Table of Content

16 February 2015 Volume 29 Issue 1

  

Application of harmonic scalpel in children with obstructive sleep apnea and hyponea syndrome

LI Jun-zheng, GAO Xiang, WU Gai-zhen, CHEN Sha, WANG Jie, TIAN Wen-dong, LI Xiang-ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  1-4.  doi:10.6040/j.issn.1673-3770.0.2014.334

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Objective To investigate the effectiveness of harmonic scalpel assisted adenotonsillectomy in the treatment of children with obstructive sleep apnea and hyponea syndrome(OSAHS). Method 38 cases of children with OSAHS were randomly divided into ultrasonic scalpel group (group A, 18 cases) and control group (group B, 20 cases). The adenotonsillectomy was operated with harmonic scalpel in group A, but without in group B. The blood loss, the operation time, postoperative pain, the condition of wounds were compared between the two groups. Results The operative blood loss, operation time, incidence of postoperative hemorrhage of the group A were much less than those of the group B, while no difference in postoperative pain and condition of wounds were noted between the two groups. Conclusion The application of harmonic scalpel in adenotonsillectomy for children with OSAHS is safe, efficient and feasible.

Three different operative methods in H-UPPP

SU Yue, WANG Zhong-liang, ZENG Zhen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  5-7.  doi:10.6040/j.issn.1673-3770.0.2014.240

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Objective To compare the effects of harmonic scalpel, low-temperature plasma scalpel or traditional scalpel in Han-uvalopalatopharyngoplasty(H-UPPP) to treat obstructive sleep apnea and hyponca syndrome(OSAHS). Methods According to the methods in the operation of H-UPPP, OSAHS patients were divided into three groups: group A (harmonic scalpel), group B (low-temperature plasma scalpel) and group C (traditional scalpel). Each group had 42 cases. Intra-operative blood loss, operation time, degrees of postoperative pain, effective rate and complications after surgery were compared among the three groups. Results Intra-operative blood loss and surgery time of group A and B were much less and shorter than those of group C. However, the differences of effective rates and complications after surgery among three groups were not identified. Conclusion For H-UPPP, harmonic scalpel or low-temperature plasma scalpel can help reduce the blood loss and shorten surgery time. Among them,,low-temperature plasma scalpel demonstrates much less postoperative reaction.

The relationship between brain derived neurotrophic factor and obstructive sleep apnea syndrome

ZHANG Chan-juan, LI Yan-zhong, WANG Yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  8-11.  doi:10.6040/j.issn.1673-3770.0.2014.223

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Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a serious, chronic sleep breathing disorder. OSAHS may affect the cardiovascular, nervous, and endocrine systems, resulting in series of concurrent symptoms. Brain-derived neurotrophic factor (BDNF) is a protein produced by brain tissues. BDNF is the most abundant and widely distributed member of the neurotrophic factor family. Recent years, a number of studies suggested that the expression of BDNF was often abnormal in OSAHS. This paper summarizes the latest research results, and the role of BDNF in the pathogenesis mechanism will be reviewed to bring up the possible clues for further study.

Treatment of palatal myoclonus objective tinnitus guided by palatal electromyogram

WANG Tan, AN Feng-wei, CHEN Jian-qiu, LIN Jia-feng, HOU Xiao-zhi, XIE Cui-li, WANG Ying, LIN Juan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  12-14.  doi:10.6040/j.issn.1673-3770.0.2014.242

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Objective To observe the clinical efficacy of botulinum toxin typeA(BTX-A) in the treatment of palatal myoclonus objective tinnitus(PMOT)under the guidance of palatal electromyography(P-EMG). Method The clinical data of 3 bilateral PMOT patients were reviewed. With endoscopic assistance, the disposable hypodermic needle electrode was inserted at the initiation site of tensor veli palatine(TVP), levator veli palatine(LVP), and termination site of LVP through nasal cavity. The direction and depth of the electrodes were adjusted according to the denseness of electric potential outbreak in the EMG diagram d. The superficial site, with the most dense electric potential outbreak was chosen as the point for injection. At each point, 5U BTXA was injected every time and the total amount was 30U . The therapeutic effects and adverse reaction were observed for 6 months afterthe injection. Result ① Therapeutic effectiveness: The PMOT was disappeared 26 h, 25 h and 28 h after the injection in 3 patients, respectively. None of positive expressions was observed in monthly endoscopic examination, P-EMG, and acoustic immittance examination 5 months after the injection. Recurrence of unilateral tinnitus was noted in only one patient.② Adverse reaction :The side effects, such as open rhinolalia, mild nasal regurgitation and mild ear stuffiness with tinnitus, were identified, but disappeared 2 weeks later afterthe treatment. Conclusion Using P-EMG during BTXA injection can accurately determine the site for injection, extend the action time of BTXA, reduce the adverse reaction, and achieve a good clinical results.

Time pattern of audiological recoverey with intratympanic steroid injection as primary treatment for sudden sensorineural hearing loss

ZHANG Cai-xia, LIU Yang-yun, CHEN Zhi-xi, JIANG Wen, LI Zheng-xian, CHEN Qiong, CHANG En-ge

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  15-18.  doi:10.6040/j.issn.1673-3770.0.2014.284

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Objective To explore the time pattern of audiological recovery with intratympanic steroid injection as primary treatment for sudden sensorineural hearing loss (SSNHL) to define best strategy. Methods All 135 patients underwent a two-week systemic steroid therapy, while 72 of them received extra intratympanic injection in the mean time. All cases were followed up 2 months. Results No difference in total effective rates between the two treatments on 3^rd day, 7^th day,14^th day and 1 month was noted. There was no difference between the 7th day and 14th day in combined treatment was noted (P=0.065) but not in systemic steroid therapy alone(P=0.029). Conclusion As a primary treatment, the curative effects between the intratympanic steroid administration and systemic steroid therapy shows no difference. The peaked time of hearing improvement of the former is earlier than that of the latter.

Different methods to treat auricular keloids (35 cases report)

SONG Sheng-hua, ZHAO Wei, JIANG Jin-qin, ZHAO Meng-ying

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  19-23.  doi:10.6040/j.issn.1673-3770.0.2014.226

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Objective To investigate the effectiveness of different methods to treat auricular keloids. Methods After the auricular keloids were sharply dissected, the epidermides at pedicle were reserved as much as possible when the keloids were soft. Then, the skin defects were sutured directly or repaired with sliding flap, rotation flap or free skin graft according to their locations and shapes. Triamcinolone 20-40 mg was injected in some patients. Radiotherapy was performed in 5 cases one to three days after the surgery. Result After 1-9 years follow-up, 29 cases(82.9%) showed completely free of lesion. An auricular lobule was pulled back with angel formed after surgery, however, no lesion was noted. There were another 3 cases(8.6%) of moderate improvement and 3 cases(8.6%) of recurrence. Conclusion After excising auricular keloids, skin defects can be sutured directly or repaired with sliding flap, rotation flap or free skin graft according to their locations and shapes. Triamcinolone, delicate suture, postoperative anti-infection and immediate radiotherapy help reduce the recurrence.

Effect of sodium salicylate on the expression of c-fos, GAD67 and GABAAα1 in rat inferior colliculus

YANG Kun, WU Sha, HUA Qing-quan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  24-27.  doi:10.6040/j.issn.1673-3770.0.2014.330

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Objective To observe the influences of sodium salicylate on the auditory brainstem response(ABR)and expression of GAD67、GABAAα1、 c-fos in rat inferior colliculus. To explore the underlying mechanisms of these changes on sodium salicylate induced ototoxicity. Methods Twenty-four Wistar rats were randomly divided into two groups:sodium salicylate group(intramuscular injection of 10% sodium salicylate, 175 mg/kg, twice daily for 28 days)、control group(intramuscular injection with saline on same does at the same time).The rats were detected ABR and observe the changes of ABR threshold before they were killed,then the rats were decapitated and inferior colliculus tissue were stripped. Real-time reverse transcriptase polymerase chain reaction(real-time RT-PCR)and Western blot were used to study the different expression of GAD67、GABAAα1、c-fos mRNA and protein level in the two groups. Results ①ABR threshold and latency of wave Ⅲ of sodium salicylate group was increased and prolonged remarkably than that of before administration and the control after injection for 28 days(P<0.01);②The inferior colliculus GAD67、GABAAα1、c-fos mRNA and protein expression level of sodium salicylate group was significantly higher than the control group(P<0.01). Conclusion In the long-term effects of sodium salicylate, the upregulation of GAD67 and GABAAα1 expression may occur as a compensatory and regulatory mechanisms for sodium salicylate ototoxicity, the elevated expression of c-fos may be associated with the increased activity of central auditory system after sodium salicylate effects on the body.

Correlation of chronic nasal-sinusitis and bronchopulmonary asthma lung function

TAN Jian-cheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  28-31.  doi:10.6040/j.issn.1673-3770.0.2014.266

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Objective To investigate the correlation of the severity of chronic nasal-rhinosinusitis (CRS) with asthma and bronchial pulmonary lung function. Methods A total of 72 patients with chronic nasal-sinusitis patients (the study group) and 64 patients with non-chronic rhino-sinusitis patients (the control group) were enrolled in this study. Impulse oscillation (IOS) and ventilatory pulmonary function were determined, and chronic rhino-sinusitis questionnaires were carried out. Results ① CRS bronchial asthma was higher in the study group, compared with the control group, FEV₁ and FEF_25-75 were statistically significant (P<0.05); ② In the study group severity and extent of CRS had some correlation with decrease of FEV₁ and FEF_25-75 (P<0.05); ③ Severity of IOS had some relevance to lung function (P<0.05). Conclusion Severity of CRS has some relevance to asthma and bronchial pulmonary lung function. Patients with CRS and bronchopulmonary asthma have a significant decline in lung function.

Role of Biyuanshu liquid for the early recovery on ostiomeatal complex after FESS

XIAN Kun-lun, ZHONG Cheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  32-34.  doi:10.6040/j.issn.1673-3770.0.2014.265

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Objective To analyze the influence of Biyuanshu liquid on ostiomeatal complex after functional endoscopic sinus surgery. Methods A total of 100 patients with chronic sinusitis were enrolled from September 2003 to May 2004 and were randomly classified into four groups: the blank control(S) and three study groups of the amoxicillin group(S1), the Biyanwan group(S2) and the Biyuanshu group(S3), each had 25 cases. Then, recovery scoring(RS) and aerobic culture rate in ostiomeatal complex(ACRO) at the 3rd week and effect at the 6th month were analyzed. Results The recovery scoring at post-operative 3rd week between the Biyuanshu group and the other three groups was significantly different(P<0.01), while the ACRO at the 3rd week and effect at the 6th month between the Biyuanshu group and the other groups was not significantly different(P>0.05). Conclusion Biyuanshu liquid may improve the recovery of OMC early after the operation, it may adjust the microecosystem of OMC and benefits to its early recovery after FESS.

Prevalence of inhaled allergens for patient with allergic rhinitis in Wuzhou city in Guangxi

LI Zhu-yang, WANG Chun, YE Tao, WU Wei-ming, CHEN Zi-hong, DENG Yan-ji, ZHONG Jin-ying, DONG Ying-hua

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  35-37.  doi:10.6040/j.issn.1673-3770.0.2014.248

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Objective To investigate the inhaled allergens in patients with allergic rhinitis in Wuzhou city. Methods A total of 2 800 patients enrolled in November 2010 to May 2013 in our hospital with suspected allergic rhinitis underwent skin prick tests. Results A total of 2 221(79.32%)patients presented positive reaction. Among the positive cases in inhalation group, the most common allergen was flour mites(91.85%), then was house dust mite(88.25%) and Blattodea(47.55%). Conclusion Flour mite and house dust are the most common allergens in Wuzhou city.

Prevalence investigation on rural cataract patients with diabetes and diabetes retinal fundus lesions in Jinan city of Shandong province

LIU Zhi-gao, YAN Shi-long, HU Zun-xia, SUN Tong-xin, YANG Ming, WANG Yu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  38-39.  doi:10.6040/j.issn.1673-3770.0.2014.241

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Objective To explore the prevalence of rural cataract patients with diabetic retinopathy (DR) over 50 years old and to provide basic epidemiological data for prevention of diabetic retinopathy. Methods According to the 1999 WHO diabetes experts committee of etiological typing diagnosis standard, 1336 cataract patients were performed the following examinations, an inquiry of the general situation and history of diabetes; ② clinical physical examination and body mass index (BMI); ③ fasting blood glucose (FPG) and glycosylated hemoglobin (HbA1c), etc; ④ fundus examination, diagnostic standard of Chinese Medical Association in 1984 to ocular fundus disease department of Ophthalmology study group DR staging criteria. Results Of the 1336 patients, 280 were diabetes, the prevalence rate was 20.95%; Of the 280 patients, 92 had diabetic retinopathy, the prevalence rate was 32.86%. The prevalence rate of diabetic retinopathy in all subjects was 5.98%. The prevalence of DR had significant differences in age (P<0.05), which was the highest in 65 to 80 years old patients 6.04%. There was a close relationship between the prevalence rate of diabetes, blood pressure and DR (P<0.05). Conclusion In-patient rural cataract patients had high prevalence of diabetes mellitus in Jinan city; Duration of diabetes, blood glucose level and hypertension are important factors influencing the development of DR diseases.

Effects of different intraocular lens on macula area of high myopia associated with cataract

ZHU Zi-cheng, WEN Yue-chun, WU Zhang-you, KE Gen-jie

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  40-43.  doi:10.6040/j.issn.1673-3770.0.2014.274

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Objective To observe and analyze the effects of different intraocular lens(IOL) on macular thickness of high myopia associated with cataract in order to provide a clinical supporting of acquiring a best IOL for these patients. Methods Totally 68 patients (78 eyes) with high myopia were performed on phacoemulsification in combination with IOL implantation, including three kinds of IOL: Bigbag, MA60MA and PMMA which were 28, 26 and 24 eyes respectively. The post-operative 1 week, 1 and 3month's best-corrected visual acuity(BCVA), pre-operative and post-operative macular thickness at different stages were observed and measured by optical coherence tomography. Results BCVA increased in different degree in the three groups. The difference of macular thickness at 1 week and 1 month after surgery in the Bigbag group was significantly smaller than that of the MA60MA and PMMA groups(P<0.05). Compared with the pre-operative macular thickness, there were no significantly changes in the three groups (P>0.05). No serious post-operative complications occurred in three groups. Conclusion Phacoemulsification in combination with Bigbag IOL implantation could improve the visual acuity of patients with cataract and high myopia, play a stabilizing role of supporting the post-operative posterior capsule so as to provide a beneficial effect on maintaining the stability of the axial apace structure in eye and reduce the influence of the posterior segment of the eyeball.

Allograft rejection after high risk corneal transplantation with Foxp3 Gene-transferred effective T cells

ZHAO Jun, LIU Jing, WANG Da-jiang, CHEN Guo-ling, WANG Qi, ZHANG Han

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  44-48.  doi:10.6040/j.issn.1673-3770.0.2014.272

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Objective To observe the effects of Foxp3 gene-transfected Teff lymphocytes against the high-risk corneal transplantation rejection. Methods The Foxp3 gene-transfected Teff lymphocytes and the Teff lymphocytes were cultured together to observe the inhibitory effects on the Teff lymphocytes. Corneal neovascularization was induced by corneal suture in Balb/c mice and after one week, penetrating corneal transplantations were performed while Balb/c mice as receptors and C57/BL6 mice as donors. One day before the surgery, injection of Foxp 3 gene-transfected Teff lymphocytes were performed via tail vein of Balb/c mice. After the surgery, the state of corneal transplantation was monitored on a day to day basis and tail vein blood was sampled once every two weeks to check the lymphocyte types. Results The in vitro experiments showed strong inhibitory effects of Foxp3 gene-transfected Teff lymphocytes on the Teff lymphocytes. To the high-risk corneal transplantation mice, the Foxp3 gene-transfected Teff lymphocytes could moderately extend the survival time of the grafts (19.71±4.19d) while the survival time of the corneal grafts in the Treg group was 19.28±4.46d (P>0.05). On the contrary, the comparison between the Foxp3 gene-transfected Teff lymphocytes and the blank group (15.57± 2.22d) demonstrated some significance (P<0.05). Flow cytology indicated that the Foxp3 gene-transfected lymphocytes could delay the proliferation of CD4+T and CD8+T lymphocytes.Conclusion The Foxp3 gene-transfected Teff lymphocytes could prevent transplant rejection.

Effects of 01% cyclosporin eye drops in combination with sodium hyaluronate eye drops in the treatment of dry eye syndrome

ZHANG Ju, WU Xin-yi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  49-51.  doi:10.6040/j.issn.1673-3770.0.2014.342

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Objective To evaluate the effects of 0.1% cyclosporin eye drops in combination with sodium hyaluronate eye drops in the treatment of dry eye syndrome. Methods A total of 60 patients (120 eyes) with dry eye syndrome were randomly divided into the experimental group (60 eyes) treated by 0.1%cyclosporin eye drops in combination with sodium hyaluronate eye drops and the control group (60 eyes) treated by bysodium hyaluronate eye drops. Both groups were measured the Schirmer I test(SIt), tear film break-up time(BUT) and corneal fluorescein staining(FLs) before and after a month. Results There were no significant differences between the experimental group and the control group in SIt, BUT and FLs before treatment (P>0.05). After treatment, all the indicators of SIt, BUT and FLs of the experimental group and the control group were better than before (P<0.05). The experimental group was superior to the control group in the three indicators (SIt, BUT and FLs)(P<0.05). Conclusion 0.1%cyclosporin eye drops in combination with sodium hyaluronate eye drops is effective in treatment of dry eye, and is superior to bysodium hyaluronate eye drops alone.

Comparison of improved membrane dissection and bimanual enbloc excision in 23G vitrectomy to treat proliferative diabetic retinopathy

LIU Hai-yang, LI Su-yan, ZHANG Zheng-pei, FAN Wei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  52-55.  doi:10.6040/j.issn.1673-3770.0.2014.260

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Objective To investigate the differences between improved membrane dissection and bimanual enbloc excision in 23G vitrectomy in the treatment of proliferative diabetic retinopathy(PDR). Method A total of 38 PDR patients(41 eyes) undergoing vitrectomy from Jun 2013 to Jan 2014 was enrolled in this study. The patients were randomly divided into bimanual enbloc excision group(19 patients, 20 eyes) and improved membrane dissection group(19 patients, 21 eyes). After the procedures, number of iaogenic holes, ratio of silicon oil fill, operation time, postoperative hemorrhage, and postoperative proliferative membrane were observed. Result Improved membrane dissection decreased the number of iaogenic holes,ratio of silicon oil fill,without increasing the operation time, incidence of postoperative hemorrhage, or proliferative membrane aggravation. Meanwhile, visual function recovery wasn't influnced. Conclusion The improved membrane dissection is better in 23G vitrectomy to treat proliferative diabetic retinopathy(PDR).

Chinese materia medica Yishi mixture in treatment of amblyopia in children

WANG Xin, WEI Wei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  56-59.  doi:10.6040/j.issn.1673-3770.0.2014.312

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Objective To objectively and scientifically evaluate the efficacy of "Yishi mixture", so as to guide clinical treatment of amblyopia in children. Methods A total of 61 eyes of 36 patients based on inclusion criteria were enrolled in this study. 27 eyes in the control group received routine treatment including vision correction and training from fine work and 34 eyes in the treatment group were treated with "Yishi mixture" based on routine treatment, 4 weeks as a course, and 3 course in total. At the beginning of treatment and at the end of 4, 8 and 12 weeks after the treatment, vision was determined, before the treatment and at the end of 3 therapeutic courses optical coherence tomography (OCT) was used to determine the neurosensory retinal thickness in the macula. Results 1. After 3 courses of therapy, of the treatment group, the effective rate was 85.3% and the main cure rate was 52.9%; of the control group (27 eyes), the effective rate was 59.3% and the main cure rate was 29.6% (P<0.05), especially for ametropic amblyopia and moderate amblyopia. 2. After the treatment, the neurosensory retinal thickness in the macula and the retinal nerve fiber layer thickness had a decrease tendency in different degrees, especially in the inferior inner macula, superior, nasal and inferior outer macula. Conclusion As an adjuvant therapy, the "Yishi mixture" can significantly improve the cure rate of amblyopia in children, shorten the treatment time, and plays some role in improving the form and function of retina and visual cortex.

Intravitreal triamcinolone acetonide combined with grid laser photocoagulation for patients with cystoid macular edema

YAN Xiao-teng, FENG Jun, KANG Xin-le

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  60-63.  doi:10.6040/j.issn.1673-3770.0.2014.258

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Objective To determine if primary intravitreal injection of triamcinolone acetonide (TA) in combination with grid laser photocoagulation (GLP) is effective in treating cystoid macular edema. Methods A prospective comparative non- randomized clinical trial was carried out. Fourteen eyes (14 patients) diagnosed with cystoid macular edema were treated with GLP and an intravitreal injection of 2mg TA. A matched control group (16 eyes,16 patients) treated with GLP was selected retrospectively from our medical records. Best-corrected visual acuity (BCVA), intraocular pressure and quantitative changes in optical coherence tomography (OCT) macular thickness were assessed. Results Compared with the pre-treatment, BCVA was significantly elevated in the two groups on 3 and 6 months post-treatment(P<0.01). No obvious improvement of visual acuity was found between the two groups after treatment at any time point (P≥0.05).Macular thickness was significantly decreased after the treatment in the two groups(P<0.01). No significant changes in macular thickness were found between the two groups before the treatment (P>0.05), but macular thickness was lower in the trial group compared with the control group at various time point(P<0.05). IOP raised in 4 eyes(28%) in the trial group. Conclusion Treatment with IVTA injections in combination with grid laser photocoagulation seems to be more effective in decreasing central subfoveal thickness in patients with cystoid macular edema. However, higher intraocular pressure and development of glaucoma must be considered seriously in patients who receive IVTA injection.

Collaterals therapy influences the expression of VCAM-1 in the retinal capillary wall of STZ-induced diabetic rats

MA Dong, GUO Cheng-wei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  64-68.  doi:10.6040/j.issn.1673-3770.0.2013.268

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Objective To observe the expression of vascular cell adhesion molecule -1 (VCAM-1) in the retinal digest preparations of streptozotocin (STZ)-induced diabetic rats treated with collaterals therapy, and to investigate the protective effects and mechanism of collaterals therapy on diabetic retinopathy microvascular injury. Methods Sixty female Wistar rats were randomly divided into 4 groups including blank group, model group, control group and collaterals therapy group. All except the blank group rats were made into models of diabetic rats and treated according to the scheme. After 24 weeks each rat's bilateral eyes were made into retinal vascular digest preparations. The right eye was treated by PAS staining for morphological observation and the left eye by immunofluorescence staining for determining the VCAM-1 expression in the vessel wall. Results PAS staining showed that collaterals therapy group had obvious improvement on morphological changes such as vessel diameter, local expansion, vascular twist and so on. However, retinal pericyte damage of collaterals therapy group was significantly suppressed (P<0.05). Immunofluorescence staining showed that VCAM-1 in collaterals therapy group had less expression than in the other groups (P<0.05). Conclusion Collaterals therapy can inhibit the expression of VCAM-1 in diabetic retinal capillary wall, effectively alleviate retinal microvascular damage caused by hyperglycemia, and improve diabetic retinal microvascular structure and function.

Orthokeratology on refractive system and intraocular pressure in teenagers

YAN Tao, LUAN Guo-gang, SHEN Jin-jin, CHEN Wen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  69-71.  doi:10.6040/j.issn.1673-3770.0.2014.264

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Objective To investigate the effects of orthokeratology on refractive system and intraocular pressure in teenagers.Methods 200 eyes (100 teenagers) were enrolled. Uncorrected visual acuity, diopter, corneal curvature, equivalent refractive,thickness of central cornea, tear break-up time and intraocular pressure were examined 5 times (before glasses-fitting; 1 weeks, one month, two month and six month after glasses-fitting). Results The uncorrected visual acuity, diopter, corneal curvature, equivalent quivalent refractive intraocular pressure were significantly decreased in 1 week and began to stabilize 1 month later. There were no significant differences between tear break-up time and central corneal thickness, or axial length. Though 98% patients presented with mild corneal staining and 10.5% with conjunctivitis, symptoms disappeared after proper treatment. Conclusion Orthokeratology can reduce the degree of myopia to improve visual acuity by changing corneal curvature. After proper treatment, there is no serious complication and no irreversible damage.

Analysis of 20 years experience of treatment in esophageal foreign body

LI Mao-cai, XIANG Xuan, LI Wen-ming, JIN Tong, QIAN Ye, WEI Dong-min, SUN Rui-jie, LIU Da-yu, LEI Da-peng, PAN Xin-liang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  72-74.  doi:10.6040/j.issn.1673-3770.0.2014.275

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Objective To analyze the clinical characteristics, diagnosis, treatment and prognosis of patients with esophageal foreign body. Methods Clinical data of 415 cases with esophageal foreign body from 1993 to 2012 were reviewed. Chest fluoroscopy or upper gastrointestinal barium meal examination were performed preoperatively in all patients. Among them, 412 patients underwent further esophagoscope examination to remove foreign bodies and. 3 patients were referred to thoracic surgery. Results There were 206 cases of esophageal mucosa injury and 48 cases of esophageal perforation and 3 cases of concurrent mediastinal abscess. All the 415 patients recovered well. Conclusion Esophageal foreign body is one of the common emergency in the department of otolaryngology. In order to prevent the complications, timely treatment is essential. Esophageal endoscopy is an effective method to treat esophageal foreign body.

Alcoholism in patients with benign symmetric lipomatosis (5 cases report)

WANG Xiao-feng, GAO Xing-qiang, LUO Xian-yang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  75-77.  doi:10.6040/j.issn.1673-3770.0.2014.238

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Objective To investigate the clinical characteristics of alcoholic patients with benign symmetric lipomatosis and improve the diagnosis and treatment. Method 5 patients underwent resection of neck lipomatous tumor with low collar incision under general anesthesia. While important tissue and organs were kept intact, fatty tissue were removed as much as possible. Result All patients were satisfactory with appearance and improved function without any complication. 5 patients were followed up for 3-5 years and no recurreence happened. Conclusion Madelung's disease is very rare. It's usually present in middle-aged men. The cause of this disease is attributed to excessive drinking and surgery is the most effective treatment. Abstinence from alcohol can effectively prevent the recurrence after operation.

Relationship between procedures and complications in thyroid surgery

FENG Yun, YANG Da-zhang, CHENG Jing-ning, WANG Cheng-yuan, LIU Dan-dan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  78-82.  doi:10.6040/j.issn.1673-3770.0.2014.379

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Objective To investigate the relationship between procedures and complications in thyroid surgery, and the implication of preserving recurrent laryngeal nerves (RLN), the external branches of superior laryngeal nerves (EBSLN), and parathyroid glands in thyroidectomy. Methods Clinical data of 152 patients with benign or malignant thyroid tumors were reviewed. All these patients underwent thyroidectomy with meticulous capsular dissection and peservation of RLN, EBSLN and parathyroid glands. Results 262 RLNs in 152 patients were identified and preserved, while 75.3% EBSLNs(174/231) were identified. In 150 patients, at least one parathyroid were identified and preserved in situ, while 2 patients underwent parathyroid autotransplantation. Transient RLN palsy occurred in 1 case and recovered within three months after the surgery. No EBSLN palsy was found. Transient hypoparathyroidism occurred in 13 cases after the surgery and recovered within one week in 9 cases, four weeks in 3 cases and 5 months in 1 case. Conclusion Identification and preservation of RLN, EBSLN and parathyroid gland in thyroidectomy is recommended in thyroid surgery to effectively avoid the complications, such as injury of RLN/EBSLN and parathyroid glands, which retains the functions of larynx and parathyroid glands and improves cure rate of thyroid tumor.

Clinical analysis of primary laryngeal non-squamous cell carcinoma (11 cases report)

WANG Yu-hong, WANG Qian, CHEN Ping, QIAN Xiao-yun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  83-88.  doi:10.6040/j.issn.1673-3770.0.2014.302

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Objective To explore the clinical and pathological features of laryngeal non-squamous cell carcinoma to improve diagnosis and treatment. Method The clinical data of 11 non-squamous cell carcinoma cases, selected from 366 cases of primary malignant tumor of larynx, were reviewed. Results All the patients came from the E.N.T department of the Affiliated Drum-Tower Hospital of Nanjing University Medical School from Jan. 2000 to Dec. 2009. The histopathology and immunophenotype were observed by HE staining and immunohistochemistry, including 2 adenocarcinoma, 1 adenoid cystic carcinoma, 2 malignant lymphoma, 1 neuroendocrine carcinoma, and 5 sarcomatoid carcinoma. Among them, the tumor located in glottic (5 cases), supraglottic (4 cases) and infraglottic regions (2 cases). All cases were confirmed by biopsy or pathologic studies after operation. Except for 2 single biopsy, other cases were diagnosed by repeated biopsy or operation. Most pathological results were chronic inflammation, inflammatory polyps, hyperplastic change, necrotic granuloma, squamous cell carcinoma and so on. All the patients underwent primary surgery except for one malignant lymphoma. Some received consecutive radiotherapy and/or chemotherapy. During the follow up, 2 cases died, 3 cases lost, and others survived. Conclusion The clinical manifestations of primary laryngeal non-squamous cell carcinoma are indefinite. It is not easy to identify it with the common laryngeal tumors. Pathological study and immunohistochemistry are helpful for diagnosis. The choice of management (surgery, radiotherapy, chemotherapy or combined) depends on pathological diagnosis.

Improved soft palate pull in the treatment of adenoid hypertrophy by exposure the nasopharyngeal

LIU Hong, LIU Tian-yue, WANG Chun-jiao, WANG Juan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  89-90.  doi:10.6040/j.issn.1673-3770.0.2014.200

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One case of uveal effusion syndrome in left eye complicated by nanophthalmos

LIU Cui-juan, FU Yu-dong, MENG Xu-xia, BAI Hai-qing, WANG Da-bo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  91-92.  doi:10.6040/j.issn.1673-3770.0.2014.239

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Traditional Chinese medicine in combination with western medicine in treatment of orbital inflammatory pseudotumor in 1 case

WANG Da-hu, ZHANG Yin-jian

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(1):  93-94.  doi:10.6040/j.issn.1673-3770.0.2013.326

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