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    A review of autofluorescence imaging of the parathyroid gland
    SONG Xicheng, ZHENG Haitao
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 19-25.   DOI: 10.6040/j.issn.1673-3770.1.2020.025
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    The temporary and permanent dysfunction caused by parathyroid injury are inevitable. The parathyroid contains a special fluorescent substance, although its mechanism is not clear. At present, two kinds of autofluorescence detection equipment(FLUOBEAM ® imaging system, PTeye fiber probe contact system)can be used for real-time localization of the parathyroid gland for intraoperative localization and protection. The major advantage of this technique is that is allows detection of the parathyroid in excised specimens. The ratios of autofluorescence intensities of the parathyroid and thyroid are 1.23 and 7.71, respectively. The proportion of autofluorescence parathyroid identification sensitivity was 76.3-98.0% and the accuracy was 90.5-99.0%. The parathyroid gland autofluorescence technique is non-invasive, less time-consuming, provides accurate real-time information, and does not use dye as a contrast agent.
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    Improving the standard treatments for thyroid nodules and malignant tumors
    PAN Xinliang
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 1-12.   DOI: 10.6040/j.issn.1673-3770.1.2020.037
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    A radiomics nomogram based on computed tomography for predicting benign and malignant thyroid nodules
    WU Xinxin, LI Jingjing, MAO Ning, ZHENG Guibin, ZHENG Haitao, CUI Jingjing, JIA Chuanliang, CHU Tongpeng, MOU Yakui, SONG Xicheng
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 32-39.   DOI: 10.6040/j.issn.1673-3770.1.2020.028
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    The safety and feasibility of transoral endoscopic thyroidectomy vestibular approach(TOETVA)in papillary thyroid cancer
    ZHENG Guibin, ZHANG Guojun, MA Chi, WEI Shujian, SUN Haiqing, WU Guochang, GUO Yawen, ZHENG Haitao, SONG Xicheng
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 58-63.   DOI: 10.6040/j.issn.1673-3770.1.2020.021
    Abstract762)      PDF(pc) (1856KB)(56)       Save
    Objective To explore the safety and efficiency of transoral endoscopic thyroidectomy vestibular approach(TOETVA)in papillary thyroid cancer(PTC). Methods This study retrospectively reviewed 146 patients who underwent TOETVA between June 2017 and January 2020 at the Affiliated Yantai Yuhuangding Hospital of Qingdao University. Of those, 139 patients with pathologically confirmed PTC were enrolled in this study. Analyses were performed of the workflow experience, visual pain score on the first postoperative day, length of hospital stay, number of central neck lymph nodes removed, complications, and results of follow-ups. Results A total of 135 cases required hemithyroidectomy plus isthmectomy and central neck dissection(CND)with a mean operation time of 132±34.9 min; 4 cases required total thyroidectomy and CND with a mean operation time of 168±38.5 min. The mean number of central neck lymph nodes removed was 7.1±4.6 and the metastasis rate was 47.5%(66/139). Postoperative hospital stay was 1.9±0.7 days. Regarding postoperative complications, the incidence of transient recurrent laryngeal nerve injury(RLN)and transient hypoparathyroidism was 1.4%(2/139)and 0.7%(1/139), respectively. No permanent RLN injury and hypoparathyroidism occurred. Mental nerve injury occurred in 5.0%(7/139). Transient abnormal motor function of the lower lip and marginal mandibular branches of the facial nerve was observed in nine cases and two cases, respectively. Conclusion TOETVA can be performed by standard workflow with the principle of enhanced recovery after surgery(ERAS). TOETVA is feasible in selected PTC patients for its cosmetical results and oncological safety.
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    COVID-19 prevention and control scheme in an ENT endoscopy unit in China
    Huimin LIANG,Liqin WANG,Wenjin WAN,Sailei SHI,Jing YUAN,Yujie SHEN,Jiacheng ZHANG,Zefan MAO,Jingzi NI,Yiwen PAN,Zhibin CHEN,Lei CHENG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 88-92.   DOI: 10.6040/j.issn.1673-3770.0.2020.078
    Accepted: 13 March 2020

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    Due to the increasing spread of the novel coronavirus disease (COVID-19), prevention and control measures have become increasingly important. As a key location for diagnosing and treating upper airway diseases, strict precautions are required in ear nose and throat (ENT) endoscopy units. Endoscopy workers have a high risk of occupational exposure. Therefore, procedures must be strictly performed according to the prevention and control plan. The prevention and control requirements for COVID-19, as directed by the National Health Commission of China, have been universally deployed in our hospital. We have carefully analyzed the risk factors of infection during the epidemic period and subsequently formulated a prevention and control scheme for COVID-19 based on the infection control measures in the ENT endoscopy unit. These have helped to avoid cross-infection in the hospital and ensure the safety of patients and medical staff during the COVID-19 epidemic.

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    Clinical analysis of malignant thyroid tumors with laryngotracheal invasion
    XIA Tongliang, WEI Dongmin, QIAN Ye, LI Wenming, JI Wei, PAN Xinliang, LEI Dapeng
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 46-51.   DOI: 10.6040/j.issn.1673-3770.1.2020.033
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    Objective To explore the clinical treatment outcomes in thyroid papillary carcinoma patients with laryngotracheal invasion. Methods The study involved 87 patients with papillary thyroid carcinomas involving the larynx and trachea who reported to the Department of Otolaryngology at the Qilu Hospital of Shandong University between January 2010 and December 2019. Their basic demographic data, tumor resection procedures, tracheal repair procedures, postoperative extubation rate, and 3-year and 5-year survival rates were retrospectively analyzed. Results All the 87 patients were treated surgically. Tumor resection procedures included sharp shaving of the tracheal wall tumor(60 cases), tracheal wall wedge resection(15 cases), tracheal sleeve resection(3 cases), partial laryngectomy(1 case), total laryngectomy(4 cases), and palliative resection(4 cases). Airway reconstruction procedures included, suturing(5 cases), pectoralis major muscle flap repair(1 case), sternocleidomastoid clavicle periosteum flap repair(1 case), end-to-end anastomosis(3 cases), laryngoplasty(1 case), and tracheostomy(12 cases). Seventy-nine patients were followed for 4–122 months, of which 15 patients underwent tracheotomy, with an extubation rate of 66.7%(10 out of 15 patients). The 3-year and 5-year survival rates were 100% and 93.0%, respectively. Conclusion Accurate preoperative evaluation and reasonable surgical treatment may significantly improve the quality of life and facilitate the satisfactory survival of patients with thyroid papillary carcinoma involving the larynx and trachea.
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    Prediction of cervical lymph node metastasis in papillary thyroid cancer based on XGBoost artificial intelligence and enhanced computed tomography
    CHEN Haibing, WEI Ya'nan, XU Xiaoquan, CHEN Xi
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 40-45.   DOI: 10.6040/j.issn.1673-3770.1.2020.031
    Abstract706)      PDF(pc) (1010KB)(52)       Save
    Objective Incorporating eXtreme Gradient Boosting(XGBoost)artificial intelligence, we aimed to build a predictive model using pre-operative enhanced computed tomography(CT)of cervical lymph node metastasis in patients with thyroid cancer, to provide a reference for pre-operative planning. Methods The clinical data of 38 patients with thyroid papillary carcinoma from October 2017 to May 2019 were retrospectively analyzed. A total of 135 lymph nodes were included. Using XGBoost artificial intelligence, the lymph node metastasis prediction model was established, and the accuracy of the prediction model was tested. Results The average accuracy of the XGBoost model was 87.41%, which was higher than that of the SVM model(79.2%). Important CT characteristics that are indicative of lymph node metastasis include degree and distribution of enhancement, location, and capsule invasion. Conclusion The predictive model of cervical lymph node metastasis in patients with thyroid cancer exhibits high accuracy and could help in the pre-operative evaluation of cervical lymph node metastasis, tumor staging, and surgical procedures.
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    Two-stage reconstructive strategy using a flap for non-circumferential tracheal defects
    DENG Di, LIU Jun, LI Linke, WANG Ji, LIU Jifeng, LV Dan, WANG Haiyang, GAN Weigang, WANG Jun, LI Bo, CHEN Fei
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 52-57.   DOI: 10.6040/j.issn.1673-3770.1.2020.032
    Abstract676)      PDF(pc) (12766KB)(24)       Save
    Objective This study aimed to investigate the clinical value of two-stage reconstructive strategy using a flap for the treatment of non-circumferential tracheal defects. Methods Patients who underwent tracheal reconstructions with a two-stage reconstructive strategy using a flap between March 2013 and December 2018 were retrospectively evaluated. Results Thirty-seven patients, with a tracheal defect length of 6-14 tracheal rings and circumferential ratio of 1/2 to 3/4, underwent stage I surgery. Twenty-two free flaps and 15 pedicled flaps were used in the stage I surgery, and the sizes of the flap ranged from 6×4 cm to 12×9 cm. Thirty-three patients underwent stage II surgery, and the postoperative respiratory, deglutition, and articulation functions recovered satisfactorily. Conclusion The two-stage reconstructive strategy using a flap is safe and effective for the treatment of non-circumferential tracheal defects.
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    Advances in molecular mechanisms of anaplastic thyroid cancer
    QING Xiaoyan, XU YiquanOverview, LI ChaoGuidance
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 26-31.   DOI: 10.6040/j.issn.1673-3770.1.2020.029
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    Anaplastic thyroid cancer(ATC)is a rare invasive thyroid tumor associated with rapid progression and poor prognosis. Currently, there is no effective treatment or early diagnosis. Some scholars have shown that the poor prognosis of ATC is due to the early mutation and invasive growth of the tumor; consequently, new directions in research involve the driving mutation of the pathogenesis of ATC and targeted drug therapies. Different molecular pathways related to tumor progression are involved in ATC. Some scholars have explored the implementation of new therapies that act on these molecular pathways to improve patients' quality of life. The research results on the molecular structural characteristics of ATC bring hope for new targeted therapies. The new molecular mechanisms will help us discover more potential therapeutic targets. We have reviewed the recent research on the molecular mechanisms of ATC.
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    Clinical experience in diagnosis and treatment of stone in nasal cavity and sinusZHAI Xingyou1, HOU Junsheng2, LI Xinjian1, WANG Xin1, XIE Yingli1, WANG Wenjia1 1. Department of Otorhinolaryngology Head and Neck Surgery, Hainan Hospital, General Hospital of PLA, Hainan Province Otorhinolaryngology Head and Neck Surgery Clinical Medical Research Center, Sanya 572013, Hainan, China; 2. Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Henan University, Kaifeng 475001, Henan, ChinaAbstract:Objective
    To explore the genesis, clinical diagnosis, treatment, and prevention mechanisms of the formation of stones within the nasal cavity and sinus as well as measures toreduce the rate of clinical misdiagnosis. MethodsA comprehensive analysis was conducted on six patients with nasal and sinus calculi who visited the hospital between April 2012 and November 2017. The etiology, pathology, clinical diagnosis, differential diagnosis, treatment, prevention, and complication management of the disease were summarized for each patient. ResultFive patients underwent surgery for the removal of stones from the nasal cavity and sinus under general anesthesia. Nasal endoscopy was also performed for the assessment of the related sinus passages. One patient recovered upon nasal irrigation and anti-inflammation treatment. All the patients were followed up for six months and the mucosal layer within the operation area that was epithelialized, recovered well. The symptoms disappeared without any additional complications. ConclusionNasal endoscopy in combination with the assessment of clinical manifestation and imaging are conducive to the diagnosis of the disease. Together, these could develop into an effective treatment regimen for nasal cavity and sinusoidal lithiasis.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 92-96.   DOI: 10.6040/j.issn.1673-3770.0.2019.376
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    Objective To explore the genesis, clinical diagnosis, treatment, and prevention mechanisms of the formation of stones within the nasal cavity and sinus as well as measures toreduce the rate of clinical misdiagnosis. Methods A comprehensive analysis was conducted on six patients with nasal and sinus calculi who visited the hospital between April 2012 and November 2017. The etiology, pathology, clinical diagnosis, differential diagnosis, treatment, prevention, and complication management of the disease were summarized for each patient. Result Five patients underwent surgery for the removal of stones from the nasal cavity and sinus under general anesthesia. Nasal endoscopy was also performed for the assessment of the related sinus passages. One patient recovered upon nasal irrigation and anti-inflammation treatment. All the patients were followed up for six months and the mucosal layer within the operation area that was epithelialized, recovered well. The symptoms disappeared without any additional complications. Conclusion Nasal endoscopy in combination with the assessment of clinical manifestation and imaging are conducive to the diagnosis of the disease. Together, these could develop into an effective treatment regimen for nasal cavity and sinusoidal lithiasis.
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    Correct interpretation of the predictors of ocular ischemic syndrome to improve diagnostic performance HUANG Yingxiang, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China Abstract:
    Ocular ischemic syndrome(OIS)is a severe ophthalmic disease caused by ocular hypoperfusion, which occurs due to stenosis or occlusion of the common or internal carotid arteries. The clinical presentations and signs of OIS are complex, incidental, and different. OIS is easily misdiagnosed or remains undiagnosed because of its asymptomatic onset and complicated ocular manifestations. Therefore, it is crucial to trace the etiology of OIS. Presently, different imaging modalities can evaluate the carotid artery blood supply, collateral circulation, and brain perfusion. Thus, appropriate modalities must be selected for OIS diagnosis based on their advantages and disadvantages. Furthermore, the auxiliary examination results should be accurately and promptly considered and interpreted when establishing a diagnosis of OIS. Thus, the management of OIS requires cooperation with ophthalmologists, cardiologists, and neurologists.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 1-4.   DOI: 10.6040/j.issn.1673-3770.1.2020.047
    Abstract537)      PDF(pc) (532KB)(56)       Save
    Ocular ischemic syndrome(OIS)is a severe ophthalmic disease caused by ocular hypoperfusion, which occurs due to stenosis or occlusion of the common or internal carotid arteries. The clinical presentations and signs of OIS are complex, incidental, and different. OIS is easily misdiagnosed or remains undiagnosed because of its asymptomatic onset and complicated ocular manifestations. Therefore, it is crucial to trace the etiology of OIS. Presently, different imaging modalities can evaluate the carotid artery blood supply, collateral circulation, and brain perfusion. Thus, appropriate modalities must be selected for OIS diagnosis based on their advantages and disadvantages. Furthermore, the auxiliary examination results should be accurately and promptly considered and interpreted when establishing a diagnosis of OIS. Thus, the management of OIS requires cooperation with ophthalmologists, cardiologists, and neurologists.
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    The efficacy and disadvantages of three excimer laser surface cutting surgeries
    Ge CUI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 67-71.   DOI: 10.6040/j.issn.1673-3770.1.2020.010
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    Contemporary excimer laser surgery includes both stoma and surface cutting surgeries. The advantages of surface cutting surgery are stable postoperative biomechanics and no flap related complications. However, the disadvantages include postoperative pain, haze under the corneal epithelium, long term use of glucocorticoids, and refractive regression. Surface cutting operations include photorefractive keratectomy (PRK), TransPRK, laser-assisted sub-epithelial keratectomy (LASEK), and Epi-laser assisted in-situ keratomileusis (Epi-LASIK). Of these, TransPRK is a truly contactless operation and involves only one set of epithelial and matrix cutting. The procedure is widely favored due to the ability to make more accurate cuts. Complications such as postoperative pain, haze, and retractive regression are the three most common complications after surface cutting surgery.

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    Lens vault changes and associated factors after implantation of implantable collamer lenses with central flow
    Bo WAN,Donghui LI,Yan LUO,Ying LI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 36-41.   DOI: 10.6040/j.issn.1673-3770.1.2020.008
    Abstract483)   HTML12)    PDF(pc) (1740KB)(167)       Save
    Objective

    To investigate the changes to the lens vault (LV) and anterior chamber structures after implantation of implantable collamer lenses (ICL) with central flow in patients with myopia. The relationship between LV and its associated factors, both preoperatively and postoperatively, will also be analyzed.

    Methods

    One hundred and forty eyes of 72 patients who underwent ICL implantations were enrolled between January 2015 and January 2017. Visual acuity, intraocular pressure (IOP), corneal endothelial cell count (ECD), refractive outcomes, LV, and other anterior chamber structures were evaluated and compared after 1 week, 1 month, 3 months and 1 year, postoperatively. We analyzed the relationship between LV and other anterior chamber structures.

    Results

    After 1 year, 73% of eyes had gained 1 or more lines of corrected distance visual acuity, progressively fewer eyes had gained an uncorrected distance visual acuity above 20/20, more than 63% were within±0.5D of the prospective mean refractive spherical equivalent (MRSE), and more than 86% were within±0.1D of the prospective MRSE. There were no significant differences in MRSE, IOP, and ECD, postoperatively (p>0.05). No complications occurred during the postoperative time. There were no significant LV differences at 1 month and 3 months postoperatively. Meanwhile, LV had decreased significantly in the first postoperative year and was negatively correlated with age, keratometric power, 500 μm angle open distance, 500 μm trabecular iris space area, and the anterior chamber angle. LV was positively correlated with the white-to-white distance, angle-to-angle distance, anterior chamber depth, axial length, and ICL length. Axial length and ICL length were independent factors of LV.

    Conclusion

    Implantations of phakic ICL with center flow are safe, effective, and predictable in correcting myopia. LV decreased significantly at 1 year postoperatively, which correlated with multiple factors, both preoperatively and postoperatively.

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    Surgical skills required for small incision lenticule extraction (SMILE), and the prevention and management of SMILE-related complications
    Caipei SU,Yabo YANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 13-16.   DOI: 10.6040/j.issn.1673-3770.1.2020.007
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    The rising incidence of myopia is a major global public-health problem. Small incision lenticule extraction (SMILE) is widely accepted by refractive experts and patients, owing to its advantages, such as its flap-free nature, requirement for a small incision, good safety, effectiveness, and predictability. However, SMILE surgery requires corneal micro-surgical skills, and the learning curve is relatively steep. Thus, surgical skills required for SMILE as well as the prevention and management of complications associated with SMILE will be discussed in this article.

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    Giant cyst formation from lymph node metastasis in papillary thyroid cancer: a case study
    WANG Jiashuo, GUO Xing, YAN Aihui
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 111-113.   DOI: 10.6040/j.issn.1673-3770.1.2020.020
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    Benign cystic tumors of the neck are relatively common. However, malignant manifestations, such as thyroid cancer, are rare. Accurate identification of cervical cystic masses in these patients is important in preventing incorrect diagnosis and misdiagnosis. We report a case of giant cystic formation by cervical lymph node metastasis in papillary thyroid carcinoma. Processes and their potential influence in diagnosis and treatment are briefly described.
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    Comparative study of the effects of different protective measures of the non-operative eye during SMILE surgery on tear film stability
    Tao ZHANG,Kaiwei CAO,Lina LIU,Ting LIU,Ji BAI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 32-35.   DOI: 10.6040/j.issn.1673-3770.1.2020.004
    Abstract372)   HTML4)    PDF(pc) (1127KB)(76)       Save
    Objective

    To observe the changes in the first non-invasive keratograph tear break-up time (NIKBUTf) and average non-invasive keratograph tear break-up time (NIKBUTav) of the non-operative eye with different protective measures during small incision lenticule extraction (SMILE) using the Keratograph 5M ocular surface analyzer and to observe the effects of different protective measures on tear film stability.

    Methods

    A prospective cohort study was conducted. From September 2019 to November 2019, patients who underwent SMILE in the Chongqing Vision Institute were included. The left eye was the observation eye. During SMILE of the right eye, the left eye was protected using deproteinized calf blood eye gel or eyeshade. The control group did not receive protective measures. The NIKBUTf and NIKBUTav of the left eye were measured using the Keratograph 5M ocular surface analyzer before and after the surgery of the right eye. SPSS 25.0 was used for statistical analysis.

    Results

    Thirty-five patients accounting for 35 left eyes were included in the study, of which 12 were allocated to the gel group, 11 to the eyeshade group, and 12 to the blank control group. Per the results of repeated-measurement analysis of variance, the variations in the NIKBUTf and NIKBUTav were significant in each group regarding time and grouping (P < 0.05). These two parameters also showed an interaction between time and grouping (P < 0.05). There was no significant difference in the left eye NIKBUTf of the gel group before and after surgery of the right eye (P<0.05). The NIKBUTav of the left eye in the gel group was longer immediately after surgery of the right eye (P < 0.05). In the eyeshade and blank control groups, both the NIKBUTf and NIKBUTav in the left eye decreased immediately after surgery of the right eye (P < 0.05). In the control group, the reductions in the NIKBUTf and NIKBUTav were the most significant (P < 0.05).

    Conclusion

    Different protective measures and time changes had an impact on the NIKBUTf and NIKBUTav. The protective measure of deproteinized calf blood eye gel in the non-operative eyes during SMILE played a protective role in the stability of the tear film. The protective effect of eyeshade on the tear film of the non-operative eye was not obvious, and the stability of the tear film was the worst during the conventional surgery with no protective measures for the non-operative eye.

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    Research advances on vault and relevant factors after implantable collamer lens implantation
    Xuanqi WANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 72-78.   DOI: 10.6040/j.issn.1673-3770.1.2020.016
    Abstract348)   HTML12)    PDF(pc) (2423KB)(65)       Save

    Implantable collamer lenses (ICL) have been widely used, with their implantation considered technically safe, efficient and stable. Vault, the distance between the posterior ICL surface and anterior crystalline lens surface, is an important follow-up index. A higher or lower vault results in a greater risk for potential complications and can affect the operation. Therefore, research on how to obtain the ideal vault and reduce postoperative complications has become increasingly important. This article summarizes the issues related to vault and attempts to provide a clinical basis for improving the safety of operations conducted and explore the direction of future clinical research.

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    A discussion on the choice of surgical methods for correction of myopia
    Ying LI,Yang JIANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 1-6.   DOI: 10.6040/j.issn.1673-3770.1.2020.001
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    Adult myopia refractive surgery has developed rapidly over the past 30 years, and the number of operations has increased yearly. The main surgical methods include laser corneal refractive surgery and posterior chamber intraocular lens implantation (ICL). Laser corneal refractive surgery is suitable for low to moderate myopia and high myopia customized correction, which is safe, effective, and predictable and provides good long-term stability. Some special cases, however, including high refractive diopters, high corneal curvature, high corneal astigmatism, high corneal topography asymmetry, and thin corneal thickness, as well as too small a corneal diameter and irregular corneal shape, are not appropriate for laser corneal refractive surgery. For these cases, ICL provides many advantages, such as wide range of correction, stable effect, no need to remove corneal tissue, small effect of aberration, and good visual quality. ICL has been widely used in clinical practice, and the number of operations has increased year by year. However, ICL is not recommended for conditions such as insufficient anterior chamber depth, large corneal aberration, intraocular structural variation, and special occupation. These two surgical methods complement each other, widening the scope of refractive surgery indications and correction, and therefore, patients can receive the best choice of operation.

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    Recent advances and clinical applications in excimer laser surface ablation surgery
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 79-84.   DOI: 10.6040/j.issn.1673-3770.1.2020.011
    Abstract338)   HTML8)    PDF(pc) (959KB)(76)       Save

    Laser corneal refractive surgery is widely performed, and corneal surface excimer laser ablation surgery is one of the main surgical options. Corneal surface excimer laser ablation surgery includes:photorefractive keratectomy (PRK), laser-assisted subepithelial keratomileusis (LASEK), epipolis laser-assisted in situ keratomileusis (Epi-LASIK), transepithelial photorefractive keratectomy (TransPRK), and phototherapeutic keratectomy (PTK). It is mainly used to correct various refractive errors and corneal disorders. From epithelium-off PRK, alcohol soaking assistant LASEK, microkeratome-associated Epi-LASIK, to laser ablation corneal epithelial TransPRK, all of the procedures have no flap-related complications and they are of less corneal injury, painess and betrer visual quality after surgery. This review summarized the choice of current commonly used surgical options, clinical applications, and recent advances in excimer laser surface ablation surgery.

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    Epidemic control practices of an otolaryngology-head and neck surgery ward in an area with non-high incidence of COVID-19
    Zhenhua JIANG,Lijun ZHANG,Ying LI,Yanqin XIAO,Chao LI,Bo SHI,Guiying ZHANG,Bin XU,Wei DENG,Gang LUO,Jifang LUO,Guoqi LIU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 93-98.   DOI: 10.6040/j.issn.1673-3770.0.2020.057
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    The COVID-19 epidemic is still severe. As a non-high incidence area outside Hubei, the epidemic prevention and control of primary otolaryngology-head and neck surgery has its own characteristics. Daily diagnosis and treatment are performed in the ward to prevent cross infection by medical staff. This article combines our department's experience and the measures taken in this area with respect to ward diagnosis and treatment practices. We hope that our experience will be helpful to our otolaryngology-head and neck surgery colleagues in non-high incidence areas outside Hubei.

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    Efficacy of different transplantation schemes for parathyroid gland resection in patients with secondary hyperparathyroidism
    WANG Maolin, LI Julan, XIAN Kunlun
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 114-119.   DOI: 10.6040/j.issn.1673-3770.1.2020.041
    Abstract328)      PDF(pc) (1954KB)(30)       Save
    Objective Retrospectively summarize the efficacy of different transplantation schemes for parathyroid gland resection in patients with secondary hyperparathyroidism. Methods A total of 86 patients who had undergone total parathyroid gland transplantation in our hospital between March 2013 to March 2018 were divided into three groups according to the three different transplantation schemes. The preoperative, postoperative, and follow-up PTH results, hospital stay, postoperative calcium supplementation days, postoperative complications, and recurrence were collected to determine the efficacy. Results The short-term treatment efficacy(1 day after surgery-1 month after surgery)was different among the three groups, while the long-term treatment effect was not different. The short-term treatment effect of group A was the worst. The short-term treatment effect of group B and group C were similar, but overall, group C was better than group B. Conclusion The particle size of the transplanted parathyroid and the blood supply of the transplanted bed are closely related to the survival and growth of the transplanted parathyroid. Refractory secondary hyperparathyroidism can be efficaciously treated by the transplantation of small particles of parathyroid tissue into the sternocleidomastoid muscle sac.
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    Combined treatment of chylous leakage after lymph node dissection for thyroid cancer
    FANG Zhongju, ZHANG Yongxia, ZHAO Jiandong, ZONG Liang, ZHAI Xingyou, LI Xinjian, PENG Xin, REN Nan, CHEN Liwei, LIU Mingbo
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 64-68.   DOI: 10.6040/j.issn.1673-3770.1.2020.040
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    Objective To explore the causes and treatment of chyle leakage after lymph node dissection(LND)for thyroid carcinoma. Methods A retrospective analysis was conducted in 647 patients who underwent LND for thyroid carcinoma. For the 11 patients who developed chyle leakage, measures such as intravenous nutrition, low-fat diet, local compression and negative pressure drainage were taken. Results Chylous leakage occurred on day 0.5 to 3 after surgery, and the incidence was 1.7%. The peak drainage of chylous leakage was 120 to 1100 mL/d. Unilateral lobectomy + isthmectomy was performed in 449 cases, total thyroidectomy in 152 cases, and unilateral lobectomy + isthmectomy + contralateral subtotal thyroidectomy in 46 cases. Simple central lymph node dissection was performed in 395 cases, 5 of whom developed chyle leakage, and the incidence was 1.26%(5/395). Lateral neck+central lymphatic dissection was performed in 83 cases, 4 of whom developed chyle leakage, and the incidence was 4.8%(4/83). Upper mediastinal dissection with endoscope was performed in 6 cases, 2 of whom developed chyle leakage, and the incidence was 33.3%(2/6). The ratio of left to right chylous leakage was 7:4. Three patients had relapse dissection(rRLN). When the daily drainage volume was less than 20 mL/d, the drainage tube was removed. The closing time of chylous leakage was 6 to 23 days, median 11 days. No second operation was performed. Conclusion When lymph node dissection for thyroid carcinoma is performed, the procedures should be standardized to prevent chylous leakage. In case chylous leakage occurs, measures such as diet adjustment and negative pressure drainage can help the cure. Surgery must be performed when the conservative treatment is ineffective.
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    Key criteria for screening before corneal refractive surgery
    Fengju ZHANG,Yu LI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 7-12.   DOI: 10.6040/j.issn.1673-3770.1.2020.014
    Abstract313)   HTML6)    PDF(pc) (1291KB)(305)       Save

    Safety, efficacy, predictability, and long-term stability are the prerequisites for satisfied outcomes after corneal refractive surgery. The most important factors are strict pre-operative screening and reasonable selection for surgical indications. This article put forward the main criteria for screening before corneal refractive surgery, which purpose is to select surgical indications rationally and avoid medical pitfalls and risks effectively. And make sure the patients could achieve the safe, effective, and stable results as well as high visual quality after corneal refractive surgery.

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    Detection of four infection indicators in 4 630 patients before refractive surgery
    Yabin HU,Yan ZHENG,Jing ZHANG,Yan WANG,Qiulu ZHANG,Jing LIU,Wen XU,Changbin ZHAI,Yuehua ZHOU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 53-56.   DOI: 10.6040/j.issn.1673-3770.1.2020.006
    Abstract297)   HTML2)    PDF(pc) (936KB)(55)       Save
    Objective

    To study and analyze the test results used for the detection of HBsAg, anti-HCV, anti-Treponema pallidum antibody (anti-TP) and anti-HIV in patients, prior to refractive surgery and to standardize the surgical management.

    Methods

    Enzyme-linked immunosorbent assay was used to detect four different indicators of infection in 4630 patients and the results were analyd retrospectively.

    Results

    The observed total positive rate, in the 4630 patients involved in the study, was 3.02% (n=140). The positive rates observed for HBsAg, anti-TP, anti-HCV, and anti-HIV were 2.13% (n=99), 0.62% (n=29), 0.19% (n=9), and 0.06% (n=3), respectively. In the present study, the total positive rate and the positive rates for HBsAg and anti-HIV were observed to be higher in male patients, compared to female patients (χ2 was 8.04, 16.11 and 6.05, respectively, P < 0.01).

    Conclusions

    Detection of infection indicators, prior to laser corneal refractive surgery, can aid in understanding the infection status of patients, which helps in decreasing the risk of infection and enhances the safe implementation of the surgical procedure.

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    Comparison of corneal epithelial remodeling after FS-LASIK and SMILE treatment for myopia and astigmatism
    Ye TAO,Yuehua ZHOU,Fusheng LI,Shen WANG,Hongzhi YIN,Si QI,Haihong YANG,Tianfeng SHAN,Fang WANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 61-66.   DOI: 10.6040/j.issn.1673-3770.1.2020.003
    Abstract293)   HTML2)    PDF(pc) (987KB)(55)       Save
    Objective

    To compare the characteristics of corneal epithelial remodeling after FS-LASIK and SMILE.

    Methods

    There were 33 males (65 eyes) and 27 females (54 eyes) with an average age of 26±6.5years. The mean spherical equivalent was -5.25±2 D. Patients were divided into two groups:the FS-LASIK group (29 patients, 58 eyes) or SMILE group (31 patients, 61 eyes). The RTvue-OCT system was used to measure the epithelium thickness within 0-2 mm and 2-5 mm from the central cornea of patients before and 1, 3, and 6 months after surgery.

    Results

    One month after surgery, however, there was a statistical difference between the average corneal epithelium thickness within 2 mm and 2-5 mm from the cornea in the FS-LASIK group (P=0.036). In the superior, nasal superior, temporal superior region, the thickness of the corneal epithelium within 2-5 mm increased less than the inferior, nasal inferior, and temporal inferior regions. These differences were statistically significant (P=0.042, P=0.031, P=0.049, respectively). There was a statistically significant difference between the average corneal epithelium thickness within 2 mm and 2-5 mm of the cornea in the SMILE group at 6 months after operation (P=0.047). In the range of 2-5 mm, the corneal epithelium thickness increased less in the superior, nasal superior, temporal superior regions than the thickness in the inferior, nasal inferior, and temporal inferior regions. These differences were statistically significant (P=0.012, P=0.035, P=0.009, respectively). Compared with the nasal and temporal sides, the thickness of the superior part was less, and the difference was statistically significant (P=0.045, P=0.017, respectively). For the FS-LASIK group, the corneal epithelium thickened from 1 to 6 months after surgery. It gradually decreased within 2 mm, and this difference was statistically significant (P=0.035). During this time period, the corneal epithelial thickness of the FS-LASIK group and the SMILE group was statistically significant at each position within a range of 0-5 mm (P<0.05).

    Conclusion

    Corneal epithelium thickening is more pronounced in FS-LASIK than in SMILE post-operation. The corneal epithelium thickening in FS-LASIK changes more obviously in the central area of the corneal resection. The corneal epithelium thickening in SMILE changes more obviously in the peripheral area of the corneal resection. Over time, the localized thickening of the corneal epithelium, which is located opposite to the incision location, continued after both procedures.

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    Lateral neck lymph node mapping in thyroid cancer surgery
    HUANG Naisi, MA Ben, GUAN Qing, WANG Yunjun, WEI Wenjun, LU Zhongwu, YANG Shuwen, XU Weibo, XIANG Jun, JI Qinghai, WANG Yu
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 69-74.   DOI: 10.6040/j.issn.1673-3770.1.2020.042
    Abstract292)      PDF(pc) (983KB)(33)       Save
    Objective Despite the high incidence of lateral neck lymph node metastasis in papillary thyroid carcinoma(PTC), its management has remained controversial. The accuracy of ultrasound and computed tomography(CT)in lateral neck evaluation for PTC is unsatisfactory. An unnecessary neck dissection may lead to increased complications, while undetected lymph node metastasis may facilitate recurrences and necessitate resurgery. We aimed to map the draining lymph nodes in the lateral neck using carbon nanoparticles and explore its potential in neck assessment. Methods We conducted a multicenter, prospective study from August 2016 to April 2019 in PTC patients who had unpalpable lateral lymph nodes that appeared suspicious on ultrasound and/or CT. Carbon nanoparticles were injected peritumorally into the thyroid gland, and modified lateral neck dissection(compartment Ⅱ-Ⅴ)was performed. The lateral lymph nodes were classified into dyed and undyed and sent for pathological analysis. Thyroidectomy and central neck compartment dissection were performed. Results A total of 125 neck dissections were performed in 122 patients. Of the dissections, 117 were for lateral neck metastases, 7 were for central metastases, and metastasis was absent in the remaining 1. A total of 4302 lateral lymph nodes were removed, 952 of them were dyed. The median number of dyed nodes was 6 per case(range: 1-33). The distribution of dyed nodes in the neck compartments was Ⅳ> Ⅲ> Ⅱ> Ⅴ, independent of tumor size, location, or extra-thyroidal extension. The percentages of dyed lymph node metastasis in Ⅱ-Ⅴ compartments were 33.3%, 60.0%, 68.8%, and 40.0%, respectively, on a per-case basis and 10.2%, 31.4%, 27.5%, and 20.8%, respectively, on a per-node basis. Compared to undyed nodes, the risk of metastasis in dyed nodes was significantly higher in all neck compartments(compartment Ⅱ: 19.9% vs. 5.6%, P<0.001; compartment Ⅲ 35.0% vs. 18.3%, P<0.001; compartment Ⅳ: 37.1% vs. 15.2%, P<0.001; compartment Ⅴ: 14.8% vs 3.7%, P<0.05). A lateral sentinel lymph node biopsy was performed in 51 patients. The sensitivity of the lateral neck sentinel lymph node biopsy was 89.5%, the false-negative rate was 26.7%, and the overall accuracy rate was 91.8%. Conclusion Using carbon nanoparticles, we successively mapped the lateral neck lymph nodes. We found that dyed nodes had a significantly higher risk of metastasis than that of undyed nodes. This method may be useful for lateral neck sentinel lymph node biopsies in PTC.
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    Implantable collamer lens implantation for regression of refraction after radical keratotomy:case report
    Shali YUE,Yingping DENG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 85-87.   DOI: 10.6040/j.issn.1673-3770.1.2020.009
    Abstract285)   HTML4)    PDF(pc) (4355KB)(74)       Save
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    Changes in visual quality during the ultra-early stage of SMILE for middle and low myopia
    Yang ZHAO,Yanyan FU,Xiaoying WU,Yewei YIN,Aiqun XIANG,Ying LU,Kaixuan DU,Yuanjun LI,Tu HU,Xingli LI,Dan WEN
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 42-46.   DOI: 10.6040/j.issn.1673-3770.1.2020.015
    Abstract285)   HTML2)    PDF(pc) (1146KB)(88)       Save
    Objective

    To observe the changes in visual quality within 24h (the ultra-early stage) after small incision lenticule extraction (SMILE) and explore the possible reasons behind these changes.

    Methods

    Forty-six eyes of 23 patients who underwent SMILE were chosen for this study. A subjective visual quality of questionnaire (SVQ) was competed by the patients before the procedure and 24 hours after treatment. The best-corrected visual acuity of the patients (distant vision 5 m, middle vision 60 cm, near vision 33 cm), contrast sensitivity (CS), glare sensitivity (GS), the near point of convergence (NPC) and the amplitude of accommodation (AA) were measured using a Binocular Vision Function Instrument (OCULUS Binoptometer 4p).

    Results

    The SVQ score illustrated a decrease in visual quality after SMILE at the ultra-early stage (P=0.001). However, uncorrected distance visual acuity (UCVA) significantly improved (P=0.0001). When comparing best-corrected visual acuity (BCVA), there was no difference between the distant vision results (P=0.096), but both the middle vision and near vision results were lower than before treatment (P=0.039, 0.003). CS and GS decreased following treatment (P=0.0001, 0.04), but there was no difference in the NPC and AA (P=0.68, 0.13).

    Conclusion

    Patients can expect improved distant vision in the ultra-early stage of SMILE. However, at the ultra-early stage, the middle vision and near vision have not yet recovered. The SVQ changes at the ultra-early stage of SMILE may be related to the changes in CS and GS.

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    Analysis of the advantages of flaps created with an optical coherence tomography-guided femtosecond laser
    Jing ZHANG,Ye TAO,Fusheng LI,Shen WANG,Dongyi QU,Ying LI,Yuehua ZHOU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 17-21.   DOI: 10.6040/j.issn.1673-3770.1.2020.002
    Abstract281)   HTML4)    PDF(pc) (1165KB)(136)       Save
    Objective

    To compare the features of corneal flaps created by using an optical coherence tomography (OCT)-guided femtosecond laser and those created by three other femtosecond lasers.

    Methods

    Four types of femtosecond laser laser-assisted in situ keratomileusis procedures were performed on 107 patients (200 eyes) with myopia and myopic astigmatism. Patients were divided into four groups of 50: group A, FEMTO LDV Z8 femtosecond laser; group B, Ziemer Crystalline femtosecond laser; group C, Wavelight FS200 femtosecond laser; and group D, Zeiss VisuMax femtosecond laser. Corneal flap thickness was measured and analyzed by RTVue OCT.

    Results

    At 1 week postoperatively, the corneal flap thickness in group A was close to the expected value and the variation range was small. The corneal flap thickness in group B was close to the expected value, but the variation range was large. The corneal flap thickness in group C was thin, that of group D was close to the expected value, and the variation ranges of both groups were small. The corneal flaps created by the four femtosecond lasers were regular and uniform in shape, and there was no statistically significant difference between central and peripheral thicknesses (P>0.05). The differences between the corneal flap thickness value and the predicted value of 110μm among the four groups were obviously different. The results of groups A(3.43±2.81)μm and D(3.13±2.89)μm were obviously better than those of groups B(6.88±4.13)μm and C(5.44±3.62)μm (F=2.397; P=0.018).

    Conclusion

    Compared with the Ziemer Crystalline and Wavelight FS200 femtosecond lasers, the OCT-guided femtosecond laser and the Zeiss VisuMax femtosecond laser featured higher accuracy and better predictability

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    Efficacy of 0.1% diclofenac sodium eye drops post-SMILE
    Yang JIANG,Ying LI,Ge CUI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 57-60.   DOI: 10.6040/j.issn.1673-3770.1.2020.012
    Abstract270)   HTML6)    PDF(pc) (959KB)(44)       Save
    Objective

    To study the safety, efficacy, and tolerability of 0.1% diclofenac sodium eye drops after the small incision lenticule extraction (SMILE) procedure.

    Methods

    Two groups were observed, including 60 patients (60 eyes) with myopia. Thirty patients (30 eyes) were treated with topical compound tobramycin eye drops 4 times daily for 10 days as the control group. Meanwhile, 30 patients (30 eyes) were treated with topical compound tobramycin eye drops 4 times daily for 10 days, and diclofenac sodium eye drops 4 times daily for 20 days. All of the patients were observed in the preoperative and postoperative periods. The visual acuity, intraocular pressure, topography and adverse reactions were recorded at 10 d and after 1 month. The differences between the 2 groups were analyzed by the single factor analysis of variance (one-way ANOVA).

    Results

    There was no significant difference between the 2 groups in terms of uncorrected visual acuity at 10 d(P=0.12, F=2.50). However, there was after 1-month (P=0.001, F=29.78). There were no significant differences between the intraocular pressure values pre-operation, and postoperatively at 10 d and 1 month (P=0.45, 0.97, 0.66, F=0.56, < 0.001, 0.19). There were no significant differences between the 2 groups in the SRI and SAI values pre-operation and at 1 month in the SRI index(P=0.32, 0.05, 0.07, F=1.01, 3.86, 3.27). However, there was a significant difference in the SAI value 1-month post the operation (P=0.01, F=7.70). Eight patients (26.67%) in the diclofenac sodium eye drops group suffered from transient mild eye pain. However, this discomfort was relieved after a short time.

    Conclusion

    Diclofenac sodium eye drops can be an effective treatment combined with corticoids after SMILE. They are safe and were satisfactory in the recovery of visual acuity and ocular surface regularity.

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    Early clinical observations of intraoperative corneal stromal pocket irrigation with dexamethasone in small incision lenticule extraction
    Gang LIANG,Rong MA,Fengju ZHANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 22-31.   DOI: 10.6040/j.issn.1673-3770.1.2020.005
    Abstract260)   HTML6)    PDF(pc) (27671KB)(42)       Save
    Objective

    This study aimed to evaluate the postoperative vision recovery and corneal morphological changes after corneal stroma pocket irrigation with dexamethasone during Small Incision Lenticule Extraction (SMILE).

    Methods

    This was a prospective case-control study, which included 48 eyes from 24 patients who underwent SMILE. One eye from each case was randomly selected to have corneal pocket irrigation with dexamethasone (experimental group, EG), while the other eye did not undergo irrigation (control group, CG). The morphological changes of the cornea were observed using in vivo confocal microscopy and anterior segment optical coherence tomography (OCT), 1 day and 7 days after surgery. The uncorrected visual acuity (UCVA), spherical equivalent (SE), corneal center thickness (CCT), and non-contact tension (NCT) values between the groups were compared 1 day, 7 days, and 1 month after surgery.

    Results

    No significant differences were observed in the UCVA (EG: 4.99±0.07, 5.06±0.08, 5.05±0.06; CG:5.01±0.07, 5.05±0.08, 5.06±0.09, P>0.05) and SE between the two groups (EG: 0.03±0.49, 0.1±0.37, 0.02±0.4; CG: 0.09±0.54, 0.19±0.48, 0±0.52) the same day as the procedure, and 1 day, 7 days, and 1 month after surgery, p>0.05. The two groups were compared at the same time, 1 day and 7 days before and after SMILE using confocal microscopy and anterior segment OCT. The cell shape, density, cell size and arrangement of the corneal epithelium[pre-operation(4 578.73±268.40, 4 539.57±329.25)cell/mm2, post-1d (4 565.21±247.31, 4 627.23±271.03)cell/mm2, post-7d(4 640.01±246.79, 4 517.71±281.43)cell/mm2] and endothelium [pre-(2541.50±259.59, 2 443.52±305.58)cell/mm2, post-1d(2 387.01±248.55, 2 495.27±238.52) cell/mm2, post-7d (2 484.49±223.71, 2 482.53±323.82)cell/mm2] were not significantly different (P>0.05). There were no significant differences observed in the corneal sub-epithelial nerve fibers. The degree of active corneal stromal cells near the cutting interface was similar between the groups, without any significant differences. Regarding the density of the corneal superficial-stromal cells [pre-(789.51±67.17, 802.03±6 794)cell/mm2, post-1d(889.37±60.62, 912.27±95.87)cell/mm2, post-7d (96.67±75.03, 818.39±59.65)cell/mm2], both groups revealed no significant difference pre- or post-operation. However, a significant difference (P < 0.05)was observed after SMILE in both groups between the day immediately before and after the procedure. Both groups revealed no significant differences regarding the density of the deep stromal cells. Comparisons of the preoperative and postoperative anterior segment OCT show no obvious inter-lamellar space and effusion in the corneal stromal pocket in the two groups. There was no significant difference in the CCT between the groups (P>0.05).

    Conclusion

    Irrigation with dexamethasone in the corneal stromal pocket during SMILE did not have a significant effect on postoperative UCVA, SE, and corneal morphological changes after surgery.

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    Case analysis of 25 cases of iris neovascularizationLI Xuan1,2, HUANG Yingxiang2 1. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; 2. Department of Fundus Disease and Eye Trauma, Eye Hospital China Academy of Chinese Medicine Sciences, Beijing 100040, ChinaAbstract:
    ObjectiveTo discuss the causes and appropriate treatment for iris neovascularization following the analysis of cases( eyes). MethodsIt was a retrospective case series study involving patients( eyes)with iris neovascularization diagnosed between September and July . All the patients underwent ophthalmic examination, and all the examination findings and treatments were recorded. The causes, correlative factors, and treatment outcomes of iris neovascularization were analyzed. ResultsOf the patients, ( eyes, .%)had retinal ischemic signs, including vitreous hemorrhage and retinal vascularization on fundus fluorescein angiography, ( eyes, .%)did not have retinal ischemic signs. After months of treatment, retinal vascularization resolved in all the cases, and iris neovascularization resolved completely in patients( eyes, .%), iris neovascularization was still found in patients( eyes, .%). ConclusionsAnterior segment ischemia may also lead to iris vascularization, although retinal ischemia was the main cause. Additionally, iris neovascularization may not always resolve with treatment for retinal ischemia. Finally, anti-VEGF drug injection was an effective treatment for iris neovascularization.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 41-47.   DOI: 10.6040/j.issn.1673-3770.1.2020.050
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    Objective To discuss the causes and appropriate treatment for iris neovascularization following the analysis of 25 cases(28 eyes). Methods It was a retrospective case series study involving 25 patients(28 eyes)with iris neovascularization diagnosed between September 2014 and July 2016. All the patients underwent ophthalmic examination, and all the examination findings and treatments were recorded. The causes, correlative factors, and treatment outcomes of iris neovascularization were analyzed. Results Of the patients, 17(20 eyes, 71.4%)had retinal ischemic signs, including vitreous hemorrhage and retinal vascularization on fundus fluorescein angiography; 8(8 eyes, 28.6%)did not have retinal ischemic signs. After 3 months of treatment, retinal vascularization resolved in all the cases, and iris neovascularization resolved completely in 20 patients(23 eyes, 82.1%), iris neovascularization was still found in 5 patients(5 eyes, 17.9%). Conclusions Anterior segment ischemia may also lead to iris vascularization, although retinal ischemia was the main cause. Additionally, iris neovascularization may not always resolve with treatment for retinal ischemia. Finally, anti-VEGF drug injection was an effective treatment for iris neovascularization.
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    A case of ophthalmic ischemic syndrome treated by chinese medicine combined with laser and operation and literature reviewGUO Xinlu, GAO Jiansheng, JIE Chuanhong Eye Hospital China Academy of Chinese Medical Sciences, Beijing 100040 Abstract:
    By analyzing the treatment process of a clinical case of ocular ischemic syndrome, the clinical significance of combined therapy in the treatment of ocular ischemic syndrome was discussed.眼缺血综合征(ocular ischemic syndrome, OIS)是由颈动脉阻塞或狭窄所致脑和眼的供血不足, 动脉灌注压过低而引起的眼前后节缺血病征, 属于一种慢性缺血性疾病。由于该病临床表现多样, 常见漏诊和误诊, 从而导致严重后果。Hedges于年在一位左侧颈内动脉完全阻塞的患者眼底中发现视网膜血管扩张和周围点状出血的现象。同年, 另有两位学者报道称约%的“静脉淤滞性视网膜病变”患者伴有单侧颈动脉狭窄或闭塞。近年来, 随着眼科医生对此类眼病认识的不断提升, 这些可能由于颈动脉狭窄或闭塞引起的眼部疾病逐渐被统称为“眼缺血综合征”。目前国内针对OIS的多学科系统研究并不多见, 大多数报道均来自眼科医师, 表明本病临床认识尚不足够。现将 例OIS患者的诊疗资料报告如下, 并结合文献资料进行讨论。
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 48-52.   DOI: 10.6040/j.issn.1673-3770.1.2020.045
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    Analysis of the literature on ocular ischemic syndrome at home and abroadMENG Bo, HUANG Yingxiang, WANG Kang, ZHAO Lu, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract:
    ObjectiveObjectiveTo analyze the literature on ocular ischemic syndrome published between January , and December , . MethodPapers on OIS that were published between January , and December , , were screened and retrieved from the CNKI and WOS databases, and those that were relevant were searched and analyzed. ResultsIn this analysis, Chinese papers on OIS were cited for times with an h-index of , while foreign papers were cited for times with an h-index of . Of the organizations that published the highest number of papers and had the highest h-indexes, the Capital Medical University and the Polish Medical University of Pomerania were the leading institutions. The Chinese Journal of Ophthalmology was the leading domestic journal, and the Journal of Ophthalmology and Plos One were the leading foreign journals. China published the highest number of papers abroad, China and South Korea had the highest h-indexes. China′s National Natural Science Foundation provided the most support to the field of OIS, accounting for .% of the total domestic literature. The most frequently cited article in the WOS database was by Hayreh, SS, which was on the prevalence and pathogenesis of ocular vascular occlusive disease and melanosis, it was also part of the top ten studies that focused on the utility of OCT in providing insights into OIS and the mechanisms of ischemia and hypoxia. ConclusionThe utility of OCT in providing insights into OIS and the mechanisms of hypoxia and ischemia represents a modern focus of researchers.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 35-40.   DOI: 10.6040/j.issn.1673-3770.1.2020.044
    Abstract243)      PDF(pc) (1272KB)(24)       Save
    Objective Objective To analyze the literature on ocular ischemic syndrome published between January 1, 2014 and December 31, 2019. Method Papers on OIS that were published between January 1, 2014 and December 31, 2019, were screened and retrieved from the CNKI and WOS databases, and those that were relevant were searched and analyzed. Results In this analysis, 35 Chinese papers on OIS were cited for 41 times with an h-index of 2, while 48 foreign papers were cited for 115 times with an h-index of 6. Of the organizations that published the highest number of papers and had the highest h-indexes, the Capital Medical University and the Polish Medical University of Pomerania were the leading institutions. The Chinese Journal of Ophthalmology was the leading domestic journal, and the Journal of Ophthalmology and Plos One were the leading foreign journals. China published the highest number of papers abroad; China and South Korea had the highest h-indexes. China's National Natural Science Foundation provided the most support to the field of OIS, accounting for 20.8% of the total domestic literature. The most frequently cited article in the WOS database was by Hayreh, SS, which was on the prevalence and pathogenesis of ocular vascular occlusive disease and melanosis; it was also part of the top ten studies that focused on the utility of OCT in providing insights into OIS and the mechanisms of ischemia and hypoxia. Conclusion The utility of OCT in providing insights into OIS and the mechanisms of hypoxia and ischemia represents a modern focus of researchers.
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    2- aminoethoxydiphenyl borate inhibits inflammatory reactions of neutrophilic nasal polyps in vitroDAI Fei, WEI Jinjin, TANG Xinyue, CHEN Zheng, LIN Lin Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital North of Fudan University, Shanghai 201907, ChinaAbstract:Objective〓
    Nasal polyps(NP)are frequently divided into subtypes, including eosinophilic and neutrophilic, among others, according to their endotypes. However, the mechanisms of neutrophilic NP need to be further elucidated. This study explores the influence of 2-aminoethoxydiphenyl borate(2-APB)on inflammatory reactions of neutrophilic NP in vitro. MethodsWe used immunofluorescence and immunohistochemical staining to detect the infiltration of neutrophils(NEU)in normal nasal mucosa and NP tissues. These tissues were subsequently cultured in vitro using an organ culture technique, and concentrations of Orai1 and myeloperoxidase(MPO)were determined using enzyme-linked immunosorbent assay(ELISA). 2-APB was administered to both cultures, and the measurement of Orai1 and MPO concentrations using ELISA was repeated. ResultsAll samples were identified as neutrophilic NP. The number of NEU was higher in NP than in normal nasal mucosa. Concentrations of Orai1 and MPO were also higher in NP cultured in vitro than in normal tissue. After the administration of 2-APB, Orai1 protein and the mediator MPO were reduced significantly in the cultures. Conclusion2-APB may inhibit inflammatory reactions of neutrophilic NP in vitro.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 97-100.   DOI: 10.6040/j.issn.1673-3770.0.2019.413
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    Relationship between nasal foreign body and allergic rhinitis in children: a preliminary studyLIN Xing, SHEN Ling, LIN Zongtong, YANG Zhongjie Department of Otorhinolaryngology, Fuzhou Children's Hospital of Fujian Province/Fuzhou Children's Hospital of Fujian Medical University, Fuzhou 350005, Fujian, ChinaAbstract: Objective〓
    To investigate the relationship between nasal foreign bodies and allergic rhinitis in children. MethodsThis single-center study retrospectively evaluated the clinical data, treatment methods used, and complications reported for 161 pediatric patients with nasal foreign bodies who were treated between January 2017 and June 2018. ResultsA total of 161 patients were reviewed(91 boys and 70 girls). Among them, the age of high hair was 3-5 years old, and accounted for 81.4% of all the patients. Of these, 137(85.1%)children had nasal itching, rubbing nose, nose-picking, sneezing, epistaxis, nasal congestion, nasal hemorrhage, and other symptoms; 112 cases(69.6%)tested positive for sIgE(specific Immunoglobulin E)and were diagnosed with allergic rhinitis. The prevalence of allergic rhinitis in children with nasal foreign bodies was 69.6%, significantly higher than that reported for the general population(7.83%-20.42%; P<0.001). ConclusionIn children, nasal foreign bodies are closely associated with allergic rhinitis. Children with nasal foreign bodies should be particularly monitored for the development of allergic rhinitis. When allergic rhinitis is suspected, it should be promptly diagnosed and optimal treatment should be administered.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 101-104.   DOI: 10.6040/j.issn.1673-3770.0.2020.243
    Abstract233)      PDF(pc) (634KB)(48)       Save
    Objective To investigate the relationship between nasal foreign bodies and allergic rhinitis in children. Methods This single-center study retrospectively evaluated the clinical data, treatment methods used, and complications reported for 161 pediatric patients with nasal foreign bodies who were treated between January 2017 and June 2018. Results A total of 161 patients were reviewed(91 boys and 70 girls). Among them, the age of high hair was 3-5 years old, and accounted for 81.4% of all the patients. Of these, 137(85.1%)children had nasal itching, rubbing nose, nose-picking, sneezing, epistaxis, nasal congestion, nasal hemorrhage, and other symptoms; 112 cases(69.6%)tested positive for sIgE(specific Immunoglobulin E)and were diagnosed with allergic rhinitis. The prevalence of allergic rhinitis in children with nasal foreign bodies was 69.6%, significantly higher than that reported for the general population(7.83%-20.42%; P<0.001). Conclusion In children, nasal foreign bodies are closely associated with allergic rhinitis. Children with nasal foreign bodies should be particularly monitored for the development of allergic rhinitis. When allergic rhinitis is suspected, it should be promptly diagnosed and optimal treatment should be administered.
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    Analysis of choroidal thickness in patients with ocular ischemic syndromeFU Qiang, WANG Hongxing Department of Ophthalmology, Beijing Chuiyangliu Hospital, Beijing 100022, ChinaAbstract: Objective〓
    Spectral-domain optical coherence tomography(SD-OCT)was used to measure and observe the characteristics of the subfoveal choroidal thickness(SFCT)in patients with ocular ischemic syndrome(OIS)as well as explore the indicators for early evaluation of OIS. MethodsThis was a retrospective case-control study. Forty-eight patients(48 eyes)were included between January 2017 and January 2020. The patients were divided into two groups: the OIS and the control groups, with each consisting of 24 patients(24 eyes). Their basic information, including age, gender, body mass index(BMI), and the history of diabetes, hypertension, and hyperlipidemia, was collected. SFCT was measured using SD-OCT in EDI mode. The basic data and SFCTs of the two groups were compared. ResultsThere were no significant differences between the ages, gender, BMIs, and the prevalence of diabetes, hypertension, and hyperlipidemia of the two groups(all P>0.05). The mean SFCT of the OIS group was 204.83±27.34 μm, and that of the control group was 226.58±33.49 μm. The differences between the two groups were statistically significant(t=2.464, P=0.018). ConclusionsSFCT was thinner in patients with OIS. SFCT can be used as an indicator for early assessment of OIS.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 60-63.   DOI: 10.6040/j.issn.1673-3770.1.2020.056
    Abstract232)      PDF(pc) (2389KB)(28)       Save
    Objective Spectral-domain optical coherence tomography(SD-OCT)was used to measure and observe the characteristics of the subfoveal choroidal thickness(SFCT)in patients with ocular ischemic syndrome(OIS)as well as explore the indicators for early evaluation of OIS. Methods This was a retrospective case-control study. Forty-eight patients(48 eyes)were included between January 2017 and January 2020. The patients were divided into two groups: the OIS and the control groups, with each consisting of 24 patients(24 eyes). Their basic information, including age, gender, body mass index(BMI), and the history of diabetes, hypertension, and hyperlipidemia, was collected. SFCT was measured using SD-OCT in EDI mode. The basic data and SFCTs of the two groups were compared. Results There were no significant differences between the ages, gender, BMIs, and the prevalence of diabetes, hypertension, and hyperlipidemia of the two groups(all P>0.05). The mean SFCT of the OIS group was 204.83±27.34 μm, and that of the control group was 226.58±33.49 μm. The differences between the two groups were statistically significant(t=2.464, P=0.018). Conclusions SFCT was thinner in patients with OIS. SFCT can be used as an indicator for early assessment of OIS.
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    Etiology of repeat keratoplasty and risk factors for failure of corneal grafts
    HAO Wenpei, ZHAI Hualei, SUN Xiaotong, ZHANG Yani, ZHU Yanhui, KONG Qianqian, CHENG Jun, ZHANG Ting
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (3): 134-140.   DOI: 10.6040/j.issn.1673-3770.0.2019.605
    Abstract231)      PDF(pc) (492KB)(36)       Save
    Objective This study aimed to analyze the causes of repeat keratoplasty and the risk factors for failure of corneal grafts. Methods This retrospective consecutive clinical case series enrolled all cases at Qingdao Eye Hospital, Shandong Eye Institute, between January 2010 and December 2018. Causes of repeat keratoplasty, primary disease before first keratoplasty, surgical methods of the first and repeat keratoplasty, and postoperative complications were analyzed. Statistical analysis was performed using SPSS 22.0 software. Results A total of 2,060 corneal transplants was performed in our hospital, of which 228(11.07%)were repeat keratoplasties. From 2010 to 2018, repeat keratoplasties were performed in 207 eyes of 204(137 male and 67 female)patients-189 eyes with first repeat keratoplasties, 15 eyes with second repeat keratoplasties, and 3 eyes with third repeat keratoplasties. The patient age was 11 to 81(mean: 49.93±14.32)years. The main reasons for repeat keratoplasty were graft ulcers(60 cases, 26.32%), corneal graft endothelial decompensation(58 cases, 25.44%), recurrence of primary disease(41 cases, 17.98%), and graft opacity(32 cases, 14.04%). First keratoplasty was most commonly performed for purulent keratitis(69 eyes, 33.33%), followed by herpes simplex keratitis(32 eyes, 15.46%), corneal burns(22 eyes, 10.63%), and corneal dystrophy and degeneration(21 eyes, 10.14%). Penetrating keratoplasty was performed in 202 cases(88.60%)for repeat corneal transplantation, anterior lamellar keratoplasty was performed in 26 cases(11.40%), and endothelial transplantation was performed in 0 cases. There was a correlation between repeat keratoplasty and previous keratoplasty(continuous correction χ2=43.365, P<0.01). Previous surgery affects the operation of repeat keratoplasties. Infectious keratopathy(P=0.005), graft diameter >8.75 mm(P=0.040), postoperative secondary glaucoma(P=0.027), and corneal graft rejection(P=0.047)were risk factors for penetrating keratoplasty graft failure. In multivariate Cox regression analysis, infectious keratopathy(P=0.011)and graft diameter >8.75 mm(P=0.016)were risk factors for anterior lamellar keratoplasty graft failure. Conclusion The most common cause of repeat keratoplasty was corneal graft ulcer, followed by corneal graft endothelial decompensation, and recurrence of the primary disease. Infectious keratitis was the most common primary disease before the first keratoplasty, followed by herpes simplex keratitis and corneal burns. Previous surgery affects the operation of repeat keratoplasties. Infectious keratopathy, graft diameter >8.75 mm, postoperative secondary glaucoma, and corneal graft rejection were risk factors for penetrating keratoplasty graft failure, whereas infectious keratopathy and graft diameter >8.75 mm were risk factors for anterior lamellar keratoplasty graft failure.
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    Posterior ischemic optic neuropathy after cataract surgery: a case report and literature reviewWANG Zongyi, QU Jinfeng Department of Ophthalmology, Peking University Peoples Hospital, Beijing 100044, ChinaAbstract:Objective〓
    To explore the best method for diagnosis and treatments of post-surgical posterior ischemic optic neuropathy(PION). MethodsReview the medical records of a 78-year-old female patient who presented with sudden vision loss in her right eye on the fourth day after phacoemulsification and implantation of a posterior chamber intraocular lens in other hospital. After the electrophysiological examination and fundus fluorescein angiography, the patient was diagnosed as posterior ischemic optic neuropathy after cataract surgery in his right eye. She was administered with a retrobulbar injection of Anisodamine and placed on steroid pulse therapy. ResultsOn the 19th day after treatment, her visual acuity had recovered to 0.05. ConclusionThis is a rare case, and since post-surgical posterior ischemic optic neuropathy(PION)has no definite and effective treatment yet, active vigilance should be maintained before surgery. Detailed systemic history and physical examination are important for patients with high risks of developing PION, especially for evaluating their systemic hemodynamics. To sum up, PION should be considered in patients who have sudden severe vision loss and/or visual field defects with no obvious changes in the fundus after excluding other optic nerve diseases.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 56-59.   DOI: 10.6040/j.issn.1673-3770.1.2020.051
    Abstract230)      PDF(pc) (2719KB)(40)       Save
    Objective To explore the best method for diagnosis and treatments of post-surgical posterior ischemic optic neuropathy(PION). Methods Review the medical records of a 78-year-old female patient who presented with sudden vision loss in her right eye on the fourth day after phacoemulsification and implantation of a posterior chamber intraocular lens in other hospital. After the electrophysiological examination and fundus fluorescein angiography, the patient was diagnosed as posterior ischemic optic neuropathy after cataract surgery in his right eye. She was administered with a retrobulbar injection of Anisodamine and placed on steroid pulse therapy. Results On the 19th day after treatment, her visual acuity had recovered to 0.05. Conclusion This is a rare case, and since post-surgical posterior ischemic optic neuropathy(PION)has no definite and effective treatment yet, active vigilance should be maintained before surgery. Detailed systemic history and physical examination are important for patients with high risks of developing PION, especially for evaluating their systemic hemodynamics. To sum up, PION should be considered in patients who have sudden severe vision loss and/or visual field defects with no obvious changes in the fundus after excluding other optic nerve diseases.
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    Dynamic analysis of rhinogenic headacheZHOU Fangming1, XIE Yan2, LIU Yang2 Overview JIANG Luyun2Guidance 1. Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, China 2. Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, ChinaAbstract:
    Rhinogenic headache is caused by rhinosinusitis or abnormal nasal anatomy. Currently, there are clear classifications and pain grading standards to diagnose the same. Further, its mechanism of action is now understood to involve trigeminal nerve stimulation and sensory neuropeptide substance P. Functional endoscopic surgery(FESS)is prioritized as a treatment modality. During surgery, it is imperative to restore the normal anatomy of the nasal cavity. Several clinical studies have reported that FESS was significantly effective in treating rhinogenic headache, with an overall effective rate of 90% and cure rate of 78%. Additionally, one report indicates that postoperative endoscopic examination and dressing change can effectively reduce the occurrence of complications and ensure safety of the treatment.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 130-133.   DOI: 10.6040/j.issn.1673-3770.0.2019.557
    Abstract229)      PDF(pc) (374KB)(28)       Save
    Rhinogenic headache is caused by rhinosinusitis or abnormal nasal anatomy. Currently, there are clear classifications and pain grading standards to diagnose the same. Further, its mechanism of action is now understood to involve trigeminal nerve stimulation and sensory neuropeptide substance P. Functional endoscopic surgery(FESS)is prioritized as a treatment modality. During surgery, it is imperative to restore the normal anatomy of the nasal cavity. Several clinical studies have reported that FESS was significantly effective in treating rhinogenic headache, with an overall effective rate of 90% and cure rate of 78%. Additionally, one report indicates that postoperative endoscopic examination and dressing change can effectively reduce the occurrence of complications and ensure safety of the treatment.
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    Neovascular glaucoma in ocular ischemic syndrome: a case report and literature reviewQIN Shuqi1, WANG Luping1, JIANG Bin2, WANG Yanling1 1. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 10050, China; 2. Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing 10050, ChinaAbstract:
    ObjectiveTo discuss the early diagnosis and multidisciplinary diagnosis and treatment of neovascular glaucoma in ocular ischemic syndrome. MethodsThe medical records of a 54-year-old male patient with cerebral infarction who presented with right-eye vision loss that had persisted for a week were reviewed. After slit-lamp examination and fluorescence angiography, he was diagnosed with ocular ischemic syndrome(OIS)complicated by neovascular glaucoma in the right eye and treated with intravitreal injection of anti-VEGF drugs and panretinal photocoagulation. ResultsAfter three months of treatment, the right-eye iris neovascularization subsided, and the intraocular pressure was controlled within normal limits. ConclusionOcular ischemia is often missed or misdiagnosed by ophthalmologists, neurologists, cardiologists, and vascular surgeons due to its insidious onset and complex clinical manifestations. Therefore, the establishment of multidisciplinary diagnosis and treatment can improve the prognosis of OIS patients.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 53-55.   DOI: 10.6040/j.issn.1673-3770.1.2020.055
    Abstract223)      PDF(pc) (2686KB)(32)       Save
    Objective To discuss the early diagnosis and multidisciplinary diagnosis and treatment of neovascular glaucoma in ocular ischemic syndrome. Methods The medical records of a 54-year-old male patient with cerebral infarction who presented with right-eye vision loss that had persisted for a week were reviewed. After slit-lamp examination and fluorescence angiography, he was diagnosed with ocular ischemic syndrome(OIS)complicated by neovascular glaucoma in the right eye and treated with intravitreal injection of anti-VEGF drugs and panretinal photocoagulation. Results After three months of treatment, the right-eye iris neovascularization subsided, and the intraocular pressure was controlled within normal limits. Conclusion Ocular ischemia is often missed or misdiagnosed by ophthalmologists, neurologists, cardiologists, and vascular surgeons due to its insidious onset and complex clinical manifestations. Therefore, the establishment of multidisciplinary diagnosis and treatment can improve the prognosis of OIS patients.
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    Potential risk factors and evaluation of a predictive risk score model for postoperative adhesion in functional endoscopic sinus surgeryCHEN Dong1, YU Hong2, LI Yang1, HUANG Qiang1, FANG Min1 1. Department of Otolaryngology, Jiangyou Peoples Hospital, Jiangyou 621700, Sichuan, China; 2. Department of Pathology, Jiangyou Peoples Hospital, Jiangyou 621700, Sichuan, ChinaAbstract:Objective〓
    This study was conducted to explore the preoperative risk factors for postoperative adhesion in patients with chronic rhinosinusitis(CRS)undergoing functional endoscopic sinus surgery(FESS), and to construct a risk score model to evaluate their predictive effect. MethodsA retrospective study was conducted on 323 patients with CRS who underwent FESS at our hospital between January 2015 and June 2018. The risk factors for postoperative adhesion were screened using a multivariate logistic regression analysis. The risk score was assigned according to the odds ratio(OR)value, and a receiver operating characteristic(ROC)curve was drawn to evaluate the predictive effect. ResultsPostoperative adhesion occurred in 35 patients(10.8%). The logistic regression results showed that concha bullosa, primary FESS, operative experience less than 10 years, and a history of middle turbinate resection were independent risk factors for postoperative adhesion in FESS. The OR values were 1.12(95% CI: 1.06-1.18), 3.87(95% CI: 2.23-5.51), 3.19(95% CI: 2.07-4.31), and 2.24(95% CI:1.95-2.53), respectively. The risk score model assigned 1 point for vesicular middle turbinate, 4 points for first time FESS, 3 points for operative experience less than 10 years, and 2 points for middle turbinate resection. The ROC curve analysis showed that the area under the curve(AUC)was 0.784(95% CI: 0.672-0.896, P<0.05). When 4 points were selected as the cut-off point, the Jordan index was the largest, with a sensitivity of 75.1% and a specificity of 73.6%. ConclusionThe incidence of postoperative adhesion in 323 patients with CRS who underwent FESS was 10.8%. The risk score model has certain reference value for predicting high-risk postoperative adhesion.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 87-91.   DOI: 10.6040/j.issn.1673-3770.0.2019.373
    Abstract223)      PDF(pc) (908KB)(32)       Save
    Objective This study was conducted to explore the preoperative risk factors for postoperative adhesion in patients with chronic rhinosinusitis(CRS)undergoing functional endoscopic sinus surgery(FESS), and to construct a risk score model to evaluate their predictive effect. Methods A retrospective study was conducted on 323 patients with CRS who underwent FESS at our hospital between January 2015 and June 2018. The risk factors for postoperative adhesion were screened using a multivariate logistic regression analysis. The risk score was assigned according to the odds ratio(OR)value, and a receiver operating characteristic(ROC)curve was drawn to evaluate the predictive effect. Results Postoperative adhesion occurred in 35 patients(10.8%). The logistic regression results showed that concha bullosa, primary FESS, operative experience less than 10 years, and a history of middle turbinate resection were independent risk factors for postoperative adhesion in FESS. The OR values were 1.12(95% CI: 1.06-1.18), 3.87(95% CI: 2.23-5.51), 3.19(95% CI: 2.07-4.31), and 2.24(95% CI:1.95-2.53), respectively. The risk score model assigned 1 point for vesicular middle turbinate, 4 points for first time FESS, 3 points for operative experience less than 10 years, and 2 points for middle turbinate resection. The ROC curve analysis showed that the area under the curve(AUC)was 0.784(95% CI: 0.672-0.896, P<0.05). When 4 points were selected as the cut-off point, the Jordan index was the largest, with a sensitivity of 75.1% and a specificity of 73.6%. Conclusion The incidence of postoperative adhesion in 323 patients with CRS who underwent FESS was 10.8%. The risk score model has certain reference value for predicting high-risk postoperative adhesion.
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    The application of arterial spin labeling in ischemic diseasesZHOU Zhuohua Overview LI Hongyang, HUANG Yingxiang, WANG Yanling Guidance Department of Ophthalmology, Beijing Friendship Hospital affiliated to Capital Medical University, Beijing 100050, ChinaAbstract:
    Arterial spin labeling(ASL)is a non-invasive imaging technique that permits the quantitative analysis of tissue perfusion without contrast agents, and it has been widely used in ischemic disease research. This paper introduces the application of ASL in the assessment of ischemic ophthalmopathy and encephalopathy and compares it with other common examination techniques of the eye and brain. ASL can be used to monitor changes in cerebral blood flow and predict ischemic events, and it has been widely used in the study of ischemic encephalopathy. It can directly reflect the dynamics of blood flow through the chorioretinal vasculature, and it can be used as a reliable method for quantifying ocular blood perfusion. ASL is also relevant for the pathophysiological studies of chorioretinal diseases, which may contribute to the early diagnosis of ischemic ophthalmopathies. Currently, the application of ASL in ophthalmology is still limited, and further studies are needed to establish the utility of ASL in assessing ischemic ophthalmopathy.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 16-22.   DOI: 10.6040/j.issn.1673-3770.1.2020.053
    Abstract214)      PDF(pc) (495KB)(22)       Save
    Arterial spin labeling(ASL)is a non-invasive imaging technique that permits the quantitative analysis of tissue perfusion without contrast agents, and it has been widely used in ischemic disease research. This paper introduces the application of ASL in the assessment of ischemic ophthalmopathy and encephalopathy and compares it with other common examination techniques of the eye and brain. ASL can be used to monitor changes in cerebral blood flow and predict ischemic events, and it has been widely used in the study of ischemic encephalopathy. It can directly reflect the dynamics of blood flow through the chorioretinal vasculature, and it can be used as a reliable method for quantifying ocular blood perfusion. ASL is also relevant for the pathophysiological studies of chorioretinal diseases, which may contribute to the early diagnosis of ischemic ophthalmopathies. Currently, the application of ASL in ophthalmology is still limited, and further studies are needed to establish the utility of ASL in assessing ischemic ophthalmopathy.
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    Cisplatin resistance in nasopharyngeal carcinoma cells is affected by Notch receptors through the regulation of epithelial-mesenchymal transition rather than cell cycle controlHAN Jibo, ZOU You, YANG Rui, TAO Zezhang Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, ChinaAbstract:Objective〓
    The objective of this study was to analyze the effects and possible regulatory mechanisms that Notch receptors could have on cisplatin resistance, observed in nasopharyngeal carcinoma. MethodsWestern blot analysis was used for the detection of Notch receptor expression in nasopharyngeal carcinoma cells and cisplatin-resistant nasopharyngeal carcinoma cells(5-8F, 5-8F/CDDP). Flow cytometry was used to investigate how the combined treatment with 10 μM CDDP and different concentrations of γ-secretase inhibitor(DAPT)could affect apoptosis in 5-8F/CDDP cells. Flow cytometry was also used for the detection of cell cycle stages in DAPT-treated 5-8F / CDDP cells. Finally, western blotting was also used for the detection of drug resistance-related protein expression. All experiments were followed by statistical data analysis. ResultsWe observed significantly higher Notch1 and Notch4 receptor expression in 5-8F/CDDP cells than in 5-8F cells(P=0.003, P=0.004). Furthermore, we described that Notch signaling was inhibited by DAPT in 5-8F/CDDP cells, followed by a significant increase in the apoptosis rate and decrease in cell proliferation, induced by cisplatin in a dose-dependent manner(P<0.05). Moreover, after inhibiting the Notch signaling pathway in 5-8F/CDDP cells, DAPT treatment significantly decreased the expression of Cyclin E and CDK-2, proteins involved in cell cycle regulation, and contributed to blocking the cells in the G1/S phase(P<0.05). At the same time, the expression levels of both the EMT-related protein Slug and the DNA excision repair protein ERCC1 significantly decreased, while that of E-Cadherin was up-regulated. ConclusionUp-regulated expression of Notch1 and Notch4 receptors is associated with cisplatin resistance in nasopharyngeal carcinoma cells. The inactivation of the Notch signaling pathway might thus have the potential to enhance the efficiency of cisplatin chemotherapy in drug-resistant nasopharyngeal carcinoma cells by inhibiting EMT rather than blocking the G1/S cell cycle phase.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 105-110.   DOI: 10.6040/j.issn.1673-3770.0.2019.503
    Abstract210)      PDF(pc) (4420KB)(25)       Save
    Objective The objective of this study was to analyze the effects and possible regulatory mechanisms that Notch receptors could have on cisplatin resistance, observed in nasopharyngeal carcinoma. Methods Western blot analysis was used for the detection of Notch receptor expression in nasopharyngeal carcinoma cells and cisplatin-resistant nasopharyngeal carcinoma cells(5-8F, 5-8F/CDDP). Flow cytometry was used to investigate how the combined treatment with 10 μM CDDP and different concentrations of γ-secretase inhibitor(DAPT)could affect apoptosis in 5-8F/CDDP cells. Flow cytometry was also used for the detection of cell cycle stages in DAPT-treated 5-8F / CDDP cells. Finally, western blotting was also used for the detection of drug resistance-related protein expression. All experiments were followed by statistical data analysis. Results We observed significantly higher Notch1 and Notch4 receptor expression in 5-8F/CDDP cells than in 5-8F cells(P=0.003, P=0.004). Furthermore, we described that Notch signaling was inhibited by DAPT in 5-8F/CDDP cells, followed by a significant increase in the apoptosis rate and decrease in cell proliferation, induced by cisplatin in a dose-dependent manner(P<0.05). Moreover, after inhibiting the Notch signaling pathway in 5-8F/CDDP cells, DAPT treatment significantly decreased the expression of Cyclin E and CDK-2, proteins involved in cell cycle regulation, and contributed to blocking the cells in the G1/S phase(P<0.05). At the same time, the expression levels of both the EMT-related protein Slug and the DNA excision repair protein ERCC1 significantly decreased, while that of E-Cadherin was up-regulated. Conclusion Up-regulated expression of Notch1 and Notch4 receptors is associated with cisplatin resistance in nasopharyngeal carcinoma cells. The inactivation of the Notch signaling pathway might thus have the potential to enhance the efficiency of cisplatin chemotherapy in drug-resistant nasopharyngeal carcinoma cells by inhibiting EMT rather than blocking the G1/S cell cycle phase.
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    Advances in the diagnosis and treatment of carotid artery stenosisXU Zeqin Overview GUO Lianrui Guidance Department of Vascular Surgery, Xuan Wu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing 100053, ChinaAbstract:
    Carotid artery stenosis is a common clinical disorder. Its main clinical symptoms are transient ischemic attacks and cerebral infarction, ocular ischemic syndrome(OIS)is rare. Its diagnostic imaging modalities include doppler ultrasound imaging, CTA, and MRA. Medical therapy, including risk factor management of atherosclerosis, is necessary for all patients with carotid artery stenosis. Carotid revascularization techniques, including carotid endarterectomy or carotid artery stenting, should be performed for asymptomatic patients with severe carotid artery stenosis and symptomatic patients with moderate carotid stenosis. Patients with carotid artery stenosis need early interventions to prevent stroke, improve ocular artery perfusion, and, ultimately, prevent further vision loss.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 11-15.   DOI: 10.6040/j.issn.1673-3770.1.2020.054
    Abstract206)      PDF(pc) (646KB)(29)       Save
    Carotid artery stenosis is a common clinical disorder. Its main clinical symptoms are transient ischemic attacks and cerebral infarction; ocular ischemic syndrome(OIS)is rare. Its diagnostic imaging modalities include doppler ultrasound imaging, CTA, and MRA. Medical therapy, including risk factor management of atherosclerosis, is necessary for all patients with carotid artery stenosis. Carotid revascularization techniques, including carotid endarterectomy or carotid artery stenting, should be performed for asymptomatic patients with severe carotid artery stenosis and symptomatic patients with moderate carotid stenosis. Patients with carotid artery stenosis need early interventions to prevent stroke, improve ocular artery perfusion, and, ultimately, prevent further vision loss.
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    Measurement of the parameters of the macular retinal and peripapillary vasculature in neuromyelitis optica spectrum disorder patientsXU Jing, QU Yuanzhen, LIANG Xiaofang, YANG Liu, TANG Yang Department of Ophthalmology,Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaAbstract: Objective〓
    To evaluate the changes in the parameters of the macular and peripapillary vasculature in patients with neuromyelitis optica spectrum disorder(NMOSD). MethodsThis case-control study involved 40(76 eyes)aquaporin-4 antibody-positive NMOSD patients and 40(80 eyes)age- and gender-matched healthy controls(HCs). Of 76 eyes with NMOSD, 34 had a history of optic neuritis(ON); 40 had no history of ON. Macular superficial vessel density(MSVD), macular deep vessel density(MDVD), and radial peripapillary capillary(RPC)density were measured by OCT-A. The retinal nerve fiber layer(RNFL)and ganglion cell complex(GCC)thicknesses were measured by OCT. Comparisons of the retinal structural and microvascular parameters of the cohorts were performed using generalized estimating equation(GEE)models. The relationship between retinal vessel density and retinal thickness was also analyzed. ResultsRPC density and MSVD were significantly lower in eyes with NMOSD+ON than in those with NMOSD-ON and HC(P<0.05). The GCC and RNFL thicknesses were also significantly thinner in eyes with NMOSD+ON than in those with NMOSD-ON and HC(P<0.001 for both). MDVD was lower in eyes with NMOSD-ON than in those with HC(P<0.05); however, other vessel densities were not significantly different(P>0.05). In eyes with NMOSD, MSVD, whole image vessel density(WIVD)of RPC, and peripapillary vessel density(PPVD)were correlated with GCC and RNFL thicknesses(P<0.001). However, MDVD and inside disc vessel density(IDVD)were not correlated with GCC and RNFL thicknesses(P>0.05). ConclusionRetinal microvascular changes were present in eyes with NMOSD+ON. However, these changes, except those in MDVD, were not significant in eyes with NMOSD-ON. Thinner GCC and RNFL were associated with lower MSVD and RPC density.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 69-74.   DOI: 10.6040/j.issn.1673-3770.1.2020.046
    Abstract192)      PDF(pc) (680KB)(27)       Save
    Objective To evaluate the changes in the parameters of the macular and peripapillary vasculature in patients with neuromyelitis optica spectrum disorder(NMOSD). Methods This case-control study involved 40(76 eyes)aquaporin-4 antibody-positive NMOSD patients and 40(80 eyes)age- and gender-matched healthy controls(HCs). Of 76 eyes with NMOSD, 34 had a history of optic neuritis(ON); 40 had no history of ON. Macular superficial vessel density(MSVD), macular deep vessel density(MDVD), and radial peripapillary capillary(RPC)density were measured by OCT-A. The retinal nerve fiber layer(RNFL)and ganglion cell complex(GCC)thicknesses were measured by OCT. Comparisons of the retinal structural and microvascular parameters of the cohorts were performed using generalized estimating equation(GEE)models. The relationship between retinal vessel density and retinal thickness was also analyzed. Results RPC density and MSVD were significantly lower in eyes with NMOSD+ON than in those with NMOSD-ON and HC(P<0.05). The GCC and RNFL thicknesses were also significantly thinner in eyes with NMOSD+ON than in those with NMOSD-ON and HC(P<0.001 for both). MDVD was lower in eyes with NMOSD-ON than in those with HC(P<0.05); however, other vessel densities were not significantly different(P>0.05). In eyes with NMOSD, MSVD, whole image vessel density(WIVD)of RPC, and peripapillary vessel density(PPVD)were correlated with GCC and RNFL thicknesses(P<0.001). However, MDVD and inside disc vessel density(IDVD)were not correlated with GCC and RNFL thicknesses(P>0.05). Conclusion Retinal microvascular changes were present in eyes with NMOSD+ON. However, these changes, except those in MDVD, were not significant in eyes with NMOSD-ON. Thinner GCC and RNFL were associated with lower MSVD and RPC density.
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    Recent ocular ischemic syndrome advancesWANG Luping Overview HUANG Yingxiang, WANG Yanling Guidance Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract:
    Ocular ischemic syndrome(OIS)is usually undiagnosed or misdiagnosed due to its asymptomatic onset, complicated ocular manifestations, and the lack of awareness, and patients with OIS have a higher mortality. Improving the understanding, diagnosis, and treatment of OIS through multidisciplinary collaboration is key to investigating and preventing systemic vascular events as well as decreasing blindness and mortality. This review summarizes the recent advances in the epidemiology, clinical diagnosis, and management of OIS.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 23-27.   DOI: 10.6040/j.issn.1673-3770.1.2020.059
    Abstract189)      PDF(pc) (401KB)(16)       Save
    Ocular ischemic syndrome(OIS)is usually undiagnosed or misdiagnosed due to its asymptomatic onset, complicated ocular manifestations, and the lack of awareness, and patients with OIS have a higher mortality. Improving the understanding, diagnosis, and treatment of OIS through multidisciplinary collaboration is key to investigating and preventing systemic vascular events as well as decreasing blindness and mortality. This review summarizes the recent advances in the epidemiology, clinical diagnosis, and management of OIS.
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    Changes in the neural plasticity of neurons and retinal remodeling in the retinal inner nuclear layer of an ocular ischemic syndrome rat model CHEN Xi, LI Shanshan, YOU Ran, ZHAO Lu, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, 100050Abstract: Objective〓
    To analyze the changes in the neurons of the retinal inner nuclear layer and in the visual function of rat models with ocular ischemia syndrome. MethodsAt the age of 8 weeks, Brown-Norway rats underwent bilateral common carotid artery occlusion(BCCAO)surgery as the model of ocular ischemia syndrome. After 1 and 2 months since the model was established, the retinal thickness was measured in eyeball slices. By applying immunofluorescence, changes in the morphology and synaptic plasticity of horizontal and bipolar cells in the retinal inner nuclear layer were observed. Changes in the visual function of rats were detected by electrophysiology. ResultsWith prolongation of the retinal ischemia time, the number of cells in each retinal layer decreased, and thicknesses of the inner and outer plexiform layers also decreased. Dendrites of horizontal and bipolar cells decreased or disappeared. The density of presynaptic membrane marker synaptophysin decreased. After 2 months since the modeling, the somatic positions of horizontal and bipolar cells migrated from the outer side to the basal side of the inner nuclear layer and formed new neurites. Synaptophysin was randomly distributed in the outer nuclear layer. Electrophysiology showed markedly reduced a- and b-wave amplitudes in BCCAO rats, indicating that the visual function of the BCCAO rats was impaired, and various retinal cell functions were affected. ConclusionIn rat models with ocular ischemia syndrome, the thickness of retinal layers and number of retinal cells decreased. Two months after the model was established, horizontal and bipolar cells migrated, and synaptic rewiring occurred, resulting in retinal remodeling.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 80-86.   DOI: 10.6040/j.issn.1673-3770.1.2020.049
    Abstract187)      PDF(pc) (8613KB)(18)       Save
    Objective To analyze the changes in the neurons of the retinal inner nuclear layer and in the visual function of rat models with ocular ischemia syndrome. Methods At the age of 8 weeks, Brown-Norway rats underwent bilateral common carotid artery occlusion(BCCAO)surgery as the model of ocular ischemia syndrome. After 1 and 2 months since the model was established, the retinal thickness was measured in eyeball slices. By applying immunofluorescence, changes in the morphology and synaptic plasticity of horizontal and bipolar cells in the retinal inner nuclear layer were observed. Changes in the visual function of rats were detected by electrophysiology. Results With prolongation of the retinal ischemia time, the number of cells in each retinal layer decreased, and thicknesses of the inner and outer plexiform layers also decreased. Dendrites of horizontal and bipolar cells decreased or disappeared. The density of presynaptic membrane marker synaptophysin decreased. After 2 months since the modeling, the somatic positions of horizontal and bipolar cells migrated from the outer side to the basal side of the inner nuclear layer and formed new neurites. Synaptophysin was randomly distributed in the outer nuclear layer. Electrophysiology showed markedly reduced a- and b-wave amplitudes in BCCAO rats, indicating that the visual function of the BCCAO rats was impaired, and various retinal cell functions were affected. Conclusion In rat models with ocular ischemia syndrome, the thickness of retinal layers and number of retinal cells decreased. Two months after the model was established, horizontal and bipolar cells migrated, and synaptic rewiring occurred, resulting in retinal remodeling.
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    Analysis of differentially expressed genes during cetuximab treatment of head and neck squamous cell carcinoma using bioinformaticsYU Kena1, SUN Kaiyue2, ZHANG Jie1, JIN Peng1 1. Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan 250033, Shandong, China; 2. Shandong Provincial Otorhinolaryngology Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250022, Shandong, ChinaAbstract:
    ObjectiveThe aim of this study was to provide new perspectives and targets for the treatment of HNSCC by screening differentially expressed genes during cetuximab treatment of head and neck squamous cell carcinoma(HNSCC)using bioinformatics. MethodsThe chip dataset, GSE109756, was downloaded from the GEO database, and the online analysis tool, GEO2R, was used to screen differentially expressed genes in head and neck squamous cell carcinoma tissues treated with and without cetuximab. The DAVID 6.8 and STRING online software were used to analyze the function of the differentially expressed genes, their pathway enrichment, and their protein interactions. Cytoscape was used to visualize and analyze the protein interactions. The online analysis tool, X2K, was used to find the transcription factors, the kinases of differentially expressed genes, and their mutual regulatory relationship with the targeted genes. ResultsNinety-one differentially expressed genes, including 50 up-regulated and 41 down-regulated genes(P<0.05; | logFC | > 1), were found in head and neck squamous cell carcinoma tissues treated with and without cetuximab. The GO and KEGG pathway analyses suggested that these differentially expressed genes were mainly enriched with immunomodulation, extracellular matrix, and other processes. Through the construction of a protein-protein interaction network, we screened CD163, VSIG4, and 3 other core differentially expressed genes(P<0.05), which were up-regulated after cetuximab treatment. In addition, our analysis shows that transcription factors, including SUZ12, TP63, and ESR1, played a key role in cetuximab treatment(P<0.05)and MAPK14, CDK1, and MAPK1 were the most important kinases during the process(P<0.05). ConclusionCD163, VSIG4, and the aforementioned transcription factors and protein kinases may be involved in the biological processes that underlie cetuximab treatment of HNSCC. This study provides new perspectives to facilitate further understanding of the biological mechanism that underlies cetuximab treatment of HNSCC and the exploration of the effectiveness of HNSCC treatment.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 117-124.   DOI: 10.6040/j.issn.1673-3770.0.2020.189
    Abstract182)      PDF(pc) (5004KB)(20)       Save
    Objective The aim of this study was to provide new perspectives and targets for the treatment of HNSCC by screening differentially expressed genes during cetuximab treatment of head and neck squamous cell carcinoma(HNSCC)using bioinformatics. Methods The chip dataset, GSE109756, was downloaded from the GEO database, and the online analysis tool, GEO2R, was used to screen differentially expressed genes in head and neck squamous cell carcinoma tissues treated with and without cetuximab. The DAVID 6.8 and STRING online software were used to analyze the function of the differentially expressed genes, their pathway enrichment, and their protein interactions. Cytoscape was used to visualize and analyze the protein interactions. The online analysis tool, X2K, was used to find the transcription factors, the kinases of differentially expressed genes, and their mutual regulatory relationship with the targeted genes. Results Ninety-one differentially expressed genes, including 50 up-regulated and 41 down-regulated genes(P<0.05; | logFC | > 1), were found in head and neck squamous cell carcinoma tissues treated with and without cetuximab. The GO and KEGG pathway analyses suggested that these differentially expressed genes were mainly enriched with immunomodulation, extracellular matrix, and other processes. Through the construction of a protein-protein interaction network, we screened CD163, VSIG4, and 3 other core differentially expressed genes(P<0.05), which were up-regulated after cetuximab treatment. In addition, our analysis shows that transcription factors, including SUZ12, TP63, and ESR1, played a key role in cetuximab treatment(P<0.05)and MAPK14, CDK1, and MAPK1 were the most important kinases during the process(P<0.05). Conclusion CD163, VSIG4, and the aforementioned transcription factors and protein kinases may be involved in the biological processes that underlie cetuximab treatment of HNSCC. This study provides new perspectives to facilitate further understanding of the biological mechanism that underlies cetuximab treatment of HNSCC and the exploration of the effectiveness of HNSCC treatment.
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    Intra-arterial thrombolysis for central retinal artery occlusion: a Meta-analysisCHEN Xi, LI Shanshan, ZHAO Lu, YOU Ran, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract:
    ObjectiveTo compare the effects of intra-arterial thrombolysis and traditional treatment in central retinal artery occlusion(CRAO). MethodsWe searched the Pubmed, Embase, Clinical.gov, CNKI, and Wan Fang databases for related studies that were published up to May , . We included clinical controls that compared intra-arterial thrombolysis and conventional treatment in CRAO. The random effect model and R software were used for data analysis. ResultsWe identified seven studies including CRAO patients. Meta-analysis results of two randomized controlled trials(RCTs)showed that there was no significant difference in visual acuity improvement between CRAO patients treated with arterial thrombolysis therapy and those with conventional therapy(RR: ., % confidence interval .-., P=.). Meta-analysis results of five cohort studies indicated that compared with conventional therapy, arterial thrombolysis therapy significantly improved visual acuity(RR: ., % confidence interval .-., P<.). The difference between thrombolysis therapy and conventional therapy may be caused by the different treatment time windows in patients. Concerning the adverse reactions after treatment, two RCTs and five cohort studies showed that the adverse reactions in the thrombolysis group are significantly higher than those in the conventional treatment group. ConclusionAlthough intra-arterial thrombolysis therapy has therapeutic potential in CRAO patients, there is still insufficient clinical evidence to prove its effectiveness and safety. Further studies with a large sample and high quality RCTs are required.
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (4): 28-34.   DOI: 10.6040/j.issn.1673-3770.1.2020.057
    Abstract182)      PDF(pc) (2347KB)(33)       Save
    Objective To compare the effects of intra-arterial thrombolysis and traditional treatment in central retinal artery occlusion(CRAO). Methods We searched the Pubmed, Embase, Clinical.gov, CNKI, and Wan Fang databases for related studies that were published up to May 14, 2020. We included clinical controls that compared intra-arterial thrombolysis and conventional treatment in CRAO. The random effect model and R software were used for data analysis. Results We identified seven studies including 563 CRAO patients. Meta-analysis results of two randomized controlled trials(RCTs)showed that there was no significant difference in visual acuity improvement between CRAO patients treated with arterial thrombolysis therapy and those with conventional therapy(RR: 1.17, 95% confidence interval 0.80-1.72, P=0.409). Meta-analysis results of five cohort studies indicated that compared with conventional therapy, arterial thrombolysis therapy significantly improved visual acuity(RR: 1.86, 95% confidence interval 1.43-2.41, P<0.001). The difference between thrombolysis therapy and conventional therapy may be caused by the different treatment time windows in patients. Concerning the adverse reactions after treatment, two RCTs and five cohort studies showed that the adverse reactions in the thrombolysis group are significantly higher than those in the conventional treatment group. Conclusion Although intra-arterial thrombolysis therapy has therapeutic potential in CRAO patients, there is still insufficient clinical evidence to prove its effectiveness and safety. Further studies with a large sample and high quality RCTs are required.
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