Expression and Clinical Significance of Mucin Gene in Chronic Rhinosinusitis.

PURPOSE OF REVIEW: This review highlights the expression and regulation of mucin in CRS and discusses its clinical implications. RECENT FINDINGS: Chronic rhinosinusitis (CRS) is common chronic nasal disease; one of its main manifestations and important features is mucus overproduction. Mucin is the major component of mucus and plays a critical role in the pathophysiological changes in CRS. The phenotype of CRS affects the expression of various mucins, especially in nasal polyps (NP). Corticosteroids(CS), human neutrophil elastase (HNE), and transforming growth factor-ß1 (TGF-ß1) are closely related to the tissue remodeling of CRS and regulate mucin expression, mainly MUC1, MUC4, MUC5AC, and MUC5B. "It is expected that CS, HNE and TGF - ß could be used to regulate the expression of mucin in CRS." However, at present, the research on mucin is mainly focused on mucin 5AC and mucin 5B, which is bad for finding new therapeutic targets. Investigating the expression and location of mucin in nasal mucosa and understanding the role of various inflammatory factors in mucin expression are helpful to figure out regulatory mechanisms of airway mucin hypersecretion. It is of great significance for the treatment of CRS.

SAE1 promotes human glioma progression through activating AKT SUMOylation-mediated signaling pathways.

BACKGROUND: The SUMO-activating enzyme SAE1 is indispensable for protein SUMOylation. A dysregulation of SAE1 expression involves in progression of several human cancers. However, its biological roles of SAE1 in glioma are unclear by now. METHODS: The differential proteome between human glioma tissues and para-cancerous brain tissues were identified by LC-MS/MS. SAE1 expression was further assessed by immunohistochemistry. The patient overall survival versus SAE1 expression level was evaluated by Kaplan-Meier method. The glioma cell growth and migration were evaluated under SAE1 overexpression or inhibition by the CCK8, transwell assay and wound healing analysis. The SUMO1 modified target proteins were enriched from total cellular or tissue proteins by incubation with the anti-SUMO1 antibody on protein-A beads overnight, then the SUMOylated proteins were detected by Western blot. Cell apoptosis and cell cycle were analyzed by flow cytometry. The nude mouse xenograft was determined glioma growth and tumorigenicity in vivo. RESULTS: SAE1 is identified to increase in glioma tissues by a quantitative proteomic dissection, and SAE1 upregulation indicates a high level of tumor malignancy grade and a poor overall survival for glioma patients. SAE1 overexpression induces an increase of the SUMOylation and Ser473 phosphorylation of AKT, which promotes glioma cell growth in vitro and in nude mouse tumor model. On the contrary, SAE1 silence induces an obvious suppression of the SUMOylation and Ser473 phosphorylation of Akt, which inhibits glioma cell proliferation and the tumor xenograft growth through inducing cell cycle arrest at G2 phase and cell apoptosis driven by serial biochemical molecular events. CONCLUSION: SAE1 promotes glioma cancer progression via enhancing Akt SUMOylation-mediated signaling pathway, which indicates targeting SUMOylation is a promising therapeutic strategy for human glioma.

Job-related factors associated with changes in sleep quality among healthcare workers screening for 2019 novel coronavirus infection: a longitudinal study.

BACKGROUND: Sleep disorders may exacerbate many physical and mental health conditions, causing difficulty function in a healthcare setting. Workers screening for the 2019 novel coronavirus (2019-nCoV) infection have a high risk of not only occupational exposure to the virus but also sleep disorders. However, the job-related factors associated with reduced sleep quality remain unclear. METHODS: All healthcare workers temporarily scheduled to screen the 2019-nCoV patients were asked to complete a self-administered questionnaire that included questions on demographics, job-related factors, and sleep quality as assessed using the Pittsburgh Sleep Quality Index (PSQI). Sleep quality was assessed over a one-month follow-up period. RESULTS: A total of 116 doctors and 99 nurses were recruited for this study. The total scheduled work time was 14.78 ± 6.69 days during follow-up. Some job-related factors, such as number of work days, years of work experience, and subjective psychological stress, were associated with changes in the PSQI score. During the study, some workers tried out cognitive behavioral therapy (CBT) for sleep disorders using methods that were available online and easily accessible. Adopting online CBT was shown to be associated with scores of components of sleep quality, sleep latency, and sleep disturbance (ß = -0.152, P = 0.01; ß = -0.175, P = 0.008; and ß = -0.158, P = 0.011, respectively). CONCLUSIONS: Healthcare workers involved in screening for 2019-nCoV experienced reduced sleep quality, and a reasonable work schedule may help with maintaining sleep quality. In addition, interventions for healthcare workers should target self-help sleep assistance.

[Clinical analysis of nasal sinus mucocele with eye symptoms as main manifestation: 3 cases report].

Endoscopic sinus surgery is effective to nasal sinus mucocele with eye symptoms as main manifestation. It is very importment to raise the awareness of the disease and to prompt imaging examination. Three cases were reviewed. One mucocele was found in the frontal sinus ethmoid sinus,1 in the fronto-ethmoid sinus and 1 in the spheno-ethmoid sinus. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. Nasal sinus mucocele with eye symptoms as main manifestation should be early diagnosed. Endoscopic sinus surgery is a safe and effective method for the treatment of nasal sinus mucocele,and could be the primary choice for it. All cases were treated by nasal endoscopic sinus surgery. The majority of symptoms, such as exophthalmos, epiphora and diplopia, disappeared in all patients. However, vision recovery was observed only in some patients.

[Clinical analysis of endoscopic sinus surgery on patients with chronic sinusitis with nasal polyps complicated and asthma].

OBJECTIVE: To investigate the efficacy of the treatment of endoscopic sinus surgery on patients dignosed as chronic sinusitis with nasal polyps(CRSwNP) complicated and asthma. METHOD: Data of 45 patients with CRSwNP complicated asthma were analyzed retrospectively. RESULT: All cases were followed up for a period of 1 to 3 years after operation. In the 45 cases treated with ESS, 32 cases were cured, 9 cases were improved and 4 cases were inefficient by the treatment. The cure rate was 91.1% (41/45). The asthma symptoms were improved in 16 patients compared to 4 before the surgery. CONCLUSION: With ESS based on combined therapy,it can significantly improve the condition of CRSwNP, asthma symptoms and pulmonary function. Meanwhile, sufficient perioperative period preparation should be made to ensure the safety of the operation.

[Clinical analysis of revision endoscopic sinus surgery for recurrent chronic rhinosinusitis].

OBJECTIVE: To investigate the therapeutic effect of revision endoscopic sinus surgery for recurrent chronic rhinosinusitis. METHOD: Clinical data of 45 cases of recurrent rhinosinusitis treated in our hospital were retrospectively analyzed. Revision endoscopic sinus surgery was performed in all the patients. RESULT: All the patients were followed up for a period of 1 to 2 years after operation. No serious complication occured. The cure rate was 75.6% (34 cases), 8 cases (17.8%) improved, while other 3 cases (6.6%) were of no effect. CONCLUSION: Recurrent rhinosinusitis is closely related with medical treatment before the surgery, adhesion in nasal cavity after the surgery, deviation of nasal septum, treatment of superior turbine and inferior turbine and regular medicament management after the surgery. Revision endoscopic sinus surgery is an effective method for recurrent recurrent rhinosinusitis. The efficacy of revision endoscopic sinus surgery can be greatly improved by reasonable perioperative management, skilled operation and regular follow-up postoperatively.

[Clinical analysis of imflammatory myofibroblastic tumor of the nasal cavity and paranasal sinus].

OBJECTIVE: To investigate the clinical features, therapeutic methods and therapeutic efficacy of imflammatory myofibroblastic tumor(IMT)of the nasal cavity and paranasal sinuses. METHOD: Clinical data of 14 cases diagnosed as IMT by pathology were retrospectively analyzed. There were 8 males and 6 females,age ranging from 18 to 77 years. 12 cases of them were treated by surgery while 2 cases received postoperative radiotherapy. RESULT: All cases were operated. All the patients were followed up for a period of 1 to 7 years after operation and two cases were proved low grade IMT pathologically. Eight cases survived with no recurrence until the last follow-up and 6 cases relapsed, of which 4 cases died and 2 were alive with tumor. CONCLUSION: IMT of the nasal cavity and paranasal sinuses is very rare. The diagonosis of IMT is based on pathology and immunohistochemistry. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures. Radical excision is still the first choice of treatment for IMT of the nasal cavity and paranasal sinuses. Chemotherapy and radiotherapy may not be helpful to prevent recurrence after operation. Due to high recurrence rate, long-term follow up is necessary after operation.

[Clinical analysis of esophageal perforation and neck abscess induced by esophageal foreign body].

OBJECTIVE: To investigate the diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body and to make a better solution for the disease. METHOD: Twenty-four cases with esophageal perforation and neck abscess induced by esophageal foreign body treated in our department were surgery under general anesthesia. The foreign bodies were removed via esophagoscope in 14 cases, thorocomy in 3 eral neck incision in 5; and no foreign bodies were found in 2 cases. RESULT: There were 16 cases complicated by abscess. Among these complications,there were 10 cases of periesophageal abscess,4 cases of neck abscess and 1 case of mediastinal abscess. In 24 patients, 21 cases cured and one died. One case was sent to the department of endocrinology because of hyperglycaemia and two cases were sent to the department of thoracic surgery for further treatment. CONCLUSION: Early diagnosis and treatment is the key to the management of esophageal perforation induced by esophageal foreign body. Thin-section CT has a high value for the diagnosis and differential diagnosis in such patients. Once deep neck abscess is diagnosed, an early abscess surgical drainage, an appropriate antibiotics and a nutrition supporting treatment are effective for the patients.

[Clinical analysis of endoscopic nasal cavity expansion surgery for treatment of obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To investigate the efficacy of endoscopic nasal cavity expansion surgery on obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal obstruction. METHOD: Clinical data of 48 OSAHS patients with structural abnormality in nasal cavity treated in our department were retrospectively analysed. These patients received endoscopic nasal cavity expansion surgery and were observed for the relief of both subjective and objective symptoms. RESULT: PSG was reexamined 12 months postoperatively. Of all the patients, 29 cases (60.4%) showed complete recovery, 10 cases (20.8%) showed remarkable improvement of the symptoms, 4 cases (8.3%) exhibited curative effect and 5 cases (10.4%) were of no effect, respectively. The symptoms of apnea, hypopnea, LSaO2 and somnolence were significantly improved in all patients,and nasal congestion was obviously relieved. The improvement of snore was not evident. CONCLUSION: Endoscopic nasal cavity expansion surgery is effective and safe for the treatment of OSAHS mainly due to nasal obstruction. Operation should be performed to correct structural abnormality in nasal cavity and adjust symmetric distribution of nasal airflow on both sides in order to maintain normal ventilation function. The procedure is applicable to OSAHS patients accompanied by nasal congestion and upper airway resistance syndrome and personalized adjustment is beneficial for better clinical efficacy according to the condition of different patients.

[Efficacy of CO2 laser in the treatment of precancerous laryngeal lesions under phonomicrosurgery and its relative factors].

OBJECTIVE: To investigate the efficacy of CO2 laser treatment for patients with precancerous laryngeal lesions under phonomicrosurgery and to explore the points for attention in operation. METHOD: They were all treated with phonomicrosurgery techniques as mucosal epitheliumablation or mucosal stripping by using CO2 laser. Eight patients with laryngeal papilloma were excised by CO2 laser. RESULT: All patients were treated with CO2 laser surgery successfully. During follow-up of 6 to 39 months, all patients survived. Local recurrence or canceration were detected in 3 cases, of which 2 cases with laryngeal papilloma underwent CO2 laser treatment in one year post-operatively, while the other case with severe dysplasia underwent laryngeal vertical partial laryngectomy and post-operative radiotherapy one and half year postoperatively due to canceration. No local recurrence occurred until the last follow up. No severe complications such as dyspnea and hemorrhage occured. CONCLUSION: CO2 laser surgery is an effective and minimally invasive treatment for precancerous laryngeal lesions. Through selecting the appropriate patient and paying attention to the operation during surgery, the adhesion of vocal cord can be reduced or even be avoided after CO2 laser surgery.

[Clinical analysis of sinonasal hemangiopericytoma].

OBJECTIVE: To investigate the clinical features, therapeutic methods and therapeutic effects of sinonasal hemangiopericytoma. METHODS: Clinical data of 6 patients with sinonasal hemangiopericytoma, diagnosed by pathology and immunohistochemistry between January 1990 and December 2012 were analyzed retrospectively. There were 4 males and 2 females, with a median age of 58 years. Clinical manifestation included epistaxis and nasal obstruction. These patients were operated on by nasal endoscopic surgery or endoscope-assisted surgery, of which 2 cases of tumor located in the nasal cavity underwent nasal endoscopic surgery and 4 cases of tumor located in the nasal cavity and sinuses underwent endoscope-assisted surgery. RESULTS: All the patients were followed up for a period of 6 months to 7 years after operation. Two cases recurred and 4 cases didn't recurred. One case recurred 6 months after operation and underwent second operation, with no recurrence by further one year follow-up. Another case recurred 17 months after operation and underwent second operation, with recurrence by further 9 months follow-up. This patient lived with tumor over two years. CONCLUSIONS: Hemangiopericytomas are rarely found in the sinonasal cavity. Nasal endoscopic or endoscope-assisted surgery provides satisfactory effect.

[Clinopahological analysis of sinonasal mucosal malignant melanoma].

OBJECTIVE: To investigate the clinopathological characteristics, differential diagnosis, therapy and prognosis of sinonasal mucosal malignant melanoma. METHOD: Clinopathological data of 18 cases which were diagnosed by pathology and immmunohistochemistry were analyzed retrospectively. All cases were proved by pathology and immmunohistochemistry. All cases were performed operations. 5 underwent single surgery. 4 underwent surgery plus adjuvant radiotherapy. 4 underwent surgery plus adjuvant radiotherapy chemotherapy. 5 underwent surgery plus adjuvant chemoradiation. RESULT: All cases were followed up for a period of 1 to 7 years after operation. Twelve patients died of tumor until the last follow-up, meanwhile 6 patients stayed alive. In Six cases recurrence occurred. In five casescervical lymph node metastasis occurred, of which 3 cases received neck dissection and 2 cases received chemotherapy and radiotherapy due to no surgical indications. In three cases distant metastasis oc- curred. CONCLUSION: Sinonasal mucosal malignant melanoma is rare and highly heterogenous. Current diagnosis depends on clinical characteristics and immunohistochemical examination. It still should be differentially diagnosed from other tumors. CT and MRI image examination can provide some helpful information to understand the extent and nature of lesions. The treatment of nasal endoscopic or the surgery under endoscopy has become to be a safe, viable and reasonable alternative to open resection. Appropriate indication must be carefully selected for these lesions.

[Endoscopic resection of benign fibro-osseous lesions of naso-sinuses with different surgical choice].

OBJECTIVE: To explore and discuss the characteristics of benign fibro-osseous lesion of naso-sinuses and the features and indications of different surgical choice with endoscope. METHOD: Fourteen patients with benign fibro-osseous lesion of naso-sinuses were treated through endoscopic surgery, of which 9 cases underwent endonasal endoscopic surgery simply, 2 cases were operated with a superciliary arch incision through endoscope, 1 case underwent endoscopic caldwell-luc' surgery, 1 case was operated with endoscopic surgery through frontal recess of tears, and 1 case was operated with Draf II surgery under endoscope. RESULT: In all of patients, 2 cases relapsed, 2 cases had residual lesions, 4 cases had complications including numbness and scar of incision, no relapse and no complications in other 6 cases. CONCLUSION: Endoscopic resection of benign fibro-osseous lesion of naso-sinuses with different surgical choice was of special advantages, but the exactly indications, relapse rate and complications should be observed and reckoned deeply.

[Report of 6 orbital apex syndrome caused by sinus diseases].

OBJECTIVE: To investigate the diagnostic and therapeutic methods of orbital apex syndrome caused by sinus diseases and to achieve earlier diagnosis and timely treatment. METHOD: Clinical data of 6 cases in our department from January 2008 to March 2012 were retrospectively analyzed. RESULT: All cases had surgical treatment. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. The postoperative pathology showed 2 cases with fungal sphenoiditis, 2 cases with ethmoid mucocele and 2 cases with sphenoid mucocele. CONCLUSION: Orbital apex syndrome caused by sinus diseases is very rare. The possible causes of misdiagnosis are low incidence of the disease, nonspecific eye symptoms, and unawareness of the doctor, especially ophthalmologist. CT, MRI or intranasal endoscopy can greatly improve the diagnosis of the disease. Endoscopic sinus surgery is a safe and effective method for orbital apex syndrome caused by sinus diseases,which is the primary therapy for the disease.

[Clinical analysis of deep neck infection and its relative factors].

OBJECTIVE: To investigate the diagnosis and treatment of deep neck infection. METHOD: Clinical data of 45 cases treated in our department from Jan 2003 to Apr 2012 were retrospectively analysed. RESULT: Nineteen cases of deep neck infection in 45 patients without abscess formation were treated with high-dose antibiotics. Performed computed tomography, the other 26 patients were treated by abscess incision and drainage, the wound healed well without complications. CONCLUSION: Early diagnosis and treatment of deep neck infection is very important. Once deep neck abscess is diagnosed, early abscess surgical drainage, appropriate antibiotics and nutrition supporting treatment are effective for deep neck abscess.

[The outcomes of endoscopic septorhinoplasty with three-line-tension-relaxing technique combined with nasal bone fracture correction for traumatic nasal septum deviation].

OBJECTIVE: To investigate the feasibility and the efficacy of endoscopic three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction for traumatic nasal septum deviation. METHOD: Clinical data of 45 cases with traumatic nasal septum deviation treated were retrospectively analysed. These patients were performed with three lines tension relaxing septorhinoplasty and nasal bone fracture correction under endoscopy 5 to 14 days after injury. RESULT: All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred. CONCLUSION: Endoscopic three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications.

[Clinical analysis of surgical approaches and efficacy of benign occupying lesion of unilateral maxillary sinus].

OBJECTIVE: To investigate the therapeutic methods and efficacy of benign occupying lesion of unilateral maxillary sinus. METHOD: The clinical data of 84 patients treated with endoscopic surgery from June 2005 to June 2012 were retrospectively analyzed. Among these patients, 39 cases were treated by endoscopic surgery only, 18 cases were treated by endoscopic plus modified Caldwell-Luc technique, 15 cases were treated by endoscopic plus inferior meatus antrostomy approach, and 12 cases were treated by endoscopic anterior lacrimal recess approach. All patients were followed up postoperatively. RESULT: All cases were followed up from 4 months to 7 years. Among them,81 cases had no recurrence,whereas three cases recurred during the follow-up period. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy,which were confirmed by pathological examination postoperatively. CONCLUSION: Maxillary cyst and fungal maxillary sinusitis are the major types of benign occupying lesions of maxillary sinus. According to different clinical features of benign occupying lesions of maxillary sinus,different surgical approaches should be adopted. It can not only effectively cure maxillary sinus lesions, but aslo minimize the operation trauma. Endoscopic sinus surgery is the preferred technique for treating benign occupying lesions of maxillary sinus.

[Clinical analysis of nasal mucosa contact headache].

OBJECTIVE: To investigate the efficacy of nasal mucosa contact point headache with the treatment of endoscopic sinus surgery. METHOD: Clinical data of 75 cases with nasal mucosa contact point headache treated in our department from Jan 2008 to Nov 2011 were retrospectively analyzed. These patients were performed with endoscopic sinus surgery. RESULT: All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred. CONCLUSION: Nasal mucosa contact point headache and primary headache had different clinical features and different treatment. Misdiagnosis were easily made if not being carefully analyzed. Three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications. Therefore, it is necessary to strengthen the awareness of this disease. Nasal structure abnormality is the main reason of nasal mucosa contact point headache. The implementation of individualized nasal endoscopic sinus surgery can achieve satisfactory curative effect.

[Clinical analysis of nasal and laryngeal neuroendocrine carcinoma].

OBJECTIVE: To investigate the clinicopathological features, therapeutic methods and therapeutic effects of neuroendocrine carcinoma in nasal and laryngeal region. METHOD: Six cases with neuroendocrine carcinoma of the nose and the larynx were analyzed retrospectively. All cases were proved by pathology and immunohistochemistry. One case was treated by only radiotherapy, and five cases by combined treatment (surgery followed by radiotherapy and chemotherapy). RESULT: All the patients were followed up for a period of 11-84 months. Two cases showed recurrence after operation. Three cases occurred cervical lymph node metastasis, of which 2 cases received neck dissection and 1 case received chemotherapy and radiotherapy due to no surgical indications. Three cases occurred local recurrence, cervical lymphadenopathy, liver or lung metastases. Until the last follow up, four patients died of tumor, while two patients lived with no evidence of disease. CONCLUSION: Nasal and laryngeal neuroendocrine carcinoma is composed of a group of different morphology and prognosis lesions. Corrent diagnosis depends on clinical characteristic, electron microscopic and immunohistochemical examination. CT and MRI examination could be helpful to understand the extent of disease and lesion nature. The prognosis and treatment method of neuroendocrine carcinoma were vary with different pathological types. Combined treatment based on surgery should be adopted to the disease.

[Clinicopathological analysis of sinonasal ectopic meningioma].

OBJECTIVE: To evaluate the diagnostic and therapeutic methods of sinonasal ectopic meningioma. METHOD: The clinical data of 8 patients treated in our department from Jan 1990 to Oct 2011 were retrospectively analysed. Among these patients, 5 cases were treated by lateral rhinotomy approach; 2 cases were treated by endoscopic plus modified Caldwell-Luc technique; 1 case was treated by endoscopic plus modified Caldwell-Luc technique. All patients were followed up postoperatively. RESULT: All patients had no complications after operation. All patients were followed up from six months to 22 years. Among them, two cases had recurred 18 months and one year postoperatively. The two cases did not recur after the second operation. CONCLUSION: Although sinonasal ectopic meningioma is difficult to diagnose because of their infrequent occurrence in this ectopic site and of their non-specific clinical appearance. The final diagnosis rests on the histological examination. Immunohistochemical studies are helpful to establish the accurate diagnosis. Prognosis is excellent after complete surgical resection.