Table of Content

20 July 2020 Volume 34 Issue 4

  

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

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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.

Application progress of thrombolysis in retinal artery occlusionYANG Ming Overview WEI Wenbin Guidance Beijing Tongren Hospital, Capital Medical University / Beijing Tongren Eye Center / Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment / Beijing Ophthalmology&Visual Sciences Key Lab / Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing 100730, ChinaAbstract:

Central retinal artery occlusion(CRAO)is the most common cause of acute vision loss. Thrombolysis is a more radical treatment than conservative treatment, including arterial thrombolysis and intravenous thrombolysis, as well as the combination therapy of thrombolysis and other therapies. Thrombolysis treatment can improve the visual acuity of CRAO patients, but because of its lack of randomized controlled trials, further clinical studies are needed to determine their efficacy and safety. Our review summarized the application progress of thrombolysis in recent ten years, further evaluated its safety and effectiveness, and provided an evidence for clinical application.

Journal of Otolaryngology and Ophthalmology of Shandong University. 2020, 34(4):  5-10.  doi:10.6040/j.issn.1673-3770.1.2020.048

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Central retinal artery occlusion(CRAO)is the most common cause of acute vision loss. Thrombolysis is a more radical treatment than conservative treatment, including arterial thrombolysis and intravenous thrombolysis, as well as the combination therapy of thrombolysis and other therapies. Thrombolysis treatment can improve the visual acuity of CRAO patients, but because of its lack of randomized controlled trials, further clinical studies are needed to determine their efficacy and safety. Our review summarized the application progress of thrombolysis in recent ten years, further evaluated its safety and effectiveness, and provided an evidence for clinical application.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

Case analysis of 25 cases of iris neovascularizationLI Xuan^1,2, 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.

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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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

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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.

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

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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.

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

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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.

Association between the classification of blood pressure and retinal vessel diameter measured by SD-OCTFENG Xue¹, WANG Haiwei², LI Wensi¹, YANG Xintong¹, SUN Cun¹, ZHAO Yuan¹, ZHAO Pengbo¹, ZHANG Jianqiang¹ 1. Department of Ophthalmology, Beijing Moslem People's Hospital, Beijing 100054, China; 2. Department of Ophthalmology, Fuxing Hospital, Capital Medical University, Beijing 100038, ChinaAbstract:

ObjectiveTo analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). MethodsThis was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. ResultsThere were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). ConclusionsAmong the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.

Journal of Otolaryngology and Ophthalmology of Shandong University. 2020, 34(4):  64-68.  doi:10.6040/j.issn.1673-3770.1.2020.052

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Objective To analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). Methods This was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. Results There were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). Conclusions Among the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.

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

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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.

Prevalence and risk factors of central serous chorioretinopathy in a hospital-based population YANG Xiufen, YOU Ran, MA Xiumei, WANG Kang, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract:Objective〓

To describe characteristics and risk factors associated with central serous chorioretinopathy(CSC)in a hospital-based outpatient sample population. MethodsIn this hospital-based cross-sectional study, CSC patients were recruited from the Beijing Friendship Hospital from 01/2019 to 12/2019. All participants underwent a standardized interview. Logistic regression models were used to assess the risk factors associated with CSC. ResultsA total of 23,878 outpatients were recorded during the period 01/2019-12/2019. Of these, 45 patients(0.19%)were diagnosed with CSC, divided in 37 male patients(82.22%)and 8 female patients(17.78%). The patients′ age ranged from 21 to 65(42.3±10.1)years. Three patients(6.67%)presented a bilateral involvement. Of all the patients, 39 were included in the present analysis. Control patients were matched for age and sex at a ratio of 1:1. The presence of CSC was associated with exposure to steroids(OR=5.04, 95% CI:1.11-22.89), sleep time(going to sleep after 12 pm)(OR=4.16, 95% CI:1.33-13.04)),and shift-work(OR=5.74, 95% CI:1.47-22.45).ConclusionsOur data showed that CSC prevalence in the analyzed outpatients was 0.19%. Exposure to steroids, sleep time, and shift-work were factors related with CSC in the observed population.

Journal of Otolaryngology and Ophthalmology of Shandong University. 2020, 34(4):  75-79.  doi:10.6040/j.issn.1673-3770.1.2020.043

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Objective To describe characteristics and risk factors associated with central serous chorioretinopathy(CSC)in a hospital-based outpatient sample population. Methods In this hospital-based cross-sectional study, CSC patients were recruited from the Beijing Friendship Hospital from 01/2019 to 12/2019. All participants underwent a standardized interview. Logistic regression models were used to assess the risk factors associated with CSC. Results A total of 23,878 outpatients were recorded during the period 01/2019-12/2019. Of these, 45 patients(0.19%)were diagnosed with CSC, divided in 37 male patients(82.22%)and 8 female patients(17.78%). The patients' age ranged from 21 to 65(42.3±10.1)years. Three patients(6.67%)presented a bilateral involvement. Of all the patients, 39 were included in the present analysis. Control patients were matched for age and sex at a ratio of 1:1. The presence of CSC was associated with exposure to steroids(OR=5.04, 95% CI:1.11-22.89), sleep time(going to sleep after 12 pm)(OR=4.16, 95% CI:1.33-13.04)),and shift-work(OR=5.74, 95% CI:1.47-22.45).Conclusions Our data showed that CSC prevalence in the analyzed outpatients was 0.19%. Exposure to steroids, sleep time, and shift-work were factors related with CSC in the observed population.

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

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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.

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

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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.

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.

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

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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.

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

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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.

Clinical analysis of 74 cases of branchial cleft cysts and fistulasWANG Yingying, ZHANG Liqing, ZHOU Han, DONG Shikun, CHEN Haibing, CHEN Xi, DONG Weida Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaAbstract:Objective〓

This study aimed to describe the clinical features of 74 patients with cleft palate cysts and fistulas and analyze the diagnosis and treatment methods. MethodsBetween January 2010 and September 2019, the clinical data of 74 patients with branchial cleft cysts and fistulas were retrospectively reviewed and analyzed with related literature in our department. ResultsOf the 74 patients, 50 patients were diagnosed with second branchial cleft anomalies, 13 patients had first branchial cleft lesions, 10 patients had third branchial cleft lesions, and one patient had a fourth branchial cleft lesion. All patients received surgical treatment. After the exclusion of 3 patients who were lost to follow-up, 67 patients were successfully treated, 3 patients reported relapse, and 1 had permanent facial paralysis. ConclusionsThe clinical manifestations of congenital cleft palate cysts and fistulas are diverse, and the differential diagnosis is complicated. It is essential to perform a detailed physical examination and preoperative evaluation to make an accurate diagnosis. The approach for management is individualized, and surgical rehabilitation is the preferred treatment.

Journal of Otolaryngology and Ophthalmology of Shandong University. 2020, 34(4):  111-116.  doi:10.6040/j.issn.1673-3770.0.2019.523

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Objective This study aimed to describe the clinical features of 74 patients with cleft palate cysts and fistulas and analyze the diagnosis and treatment methods. Methods Between January 2010 and September 2019, the clinical data of 74 patients with branchial cleft cysts and fistulas were retrospectively reviewed and analyzed with related literature in our department. Results Of the 74 patients, 50 patients were diagnosed with second branchial cleft anomalies, 13 patients had first branchial cleft lesions, 10 patients had third branchial cleft lesions, and one patient had a fourth branchial cleft lesion. All patients received surgical treatment. After the exclusion of 3 patients who were lost to follow-up, 67 patients were successfully treated, 3 patients reported relapse, and 1 had permanent facial paralysis. Conclusions The clinical manifestations of congenital cleft palate cysts and fistulas are diverse, and the differential diagnosis is complicated. It is essential to perform a detailed physical examination and preoperative evaluation to make an accurate diagnosis. The approach for management is individualized, and surgical rehabilitation is the preferred treatment.

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

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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.

Advances in research on related signaling pathways in allergic rhinitisHUANG Jiali¹ Review YANG Shurong²〓Guidance 1.Department of Clinical Medicine, Jiangxi University of Traditional Chinese Medicine,Nanchang 330000, Jiangxi, China 2.Department of Otolaryngology, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330000, Jiangxi, ChinaAbstract:

The occurrence and development of allergic rhinitis involves a variety of signal transduction pathways. Studying signal transduction pathways can promote the progress of pathogenesis research, suggesting that we can block the conduction of pathways in a pathway to achieve therapeutic effects. Open up new prospects for designing and developing more effective new drug treatments.The common signaling pathways in allergic rhinitis are reviewed in this article to provide a reference for the treatment of allergic rhinitis.

Journal of Otolaryngology and Ophthalmology of Shandong University. 2020, 34(4):  125-129.  doi:10.6040/j.issn.1673-3770.0.2019.355

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The occurrence and development of allergic rhinitis involves a variety of signal transduction pathways. Studying signal transduction pathways can promote the progress of pathogenesis research, suggesting that we can block the conduction of pathways in a pathway to achieve therapeutic effects. Open up new prospects for designing and developing more effective new drug treatments.The common signaling pathways in allergic rhinitis are reviewed in this article to provide a reference for the treatment of allergic rhinitis.

Dynamic analysis of rhinogenic headacheZHOU Fangming¹, XIE Yan², LIU Yang² Overview JIANG Luyun²〓Guidance 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

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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.

Advances in the study of obstructive sleep apnea syndrome and laryngopharyngeal reflux diseaseWANG Hongyan, WANG SanchunOverview TENG Bo, GE Min Guidance Department of Otolaryngology Head & Neck Surgery, the Second Hospital of Jilin University, Changchun 130022, Jilin, ChinaAbstract:

Obstructive sleep apnea syndrome(OSAS)and laryngopharyngeal reflux disease(LPRD)are two common diseases in otolaryngology. In recent years, with the increasing incidence, these diseases have affected the health of more and more people. As research on these two diseases continues to expand, the correlation between them has captured the attention of a number of scholars. In this study, we reviewed the recently published literature on the two diseases, concluding that there is a correlation between them. We have also elaborated on the factors and mechanisms of their mutual influence, analyzed the existing treatment methods of OSAS and LPRD, and provided new ideas for further refinement of the diagnosis and treatment.

Journal of Otolaryngology and Ophthalmology of Shandong University. 2020, 34(4):  134-138.  doi:10.6040/j.issn.1673-3770.0.2019.565

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Obstructive sleep apnea syndrome(OSAS)and laryngopharyngeal reflux disease(LPRD)are two common diseases in otolaryngology. In recent years, with the increasing incidence, these diseases have affected the health of more and more people. As research on these two diseases continues to expand, the correlation between them has captured the attention of a number of scholars. In this study, we reviewed the recently published literature on the two diseases, concluding that there is a correlation between them. We have also elaborated on the factors and mechanisms of their mutual influence, analyzed the existing treatment methods of OSAS and LPRD, and provided new ideas for further refinement of the diagnosis and treatment.