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    16 December 2008 Volume 22 Issue 6
      
    Articles
    Tracheotomy in surgical treatment for severe obstructive sleep apnea hypopnea syndrome
    ZHANG Qing-Quan, WANG Wen-Yi, WANG Qiang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  481-482. 
    Abstract ( 1292 )   PDF (245KB) ( 1214 )   Save
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    To explore the role of tracheotomy in surgical management for patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS). Methods The clinical data of 19 patients with tracheotomy hospitalized since 2003 were retrospectively analyzed. 8 were subjected to tracheotomy during radix linguae and/or corpus linguae partial resection, 2 were subjected to tracheotomy before general anesthesia and UPPP surgery because of obesity and short neck, 3 were subjected to tracheotomy because of difficult tracheal intubation before general anesthesia, 3 because of 3-platform operations, and 3 because of respiratory tract obstruction after tracheal extubation postoperatively in the ICU. Results16 patients were successfully subjected to UPPP and 3 patients who suffered from respiratory tract obstruction recovered after tracheotomy without severe complications. Conclusions At present with advanced facilities and techniques, tracheotomy is important and effective for OSAHS patients.

    Anesthesia  for obstructive sleep apnea hypopnea syndrome surgery
    YANG Chang-Zhao, Jiang Xiu-Liang, Li Ai-Zhi, Ma Jia-Hai
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  483-485. 
    Abstract ( 1500 )   PDF (247KB) ( 1206 )   Save
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    To explore the anesthesia management for obstructive sleep apnea hypopnea syndrome(OSAHS) during the operations.  Methods145  patients  with OSAHS were subjected to the Mallampati classification based on the throat exposure. 114 cases of gradeⅠto Ⅱ were classed to the rapid intubation group, 25 of grade Ⅲ to Ⅳ to the clear intubation group and 6 cases over 100 kg and with short necks and grade Ⅲ to Ⅳ to the tracheotomy group. Patients in the rapid intubation group  were subjected to extubation after sobering and sent to the care ward. Patients in the sober intubation group and tracheotomy group were sent to the ICU care. ResultsPatients in the rapid intubation group and tracheotomy group were successfully intubated. 7 cases in the sober intubation group with respiratory depression were successfully intubated after respiratory mask support. None of the three groups had obstructions in the upper respiratory tract. When performing extubation, 6 cases in  the rapid intubation group had nausea or vomiting and 8 had respiratory depression. ConclusionTo reduce the perioperative risks, it is important to select a correct induction method, make a pre-operative visit and a reasonable drug choice, grasp the extubation time,  and strengthen custody after the operations.

    Peri-opeartive management after hyoid bone suspension and uvulopalatopharyngoplasty in normal wards
    LV Qiao-Ying, LI Shu-Hua, SONG Rui-Ying, GONG Ben-Na
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  486-488. 
    Abstract ( 2193 )   PDF (307KB) ( 917 )   Save
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    To study the necessity of peri-operative observation and management after hyoid bone suspension and uvulopalatopharyngoplasty(UPPP) surgery in treating obstructive sleep apnea hypopnea syndrome (OSAHS). MethodsAll patients were subjected to polysomnography(PSG) and necessary preoperative examinations before the operations, and after being treated for related diseases, were subjected to CPAP for 3-7 days, and were subjected to electrocardio-monitoring after being transferred from the ICU department to the normal wards. ResultsOne patient suffered from secondary bleeding by coughing and was subjected to a second operation. 2 cases suffered from cervical cut effusion and were healed after changing dressings. 6 suffered from bucking when eating at the beginning and were relieved after 3-day practicing. And the rest suffered a mild difficulty in moving their tongue and recovered 5 to 7 days later. ConclusionsThere are potential dangers after hyoid bone suspension and UPPP surgery, which can be decreased by intensive nursing.

    Expressions and clinical significance of osteopontin and uPA in squamous cell carcinoma of the larynx
    ZHANG Zhong-Hua, LIANG Kun, MA Chao, LEI Da-Peng, PAN Xin-Liang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  491-494. 
    Abstract ( 1386 )   PDF (457KB) ( 753 )   Save
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    To investigate expressions of osteopontin (OPN) and urokinase-type plasminogen activator(uPA) and their relation to the invasiveness and metastasis of squamous cell carcinoma of the human larynx. MethodsExpressions of OPN and uPA in 64 cases of laryngeal carcinoma tissue and 18 cases of adjacent normal tissue were detected by using an immunohistochemistry method. Differences of age, sex, differentiation degree, clinical stage and lymphatic metastasis were analyzed. ResultsIn 64 cases of laryngeal carcinoma tissues, the positive expression rates of OPN and uPA were 62.5%(40/64) and 65.6% (42/64) respectively ,which were obviously higher than those in adjacent normal tissues(P<0.05). Expressions of OPN and uPA in carcinoma tissues were related to clinical pathological stage and lymphatic metastasis(P<0. 05), but not related to age, sex or differentiation degree (P>0. 05). Expression of OPN was positively correlated with that of uPA in laryngeal carcinoma tissues(r=0.6625, P<0.05). ConclusionExpressions of OPN and uPA can reflect biological characteristics of laryngeal carcinoma and could be used as important molecular markers in the prognosis of laryngeal carcinoma.

    Selective neck dissection for reference in treating noncancerous diseases in the neck
    CAI Qian, HUANG Xiao-Ming, HU Yao-Dong, PENG Jie-Ren, ZHENG Yi-Qing, GUAN Zhong, CHEN Bin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  495-496. 
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    To investigate the effect of selective neck dissection (SND) in treating noncancerous neck diseases.  MethodsThirteen patients (5 abscess or ulcerlymphoid tuberculosis, 7 recurrent branchial fistula, 1 trachelophyma after biopsy) were treated by RND.  All pathologically abnormal tissues were completely dissected.  ResultsRND was good in removing the pathologically changes which were closely sticking to peripheral tissues with an indefinite boundary, widely distributed and had an undesired effect after conventional treatments.  No accessory nerve or laryngeal nerve injury adverse wound healing occurred in this present study.  Conclusion RND is effective in the treatment of recurrent second and third bronchial fistula, and abscessformed (>3cm) or fistulized lymphoid tuberculosis.

    Expressions of Ets-1 and phosphorylated-STAT3 correlated with invasion and metastasis of hypopharyngeal carcinoma
    BU Ming-Qiang, XU Wei, LV Zheng-Hua, LI Hui-Zheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  497-500. 
    Abstract ( 1494 )   PDF (447KB) ( 985 )   Save
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    To explore expressions of transcription factor Ets-1 and phosphorylated-signal transducers and activators of transcription 3(P-STAT3) in hypopharyngeal primary carcinoma and metastatic cervical lymph nodes and to study their correlation with invasion and metastasis of hypopharyngeal carcinoma. MethodsImmunohistochemical staining was adopted to determine expressions of Ets-1 and P-STAT3 protein in 52 cases who had radical resection of hypopharyngeal carcinoma and matched 36 metastatic lymph nodes. ResultsIn 52 cases of hypopharyngeal carcinoma,  expression rates of Ets-1 and P-STAT3 protein were 61.54%(32/52) and 75.00%(39/52). The positive rates of Ets-1 and P-STAT3 in T3 and T4 classification were significantly higher than those in T1 and T2 classification(P<0.05,P<0.01). The positive rates of Ets-1 and P-STAT3 in metastatic lymph nodes were significantly higher than those in non-metastatic lymph nodes(P<0.05). The positive rate of Ets-1 in metastatic lung tissues was significantly higher than that in nonmetastatic lung tissues (P<0.05). In 36 cases of hypopharyngeal carcinoma with metastatic lymph nodes, expression rates of Ets-1 and P-STAT3 protein in metastatic lymph nodes were 47.22% (17/36) and 58.33% (21/36). The positive rate of P-STAT3 in primary carcinoma was significantly higher than that in metastatic lymph nodes(P<0.01). ConclusionEts-1 and P-STAT3 are over-expressed in hypopharyngeal carcinoma and are closely related to the T classification and cervical lymph node metastasis, expression of Ets-1 is also significantly related to lung metastasis.

    A comparison between laser and cryotherapy in the treatment of the earlobe scar
    ZHANG Min, YIN Zhao-Fu, MA Li-Juan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  501-503. 
    Abstract ( 1567 )   PDF (260KB) ( 1044 )   Save
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    To summarize the experience for treatment of earlobe scar with YAGlaser. Methods32 cases(34 ears) were treated by YAG-laser and 25 cases(26 ears) were treated by cryotherapy.  Lidocaine was injected into the around of the  earlobe scar, and the central and round were radiated with YAGlaser. ResultAll cases were cured. In the YAG laser group, 29 ears were cured by one treatment, 3 by two treatments and 2 by three treatments. In the cryotherapy group, 19 ears were cured by one treatment, 2 by two treatments and 5 by over three treatments. ConclusionThe response of the two methods is not significantly different, but YAGlaser is superior to cryotherapy in safety and treatment duration.

    Treatment for otitis media with effusion with endotoscopic myingotomy and grommet insertion
    WU Xiao-Fei, LIAN Zhuang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  504-505. 
    Abstract ( 1750 )   PDF (237KB) ( 1542 )   Save
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    To evaluate the effect of endotoscopic myingotomy and grommet insertion in treatment of otitis media with effusion. MethodGrommet insertion was performed on 98 ears of 84 cases under endotoscopic myingotomy from October 2003 to May 2007. Pure tone threshold was determined preoperatively and postoperatively. ResultsAll patients were followed up from 6 months to 18 months (with an average of 10 months). 57 ears were healed, 38 ears were improved and 3 ears were invalid. ConclusionEndotoscopic myingotomy in combination with grommet insertion has advantages of good vision, minimal invasion,  quick recovery and excellent curative effects, and it is simple and effective for otitis media with effusion.

    Effect of fibrinogenase on sudden hearing loss
    MA Jing, HE Jun-Ling, ZHOU Liu-Qing
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  506-507. 
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    To study the efficacy of fibrinogenase in the treatment of sudden hearing loss. Methods  Eighty-seven patients were randomly divided into 2 groups: patients treated by dextran-40 for 10 days served as the control group and patients treated by dextran-40 treatment in combination with fibrinogenase served as the experimental group. ResultSymptoms of the experimental group were obviously improved compared with the control group(P<0.05). ConclusionFibrinogenase is effective and safe in the treatment of sudden hearing loss.

    Diagnosis and surgery for cholesterol granuloma of the middle ear
    CHEN Jian, HAN Yu-Chen, FAN Zhao-Min, QIU Jian-He, LI Jian-Feng, ZHANG Dao-Gong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  508-510. 
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    To investigate the etiology, clinic characteristics, and pathogenesis of cholesterol granuloma(CG) of the middle ear, as well as to discuss the effect of surgeries. MethodsForty-three patients (43 ears) with cholesterol granuloma of the middle ear were enrolled in this retrospective study, and 42 received middle ear mastoid surgery and were confirmed by a pathologic examination post-operatively. The main clinical manifestations of CG were hearing loss (43/43), tinnitus (26/43), sense of fullness (29/43), and bloody otorrhea (12/43), with blue drum as a typical physical sign (36/43). Temporal bone high resolution computed tomography (HRCT) scan showed soft tissue shadows in 43 cases with erosion of the ossicular chain in 17 cases, which was confirmed by surgeries in 13 cases. Results 31 patients underwent a combined modality treatment of mastoidectomy, tympanotomy, and grommet insertion and other 11 patients were subjected to a combined strategy of mastoidectomy, tympanotomy, and reconstruction of the ossicular chain. The eardrums of patients became normal 1 to 2 months after the surgeries. The hearing threshold was improved (the improvement of ABgap was 25±3.5dB) and no symptoms recurred in all patients after a follow-up from half to  3 years. ConclusionThe main clinical features of cholesterol granuloma of the middle ear are hearing loss, tinnitus, sense of fullness, and bloody otorrhea, as well as blue drum. HRCT is useful for diagnosis and operation. As for the treatment of CG, mastoid surgery should be performed on, in which the affected tissues in the middle ear  should be completely removed;  a ventilation system of the mastoid tympani should be established.

    Choice and effect of surgical treatment for sinonasal inverted papilloma
    WANG Xue-Hai, LI Xue-Zhong, CAI Xiao-Lan, ZHANG Li-Qiang, XU Hao-Jie, CHEN Cheng-Fang, HAN Xue-Feng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  511-514. 
    Abstract ( 1552 )   PDF (281KB) ( 1294 )   Save
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    To evaluate the effects and difference of endoscopic surgery , endoscopic surgery combined with an external approach and traditional procedures in the treatment of sinonasal inverted papilloma(NIP). MethodsOne hundred and twentyfour patients with NIP treated by the three surgical approaches were retrospectively reviewed.Parameters for comparison included operative time, estimated blood loss during operation and length of admission. ResultsThere were significant differences between the group of endoscopic surgery combined with an external approach and the group of traditional procedure(P<0.05). In the Krouse Ⅰ and Ⅱ cases, recurrence was lower in the endoscopic surgery group than that in  the traditional procedure group(P<0.05). In the Krouse Ⅲ cases,  recurrence was lower in the endoscopic surgery combined with an external approach group than that in the other two groups(P<0.05), but there was no difference between the endoscopic surgery and traditional procedure groups. Average operation time was similar in the three groups, the average estimated blood loss during the operations and length of admission time were statistically shorter in the  endoscopic group than those in the other two groups(P<0.05). ConclusionsEndoscopic surgery is a safe,economical and effective method for the NIP cases in Krouse Ⅰ and Ⅱ. For the Krouse Ⅲ or/and Ⅳ cases with recurrence or extensive disease, endoscopic surgery combined with an external approach is a better choice which should be studied in clinical practice.

    Endonasoscopeassisted diagnosis treatment in pediatric sinonasal neoplasm
    HOU Dong-Ming, CAO Rong-Ping, MENG Guo-Zhen, YANG Jun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  515-516. 
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    Expression of p38 protein and its significance in chronic rhinosinusitis and nasal polyp tissues
    KANG Li-Fang, XIA Li-Jun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  517-519. 
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    To investigate the different expressions of p38 protein in chronic rhinosinusitis(CRS),nasal polyps (NP) and normal mucosa tissues, and to explore its effect on immunology cytokine. MethodTissue samples were obtained from 20 patients with chronic rhinosinusitis, 20 patients with nasal polyps and 15 patients with normal mucosa tissues. Expression of p38 MAPK was determined by the Western blot method; IL-4 and IFN-γ were determined by the ELASE method. Result① Compared with controls, expression of p38 protein was significantly increased(P<0.05), but  was not significant between the two experimental groups  (P>0.05). ② IL-4 was significantly increased only in NP tissues (P<0.05). ③ Compared with controls, IFN-γ was increased both in CRS and NP tissues (P<0.05), more significantly in the former. ④ There was a positive correlation between p38 protein and IL-4 in NP  and a positive correlation between p38 protein and IFN-γ in CRS tissues.Conclusion① Expressions of I-4 and  IFN-γ are different in CRS and NP. ② p38 protein may induce T cell to differentiate into Th1 or Th2 cells. ③ The inflammatory reaction of CRS and NP are not exactly the same.

    Effect of GATA3 on IL-4 and IL-5 in rats with allergic rhinitis
    Li-Qin ,Ma Yan-Yan, CHEN Yan-Lin, DU Yang-Hua, ZHANG Yong-Dong, WU Cai-Xia
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  520-522. 
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    To investigate the relationship between GATA3 and IL-4 and IL-5 in rats with  allergic rhinitis. Methods32 Wistar rats were randomly divided into a control group(A) and an allergic rhinitis  group(B). Ovalbumirl (OVA) absorbed to aluminum hydroxide was used to construct the allergic rhinitis mode (group B). Nasal lavage fluid was collected on day 30, levels of interleukin-4 (IL-4)and  interleukin-5 (IL-5) were determined by enzyme-linked immunosorbent assay(ELISA), together with the pathologic changes and expression of GATA3 were observed by immunohistochemistry. ResultsLevels of IL4(90.5±18.8pg/mL) and IL-5(59.6±11.4pg/mL), were significantly increased compared with group A (P<0.01). In group B, there were mucosal congestion and edema thickening with inflammatory cells infiltration mainly of eosinophils; Immunohistochemistry showed a significant increase of the GATA3 expression in the nasal tissues of group B. ConclusionsGATA3 contributes to the production of IL-4 and IL-5 in rats with  allergic rhinitis.

    Secondary palatorrhaphy through the nasal cavity by nasal endoscopy
    ZHANG Wen-Shan, CAO Gui-Xia, YU De-Xian
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  523-524. 
    Abstract ( 1398 )   PDF (202KB) ( 1078 )   Save
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    To develop a new way for secondary palatorrhaphy. MethodsThe clinical data of 11 cases that had undergone secondary palatorrhaphy from September 2003 to August 2007 were retrospectively analyzed.  ResultsAll patients were cured by one operation and felt fine ventilation through their noses. ConclusionsSecondary palatorrhaphy through the nasal cavity by nasal endoscopy is effective and the mucoperiosteal flap is unique for the repair.

    Clinical value of serum squamous cell carcinoma antigen in nasal inverted papilloma
    HAN Zhen-Qiang, WANG Jian-Guo
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  525-527. 
    Abstract ( 1396 )   PDF (221KB) ( 1363 )   Save
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    To investigate the significance of the serum level of squamous cell carcinoma antigen(SCCAg) in nasal inverted papilloma(NIP). MethodsThe serum SCCAg levels were determined by microparticle enzymeimmunoassay(MEIA) in 34 patients with NIP and 12 patients with nasal squamous cell carcinoma (NSCC) before and after the operations. ResultsThe positive rate of squamous cell carcinoma antigen in 34 patients with NIP was 67.64% (23/34) and in 12 patients with NSCC it was 75%(9/12). The postoperative serum level of SCCAg had a statistical significance compared to that before the operations(P<0.05). The serum SCCAg levels in patients with recurrence significantly increased half a year later. ConclusionThe SCCAg level plays an important role in evaluating the biological characteristics, therapeutic effects and  prognosis in patients with NIP.

    Application of HRT-II in the diagnosis of chronic primary angle-closure glaucoma
    QU Hong-Bo, TANG Gui-Lan, LIU Shao-Jun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  538-540. 
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    To investigate the diagnostic value of HRT-II for chronic primary angle-closure glaucoma(CPACG). MethodsThirty cases (60 eyes) of CPACG were detected by HRT-II and auto visual field examination. The sensitivity, characteristics of different disk section, and correlation between optic disc parameters and mean defect of the visual field were analyzed. Results1. Fifty-three eyes were abnormal by visual field detection and fifty-four eyes abnormal by HRT-II. The corresponding ratio between visual field detection and HRT-II was 98.15%. In the group of single eye abnormal in the visual field, there were 2 eyes which were normal in the visual field but abnormal in HRT-II and 5 eyes were normal in both the visual field and HRT-II; 1 eye was abnormal in the visual field but normal in HRT-II. The Rim area of the abnormal ratio in the temporal inferior section was the highest in HRT-II.  2. Mean defection showed a statistically significant correlation with rim area, rim volume, cup/disc (C/D) area and cup shape (P<0.05). ConclusionHRT-II is sensitive and is related to the visual field result. HRT-II can probably be used for follow-up and early diagnosis of CPACG.

    Intravitreal triamcinolone acetonide and laser photocoagulation for diabetic macular edema
    SHENG Yan-Juan, WANG Yu, SHU Xiang-Wen
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  541-543. 
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    To evaluate the clinical outcome of intravitreal triamcinolone acetonide (IVTA) combined with laser photocoagulation for diffuse diabetic macular edema (DME). MethodsThirty eyes of 24 patients with macular edema were randomly divided into two groups: the simple laser photocoagulation  group (n=15) and the laser combination with IVTA-photocoagulation group (n=15). Eyes in the combination group were subjected to laser photocoagulation one week after 4 mg IVTA. The best-corrected visual acuity, foveal thickness (FT) (by optical coherence tomography) and postoperative complications were compared between the two groups. ResultsBaseline VA and FT was respectively 0.10±0.09 and 518.1±117.5μm in the photocoagulation group and 0.11±0.120 and 524.9±147.4μm in the combination group, which was not statistically significant between the two groups. Visual acuity was improved and FT was reduced in the two groups. BCVA was 0.19±0.16 and 0.23±0.18 at 3 months and 0.17±0.13 and 0.28±0.15 at 6 months after treatments, FT was 324.1±115.2μm and 279.4±98.8?μm at 3 months and 354.1±121.2μm and 248.4±102.6μm at 6 months after treatments, for the laser photocoagulation group and combined group, respectively (P<0.001). 2 cases had an increased transitory intraocular pressure and were controlled by drugs, and 1 case had cataract progression in the combination group. ConclusionIVTA combined with laser photocoagulation is superior to simple laser photocoagulation in improving VA and reducing FT.

    Effect of vitrectomy on proliferative diabetic retinopathy
    WUChang-Long, WANG Yu, TAN Rui-Li, WANG Jian-Rong, JI Qiang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  544-546. 
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    To evaluate the effect of vitrectomy on proliferative diabetic retinopathy(PDR). Methods198 eyes of 156 patients with PDR who had undergone vitrectomy were retrospectively analyzed.  ResultsFollowed up from 6 to 12 months(mean 10 months), the final visual acuity increased in 146 eyes(73.74%), 116 eyes (79.45%) were in stage Ⅳ to Ⅴ and 30 eyes (20.55%) were in stage Ⅵ; the visual acuity had no changes in 32 eyes(16.16%)and was decreased in 20 eyes(10.10%). Retinal detachment, vitreous hemorrhage and high intraocular pressure were found after the operations. ConclusionVitrectomy is valuable in improving visual acuity

    A simple repair of partical iridoialysis in 16 cases
    ZHANG Ning, TIAN Jie, ZHAO Jun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  547-548. 
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    To discuss a microsurgical repair method of partical iridodialysis.  MethodsUnder microscopy 16 cases (16 eye) of partical iridodialysis were repaired by puncturing tunnels on the scleras. ResultAfter the operations, all the pupils became circular and eyesight was improved. ConclusionIt is simple, safe and effective to repair partical iridodialysis by puncturing tunnels on the scleras.

    Corneal confocal microscopy in etiological diagnosis of corneal ulcer
    JIN Lei, CUI Jian-Ping
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  549-550. 
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    To evaluate the role of confocal microscope  in etiological diagnosis of corneal ulcer. MethodConfocal microscopy was used to examine 36 patients having corneal ulcer. Results16 cases(16 eyes)  had corneal stroma with mycelium of bright linear form in a relatively dark background under the confocal microscopy, 2 cases(2 eyes) had Abacha cysts which were white flash circular bodies in the matrix layer. ConclusionAs a non-invasive rapid diagnostic technique, confocal microscopy has significant advantages for corneal ulcer.

    Reconstructive surgery for laryngeal and tracheal injuries at stageⅠ
    ZHOU Xuan-Yan, TAO Qian, ZHANG Feng, GAO Zhen-Feng, LV Ling-Yan, WU Yu-Mei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  553-555. 
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    To explore a reasonable reconstructive surgery for laryngeal and tracheal injuries at stage Ⅰ. MethodsThe clinical data of 45 cases of laryngeal and tracheal injuries from November 1987 to November 2007 were retrospectively analyzed. Of them, 30 had open laryngeal and tracheal injuries and 15 had closed ones. ResultsAll were subjected to explorations, 40 cases successfully underwent extubation, 12 of whom were found hoarse; 4 had laryngeal stenosis,  2 of whom were subjected to extubation after second operations and 2 cases were subjected to delayed extubation because they were subjected to granulation tissues or scar stricture removal by laser or reoperation; and 1 who committed suicide gave up the continuing treatment and  died 2days later. ConclusionLaryngeal and tracheal injuries should be recommended in emergency and early exploration should be performed on severely close ones.

    Pathogens in the ENT department in the First Hospital of Fujian Medical University from 2005 to 2007
    LIN Wei, CHENG Jin-Mei, HUANG Jin-Qiao, OU Qi-Shui, XU Yuan-Teng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  556-559. 
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    To explore the species and distribution of fungi, bacteria and other pathogens isolated from our department and to explore the sensitivity results. MethodA survey on the isolated pathogens from March 2005 to October 2007 was carried out. ResultsThe total number of samples increased from 248 in 2005 to 306 in 2007, and the positive cases of fungi and bacteria increased from  115 in 2005 to 181 in 2007, and its positive ratio increased from 46.4% to 59.2%. ConclusionsFrom 2005 to 2007, the pathogen infection the Department of Otorhinolaryngology in the First Hospital of Fujian Medical University had an upward trend.

    Tracheobronchial foreign bodies in 1368 cases
    RIN Xiu-Min, SHAN Chun-Guang, HE Qiang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  560-562. 
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     To investigate the characteristics of tracheobronchial foreign bodies and  effective methods for them so as to decrease complications and mortality. MethodsThe clinical data of 1368 cases were retrospectively analyzed. Of them 1334 cases had the foreign bodies taken out by bronchoscopy under general anesthesia, 20 cases by bronchoscopy without anesthesia, 6 by tracheotomy and 8 by thoracotomy. Results1365 cases had the foreign bodies taken out, and 1345 cases were successfully operated on one time and 6 cases two times. After the operations, 25 cases had edema of the larynx and 2 died of asphyxia.  ConclusionTotal intravenous anesthesia combined with surface anesthesia of the respiratory tract mucosa is the ideal anesthesia method for taking out foreign bodies in the respiratory tract by bronchoscopy. In some cases, tracheotomy and thoracotomy are needed.

    Three-dimensional reconstruction and visualization of the structure correlative to a fibrolaryngoscope approach
    YU Wen-Jie, WANG Bin-Quan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  563-565. 
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    67 cases of special different type foreign bodies in the respiratory passage
    CAI Gang, ZHANG Si-Yi, ZHANG Duan-He
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(6):  566-567. 
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    To explore an effective way for taking out different type foreign bodies in the respiratory passage. MethodThe clinical data of 67 cases were retrospectively analyzed and 2 of them were specially analyzed. ResultAll bodies were successfully taken out, but 1 case died and 1 became vegetative person after the operations. ConclusionThe successful key is to understand the type and shape of the foreign body before operations.