Combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study surgical techniques and clinical applications of the intranasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment.@*METHOD@#A retrospective clinical analysis of 3 patients whose admitted for orbital floor fractures or medial wall fractures operated by the intranasal endoscopic middle meatus with expand prelacrimal recess-maxillary ainus approach surgical treatment was studied, and the treatment effects and the postoperative complications were analyzed.@*RESULT@#All patients had been followed up for 6 to 12 months. All cases of diplopia symptom were disappeared, enophthalmos were totally corrected, no cases of complication were found.@*CONCLUSION@#Endonasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment have great and clear view. This approach with less tissue damage and high therapeutic effect makes the cost lower than other methods and complications will be decreased as well, it has a great advantage in the orbital fracture treatment.

Imaging classification for horizontal segment of uncinate process and its guiding significance in functional endoscopic sinus surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore a new method for horizontal segment of uncinate process classification from image of nasal sinus.</p><p><b>METHODS</b>On the level of horizontal segment of uncinate process of nasal sinus high resolution CT (HRCT) coronal scan. A vertical line and a parallel line were drawn started from the fornix top of the inferior meatus and orbital floor. The uncinate process which suited in the 'Cross' regional was divided into four types by these lines. These were: intra-superior, intra-inferior and extra-superior, extra-inferior. According to this method, 119 patients with chronic sinusitis which were divided into these four types by the imaging classification for horizontal segment of uncinate process operated by functional endoscopic sinus surgery, and the treatment effects and the postoperative complications were analyzed.</p><p><b>RESULTS</b>These 119 chronic sinusitis patients (238 sides uncinated process) were divided into four types by the imaging classification for uncinated process. The amount of intra-superior types was 66.0% (157/238), the amount of intra-inferior types was 16.8% (40/238), the amount of extra-superior types was 13.9% (33/238), and the amount of extra-inferior types was 3.4% (8/238). Functional endoscopic sinus surgery was performed according to this classification. All maxillary sinus natural ostium were found. Two cases occured orbital board damage (one was intra-superior, the other was extra-inferior).</p><p><b>CONCLUSION</b>The imaging classification for horizontal segment of uncinate process demonstrates a guiding significance for us to predict the difficulty of the operation and prevent the complications.</p>

Synergistic interactions of TRAIL and paclitaxel on the nasopharyngeal carcinoma cell lines in vitro / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the synergistic cytotoxicity of TRAIL and paclitaxel on nasopharyngeal cell lines CNE-1 and CNE-2.@*METHOD@#CCK-8 assays the growth inhibition rate of CNE-1 and CNE-2 which was treated with TRAIL or paclitaxel or combination of both. Flow cytometry tests the apoptosis rate of CNE-1 and CNE-2 which was treated with TRAIL or paclitaxel or combination of each other.@*RESULT@#In certain range of time and concentration,TRAIL and paclitaxel inhibited the growth of the cell lines of CNE-1 and CNE-2 in a time-dose dependent manner (P < 0.05). The rate of growth inhibition and apoptosis in TRAIL and paclitaxel combinative group was more significant than that in the TRAIL and paclitaxel singular group (P < 0.05).@*CONCLUSION@#TRAIL and paclitaxel had a synergistic killing effect on NPC cell lines and showed better affection than singular group, which provides a novel and prospective strategy for NPC chemotherapy.

The expression and correlation of HMGB1 and VEGF protein in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and biological significance of HMGB1 and VEGF protein in tissue specimens of laryngeal squamous cell carcinoma (LSCC), and further study the correlation between HMGB1 and VEGF protein.@*METHOD@#The expression of HMGB1 and VEGF protein was evaluated by immunohistochemical staining in 69 cases of LSCC specimens and 15 cases of adjacent epithelial tissue samples, and futher correlated with clinicopathologic parameters.@*RESULT@#The positive rates of HMGB1 and VEGF in LSCC tissues were significantly higher than those in adjacent non-cancerous mucosa (P 0. 05). There was a positive correlation between the expression of HMGB1 and VEGF (P < 0.05). The Kaplan-Meier survival analysis showed that patients with strong expression of HMGB1 or VEGF had poorer overall survival compared with that in patients with relative low HMGB1 or VEGF expression (P < 0.05). Multivariate COX regression analysis revealed that both lymph node metastasis and HMGB1 expression were independent prognostic factors for patients with LSCC.@*CONCLUSION@#This study demonstrated that HMGB1 and VEGF protein overexpression were closely associated with clinical stage, metastasis and poorer prognosis in patients with LSCC. Increased expression of these two proteins in LSCC suggested that HMGB1 and VEGF might play a critical role in the initiation and progression of LSCC.

Expression and significance of Survivin mRNA in xenotransplanted nasopharyngeal carcinoma treated by paclitaxel combined with radiotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and significance of Survivin mRNA in xenotransplanted nasopharyngeal carcinoma treated by paclitaxel combined with radiotherapy.@*METHOD@#Xenotransplanted nasopharyngeal carcinoma was established by CNE-2 cell line, then grouped and treated with paclitaxel, radiotherapy, paclitaxel combined with radiotherapy respectively. Xenotransplanted tumor volume was measured; tumor specimens were confirmed by routine hemotoxylin-eosin staining; apoptosis index was assayed by flow cytometry and Survivin mRNA was detected by one step RT-PCR.@*RESULT@#Xenotransplanted tumor growth was significantly inhibited by paclitaxel combined with radiotherapy and its inhibition rate was 99.3%. Compared to control group, apoptosis index was apparently increased in the other three groups (P0.05).@*CONCLUSION@#Paclitaxel combined with radiotherapy can induce significant killing effect in xenotransplanted nasopharyngeal carcinoma; paclitaxel can enhance the radiosensitivity of xenotransplanted nasopharyngeal carcinoma and its mechanism may rely on the down-regulation of Survivin expression.

Analysis of imaging characteristics of B-cell non-Hodgkin lymphoma of skull base (reports of 2 cases) / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the imaging characteristics of B-cell non-Hodgkin lymphoma of skull base.@*METHOD@#Two patients with B-cell non-Hodgkin lymphoma of skull base in our hospital were reported, meanwhile the imaging characteristics were summarized and analyzed with the related literature.@*RESULT@#The imaging feature of B-cell non-Hodgkin lymphoma of skull base was equal or low signal on MR T2-weighted and not obviously enhanced. The width of the soft tissue invaded in intracalvarium appeared much bigger than the width of bone destruction, and the lesion infiltrated along the dural surface.@*CONCLUSION@#Characteristic imaging appearance of B-cell non-Hodgkin lymphoma of skull base have the significance in diagnosis and differential diagnosis.

Complication and prevention of transnasal endoscopic adenoidectomy in children / 中南大学学报(医学版)

OBJECTIVE@#To discuss the complication and the prevention of transnasal endoscopic adenoidectomy in children.@*METHODS@#A total of 215 children patients with adenoid hypertrophy were treated with transnasal endoscopic adenoidectomy and were followed up for 1-6 months postoperatively. We summarized the complication and their management.@*RESULTS@#The children had a disappearance or relief of their clinical symptoms and manifestations after endoscopic adenoidectomy. Involved complication included 10 nose bleedings, 30 nasal synechia, 1 adenoidal regrowth.@*CONCLUSION@#Endoscopic adenoidectomy is performed under direct and clear view that allows surgeons to operate conveniently and shorten surgical time. Surgeons still have to be alert to these complications and try to avoid them.

Transnasal endoscopic reconstruction of the nasal-skull base defect to manage the cerebrospinal fluid leaks with intranasal autologous grafts / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the methods and feasibility of the transnasal endoscopic reconstruction of the nasal-skull base defect to manage the cerebrospinal fluid leaks using intranasal autologous grafts.@*METHOD@#Ninety six nasal-skull base defect patients with cerebrospinal fluid leaks were managed under endoscope with intranasal autologous materials. The repair materials and methods for the management of the cerebrospinal fluid leaks were tailored based on the different location and size of nasal-skull base defect. Eighteen cases with nasal-skull base defects less than 0.5 cm in diameter were repaired by an overlay technique using free mucoperiosteal graft from the middle turbinate. Thirty five patients with defects in the ethmoid roof and ethmoid plate ranging in size from 0.5 to 1.0 cm in diameter were repaired by an overlay technique using a pedicled middle turbinate flaps. Twelve cases with defects in the sellar clivus ranging in size from 0.5 to 1.0 cm in diameter were repaired by an overlay technique using a pedicled septal mucoperiosteal grafts. Nineteen cases with a diameter of 1.0 to 1.5 cm defects were repaired using free septal cartilage and mucoperiosteal grafts. Seven cases with defects in the ethmoid roof and ethmoid plate ranging from 1.5 to 2.5 cm in diameter were repaired using a pedicled middle turbinate and ethmoid plate flaps. Five sellar clival defect cases ranging from 1.5 to 2.5 cm in diameter were repaired using ethmoid plate and pedicled septal mucoperiosteal flaps.@*RESULT@#Six months to 6 years' follow up indicated that two patient developed postoperative cerebrospinal fluid leaks one year and two years after operation, respectively. One was successfully managed by conservative treatment. The other was successfully repaired by second surgery. Three patients developed transient postoperative cerebrospinal fluid leak that was spontaneous recovered without special treatment. No other new postoperative cerebrospinal fluid leaks occurred.@*CONCLUSION@#We concluded that transnasal endoscopic reconstruction of the nasal-skull base defect is a highly effective method for managing the cerebrospinal fluid leak with the advantage of easily obtaining the intranasal autologous materials. The autologous materials should be varied based on different size and location of the skull base defects.

Analysis of sphenoid sinus malignant tumor misdiagnosis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical characteristics, therapeutic efficacy and misdiagnosis status of sphenoid sinus malignant tumor in order to improve the diagnosis rate.@*METHOD@#Analysing and summarizing 18 patients with sphenoid sinus malignant tumor in our department from 1996 to 2005.@*RESULT@#The metastatic nasopharyngeal carcinoma is the most of sphenoid sinus malignant tumor,the second is chordocarcinoma and non-Hodgkin lymphoma, its clinical manifestation was headache (78%), sight alteration (50%), cranial nerve palsy (39%), nose bleed (11%); the clinical diagnosis rate was 56%.@*CONCLUSION@#The nasal endoscopy is the convention examination for these patients with sphenoid sinus malignant tumor whose imageology diagnosis is of limitation.

In vitro experimental study of killing Hep-2 cells of laryngeal cancer with suicide fusion gene CDglyTK / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the killing effect of suicide gene CDglyTK combined with GCV or 5-FC on the human laryngeal carcinoma Hep-2 cell line in vitro.@*METHOD@#Constructed plasmid pcDNA3.1 (-) CMV. CDglyTK was verified by enzyme digestion of Xho I /Hind III and automatic sequence analysis, then it was introduced into Hep-2 cells by electroporation to yield cells expressing CDglyTK stably after selecting with G418(400 ng/L) for 14 da. The expression of CDglyTK mRNA in transfected Hep-2 cells was tested by RT-PCR. Compared with Hep-2 cells transferred with pcDNA3.1(-), in vitro chemosensitivity of CDglyTK-expressing Hep-2 cells to 5-FC, GCV or 5-FC + GCV was detected by MTT assay.@*RESULT@#The recombinant plasmid contained full-length coding region sequence of CD and TK gene. A anticipated 707 bp fragment was amplified from total RNA of CDglyTK-expressing Hep-2 cells by RT-PCR and a fusion protein of 59 000 was detected in cell extract from transfected Hep-2 cells. In vitro study growth of CDglyTK-positive Hep-2 cells were inhibited by 5-FC, GCV or 5-FC + GCV respectively, and the antitumour effect of 5-FC + GCV is superior to 5-FC or GCV.@*CONCLUSION@#CDglyTK may be a candidate for treating human laryngeal cancer.

Identification of AP1 cis-element and transcriptional effect on cytokeratin 13 gene expression / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify the type of CTGAATCA from -nt.199 to -nt.192 of the cytokeratin 13(CK13) gene 5' flanking region and determine its transcriptional effect on CK13 gene expression.</p><p><b>METHODS</b>The CAT systems were used to assess the effects of different motifs of CK13 gene 5' flanking region on transcription. The clones of pCAT-enhancer with the total length, -nt.207 to +nt.63 and the same length of -nt.207 to +nt.63, but the T, G of -nt.198, -nt.197 being changed to A, T of the CK13 gene 5' flanking region, were constructed and transferred to HeLa cells with the help of lipofectin. Then work was done to detect the instant CAT expression of different clones and evaluate the effects of CTGAATCA of the 5' flanking region on CK13 gene expression. The type of the cis-element of CTGAATCA was identified with electrophoretic mobility shift assay (EMSA) and competition-EMSA.</p><p><b>RESULTS</b>CTGAATCA in the CK13 gene 5' flanking region is an AP1 cis-element by EMSA and competition-EMSA, it promotes CK13 gene expression.</p><p><b>CONCLUSION</b>CTGAATCA from -nt.199 to nt.192 of the CK13 gene 5' flanking region is an AP1 reaction element, not a cAMP reaction element. It promotes transcriptional activity of CK13 gene 5' flanking region.</p>

MDM2 gene expression in nasopharyngeal carcinoma and its relationship with p53 protein expression and EB virus latent infection / 临床耳鼻咽喉头颈外科杂志

Objective:To define the expression levels of MDM2 gene in nasopharyngeal carcinoma (NPC)and its relationship with p53 protein expression and EB virus latent infection. Method :MDM2 gene expression atmRNA and protein levels,p53 protein and EB virus DNA were detected by nonradioactive in situ hybridization(ISH) ,immunohistochemistry(IHC) and polymerase chain reaction (PCR) separately in 46 cases of NPC tissuesand 12 cases of chronic inflammation of nasopharyngeal epithelium (CINE). Result: Fourteen cases of NPCshowed MDM2 mRNA and protein overexpression, 38 cases were p53 protein positive,and 43 cases were EBV-DNA positive. Neither MDM2 nor p53 protein was expressed in any case of CINE. MDM2 expression was signifi-cantly related to p53 protein expression ( P ＜0. 05), but not to EB virus latent infection in NPC. Conclusion:MDM2 gene may play an important role in the pathogenesis of NPC through interacting with p53 protein.