Application research on RBH perceptual evaluation of voice disorders / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the reliability of RBH perceptual evaluation system, and the correlation between its perceptual and acoustic parameters inorder to providing the evidence for clinic practice.</p><p><b>METHODS</b>The voice samples were collected from 100 patients with variable dysphonia and 15 normal people. According to the R, B, H parameters of the RBH system,voice samples were rated on 4-point scale from 0 to 3. The interrater agreement and intrarater reliability were tested. The differences of the acoustic parameters between adjacent ranks in the perceptual parameters were investigated. The correlation between perceptual parameters and acoustic parameters were also studied.</p><p><b>RESULTS</b>The interrater agreement and intrarater reliability were good. Intrarater reliability was varying from 0.428 to 0.608 using Kappa coefficient; intraclass correlation coefficients for interrater agreement were 0.741-0.797 and 0.689-0.762 in the twice perceptual assessments. The differences of the acoustic parameters between adjacent ranks in the perceptual parameters (R, B, H) were significant (P < 0.05). The perceptual parameters (R, B, H) were significantly correlated with the acoustic parameters (Jitter, Shimmer, HNR, MPT and DSI, with r varying from 0.360 to 0.551 or from -0.472 to -0.620, P < 0.01).</p><p><b>CONCLUSION</b>The reliability of RBH perceptual evaluation system is good; its 4-point scale is acceptable; the perceptual parameters are correlated with the acoustic parameters; the RBH system has broad prospects in clinic practice.</p>

Surgical management and reconstruction of petrous internal carotid artery involved in malignant tumors of lateral skull base / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of reconstruction of internal carotid artery after ablation of malignant tumors in lateral skull base.</p><p><b>METHODS</b>Four male patients with malignant tumors in lateral skull base involved internal carotid artery underwent surgical treatment during Jan 2006 to Jan 2009 were retrospectively analyzed. MRI, CT and DSA were performed in all patients and showed that petrous internal carotid arteries (PICAs) were invaded, with luminal narrow. After radical dissection of tumors and the invaded PICAs, saphenous veins were used to reconstruct the PICAs. All cases were applied with postoperative concomitant radiochemotherapy. Three cases underwent total resection of temporal bone and one case underwent sub-total resection of temporal bone. Retrusion of facial nerve was performed in one case and reconstruction of facial nerve in three cases; Resection of sigmoid sinus and jugular foramen was performed in three cases. Resection and repair of meninges were performed in three cases. Free abdominal rectus and latissimus dorsi muscle myocutaneous flaps were used to repair the defect of lateral skull base and the flaps were well survived.</p><p><b>RESULTS</b>No significant neurovascular complications occurred in the patients. Postoperative DSA showed that the reconstructed PICAs were in well conditions. Follow up showed two patients survived tumor-free for five years, one patient had recurrence three years after operation and survived with tumor, and one patient died of recurrence one year after operation.</p><p><b>CONCLUSIONS</b>Reconstruction of PICA by saphenous vein offered the possibility of radical resection of malignant tumors in lateral skull base involved PICAs.</p>

Sternum-hyoid muscle transposition and arytenoid adduction for unilateral vocal cord paralysis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the therapeutic effect of sternum-hyoid muscle transposition and arytenoid adduction for unilateral vocal cord paralysis (UVCP).</p><p><b>METHODS</b>Included in this study were 19 patients with UVCP lasted for 12 months to 15 years. The surgical technique was as follows. The thyroid cartilage was engaged with a skin hook and gently rotated anteriorly. The lateral-inferior corner of the thyroid cartilage was exposed and the muscular process of the arytenoid was identified. Then, the thyroid lamina on the involved side was parasagittally separated 5 mm off the midline. The inner perichondrium was carefully freed from the overlying thyroid cartilage. The lamina was retracted laterally, and a 3-0 prolene suture was placed through the muscular process and tied to the cricoid cartilage at the origin of the lateral cricoarytenoid muscle. A bipedicled strap muscle flap was then transposed into the space between the lamina and the inner perichondrium. Pre- and postoperative voice evaluations measured mean fundamental frequency, jitter, shimmer, harmonic ratio and maximal phonation time, as well as assessments of voice quality.</p><p><b>RESULTS</b>Vocal improvement was obtained in 100% (19 of 19) of patients. Immediately after the operation, the ingression could be observed in vocal cord membrane and vocal process, vocal cord volume was amplified. There was a significant difference (P < 0.05) in all parameters (fundamental frequency, jitter, shimmer, harmonic ratio and maximal phonation time) between pre- and postoperative voice evaluations measured mean. There was no significant difference (P > 0.05) in voice evaluations measured mean between 2 months and 12 months after operation in all patients. No major complications were noted in any patient.</p><p><b>CONCLUSION</b>Sternum-hyoid muscle transposition and arytenoid adduction for unilateral vocal cord paralysis is simple and convenient, no immune rejection, and the long-term result is stable.</p>

Combination of genioglossus advancement by non-trephine technic with uvulopalatopharyngoplasty for treatment of obstructive sleep apnea-hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and reliability of genioglossus advancement and hyoid suspension with non-trephine technic (GAHM) and uvulopalatopharyngoplasty (UPPP) for surgical obstructive sleep apnea-hypopnea syndrome treatment.</p><p><b>METHODS</b>Twenty-six patients (4 female and 22 male) were classified as moderate and severe cases in terms of apnea hypopnea index (AHI) and Friedman classification in the present study. All cases patients underwent genioglossus advancement and hyoid suspension with non-trephine technic Uvulopalatopharyngoplasty UPPP. Pre- and postoperative polysomnography and Epworth sleepiness scale were performed to assess the therapeutic outcomes.</p><p><b>RESULTS</b>The whole operation time ranged from 120-180 minutes. The average amount of bleeding in genioglossus advancement was about 50-100 ml. There were no severe complications during and after the operation. All the cases were followed up to one year. After surgery, AHI was decreased in both group cases, (42.9 +/- 6.6 vs 16.2 +/- 5.7) in the severe group, and 21.3 +/- 4.4 vs 11.3 +/- 5.2 (x(-) +/- s) in the moderate group. With success defined as AHI decreased by more than 50 per cent after surgery, the total success rate in moderate and severe group was 83.3% and 91.7%, respectively (P < 0.01). Furthermore, the success rate of the moderate group was higher than those of the severe group (P < 0.01).</p><p><b>CONCLUSION</b>GAHM combined with UPPP may be beneficial for the moderate and severe OSAHS patients with oropharyngeal and hypopharyngeal obstruction.</p>

Release profile of compound liposomes entrapped with vincristine sulfate and mitoxantrone chlorhydric acid in vitro and their distribution in mice / 药学学报

<p><b>AIM</b>To study on the release profile in vitro and biodistribution in mice of the compound liposomes carried with vincristine sulfate (VCR) and mitoxantrone chlorhydric acid (MTO).</p><p><b>METHODS</b>The release behaviors of the VCR and MTO from compound liposomes were studied in vitro. HPLC was developed for the determination of the contents of VCR and MTO in tissues in mice.</p><p><b>RESULTS</b>The release time of VCR from compound liposome was 24 h and that from free drug (in control solution) was 6 h. The release of MTO from compound liposome was 0.05% after 288 h and release time of MTO from free drug (in control solution) was 12 h. The liposomes and free drugs were injected intravenously at same dose to mice. The elimination half-life time (T 1/2) in plasma of liposomal and free VCR were 0.16 h and 0.14 h, and the AUCs (0 - 48 h) of them were 2.69 (ug x g(-1)) x h and 1.58 (ug x g(-1)) x h, respectively. The elimination half-life times (T 1/2) in plasma of liposomal and free MTO were 21.6 h and 0.05 h and the AUCs (0 - 48 h) of them were 17.06 (ug x g(-1)) x h and 0.42 (ug x g(-1)) x h, respectively.</p><p><b>CONCLUSION</b>The compound liposome with high entrapping efficiency and small particle size could be prepared by pH-gradients method and reverse evaporation technique. Two drugs were sustained-released from the compound liposome. Mice tail intravenous injection of compound liposomes showed that compound liposome prolonged the retention time and improved the concentration of MTO and VCR in the blood circulation system compared to control. In the mean time, compound liposome reduced the concentration of the MTO and VCR in heart, lung, kidney etc. These observations indicated that compound liposome could improve anticancer activity and reduce side effect.</p>

Effect of Spatholobus suberectus on the bone marrow cells and related cytokines of mice / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of Spatholobus suberectus on proliferation and the hematonic mechanism.</p><p><b>METHOD</b>The techniques of culture of hematopoietic cell and hematopoietic growth factor (HGF) assay were used.</p><p><b>RESULT</b>Spatholobus suberectus could obviously promote the proliferation of bone marrow cells in healthy and anaemic mice. The culture media of spleen cell, macrophage, lung and skeletal muscle treated with S. suberectus had much stronger stimulating effects on hematopoietic cells.</p><p><b>CONCLUSION</b>S. suberectus may enhance hematopoiesis by directly or indirectly stimulating stroma cell in hematopoietic inductive microenvironment and muscle tissue to secrete some HGF (Epo, GM-CSF, IL, and MK-CSF). This is one of the biological mechanisms for hematonic effect of S. suberectus.</p>

Changes of TNF-?and IL-10 expression in transplanted laryngeal tissues during acute rejection after laryngeal transplantation in rats / 第二军医大学学报

Objective:To explore the expression of TNF a and IL-10 in different layers of laryngeal tissues after laryngeal transplantation and its relationship with acute rejection.Methods:Laryngeal heterotopic transplantation was performed in Wistar and SD rats(Wistar→SD rats).The SD rats were divided into 4 groups:GroupⅠ:Sham control(receive no transplantation): GroupⅡ(receive transplantation,without cyelosporine A treatment);GroupⅢ(receive transplantation.with 5 mg?kg~(-1)?d cyelosporine A treatment):and GroupⅣ(receive transplantation.with 10 mg?kg~(-1)?d~(-1)cyelosporine A treatment).The transplanted larynx was harvested on 3,7 and 11 days after transplantation for pathological examination.The expression of TNF-?and IL-10 in different layers of grafts was detected immunohistochemically.Results:Pathological observation showed mild,moderate and severe acute rejection in GroupⅡandⅢon 3.7 and 11 days after transplantation,respectively:there was no obvious rejection in GroupⅣ.Immunohistochemical staining showed expression of TNF-?and IL-10 in GroupⅡ.Ⅲ.andⅣ,not in GroupⅠ.The ratios of the positive areas of TNF-?and IL-10 in the mucosal and submucosal layers were significantly higher than those in the muscle and cartilage layers of laryngeal tissues(P