Isolated metastasis of the ascending ramus of the mandible of thyroid follicular carcinoma: a case report / 临床耳鼻咽喉头颈外科杂志

The mandibular metastatic spread of carcinoma from the thyroid gland is exceedingly rare. Follicular thyroid carcinoma is the second most common type of thyroid carcinoma，accounting for approximately 10% to 15% of all thyroid cancers. The prognosis of FTC is relatively satisfactory. Due to its rich blood transport, it is easy to metastasize hematological, with the main sites of metastasis are bone and lung. However，mandibular metastasis of thyroid follicular carcinoma is rare. We report a case of thyroid follicular carcinoma that metastasized to the ascending ramus of the mandible 21 years after surgery.The operation was successfully completed, and there was no recurrence during postoperative follow-up. Due to the absence of obvious clinical symptoms in the patient, the diagnosis and treatment were challenging. We have provided detailed radiographic and pathological images to facilitate understanding and discussion of the disease.

A multi-center observation of the therapeutic efficacy of Bencycloquidium bromide in the treatment of seasonal allergic rhinitis with predominant symptoms of rhinorrhea / 临床耳鼻咽喉头颈外科杂志

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.

Effects of survival motor neuron gene knockdown on acute kidney injury induced by cisplatin in mice / 中华肾脏病杂志

Objective:To investigate the role of survival motor neuron ( SMN) gene knockout in mice with cisplatin-induced acute kidney injury (AKI). Methods:A mouse model (C57BL/6) of cisplatin-induced AKI was constructed. Twenty male wild type (WT) and SMN+/- mice weighing 22-24 g were randomly divided into four groups: WT mice with saline injection group (WT vehicle, n=5), SMN+/- mice with saline injection group ( SMN+/- vehicle, n=5), WT mice with cisplatin injection group (WT cisplatin, n=5) and SMN+/- mice with cisplatin injection group ( SMN+/- cisplatin, n=5). Mice were injected intraperitoneally with 20 mg/kg cisplatin or 0.9% saline. 72 hours later, the mice were sacrificed, and serum and kidney tissues were collected. The real time PCR and Western blotting were used to measure the expression levels of SMN mRNA and protein. The sarcosine oxidation and urease method were used to measure serum creatinine (Scr) and blood urea nitrogen (BUN) levels. Renal pathologic changes were observed by PAS staining. TUNEL immunofluorescence assay was used to detect the level of apoptosis. Western blotting and immunohistochemistry were used to detect the protein expression levels of apoptosis index poly (ADP-ribose) polymerase (PARP) and endoplasmic reticulum stress index CHOP. Results:Compared with WT mice, SMN mRNA and protein expression levels were lower in SMN+/- mice, and the expression level of SMN mRNA and protein was further decreased after intraperitoneal cisplatin injection (all P<0.05). Compared with WT mice with saline injection group, WT mice with cisplatin injection group had higher levels of Scr, BUN, tubular damage scores, TUNEL positive cell numbers, PARP and CHOP, while the expression levels of above indexes in the SMN+/- mice with cisplatin injection group were higher than those in the WT mice with cisplatin injection group (all P<0.05). Conclusions:SMN gene knockout can aggravate renal pathological damage and apoptosis of renal tubular epithelial cell in cisplatin-induced AKI mice. SMN may be a potential therapeutic target of AKI.

Chinese Society of Allergy and Chinese Society of Otorhinolaryngology-Head and Neck Surgery Guideline for Chronic Rhinosinusitis

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.

Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.

Complementary and alternative medicine for rhinitis and sinusitis / 中华耳鼻咽喉头颈外科杂志

Complementary and alternative medicine (CAM) describes a broad category of practices and treatments for the prevention or treatment of disease outside the realm of conventional medicine. CAM is widely used in the treatment of allergic rhinitis, acute and chronic rhinosinusitis. This article summarizes a variety of CAM and the efficacy in the treatment of rhinitis and sinusitis, with the purpose of increasing people′s awareness of CAM and enriching the treatment of rhinitis and sinusitis, so that patients can benefit from it.

Measurement of morphological parameters of internal acousticmeatus using thin-section CT / 中华耳鼻咽喉头颈外科杂志

Objective@#This study aimed to measure the morphological parameters of the internal acoustic meatus(IAM) and its adjacent structures using temporal-bone thin-section CT(computed tomography).@*Methods@#CT images were obtained from 50 Chinese adult patients (25 males and 25 females, 100 sides) which had no visible lesion in the petrous part of the temporal bone and inner ear, the morphological parameters of all inner ear parts were sectionally measured on the specified plane using SPSS 22.0 software for statistical analysis.@*Results@#The integral morphological characteristics of the IAM were observed. These results revealed that anterior-posterior diameter of the internal acoustic poer(IAP)(CD) was (6.93±1.85)mm, the superior-inferior diameter of the IAP(EF) was (4.40±0.86)mm, the length of the IAM(AB) was (9.30±1.60)mm, the superior-inferior diameter of the IAM(the intersection of inner 1/3 section and middle 1/3 section) was (4.13±0.83)mm, the superior-inferior diameter of the IAM(the intersection of middle 1/3 section and outer 1/3 section) was (4.61±1.02)mm, the anterior-posterior diameter of the IAM(the intersection of inner 1/3 section and middle 1/3 section) was (6.62±1.92)mm, the anterior-posterior diameter of the IAM(the intersection of middle 1/3 section and outer 1/3 section) was (6.28±1.65)mm, the depth of transverse crest (superior wall) was (3.10±0.75)mm, the depth of transverse crest (interior wall)the was (1.46±0.59)mm, the distance from transverse crest vertex A to the superior wall of the IAM was (2.05±0.42)mm, the distance from transverse crest vertex A to the interior wall of the IAM was (2.93±0.41)mm, the thickness of the superior bone wall of the IAM (the intersection of inner 1/3 section and middle 1/3 section) was (4.45±1.34)mm, the thickness of the superior bone wall of the IAM (the intersection of middle 1/3 section and outer 1/3 section) was (4.32±1.12)mm, the thickness of the superior bone wall of the IAM (the intersection of outer 1/3 section and transverse crest vertex) was (4.37±1.28)mm, and the appearance ratio of the cells in the whole IAM superior wall was 32%.The whole IAM assumed the shape of short cylinder, inclining about 1 cm outward, with the upper-lower diameter and anterior-posterior diameter about 5 mm.@*Conclusion@#It is necessary for carrying out preoperative the temporal-bone thin-section CT to obtain the morphological parameters of the IAM, determine its basic morphology, and provide references to avoid damaging the other important structures during IAM surgeries.

The inhibiting role of recombinant plasmid PGCsi-AQP1 on laryngeal carcinoma in vivo / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To construct a kind of recombinant plasmid PGCsi-AQP1 delivery with DOPC and explore the inhibit effect of laryngeal carcinoma by RNAi targeting AQP1 in vivo.@*METHOD@#Male BALB/c mice, 6 weeks of age transplanted with laryngeal carcinoma cell line Hep-2, four groups were divided randomly: Tail vein injection group (TVIG), Carcinoma around injection group (CAIG), negative control group (NCG) and blank control group (BCG). The recombinant plasmid PGCsi-AQP1 delivery with DOPC were inject into tail vein or surrounding tumor. HE pathological slides and tumor size were observed and inhibitory rate was figured up. The level of AQP1 protein expression and high microvessel density were detected by Immunohistochemical staining (IHC).@*RESULT@#We constructed BALB/c mice models of laryngeal carcinoma successfully (1) HE staining: cell putrescence, nuclear pyknosis and apoptotic bodies were more in the tumor tissues of experimental groups than two control groups. (2) The total volumes of tumor in experimental group were both smaller than in two control groups (P 0.05). (3) IHC: the AQP1 positive cells and microvessel density in TVIG and CAIG were both less than in two control groups (P < 0.01).@*CONCLUSION@#Neutral lipsomes DOPC could help carriaging the recombinant plasmid PGCsi-AQP1 to tumor and then play an inhibit role in laryngeal carcinoma tissue by RNAi targeting AQP1 in vivo.

Role of Irbesartan on cardiac endothelial-to-mesenchymal transition in diabetic rats / 中华肾脏病杂志

Objective To explore the effect of irbesartan on cardiac endothelial-mesenchymal transition (EndMT) in diabetic rats.Methods The model of diabetic rat was induced by intraperitoneal injection with streptozotocin (STZ,35 mg/kg) in spontaneous hypertensive rats (SHR).Diabetic rats were divided into diabetic group and the Irbesartan treated group.The pathological changes were investigated by fluorescence microscope and electron microscope.The EndMT was studied in human aortic endothelial cells (HAEC) exposure to high glucose.The concentration of angiotensin Ⅱ in the supernatant was detected by radioimmunoassay.Immunofluorescence staining was performed to detect the co-localization of CD31 and FSP1.Results The significant myocardial fibrosis was presented in the diabetic group.Endothelial protrusions were prominent feature in myocardial microvascular of diabetic rat compared with the control group rats.Double staining of HAEC showed co-localization of CD31 and FSP1,which was decreased by the treatment of Irbesartan (P ＜ 0.05).When HAEC was exposed to high glucose,it showed some cells acquired spindle-shaped morphology and lost CD31 staining,and FSP1 and α-SMA protein expression levels were markedly upregulated,which attenuated by the treatment of Irbesartan.Conclusion Irbesartan might prevent diabetes from myocardial fibrosis via inhibition of EndMT in diabetic rats.

Allergic factors affect on severity of chronic rhinosinusitis and postoperative outcomes / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate whether the allergic factors impact the severity of chronic rhinosinusitis or not, further more, to explore the relationship between allergic rhinitis and chronic rhinosinusitis.@*METHOD@#A retrospective review was done on 103 patients. All of these patients were under functional intranasal endoscopic sinus surgery after expectant treatment is ineffective. We devided the patients into different groups according to the result of skin prick and specific IgE and if there is difference in VAS score, Lund and Kennedy endoscopic score, Lund-Mackay CT score between the groups. We also analysed the symptoms in different chronic rhinosinusitis patients allerged to variant kinds of allergen. The SPSS 17.0 software was used to analyze the data. Statistical analysis was performed by t-test, rank order test or χ2 test.@*RESULT@#The duration of the disease, VAS score of nasal blockage, score of Lund-Mackay CT and Lund and Kennedy endoscopic before the operation were in no statistical sense after when compared with the two groups of patients with chronic rhiriosinusitis who grouped according the result of skin prick and specific IgE. The VAS score of facial pressure and loss of smell was higher in patients with chronic rhinosinusitis which the skin prick and specific IgE were positive. The VAS score of nasal discharge was higher in patients with chronic rhinosinusitis who got negative skin prick and specific IgE result. The symptoms of chronic rhinosinusitis improved with operation no matter the group of skin prick and specific IgE positive or negative and VAS score of nasal blockage improved significantly in negative group. The symptoms of sneezing, rhinorrhoea and rhinocnesmus improved after operation among the chronic rhinosinusitis patients with skin prick and specific IgE. The number of cockroach allergy is larger among the patients with chronic rhinosinusitis without polyps than the one among the patients with chronic rhinosinusitis with polyps.@*CONCLUSION@#Allergic factor didn't impact much the severity of chronic rhinosinusitis patients who were failed in expectant treatment, besidesthe postoperative outcomes showed that only influence the severity of nasal discharge, facial pressure and loss of smell. Different kinds of allergen were found between the patients of chronic rhinosinusitis with or without polyps. No significantly functional endoscopic sinusitis sugrery outcome were related to the allergic factor. But the allergic factor may interfere the remission of nasal discharge after surgery.

Follicular dendritic cell sarcoma: a case report and review of literature / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To report a case of follicular dendritic cell sarcoma (FDCS) of tonsil,analyze its clinical and pathological features, as well as the diagnosis and differential diagnosis.@*METHOD@#Tonsillectomy of low temperature coblation were done with general anesthesia. Histopathology, immunohistochemistry, electron microscope were used to analyzed the features of FDCS. The clinical character and treatment were reported.@*RESULT@#There was no evidence of recurrence in two years.@*CONCLUSION@#A correct diagnosis of FDCS was difficult to make , and immunohistochemical and ultrastructural studies are useful to FDCS's diagnosis. Low temperature coblation used in FDCS need more experience.

Research of cellular toxic effect to Hep-2 of recombinant toxin MSH-Ang / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the cytotoxicity of recombinate toxin MSH-Ang to Hep-2.@*METHOD@#The depurated MSH-Ang were applied in cytotoxicity experiment, and the growth inhibiting action to laryngeal carcinoma cell Hep-2 were observed.@*RESULT@#Recombination protein inhibited the growth of laryngeal carcinoma cell Hep-2, and its inhibiting action enhanced and corpuscular mortality rate increased along with the concentration increasing.@*CONCLUSION@#Recombinant toxin MSH-Ang can not only take special effect in tumors with high MSHR, but also target to many other popular tumors.

Expression of SleX in nasal epithelium with chronic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the expression of SleX in nasal epithelium in patients with chronic rhinosinusitis.@*METHOD@#Nine nasal epitheliums from patients with chronic rhinosinusitis and 7 normal controls were stained with SleX antibody by immunohistochemistry, and its expression were analyzed.@*RESULT@#Both nasal epithelial cells and neutrophils expressed SleX. Nearly 88.9% nasal epithelium from patients with chronic rhinosinusitis expressed SleX while 14.3% in normal control. Expression of SleX in nasal epitheliums from patients with chronic rhinosinusitis were higher than that in normal control. There were significant difference between two groups.@*CONCLUSION@#Nasal epithelium from patients with CRS is highly expressed SleX. It may involve the occurrence of chronic rhinosinusitis.

Characteristics of mRNA level of interleukin 12 and intercellular adhesion molecule 1 and monocyte chemotactic protein 3 in human nasal epithelial cells / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the mRNA level of IL-12, ICAM-1 and MCP-3 in human nasal epithelial cells.@*METHOD@#Firstly, human primary nasal epithelial cells were cultured, and then 4 pairs of primers were designed for detecting mRNA level of IL-12, ICAM-1 and MCP-3. The 938 bp PCR products of GAPDH were used as internal standards. The mRNA expression levels of IL-12, ICAM-1 and MCP-3 in primary nasal epithelial cells was measured with semi-quantitative reverse transcription-polymerase chain reaction.@*RESULT@#The round or irregular primary nasal epithelial cells were observed sticking to the bottom of cell culture plates under 400 times optical microscope. The expressions of IL-12 p35, ICAM-1 and MCP-3 mRNA were found in primary nasal epithelial cells while IL-12 p40 subunit was not detected.@*CONCLUSION@#IL-12 p35, ICAM-1 and MCP-3 mRNAs are expressed in primary nasal epithelial cells, whereas effective IL-12 with integrity is not present in nasal epithelial cells.

Expression and distribution of monocyte chemotactic protein-3 and its significance in laryngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate monocyte chemotactic protein-3 (MCP-3) mRNA and protein expression and distribution in laryngeal squamous cell carcinoma (LSCC) tissue, so as to study its function in the tumor development.@*METHOD@#Immunohistochemical staining and RT-PCR, and western blot were performed to detect the LSCC tissue and the normal tissue adjacent tumor.@*RESULT@#The expression of MCP-3 mRNA and protein were found in the LSCC tissue and the normal tissue adjacent tumor. The expression of MCP-3 mRNA and protein in LSCC tissue is much higher than that in normal tissue adjacent tumor (P<0.05). There is a significant difference between I-II stage III-IV stage (P<0.05). Immunohistochemical staining: positive staining of MCP-3 was yellow and mainly detected in the tumor cell cytoplasm and also in some normal glandular epitheliums.@*CONCLUSION@#MCP-3 might be involved in the mechanism of the tumor development, its function of chemotaxis and activation of the tumor-associated macrophages would be highlighted, so that the inflammatory microenvironment might play an important role in the development of tumor.

Expression of TLR9 in human nasal epithelial cells / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze expression of TLR9 in human nasal epithelial cells by semi-quantitative reverse transcription-polymerase chain reaction, immunohistochemistry and flow cytometry.@*METHOD@#Human primary nasal epithelial cells (HNECs) were cultured, and then analyze the expression of TLR9 in primary cultured HNECs measured by semi-quantitative RT-PCR and immunohistochemistry and flow cytometry.@*RESULT@#Primary cultured HNECs were observed by 400 x optical microscopes. Round or irregular cells stick to the bottom of cell culture plates. RT-PCR showed that mRNA expressions of TLR9 were found in primary nasal epithelial cells by 1% agarose gel electrophoresis. Interestingly, by analyzing with gray level of GAPDH, expression of TLR9 mRNA in HNECs was higher than positive control PBMCs.@*CONCLUSION@#TLR9 is expressed by HNECs. Expression of TLR9 mRNA in nasal epithelial cells is higher than in PBMCs.

Expression and distribution of aquaporin 1 in laryngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To detect expression level and distribution of aquaporin 1 (AQP1) in laryngeal carcinoma tissues and try to find out the significance about the mechanism of AQP1 in the invasion of laryngeal carcinoma.@*METHOD@#Twenty cases of laryngeal carcinoma tissues and 15 cases of normal tissues beside tumors were acquired immediately after surgery. The expression and distribution of aquaporin 1 in laryngeal carcinoma were examined by RT-PCR, western blot analysis and immunohistochemical technique.@*RESULT@#AQP1 expresses on the capillary endothelia of laryngeal mucous lamina propria and laryngeal mucous glands of normal tissues and mainly on the capillary endothelia cells, tumor cells and cancer nests of laryngeal carcinoma tissues. AQP1 mRNA and protein expression level in laryngeal tumor tissues is remarkably stronger than that in normal tissues beside tumors.@*CONCLUSION@#The expression of AQP1 was increased in laryngeal carcinoma tissues over normal laryngeal tissues. It suggests that the mechanism of AQP1 in laryngeal carcinoma etiopathogenesis needs to be studied.

Experience in treating anterior-lateral benign tumor in middle cranial fossa base through standard facial translocation approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the feasibility and effect of improved standard facial translocation approach in treating anterior-lateral benign tumor in middle cranial fossa base.@*METHOD@#We excised 10 cases of benign tumor originating from pharynx nasals of pterygopalatine fossa and expanding toward the cavernous sinus of middle cranial fossa, infratemporal fossa or pterygo-maxillary space. We ameliorated, facial incision, maxilla disassembled, reestablishment, fixation,maxillary mucosal option and remained lateral wall of nasal cavity to some extent.@*RESULT@#The mean time of following-up was 38 month postoperatively without complications of bleeding, infection and necrosis or prolapse of displacing bones. Nine patients were treated successfully, one died.@*CONCLUSION@#Reforming facial translocation approach in treating anterior-lateral benign tumor in middle cranial fossa base was safe and obtained ideal curative effect in near future.

Expression of SleX and CD24 in nasal inverted papilloma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the expression of SleX and CD24 in nasal inverted papilloma and its pathologic features.METHODS HE staining were conducted to study the pathologic features in specimens of 11 cases with nasal inverted papilloma. Further,immunohistochemistry stain for SleX and CD24 were performed in total specimens.RESULTS One case(9.1%) was diagnosed as severe atypical hyperplasia but tumor cells did not invaded basal membranes.SleX staining located at cell membranes. Positive SleX staining was found in 9 specimens (81.8%) and 1 normal nasal epithelium (16.7%).CD24 staining located in cytoplasm.Positive CD24 staining was found in 8 specimens of nasal inverted papilloma (72.7%). CD24 was negative in nasal epithelial cells and only a few lymphocytes were positive.CONCLUSION Some cases of nasal inverted papilloma are diagnosed with severe atypical hyperplasia.Most of cases express CD24,so nasal inverted papilloma may be a borderline tumor.Expression of SleX and infiltration of inflammatory cells suggest that nasal inverted papilloma may be related to inflammatory reactions.