Effect of nasal swell body on nasal airflow and Artemisia pollen deposition / 临床耳鼻咽喉头颈外科杂志

Objective:The nasal swell body（NSB） consists of the nasal septal cartilage, nasal bone, and swollen soft tissue, all of which are visible during endoscopic and imaging examinations. Although the function of the NSB remains uncertain, there is evidence to suggest that it plays a vital role in regulating nasal airflow and filtering inhaled air. Based on anatomical and histological evidence, it is hypothesized that the NSB is indispensable in these processes. This study aims to investigate the impact of NSB on nasal aerodynamics and the deposition of allergen particles under physiological conditions. Methods:The three-dimensional （3D） nasal models were reconstructed from computed tomography （CT） scans of the paranasal sinus and nasal cavity in 30 healthy adult volunteers from Northwest China, providing basis for the construction of models without NSB following virtual NSB-removal surgery. To analyze the distribution of airflow in the nasal cavity, nasal resistance, heating and humidification efficiency, and pollen particle deposition rate at various anatomical sites, we employed the computed fluid dynamics（CFD） method for numerical simulation and quantitative analysis. In addition, we created fully transparent segmented nasal cavity models through 3D printing, which were used to conduct bionic experiments to measure nasal resistance and allergen particle deposition. Results:①The average width and length of the NSB in healthy adults in Northwest China were （12.85±1.74） mm and （28.30±1.92） mm, respectively. ②After NSB removal, there was no significant change in total nasal resistance, and cross-sectional airflow velocity remained essentially unaltered except for a decrease in topical airflow velocity in the NSB plane. ③There was no discernible difference in the nasal heating and humidification function following the removal of the NSB; ④After NSB removal, the deposition fraction（DF） of Artemisia pollen in the nasal septum decreased, and the DFs post-and pre-NSB removal were（22.79±6.61）% vs （30.70±12.27）%, respectively; the DF in the lower airway increased, and the DFs post-and pre-NSB removal were（24.12±6.59）% vs （17.00±5.57）%, respectively. Conclusion:This study is the first to explore the effects of NSB on nasal airflow, heating and humidification, and allergen particle deposition in a healthy population. After NSB removal from the healthy nasal cavities: ①nasal airflow distribution was mildly altered while nasal resistance showed no significantly changed; ②nasal heating and humidification were not significantly changed; ③the nasal septum's ability to filter out Artemisia pollen was diminished, which could lead to increased deposition of Artemisia pollen in the lower airway.

Computational investigation of Artemisia pollen deposition in realistic nasal cavities of residents in northwest China / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the deposition rate of Artemisia pollen in different nasal cavity regions and its influence factors in residents of northwest China.@*Methods@#Thirty healthy adults from northwest China were enrolled. The computational fluid dynamics (CFD) and discrete phase model (DPM) were used for numerical simulation of nasal structures. The pollen deposition fraction in each anatomical part was counted and the effects of pollen density and breathing rate on deposition were analyzed. SPSS 19.0 software was used for statistical analysis.@*Results@#The hottest deposition parts of Artemisia pollen were nasal septum (30.70%±12.27%), vestibule (27.45%±8.21%), middle turbinate area (13.59%±8.98%) and nasopharynx (7.14%±5.90%). When the inspiratory flow rate increased to 30 L/min, the deposition rates of pollen in nasal vestibule and nasal septum were significantly higher than that at the rate of 15 L/min (43.20%±11.14% vs 27.45%±8.21%, 51.48%±9.77% vs 30.70%±12.27%, t value was -8.126,-5.264, respectively, all P<0.05), which indicated that with the increase of the inspiratory flow rate, the deposition hotspot moved forward. Compared with the wet Artemisia pollen, the deposition rate of the dry pollen in nasal vestibule and nasal septum decreased significantly (16.55%±4.33% vs 27.45%±8.21%, 7.09%±3.69% vs 30.70%±12.27%, t value was 8.669, 9.173, respectively, all P<0.05). The escape rate at outlet increased from 17.00%±9.57% to 43.48%±13.43% (t=-9.282, P<0.05).@*Conclusions@#The deposition of Artemisia pollen in nasal cavity is highly concentrated. The inhalation velocity and the dry-wet degree of pollen are the main determinants of the deposition site.

Study on related factors of repeated attack of child otitis media with effusion / 重庆医学

Objective To investigate the risk factors of repeated episodes of child otitis media with effusion(OME).Methods One hundred and twenty-one children cases of repeated OME within 1 year in the Affiliated Children's Hospital of Nanjing Medical University from February 2013 to August 2015 were selected as the repeated group and contemporaneous 125 cases of non-repeated OME were selected as the control group.The repeated OME related factors were performed the univariate and multivariate analysis.Furthermore the occurrence rates of main risk factors and annual onset frequency of nasal disease were compared among different age groups.Results The Logistic multivariate regression analysis results indicated that younger age,allergic rhinitis,recurrent upper respiratory tract infections,tonsil hypertrophy Ⅳ°,adenoid hypertrophy Ⅲ °and Ⅳ ° and poor mastoid gasification were major risk factors for recurrence of OME.The incidence rate of repeated upper respiratory tract infections in the 3-＜7 years old group and ＜3 years old group was obviously higher than that in the7-14 years old group(P＜0.05),adenoid hypertrophy in the ＜3 years old group and 7-14 years old group was lower than that in the 3-＜7 years old group(P＜0.05).The annual onset frequency of nasal disease in the repeated group was significantly higher than that in the control group(P=0.000).Conclusion Child OME is the results of multivariate factors combined action.The smaller the age,the more the annual onset frequency and the higher the possibility of OME repeated onset.

Effect of tympanostomy tube insertion or tympanocentesis on transnasal endoscopic adenoidectomy in the treatment of pediatric patients with secretory otitis media / 重庆医学

Objective To discuss the tympanic membrane puncture or tympanostomy tube under endotoscope combined with adenoidectomy under nasal endoscopy on the influence of invalid conservative treatment of pediatric secretory otitis media.Methods A total of 112 cases of secretory otitis media with invalid conservative treatment were selected in the department of otorhinolaryngology of children′s hospital of Nanjing Medical University from July 2013 to August 2015.They were divided into three groups,the group A of 38 cases(68 ears)underwent transnasal endoscopic pure adenoidectomy;the group B of 37 cases(60 ears)underwent transnasal endoscopic adenoidectomy combined with tympanocentesis;the group C of 37 cases(59 ears)underwent tympanostomy tube insertion.The clinical treatment effect,the period of middle ear effusion,postoperative recurrence and complication were observed and compared.Results The total effective rate of the 3 groups was improved after 3 months(P<0.05);the total effective rate in group B and group C at one week and 3 months after operation were higher than those of group A(P<0.05);and the total effective rate in group C at 3 months after operation was significantly higher than that of group B(P<0.05).The level of auditory brainstem evoked potential(ABR)and the latency of ABR wave Ⅰ latency were decreased at 1 year after operation(P<0.05);the ABR changes in group B and group C at 1 week and 1 year after operation were lower than those in group A(P<0.05).The incidence of recurrence rate and the period of middle ear effusion in group C were lower than those in group A and B(P<0.05).The incidence of complication of group A was lower than those of group B and group C(P<0.05).Conclusion Using tympanostomy tube combined with adenoidectomy under endoscope can improve the children with hearing,which not only can shorten the time of the middle ear effusion,but also effectively reduce the recurrence rate.

Clinical analysis of nasal endoscope antrostomy treatment of maxillary sinus cyst through two approaches / 中国医师进修杂志

Objective To explore the clinical effect of nasal endoscope antrostomy treatment of maxillary sinus cyst through two approaches. Methods Eighty patients with maxillary sinus cyst were selected. The patients were divided into experiment group and control group according to the treatment method. Experiment group (40 cases) was treated through windowing middle meatus maxillary sinus associated with antrostomy of inferior nasal meatus approach. Control group (40 cases) was treated through antrostomy of inferior nasal meatus approach. On the basis of the review, the local state of the nasal endoscope and the CT examination of the sinus and the nasal sinuses, the patients were evaluated comprehensively. Results The recovery rate in experiment group was significantly higher than that in control group:97.5%(39/40) vs. 77.5% (31/40), and the complication rate in experiment group was significantly lower than that in control group:10.0%(4/40) vs. 35.0%(14/40). And there were statistical differences ( P<0.01). Conclusions The approach of windowing middle meatus maxillary sinus associated with antrostomy of inferior nasal meatus in the treatment of maxillary sinus cyst in nasal endoscope has wide field and no dead ends. Moreover, the lesions can be cleared completely. The procedure can reduce the recurrence. The complication rate is lower than the antrostomy of inferior nasal meatus approach.

Effect analysis of hiatus sinus maxillaris treatment with different methods during nasal endoscope paranasal sinuses operation / 中国医师进修杂志

Objective To explore the relationship between different treatment methods of hiatus sinus maxillaris during nasal endoscope paranasal sinuses operation and prognosis.Methods Eighty patients with chronic rhinosinusitis and rhinopolyp were divided into observation group and control group byrandom digits table method with 40 cases each.Expanding hiatus sinus maxillaris were given according to the modality of hiatus sinus maxillaris and lesion of maxillaris sinus in observation group.The patients in control group were given expanding hiatus sinus maxillaris.The opening rate of hiatus sinus maxillaris and postoperative complication were observed.Results All the patients were followed up ≥ 1 year.The opening rate of hiatus sinus maxillaris in observation group (97.5％,39/40) was significantly higher than that in control group (77.5％,31/40),the rate of postoperative complication in observation group (5.0％,2/40) was significantly lower than that in control group (27.5％,11/40),and there were statistical differences (P ＜ 0.01).Conclusion Whether or not to enlarge hiatus sinus maxillaris during nasal endoscope paranasal sinuses operation should base on intraoperative specific situation,and it can reduce intraoperative injury,prevent the shutting of sinus and postoperative complication.

Diffusion Tensor Imaging Study of Central Auditory Pathway in Patients with Acquired Sensorineural Hearing Loss / 听力学及言语疾病杂志

Objective Magnetic resonance diffusion tensor imaging (DTI) was applied to study the cantral auditong pathway in patients with .Methods A total of 30 cases of acquired hearing loss patients were divided into 2 groups ,group 1 (15 ,sudden deafness) and group 2 (15 ,with duration up to 2 years SNHL group from the time of onset) .A total of 15 cases of normal-hearing patients on MRI examination were selected as the control group for the same period .All subjects received DTI of whole brain .The values of the whole brain DTI were obtained from the inferior colliculus and lateral lemniscus ,consisting of the fractional anisotropy (FA) ,radial diffusion (RD) ,axi‐al dispersion (AD) and mean diffusivity .Results There were significant differences(P0 .05) .Conclusion There was no obviously abnormal change on the central auditory processing in sudden deafness group ,but significant destruction was found on 2 years SNHL group .It indicated that central auditory processing of the history of sensorineural deafness affected the structural changes of the central au‐ditory pathway .

Expression level and significance of IL-17 and IL-23 in serum and nasal secretion of patients with allergic rhinitis and non-allergrie rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of IL-17 and IL-23 in the pathogenesis of allergic rhinitis(AR) and non. allergic rhinitis(NAR).@*METHOD@#Selected 156 cases of patients with allergic rhinitis (AR group) and 59 cases of patients with non-allergic rhinitis (NAR group), 60 cases of healthy people (control group). All cases in AR group and NAR groups were evaluated by a visual analog scale (VAS) score of nasal symptoms. Collected peripheral blood and nasal secretions in all cases and then detected IL-17 and IL-23 expression levels.@*RESULT@#There was no significant difference in VAS score of AR group and NAR group (P>0. 05). IL-17 and IL-23 levels of serum and nasal secretions in AR group and NAR group were both higher than control group, with a highly significant difference (P <0. 05). The research showed a clear correlation between expression of IL-17 and IL-23 both in serum and nasal secretions of AR group and NAR(P<0. 05).@*CONCLUSION@#IL-17 and IL-23 may be important cytokines and IL-23/IL-17 pathway may play a significant role in the pathogenesis of allergic rhinitis and non-allergic rhinitis.

Expression and significance of Notch receptors in the mouse model of allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and significance of related receptors of Notch signaling pathway in mouse model of allergic rhinitis (AR).@*METHOD@#Sixteen BALB/c mice of seven-eight weeks old were randomly assigned to two groups,including controls group and model group. AR model mice was sensitized with ovalbumin(OVA). Symptom score, hematoxylin-eosin for pathological alteration and infiltration of inflammatory cells in nasal mucosa were analyzed as well as enzyme linked immunosorbent assay was taken to detect IgE in pe- ripheral serum. Nasal septum mucosa and peripheral blood mononuclear cells were collected from 16 BALB/c mouse(8 Allegic rhinitis,8 controls). Notch 1-4 were checked by real-time quantitative polymerase chain reaction and flow cytometry from different levels.@*RESULT@#BALB/c mice model of allergic rhinitis was established successfully. The mRNA of Notch1, Notch3, Notch4 in nasal septum mucosa of allergic rhinitis mice model groups were obviously higher than that in normal controls, and the difference were statistically significant (P < 0.01). However, The expression of Notch2 is lower than the control group and the difference was statistically significant (P < 0.05). In line with the above, the protein expression of Notch1, Notch3, Notch4 in peripheral blood mononuclear cells (PBMC) of model groups were significantly higher than that in health controls, and the difference were statistically significant (P < 0.01). But comparing control, expression of Notch2 was lower and the difference was statistically significant (P < 0.05).@*CONCLUSION@#There were significant changes of Notch genes in mouse model of AR. This intimated that related genes of Notch signaling pathway may paly important roles in the development and progression of AR and provide ideas for in depth study of the pathogenesis of AR.

Cultivation and identification of follicular papilla cells from back skin of actual rat in vitro / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To establish more efficient method to isolate of dermal papilla cells (DPCs) from back skin of SD rats, and then to study the growth ability and characteristics of SD rat dermal papilla cells in vitro.@*METHOD@#DPCs were separated from back skin of SD rats according to the modified method of two-step enzymatic digestion. The DPCs morphological observation under inverted microscope, the growth kinetics by cells number, the cell cycle analysis by flow cytometry analysis and determine the surface epitopes by immunohistochemical staining and flow cytometry analysis.@*RESULT@#Cultured DPCs were similar to fibroblasts in appearance, but generally and periodically exhibited an aggregative growth pattern. The growth kinetics showed that the number of DPCs presented progressive increase in a logarithm mode in the first 3 days and entered into plateau after 9 days, P1, P3, P5 multiplication time was 68 h, 52 h and 36 h, respectively. The flow cytometrical analysis showed that DPCs of P1, P3, P5 G0/G1 stage were (90.21 +/- 5.13)%, (81.23 +/- 1.85)% and (75.16 +/- 5.32)%, respectively. G0/G1 stage cells became less following passage subculture and elongation of culture time, but most of the DPCs stayed resting stage still. The cultivated dermal papilla cells expression of alpha-smooth muscle and CD44 on cell surface was positive, CK and CD34 were negative.@*CONCLUSION@#DPCs can be separated by the modified method of two-step enzymatic digestion successfully. The cultivated dermal papilla cells vitro show the feature of stem cells and has important potentially as a new seed cell source for cell engineering.

The cloning and sequencing of SD rat Atoh1 gene CDS region / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To clone Atoh1 gene coding sequence of SD rat and construct the Eukaryotic expression plasmid pAtoh1-IRES2-EGFP,and to study its expression in 293T cells.@*METHOD@#Total RNA was extracted from colon of SD rat. Atoh1 cDNA was obtained by RT-PCR amplification and subcloned into PMD-19T vector. The purified digested fragment was connected into Eukaryotic expression vector pIRES2-EGFP to construct the recombinant plasmid. The recombinant expression plasmid was identified by enzyme digestion and sequence analysis and then transfected into 293T cells with Lipofectamine. The expression of green fluorescent protein was detected through fluorescence microscope.@*RESULT@#Compared cloned DNA sequence of Atoh1 gene CDS area with the reference sequences published in GeneBank, there were two base nonsense mutation in the sequence, deduced amino acid of cloning sequences as the same as reference sequences. Two bases should be single nucleotide polymorphism. Results of enzyme digestion and sequencing confirmed the successful construction of the recombinant plasmid. The expression of the green fluorescent protein was observed in the transfected 293T cells 24 h after transfection by fluorescence microscope.@*CONCLUSION@#pIRES2-EGFP-Atoh1 can be constructed and expressed successfully in the 293T cells, which will guide further research on gene therapy for sensorineural hearing loss.

Construction of expression vector for NT4-ADNF-9 fusion gene / 药物分析学报

Objective To construct the prokaryotic expression vector bearing fusion gene NT4-ADNF-9 and lay foundation for further study on genetic therapy of neuraseusory deafness. Methods By means of asymmetrical prince/ template, double stranded eDNA of activity dependent neurotrophic factor-9 (ADNF-9) was obtained, which included restriction enzymes sites on the two extremities. ADNF-9 eDNA was ligated to the signal and leader peptides of nenrotrophin 4 (NT4), and the fusion gene was named NT4-ADNF-9. Then it was suheluned into prokaryotic expression vector pBV220, and called pBV220/ NT4-ADNF-9. Results Evidences of DNA sequence analysis and restrtction enzymes digestion showed that we recombined ADNF-9 eDNA to the 3'terminal of the signal and leader peptides of NT4, and the fusion gene was subcluned into pBV220 successfully. Bioactivity of the products was proved that it could support the cell survival and neurite growth in the primary cultures of dorsal root ganglia (DRG) of embryonic day-8 cbicken neurons as compared to the control. Conclusion Prokaryotic expression vector pBV220/NT4-ADNF-9 can be constructed successfully and the bioactivtty is satisfactory.

Recombinate adeno-associated virus rAAV-NT4-ADNF-9 transfects to the cultured cochleae of rats in vitro / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To construct an universal recombinate adeno-associated virus (AAV), rAAV-NT4-ADNF-9, and to detect the ability of transfection of the rAAV vector into cochlea in vitro.@*METHOD@#pSSVHG-CMV-ADNF-9 plasmid was introduced into 293 cell by method of Ca3 (PO4)2 using three plasmids of pSSHG-CMV-NT4-ADNF-9, pFG140 and pAAV/Ad. The recombinate adeno-associated virus (rAAV) was harvested, and the titrations of the rAAV concentrated was detected by dot-blot test. Isolate and culture the cochlear hair cell of SD rats newly born in vitro. The rAAV-NT4-ADNF-9 was added to the medium while plating. Cochlear were collected 24 h after cultivation for RT-PCR to detect the transfection of rAAV-NT4-ADNF-9.@*RESULT@#The titration of rAAV stock produced 2 x 10(16) total particles/L, which showed that rAAV-NT4-ADNF-9 was constructed successfully. The cochlear hair cell of SD rats newly born was isolated and cultured in vitro successfully. It certified that rAAV-NT4-ADNF-9 was able to transfect into cochlear and express secretory NT4-ADNF-9 peptide by RT-PCR.@*CONCLUSION@#The rAAV vector constructed in this paper, rAAV-NT4-ADNF-9, can transfer into cochlear cultured in vitro, which layed a foundation of further research for gene therapy.

Application of midline partial glossectomy for OSAHS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the prospective effect of applying midline partial glossectomy with Uvulopalatopharyngoplasty in the treatment of OSAHS.@*METHOD@#The data of 40 patients with OSAHS operated with midline partial glossectomy with UPPP were analyzed.@*RESULT@#The follow-up polysomnography (6-month follow-up) revealed that the mean apnea and hypopnea index decreased from 62.39+/-21.68 to 18.60+/-5.01 (P<0.01), and the mean minimal oxygen saturation (SaO2) increased from 64.40%+/-14.96% to 88.39%+/-9.21% (P<0.01). In general, 29 patients were with excellent curative effect, 8 with good effect, and 3 with bad effect. Total effective rate was 92.5%.@*CONCLUSION@#The study confirms that the same-stage midline partial glossectomy with UPPP for OSAHS is a safe and effective procedure.

The expression of interleukin-1? and matrix metalloproteinase-9 in middle ear cholesteatoma / 西安交通大学学报(医学版)

Objective To explore the effects of interleukin1?(IL-1?) and matrix metalloproteinase-9(MMP-9) in middle ear cholesteatoma and to explore the correlation between their expression and the ability of destruction of cholesteatoma.Methods IL-1? and MMP-9 were determined immunohistochemically in the specimens from 21 cases cholesteatomas and 10 external ear skin of patients with cholesteatoma.Results The positive expression of IL-1? and MMP-9 in cholesteatoma epithelialium were increased greatly than that in external epidermis(P

The effect of exogenous surfactant on the Eustachian tube function in the gerbil model of secretory otitis media / 西安交通大学学报·英文版

Objective: To investigate the effect of exogenous surfactant on Eustachian tube opening function. Methods: This reasarch measures for the Eustachian tube opening pressure by injection of surface active substance into middle ear space, studying the effect of surfactant on Eustachian tube opening function. Results: It has been showed that the injection of killed streptococcus pneumoneac bacteria by the transtympanic route, successfully developed a secretory otitis media model. Eustachian tube opening pressure in ears with SOM was significantly greater than those without effusion (P<0.01). Irrigation the middle ear space with surfactant resulted in a dramatic decrease in eustachian tube passive opening pressure in both normal and patients (P<0.01). Conclusion: The results indicate that flushing with exogenous surfactant by the transtympanic rote reduce of eustachian tube surface tension, and it benefits the Eustachian tube opening.