A prospective study of the effect of functional endoscopic sinus surgery on the recovery of olfactory function in patients with chronic rhinosinusitis with nasal polyposis / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the efficacy of functional endoscopic sinus surgery（FESS） in the treatment of olfactory dysfunction in patients with chronic rhinosinusitis with nasal polyps （CRSwNP） , at the same time, it provides an evidence for the prognosis evaluation of olfaction and the clinical application of oERPs to evaluate the plasticity of olfaction cortex. Methods:From October 2021 to October 2022, 45 patients with CRSwNP who underwent FESS nine-step standardized treatment in our department were recruited as the research subjects, divided into 22 patients with eosinophilic CRSwNP（ECRS）and 23 patients with non-eosinophilic CRSwNP（nECRS）. VAS-olfactory dysfunction （VAS-OD） score, SNOT-22 olfactory score, Sniffin' Sticks test and oERPs collection and processing were performed before the operation. All items were evaluated again 3 months after the operation. Results:VAS-OD and SNOT-22 olfactory score were significantly lower in all CRSwNP patients after the operation than those before the operation[F（1, 43） =357.429, P<0.001; F（1, 43） =185.657, P<0.001], the scores of T, D, I and TDI scores in Sniffin' Sticks test were significantly higher than those before the operation[F（1, 43） =126.302, P<0.001; F（1, 43） =311.301, P<0.001; F（1, 43） =131.401, P<0.001; F（1, 43） =295.885, P<0.001]; The decrease of VAS-OD and SNOT-22 olfactory score in the ECRS group was smaller than that in the nECRS group[F（1, 43） =4.825, P=0.033; F（1, 43） =9.916, P=0.003], T, D and TDI scores were significantly lower in nECRS group than those in nECRS group[F（1, 43） =6.719, P=0.013; F（1, 43） =4.890, P=0.032; F（1, 43） =4.469, P=0.040]; There was a positive correlation between preoperative eosinophil-to-lymphocyte ratio（ELR） and SNOT-22 olfactory score and how much it changes（r=0.455, P=0.002; r=-0.414, P=0.005）, a negative correlation between T, TDI score and how much they change respectively（r=-0.431, P=0.003; r=-0.385, P=0.009; r=-0.383, P=0.010; r=-0.316, P=0.035）. The latency of P3 was significantly shorter after operation than that before operation in all CRSwNP patients[F（1, 14） =24.840, P<0.001], however, the amplitude has no significant surgical effect. Conclusion:FESS could significantly improve the olfactory function of CRSwNP patients, while changes in plasticity may occur in the olfactory cortex. In addition, the preoperative peripheral blood eosinophil granulocyte level can predict the postoperative olfactory improvement.

Application of 3D printing in the flipped classroom in practice teaching of otolaryngology-head and neck surgery / 中华医学教育探索杂志

Objective@#To investigate the application of 3D printing in the flipped classroom in the practice teaching of otolaryngology-head and neck surgery.@*Methods@#A total of 68 medical undergraduates of the Grade 2013 in Air Force Medical University were divided into experimental group and control group, with 34 undergraduates in each group. The undergraduates in the experimental group received the teaching method of 3D printing in the with flipped classroom, and those in the control group received traditional teaching. The teaching effect was evaluated by questionnaire and examinations of basic knowledge and clinical skills, Independent-samples t test was used for between-group comparison with SPSS 20.0.@*Results@#Compared with the control group, the experimental group had significantly higher scores in theoretical examinations (34.79±2.20 vs. 31.73±3.12, t=4.676, P=0.000) and clinical skill examination (50.06±2.98 vs. 45.82±4.68, t=4.449, P=0.000). The questionnaire survey showed that among the 34 undergraduates in the experimental group, 31(91.2%) thought that the new teaching method could increase their learning interest, 33(97.0%) believed it could improve learning efficiency, 25(73.5%) believed the models obtained by 3D printing had good quality, 32(94.1%) felt that it could improve clinical skills, 28 (82.4%) thought it could enhance the interaction between students and teachers, and 29(85.3%) thought it did not bring extra burden.@*Conclusion@#The teaching method of 3D printing combined with flipped classroom in the practice teaching of otolaryngology-head and neck surgery can improve students' learning interest, academic scores, and clinical skills, and therefore, it holds promise for application in teaching.

Application of 3D printing in the flipped classroom in practice teaching of otolaryngology-head and neck surgery / 中华医学教育探索杂志

Objective To investigate the application of 3D printing in the flipped classroom in the practice teaching of otolaryngology-head and neck surgery. Methods A total of 68 medical undergraduates of the Grade 2013 in Air Force Medical University were divided into experimental group and control group, with 34 undergraduates in each group. The undergraduates in the experimental group received the teaching method of 3D printing in the with flipped classroom , and those in the control group received traditional teaching. The teaching effect was evaluated by questionnaire and examinations of basic knowledge and clinical skills, Independent-samples t test was used for between-group comparison with SPSS 20.0. Results Compared with the control group , the experimental group had significantly higher scores in theoretical examinations (34.79 ±2.20 vs. 31.73 ±3.12, t=4.676, P=0.000) and clinical skill examination (50.06 ±2.98 vs. 45.82 ±4.68, t=4.449, P=0.000). The questionnaire survey showed that among the 34 undergraduates in the experimental group, 31(91.2％) thought that the new teaching method could increase their learning interest, 33 (97.0％) believed it could improve learning efficiency, 25 (73.5％) believed the models obtained by 3D printing had good quality, 32 (94.1％) felt that it could improve clinical skills, 28 (82.4％) thought it could enhance the interaction between students and teachers, and 29(85.3％) thought it did not bring extra burden. Conclusion The teaching method of 3D printing combined with flipped classroom in the practice teaching of otolaryngology-head and neck surgery can improve students' learning interest, academic scores, and clinical skills, and therefore, it holds promise for application in teaching.

Perioperative nursing care to patients with maxillary defect repaired by 3D printing individualized titanium mesh / 现代临床护理

Objective To summarize the care points of nursing to patients with maxillary defect repaired by 3D printing individualized titanium mesh. Methods Nursing staff cooperated with doctors to control the disease of the whole body and prevent oral infection by performing psychological nursing, keeping the respiratory tract smooth after operation, preventing bleeding and infection of the wound, conducting oral, eye and pain care, preventing cerebrospinal fluid leakage, intracranial infection and venous blood thrombus of lower extremity and helping the patients with rehabilitation training. Results The hospitalization time of 5 patients was 11～20d with an average of (14.80 ± 3.31) d. 1 case had cerebrospinal fluid leakage during the operation and 1 had postoperative corneal edema. After treatment and nursing, all the patients were discharged from the hospital. Follow-up of 6 months showed no recurrence and good appearance in the maxillofacial region. Conclusion The nursing measures for the patients with to patients with maxillary defect repaired by 3D printing individualized titanium mesh include respiratory tract management, oral cavity, eye and pain nursing, prevention of bleeding and infection of wound, prevention of cerebrospinal fluid leakage, intracranial infection and venous thrombosis of lower extremities, which can promote the recovery of the patients soon.

Diagnosis and treatment of solitary pterygoid benign lesions / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical and pathological features of solitary pterygoid benign lesions, as well as the treatment and outcome of endoscopic surgery.@*METHOD@#We retrospectively analyzed clinical data of 4 patients with pterygoid benign lesions in our department. High resolution CT and enhanced MRI were performed before the operations, then endoscopic surgeries were carried out under the circumstance of general anesthesia. After a follow-up in 12 months to 48 months, nasal endoscopy and MRI examination were performed. Therefore we are able to understand the situation of operations and postoperative recurrences, and to inquire about the changes of symptoms and the relief of symptoms before and after surgery.@*RESULT@#From the Pathological diagnosis, it showed 2 cases of cystic lesions, 1 case of spindle cell lipoma, 1 case of inflammatory lesion. Postoperative follow up showed scar formation, smooth surface, no recurrence, and no new symptom. Nasal obstruction is relieved after the surgery, and no changes in the sympotoms of headache were observed.@*CONCLUSION@#The combination of high resolution CT with enhanced MRI isimportant for ascertaining the location, extent and nature of the pterygoid lesions. Endoscopic surgery is a minimally invasive, safe, and effective method for the treatment of solitary pterygoid benign lesions.

Long-term outcome of budesonide middle meatus treatment for chronic rhinosinusitis patients following endoscopic sinus surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the long term clinical effect of budesonide treatment in middle meatus for chronic rhinosinusitis(CRS) following endoscopic sinus surgery (ESS).@*METHOD@#A total number of 53 patients with CRS received ESS were divided into two groups according to budesonide treatment: budesonide-treated group with 21 cases (39.6%) and control group with 32 cases (60.4%). Gelatin sponges soaked with 1 ml budesonide suspension were put in middle meatus in budesonide-treated group, while only gelatin sponges were put in middle meatus in control group. Visual analogy score (VAS), sino-nasal outcome test-22 (SNOT-22) and Lund-Kennedy endoscopic scale were carried out before ESS and two years after ESS.@*RESULT@#In budesonide-treated group, there were a statistical difference before and after ESS in the VAS, SNOT-20 and Lund-Kennedy score (P<. 05). In control group, difference was also significant in VAS, SNOT-20 and Lund-Kennedy score before and after ESS (P < 0.05). The VAS gap of post-operative and pre-operative in two groups are significantly different (P<. 05). However, there was no significant difference in the SNOT-20 and Lund-Kennedy endoscopic scale gap before or after the operation between two groups.@*CONCLUSION@#It is safe, convenient and practicable to perform budesonide treatment in middle meatus following ESS, which can significantly ease the post-operative discomfort of nose.

Comparative study on packing with or without Merocel after endoscopic sinus surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of nasal packing with or without Merocel after endoscopic sinus surgery (ESS) in short and long term.</p><p><b>METHOD</b>A total of 112 patients with chronic rhinosinusitis who received endoscopic sinus surgery were randomly divided into two groups: packed group and non-packed group. In packed group, there were 37 cases, of which 10 cases were combined with allergic rhinitis and 11 cases received correction of nasal septum at the same time. In non-packed group, there were 75 cases, of which 15 cases were combined with allergic rhinitis and 26 cases received correction of nasal septum at the same time.Visual analogue score (VAS), Nasal bleeding and sinonasal outcome Test-22 (SNOT-22) were used to evaluate the clinical effect between two groups in short and long term respectively.</p><p><b>RESULT</b>The VAS of nasal obstruction, rhinodynia, dysphoria, epiphora, itching, sneeze, headache and facial pain in non-packed group were significantly lower than those in packed group (P < 0.05). Within 48 hours after ESS, the amounts of nasal bleeding were 0-45 ml (median 3 ml) in packing group and 0-18 ml (median 2 ml) in non-packing group. There were significant difference between two groups (Z = -3.54, P = 0.00). The difference value of postoperative and preoperative SNOT-22 of the packed group was 38.47 ± 20.25 and the non-packed is 41.03 ± 22.73 six months after ESS (t = 0.58, P = 0.56). Each group had one case of nasal adhesion. And as for middle turbinate dislodgement, there was one case in the packed group and two cases in the unpacked group. There was no case of nasal septum hematoma in the packed group, but two cases in the un-packed group. The results showed that there was no significant difference of clinical effect between the postoperative packing and unpacking groups.</p><p><b>CONCLUSIONS</b>It is safe and practicable to manage chronic rhinosinusitis without nasal packing after ESS, which in short term not only decrease discomfort, but also reduce nasal bleeding. Also, there is no significant difference of clinical effect between the postoperative packing and unpacking groups in long the term.</p>

AIF Distribution and Expression in CuItured SpiraI GangIion Neuron Injured by GIutamate / 听力学及言语疾病杂志

Objective The study aimed to explore the relationship between AIF related pathway and the inju-ring of cultured SGNs (spiral ganglion neurons)by glutamate toxicity,and to find AIF expression and distribution changes in SGNs.Methods SGNs of 40 newborn rats within 3 day were obtained and cultured in vitro.Cultured cells were divided into four groups:the normal control group,10 mM,20 mM and 40 mM glutamate injured group, separately.After 48 h hours culturing,optical microscopy,immune fluorescence staining and real-time fluores-cence quantitative PCR were used to observe the morphology,AIF distribution,and AIF,calpain,Caspase3 expres-sion changes in SGNs in vitro.TUNEL was used to verify the cell apoptosis.ResuIts Noticeable morphological chan-ges and cell apoptosis were occurred in 20 mM glutamate group,with AIF nuclear translocation.AIF gene expression was significantly higher than normal after glutamate administration (P0.05). ConcIusion In the process of cultured SGNs injured by glutamate,AIF participated in the cell apoptosis.Noticeable cell apoptosis were occurred in 20 mM glutamate group with AIF nuclear translocation.Calpain up-expression also contributed to excitatory neurotransmitter injury on SGNs,but Caspase 3 had no obvious effects.

Complications and treatment for button battery in the nose / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the injury of button battery to nose and discuss its management.@*METHOD@#Thirteen cases with button battery in nose were reviewed. After the removal of button battery, nasal cavity irrigations were carried out carefully by nasal endoscopy in all cases. Gelfoam full of erythromycin eye ointment was used to cover the injured mucous membrane.@*RESULT@#Among all the cases, 10 got full recovery without any complication. There are 2 cases of synechia nasal and 1 case of septum perforation.@*CONCLUSION@#Removal as soon as possible, careful cleaning and systemic drug are necessary. Nose bleed, septum perforation, adhesion and rhinostenosis should be noticed.

Diagnosis and treatment of unilateral allergic fungal sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical and pathological manifestation, prognosis of unilateral allergic fungal sinusitis (AFS), and to analyze the characters and treatment paradigm of unilateral AFS.@*METHOD@#Clinical and pathological information of 10 cases of unilateral AFS were analyzed. Nasal endoscopy, skin prick test, and visual analogue score (VAS) of severity of illness were taken before surgery. Mucosa membrane and inspissated secretion obtained during endoscopic surgery were stained with hematoxylin-eosin and silver hexosamine. Regular clean of sinus and intranasal steroid spray were taken after surgery.@*RESULT@#Endoscopy showed that 5 cases had pale mucous membranes in the ipsilateral nasal cavity. Skin prick test was positive in all patients. Nasal CT scan demonstrated unilateral lesion in all 10 patients. In the involved sinus, all 10 patients had brown or yellow brown viscous secretion, which demonstrated eosinophilic amorphous mass with accumulation of eosinophils, Charcot-Leyden crystallization and fungal hyphae under microscope. The number of eosinophils in lamina propria of sinus mucosa membrane was 72 +/- 11/hpf. After follow-up for 16 to 26 months(mean 22 months), 9 cases were cured and 1 improved. The pre-operative VAS was 8.5 +/- 1.2, and the post-operative VAS was 1.1 +/- 1.0 (P < 0.01).@*CONCLUSION@#The systemic and local allergic reaction may co-exist in unilateral AFS, in which local hypersensitivity may be the dominant reaction. Endoscopic sinus surgery and intranasal steroid spray are effective in the treatment of unilateral AFS.

Construction of professional curriculum website for otolaryngology-head and neck surgery based on CMS and its application / 中华医学教育探索杂志

Construction of excellent professional curriculum website is the most important part of medical teaching quality and teaching innovation.Requirements,designing procedure,construction and evaluation process as well as the future development for construction of professional curriculum website of otolaryngology-head and neck surgery were proposed by applying content management system (CMS),which based on the technology of dynamic web page and database and by combining with characteristics of the discipline to resolve problems occurred in construction of tradition statical network station.High-quality professional curriculum website is expected to improve teaching quality.

Study on protective effect of alcohol extract of Potentilla Anserinea against acute myocardial ischemia/reperfusion-induced myocardial apoptosis in rats / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the protective effect of alcohol extract of Potentilla anserina against myocardial apoptosis induced by acute myocardial ischemia/reperfusion by arteria coronaria ligation and the effect on the expressions of Caspase-3 and Caspase-9 in myocardial apoptosis signal pathway.</p><p><b>METHOD</b>Male SD rats were randomly divided into the sham-operated group, the model group, the diltiazem group (30 mg x kg(-1)) and P. anserine alcohol extract intervention groups (0.9, 1.8, 3.6 g x kg(-1)). Rat acute myocardial ischemia/reperfusion model was established by ligating left anterior descending. Apoptosis of myocardial cells were detected by TUNEL (Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay). The expressions of Caspase-3 and Caspase-9 mRNA were assayed by reverse transcription-polymerase chain reaction (RT-PCR). Semi-quantitative analysis was made for the expressions of Caspase-3 and Caspase-9 by immunohistochemistry.</p><p><b>RESULT</b>According to TUNEL results, after I/R injury-induced myocardial apoptosis, the apoptotic index (AI) of model group was (31.5 +/- 3.6)%. All P. anserine alcohol extract intervention groups showed obvious inhibition of ischemia/reperfusion-induced myocardial apoptosis. In the model group, myocardial apoptosis caused increased expression of Caspase-3, Caspase-9 mRNA and proteins. After the administration of P. anserine alcohol extract, 1.8, 3.6 g x kg(-1) dose groups showed notable decrease in Caspase-9 mRNA (P < 0.05), while the 0.9 g x kg(-1) dose group showed no significant difference with the model group. Alcohol extract of P. anserina in all dosages showed inhibitory effect on the expression of Caspase-3 mRNA in myocardial cells compared with model group (P < 0.05). Immunohistochemistry showed that administration of all dosages of alcohol extract of P. anserina could significantly reduce Caspase-3 and Caspase-9 protein expressions after I/R injury (P < 0.05).</p><p><b>CONCLUSION</b>The administration with alcohol extract of P. anserina can protect the myocardial tissue from apoptosis after acute myocardial ischemia and reperfusion injury in rats and inhibit the expressions of Caspase-9 and Caspase-3 mRNA and proteins.</p>

Analysis of 167 postnasal drip syndromes ambulatory treatment / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Carry out analysis on to diagnosing the result that the patient cures for postnasal drip syndrome cases, discuss the disease curing method.@*METHOD@#One hundred and sixty-seven patients who diagnosed postnasal drip syndrome makes a definite diagnosis that the patient adopt a decongestant, part system such as using glucocorticoid, improving the sticky film cilium function treats.@*RESULT@#All above follow-up of one-hundred and sixty-seven example patients three mouths. With subjectivity, if symptom improve action appraises an index, there are 153 cases have different improve. Fourteen cases don't feel their symptom improved obviously. Have efficiency amounting to 94%.@*CONCLUSION@#Despite of Postnasal drip syndrome cause of disease complicated. If it is cured by systemic medication, it will get ideal therapeutic efficacy.

Effect and evaluation of image guided navigation system in complex endoscopic endonasal surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effect of image guided navigation system (IGNS) in complex endoscopic endonasal surgery.@*METHOD@#Three hundred and five patients were undergone endoscopic surgery using IGNS. The detailed information and data including the IGNS accuracy, the operation procedure time, the operator's satisfaction degree and self-confidence, and the perioperative complication were analysed and summarized to evaluate the effect of IGNS.@*RESULT@#The operation procedures were successfully performed in all the 305 patients without perioperative complication. In 98.7% of the total operation IGNS provided an accurate anatomical localization less than 2 mm localization error (0.5-2.0 mm,mean 1.2 mm). The application of IGNS reinforced the operators self-confidence, increased the patients' safety with the almost same time as that of routine endoscopic surgery (ESS).@*CONCLUSION@#IGNS could elevate the effectivity and security of ESS, indicating it's a valuable tool in deal with complex endoscopic endonasal surgery.

Retrospective analysis of 1062 cases consulted by an otolaryngology chief resident / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To describe consultation practice patterns of an otolaryngology chief resident in China.@*METHOD@#The pattern and frequency of patient encounters during the Xijing Hospital of the Fourth Military Medical University otolaryngology residency program for one chief resident were retrospectively analyzed.@*RESULT@#A total of 1062 new inpatients were consulted during a 10-month period of otolaryngology residency, including emergency consultation for 467 cases (43.97%) and routine consultation for 595 cases (56.03%). The chief resident consulted an average of 28 new patients perweek. The most common diagnosis for an emergency consultation was epistaxis (279 cases, 59.72% of emergency consultation), characterized by disturbances of blood coagulation, hypertension, renal failure or liver failure, iatrogenic factors. The second cause was laryngeal obstruction and tracheotomy (113 cases, 24.19% of emergency consultation). There were 43 cases with foreign body in bronchus . For routine consultation on general internal medicine, chronic rhinitis and sinusitis (169 cases) was the most common disorder, followed by chronic pharyngitis, acute or chronic tonsillitis. For consultation on surgery, most cases were concerned about preoperative evaluations (67 cases) of the chronic otolaryngological disorders.@*CONCLUSION@#Consultation is an inimitable clinical practice and a challenge to otolaryngology residents. The chief residents should be prepared for the consultation practice. Accumulation of related data from consultation is necessary and helpful for chief residents.

The expression of transforming growth factor α and its receptor in nasal polyps / 临床耳鼻咽喉头颈外科杂志

Objective:To assess the possible role of expression of TGFα and EGFR in nasal polyps and its re-lationship with PCNA labeling index. Method: Specimens from 20 patients of nasal polyps were studied with im-munohistochemical technique. Result: The expression of TGFα,EGFR and PCNA were increased in the epitheli-um, gland cells and inflammatory cells of nasal polyps. There was a close correlation between the intensities ofTGFα,EGFR and PCNA. Conclusion: TGFα may play a key role in epithelial cell proliferation in nasal polyps.