Common Medical Ethical Problems in the Diagnosis and Treatment of Otorhinolaryngology Diseases / 中国医学伦理学

Otorhinolaryngology is a high-risk department of a hospital, where there are many emergency critical diseases, common multiple diseases and major malignant diseases. Therefore, it is easy to cause many medical ethical problems. This paper analyzed the clinical status and characteristics of various otolaryngology diseases systematically, and expounded the related medical ethical issues in the diagnosis and treatment of otorhinolaryngology, including doctor-patient trust, safety and informed consent. Finally, the paper put forward a number of measures to do well the psychological evaluation and nursing care of patients, improve the professional skills of medical and nursing care, formulate the treatment plan of diseases, enhance the supervision and management of the network, and promote the social support of patients. The aim was to alleviate the "doctor-patient conflict" and create a harmonious medical environment.

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.

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.

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.

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

Situation and thought on constructing confidence ethics in hospitals / 中国医学伦理学

This article analyzed the ethical situation in hospitals. The author pointed out the defect of confidence between doctor and patient is the primary cause that leaded to the deterioration of doctor-patient relation, and the retardation of medical service management is the important factor that affected the confidence construction. According to all this above, the author proposed the suggestion of strengthening the understanding and communication between doctor and patient, transforming the medical service concept, enhancing the medical service quality, completing the supervising system, increasing the hospital ability of realizing medical service defect and improving the five thoughts of follow up confidence system to direct the hospital confidence ethical construction.