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Objective:To investigate the changes of ROS/TXNIP/NLRP3 signaling pathway in pyroptosis of human embryonic trophoblast cells induced by high glucose.Methods:Human embryonic trophoblast cells were cultured in vitro to establish high glucose injury model, and they were randomly divided into control group, high glucose (HG) group and HG + ROS inhibitor N-acetyl-L-cysteine (HG + NAC) group. MTT assay was used to detect the cell survival rate. The level of ROS in each group was detected by dihydroethidine ROS fluorescence probe. Expression of TXNIP and NLRP3 mRNA was detected by real-time quantitative PCR (RT-qPCR). Western blot analysis was used to detect the expression levels of TXNIP, NLRP3, Caspase-1, interleukin (IL) -1β, tumor necrosis factor-α (TNF-α) and GSDMD proteins. In addition, pyroptosis was detected by flow cytometry.Results:The optimal glucose concentration for high glucose-induced injury of human embryonic trophoblast cells was 30 mmol/L. Compared with the control group (96.27±3.10) %, the survival rate of human embryonic trophoblast cells in HG group (55.44±2.15) % was significantly lower ( P<0.05), while the fluorescence intensity (ROS level) of 7 'dichlorofluorescein (DCF), the expression levels of TXNIP and NLRP3 proteins, the number of pyroptosis, expression levels of Caspase-1, GSDMD, IL-1β and TNF-α proteins were significantly higher ( P<0.05) ; Compared with HG group, the survival rate of human embryonic trophoblast cells in HG+NAC group (84.75±2.33) % was significantly higher ( P<0.05), the fluorescence intensity (ROS level) of DCF, the expression levels of TXNIP and NLRP3 proteins, the number of pyroptosis, and expression levels of Caspase-1, GSDMD, IL-1β and TNF-α proteins were significantly lower ( P<0.05) . Conclusion:Inhibition of ROS level in human embryonic trophoblast cells induced by high glucose may promote cell proliferation and reduce the occurrence of pyroptosis by inhibiting TXNIP/NLRP3 signaling pathway.
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Objective:To analyze the detective value of placental tissue resistin, human lipid carrier protein (LCN) and blood glucose and lipid metabolism in pregnant women with gestational diabetes mellitus (GDM) complicated with preeclampsia (PE) , providing guidance for the early treatment of GDM complicated with preeclampsia.Methods:96 pregnant women with GDM complicated with PE (GDM-PE group) admitted to Yantai Yantaishan Hospital from Jan. 2017 to Jan. 2020 were selected and retrospectively studied. According to the ratio of 2:1, the pure GDM pregnant women (GDM group) and 48 normal pregnant women (the control group) were selected. The placenta tissue resistin and LCN levels were determined by immunohistochemistry. Blood samples were collected to determine the glucose and lipid metabolism. The pregnancy outcomes of each group were compared and the relationship between resistin, LCN, glucose and lipid metabolism and GDM complicated with PE was analyzed.Results:Fasting blood-glucose (FBG) was (4.57±0.66) mmol/L in GDM group and (5.23±0.61) mmol/L in GMD-PE group. FINS (11.97±1.5) mIU/L, (15.12±3.52) mIU/L were higher than those of control group (4.11±0.23) mmol/L, (6.75±1.34) mIU/L ( P<0.05) . FBG, FINS, glycosylated hemoglobin (HbA1c) in GDM-PE group were higher than those in GDM group. TC) (6.71±1.63) mmol/L, triglyceride, TG (6.59±0.87) mmol/L was higher than that of control group (5.87±0.73) mmol/L, (4.57±0.59) mmol/L and GDM group (6.02±1.55) mmol/L, (4.71±0.63) mmol/L ( P<0.05) . high density lipoprotein cholesterol (HDL-C) (1.21±0.34) was lower than that of control group (1.54±0.39) and GDM group (1.55±0.43) ( P<0.05) . The positive rates of resistin 85.42%, 60.42%, LCN 81.25%, 56.25% in GDM-PE group and GDM group were higher than those in control group 39.58%, 31.25% ( χ2=32.096, 4.167; 34.975, 6.095, both P<0.05) . The positive rates of resistin and LCN in GDM-PE group were higher than those in GDM group ( χ2=11.322, 11.257, both P<0.01) . The gestational age of delivery in GDM-PE group was (37.11±2.06) weeks earlier than that in GDM group (38.21±1.75) weeks and control group (38.36±1.42) weeks ( F=9.836, P<0.05) . The birth weight of neonates (2 905.45±356.79) g was lower than that of control group (3 321.52±366.46) g and GDM group (3 425.14±269.87) g ( F=46.606, P<0.05) . Postpartum blood loss (415.34±126.75) ml was significantly higher than that of GDM group (338.65±105.63) ml and control group (298.42±75.26) ml ( F=19.932, P<0.05) . The preterm birth rate of 20.83% was higher than that of the GDM group (8.33%) and the control group (4.17%) ( χ2=9.075, P<0.05) . The postpartum blood loss of the GDM group was higher than that of the control group ( t=-2.148, P<0.05) . The incidences of fetal distress, premature rupture of membranes, fetal growth restriction and postpartum hemorrhage in GDM-PE group were higher than those in control group ( χ2=4.571, 6.867, 5.941, 5.123, P<0.05) . The protein expressions of resistin and LCN in placenta of pregnant women with GDM-PE were positively correlated with FBG, FINS, TC and TG ( r=0.517, 0.463, 0.559, 0.521, 0.485, 0.497, 0.557, 0.571, P<0.05) . Was negatively correlated with HDL-C ( r=-0.317, -0.357, P<0.05) . Conclusions:The positive rate of resistin and LCN in the placenta tissue of pregnant women with GDM complicated with PE is higher than that of GDM and normal pregnant women, their disorder of glucose and lipid metabolism is more obvious, and the incidence of adverse maternal and infant outcomes is higher. It is speculated that resistin and LCN may synergistically affect the metabolism of glucose and lipids causing adverse pregnancy outcomes in GDM complicated with PE.
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Objective:To investigate the expressions of thioredoxin-interacting protein (TXNIP) /NLR family pyrin domain containing 3 (NLRP3) pathway in placental tissues of gestational diabetes mellitus (GDM) patients and its role in the migration and invasion of placental trophoblast cells.Methods:The placenta tissues of 25 GDM pregnant women (GDM group) and 25 normal glucose tolerance pregnant women (normal group) were collected. The cultured human chorionic trophoblast cells were divided into control group (untransfected) , siNC group (negative control) , siTXNIP group (siRNA-TXNIP) , siTXNIP+pcDNA group (co transfected with siRNA-TXNIP and pcDNA3.1 empty vector plasmids) and siTXNIP + NLRP3 group (co transfected with siRNA-TXNIP and pcDNA3.1-Flag-NLRP3 over expression plasmids) . The expressions of TXNIP and NLRP3 mRNAs were detected by real-time fluorescence quantitative PCR, and the expressions of TXNIP and NLRP3 proteins were detected by Western blot. Cell viability was measured by thiazole blue method. Cell migration ability was detected by scratch test, and cell invasion was detected by Transwell’s cell experiment.Results:Compared with those in the normal group, mRNA and protein expression levels of TXNIP and NLRP3 in the placenta of patients in GDM group were significantly higher ( P<0.05) . Compared with those in the control group or siNC group, mRNA and protein expression levels of TXNIP in siTXNIP group were significantly lower, however, the cell viability and migration rate were significantly higher, and the number of transmembrane cells was significantly higher ( P<0.05) ; but there was no significant difference in the above indexes between siNC group and the control group ( P>0.05) . Compared with those in siTXNIP group or siTXNIP + pcDNA group, mRNA and protein expression levels of NLRP3 in siTXNIP + NLRP3 group were significantly higher, however, the cell viability and migration rate were significantly lower, and the number of transmembrane cells was significantly lower ( P<0.05) ; but there was no significant difference in the above indexes between siTXNIP + pcDNA group and siTXNIP group ( P>0.05) . Conclusions:TXNIP/NLRP3 pathway is closely related to the occurrence and development of GDM. TXNIP can inhibit the migration and invasion of placental trophoblast cells by activating NLRP3.
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Objective To investigate the expression and significance of microRNA-195 (miR-195) and Bcl-2 in different type of childhood acute lymphoblastic leukemia (ALL) cells.Methods A total of 110 patients diagnosed as ALL from the Pediatrics Department and Outpatient Department of the First Affiliated Hospital of Zhengzhou University from July 2010 to December 2016 were recruited.The patients included newly diagnosed group,remission group and relapse group in which the newly diagnosed group was divided into standard risk(SR) group,intermediate risk (IR) group and high risk (HR) group.And another 14 gender-and age-matched children received bone orthopaedic surgery who excluded tumor and blood system diseases in the same hospital were recruited as control group during the same period.Bone marrow samples of 2-5 mL were drawn from all the subjects.The samples of miR-195 and the expression of Bcl-2 mRNA were detected by using quantitative real time polymerase chain reaction,while the expression of Bcl-2 protein was also detected by using Western blot.Results MiR-195 expression was lower in the newly diagnosis and relapse ALL children (SR:1.25 ± 0.15;IR:1.63 ± 0.54;HR:0.78 ± 0.35;relapse:0.46 ± 0.18),compared with the control group,and there were statistically significant differences (t =42.44,28.63,41.35,42.65,all P =0.000),but the expression of Bcl-2 mRNA was higher in the newly diagnosis and relapse ALL children than that in the control group (SR:2.56 ± 0.91;IR:4.52 ± 0.43;HR:5.49 ± 1.28;relapse:5.32 ± 1.15),which had statistically significant differences (t =3.58,9.86,10.12,8.81,all P =0.000).With the rising of the criticality of ALL,the expression of miR-195 reduced gradually,and the expression of Bcl-2 mRNA increased step by step.Determining the protein of Bcl-2 detected by Western blot showed the same result.Conclusions The lower expression of miR-195 and the higher expression of Bc1-2 may be a marker to distinguish the risk factors of ALL,which may be important for the diagnosis and the determination of the degree of risk for the ALL children.
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Objective To evaluate the clinical value of multi-slice spiral CT (MSCT)in the screening of coronary artery lesions in elderly patients with diabetes mellitus.Methods MSCT and coronary angiography(CAG)were performed in 136 elderly patients(68 patients with diabetes and 68 patients without diabetes).The number of diseased coronary segments and the plaque type (noncalcified,mixed and calcified)for each patient were determined.The characteristics of coronary lesions were compared between patients with and without diabetes.The sensitivity and specificity of MSCT were evaluated.Results More noncalcified and calcified plaques and few ermixed plaques were observed in patients with diabetes,compared with patients without diabetes(noncalcified plagues:10 cases or 14.7％ vs.4 cases or 5.9％;calcified plagues:47 cases or 69.1％ vs.39 cases or 57.4％)(P＜ 0.05).In addition,diabetic patients showed a significantly higher frequency of multivessel disease(P＜0.05).Furthermore,MSCT was able to clearly show stenosis and plaque type in the trunk and branches of the coronary artery,with a sensitivity of 91.0％,a specificity of 95.0％,a positive predictive value of 93％ and a negative predictive value of 96.0％.Conclusions Diabetes is associated with a higher risk of coronary artery disease.MSCT can effectively detect the characteristics of coronary artery disease in diabetic patients and is an effective,noninvasive,and safe screening method.
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Objective:To explore the diagnosis, treatment and curative effect of cervical cellulitis combineing mediastinal pleural abscess. Method:Clinical data of 37 patients with the cervical cellulitis and mediastinal pleural abscess were analyzed, all patients were confirmed using ultrasond, X-ray, CT, puncture and microbiology examination. The result will analysis the diagnosis, treatment and curative effect through the comparison of conservative treatment and surgical treatment. Result:Twenty-three cases of patients were underwent tracheotomy because of difficulty in breathing and successfully extubated after treatment. Nine cases of patients were given anti-infection treatment and recovered after conservative treatment. Twenty-one cases of neck multiple pus cavity were underwent cavity incision, full removal of necrotic tissue and pipe flushing; 7 cases of patients with neck and mediastinal abscess and within which 2 cases were with toxic shock were underwent adequate drainage of lavage and abscess incision through jugular joint path; the companion of pyothorax in 2 cases were underwent the chest closed drainage. All patients were giving sensitive antibiotic after drug sensitive test, anti-shock treatment and supportive treatment. All the patients were recovered and discharged. The average hospitalization days with conservative treatment of these patients were 15.7 days, and the average hospitalization days with surgical treatment of patients were 25.3 days. Conclusion:The condition of cervical cellulitis is complex, a few case can be cured with conservative treatment. The others progress rapidly when merging mediastinal pleural abscess can cause serious complications, surgical treatment is risky, fully abscess incision, lavage drainage and combine with sensitive antibiotics and supportive treatment are the keys to therapy.
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Objective To explore the microsurgical technique of ependymoma in conus medullaris and cauda equina. Methods Sixteen patients with ependymoma confirmed by pathology after operation in conus medullaris and cauda equina were analyzed retrospectively for their clinical manifestations, imaging features and microsurgical treatment. Results All patients conducted preoperative MRI, and total tumor resection was achieved in 14 patients and subtotal resection in 2 patients. The pathological examinations confirmed the tumor as myxopapillary ependymomas in 7 patients. Symptoms of fifteen patients were alleviated significantly after operation. One patient had urine retention after operation and was gradually restored 1 week after operation. All patients were followed up for 1-3 months, and there was no case of recurrence. Conclusions Ependymoma in conus medullaris and cauda equina is rare and easily misdiagnosed, with no specific clinical manifestations. MRI should be conducted as soon as possible to identify the diagnosis. Microsurgical treatment is an effective method for ependymoma in conus medullaris and cauda equina.
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ObjectiveTo analyze the therapeutic experience and value of hemoperfusion in children with acute tetramine poisoning.MethodsAccording to the choice of children's legal guardian,67 cases with acute tetramine poisoning were divided into two groups:the perfusion group (48 cases),and the control group (19 cases).The patients in perfusion group received blood perfusion based on conventional treatment,while the patients in control group received conventional treatment only.Survival outcomes of patients with different serum tetramine concentrations in two groups were compared.ResultsWhen the serum concentration of tetramine was ＞0.5 mg/dl,patients in both groups died in a short time.When the serum concentration of tetramine was 0.20～0.49 mg/dl,the drop value of serum concentration of tetramine significantly greater in perfusion group [(0.28±0.02) mg/dl] than that in control group [(0.13±0.03) mg/dl] (P＜0.05).When the serum concentration of tetramine was ＜0.2 mg/dl,the drop value of serum concentration of tetramine in two groups showed no significant difference [ (0.12±0.02) mg/dl vs (0.11±0.03) mg/dl] (P＞0.05).Conclusion The treatment method for tetramine poisoning should be selected based on the serum concentration of tetramine.
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Objective: To study the optimal combined ratio of baicalin, icariin and Astragalus saponin I from a Chinese herbal compound Biminne. Methods: Firstly, a mouse model of allergic rhinitis was established by intraperitoneal injection of ovalbumin (OVA) and aluminum hydroxide gel suspension, and the effective dose range of baicalin, icariin and Astragalus saponin I was detected by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide inner salt method. Secondly, 10 groups of combinations of baicalin, icariin and Astragalus saponin I assembled by U*(10)(10(8)) form were employed to determine the optimal combination by means of analyzing of the inhibitory effect on the splenocyte proliferation. Finally, the effects of each effective ingredient and the optimal combination were compared by observing the splenocyte proliferation, the contents of interleukin-4 (IL-4), IL-5, interferon-gamma (IFN-gamma) in supernatant of the splenocyte cultures and the ratio of IL-4 to IFN-gamma in order to verify the result. Results: Baicalin or icariin at concentrations ranging from 2 to 10 mumol/L, and Astragalus saponin I from 1 to 10 mumol/L effectively suppressed the splenocyte proliferation. When the proportion of baicalin, icariin and Astragalus saponin I was 1:2.14:2.65, the inhibitory effect was most remarkable. Further research confirmed the rationality of the optimal combination. Conclusion: An optimal combination of the major effective ingredients from Chinese herbal compound Biminne most effectively suppresses the proliferation of splenocytes from sensitized mice and regulates the cytokine secreting.
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OBJECTIVE@#To investigate the expression of neuropeptides in the nasal septum of the perennial allergic rhinitis patients, and the mechanism of the alleviation effect of nasal septum rectification to allergic rhinitis.@*METHOD@#Forty-five patients with deviation of nasal septum (20 with allergic rhinitis and 25 without), who undergone nasal septum rectification in Changhai hospital during Jun to Dec, 2007, were included in this research. The levels of SP, VIP, CGRP of the nasal septum were determined by radioimmunoassay.@*RESULT@#In the normal controls, the SP, VIP and CGRP levels of the nasal septal cartilages were lower than that of the nasal septal bones (P0.05), and the CGRP level of the nasal septal cartilages was higher than that of the nasal septal bones (P0.05). There were no statistical significance between the CGRP levels of the nasal septal cartilages in the two groups (P>0.05), neither did that of the nasal septal bones in the two groups (P>0.05).@*CONCLUSION@#The SP level of the nasal septum in the perennial allergic rhinitis patients was higher than that in the normal controls, which was more obvious in the nasal septal cartilages. The VIP level of the nasal septum in the perennial allergic rhinitis patients was higher than that in the normal controls, which was more obvious in the nasal septal cartilages. There were no statistical significance between the CGRP levels of the nasal septum in the perennial allergic rhinitis patients and the normal controls.
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Humanos , Péptido Relacionado con Gen de Calcitonina , Metabolismo , Estudios de Casos y Controles , Mucosa Nasal , Metabolismo , Tabique Nasal , Metabolismo , Rinitis Alérgica Perenne , Metabolismo , Sustancia P , Metabolismo , Péptido Intestinal Vasoactivo , MetabolismoRESUMEN
Objective To sum up the experiences of early diagnosis and surgical treatment of thoraco abdominal injuries. Method The clinical material in 65 cases of thoraco abdominal injuries treated from 1990 to 1998 was retrospectively reviewed. Result Thoracic explorations and closed thoracic drainage and abdominal operations were carried out in 15 cases and in 50 cases respectively. 65 cases were cured and 3 cases (5%) died of large cardiac blood vessel injuries and excessive blood loss. Conclusion The thoraco abdominal injuries are of very critical illness, it′s important to make early dignosis,promt and proper surgical operation.Meanwhile,active antishock measures, postoperative complication prevention, critical care for the patients are also very important for a better prognosis.
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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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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 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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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 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 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.
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Fourty four specimens of maxillary mucosa from 36 patients with chronic maxillary sinusitis were examined in order to observe whether and where immune complexes are deposited in and to assess the quantity of various immunoglobulins (IgG, IgM, IgA) bearing cells with immunofluorescence technique. Erythrocyte immune adherent function and circulating immune complex (CIC) level were also measured in patients with chronic maxillary sinusitis. The results showed that CIC level was increased and erythrocyte immunological function was disturbed, which led to a lot of immune complexes depositing in maxillary mucosa. The results reveal the relationship between chronic sinusitis and type Ⅲ allergic reaction.