Application of Individualized Hollow Resin Plugs to Prevente External Auditory Canal Restenosis after Canaloplasty of External Auditory Meatus for Microtia Patients / 听力学及言语疾病杂志

Objective To investigate the application and the effects of individualized hollow resin plugs in the prevention of external auditory canal stenosis after canaloplasty of external auditory meatus for microtia patients . Methods The clinical data of 65 patients (68 ears) with microtia and aural atresia hospitalized in our department from January ,2006 to December ,2015 were summarized .Otoplasty of external ears and canaloplasty of external auditory meatus were operated on all patients under general anesthesia .Thigh flap transplantation was lined in the bony canal .One month later ,individualized hollow resin plugs were made and worn for 6 to 12 months ,and fol-lowed up for 1～2 years .Results The shapes of the reconstructed auricles were satisfactory .Sixty-four ears with wide external auditory canal openings were recorded in 68 ears .Preoperative hearing was 70 .45 ± 5 .5 dB HL ,and postoperative hearing was 55 .55 ± 5 .2 dB HL .Their hearing was not affected .External auditory canal restenosis occurred in 4 ears .Conclusion The individualized hollow resin plugs do not affect the hearing in use ,and can effec-tively prevent the restenosis of the external auditory canal after microtia reconstruction .

Cartilage Engineering Using Fibrin Gel and Chondrocyte Cell Sheets / 中山大学学报(医学科学版)

Objective]To study the feasibility of Cartilage engineering using fibrin gel and chondrocyte cell sheets.[Methods]rabbit auricular chondrocytes were isolated and cultured to form cell sheets in flasks. The cell sheets were harvested using cell scrapers,and cut into fragments. The two precursor solutions of Fibrin gel were used to suspend the cell sheet fragments and isolated chondrocytes,and then added into the wells of a 48-well plate to form Gelatinous chondroid disc constructs. After in vitro culture, the constructs were implanted into nude mice. After 8 weeks,the constructs were harvested,and the specimens were evaluated using grossly observing, histological and immunohistochemical observation. [Results]Mature cartilage discs were obtained. The histomorphology of the explanted discs appeared non-uniform cartilaginous tissue comprise of regenerated cartilage islands with different size and irregular shape. Immunohistochemistry staining demonstrated that type II collagen highly expressed in the ECM of the cartilage islands. In 1 of the 8 discs,partial ossification was observed.[Conclusion]Fibrin gel is a favourable carrier. Artificial cartilage with stereochemical structure was constructed via combining the fibrin gel and chondrocyte cell sheets.

Chondrogenesis of chondrocyte cell sheets / 中国组织工程研究

BACKGROUND:The cell-sheet technology, based on a temperature-responsive culture, has been drawing more and more attention;however, the temperature-responsive culture dish is quite expensive. Therefore, it is imperative to develop a substitutive technique.OBJECTIVE: To study the feasibility of cell-sheet ulturing using common culture dish, and investigate the chondrogenesis of the cell sheet. METHODS: A piece of nasal septal cartilage was adopted from a patient with deviation of nasal septum to extract primary chondrocytes that were then cultured and amplified. The passage 3 chondrocytes were used to construct ell sheets. Monolayer cell sheet was formed by intensive culturing and allowing the extracellular matrix secretion. Bilayer cell sheet was constructed by seeding passage 2 chondrocytes on the monolayer cell sheet. The cell sheets were harvested using cell scraper, their properties were investigated prior to plantation into nude mice to construct the tissue-engineered cartilage. RESULTS AND CONCLUSION: Both bilayer and monolayer cell sheets with soft tremellose structures showed no significant difference through naked eyes. The newly harvested cell sheets appeared to have good fluidity and gelation. Eight weeks after mplantation into the nude mice, mature cartilage blocks were obtained. Histologically, the cell sheets were thin films composed by layered chondrocytes and extracellular matrix. Glycosaminoglycan formation and type Ⅱ collagen expressions were observed in the cell sheets cultured in vitro. The explanted samples exhibited ature cartilaginous tissue at 8 weeks after implantation. Biochemical analysis showed that the DNA contents of the neocartilages were higher than those of native human costal cartilage, while the contents of glycosaminoglycan and hydroxyproline were similar to native human nasal septal cartilage. To conclude, the hondrocyte cell sheets are likely to be constructed and harvested successfully using common culture dish, and the cell sheets exhibit favourable chondrogenesis.

Ryan index for detection of laryngopharyngeal reflux diseases / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the utility of pharyngeal pH monitoring which positive standard is Ryan index in diagnosis of laryngopharyngeal reflux disease.@*Methods@#In a retrospective study, clinical data of 590 patients who had symptoms laryngopharyngeal reflux disease from February 2016 to March 2017 were analyzed. All patients were received electronic laryngoscopy, assessment of reflux symptom index(RSI) and reflux finding score(RFS), and pharyngeal pH monitoring. SPSS 19.0 software was used to analyze the date.@*Results@#There were 94 patients whose Ryan index were positive(15.93%). Among the 94 patients, 70 were positive during upright, 12 during supine and 12 during both upright and supine. There were 40 patients(6.78%)with pH decline events related to symptoms, while those Ryan index were normal. There were 536(90.85%), 417(70.68%), 233(39.49%) and 117(19.83%) patients with pH<6.5, pH<6.0, pH<5.5 and pH<5.0 events respectively. The positive rate of RSI, RFS, RSI and RFS, RSI or RFS were 44.24%, 16.78%, 7.12%, 53.90% respectively. The RFS score in Ryan index positive group was higher than that in Ryan index negative group[(8.2±2.4) vs (4.0±2.9), u=5.424, P<0.05], while the RSI score in Ryan index positive group was not statistically different from that in Ryan index negative group[(11.3±6.2) vs (12.7±5.8), t=1.247, P=0.167].@*Conclusions@#Pharyngeal pH monitoring is an objective and non-invasive method which can reflect laryngopharyngeal reflux directly. However, with the Ryan index as a criterion for the diagnosis of laryngopharyngeal reflux disease, partial patients may be missed. Further studies are needed to obtain more accurate and objective laryngopharyngeal pH statistical index for diagnosis of laryngopharyngeal reflux disease.

Morphological changes on cochlear hair cells of rats in simulated weightlessness and inboard noise / 北京大学学报(医学版)

Objective: To observe the morphological changes on cochlear hair cells of rats in simulated weightlessness and inboard noise and to investigate the different changes in three turns of hair cells.Methods: Thirty-two healthy SD rats, all males, were randomly divided into four groups: control group, weightlessness group, noise group and weightlessness+noise groups (n=8).Then rats were exposed to-30° head down tilt as simulated weightlessness and inboard noise including steady-state noise which was (72±2) dB SPL and impulse noise up to 160 dB SPL in spaceship environment.The control group was kept in normal condition for 8 weeks.Bilateral auditory brainstem response (ABR) thresholds were tested before and after exposure respectively, and immunofluorescence staining and scanning electron microscopy (SEMs) of basilar membrane were applied after exposure.Results: ABR threshold shifts of each group were higher after exposure.There was difference between ABRs of the experiment groups before and after exposure (Pnoise group>weightlessness group>control group and the damage degree of the four turns of hair cells: basal turn>mid turn>top turn.Conclusion: The rats exposed to the above environment for 2 weeks displayed obvious changes in cochlea morphology, and the weightlessness+noise group had the most obvious damage.

Tissue-engineered cartilage construction using microfibrillar collagen / 中国组织工程研究

BACKGROUND:To seek for ideal scaffold materials is still an important task for cartilage tissue engineering.OBJECTIVE:To investigate the application of the AviteneTM microfibrillar collagen hemostat sponge in cartilage tissue engineering.METHODS:Rabbit auricular cartilage was harvested via surgical operation,and primary chondrocytes were isolated and amplified.Microfibrillar collagen hemostat sponge was cut into small bricks.The passage 2 chondrocytes were suspended and seeded onto the spongy bricks.After 1 week of in vitro culture,the constructs were then implanted into nude mice.After 8 weeks,the specimens were collected and evaluated using gross,histological and immunohistochamical observation.RESULTS AND CONCLUSION:During the cell seeding,the scaffold maintained its dimensions.No shrinkage was observed when the cell suspension was added.There was no considerable change in dimensions during the 1-week in vitro culture and at 8 weeks after implantation in nude mice.At 8 weeks post-implantation,mature cartilage blocks were harvested,which were white,translucent,and flexible.Histologically,the constructs appeared to have typical mature cartilaginous tissues,with robust extracellular matrix secretion,in which the microfibrillar collagen was incompletely degraded.We conclude that the microfibrillar collagen is a favorable scaffold material for cartilage tissue engineering.

The Observation of Cochlea Hair Cell Death and Expression of Caspase-3 after Intense Low Frequency Noise Exposure in Bama Pig / 听力学及言语疾病杂志

Objective To investigate the effects of intense low frequency noise on expression of caspase -3 in bama pigs ,and observe the death of cochlea hair cell .Methods 8 bama pigs were randomly divided into a normal control group(2 pigs) and experimental groups(6 pigs) .Auditory brainstem responses(ABR) were tested before the experiment .The control group was the same as the experimental groups except noise exposure .The experimental group was randomly divided into immediate group ,36 h group ,and 84 h group(2 pigs per group) .They were ex-posed to intense low frequency noise at 142 dB of 50 Hz for 5 min according to the three time points .ABR were test-ed again before the cochlea were collected at different time points .The expression of caspase -3 was studied through immunohistochemistry and immunofluorescence ,hair cell loss rate by counting to determine cell death .Results The average ABR threshold of 8 bama pigs(16 ears) before the exposure was 61 .25 ± 10 .72 dB nHL .ABR thresh-olds were not elicited after exposure to the noise .Different parts of bama pigs showed positive expression of caspase -3 in two ways .As time prolonged after exposure ,the positive expression of caspase -3 gradually weakened .The im-mediate group and 36 h group ,compared with the control group ,showed the apparent misplace of three out hair cells in the arrangement and levels .The 84 h group through immunofluorescence lost out hair cells ,and only inner hair cells were visible .Conclusion ABR thresholds were elevated after noise exposure .The procedure of hair cell nucleus damage and caspase-3 expression is different ,and the noise can induce opening apoptotic program of spiral ganglion .

Observation of fixed -point cervical rotatory manipulation in face -upward position in cervical type cervical spondylosis / 中国基层医药

Objective To observe the clinical effect of the treatment of cervical spondylosis by the fixed rotation pulling method in the supine position.Methods 110 patients with cervical spondylosis met the inclusion criteria were selected as research objects,which were randomly divided into treatment group and control group,55 cases in each group,the treatment group were given fixed -point cervical rotatory manipulation in face -upward position, 1 times a day,3 times a week,1 weeks for 1 courses,the control group were received traditional massage treatment, 1 times a day,5 times a week,rest for 2 days,1 week for a course of treatment.both group had been treated for 2 courses, the cervical curvature were detected by borden,the cervical vertebra activity were detected by tape,then the effects were evaluated.Results The neck vertebral lordosis and activity degree of cervical flexion,extension,left rotation and right rotation,left and right flexion of the treatment group and the control group after treatment were significantly better than before treatment[(9.87 ±3.88)mm vs(6.75 ±3.40)mm,(3.22 ±1.16)mm vs (6.51 ±1.95)mm,(16.69 ± 1.49)mm vs (14.49 ±1.30)mm,(11.26 ±0.95)mm vs (14.07 ±1.16)mm,(11.59 ±1.28)mm vs (13.11 ± 1.71 )mm,(12.59 ±0.96)mm vs (13.02 ±1.14)mm,(12.09 ±0.91)mm vs (12.49 ±0.92)mm],the differences were statistically significant(t =6.226 and 3.558,5.554 and 3.408,4.702 and 3.382,5.003 and 3.605,7.004 and 3.882,5.036 and 3.554,4.818 and 3.588,all P <0.05).After treatment,the neck vertebral lordosis and Activity degree of cervical flexion,extension,left rotation and right rotation of the treatment group were significantly better than the control group,the differences were statistically significant(t =3.312,363.8,3.0338,3.251 and 3.422,all P <0.05).The effective rate of the treatment group was 96.3%,which of the control group were 81.8%,the difference was statistically significant(χ2 =11.444,P <0.05).Conclusion The fixed -point cervical rotatory manipulation in face -upward position has better effect than traditional massage in cervical type cervical spondylosis,which obvious advantages in improving the cervical physiological curvature and the activity,shortening the treatment time,to improve the clinical efficacy,which is worthy of clinical use.

Effects of simulated noise-weightlessness combined factors in spaceship on auditory function of rats after a medium-long term / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the effects of simulated noise-weightlessness combined factors on auditory brainstem response thresholds and the cochlear structure after a medium-long term (2-8 weeks). METHODS Healthy adult rats were randomly divided into male/female experimental and control groups. The male and female experimental groups were exposed to simulated noise-weightlessness environment and exerted impulse noise exposure at the end. Auditory brainstem response (ABR) threshold was recorded at the beginning, the 2nd, 4th and 8th weeks and after impulse noise exposure exerting. The cochlea was also examined by scanning electron microscopy each time after ABR threshold record. RESULTS ABR thresholds in experimental groups after impulse noise exposure were significantly increased (P<0.05). Female experimental group were lower than those of the male experimental group at 2 and 4 weeks (P<0.05). Scanning electron microscope observation showed that the inner and outer hair cell were losing and lodging, and the longer exposed to the compound factors, the heavier pathological changes observed on the cochlear hair cell. CONCLUSION Noise-weightlessness combined factors can cause the morphology and function damage of rat cochlear in medium-long term. The damage of impulse noise was more than steady noise on rat auditory function. Sex differences was also observed. Rat cochlear hair cell pathological changes increased with the exposed time.

The clinical efficacy of abdominal massage and its possible mechanism in the treatment of generalized anxiety disorder / 中国基层医药

Objective To investigate the clinical outcomes of abdominal massage in the treatment of general-ized anxiety disorder (GDA ),and to carry out preliminary exploration of its possible mechanism.Methods 126 patients were randomized to receive GDA abdominal massage and medicine treatment.Hamilton Anxiety Scale (HAMA)score,anxiety (SAS)score,serotonin (5 -HT)levels and overall treatment effect level were observed. Results After treatment,body anxiety score,psychic anxiety score,SAS score,HAMA score,5 -HT levels in two groups showed clear downward trend compared with before treatment [abdominal massage group:(9.44 ± 3.12)points,(12.04 ±3.97)points,(53.16 ±6.25)points,(37.49 ±10.08)points,(315.26 ±25.33)points;med-icine treatment group:(9.15 ±3.59)points,(12.71 ±4.55)points,(54.69 ±5.19)points,(36.35 ±10.14)points, (314.22 ±31.29)points],the differences were statistically significant (the massage group:t =11.839,12.037, 38.769,12.696,37.010,P =0.000,0.000,0.000,0.000,0.000;medicine group:t =9.638,12.056,43.947, 13.459,29.997,P =0.000,0.000,0.000,0.000,0.000).But before treatment,after treatment,differences between the two groups were not statistically significant (before treatment:t =0.484,0.629,-0.881,P =0.629,0.380, 0.138;after treatment:t =-0.778,0.577,1.907,P =0.438,0.565,0.000).The effective rates of abdominal mas-sage group and western medicine group were 93.65% and 95.24% respectively,the difference was not statistically significant (χ2 =0.151,P =0.697).Conclusion Abdominal massage is a safe,reliable and effective means of treat-ment of GDA and may have some relationship with decreased 5 -HT levels in the body.

The Synergistic Effects of Simulated Microgravity and Noise Exposure on Damage of Auditory Function and Corti Organs in Rat / 听力学及言语疾病杂志

Objective To investigate the synergistic effects of simulated microgravity and noise on the audito‐ry functions and corti organs in rats .Methods A total of 48 healthy rats were randomly divided into 4 groups (n=12):control group (Group A) ,microgravity only group (Group B) ,noise only group (Group C) and microgravity+noise group (Group D) .The microgravity environment was simulated by suspending the posterior limb using Morey-Holton method .The noise exposure was the simulation of the noise environment in spaceship including steady -state noise (72 ± 2) dB SPL and impulse noise up to 160 dB SPL .The control group was kept in normal conditions without any exposure .Auditory brainstem responses (ABRs) ,HE stainings ,immunofluorescence stainings and scanning electron microscopes (SEMs) were tested after 1week and 2 weeks exposure respectively (n=6) .Results The average of ABR threshold shifts of 2 weeks exposure were higher than those of 1 week in each group .Group D showed the highest ABRs (P<0 .01) .The HE stainings showed different degrees of injury in corti organs in all experimental groups ;which Group D being the most serious ,followed by Group C .The results of immunefluorescence in hair cells showed that swelling necrosis was the main damage of cochlear hair cell after 1 week's exposure .The swelling rate of Group D was the highest ,followed by Group C .Nucleus missing in hair cells was observed after 2 weeks'exposure . Group D had the highest missing rate and the main missing of Group B happened in the inner hair cells .SEM showed that the most serious damage of stereociliums in Group D ,followed by Group C ,then Group B .Conclusion The synergistic effects of simulated microgravity and noise lead to significant damage of the auditory function and cochlea Corti organs in rat .

Rapid prototyped titanium plate combined with autologous cancellous bone graft repairs canine mandibular defects / 中国组织工程研究

BACKGROUND:Rapid prototyping technique has been recently applied in the medical reconstruction and al ows the production of individual implant for patients with tissue defects, achieving an accurate repair. OBJECTIVE:To repair discontinuous mandibular defects in dogs using rapid prototyped titanium plate in combination with autologous cancellous bone graft. METHODS:Nine hybrid canines were used, and the skul was scanned using spiral CT. Then CT data were used to construct three-dimensional digital model, in which virtual partial mandibulectomy was performed, and an individualized bone-grafting plate was designed. A titanium plate was manufactured using rapid prototyping and titanium casting. Animal experiment was then performed. A 40-mm discontinuous defect in the right mandibular body was created in the involved dogs. The defect was restored immediately using the customized plate in combination with autologous cancellous iliac blocks. Sequential radionuclide bone imaging, biomechanical testing, three-dimensional microcomputed tomographic scanning, radiology and histological examination were used to evaluate the turnover of the grafts. RESULTS AND CONCLUSION:A symmetric mandible was reconstructed using the rapid prototyped grafting plate. The grafted bone survived and got corticalized, while a fibrous intermedium was found between the bone graft and the plate. In the reconstruction of mandibular defects, optimal functional and aesthetic outcomes could be achieved using the rapid prototyped grafting plates.

The ear angioplasty and hearing reconstruction of microtia / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To Study the clinical features of congenital microtia and atresia . To evaluate the methods and results of the same microtia surgery, ear canal and middle ear reconstruction.@*METHOD@#Statistically analysis of the data of the hospitalization microtia 62 ears of 58 cases of patient in our department from January 2005 to October 2010 waw conducted. These patients with congenital ear malformations are associated with aural atresia, ossicular chain abnormalities, severe conduction Deafness. All patients received preoperative temporal bone CT examination and reconstruction, hearing examination. Operation was given in two phases, first operation aim to form a line of ear, ear canal reconstruction, ear reconstruction, the second one aim to line of ear skin graft, cranial angle of the ear reconstruction. The preoperative and postoperative data were retrospectively analyzed.@*RESULT@#The auricle plus external auditory canal, middle ear reconstruction came out with a good shape of the ear and the ear canal in close proximity to the normal population. Most patients' hearing were improved after surgery.@*CONCLUSION@#Surgeries of patients with congenital ear malformations and aural atresia should be carefully designed according to the three-dimensional reconstruction of multislice spiral CT reconstruction, which can provide information about surgery approach and middle ear abnormality. The whole ear shape and hearing ear after reconstruction are improved after the surgery.