Diagnostic value of serum miRNA let-7a for laryngeal carcinoma and effects of let-7a on proliferation and apoptosis of laryngeal carcinoma cells / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the diagnostic value of serum miRNAlet-7a in laryngeal carcinoma and the effect of let-7a on proliferation and apoptosis of laryngeal carcinoma cells.@*Methods@#Real-time quantitative PCR was used to determine the expression level of serum miRNAlet-7a. The miRNA let-7a mimetic was synthesized and transiently transfected into the laryngeal carcinoma Hep-2 cell line by cationic liposome method. The effects of up-regulation of let-7a expression on laryngeal cancer Hep-2 cells were detected by FCM and MTT assays,respectively. The association of let-7a levels with laryngeal cancer and the diagnostic value for laryngeal cancer were analyzed. Measurement data were taken by t test or analysis of variance; Counting data were analyzed by χ2 test and Fisher exact probability method. The receiver operating characteristic curve was used to analyze the diagnostic value of let-7a for laryngeal cancer.@*Results@#The relative expression of serum let-7a in healthy subjects was significantly higher than that in patients with laryngeal cancer (0.931±0.094) vs (0.380±0.113) (t=26.507,P<0.01). The relative expressions of serum let-7a in patients with laryngeal cancer before and after surgery were (0.380±0.113) vs(0.493±0.164),with significant difference (t=3.848,P<0.01).The relative expression of serum let-7a was related to lymph node metastasis (t=2.946, P<0.01). There was a positive correlation between the relative expression of let-7a in laryngeal carcinoma and that in serum (r=0.466,P=0.003). After transfection of let-7a mimics, Hep-2 cells showed an increased significant increase in the expression of let-7a (P<0.01), proliferation (P<0.01) and apoptosis (P<0.01). ROC curve analysis showed that the best critical value for relative expression of let-7a in the diagnosis of laryngeal carcinoma was 0.557 with a sensitivity of 0.794,a specificity of 0.727,an area under curve(AUC) of 0.859,and a 95%CI of 0.773-0.926.@*Conclusions@#miRNA let-7a can inhibit the proliferation of laryngeal carcinoma Hep-2 cells and promote apoptosis. Serum let-7a is down-regulated in patients with laryngeal cancer and the level of let-7a is related to lymph node metastasis,which would help early diagnosis and postoperative disease monitoring of laryngeal cancer,but further research is needed.

The review of transoral laser microsurgery in laryngeal cancer / 临床耳鼻咽喉头颈外科杂志

Transoral laser microsurgery (TLM) has developed more than 40 years in the treatment of laryngeal cancer. TLM is especially important in the minimally invasive surgery of laryngeal carcinoma. Compared with the traditional open surgery, it is a major breakthrough, which has the significant advantages such as safety, effectiveness, low rate of local recurrence and high rate of larynx preservation. Not only can cure early laryngeal cancer, but also more and more the use of TLM in advanced supraglottic and glottic laryngeal cancer were reported. This article will review the characteristics, indications, superiority, surgical options and efficacy of the TLM in laryngeal carcinomas.

Analysis of the clinical diagnosis and therapy and misdiagnosis for congenital middle ear cholesteatoma / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo investigate the methods of diagnosing and treating congenital middle ear cholesteatoma and causes of misdiagnosis.METHODSThis was a retrospective review of 9 cases of congenital middle ear cholesteatoma in this hospital.RESULTS9 patients all received operative treatment and definite diagnosis was made by histopathologic investigation. The ossicular reconstruction was performed to 6 patients. All of the cases were followed-up for 3 months-2.5 years. A-B gap was 20 dB. After 1 year, no residual or recurrence of cholesteatoma was found in CT scan. All patients had been misdiagnosed. Misdiagnosis rate was 100%.CONCLUSIONCongenital middle ear cholesteatoma is a clinically rare and diagnosis is usually delayed in clinical practice due to the silent nature of the disease in its early stage. Preoperative diagnosis may be based on Levenson diagnostic criteria and CT imaging. Early surgical treatment can obtain a good effect of hearing reconstruction. To avoid misdiagnosis and incorrect treatment, radiological evaluation and careful local examination are really important, which may also avoid serious complications.

Application of low temperature radiofrequency volumetric tissue reduction in patients with tongue cancer / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo evaluate the effectiveness of low temperature radiofrequency ablation on tongue cancer in early stage (<2 cm T1 stage) .METHODS High differentiated tongue squamous cell carcinoma(<2 cm T1 stage) were removed with radiofrequency ablation in 11 patients and with high-frequency electrotome in 20 patients from 2009 to 2014 in our hospital. All the patients underwent elective neck dissection(I,Ⅱ,Ⅲ regions). Intraoperative blood loss, VAS ratings of post-operative pain, post-operative bleeding rate and the recurrence rate of tongue cancer or lymph node metastasis were compared between the two groups.RESULTSIn the radiofrequency ablation group, the mean intraoperative blood loss was 13.82±7.40ml, the VAS ratings of post-operative pain were 3.8±1.3 (day 1), 2.5±0.7 (day 3) and 1.8±0.6(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in one case at 6 month after operation. In the high-frequency electrotome group, the mean intraoperative blood loss was 40.55±12.03ml, the VAS ratings of post-operative pain were 6.8±1.3(day 1), 4.4±1.1(day 3) and 2.3±0.7(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in 3 cases at 6 month to one year after operation. The intraoperative blood loss and post-operative pain in radiofrequency ablation group were significantly lower and less than that in the high-frequency electrotome group.CONCLUSIONRadiofrequency ablation is a promising method for early stage tongue cancer with less blood loss, invasiveness and complications.

Serum S100 protein and NSE levels and significance of changes after treatment in patients with severe OSAHS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Understand the changes before and after treatment in patients with severe OSAHS serum S100β protein, NSE levels and cognitive function. To investigate the molecular mechanisms of cognitive dysfunction in patients with severe OSAHS. Serum S100β protein, NSE levels and cognitive function were examined before and after the therapy.@*METHOD@#Select one hundred patients diagnosed as severe OSAHS were included, by polysomnography (PSG) diagnosis of severe OSAHS patients. Determination of serum S100β protein, and NSE levels and theat the same time be MoCA score were checked at after the day after admission, CPAP treatment for the 7th days after CPAP treatment and the 90th day after, comprehensive treatment in these patients for 3 months. Assessment of severe OSAHS patients with serum S100β protein, NSE basic level and MoCA score situation. Comparison of three groups serum S100β protein, NSE levels and MoCA score changes. Serum S100β protein, NSE detection assay (ELISA) method using enzyme-linked immunosorbent.@*RESULT@#(1) Severe OSAHS patients with serum S100β protein, and NSE levels in severe OSAHS patients were positively correlated with AHI, but negatively correlated with lowest oxygen saturation (LSaO2); (2) MoCA score in patients with severe OSAHS was significantly negatively correlated with AHI, but positively correlated with LSaO2; (3) S100β protein, NSE levels were negatively correlated with MoCA score; (4) Compared with admission, serum S100β protein, and NSE levels in these patients have declined after 7 days CPAP therapy, compared with admission the difference was statistically significant (P 0.05). After 3 months of comprehensive treatment, MoCA score improved significantly, compared with the admission and 7 days after CPAP treatment the difference was statistically significant (P < 0.05).@*CONCLUSION@#Comprehensive treatment can reduce serum S100β protein, and NSE levels, and improve MoCA score. Disease severity in patients with OSAHS have a correlation some relative.with the serum S100β protein, NSE levels and MoCA score. Long-term hypoxemia and the structure of sleep disorders may be the cause of elevated serum S100β protein, NSE levels elevated and causes of cognitive dysfunction. Comprehensive treatment can improve patient hypoxemia, correct disorders of sleep structure ,and can improve cognitive function and to improve the quality of life of patients.

Effect of multimodality therapies on plasma soluble tumor necrosis factor receptor I in OSAHS patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#As a subtype membrane receptor of tumor necrosis factor alpha, not much is known about the link between the soluble TNF receptor-I and obstructive sleep apnea hypopnea syndrome. We hypothesized that the TNF receptor might play an important role in the inflammation in patients with OSAHS, moreover this study was undertakan to investigate the effects of multimodality therapies on its periphery blood level.@*METHOD@#Seventy-seven adults with habitual snoring and mean age of 34.9 +/- 11 years old consented to participate in the study. All participants were studied with overnight polysomnography, physical examination and a blood crew at baseline. According to the severity of OSAHS, they were categorized into three groups and one control group. Moderate and severe OSAHS groups returned for a repeat test of polysomnography and a blood crew at 3 months after the ENT surgery or continuous positive airway pressure (CPAP). serum levels were measured by using an immunoluminometric assay kit.@*RESULT@#(1) Compared with control non-OSAHS group, serum sTNF-R I levels prior to treatment in OSAHS groups were significantly greater, with a mean serum levels at (742 +/- 258 & 340 +/- 102) pg/ml (P < 0.05), respectively. (2) Plasma solube tumor necrosis factor receptor-I responsed sensitively to the effect of comprehensive therapies when we compared its prior treatment levels with post ones. (3) Analysis was used to assess the associations adjusting for age, gender, BMI and weight ,a positive assosiation were found between apnea-hypopnea index (AHI) and sTNF-R I (r = 0.646, P < 0.01) a negative assosiation were found between lowest nadir oxygen saturation (LSaO2) and (r = 0.522, P < 0.01).@*CONCLUSION@#ln summary, independent of age, gender, BMI and weight ,our datas suggest a relationship can be found between the the severity of OSAHS and periphery blood level of soluble TNF receptor-I. Comprehensive therapies is effective in changing sTNF-R I. sTNF-R I may be recommended as a Inflammation factor of OSAHS.

The relationship of the expression of thymic stromal lymphopoietin in nasal polyps tissues and Th2 inflammatory response / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the relationship of the expression of thymic stromal lymphopoietin (TSLP) in nasal polyps tissues and the Th2 inflammatory response.@*METHOD@#Sixty patients with nasal polyps were collect ed. The immunohistochemical staining method was used to detect the expression of TSLP in nasal polyps tissues and ELISA method to the expression of IL-4, IL-5, IFN-gamma, IL-13 and analyzed the correlation between them.@*RESULT@#The expression of TSLP in nasal polyp tissues was higher than that in normal inferior turbinate mucosa (P < 0.05). The expression level of IL-4, IL-5, IFN-gamma and IL-13 in nasal polyps tissues were significantly higher than those in control group (P < 0.05). TSLP staining was a statistically significant positive correlation with IL-4, IL5 and IL-13 (r = 0.475, 0.594 and 0.582, respectively, P < 0.01), while inverse correlation with IFN-gamma (r = -0.614, P < 0.01).@*CONCLUSION@#The high expression of TSLP might promote T cell differentiation towards Th2, and participated in the occurrence/development of nasal polyps, aggravated the nose Th2 inflammatory response.

Prevalence of sinusitis in poorly controlled asthma children / 中华实用儿科临床杂志

Objective To investigate the prevalence of sinusitis in poorly controlled asthma children.Methods Asthmatic children from the Asthma Specialist Department of Hunan Provincial People's Hospital were selected as the study cases,of which 107 children coughing for more than 4 weeks after treatment were allocated to the research group and 105 newly diagnosed asthmatic children were selected as the control group.Results 1.The CT confirmed sinusitis prevalence was 81.3％ (87/107 cases) in research group and 51.4％ (54/105 cases) in the control group,respectively.The 2 groups were significantly different (x2 ＝ 21.242,P ＜ 0.05).2.The patient complained nasal obstruction in sinusitis group was 80.5％ (70/87 cases) compared to 50.0％ (10/20 cases) in non sinusitis group,and the difference between 2 groups was statistically significant (x2 =7.997,P ＜ 0.05).3.In the research group,69.2％ (74/107 cases) suffered from maxillary sinusitis,61.7％ (66/107 cases) ethmoid sinusitis,14.0％ (15/107 cases) frontal sinusitis,and 30.8％ (33/107 cases) sphenoid sinusitis.All the 4 nasosinus involved was 10.3％ (11/107 cases).The frequency of allergic rhinitis symptoms in 4 groups of sinuses had no significant difference (P ＞ 0.05).Conclusions Chronic cough in poorly controlled asthma children is related to sinusitis and upper airway cough syndrome.

Research on the serum levels of matrix metalloproteinase-9 and free fatty acids in OSAHS cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression of matrix metalloproteinase-9 (MMP-9) and free fatty acids (FFA) in obstructive sleep apnea-hypopnea syndrome(OSAHS) patients. And the relativity among the serum level of MMP-9, FFA, four factors of blood lipids,hypopnea index (AHI), minimum oxygen saturation, body mass index (BMI) in OSAHS patients.@*METHOD@#Fifty cases diagnosed of OSAHS,with integral clinical data in our department, were enrolled in the research. Fifty cases were selected as control group by the sleepiness scale score and the exclusion of the physical examination OSAHS. There was no significant difference (P > 0.05) of the body mass index (BMI) and age in the two groups. Two fasting venous blood samples of 3 ml were taken from every object in the morning wake from sleep monitoring and kept at room temperature for 30 min. The samples were sent to the laboratory to test the four factors of blood lipid and the FFA by colorimetric determination. Another fasting venous blood samples of 3 ml was preserved in refrigerator at -75 degrees C, used for serum MMP-9 test with Enzyme-linked immunoadsorbent assay (ELISA). SPSS 13.0 statistical software was used for all relevant data processing and analysis.@*RESULT@#Serum levels of MMP-9 and FFA in severe OSAHS cases were significantly higher than those in control group (P < 0.01). Serum four factors of blood lipids level of severe OSAHS was a little higher(P < 0.05) than those in control group. There were a close relationship among serum FFA and TG, LSaO2 , BMI and AHI in severe O()SAHS patients. Serum FFA level was positively related with TG, BMI and AHI and negatively related with LSaO2. There were also a close relationship among serum MMP-9 and FFA, LSaO2 and AHI. The serum MMP-9 was positively related with FFA and AHI and negatively related with LSaO2. There was a positive linear correlation between serum FFA concentration and MMP-9 concentration in severe OSAHS cases.@*CONCLUSION@#The higher risk of endocrinopathy and cardiovascular diseases were happened in OSAHS patients. The higher expression of both MMP-9 and FFA in OSAHS cases suggested a higher risk than that of the single high expression of them.

Research on the relationship of IgE between adenoid and middle ear effusion in children otitis media with effusion cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression of IgE in recur repeatedly children otitis media with effusion (OME), and the relativity of IgE between adenoid and middle ear effusion.@*METHOD@#Thirty-five cases diagnosed of OME in our department, were enrolled in the research. Thirty-one adenoidal hypertrophy cases were selected as control group. Obtained middle ear effusion and adenoid samples from experimental group, and obtained adenoid samples from control group. All adenoid samples were taken for tissue homogenate. Determination all samples of concentration of IgE by ELISA. SPSS 18.0 statistical software was used for all relevant data processing and analysis.@*RESULT@#Compared the IgE content between experimental group and control group with adenoid samples, IgE content increased significantly in experimental group (P < 0.05), and IgE in experimental group of middle ear effusion samples were also increased (P < 0.05). The content of IgE in the experimental group of middle ear effusion and adenoid assumed straight-line correlation, in negative correlation (r = 0.580, P < 0.05).@*CONCLUSION@#The occurrence of OME is related to immune factors. Adenoidal hypertrophy may lead to local immunity enhancement, may cause middle ear cavity immune system abnormality, give rise to recur repeatedly with OME and procrastinate does not recover.

Correlative study of nuclear factor-kappa B subunit p50 activity and IL-4 gamma-IFN expression in nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the possible regulation mechanism of nuclear factor-kappa B subunit p50 on Th1/Th2 cytokine in nasal polyps.@*METHOD@#The expression of IL-4, gamma-IFN and p50 were examined by the method of immunohistochemistry staining in 40 cases of nasal polyps and 20 normal subjects, and the linear correlations between activity of p50 and IL-4, gamma-IFN were evaluated.@*RESULT@#The expression of p50 mainly distribute in the cytoplasm of epithelia, inflammatory cell and the epithelia of gland. The expression of IL-4 and the activity of p50 was increased significantly in nasal polyps (all P0.05). Pearson correlation analysis demonstrated that p50 nuclear-presented closely correlation with IL-4 level, but not gamma-IFN. The correlation coefficient was 0.70 for p50 and IL-4 (P0.05).@*CONCLUSION@#The activity of p50 in nasal polyps is increased significantly. The activation of p50 may play an important role in the imbalance of Th1/Th2-typed cytokines by upregulating the level of IL-4.

Reconstruction of laryngotracheal stenosis with hyoid graft and pedicle sternohyoid muscle flaps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the possibility and reliability of hyoid graft and pedicle sternohyoid muscle flaps in the reconstruction of laryngotracheal stenosis.@*METHOD@#Using the single or double pedicle sternohyoid muscle flaps and hyoid graft, we repaired laryngotracheal stenosis.@*RESULT@#In all 21 cases with laryngotracheal stenosis, 16 cases were cured after one surgical procedure, and 3 cases were cured after two times of surgical procedures, and 19 cases were decannulated, but one case was failure, and one case was lost visiting.@*CONCLUSION@#The hyoid sternohyoid graft transfer method was convenient, slightly damaging, and had good supporting effects and high survival rate in the reconstruction of laryngotracheal stenosis.

Clinical analysis of 19 cases of esthesioneuroblastoma under classic surgical approaches and surgical approaches with the assistant of nose endoscope / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To summarize the curative effect and esthesioneuroblastoma (ENB) by classic surgical approaches and surgical approaches with the assistant of nose endoscope.@*METHOD@#A retrospective review was conducted in 19 cases treated from 1980 to 2000. Ten cases were treated by classical surgical approaches. Tumors in 4 patients (According to the Kadish system, stage A, 3 cases; stage B, 1 case) were removed via a transnasal approach, 6 patients (stage B, 5 cases; stage C, 1 case) were performed by lateral rhinotomy. After 1995, 9 cases (stageA, 2 case; stageB, 5 cases; stageC, 2 cases) received surgical resection with nasale endoscope. All of the patients were conducted radiation after operation.@*RESULT@#The 5-year survival rate for the classic procedure and the surgical procedure with the assistant of endoscope were 50.0%, 88.9%, respectively. And the local recurrence rates were 50.0%, 33.3%, respectively (had no statistical significance). And the mean recurrent time were 5.2 months, 16 months, respectively. With the assistant of endoscope, the recurrent time was significant retarded.@*CONCLUSION@#There are better illumination and better operation field during the surgical operation with the assistant of endoscope. And the tumors are more likely resected entirely and the tumor recurrent time could be deferred.

Diagnose and treatment of severe obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the diagnose and treatment of severe OSAHS with distinction of different extent.@*METHOD@#All 256 severe OSAHS patients were divided into two groups according to sleep apnea hypopnea index (AHI): group one (severe group), 40 or = 65. All patients were underwent CPAP treatment for at least one week before modified UPPP in general anesthesia. UPPP and (or) nasal septum plasty or partial inferior turbinectomy were operated in one stage if tracheotomy was conducted. If tracheotomy were not conducted, the patient was only accepted UPPP under general anesthesia. The other operations to remove the multi block factors were operated in local anesthesia.@*RESULT@#In 198 group one patients, there were 169 patients accepted UPPP in general anesthesia without tracheotomy, the other 29 patients were conducted with tracheotomy. The tracheotomy rate was 14.6%. The total effective cure rate was 85.9%. In all 58 group two patients, tracheotomy were conducted, and the total effective cure rate was 63.8%. The complication rate of all the two groups' patients was 3.5%. After three weeks,the uvulas decurtated from(4.89 +/- 0.58) cm to (3.12 +/- 0.46)cm.@*CONCLUSION@#It is important to divide the severe OSAHS patients into severe group and extra severe group because the treatments were different. Not all the severe OSAHS patients need tracheotomy. There were advantages to retain the uvula in UPPP and patients' life quality was improved with uvula reserved.