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Objective To analyze the relation between calcium and phosphate metabolism and the death for cardiovascular disease in continuous peritoneal dialysis patients.Methods60 peritoneal dialysis patients from our hospital were collected from July,1999 to December,2007 were divided into two groups by the death causes:the death cause for CVD group and the death cause for non-CVD group,and then compare their gender、age、time for dialysis、difference for pulse pressure(PP)、the content of Ca、P、Ca?P and PTH in serum.Results There are 28 cases in CVD group(47%);there are 32 cases in non-CVD group(53%).There are not differences for age、gender、time for dialysis and serum calcium between two groups;there are significant differences for PP、serum phosphorus、Ca?P、PTH between two groups.ConclusionThe high value for phosphorus、Ca?P and PTH in serum are closely related to the death cause for CVD in continuous peritoneal dialysis patients,which are the main dangerous factors in the death cause for CVD.
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OBJECTIVE To study the therapeutic effect of arytenoid within-shift combining with recurrentlaryngeal nerve (RLN) anastomosis to ansa cervicalis for patients with long-term unilateral vocal cord paralysis (UVCP) . METHODS Twelve patients with traumatic RLNs paralysis were studied. The courses of injury varied from 3 to 22 years. RLN was anastomosed to ansa cervicalis and arytenoid was within-shifted on ipsilateral side in all patients. Therapeutic efficacy was evaluated by laryngoscope, strobe-laryngoscope, voice evaluation, voice acoustics parameter analysis, and laryngeal electromyography (LEMG) . RESULTS The voice was improved in all cases after arytenoid within-shift immediately. The mean values of voice acoustics parameters (jitter, shimmer, NNE) were significantly smaller and maximum phonation time (MPT) were significantly longer after operation compared with those of before treatment. Laryngoscope showed that arytenoid was significantly within-shifted. The glottic posterior chink vanished in 9 cases and reduced in 3 cases. The voice resumed normal, obviously improved, improved and no improved were found in 9、 3、0、0 cases respectively 12 months after operation. The mass and tension of all treated vocal cords may become the same as the contralateral normal vocal cords, thus resuming symmetric vibration of the vocal cords. The reinnervation of the RLNs were approved by LEMG in these patients whose RLNs were restored. CONCLUSION Arytenoid within-shift combining with RLN anastomosis to ansa cervical can restored normal voice in patients with long-term UVCP.
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OBJECTIVE To investigate the inhibiting effect of Pingyangmycin on cultured vein endothelial cells in vitro and illustrate the mechanism of Pingyangmycin on treatment cavernous hemangioma of head and neck. METHODS By MTT assay,the inhibiting rates of cultured Ecv-304 cells which were managed with Pingyangmycin for 24h and 48h were compared respectively. The changes in the cell cycle,apoptosis,and Caspase 3 protein expression of the cells managed with Pingyangcin for 24h were examined by flow cytometry(FCM). RESULTS The results showed that the inhibiting rate of Ecv-304 was dependent on the concentration of Pingyangmycin. However,in the same concentration,the inhibiting effect for 24h was stronger than that for 48h. The percentage of G1 phase cells increased while the S phase decreased,but the percentage of G2 phase cells remained unchanged after managed with Pingyangcin for 24h. An apoptosis peak appeared before G1 phase. The apoptosis rate was also concentration-dependant. The expression of caspase 3 increased in every group of different concentration. CONCLUSION Pingyangmycin can possibly arrest the growth of Ecv-304 in the G1 phase through the mechanism of inducing apoptosis. Caspase 3 may play an important role in the induced apoptosis.
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Objective： To study the application of DSA in the diagnosis and treatment of ENT diseases. Methods： The diagnostic and therapeutic roles of DSA in ENT patients admitted from November 1995 to December 1999 were retrospectively studied. Results： Therapeutic vascular embolization using DSA was performed in 9/10 patients with severe epistaxis. The treatment was successful in 8/9 patients with a successful rate of 88.89%; embolization of tumor supplying vessels using DSA as a preoperative measure for reducing operative blood loss in 3 patients with nasopharyngeal fibrohemangioma obtained a total success; diagnosis was clarified in 2 patients using DSA. No patients were with severe complications. Conclusion： DSA is not only a safe and effective measure for diagnosis and therapy, but also effective in differential diagnosis of space occupying lesions. Preoperative selective embolization of tumor supplying arteries can reduce operative blood loss.
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Objective:To promote the hearing, improve the appearance, shorten the therapeutic course in congenital malformation of external and middle ear,the program of primary restoration has been designed. Method:Under general or local anaesthesia a Z-shaped incision is made in skin. After turn up the flap A(defective ear)and flap B(retroauricular skin), a periosteal flap C with pedicle in front is made and elevated from mastoid.Then made frameworklize on mastoid and perform tympanoplasty. Once the myringograft is put properly the flap C is turn into the mastoidal cavity to serve as the lining of anterior wall. Flap A is sutured with the edge of retroauricular incision to serve as the lower part of new auricle. Then use the flap B to wrap a siliceous frame to make the upper part of new auricle.Finally,the naked walls of mastoidal cavity are lined with free skin graft and the cavity is packed with vaseline gauze for two weeks. Result:Two cases of congenital malformation of external and middle ear were treated with the procedure mentioned above and were followed up for one and 3 years respectively. Both effects of shape and hearing were good.Conclusion:The primary restoration for congenital malformation of external and middle ear designed by the authors is an excellent method worthy to be recommended.
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To study an improved translabyrithine approach, twenty adult cadaver heads (40 sides) fixed with formalin were dissected by mimicking translabyrithine method under light microscope ,and measurements were performed . The results showed that the rate of meeting with mastoid emissary was 33/40(82. 50%). The distance between the middle part of sigrnoid and the vertical part of facial nerve was 7. 22 ?1.95 mm. The width of the middle part of sigmoid was 10. 5 ? 0. 79mm, the left side was 8. 89 ? 1. 03mm, and the right side was 9. 88 ?2.14mm. The height of jugular bulb was 8. 08?3. 46mm,the left side was 6. 78 ? 3. 17mm,and the right side was 9. 07?3. 04mm. The distance between the highest point of jugular bulb and the base of internal acoustic meatus was 4. 54 ? 2. 81 mm, the left side was 5. 93?3. 12mm, and the right side was 2. 65?1. 87 mm. The distance between the inferior margin of internal acoustic meatus aperture and superrior petrosal sinus was 5. 09?1. 29mm . The diameter of superrior petrosal sinus was 1. 43?0. 08 mm. There were two types of superrior petrosal sinus entering to the sigmoid (or transverse sinus). The angle between superrior petrosal sinus and sigmoid was 52. 17 ?6. 93?. The results suggest that the improved translabyrithine approach can give enough vision for cerebellopontine angle operation.
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Aim: To report 3 cases of relapsing polychondritis admitted within a month, and to explore the therapeutic programme. Methods: Based on therapeutic effect of traditional immuno suppressant and their side effects, the programme was designed as follows: During acute episode, 60～90mg of tripterygium glucosides and 30～60mg of prednisone were medicated orally every day and 1ml(5mg) of diprospan was injected into the painful cortilaginous areas. After the symptoms subsided, the daily dosages of oral drug were gradually decreased to 30～60mg of tripterygium glucosides and 10～20mg of prednisone for four months' course. Results: All the 3 cases′ symptoms were obviously subsided within a half month. All of them were followed up for 22 months. hyperemia, swelling or pain were not fou and in all suffering areas. One case remained a mild cauliflower ear and another case a mild saddle nose. Conclusions: Otorhinolaryngologists need to improve the capabillity of detecting the relapsing polychondritis, in order to make the diagnosis and treatment as early and correctly as possible. Tripterygium wiifordii and steroid have a good therapeutic effect for relapsing polychondritis.
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Objective: To investigate the surgical methods and outcomes of the enlarged translabyrinthine approach in the removal of large acoustic neuromas. Methods: A large mastoidectomy involved complete exposure of the sigmoid sinus, the dura behind the sinus for at least 1 cm, the superior petrosal sinus and the middle fossa dura. The jugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonized and uncovered for at least 270°.The debulking of the tumor began inside the anterior and inferior poles in order to find the brainstem and the facial nerve root as early as possible, and then the dissection of the nerve was done medially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were done in all cases. Results: Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size: 4.2 cm). There were no deaths or other complications such as intracranial infection and persistent cerebrospinal fluid leakage. There were no obvious cerebral sequelae. The facial nerve was preserved both anatomically and functionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases, Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in 4 patients who all had severe facial palsy or nerve interruption before operation. Sixteen patients resumed work within 1-3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via the translabyrinthine approach, with good preservation of facial nerve function and minimum incidence of morbidity.
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Objective:To investigate the surgical methods and results of enlarged translabyrinthine approachin the removal of large acoustic neuromas. Method:A large mastoidectomy involved complete exposure of sigmoidsinus, the dura behind the sinus for at least lcm, the superior petrosal sinus and the middle fossa dura. Thejugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonizedand uncovered for at least 270°. The debulking of the tumor began inside the anterior and inferior poles in orderto find the brainstem and the facial nerve root as early as possible, then the dissection of the nerve was performedmedially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were performed in allcases. Result:Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size:4.2 cm).There were no death as well as other complications such as intracranial infection and persistent cerebrospinalfluid leakage. There were no obvious cerebral sequela. The facial nerve was preserved both anatomically andfunctionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases,Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in4 cases who all had severe facial paralysis or nerve interruption before operation. 16 patients returned to workwithin 1～3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via thetranslabyrinthine approach, with good result of facial nerve function and minimum incidence of morbidity.
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AIM: There has been accumulating evidence demonstrating that activators for peroxisome proliferator-activated receptor ? (PPAR?) have antiinflammatory, antiatherogenic, and vasodilatory actions. We investigated the effect of PPAR? activator, fenofibrate, on trombin-induced endothelin-1 (ET-1) expression in cultured vascular endothelial cells. METHODS: Bovine aortic endothelial cells (BAECs) were treated with the PPAR? activator, fenofibrate. The ET-1 concentrations were evaluated by radioimmunoassay. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the ET-1 mRNA expression. RESULTS: Thrombin(10U/L) induced ET-1 release in BAECs [(22.4?4.7) nmol/g protein vs control (13.2?1.6) nmol/g protein, P
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Objective:Ciliary neurotrophic factor (CNTF) plays important roles in the maintenance and survival of motor neurons. This study attempted to explore the expression and distribution of CNTF mRNA and its protein in the ambiguous nucleus(Amb) motoneuron in order to clarify its functional state after long term laryngeal denervation. Methods: The recurrent laryngeal nerves were obtained from dogs. Brain stems were removed and sectioned for histochemistry, immunohistochemistry and in situ hybridization of CNTF. Amb motoneurons were identified by Nissl staining. The count and intensity of positive reactive motoneurons were measured by computer image processing system. Results: Transection of the laryngeal nerve led to a very marked reduction in the count and intensity of CNTF mRNA positive reactive motoneurons, and reached minimal levels at week 3. CNTF immunoreactivity increased rapidly and reached maximal levels also at week 3. At week 4, a significant increase in CNTF mRNA expression and decrease in CNTF immunoreactivity were observed. At week 6, both CNTF mRNA and its protein expression were significantly less than those of unlesioned contraletaral sides. Although a difference between week 6 and 12 was observed, the motoneurons were generally stable in the expression level of CNTF mRNA and its protein, and in the size and count after 12 weeks, with 78%, 84.4%, 80.9% and 83.7% respectively as compared with the unlesioned contralateral Amb. Conclusion: The results indicate that although degenerating changes occurre in the Amb motoneurons after long term laryngeal denervation, the ciliary neurotrophic factors activity of the lesioned motoneurons is still maintained at a certain level. [
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Objective: To investigate the pathogenesis of allergic rhinitis at cell level by determing basophil histamine releasability in guinea pigs and attempt to find an objective way for the diagnosis of allergic rhinitis. Methods: A model of allergic rhinitis was established after healthy guinea pigs were randomly divided into 2 groups. The basophil histamine releasability to the stimulant of concanavalin A between normal and experimental guinea pigs was compared by means of fluorometric assay of histamine. Results: Basophil histamine release to various concentrations of concanavalin A in allergic rhinitis group was significantly enhanced as compared with that in normal control ( P
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Objective: To investigate the influence of histamine content in nasal mucosa on blood flow. Methods: Sixty guinea pigs were randomly devided into control group and allergized group and guinea pigs were sacrificed before nasal challenge with allergen and immediately after nasal challenge, at 24, 48, 72 h. The content of histamine in nasal mucosa was examined. Nasal mucosa blood flow was examined in all guinea pigs before sacrifice. The data were analyzed using linear correlation and linear regression. Results: As compared with normal guinea pigs, the content of histamine and blood flow in nasal mucosa of allergic rhinitis guinea pigs were significantly increased before challengd with allergen( P
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Objective: The activity of nitric oxide synthase(NOS)in nasal mucosa of normal guinea pigs was compared with that of allergic rhinitis(AR)guinea pigs to investigate the relationship between NOS and AR. Methods: Localization of NOS in nasal mucosa of normal and AR guinea pigs was examined by means of NADPH diaphorase (NADPH d) histochemical stain. Results: Nasal mucosa of both normal and AR groups was positive for NADPH d, though the AR group reacted more strongly. Reaction was localized to the cytoplasm of glandular cell, epithelium and vascular endothelium. Conclusion: There is distribution of NOS in nasal mucosa of normal guinea pigs. The activity of NOS in guinea pig AR model was significantly stronger than that in normal group. NOS is related to AR. [
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Objective: To investigate the effects of basic fibroblast growth factor(bFGF) on nerve regeneration of the posterior cricoarytenoid muscles(PCM) in dogs. Methods: After transection of the laryngeal recurrent nerves, the denervated PCM were reinnervated by nerve muscle pedicle implantation in 9 dogs. The animals were divided into 3 groups: bFGF and fibrin glue(FG) group(bFGF+FG), FG group and control group. Functional recovery of PCM was observed laryngoscopically. Electrophysiological acvitity and muscle contract strength were determined. Histochemical studies were demonstrated by Karnovsky and H E stain. Results: Six months after operation, functional recovery and nerve regeneration of the PCA in bFGF+FG group were the best in 3 groups (close to normal), and functional recovery in FG group was better than that in control group. The parameters of electrophysiological acvitity and muscle contract strength were different in bFGF+FG group , FG group, and control group( P
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Objective: To validate thyroid perichondrium with muscular pedicle in laryngopharyngeal repair.Methods: The thyroid perichondrium with muscular pedicle was used. in 2 cases undergoing resection of laryngopharyngeal cancer during different patterns of repair operation. Results: A 1 5 year follow up study showed that both cases achieved the goal of reparative healing. Conclusion: The advantages of this technique are easy to draw materials, good enough in blood supply, mobile for use, and benefitial to epithelializing and filling up the tissue defect. The disadvantages are the limited area and sometimes mild contraction or fibrosis. [
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Objective: To study quantitative changes of cochlear hair cells and spiral ganglion cells after blast exposure in guinea pigs. Methods: The number of hair cells was calculated using the surface specimen technique and computer image analysis technique after blast exposure. The number of spiral ganglion cells was calculated using pathologic technique and computer image analysis technique after blast exposure. Results: Quantitative observation was carried out 21 days after blast exposure. The number of total hair cells in uncus, the first and second gyre in normal control group and in blast group was 3 599?159.6 and 6 022?98.4 respectively, and the number of spiral ganglion cells in the 2 low parts of cochlear in normal control group and in blast group was 51? 4.72 and 27? 6.94 respectively, the difference in mean value between the groups being significant. Conclusion: Not only the hair cells reduce, but also the spiral ganglion cells are severely damaged after blast exposure. [
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Objective: To study the influence of ligating different sites of carotid arteries on face and nose blood flow in rabbits. Methods:Different levels of carotid arteries were ligated using laser Doppler flowmetry to observe the change of blood flow in face and nose regions before and after operation. Results: Blood flow of rabbit nose was more than that of the face region. Among the four operations of ligating different blood vessels to reduce blood flow of face and nose region, the most effective method was to ligate ipsilateral carotid artery and its branches on the same side. Conclusion: Ligation of some relating blood vessels, resulting in the establishment of collateral circulation, and the blood flow is quicker in the early stage. [
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Objective To investigate laryngeal reinnervation for recurrent laryngeal nerve injury caused by thyroid surgery. Methods Included in this series were 42 patients with recurrent laryngeal nerve injury, undergoing nerve decompression in 8 cases, end-to-end anastomosis of recurrent laryngeal nerve in 6, anastomosis of main branch of ansa cervicalis to recurrent laryngeal nerve in 21, end-to-end anastomosis of recurrent laryngeal nerve in 6 cases, phrenic nerve graft combined with nerve muscular pedicle (NMP) technique or nerve decompression in 7. All cases were subjected to preoperative and postoperative videolaryngoscopy, voice recording, acoustic analysis and electromyography. Results In 5 patients with unilateral injury and with a course less than four months, nerve decompression restored functional adductory and abductory motion of the vocal cord. Although functional motion of vocal cord was still absent in two patients receiving nerve decompression with a course longer than 4 months and in one less than 4 months, and in all cases with unilateral vocal cord paralysis receiving ansa cervicalis anastomosis and end to end anastomosis of recurrent laryngeal nerve, these procedures did result in symmetric vibration of the vocal cords and physiological phonation. Good inspiratory abductent motion of the glottis was observed on the reinnervated sides by the phrenic nerves in 6 cases with bilateral vocal cord paralysis and the vocal cord excursion was from 3 to 5 mm. On the opposite reinnervated sides, 2 cases with nerve decompression restored functional adductory and abductory motion of the vocal cord; while 4 cases with NMP technique restored only slight abductent motion or no motion. These patients have achieved sufficient airway so that exercise to tolerance for daily activities is adequate without a tracheotomy. In no case was the voice weakened, no was there any problem with aspiration. Conclusions Nerve decompression seems to be the best procedure in laryngeal reinnervation; Main branch of ansa cervicalis technique achieves satisfactory reinnervation of adductor muscles; Phrenic nerve graft yields more satisfactory vocal cord abductory motion than NMP technique. Selection of the laryngeal reinnervation protocols should depend on the course, severity, type of nerve injury.
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Objectives To explore therapeutic effect,indication and timing of nerve decompression for traumatic recurrent laryngeal nerve injury inducing vocal cord paralysis. Methods A total of 42 patients with recurrent laryngeal nerve injury inducing vocal cord paralysis within six months, were divided into nerve decompression group (15 cases), end to end anastomosis of recurrent laryngeal nerve group (six cases) and nonsurgical treatment (21 cases). Nerve decompression was performed in the patients who were operatively found to have compressing sutures or compression due to cicatricial hypertrophy. Results In 13 patients with a course less than four months, nerve decompression restored normal functional adductory and abductory motion of the vocal cord in 11 patients and motionless in two. Although functional motion of vocal cord was not seen in two patients with a course less than four months and two longer than four months, the mass and tension of the reinnervated vocal cord became much the same as the contralateral normal vocal cord, thus resuming symmetric vibration of the vocal cords and physiological phonation. End-to-end anastomosis of recurrent laryngeal nerve failed to restore motion of the glottis. Nevertheless, the procedures enabled adductory muscles to be reinnervated and then restored normal voice. Although nonsurgical treatment improved severe hoarseness, the vocal cord didn't restore normal functional motion of the vocal cord and normal voice. Conclusions Early and mid-stage recurrent laryngeal nerve decompression may restore normal motion of the vocal cord. End-to-end anastomosis of recurrent laryngeal nerve enables adductory muscles to be reinnervated and thus restores normal voice.