Experimental study of dopamine ameliorating the inflammatory damage of olfactory bulb in mice with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the effects of dopamine on olfactory function and inflammatory injury of olfactory bulb in mice with allergic rhinitis (AR). Methods: AR mouse model was established by using ovalbumin (OVA), and the mice were divided into two groups: olfactory dysfunction (OD) group and without OD group through buried food pellet test (BFPT). The OD mice were randomly divided into 2 groups, and OVA combined with dopamine (3, 6, 9 and 12 days, respectively) or OVA combined with an equal amount of PBS (the same treatment time) was administered nasally. The olfactory function of mice was evaluated by BFPT. The number of eosinophils and goblet cells in the nasal mucosa were detected by HE and PAS staining. Western blotting, immunohistochemistry or immunofluorescence were used to detect the expression of olfactory marker protein (OMP) in olfactory epithelium, the important rate-limiting enzyme tyrosine hydroxylase (TH) of dopamine, and the marker proteins glial fibrillary acidic protein (GFAP) and CD11b of glial cell in the olfactory bulb. TUNEL staining was used to detect the damage of the olfactory bulb. SPSS 26.0 software was used for statistical analysis. Results: AR mice with OD had AR pathological characteristics. Compared with AR mice without OD, the expression of OMP in olfactory epithelium of AR mice with OD was reduced (F=26.09, P<0.05), the expression of GFAP and CD11b in the olfactory bulb was increased (F value was 38.95 and 71.71, respectively, both P<0.05), and the expression of TH in the olfactory bulb was decreased (F=77.00, P<0.05). Nasal administration of dopamine could shorten the time of food globule detection in mice to a certain extent, down-regulate the expression of GFAP and CD11b in the olfactory bulb (F value was 6.55 and 46.11, respectively, both P<0.05), and reduce the number of apoptotic cells in the olfactory bulb (F=25.64, P<0.05). But dopamine had no significant effect on the number of eosinophils and goblet cells in nasal mucosa (F value was 36.26 and 19.38, respectively, both P>0.05), and had no significant effect on the expression of OMP in the olfactory epithelium (F=55.27, P>0.05). Conclusion: Dopamine can improve olfactory function in mice with AR to a certain extent, possibly because of inhibiting the activation of glial cells in olfactory bulb and reducing the apoptotic injury of olfactory bulb cells.

The expression and significance of TRPM8 among chronic rhinosinusitis with nasal polyps / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the expression and difference of melastatin-related transient receptor potential 8(TRPM8) among chronic rhinosinusitis, nasal polyps and normal mucosa tissues. And to explore the significant expression of TRPM8 among CRSwNP. Methods: Fifty-one patients underwent endoscopic sinus surgery in the Department of Otorhinolaryngology Head and Neck Surgery of Renmin Hospital of Wuhan University from February 2019 to January 2020 were recruited, including 33 males and 18 females, aged from 14 to 65 years old (34.55±1.689).Immunohistochemistry was used to detected the expression of TRPM8 protein among CRSsNP(17),CRSwNP (17) and control tissuses(17). In addition, the correlation between the expression of TRPM8 protein in CRSwNP patients and preoperative CT Lund-Mackay scores and preoperative VAS scores and sinonasal outcome test-20 scores was analyzed, respectively. The primary human nasal epithelial cells were cultured in vitro and the expression of TRPM8 was detected by quantitative real-time PCR and western blotting . The tissue in control group, chronic rhinosinusitis without nasal polyps (CRSsNP) group and the CRSwNP group were collected and grinded into tissue homogenized. The expression of TRPM8 protein was detected by western blotting after 24 h stimulation after homogenate was added into the medium of RPMI 2650 and primary nasal epithelial cells. Results: Compared with the control, the expression of TRPM8 was significantly up-regulated in nasal polyps (t=6.852, P<0.05). TRPM8 was mainly expressed in epithelial cells. The expression of TRPM8 in the epithelial cells of CRSsNP had no difference with the control group (t=1.980, P>0.05). In addition, the expression of TRPM8 in CRSwNP patients was positively correlated with the preoperative CT Lund-Mackay scores and VAS scores and SNOT-20 scores (r=0.512, P<0.05;r=0.853, P<0.01;r=0.814, P<0.01). After cultured primary epithelial cells in vitro, the expression level of TRPM8 in epithelial cells derived from nasal polyp was significantly higher than that in control group (t=8.845, P<0.05). By adding the homogenization of control and CRSsNP and CRSwNP tissues, the expression of TRPM8 in RPMI 2650 cells and primary nasal epithelial cells was changed and that was significantly increased after adding the homogenization of the group of CRSwNP. Conclusion: TRPM8 is highly expressed in nasal polyps epithelial cells, suggesting that TRPM8 may be involved in the pathogenesis of nasal polyps regulated by nasal epithelial cells.

Comparison of outcomes between endoscopic surgery and conventional nasal packing for epistaxis in the posterior fornix of the inferior nasal meatus

Objective: To investigate the clinical features of epistaxis in the posterior fornix of the inferior nasal meatus and compare the treatment outcomes of endoscopic surgery and conventional nasal packing for this intractable form of epistaxis

Methods: Between August 2011 and August 2014, the medical records of 53 adult patients with idiopathic epistaxis in the posterior fornix of the inferior nasal meatus diagnosed by nasal endoscopy were obtained from our department. Of these, 38 patients underwent endoscopic surgery [surgery group] and 15 received a nasal pack [packing group]. The patients' background characteristics, incidence of re-bleeding, extent of discomfort after treatment as assessed using a 10-point visual analogue scale [VAS] and incidence of nasal cavity adhesion after treatment were analysed

Results: There were no significant differences in background characteristics between the two groups. The incidence of re-bleeding [0/38 vs. 4/15, surgery vs. control, P = 0.001], VAS score for discomfort [2.4 +/- 1.4 vs. 7.6 +/- 1.0, surgery vs. control, P = 0.001] and incidence of nasal cavity adhesion after treatment [2/38 vs. 7/15, surgery vs. control, P = 0.007] were significantly lower in the surgery group than in the packing group

Conclusion: Endoscopic surgery is superior to conventional nasal packing for the management of epistaxis in the posterior fornix of the inferior nasal meatus. During surgery, it is crucial to expose the bleeding sites by shifting the inferior turbinate inward by fracture

Anti-tumor effect of LTA combined with 5-FU on H22 tumor bearing mice

OBJECTIVE@#To study the effect of lipoteichoic acid (LTA) and 5-FU on the expression of caspase-3, EGFR, TGF-α proteins of tumor tissue of H22 cancer bearing mice and its anti-tumor mechanism.@*METHODS@#A total of 40 SPF grade Kunming mice were selected to establish H22 liver cancer model, and then the mice were divided into 4 groups at random with ten mice in each group. Group A was given saline lavage treatment, Group B was treated with 5-FU by intraperitoneal injection, Group C was treated with LTA by lump body injection; Group D was treated with LTA by lump body injection and 5-FU by intraperitoneal injection. Two weeks after the treatment, the mice in each group were executed and the tumor tissue was stripping and weighted, and the tumor growth inhibition ratio was calculated. Then the tumor tissue was processed for conventional embedding, sectioned to observe the expression of caspase-3, EGFR, TGF-α by immunohistochemical staining method.@*RESULTS@#The tumor inhibitory rate o f Group D was significantly higher than Groups B and C (P  0.05). The IDO values of TGF-α, EGFR proteins in Groups B, C, D mice tumor tissue were significantly lower than that in group A (P < 0.05); while IDO value of caspase-3 in Groups B, C, D group mice tumor tissue was significantly higher than that in Group A (P < 0.05). The IDO value of TGF-α, EGFR in Group D mice tumor tissue were significantly lower than that in Groups B and C; While IDO value of aspase-3 in Group D was significantly higher than that in Groups B and C (P < 0.05).@*CONCLUSIONS@#LTA combined with 5-FU can effectively inhibit the tumorigenesis of H22 tumor bearing mice, increase the caspase-3 protein expression, inhibit TGF-α and EGFR protein expression, further promote tumor cell apoptosis and play a synergistic antitumor effect.

Anti-tumor effect of LTA combined with 5-FU on H22 tumor bearing mice

Objective: To study the effect of lipoteichoic acid (LTA) and 5-FU on the expression of caspase-3, EGFR, TGF-α proteins of tumor tissue of H22 cancer bearing mice and its anti-tumor mechanism. Methods: A total of 40 SPF grade Kunming mice were selected to establish H22 liver cancer model, and then the mice were divided into 4 groups at random with ten mice in each group. Group A was given saline lavage treatment, Group B was treated with 5-FU by intraperitoneal injection, Group C was treated with LTA by lump body injection; Group D was treated with LTA by lump body injection and 5-FU by intraperitoneal injection. Two weeks after the treatment, the mice in each group were executed and the tumor tissue was stripping and weighted, and the tumor growth inhibition ratio was calculated. Then the tumor tissue was processed for conventional embedding, sectioned to observe the expression of caspase-3, EGFR, TGF-α by immunohistochemical staining method. Results: The tumor inhibitory rate o f Group D was significantly higher than Groups B and C (P 0.05). The IDO values of TGF-α, EGFR proteins in Groups B, C, D mice tumor tissue were significantly lower than that in group A (P < 0.05); while IDO value of caspase-3 in Groups B, C, D group mice tumor tissue was significantly higher than that in Group A (P < 0.05). The IDO value of TGF-α, EGFR in Group D mice tumor tissue were significantly lower than that in Groups B and C; While IDO value of aspase-3 in Group D was significantly higher than that in Groups B and C (P < 0.05). Conclusions: LTA combined with 5-FU can effectively inhibit the tumorigenesis of H22 tumor bearing mice, increase the caspase-3 protein expression, inhibit TGF-α and EGFR protein expression, further promote tumor cell apoptosis and play a synergistic antitumor effect.

Construction of recombinant house dust mite group 1 allergen vaccine and study on immune response induced by nasal immunization / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the preparation of recombinant house dust mite group 1 allergen vaccine (chitosan-pVAX1-Derp1 nanoparticles, pVAX1-Derp1/CS) and to investigate the efficacy and mechanism of intranasally given chitosan-pVAX1-Derp1 nanoparticles on mouse model with allergic rhinitis (AR).</p><p><b>METHODS</b>The chitosan-pVAX1-Derp1 nanoparticles was prepared by complex coacervation, and its nature was identified and analysed. A total of 40 BALB/c rats were randomly divided into 5 groups: the normal group (group A), the AR model group (group B), the chitosan (CS) prevention group (group C), the pVAX1-Derp1 prevention group (group D), and the pVAX1-Derp1/CS prevention group (group E). The nasal cavity of rats in the group B, C, D and E were dripped with phosphate buffered saline (20 µl), CS (20 µl), pVAX1-Der p1 (20 µl), pVAX1-Derp1/CS nanoparticles (20 µl) on the first day and day 8, once daily. Rats in the latter 4 group were sensitized with Der p1 and Al(OH)3 in day 15 and day 22, and challenged with Der p1 to establish AR model from day 36 to day 43, while rats in group A were treated with PBS. Then the level of cytokines in serum was assayed by ELISA, inflammatory reactions in nasal mucosa were analyzed by haematoxylin and eosin staining.</p><p><b>RESULTS</b>pVAX1-Derp1/CS nanoparticles was successfully constructed, the mean grain size of pVAX1-Derp1/CS was (205.3 ± 12.8) nm, and the zeta potential was (30.5 ± 5.6) mV. In nasal mucosa tissue, group B and C showed significant allergic inflammation, while group D and E showed lighter allergic inflammation. Compared with the group B, the group D and E could effectively reduced serum IgE level and IL-4 level [group B: (120.0 ± 8.8) ng/ml, (248.7 ± 10.6) pg/ml; group D: (109.6 ± 14.5) ng/ml, (192.5 ± 10.2) pg/ml; group E: (88.1 ± 8.3) ng/ml, (165.7 ± 9.7) pg/ml; IgE: t value were 3.5, 6.9, all P < 0.01; IL-4: t value were 10.0, 15.2, all P < 0.01], and increased IFN-γ level [group B: (709.0 ± 26.5) pg/ml; group D: (856.3 ± 37.4) pg/ml; group E: (904.8 ± 37.7) pg/ml; t value were 8.2, 10.8, all P < 0.01)]. IL-10 level of group D [(129.9 ± 16.1) pg/ml] and E [(107.1 ± 11.8) pg/ml] was lower than IL-10 level of group B [(160.6 ± 24.2) pg/ml]. The difference were significantly (t value were 2.9, 5.5, all P < 0.05).</p><p><b>CONCLUSIONS</b>Chitosan can effectively encapsulate pVAX1-Derp 1 and inhibit nuclease degradation of the plasmid, the DNA vaccine has some preventive effect on AR animal model by nasal immunization.</p>

A prospective multicenter clinical trial of medical and surgical treatment for chronic rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To demonstrate the clinical outcomes of maximal medical therapy(MMT) and functional endoscopic sinus surgery+ maximal medical therapy (FESS+MMT) for moderate to severe chronic rhinosinusitis without nasal polyps (CRSsNP) in China, to provide clinical evidence for treatment recommendation.</p><p><b>METHODS</b>A prospective multicenter case control study consisting of 90 strictly selected CRSsNP patients were carried out by ENT Hospital of SUN Yet-sen university and 7 other university affiliated hospitals across China from March 2011 to October 2012. All patients were selected to MMT group or FESS+MMT group followed by 3 months treatment and 6 months follow up. Treatment efficacy evaluation indicators included improvement of visual analogue scale (VAS) score, quality of life, CT score and post-operative nasal endoscopic evaluations. SPSS16.0 software was used to analyze the data.</p><p><b>RESULTS</b>All patients enrolled complied with moderate to severe CRSsNP evaluation criteria. There were no significant differences found in the baseline data between two groups (P > 0.05). (1) At the 3 time points (pre-treatment, 3 months and 6 mongths after treatment) , VAS overall symptom score in MMT group were 6.52 ± 2.61, 2.66 ± 2.10, 2.40 ± 1.56, significant differences were found among them (t value were 2.083 and 2.295, both P < 0.05); in FESS+MMT group the values were 6.99 ± 2.70, 0.95 ± 0.84, 0.60 ± 0.81, significant differences were found among them (t value were 3.582 and 5.196, both P < 0.05); SNOT-20 score in MMT group were 38.61 ± 17.36, 18.59 ± 14.04, 18.40 ± 8.91, significant differences were found among them (t value were 2.737 and 2.657, both P < 0.05); in FESS+MMT group the values were 38.21 ± 19.61, 5.94 ± 5.01, 2.65 ± 2.31, significant differences were found among them (t value were 3.247, 3.319, both P < 0.05). (2) FESS+MMT group relative to the MMT group in VAS overall symptom score and quality of life improvements appeared earlier and were more pronounced. (3) Overall treatment efficacy showed that in MMT group: complete control 14 cases (30.4%), partially control 31 cases (67.4%), uncontrolled 1 cases (2.2%); In FESS+MMT group: complete control 17 cases (38.6%), partially control 26 cases (59.1%), uncontrolled 1 cases (2.3%). (4) Patients' satisfaction survey showed that the number of the patients who were very satisfied with the efficacy in the FESS+MMT group were 2 times higher than the MMT group.</p><p><b>CONCLUSIONS</b>(1) For moderate to severe CRSsNP, both MMT and FESS+MMT treatment can effectively control the overall symptoms and classified symptoms, reduce CT scores and significantly improve the quality of life, the ineffective rate is less than 5%. (2) FESS+MMT group in terms of improving symptoms and the onset time are better than MMT group, especially in improving the stuffy nose, head and face fullness, and mental and physical symptoms are better than MMT group. (3) FESS+MMT group showed better results in patient satisfaction survey compared to the MMT group. Therefore for moderate to severe CRSsNP patients, FESS+MMT therapy could be recommended as the preferred treatment.</p>

Investigation of skin prick test on 2707 patients with allergic rhinitis in Wuhan area / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the distribution of common allergens in patients with allergic rhinitis (AR) from 2006 to 2010 in Wuhan area, and provide the objective evidence for the prevention and treatment of AR.</p><p><b>METHODS</b>The medical records of skin prick test (SPT) performed on 2707 AR patients from 2006 to 2010 were retrospectively analysed, and the positive rate of different allergens and changing trends in this time were compared. SPSS 17.0 software was used to analyse the data.</p><p><b>RESULTS</b>There were significant differences among the Dermatophagoides pteronyssinus positive rate (χ(2) = 12.11, P < 0.05) and Dermatophagoides farinae positive rate (χ(2) = 11.11, P < 0.05) in the past 5 years. Meanwhile, there was an upward trend in the positive rate of dust mite, which the positive rate of Dermatophagoides pteronyssinus increased from 84.5% in 2006 to 90.5% in 2010 (χ(2) = 6.88, P < 0.05), positive rate of Dermatophagoides farinae increased from 81.5% in 2006 to 89.0% in 2010 (χ(2) = 9.68, P < 0.05); There were significant differences among the Mugwort and Ragweed positive rate of 5 years (χ(2) = 194.10, P < 0.05; χ(2) = 67.06, P < 0.05). There were significant differences among the mold I and mold II positive rate of 5 years between (χ(2) = 18.95, P < 0.05; χ(2) = 36.62, P < 0.05). Meanwhile, there was an upward trend in the positive rate of mold and fluctuant trend in the positive rate of spring-pollen.</p><p><b>CONCLUSIONS</b>Nearly five years, dust mites is still the most common allergens in AR patients, presenting upward trend; the positive rate of mold presenting upward trend; the positive rate of wormwood and guinea wood presenting downward trend; the positive rate of pollen presenting fluctuant trend.</p>

Relationship between bacterial biofilm and chronic rhinosinusitis: a systematic review / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between bacterial biofilm (BBF) and chronic rhinosinusitis (CRS).</p><p><b>METHODS</b>The database on line was searched to collect the studies on BBF and CRS. The method of meta analysis was used to analyze the data of suitable studies.</p><p><b>RESULTS</b>Fourteen studies were included. System evaluation indicated that the BBF detection rate in CRS group was significantly higher than that in the control group (OR = 17.01, P < 0.01), and the nasal surgery's rate of BBF positive group was significantly higher than the negative group (OR = 3.99, P < 0.01). Preoperative Lund-Kennedy endoscopic score, Lund-MacKay CT score, symptom severity score, postoperative Lund-Kennedy score after six months showed no difference between BBF positive group and negative group.</p><p><b>CONCLUSION</b>The presence of BBF is related to the pathogenesis of CRS and the history of nasal surgery.</p>

Complications of hyoid suspension with Repose system on obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the complications of hyoid suspension with Repose system on obstructive sleep apnea hypopnea syndrome (OSAHS) and to find out the effective prevention strategies.</p><p><b>METHODS</b>Forty four patients diagnosed by polysomnography as OSAHS were received hyoid suspension with Repose system from June 2005 to July 2009. The intraoperative and postoperative complications were analyzed retrospectively. The patients who reported abnormal swallowing were evaluated with water drinking test and video fluorography swallow study to assess biomechanical changes in swallowing.</p><p><b>RESULTS</b>Incidence rate of perioperative titanium nial amotio was 15.9% (7/44). It was avoided by implanting titanium nial again. No perioperative complications occurred such as injury of superior laryngeal nerve, blood vessel and thyrohyoid membrane, fracture of hyoid bone, suture break. All patients developed dysfunctions of pronunciation and swallowing, edema of mouth floor, dysfunctions of movement of tongue that could relieved gradually after three days on most patients. No postoperative complications occurred such as titanium nial amotio, fat liquoring, edema of mouth floor, hematoma, infection, foreign body reaction, injury of root apex of anterior tooth, dysfunctions of movement and sensation of tongue, suture break and death. All patients had over 2 year postoperative follow up. Incidence rate of dysfunctions of pronunciation and swallowing was 4.5% (2/44) and 15.9% (7/44) respectively. Main situation for dysfunctions of pronunciation was speaking ambiguity. Major manifestations of swallowing abnormalities were occasional aspiration, food going down the wrong tube, food becoming stuck in the throat, deglutition with bowing head. Seven patients who had abnormal swallowing possessed normal water drinking test and occurred asynersis of hyoid movement and laryngeal elevation, but aspiration were not observed. Three patients presented obvious stagnation in epiglottic vallecula and sinus piriformis.</p><p><b>CONCLUSIONS</b>Most complications of hyoid suspension with Repose system may be avoided or recovered on short term. Postoperative dysfunctions of pronunciation and swallowing may exist for a long time.</p>

Complications of tongue base reduction with radiofrequency tissue ablation on obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the complications of tongue base reduction with radiofrequency tissue ablation on patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and find out the effective prevention strategies.</p><p><b>METHODS</b>One hundred and ninety three OSAHS patients diagnosed by polysomnography were received tongue base reduction with radiofrequency tissue ablation between March 2008 and December 2009. The intraoperative and postoperative complications including bleeding, hematoma of tongue base, abscess of tongue base, altered taste, tongue numbness, deviation of tongue extension movement, dysfunctions of pronunciation and swallowing as well as the managements were analyzed retrospectively.</p><p><b>RESULTS</b>No perioperative complications occurred. There were 186 cases with postoperative pain (96.4%), 155 cases with submandibular edema (80.3%). Nocturnal sudden cardiac death was encountered in 1 case and secondary bleeding in 1 case. There was no ulceration of tongue base mucose, hematoma or abscess of tongue base, altered taste, tongue numbness, tongue deviations, speech, swallowing and taste disorder after operation. The scale of postoperative pain claimed by patients was ranged between mild to moderate. Diclofenac suppository had analgesic effect for these patients. The quantity of bleeding in patient with secondary hemorrhage was so little that after proper treatment the bleeding was stopped and never happened again. Patient with nocturnal sudden cardiac death occurred at thirty-seven hours after operation, because of swelling and pain of tongue base aggravated sleep apnea and night hypoxemia inducing fatal arrhythmia.</p><p><b>CONCLUSIONS</b>Postoperative pain and submandibular edema were 2 most common postoperative complications which can be easily controlled by antibiotics, Glucocorticoids and Diclofenac suppository. For those severe OSAHS patients accompanied by cardiopulmonary diseases, the tongue base reduction with radiofrequency tissue ablation can induce nocturnal sudden cardiac death. It is important to pay more attention on arrhythmias at night in severe OSAHS patients.</p>

Effect of intranasal glucocorticoid on the pathological change of nasal mucosa in rats with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of inhaled glucocorticoid on the pathological change of the nasal mucosa in allergic rhinitis.</p><p><b>METHODS</b>One hundred and eighty Sprague-Dawley (SD) rats were selected. According to the random number table, these animals were randomly divided into two groups: the control Group A and the experimental group. There were 60 rats in Group A and 120 rats in experimental group. First of all, the rats in experimental group were sensitized by intra-peritoneal injection with ovalbumin (OVA), enhanced and local stimulated. Next, the rats in the experimental group were randomly divided into B and C groups. The number of rats in each group was 60. Group B still had the intranasal dropping on each side with OVA in the same volume and concentration twice a week. The rats in Group C also had the intranasal dropping on each side with OVA in the same volume and concentration twice a week. But, at the same time, these animals had fluticasone propionate (FP) nasal spray each side 50 microl/per day. While doing intra-peritoneal injection with physiological saline in the same volume and intranasal dropping on the rats in normal Group A. Ten rats from each group were randomly selected to be killed at the end of first, second, fourth, eighth, twelfth and sixteenth weeks after treatment. One from the ten rats in each group was used for micro-vascular casting of nasal mucosa, and the remaining nine were used for pathological examination.</p><p><b>RESULTS</b>The model of the rats in experimental group was established successfully. After allergen stimulation, the nasal mucosa showed metaplasia of the goblet cells, epithelial denudation, inflammatory cells infiltration especially eosinophils, hyperplasia of the number of gland and density of micro-blood vessels. The capillary became netted. Cilia of epithelial shed to different extent and were uneven, and the layers of reticular formation of basal membrane became thick, and collagen deposition and fabric hyperplasia were seen under the electron microscope. In Group B, due to continuously contact with allergen, the mucosa remodeling enhanced. In Group C, glucocorticoid controlled the symptoms of allergic rhinitis better, but the cilia of epithelial shed, metaplasia of the goblet cells, inflammatory cells infiltration, hyperplasia of gland and micro-blood vessels, collagen deposition and fabric hyperplasia also could be seen in rat nasal mucosa.</p><p><b>CONCLUSIONS</b>The pathological change of the nasal mucosa was found in allergic rhinitis. If the allergen was continuously contacted, the pathological change aggravated. Glucocorticoid could control the symptoms of allergic rhinitis better and reverse the mucosa pathological change to some extent, but it could not retro-converse or repair the nasal mucosa while the irreversibile change had occurred.</p>

Activation of nuclear factor-kappaB and aberrant gene expression of interleukin 6 in middle ear cholesteatoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To establish the activation of NF-kappaB in middle ear cholesteatoma, discuss the relationship of NF-kappaB and the gene expression of IL-6 and explore the pathogenesis of middle ear cholesteatoma.</p><p><b>METHODS</b>Ten cases of cholesteatoma and 6 cases of normal external meatal skin were obtained from middle ear surgery. The NF-kappaB DNA binding activity and the mRNA level of IL-6 in these two kinds of tissues were detected by electrophoretic motility shift assay (EMSA) and Reverse transcription polymerase chain reaction (RT-PCR) respectively. The relationship of NF-kappaB DNA binding activity and the mRNA level of IL-6 were analyzed.</p><p><b>RESULTS</b>The NF-kappaB DNA binding activities of cholesteatoma [(15.9 +/- 8.2)%] were higher than those in normal skin [(1.36 +/- 0.94)%, t = 3.502, P < 0.05]. The expression of IL-6 mRNA was increased significantly in patients with cholesteatoma, as compared with that in the control specimens (t = 2.166, P < 0.05) and had a significant positive correlation with NF-kappaB DNA binding activity (r = 0.752, P < 0.05).</p><p><b>CONCLUSIONS</b>The IL-6 mRNA expression in cholesteatoma is closely related with the activity of NF-kappaB. It is tempting to speculate that NF-kappaB play a key role in the activation of cytokine in cholesteatoma.</p>

Relationship between nasal discharge eosinophils and responses to treatment of inhaled glucocorticosteroid in patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the treatment responses of persistent allergic rhinitis with and without nasal discharge eosinophilia (EOS) to inhaled glucocorticosteroid (CS), and therefore to verify whether low nasal discharge eosinophils predict poor response to treatment with CS.</p><p><b>METHODS</b>Forty-two symptomatic allergic rhinitis patients, who had not received CS therapy in three months preceding the study, were examined before and 2 month,4 months and 6 months after treatment with CS. At each visit, all patients underwent symptom scoring and physical sign scoring. The level of eosinophil cationic protein (ECP) in the nasal discharge supernatants was measured by radioimmunoassay. The patients were divided into 2 groups according to nasal discharge EOS percentages, an EOS group (group A, EOS > or = 0.03) and a non-EOS group (group B, EOS < 0.03). The response to CS therapy (as measured by symptom and physical sign scores) and the changes of nasal discharge measurements were compared between the 2 groups.</p><p><b>RESULTS</b>In the group A, the baseline EOS [0.086 (0.065; 0.176)] and ECP level [(326 +/- 145) microg/L] were significantly higher than those of the group B [0.016 (0.005; 0.022)] and ECP level (154 +/- 58) microg/L], respectively, t = 4.40, 3.33, both, all P < 0.01. After 2 month and 6 months CS therapy, the nasal discharge EOS, ECP pred were 0.038 (0.006; 0.070), 0.019 (0.010; 0.060), (175 +/- 122) microg/L, (175 +/- 153) microg/L, respectively in the EOS group, which were significantly different as compared to baseline values (F = 6.73, 7.38, respectively, all P < 0.05). But in the non-EOS group, the nasal discharge EOS ECP pred were 0.014 (0.004; 0.032), 0.015 (0.000; 0.026), (118 +/- 60) microg/L, (112 +/- 60) microg/L, respectively at 2 and 6 months, which showed that the the nasal discharge EOS pred and the symptom and physical sign scores improved did not change (F = 0.82, P > 0.05), but the ECP level improved (F = 3.78, P < 0.05). and the average daily dose of CS wear not different between the two groups at any visits.</p><p><b>CONCLUSIONS</b>In persistent allergic rhinitis with low nasal discharge EOS, CS therapy for 6 months failed to improve symptom and physical sign.</p>

Short hairpin RNA silencing of vascular endothelial growth factor, telomerase reverse transcriptase, and Bcl-xl expression in human laryngeal squamous carcinoma xenografted in nude mice / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the biological impact of pEGFP-shVEGF-shTERT-shBcl-xl expression in human laryngeal squamous carcinomas xenografted in nude mice and the related antitumor mechanism.</p><p><b>METHODS</b>A recombinant plasmid vector containing 3 different short hairpin RNA (shRNA) segments including pEGFP-shVEGF-shTERT-shBcl-xl was constructed and directly injected into the grafted tumors of human laryngeal squamous carcinoma in nude mice. The mRNA and protein expressions were determined by real-time RT-PCR and Western blot respectively. Apoptosis was determined by TUNEL assay using a commercial kit. Intratumoral microvessel density (MVD) was assessed by immunhistochemistry.</p><p><b>RESULTS</b>On the 14th days after the final treatment, mRNA and protein expression of VEGF, TERT, and Bcl-xl were markedly suppressed. The tumor sizes were significantly smaller than those in the other two group, with an overall tumor inhibition ratio of 91.2%. MVD counts in the pEGFP-shVEGF-shTERT-shBcl-xl treated group were significantly lower than those of the other two groups, along with increased apoptotic cells.</p><p><b>CONCLUSIONS</b>The data showed that inhibition of VEGF, TERT, Bcl-xl expression by RNAi technique induces cellular apoptosis and suppresses the growth of laryngeal squamous carcinoma in vivo. VEGF, TERT and Bcl-xl may be involved in the development of laryngeal cancers. The findings suggest a synergistic tumor therapeutic effect through simultaneous inhibition of the three genes. Multi-target RNA interference may provide a powerful strategy against human laryngeal cancers.</p>

Expression and activation of nuclear factor-kappaB in middle ear cholesteatoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the expression and activation of NF-kappaB in middle ear cholesteatoma.</p><p><b>METHODS</b>The protein expression of NF-kappaB p65 in 21 middle ear cholesteatoma tissues and 8 normal external ear canal skin obtained in middle ear surgery were examined by immunohistochemistry; NF-kappaB DNA binding activity in these two kinds of tissues were also detected by electrophoretic motility shift assay (EMSA). The influence of cholesteatoma debris on the NF-kappaB DNA binding activity of HaCat cell were further analyzed.</p><p><b>RESULTS</b>All epithelial cell of cholesteatoma revealed a relatively abundant plasma expression of NF-kappaB p65 protein, among which 12 cases showed nuclear positive expression. In contrast,the normal skin epithelium only revealed a sparse plasma distribution of NF-kappaB protein. The levels of NF-kappaB p65 protein expression in the epithelium of middle ear cholesteatoma tissue and normal skin were 0.168 +/- 0.051, 0.088 +/- 0.019 (t = 4.211, P < 0.01), respectively. The NF-kappaB DNA binding activities of cholesteatoma [(16.5 +/- 10.1)%] were also higher than those in normal skin [(1.38 +/- 1.24)%, t = 3. 600, P = 0.014]. The NF-kappaB DNA binding activity of HaCat cell increased when exposed to cholesteatoma debris in a dose dependent manner.</p><p><b>CONCLUSION</b>NF-kappaB might be an important factor which was involved in the occurrence and development of cholesteatoma.</p>

Perioperative management of modified uvulopalatopharyngoplasty / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Experiences and lessons of uvulopalatopharyngoplasty (UPPP ) perioperative management, especially causes of postoperative tracheotomy, were analyzed, and related strategy was raised to have a better perioperative management and to avoid tracheotomy.</p><p><b>METHODS</b>Two hundred and fifty eight cases of obstructive sleep apnea hypopnea syndromes (OSAHS) diagnosed with polysomnography (PSG) were treated with modified uvulopalatopharyngoplasty (UPPP). The perioperative management was summarized. Patients were divided into two groups according to the perioperative management: without or with perioperative comprehensive management. In group A, there were 32 patients, without comprehensive management, and in group B there were 226 cases with comprehensive management. Sixty eight cases in group B whose apnea hypopnea index over 50 times per hour and the lowest arterial oxygen saturation was less than 0.5 were treated with continuous positive airway pressure (CPAP) for 1 to 3 weeks. For all the 258 cases, perioperative management includes treatment of medical complications, treatment with antibiotics 2 or 3 days before the operation. None of these cases had tracheotomy before surgery.</p><p><b>RESULTS</b>In group A, three of 32 patients had postoperative tracheotomy, two because of bleeding, and another one because of laryngeal spasm. In group B, none of 226 patients underwent tracheotomy, which owing to modified operative apparatus and effective perioperative and postoperative treatment (chi2 = 21.35, P < 0.001). In group A, 5 of 32 patients had oral pharynx bleeding after 24 hours of the operation. While 26 of 226 patients in group B did so (chi2 = 0.15, P > 0.05).</p><p><b>CONCLUSION</b>Comprehensive perioperative management can effectively lower down the complication rate for patients receiving uvulopalatopharyngoplasty.</p>

Inhibition of growth and proliferation of Hep-2 cells by targeting human telomerase reverse transcriptase mRNA using RNA interference technology / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the effect of RNA interference by targeting human telomerase reverse transcriptase (hTERT) mRNA in the larynx cancer cell line, Hep-2.</p><p><b>METHODS</b>The primary structures of hTERT cDNA were found in GenBank. Then the structure analysis were done according to RNAi strategy which determined the specific base sequences to design shRNA plasmid. Two types of plasmid, pshRNA1 and pshRNA2, involved in fluorescein gene were synthesized based on the specific base sequences. Control pshRNA3, a random sequence, and control pshRNA4, without additional specific sequence were also constructed. Cells were treated daily with pshRNA1-4 or normal culture medium respectively. The pshRNA1-3 was identified by electrophoresis. After administration of pshRNA1-4, fluorescence expression was detected by confocal microscopy, the expression of hTERT of the transfected cells was determined by Western blotting, telomerase activity was measured by TRAP-PCR ELISA, cell viability was determined by MTT assay, morphological changes and apoptosis were examined by inverted microscope and TUNEL respectively.</p><p><b>RESULTS</b>There was a 400 bp balteum in pshRNA1-3 after cut by SalI, which was identical with the size of the objective gene. Many cells presented green fluorescence after being treated by pshRNA1-4, but there are much more dead green fluorescent cells in the pshRNA1 and pshRNA2 group. hTERT protein and telomerase activity was significantly decreased after treated by pshRNA1 or pshRNA2. It was observed that treatment with pshRNA1 or pshRNA2 in the presence of a valid transfection reagent could reduce cell viability of Hep-2 cells within 96 h (P < 0.01). Under the same culture conditions, cells grew more sparsely and the number of apoptotic cell increased significantly.</p><p><b>CONCLUSIONS</b>shRNA plasmid directed against human telomerase reverse transcriptase can effectively transfect Hep-2 cells. shRNA targeted hTERT gene can significantly inhibit the growth and proliferation of Hep-2 cells, which results in apoptotic cell death. RNA interference may be a promising strategy for the treatment of laryngeal cancer.</p>