Clinical Diagnosis and Treatment of Idiopathic Subglottic Stenosis: a Report with Four Patients / 现代生物医学进展

Objective:To investigate the clinical diagnosis and treatment of idiopathic subglottic stenosis.Methods:From May 2012 to January 2014,four patients with idiopathic subglottic stenosis admitted in the Department of Otolaryngology,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China were selected for review.Results:All the four patients with idiopathic subglottic stenosis were resolved after the resection of the pathological tissues and subsequent hormone treatment.Conclusions:The confirmed diagnosis of idiopathic subglottic stenosis mainly relied on the medical history and pathological examination.Favorable treatment effects might be obtained by combining surgical resection and hormone treatment.

Instructions of Neural Response Telemetry for Prediction of the Rehabilitation Effects and Mapping in Children Cochlear Implant / 听力学及言语疾病杂志

Objective To study the stability of NRT threshold and the correlation between NRT threshold and the value of behavior T ,C in order to instruct mapping in infant cochlear implant ,and to study whether the elic‐itation of NRT waveform can be applied to determine the effects of rehabilitation .Methods There were 159 cases with complete information in data in this study .150 out of the 159 cases coincided with the study requirements of the changes and correlation .We had collected the NRT thresholds of the electrodes of No .1 ,6 ,11 ,16 ,22 in switch-on ,one month after switched -on ,half a year and one year after switched -on .The analysis of variance method was adopted to compare the threshold changes of each electrode in different stages .We had collected the values of behavior T ,C in one year after switched -on .Pearson regression analysis was used to compare the correlation be‐tween NRT threshold in switch -on and this value of behavior T ,C .We applied MAIS assessment scale to make a questionnaire for all 159 patients during the follow -up at one year after switched -on .We had gathered the scores in three aspects ,the average score in questionnaire and the average hearing threshold of every child .All children were divided into four groups according to whether the elicitation of NRT waveform during - operation ,post-op‐eration .Results Regarding the NRT threshold ,there was no significant difference in the pairwise comparison of four time points(P>0 .05) .There was positive correlation between NRT threshold and behavior T ,C(P 0 .05) .Conclusion The NRT threshold remains steady from switched -on .A positive correlation exists between NRT threshold and the actual T ,C value .The NRT threshold can be used to estimate the T ,C value .But the accuracy of the measured value is less than the behavior method .We still need to use behavior method to measure as soon as possible .The NRT waveform appearance on the post-operation is more significant than that on the during -operation to prognosis of rehabilitation .

Polyethylenimine for Plasmid Delivery to the Basilar Membrane of the Neonatal C57BL/6J Mice Cochlea in Vitro / 听力学及言语疾病杂志

Objective To study the effects of using 25 kDa linear and branched PEI to transfer plasmid DNA pEGFP -C1 (pDNA ,encoding the enhanced green fluorescent protein reporter gene ) to the basilar membrane of the C57BL/6 mice cochlea in vitro .Methods L -PEI/pDNA and B -PEI/pDNA polyplexes were generated in 0 .1M phosphate buffer solution (PBS) or 5% glucose solution .Polyplexes were characterized by transmission electron mi-croscopy .Agarose gel retardation assay was used to determine the plasmid binding ability of L -PEI and B -PEI . The toxicity was investigated by MTT assay .The transfection was firstly evaluated in 293T cell line ,and then the appropriate amount of PEI and plasmid were applied for cochlear explant transfection of P4 mice pups .Results Un-der the same condition ,B -PEI had better transfection efficiency than L -PEI ,but its toxicity was also higher . When generated in PBS ,the polyplexes had lower toxicity than in glucose solution .L -PEI-pDNA nanoparticles could transfect the spiral limbus fibrocytes ,some spiral ganglion neurons and supporting cells ,but the efficiency was low .Conclusion L -PEI could be used as the non -viral vector for the transfection of the cultured basilar mem-brane of P4 mice pups ,but it should be modified to reach higher efficiency .

The summary of experience and effect observation of cochlear implants in adults with different causes / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This article summarizes the matters warranting consideration in adult cochlear implants before and after operation with different deafness causes and investigates the impact of etiological variables that affect hearing and speech ability rehabilitation after cochlear implantation.@*METHOD@#We retrospectively reviewed the preoperative data of 30 adults who have received cochlear implantation, switch on, and periodical post operative mapping. 'Nijmegen Cochlear Implant Questionnaire' was used for every patient during follow-up and test their hearing thresholds at one year after switched-on. The average score of every patient in the six aspects of questionnaire, along with the average hearing threshold, has been gathered.@*RESULT@#The average hearing threshold of every patient is lower than 35 dBHL. The average score of 28 patients is more than or equal to 75 in the basic sound perception, advanced sound perception as well as self-esteem. The average score of 26 patients is more than or equal to 75 in capacity for action. Besides, as for sociability and speech ability, the average score of 22 patients is more than or equal to 75.@*CONCLUSION@#Auditory perception can be greatly improved regardless of deafness causes, on the premise that appropriate candidate is selected. The primary disease should be brought under control before and after the operation. The influence of various causes to the language ability rehabilitation largely depends on the development of the language center at deafness onset. Self-esteem and social identity can be significantly enhanced after cochlear implantation in adult patients, particularly those with acquired deafness.

The Factors Affecting the Rehabilitation Efficacy after the Operation of Adults Cochlear Implantation / 听力学及言语疾病杂志

Objective We will discuss the related factors affecting the rehabilitation efficacy after the opera-tion of adults cochlear implantation .Methods Nijmegen Cochlear Implant Questionnaire'was adopted .There were questionnaire surveys on 29 adult patients with cochlear implantation .The individual scores and total scores of all subjects were collected together with the personal information ,including age ,bilateral effects and other factors . They were grouped in accordance with different grouping standards of different affecting factors .Results Compared to the communication manner of long -term hearing loss ,the rehabilitation efficacy of the group using lip -reading preoperatively was greater than the group using sign language or writing ;the rehabilitation efficacy of the group with the aggregate time of using CIs more than two years was superior to that similar group of less than two years , and the average P within the group of these two factors was 0 .05 .Conclusion Ages ,the bilateral deafness ,and auditory dep-rivation have no obvious effects on the rehabilitation efficacy after the operation .The patients with postlingual deafness can improve their hearing with proper rehabilitation .Lip-reading preoperatively has positive effects on the rehabilitation effica-cy after the operation ;the length of using CIs has become the major factor affecting the rehabilitation efficacy .

Expressions of HMGB1, MMP-2 and MMP-9 and prognostic alue in human laryngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expressions of high mobility group box B1 protein (HMGB1), matrix metalloproteinases-2(MMP-2) and matrix metalloproteinases-9 (MMP-9) in human laryngeal carcinoma and study their relationships with clinicopathological characteristics and prognosis.@*METHOD@#The expressions of HMGB1, MMP-2 and MMP-9 proteins were examined with the EnVision immunohistochemical method in 61 cases of laryngeal carcinoma. The expressions of HMGB1, MMP-2 and MMP-9 mRNA were detected by real-time quantitative RT-PCR method in 30 cases of laryngeal carcinoma.@*RESULT@#The positive expression rates of HMGB1, MMP-2 and MMP-9 proteins were significantly higher in laryngeal carcinoma than those in adjacent tissue (chi2=44.934, 49.923 and 36.054, P<0.01). The relative expression levels of HMGB1, MMP-2 and MMP-9 mRNA in laryngeal carcinoma were significantly higher than those in adjacent tissue (t=5.940, 7.005 and 7.664, P<0.01). The high level expression of HMGB1, MMP-2, MMP-9 proteins was closely associated with T stage, clinical stage and the status of lymph node metastasis (P<0.05 or P<0.01). There was a positive correlation between the expression of HMGB1 and MMP-9 protein (r=0.381, P<0.01). Univariate analysis indicated that the overall survival rate was lower in patients with a positive expression of HMGB1 and MMP-9 than those with negative expression (chi2= 4.974, 6.418, P<0.05). Multivariate analysis showed that HMGB1 was a risk predictor. A higher expression of HMGB1 was associated with a shorter survival time.@*CONCLUSION@#HMGB1, MMP-2 and MMP-9 play a role in invasion and metastasis of laryngeal carcinoma; Also there is a synergistic effect between HMGB1 and MMP-9; Moreover HMGB1 may be a independent prognostic factor.

Clinical significance of Stat3 and Cyclin D1 expression in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To examine the expression and clinical significance of the Stat3 and Cyclin D1 in laryngeal squamous cell carcinoma (LSCC).@*METHOD@#The expression of Stat3 and Cyclin D1 in LSCC tissue were detected by the RT-PCR and Western blot method respectively, and then the relationship between Stat3 and Cyclin D1 protein expression level and relevant clinical factors of LSCC was explored.@*RESULT@#Compared to the normal larynx mucosa group, the expression level of Stat3 and Cyclin D1 was significantly higher in LSCC (P < 0.01). The high expression level of Stat3 and Cyclin D1 protein in LSCC was correlated with the clinical stage, tumor differentiation and lymph node metastases (P < 0.01). The expression level of Stat3 was positively correlated with that of Cyclin D1, The correlation coefficient(r) was 0.564 (P < 0.01) for the protein expression and 0.552 (P < 0.01) for the mRNA expression.@*CONCLUSION@#Stat3 signaling pathway may play an important role in the tumorigenesis and progression of LSCC. The expression level of Stat3 and its target gene Cyclin D1 can reflect the malignancy degree of LSCC.

A verification study on the genes associated with laryngeal squamous cell carcinoma by cDNA microarray / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Our previous study revealed many genes differentially expressed in human laryngeal squamous cell carcinoma tissues (LSCC) and related adjacent normal tissues. We verificated the differentiated expressions of target genes, possibly related to LSCC. And these results can be foundations of further study of these target genes function.@*METHOD@#SENP1, CD109, Laminin alpha 2, Laminin alpha 3 were selected according to the cDNA microarray results. The expression of these genes mRNA and protein were detected by RT-PCR and Western blot in 12 cases of LSCC and related adjacent normal tissues.@*RESULT@#The mRNA expression of SENP1, CD109 and Laminin alpha 3 were significantly higher while Laminin alpha 2 were significantly lower in LSCC tissues than in corresponding adjacent normal tissues by Semiquantitative RT-PCR. Western blot analysis revealed SENP1, CD109 protein expression were significantly higher in LSCC tissues than in corresponding adjacent normal tissues.@*CONCLUSION@#SENP1, CD109, Laminin alpha 2 and Laminin alpha 3 may correlated with tumorigenesis and development of LSCC and can provide beneficial clue for study pathogenesis of LSCC in molecular level.

Effectiveness of Microresection Combined with Radiofrequency Ablation under Laryngoscope and Rigid Telescope for Laryngeal Precancerosis / 中国微创外科杂志

Objective To investigate the effectiveness of microresection combined with radiofrequency ablation under laryngoscope and rigid telescope for laryngeal precancerosis. Methods Fifty-one patients with laryngeal precancerosis, which was diagnosed pathologically, were treated with microresection combined with radiofrequency ablation under laryngoscope and rigid telescope. The patients were followed up for over 6 months. Results During a mean of 26-month follow-up (6 months to 4.5 years), 7 of the patients had recurrence (vocal cord leukoplakia in 3, atypical hyperplasia in 2, and laryngeal papilloma in 2); 4 had carcinomatous change (vocal cord leukoplakia in 1, atypical hyperplasia in 2, and laryngeal papilloma in 1);and 2 patients developed laryngeal web after surgical treatment for bilateral vocal cord leukoplakia. One month after the operation, the Jitter, Shimmer, and NNE were decreased significantly (P