The effect of endoscopic sinus surgery on pulmonary function of chronic rhinosinusitis patients with asthma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the effection of the pulmonary function of patients of chronic rhinosinusitis (CRS) with asthma which treated with endoscopic sinus surgery (ESS) based comprehensive treatment.@*METHOD@#There were 50 cases of chronic rhinosinusitis with asthma whom met the study criteria. 35 cases enrolled in the tri al group, which treated with endoscopic sinus surgery, and routine perioperative tratment. Another 15 cases as control group which underwent conservative treatment. Both groups underwent the rule treatment of asthma. The main monitoring indexes, which included visual analogue scale (VAS) score, endoscopic Lund-Kennedy score, control of asthma symptoms, the pulmonary function which involved forced expiratory volume in first second (FEV1), forced vital capacity (FVC), the ratio of forced expiratory volume in first second and forced vital capacity (FEV1/FVC) and peak expiratory flow (PEF), were measured in the patients of each groups before surgery, follow-up for 1 year and 3-year.@*RESULT@#Our study found that the VAS score of CRS with asthma was significantly negatively correlated with FEV1 and PEF (P < 0.05), endoscopic Lund-Kennedy score was significantly negatively correlated with PEF (P < 0.05); After the trial group underwent ESS based comprehensive treatment, the improvement of VAS score and endoscopic Lund-Kennedy score of postoperative compared with preoperative and the same period in the control group were significantly (P < 0.05). The difference of the postoperative asthma control rate of trial group after 1 year and after 3 years, respectively, compared with the same period control group were statistically significant (P < 0.05). The preoperative FEV1, FVC, FEV1/FVC and PEF of trial group compared with preoperative were significantly (P < 0.05). Even the difference of them compared with the same period control group were significantly (P < 0.05), except the FVC in the follow-up 3 years (P = 0.088).@*CONCLUSION@#The CRS may aggravate asthma symptoms and affect negatively the pulmonary function, and poor asthma control or aggravate may exacerbate the CRS in the course of CRS with asthma patient. With ESS based on combined therapy, it can improve the condition of CRS significantly and improve the control of asthma symptoms and pulmonary function else.

Fas/APO-1, Caspase-3 and apoptosis of human middle ear cholesteatoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the expressions and significance of Fas/APO-1 protein and caspase-3 in human middle ear cholesteatoma and to investigate the relationship between their expressions and the apoptosis of cholesteatoma. METHODS The specimens from the middle ear cholesteatoma tissue of 20 cases and external ear skin of 10 cases were examined by immunohistochemical SP method and TUNEL method. RESULTS There was a significant difference in the expressions of Fas/APO-1 and caspase-3 positive cells between choleseatoma epithelium and normal external ear canal skin(P

Management of cerebral ischemia due to Takayasu's arteritis / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To explore the management of cerebral ischemia caused by Takayasu's arteritis.</p><p><b>METHODS</b>Ninety-three cases treated from June 1984 to September 1999 at the General Post & Telecom Hospital, the Sir Run Run Shaw Hospital, the First Affiliated Hospital of Zhejiang University, the Second Medical College of Beijing University, Beijing An Zhen Hospital, and the Beijing Union Medical College Hospital, including 10 men and 83 women, were reviewed. Of the 93 cases, bypasses from the ascending aorta to the axillary or subclavian artery and from graft to the carotid artery were performed in 47 cases. Subclavian to carotid bypass was performed in six cases. Percutaneous transluminal angioplasty (PTA) was used in five cases and stenting in one.</p><p><b>RESULTS</b>Marked improvement was achieved in 30.3%, fair in 34.9%, improvement in 21.2%, unchanged in 4.6%, and death in 9.0% before discharge; 30.6%, 38.8%, 16.3%, 4.1%, and 2.0% respectively during a mean follow-up of 48 months, and recurrence requiring revision in 8.2%.</p><p><b>CONCLUSION</b>Patients with occlusive lesions of all four cervical arteries always have severe cerebral ischemia and their distal runoff is always unvisualised by angiography. However, we found by exploration that the internal carotid artery is patent in all but one patient. Therefore, an ascending aorta to carotid bypass is feasible in most instances, and this can and should be done when the cerebral perfusion is jeopardized at a time when the patient is in a stable or relatively stable condition. Unfortunately, the cerebral re-perfusion syndrome is still a serious and not completely solved problem.</p>