IgG1, IgG2a, IgA and cytokines including IL-17A, IL-4 and IFN-γ were significantly higher in mice immunized with chitosan-potD nanoparticles than mice with naked potD or pVAX1 ( P <0.05) only. More importantly, much less Pneumococci were recovered from mice immunized with chitosan-potD nanoparticles than the other groups(P <0.05). Conclusion Chitosan-potD nanoparticles significantly enhanced the immunogenicity and protection efficacy of DNA vaccines by intranasal immunization and could be used as a potential mucosal vaccine to prevent pneumococcal infection.

The study on the immunogenicity of Streptococcus pneumoniae pneumolysin DNA vaccine in Rhesus macaques / 中华微生物学和免疫学杂志

Objective To study the immunogenicity of Streptococcus pneumoniae pneumolysin DNA vaccine in Rhesus macaques. Methods The deletion of the gene sequence encoding for the 11 amino acids at the carboxyl terminal of pneumolysin (PN) from its wild type gene (pn) by PCR resulted in a mu-tant pneumolysin gene (pnd). The wild type pn gene encoding PN and the mutant gene (pnd) encoding PND were cloned into pVAX1 vector respectively and then tested as Ppn and Ppnd DNA vaccines. The PN and PND proteins were purified from recombinant E. coli. Rhesus macaques were immunized by intramuscu-larly (i.m.) injection of Ppn or Ppnd DNA vaccine with electroporation (EP). Results Because of the deletion of the gene sequence encoding for the eleven amino acids at the carboxyl terminal of the PN from pn gene, the recombinant PND antigen lost its hemolytic activity while its antigenicity was remained. The spe-cific humoral immunity against pneumolysin was induced by injecting monkey with 500 μg DNA followed by EP. Boosting the Ppn or Ppnd DNA/EP primed animals with corresponding recombinant protein, PN or PND, evoked strong immune response at about 4 fold increase in the antibody titer. Conclusion Specific antibody responses were induced in the monkeys by DNA vaccination and electroporation. The immunogenic-ity of the DNA vaccines were significantly enhanced when PN or PND protein boost was applied 10 d after third DNA vaccination.

Impedance between modiolus and different walls of scala tympani / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the impedance between the modiolus and the inner wall of scala tympani with that between the modiolus and the outer wall of scala tympani.@*METHOD@#The impedances between the modiolus and the inner wall of scala tympani and the impedance between the modiolus and the outer wall of scala tympani were measured, calculated and compared under different stimulating rates 0.1, 1.0, 10.0 kHz.@*RESULT@#The impedance between the modiolus and the inner wall of scala tympani is less than that between the modiolus and the outer wall of scala tympani (P < 0.05).@*CONCLUSION@#To effectively stimulate the residual neurons in the spiral ganglion, the electrodes should be kept close to the inner wall of scale tympani.

The effects of small dose of intratympanic gentamicin injection on intractable Meniere's disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the efficacy of small dose of intratympanic gentamicin injection on intractable Meniere's disease.@*METHOD@#Retrospectively study the efficacy of gentamicin intratympanic injection on intractable Meniere's disease. The end-point of treatment was determined based on bedside tests (Spontaneous Nystagmus test, Head shaking test and Head Thrust test), hearing tests, or the improvement of patients symptoms.@*RESULT@#Nineteen patients with Meniere's disease were treated with intratympanic gentamicin injection. Vertigo control was achieved in 17 patients (89%). Of them, vertigo of 5 patients was successfully controlled after single injection. Eight patients need double injections and 4 patients need the third injections to control the vertigo. Endolymphatic sac shunt was performed to 1 patient because he could not tolerate the fullness of ear due to injection. The remainder 2 patients with double injections showed no improvement of vertigo and rejected further treatment. Hearing was improved in two patients after gentamicin injection. Three patients complained of hearing loss after intratympanic gentamicin injection. The hearing of the other patients did not change.@*CONCLUSION@#Three weeks after using small dose of gentamicin intratympanic injection to treat intractable Meniere's disease, it was determined whether more injections is required. The results showed that by using this approach, the vertigo could be effectively controlled and the risk of hearing loss following intratympanic gentamicin injection could be reduced.

Malleostapedotomy in stapes surgery for otosclerosis with malleus/incus mobility disorder / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the feasibility, safety and effectiveness of malleostapedotomy based on malleus-oval window technique in otosclerosis with malleus/incus mobility disorder.@*METHOD@#Six cases with malleostapedotomy on stapes footplate fixation accompanied by malleus/incus movements disorder from March 2005 to March 2007 were analyzed retrospectively, when totally 78 cases of conventional stapes surgeries were performed on isolated otosclerosis . The surgical procedures, intraoperative findings and postoperative vertigo as well as pure tone gain were discussed.@*RESULT@#All of the 6 cases showed stapes footplate fixation. Both abnormal incudomalleolar joint and incudostapedial joint were found in 2 cases. It was suspected that previous inflammation resulted in yellowish mucosa, ossicular malformation and stiffness. The third one showed local tympanosclerosis in the attic. In another 2 cases, idiopathic malleus head fixation related to the anterior and superior mallear ligament abnormal were presented while a surgical incudomalleolar joint dislocation prior to the observation happened in the last one. Among these 6 cases, there was no 4.0 Hz notch and postoperative vertigo which needs a further care. Postoperative air-bone gap on 0.5 kHz, 1.0 kHz, 2.0 kHz, 4.0 kHz averaged less than 10 dB. All the patients had been followed up for 3 months.@*CONCLUSION@#Malleostapedotomy based on malleus-oval window technique is a safe and effective procedure available for otosclerosis with malleus/incus movement disorder from different origins.

Cloning of the pneumolysin gene / 中国耳鼻咽喉头颈外科

OBJECTIVE To prepare pneumolysin(Pn)by genetic engineering and thereby establish the basis for the study of vaccines against otitis media. METHODS A pair of primers including two restriction sites was designed based on the pneumolysin gene sequence reported by Walker in 1987. The pneumolysin gene was PCR-amplified from pneumococcal DNA. The resulting fragment, digested by restriction enzymes, was ligated into the vector PET-28a and then transformed into host cell E.coli JM109(DE3). RESULTS The sequence of the inserted pneumolysin gene was confirmed by DNA sequencing. CONCLUSION The pneumolysin gene was successfully cloned into the host cell.

Responsibility of auditory event-related potential in rats / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore whether auditory event-related potential (AERP)exists in rat and what its features are,and to set up a set of AERP recording technique. METHODS Ten normal juvenile and 10 adult rats were served as subjects. Each rat was anesthetized and recorded AERP with passive mode. The responsibility of AERPs between juvenile and adult rats was compared. Also,the responsibility of AERP between rats and normal humans was compared. RESULTS AERPs could be evoked with passive recording mode in rats. Although the latencies and amplitudes of juvenile rats were respectively shorter and lower than thoses of adult rats,there were no significance in statistics. The AERP waveform of rats was similar to that of humans essentially. However,compared to the humans,the responsibility and stability of AERP in rats were less satisfied. CONCLUSION A similar AERP exists in rat and human. AERP has a process of development,differentiation and maturation,which may accomplish in early age in rat. Rat can serve as the candidate animal for AERP research.

The Changes of Peripheric Auditory Activity Induced the Expression of Synaptic NMDA Receptors in Auditory cortex in Vivo / 听力学及言语疾病杂志

Objective To study the changes of N-methyl-D-aspartate receptors(NMDARs) expression at local sy-(napses) in auditory cortices after ototoxic deafened and following electrical intracochear stimulation(EIS).Methods We prepared highly purified synaptosomes from primary auditory cortex by two discontinuous gradient centrifugations, and compared the differences of NMDA receptors expression in ototoxic deafened group control group, normal control group and different experimental groups (EIS from 0.5h to 2h ) by Western blotting.Results We found that EIS for as little as half and one hour the adult and developmental rats of auditory deprivation can induce a significant increase in NMDAR subunit2A (NR2A) protein. But the changes of NMDAR subunit1(NR1) and NMDAR subunit2B(NR2B) are not significant.Conclusion There is a rapid activity-dependent expression of synaptic NR2A receptors in primary auditory cortex in vivo.

The Imaging Feature of Merkel Cell Carcinoma and Its Pathologic Basis / 中国医师杂志

Objective To explore the imaging diagnostic method of Merkel cell carcinoma(MCC). Methods Imaging and pathologic features of MCC of 1 female and 44 years old patient were determinded by CT, MRI, pathologic examination and operative observation. Results MCC is a rare subepidermal carcinoma, and most located in the head, neck region and extrimities. Clinically, only a presumptive diagnosis of MCC can be established. The definite diagnosis of MCC can be made only by pathologic examination, especially immunohistological method. MCC is red and brown, and looks like rotten meat. MCC texture is middle with rich blood supply. MCC can invade occipital bone, occipital muscles, dura and cerebellar tissues. Optical microscope observation showed that MCC is located at dermis, and sometimes at subcutaneous tissues. MCC cells are gathered in groups, their sizes are unanimous, and their shapes look like lymphocytes. The cell nuclei of MCC looklike empty bubbles, and have many karyokinesis. The chromatin of MCC is very fine. The cytoplasms of MCC are little, and oxyphil staining. Immunohistological staining showed that both NSE (neuron-specific enolase) and CK(cytokeratin) are positive. The CT imaging of MCC is higher density. The MRI imaging of MCC is lower signals with unclear border in T1w and T2w, but becomes clear in enhanced MRI. Tumor cells invasion to soft tissues and bones could be seen on CT or MRI. Conclusion CT and MRI could clearly show the characteristics of MCC, and provide valuable information for operative treatment of MCC.

Intraarterial Chemotherapy Followed by Radical Hysterectomy for Locally Advanced Cervical Cancer / 复旦学报（医学版）

PurposeTo evaluate the curative effect and possibility of the intraarterial chemotherapy followed by radical hysterectomy for locally advanced cervical cancer. Methods59 patients with FIGO stage lb-IV cervical cancer were enrolled and the tumor size with stage lb and Ua must be more than 4 cm. Treatment consisted of bilateral internal iliac artery infusion of cisplatin 80 rog, 5-Fu 1 500 rog, and AT1258 60 mg for 1 - 3 courses separated by 3 weeks. The tumor size was measured by vagina ultrasonic and CT before and after chemotherapy to calculate the shrunk size percent. All patients underwent radical hysterectomy. Patients with disease in the vagina, parametrium, pelvic lymphnodes or microscopic tumor emboli were followed postoperative pelvic irradiation. Results59 patients underwent 122 courses of intraarterial chemotherapy for 1 - 3 courses each. The total response rate was 95 %. Complete response (CR) was achieved in 18 of 59 patients (31%) ,while a partial response (PR) was noted in 38 (64%) and stable disease (SD) in 3 (5% ). No patient had progressive disease. 14 patients with pelvic lymphnode metastasis were all found to have PR and SD. No patient had lymphnode metastasis in CR. Of 18 patients with CR, 17 patients had not recurrence. Only one patient with stage lla recurred 20 months after operation. But he also cured. All 18 patients with CR were living free of disease. But 3 in 38 patients with PR died and 3 patients with SD were all died. There were no severe complications related to intraarterial chemotherapy and radical hysterectomy. Conclusionslntraarterial chemotherapy before operation can shrink tumor size, decrease the lymphnode metastasis. It is feasible in helping elevating cure rate of patients with locally advanced cervical cancer who are at high risk for failure with conventional treatment.

Comparison of Auditory Event-Related Potential Between Ipsilateral and Contralateral Recordings / 听力学及言语疾病杂志

Objective To study the neuroelectrophysiological responsibility, mechanism and clinical application of auditory event-related potential (AERP) generated in bilateral auditory centers with ipsilateral and contralateral recordings. Methods 14 normal young adults were served as subjects. AERPs, including the responsibility, latencies, amplitudes and waveforms, were simultaneously recorded on ipsilateral and contralateral vertexes and analyzed. Results The latencies and amplitudes of AERPs did not show significicant difference statislically between ipsilateral and contralateral vertexes recordings. However, the responsibility of AERP recorded on ipsilateral vertex was more satisfied than that on contralateral vertex, which exhibited smoothing waves, discriminative wave peaks and little hetero-wave. Conclusion The origins of AERP in bilateral auditory centers were essentially symmetrical. Nevertheless, the responsibility of AERP recorded on ipsilateral vertex was more satisfied than that on contralateral vertex, which was related to the components of auditory subcortex, transmission of auditory nerve to bilateral centers and the contralateral inhibiting effect of medial olivo-cochlear system. The effects of multi-generation and multi-component of AERPs on the clinical application should be considered.