Correlation analysis between Dx-pH monitoring and proton pump inhibitor test in the diagnosis of laryngopharyngeal reflux disease / 中华耳鼻咽喉头颈外科杂志

Objective@#The consistency of 24-hour oropharyngeal Dx-pH monitoring and proton pump inhibitor(PPI) test in the diagnosis of laryngopharyngeal reflux disease (LPRD) was investigated.@*Methods@#Sixty patients with laryngopharyngeal reflux (LPR) related symptoms who had never received PPI treatment were assessed by reflux symptom index (RSI) and reflux finding score (RFS) between October 2017 and October 2018, including 28 males and 38 females, aged from 16 to 72 years, with a medium age of 38 years. Prior to treatment, all patients were evaluated with 24 hours oropharyngeal Dx-pH monitoring(Restech). After empiric therapy with PPI twice-daily for 8 weeks, the efficacy was evaluated according to posttreatment RSI score.The data was analysed with Kruskal-Wallis test, Student Newman Keuls test and consistency check.@*Results@#(1)Among all 60 patients,13 patients (21.7%) had pathologic Ryan score and all resulted responsive to PPI;27 patients (45.0%) with a negative Ryan score were unresponsive to PPI; 20 patients (33.3%) despite a negative Ryan score resulted responsive to PPI therapy. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of Ryan score were 39.4%, 100%, 100% and 57.4% respectively. The Kappa value was 0.369 (P<0.01). (2)Among 34 patients (56.7%) with positive Dx-pH results (24-hour oropharyngeal acid reflux events≥ 3 times), 29 patients were positive and 5 patients were negative in PPI test. Among 26 patients with negative Dx-pH results (24-hour oropharyngeal acid reflux events<3 times), 4 patients were positive and 22 patients were negative in PPI test. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of 24-hour oropharyngeal acid reflux events were 87.9%, 81.5%, 85.3% and 84.6% respectively. The Kappa value was 0.696(P<0.01).@*Conclusions@#There is a positive correlation between 24-hour oropharyngeal Dx-pH monitoring positive results (24-hour oropharyngeal acid reflux events≥3 times) and PPI test in the diagnosis of LPRD. The 24-hour oropharyngeal Dx-pH monitoring can be a promising tool for the diagnosis of suspected LPRD patients, and more sensitive and accurate Dx-pH diagnostic index will be required in the clinic.

Expression and clinical significance of CK4, CK13 in sinonasal squamous cell carcinoma / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo investigate the expression of cytokeratin (CK) 4 and 13 in sinonasal squamous cell carcinoma (SNSCC) and their pathobiological implications for tumor angiogenesis and metastasis. METHODSThe expression of CK4 and CK13 was detected by immunohistochemistry in normal and cancerous tissues in 42 cases of SNSCC, integral optical density (A) was measured by computer analysis of images and analyzed by SPSS13.0.RESULTSCK4 and CK13 were expressed significantly higher in normal tissues than in cancerous tissues of SNSCC. Moreover, the expression level of CK4 and CK13 was related to the differentiation of SNSCC, which was higher in the well/middle differentiated ones than in poor ones. The expression of CK4 was significantly associated with the tumor size, clinical stage and cervical lymphatic metastasis in SNSCC. While CK13 had no relationship with these three factors.CONCLUSIONThe detection of CK-4 and CK-13 might play an important role in the prognostic evaluation of SNSCC.

Onset time and efficacy of sublingual immunotherapy with Dermatophagoides farinae drops in children with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the onset time and efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in children with house dust mites (HDM)-induced allergic rhinitis (AR).</p><p><b>METHODS</b>One hundred and forty three children with perennial moderate to severe HDM-induced AR were treated by SLIT with standardized Dermatophagoides farinae extract. One hundred children who finally completed two years treatment were divided into two groups according to the age: younger children group (aged 4-8 years, n = 52) and older children group (aged 9-14 years, n = 48). Respectively, Each children was assessed before and after 1st, 2nd, 3rd, 6th, 12th, 24th months of the treatment. Total nasal symptom score (TNSS), total medication score (TMS) and visual analogue scale (VAS) were evaluated at each visit. All clinical data were analyzed retrospectively with the SPSS 19.0 software.</p><p><b>RESULTS</b>TNSS, TMS and VAS of two groups decreased significantly after three months of the treatment compared with before (younger children group: Z value was -3.843, -3.534, -3.940, older children group: Z value was -3.938, -3.405, -3.953, all P < 0.05). TNSS and VAS of younger children group decreased significantly after two months of the treatment compared with before (6.4 ± 1.6, 5.3 ± 1.4 vs 8.6 ± 1.2, 7.9 ± 1.6, Z value was -3.843, -3.940, both P < 0.05). Five children (5%) experienced local adverse events and 2 children (2%) experienced mild systemic adverse events. No severe adverse events happened during the treatment.</p><p><b>CONCLUSIONS</b>SLIT with Dermatophagoides farinae drops is an efficient and safe treatment for children with HDM-induced AR. Its onset of action can be observed as early as 3 months after treatment.</p>

Application of the medial plantar flap on repairing the medial ankle and foot soft tissue defects / 中国综合临床

Objective To investigate the application and clinical significance of the medial plantar flap on repairing the medial ankle and foot soft tissue defects. Methods A total of 13 patients with the medial ankle and foot soft tissue defects were repaired by the local transferred medial plantar flap alone or in combination with sural neurovascular flap transplantation in the Yuebei People's Hospital Affiliated to the Medical College of the Shantou University from Jun. 2006 to Dec. 2012. Results All patients were followed-up of 4-21 weeks,and the average follow-up periods were 6. 3 weeks. All of the skin and soft tissue defects of the medial ankle and foot were repaired,and there were 2 cases of partial necrosis of flap were repaired after tow times skin grafting operation,and all cases without complications of wound infection or iatrogenic nerve injury. Conclusion The medial plantar flap on treating ipsilateral medial malleolus and foot skin and soft tissue defects is useful and effective with less complications,satisfactory effects,intact the ankle flexor and extensor device,allowing early functional exercise,good functional recovery.

Control study between behavioral and pathological findings of the transected spinal cord model in rats / 中国组织工程研究

BACKGROUND:Ideal models of spinal cord injury should simulate human spinal cord injury, exclude confounding factors affecting effects, and have extensive repeatability. Spinal cord transection model is an ideal choice at present. Nevertheless, the operation is diverse, so therapeutic effects have great differences, and the research results lack of comparability. OBJECTIVE:To compare and analyze behavioral changes and pathological features of rat hindlimb after spinal cord transection by establishing standardized model of transected spinal cord in rats. METHODS:A total of 60 adult female Sprague-Dawley rats were randomly divided into sham surgery group (n=12), conventional spinal cord transection group (n=24) and microscopic spinal cord transection group (n=24). Each group was randomly assigned to 7-day, 14-day and 28-day groups according to time points after model establishment. T9 vertebrae were considered as a center. Sham surgery group underwent laminectomy. Other groups underwent spinal cord transection. Thus, models of acute spinal cord injury were induced. Models in the conventional spinal cord transection group were established by conventional surgical methods. Models in the microscopic spinal cord transection group were established by standardization micromanipulation technique. At 7, 14 and 28 days after model establishment, motor function of hindlimb was evaluated using Basso, Beattie and Bresnahan (BBB) scoring system. Histopathology of transected spinal cord was observed. The thickness of the glial scar, the longitudinal distance between the two stumps, the transverse diameter of the spinal cord cavity and cerebrospinal fluid cyst formation were measured at the transected site of the spinal cord. RESULTS AND CONCLUSION:In the sham surgery group, preoperative and postoperative BBB scores and pathology of the spinal cord did not clearly change. In the conventional spinal cord transection group and microscopic spinal cord transection group, complete paralysis of hindlimb was detected after model establishment. Hindlimb function did not recover in the conventional spinal cord transection group. At 1 to 2 weeks after model induction, spontaneous recovery of hindlimb function was visible in rats of the microscopic spinal cord transection group. Spinal pathology index value was significantly lower in the microscopic spinal cord transection group than in the conventional spinal cord transection group (P<0.01). Pathological observations were not correlated with BBB scores in each group. These data indicated that standardized spinal cord transection method helps to eliminate individual differences and to quantitatively analyze and to compare studies addressing therapeutic effects.

Study the influence of pre-hospital emergency professional technology for nerve function, disability rate and mortality in the critically injured patients / 中国医师进修杂志

Objective To study the influence of pre-hospital emergency professional technology for nerve function,disability rate and mortality in the critically injured patients.Methods One hundred critically injured patients were selected as pre-hospital group,100 critically injured patients who immediately went to hospital emergency department were selected as hospital group.The Glasgow coma score,shock index,trauma index,mortality were compared between the 2 groups.Resuts There was no statistical difference in Glasgow coma score at 12 h after treatment between the 2 groups (P ＞ 0.05),Glasgow coma score at 24 h after treatment in pre-hospital group was significantly higher than that in hospital group [(13.9 ± 3.6) scores vs.(11.9 ± 4.8) scores],there was statistical difference (P ＜ 0.05).The trauma index at 12,24 h after treatment in pre-hospital group were significantly lower than those in hospital group (12.1 ± 5.1 vs.14.6 ± 4.8,11.9 ± 4.6 vs.14.3 ± 3.8),there were statistical differences (P ＜ 0.05).There were no statistical differences in shock index at 12 and 24 h after treatment and mortality (P ＞0.05).Conclusion Pre-hospital emergency professional technology has important the role for the treatment of critically injured patients.

Clinical characteristics of benign paroxysmal positional vertigo secondary to sudden deafness / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To retrospectively analyze the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) secondary to the sudden deafness (SD) and to explore pathogenetic mechanism.@*METHOD@#One hundred and seventy-eight cases of the SD in our department were retrospectively analyzed. They were all treated under the guidance of clinical guidelines.@*RESULT@#(1) In all these patient's with SD, there were 31 cases with BPPV secondary to the SD. There were 26 cases of BPPV of posterior semicircular canal and 5 cases of BPPV of lateral BPPV semicircular canal. All patients with BPPV were diagnosed as the same ears as the SD, including 16 cases on left sides and 15 on right sides. (2) The interval between the onset of SD and BPPV was less than one week in 27 cases, between one week and one month in 3 cases, and between one and three months in 1 case. (3) All patients with BPPV secondary to the SD were cured with Epley maneuver or Barbecue roll maneuver.@*CONCLUSION@#The occurrence of BPPV may follow SD, and the major of BPPV secondary to the SD occurs in the posterior semicircular canal. The canalith repositioning is an effective therapy to the secondary BPPV.

Functional evaluation of human umbilical cord blood mesenchymal stem cell transplantation for spinal cord injury in rats / 中国组织工程研究

BACKGROUND: Basso, beattie and bresnahan (BBB) score and tilt table test are associated with the height of spinal cord injury degree in study of spinal cord models. OBJECTIVE: To establish modified complete spinal cord transected rat models, and to observe effects of BBB score and tilt table test on function following human umbilical cord blood mesenchymal stem cell transplantation. DESIGN, TIME AND SETTING: The observation control experiments were performed at the Key Laboratory of Tissue Construction and Detection of Guangdong Province from April 2007 to July 2008. MATERIALS: Cord blood was collected from healthy puerperants after full-term delivery. Fifty SPF healthy adult female Sprague Dawley rats were randomly divided into group A (sham operation) (n=10), group B (spinal cord transection and phosphate buffered saline, PBS injection) (n=20), group C (spinal cord transection and hMSCs transplantation) (n=20). METHODS: Human umbilical cord blood stem cells were harvested and cultured in vitro. After incising rat dural sac, arachnoid membrane, spinal cord, bilateral wall and ventral dura mater of spinal cord were completely incised in the dural mate of spinal cord to establish complete spinal cord transected rat models. Vertebral plates were only opened in the group A. Rats in the group C were injected with human umbilical cord blood mesenchymal stem cells (6?109 -7?109L-1) at two broken ends of fractured spinal cord. Phosphate buffer saline was injected into rats in the group B. MAIN OUTCOME MEASURES: At 12 weeks after surgery, a behavioral testing was performed every 2 weeks upon each hindlimb for all animals by using the BBB scoring system and tilt table test. RESULTS: No significant difference in hindlimb motor function was detected in the group A. From the second weeks after surgery, motor function of hindlimbs was gradually recovered in the groups B and C. BBB scoring system and tilt table test showed a consistent increasing tendency in a positive correlation. From the fourth week after surgery, significant difference in tilt table test was detected between rats with BBB score

Micromanipulation used in surgical procedure of transected spinal cord treated with umbilical cord blood stem cells grafts in rats / 中国矫形外科杂志

[Objective]To establish effective and reliable complete spinal cord transection models in rats,and to investigate the effects of micromanipulation used in surgical procedure of transected spinal cord treated with human umbilical cord blood stem cells(UCBSCs) grafts in rats.[Method]Human UCBSCs were obtained from umbilical cord blood of term deliveries.Sixty Sprague-Dawley(SD) female rats were divided randomly into group A(control group),group B(spinal cord transection and PBS injection),group C(spinal cord transection and UCBSCs transplantation) and group D(spinal cord transection and UCBSCs transplantation by using micromanipulation).All groups were operated,and 1 ?l UCBSCs(6?109/L ~7?109/L) were injected into the both ends of the completely transected spinal cord at the groups C and D by two different surgical procedures respectively.From 1 week to 8 week post-operation,a behavioral testing was performed weekly upon each hindlimb for all animals according to the BBB scoring system.At the 8th week,all animals were sacrificed and the spinal cords were taken out for morphological observation.[Result]No changes were observed at group A pre-and post-operation.After 2 weeks post-operation,the hindlimb motor function of groups C and D began to recover.After 3 weeks post-operation,the group D showed more improvement than group C,and the difference between groups D and C were significant in the BBB scores(P

Blood-gas and morphology study of functional pulmonary lobectomy on dogs / 中华胸心血管外科杂志

Objective To investigate the feasibility of the functional pulmonary lobectomy (FPLT) by studying the blood-gas and morphology of the FPLT model. Methods 18 healthy dogs were divided into three groups randomly: Group A (n=6): the target bronchus and lung bubbles were filled with emulsion of iodine oil and pingyangmycin(PYM)and then target bronchus was occluded with polymethylmethacrylate(PMMA).Group B (n=6): the target bronchus was only occluded with PMMA and Group C (n=6): the target pulmonary lobe was resected. Artery blood gas were measured at the time of pre-operation and post-operation immediately and then 1st, 2nd, 3rd and 4th week after operation respectively. Chest radiolography and histology and bacterial culture of tissue of target lung lobe were made after 4 weeks. Results There was a significant difference in artery blood-gas among 3 groups pre-operation compared with post-operation immediately (P0.05) compared with 1st, 2nd, 3rd and 4th week after operation. It showed atelectasis radiologically and fibrosis of target lung lobe histologically and no bacterium grew in target tissue the 4th week after operation. There were 3 cases of lung atelectasises but no pulmonary fibrosis in group B. Conclusion FPLT may be obtained after the target bronchus and lung bubbles were filled with emulsion of iodine oil and PYM and then target bronchus were occluded.FPLT is a minimal invasive, safe and effective procedure and might partially replace the surgical pulmonary lobectomy in future.