Application of Mohs microsurgery in nasal basal cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective@#To discuss the application of Mohs microsurgery in nasal and facial basal cell carcinoma (BCC) and analyze the pathological and clinical features. @*Methods@#The clinical data of 127 patients who were diagnosed by pathology as nasal and facial BCC in Qilu Hospital of Shandong University from January 2010 to January 2015 were retrospectively analysed. The value of Mohs microsurgery was discussed and the nasal & facial sites of BCC lesions, clinical and histopathology features were summarized. @*Results@#The proportion of male and female was 1.27︰1 in 127 patients, the ages ranged from 27 to 91 years. The top three inflicted area in nasal and facial was followed by nasal dorsum, nasal root and upper lip.The most frequent clinical type was nodular ulcerative type.The most common pathological type was nodular and pigmented. Routine surgical resection was performed in 62 cases (48.8%) while Mohs micrographic surgery in 38 cases (29.9%). Follow-up duration was 37 months on average. Local recurrence occurred in 5 cases in routine surgical resection group while there was no recurrence in Mohs micrographic surgery group. There was no distant metastasis in all cases. @*Conclusions@#There are few specific clinical manifestation in nasal & facial BCC. Surgical treatment is prefered, especially by Mohs micrographic surgery, because it can strictly control the scope of surgical resection and obtain malformation repairment as well as beauty in nasal and facial region.

Cerebral protective effect of isoflurance preconditioning for adult rat model with local cerebral ischemia / 安徽医科大学学报

Objective To investigate the brain protective effects of isoflurane preconditioning for local cerebral is-chemia adult rat model by detecting HIF-1α, HO-1 and Bcl-2 expression level. Methods 84 two-month old Spra-gue-Dawley male rats were randomly divided into sham group, ischemia-reperfusion group ( MCAO group) and isoflurance preconditioning group (ISO group). ISO group was exposed to isoflurane for 30 min and then underwent a 90 min middle cerebral arterial occlusion (MCAO), while MCAO group underwent MCAO only. At 24 h after reperfusion all the groups were investigated by modified neurological severity score for neurological deficits, TTC staining for infarct percentage. Cerebral cortices were harvested for HIF-1α, HO-1 and Bcl-2 protein expression level detection at 6 h, 24 h and 72 h after reperfusion using RT-PCR and western blot. Results The mNSS score and infarct percentage in ISO group decreased significantly compared with those of MCAO group at 24 h after reper-fusion(P 0. 05). Conclusion Isoflurane preconditioning plays short-term cerebral protective effect through the up regulation of HIF-1α, HO-1 and Bcl-2 gene expression.

Application of endotracheal intubation in the rescue of children with severe trachea and bronchial foreign body / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the application of endotracheal intubation in the rescue of children with severe trachea and bronchial foreign body. By observing the patient's clinical pathological characteristics, the diagnosis and treatment experience were summarized.@*METHOD@#A retrospective analysis of 10 children with severe tracheal and bronchial foreign bodies were performed. They were given emergency intubation and cardiopulmonary resuscitation to relieve respiratory and circulatory failure after reaching hospital. After the restoration of spontaneous respiration, oxygen saturation increased by more than 90 percent and vital signs stable, the foreigh body was removed with bronchoscopy. The role of endotracheal intubation before and after the treatment of tracheal and bronchial foreign bodies in children was observed.@*RESULT@#Ten cases of children were rescued successfully. No one died and the complications such as cerebral palsy, pneumothorax and pneumomediastinum didn't happened.@*CONCLUSION@#For the children with severe tracheal and bronchial foreign body, endotracheal intubation can establish effective ventilation in a shorter period of time. The earlier endotracheal intubation, the shorter time required and the higher success rate. Endotracheal intubation can increase the survival rate of children with cardiopulmonary resuscitation, and can reduce disability.

Expression of YKL-40 and TLR4 in patients with chronic rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the expression of YKL-40, TLR4 and NF-κB in chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP and CRSsNP), and to investigate their expressional correlation and the potential role in pathogenesis of CRS.</p><p><b>METHODS</b>The specimens were obtained from sinus mucosa and inferior turbinate mucosa of the patients with informed consent. The different expression of YKL-40, TLR4 and NF-κB among each group was detected by real time RT-PCR and immunohistochemistry (S-P method). SPSS 17.0 software was used to analyze the data.</p><p><b>RESULTS</b>mRNA level: The relative expression of YKL-40 in CRSwNP group (0.91±0.17) was higher than those in the control group (0.49±0.09), the difference was significant (t=2.12, P<0.05). The relative expression of TLR4 in CRSsNP group (0.88±0.19) and CRSwNP group (0.67±0.13) were lower than those in control group (1.48±0.14), the differences were significant (t value was -4.11, -2.48, all P<0.05). The relative expression of NF-κB in CRSsNP group (0.69±0.13) and CRSwNP group (0.72±0.14) were lower than those in control group (1.20±0.15), the differences were significant (t value was 2.33, 2.27, all P<0.05). Protein level: The expression of YKL-40 in CRSwNP group was stronger than that in CRSsNP group and control group (U value was 72.5 and 73, all P<0.01). The expression of TLR4 in CRSwNP group and CRSsNP group was weaker than that in control group (U value was 62 and 38, all P<0.01). There was a negative correlation between YKL-40 and TLR4 (rmRNA=-0.741, P<0.01; rprotein=-0.46, P<0.05) in CRSwNP group.</p><p><b>CONCLUSIONS</b>The expression of YKL-40 in pantients with CRSwNP is higher than those in healthy control and CRSsNP patients. There was a negative correlation between YKL-40 and TLR4. Both of them may be involved in the pathogenesis of CRSwNP.</p>

Endoscopic surgery for maxillary sinus inverted papilloma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of endoscopic surgery for maxillary sinus inverted papilloma.</p><p><b>METHODS</b>From 2000 to 2011, 50 patients with maxillary sinus inverted papilloma were treated with intranasal endoscopic surgery or combined approach. Among them, 39 cases were primary and 11 cases were recurrent, which included 17 patients with Krouse stage IIand 33 cases with Krouse stage III. Different surgical approaches were selected according to the range and positions of the lesions. One case with severe atypical hyperplasia received postoperative radiotherapy.</p><p><b>RESULTS</b>All cases were followed up for 3-14 years, 7 cases recurred. All occurrence within 2 years after operation. Malignant change and death was found in 1 case. After operation, epiphora occurred in 2 cases, maxillary sinus labiogingival groove fistula occurred in 2 cases, facial numbness occurred in 4 cases and incision hemorrhage occurred in 1 case. All the complications were cured after appropriate treatment.</p><p><b>CONCLUSIONS</b>Naso-endoscopic surgery or combined approach is a safe, effective and microinvasive treatment for patients with maxillary sinus inverted papilloma. Accurate selection of suitable approach according to the range and positions of the lesions and correct management of the base of the tumor are critical to the success of the operation.</p>

Preliminary design for a VI system combining the voice acoustic analyzing and glottal image analyzing / 生物医学工程学杂志

This work is directed at developing a virtual instrument system as an accessorial diagnostic instrument for laryngeal diseases. Programmed with LabWindows/CVI, the system combines the voice acoustic analyzing function with the glottal image measuring function. The voice acoustic analyzing system can sample, store and replay vocal signals; can extract and analyze parameters, including fundamental frequency (F0), frequency perturbation quotient (FPQ), amplitude perturbation quotient(APQ), harmonics-to-noise ratio (HNR), jitter frequency (JF), Shimmer; and can do 3D sound graph analysis. The glottal image analyzing system can sample and store the image observed by the laryngostroboscope; can display any phase in one cycle of the vibration of the vocal cords or a slow and continuous movement of vibrating vocal cords; can snap and save the diagnostic frame of image; and can extract the parameters of the image such as the length and area of the glottis, the length and area of the vocal cords and the diseased part.

Diagnosis and treatment of nasal sinus osteoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the clinical characteristic and surgical treatment of nasal sinus osteoma.@*METHOD@#Fifty-one cases with nasal sinus osteoma were diagnosed by nasal sinus X ray or CT scan. All of these osteoma patients were cured by surgical resection. Supraorbital Lynch approach were applied in forty-two cases, lateral rhinotomy Moure approach in 4 cases, Caldwell-Luc approach in 3 cases and Dandy approach that combined with cranium and facial route in 2 cases.@*RESULT@#Operative incisions in all cases healed in 1 period, no complications such as brain spinal fistula occurred. All cases were followed up for 6 months to 5 years, there were no recurrence of osteomas and occurrence of mucus cysts.@*CONCLUSION@#Osteomas in nasal sinus grow slowly. X ray or CT scan is helpful to confirm the diagnosis and choose the surgical approach reasonably.