Plasma SCF/c-kit Levels in Patients with Dipper and Non-Dipper Hypertension / 中国医学科学杂志(英文版)

Objective The aim of this study was to investigate the relationship between peripheral plasma stem cell factor (SCF)/c-kit levels and the types of dipper and non-dipper hypertension in hypertensive patients. Methods This cross-sectional study included newly diagnosed hypertensive patients who underwent 24-hour ambulatory blood pressure monitor (ABPM) between January 2009 and 2012 in Jiangning city. Patients were divided into the dipper group and the non-dipper group according to ABPM measurements. The levels of SCF and its receptor c-kit, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) in peripheral blood were measured via enzyme-linked immunosorbent assays. The serum levels of glucose and lipid were examined as well. The levels of SCF/c-kit were compared between the dippers and the non-dippers; and their correlation with 24-hour mean systolic blood pressure (MSBP), 24-hour mean diastolic blood pressure (MDBP), TNF-α and IL-6 were investigated using linear regression analyses statistically. Results A total of 247 patients with newly diagnosed hypertension were recruited into the study, including 116 non-dippers and 131 dippers. The levels of peripheral plasma SCF were higher in non-dipper group (907.1±52.7 ng/L vs. 778.7±44.6 ng/L; t=2.837, P<0.01), and the levels of c-kit were higher in non-dipper group too (13.2±1.7 μg/L vs 9.57±1.4 μg/L; t=2.831, P<0.01). Linear regression analysis revealed that SCF/c-kit levels were significantly positively correlated with MSBP, MDBP, plasma TNF-α, and IL-6 levels (all P<0.01). Conclusions Peripheral plasma SCF/c-kit levels are higher in patients with non-dipper hypertension than those with dipper one, and significantly correlate with 24-hour MSBP, 24-hour MDBP, serum TNF-α and IL-6 levels.

Surgery and function reconstruction of laryngeal cancer involved supraglottic and glottis area / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the surgery preserving epiglottis, the repair and the postoperative functions in laryngeal carcinoma involving supraglottic and glottic areas.</p><p><b>METHODS</b>A total of 97 cases with laryngeal cancer involving both supraglottic and glottic areas with normal epiglottis underwent surgery between June 2005 and December 2010 was reviewed. Of them 37 cases were stage II, 41 cases were stage III, and 19 cases were stage IV. Vertical partial laryngectomy (VPL) or extended VPL with the repair and functional reconstruction was carried out in 86 cases and cricohyoidoepiglottopexy (CHEP) in 11 cases. Postoperative survival rate, laryngeal functions and quality of life were evaluated.</p><p><b>RESULTS</b>The 3-year and 5-year total cumulative survival rate (Kaplan-Meire survival analysis) were 87.1% and 69.6% in the 97 cases; 86.6% and 68.3% in VPL/EVPL group; 90.0% and 78.8% in CHEP group, respectively, with no significant difference between VPL/EVPL and CHEP groups (P > 0.05). Of 97 cases, 86(88.7%) cases were decannulated postoperatively. The rates of decannulation were 87.2% (75/86) in VPL/EVPL group and 100% (11/11) in CHEP group, with no significant difference (P > 0.05). Average oral diet recovery time of VPL/EVPL group and CHEP group was (5.2 ± 1.3) and (15.7 ± 5.2) days, respectively, with a significant difference (P < 0.01). Voice evaluation showed the mean maximum phonation time of VPL/EVPL group was shorter than that of CHEP group (P < 0.01) and the S/Z ratio of VPL/EVPL group was higher than that of CHEP group (P < 0.01). Perceptual voice evaluation GRBAS ratings showed patients in VPL/EVPL group had higher G and B ratings compared to patients in CHEP group (P < 0.01), but no significant difference in R-rating between two groups (P > 0.05). Voice handicap index-10 (VHI-10) scores of VPL/EVPL and CHEP groups were 29.5 ± 4.7 and 31.6 ± 6.3, respectively, no significant difference (P > 0.05).</p><p><b>CONCLUSIONS</b>For patients with the laryngeal carcinoma involving both supraglottic and glottic areas, VPL has better anatomical and functional outcomes than CHEP. The preservation of at least 2/3 of the lamina of thyroid cartilage on one side and shift-down of epiglottis were key to successful VPL and postoperative decannulation.</p>

Treatment of pyriform sinus carcinoma involving the lateral wall / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To present and discuss the clinical features, treatment, and efficacy of pyriform sinus carcinoma involving the lateral wall.</p><p><b>METHODS</b>Seventy-seven patients with pyriform sinus cancer involving the lateral wall (stage I 8, stage II 10, stage III 32, stage IV 27, according to UICC 2002 staging) were treated from Jun 1997 to Jun 2009 in the department of otorhinolaryngology head and neck surgery, Yuhuangding Hospital. The patients were divided into two groups: Group one 17 cases, simply underwent radiation therapy (R group); Group two 60 cases underwent surgery plus postoperative radiation (SR group). All patients underwent radiotherapy 50-75 Gy. In SR group, hyoid area and lateral pharyngeal approaches were taken according to the lesions for resection. To repair the defects and reconstruct the functions of larynx and pharynx, regional roping in suture, fascial flap/muscular- fascial of strap muscles, glosso-flap, musculocutaneous flap of major pectoral muscle, joint split graft or heterologous (bovine) acellular dermal matrix were used respectively.</p><p><b>RESULTS</b>In group R, the primary tumor and neck lymph node metastasis disappeared at the end of radiotherapy in 15 cases. For one case, the N3 cervical lymph nodes shrank, but failed in local control and died of systemic metastases after 7 months. For another case, the N2 neck lymph nodes significantly reduced after the full course of radiation, PET-CT and biopsy did not find the cancer, but the tumor grew again after 6 months, and died of a neck bleeding 11 months later. All repairing materials used were alive in SR group. Two cases developed postoperative wound infection, and 2 cases suffered from pharyngeal fistula. All patients retained laryngeal functions, and all patients in SR group recovered diet 12 - 30 days, the mean time was 15.6 days. Three and 5 year survival rates for all 77 patients were 59.1% and 41.4%. For stage I + stage II cases in SR group and R group, 3 and 5 year survival rates were 63.6%, 53.0% and 66.7%, 50.0% respectively. There was no significant difference between the two groups (χ(2) = 0.021, P = 0.884). For cases of stage III + stage IV of the SR group and R group, 3 and 5 year survival rates were 63.9%, 43.7%, 16.4%, and 0. There was a very significant difference (χ(2) = 20.496, P = 0.000); all cases in SR group and in R group for 3, 5-year survival rates were 63.6%, 45.8%, 41.5%, and 24.9% respectively. There was also a significant stastical difference (χ(2) = 4.644, P = 0.031).</p><p><b>CONCLUSIONS</b>Pyriform sinus carcinoma involving the lateral wall is characterized with scattered growth on the surface of mucous or submucously, tending to invade lamina cartilaginis thyroidea. Simple radiotherapy can get better therapeutic effect for early stage cases. The comprehensive therapy measures should be taken in advanced cases, especially those with surgical indications should be taken to surgery plus radiotherapy. For the purpose of excising the tumor thoroughly and preserving good laryngeal functions, proper operative approaches and ways of repairing should be selected.</p>

Repairing of palatum durum defects following maxillectomy using nasal septum tissue flap / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the effect of repairing of palatum durum defects following maxillectomy using nasal septum tissue flap.</p><p><b>METHODS</b>Twenty-six patients underwent maxillectomy and the defects were repaired by using full (16 cases) and partial (10 cases) nasal septum tissue flaps.</p><p><b>RESULTS</b>Twenty-one patients were healed by first intention, recovering swallowing and pronunciation function. Five patients suffered from fistula holes, and 2 healed after dressing while 2 of the other 3 patients healed after second suturing with 1 still got a small fistula hole. Facial deformity include 4 exterior cheek mild concave and 6 complained about unsuited false teeth and no dorsal subsidence was found. The 3, 5, 10 year survival rate was 46.2%, 30.8% and 11.5% respectively.</p><p><b>CONCLUSIONS</b>Repairing defects with nasal septum tissue flap has advantages. Nasal septum can not be invaded easily, and the material can be got with ease, with rich blood supply, being resistant to infection, easy to heal and less chance of leading to fistula holes. With the cartilage of nasal septum as support, facial deformity can be reduced. And the method is worth spreading and exploiting.</p>

Resection and one-stage repair of basal cell carcinoma of external nose / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To present the method of resection and one-stage repair of basal cell carcinoma of external nose.</p><p><b>METHODS</b>Sixty-two patients with basal cell carcinoma of external nose were hospitalized and underwent surgeries from January 2002 to June 2010. The defects after resection were as follows: 1 partial defect of soft tissue of lateral ala nasi, associated defect of ala nasi margin, total defect of ala nasi, defect of soft tissue of apex nasi, defect of apex nasi and ala nasi, defect of the bridge of the nose. Various flaps were applied according to the degree of defects. With nasal parabolic sulci and nasolabial sulcus as the center, different flaps were used, including advanced skin flap, pedicle tunnel island flap of nasolabial sulcus, and flip flap of nasolabial sulcus, forehead axial flap, dissociated auricle compound soft tissue flap for one-stage repair respectively.</p><p><b>RESULTS</b>Two flaps failed because of thanatosis after the surgeries. One flap mostly was a necrosis with the upper small part survived. A marginal partial necrosis of the flap appeared in 2 patients. Two fixing nasal apex and nasal wing suffered a partial circum exfoliation. All other 55 flaps were successfully implanted with satisfying looks and breathing functions with the exception of 1 complaining about obvious nasal obstruction. The rest were followed up for 6 months to 8 years with no relapse.</p><p><b>CONCLUSIONS</b>Most of the tumors of external nose are basaloma, and the margin of safety should be secured during the operation with Mohn's surgery, and once thoroughly resected, there are barely relapses, and radiotherapy or chemotherapy is unnecessary. Pedicled skin flaps can be used as in one-stage repairing of the defect of external nose, with high rate of success and close color shade and good outcome.</p>

Endoscopic maxillary sinus surgery through anterior or posterior nasolacrimal duct approach / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility and effectiveness of the approaches and methodology of the endoscopic surgery for maxillary sinus lesions through the medial wall of the maxillary sinus.</p><p><b>METHODS</b>From Jun. 2003 to Aug. 2010, endoscopic surgery through anterior or posterior nasolacrimal duct approaches to remove maxillary sinus lesions were conducted in 139 patients. Among them there were 43 cases with inverted papilloma, 63 cases with fungal maxillary sinusitis, 28 cases with maxillary sinus cyst, 3 cases with hemorrhagic necrotic polyps, and 2 cases with osteomas. All patients underwent preoperative CT scans, and patients with inverted papillomas also had MRI tests. Anterior-nasolacrimal canal paths included 3 ways: pyriform aperture, lacrimal bone recess (dissecting nasolacrimal duct or not were 2 subtypes), pyriform aperture-nasolacrimal duct approaches, and 97 patients were treated. Posterior-nasal lacrimal duct paths were also divided into 3 subtypes: the inferior turbinate flip flap, double pedicle inferior turbinate, single pedicle inferior turbinate, and 42 patients were treated. The postoperative effects were observed.</p><p><b>RESULTS</b>All lesions were completely removed under endoscope, the nasolacrimal ducts and inferior turbinates were protected, no nasal lacrimal duct injury and inferior turbinate necrosis were found. Postoperative nasal congestion, headache, swelling discomfort, strange odor, dental pain and numbness and other symptoms gradually disappeared. Nine patients felt nasal dryness, and after nasal washing for about 1 month, the symptom gradually disappeared. Patients were followed up for 6 months to 79 months. In case of osteoma, and hemorrhagic and necrotic polyps, no recurrences were found. Apparent edema, hypertrophy of sinus mucosa could be seen during the surgery in all patients with fungal maxillary sinusitis, and the edema gradually disappeared after 3 months or so, with no relapse. Two cases of maxillary sinus cysts were found in other parts of the maxillary sinus 10 months and 18 months after the surgery, but the cysts were small and asymptomatic, so no further management needed, and they were still under follow-up. Three patients, recurred. In 1 case with inverted papilloma, a local lump on the opening were found 17 months after the surgery, and was removed in out-patient department and pathology showed papillary tumor recurrence, no relapse was found 1 year later; 1 patient had recurrence in anterior ethmoid sinus 15 months after operation, total ethmoidectomy was done and no relapse was found in 3 years. One patient had local recurrence in the posterolateral wall of the maxillary sinus 26 months after operation, and the secondary surgery was done via single pedicle inferior turbinate. The papilloma relapsed again after 1 year, an endoscopic Denker surgery was performed, with no recurrence after 18 months of follow-up. Three months after surgery, the maxillary sinus was scar-covered in all cases. Inferior turbinate maintained good shape, compared to those with inferior nasal meatus windowing surgery. Scars were significantly smaller, but no latch or obstruction of drainage were found.</p><p><b>CONCLUSIONS</b>Endoscopic maxillary sinus surgery through anterior or posterior nasolacrimal duct approach can reduce the trauma, fully expose the sinuses, and facilitate postoperative treatment and review with a window. Retained inferior nasal turbinate is helpful to avoid dryness, crusting, headache and other complications due to too much removal of nasal exteral walls.</p>

Endoscopic removal of ethmoid osteomas under navigation guidance / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the minimally-invasive ablation of osteomas of the ethmoid sinuses endonasally.</p><p><b>METHODS</b>A retrospective analysis was done in 19 patients (15 male, 4 female, aged between 14 - 67, medium 37) diagnosed as osteomas of ethmoid sinuses hospitalized from April 2005 to October 2009. All patients underwent sixteen-detector row computed tomography scan and 3D reconstruction preoperatively. All underwent operation with the help of navigation system and nasal endoscope.</p><p><b>RESULTS</b>The ethmoid osteoma in all 19 patients was removed successfully with endoscope and navigation system. Two open procedures (1 through superciliary arch incision and 1 through labiogingival incision) were performed to assist the removal of the tumor, 17 tumors were removed under endoscopic and navigation guidance. In 5 patients whose osteoma was localized or with the diameter no more than 2 cm, these osteomas were removed endonasally with the help of navigation system. The osteomas in 2 patients was found to have narrow basilar part and relatively dissociative were removed from oral cavity after abscisin the basilar part. The osteomas in 12 patients were found to have basilar part connected with ante-meso skull base, lamina papyracea, orbital apex, cranialis opticus, fossa orbitalis bone, these osteomas were removed using electric drill with the guidance of navigation system. All patients were followed up from 8 to 64 months, and were asymptomatic (1 patient who suffered from amblyopia had the symptom disappeared, 2 patients suffered from prosopo-eminence, 1 patient was asymptomatic and 1 patient was feeling better). Two patients underwent removal of crista galli, 1 of them suffered from postoperative cerebro-spinal rhinorrhea, and recovered after endoscopic repairing procedure and iodoform gauze packing and recovered 15 days later. Two patients who underwent removal of crista galli suffered from anosmia and never recovered after 9 and 26 months follow-up. One patient with enormous osteoma suffered from repeated crusting and abnormal odor, and recovered after nasal flushing.</p><p><b>CONCLUSIONS</b>Endoscopic ablation of osteomas of the ethmoid sinuses with the guidance of navigation system is an accurate, secure, minimally-invasive procedure. Osteomas on median line and localized in ethmoid sinus is an indication of this operation. Preoperative CT scan is a safeguard for an accurate operation.</p>

Dynamic observation of applying repairing laryngeal mucosal defect with heterogeneous acellular dermal matrix / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the clinical effect of heterogeneity (cattle) acellular dunal matrix in repairing mucosa defect in laryngeal surgery.</p><p><b>METHODS</b>Eighteen cancer patients with mucosa defect in central vocal area accepted treatment with heterogeneity acellular dunal matrix after surgery. There were two methods to repair mucosa defect. One was simple use of acellular dunal matrix, the second was combined use of acellular dunal matrix and muscle lamella or muscle and tendon film lamella. 18 cases had cancer in central vocal area: T2N0M0 (8), T3N1M0 (5), T3N2M0 (4), T4N2M0 (1). All were squamous cell carcinoma. Ten cancer patients accepted radiation after surgery. The radiotherapy volume was 60-80 Gy. After the operation, the patients were checked by fibrolaryngoscope four or five times after half a year, observing the dynamic development.</p><p><b>RESULTS</b>All 18 patients were healed, rechecked by endoscope after 0.5-6 months, heterogeneity acellular dunal matrix mingled with mucosa within 30-60 d, no allergy and irritation were found. The laryngeal function, including breathing, pronouncing and swallowing, was recovered. The survival rate (1 year) was 100%, and 10 patients survived after 2 years. After radiotherapy, the process of recovery was not affected.</p><p><b>CONCLUSIONS</b>Heterogeneity acellular dunal matrix can be easily obtained and it is a new method to repair mucosa defect. The operative procedure is easy to perform and worthwhile to use clinically.</p>

Study of relationship between the onset time of sudden deafness and blood rheology / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the correlation of the onset time of sudden deafness and blood rheology using a large-scale retrospective study.</p><p><b>METHODS</b>One hundred and ninety-eight patients of sudden deafness were examined with blood rheology and compared with 60 healthy people. Thirty patients were as subjects to study the circadian of blood rheology in order to search whether the blood rheology of morning was the highest. By divided 24 hours into twelve groups, each group contained two hours. Then the 198 patients were separated into twelve groups according to the time of onset. The blood rheology of each group was analyzed and compared with each other to observe which group was the highest.</p><p><b>RESULTS</b>Most blood rheology index of the patients were higher than that of the healthy people. The onset time in most of the patients was during 4 am-8 am, but 45 patients during 4 am-6 am and 40 patients during 6 am-8 am. By analyzing and comparing the blood rheology of each group, the results showed that the blood rheology index in the group of 4 am-8 am was highest. And the blood rheology index of sudden deafness was highest in the morning.</p><p><b>CONCLUSIONS</b>There was a close relation between blood rheology and sudden deafness. The peak time of onset was 4 am-8 am, and the patients whose blood rheology were the highest should be more predisposed to sudden deafness than the other patients.</p>

Comparison of the painless effect of four anesthetic methods during pulpal treatment / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To compare the painless effect of four anesthetic methods during opening pulp cavity and undergoing pulpectomy for acute or chronic pulpitis.</p><p><b>METHODS</b>80 teeth of 80 patients were randomly allocated into four groups. Each group had 20 teeth. Anesthetic methods applied four different groups included block anesthesia of nerve, supraperiosteal infiltration, periodontal membrane injection and intrapulpal injection. Anesthesia doses were recorded and the pierced points, the zones of pain, the time of anesthesia action, the time of anesthesia persistence and the degrees of anesthesia were evaluated with four levels synthetic evaluation standard of anesthesia.</p><p><b>RESULTS</b>Compared with periodontal membrane injection and intrapulpal injection, block anesthesia of nerve and supraperiosteal infiltration had the later time of anesthesia action and the longer time of anesthesia persistence (P<0.05). In four anesthetic methods, block anesthesia of nerve had the best painless effect (P<0.05).</p><p><b>CONCLUSION</b>Four anesthetic methods have their own superiorities, and we should select proper anesthetic methods in clinical work.</p>

Relation Between Hemoglobin and Blood Pressure / 中华高血压杂志

Objective To study the relationship between peripheral blood hemoglobin (HB) and blood pres- sure.Methods We performed a cross-sectional analysis in 1153 subjects aged 29-83 years.Waist circumfer- ence,HB,blood pressure,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL- C),triglycerides (TG),total cholesterol (TC) were determined.Results ①With the increasing of blood pres- sure,HB had a clearly increasing trend (HB,normotensive:137.5?14.7 vs prehypertension:143.4?14.4 vs hy- pertension:144.3?13.8 g/L,P

Thyroid cartilage flap reconstruction of cricoid in the management of subglottic carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of conservative surgical management on patients with subglottic cancer.</p><p><b>METHODS</b>Nine cases with subglottic carcinoma were treated surgically from 1984 to 1999. There were T2N0 lesions in 2 cases, T3N0-1 in 3 cases and T4N0-1 in 4 cases. All the cases underwent partial laryngectomy including partial cricoid resection. Variations of a pedicled thyroid cartilage flap were used for reconstruct the cricoid defect. The pedicle based muscle was thyrohyoid, sterno-thyroid or inferior constrictor. Unilateral neck dissection was performed on 7 cases and bilateral on two.</p><p><b>RESULTS</b>The function of phonation were preserved in all cases. Eight of nine 8/9 were decanulated. Normal deglutition were achieved for all patients. The 3 and 5 year survival rates were 8/9 and 6/9, respectively.</p><p><b>CONCLUSION</b>Pedicled thyroid cartilage flap is appropriate for reconstruction of the cricoid defect in the conservative surgery of selected subglottic carcinoma.</p>

The survey of prosthetic treatment in the elderly / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To acquire teeth and prosthetic conditions of the elderly.</p><p><b>METHODS</b>1166 patients of over 60 years old had been given prosthetic treatment, and the teeth conditions were analyzed.</p><p><b>RESULTS</b>The average number of missing teeth was 10.25. The maxillary missing teeth were more than mandibular ones. The rate of missing teeth were as follows: maxillary teeth > mandibular teeth; molars > bicuspids > incisors > cuspid. 1120 cases were treated with removable dentures. 59% of the removable partial dentures had free-end saddles. 46 cases were treated with fixed bridges.</p><p><b>CONCLUSION</b>The characteristics of prosthetic patients in the elderly were as follows: a large number of missing teeth and free-end missing teeth, attrition of resident teeth, food impaction, existing-residual root and loosen teeth. Removable denture was the main method of the prosthetic therapy for the elderly patients. Fixed bridge was used when the patient condition was good. The cuspid, treated residual root and the third molar should be used for the retention and support of the prosthesis.</p>