Clinical Characteristics and Endoscopic Endonasal Removal of Foreign Bodies within Sinuses, Orbit, and Skull Base / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Foreign bodies within the sinuses, orbit, and skull base (FBSOS) are rare; hence, diagnosis and management guidelines are lacking. Endoscopic sinus surgery (ESS) removal is preferred because of the less invasiveness and minimal morbidity. This study was designed to summarize clinical experience with ESS management of FBSOS.</p><p><b>METHODS</b>We retrospectively reviewed clinical manifestations, imaging findings, treatment, and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center. The Chi-square test was performed to compare the infection rate between wooden and nonwooden FBSOS.</p><p><b>RESULTS</b>There were 23 male and five female patients, with median age of 11 years. FBSOS were located within the sinuses (86%), orbit (75%), and skull base/intracranial region (46%). Wooden FBSOS had a significantly higher risk of infection (78%) compared with nonwooden FBSOS (5%, P < 0.05). Contrast-enhanced computed tomography (CT) plus three-dimensional reconstruction was sensitive in all cases. Twenty-seven (96%) FBSOS were removed by ESS alone, while 1 (4%) FBSOS was removed using the combined ESS and lateral cervical approach. Four of the nine intracranial penetrating FBSOS patients had intraoperative cerebrospinal fluid (CSF) leak and received endoscopic CSF leak repair. Twelve (43%) patients suffered complications (meningitis, diplopia, and vision loss).</p><p><b>CONCLUSIONS</b>ESS is a minimally invasive, safe, and promising surgical approach for FBSOS removal. Contrast-enhanced CT is effective in preoperative diagnosis and intraoperative guidance. Wooden FBSOS had higher risk of infection, thus antibiotics are recommended.</p>

Inhibition of micro RNA-9 expression promotes UV-induced ROS damage in nasopharyngeal carcinoma cells / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of down-regulated miR-9 expression on ultraviolet rays (UV)-induced reactive oxygen species (ROS) damage in nasopharyngeal carcinoma (NPC) cells.</p><p><b>METHODS</b>The NPC cells were transfected with inhibitors of miR-9 by lipofectamine to decrease the expression of miR-9, and the cells transfected with inhibitor control as the control. ROS levels following UV exposure were examined with DCF-DA method and the concentration of glutathione was analyzed via the benzoic acid method; DNA damage and apoptosis also were evaluated.</p><p><b>RESULTS</b>There was significant difference in ROS levels between miR-9 expression-inhibited cells and control cells (26 895 ± 218 vs 15 765 ± 927, t = 39.754, P < 0.001), and also there were significant differences in DNA damage rates (28.0% ± 10.0% vs 23.6% ± 9.2%) and in apoptosis rates (8.0% ± 0.9% vs 4.5% ± 0.8%) following UV exposure between two groups of cells. The miR-9 expression-inhibited cells showed lower level (1.87 ± 0.15) µmol/L of glutathione compared with the control cells (9.85 ± 0.15) µmol/L (t = -48.832, P < 0.001).</p><p><b>CONCLUSION</b>Inhibition of miR-9 expression promoted UV-induced ROS damage in nasopharyngeal carcinoma cells.</p>

DJ-1 expression in laryngeal squamous cell carcinoma and its relationship with tumor recurrence and metastasis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To detect the expression of DJ-1 in laryngeal squamous cell carcinoma (LSCC) and to study the relationship between DJ-1 expression and clinical indexes of LSCC.</p><p><b>METHODS</b>The expressions of DJ-1 protein in 71 LSCC samples and 9 cases control samples from laryngeal mucosa tissues of non-LSCC patients were detected using streptavidin peroxidase immunohistochemistry staining and the relationships between DJ-1 protein expression and clinicopathologic characteristics were analyzed.</p><p><b>RESULTS</b>(1) The positive expression rate of DJ-1 protein in LSCC was 85.9%(61/71), which was significantly higher than the rate (55.5%, 5/9) in control laryngeal mucosa tissues (P < 0.05). (2) DJ-1 expression was related to tumor recurrence (P < 0.05), but not to sex, age, primary cancer position, T stage, clinical stage, lymph node metastasis and tumor differentiation. Tumor recurrence rate (53.3%) in the patients with higher expression of DJ-1 protein was higher than the rate (26.8%) in the patients with lower expression of DJ-1 protein (χ(2) = 5.164, P < 0.05). (3) With Kaplan-Meier curves and Cox regression analysis, the cumulative 5-year survival rates were correlated with DJ-1 expression levels in laryngeal cancer tissues or cervical lymph node metastasis (all P < 0.05), but not to sex, age, primary cancer position, T stage, clinical stage and tumor differentiation.</p><p><b>CONCLUSIONS</b>The expression of DJ-1 protein in LSCC is higher than that in control laryngeal mucous tissues. Overexpression of DJ-1 is associated with poor overall survival in LSCC patients.</p>

Diagnosis and treatment of traumatic delayed cerebrospinal fluid rhinorrhea / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the etiological factor, diagnostic localization and treatment of delayed cerebrospinal fluid (CSF) rhinorrhea.</p><p><b>METHODS</b>The medical records of 79 patients who had undergone endoscopic repair of CSF rhinorrhea between 2000 and 2008 were reviewed. Thirteen patients with CSF leaks occurred 3 months after head trauma. All 13 patients with delayed CSF leak were retrospectively evaluated with CT or MRI and surgically treated. The operative findings were compared with the results of CT or MRI to estimate the diagnostic value of imaging technique.</p><p><b>RESULTS</b>Bony defects had been found on CT scanning in all 13 patients. Neural tissue herniation into the nasal sinuses was found in 11 patients during the surgery. The sizes of the leak ranged from 0.1 cm x 0.2 cm to 1.2 cm x 1.5 cm. Reconstruction of the skull base was done through endoscopic approach. No complications were found. Thirteen patients were followed up from 12 - 36 months, and none was recurrence.</p><p><b>CONCLUSIONS</b>Herniation of mucosal tissue into the nasal sinuses after skull base defects could result in delayed CSF leak. CT and MRI can clearly show the skull base defects and neural tissue herniation. Endoscopic closure of CSF leaks was both safe and effective.</p>

Ophthalmic complication and management of endoscopic sinus surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the possible reasons and the treating experiences of ophthalmic complications in order to elevate the attention of the nasal endoscopic surgeon.</p><p><b>METHODS</b>This study was involved 8 categories in 22 cases which had typical characteristic of ophthalmic complications of endoscopic sinus surgery, including injury of lamina papyracea, obstructive cyst of frontal and ethmoid sinuses, orbital infection, injuries of lacrimal passages, injury of extraocular muscles, orbital hemorrhage, optic nerve injury and arterial embolism of optic fundi. The patients were given corresponding treatment.</p><p><b>RESULTS</b>Injury of lamina papyracea was cured by medical treatment while orbital infection, injury of lacrimal passages, obstructive cyst of frontal and ethmoid sinuses were completely recovered by endoscopic surgery. In one of the cases, the injured optic nerve had recovered after transnasal optic and orbital apex decompression but the other 6 sides of 6 patients had not been improved. In one case who had suffered from injury of extraocular muscles, their diplopia disappeared mostly, but the other cases had a slight diplopia after surgery. One case who had visual descending caused by orbital hemorrhage recovered. Two cases of visual loss caused by intraorbital hemorrhage and arterial embolism of optic fundi respectively were not improved.</p><p><b>CONCLUSIONS</b>It is very difficult to cure if the patients lose the sight because of optic nerve injury, orbital hemorrhage and the ischemia of orbit, however, if the patients had remnant vision the prognosis should be much better.</p>

Transnasal endoscopic repair of frontal cerebrospinal fluid rhinorrhea / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the surgical approaches, methods and techniques of repair of cerebrospinal fluid (CSF) rhinorrhea via frontal sinus under transnasal endoscopy.</p><p><b>METHODS</b>Cerebrospinal fluid rhinorrhea, located at the posterior wall of the frontal sinus (n = 9) and posterior lateral wall of the frontal recess (n = 4) had been repaired surgically. A transnasal endoscopic approach was chosen in 12 patients and combined approach was used in 1 patient during the first procedure. Three patients needed the second surgery. Among them, one patient needed to repair CSF rhinorrhea, 1 patient needed to treat intracranial abscess of frontal lobe via combined approach and another one was treated because of the complication of frontal cyst.</p><p><b>RESULTS</b>Twelve patients were successfully repaired in the first surgery. Only 1 patient needed second surgery. Two patients occurred complications. One was intracranial infection after surgery, external drainage and packing in the frontal sinus was used. Another was obstructive cyst in frontal sinus, transnasal endoscopic frontal sinusotomy was performed.</p><p><b>CONCLUSIONS</b>CSF rhinorrhea which located at the posterior wall of the frontal sinus can be successfully repaired via transnasal endoscopic approach if the leak was visible under endoscopy. The size of the frontal ostium and leak vantage should be considered to prevent the drainage of the frontal sinus which would result in obstructive cyst in frontal sinus, frontal sinusitis and intracranial infection. Combined approach was suggested to the patients that leakage could not be seen in frontal sinus or frontal ostium was difficult to enlarge.</p>

HLA-DQA1 genotyping by using oligonucleotide microarrays / 中国实验血液学杂志

In order to fabricate the HLA-DQA1 genotyping chip and develop an integrated, parallel technical platform to type HLA system, a pair of primers and a set of probes were designed according to the sequences of HLA-DQA1 exon 2, where the polymorphism is concentrated. The oligonucleotide chip was made with the methods developed in our laboratory. The target DNA was asymmetrically amplified with the labeled sense primer. The signals were scanned and analyzed after the hybridization between microarray and PCR product. The allele types of the samples were identified. The result was verified by the standard DNA and DNA sequencing. The results showed that the genotyping was successfully carried out in 50 standard DNA samples and 50 clinical samples. Among them, results of the 50 standard DNA samples matched their templates. In the other 50 samples, results of the randomly selected 10 matched their sequencing results except that two of them got the incompletely result. In reproducible tests, the signal reappear rate was 95%. It is concluded that HLA-DQA1 genotyping by using our array system is simple and convenient with satisfied accuracy and reproducibility.

Effects of wide band frequency noise on ERK, GDNF and ABR threshold in the different area of brain of AD rats poisoned by glutamatic acid / 中国应用生理学杂志

<p><b>AIM</b>To investigate the change of ERK, GDNF expression activity in temple and frontal lobe of AD rat after 96 dB wide band noise exposure.</p><p><b>METHODS</b>Experimental group SD rats(weight from 150-220 g), either male or female, were randomly assigned to three groups: control (n=10); physiological brine-injected control (n=8); glutamic acid-injected group (n=8) after getting rid of memory loss(indicating "a little memory" and "no memory") rats culled by behavior training. The rats were micro-injected at the stereotaxic device (AP3.2-3.4, L2.0-2.4,H2.8-3.0)by glutamic acid or same volume of physiological brine in the each side of hippocampus CA1. Western Blot and image quantitative analysis technique, combined with auditory brainstem response (ABR) measurement.</p><p><b>RESULTS</b>(1) Expressions of ERK in frontal cortex for control rat are much more than that of other group, which has a obvious up-regulation after being given 96 dB noise. Expression of ERK in temple cortex for 3 groups rat have a increase(plus noise), moreover, they are stronger than expression in frontal cortex for different group. (3) GDNF in frontal cortex for control rat have a higher expression than that of the same group before adding noise (up-regulation). (4) GDNF expression in temple lobe for glutamatic acid group have a remarkable down-regulation trend. (5) Expression of GDNF in frontal for control rat is much less than in temple.</p><p><b>CONCLUSION</b>ERK in frontal cortex for AD model rat have fewer expressions and not being affected by 96 dB noise, but it is reverse in temple. Wide band frequency noise can reduce the expression of GDNF in temple lobe of AD model rat.</p>