Meta-analysis on autogenous fat injection for unilateral vocal cord paralysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This study conduct a qualitative synthesis and quantitative meta-analysis of VFAFI, aimed to study whether it is a useful treatment for UVCP.@*METHOD@#Electronic databases PubMed, YZ365. COM, WANFANG DATA, CMJD, CHKD,CNKI were searched using relevant keywords. Reported treatment outcomes were clustered into three categories,i. e. subjective, perceptual,acoustic,aerodynamic,and stroboscopic. Meta-analyses were performed on studies with numerical results using random effects model.@*RESULT@#Five articles were identified with a total of 404 patients. All the studies reported significant improvements or decrease after VFAFI in each category of outcome measurements. Meta-analysis demonstrated a significant increase or decrease in all categories. Adverse effects include slight inflammatory reponse can resolve spontaneously within 1 month. The recurrence rate after VFAFI was high due to the self absorption. NNE and Jitter of post-operation is lower than pre-operation,there is no significantly change between the control group and experimental group; F0, Shimmer and MPT of post-operation is higher than pre-operation, there is no significantly change between the control group and experimental group.@*CONCLUSION@#The invasiveness and morbidity of VFAFI are low and the side effects are self-limited. Meta-analyses demonstrated significant improvements or decreased from both objective and subjective measurements. Further controlled studies with longer follow-up periods and more person were included may evaluate the effectiveness of VFAFI more reliably.

Combined Coblation Total Arytenoidectomy with Posterior Cordectomy for Bilateral Vocal Cord Paralysis / 听力学及言语疾病杂志

Objective To study the out come of coblation arytenoidectomy combined with true and false pos-terior cordectomy for treatment of bilateral vocal cord paralysis (BVFP) .Methods The group included 17 patients (8 incomplete BVFP and 9 complete BVFP) .All the patients had waited more than 6 months before surgery with no spontaneous recovery .The patients underwent arytenoidectomy combined with true and false posterior cordecto-my using coblation under video suspension laryngoscope .Electric fibrolaryngoscope was performed before and after operation to evaluate the size of the glottis .The patients'voices were recorded before and after operation and evalua-ted by 3 laryngologists through GRBAS .Results Preoperational laryngoscope showed that in the incomplete BVFP ,the vocal folds were close to the middle line with limited abduction .In the complete BVFP ,the vocal folds failed in adduction and abduction and the size of the glottis was 2 -3mm .3 of the patients had underwent tracheotomy . Post operational electric fibrolaryngoscope showed proximate triangulate breathing space which was more than 4mm in the posterior glottis .The patients were followed up 6 to 44months .15 of the 17 were allowed for decannulation . One patient among them underwent posterior cordectomy and arytenoidectomy on the contralateral side respectively after the first operation because of dyspnea owing to scar diathesis .Two patients bunged up the canula but did not de-cannulate .Among them one was a 8-year old boy diagnosed as congenital heart disease .One was thyroid cancer with stiff neck due to radiology .The only postoperative complication was the appearance of granulations in the operation region in 2 patients ,which were disappeared spontaneously .Quality of the voice improved in 2 patients ,unchanged in 10 and worsened in 5 .Conclusion This study demonstrates that arytenoidectomy associated with posterior cord-ectomy is a satisfactory surgical treatment of bilateral vocal fold paralysis because it leads to a considerable and stable enlargement of the breathing space and preserved the voice quality .

Clinical analysis of 49 cases of esthesioneuroblastoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the optimal treatment and prognostic factors of esthesioneuroblastoma (ENB).</p><p><b>METHOD</b>Forty-nine cases of ENB, received therapies in Chinese people liberation army general hospital from October 2004 to June 2013, were reviewed retrospectively. The therapeutical strategies and prognostic factors were analyzed using the Kaplan-Meier method. Efficacy of different therapeutical strategies was compared.</p><p><b>RESULT</b>The 5-year overall survival (OS) in the group was 63.8%. The 5-year OS of Kadish stage A, B, C were 90.0%, 77.1%, 32.6%, respectively, with significant difference (χ(2) = 7.379, P = 0.03). The 5-year OS of the patients treated by surgery and radiotherapy, chemoradiotherapy, surgery with chemoradiotherapy were 68.6%, 0, 92.3%, respectively, with significant difference (χ(2) = 8.140, P = 0.02). The 5-year OS of the patients with transnasal endoscopic resection (or combined with transcranial resection) and lateral rhinotomy ( or combined with transcranial resection) were 63.7%, 50.0%, respectively, which had no significant difference (χ(2) = 3.818, P = 0.05).</p><p><b>CONCLUSIONS</b>ENB has a relatively good prognosis in head and neck malignancies, the prognosis is associated with clinical stages and treatment approaches. Transnasal endoscopic surgery based multimodality is the preferable choice.</p>

Assessment of a portable monitoring device Watch PAT 200 in the diagnosis of obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the accuracy of a wrist worn Watch PAT 200 in diagnosing obstructive sleep apnea hypopnea syndrome (OSAHS) by comparing with the standard polysomnography (PSG).@*METHOD@#Twenty-eight adults with suspected OSAHS underwent a standard in-lab PSG while wearing a Watch PAT 200. PSG events were manually scored according to standard criteria (AASM). Watch PAT data were collected including changes of apnea hypopnea, sleep stages, peripheral arterial volume, signal oxygen saturation and heart rate, and then apnea hypopnea index (AHI) was analyzed by an automatic algorithm.@*RESULT@#For PSG, the mean score of AHI was (23.00 +/- 21.55)/h, and for Watch PAT, a mean score of AHI was (25.99 +/- 19.09)/h. There is a statistically positive correlation between PSG-AHI and PAT-AHI (r = 0.92, P < 0.01). The Coincidence rate of the sleep-wake assessment based on 30-second bins between the PSG and Watch PAT 200 was (89 +/- 6)%.@*CONCLUSION@#Watch PAT 200 could detected OSAHS based on AHI with comparable accuracy with standard PSG. And it would provide a reasonably accurate estimation of sleep and wakefulness stages in patients with OSAHS.

Clinical analysis of 182 cases esophageal foreign bodies and treatment for special cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To provide clinical reference by summarizing and analyzing characteristics, therapeutic principles and methods for special cases of esophageal foreign bodies.@*METHOD@#Statistical analysis 182 cases with esophageal foreign bodies, including 41 special cases. Surgery 165 cases, 17 cases without surgery.@*RESULT@#One hundred and seventy-five cases were cured, 7 cases improved. Hospitalization time 0.5-50 d (average 4.5 d).@*CONCLUSION@#It is important to learn about characteristics of esophageal foreign bodies, therapeutic principles and methods for special cases, and it's a key point to diagnosis early and remove the foreign bodies as soon as possible, and comprehensive treatment measures are really effective to process special cases.

Comparison of the exposure when using endoscopes of different angles for microlaryngoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the exposure of the vocal lesions under endoscopes of different angles and to contrast the endoscopes' influence on surgery.@*METHOD@#Fifty patients with benign vocal lesions were selected randomly. During microlaryngoscopic surgery, the laryngoscope was placed softly and the different rigid endoscope (30 degrees, 45 degrees or 70 degrees) was connected to video system to expose the glottis and vocal folds. The operation was taken through looking at the color monitor.@*RESULT@#The vocal fold lesions were completely examined and successfully excised in all patients, only two of them got soft palate mucosal abrasion. No one got complications.@*CONCLUSION@#Rigid endoscopy associated with microlaryngeal surgery brings a better observation to the vocal lesions and a lower incidence rate of complicatons. It's regarded that 45 degrees rigid endoscope is better than the others, for it provides not only a good exposure to the vocal cords, anterior commissure and subglottis, but also convenience to operate. The second one is 30 degrees rigid endoscope, which can save the cost, because of the widely using in many other departments.

Diagnosis and treatment of esophagus perforation caused by esophageal foreign bodies / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Summarize the treatment skills of esophagus perforation caused by esophageal foreign bodies.@*METHOD@#Retrospectively analyze the seven cases of esophagus foreign body perforation with various complications in our department.@*RESULT@#Six cases recovered in 3 to 18 days after operation, on average 14.2 day, while one case recovered in 49 days by conservative method.@*CONCLUSION@#Foreign bodies removing, fistulae repairing, abscess incising, effusion rinsing, effective antibiotics administrating and support treatment are effective to treat esophagus perforation caused by esophageal foreign bodies. It will take a relative long time to be treated only by conservative way.

Genetic and Audiological Characteristics of a Chinese Family with Autosamal Dominant Hereditary Non-syndromic Low-frequency Sensorineural Hearing Loss / 听力学及言语疾病杂志

Objective To investigate the phenotype and genetic characteristics of a Chinese family with an autosomal-dominant inherited sensorineural hearing loss.Methods A Chinese pedigree associated with an autosomal-dominant inherited low-frequency sensorineural hearing loss (LFSNHL) was investigated.After obtaining informed consent from all study participants medical and audiological examination were used to rule out any syndromic hearing impairment.Five patients were tested with DPOAE and ABR,while two patients were tested with vestibular function and computed tomography scan of the temporal bone to exclude auditory neuropathy and other possible aural disorders.Twenty-one loci and twenty-three genes of DFNA screening had been done by using microsatellite markers and linkage analysis.Results Proband of the family had been diagnosed with low-frequency sensorineural hearing loss.A Chinese family BJ-L046 with non-syndromic autosomal dominant hearing loss was ascertained.Hearing impairment in the affected members in family BJ-L046 occured from 10 to 20 years of age and mainly affected the low frequencies,causing an upsloping audiogram.Higher frequencies were getting involved with increasing age,thus causing a flat-type audiogram.No positive result was found in twenty-one loci and twenty-three genes of DFNA screening.Conclusion A Chinese family with late-onset low-frequency sensorineural hearing loss was clinically studied.No positive result was found by linkage analysis,and twenty-one loci and twenty-three genes of DFNA were preliminary excluded.

Observe the curative effect of n-Butyl cyanoacrylate injection in treating laryngopharynx hemangioma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical effectiveness of injection n-Butyl cyanoacrylate (NBCA) in treating laryngopharynx hemangioma.@*METHOD@#Thirty cases of laryngopharynx hemangioma who received NBCA injection were obtained from our department 1998-2007. Twenty-five cases had tracheotomy under General anesthesia, and NBCA was injected into hemangioma by direct laryngoscopy. NBCA was mixed with iodide, and the concentration was 25.00% to 33.33%, NBCA dosage was 0.5 ml to 2.0 ml. There were 5 cases whose hemangioma confined to oropharynx didn't have tracheotomy, and they were injected straightly with the speculum oris. We observed the shedding of hemangioma in different time.@*RESULT@#Hemangioma with diameter less than 1 cm, shedded in about 1 month. However, hemangioma with diameter more than 4 cm, shedded in a period more than 3.5 month. No recurrence was observed in the follow up of 3 months to seven years.@*CONCLUSION@#Avoiding dissection of neck and repetitious operation, NBCA injection could be a safe, simple and effective therapy for laryngopharynx hemangioma.

Endoscopic surgery in sinonasal inverted papillomas / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effect and application value of endoscopic resection in sinonasal inverted papillomas.@*METHOD@#In a retrospective study, clinical data of 40 patients underwent transnasal endoscopic approach in Chinese PLA General Hospital from July 1999 to April 2005 were analyzed. Tumor stage according to Krouse was T1: 4, T2: 23, T3: 12, T4: 1, respectively.@*RESULT@#All lesions were removed completely and 5 patients received post-operative radiation therapy. There were no serious complications occurred. The follow-up period ranged from 24 to 93 months (mean, 45.1 months). Recurrence rate was 15% (6/40) and the rate of malignant transformation and mortality were 7.5 % (3/40), respectively. Average time to recurrence was 37.3 months.@*CONCLUSION@#Endoscopic surgery offers a safe and effective treatment for sinonasal inverted papillomas with a minimally invasion. Thorough removal of the tumor and regular follow-up are the key points for success.

Application of hydrogel soft contact lens to the treatment of persistence corneal epitheliopathy after intraocular surgery / 眼科

Objective To investigate the efficacy and safety of hydrogel soft contact lens(HSCL) for persistence corneal epitheliopathy after intraocular surgery.Design Retrospective case series.Participants 36 patients(36 eyes) with bullous keratopathy(n=5) or other keratopathy(n=31) including corneal erosion,epithelium missing,and dendritic keratopathy after intraocular surgery,which failed to medicine treatment 2 weeks ago.Method All patients were fitted with HSCL after suitable processing of the corneal foci.The lenses were removed immediately as long as the keratopathy recovered.A new lens was replaced after 3 weeks if still needed.Main Outcome Measures Changes of keratopathy,pain relief and complications.Result 35 patients(97.22%) fitted with HSCL were very comfort within 3 days.At the follow-up of 6 months,30 patients(83.33%) achieved complete remission of keratopathy,6 patients (16.67%) remarkable remission.30 patients(86.11%) had vision increase.All of the non-bullous keratopathy recovered within 3 weeks,while the lenses were fitted much longer in bullous keratopathy.No other lens-related complications appeared.Conclusion The application of hydrogel soft contact lens to persistence corneal epitheliopathy after intraocular surgery is safe,effective,and practical.

Detection of WFS1 gene mutations in the Chinese pedigree with low frequency sensorineural hearing loss / 解放军医学杂志

Objective To analyze the mutations of candidate WFS1 gene in the Chinese pedigree with Low frequency sensorineural hearing loss. Methods PCR were performed with fourteen pairs of primers in the coding sequence of WFS1 gene. The PCR products were subsequently sequenced in the 38 individuals of LFSNHL family for screening the gene mutations. Results The PCR amplification fragments showed well quality in the five pairs of primer, and further analysis with frequencing showed no polymorphism and mutations in the members. Conclusion The present study rule out the possibility that the deafness gene WFS1, which locates on the 4p16, lead up to the hearing loss of LFSNHL pedigree.

DIAGNOSIS AND MANAGEMENT OF EXTRANODAL ROSAI-DORFMAN DISEASE IN NASAL SINUSES / 解放军医学杂志

Objective To evaluate the clinical manifestations, pathological features, diagnosis, differential diagnosis and treatment of extranodal Rosai Dorfman disease(RDD) in paranasal sinuses. Methods The clinical manifestations, pathological findings, and imaging data of a rare case of extranodal RDD in the paranasal sinuses, who had received repeated surgical interventions, were analyzed. Results The lesion was situated in the paranasal sinuses, It had been repeatedly removed and misdiagnosed. Physical examination showed a red spherical mass in the nasal cavity. CT scan of the sinuses revealed a 5cm 5 cm soft tissue opacification of the right nasal cavity and paranasal sinuses. There was also erosion of the lateral wall of the maxillary sinus, the medial wall of orbit, parts of pterygopalatine fossa, and infratemporal fossa. Through the previous incision, all visible tumours in the lateral nasal cavity, paranasal sinuses, pterygopalatine fossa and orbital base were again removed. The tumour was attached to the orbital periosteum. The orbit was not removed, but the tumour was stripped off as completely as possible. Microscopic examination revealed intermingling spindled shaped and polygonal histiocytes, admixing with few plasma cells. The infiltrating histiocytes had large round or oval nuclei. The cytoplasm was abundant, granular or vacuolated and foamy. Immunohistochemical studies showed that the histiocytes were strongly reactive with antibodies against S100 protein and Vimetin. Conclusion The diagnosis of extranodal RDD in the paranasal sinuses should be differentiated with rhinoscleroma, eosinophilic granuloma, plasmacytoma, or fibrous histiocytoma. The identification of the distinctive histocytes which are typically immunoreactive to S 100 and CD68 can be quite helpful for correct diagnosis. Surgical excision supplemented by chemotherapy and radiotherapy, may be the optimal treatment, and long term follow up is essential.

Study of the Mechanism of Vocal Cord Granulomas and Principles of Treatment / 听力学及言语疾病杂志

Objective The objective of this experiment was to find out the causes and mechanisms of vocal cord granulomas,to analyze the results of different treatments and to establish an effective protocol of treatment.Methods 24 patients with vocal cord granulomas were analyzed in terms of genders,ages,occupations,etiologies,such as voicing,gastroesophageal reflux,and treatment under general anesthesia and jet-ventilation,treatments and outcomes.Results Based on different etiologies,patients were divided into 4 groups: Group I of 9 patients with pathologic phonation,Group II of 8 patients with gastroesophageal reflux,Group III of 2 patients with treatment under general anesthesia and jet-ventilation,Group IV of 5 patients with unknown causes.9 patients received operations while 8 demonstrated good prognosis and one was completely cured.The vocal cord granulomas for 11 patients disappeared,8 had reduced vocal cord granulomas,and the vocal cord granulomas for 5 patients without any treatment were gone 6 months later.Conclusion The vocal cord granulomas can be caused by many factors with gastroesophageal reflux as a main etiology.Higher recurrences were noted after surgical treatment;therefore,treatment for gastroesophageal reflux and voice therapy should be considered as major approaches.

Treatment of nasolacrimal duct obstruction with recessive placement of nasolacrimal stent combined with lacrimal syringe / 眼科

Objective To evaluate the efficacy of recessive placement of nasolacrimal stent in the treatment of nasolacrimal duct obstruction and factors affecting the prognosis of the procedure.Design Retrospective case series.Participants One hundred eighty six patients(207 eyes) with nasolacrimal duct obstruction.Methods One hundred eighty six patients(207 eyes) of nasolacrimal duct obstruction confirmed by dacryocystography had undergone recessive placement of nasolacrimal stent after probing and dilation of nasolacrimal duct.All patients received regular postoperative nasolacrimal duct syringe.Main Outcome Measures Status of postoperative lacrimal syringe.Results The stents were removed 3～12 months postoperatively,the patients were followed-up average 6 months.The operation success rate was 97.1%.167 eyes achieved complete success(80.7%).25 eyes became better(12.1%),and nasolacrimal duct obstructed again in 15 cases(7.2%).Conclusions Recessive placement of nasolacrimal stent combined with postoperative nasolacrimal duct syringe is a simple,effective and safe technique in the treatment of nasolacrimal duct obstruction.Selecting correct patients,skillful technique of nasolacrimal duct probing and regular postoperative syringing of nasolacrimal duct are the main factors of successful procedures.

Histopathological findings in human epikeratophakia lenticules / 眼科

Six human epikeratophakia lenticules were remo- ved 1 to 23 months after refractive keratoplasty for aphakia(2)and myopia(3).The myopic group in- cluded one epi-lens treated with ArF-excimer laser for hyperopia.Causes of removal were epithelial de- fect(4),edema of host cornea(1)and overcorre- ction(1),The epi-lens stroma showed a central regular fibrillar structure with a low keratocyte den- sity.Electronmicroscopy revealed preserved cytoplas- mic organelles and nuclear appearance.Lymphocytes and other mono-nuclear cells were absent,Bowan's membrane was normal in all cases.Breaks were not seen while a slight wavy appearance and occasionally focal bends occurred.The epithelium was somewhat irregular and changing in thickness.In the peripher- al wound region stromal and epithelial irregularities were evident.

Transillumination guided cyclocryotherapy in the treatment of secondary glaucoma / 眼科

A consecutive series of 37 eyes of 34 glaucoma patients treated by transillumination guided cyclocryo- therapy(CCT)either to obtain pain relief or to achieve IOP control in Helsinki University Eye Hos- pital was studied.The follow-up range was 1～43 months(mean 9 months).Pretreatment IOP was 38?14mm Hg and postoperative 27?17mm Hg(mean ?SD).Twenty-four eyes underwent one and 13 eves 2～5 procedures.IOP control(IOP 9～24mm Hg) was achieved in 51%.The response was more favo- rable in eyes without iris neovascularization(62% achieved lOP control)than in eyes with neovascular glaucoma(38% achieved IOP control).The best response was achieved in eyes with chronic uveitis (6/7 of eyes achieved lOP coutrol).Repeated proce- dures improved IOP control rate.Thirteen eyes needed primarily pain relief and 85% achieved it.Postope- rative vision was unchanged in 30% and became worse in 54%.Transillumination guided the applica- tion of the cryoprobe to the correct site.Hypotony (IOP

EVALUATION FOR FIVE INDICATORS FOR AGING / 重庆医科大学学报

The following indexes of 2, 10 and 24 months old wistar rats were measured. the activities of RBC membrane Na+-K+-ATPase, RBC superoxide dismutasc (SOD), blood glutathione. peroxidase (GSH-Px), and the levels of lipid peroxides (EPO) in plasma and RBC membrane From 2 to 10 month-old animals, increases of 24.16%,40.07%, 102.7% and 44.44%in Na-K-ATPase activity, GSH-Px activity, plasma LPO and RBC membra no LPO levels, respectively, were found (P

A preliminary study of leucine-enkephalin and its effect in the uterus / 中国病理生理杂志

By means of radioimmunoassay, leucine-enkephalin (L-ENK) in the uteri of women and rats was studied and its responses to ovarian steroids were observed. The histological localization of L-ENK and the influence of naloxone (NAL) on estrogen regulation of the rat uterus in terms of cAMP and eGMP determination were also studied. Results of the study demonstrated that presence of L-ENK like substance in the uteri of women and rats, and the concentrations varied in the various phases of the sexual cycle. indicating a positive correlation with levels of estrogen in the body. L-ENK was found localized in the interstetial cells of the human endometrium, and in the rat uterus. Effect of extrogen on nucleotide was influenced by NAL. The findings suggested that L-ENK may play an important role on physiologic function of utetus.

The clinical observation and CT image processing of nasal septum deviation and unilateral inflammatory maxillary sinus disease / 解放军医学杂志

0.05). Conclusion The difference of cross sectional area in nasal cavity resulted from nasal septum deviation. Compensatory hypertrophy of inferior turbinate, uncinate process and middle turbinate in wide side resulted in the similar proportion of nasal airway of two sides of nasal cavity. However, compensatory hypertrophy lead to obstruction and stricture, accordingly, the probability of unilateral inflammatory maxillary sinus diseases in wide side of nasal cavity was higher than that in narrow side. In clinical practice, the deviated nasal septum should be corrected at the time of dealing with inflammatory maxillary sinus diseases. The normal structure and function of nasal cavity were recovered. The decompensation due to septum deviation was blocked.