Relationship between bacterial biofilms and chronic rhinosinusitis by scanning electron microscopic study / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To determine the presence and the morphological features of bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis (CRS) compared with control patients without CRS by scanning electron microscopy (SEM), and to evaluate the role of biofilm on the pathogenesis of CRS.</p><p><b>METHODS</b>Fifteen patients with CRS undergoing endoscopic sinus surgery and 11 control patients with fracture of nasal bone were enrolled in this study. Clinical information was recorded from each patient. All patients underwent a thorough otolaryngological examination, preoperative paranasal sinus computerized tomography (CT) scanning which were evaluated according to the Lund-Mckay CT scoring system. All the samples including uncinate process, ethmoid mucosa from CRS group and uncinate process, ethmoid bulla from control group were prepared using standard methods for SEM. The presence of bacterial biofilms on the samples of two groups was observed by SEM. Statistical analysis was performed using SPSS 13.0. Continuous data was analyzed by Student t test and dichotomous data was analyzed by chi² or Fisher exact test. P was considered to be significant at a level of 0.05.</p><p><b>RESULTS</b>Nine (60.0%) of the 15 patients were found to have evidence of biofilms. In control group, only 1 (9.1%) of 11 patients had biofilm. The difference was statistical significant (chi² = 6.949, P < 0.01). All controls except one had healthy appearing cilia and goblet cells without biofilms. All the 16 CRS patients showed aberrant findings of the mucosal surface with variation in degrees of severity from disarrayed cilia to complete absence of cilia and goblet cells. Among them the typical morphologic feature such as water channels, 3-D structure, and matrix-embedding spherical or elliptical bodies were noted in 9 cases. Five samples including one case from control showed cilia aggregation. The preoperative CT scores of the CRS patients with biofilms (n = 9) were significantly higher than those without biofilms (n = 6, t = 2.14, P < 0.05).</p><p><b>CONCLUSIONS</b>The typical morphologic feature of BF such as water channels, 3-D structure, and matrix-embedding spherical or elliptical bodies were noted in sinus mucosa of patients with CRS by the SEM. The positive rate of bacterial biofilms in CRS group was significantly higher compared to control group, which indicated bacterial biofilms might play an important role in the pathogenesis of CRS. Besides the typical bacterial biofilm features, cilia aggregation was found in five cases of CRS patients. We consider cilia aggregation can be regarded as one morphologic feature of bacterial biofilm in nasal mucosa, which needs further study. The presence of bacterial biofilms in CRS patients is associated with paranasal CT scores, which indicates that bacterial biofilm is correlated with the severity of CRS.</p>

Serum ECP levels in patients with allergic rhinitis and chronic rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the serum eosinophil cationic protein (ECP) levels in patients with allergic rhinitis (AR) or chronic rhinosinusitis with polyps(CRSWP), and its relations with allergic symptoms in patients with AR.</p><p><b>METHODS</b>The ECP in serum and Phadiatop tests were detected by UniCAP100 system. Blood sample was taken from 87 patients with inhaled AR, 49 patients with CRSWP and 20 healthy individuals. The serum ECP levels were detected by enzyme-linked immunosorbent assay. The allergic symptoms in patients with inhaled AR were graded.</p><p><b>RESULTS</b>Phadiatop level was 5185.0 [983.0, 14469.0] Fu in inhaled AR, 317.5 [125.0, 526.8] Fu in CRSWP with Phadiatop positive, 30.0 [28.0, 43.0] Fu in CRSWP with Phadiatop negative and 43.5 [29.0, 105.0] Fu in healthy individuals. The level of ECP in patients with inhaled AR was 24.8 [14.6, 49.1] microg/L, higher than that in CRSWP with Phadiatop positive 7.7 [3.3, 25.6] microg/L, CRSWP with Phadiatop negative 12.5 [6.7, 16.7] microg/L and control 8.8 [5.4, 20.2] microg/L. The difference was significant. There were correlations among the allergic symptoms, serum ECP and Phadiatop levels.</p><p><b>CONCLUSIONS</b>Among patients with inhaled AR, there was an up-regulated concentration of serum ECP, which had relations to allergic symptoms. The detection of serum ECP could be used as a convenient screening test for inhaled AR. Its concentration had correlation with the severity and prognosis of the disease. To the contrary, the serum ECP did not significantly increased in patients with CRSWP.</p>

Treatment of allergic rhinitis with nasal mometasone furoate / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the effects of nasal mometasone furoate on moderate to severe allergic rhinitis.</p><p><b>METHODS</b>Patients with moderate to severe allergic rhinitis were enrolled and received mometasone furoate nasal spray 200 microg once daily for four weeks. Four hundreds and sixty-three patients completed the study. We weekly interviewed the patients to evaluate the symptoms, and the affection of disease on night sleep and daily life. Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life.</p><p><b>RESULTS</b>The individual and total symptomatic scores of week 1, week 2 and week 4 decreased compared with baseline. The scores of Mini-RQLQ and NRQLQ of week 1, week 2 and week 4 decreased compared with baseline too. The scores of the next visit were significantly lower than those of the previous visit (P < 0.01).</p><p><b>CONCLUSIONS</b>A four-week administration of mometasone furoate nasal spray can effectively treat allergic rhinitis.</p>

Experimental study on embryonic neural stem cells transplantation into natural rat cochlea via round window / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the survival of neural stem cell (NSC) infected by recombinant adenovirus with GFP (Ad-GFP) and the expression of GFP in normal rat cochlea and their potential effect on auditory function and cochlea structures via round window transplantation.</p><p><b>METHODS</b>In comparison with the normal rats without any transplantation (Group III), normal rat cochleae were transplanted with NSC infected with Ad-GFP (Group I) or the artificial perilymph (Group II) via round windows. Auditory functions were monitored by thresholds of auditory brain stem responses (ABR); the cochlea structures were examined by HE staining; survivals of implanted NSC were determined by the expression of GFP; survivals of hair cells were accessed by whole mount preparation.</p><p><b>RESULTS</b>Neither at pre-transplantation nor at post-transplantation, there were significant differences in the click-ABR thresholds in rats between Group I and Group II (P > 0.05). There were no significant differences in these values before and after transplantation in the same rats from each group. After transplantation, the cochlea structures were normal in both Group I & Group II. Grafted NSC was visualized by the GFP expression in every turn of the cochlea in all animals of Group I. There were no significant differences in the loss of outer hair cell (OHC) among three groups. The inner hair cell (IHC) and most OHC were normal in every turns of cochleae of all groups.</p><p><b>CONCLUSIONS</b>The embryonic NSC infected with Ad-GFP could survive and express the GFP gene in normal rat cochlea after transplantation via round window, which had not obvious affection to auditory function and inner ear pathology of rat cochlea.</p>

Gene transfer into primary cultures of fetal neural stem cells by a recombinant adenovirus carrying the gene for green fluorescent protein / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To evaluate the transduction efficiency of a recombinant adenovirus carrying the gene for green fluorescent protein (Ad-GFP) into the primary cultures of fetal neural stem cells (NSCs) by the expression of GFP.</p><p><b>METHODS</b>The Ad-GFP was constructed by homologous recombination in bacteria with the AdEasy system; NSCs were isolated from rat fetal hippocampus and cultured as neurosphere suspensions. After infection with the recombinant Ad-GFP, NSCs were examined with a fluorescent microscopy and a flow cytometry for their expression of GFP.</p><p><b>RESULTS</b>After the viral infection, flow cytometry analysis revealed that the percentage of GFP-positive cells was as high as 97.05%. The infected NSCs sustained the GFP expression for above 4 weeks. After differentiated into astrocytes or neurons, they continued to express GFP efficiently.</p><p><b>CONCLUSION</b>We have successfully constructed a viral vector Ad-GFP that can efficiently infect the primary NSCs. The reporter gene was showed fully and sustained expression in the infected cells as well as their differentiated progenies.</p>

Clinical significance of angiopoietin-2 expression in oral squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of angiopoietin-2 (Ang-2) and its clinical significance in oral squamous cell carcinoma.</p><p><b>METHODS</b>The expression of Ang-2 mRNA was measured by real-time RT-PCR, and the expression of Ang-2 protein in tissue samples was detected by immunohistochemical staining.</p><p><b>RESULTS</b>The mean dCt value of Ang-2 mRNA expression in the cancer tissue was 6.86 +/- 1.37, significantly lower than that in the paired adjacent non-cancerous tissue (7.95 +/- 2.08, P < 0.05), indicating a significantly higher expression of Ang-2 mRNA in the cancerous tissue than that in the adjacent non-cancerous tissue. The distribution of Ang-2 protein was found not only in the vascular endothelial cells but also in tumor cells. Semi-quantitative analysis revealed that the expression of Ang-2 protein in tumor specimens (53.6%) was significantly higher than that (24.0%) in the paired adjacent non-cancerous tissue (P < 0.05), the result was well consistent with that measured by RT-PCR. The dCt value of Ang-2 mRNA expression was 6.48 +/- 1.16 in the patients with metastasis in lymph nodes versus 7.16 +/- 1.49 in those without, with a non-significant difference between the two groups (P > 0.05). As regards the clinical stages, no significant difference was found between the expressions of Ang-2 mRNA in stage I + II (7.11 +/- 1.63) and stage III + IV cases (6.49 +/- 1.10, P > 0.05).</p><p><b>CONCLUSION</b>Angiopoietin-2 protein is expressed not only in vascular endothelial cells, but also in tumor cells, suggesting that angiopoietin-2 may take part in angiogenesis in oral squamous cell carcinoma. However, our results that high expression of angiopoietin-2 mRNA is not correlated with lymph node metastasis and clinical stages, needs to be further verified in a large scale study.</p>

Transnasal endoscopic repair of acquired posterior choanal stenosis and atresia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There are congenital and acquired choanal atresias and many approaches have been used for their repair. We assessed the clinical effect of power instrument, endoscopic repair of acquired choanal stenosis and atresia.</p><p><b>METHODS</b>Nineteen patients, aged from 32 to 61 years, with acquired choanal stenosis and atresia (from trauma in 5 cases and from radiotherapy after nasopharyngeal carcinoma in 14; 6 bilateral and 13 unilateral cases), underwent transnasal endoscopic repair of choanal stenosis and atresia. No patient had stenting. Antibiotic and local glucocorticoid were administered postoperatively.</p><p><b>RESULTS</b>Eighteen patients remained free of symptoms for 12 - 40 months after the surgery, and the diameter of the neochoana was more than 1 cm after the procedure. One patient required revision surgery and recovered completely with no restenosis at 12 months after the second surgery. There were no postoperative complications. Histology of the resected tissue revealed respiratory epithelial-lined stromal tissue with chronic inflammation, edema and fibrosis, but no tumor cells.</p><p><b>CONCLUSIONS</b>Transnasal endoscopic approach is a useful procedure for the repair of acquired choanal stenosis and atresia: it is highly successful, safe and effective with swift recovery and short time of hospitalization. It is very important in postoperative care to remove any granulation or polyps at the site of the neochoana at that time.</p>

Self-reported prevalence of allergic rhinitis in eleven cities in China / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The aim of this study is to investigate the self-reported prevalence and other epidemiological characteristics of allergic rhinitis from 11 cities throughout the mainland of China.</p><p><b>METHODS</b>Telephone interviews were conducted in the two main municipalities (Beijing, Shanghai) and eight capital cities (Changsha, Changchun, Hangzhou, Guangzhou, Nanjing, Shenyang, Wuhan, Urumqi and Xi'an) of main provinces throughout the mainland of China after sampling target phone numbers by the approach of random digital dialing (RDD) via computer.</p><p><b>RESULTS</b>In total, the survey had sampled 684 blocks of telephone numbers in 11 cities, and dialed 119 319 telephone numbers. Of the 38 203 respondents, 4253 subjects reported allergic rhinitis, while the other 33 950 were screened negative in the telephone interviews. The self-reported prevalence of allergic rhinitis was lowest in Xi'an (8.0%), and highest in Urumqi (21.4%), with Nanjing having intermediate value (11.5%). The gender-adjusted prevalence ranged from 8.5% in Xi'an to 21.3% in Urumqi, while the age-adjusted prevalence of self-reported allergic rhinitis ranged from 8.7% in Beijing to 24.1% in Urumqi.</p><p><b>CONCLUSIONS</b>The study demonstrates that the self-reported prevalence of allergic rhinitis in 11 cities throughout the mainland of China has wide variations, and the strategy of prevention for allergic rhinitis should be conducted according to the epidemic features of it.</p>