Limonin inhibits apoptosis, promotes autophagy and improves non-alcoholic fatty liver disease by promoting oxidative metabolism of fatty acids through PPARα / 药学学报

Non-alcoholic fatty liver disease (NAFLD) is a very common chronic liver disease in clinic, which can further develop into liver fibrosis, cirrhosis, eventually hepatocellular carcinoma and liver failure. Limonin is a natural triterpenoid compound containing furan rings. Previous studies have found that limonin has good anti-inflammatory, analgesic and liver protective functions. However, the mechanism of action of limonin on NAFLD has not been clarified. Based on the background, C57BL/6J male mice were fed with high fat diet (HFD) to establish NAFLD model (the experiment was approved by the Animal Ethics Committee of Hefei University of Technology, the approval number is HFUT20220429001), and limonin was added to the mice for administration by intragastric administration (i.g.). The results showed that HFD can induce typical NAFLD phenotypes, including impaired liver function, increased fat accumulation, and increased serum aspartate amino transferase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP) levels in mice. Mice were treated with limonin (50 and 100 mg·kg-1) for 10 weeks, and it was found that limonin could restore dyslipidemia and improve fat accumulation in liver cells of mice. In addition, we conducted in vitro experiments with human hepatoma cell line HepG2 cells, and found that limonin can promote the expression of oxidative metabolism and autophagy related genes and inhibit apoptosis in HepG2 cells. Mechanistically, limonin improves high-fat food-induced NAFLD by promoting the expression of oxidative metabolism genes transcriptional coactivator of peroxisome proliferator activating receptor γ (PPARγ) (PGC1α) and carnitine palmitoyl transferase 1 alpha (CPT1α) through peroxisome proliferator activates receptor alpha (PPARα). These results indicate that limonin can inhibit apoptosis, promote autophagy and improve NAFLD by promoting oxidative metabolism of fatty acids through PPARα.

Application of 3D printing models to clinical teaching in otolaryngology / 基础医学与临床

Objective To apply three-dimensional(3D) printing techniques to the clinical anatomy teaching of otolar-yngology. Methods We reconstructed the three-dimensional models of temporal bones and paranasal sinuses based on CT scan data,and divided them into sub-models according to several interested planes on CT scan. Sub-models were printed with 3D printer.The CT images of interested planes were printed by normal printer and pasted to the appropri-ate sub-models. We also checked the accuracy of the anatomy models. Results We successfully made the digital and 3D printing models of temporal bones and paranasal sinuses. The CT scan images were compounded to the models. The key anatomy structures outside and inside of the temporal bone and paranasal sinuses can be shown clearly and exactly on the models. Conclusions The 3D printing models help the medical students to understand and master the clinical anatomy and radiology knowledge of otolaryngology as a supplement for traditional teaching methods.

Quality of life survey on patients with peripheral facial paralysis by using Chinese version of the FaCE scale / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the health related quality of life (QOL) status of patients with peripheral facial paralysis.</p><p><b>METHODS</b>By introducing, translating and adjusting of the FaCE (Facial Clinimetric Evaluation) scale, a Chinese version came into being. The scale was further strictly tested in eighty-one patients with peripheral facial paralysis and thirty healthy volunteers.</p><p><b>RESULTS</b>The feasibility, reliability, validity and responsibility of Chinese version of FaCE scale all passed the test. The split-half reliability, Cronbach's alpha and intraclass correlation coefficient were 0.79, 0.88 and 0.87, respectively. The criteria validity calculated between FaCE and SF-36 was 0.41 (P < 0.05). Factor analysis of the construct validity showed that the 15 items were classified into six domains, which were in accordance with the original version. Every domain was sensitive and effective to discriminate between patient population and healthy population (P < 0.05). Chinese version of FaCE scale showed significant correlation with HBGS and SBGS scores (r = -0.40 and 0.42, P < 0.05).</p><p><b>CONCLUSION</b>Chinese version of the FaCE scale can effectively assess QOL status of patients with facial paralysis in China.</p>

Diagnosis and treatment of facial nerve schwannoma in patients with normal facial nerve function or slight facial palsy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of facial nerve schwannomas with facial nerve function House-Brackmann grade (HB) ≤ grade II.</p><p><b>METHODS</b>A retrospective study was conducted in Peking Union Medical College Hospital. We reviewed eight cases of facial nerve schwannomas with facial nerve function HB ≤ grade II, which were diagnosed and managed between Jan 1996 and March 2011.</p><p><b>RESULTS</b>The initial presenting symptoms of the eight patients were not facial paralysis. Eight patients were misdiagnosed and six had mistreatment histry. CT and(or) MRI results in all patients showed that the tumors originated from different part of the facial nerves. All patients received operation. Facial nerves were completely preserved in four patients because of easy separation of the tumors from the facial nerves in surgery, facial function was gradeII-III over 17 - 180 months' follow-up. The tumors were attached with the facial nerves in two patients with wide extension involving cochlea and labyrinth, therefore the tumors were removed together with the attached facial nerves, and the nerves were repaired by using the greater auricular nerves. Facial function was grade VI over 56 - 79 months' follow-up. One patient refused to sacrifice the facial nerve, wide decompression of facial nerve and tumor was undertaken, facial function was grade III over 8 months' follow-up. One chorda tympani neuroma was removed with the branch of the facial nerve, facial function was grade II over 8 months' follow-up.</p><p><b>CONCLUSIONS</b>The facial nerve schwannomas with facial nerve function HB ≤ grade II is difficult to diagnosis. The therapy strategy should depend on the patients' choice, position of the tumor and adherences of the tumor to facial nerve. Facial nerve could be preserved if the tumor is easy to be separated from the facial nerve during operation, if not, total remove the tumor and nerve repairment are indicted when invasion into the inner ear canal, cerebro pontine angle, cochlea or labyrinth. If patients refuse to sacrifice the facial nerve, facial nerve decompression and periodic follow-up are recommended.</p>

Facial paralysis induced by herpes simplex virus type 1 and the study of facial neurons apoptosis in mice / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the apoptosis of facial motor neurons and the expression of apoptosis-related genes, Bcl-2 and Bax, in the animal model of viral facial paralysis.</p><p><b>METHODS</b>Total of 84 Balb/c mice were divided into viral inoculation group and nerve transaction group. The animals were executed 1, 3, 7, 10, 15, 20 and 30 days after being operated respectively. The histopathological features of facial neurons in brain stem were observed by HE and Nissl stain. The changes of facial neuronal apoptosis were observed by TUNEL. The changes of expression of Bcl-2 and Bax genes in facial neurons were observed by immunohistochemistry staining.</p><p><b>RESULTS</b>After nerve transection, increased apoptotic cells were found in homolateral facial motor nucleus and the peak appeared at 10 and 15 days. The level of Bcl-2 expression in neurons declined while the expression of Bax increased gradually. Correspondingly, the ratio of Bcl-2/Bax declined. In the viral inoculation group, no visible change of apoptosis and Bax expression, but the level of Bcl-2 and the ratio of Bcl-2/Bax increased gradually.</p><p><b>CONCLUSIONS</b>Comparing to axotomy, facial motor nucleus in HSV-1 infective animal model are free of apoptosis. Both the mild form of lesion and the ability to block apoptosis of HSV-1 are likely to be involved into the phenomenon. Bcl-2 and Bax might interfere with the apoptotic response.</p>

Three-dimensional anatomical research on sellar region for transnasal endoscopic surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To develop a new method to explore the three-dimensional characteristics of anatomical structures at the sellar region in transnasal endoscopic surgery.</p><p><b>METHODS</b>(1) The MicronTracker binocular visual navigation system was modified, and the tool's accuracy was tested by comparing the vernier caliper and turntable. (2) The basis nasi plane and median sagittal plane were used as datum plane, S point (the lateral margin point of nasal spine) and M point (maxillary line midpoint) were used as datum point to orientate the structures. The pitching angle, direction angle and distance of the important structures were measured by the tool designed by us based on the MicronTracker binocular visual navigation system and made a computer graphics model.</p><p><b>RESULTS</b>(1) The tool's accuracy had no statistical difference as compared with vernier caliper and turntable. (2) The pitching angle, direction angle and distance of the important structures were obtained. (3) 3D-max 9.0 and AutoCAD-2008 were used to set up three-dimensional anatomical model of the anatomical structures.</p><p><b>CONCLUSION</b>Based on the familiar point and datum of the skull, the orientation data of the important structures could be obtained and the three-dimensional model of the sella region anatomical structures could be constructed.</p>

Applied anatomy of the internal maxillary artery in pterygopalatine fossa under transnasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the rules about the pathway and branch patterns of the internal maxillary artery in pterygopalatine fossa, provide the anatomic basis for treating the internal maxillary artery during the transnasal endoscopic surgery.@*METHOD@#Ten adult cadaveric skull base were dissected, the sphenopalatine artery and its branches were observed. The pterygopalatine fossa was opened through trans-maxillary sinus endoscopic approach, all the branches of the internal maxillary artery in pterygopalatine fossa were exposed. The concave of the maxillary sinus posterior-medial wall was defined as point A, the cross point of the horizontal line pass through the infraorbital foramen, the maxillary sinus anterior wall and posterior-lateral wall as point B, the cross point of the maxillary sinus anterior wall, floor and posterior-lateral wall as point D, the midpoint of BD as C, the C' denoted the first branch root of internal maxillary artery in pterygopalatine fossa. Observed the pterygopalatine segment of internal maxillary artery based on the marking points.@*RESULT@#The distance between the sphenoid sinus os and the sphenopalatine fossa was (5.88 +/- 2.21) mm. The C' point locate on AC at 13 sides specimen, locate on AB at 5 sides specimen, locate on AC at 1 side specimen, higher than AB at 1 side specimen.@*CONCLUSION@#Being familiar with the pathway and branch patterns of the internal maxillary artery in pterygopalatine fossa is important for treating the uncontrol epistaxis and endoscopic pterygopalatine fossa surgery, the rules described by A, B, C, D in our experiments will be helpful in ligation of internal maxillary artery during the endoscopic transnasal/maxillary-pterygopalatine fossa surgery.

Preliminary study on the applied anatomy data collection for the transnasal endoscopic surgery of skull base / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the feasibility to measure the anatomy landmarks in the anatomy research, even in the operation by the MicronTracker binocular visual navigation system, and to study the anatomy of the transnasal endoscopic surgery of skull base.@*METHOD@#We designed a new anatomy data collection system based on the MicronTracker binocular visual navigation system to measure and record the anatomy landmarks, and measured the angles and distances between the related planes and the important structures on 67 dry adult cranium specimens (32 male, 35 female).@*RESULT@#1) The system is reliable, the angles and the distances can be acquired in the real time. 2) The major date of the landmarks was the pitch of the Frankfurt horizontal plane according to the frontal bone plane, male: (77.7 +/- 4.7) degrees, female: (81.6 +/-4.5) degrees; the pitch of the bony nasal floor according to the frontal bone plane, male: (78.6 +/- 5.8) degrees, female: (82.0 +/- 4.5) degrees; from the same side of nasal spine to the anterior edge of foramen lacerum, pitch, male: (61.3 +/- 7.6) degrees, female: (65.6 +/-7.1) degrees, azimuth, male: (7.0 +/- 2.6) degrees, female: (7.1 +/- l.8) degrees, the distance, male: (68.9 +/- 4.1) mm, female: (66.3 +/- 3.9) mm; from the same side of the nasal spine to the aperture of the sphenoidal sinus, pitch, male: (40.5 +/- 9.3) degrees, female: (46.4 +/- 6. 8) degrees, azimuth, male: (2.1 +/- 1.8) degrees, female: (3.6 +/- 2. 6) degrees, the distance, male: (56.2 +/- 3.1) mm, female: (53.4 +/- 3.0) mm.@*CONCLUSION@#1) The anatomy data collection system based on the MicronTracker binocular visual navigation system can be used to measure the anatomy landmarks conveniently, accurately and quickly. 2) The relationship between the landmarks of the skull base and the nasal cavity and the frontal bone plane and the sagittal plane is stable, and the planes can be used as the datum plane to look for the landmarks in the transnasal endoscopic surgery of skull base.

Effects of CD4+ T cell transplantation on facial motoneuron survival in nude mice model with facial nerve axotomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the specific T cell subpopulation and the relationship with facial motoneuron in immune deficiency mouse model with facial nerve paralysis, so as to find information for new strategy of facial palsy treatment.</p><p><b>METHODS</b>Firstly, purifying the CD4+ T cell from wild type mouse and reestablishing the immune function of nude mouse by infusing the CD4+ T cell through the tail vein a week before the surgery. Then the all nude mouse (BALB/c background) and wild type mouse (BALB/c background) were subjected to a right facial nerve axotomy. Then the mouse was studied by application and assessment with fluorogold retro tracer at specific time. After collecting the slices of brain stem three days post the operation, the facial motoneurons was observed under fluorescence microscope, then analyzed and counted with the software Image Pro Plus5. 1.</p><p><b>RESULTS</b>The number of survival facial motoneuron in the group with CD4+ T cell transplantation and control group was (3444.5 +/- 84.2, x +/- s) and (3013.2 +/- 65.3) respectively. There was significant difference of the number of survival facial motoneurons between nude mouse transplanted with CD4+ T cell and PBS at three days post the operation (t = 5.52, P = 0.0003). But there was no significant difference of survival facial motoneurons between nude mouse transplanted with CD4+ T cell and wild type mouse three days post the operation (t = 0.49, P = 0.6347). It was the transplantation of CD4+ T cell that rescued the survival facial motoneuron to the level of wild type.</p><p><b>CONCLUSIONS</b>CD4+ T cell have the ability to rescue the injuring facial motoneuron from death. It may suggest that there is a critical role of the specific T cell subpopulation in facial nerve repair and regeneration.</p>

Surgical treatment in otogenic facial nerve palsy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the character of facial nerve palsy due to four different auris diseases including chronic otitis media, Hunt syndrome, tumor and physical or chemical factors, and to discuss the principles of the surgical management of otogenic facial nerve palsy.</p><p><b>METHODS</b>The clinical characters of 24 patients with otogenic facial nerve palsy because of the four different auris diseases were retrospectively analyzed, all the cases were performed surgical management from October 1991 to March 2007. Facial nerve function was evaluated with House-Brackmann (HB) grading system.</p><p><b>RESULTS</b>The 24 patients including 10 males and 14 females were analysis, of whom 12 cases due to cholesteatoma, 3 cases due to chronic otitis media, 3 cases due to Hunt syndrome, 2 cases resulted from acute otitis media, 2 cases due to physical or chemical factors and 2 cases due to tumor. All cases were treated with operations included facial nerve decompression, lesion resection with facial nerve decompression and lesion resection without facial nerve decompression, 1 patient's facial nerve was resected because of the tumor. According to HB grade system, I degree recovery was attained in 4 cases, while II degree in 10 cases, III degree in 6 cases, IV degree in 2 cases, V degree in 2 cases and VI degree in 1 case.</p><p><b>CONCLUSIONS</b>Removing the lesions completely was the basic factor to the surgery of otogenic facial palsy, moreover, it was important to have facial nerve decompression soon after lesion removal.</p>

Clinical analysis of primary facial nerve neuroma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features of facial nerve neuroma about its diagnosis and management.</p><p><b>METHODS</b>Ten patients with facial nerve neuroma were analyzed retrospectively from February 1993 to August 2005. The period of follow-up varied from 1.5 years to 10 years (mean 5 years). Facial nerve function was evaluated with House-Brackmann grading system.</p><p><b>RESULTS</b>The patients complained of facial paralysis in 7 cases, otitis media in 1 case, a mass in parotid gland in 1 case and a mass on the side of the orbital on face in 1 case. Seven patients were undergone either CT scan or MRI or both. Image studies revealed mass located along the facial nerve course from the nerve endings to the intracranial parts. All the patients accepted the surgery. Intraoperative findings showed that the tumor location matched the image findings. Postoperative pathological diagnosis demonstrated 8 Schwannoma, 2 neurofibroma. There was partial tumor resection in 1 patient accepted and his nerve function was unchanged. Four patients were undergone facial nerve graft but 1 case failed while facial nerve function was improved in 3 other patients. Two patients underwent tumor resection while the continuity of facial nerve was preserved as result their facial nerve function improved respectively. No facial nerve reconstruction was done on other 2 patients.</p><p><b>CONCLUSIONS</b>Multiple origins of facial nerve neuroma were noted and the most common system was facial nerve palsy. The decision on how to treat these patients should be individualized and based on initial facial function, growth rate, surgical experience and informed patient consent. The more effective methods need being seeked for the management of facial nerve neuroma.</p>

Comparative study of several methods for producing experimental animal model of viral facial palsy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To select the optimal method for developing experimental animal model of viral facial paralysis by comparing several inoculation methods.@*METHOD@#One hundred and twenty Balb/c mice were divided into 4 groups, with each group having 30 mice. Group A, the posterior auricular branch of right facial nerve were incised and inoculated with 25 microl HSV-1; group B, 25 microl HSV-1 were inoculated into the posterior aspect of the right auricle by cutaneous scarification; group C, 25 microl HSV-1 were injected into subcutaneous tissue of the posterior aspect of the right auricle; group D, 100 microl HSV-1 were inoculated in the way similar to that of group C. The symmetry of mouse face was observed, and the incidence of paralysis and death were analyzed. The temporal bones of paralyzed mice were serially sectioned and stained with hematoxylin and eosin.@*RESULT@#Thirteen (43.33%) mice developed the right facial paralysis and recovered from it 3-7 days later in group A. Six (20%) mice developed the paralysis and recovered from it 2-9 days later in group B. Group C had no signs of facial paralysis and group D had 1 paralyzed animal. Except for 12 mice in group D, there was no death in the other groups. Nerve swelling was observed in right temporal facial nerve of paralyzed mice. Facial nerve to facial canal cross-sectional area ratio (FN/FC) of the right side was much higher than that of the left side.@*CONCLUSION@#Inoculating HSV-1 into the posterior auricular branch of facial nerve can produce an acute and transient facial paralysis in mice. With the advantage of higher morbidity of facial paralysis and lower mortality in comparison to the other methods, it is an optimal method.