The effect of hyperbaric oxygen therapy to different degree of hearing loss and types of threshold curve in sudden deafness patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of hyperbaric oxygen therapy to different degrees of hearing loss and different types of threshold curve in sudden deafness patients, and establish a personalized therapy, so as to promote clinical effect to sudden deafness.@*METHOD@#One hundred and twenty cases were divided into two groups respectively (each group 60 cases). Drug treatment had been used in group A for two weeks. The patients in group B received drug treatment combined with hyperbaric oxygen therapy for two weeks. According to the different degrees of hearing loss and the types of audiogram in two groups, the statistical analysis to the difference of hyperbaric oxygen therapeutic effect was done.@*RESULT@#The effective rates was statistically different (chi2 = 8.044, P < 0.01) between group A (60.00%, 36/60) and group B (83.33%, 50/60). There was no statistical difference between two treatment program in mild and the profound deafness patients. The statistical difference could been found between moderate and the severe deafness, the value of chi2 and p were 4.969, 5.560 and 0.040, 0.035, respectively. In group A, the statistical difference could only been found between mild and the profound deafness patients (chi2 = 6.739, P < 0.05). In group B, the statistical difference could been found in mild and the profound deafness, the moderate and the profound deafness, the severe and the profound deafness patients. The value of chi2 were 11.500, 15.058,10.221 and P < 0.01 respectively. The effective rates was no statistical difference in two treatment programs in the upsloping audiogram and the profound deafness. The statistical difference could been found between the downsloping and the flat audiogram, with the value of chi2 and p were 5.144 and 5.969, P < 0.05, respectively. In group A, the statistical difference could been found between the ascending and descending audiogram, the ascending and the flat audiogram,the ascending type and the profound deafness. The value of chi2 were 6.188, 7.247, 8.082 and P < 0.05, respectively. No statistical difference could been found among the other types of audiogram. In group B, no statistical difference could been found among all types of audiogram.@*CONCLUSION@#The effect of hyperbaric oxygen therapy varies with degree of hearing loss and audiogram type. Drug treatment combined with HBOT can promote clinical effect for patients in moderate deafness and severe deafness, the descending and flat type of audiogram.

Expression and clinical significance of inducible nitric oxide synthase and β-catenin in nasopharyngeal carcinoma tissue / 中国癌症杂志

Background and purpose: There have been no reports on the clinical and biological significance of the co-expression of inducible nitric oxide synthase (iNOS) and β-catenin (β-cat) in has.pharyngeal carcinoma(NPC). This study was aimed to investigate the expression of iNOS and β-cat in NPC, to analyze their interrelation, and to explore their roles in the carcinogenesis, development, invasion, and metastasis of NPC. Methods: The expression of iNOS and β-cat was examined in 50 poorly differentiated NPC and 15 normal nasopharyngeal epithelium tissue by immunohistochemical staining (SP method). None of the patients had received radiotherapy and chemotherapy. The results of immunostaining were observed by two pathologists independently, using double blind scoring method. iNOS and β-cat expression were categorized by the extent and intensity of staining using a semiquantitative method. Results: No iNOS expression was observed in 15 normal nasopharyngeal epithelium, but β-cat expression was located in cytomembrane in normal samples. The positive rate of iNOS protein expression was 74.0% (37/50) in NPC tissues. The expression of iNOS was statistically different among the NPC group and normal nasopharyngeal epithelium group, T_(1-2) group and T_(3-4) group, metastatic lymph nodes group and no metastatic lymph nodes group. There was a great quantity of β-cat expression in cytoplasm, little or no β-cat expression in cytomembrane and nucleus in NPC tumorous tissues. Statistical analysis indicated that strong positive expression of β-cat in cytoplasm was significantly higher in NPC than those of normal nasopharyngeal epithelium. The positive expression of β-cat was significantly correlated with clinical stage, invasion and lymph gland metastasis. Neither iNOS nor β-cat was significantly different between different ages and genders. There was a positive relationship between iNOS and β-cat expression in NPC tissues (r=0.394, P=0.005). Conclusion: The positive expressions of iNOS and β-cat in cytoplasm were significantly correlated with clinical stage, invasion and metastasis, and were not significantly different in terms of ages and genders of the patients. There was a positive relationship between the expression of iNOS and β-cat in NPC tissues. Co-overexpression of iNOS and β-cat may play an important role in carcinogenesis, development, invasion, and metastasis of NPC.

Choice of treatment plan and operation time on pediatric chronic sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the curative effect of pediatric chronic sinusitis and analyze its relative factors, so that the best treatment plan and operation time can be choose.@*METHOD@#Two hundred and twenty cases of pediatric chronic sinusitis were divided into 4 groups: group A with only simple chronic sinusitis, group B accompanied adenoid hypertrophy. Among group B, group B1 with no nasal cavity structural abnormalities but group B2 on the contrary. Group C accompanied only nasal cavity structural abnormalities. According to the documents, all patients were administered with standard and systematical three-stage treatment. The curative effect of each group was calculated and analyzed in each treated stage.@*RESULT@#After the first stage treated in 220 pediatric chronic sinusitis, a statistical significance of curative effect could be observed between group A and B, A and B1, A and B2, A and C (P 0.01). Ninety-four patients in group B were accepted the second stage treated: adenoidectomy after first treatment failed. There was a statistical significance of curative effect between group B1 and B2 (P < 0.01). Once the above management both failed, endoscopic sinus surgery (FESS) was carried out. The total effective rate of FESS was 89.65%.@*CONCLUSION@#The systemic, disciplinary medical management has some referred value in the treatment for children with chronic sinusitis. Adenoid hypertrophy and nasal cavity structural abnormalities are two relative factors of the curative effect in pediatric chronic sinusitis. The time and cost of therapy can be saved if adenoidectomy and FESS are done for cases with adenoid hypertrophy or (and) nasal cavity structural abnormalities with the systemic, disciplinary medical management simultaneously.

The value of cyclooxygenase-2 to predict the effect of radiotherapy in nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the relation between the expression of COX-2 protein and the effect of radiotherapy, estimate the value of COX-2 in predicting the effect of radiotherapy in patients with nasopharyngeal carcinoma,provide theoretical basement for establishing characteristic project of treatment and raising curative effect and life quantity.@*METHOD@#The expression of COX-2 protein was examined in 30 radiosensitive and 30 radioresistant poorly differentiated NPC by immunohistochemical staining (SP method) before radiotherapy. The relation between the expression of COX-2 and the effect of radiotherapy was analyzed.@*RESULT@#The positive rate of COX-2 protein expression was 61. 67% in NPC tissues, there was statistical difference( P <0. 01) of the positive rate between the 86. 67 % of 30 radioresistant and 36. 67 % of radiosensitive NPC tissues. The intensity of COX-2 protein expressions showed statistical difference( P <0. 05),too. Based on the expression of COX-2, the effect of radiotherapy, sensitivity, specificity, accuracy, positive predictive value, negative predictive value, false positive and false negative were predicted as follows: 86. 67Y, 63. 33% ,75. 00%, 70. 27% ,82. 61% ,36. 67% and 13. 33 , respectively.@*CONCLUSION@#COX-2 expression may serve as a marker in predicting the response to radiotherapy in NPC. According to the expression of COX-2, the sound treatment scheme can be selected.

The value of inducible nitric oxide synthase to select the project of treatment in nasopharyngeal carcinoma / 中国癌症杂志

Background and purpose:Concurrent chemo-radiotherapy(CCRT) was considered the best treatment plan for advanced nasopharyngeal carcinoma(NPC),but there was no uniform conclusion as to which category of patients and which chemotherapy associated radiotherapy would have the best therapeutic effect. As the standard treatment plan for advanced NPC, DDP concurrent chemo-radiotherapy was recommended by some scholars. DDP can raise the expression of inducible nitric oxide synthase(iNOS) protein and synthesize nitric oxide (NO) with anti-tumor effects, so we considered whether the therapeutic effect could be predicted and the corresponding treatment plan could be selectived to detect the iNOS expression in the pretherapy NPC tissues.The purpose of this study was to investigate the relation between the expression of iNOS protein and the nasopharyngeal tumor with complete response or with residue after DDP concurrent chemo-radiotherapy, so that the most appropriate plan of treatment can be adopted and the complete response rate of nasopharyngeal tumor can be raised. Methods:All patients were poorly differentiated NPC.The expression of iNOS protein was examined in 30 patients of nasopharyngeal tumor with complete response and 30 patients with residual tumor after DDP concurrent chemo-radiotherapy by immunohistochemical staining (SP method).None of the patients had received radiotherapy and chemotherapy.Results:Immunohistochemical examination revealed that iNOS expression in the NPC tissues was located in both the nucleus and cytoplasm of the tumorous tissues. The intensity of iNOS expression was stronger in the nucleus than in the cytoplasm of the tumorous tissues.The positive rates of iNOS protein expressions were 71.67%(43/60) in NPC tissues. It was 86.67% and 53.33% in 30 tumors with complete response and with residual tumor, respectively. The difference was statistically significant.The rate of iNOS strong postive expressions in the group of residual tumors was higher than that of the group with complete response. It was statistically different,but weak and moderate postive expressions did not have statistical difference.Conclusions:According to the difference of iNOS expression, it is a valuable method to select the most appropriate plan of treatment and the complete response rate of nasopharyngeal tumor can be raised.

Expression of inducible nitric oxide synthase in nasopharyngeal carcinoma(NPC) and its significance / 中国癌症杂志

Background and purpose:Inducible nitric oxide synthase(iNOS) overexpression has been detected in various malignancies.Nitric oxide(NO) produced by iNOS play an important role in the carcinogenesis,growth,invasion,metastasis and angiogenesis of tumors.However,the clinical and biological significance of the expression of iNOS in NPC were rarely reported in the literature.This study was to investigate the expression of iNOS in NPC and its role in the carcinogenesis,development,invasion and metastasis of NPC.Methods:The expression of iNOS was examined in 40 poorly differentiated NPC and 10 normal nasopharyngeal epithelium tissues by immunohistochemical staining(SP method).The results of immunoassaying were observed by two pathologists independently,using double blank scoring method.iNOS expression was categorized on the base of extent and intensity of staining using a semi quantitative method.The immunoreactive score was obtained by multiplying the extent score with the intensity of score.An immunoreactive score of 2 or higher was considered positive expression.Results:① iNOS was expressed in both the nucleus and cytoplasm of the tumor tissues.The intensity of iNOS expression was stronger in the nucleus than in the cytoplasm of the tumor tissues.②iNOS expression were significantly higher in NPC than those of normal nasopharyngeal epithelium.The positive protein expression rates of iNOS were 67.5%(27/40).The positive expressions of iNOS were significantly correlated with clinical stage,invasion and metastasis. There were no significant difference in terms of age and gender.Conclusions:① Immunohistochemical examination revealed that iNOS expression in the NPC tissues was located in both the nucleus and cytoplasm of the tumorous tissues.The intensity of iNOS expression was stronger in the nucleus than in the cytoplasm of the tumorous tissues.②iNOS may play an important role in the carcinogenesis,development,invasion,metastasis of NPC,respectively.The radiotherapeutic response of NPC may be enhanced by using the selective inhibitors of iNOS.

Study on Relationship between Cleftpalate and Secretory Otitis Media / 中国医师杂志

Objective To investigate the relationship between cleftpalate and secretory otitis media so that the secretory otitis media resulted from cleftpalate was treated and prevented effectively. Methods 116 children with cleftpalate and 73 normal children were investigated by tympanogram, hearing threshold and auditory brain response. Results The incidence of secretory otitis media and hearing loss had significant difference between the two groups. Conclusions Children with cleftpalate had high incidence of secretory otitis media and hearing loss. We should pay more attention to the treatment and prevention of secretory otitis media in children with cleftpalate. It is necessary for the cleftpalate children to insert the tympanal pressure equalization tubes while palatal surgery is performed.