Clinical analysis of diversity of defect repair with supraclavicular island flap after head and neck tumor surgery / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the diversity and clinical effect of supraclavicular island flap in repairing the defect after head and neck tumor surgery. Methods:A retrospective analysis was performed on 30 patients who received the repair of head and neck defects with supraclavicular island flaps at Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Chongqing Medical University from January 2017 to March 2023. The sites and types of defects, intraoperative blood loss, time of flaps preparation, areas of flaps, survival of the flaps and other complications were recorded. Results:A total of 30 patients were enrolled, including 26 males and 4 females, aged 36-82 years. Among them, 22 patients with hypopharyngeal partial defect were repaired （19 patients with ipsilateral defect and 3 patients with contralateral defect）. In addition, 2 patients were repaired with contralateral pectoralis major musculocutaneous flap around the hypopharynx, the neck skin defect was repaired in 2 patients, the parotid skin defect was repaired in 2 patients, the temporal bone skin defect was repaired in 1 patient, and the cervical esophageal defect was repaired in 1 patient. The average blood loss during the operation was 8 ml, and the average time was 32 min. The flap areas ranged from 5.0 cm×4.0 cm to 20.0 cm×8.0 cm. 27 of 30 flaps survived（90.0%）, and pharyngeal fistula occurred in 6 patients after operation（4 flaps survived after local dressing）. One patient was complicated with venous thrombosis（the flap necrosis after local dressing）. Shoulder and neck functions（lift, internal rotation and abduction） were not significantly affected in 29 patients, and the function of 1 patient with shoulder infection was not affected after treatment. Conclusion:Supraclavicular island flap is a highly vascularized axial fascial flap. It is easy to make, thin, and soft in texture, and can be used to repair different sites and types of postoperative head and neck tumor defects with a low donor site complication rate. Good results in post-operative repair of head and neck tumors are worth promoting.

Prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer. Methods:A retrospective analysis was conducted on the clinical data of 91 patients with T3 glottic laryngeal cancer. Results:Among the 91 patients, 58 cases （63.7%） had anterior invasion and 33 cases （36.3%） had posterior invasion. The posterior invasion was significantly correlated with invasions of the dorsal plate of cricoid cartilage （P<0.001）, arytenoid cartilage （P= 0.001）, and subglottic region（P = 0.001）. There was no statistical difference in survival outcomes between the total laryngectomy group and the partial laryngectomy group. But in the partial laryngectomy group, the 5-year disease-free survival（DFS） of patients with anterior invasive tumors was better than that of patients with posterior invasion tumors （HR: 4.681, 95%CI 1.337-16.393, P=0.016）, and subglottic invasion was associated with worse loco-regional recurrence-free survival（LRRFS）（HR: 3.931, 95%CI 1.054-14.658, P=0.041）. At the same time, we found that involvement of the dorsal plate of cricoid cartilage was an independent risk factor for postoperative laryngeal stenosis in partial laryngectomy patients （HR:11.67, 95%CI 1.89-71.98,P=0.008）. Conclusion:Compared with total laryngectomy, selected partial laryngectomy can also achieve favorable oncological outcomes. Posterior invasion and subglottic extension are independent prognostic factors for recurrence of partial laryngectomy in T3 glottic laryngeal cancer, and the involvement of the dorsal plate of cricoid cartilage is associated with postoperative laryngeal stenosis. The tumor invasion pattern of laryngeal cancer should be further subdivided in order to select a more individualized treatment plan.

Significance of neoadjuvant immunotherapy combined with chemotherapy in the treatment of larynx preservation in locally advanced hypopharyngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the clinical significance of neoadjuvant immunotherapy combined with chemotherapy in the treatment of larynx preservation in locally advanced hypopharyngeal squamous cell carcinoma. Methods:Patients with locally advanced HPSCC（cT3-T4aN0-N3M0） were eligible. All received 2 cycles of pembrolizumab combined with docetaxel and platinum neoadjuvant induction therapy. After two cycles, the efficacy was evaluated, followed by radical chemoradiotherapy or surgery and adjuvant chemoradiotherapy according to the efficacy. The primary endpoints were objective response rate（ORR） ，larynx-preservation（LP） rate at 3 months post-treatment and the adverse reactions during neoadjuvant therapy. Results:From December 2021 to December 2022, 10 patients with locally advanced HPSCC（cT3-T4aN0-N3M0） were enrolled. After 2 cycles of the neoadjuvant therapy, 2 patients achieved complete response（CR）, 7 patients achieved partial response（PR）, 1 patient was stable disease（SD）, objective response rate（ORR） was 90%, and disease control rate（DCR） was 100%. 5 patients received radical chemoradiotherapy, 5 patients received surgery and adjuvant chemoradiotherapy, four of them received partial laryngectomy and partial hypopharyngeal resection surgery, and one of them received total laryngectomy and partial hypopharyngeal resection surgery. All patients were able to withstand adverse reactions of neoadjuvant therapy and successfully completed the whole treatment of HPSCC without grade 3-4 treatment-related adverse reactions. There was no recurrence or metastasis during 3-18 months of follow-up. 1 patient died of severe pneumonia 3 months after the completion of radical chemoradiotherapy. At 3 months after treatment, the larynx-preservation rate was 80%. Conclusion:Neoadjuvant immunotherapy combined with chemotherapy has good short-term efficacy and the adverse reactions were tolerable. It can improve the larynx-preservation rate of patients with locally advanced HPSCC, thus improving the prognosis and quality of life of patients.

A cohort study of low molecular weight heparin calcium combined with aspirin for prevention of portal venous thrombosis in liver cirrhosis patients after splenectomy and devascularization / 中华肝胆外科杂志

Objective@#To analyze the clinical effect of low molecular weight heparin calcium(LMWH) combined with aspirin in preventing portal venous thrombosis (PVT) after devascularization.@*Methods@#Retrospective cohort study was carried out. A total of 61 patients with portal hypertension in Zhongshan Hospital affiliated to Fudan University from December 2014 to April 2017 were included in the study, including 43 males and 18 females, aged 24~74 years. According to anticoagulation methods, the patients were divided into treatment group (31 cases of LMWH combined with aspirin) and control group (30 cases of aspirin). Splenectomy and pericardial devascularization or combined devascularization were performed in both groups. Platelet count, prothrombin time, Child-Pugh score, PVT status and surgical complications were observed after surgery.@*Results@#There were no significant differences for platelet count and prothrombin time between the two groups after 7, 14, 30, 60 and 90 days (P>0.05). Child-Pugh scores at 3, 7, 14, 30, 60 and 90 d after operation of the two groups showed no significant differences (P>0.05). Seven days after the operation, PVT in the treatment group and control group was 7 (22.6%) and 7 (23.3%), respectively. Thirty days after the operation, PVT was detected in 8 patients (25.8%) in the treatment group and 15 patients (50.0%) in the control group. Sixty days after the operation, 6 patients (19.4%) had PVT in the treatment group and 13 patients (43.3%) in the control group. PVT was detected in 4 patients (12.9%) in the treatment group and 12 patients (40.0%) in the control group 90 days after operation. The incidence of PVT in the 30, 60 and 90 days after surgery was lower than that in the control group, with significant difference (P<0.05), and the degree of thrombosis was relatively mild. There were 6 cases (20.0%) of complications in the control group and 6 cases (19.4%) in the treatment group, there were no significant differences between the two groups (P>0.05).@*Conclusion@#LMWH combined with aspirin is safe and effective in preventing PVT after devascularization.

A cohort study of low molecular weight heparin calcium combined with aspirin for prevention of portal venous thrombosis in liver cirrhosis patients after splenectomy and devascularization / 中华肝胆外科杂志

Objective To analyze the clinical effect of low molecular weight heparin calcium (LMWH) combined with aspirin in preventing portal venous thrombosis (PVT) after devascularization.Methods Retrospective cohort study was carried out.A total of 61 patients with portal hypertension in Zhongshan Hospital affiliated to Fudan University from December 2014 to April 2017 were included in the study,including 43 males and 18 females,aged 24 ～ 74 years.According to anticoagulation methods,the patients were divided into treatment group (31 cases of LMWH combined with aspirin) and control group (30 cases of aspirin).Splenectomy and pericardial devascularization or combined devascularization were performed in both groups.Platelet count,prothrombin time,Child-Pugh score,PVT status and surgical complications were observed after surgery.Results There were no significant differences for platelet count and prothrombin time between the two groups after 7,14,30,60 and 90 days (P ＞ 0.05).Child-Pugh scores at 3,7,14,30,60 and 90 d after operation of the two groups showed no significant differences (P ＞0.05).Seven days after the operation,PVT in the treatment group and control group was 7 (22.6％) and 7 (23.3％),respectively.Thirty days after the operation,PVT was detected in 8 patients (25.8％) in the treatment group and 15 patients (50.0％) in the control group.Sixty days after the operation,6 patients (19.4％) had PVT in the treatment group and 13 patients (43.3％) in the control group.PVT was detected in 4 patients (12.9％) in the treatment group and 12 patients (40.0％) in the control group 90 days after operation.The incidence of PVT in the 30,60 and 90 days after surgery was lower than that in the control group,with significant difference (P ＜ 0.05),and the degree of thrombosis was relatively mild.There were 6 cases (20.0％) of complications in the control group and 6 cases (19.4％) in the treatment group,there were no significant differences between the two groups (P ＞ 0.05).Conclusion LMWH combinedwith aspirin is safe and effective in preventing PVT after devascularization.

Characteristics of cervical lymph node metastasis of cN0 laryngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the incidence of occult cervical lymph node metastasis and the common neck level of metastases in cN0 laryngocarcinoma, and the relationship between the clinicopathologic features of laryngocarcinoma and cervical lymph node metastasis.@*Methods@#A total of 506 cases with cN0 laryngocarcinoma treated at the First Affiliated Hospital of Chongqing Medical University between March 2011 and March 2018 were enrolled, and their medical records and follow-up data were retrospectively analyzed. Of them, 211 cases of were glottic carcinoma in stage T1 without neck dissection and they were observed by clinical follow-up; other 295 cases, including glottic carcinoma, supraglottic carcinoma and hypopharyngeal carcinoma in stage T2-T4 were treated with surgical resection of the primary lesions and selective neck dissection. SPSS 22.0 software was used to analyze the data.@*Results@#The total incidence of cervical lymph node metastasis was 10.87%(55/506), with a lower incidence in T1 stage glottic carcinoma(6/211,2.84%) than that in other cases(49/295,16.61%). The incidence of cervical lymph node metastasis in glottic carcinoma (29/426, 6.81%) was lower than those in supraglottic carcinoma (22/71,30.99%) and subglottic carcinoma (4/9) (χ2=35.810,P<0.01).The pN+ rates of glottic carcinoma at T1, T2, T3 were 2.84%(6/211), 5.31%(6/113), 16.05%(13/81), and 19.05%(4/21), respectively (χ2=18.572, P<0.01). The pN+ rates of supraglottic carcinoma at T2, T3 and T4 were 3/13, 32.50%(13/40) and 6/13, respectively (χ2=3.649,P>0.05). The incidence of cervical lymph node metastasis in poorly differentiated carcinoma (17/42, 40.48%) was higher than those in moderately differentiated carcinoma (26/205, 12.68%) and high differentiated carcinoma(12/246, 4.88%)(χ2=36.356, P<0.01). Moreover, 85 pN+ lymph nodes were obtained by selective neck dissection, respectively 43(50.59%) in level Ⅱa, 30(35.29%) in level Ⅲ, 1(1.18%) in level Ⅳ and 11(12.94%) in level Ⅵ.@*Conclusions@#The occult cervical lymph node metastasis was frequently found in cN0 laryngocarcinoma. Selective neck dissection should be performed with surgery for the primary lesions in T3-T4 glottic laryngeal cancer, T2-T4 supraglottic laryngeal cancer and subglottic carcinoma, and the neck dissection for level Ⅱa and Ⅲ is appropriate. It is required to detect pre-laryngeal and pre-tracheal lymph nodes in patients with subglottic laryngeal carcinoma.

Construction of a new skill training program of sensory system for medical students in "5 + 3"education model / 中华医学教育探索杂志

To explore the organ-system oriented integrated program, this project constructed a new clinical skill training program of sensory system for"5+3" medical students. According to the current trend and requirement of medical teaching reform, taking into consideration of the present status of clinical skills teaching, this project integrated the basic and clinical teaching contents of otolaryngology, ophthalmology and dermatology to design a new training program of clinical skills for"5+3"medical students. Specifically, the project group edited a new textbook and syllabus, and set up a specialized teaching group. In this system, the training models included simulation training and practical bedside training, the assessment included operation ability and analyzing ability for clinical cases, and the training contents involved all conventional skills of each specialty. It has been demonstrated that the new training program is capable of promoting the clinical skills of students quickly and effectively.

Thoughts on the training reform of application-oriented professionals of otolaryngology / 中华医学教育探索杂志

There exists unbalanced development of medical technology and uneven quality of medi-cal staff in our current medical status,so it is urgent to reform the training mode of talents. Through the analysis of the shortcomings of traditional talents training and based on the thought of training applied talents, we explore the best training model of application-oriented professionals of otolaryngology head and neck surgery which is suitable for our country's national conditions by reforming clinical teaching methods, theo-retical teaching curriculum revision and clinical skills training, in order to strengthen the quality of person-nel training.

The preliminary analysis of the endoscopic holistic rhinoplasty—report of 52 cases / 中华整形外科杂志

Objective@#To analyze the clinical effect of the endoscopic holistic rhinoplasty in order to improve its clinical application and safety.@*Methods@#The patients with external nasal deformities and complained nasal congestion were assessed before operation and undergoing endoscopic holistic rhinoplasty from January 2015 to June 2017. Therefore, the internal nasal plasty and external nasal plasty were performed simultaneously, so as to correct the abnormalities of internal and external nasal structures, restore nasal ventilation function, and achieve the purpose of external nose cosmetology. The nasal congestion, visual analog scale, rhinomanometry and acoustic rhinometry and patient satisfaction were used to assess the efficacy. SPSS 21.0 was used for statistical analysis. Paired sample t test was used for preoperative and postoperative comparison, and P<0.05 was taken as statistically significant difference.@*Results@#All the patients were followed up from one month to one year without complications. Postoperative nasal obstruction VAS score (1.63±0.76) was significantly lower than preoperative(6.35±0.65) (t=6.315, P<0.001). The minimum nasal cross-sectional area was (0.38±0.29) cm2 preoperatively and (0.52±0.14) cm2 postoperatively, which was significantly higher than that before the operation (t=9.732, P<0.001). Postoperative nasal volume (9.21±3.23) cm3 was significantly higher than preoperative (6.44 ± 1.04) cm3 (t=9.559, P<0.001), and postoperative nasal resistance (0.26 ± 0.07) kPa·s/L was lower than preoperative (0.65±0.21) kPa·s/L(t=7.524, P<0.001). The postoperative satisfaction survey result were very satisfactory in 41 cases (78.85%), accounted satisfaction in 11 cases (21.15%).@*Conclusions@#The application of the endoscopic holistic rhinoplasty has a good clinical effect and a high degree of satisfaction.

Integrated multimedia presentation in multidisciplinary head and neck oncology clinical teaching / 中华医学教育探索杂志

Multidisciplinary team is the basic model of modern head and neck oncology treatment. We try to integrated multimedia presentation in multidisciplinary head and neck oncology clinical teaching. Through building a multidisciplinary platform for discussion , on the basis of teacher's instruction and student's self-learning, we integrate the related knowledge with multimedia presentation and computer net-work to guide the learning of core knowledge and key problems of head and neck cancer, thus forming a new clinical teaching mode combining theory study with practice training. In the process of implementation, we should pay attention to arranging the learning tasks in advance, and highlight the key learning content in the multidisciplinary discussion, so as to improve the students' interest and enthusiasm in learning.

Clinical analysis of 258 cases of nasal-sinus benign and malignant tumors / 重庆医学

Objective To analyze the clinical features of 258 cases of nasal-sinus benign and malignant tumors to improve the accuracy of clinical diagnosis.Methods The clinical data of 258 patients with nasal-sinus tumor confirmed by pathology were retrospectively analyzed and the clinic differences between benign and malignant tumors were compared.Results The clinic manifestations of sinonasal neoplasm were varied.The incidences of epistaxis or blood in the tears,headache,facial numbness or pain,eye pain or epiphora were significantly higher in the benign tumors group than in the malignant tumors group (P＜0.05).Among 196 patients undergoing surgery,the coincidence rates of preoperative and postoperative paraffin sections were similar in the two groups (P＞0.05).Among 63 surgical patients with malignant tumors,the coincidence rate of 232 incised-margin frozen sections and postoperative paraffin sections was 98.70％ (229/232).Among 34 cases,the coincidence rate of frozen sections and postoperative paraffin sections was 91.18％0 (31/34),in which 6 cases were immediately intraoperative frozen,and 66.67％ (4/6) of the cases that changed into malignancy from benignity were not consistent with the preoperative diagnosis of paraffin sections.Conclusion The sinonasal tumors are lacking specificity in clinical manifestations,but rapid intraoperative frozen section examination is helpful to improve the diagnosis rate;continuously frozen pathological examination should be performed in malignant tumor margins.

A primary analysis on CT and MRI features of common malignant sinonasal tumors / 实用医学杂志

Objective To explore the imaging characteristics of common malignant sinonasal tumors for improving the diagnostic accuracy of the disease. Methods Radiological and clinical data of 78 patients with sino-nasal malignant tumors confirmed by pathological examination were retrospectively analyzed. Results Sinonasal malignant tumors lacked imaging specificity. Most of CT showed uneven soft tissue densities with unclear boundary and destruction of bone which invaded the soft tissue outside of the cavity including orbit or intra-cranium. There was moderate to remarkable enhancement of the lesion. T1WI in MR demonstrated homo-and hypo-intense signal , while T2WI revealed homo- and hyper-intense signal ,and post contrast MR imaging displayed heterogeneous con-trast enhancement. There was no significant statistical difference between CT and MRI in the detection rate of ma-lignant tumors(P > 0.05),but CT in combination with MRI improved the positive rate of detection(P < 0.05). Conclusions The imaging of sinonasal malignant tumors is complicated and lacks specificity. For complicated si-nonasal malignant tumors,enhanced CT in combination with MRI should be used to determine the nature and limi-tation of the tumor,and its relationship with the surrounding structures,resulting in improvement of the diagnostic accuracy of the disease.

Analysis of clinical characteristics of sigmoid sinus diverticulum / 中国耳鼻咽喉头颈外科

OBJECTIVE To analyze the clinical features of 8 patients with sigmoid sinus diverticulum and to improve the level of diagnosis and treatment. METHODS The tinnitus patients were asked in detail about the history, and performed a series of routine hearing tests (pure tone audiometry, acoustic impedance audiometry, otoacoustic emission inspection and brainstem auditory evoked potential (BAEP) etc.) and temporal bone HRCT scan. Eight cases were diagnosed with sigmoid sinus diverticulum, in which six cases undertook a surgery to reconstruct the sinus wall while the other 2 cases chose conservative treatment. RESULTS The diagnosis of 6 cases was proved to be correct by surgery, and the pulsatile tinnitus disappeared after reconstructing the sinus wall. No one recurred after following up from 2 to 12 months. Two cases of conservative treatment had no obvious improvement in symptoms. CONCLUSION Clinical manifestation, hearing examination, temporal bone CT/HRCT and Cranial CTA/CTV contributed to the diagnosis of sigmoid sinus diverticulum. Sinus wall reconstruction is a better approach.

Study of the therapeutic efficacy of Montelucast and Cetirizine on allergic rhinitis in children and their effects on the level of serum cytokines / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo study the therapeutic efficacy of Montelucast and Cetirizine on allergic rhinitis in children and their effects on the level of serum IFN-γ and IL-4.METHODS Sixty allergic rhinitis children were randomly divided into treatment group (30 children) and control group (30 children). The control group were treated with cetirizine drops (po, ages 2-6, 5 mg, qd, ages >6, 10 mg, qd.). Treatment group were treated with cetirizine drops combined with Montelucast (po, ages 2-5, 4 mg, qn, ages 6-12, 5 mg, qn, ages >12, 10 mg.). Thirty health children were selected as health group.RESULTSBefore treatment, the level of serum IFN-γ in treatment group and control group were significantly lower than that in health group (P0.05). After treatment, the level of serum IFN-γ of both groups increased, and the level of serum IL-4 of both groups decreased. However, the level of serum IL-4 and IFN-γ in treatment group changed significantly (P<0.01). After treatment, VAS scores were lower than that of before treatment, however that of the treatment group was the lowest (P<0.01). After one month follow-up, there was no significant difference between the two groups.CONCLUSIONThe mechanism of Montelucast and cetirizine on treatment of allergic rhinitis may be related to the correction of the disorder of IFN-γ and IL-4.

Multi-center study on the treatment of sudden deafness accompanied with tinnitus / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and the effects of different drug therapies in patients of sudden deafness accompanied with tinnitus.</p><p><b>METHODS</b>The international standardized clinical research methods, the unified design and program were used in the study. The patients of sudden deafness accompanied with tinnitus, aged between 18 to 65 years old, were recruited, whose duration was less than two weeks with no medication. The patients were divided into four types according to the hearing curve: type A was acute sensorineural hearing loss in low tone frequencies, type B was acute sensorineural hearing loss in high tone frequencies, type C was acute sensorineural hearing loss in all frequencies and type D was total deafness. Each type had four different treatment programs, based on the unified designed randomized table.</p><p><b>RESULTS</b>A total of 1024 cases with single side sudden deafness were recruited in the study by 33 hospitals in China from August 2007 to October 2011. Among the 1024 cases, 922 cases were accompanied with tinnitus (90.04%). By classification of audiogram, among the 922 cases, 169 cases were type A (82.44%), 127 cases were type B (90.07%), 370 cases were type C (92.04%), and 256 cases were type D (92.75%). The tinnitus mostly was persistent and low tone tinnitus. The degree of the tinnitus was mostly 2-3 grade. The curative effects of different types were analyzed, type A had the highest rate of 96.18%, type C was 87.75%, type B was 81.51%, and type D had the lowest rate of 75.32%. Significant difference of curative rate between different types was detected (χ² = 125.33, P = 0.000). There had no significant difference between the four different treatment groups (all P > 0.05).</p><p><b>CONCLUSIONS</b>In the cases with single side sudden deafness accompanied with tinnitus, the type in low tone frequencies has the best curative effect, followed by the type in all frequencies. The type in high tone frequencies and the total deafness type have poor curative results. The steroid plays a good effect in the treatment.</p>

Surgical treatment of pancreatic sinistral portal hypertension and literature review / 中华肝胆外科杂志

Pancreatic sinistral portal hypertension is a localized kind of portal hypertension that usually occurs as a result of the splenic vein obstruction caused by pancreatic diseases.Furthermore,it is also an important cause of upper gastrointestinal hemorrhage.Management in clinical practice should be directed at the sinistral portal hypertension and primary pancreatic diseases.

Comparison of curriculum and degree conferment in higher medical education between Germany and China / 中华医学教育探索杂志

The higher medical education in China starts late and needs further exploration and improvement.While in Germany,it is elite education with a long history.Compared with China,in curriculum setting,Sociology,Medical health security,Humanities and Social Sciences and Organ system classification courses are more emphasized,and in terms of degree,it only has Doctor degree but with higher quality in Germany.Higher medical education in China will also take the path of the elite education.We can learn from the German medical education development experience and pay attention to solving the lack of the curriculum by supplementing social medicine and medical health security,increase the autonomy of the instructors in the training process,strengthen the medical students' social responsibility,and improve the quality of higher medical education in China.

Mutation analysis of CSMD3 gene in a pedigree of familial cortical myoclonic tremor with epilepsy / 中国医师杂志

Objective To investigate mutations of CSMD3 gene in a pedigree of familial cortical myoclonic tremor with epilepsy (FCMTE).Methods Peripheral blood (5 ml) was obtained from FCMTE patients (7 cases),suspected cases,and control individuals.Polymerase chain reaction (PCR) and purification of PCR products for sequencing were used to detect the existence of mutations in 73 exons of gene CSMD3.The resulting products were subjected to agarose gel electrophoresis and gel-imaging system.The PCR amplification products were sequenced.Results The sequencing results of 73 exons were compared with CSMD3gDNA sequence in human GenBank.We neither found any DNA sequence variation nor disease-related mutations.Conclusions The family does not have a mutation in the CSMD3 gene.We need to further find the disease genes and the mutations in this family.

Effect observation of batroxobin for treatment on above moderate degree of sudden hearing loss / 重庆医学

Objective To evaluate the effect of treatment with batroxobin on above moderate degree of sudden hearing loss (SHL) ,in order to achieve better clinical therapy .Methods The clinical records of 56 patients (57 ears) with above moderate de‐gree of SHL hospitalized from October 2010 to October 2011 were retrospectively studied .57 ears contained 22 ears of flat type and 35 ears of total type ,33 ears were treated with conventional drugs(conventional group) ,while 24 ears were treated with batroxobin and conventional drugs(combination group) .Results The differences of the total effective rate were statistically significant be‐tween conventional group and conventiona group(P=0 .012 8) and between flat type group and total type group(P=0 .012 6) . Conclusion The combination therapy with batroxobin and conventional drugs can significantly increase the total effective rate of the patients with above moderate degree of SHL ,which is superior to conventional drugs .The prognosis of patients with total type is poor than flat type .

The role of interleukin-2 pathway in pathogenesis of nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression of Interleukin2 (IL-2) signaling pathway related factors and Treg cell in nasal tissue of nasal polyps, so that to investigate the possible mechanism of IL-2 signaling pathway in the progress of nasal polyps and the correlation between IL-2 pathway and Treg cell.@*METHOD@#Thirty patients were enrolled for study, including the patients with nasal polyps and those with only deviated nasal septum as normal control. The nasal polyps tissue and the turbinate mucosa of the patients were collected during surgery. The expression levels of IL-2 and IL-2R were measured by means of ELISA. The level of pSTAT5 was evaluated by Western blot. We measured the level of Foxp3 mRNA in the tissue by real-time PCR, and the proportion of Treg cells was evaluated by flow cytometry. Finally. we analyzed the correlation between IL-2 pathway related factors and Treg cells in nasal polyps.@*RESULT@#The expression levels of IL-2. IL-2R and pSTAT5 were significantly decreased in the nasal polyps compared with normal control (P < 0.05), and the level of Foxp3 mRNA and proportion of Treg cells in patients with nasal polyps were significantly lower than in normal control (P < 0.05). Moreover, there was positive correlation between the levels of IL-2 pathway related factors and the levels of Foxp3 mRNA and Treg cells proportion in nasal polyps.@*CONCLUSION@#The activated state of IL-2 signaling pathway got changed in nasal polyps tissue, the level of which was positively correlated with the expression of Treg cells, indicating that the IL-2 signaling pathway may play a crucial role in the development of nasal polyps, and the decreased level of Treg cells in nasal polyps may result from the downregulation of IL-2 signaling pathway.