[Effects of voice therapy and psychological intervention on anxious and depressive in patients with voice disorders].

Objective:To investigate the expression of miR 34a in epithelial cells of nasal polyps (NPs) and to determine its effects on hypoxia induced epithelial mesenchymal transition (EMT).method:Nasal epithelial cells (NECs) were collected from NPs and normal inferior turbinates. miR-34a expression was detected by means of quantitative reverse transcriptase polymerase chain reaction. In addition, normal NECs were cultured under normoxia/hypoxia conditons. The effects of miR-34a mimics on hypoxia induced EMT were investigated.result:miR-34a was specifically down-regulated in NECs of NP. Hypoxia decreased miR-34a expression in vitro. Furthermore, E-cadherin and α-SMA were down-regulated and up-regulated, respectively. miR-34a mimics transfection can reverse this process.Conclusion:miR-34a suppress hypoxia-induced EMT in NECs. The down-regulation of miR-34a may contribute to nasal polypogenesis.

[High mobility group box1 contributes to hypoxia-induced barrier dysfunction of nasal epithelial cells].

Objective:To investigated the promotion of high mobility group box1 (HMGB1) under hypoxia, and determined the regulatory role of HMGB1 on the barrier function of nasal epithelial cells.Method:Primary nasal epithelial cells (NECs) collected from patients with septal deviation were cultured at air-liquid interface. The release of HMGB1 under hypoxia was detected by ELISA. The effect of HMGB1 on fluorescein isothiocyanatedextran 4 kDa (FD4) permeability of NECs was measured. Western blot analysis was utilized to examine the level of major junction proteins, namely E-cadherin, ZO-1, Occludin and Claudin-1.Result:The release of HMGB1 was significantly upregulated in NECs under hypoxia. Recombinant human HMGB1 increased FD4 permeability in a dose and time-dependent manner, indicating the impaired epithelial barrier function. HMGB1-mediated barrier hyperpermeability was accompanied by the selective downregulation of ZO-1, occludin and Claudin-1, but not E-cadherin.Conclusion:HMGB1 mediates hypoxia-induce barrier dysfunction of nasal epithelium, which may be a potential target for the treatment of chronic rhinosinusitis.

[Endoscopic surgery and reconstruction for extensive osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma].

Objective: To investigate the clinical efficacy of endoscopic surgery for extensive osteoradionecrosis (ORN) of skull base in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods: Seventeen patients diagnosed as ORN of skull base after radiotherapy for NPC and underwent endoscopic surgery were retrospectively studied with their clinic data. Results: Based on the CT and endoscopic examination, all patients had large skull base defects with bone defects averaged 7.02 cm2 (range, 3.60 - 14.19 cm2). Excepting for curetting the sequestra, endoscopic surgery was also used to repair the wound or to protect the internal carotid artery with flap in 12 patients. No bone reconstructions were conducted in all patients with the bone defects of skull base. CT examinations were taken after endoscopic surgery when required. The postoperative follow-up ranged from 8 months to 6 years (average, 14 months). Aside from 1 patient with delayed cerebrospinal fluid (CSF), others had no related complications. Conclusions: The patients with extensive ORN can be treated with endoscopic surgery to curette the necrotic bone of skull base, and endoscopic reconstruction provides an alternative technique. It may not be necessary to reconstruct the bone defects at skull base, however, the exposed important structures of skull base, such as internal carotid artery, need to repair with soft tissue such as flap.

[Analysis of the characteristics of salvage endoscopic surgery for residual or recurrent nasopharyngeal carcinoma with different rT grading after radiotherapy].

Objective:To understand the characteristics and the treatment methods of the Salvage endoscopic surgery for residual or recurrent nasopharyngeal carcinoma（rNPC）with different rT grading after irradiation failure, and to explore the effect of different endoscopic procedures on the prognosis of the diseases.Method:Ninety-six patients who underwent endoscopic salvage nasopharyngectomy for rNPC in our department between June 2009 and March 2015 were retrospectively reviewed.All the patients underwent the corresponding salvage endoscopic surgery under general anesthesia according to the different rT grading and the patients with cervical metastasis received the radical neck dissection at the same time.Result:The number of the patients whose lesions were completely removed was 44(Total removal rate 45.8%),and the number of subtotal removal was 52(subtotal removal rate 45.8%),respectively.Postoperative follow-up continued until April 2015，the median follow-up was 19 months(1-57 months),the number of overall survival patients was 62(64.6%),the number of death was 34（35.4%）. The overall 1 year survival rate(SR),2 year SR,3 year SR were 83%,68%,63%,respectively.The median survival time was 43 months.Conclusion:The patients who underwent salvage endoscopic surgery for rNPC could have a good survival rate,and the different rT grading made the different methods to resect the lesions by the endoscopy. The use of frozen pathological examination during the operation to determine the negative rate of the surgical margins is the key to ensure the operation curative effect.