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Aim To explore the effects of Shp2 on cig-arette smoke extract (CSE)-induced epithelial-mesen-chymal transition (EMT). Methods The effects of CSE on TGF-β1 levels in epithelial cells were meas-ured by Q-PCR and ELISA. Immunofluorescent stai-ning was used to assess the expressions of CSE-induced EMT-related markers. The activation of CSE-induced Shp2,Smad2 was investigated by Western blot. Re-sults CSE induced Shp2 phosphorylation in a concen-tration-dependent manner in A549 cells. PHPS1 inhib-ited the increase in mRNA and protein expression of TGF-β1 induced by CSE. PHPS1 regulated the expres-sions of CSE-induced EMT markers (down-regulation of E-cadherin,up-regulation expression of Vimentin and α-SMA). The inhibition of either Shp2 inhibitor or Shp2 siRNA decreased Smad2 phosphorylation induced by CSE. Conclusions CSE initiates EMT through the Shp2 / Smad2 signaling pathway,which is activated by CSE through TGF-β1 generation. It is suggested that Shp2 might be a possible new target for COPD and lung cancer therapy.
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Objective To investigate the intranasal anatomic abnormalities and clinical features of mucosal contact point headache, as well as the outcomes of endoscopic surgery. Methods The clinical data of 29 patients with mucosal contact point headache, received treatment in our hospital from October 2008 and May 2010, were reviewed retrospectively. All cases received CT scans, endoscope examinations and local anesthesia tests. Endoscopic surgery was performed to correct the contact points for these cases. They were followed-up for at least 1 year; and the changes of intensity, duration and frequency of headache of these patients were observed. Results Most common anatomic abnormalities included septal spurs in contact with the turbinates, uncinate process hypertrophy,pneumatized middle turbinates, abnormal curve of middle turbinate and large ethmoid bulla. The intensity, duration and frequency of headache after surgery decreased significantly as compared with those before the surgery (P<0.05). Nineteen of the 29 patients (65.52%) got benefits from surgical intervention, and 8 patients (27.59%) had complete relief of headache. Pain was the same as before the surgery in 10 cases (34.48%) in the follow-up period. Conclusion Intranasal contact points must be considered in patients who have no other obvious cause of headache. Significant relief of headache can be obtained by endoscopic surgery in selected cases.
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<p><b>OBJECTIVE</b>To develop a transparent, non-toxic, non-irritating anti-fogging agent with long-lasting effect for nasal endoscopy.</p><p><b>METHODS</b>The anti-fogging agent was prepared by mixing ethanol, propylene glycol, polyoxyethylene lauryl ether, sodium dodecyl sulfate, polyethylene glycol 400 and deionized water at different proportions based on an orthogonal test design. Twenty-seven test samples of the anti-fogging agents were obtained, which were colorless, transparent, and non-irritating, with a pH value of 7-8. Storz00 nasal endoscopy and its imaging system were used to test the anti-fogging time of the 27 samples, and each agent was tested for 3 times with medical Seoul iodine and 95% ethanol as control.</p><p><b>RESULTS</b>The optimal composition of the anti-fogging agent was 20% ethanol, 10% propylene glycol, 20% polyoxyethylene lauryl ether, 4% sodium dodecyl sulfate, 4% polyethylene glycol, 42% deionized water. The anti-fogging time of this agent reached 15 min, significantly longer than that of medical Seoul iodine (4 min) and 95% ethanol (18 s).</p><p><b>CONCLUSION</b>This anti-fogging agent for nasal endoscopes is colorless and safe and has a long anti-fogging time by forming a homogenous transparent membrane over the endoscopic lens.</p>
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Endoscopios , Endoscopía , Métodos , Etanol , Nariz , Cirugía General , Polietilenglicoles , Dodecil Sulfato de Sodio , Soluciones , QuímicaRESUMEN
<p><b>OBJECTIVE</b>To observe the optimal timing of operation and the therapeutic effect of endoscopic optic nerve decompression for traumatic optic neuropathy (TON).</p><p><b>METHODS</b>The clinical records of 90 consecutive patients with TON (93 eyes) after head and/or maxillofacial trauma from April 1998 to March 2007 were reviewed and analyzed. All patients were either unresponsive or intolerant to medication before they underwent intranasal endoscopic optic nerve decompression. The time interval between the injury and operation ranged from one day to 97 days (median 5.5 days). Among the 93 eyes, there were 71 eyes with no visual acuity before operation and 22 eyes with residue visual acuity, including light perception in 1 eye, hand movement in 5 eyes, counting fingers in 13 eyes, 0.04 in 1 eye, and 0.1 in 2 eyes. Duration of follow-up ranged from 6 days to two years (median 8 days).</p><p><b>RESULTS</b>After decompression, 35 patients (36/93 eyes, 38.7%) showed improvement of visual acuity, 53 patients (55 eyes, 59.1%) remained the same as before operation, while 2 patients (2 eyes, 2.2%) showed decreased visual acuity. Among patients with visual acuity beyond light perception before decompression, 68.2% of them (15/22 eyes) experienced visual improvement, whereas only 22.9% (8/35 eyes, 0.02 in two eyes) among patients who lost visual acuity immediately after injury, and 36.1% (13/36 eyes, 0.02 in five eyes) among those who lost visual acuity gradually after injury. There was a significant difference in visual improvement between group with visual acuity and group with no visual acuity (chi(2) = 11.864, P < 0.01). Among patients with no visual acuity, 41.2% of those (7/17 eyes) who underwent operation within 3 days of injury, experienced improvement in visual acuity, compared with 25.9% (14/54 eyes) for those who underwent the operation more than 3 days after injury. It was indicated that no significant difference in visual improvement between these two groups (chi(2) = 1.46, P > 0.05). When comparing different sites of fracture, the effect of surgery was the most desirable (55.6%, 10/18 eyes improved) if the fracture occurred simultaneously in both exterior and interior walls of optic canal, followed by the interior wall fracture (45.7%, 21/46 eyes). The operation was less effective if there was no fraction (20%, 4/20 eyes) or if the fracture occurred in exterior wall alone (11.1%, 1/9 eyes).</p><p><b>CONCLUSIONS</b>Endoscopic optic nerve decompression is a minimally invasive procedure with no adverse cosmetic effects. Early operation is recommended for saving vision, even though visual acuity is lost immediately after injury. However, the satisfactory clinical effects of endoscopic optic nerve decompression require further study.</p>
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Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Descompresión Quirúrgica , Métodos , Endoscopía , Procedimientos Neuroquirúrgicos , Nariz , Cirugía General , Traumatismos del Nervio Óptico , Cirugía General , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>The expression of glucocorticoid receptor (GR) expression in obstructive sleep apnea hypopnea syndrome (OSAHS) in children is currently unknown. The aim of this study was to determine the GR-alpha and GR-beta status in the adenoidal tissues in children with OSAHS.</p><p><b>METHODS</b>Thirty-four pediatric patients (aged 3-14 years, median 7.8 years) had sleep study with polysomnography before adenoidectomy. According to the criteria of apnea hypopnea index (AHI) > or = 5 /h or/and apnea index (AI) > or = 1/h, they were divided into OSAHS and non-OSAHS sub groups. The study was based on fluorescent quantitative PCR (FQ-RT-PCR) for the mRNA expression of GR-alpha and GR-beta in the adenoidal tissues in children.</p><p><b>RESULTS</b>GR isoforms mRNA encoding for expression of both GR-alpha and GR-beta were detected in the adenoids of all children. GR-alpha mRNA level [(9.40 +/- 3.06) x 10(5) cDNA copies/microg total RNA] in the adenoidal tissues in OSAHS was lower than those in the non-OSAHS [(1.60 +/- 0.26) x 10(6) cDNA copies/microg total RNA] (F = 40.285, P < 0.001), whereas no differences found for GR-beta [(1.57 +/- 0.35) x 10(4) cDNA copies/microg total RNA, (1.52 +/- 0.18) x 10(4) cDNA copies/microg total RNA]. GR-alpha/GR-beta ratio was 62.3 +/- 20. 3 in OSAHS and 107.4 +/- 24.4 in non-OSAHS. AHI or AI was not related to the mRNA levels of GR-alpha and GR-beta in OSAHS or non-OSAHS.</p><p><b>CONCLUSIONS</b>GR-alpha and GR-beta were detectable in the adenoidal tissues in children. These data indicated that the relationship between the expressions of GR and the clinical significance in OSAHS need further and profound investigation.</p>
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Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Tonsila Faríngea , Metabolismo , ARN Mensajero , Genética , Receptores de Glucocorticoides , Metabolismo , Apnea Obstructiva del Sueño , MetabolismoRESUMEN
<p><b>OBJECTIVE</b>To summarize the experience of transnasal endoscopic repair of nasal-skull base defect.</p><p><b>METHODS</b>The clinical data of 69 patients with transnasal endoscopic repair of skull base defect from January 1998 to June 2006 were analyzed retrospectively. The causes, sites of defect and the effect and key technique of transnasal endoscopic repair were investigated.</p><p><b>RESULTS</b>All patients were followed-up for 6 months to 11 years. The causes were mainly traumatic fracture, occupying lesions and iatrogenic trauma. The sites were mainly in ethmoid sinus and sphenoid sinus. The success rate of one attempt was 91.3% (63/69), the ultimate success rate was 95.7% (66/69).</p><p><b>CONCLUSIONS</b>Transnasal endoscopic repair of skull base defect may be the best approach. Debriding and raw edge of defect area and "inlay-plug" method are of key technique. The liber muscle and fascia are ideal repair material.</p>
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Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto Joven , Endoscopía , Procedimientos Quirúrgicos Otorrinolaringológicos , Métodos , Estudios Retrospectivos , Base del Cráneo , Cirugía GeneralRESUMEN
<p><b>OBJECTIVE</b>To investigate the effectiveness of intranasal endoscopic resection of olfactory neuroblastoma and the significance of assistant radiotherapy.</p><p><b>METHODS</b>Six patients (4 men and 2 women) ranging in age from 9-68 years (median age, 48 years) with olfactory neuroblastoma treated endoscopically at the Third Affiliated Hospital of SUN Yat-sen University between August 2001 and September 2005 were retrospectively analyzed. The Kadish clinical stage was determined for all six cases, two cases with stage B, and 4 with stage C. The duration of endoscopic follow-up ranged from fourteen months to sixty three months.</p><p><b>RESULTS</b>The tumor in five patients was completely excised including one case underwent craniotomy firstly and one case underwent neck dissection and the another case had her tumor subtotally resected. Five cases underwent assistant radiotherapy after operation without any evidence of recurrence so far, while the other one (Kadish stage B, tumor totally resection), who had no radiotherapy after first procedure, died from local recurrence and cerebellar metastasis 31 months after operation. The medium survival duration was 44.5 months.</p><p><b>CONCLUSIONS</b>With simple approach, excellent visualization, a less operative invasiveness and no scar on face, the endoscopic approach appears to be the method of choice for the treatment of olfactory neuroblastoma. But it was necessary for good prognosis to combine with radiotherapy after operation.</p>
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Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Endoscopía , Estesioneuroblastoma Olfatorio , Cirugía General , Cavidad Nasal , Neoplasias Nasales , Cirugía General , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To observe the natural process of adenoid growth and degeneration as the age grows, to investigate the related clinical significance and pathologic characteristics of hypertrophied adenoid.</p><p><b>METHODS</b>Totally 2650 (age 2 to 87) cases with nasal obstruction or/and other symptoms were included in the patients group, and 810 (age 3 to 85) subjects without symptoms were included as the control group. Morphological characteristics examined with nasal endoscope. Biopsy was performed for 39 cases. The adenoid was calcified as 4 degrees according to the size.</p><p><b>RESULTS</b>In the patient group, age 2 to 9, degree III and degree II adenoid were 81.1% (198/244) and 18.9% (46/244) respectively. And adenoid of children whose age 2 to 5 was 100.0% in degree III; In above 10 years old group, the adenoid was mostly degree II. In age 60 to 69 group, degree 0 was (66.5%), and in age 81 or above, degree 0 reaches 100%. And 19 years old was the youngest age at which adenoid of degree 0 started to be found and 21 was the oldest age at which there is no adenoid of degree III. In the control group, compared with the patient group, no statistical significant difference found in all other groups except in age 2 to 9 (degree III 57.9%, 22/38, degree II 42.1%, 16/38). Shapes of adenoids at degree II varied while degree I were almost like peeled orange. Pathologically, among children there are abundant of adenoidal lymph tissue, while in adults the lymph tissue getting less as age grows but with evident inflammation reaction. Among patients, the incidence of sinusitis and snoring was higher in degree III group compared with others, 47.4% and 18.7% respectively, and the differences is statistically significant (chi2 = 51.28, P < 0.01; chi2 = 40.26, P < 0.01).</p><p><b>CONCLUSIONS</b>Adenoid volume of children (age < 10) is the biggest, especially of children under 5 years old.</p>
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Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Tonsila Faríngea , Patología , Cirugía General , Estudios de Casos y Controles , Endoscopía , Obstrucción Nasal , Patología , Cirugía GeneralRESUMEN
BACKGROUND: Management of patients with cerebrospinal fluid (CSF) rhinorrhea remains controversial. OBJECTIVE: The therapeutic effect of endoscopic repair of CSF rhinorrhea was evaluated. METHOD: Sixteen patients with CSF rhinorrhea involving the anterior skull base underwent intranasal endoscopic management between 1991 and 1998. Repair materials included free nasal mucosa, muscle tissue and myofascia. RESULTS: Of the sixteen patients, ten were results of head trauma, three were results of endoscopic surgery, two were at the postoperative stage of meningoma, and one was at the postoperative stage of hypophyseal adenoma. Fourteen patients had one fistula and the others two. During follow-ups lasting five months to six years, all of the cases were successfully treated without complication either intra- or post-operatively on the first attempt. CONCLUSION: The endoscopic technique provides a safe and effective means for repairing many patients with CSF rhinorrhea. Some key points to keep in mind when applying this techniques are to prepare a fresh graft recipient site and to embed free muscle into the intracranial cavity through the entrance of the dural defect.