Effect evaluation of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: Using propensity score matching method(PSM) to investigate the clinical effect of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma. Methods: A retrospective analysis was conducted on the clinical data of 324 patients diagnosed with advanced tonsillar squamous cell carcinoma and treated in Peking Union Medical College Hospital from 2000 to 2018, confirmed by pathology and without distant metastasis. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching(PSM). Results: Of the 324 patients, 102 were treated with non-surgery chemoradiotherapy treatment strategies and 222 with surgical plus radio(chemo)therapy treatment. Cox multivariate analysis showed that the non-surgery treatment group had a favorable prognosis than the surgical treatment group, however, these outcomes were not significantly different [overall survival(OS): adjusted Hazard Ratios(aHR): 0.92, 95% confidence interval(CI): 0.60-1.42; disease-specific survival(DSS): aHR: 0.71, 95%CI: 0.43-1.20; disease-free survival(DFS): aHR: 0.82, 95%CI: 0.53-1.28]. The new patient cohort consisted of 102 subpairs after PSM. There were no significant differences between two groups(OS: aHR: 0.85, 95%CI: 0.51-1.40; DSS: aHR: 0.62, 95%CI: 0.35-1.11; DFS: aHR: 0.80, 95%CI: 0.49-1.33). Conclusion: Our findings indicate that patients with non-surgical treatment do not have significantly better survival outcomes compared to surgical treatment group, while non-surgical treatment has advantages in improving the quality of life of patients, so comprehensive treatment based on radiotherapy and chemotherapy may be recommended for advanced tonsillar squamous cell carcinoma.

HPLC Fingerprint Analysis of Substance Benchmark of Xiao Chengqitang / 中国实验方剂学杂志

Objective:To establish a high performance liquid chromatography （HPLC） fingerprint of the substance benchmark of Xiao Chengqitang and evaluate its quality with chemical pattern recognition method. Method:Diamonsil C₁₈ column （4.6 mm×150 mm， 5 μm） was used， mobile phase was consisted of methanol （A）-0.1% phosphoric acid solution （B） for gradient elution （0-60 min， 20%-90%A； 60-70 min， 90%-100%A）， the flow rate was 1 mL·min^-1， the column temperature was 25 ℃， and the detection wavelength was 254 nm. The similarity evaluation system of chromatographic fingerprint of traditional Chinese medicine （2012 edition） was used to evaluate the similarity of HPLC fingerprint of 15 batches of substance benchmark of Xiao Chengqitang， and the chromatographic data were analyzed by cluster analysis， principal component analysis and orthogonal partial least squares-discriminant analysis， in order to evaluate the quality difference between different batches of substance benchmarks of Xiao Chengqitang and find out the main chemical components that caused the quality difference. Result:The HPLC fingerprint of Xiao Chengqitang substance benchmarks was established， 31 common peaks were identified， and 18 components were identified by comparing with the reference substances. The similarities of 15 batches of HPLC fingerprint of Xiao Chengqitang substance benchmarks were >0.92. The samples could be divided into two categories by three chemical pattern recognition methods. Nine main components leading to the quality discrepancy of samples between batches were screened out， including rhein， chrysophanol-8-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-glucoside， aloe-emodin-8-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-glucoside， sennoside A， chrysophanol-1-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-glucoside， rhein-8-<italic>O</italic>-glucoside and others. Conclusion:The established fingerprint analysis method is accurate， stable and reproducible， which basically reflects the overall chemical composition characteristics of Xiao Chengqitang， and can be used for the quality control of Xiao Chengqitang preparations.

Review of Research on Xiao Chengqitang / 中国实验方剂学杂志

Xiao Chengqitang, derived from Treatise on Febrile Diseases, is composed of Rhei Radix et Rhizoma, Magnoliae Officinalis Cortex and Aurantii Fructus Immaturus. It is often used to treat Yangming Fushi light syndrome. This formula was included in the Catalogue of Ancient Classical Prescription (The First Batch), which has a high clinical application value. Current researches on the chemical composition, pharmacological effect and clinical application of Xiao Chengqitang have been carried out, but the history of Xiao Chengqitang is unclear and the dose conversation method is vague. It has great difficulties in clinical rational applications of Xiao Chengqitang and the research and development of its compound preparations. In this article, the literature reports on Xiao Chengqitang were summarized from the aspects of historical evolution, literature researching of Chinese herbs, dosage conversation method, modern research in case to clarify the historical context of Xiao Chengqitang and to provide basis for the clinical application and modern scientific research of this formula.

Clinical analysis of 14 patients with extraorbital inflammatory myofibroblastic tumor of the head and neck / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical features of extraorbital inflammatory myofibroblastic tumor (IMT) of the head and neck.</p><p><b>METHODS</b>Fourteen cases of extraorbital IMT treated in recent 20 years were analyzed retrospectively.</p><p><b>RESULTS</b>Of the 14 patients, 9 cases with limited lesion in maxilla (n = 5), mandible (n = 2) or neck (n = 2) underwent local resection, and no recurrences were found after 1.5 to 20.0 years; 3 cases diagnosed as maxillary IMT involved in orbit, hard palate or pterygopalatine fossa received conservative therapy (prednisone, prednisone plus radiotherapy or prednisone plus chemotherapy), and no disease progression was found after 6, 9 or 2 years respectively; and 1 case diagnosed as maxillary IMT involved in orbit and pterygopalatine fossa was confirmed with cervical metastases after two operations and died of brain invasion within 17 months. One patient with localized lesion around the common carotid artery was treated with prednisone and had no disease progression with a 2-year follow-up.</p><p><b>CONCLUSIONS</b>Extraorbital IMT of the head and neck is a rare clinical entity. Pathology examination is required for final diagnosis. Corticosteroid administration may be a choice of treatments, and radical resection should be taken selectively for limited lesions.</p>

Assessment of dysphagia: report of 37 cases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the assessment methods of dysphagia.</p><p><b>METHODS</b>The data of 37 patients with dysphagia were retrospectively analyzed. These patients took the Kubota drinking test, Tengdao's evaluation, videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES).</p><p><b>RESULTS</b>Fourteen out of thirty-seventh patients showed abnormal results during Kubota drinking test. Tengdao's evaluation results showed that 29/37 patients were abnormal. There 27/37 and 33/37 patients showed abnormalities in positive-aspiration score and swallow dysfunction score of VFSS. The number of abnormal patients in aspiration score of FEES was 19/21. The Kappa values were 0.137, 0.416 between Kubota drinking test. Tengdao's evaluation and VFSS. The FEES was measured against the VFSS for sensibility, specificity, positive predictive value, and negative predictive value, the values were 88.9%, 66.7%, 94.1% and 50.0%.</p><p><b>CONCLUSIONS</b>Kubota drinking test and Tengdao's evaluation can be applied for screening purpose and evaluating result after treatment; VFSS and FEES can be used as more accurate assessments, they can study the dysphagia's character, position and severity. The combination of a variety of dysphagia evaluation methods is the most important basis for diagnosis and treatment of deglutition disorders.</p>

A simplified Chinese version of the Quebec sleep questionnaire was evaluated for reliability and validity / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To develop a simplified Chinese version of the 32-item Quebec sleep questionnaire (QSQ) and to examine the reliability and validity.</p><p><b>METHODS</b>A cross-sectional sample of 141 patients [22 simple snorers and 119 obstructive sleep apnea hypopnea syndrome (OSAHS)] and a longitudinal sample of 55 patients [35 in uvulopalatopharyngoplasty (UPPP) group and 20 in control group] completed the simplified Chinese version of QSQ for assessment of its feasibility, reliability, validity and responsiveness.</p><p><b>RESULTS</b>QSQ had good feasibility. All internal consistency coefficients exceeded 0.65. Intraclass correlation coefficients of five domains for test-retest reliability ranged from 0.82 - 0.91. There were significant differences in four domains (daytime sleepiness, diurnal symptoms, nocturnal symptoms and social interactions) among patients with different severity of apnea hypopnea index (AHI) and lowest saturation of arterial oxygen (LSaO2, P < 0.01 or < 0.05). Correlations between QSQ scores and five domains and Epworth sleepiness scale (ESS) were statistically significant (P < 0.01). Correlations between QSQ scores and three domains (daytime sleepiness, nocturnal symptoms and social interactions) and polysomnography (PSG) indices (AHI and LSaO2) were statistically significant (P < 0.05). There were significant differences in scores of five domains of patients between at baseline and after UPPP. There were significant differences in change scores of five domains between patients who were treated and those who were not.</p><p><b>CONCLUSION</b>The simplified Chinese version of QSQ offers good reliability, validity and responsiveness and can be used as a OSAHS-specific instrument to assess impact of illness and treatment effectiveness in OSAHS patients.</p>

Reliability and validity of the simplified Chinese version of Epworth sleepiness scale / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the reliability and validity of the simplified Chinese version of Epworth sleepiness scale(ESS).</p><p><b>METHODS</b>Five hundred and eighty-five patients with suspected obstructive sleep apnea hypopnea syndrome (OSAHS) and 103 OSAHS patients who underwent operations were included in this study. The ESS was filled before polysomnography (PSG) monitoring under the direction of professional technicians. The patients who underwent operations did both PSG and ESS tests more than 6 months after operation. Fifty-one patients who underwent PSG at our hospital from July to August, 2010 were chosen to assess the ESS test-retest reliability on two separate occasions at least more than one week.</p><p><b>RESULTS</b>The total Cronbach's Alpha of ESS was 0.814. The test-retest reliability of ESS total scores was 0.679 and for each item was from 0.473 to 0.698(P < 0.01). Split-half reliability was 0.817 (P < 0.01). In the analysis of discriminant validity with apnea hypopnea index (AHI), the ESS total scores and each item's scores had significant differences in severity in OSAHS patients and simple snoring patients (P < 0.05), and this was also true in different degrees of lowest saturation of arterial oxygen (LSaO(2)) patients and normal LSaO(2) patients (P < 0.05). The factor analysis of construct validity showed that 4 factors were extracted. The cumulative proportion was 74.270%. The loading was higher than 0.4 among every item. The correlation coefficiency of overall ESS scores and each item's scores was relatively high except the last item. The ESS had low consistency with clinical diagnosis(κ = 0.099, P < 0.01) and the predictive validity was not good (r = 0.138, P < 0.01).As for 103 patients who had operations, the initial assessment of total ESS scores were 15.0[10;20] (M[P(25); P(75)]), and improved to 4[1;6] after operation. The patients who got effective results had significant difference in the total ESS scores before and after operation (Z = -7.528, P < 0.01), so was the patients who got ineffective results (Z = -4.382, P < 0.01) .</p><p><b>CONCLUSIONS</b>The simplified Chinese version of ESS had a good reliability and validity. It can be used to evaluate the chance of dozing in the daytime.</p>

Clinical value of upper airway pressure measurement and Friedman staging system in preoperative evaluation for obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of localization of upper airway obstructive site with pressure measurements and Friedman staging system in preoperative upper airway reconstructive surgery for obstructive sleep apnea-hypopnea syndrome (OSAHS), and to evaluate the value of Friedman staging system in predicting the upper airway obstructive site.</p><p><b>METHODS</b>One hundred and three patients with snoring, daytime sleepiness diagnosed as OSAHS by polysomnography were first classified using Friedman staging system, and then examined using whole night recording, including airway continuous pressure measurements (Apnea Graph, AG). AG transducer catheter containing two pressure and two temperature sensors used for obstruction site determination and detection of apnea events during sleep. Obstructive sites were divided into upper (retropalatal region) or lower level (retroglossal region). Using constituent ratio to reflect the obstructive proportion of different levels so as to find the correlation between Friedman staging system and localization of upper airway obstructive site with pressure measurements performed during sleep, and to evaluate the clinical value of Friedman staging system in predicting the severity of OSAHS.</p><p><b>RESULTS</b>There was statistically significant difference in the constituent ratio of retroglossal obstruction determined by AG, according to Friedman staging system, Friedman tongue position (FTP) and tonsil size grading (F = 13.876, 7.655, 10.207 respectively, P < 0.05). The constituent ratio of retroglossal obstruction between stage IV and I, II, III (P < 0.01) was significantly different. With the increasing of Friedman staging, the constituent ratio of retroglossal obstruction had the tendency of increasing. The constituent ratio of retroglossal obstruction between FTP grade 2 and grade 3, grade 4 (P < 0.05) was significantly different. With the increasing of FTP grading, the constituent ratio of retroglossal obstruction had the tendency of increasing. The constituent ratio of retroglossal obstruction between the Friedman tonsil size grade 4 and grade 1, grade 3 (P < 0.01), grade 2 (P < 0.05) was significantly different.</p><p><b>CONCLUSIONS</b>Friedman staging system, in particular the FTP grading, had a correlation with upper airway pressure measurements (AG) in determination of the lower level of upper airway obstructive site, especially the retroglossal region, which could predict the main localization of upper airway obstructive site identified by upper airway pressure measurements during the sleep.</p>

Outcomes of upper airway reconstructive surgery for moderate to severe obstructive sleep apnea syndrome based on upper airway pressure measurements / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To assess the effect of upper airway reconstructive surgery for moderate to severe obstructive sleep apnea-hypopnea syndrome (OSAHS) with the obstructive sites determined by pressure measurements, and to evaluate the clinical value of upper airway manometry in localizing the obstructive sites.</p><p><b>METHODS</b>Fifty-one moderate to severe OSAHS patients were examined using whole night recording, including airway continuous pressure measurements (ApneaGraph, MRA-Medical Ltd, UK). ApneaGraph (AG) transducer catheter contains two pressure and two temperature sensors used for obstruction site determination and detection of apnoeic events during sleep. Obstructive sites were divided into upper (retropalatal region) and lower level (retroglossal region). The lower limit of obstruction was determined by AG pressure pattern. Using constituent ratio to reflect the obstructive proportion of different levels. All patients were divided into two groups (retropalatal or retroglossal) according to the primary obstructive level. The patients of retropalatal group were treated with modified uvulopalatopharyngoplasty (UPPP), or plus hard palate shortening. The patients of retroglossal group underwent tongue and palatal surgical procedures such as UPPP, hyoid suspension, radiofrequency ablation of tongue base, genioglossus advancement etc. All patients were followed-up at least 6 months using Apneagraph. Clinical outcomes included the Epworth sleeping scale (ESS), apnea-hypopnea index (AHI) and lowest arterial oxygen saturation (LSaO2).</p><p><b>RESULTS</b>Five patients had moderate OSAHS and 46 were severe. Four patients had experienced UPPP failures. The ESS reduced from average 17.6 ± 4.7 to 4.3 ± 4.3 (x(-) ± s, t = 15.195, P < 0.001). The AHI reduced from average 52.4 ± 17.5 to 16.3 ± 18.2 (t = 10.873, P < 0.001). The LSaO2 increased from 0.706 ± 0.099 (x(-) ± s) to 0.823 ± 0.092 (t = -8.396, P < 0.001). The success was defined as a ≥ 50 percent reduction and final apnea-hypopnea index < 20/h, the total success rate was 76.5%. Retropalatal group had 27 patients and 24 cases were in retroglossal group.Their success rate were 81.5% and 75.0% respectively.</p><p><b>CONCLUSION</b>The upper airway pressure measurements can identify the level of obstruction accurately and prove to be effective in the treatment of OSAHS.</p>

Clinical and pathological features of Riedel's thyroiditis / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the clinical and pathological features of Riedel's thyroiditis (RT), and current diagnostic and treatment methods for that disease.</p><p><b>METHODS</b>Five RT cases identified by surgery and pathological examinations at Peking Union Medical College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the literature in terms of clinical and pathological features. Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.</p><p><b>RESULTS</b>All the five cases were females, aged 45-55 years. Elevation of serum thyroid autoantibodies was found in only one patient, who had longer disease duration than the others. Pathological examination revealed invasive fibrosclerosis of the thyroid follicles, thyroid capsule, and the surrounding tissues. In RT tissues, the number of cells containing lambda chains was a little higher than those containing kappa chains.</p><p><b>CONCLUSIONS</b>RT is a rare disease which might be more common in middle-aged females than in other populations. Pathological features include the destruction of thyroid follicle, extension into surrounding tissues by inflammatory cells and fibrous tissues. Immunohistochemical staining of kappa and lambda chains could help diagnose RT.</p>

One night treatment of obstructive sleep apnea and hypopnea syndrome with nasopharyngeal airway / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutical effect and feasibility of treating obstructive sleep apnea hypopnea syndrome (OSAHS) with nasopharyngeal airway.</p><p><b>METHODS</b>Thirty-two OSAHS patients were treated with silicone nasopharyngeal airway for one night. Each patient had Somite polysomnography (PSG) for the first night and repeated PSG with the nasopharyngeal airway treatment for the second night. PSG parameters were compared between the two nights. With normal distribution data in (x(-) +/- s), Paired-Samples t test was used.</p><p><b>RESULTS</b>Overall patient tolerance of the nasopharyngeal airway for one night was 90.6% (29/32). With the nasopharyngeal airway treatment, the AHI of the 29 patients decreased from (44.7 +/- 16.0)/h to (14.6 +/- 10.0)/h, the longest time of apnea shortened from (44.3 +/- 11.5) s to (30.1 +/- 13.2) s, the lowest arterial oxygen saturation increased from (0.722 +/- 0.080) to (0.861 +/- 0.070) and the percentage of sleep time with arterial oxygen saturation < 0.90 decreased from (19.2 +/- 18.0)% to (1.5 +/- 4.0)%. Data showed obvious therapeutical effect (Paired-Samples t test, P < 0.001). The subject symptoms of the 29 patients improved obviously that night with treatment and the following day after treatment. The therapeutical successful rate for one night was 65.5% (19/29, a reduction of AHI by 50% and AHI < 20/h). The noneffective reason of the six patients was probably that they had higher proportion of tongue base obstruction.</p><p><b>CONCLUSIONS</b>The single-night preliminary experiment shows that the treatment using nasopharyngeal airway has obvious therapeutical effect for OSAHS patients with retropalatal obstruction and provides clinical evidence for developing a new treatment approach in the future. In addition, based on the result of nasopharyngeal airway treatment, the obstruction level may be evaluated.</p>

Management of nasopharyngeal stenosis following uvulopalatopharyngoplasty / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Severe nasopharyngeal stenosis (NPS) is a rare complication of uvulopalatopharyngoplasty (UPPP) and very difficult to manage. This report presents our successful treatment experience.</p><p><b>METHODS</b>From Nov 1997 to Feb 2006, 6 adults patients with NPS secondary to UPPP were treated in Peking Union Hospital. Two cases was grade II stenosis, received surgery of local pharyngeal and soft palate mucosa flap rotation to enlarge nasopharyngeal airway with stenosis; For the remaining 4 cases with more severe NPS (grade III) who had received 1-3 times unsuccessful repair procedures previously, prolonged nasopharyngeal hollow obturators were used for 6 months after stenosis repair surgery.</p><p><b>RESULTS</b>With 9-48 months follow-up, All cases results were satisfactory. Nasal obstruction symptom was eliminated, NPS corrected, no velopharyngeal insufficiency complication happened. Daytime removable nasopharyngeal hollow stent obturators with palate support device is more comfortable for patients.</p><p><b>CONCLUSIONS</b>Local flap rotation to enlarge stenosis airway and prolonged use nasopharyngeal hollow obturators are reliable methods of correction NPS following UPPP.</p>

Comparison of diagnosis and localization methods in obstructive sleep apnea syndrome: apneagraph vs polysomnography and apneagraph vs endoscopy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>ApneaGragh is a new device for simultaneous determination of obstructive sleep apnoeic events and continuous pressure measurements for localization of upper airway obstructive site. This study is to evaluate the clinical value of it.</p><p><b>METHODS</b>From April to October in 2006, 32 obstructive sleep apnea (OSA) patients diagnosed by polysomnography (PSG) were examined by two methods: Endoscopy with müller's maneuver at daytime and continuous upper airway pressure recording with ApneaGraph at night in Peking Union Medical College Hospital. The upper airway obstructive sites determined by the two methods were compared. ApneaGraph transducer catheter contains two pressure sensors and two temperature sensors used for obstruction site determination and detection of apnoeic events during sleep. Obstructive sites were divided into upper (retropalatal oropharynx) or lower level (retroglossal region). The lower limit of upper airway obstruction was determined by observed pressure pattern. Used constituent retio to reflect the obstructive proportion of different levels. The apnea hypopnea index (AHI) measured by PSG and ApneaGraph were also compared.</p><p><b>RESULTS</b>Two patterns of obstruction were observed in our group: 1. The site of obstruction was located only at the upper level. 2. The obstruction of upper and lower level all present. Site of obstruction determined by Apneagraph: 28 (87.5%) cases had predominant sites of obstructions in upper level (the constituent retio of retropalatal obstruction > 50%), the others in lower level (the constituent retio of retroglossal obstruction > 50%). Endoscopy localization of obstruction: 18 cases had retropalatal obstructions alone, 13 cases had obstructions of retropalate combined with retroglossa, only 1 patient didn't have obstruction. Defined the constituent retio higher than thirty percent the criteria of obstruction, then identical results were obtained by both methods in retropalatal segment in 27 (84.4%) of the patients, while in only 17 (53.1%) obstructions was determined by the both methods in retroglossal areas. The polysomnograpic AHI (x +/- s) was 52.2 +/- 18.1, versus 50.2 +/- 16.0 obtained by ApneaGraph. There was a significant correlation between them (r = 0.876, P < 0.001).</p><p><b>CONCLUSIONS</b>ApneaGraph can identify the level of upper airway obstruction more accurate than fiberoptic pharyngoscopy. In the meantime, it also can serve as a portable PSG to diagnose sleep disordered breathing qualitatively.</p>

Investigation of CXCR4 in oral squamous cell carcinoma and its influence on proliferation of tumor cells in vitro / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the expression of CXCR4 in oral squamous cell carcinoma (OSCC) and its influence on the proliferation of OSCC cells.</p><p><b>METHODS</b>The expression of CXCR4 was evaluated by immunohistochemical study in 91 surgically resected oral squamous cell carcinoma, and the relation between the staining and clinicopathological features was examined. Flow cytometry was used to detect CXCR4 expression in oral squamous cell carcinoma cell line. MTT assay was used to evaluate the SDF-1/CXCR4 influence on proliferation of tumor cells.</p><p><b>RESULTS</b>The expression of CXCR4 in OSCC was 62.6% and there was a significant association between the expression of CXCR4 and lymph node metastases (P < 0.05), tumor size (P < 0.01) and tumor histology grade (P < 0.01). In flow cytometry, a significant shift in fluorescent staining was seen in cells. In MTT assay, recombinant SDF-1 stimulated proliferation of OSCC cell and CXCR4 neutralization by monoclonal antibodies decreased proliferation.</p><p><b>CONCLUSIONS</b>The expression of CXCR4 was significantly correlated with the clinicopathological features and tumor proliferation. CXCR4 might be a valuable biomarker to predict the progression of OSCC.</p>

Expression of Scleraxis in human periodontal ligament cells and gingival fibroblasts / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To study if Scleraxis, a basic helix-loop-helix type transcription factor, could be expressed in human periodontal ligament cells (hPDLC), bone marrow cells (hBMSC) and gingival fibroblasts (hGF), and to investigate if Scleraxis was involved in hPDLC differentiation.</p><p><b>METHODS</b>hPDLC, hBMSC and hGF were cultured. Expression of Scleraxis in hPDLC from different passages and in hBMSC and hGF was analyzed by reverse transcription polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>Scleraxis expression in hPDLC, hBMSC and hGF were significantly different (P < 0.05). The A values of Scleraxis/beta-actin in these kinds of cells were 0.877 +/- 0.024, 0.438 +/- 0.031, 0.313 +/- 0.083, respectively. The expression of Scleraxis was the highest in hPDLC and lowest in hGF. Scleraxis expression of hPDLC decreased with increase of passages in culture.</p><p><b>CONCLUSIONS</b>Scleraxis was expressed in hPDLC, hBMSC and hGF in vitro, and may play an important role in differentiation of hPDLC.</p>

Diagnosis and treatment of Madelung's disease / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To review the characteristics of Madelung's disease which is rare and unfamiliar to clinicians and to find the method of diagnosis and treatment.</p><p><b>METHODS</b>Detailed clinical data of 7 patients with Madelung's disease were reviewed and analyzed. And related literatures were discussed together.</p><p><b>RESULTS</b>All of 7 patients have excessive subcutaneous fat deposit predominantly around neck. One patients had the complication of central and peripheral neuropathy, One patients had the complication of glucose intolerance, One patients had the complication of chronic hepatopathy and hyperuricaemia. These 3 patients were associated with sleep apnea syndrome simultaneously. Another one patient was accompanied by autonomic nervous system disease only. Total neck lipectomy and abstinence from alcohol were performed on 5 patients. No recurrence was seen during a follow-up of 6 months to 5 years. One patient received partial lipectomy twice and relapsed again. All pathological results were nonencapsulated fat. One patient refused treatment. Six men patients were alcohol abusers.</p><p><b>CONCLUSIONS</b>Madelung's disease is characterized by massive accumulation of nonencapsulated subcutaneous fat mainly located symmetrically in the neck. Chronic alcoholism may be a major risk factor. It may be associated with some internal diseases. Total neck lipectomy to improve figuration and relieve pressure and abstinence from alcohol may be the main effective therapy.</p>