ABSTRACT
Objective To study the curative effect and the prognostic factors of endoscopic traumatic optic neuropathy (TON). Methods The clinical data of 53 patients with TON from 2010 to 2015 years was retrospectively analyzed. Divided the patients into the surgery group and the non-surgery group, according to whether or not accept the treatment of endoscopic optic decompression. And evaluating the potential prognostic factors in chi-square test, group t-test and multiple regression analysis. Results In 53 patients (55 eyes ), 31 eyes have no visual acuity before treated: 8 eyes’ visual acuity was improved in 16 eyes (8/16) that accepted operation; 3 eyes’ visual acuity was improved in 15 eyes (3/15) that with non-operation;24 eyes have visual acuity before treated:11 eyes’ visual acuity was improved in 14 eyes (11/14) that accepted operation;3 eyes’ visual acuity was improved in 10 eyes (3/10) that with non-operation;19 eyes’ visual acuity was improved in 30 eyes (19/30) that accepted operation, the total effective rate was 63.3%, and there was no complications happened in the patients who accepted operation. The age, eye-side, sex, visual acuity, optic canal fracture , orbit fracture , all these factors have no correlation to the prognosis (P>0.05), but the interval time between injury and operation (less than 3 days) and the way of the treatment are benefit to improve vision (P<0.05). Conclusions The endoscopic optic decompression is an effective treatment in TON, and it’s better to improve vision in 3-day after TON.
ABSTRACT
Objective@#To summarize our experience in the diagnosis of internal carotid artery trauma in patients with traumatic optic neuropathy, and to make recommendations for the treatment.@*Methods@#The clinic data of 6 cases who had traumatic optic neuropathy with internal carotid artery trauma and who were admited in Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from Jan. 2013 to Dec. 2015 were analyzed retrospectively.@*Results@#All 6 cases were monocular blindness. Four cases did not undergo nasal endoscopic optic nerve decompression because of the diagnoses of internal carotid artery trauma. One case was diagnosed after nasal endoscopic optic nerve decompression because of fatal bleeding during the operation. One case was diagnosed because of late-onset recurrent epistaxis. Among the 6 cases with internal carotid artery trauma, 3 cases were successfully treated with endovascular interventional treatment (stent embolization was used in one case, Coil embolization was used in two cases), and 3 patients refused treatment.@*Conclusions@#The patients with traumatic optic neuropathy have the possibility of severe carotid artery trauma. Endoscopic optic nerve decompression is not suitable for these cases. It should pay more attention to patients with traumatic optic neuropathy. For suspected cases, vascular-enhanced computed tomography screening and digital subtraction angiography should be recommended and patients should be treated by endovascular intervention in a timely manner.
ABSTRACT
OBJECTIVE To investigate the effect of subcutaneousimmunotherapy(SCIT) on levels of the serum human beta defensin-2 in children with allergic rhinitis. METHODS 30 cases of children with allergic rhinitis who were treated by SIT were selected as the treatment group, 20 cases of healthy children as the control group. Serum HBD-2 concentration of the control group was tested. Serum HBD-2 concentration of the treatment group was tested at three different time points: before SCIT, half a year after SCIT and one year after SCIT. And total nasal symptom scores(TNSS) and medication scores were recorded at each time point. RESULTS The serum HBD-2 concentration of the control group, that of the treatment group before SIT, half a year after SIT and one year after SIT were 4.62[4.08; 4.87], 3.74[3.37; 4.61], 4.62[4.13; 5.54], 4.79[4.45;6.19]ng/ml. The HBD-2 concentration gradually increased after SCIT. The TNSS of the treatment group before SCIT, half a year after SCIT and one year after SCIT were 7.43±2.15, 4.17±2.16, 4.20±1.92, The medication scores of the treatment group before SCIT, half a year after SCIT and one year after SCIT were 1.25[0.75; 1.38], 0.25[0; 0.75, 0.25[0; 0.75].There was no correlation (all P>0.05) between the serum HBD-2 concentration and TNSS or medication scores of the treatment group. CONCLUSION The serum levels of HBD-2 in patients with allergic rhinitis were lower than those in normal persons. The specific immunotherapy raised the serum HBD-2 levels of allergic rhinitis patients.
ABSTRACT
Objective To study the effect and postoperative reaction of nasal endoscopic low temperature plasma radiofrequency ablation on children with snoring. Methods 104 cases with snoring received surgical treatment from May 2013 to May 2015 were divided into experimental group and control group. The experimental group patients re-ceived nasal endoscopic low temperature plasma radiofrequency ablation, the control group received adenoidectomy curettage combined with tonsillectomy. Then the surgery condition, postoperative pain, stress response and ventila-tion function were compared between the two groups. Results Operation indicator: the experimental group operation time, postoperative pain time, symptoms remission time, intraoperative blood loss were significantly lower than the control group ( < 0.05); Pain degree: 6 h, 24 h, 48 h, 72 h after surgery, the experimental group VAS score were significantly lower than that in control group ( < 0.05); Stress reaction: 24 h after surgery, the experimental group patients serum MDA, 8-isoPG, 3-NT content were significantly lower than that in control group, SOD, GSH content were significantly higher than that in control group ( < 0.05); Ventilation function: 6 months after surgery, the ex-perimental group AHI, ODI, SLT90%, LAT were significantly lower than that in control group, LSaO2 were signifi-cantly higher than that in control group ( <0.05). Conclusion Nasal endoscopic low temperature plasma radiofre-quency ablation can reduce surgical trauma and relieve postoperative pain and stress reaction, improve ventilation function, it's an ideal operative method for the treatment of children with snoring.
ABSTRACT
[ABSTRACT]OBJECTIVETo study the changes of symptoms, signs and esophageal dynamics characteristics of laryngopharyngeal reflux diseases(LPRD) before and after treatment with esomeprazole and itopride.METHODS The suspected LPRD patients were took the diagnostic treatment with esomeprazole and itopride. Reflux finding score(RFS), reflux symptoms index(RSI) score and high-resolution esophageal pressure were evaluated before and after treatment. The patients were divided into pure LPRD group and LPRD with GERD group according to gastroesophageal reflux disease(GERD) questionnaire scores.RESULTS There were 38 patients confirmed with LPRD(pure LPRD group:12 cases, LPRD with GERD group:26 cases). The BMI, age, gender ratio had no statistical difference between the two groups(P>0.05). In LPRD group, RSI had significant difference before and after treatment(Z=-3.009,P0.976). In LPRD with GERD group, the RSI and RFS had significant difference before and after treatment(P0.05), but in LPRD with GERD group, esophageal dynamic parameters of UESP, LESP, DCI, DL had significant difference before and after treatment(P<0.05).CONCLUSIONIn pure LPRD group, the reflux symptoms improved obviously after treatment, but the signs may need treatment for more time. Esomeprazole combined with itopride can improve the esophageal dynamics in LPRD with GERD group, but can not improve that in pure LPRD group. The results suggested that the LPRD and GERD have different pathogenesis.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate effectiveness therapeutic regimens for obstructive sleep apnea hypopnea syndrome (OSAHS) children at an acceptable cost.</p><p><b>METHOD</b>This study was performed at Yuying Children's Hospital of Wenzhou Medical University from Mar. 2008 to Dec. 2010. Prospective random number table method was used for the analysis; 60 children with mild OSAHS were divided into Mild OSAHS Montelukast Treatment (MM) group and Mild OSAHS Adenotonsillectomy Treatment (MAT) group. 32 children in MM group were treated with leukotriene receptor antagonists (LTRAs), while 28 children in MAT group were treated with adenotonsillectomy. Also, 58 children with moderate and severe OSAHS were divided into severe OSAHS Montelukast Treatment (SM) group and severe OSAHS Adenotonsillectomy Treatmen (SAT) group. Twenty-two children in SM group were treated with LTRAs, while 36 children in SAT group were treated with adenotonsillectomy. All selected children were evaluated by polysomnography (PSG) and Obstructive Sleep Apnea-18 (OSA-18) items before and after a six-month treatment. Both records were taken and analyzed, surgical complications and the reason for non-remission after operation were also analyzed. Two therapies were compared based on economic consideration and therapeutic effect. Result (1) PSG: A significant change of a significant change of Apnea Hypopnea Index (AHI) was observed in MM group after the treatment (before receiving the treatment 4.56 ± 1. 26, and after receiving the treatment 3. 48 ± 1. 52, t =3. 50, P <0. 05). But for oxygen desaturation Index (ODI) (MM group 2. 18 ± 2. 19, and MAT group 1. 80 ± 2. 34) and Lowest Oxygen satuation (LSaO2) (MM group 91. 66 ± 2. 34, and MAT group 92. 79 ± 2. 18), there was no significant difference in MM group and MAT group after the treatment (ODI, t =0. 65, and LSaO2 t = - 1. 93, P >0. 05). (2) OSA-18 scores: Significant differences were found in sleeping disorder (before 14. 81 ± 6. 28, and after 10. 56 ± 3. 57), the degree of familial stress (before 13. 56 ± 3. 54, and after 8. 97 ± 2. 96), and OSA-18 total scores (before 52. 66 ± 1. 11, and after 42. 56 6. 48) in MM group after the treatment (sleeping disorder Z - 3. 14, the degree of familial stress Z = -4. 50, and OSA-18 total scores Z= -4. 01, P <0. 05). (3) In addition to the cost of drugs, groups with surgical treatment had a larger economic burden than those with LTRAs treatment. (4) Treatment was totally effective for 28 children (88%) in MM group, and 28 children (100%) in MAT group. Meanwhile, treatment also achieved an obvious effect on 2 children (9%) in SM group, and in 35 children (97%) in SAT group. In MAT group, 3 children improved (11%). And in SAT group, 7 children improved (19%), but treatment was found to be ineffective in 1 case (3%). Among those effective and ineffective cases in groups with surgical treatment, there were 9 children with nasal diseases.</p><p><b>CONCLUSION</b>(1) Surgical treatment is recommended as the first choice for children with moderate and severe OSAHS. And for those who also suffer from nasal diseases, treatment combining drugs with surgery is necessary. (2) LTRAs therapy has a good effect for mild OSAHS. Surgery is also recommended when drugs could not achieve any obvious improvement in clinical symptoms of children with mild OSAHS.</p>
Subject(s)
Child , Humans , Adenoidectomy , Blood Gas Analysis , Cost of Illness , Oxygen , Polysomnography , Prospective Studies , Sleep Apnea, Obstructive , General Surgery , Sleep Wake Disorders , Tonsillectomy , Treatment OutcomeABSTRACT
Objective To evaluate the effect of a specific cathepsin B inhibitor,CA-074 Me,on the expression of cathepsin B in coxsackievirus B1-induced polymyositis in guinea pigs,and to elucidate the protective mechanisms of CA-074 Me on muscle fibers.Methods Polymyositis model was established in 32 guinea pigs by infection with coxsackievirus B1,which were then equally divided into 4 groups: γ-interferon group treated with intraperitoneal γ-interferon (150 000 IU per kilogram per day) from week 5 to week 8,polymyositis model group receiving no treatment,pseudo-intervention group treated with intraperitoneal sodium chloride physiological solution,CA-074 Me group treated with intraperitoneal CA-074 Me (4 mg per kilogram per day) for 7 days,after the infection with coxsackievirus B1.Eight guinea pigs receiving no infection or treatment served as the healthy control group.Blood samples and muscle tissue samples were obtained from the guinea pigs in the γ-interferon group on week 8 and in the other 4 groups on week 5.The serum level of muscle enzymes including creatine kinase (CK),CK-MM,aspartic transaminase (AST) and l-lactate dehydrogenase (LDH) were determined.Muscle tissue samples were studied by hematoxylin and eosin (HE) staining,and Envision two-step method was used to quantify the expression of cathepsin B and to numerate CD8+ T cells.The apoptosis in muscle cells was detected by terminal deoxynucleotide transferase-mediated dUTP-biotin nick end labeling (TUNEL).One-way analysis of variance (ANOVA) was conducted to compare the serum level of muscle enzymes,inflammation score of muscle and apoptosis index of muscular cells,and Pearson chi-square test to compare the count of CD8 + T cells and cathepsin B expression,among these groups.Results Polymyositis model was successfully established by infection with coxsackievirus B1 in the 32 guinea pigs with a marked increase in the serum level of the tested enzymes,especially in that of CK.In detail,the serum level of CK was (410.7 ±167.9) U/L in the healthy control group,significantly lower than that in the polymyositis model group ((3537.3 ± 2141.6) U/L,P ＜ 0.05),pseudo-intervention group ((2222.0 ± 226.9) U/L,P ＜ 0.05),γ-interferon group ((973.8 ± 423.2) U/L,P＜ 0.05) and CA-074 Me group ((814.0 ± 268.4) U/L,P＜ 0.05).Compared with the pseudo-intervention group,the γ-interferon group and CA-074 Me group showed a slight increase in the serum level of all the four enzymes (all P ＜ 0.05).There was a significant elevation in the inflammation score of skeletal muscles in the polymyositis model group,pseudo-intervention group,γ-interferon group and CA-074 Me group compared with the healthy control group (1.75 ± 0.50,1.40 ± 0.55,2.38 ± 0.74 and 1.20 ± 0.45 vs.0.00 ± 0.00,all P ＜ 0.05),with the most intense infiltration of inflammatory cells observed in the γ-interferon group.Moreover,the number of CD8 + T cells,cathepsin B expression and muscular cell apoptosis index were all significantly higher in the polymyositis model group,pseudo-intervention group,γ-interferon group and CA-074 Me group than in the healthy control group (all P ＜ 0.05).Compared with the pseudo-intervention group,the CA-074 Me group showed less CD8+ T cells (42.3 ± 27.4 vs.68.0 ± 13.2,P ＜ 0.05) and lower expression of cathepsin B (31.3 ± 6.7 vs.37.5 ± 9.2,P ＜ 0.05),whereas the γ-interferon group exhibited elevated cathepsin B expression (49.3 ± 17.0 vs.37.5 ± 9.2,P＜ 0.05) and apoptosis index (40.1 ± 6.7 vs.25.4 ± 5.0,P＜ 0.05).Conclusions Cathepsin B is highly expressed in the guinea pig model of polymyositis,while CA-074 Me may protect muscle tissue in this model by downregulating the expression of cathepsin B and attenuating the inflammation and apoptosis induced by cathepsin B.
ABSTRACT
Objective To investigate the effects of orexin-A on learning and memory of pentyleneterazol (PTZ)-kindled epileptic rats.Methods Adult Wistar rats were randomly divided into control group(normal saline,NS)and PTZ group.The PTZ-kindled rats were randomly divided into,orexin-A group and NS group administrated by intracerebroventricular(i.c.v.)injection of 10μl orexin-A(1.4 nmol/μl)or 10μl NS.Using Morris water msze experiment,the ability of learning and memory was measured in all rats.Results Eighty percent of rats in PIZ group were kindled successfully after intraperitoneal injection of 35mg/kg PTZ every day for 30 days.Compared to control group,the escape latency in the PTZ-kindled rats was significantly increased in place navigation test(PNT)(F=200.956,P<0.01),whereas a remarkable reduction of time spent in the target quadrant and number of pool circlings in 120 seconds Was observed during probe trials.Following injection of orexin-A,the latency of escape platform was significantly declined in both PTZ-kindled((39.73±2.03)8,(33.76±2.96)s)and NS rats,increased the number of crossing the platform(10.83±1.80)vs(4.67±3.34).In addition,the treatment with orexin-A markedly increased swim velocity and number of pool circlings in beth groups(P<0.01),particularly to the PTZ-kindled rats.Conclusion Spatial learning and memory in the PIZ-kindled rats can be improved by treatment with orexin-A.
ABSTRACT
Objective To evaluate the detection of alpha 5 (Ⅳ) collagen chain of skin basement membrane in diagnosis of Alport syndrome among suspected patients. Methods Data of suspected patients with the detection of alpha 5 (Ⅳ) collagen chain of skin basement membrane were retrospectively collected and analyzed from January 2007 to March 2008. Results A total of 254 suspected patients ranged from 1 to 71 years old with an average age of (25.85±17.03) years old were enrolled (male/female ratio, 0.76). There was no significant difference in average age between male and female. Abnormal alpha 5 (Ⅳ) collagen chain expression of skin basement membrane was found by indirect immunofluorescense in 19 patients among whom 12 cases were negative and 7 cases were diseontinous deposit. These 19 patients were diagnosed as Alport syndrome and the diagnostic rate was 7.5%. Conclusions The diagnostic rate of Alport syndrome by detection of alpha 5 (Ⅳ) collagen chain in skin basement membrane is significant and helpful for early and differential diagnosis of Alport syndrome.
ABSTRACT
Objective The interaction between anti-neutrophil cytoplasmic antibaties (ANCA) and receptors at the Fc portion of immunoglobulins (FeγR) is central in the pathogenisis of primary systemic small vasculitis. The aim of this study is to investigate the role and clinical value of ANCA on the expression of neutrophils FCγRⅡ/Ⅲ (CD32/CD16). Methods ANCA IgG was prepared from the sera of patients with active We-gener's granulomatosis (WG) and microscopic polyangiitis (MPA). Neutrophils were isolated from the blood of healthy volunteers. The expression of CD32/CD16 on neutrophils was assessed by flow cytometry after stimulated by ANCA for 1 hour. We compared the expression of CD32/CD16 between 18 primary systemic small vaseulitis (PSV) patients and 35 healthy volunteers. Furthermore, the correlation was also be analyzed between the expression of CD32/CD16 and Birmingham vasculitis activity score (BVAS). Results The expression of CD16 was significandy elevated by ANCA (Mnx 67±23 vs 54±21, P<0.01 ). The expression of CD16 was higher in patients than in healthy volunteers (Mnx 62±12 vs 53±10, P<0.01), which was in correlation with BVAS (r=0.728 86, P<0.01). But no such correlation was found for CD32 . Conclusion ANCA may play a role in the pathogenesis of PSV by modulating the expression of the FCγR. Monitoring the expression of CD16 on neutrophils is helpful for the evaluation of PSV activity.
ABSTRACT
Objective To investigate the effects of tg19320,a small peptide,interfering with IgG-FcγR interaction on the adhesion of neutrophils to endothelium and the expression of intercellular adhesion molecule 1 (ICAM-1)in endothelial cells and its possible mechanism.Methods Tg19320 was prepared by solid-phase peptide synthesis.ANCA IgG was isolated from the serum of active ANCA-associated systemic vasculitis(AASV)patients.When primary human umbilical vein endothelial cells(HUVEC)grew into connuence in cytokine-free eonditions,the cells were stimulated with TNF-α,human normal IgG,ANCA IgG and ANCA IgG+tg19320 respectively.HUVEC were pretreated with tg19320 for 45 minutes before being stimulated by ANCA IgG.Non-activated neutrophils was added to treat HUVEC and adhesion was measured by cell count.The expression of ICAM-1 mRNA and protein was assessed by real-time PCR and Western blot respectively.Soluble ICAM-1(sICAM-1)was determined using ELISA technique.Phosphorylation of IκB-α was assessed by Western blot. Results ANCA IgG significantly up-regulated the expression of ICAM-1 in HUVEC and promoted sICAM-1 release(P＜0.05),and TNF-α enhanced the effect of ANCA.These effects were almost completely abolished by tgl9320 both at protein and mRNA level.Furthermore,ANCA IgG increased the IκB-α phosporylation in HUVEC and tg19320could inhibit the effect. Conclusions ANCA IgG can modulate the expression of ICAM-1 and sICAM-1 release in endothelial cells.FcγR probably play a critical role in the ICAM-1 expression up-regulated by ANCA,which is mediated in part through NF-κB signaling pathway.Tg19320 has protective effect on endothelium in AASV in vitro.
ABSTRACT
Objective To investigated the inhibitory effect of an IgG-Fc region specific inhibitory peptide on the ANCA-accelerated apoptosis of neutrophils. Methods The peptide was prepared by solid-phase peptide synthesis and its biological activity was identified by rosette formation assay. ANCA was prepared from the sera of active Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA) patients. Neutrophils isolated from the blood of healthy volunteers were primed with TNF-?(2 ng/ml) then incubated with ANCA. At different intervals(3, 6, 12, 18 hours) the neutrophils were harvested to assess the apoptosis by flow cytometric analysis of JC-1 staining, Sub-G1 population and fonnation TUNEL technique. Results Tg19320 bound tightly to human IgG dose-dependendy and inhibited statistically the rosette formation between SRBC-IgG and U937 cells(20.3% vs 53.2% ,P
ABSTRACT
Objective To improve the treatment level of serous otitis media(SOM)in children.Methods 56 patients were treated by positive pressure tympanic administration of ?-Chymotrypsin and Triamcinolone Acetonide through auripuncture into a single hole and 55 cases by myringotomy with grommet insertion.Results The total effective rate of serous otitis media by positive pressure tympanic administration through auripuncture into a single hole and by myringotomy with grommet insertion was 89.8%,90.8% respectively.But the former obviously had more advantages over the latter.Conclusion The technique is better in that it is safe,painless,economical,and non-traumatic.It is an effective method in treating serous otitis media in children.
ABSTRACT
AIM:To observe the alterations in cognition of growing rats exposed to chronic intermittent hypoxia (CIH) and to explore its underlying mechanisms. METHODS:Forty male Sprague-Dawley rats (3-week-old～4-week-old and 80 g to 100 g),which had been trained to complete the 8-arm (4-arm baited) radial maze,were randomly divided into 4 groups:2-weeek-CIH group (2IH),4-week-CIH group (4IH),-week -control group (2C) and 4-weeek-control group (4C). The intermittent hypoxia model was induced by putting the animals in an intermittent hypoxia cabin. When intermittent hypoxia was terminated,spatial memory of these growing rats was tested by 8-arm (4-arm baited) radial maze task,then,one rat in each group was randomly selected for ultrastructural observation. The hippocampus and prefrontal cortexes of the rats were collected for analyzing the mRNA and protein expression of CREB by RT-PCR and Western blotting,respectively. RESULTS:(1) In the 8-arm (4-arm baited) radial maze task,the results indicated that the rats in the 4 groups displayed significant difference in their performance assessed by three measuremens:the reference memory error,the working memory error and total memory error (P 0. 05,respectively). CONCLUSION:Exposure to experimentally-induced IH in growing rats is associated with time related spatial memory impairment. Chronic intermittent hypoxia leads to the disorders of neuron ultra-structure in memory related brain regions. It also inhabits the CREB transduction,expression and CREB phosphorylation,decreases the synthesis of the memory related protein. These factors maybe contribute to learningmemory impairment of growing rats exposed to chronic intermittent hypoxia.
ABSTRACT
Objective To provide anatomic data for operation of inserting the electron cochlear in young children. Methods Fourteen heads,28 sides specimens of young children of 1to-5-year old were dissected,through posterior tympanum approach,via mastoidectomy,posterior tympanoto to enter posterior tympanum.The related anatomy structures of the location of the electron cochlear inserted into the proper sites were observed and measured under surgical microscope. Results The round window was seated in superior part of the round window niche.The pyramidal eminence,tendo musculi stapedius,incudostapedial joint,base of stapes,cochleariform process,round window niche and promontorium tympani were all visible from different directions.The posterior arch of stapes was situated in the prozone of scala.Scala was situated in the posteroinferior scala vestibuli.The distance from the middle point of the anterior border of the round window niche to the inferior wall was(1.49?0.42)mm,to the posterior wall of the Scala tympani(0.90?0.31)mm,to the basal tissue(1.49?0.41)mm,to the pyramidal eminence(3.28?0.55)mm,to the lateral semicircular canal(7.41?0.90)mm,to the inferior margin of the base of stapes(3.09?0.53)mm.Conclusion It is considered that the location of the insertion should be at the middle point of anterior border of the round window niche anterior from 0.90mm to 1.49mm,deorsum from 0mm to 1.49mm.When the round window niche is not found,the location of the insertion has to be at the middle point of the inferior margin of the base of stapes deorsum 3mm.