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OBJECTIVE@#To investigate the efficacy and safety of Mizolastine in the treatment of perennial allergic rhinitis.@*METHOD@#Multicentric random Double-blind parallel-controlled study was adopted, and compared with placebo and Cetirizine. Patients (n = 177) were grouped, seventy-two in Mizolastine group, sixty-nine in Cetirizine and thirty-six in placebo group.@*RESULT@#In the seventh curative day symptomatic and sign marks in Mizolastine group and Cetirizine group were lower, but the mark in Mizolastine group reduced more than in Cetirizine group and placebo group. Mizolastine group is better than Cetirizine group in improvement of nasal obstruction and itching with Visual analogue scale. In the twenty first curative day reduction of symptomatic and sign marks in Mizolastine group was lower than Cetirizine group, but no statistic difference. There were 27 adverse events, no serious adverse events in 177 patients during experimental period. Most adverse events were headache and dryness in mouth and eyes. There were 10 cases adverse events in Mizolastine group, one case was related with experiment and four cases might be related with experiment. There were 14 cases adverse events in Cetirizine group, one case was related with experiment and four cases might be related with experiment. There were three cases adverse events in placebo group.@*CONCLUSION@#Generally speaking the efficacy of Mizolastine in treatment of perennial allergic rhinitis is better than Cetirizine, Bad events are less. It is safe.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Benzimidazoles , Therapeutic Uses , Cetirizine , Therapeutic Uses , Double-Blind Method , Histamine H1 Antagonists, Non-Sedating , Therapeutic Uses , Rhinitis, Allergic, Perennial , Drug Therapy , Treatment OutcomeABSTRACT
OBJECTIVE To study the therapeutic effect of arytenoid within-shift combining with recurrentlaryngeal nerve (RLN) anastomosis to ansa cervicalis for patients with long-term unilateral vocal cord paralysis (UVCP) . METHODS Twelve patients with traumatic RLNs paralysis were studied. The courses of injury varied from 3 to 22 years. RLN was anastomosed to ansa cervicalis and arytenoid was within-shifted on ipsilateral side in all patients. Therapeutic efficacy was evaluated by laryngoscope, strobe-laryngoscope, voice evaluation, voice acoustics parameter analysis, and laryngeal electromyography (LEMG) . RESULTS The voice was improved in all cases after arytenoid within-shift immediately. The mean values of voice acoustics parameters (jitter, shimmer, NNE) were significantly smaller and maximum phonation time (MPT) were significantly longer after operation compared with those of before treatment. Laryngoscope showed that arytenoid was significantly within-shifted. The glottic posterior chink vanished in 9 cases and reduced in 3 cases. The voice resumed normal, obviously improved, improved and no improved were found in 9、 3、0、0 cases respectively 12 months after operation. The mass and tension of all treated vocal cords may become the same as the contralateral normal vocal cords, thus resuming symmetric vibration of the vocal cords. The reinnervation of the RLNs were approved by LEMG in these patients whose RLNs were restored. CONCLUSION Arytenoid within-shift combining with RLN anastomosis to ansa cervical can restored normal voice in patients with long-term UVCP.
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OBJECTIVE The roles of sense neuropeptides in the allergic rhinitis were investigated by observing the symptoms and changes in the level of the neuropeptides in rabbits sensitized after severing of their sphenoidpalatine or sympathetic nerve. METHODS ①SP and CGRP were observed in nasal mucosa of rabbits in four weeks. ② Twenty rabbits were divided into three groups: group C(sphenoidpalatine nerve severed),group D(sympathetic nerve severed) and group E(not operated on).Groups C and D were sensitized three days after the operation. Four rabbits were killed at two and four weeks post-operation in groups C and D. RESULTS ①There was no difference between SP and CGRP levels in four weeks. ②The levels of SP in the nasal mucosa of group C at two and four weeks after sensitization were 16.1?0.77 and 15.02?0.24, respectively. The levels of SP in group D were 34.13?1.45 and 33.23?1.99, respectively. The levels of SP in group E were 20.68?0.01 and 20.56?1.27, respectively. The level of SP in Group C was lower than in Group E. The level of SP in Group D was higher than in Group E. The level of CGRP correlates with the level of SP. CONCLUSION SP and CGRP levels are correlated with the occurrence and development of allergic rhinitis.
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OBJECTIVE To investigate the inhibiting effect of Pingyangmycin on cultured vein endothelial cells in vitro and illustrate the mechanism of Pingyangmycin on treatment cavernous hemangioma of head and neck. METHODS By MTT assay,the inhibiting rates of cultured Ecv-304 cells which were managed with Pingyangmycin for 24h and 48h were compared respectively. The changes in the cell cycle,apoptosis,and Caspase 3 protein expression of the cells managed with Pingyangcin for 24h were examined by flow cytometry(FCM). RESULTS The results showed that the inhibiting rate of Ecv-304 was dependent on the concentration of Pingyangmycin. However,in the same concentration,the inhibiting effect for 24h was stronger than that for 48h. The percentage of G1 phase cells increased while the S phase decreased,but the percentage of G2 phase cells remained unchanged after managed with Pingyangcin for 24h. An apoptosis peak appeared before G1 phase. The apoptosis rate was also concentration-dependant. The expression of caspase 3 increased in every group of different concentration. CONCLUSION Pingyangmycin can possibly arrest the growth of Ecv-304 in the G1 phase through the mechanism of inducing apoptosis. Caspase 3 may play an important role in the induced apoptosis.
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Objective:To investigate the value of video laryngoscope in diagnosis of laryngeal diseases. To study the effect of video laryngoscope in treatment of laryngeal diseases.Method:Pentax VNL-1530T and Olympus BF-240T video laryngoscope were used in diagnosis of 3628 cases of laryngeal diseases and in treatment of 1221 cases of laryngeal diseases.Result:3628 cases were examined by video laryngoscope,and correct diagnosis was made.768 cases of vocal cord polyp and 249 cases of vocal cord node were excised, 113 cases of foreign bodies in hypopharynx or larynx were removed.91 cases of other laryngeal diseases were treated under video laryngoscope.Conclusion: Video laryngoscope is a new excellent instrument in diagnosis and treatment of laryngeal disease.
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Objective： To study the application of DSA in the diagnosis and treatment of ENT diseases. Methods： The diagnostic and therapeutic roles of DSA in ENT patients admitted from November 1995 to December 1999 were retrospectively studied. Results： Therapeutic vascular embolization using DSA was performed in 9/10 patients with severe epistaxis. The treatment was successful in 8/9 patients with a successful rate of 88.89%; embolization of tumor supplying vessels using DSA as a preoperative measure for reducing operative blood loss in 3 patients with nasopharyngeal fibrohemangioma obtained a total success; diagnosis was clarified in 2 patients using DSA. No patients were with severe complications. Conclusion： DSA is not only a safe and effective measure for diagnosis and therapy, but also effective in differential diagnosis of space occupying lesions. Preoperative selective embolization of tumor supplying arteries can reduce operative blood loss.
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Objective: To explore the heat injury level of vocal cord by different power of the Diomed 25 semi conductor laser so as to provide scientific evidence for clinical laser therapy of larynx diseases. Methods: Canine was used. The power of laser was set on 5, 10 and 20 W respectively, and the time of laser exposure was fixed on 2 s.When canine vocal cord was hit by laser in vivo , the depth and width of the tissue heat injury were measured. Results: When laser hit with 5, 10 and 20 W for 2 s exposure time, the corresponding depth of the tissue heat injury were 0.2 0.4,0.4 0.6,0.8 1.0 mm respectively, the corresponding width of the tissue heat injury were 1.0 1.7,1.7 2.0,2.0 2.6 mm respectively. There was significant difference between the tissue heat injury levels caused by different laser power under the same exposure time( P
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Objective:To investigate the surgical methods and results of enlarged translabyrinthine approachin the removal of large acoustic neuromas. Method:A large mastoidectomy involved complete exposure of sigmoidsinus, the dura behind the sinus for at least lcm, the superior petrosal sinus and the middle fossa dura. Thejugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonizedand uncovered for at least 270°. The debulking of the tumor began inside the anterior and inferior poles in orderto find the brainstem and the facial nerve root as early as possible, then the dissection of the nerve was performedmedially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were performed in allcases. Result:Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size:4.2 cm).There were no death as well as other complications such as intracranial infection and persistent cerebrospinalfluid leakage. There were no obvious cerebral sequela. The facial nerve was preserved both anatomically andfunctionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases,Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in4 cases who all had severe facial paralysis or nerve interruption before operation. 16 patients returned to workwithin 1～3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via thetranslabyrinthine approach, with good result of facial nerve function and minimum incidence of morbidity.
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Objective: To investigate the surgical methods and outcomes of the enlarged translabyrinthine approach in the removal of large acoustic neuromas. Methods: A large mastoidectomy involved complete exposure of the sigmoid sinus, the dura behind the sinus for at least 1 cm, the superior petrosal sinus and the middle fossa dura. The jugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonized and uncovered for at least 270°.The debulking of the tumor began inside the anterior and inferior poles in order to find the brainstem and the facial nerve root as early as possible, and then the dissection of the nerve was done medially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were done in all cases. Results: Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size: 4.2 cm). There were no deaths or other complications such as intracranial infection and persistent cerebrospinal fluid leakage. There were no obvious cerebral sequelae. The facial nerve was preserved both anatomically and functionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases, Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in 4 patients who all had severe facial palsy or nerve interruption before operation. Sixteen patients resumed work within 1-3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via the translabyrinthine approach, with good preservation of facial nerve function and minimum incidence of morbidity.
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Objective:Ciliary neurotrophic factor (CNTF) plays important roles in the maintenance and survival of motor neurons. This study attempted to explore the expression and distribution of CNTF mRNA and its protein in the ambiguous nucleus(Amb) motoneuron in order to clarify its functional state after long term laryngeal denervation. Methods: The recurrent laryngeal nerves were obtained from dogs. Brain stems were removed and sectioned for histochemistry, immunohistochemistry and in situ hybridization of CNTF. Amb motoneurons were identified by Nissl staining. The count and intensity of positive reactive motoneurons were measured by computer image processing system. Results: Transection of the laryngeal nerve led to a very marked reduction in the count and intensity of CNTF mRNA positive reactive motoneurons, and reached minimal levels at week 3. CNTF immunoreactivity increased rapidly and reached maximal levels also at week 3. At week 4, a significant increase in CNTF mRNA expression and decrease in CNTF immunoreactivity were observed. At week 6, both CNTF mRNA and its protein expression were significantly less than those of unlesioned contraletaral sides. Although a difference between week 6 and 12 was observed, the motoneurons were generally stable in the expression level of CNTF mRNA and its protein, and in the size and count after 12 weeks, with 78%, 84.4%, 80.9% and 83.7% respectively as compared with the unlesioned contralateral Amb. Conclusion: The results indicate that although degenerating changes occurre in the Amb motoneurons after long term laryngeal denervation, the ciliary neurotrophic factors activity of the lesioned motoneurons is still maintained at a certain level. [
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Objective: To study the diagnostic and therapeutic effects of electronic laryngoscope in treating laryngeal diseases and discuss some problems concerned. Methods: Follow up studies were conducted in 846 patients with laryngeal diseases who were treated electronic laryngoscopically in our department and sex, site of lesion and therapeutic effect were analyzed. Results: The incidence of vocal polyp and nodules in female was significantly higher than that in male, and vise versa in vocal cyst and leukoplakia. Vocal nodules could be located bilaterally, while vocal cyst unilaterally. The operative style applied showed good therapeutic effect. The effective rate for vocal polyp, nodule, and cyst was 99.84%~100%, and that for vocal leukoplakia, 66.67%. Conclusion: Operation under electronic laryngoscope has advantages of rapid performance, small dead angle, high accuracy, few complications, clear image, and little pain, and is beneficial to early diagnosis and treatment of laryngeal diseases. So it is worthy of wide application. [
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Objective: To investigate the influence of histamine content in nasal mucosa on blood flow. Methods: Sixty guinea pigs were randomly devided into control group and allergized group and guinea pigs were sacrificed before nasal challenge with allergen and immediately after nasal challenge, at 24, 48, 72 h. The content of histamine in nasal mucosa was examined. Nasal mucosa blood flow was examined in all guinea pigs before sacrifice. The data were analyzed using linear correlation and linear regression. Results: As compared with normal guinea pigs, the content of histamine and blood flow in nasal mucosa of allergic rhinitis guinea pigs were significantly increased before challengd with allergen( P
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Objective: To investigate the effects of basic fibroblast growth factor(bFGF) on nerve regeneration of the posterior cricoarytenoid muscles(PCM) in dogs. Methods: After transection of the laryngeal recurrent nerves, the denervated PCM were reinnervated by nerve muscle pedicle implantation in 9 dogs. The animals were divided into 3 groups: bFGF and fibrin glue(FG) group(bFGF+FG), FG group and control group. Functional recovery of PCM was observed laryngoscopically. Electrophysiological acvitity and muscle contract strength were determined. Histochemical studies were demonstrated by Karnovsky and H E stain. Results: Six months after operation, functional recovery and nerve regeneration of the PCA in bFGF+FG group were the best in 3 groups (close to normal), and functional recovery in FG group was better than that in control group. The parameters of electrophysiological acvitity and muscle contract strength were different in bFGF+FG group , FG group, and control group( P
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Objective: To study the influence of ligating different sites of carotid arteries on face and nose blood flow in rabbits. Methods:Different levels of carotid arteries were ligated using laser Doppler flowmetry to observe the change of blood flow in face and nose regions before and after operation. Results: Blood flow of rabbit nose was more than that of the face region. Among the four operations of ligating different blood vessels to reduce blood flow of face and nose region, the most effective method was to ligate ipsilateral carotid artery and its branches on the same side. Conclusion: Ligation of some relating blood vessels, resulting in the establishment of collateral circulation, and the blood flow is quicker in the early stage. [
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Objective To investigate laryngeal reinnervation for recurrent laryngeal nerve injury caused by thyroid surgery. Methods Included in this series were 42 patients with recurrent laryngeal nerve injury, undergoing nerve decompression in 8 cases, end-to-end anastomosis of recurrent laryngeal nerve in 6, anastomosis of main branch of ansa cervicalis to recurrent laryngeal nerve in 21, end-to-end anastomosis of recurrent laryngeal nerve in 6 cases, phrenic nerve graft combined with nerve muscular pedicle (NMP) technique or nerve decompression in 7. All cases were subjected to preoperative and postoperative videolaryngoscopy, voice recording, acoustic analysis and electromyography. Results In 5 patients with unilateral injury and with a course less than four months, nerve decompression restored functional adductory and abductory motion of the vocal cord. Although functional motion of vocal cord was still absent in two patients receiving nerve decompression with a course longer than 4 months and in one less than 4 months, and in all cases with unilateral vocal cord paralysis receiving ansa cervicalis anastomosis and end to end anastomosis of recurrent laryngeal nerve, these procedures did result in symmetric vibration of the vocal cords and physiological phonation. Good inspiratory abductent motion of the glottis was observed on the reinnervated sides by the phrenic nerves in 6 cases with bilateral vocal cord paralysis and the vocal cord excursion was from 3 to 5 mm. On the opposite reinnervated sides, 2 cases with nerve decompression restored functional adductory and abductory motion of the vocal cord; while 4 cases with NMP technique restored only slight abductent motion or no motion. These patients have achieved sufficient airway so that exercise to tolerance for daily activities is adequate without a tracheotomy. In no case was the voice weakened, no was there any problem with aspiration. Conclusions Nerve decompression seems to be the best procedure in laryngeal reinnervation; Main branch of ansa cervicalis technique achieves satisfactory reinnervation of adductor muscles; Phrenic nerve graft yields more satisfactory vocal cord abductory motion than NMP technique. Selection of the laryngeal reinnervation protocols should depend on the course, severity, type of nerve injury.
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Objectives To explore therapeutic effect,indication and timing of nerve decompression for traumatic recurrent laryngeal nerve injury inducing vocal cord paralysis. Methods A total of 42 patients with recurrent laryngeal nerve injury inducing vocal cord paralysis within six months, were divided into nerve decompression group (15 cases), end to end anastomosis of recurrent laryngeal nerve group (six cases) and nonsurgical treatment (21 cases). Nerve decompression was performed in the patients who were operatively found to have compressing sutures or compression due to cicatricial hypertrophy. Results In 13 patients with a course less than four months, nerve decompression restored normal functional adductory and abductory motion of the vocal cord in 11 patients and motionless in two. Although functional motion of vocal cord was not seen in two patients with a course less than four months and two longer than four months, the mass and tension of the reinnervated vocal cord became much the same as the contralateral normal vocal cord, thus resuming symmetric vibration of the vocal cords and physiological phonation. End-to-end anastomosis of recurrent laryngeal nerve failed to restore motion of the glottis. Nevertheless, the procedures enabled adductory muscles to be reinnervated and then restored normal voice. Although nonsurgical treatment improved severe hoarseness, the vocal cord didn't restore normal functional motion of the vocal cord and normal voice. Conclusions Early and mid-stage recurrent laryngeal nerve decompression may restore normal motion of the vocal cord. End-to-end anastomosis of recurrent laryngeal nerve enables adductory muscles to be reinnervated and thus restores normal voice.
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Objective:To explore the expression and distribution of ciliary neurotrophic factor (CNTF) in laryngeal nerve degeneration and regeneration. Methods:Transection of the recurrent laryngeal nerves in 8 dogs and suture following transection in 12 cases were performed. Both proximal and distal ends of transected or sutured region were sectioned at various survival times for CNTF immunohistochemistry and CNTF mRNA in situ hybridization. The area and intensity of reactive product were measured by computer image processing system. Results:After nerve transection, reactive product of CNTF mRNA and its protein reduced rapidly in distal stumps, after neurorrhaphy, they were observed in thin Schwann cell processes ensheathing axons and not found in the proliferating Schwann cells which didn′t ensheathe axons. CNTF immunoreactivity was also detected in the regenerated nerve axons. CNTF expression increased with survival time, but even at the longest survival time, it was still significantly less than that in intact nerve. The same change was observed in a short segment proximal to the transected or sutured region. Conclusion:CNTF expression is in the down regulation and is collected with Schwann cell axon in peripheral nerve degeneration and regeneration. The changed distribution of CNFT might provide a supportive environment for axonal regeneration.
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The synchronous electromyography of the extrinsic laryngeal muscles (sternohyoid muscle, sternothyroid muscle and thyrohyoid muscle) and thyroarytenoid muscle of dogs was analyzed in this study. The result showed that the electrical activity of the thyrohyoid muscle were synchronous to that of the thyroaryienoid muscle during quiet respiration, deep inspiration, phonation and swallowing. The discharge of the sternohyoid muscle was recorded during expiration and phonation. The electrical activity of the sternothyroid muscle was also recorded during inspiration and phonation, and was increased during deep inspiration. The study suggests that reinnervation of the thyroarytenoid muscle from thyrohyoid branch of the ansa cervicalis for functional rehabilitation could fit well the physiological characteristic of the larynx.
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The recurrent laryngeal nerves of 16 dogs were sectioned to paralyze the vocal cord on the left side. The ansa hypoglossi nerve was cut on the same side, its proximal end was implanted into the thyroarytenoid (TA) muscle belly on the left side in six animals. It was anastomosed with the adductor branch of the recurrent larygeal nerve on the left side in five animals and the other five didn't receive reinnervated operations. After a period of five to six months, the operated areas were reexplored. The excitability values of the implanted nerve, anastomosed proximal and distal nerves, right recurrent laryngeal nerve, normal TA muscle, reinnervated TA muscle and denervated TA muscle were tested respectively in 16 dogs. The results indicated that the excitability values of the implanted and anastomosed nerves were equivalent to those of the normal nerves and were significantly higher than those of the reinnervated muscle which were equivalent to those of the normal muscle. The excitability values of the denervated TA muscles were lowest.
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Objective To assess the feasibility and curative effects of laser surgery in treatment of early-stage glottic carcinoma under self-retaining laryngoscope with nasal endoscopic assistance.Methods Thirteen cases of glottic carcinoma(TisN0M0:2 cases;T1aN0M0:7 cases;T1bN0M0:3 cases;T2N0M0:1 case) extirpated with Nd:YAG laser or Diomed laser from June 1999 to March 2003 were retrospectively analyzed.Because of the poor glottic exposure with self-retaining laryngoscope under general anesthesia,various angular nasal endoscopes were used.The tumor was distinctly displayed on monitor screen with nasal endoscopic assistance and were completely removed through vapourization or removed with Nd:YAG laser or Diomed laser.Results The follow-up period was three to five years.Two patients were found to have local recurrence.One patient received treatment with Nd:YAG laser surgery under electronic laryngoscope with local and superfacial anesthesia,and the patient was followed up for three years without showing recurrence.The other patient underwent vertical hemilaryngectomy and was followed up for three and half years without showing recurrence.All 13 cases were followed up for three years,and all of them were alive.Three-year survival rate was 100%(13/13).When they were followed up for five years,one patient lost track(counted as death),therefore the five-year survival rate was 92.3%(12/13).Conclusions With the assistance of various angular nasal endoscope,the glottic tumors can be exposed distinctly under self-retaining laryngoscope and removed completely.Nd:YAG laser or Diomed laser is an effective and safe procedure with minimal invasion for the treatment of early-stage glottic carcinoma.The advantages of this technique include lower complication rate and high rate of preservation of laryngeal functions,avoidance of tracheotomy and the sequela of laryngeal fissure.