Efficacy of magnetic traction hyoid suspension surgery in the animal model of OSAHS / 西安交通大学学报(医学版)

【Objective】 To explore the effectiveness of creating the obstructive sleep apnea hypopnea syndrome (OSAHS) animal model of glossocoma using the botulinum toxin type A in white rabbits, and to explore the effectiveness and safety of magnetic traction hyoid suspension operation in the OSAHS animal model of glossocoma. 【Methods】 A total of 12 adult male experimental white rabbits were randomly divided into two groups. The animals in the experimental group were injected with 0.4 mL (10 U) of botulinum toxin type A in the genioglossus muscle to construct the OSAHS animal model of glossocoma. The animals in the control group were injected with 0.4 mL of normal saline. We designed and 3D printed a polyacrylate shell that could be loaded with inner and outer neodymium iron boron (NdFeB) magnets. After the modeling, a polyacrylate shell with the inner magnet device was fixed on the hyoid bone of the animals in the experimental group. All animals in the experimental group wore the polyacrylate orthotic neck brace containing the outer magnet 10 days after the operation. The arterial blood oxygen detector was used to record the oxygen saturation (SaO2) of the femoral artery, and multi-slice CT plain scan was used to measure the diameter of the narrowest part of the upper airway. 【Results】 The animals in the experimental group gradually showed decreased activity, labored breathing, blue lips and ear margins and other manifestations of hypoxemia 5 days after intramuscular injection of botulinum toxin type A in the genioglossus, and their body weight dropped from (3.72±0.21)kg to (3.40±0.20)kg, the average SaO2 of the femoral artery decreased from (93.84±5.14)% to (84.00±3.35)%, and the diameter of the narrowest part of the upper airway decreased from (4.83±0.47)mm to (3.52±0.83)mm (P<0.05). In the control group, the animals’ weight, the average SaO2 of the femoral artery, and the diameter of the narrowest part of the upper airway did not significantly change before and after injection of normal saline into the genioglossus muscle (P>0.05). The animals in the experimental group completed the magnetic traction hyoid suspension surgery. After wearing the orthotic neck brace containing an external magnet for hyoid magnetic traction, the food intake and activity of the animals in the experimental group increased, the color of the lips changed from purple to pink, the SaO2 of the femoral artery increased significantly to (90.44±5.95)%, and the diameter of the narrowest part of the upper airway increased significantly to (4.42±0.15)mm (P<0.05). 【Conclusion】 The genioglossus muscle injection of botulinum toxin type A in white rabbits could successfully establish the OSAHS animal model of glossocoma. Magnetic traction hyoid suspension surgery in the treatment of OSAHS animal model could effectively correct the upper airway stenosis related symptoms and hypoxemia caused by glossocoma.

Risk factors for central neck lymph node metastases of papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the impact factors for central neck lymph node metastases(CLNM) of papillary thyroid carcinoma(PTC).@*Methods@#A total of 498 patients with PTC who underwent total or hemi-thyroidectomy plus central neck lymph node dissection between January 2014 and July 2016 were included. Univariate and multivariate analyses were performed to identify clinicopathological characteristics, thyroid function parameters and US findings that associated with CLNM of PTC. A nomogram was developed to predict the probability of CLNM. The receiver operating characteristic curve(ROC) was used to estimate the efficiency of the nomogram.@*Results@#Among 498 patients, 284 patients were affected by CNLM. The sensitivity and specificity of US in predicting PTC metastasis in the central neck were 31.3% and 88.3%, respectively. Univariate and multivariate analyses showed that gender, age, number and size of suspicious malignant nodules in thyroid, and suspicious lymph node metastasis detected by ultrasonography were independently correlated with CLNM. The ROC showed that the AUC was 0.748, with sensitivity of 80.8%, and specificity of 59.8%.@*Conclusions@#Gender, age, number and size of suspicious malignant nodules in thyroid, suspicious lymph node metastasis were predictive factors for CLNM in patients with PTC. The nomogram developed based on related factors with CLNM is more sensitive than sonographic central neck lymph node features in predicting the probability of CLNM.

Clinical features of unilateral oculomotor nerve palsy related to multiple myeloma:a case report and literature review / 中华全科医师杂志

Objective To analyze the clinical features of unilateral oculomotor nerve palsy caused by multiple myeloma(MM).Methods A 79-year-old female diagnosed MM for 3 years was admitted due to the disease relapse.The patient presented left oculomotor nerve palsy,bone marrow biopsy showed 4.5％ of myeloma cells,the serum level of λ light chain was up to 18 g/L,and brain CT/MRI scan revealed left parasphenoidsinus lesion.A diagnosis of relapsing intramedullary and extramedullary MM,IgGλ type,stage ⅢA was made.Ten cases were retrieved from literature since 1990,the clinical features of 11 cases were analyzed as follows.Results Among 11 cases of unilateral oculomotor nerve palsy caused by MM,7 were males and 4 females with a mean age of (60 ± 12) years (40-79 years).The sub-types of MM were IgG type (7 cases),IgA type (2 cases),biclonal of IgG and IgA type (1 case),and IgD type (1 case).Oculomotor nerve palsy was presented as the initial manifestation of MM in 9 cases,as a sign of relapse of MM in 1 case,and during MM treatment in 1 case.In 7 cases,oculomotor nerve was the only cranial nerve involved,while in other 4 cases,the Ⅳ,Ⅴ,Ⅵ cranial nerves were also involved.Neuroimaging revealed parasphenoid sinus lesions in 9 cases,and myeloma meningitis in 2 cases.Most of the reviewed cases achieved significant clinical improvement after chemotherapy and/or radiotherapy,except 2 cases with myeloma meningitis.The case in our department was improved significantly and rapidly after receiving chemotherapy with bortezomib.Conclusion MM should be considered when unilateral oculomotor nerve palsy is presented with or without the history of MM,the disease is sensitive to chemotherapy in most circumstances.

To explore the method of exposure of recurrent laryngeal nerve in thyroid second operation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the safe approach to exposure of the recurrent laryngeal nerve (RLN) in thyroid second operation.@*METHOD@#The data of 153 patients with thyroid second operation were analyzed retrospectively to compare the effectiveness of superior and inferior approach in the exposure of RLN.@*RESULT@#A total of 177 RLNs were exposed in 153 cases. Among those 39 RLNs were exposed by superior approach, 34 by inferior approach after failure of superior approach, and 104 by inferior approach.@*CONCLUSION@#In thyroid second operation, inferior approach is a safe and efficient method to expose RLN. Trachea and esophagus are the most important anatomical landmarks to look for the left RLN. Innominate artery and common carotid artery are the most important anatomical landmarks to look for right RLN.

Application of the xenogenic acellular dermal matrix membrane application used in the postoperative tissue shortage repair / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the short-term and long-term curative effect of the xenogenic acellular dermal matrix membrane (or joint muscle flap transfer) application used in the 82 cases postoperative tissue shortage repair that after the head neck carcinoma resection.@*METHOD@#To held the 82 cases head neck carcinoma postoperative mucosa shortage repaired after resection by the xenogenic acellular dermal matrix membrane (or joint muscle flap transfer), 65 cases mucosa shortage wound be directly covered by the repair membrane and the other 17 cases mucosa shortage wound be repaired by the tranfered muscle tissue flap with the repair membrane covered; 53 cases underwent additional postoperative radiotherapy between 2-4 weeks and follow-up in 1, 3, 6, 12, 18, 24, 30, 36, 48, 60 months and observed the operation site repair process through the electronic laryngoscope, observed the patients respiration, swallow, phonation function.@*RESULT@#Seventy-seven cases patients operation incision reached I phase healing standard, another 5 cases patients operation incision reached II phase healing standard because of the wound infection and fully-recovered through the local wound drainage,dressing process. All the patients tracheal cannula,the stomach tube be extubated successfully and without the local cicatricial constriction occurred. Seventy-eight cases follow up period reached 1 year including 53 cases who underwent postoperative radiotherapy, 49 cases follow up period reached 3 years including 32 cases who underwent postoperative radiotherapy, 14 cases follow up period reached 5 years including 12 cases who underwent postoperative radiotherapy. The patients with static local lesions discovered no reaction such as exclusion, allergy.@*CONCLUSION@#The application of xenogenic acellular dermal matrix membrane (or joint muscle flap transfer used in in the postoperative tissue shortage repair that after the head neck carcinoma resection have several advantage such as comparatively easily implementation, operation safety edge enough,well preserved organ function, comparatively low incidence about the laryngeal stenosis, the short-term and long-term repair effect are all exact.

Effect of dexmedetomidine on noise-induced hearing loss in guinea pigs / 中华麻醉学杂志

Objective To evaluate the effect of dexmedetomidine on noise-induced hearing loss in guinea pigs.Methods Twenty-four adult male guinea pigs,aged 3 months,weighing 400-500 g,were randomly divided into 3 groups (n =8 each) using a random number table:dexmedetomdine group (group D),noise-induced hearing loss group (group N) and dexmedetomidine + noise-induced hearing loss group (group DN).A loading dose of dexmedetomidine 5 μg/kg was infused over 5 min,followed by 135 min of infusion at a rate of 10 μg· kg-1 · h-1.The equal volume of normal saline was infused in group N.Groups N and DN were exposed to noise of 4 kHz center frequency and 118-122 dB SPL for 120 min starting from 20 min of administration.Mean arterial pressure (MAP) and cochlear blood flow (COBF) were recorded before administration and every 5 min during drug administration.The changing rate of COBF was calculated.Arterial blood samples were collected for determination of plasma concentration of noradrenaline (NE) by high performance liquid chromatography at 20 and 140 min of administration.Auditory brainstem response (ABR) threshold was recorded before administration and at 1 and 72 h and 10 days after the end of administration.Results Compared with group N,MAP was significantly decreased,the changing rate of COBF was increased at 5-10 min and 30-140 min of administration,ABR threshold was decreased at 1 and 72 h and 10 days after the end of administration,and the plasma concentration of NE was decreased at 140 min of administration in D + N group (P ＜ 0.05).Conclusion Dexmedetomidine can attenuate noise-induced hearing loss in guinea pigs possibly through inhibiting activation of sympathetic nerves and increasing COBF.

Endoscope thyroid lobectomy through subclavicular approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical applications of endoscopic thyroid lobectomy through subclavicular approach and to summarize the surgical experiences.@*METHOD@#Thirty-five cases were subjected to endoscopic thyroid lobectomy through subclavicular approach. Briefly, operative cavities were established by automatic retractors and the affected lobes were dissected and removed using suction dissectors combined with the harmonic scalpels. The inferior thyroid artery was used as the mark to locate the recurrent laryngeal nerve.@*RESULT@#All the operations achieved successfulness with no complication. 33 out of 35 were intraoperatively diagnosed by frozen-pathology as goiter and the last two cases were diagnosed as papillary thyroid carcinoma. There were no postoperative swelling, numbness or other kinds of uncomfortableness with benign patients and they were satisfied with the cosmetic outcomes.@*CONCLUSION@#Endoscopic thyroid lobectomy through subclavicular approach for thyroid benign lesions has the advantages of minimal invasion, high safety, easy manipulation and good cosmetic outcomes, which are worth of wide applications.

Resveratrol increases sensitivity of CNE2 cells to chemotherapeutic drugs under hypoxia / 中西医结合学报

Objective: To explore the sensitization effects of resveratrol on CNE2 nasopharyngeal carcinoma cell line with hypoxia-induced chemotherapy resistance and the potential mechanism. Methods: Human CNE2 nasopharyngeal carcinoma cell line was cultured under hypoxic conditions (37 degrees centigrade, 5% CO(2), 2% O(2)) in vitro. The cultured cells were treated with different concentrations of resveratrol for 48 h. Reversal fold (RF) of reseratrol to chemotherapeutic drugs in CNE2 cells was measured by methyl thiazolyl tetrazolium (MTT) assay. Apoptotic rate of CNE2 cells was observed by flow cytometry. Reverse transcription-polymerase chain reaction (RT-PCR) method and Western blotting were used to investigate the expressions of multidrug resistance gene 1 (mdr1), multidrug resistance-associated protein 1 (MRP1) and hypoxia inducible factor 1alpha (HIF-1alpha) in CNE2 cells. Results: Resveratrol combined with chemotherapeutics produced a synergistic effect. The RF of 200 alphamol/L resveratrol to paclitaxel was 2.58. Combined with paclitaxel, 25, 50, 100 and 200 alphamol/L of resveratrol increased the apoptotic rate of CNE2 cells from (22.14+/-1.09)% to (23.24+/-1.37)%, (27.57+/-2.01)%, and (30.36+/-2.31)%, respectively. Resveratrol could down-regulate the expressions of HIF-1alpha, mdr1 and MRP1 significantly. After being treated with resveratrol at different concentrations separately, the expressions of HIF-1alpha, mdr1 and MRP1 in CNE2 cells decreased significantly as compared with paclitaxel alone or paclitaxel plus verapamil (P<0.01). Conclusion: Resveratrol can enhance the sensitivity of CNE2 cells to chemotherapeutic drugs under hypoxia. The potential mechanism is partly attributed to inhibiting the gene expressions of HIF-1alpha, mdr1 and MRP1.

Cloning and sequencing of a DNA fragment encoding N37 apoptotic peptide derived from p53 / 药物分析学报

Objective It was reported that p53 apoptotic peptide (N37) could inhibit p73 gene through being bound with iASPP, which could induce tumor cell apoptosis. To further explore the function of N37, we constructed the cloning plasmid of DNA fragment encoding p53 (N37) apoptotic peptide by using DNA synthesis and molecular biology methods. Methods According to human p53 sequence from the GenBank database, the primer of p53(N37) gene was designed using Primer V7.0 software. The DNA fragment encoding p53 (N37) apoptotic peptide was amplified by using self-complementation polymerase chain reaction (PCR) method and cloned into the pGEM-T Easy vector. The constructed plasmid was confirmed by endonuclease analysis and sequencing. Results The insertion of objective DNA fragment was confirmed by plasmid DNA enzyme spectrum analysis, p53 (N37) gene was successfully synthesized chemically in vitro. The sequencing result of positive clone was completely identical to the human p53(N37) sequence in GenBank using BLAST software (http://www. ncbi. him. nih. gov/cgi-bin /BLASTn). Conclusion The cloning of DNA fragment encoding p53(N37) apoptotic peptide was constructed by using DNA synthesis and pGEM-T Easy cloning methods. With the constructed plasmid, we could further investigate the function of N37 peptide.

Clinical analysis of 43 cases with carcinomas in maxillary sinus by sequent combination therapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical effects and life quality of 43 cases with carcinomas in maxillary sinus by sequent combination therapy.@*METHOD@#All the patients were subjected sequent and combination therapy, which included inductive chemotherapy through superficial temporal artery, operation and radical radiation therapy, and of these, 18 patients were added consolidation chemotherapy after combination therapy. Three year survival rate, 5- year survival rate and life quality were observed in a 5 years follow up.@*RESULT@#All patients completed this therapy, the overall 5-year survival rates were 46.5% (20/43) and 3-year were 65.1% (28/43). None were undertaken orbital exenteration and 12 patients recovered their ability of work and manual labour.@*CONCLUSION@#The sequent combination therapy is an effective method to enhance the prospective efficacy of treating the carcinoma of maxillary sinus and can raise the local controlling rate. The induced chemotherapy through the temporal artery superficial has many advantages, such as high density of topical remedy, obvious tumor regression after only a cycle chemotherapy, not delaying the surgery opportunity and so on. The consolidation chemotherapy after this combined therapy can reduce the risks of distant metastasis further.

Transcranial endoscopic excision of glossopharyngeal nerve to treat glossopharyngeal neuralgia / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To introduce a new transcranial endoscopic approach of glossopharyngeal neurotomy to treat glossopharyngeal neuralgia.@*METHOD@#The clinical data, the operative technique, the operative effect and the result of follow-up of two patients were presented. Through reviewing pertinent literature, we discussed the therapeutic advancement of glossopharyngeal neuralgia and the preponderance of transcranial endoscopic approach of glossopharyngeal neurotomy.@*RESULT@#The two patients both have satisfied outcomes and remained free of disease after surgical treatment. The endoscopic surgery has many significant advantages, such as rigorous operation, little injury, precise therapeutic effect, few complication, and so on.@*CONCLUSION@#Transcranial endoscopic approach of glossopharyngeal neurotomy is an ideal method to treat glossopharyngeal neuralgia.

The value of exposure recurrent laryngeal nerve in thyroidectomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the advantage of exposure recurrent laryngeal nerve in thyroidectomy. METHODS Exposure the recurrent laryngeal nerve was performed deliberately in 452 cases during thyroidectomy. The larynx was examined with laryngoscope before and after operation. RESULTS Of the 452 cases with 748 exposed recurrent laryngeal nerve, only 14 cases (1.88%) occurred temporary recurrent laryngeal nerve palsy, and 2 cases (0.27%) occurred permanent recurrent laryngeal nerve palsy. CONCLUSION Exposure the recurrent laryngeal nerve during thyroidectomy can protect the nerve from surgery injury.

The Discussion about Prevention Care of Vagus Nerve Reflex after Cardiac Intervention Operation / 医学研究杂志

Objective To study the prevention care of vagus nerve reflex after cardiac intervention operation.The reflection happens fast,progress quickly and high danger ously.Take effective care for a sick person could reduce the incidence of vagal reflex.Methods The methods inclucled psychological preparation for surgery,training emiction in the bed,fasting four hours,monitor of vital signs after surgery,drinking more water,fix somato.Results The complicatlons had been effective controled.Conclusion Applying certain preventional measures could reduce the incidence of vagal reflex.

Nosocomial Infections among Patients with Multiple Myeloma / 中华医院感染学杂志

OBJECTIVE To clarify the features of nosocomial infections for patients with multiple myeloma(MM).METHODS One hundred and seventy eight cases of MM treated in our hospital from Oct 1982 to Dec 2006 were analyzed retrospectively.RESULTS Eighty five patients(47.8%) suffered from nosocomial infections.The nosocomial infection took place more frequently on respiratory tract.Elder,granulocytopenia,hypoproteinemia,severe anemia,and diabetes were the risk factors.Totally 91 pathogens were isolated.Gram-negative bacilli accounted for 45.1%,and were the major pathogens.Fungi accounted for 37.4% and Gram-positives accounted for 17.6%.The ESBLs producing strains accounted for 31.6% in Klebsiella pneumoniae and Escherichia coli.Vancomycin resistant strains were found.The top one of fungi presented organism was the Candida albicans.CONCLUSIONS Nosocomial infections for patients with multiple myeloma has a high incidence.There are many risk factors.The resistance of commonly encountered bacteria to antimicrobial agents is a serious problem.Immunity protection and the rational use of antimicrobial agents should be emphasized.

Research on social part transformation of postoperative patient of laryngeal carcinoma / 中国医学伦理学

Objective Through studying the change of life style and social part constractly on patients of laryngeal carcinoma with different modus operandi.To elevate the living quality through combined treatment of laryngeal carcinoma.Methods One hundred and thirty two patients of laryngeal carcinoma were divided into two groups: total laryngectomy and partial laryngectomy.Through investigation of questionnaire to analyse the living quality between the different modus operandi.Results There has significant difference between two groups of total and partial laryngectomy on living state and mental state(P