Endoscopic surgery and endoscopy-assisted surgery for the malignant transformation of sinonasal inverted papilloma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate malignant transformation of sinonasal inverted papilloma (SIP) treated by nasal endoscopic and endoscopy-assisted surgery.</p><p><b>METHODS</b>Seven cases with malignant transformation of SIP treated by nasal endoscopic and endoscopy-assisted surgery from February 2001 to December 2010 were reviewed. Followed-up time after surgery for each case was over 3 years. All cases were unilateral disease and at grade IV according to the SIP grading standards of Krouse. One case was T2, five T3, and one T4. The surgery were performed under general anaesthesia or local and strengthen anaesthesia. Postoperative radiotherapy was applied, with the doses of 60 - 70 GY.</p><p><b>RESULTS</b>All cases were squamous cell carcinoma confirmed pathologically after surgery. The patients were followed up with endoscopic examination for 3 - 5 years. Of 7 cases, recurrent disease occurred in 3 years after operation, but no recurrence in other 4 cases.</p><p><b>CONCLUSIONS</b>Nasal endoscopic and endoscopy-assisted surgery can be used in the treatment for the malignant transformation of SIP, with the advantages of minimally invasion, fewer complications and the well-preserved nasal functions. Application of radiotherapy after surgery could improve long-term survival efficacy of the patients.</p>

Dynamic changes and clinical significance of serum Thl/Th2 cytokines in hemorrhagic fever with renal syndrome / 中国地方病学杂志

Objective To investigate the changes and pathogenic significance of serum interleukin-12p70 (IL-12), intefferon-γ,(IFN-γ) and IL-4 in the course of hemorrhagic fever with renal syndrome(HFRS). Methods Twenty five eases were divided into mild group (14 eases) and severe group (11 cases) according to the severity of illness. Blood samples were collected in various stages(fever, hypotensian and oliguria,diuresis stage). Serum IL-12 and IFN-γ levels were determined by enzyme-linked immunoserbent assay(ELISA), IL-4 by radioimmunoassay (RIA), blood urea nitrogen (BUN) and platelet by automatic biochemical analyzer and blood analyzer. Results Serum IL-12 levels in mild and severe groups were significantly different during various stages of HFRS (F=5.765, P<0.01). The IL-12 level of both patient groups significantly increased(P<0.01) in fever[ (0.87±0.38), (1.08± 0.77)μg/L], hypotension and oliguria [ (0.77±0.21), (2.11±2.13)μg/L] ,and diuresis stage [ (1.42±1.10), (1.20±0.88)μg/L], compared with control group [(0.56±0.10)μg/L]. In various stages, IFN-γ levels of both case groups were respectively (8.04±13.05), (5.94±8.24), (15.95±18.05), (4.41±4.10), (1.09±1.24), (1.38±1.74), (1.12±1.26), (0.19±1.29)μg/L, and the difference was statistically significant compared with control [ (0.27±0.15)rig/L]. K,-4 levels did not change significantly in the stages(F=0.682, P0.05), while the ratios of IFN-γ and IL-4 contents in mild and severe cases were significantly higher than control [(0.36±0.26) μg/L] in fever[ (2.46±3.52), (16.92±22.77)p.g/L], hypotension and oliguria[(2.52±2.72), (1.77±2.06) μg/L],diuresis stage [(1.45±2.28), (2.32±3.98)μg/L], the difference had statically significant (P<0.05 or 0.01).The curve of IL-12 was similar to that of BUN, but was contrary to blood platelet count. Conclusions The elevated levels of IL-12 and IFN-γ, with the imbalance of Th1/Th2 might be the main cause of systemic inflammatoryresponse and involved in the pathogenesis of HFRS.