Contribution of Tissue Hypoxia to Corpus Luteum Formation / 中国医学科学院学报

Corpus luteum is a temporary endocrine organ that is formed and regressed during the female reproductive cycle.It is developed from the residual follicular tissue after ovulation,which is associated with the rapid angiogenesis.Vascular endothelial growth factor(VEGF)is the most important stimulatory factor that regulates the luteal angiogenesis and also plays a key role during corpus luteum formation.VEGF is regulated by hypoxia-inducible factor(HIF)-1,which is a heterodimeric transcription factor consistent of HIF-1α and HIF-1β.The local hypoxia of ovary due to the ruptured follicle and the lack of new vascular networks induces HIF-1α expression and participates in the luteal formation through VEGF-dependent angiogenesis.The present article describes the functional and structural changes during the luteal formation from the local and hypoxic conditions immediately before and after ovulation,with an attempt to clarify the roles of hypoxia in luteal formation as well as ovarian physiology.

Cochlear implantation for prelinguistic deaf patients with central nervous system diseases / 中华神经医学杂志

Objective To investigate the preoperative evaluation methods of multi-channel cochlear implantation in prelinguistic deaf patients with central nervous system diseases,and explore the outcomes of speech rehabilitation.Methods Multi-channel cochlear implantation was conducted in 23 prelinguistic deaf patients with central nervous system diseases,admitted to our hospital from January 1996 to January 2009.Of the 23 patients,13 had white matter abnormalities,4 pallium dysplasia,2 hydrocephalus,2 congenital temporal lobe cyst,1 Tourette syndrome and 1 Down's syndrome.Another 30 prelinguistic deaf patients without central nervous diseases and performed cochlear implantation at the same period were chosen as control group.Preoperative hearing and imaging data,developmental assessments,implantation methods and postoperative outcomes of patients from these two groups were compared.Results These 23 patients were reconstructed hearing successfully after cochlear implantation without serious complications; postoperative mean thresholds in sound field 6 months after the surgery were (42.89±3.5) dBHL,which were significantly higher than those in control group ([32.4±4.5] dBHL,P＜0.05); the mean value of speech discrimination rate in close-set word list one year after the surgery was (65.18 ±3.1)％,which was significantly lower than that in control group ([81.63±3.7]％,P＜0.05).Outcomes of hearing-speech rehabilitation were good,but the patients with serious white matter abnormalities and pallium dysplasia had a lower hearing-speech rehabilitation rate than the other patients.Conclusion Cochlear implantation can be performed safely and effectively in patients with central nervous diseases after comprehensive pre-operative imaging and audiological evaluation are performed;type and severity of the central diseases can affect postoperative rehabilitation.

Nasal mucosal contact point headache: a clinical analysis of 29 cases / 中华神经医学杂志

Objective To investigate the intranasal anatomic abnormalities and clinical features of mucosal contact point headache, as well as the outcomes of endoscopic surgery. Methods The clinical data of 29 patients with mucosal contact point headache, received treatment in our hospital from October 2008 and May 2010, were reviewed retrospectively. All cases received CT scans, endoscope examinations and local anesthesia tests. Endoscopic surgery was performed to correct the contact points for these cases. They were followed-up for at least 1 year; and the changes of intensity, duration and frequency of headache of these patients were observed. Results Most common anatomic abnormalities included septal spurs in contact with the turbinates, uncinate process hypertrophy,pneumatized middle turbinates, abnormal curve of middle turbinate and large ethmoid bulla. The intensity, duration and frequency of headache after surgery decreased significantly as compared with those before the surgery (P<0.05). Nineteen of the 29 patients (65.52%) got benefits from surgical intervention, and 8 patients (27.59%) had complete relief of headache. Pain was the same as before the surgery in 10 cases (34.48%) in the follow-up period. Conclusion Intranasal contact points must be considered in patients who have no other obvious cause of headache. Significant relief of headache can be obtained by endoscopic surgery in selected cases.

Cochlear implantation and rehabilitation in prelingually deafened adolescents and young adults / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the outcomes of prelingually deafened adolescents and young adults receiving cochlear implantation (CI).</p><p><b>METHODS</b>Thirty-three patients with prelingual deafness aged 7-33 years at the time of CI were followed up for 4 years. The Speech Discrimination Score (SDS) was tested using disyllabic words and short sentences with close-set and open-set, respectively.</p><p><b>RESULTS</b>After appropriate mapping, sound field audiometry with warble tone showed that the warble tone threshold average (WTA) of the patients reached 25-41 dBHL, with a mean threshold of 28.62∓2.37 dBHL. At 1 year after the operation, the mean value of SDS was 70.03% in close-set word list with lip-reading and 61.18% without lip-reading, and was improved to 82.12% and 72.67% at 4 years, respectively. In open-set word list, the mean value of SDS was 77.94% with lip-reading and 67.85% without lip-reading. The safety and the benefits-cost evaluation of CI for prelingually deafened school age children and adolescents had been recognized by 90.9% of the families involved.</p><p><b>CONCLUSION</b>These patients can obtain appropriate speech discrimination scores with improved quality of life after CI.</p>

Timing of operation and therapeutic effect of endoscopic optic nerve decompression for traumatic optic neuropathy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the optimal timing of operation and the therapeutic effect of endoscopic optic nerve decompression for traumatic optic neuropathy (TON).</p><p><b>METHODS</b>The clinical records of 90 consecutive patients with TON (93 eyes) after head and/or maxillofacial trauma from April 1998 to March 2007 were reviewed and analyzed. All patients were either unresponsive or intolerant to medication before they underwent intranasal endoscopic optic nerve decompression. The time interval between the injury and operation ranged from one day to 97 days (median 5.5 days). Among the 93 eyes, there were 71 eyes with no visual acuity before operation and 22 eyes with residue visual acuity, including light perception in 1 eye, hand movement in 5 eyes, counting fingers in 13 eyes, 0.04 in 1 eye, and 0.1 in 2 eyes. Duration of follow-up ranged from 6 days to two years (median 8 days).</p><p><b>RESULTS</b>After decompression, 35 patients (36/93 eyes, 38.7%) showed improvement of visual acuity, 53 patients (55 eyes, 59.1%) remained the same as before operation, while 2 patients (2 eyes, 2.2%) showed decreased visual acuity. Among patients with visual acuity beyond light perception before decompression, 68.2% of them (15/22 eyes) experienced visual improvement, whereas only 22.9% (8/35 eyes, 0.02 in two eyes) among patients who lost visual acuity immediately after injury, and 36.1% (13/36 eyes, 0.02 in five eyes) among those who lost visual acuity gradually after injury. There was a significant difference in visual improvement between group with visual acuity and group with no visual acuity (chi(2) = 11.864, P < 0.01). Among patients with no visual acuity, 41.2% of those (7/17 eyes) who underwent operation within 3 days of injury, experienced improvement in visual acuity, compared with 25.9% (14/54 eyes) for those who underwent the operation more than 3 days after injury. It was indicated that no significant difference in visual improvement between these two groups (chi(2) = 1.46, P > 0.05). When comparing different sites of fracture, the effect of surgery was the most desirable (55.6%, 10/18 eyes improved) if the fracture occurred simultaneously in both exterior and interior walls of optic canal, followed by the interior wall fracture (45.7%, 21/46 eyes). The operation was less effective if there was no fraction (20%, 4/20 eyes) or if the fracture occurred in exterior wall alone (11.1%, 1/9 eyes).</p><p><b>CONCLUSIONS</b>Endoscopic optic nerve decompression is a minimally invasive procedure with no adverse cosmetic effects. Early operation is recommended for saving vision, even though visual acuity is lost immediately after injury. However, the satisfactory clinical effects of endoscopic optic nerve decompression require further study.</p>

Cochlear implant in patients with congenital malformation of the inner ear / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the clinical experience with multi-channel cochlear implantation in patients with inner ear malformations and evaluate and the outcomes of speech rehabilitation.</p><p><b>METHODS</b>A retrospective study was conducted in 295 patients receiving cochlear implantation from 1998 to 2007, including 25 patients with large vestibular aqueduct syndrome (LVAS), 9 with Modini malformation, and 5 with common cavity deformity. All the patients received the Nucleus24 cochlear implants. In LVAS cases, 4 had Nucleus 24R (ST) implants, 8 had Contuor implants, 10 had Contuor Advance, and the remaining cases used Nucleus24(M) straight-electrode implants.</p><p><b>RESULTS</b>Severe gusher appeared in 3 cases of LVAS, and perilymph fluctuation were seen in other 15 cases. Four patients with Mondini malformation and 2 with common cavity malformation also experienced severe gusher, but the electrodes were inserted smoothly in all the patients without postoperative facial paralysis or cerebrospinal fluid leakage. The hearing threshold in these patients was similar to that in patients with normal cochlear structure. After speech rehabilitation for over 6 months, the abilities of speech discrimination and spoken language improved in all the cases in comparison with the preoperative lingual functions.</p><p><b>CONCLUSION</b>Multi-channel cochlear implantation can be performed in patients with inner ear malformation, but should not be attempted in patients with poor cochlear and cochlear nerve development. A comprehensive pre-operative radiographic and audiological evaluation is essential.</p>

Targeted distribution of cis-platin magnetic nanoparticles in mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the targeted distribution of cis-platin magnetic nanoparticles (CDDP-MNP) in normal mice.</p><p><b>METHODS</b>Thirty-two normal mice were randomly assigned into 4 equal groups. External magnetic field of 4100-4200 Gs was established in the unilateral kidney area of each mouse, and CDDP-MNP was administered via the tail vein, with the external magnetic field maintained in groups A, B, C, and D for 30 min and 1, 2 and 4 h after the injection, respectively. A flame atomic absorption spectrometer (AAS) was used to detect CDDP concentration in the mouse kidney tissues. Magnetic resonance imaging (MRI), Prussian blue staining, and transmission electron microscopy (TEM) were used to detect the distribution of the magnetic nanoparticles in vivo.</p><p><b>RESULTS</b>In groups A, B and C, the concentrations of CDDP in the targeted kidney tissues increased significantly in comparison with those in non-targeted kidney. The signal intensity of the targeted kidney tissue was lower than that of the non-targeted kidney on T2-weighted MR images. TEM and Prussian blue staining demonstrated MNP distribution in the lumens and endothelial cells of the blood capillary in the kidney tissue.</p><p><b>CONCLUSION</b>CDDP-MNP allows targeted distribution induced by external magnetic field in normal mice after intravenous injection.</p>