Application of low- temperature plasma technology in nasal endoscope cerebrospinal fluid rhinorrhea repair surgery / 中国医师进修杂志

Objective To analyze the application of low-temperature plasma technology in nasal endoscope cerebrospinal fluid rhinorrhea repair surgery. Methods Ten patients with cerebrospinal fluid rhinorrhea from August 2016 to September 2017 were collected, including 5 cases of spontaneous rhinorrhea, and 2 cases after transsphenoidal pituitary surgery, 1 case after nasal polyps and 2 cases after trauma. The repair of cerebrospinal fluid rhinorrhea under nasal endoscope was performed in 10 cases, and the low-temperature plasma technique was used to treat the herniated brain tissue or the soft tissue around the leaks, and the autologous material was used for repair. Results All the patients were followed up for 6 months, and all patients recovered without complications and second operation in cerebrospinal fluid rhinorrhea. Conclusions Low-temperature plasma technique plays an important role in the repair of cerebrospinal fluid rhinorrhea under nasal endoscope. It has the unique advantage of small heat injury, quick recovery, thorough clearance of mucous membrane and no bleeding.

Nasal sinus inflammatory myofibroblastic tumor:four cases report and literature review / 中国医师进修杂志

Objective To investigate clinical, pathological and radiographic features of inflammatory myofibroblastic tumor (IMT) of the nasal cavity. Methods Four cases of pathologically confirmed IMT in the Shengjing hospital of China Medical University from April 2015 to April 2017 were retrospectively analyzed. Three dimensional CT and enhanced MRI was performed in all patients. Results The main symptoms were local obstruction, oppression or infringement. In 4 cases, IMT was single, with 2 cases of primary maxillary sinus, 1 case of nasal cavity, and 1 case of nasal septum;Pathological morphology presented diversity, consisting mainly of spindle-shaped cells which distributed in bundles or whirlpools, and showed inflammatory cell infiltration. Immunohistochemical results showed SMA (+) in 4 cases, Desmin (-) in 4 cases , and ALK (-) in 3 cases. CT plain tumors showed mostly uniform soft tissue densities. MR showed more enhancement of tumors, 1 case with necrotic cystic changes in the maxillary sinus IMT tumors, showed a significant ring after enhancement. Conclusions The IMT of nasal cavity and paranasal sinuses is rare and the clinical symptoms are non-specific. The diagnosis mainly depends on pathological examination and immunohistochemical staining. Preoperative CT and MRI examinations can not only provide information on the lesion location, extent, and adjacent tissue invasion, but also on the blood supply of the tumor and the internal components of the tissue, which will facilitate the choice of treatment options.

Clinical study of Rhubarb water extract gavage combined with external application of mirabilite and western medicine in the treatment of severe acute pancreatitis / 国际中医中药杂志

Objective To investigate the effects of Rhubarb water extract gavage combined with external application of mirabilite and western medicine in the treatment of severe acute pancreatitis (SAP). Methods A total of 62 patients with SAP meeting the inclusion criteria were randomly divided into 2 groups, with 31 cases in each group. The control group was treated with western medicine routine treatment. The study group was given the combination of raw and rhubarb water infusion and mirabilite external application on the basis of the control group. After treated with 28 d, the duration of blood purification, abdominal pain disappeared time, blood amylase recovery time, bowel peristalsis recovery time, hospitalization time and 28 d mortality were observed in the 2 groups. Results The duration of blood purification time, abdominal pain disappeared time, blood amylase recovery time, bowel peristalsis recovery time, hospitalization time of the study group were significantly lower than those of the control group (t=2.434, 2.507, 2.804, 2.318, 2.614, P<0.05). After treatment 1, 3, 7 d, the level of D-lactic acid in the study group was respectively which were significantly lower than those of the control group (t=38.752, 36.975, 36.018, P<0.05). The level of DAO in the study group was respectively which were significantly lower than those of the control group (t=4.119, 4.632, 3.907, P<0.05). The level of ET in the study group was respectively which were significantly lower than those of the control group (t=25.699, 23.805, 24.472, P<0.05). The level of hs-CRP in the study group was respectively which were significantly lower than those of the control group (t=4.791, 5.025, 5.288, P<0.05). The level of PCT in the study group was respectively which were significantly lower than those of the control group (t=4.350, 4.742, 6.012, P<0.05). The APACHE II scores in the study group were respectively which were significantly lower than those of the control group (t=3.988, 4.350, 5.722, P<0.01). Conclusions The application of Rhubarb water extract gavage combined with external application of mirabilite and western medicine in the treatment of severe acute pancreatitis can protect the intestinal mucosal barrier of SAP patients, reduce the level of inflammatory reaction, shorten the time of symptom relief and improve the curative effect.

Bioinformatic analysis of antibody repertoire development in response to influenza vaccination / 中华微生物学和免疫学杂志

Objective To analyze the immunogenomic characteristics of antibody repertoire in re-sponse to influenza vaccine in order to provide a theoretical basis for further development of antibody. Meth-ods Based on a time-series immunoglobulin heavy chain ( IGH) repertoire sequencing dataset, we analyzed the immunogenomic characteristics of antibody repertoire in response to trivalent influenza vaccine ( TIV ) from three aspects which included the features in complementarity-determining region 3 ( CDR3 ) , antibody mutation and VDJ usage. Results The frequency of antibody mutation increased significantly upon vaccina-tion. Analysis of the CDR3 region indicated that polar and aromatic amino acids had a higher preference. The length of CDR3 region in naive B cells followed a normal distribution, while specific CDR3 sequences with 15 to 18 amino acids in length occupied a dominant position after vaccination. In addition, the VDJ us-age altered obviously and IGHV3-7-derived antibody had a significant response to the vaccine. Response in-tensity reached the peak on day 7 and gradually weakened over time. Conclusion Antibody repertoire evolves dynamically to express specific antibody upon vaccination and the characteristics of immune responses at sequence level could be used to evaluate their effectiveness.

Study of synergistic mechanism in the combination ofberberine and evodiamine from the perspective of miRNA / 中国药理学通报

Aim To explore the mechanisms of action (MOA) of synergistic anticancer function in the combination of berberine and evodiamine.Methods We first analyzed the action of suppression in the drug combination from the cell level and validated the dose scope as well as ratio of concentration in synergistic effects of drug combination.Then, the miRNA chip of liver cancer cell BEL-7402 under different treatment was analyzed.By building the miRNA-mRNA network, the MOA of the synergistic drug combination was illustrated.Results Berberine and evodiamine used in combination could significantly synergistically suppress the proliferative ability of liver cancer cells.The special differentially expressed miRNAs (DEmiRNAs) mainly participated in some cancer proliferation-related pathways and biological processes, such as MAPK signaling pathway, endocytosis pathway and insulin signaling pathway.The special target genes influenced by the drug combination not only covered three kinds of membrane receptors, but also took part in the regulation of downstream pathways.Conclusions From the regulation of miRNAs, it is clear that berberine may play a primary role in the synergistical suppression activity of the drug combination in cancer cells.The discovery of synergistic MOA in the combination of berberine and evodiamine from the miRNA level will provide a new guidance to explore more synergistic drug combinations in the future.

Expression and clinical significance of Eotaxin-3 in chronic rhinosinusitis with and without nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and clinical significance of Eotaxin-3 in chronic rhinosinusitis with and without nasal polyps.@*METHOD@#The ethmoid inflammation mucosa of 15 cases diagnosed as chronic rhinosinusitis (sinusitis group), the nasal polyps in the middle meatus of 25 cases diagnosed as nasal polyps (nasal polyp group) and the ethmoid or uncinate process mucosa of 7 cases diagnosed as sinonasal non-inflamnatory diseases (control group), were collected as the research object. Eotaxin-3 expression was detected in the tissues by immunohistochemical SABC assay and the correlation between Eotaxin-3 and blood eosinophil counts was analyzed.@*RESULT@#Eotaxin-3 were detected both in sinusitis group and nasal polyp group, and the expression level in sinusitis group and nasal polyp group were higher than that in control group. The difference was statistically significant (P < 0.05). The Eotaxin-3 expression in nasal polyps group was higher than that in sinusitis group, and the difference was statistically significant (P < 0.05). The expression of Eotaxin-3 in nasal polyps group and sinusitis group were both significantly positively correlated with the eosinophil counts in the blood (P < 0.05).@*CONCLUSION@#Eotaxin-3 may be involved,in the pathogenesis of chronic rhinosinusitis with and without nasal polyps, and further research will help us to understand the pathophysiology of chronic rhinosinusitis with and without nasal polyps.

The observation of normal uncinate process mucosa compared with inferior turbinate in epithelium ultrastructure / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the morphological differences between normal uncinate process(UP) mucosa and inferior turbinate mucosa, and explore the physiology function of the UP with the electron microscope.@*METHOD@#The experiment chose 12 patients who have taken nasal endoscopic surgeries(8 cases for normal UP, 4 cases for normal inferior turbinate mucosa). During the surgery, take the mucosa upwards on the filter paper and immediately use scanning electron microscopy and transmission electron microscopy specimens for standard sample preparation methods. Observe the cilia shape, structure and the distribution and the swing direction.@*RESULT@#(1)The internal side and the external side of UP mucosa and inferior turbinate mucosa are all pseudostratified ciliated columnar epithelium, the shapes of cilia are classic "9+2" structures. The distribution of cilia on internal and external lateral of UP and inferior turbinate mucosa are in high density. (2)The direction of cilia on normal inferior turbinate mucosa are generally swing to up and backwards; the cilia on internal lateral of the UP generally swing towards inner side, down and backwards; the cilia on external lateral of the UP generally swing towards down and backwards.@*CONCLUSION@#The cilia on internal side and the external side of UP mucosa and inferior turbinate mucosa are in the same structure and shape, but the swing direction of cilia have their own characteristics. It can be concluded that the internal and external lateral of UP may have different functions in nasal sinuses mucus cilia clearance system.

Thirty-two cases of nasal lymphoma CT and MRI analysis / 临床耳鼻咽喉头颈外科杂志

Objective:Analysis of nasal lymphoma CT and MRI data, summarize imaging characteristics, provide help for clinical diagnosis. Method:Retrospectively analyzed the image manifestations of 32 cases of nasal lymphoma diagnosed by surgery and pathology. Lesion locations, tumor extension, bone destruction and its density, signal characteristics, enhancement degree, the situation of adjacent tissues were evaluated. Result:NK/T cells, T cell NHL have the characteristics: the lesions to diffuse growth, widely existed in nasal breathing zone, often involving middle and inferior turbinate, local bone slightly damaged, and no obvious bony shift. Tumor of uneven density, fuzzy boundaries, mixed signalse. The characteristics of B cell NHL: the lesion originated in the front of the nasal cavity, on the surrounding adjacent tissue compression performance, local feature is swelling growth and bone have insect damage sample sample, the dotted line change, very mild osseous shift, the tumor boundary is relatively clear, lesions density is uniform, and part of the uniform tumors had signal. Conclusion:Nasal lymphoma imaging changes have its characteristics. Image change prompts the pathological classification, providing help for clinical diagnosis.

Expression level of IL-25 and IL-33 mRNA in nasal mucosa of allergic rhinitis mice / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo investigate the expression levels of IL-25 and IL-33 mRNA in the nasal mucosa of allergic rhinitis(AR) mice.METHODSBalb/c mice were used for establishing the animal model of allergic rhinitis with oval bumin sensitization as AR group, at the same time, the physiological saline as the control group. IL-25 and IL-33 mRNA in nasal mucosa of the two groups were detected by real-time quantitative PCR.RESULTSThe expression of IL-25 and IL-33 mRNA could be detected in both the control and AR group. The expression level of IL-25 and IL-33 mRNA in AR group were significantly higher than that in control group, the difference was statistically significant (P<0.05).CONCLUSIONIL-25 and IL-33 were involved in the development of allergic rhinitis. This result will be helpful for the further understanding of the pathogenesis of allergic rhinitis, and provide a theoretical basis for the treatment of allergic rhinitis.

Expression of IL-9 and its receptor mRNA in nasal mucosa of allergic rhinitis mice / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the expression and roles of IL-9 and its receptor (IL-9R) mRNA in the nasal mucosa of ovalbumin-induced allergic rhinitis (AR) mice. METHODS Sixteen Balb/c mice were selected and randomly divided into two groups with 8 mice in each group. Mice were used for establishing the animal model of AR with ovalbumin sensitization as AR group, at the same time, the physiological saline as the control group. In each group, 4 mice were randomly taken from each group, and the pathological examination showed that the model was successful. The nasal mucosa was taken from the remaining 4 mice in each group and then to detect IL-9 and IL-9R mRNA in nasal mucosa of the two groups by using real-time quantitative PCR. RESULTS The expression of IL-9 and IL-9R mRNA could be detected in both the control and AR groups. The expression levels of IL-9 and IL-9R mRNA in the nasal mucosa of the AR group were both higher than that in the control group (P<0.05). The expression level of IL-9 mRNA was positively correlated with the expression of IL-9R mRNA in the nasal mucosa of mice (r =0.857, P<0.05). CONCLUSION IL-9 and its receptor IL-9R are involved in the development of AR, and play an important role in the development of allergic rhinitis. It provides a new perspective for the further understanding of the pathogenesis of AR and provides a new clue for the treatment of allergic rhinitis.

Expression and role of IL-33 and its receptor ST2 in eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and role of Interleukin-33 (IL-33) and ST2 in the nasal polyps of human Eosinophilic and non-Eosinophilic chronic rhinosinusitis with nasal polyps (ECRS and non-ECRS).@*METHOD@#IL-33 and ST2 protein expression in nasal polyps of ECRS and non-ECRS as well as in seemingly normal mucosa of the inferior turbinate tissue was investigated by immunohistochemical staining and messenger RNA (mRNA) expression of IL-33 and ST2 was assessed by realtime polymerase chain reaction (PCR) in 27 subjects with ECRS, 33 subjects with non-ECRS, and 11 control subjects.@*RESULT@#(1) The ST2 was found both in nasal polyps of ECRS and non-ECRS,especially in ECRS, yet hardly found in the normal mucosa of the inferior turbinate tissue; (2) The expression of ST2 mRNA in nasal polyps of ECRS was higher than that in non-ECRS and normal inferior turbinate tissue, and the difference was both prominent in statistics (P0.05).@*CONCLUSION@#The IL-33 and its receptor ST2 were both expressed in human nasal polyps including ECRS and non-ECRS, meanwhile the expression patterns of ST2 at both mRNA and protein levels were significantly higher in nasal polyps of ECRS. The current study suggests that IL-33 and its receptor ST2 may play important roles in the pathogenesis of chronic rhinosinusitis with nasal polyps, especially in ECRS through the increased expression of ST2 in Eosinophils as a hypothesis.

The clinical significance of 1,3-beta-D glucanase detection in plasma to the diagnosis of fungal rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical significance of 1,3-beta-D glucanase detection in plasma to the diagnosis of fungal rhinosinusitis.@*METHOD@#MB-80 rapid microorganism detection system was used to detect preoperative and postoperative 1,3-beta-D glucanase in plasma of 37 patients of fungal rhinosinusitis which were treated by endoscopic sinus surgery and confirmed by postoperative pathology. Blood samples of 47 patients who underwent endoscopic surgery(fungal rhinosinusitis excluded) were taken as control group.@*RESULT@#1,3-beta-D glucanase content is more than 10 pg/ml in 34 cases of the fungal rhinosinusitis group,and every 1,3-beta-D glucanase content of 47 control cases is less than 10 pg/ml. Significant difference is found between case and control groups(chi2 = 72.6, P < 0.01).@*CONCLUSION@#1,3-beta-D glucanase detection in plasma is a simple,rapid diagnostic method of fungal rhinosinusitis.

Study of drug function based on similarity of pathway fingerprint

Drugs sharing similar therapeutic function may not bind to the same group of targets. However, their targets may be involved in similar pathway profiles which are associated with certain pathological process. In this study, pathway fingerprint was introduced to indicate the profile of significant pathways being influenced by the targets of drugs. Then drug-drug network was further constructed based on significant similarity of pathway fingerprints. In this way, the functions of a drug may be hinted by the enriched therapeutic functions of its neighboring drugs. In the test of 911 FDA approved drugs with more than one known target, 471 drugs could be connected into networks. 760 significant associations of drug-therapeutic function were generated, among which around 60% of them were supported by scientific literatures or ATC codes of drug functional classification. Therefore, pathway fingerprints may be useful to further study on the potential function of known drugs, or the unknown function of new drugs.

Clinicopathologic features of respiratory epithelial adenomatoid hamartoma of bilateral olfactory clefts / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To describe five rare cases of bilateral olfactory clefts respiratory epithelial adenomatoid hamartoma (REAH), and investigate the clinicopathologic features in REAH.@*METHOD@#Five cases with REAH were reported and the relevant literatures were reviewed. All the cases were confirmed by pathology.@*RESULT@#The chief complaint in 4 cases when visited was nasal obstruction and rhinorrhea, with or without hyposmia and headache. Another was discomfortable of head-facial region, sometimes with pus discharge and blood in nasal discharge. Polypoid neoplasms can be seen in nasal meatus of the 5 cases. Endoscopic sinus surgery was utilized to eliminate foci in 5 cases. All REAH foci located in bilateral olfactory clefts areas, four of which appeared polypoid changes,one appeared obvious inflammatory edema. All of them presented as wide-based lesion with tenacious quality compared to polyps. Histologically, these lesions were characterized by a glandular proliferation lined by ciliated respiratory epithelium originated from the surface epithelium, and the glands surround into round or oval, with various sizes and separated by stromal tissue.@*CONCLUSION@#It is possible to continue developing after operation, if REAH is not completely resected. Complete resection of lesions is the key to treatment success for this entity in endoscopic sinus surgery. Although REAH arising from the rhino sinusal region is very rare, rhinolaryngologists must know this entity in order to differentiate it from inverted papilloma and adenocarcinoma.

Evaluation to the quality of life of patients with chronic sinusitis and polyps and analysis of influential factors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate how functional endoscopic sinus surgery (FESS) modifies patients symptom profiles and the quality of life and analyze the influential factors.@*METHOD@#The questionnaires modified according to the SNOT-20 scale were given to 100 patients who underwent sinus surgery at the department of otorhinolaryngology.@*RESULT@#After a postoperative follow-up of 3 months, an amelioration of the quality of life was achieved in 88.24%; the leading influences to life before operation respectively are nasal obstruction (52.94%) in the first dimension, decrescence of remembrance (18.82%) in the second dimension, worrying themselves all day (8.24%) in the third dimension, and interference to social intercourse (14.12%) in the forth dimension; the leading ameliorations after operation respectively are nasal obstruction (58.82%) in the first dimension, decrescence of remembrance (10.59%) in the second dimension, tantrums (9.41%) in the third dimension,and interference to social intercourse (10.59%) in the forth dimension; the preoperative influential factors are age, sex and complication. The postoperative factors are age, sex, complication, history of previous operation, postoperative treatment and follow-up. Types have no effect on the quality of patient's life.@*CONCLUSION@#As the most effective therapy at present, FESS can improve the quality of life of patients with chronic sinusitis obviously. The major correlative factors are age, sex, complication, history of previous operation, postoperative treatment.

The effects on nasal mucociliary clearance system of excising partial inferior turbinectomy with HUMMER or microwave / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the effects of excising partial inferior turbinectomy with powered sinus clissector (HUMMER) and microwave on nasal mucociliary clearance system, and offer the theoretical foundation to choose rational operational technique.@*METHOD@#The patients of HUMMER group were excised partial inferior turbinectomies with HUMMER and the microwave group with microwave, each group included 20 patients. Ten patients without nasal disease were selected as control. Every case was drawn nasal mucus of inferior turbinectomy preoperatively, three months and six months after surgery. Five control cases selected randomly were drawn specimens. The specimens were observed under light microscope and scanning electron microscope. Every case accepted saccharin test before the specimen was drawn. All data were analyzed with paired sample t-test and analysis of variance.@*RESULT@#(1) Saccharin test: MTR(mucociliary transport rate)for before surgery, three months after surgery and six months after surgery with HUMMER were (3.63+/-0.57) ,(3. 76+/-0.43) and (6. 09+/-1. 19)mm/min, respectively. MTR for six months after surgery significantly increased compared with that before surgery and three months after surgery(both P <0. 01). MTR for three months after surgery and six months after surgery with microwave were (3. 96+/-0. 40)and (3. 95+/-0. 32)mm/min,respectively. MTR for three months and six months after surgery both significantly increased compared with that of controls (both P <0. 01). MTR for six months after surgery with microwave significantly increased compared with that with HUMMER ( P <0. 01). (2) Observation of Light microscope and scanning electron microscope: Before surgery with HUMMER and with microwave, goblet cells increased in nasal mucous epithelial of patients. The cilia changes included fracture, disorder, deletion and confluence. Thickness and size of cilia were not coincident. Partial nasal mucous epithelial metaplasis from pseudostratified ciliated columnar epithelium to simple cuboidal epithelium. Nasal mucous epithelia regenerated to pseudostratified ciliated columnar epithelium after surgery with HUMMER, which mainly coincided with normal nasal mucociliary system. Nasal mucociliary epithelial regenerated little after surgery with microwave. There were squamous epithelial metaplasia on nasal mucus and serious deletion of cilia.@*CONCLUSION@#The surgery of excising partial inferior turbinectomy with HUMMER has obvious advantage in protecting and recovering physiological function of nasal cavity.

The expression of neuN in the development of olfactory bulb and epithelium of mice / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression characteristics of NeuN (neuron-specific nuclear protein/neuronal nuclei) in the development of mice olfactory bulb and epithelium.@*METHOD@#The expression of NeuN in the heads of E9.5, E11.5, E14.5, E17.5, newborn and adult mice were examined by immunofluorescence method.@*RESULT@#NeuN was expressed in mature neural cells at the margin area of olfactory bulb of new natal mice while the layers of olfactory bulb could not be distinguished. Mature neural cells expressing NeuN aggregated in the granule cells layer, when layers of olfactory bulb of adult mice were clearly formed. The expression of NeuN could not be observed in bipolar olfactory receptor neurons (ORN) in olfactory epithelium.@*CONCLUSION@#It is usually believed that NeuN is expressed in most mature neurons. However, during the development of olfactory bulb and epithelium, NeuN is expressed only in mature neural cells migrating from margin area to the inner granule cells layer of olfactory bulb. It is proposed that the migration of granule cells in olfactory bulb might be related to the formation of smell pattern.