Experience of diagnosis and treatment for congenital pyriform sinus fistula / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the imaging features, clinical presentation, operative methods complication and the surgical outcomes of the congenital pyriform sinus fistula(CPSF). @*Methods@#The clinical data of 185 patients with CPSF treated from January 2013 to October 2017 at the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. @*Results@#The lesions were predominantly on the left side(170/185). Among 185 cases, 146 cases received endoscopic coblation cauterization, 27 cases had traditional open surgery, 8 cases underwent endoscopic coblation cauterization plus traditional open surgery, 2 cases for endoscopic chemocauterization, and 2 cases for endoscopic electrosection. Twenty-eight cases recurred, with a recurrence rate of 15.1%. Postoperative hoarseness occurred in 22 cases, disappeared within 0.5-6.0 months later. @*Conclusions@#Patients with a history of recurrent cervical abscess should be highly suspect the existence of CPSF. Endoscopic coblation cauterization is a kind of surgical method with minimal injury, with low recurrence rate and low operative risk.

Research on risk factors of depression symptoms in 1 327 patients with obstructive sleep apnea-hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the comorbidity rate of depression symptoms in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) in Henan province and to ascertain the risk factors.</p><p><b>METHODS</b>One thousand three hundred and twenty-seven patients with OSAHS determined by overnight polysomnogram (PSG) were enrolled in this study. After screening the Symptom Checklist 90 (SCL-90) and Self-rating Depression Scale (SDS), the patients were divided into two groups: OSAHS (control group, n = 698) and OSAHS+depression (n = 629). The correlation was explored between the depression symptoms in patients with OSAHS and the sociodemographic variables and health status including smoking, drinking, marital status, apnea hyponea index (AHI), anoxicity, Family Burden Scale of Disease (FBS), Family APGAR Index (APGAR), Perceived Social Support Scale (PSSS) and so on. Furthermore, In-depth analyses were carried out between the depression symptoms in patients with OSAHS and the social and family factor items (FBS, APGAR and PSSS).</p><p><b>RESULTS</b>The comorbidity rate of depression symptoms in patients with OSAHS in Henan province was 47.4%, and was correlated with the gender, marital status, FBS, APGAR, AHI, PSSS and anoxicity. Logistic regression analysis indicated that single marital status, APGAR, AHI, PSSS, hypoxemia and heart disease were all independent risk factors for depression in OSAHS patients. The total of the FBS score and three of its subfactors scores (family daily activities, family relationships and mental health of family members) were higher, and the total of the APGAR score and two of its subfactors scores (adaptabilith and affection) were lower in OSAHS with depression compared with the control group (P < 0.05). Besides, the total score for the PSSS AND Scores for its two subfactors (family support and social support) were all lower in OSAHS patients with depression than those of the control group (P < 0.05).</p><p><b>CONCLUSION</b>In patients with OSAHS, depression symptoms are common and are associated with marital status, AHI, anoxicity, concomitant diseases (hypertension, heart disease), concerns and supports from the family and society.</p>

NRP-1/shRNA silencing suppresses nasopharyngeal carcinoma cell growth in vitro and in vivo / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of RNA interference (RNAi) targeting NRP-1 gene on the growth and proliferation of nasopharyngeal carcinoma (NPC) CNE-2Z cells.</p><p><b>METHODS</b>Short hairpin RNA (shRNA) plasmids targeting NRP-1 were designed and synthesized. These plasmids were respectively transfected into human NPC CNE-2Z cells and xenograft tumors in nude mice. The expressions of Fluorescein-labeled plasmids in NPC CNE-2Z cells and xenograft tumors were observed by fluorescence microscopy. Cell proliferation was detected by MTT assay. The inhibitory effects on target genes were evaluated with RT-PCR and Western blotting, respectively. The inhibitory effect of plasmids with the most effective sequence on xenograft tumors in nude mice was observed.</p><p><b>RESULTS</b>CNE-2Z cell proliferation was significantly inhibited by NRP-1/shRNA silencing. RT-PCR showed NRP-1 mRNA expression was significantly decreased. Western blotting demonstrated the NRP-1/shRNA silencing can effectively inhibit the expression of target proteins in CNE-2Z cells. After six weeks, there were significant differences in the mean tumor volumes in nude mice between plasmid group and negative control group [(0.599±0.002) vs (1.141±0.013) cm(3), P<0.05] or blank control group [(0.599±0.002) vs (1.165±0.308) cm(3), P<0.05], and the inhibitory rate of tumor growth was 48.6%.</p><p><b>CONCLUSION</b>RNA interference targeting NRP-1 can remarkably inhibit the growth of CNE-2Z cells in vitro and in vivo.</p>

Two cases of neck region Kimura's disease / 临床耳鼻咽喉头颈外科杂志

Kimura's disease is a rare, benign, slow-growing chronic inflammatory swelling with a predilection for the head and neck region and is almost always with peripheral blood eosinophilia and elevated serum IgE levels. It is endemic in Asian males and rare in Western people. Surgical excision of the lesion is the first line therapy. Drug and radiation therapy have to be considered for the refractory lesions.

Correlation of Rab coupling protein expression with clinicopathological characteristics and prognosis in laryngeal squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the RCP protein expression and its clinicopathological significance in laryngeal squamous cell carcinoma (LSCC).</p><p><b>METHODS</b>RCP protein expression in human head and neck squamous cell carcinoma cell lines (NP-69, Tu686, Tu212, M2 and M4) was analyzed by Western blotting. Besides, its expression in 87 cases of LSCC, 18 cases of adjacent epithelial mucosa and 16 cases of vocal cord leukoplakia was detected by immunohistochemistry, and their correlation with clinicopathological parameters and patients' outcome was analyzed.</p><p><b>RESULTS</b>The NP-69, Tu212 Tu686, M2 and M4 cells showed a gradual increase in the expression of RCP protein. The average relative expression levels of RCP protein in the NP-69, Tu212, Tu686, M2 and M4 cells were 0.05±0.01, 0.38±0.05, 0.63±0.02, 0.84±0.06 and 0.96±0.04, respectively. The same situation occurred in the adjacent mucosa, vocal cord leukoplakia and LSCC. Specifically, only 3 of 18 adjacent mucosa showed a low RCP expression (scored 0-2). Although the 16 cases of vocal cord leukoplakia had a low RCP expression, all their scores ranged from 0 to 3. While in the LSCC specimens, 59 (67.8%) cases demonstrated a high RCP expression (scored 8-15), 18 cases showed a lower RCP expression (scored 4-7), and only 10 cases were scored 2-3. Among the 87 LSCC cases, there were 28 cases (32.2%) of low RCP expression and 59 cases of high RCP expression. All the 18 cases of cancer-adjacent tissues and 16 cases of vocal cord leukoplakia were of low RCP expression. RCP overexpression was significantly associated with T classification, clinical staging, lymph node metastasis and recurrence (P<0.05 for all). Survival analysis revealed that the 5-year survival rate was 40.0% in the patients with high RCP expression and 75.0% in the patients with low RCP expression, the tumor-free 5-year survival rate was 30.7% and 64.0%, respectively, both showing a significant difference between the two subgroups (P<0.05). Univariate analysis revealed that alcohol history; smoking, T classification, clinical staging, lymph node metastasis and RCP expression were significantly associated with a poor prognosis (P<0.05 for all). The multivariate analysis showed that only recurrence and RCP expression were independent prognostic factors affecting the prognosis for patients with LSCC (P<0.05 for both).</p><p><b>CONCLUSIONS</b>Expression of RCP protein may contribute to the malignant progression of LSCC, and may become a novel marker predicting tumor recurrence, cervical lymph node metastasis and prognosis for patients with laryngeal squamous cell carcinoma.</p>

Expression of glucose-regulated protein 78 in human laryngeal squamous cell carcinoma and its clinical significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of glucose-regulated protein78 (GRP78) in human laryngeal squamous cell carcinoma,and to evaluate its role in the development progress of human laryngeal squamous cell carcinoma.@*METHOD@#The expressions of GRP78 in human laryngeal squamous cell carcinoma, matched pair pericarcinomatous tissue and normal laryngeal squamous epithelial tissue from 90 patients were detected using immunohistochemistry analysis. In addition, the relationship between GRP78 expression and clinical parameters of patients, such as gender, tumor differentiation grade stage, and lymphatic metastasis was analyzed.@*RESULT@#The positive ratio of GRP78 expression in LSCC, matched pair pericarcinomatous tissue and normal laryngeal squamous epithelial tissue were 86.67%, 32.22% and 8.89%. The GRP78 expressions in different tissues were significantly different (P 0.05).@*CONCLUSION@#The expression level of GRP78 protein in human laryngeal squamous cell carcinoma is high and its expression is positively associated with the malignancy of carcinoma. The expression of GRP78 protein participates in the development progress of human laryngeal squamous cell carcinoma.

Diagnosis and treatment of the primary cricopharyngeal achalasia / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To summarize the diagnostic and therapeutic experience of primary cricopharyngeal achalasia and introduce new operandi modus.@*METHOD@#Report the two cases we treated in 2008 and integrate published literature, and approach its diagnostic and therapeutic experience and make use of new operandi modus.@*RESULT@#The diagnosis of primary cricopharyngeal achalasia is difficult, and we must apply exclusive diagnosis according to the examinations of fibrolaryngoscopy, esophagoscopy and barium meal et al.@*CONCLUSION@#Surgical treatment is the best option. Partial resection of cricopharyngeal muscle and upper esophageal ring-shaped muscle is superior to simple cricopharyngeal myotomy.